Sen. Ujifusa, Rep. Tanzi introduce bills to help patients with mental health and substance use disorders

 

STATE HOUSE – Sen. Linda Ujifusa and Rep. Teresa Tanzi have introduced two bills to address problems faced by those with mental health or substance abuse problems: lack of parity between mental and physical health care insurance coverage, and denial of prior authorizations by insurers.

Says Senator Ujifusa (D-Dist. 11, Portsmouth, Bristol), “There is no question that since COVID, mental health and substance abuse problems have been increasing among people of all ages and demographics. If we don’t address these problems today, we’ll face more serious and expensive problems later.”

The first bill (2024-S 2612, 2024-H 7876) would specify the insurance coverage standards, protocols and guidelines for treatment of individuals with mental health or substance abuse use disorders. It is based on a model parity bill developed by The Kennedy Forum in partnership with the American Psychiatric Association and more than 30 additional national organizations.  So far, four states have adopted the legislation in full – California, Illinois, Georgia, and Oregon.

“Despite a 2008 federal law that requires insurance coverage for mental health conditions, including substance use disorders, to be no more restrictive than insurance coverage for other medical conditions, insurers can routinely deny critical mental health treatment based on their own rules, which are designed to minimize patients’ use of care,” said Representative Tanzi (D-Dist. 34, South Kingstown, Narragansett).  “If you wake up from a diabetic coma, your insurance will cover continuing care for your diabetes. But a person can be hospitalized for an overdose and be denied coverage for substance dependency treatment. Both cases are life-threatening health issues that warrant care, but they are not always treated equally by insurers.”

Explains Mental Health Association of RI (MHARI) Executive Director Laurie-Marie Pisciotta, “Many insurers develop their own ‘medical necessity’ guidelines, which can vary greatly from plan to plan, and need not align with what providers believe is in the best interest of their patients. This can result in behavioral health problems, such as depression or anorexia, too often being viewed as acute problems that do not require longer-term care.”

The legislation specifically prohibits insurers from limiting benefits or coverage for chronic or pervasive mental health and substance use disorders to short-term or acute treatment.

In Rhode Island, the bill is supported by MHARI, RIPIN, Newport Mental Health, Protect Our Healthcare RI, Rhode Island Medical Society, Lifespan, Rhode Island Psychological Association, the Economic Progress Institute, and behavioral health care providers. 

The second bill (2024-S 2393, 2024-H 7624) would prevent insurers from requiring that patients obtain prior authorization before seeking in-network mental health or substance use disorder health care.

Blue Cross Blue Shield of Rhode Island (BCBSRI) proactively dropped its preauthorization for such services in 2018, and the sponsors introduced the bill to require other insurers to follow suit.

“BCBSRI has had this policy for years and likely saved money because it was not blocking early access to behavioral health care,” said Representative Tanzi. “There is no evidence that other insurance companies would face hardships in complying, and this bill is supported by the Office of the Health Insurance Commissioner, the Department of Behavioral Health and Developmental Disabilities and Hospitals, as well as MHARI, RIPIN, Lifespan, Newport Mental Health and behavioral healthcare providers.”

Both bills been held for further study by the House Health and Human Services Committee, and will be heard in the Senate Health and Human Services Committee in the coming weeks at a date to be determined. Senator Ujifusa and Representative Tanzi urge patients and their advocates to testify in person, and submit testimony by email with the subject line “In support of S2612/H7876 and S2393/H7624.”  Written testimony should describe why the writer supports the bills, including challenges caused by lack of parity and prior authorization requirements. Send testimony to the Senate HHS Committee to This email address is being protected from spambots. You need JavaScript enabled to view it. and to the House HHS Committee to This email address is being protected from spambots. You need JavaScript enabled to view it..

 

 

A key report shows wholesale inflation slowed last month. The July Producer Price Index shows a rise of zero-point-one percent. The PPI measures prices that businesses receive for goods and services. Economists had been expecting a slightly higher increase, according to a survey by the Wall Street Journal.        Over one-point-three million people tuned into Elon Musk's conversation with former President Trump on X last night. Some technical issues delayed the conversation, but the pair still spoke for over two hours. They discussed the attempted assassination of Trump in Pennsylvania, immigration, Russian President Vladimir Putin, the threat of global warming, and more.        Voters are heading to the polls for primary elections in Connecticut, Minnesota, Vermont, and Wisconsin today. In Minnesota, progressive Congresswoman Ilhan Omar will defend her seat against former Minneapolis City Council member Don Samuels. The contest comes after two other members of the so-called progressive "Squad," Jamaal Bowman and Cori Bush, lost their Democratic primaries this cycle.        Tropical Storm Ernesto isn't expected to hit the U.S. mainland as it heads up the Atlantic Ocean. Current forecasts show the storm will bring heavy rain and flooding to Puerto Rico and Virgin Islands today. The National Hurricane Center says Ernesto will then head northward and into the Atlantic.        A former Colorado clerk is facing up to 22 years in prison for election tampering. Tina Peters was convicted yesterday and will be sentenced in October. Prosecutors argued she let an unauthorized person access Mesa County's voting equipment in 2021 and make a copy of hard drives, as well as pictures of passwords, and then tried to cover it up.        U.S. gymnast Jordan Chiles will not have her appeal heard by the Court of Arbitration for Sport. On Sunday, the International Olympic Committee said it would take away her bronze medal because of a scoring error. Monday, USA Gymnastics said in a statement that it was notified that CAS rules don't allow for an arbitral award to be reconsidered.