Ohio bill aims to increase in-network care for mental health, addiction treatment

https://www.cleveland.com/open/2019/12/ohio-bill-aims-to-increase-in-network-care-for-mental-health-addiction-treatment.html?utm_campaign=KHN%3A%20Daily%20Health%20Policy%20Report&utm_source=hs_email&utm_medium=email&utm_content=80556146&_hsenc=p2ANqtz-95eAqknoKKmOGsJQR-TXaBq7-CivGhvQZ0RC3T9F3x6dKxMm4Y2MuGsFxOivNtS3cR8N3cK9YeaakZ2-w7kOytHaRAITNzQmHX85y3Ct_57SoKTuY&_hsmi=80556146

Comment; I cannot believe that insurers are still allowed to discriminate against a proven disease–why not say they won’t pay for treatment for common UTI’s, URI’s, fractures or other care? Why is addiction a “carve-out”? STIFF penalties are needed! Patients should be reimbursed for what they spent for such care, with interest!

Updated Dec 09, 2019;Posted Dec 09, 2019

5176sharesBy Laura Hancock, cleveland.com

COLUMBUS, Ohio – A new bill in the General Assembly aims to increase mental health and addiction treatment covered by Ohio insurance companies, after a recent report showed patients are increasingly going out-of-network for care.

House Bill 443 is sponsored by Reps. Allison Russo, a Columbus-area Democrat, and Phil Plummer, a Dayton Republican.

The bill would align Ohio’s insurance laws with the 2008 federal law that prohibits health plans from imposing less favorable benefit limits on mental health care than on medical and surgical care.

Russo, a health care consultant outside the legislature, said the bill also allows the Ohio Department of Insurance to obtain reports from insurance companies evaluating how they are complying with the law.

State health plans, such as those offered for state employees and through Ohio Medicaid, would regularly report how they are complying with the law, even when the state plans contract with private health insurance companies.

The bill would educate the public about the law, and how to complain when there are a lack of psychiatrists, therapists and in- and out-patient facilities offered in their plan in comparison to medical and surgical providers, she said.

Thus far in 2019, the Ohio Department of Insurance has only received one complaint about providers being out of network.

“Most patients don’t know that this is in fact the law,” she said. “And they don’t know how to complain.”

As the opioid epidemic rages, Russo said that people need access to treatment. Most opioid addicts get into treatment through Ohio Medicaid — “which is why it’s important to cover some of these public entities to make sure Medicaid is in fact following the federal parity law.”

More Ohioans seeking out-of-network mental health, addiction treatment, despite federal insurance law

A new report shows Ohio mental health reimbursement rates are not on par with medical or surgical rates, and more people are going out of network for care at treatment facilities.

A recent report by Seattle actuary Milliman looked at claims data for policies covering 2.8 million Ohioans between 2013 and 2017. It found that more people were seeking mental health care out of network, suggesting health plans aren’t offering enough in-network providers. It also showed that insurance reimbursement rates were going down– when medical and surgical reimbursement rates were going up