October shines a light on gender parity in mental health


October 11, 2021

Earlier this year, the Texas legislature designated October as Mental Health and Substance Use Disorder Awareness Month to educate Texans about parity in behavioral health. The designation came as part of House Bill 2595, which the legislature passed and Governor Greg Abbott signed in June.

Parity in behavioral health occurs when the treatment of mental health problems and substance use disorders is covered by health insurance plans, just like the treatment of other health problems. Some health plans may not cover treatment for mental health or substance abuse disorders, but if they do, state law requires coverage to be equal to coverage provided for treatment of other medical conditions. .

For example, if a person’s health plan offers unlimited visits for a chronic illness like diabetes, then it may offer unlimited visits for a substance use disorder or mental health problem. Other aspects of coverage that may be equal or comparable include:

  • Inpatient services
  • Residential treatment services
  • Intensive outpatient services
  • Emergency care
  • Arrangement
  • Copays and franchises
  • Maximum expenses
  • Provider reimbursement rate
  • Geographical location of services

The HHS Ombudsman for Behavioral Health has seen an increase in parity cases as more Texans ask questions about being denied access to mental health services.

“When the Legislature created the Ombudsman for Behavioral Health in 2015, it allowed our organization to focus on the needs of people who sometimes struggle to be heard clearly,” said Avril Hunter, l ombudsman manager of this program. “Our team takes pride in really trying to understand the concern before moving to a resolution.”

When the HHS Behavioral Health Ombudsman is contacted, their staff determine if there is a potential parity violation, then help the client gather evidence to support their claim. While working with the appropriate entity to investigate the complaint, they keep the customer informed of any updates. If the complaint is determined to be a parity violation, the entity is expected to resolve the issue with the customer.

“Parity is a simple concept, but in some ways it’s hard to deal with for large organizations,” said HHS Ombudsman Joel Schwartz. “Parity Awareness Month gives HHS mediators the opportunity to share examples of their work with other HHS staff. And we hope it will help more people to solve their problems. “

Texans who are struggling to get mental health services should first contact their health plan and review their policy. If they still need help, they can call 800-252-8154 or visit the HHS Ombudsman for Behavioral Health webpage.

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