Harry Nelson was quoted in an article published by Behavioral Healthcare titled “Significant challenges remain in enforcing parity laws”.
The American healthcare system has made significant strides in improving behavioral healthcare coverage over the last decade, however, experts say it will still be years before true parity is achieved for patients.
Since the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) went into effect in October 2009, stakeholders have seen a significant expansion in service coverage. According to a recent report from the Substance Abuse and Mental Health Services Administration (SAMHSA), it’s estimated that nearly one-fifth of all Americans either have new or enhanced access to behavioral healthcare coverage as a result of the parity laws.
Nonquantitative treatment limits aren’t the only obstacle for the industry. Harry Nelson, JD, a founder and managing partner in Nelson Hardiman, a Los-Angeles based law firm that focuses on healthcare regulation, says he believes spiraling healthcare costs are driving insurance companies to drastically reduce what they are paying behavioral healthcare providers.
“We’ve seen the levels of reimbursement come way, way down,” he says. “So for residential treatment, we’ve seen reimbursements for out-of-network care drop from a median of something like $1,700 to $1,800 per day last year to a number like $200 to $300 a day this year,” he says.
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