Georgia

TexasTowelie

(116,744 posts) Wed Jan 5, 2022, 03:35 AM Jan 2022

Ga. legislators plan push to insure mental health on par with physical coverage

A little-known federal law passed when President George W. Bush occupied the White House requires insurers to give behavioral health care equal footing with medical benefits.

That means, if a person’s co-pay is $10 to have chest pains checked out by a medical doctor, then an insurer that offers mental health coverage cannot charge a higher co-pay for the same person to see a behavioral health specialist about anxiety or depression. The law applies to both mental health and substance use disorder treatment.

But advocates question whether that nearly 14-year-old federal law – the enforcement of which is partly left to the states – is being enforced in Georgia. A coalition of advocacy groups has pegged ramping up enforcement of the law in Georgia as its top priority this year.

“We have no idea if the state is following federal law,” Abdul Henderson, executive director of Mental Health America of Georgia, recently told a group of lawmakers. “Georgia has not done anything to determine if group health plans and insurers in the state are following the law. I have a saying regarding parity, and it goes, ‘In states where there is no enforcement, you will find non-compliance.’

Read more: https://georgiarecorder.com/2022/01/05/ga-legislators-plan-push-to-insure-mental-health-on-par-with-physical-coverage/

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Ga. legislators plan push to insure mental health on par with physical coverage (Original Post) TexasTowelie Jan 2022 OP

Here is a big problem unaddressed in that law or Obamacare: spooky3 Jan 2022 #1

spooky3

(36,193 posts)

1. Here is a big problem unaddressed in that law or Obamacare:

Reply to TexasTowelie (Original post)

Wed Jan 5, 2022, 04:15 AM

Jan 2022

Psychologists get hourly rates from private insurance based on what Medicare will pay. But that rate is so low that a friend who is a counselor said it would not cover her office and insurance expense. She has no office assistant and has a reasonable office. So, she and most other psychologists who are good and experienced do not accept insurance or Medicare. Or, they will accept it as partial payment, about half of what they charge patients, which excludes them from many PPO lists. Therefore, if you can’t afford to pay at least half, plus any deductible, coinsurance, etc., you won’t get care.

On paper this looks as if the policy is the same for mental and physical treatment. But it isn’t. The psychologist cannot delegate any of the care to lower paid PA, techs, NPs, and can’t limit you to a 10 or 15 minute appointment and then charge $150. So it will be very difficult to find a counselor in most big cities who is both good and affordable.

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