The Mental Health Association of Rhode Island (MHARI) launched its Rhode Island Parity Initiative (RIPI) on Thursday at Butler Hospital’s Ray Conference Center. RIPI is a statewide public awareness campaign to educate and empower people to understand and assert their rights to health insurance coverage for mental health – including addiction – treatment and services.
“It is time for health insurers to stop the practice of stigmatizing mental illness,” said Ruth Feder, MHARI executive director. “Mental illnesses are no less real, no less serious and, often, no less lethal than other medical conditions. We want every Rhode Islander to understand what parity means. Our goal is to arm Rhode Islanders with the basic knowledge of their rights to parity, how to assert those rights, and where to get assistance to assert them, if needed. By helping all to assert their right to equal treatment by insurers, we can make change.”
A common violation of mental health parity is the weak networks of mental health providers covered by many health insurance plans, due in part to lower insurer payments to mental health professionals than to physical health providers for the same types of services. A 2017 survey conducted by Milliman found that nationally, more than 30 percent of outpatient mental health care was out-of-network.
“Shortages of in-network outpatient treatment for children too often mean six-month wait lists for an initial evaluation, or at least six months for a clinician to be paneled by insurance so they can provide treatment,” said Marilyn Matzko, an adoptive parent of a child with reactive attachment disorder, and a member of the Family Advisory Group at Bradley Hospital who spoke to this issue. “Many highly experienced clinicians have simply given up waiting to be paneled, or decide to forego insurance in order to provide the treatment they believe will lead to the best outcomes for the child, without insurer imposed obstacles. This forces families to seek out and pay up front for out-of-network services and wait for reimbursement from their insurers. Most families do not have the means to do this, with potentially devastating results for their child.”
Parity laws dictate that, in most circumstances, health plans cover mental health services the same way they do medical and surgical services. Yet, as Feder pointed out, a recent market conduct exam of Blue Cross Blue Shield of Rhode Island (BCBSRI) conducted by the Office of Health Insurance Commissioner (OHIC), found evidence that BCBSRI and its utilization review agent applied criteria in a “clinically inappropriate” manner and that in many cases review procedures were “unreasonable and inequitable” and “did not properly consider patients’ welfare and safety.”
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“BCBSRI has already taken positive steps to change its’ review procedures,” Feder added.
Deborah Flitman, a Cranston resident who was denied coverage for mental health services for her child spoke, stating “I pay over $25,000 dollars a year for health insurance coverage, with the expectation that benefits will be there when I need them. I never expected my health insurance company to continuously put up roadblocks when my child needed health care.”
“We don’t need any more bad statistics emanating from health insurance for treatable diseases like mental illness. Subscribers should know that they have recourse if they are ever denied a covered benefit. Insurance needs to be held accountable. I encourage others to know their rights and to take action by visiting RIParity.org.” Flitman added.
Speakers included Governor Gina Raimondo, who last year signed an Executive Order to improve access to treatment for mental health and substance use disorders. “Too many Rhode Islanders are struggling with mental illness, and I know how difficult it can be for them and their families to reach out for help. But with the right treatment, people can and do get better. That’s why the kickoff of the Parity Initiative today is so important: we need to help people think of their mental health the way they think of their physical health,” said Raimondo.
Sam Salganik, an attorney with the Rhode Island Parent Information Network (RIPIN), said, “I’m not sure many people appreciate how much more difficult it can be for patients who need behavioral health services to get covered. In-network care is hard to find, numerous subcontractors and intermediaries play complex roles in approving care, and inpatient services sometimes require re-authorization on an almost-daily basis. That’s why we are excited to participate in RIParity.org.” Salganik also encouraged Rhode Islanders to call the state’s Health Insurance Consumer Hotline housed at RIPIN at 401-270-0101. “ANY Rhode Islander, with ANY kind of health insurance problem can call us, and we’ll help you sort it out. Our service is FREE…and our skilled staff guides callers through any problem from beginning to end, whatever it takes.”
The public awareness campaign includes posters and other materials that health care providers, community organizations, employers, and others are encouraged to share. Materials are free and can be downloaded or ordered by visiting RIParity.org or by emailing email@example.com.
Ruth Feder concluded her comments by saying, “Parity is a civil rights issue. For too long, people seeking mental health services, including addiction services, have experienced discrimination. This campaign will work to make sure Rhode Islanders are informed and ready to assert their rights. Every patient has a right to appeal an insurance denial, and most with mental health disorders, including addiction, have special protection under Federal and State parity laws. We encourage Rhode Islanders to visit RIParity.org for information about their rights and how to get help.”
The Rhode Island Parity Initiative is supported with funds from the Rhode Island Foundation, the United Way of Rhode Island, and the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities & Hospitals.