By Consumers for Quality Care, on November 1, 2023
Recent bills introduced in the Michigan state legislature would require insurance companies to cover medically necessary mental health or substance abuse treatments in the same way they do physical health care, according to Bridge Michigan.
A 2008 federal law requires insurers to cover mental health treatments and care just as they would cover anything else, meaning that consumers cannot be charged higher copays or face additional prior authorizations for mental health care. Still, many families report that these claims are being denied, with insurers arguing such care isn’t “medically necessary.”
The legislation introduced in Michigan would rectify this issue by requiring insurance providers to cover care as outlined in national guidelines, such as those established by the American Association of Community Psychiatrists and the American Society of Addiction Medicine.
Additionally, when in-network services are not available, insurance providers would be required to find and cover out-of-network and emergency services. Similar legislation that was introduced in the State Senate would codify the federal legislation into state law without the out-of-network component.
This news comes as the Biden administration announces new proposed rules meant to address some of the loopholes that insurers exploit to deny coverage for mental health treatment. White House Domestic Policy Adviser Neera Tanden said these rules “will stop the industry evasion that has led millions of people to pay for care even when they have insurance. It will help ensure we finally fulfill the promise of mental health parity required under the law.”
CQC urges lawmakers and regulators to take action to ensure that all patients can access the mental health care they need and deserve.