When Love is Not Enough

When Love is Not Enough: Know When to Seek Help
One in five children in the U.S. show signs or symptoms of a mental health disorder in a given year. Yet, nearly 80% of children who need mental health services don’t get them. Parents and caregivers often don’t know what to do to help a child who is struggling with a mental illness.
Attend the forum to hear an in-depth conversation about the mental health crises affecting children and families. Learn the signs to look for at home, and how to partner with schools and community agencies to address mental health concerns.
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Final Mental Health Parity Rule Issued

The U.S Departments of Health and Human Services, Labor, and the Treasury jointly issued the final rule on parity under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) in November. The regulation is effective January 13, 2014 and generally applies to plan years (in the individual market, policy years) beginning on or after July 1, 2014.
Originally passed in 2008, MHPAEA requires insurance plans that cover mental health or substance use disorders to provide the same level of benefits that they do for general medical treatment.
What’s Included in the Federal Parity Law?

The requirement applies to:

  • copays, coinsurance, and out-of-pocket maximums;
  • limitations on services utilization, such as limits on the number of inpatient days or outpatient visits that are covered;
  • the use of care management tools;
  • coverage for out-of-network providers; and
  • criteria for medical necessity determinations.

MHPAEA does not require insurance plans to offer coverage for mental illnesses or substance use disorders in general, or for any specific mental illness or substance use disorder. It also does not require plans to offer coverage for specific treatments or services for mental illness and substance use disorders. However, coverage that insurance plans do offer for mental and substance use disorders must be provided at parity with coverage for medical/surgical health conditions.

Read more about the Final Parity Rule at SAMHSA.gov.

Mental Health Parity Act

Nov. 8 (Bloomberg) — The U.S. will release long-awaited rules today requiring insurers to cover treatment for mental illness in the same manner they provide care for physical health, a senior administration official said.

The regulations, five years in development, mean that insurance companies won’t be able to charge higher co-payments or deductibles for treatment of mental illness or limit the duration of care any more than they would for treatment of a physical condition.

The requirements will apply to almost all health plans in the nation including new ones sold under the health-care overhaul, the Patient Protection and Affordable Care Act of 2010. The U.S. health secretary, Kathleen Sebelius, will announce the final mental health rules at a conference this morning in Atlanta with Rosalynn Carter, the former first lady, the official said.

The administration also considers the rules to be a chief component of an effort to reduce gun violence, the official said. The White House included improving mental health services as one of 23 executive actions it announced to combat gun violence after 26 children and adults were killed in a shooting at Sandy Hook Elementary School in Newtown, Connecticut, in December.