Where behavioral science and humanism get out of the ivory tower, and into the world.

Thursday, May 13, 2010

Who saw this one coming?

So, remember how that health reform bill got passed and a lot of stuff got gutted from it as a concession to the health insurance industry? I guess it wasn’t enough. I had heard through the grape vine of a few instances where insurance companies were acting like they weren’t up to speed with the new regulations. Looks like what’s really happening is they’re trying to get around a whole bunch of laws.

Quick history lesson for those of you who’ve never really dealt with mental health managed care. Insurance companies treat mental health and physical health very differently. You can go to an M.D. as much as you want, stay in a hospital for as long as medically necessary and the health insurance folk don’t have too much say in it. In the mental health and addiction recovery worlds however, there are session limits, need for continuing care requests, pain in the butt treatment plans  and all kinds of crazy different co-pay rates which don’t exist in the M.D. side of insurance.

This causes problems because therapy isn’t like going to the doctor for an annual checkup and maybe a follow up a few weeks later when the tests come back. Therapy is usually a weekly visit, and it often takes a few months. I used to work for a site that only could provide ultra-brief therapy with an 8 session limit. People usually don’t get really into the really deep parts of therapy until session 5 or 6 anyway.

The new laws passed as part of the bill say that physical and mental health insurance needs to work the same. So if you have unlimited M.D. visits, you also get unlimited visits with a mental health worker, same co-pays etc.

The insurance companies don’t like that their profit margins would lower a little as a result of having to cover cost of care for people. So it looks like from this article that many insurance companies are trying to back slide and continue not to provide adequate levels of mental health care. Guess I’m just a little bitter about the whole thing. Still, I strongly encourage everyone to call their representatives, and let them know if you feel this is a problem. Hopefully with enough noise they’ll stand up to the companies for us and require them to do what is expected of them: To cover the cost of health needs.