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FOR IMMEDIATE RELEASE
Contact: Robert Collins
(202) 682-6056
rcollins@psych.org
October 13, 1999
Steven S. Sharfstein, M.D., Discusses Effects of Maryland’s 1995 Mental Health Parity Law
Arlington, VA-Today Steven S. Sharfstein, M.D., on behalf of the American Psychiatric Association (APA), delivered the keynote address to a conference of participating carriers in the Federal Employees Health Benefits Program (FEHBP) that are charged with developing guidelines to implement President Clinton’s mental health parity and substance abuse initiative for federal employees.
Dr. Sharfstein spoke about the example of Maryland’s parity legislation. This law applies to all in-state insurers, non-profit health service plans or HMOs on a group or individual basis. The Maryland law stipulates equal treatment for mental and addictive disorders determined to be medically necessary, prohibits separate mental illness lifetime maximums, and provides that psychiatric medication management may not be counted against the number of outpatient psychiatric visits.
After the first full year of implementation of the Maryland law, a state-wide study found that the proportion of the total medical premium attributable to the mental health benefit actually decreased by 0.2 percent after the law was in effect the first year. However Dr Sharfstein was quick to point out that the decreases were due to denial or unreasonable barriers to care, true parity was not achieved because there is little of the law benefit if patients still do not have access to medically necessary mental health care.
"Mental illness and addiction disorders are real diseases, and the scientific bodies of evidence show the effectiveness of mental illness and substance abuse treatment. While offering parity may initially seem like an increased cost, the result of not providing such coverage means additional health-related costs, as well as increased criminal justice and social welfare costs," said Dr. Sharfstein.
Dr. Sharfstein cautioned the Conference that access to mental health and substance abuse services must be closely monitored to prevent inappropriate cost driven denial of care via discriminatory managed care utilization review requirements. If care is not taken to ensure utilization review is done in a nondiscriminatory way, President Clinton’s call for parity could have little effect on those suffering from mental illness or addiction disorders.
"As we all move toward making President Clinton’s vision of mental health and substance abuse a reality, we need to ensure this is more than a symbolic victory," concluded Dr. Sharfstein. "As insurance carriers begin defining parity for 2001, they need to be cognizant of the need for greater accountability regarding "medical necessity." Inadequate treatment of mental illnesses and addiction disorders in the name of cost savings is not the road to parity; indeed, it is a path to a prescription for disaster."
Steven S. Sharfstein is currently President and Medical Director at the Sheppard Pratt Health System, a not-for-profit behavioral health care system in Baltimore, and Clinical Professor of Psychiatry at the University of Maryland. A practicing clinician for over twenty years, he specializes in psychotherapy and psychopharmacology, especially for patients with long-term mental illness. Dr. Sharfstein is widely considered an expert on the FEHBP program. He has written on a wide variety of clinical and economic topics and has published more than 140 professional papers, 40 book chapters, and 10 books, including (as co-author) Madness and Government: Who Cares for the Mentally Ill?, a history of the federal community mental health centers program.
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