Analysis of State Programs Which Mandate Mental Health Benefits under Private Health Insurance

摘要

Thirty-three States have passed legislation which defines the terms for provider reimbursement, primarily consisting of coverage for licensed or certified mental health practitioners who are providing services in organized settings of care with some type of mechanism for peer review. The vast majority of States have limited private practice coverage to licensed physicians or psychologists. Five States mandate the reimbursement of social workers in private practice. Of key interest in the legislative process was the general absence of union, business, or public support/opposition to legislation; that is, those responsible for absorbing the cost of the proposed benefits were conspicuously absent from the debates and hearings, thereby leaving most of the advocacy efforts for the legislation up to providers and consumer associations, with the insurers offering their opposition. None of the major insurers interviewed could provide meaningful data on mental health claims. Information was obtained from extensive interviews and readily available and relevant data. The findings are reported.