Coalition goes to Washington to discuss behavioral health infrastructure

The Coalition for Whole Health had the opportunity to meet with the Department of Health and Human Services (HHS) to discuss mental health parity, health insurance enrollment, essential health benefits, network adequacy and Medicaid on January 9. One key takeaway was that HHS wants to find ways to work with insurers to build up the infrastructure needed to support those with behavioral health needs.

“It was very exciting,” says Nathaniel Counts, JD, a policy associate with Mental Health America. “SAMHSA (Substance Abuse and Mental Health Services Administration), CCIIO (Center for Consumer Information and Insurance Oversight) and CMS (Centers for Medicare and Medicaid Services) are doing incredible things with enrollment, and it’s growing. Many people are newly insured and that number’s just going to keep increasing.”

According to tracking tool acasignups.com, the new insurance-exchange plans had confirmed 7.5 million people signed up for coverage as of January 8, 2015.

Progress in the year ahead
In addition to the mental health parity regulations and new reporting regulations coming into play in 2015, Counts says another positive sign is increased enrollment among special populations such as LGBT. More positive change could be on the horizon.

“We’re excited to see how all the different oversight mechanisms will work as CCIIO and states figure out their respective authorities and work to look over the massive amounts of information they’re now collecting,” he says.

Currently, Counts says, a majority of CCIIO oversight focuses on consumer complaints and reviewing health plan language, meanwhile other issues slip through the cracks. Specifically, in behavioral healthcare, patients aren’t always receiving the assessments they need or referrals for necessary services.

For example, he says, a child should receive yearly mental and emotional behavioral health assessments, and if needed, referrals to resources. Some examples might include parent/child behavioral training along the lines of Strengthening Families.

This isn’t available in most areas, and through plan language, utilization management guidelines and complaints, you’ll never find out that people aren’t receiving these services,” he says. “[HHS representatives] were interested in hearing more about ways to work with insurers to build out this larger infrastructure. Because mental health parity is so new, few networks are totally adequate at the moment, if any, relative to where you’d hope to see behavioral health go in the future.”

Another topic that was discussed was better clarifying the enforcement role between the federal CCIIO versus the state regulators, and making sure that both are working together.

“CCIIO is already working very closely with state enforcement, but we just hope to keep ensuring in the future that there’s clear delegation,” Counts says.