Practical Implications of Georgia’s New Mental Health Law – InsuranceNewsNet

With rare unanimous votes in Georgia House and Georgia SenateGeorgia House Bill 1013, titled the Mental Health Parity Act, was signed into law by Gov. Brian Kemp On April 4.

The passage of the bill is a positive step in efforts to halt the progress of what most observers would rightly characterize as a pervasive mental health epidemic spreading across our nation that collectively negatively impacts the lives of millions of Georgians.

For too long, mental health care has been somewhat relegated to second-tier status by many in the health care provider and insurance industries. As infrastructure, investment, and innovation have accelerated widely for “conventional medicine,” mental health care as a whole has received little more than lip service from most health systems and health insurers.

Fortunately, there are exceptions to this rule, as some key market leaders identified mental and behavioral health as a priority years ago, strategically invested in increasing resources, and now have the ability to point to empirical data confirming that their investment in resources for mental health have resulted in demonstrably positive outcomes for patients’ mental health.

Fortunately, groundbreaking work by leading health systems, mental health providers, and mental health advocates has turned the tide to some extent. Mental health care is now more properly prioritized (and destigmatized), and as this continues to happen, significant positive change in terms of provider infrastructure, insurance funding, and patient outcomes is likely to follow.

The Georgia Mental Health Equity Act states, among other things, that “any health insurer that provides coverage for mental health or substance use disorders as part of a health care plan shall provide coverage for the treatment of mental health or substance use disorders in accordance with the Mental Health Parity and Addiction Parity Act 2008.”

For context, the Mental Health Equity and Addiction Equity Act is a federal law that generally dictates that most health plans must ensure that if they provide mental health coverage under their policies, the benefits of their coverage for mental health care should be, at least, at a point of parity with coverage levels for non-mental health needs. For example, if a health insurance policy includes access to an unlimited number of visits to a primary care physician for “physical health care,” the policy cannot impose a visit limit on visits to a mental health care provider.

Most employers sponsoring group health plans will find that their policies are already compliant with the MHPAEA, and as a result, the majority of group health plans will now find themselves compliant with the Georgia Mental Health Parity Act. However, because the MHPAEA does not apply to a subset of health insurance plans, including some self-funded small group plans, predecessor large group plans, etc., the Mental Health Parity Act imposes a general requirement for coverage parity across the board. Importantly, the Mental Health Parity Act will not apply to employee benefit plans located in another state; however, all health insurance companies with plans located in State of Georgia will now be forced to make the necessary adjustments to their policy language to ensure compliance.

From a practical standpoint, now that coverage parity is mandated as stated above, the next focus will need to be on increasing the number of mental health providers, strengthening provider networks so that the insured can find their preferred in-network providers and continuing to invest in innovative solutions to improve the scalability and efficiency of mental health care.

Fortunately, the Mental Health Parity Act goes beyond simply mandating health insurance coverage parity to include other key provisions that will, among other things, allocate funds and incentives to try to increase the number of practicing psychiatrists in the state , create a behavioral health care workforce database, create a grant program to support outpatient treatment programs, improve transparency, reauthorize the Commission on Behavioral Health and Innovation and more.

There is no doubt that solving the mental health crisis will require much more than one bill. However, thanks to the cooperation and focus between the parties on this key issue they face State of Georgia, our legislators should be commended for their efforts. And we all look forward with hope that mental and behavioral health resources will continue to grow and, as a result, patient outcomes will continue to improve.

Leave a Comment

Your email address will not be published.