Quality & Science

CSOO Members Advocate for Full Federal Parity Act Application Across Medicare, Medicaid, and TRICARE

by | October 15, 2021

On October 13th, ASAM, along with members of the Coalition to Stop Opioid Overdose (CSOO) and members of the Mental Health Liaison Group (MHLG), sent a letter to Chairman Ron Wyden and Ranking Member Mike Crapo of the Senate Committee on Finance, encouraging full extension of federal mental health and substance use disorder parity protections to Medicare, all of Medicaid, and TRICARE. Too many Americans who are enrolled in these programs and in need of care for mental health or substance use disorders continue to encounter challenges receiving comprehensive coverage.

In the letter, signatories highlighted how an absence of parity protections and adequate coverage in these public health insurance programs have a wide range of negative effects on the entire healthcare system. For example, programs like Medicare often set the standard that other commercial plans follow.   As a result, insufficient Medicare coverage of mental health and substance use disorders and disparities in its rate-setting process can transfer into commercial markets, creating coverage gaps and potentially undervaluing reimbursement rates for these services. Specific Medicare coverage deficiencies include limited coverage of residential and intensive outpatient levels of care for mental health and substance use disorders, lifetime caps on impatient psychiatric hospital services, a narrow range of covered mental health and substance use disorder treatment providers, and restrictions on telehealth services for mental health and substance use disorders.

For the millions of Americans covered by Medicare, Medicaid, or TRICARE who continue to face challenges receiving comprehensive coverage, extending the vital protections of the Federal Parity Act and addressing various coverage gaps would enhance their ability to seek care and receive the quality mental health and substance use disorder treatment that they deserve.

 

Read the letter here