Many advocates, agencies, families and caregivers are celebrating a roller coaster 2022 General Assembly with the passage of HB 1013, otherwise known as the Mental Health Parity Act. One component of the bill addresses the parity law that has been on the books for years, but never adequately enforced. Now with the passage of this bill by a bipartisan supported vote, Georgians will have better access to mental and behavioral health treatment under coverage by their insurers.
Commercial Insurance as well as the Medicaid Care Management Organizations have required Georgia families to jump through many hoops to get the required mental health treatment they deserve. Often necessary care is denied before it is ever started and Georgians are instructed to attempt and fail at lower levels of care before they can access much-needed treatment or hospitalization. Imagine going to the Emergency Room for a serious injury that may require surgery only to be told to go to your family doctor first to see if they can fix the injury!
This new law will require Insurance and Medicaid to provide the same criteria and benefits for mental health treatment as they do for medical health benefits. If you have unlimited coverage to see your Internist, then you should have the same coverage for outpatient treatment with a therapist or psychiatrist. If under your Medical plan you do not need preauthorization for high-end medical treatment, i.e. ERs or hospitalization, then you should not be required to preauthorize psychiatric hospitalization for suicidal thoughts, self-harm, psychosis, or depression. Having Georgians go thru ER visits to be sent home for a mental crisis numerous times to finally get critical intensive mental health treatment only further traumatizes the individual and their family.
The new Mental Health Parity Act will be enforced by the Department of Community Health for Medicaid and the Office of the Commission of Insurance for private insurers. Should an individual or family feel that their insurer is requiring separate rules to access mental health versus their medical plans then there are steps that they can take:
- First, they can contact their insurer and dispute the denial or unnecessary requirements for access and document the call, emails and responses.
- If the insurer refuses to follow the law, inform them of the Mental Health Parity Act.
- The next step is to contact the Office of the Insurance Commissioner for private insurance at https://oci.georgia.gov/file-consumer-insurance-complaint or the Department of Community Health for Medicaid at https://dch.georgia.gov/about-us/contact-us.
This law is a dramatic change to the Georgia Mental Health landscape for a state that is ranked one of the lowest in the nation for providing adequate care to its citizens with mental health needs. It will take time and filing of complaints by individuals, families, and agencies to enforce the insurers to do what is right and required for mental health parity. Advocates are extremely grateful that this has passed and anticipate Georgia services to move up the ranks in providing needed and deserved care. It will take us all to stop the cycles of trauma and inadequate care created by a cost-containment focus as we shift to improving access to treatment and overall health improvement.