PEORIA — Area behavioral health experts expressed cautious optimism over the mental health parity bill sitting on Gov. Bruce Rauner’s desk.
Senate Bill 1707 received strong bipartisan support, passing at the end of May by a vote of 106-9 in the Illinois House and 52-0 in the Illinois Senate.
If signed into law by the governor, the legislation will make Illinois’ parity law the strongest in the nation, according to the Kennedy Forum.
Parity, in this sense, means that if a health plan provides coverage for a chronic condition, such as diabetes, then the same level and terms of coverage must be applied to mental health.
“Our mental health parity law was one of the weaker ones in the nation,” said Cheryl Crowe, director of behavioral health Services for OSF HealthCare. “If the governor signs this bill it will be the strongest. We’re really hopeful. It addresses our key issues. With opioid death and suicides rising, we gotta do something. And this is taking steps in the right direction.”
The bill beefs up enforcement, requiring both commercial insurers and Medicaid managed care organizations to submit detailed analysis to demonstrate they are in compliance with both the Illinois and Federal Parity Act. It also requires the Illinois departments of Insurance and Healthcare and Family Services to take concrete steps to verify that people with mental health and addiction issues are not being discriminated against by their health care plans.
“Requiring all insurers to provide reimbursement for mental health and substance abuse is huge,” said Crowe. “Therapy and treatment with a psychiatrist is very expensive. Those insurance companies that offered it at all, it wasn’t at a good rate, or there were restrictions.”
The bill is also addresses the opioid crisis by making the drugs used in Medically Assisted Treatment easier to get and more affordable. It prohibits prior authorization and step-therapy requirements for FDA-approved medications to treat substance use disorders, and places generic FDA-approved medications for substance use disorder on the lowest tier of prescription formularies, and branded medications on the lowest tier for branded medicines.
“It will really enable individuals to access treatment at a lower cost,” said Crowe.
Dr. Kirk Moberg, executive medical director of the UnityPoint Health Illinois Institute for Addiction Recovery, is encouraged by the legislation, but wants to know more about how parity will be enforced.
“The Federal Parity Act has been around for a long time and there are still issues,” he said. “The experience of myself and other providers like me, addiction still is not treated as other medical conditions are. Treatment is often micromanaged from afar, particularly by third party payers in general.”
Moberg wants to know more about how parity will be enforced on the different types of insurance plans. In spite of what he describes as a healthy skepticism, Moberg says he fully supports the bill.
“The legislation is a huge step in the right direction in assuring needed medical care to people who suffer with behavioral health issues like addiction,” he said. “I’d like to see how it actually gets implemented — that’s where the rubber meets the road.”
Leslie Renken can be reached at 686-3250 or email@example.com. Follow her on Twitter.com/LeslieRenken, and subscribe to her on Facebook.com/leslie.renken.