This video explains why equitable insurance coverage of mental health and substance use disorders is so important.
To file a complaint for inequitable treatment for a mental health disorder: call 877-693-5236 or email: Consumer.Services@myfloridacfo.com
published April 2021
https://www.parityregistry.org/ - resources for equitable insurance coverage.
A new report released today from The Bowman Family Foundation confirms the experience that so many NAMI members face – that mental health care is far too hard to find, and for those who do find it, they end up going out of network for much of their treatment.
The report, Equitable Access to Mental Health and Substance Use Care: An Urgent Need, is based on a survey of 2,794 individuals conducted by NORC, including many NAMI members. The survey found challenges for adult-focused services and even more challenges for youth in need of mental health care.
Some key results include:
For the past 20 years, NAMI has fought for parity—the fundamental tenant that mental health care is just as important as physical health care. We have steadily made progress on this issue in both the hearts and minds of the country and its policies.
NAMI knows that the U.S. system of mental health care is failing to engage many people who seek help. The facts say it all: Many people who seek mental health care drop out. 70% that drop out do so after their first or second visit.
The first moments of interaction between a service provider and a person seeking care for a mental health condition can set the tone and course of treatment. This first interaction can start a journey to recovery and a satisfying life—or it can leave a person unsure or even hopeless about their future and unwilling to go back a second time.
NAMI recommends that insurance companies take the following steps to improve coverage under federal parity law:
Additionally, they recommend:
Examples of Non-Parity:
Florida’s OIR (Office of Insurance Regulation) needs the full support of the Florida legislature to evaluate and enforce the Federal Parity Law under the MHPAEA (Mental Health Parity and Addiction Equity Act). Employers who sponsor self-funded health plans that cover Mental Health and Substance Use Disorders should know that any difference between the handling of MH/SUD benefits and comparable medical/surgical benefits is probably illegal.
If parity is enforced:
In Florida, the existing law permitting discrimination against MH/SU disorder patients must be repealed, from HB939: 409.967, F.S.; requiring Medicaid managed care plans to submit an annual report to the Agency for Health Care Administration (AHCA) relating to parity between mental health and substance use disorder benefits and medical and surgical benefits; specifying required information in the report; amending s. 627.6675, F.S.; conforming a provision to changes made by the act; transferring, renumbering, and amending s. 627.668, F.S. (commercial health insurance companies).
Since most mental health care is provided through Medicaid and at more reasonable rates, we should expand Medicaid in Florida to include the “working poor” who currently make too much to qualify for Medicaid but also can not afford their own health insurance.
Read NAMI's report, “Mental Health Parity at Risk.”
A report issued by Florida's AHCA (Agency for Health Care Administration), which oversees Florida's Medicaid Managed Care program, found that the average rates of performance for these companies in the behavioral health domain did not meet AHCA’s 2020 performance targets.
Download and read the report below. Information on performance measures for behavioral health begins on page 22.
Get confidential help by calling 9-8-8 to reach Florida's Lifelines.