Good news from Beacon Hill Concerning Mental Health Coverage. Last month, Governor Cellucci signed into law the "Mental Health Parity Law." Under this new legislation, insurance plans operating in Massachusetts must offer parity between medical benefits and mental health benefits for certain disorders. If a plan offers treatment for medical conditions up to a certain annual or lifetime limit, it cannot discriminate against therapy for mental health conditions by offering any less benefits. This rule applies to mental disorders that are biologically-based or are one of the following: schizophrenia, schizoaffective disorder, major depressive disorder, bipolar disorder, paranoia and other psychotic disorders, obsessive compulsive disorder, panic disorder delirium and dementia, and affective disorders. In addition, plan members are entitled to 24 visits of out-patient treatment per year, subject to clinical review, for talk therapy for such issues as marital problems, career adjustments, etc. Unlike the past, out-patient mental health benefits will not be capped at arbitrary dollar limits. Insured patients will also be covered for 60 days of inpatient psychiatric care under this law.

Other stipulations of this law include parity of mental health benefits to medical benefits for patients undergoing diagnosis and treatment for emotional disorders related to rape or for victims of an assault with an attempt to commit rape. Furthermore, patients under the age of 19 will receive a parity of mental health benefits for treatment of non-biologically based, emotional, and behavioral problems which either prevents them from attending school, severely limits social interaction, necessitates hospitalization, or causes behavior which is harmful to the self or others. If a child has been receiving treatment for such a condition before his/her 19th birthday, coverage must continue after the age of 19 under these same guidelines until treatment is completed. The regulations which apply to mental health benefits apply to patients who require treatment for alcoholism or chemical dependency and are concurrently receiving treatment for any mental health disorders.

These changes in coverage for mental health benefits take affect for group insurance plans effective 1/1/2001, and are effective for non-group plans on 1/1/2002. In the meantime, the Massachusetts Division of Insurance will be ironing out any details and the health insurance plans will be revising their systems to adapt to the new regulations.

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