MEDICAL MARKETS

House urges mental health parity

Concerns follow UnitedHealth Group's exclusion of mental health from its decision to eliminate its preauthorization requirement for treatment.

By Bonnie Booth, AMNews staff. Dec. 27, 1999.
AMNews Interim Meeting '99 coverage - AMA's Interim Meeting site.

San Diego -- Delegates to the AMA's Interim Meeting here asked the Association to more aggressively pursue mental health parity, following a move by UnitedHealth Group last month that excluded mental health from the health plan's decision to eliminate its preauthorization requirement for treatment.

"[UnitedHealth Group] got great public relations before we got to the nitty-gritty and found out we were left out," said Sara Charles, MD, of the American Psychiatric Assn. "Psychiatrists should have the same freedom as any other physicians in selecting the best treatment for their patients."

Although the AMA has long supported mental health parity, some believe the Association needs to take a stronger stand in the wake of the UnitedHealth Group decision.

Delegates agreed that the AMA should petition all insurance companies to treat psychiatric patients no differently than they treat other patients with respect to precertification policies and utilization review and to afford the same degree of authority to psychiatrists that they give to other physicians.

Delegates also asked the AMA to develop model state legislation that provides psychiatric patients with nondiscriminatory utilization review and precertification so state societies can begin working at that level to fix the problem.

"This is an issue of respect for the patient," said Jeremy Lazarus, MD, a psychiatrist from Engelwood, Colo. "Even in the 24 states where there is parity, only one state has nondiscriminatory utilization review."

Delegates also agreed to ask the AMA's Council on Medical Service to revisit the issue of mental health carve-outs and report back to the house in December 2000. Responsibility for utilization review and precertification for mental health are treated separately in many insurance plans.

"Discriminatory policies at carve-out are at the heart of the discriminatory policies of many of these plans," said Thomas E. Allen, MD, a Maryland psychiatrist.

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