 Kent Sullivan
Insurance Commissioner
Almost one in
five adults experiences a mental health illness each year, but fewer than
half receive treatment. Can better enforcement of mental health parity
laws help us improve those statistics? It’s time to find out.
If a health
insurance plan covers mental health issues, state and federal laws
require it to give the same level of benefits, such as the number of
office visits or access to emergency care, as it does for a physical
illness or injury. This is known as mental health parity. The concept is
simple. But ensuring parity among different medical specialties can be
difficult.
The Texas
Department of Insurance (TDI) is exploring ways to better evaluate parity
and identify treatment limitations within health plans. As part of this
effort, we’ve met with stakeholders and asked for broad input to identify
best practices to enforce mental health parity.
We’ve talked
to leaders in the mental health field and patient advocates. They tell us
that many mental health patients don’t know their health insurance may
cover their treatment, and providers may still face barriers getting
medically necessary services approved or adequately reimbursed. Even more
troubling, advocates tell us that it can be difficult to get providers or
patients to file a complaint if they have a problem. That silence creates
an additional barrier to parity.
It’s
essential that mental health providers, patients, and advocates share
information with TDI. It helps us identify and quantify problems so we
can take action. You can file a complaint online, call our Help Line at
1-800-252-3439 to learn about your options, or review our How to get help with a mental health issue
webpage. You can also share your thoughts and experiences by emailing commissioner@tdi.texas.gov.
A survey by
the U.S. Substance Abuse and Mental Health Services Administration found
that only 43% of adults experiencing mental illness received treatment in
2018. Let’s change that.
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