Plan Design, Policies & Procedures | Behavioral Health Today

HHS to Give States More Flexibility to Implement Health Reform – Impact Felt Among Essential Health Benefits

FOR IMMEDIATE RELEASE December 16, 2011

Contact: HHS Press Office (202) 690-6343 Approach will help ensure consumers have quality, affordable coverage starting in 2014

The Department of Health and Human Services today released a bulletin outlining proposed policies that will give states more flexibility and freedom to implement the Affordable Care Act.

The Affordable [...]

GAO Finds Employers’ Insurance Coverage Enhanced by MHPAEA

GAO-12-63 November 30, 2011 Full Report PDF

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires that employers who offer health insurance coverage for mental health conditions and substance use disorders (MH/SU) provide coverage that is no more restrictive than that offered for medical and surgical [...]

The Center for Consumer Information & Insurance Oversight (CCIIO) Issues Parity FAQs

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) supplemented the Mental Health Parity Act of 1996 (MHPA). Generally, MHPAEA specifies that the financial requirements and treatment limitations imposed on mental health and substance use disorder benefits cannot be more restrictive than the predominant financial requirements and treatment limitations that apply to [...]

The Blue Cross and Blue Shield Association Unveils Action Plan To Improve Healthcare Quality And Rein In Rising Healthcare Costs

Comprehensive new proposal will save federal government more than $300 billion

October 4, 2011

Contact: Kelly Miller (Media Inquiries Only) 202.626.4825

WASHINGTON – The Blue Cross and Blue Shield Association (BCBSA) today released a comprehensive, interconnected action plan that fundamentally transforms the healthcare system, moving it away from a fee-for-service model to a patient-centered model. [...]

For-Profit Publicly Traded Medicaid Managed Care Plans Rack Up Higher Admin Costs

The Commonwealth Fund reports that for-profit publicly traded plans spent 14% of member premiums on administrative costs, while non-publicly traded plans owned by health systems, local providers and clinics spent 10% of premiums on administrative costs. Provider-owned and operated plans had the lowest administrative costs, with a paltry 8% of member premiums spent on [...]

Carve-In Making a Comeback?

One of the ten largest health plans in the country announced recently that it will be in-sourcing what it had previously out-sourced: Disease Management. A quick review of their rationale exposes some very compelling reasons to carve services back into the broader health plan suite of functions.

For starters, the health plan expects to [...]

The Mental Health and Addiction Equity Act-Are you ready for Parity?

Next week’s webinar will offer payors a roadmap to readiness. Register here:

http://behavioralhealthcentral.com/index.php/Event-Registration/vmchk.ht

Parity Legislation Compliance Webinar Series Part 1: Getting Ready for Mental Health Parity Wednesday, December 9 at 2 p.m.

The Mental Health Parity [...]

Parity Regulations & Technical Guidance Delayed until after January 1, 2010. Can Pamela Hyde Get Approved and Help?

Surprised about the delay? No, but employers and plans will need to move forward carefully, doing everything they can to comply reasonably and in “good faith” until we receive clarification.

On October 2nd, HHS Secretary Kathleen Sebelius wrote to House and Senate lawmakers saying that the administration “aims” to issue regulations for the one-year [...]

Employee Assistance Programs (EAP) & Parity: What Should Employers Do?

The question of what to do with employee assistance programs or EAP when Parity legislation drastically expands behavioral health coverage is not new. We have been dealing with this question for more than a decade. The questions take on several different flavors:

Is it true that mental health and substance abuse coverage will be [...]

To Carve-In or Carve-Out…that is the Question

As health plans and self-insured employers around the country prepare for and implement the new federal Parity law, they are confronted by the choice between beginning/continuing a “carve out” with a managed behavioral health organization (MBHO) or applying the rival approach: a behavioral health “carve-in”. Both options offer advantages as well as issues and [...]

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