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Volume 13 Number 26 News: Mental Health Business groups are warning House Speaker Nancy Pelosi (D-Calif.) that broad mental health parity legislation (H.R. 1424) would threaten their ability to continue offering mental health coverage. Industry voiced its concerns on the same day the House approved a temporary extension (H.R. 4848) of current parity law. In a Feb. 7 letter to Pelosi, the U.S. Chamber of Commerce, the National Retail Federation, and the National Association of Wholesaler-Distributors said H.R. 1424 should be defeated when it comes to a vote in the House. Industry sources say a vote on the bill is likely in the next few weeks. "Successive markups in the three House Committees of jurisdiction (Education and Labor; Energy and Commerce; and Ways and Means) failed to improve [H.R. 1424] and in fact made it progressively worse," the letter stated. Coverage Threatened "The House bills would threaten our ability to maintain the mental health coverage that today is a vital component of employer-sponsored health plans," the groups said. The groups said they oppose H.R. 1424 because it would impose a broad benefit mandate (via use of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, or DSM-IV); lacks adequate protection for medical management of benefits; would allow states to enact more extensive laws, including an alternative remedy structure; and mandates out-of-network coverage. Business groups and mental health care advocates have mostly thrown their support behind the Senate mental health parity bill (S. 558), saying it was the product of extensive negotiations between stakeholders and lawmakers. The Senate approved S. 558 in September 2007. H.R. 1424 last year was approved by three House committees, the last of which, the Energy and Commerce Committee, approved it Oct. 16, 2007. The bills would require employer-sponsored health plans to offer mental health care and addiction disorders benefits on par with medical and surgical services. House Bill More Substantive Supporters of H.R. 1424 have said their bill is more substantive, and have argued that it would ensure true parity for mental health treatment is achieved. Supporters of S. 558 say the House bill in its current form would never pass the Senate and likely would be vetoed by President Bush. "S. 558 enacts true mental health parity without sacrificing the flexibility employers need to maintain affordable health coverage," the letter said. Lawmakers from the two chambers tried to resolve their differences over the bills late in the first session of the 110th Congress, with little progress reported. A Senate GOP aide said Feb. 7 that talks with the House are ongoing, "but it does appear that the House may well insist on moving its own bill." The aide said it is unclear what would happen in conference between the two chambers if the House bill is approved. Business groups and parity advocates are concerned that if the stalemate between the House and Senate is not resolved this year, it could be many years before a comprehensive parity bill is approved. "With the House overreaching, we may be doomed to our own version of 'Groundhog Day' and will be forced to fight for another five to 10 years," said E. Neil Trautwein, vice president at the National Retail Federation. House-Passed Extension Bill The House Feb. 7 acted on a much less comprehensive parity measure (H.R. 4848). By a vote of 384-23, the chamber approved legislation extending current mental health parity law until the end of 2008. The bill next goes to the Senate for its consideration. The bill would impose a $100 fine per day for violations. Under current law, enacted in 1996, group health plans that offer mental health benefits must set the same annual and lifetime caps on mental health coverage as for other medical/surgical services. Mental health advocacy groups say the 1996 law has loopholes that need to be closed by barring group health plans from requiring higher copayments, deductibles, and coinsurance payments for mental health services, compared to other health benefits. These groups have criticized Congress for merely passing extensions of the current law, rather than addressing the cost-sharing issues. The extension of current law, H.R. 4848, also includes a provision requiring the Centers for Medicare & Medicaid Services to use the Federal Payment Levy Program to collect back taxes owed by physicians and hospitals participating in Medicare. The program allows the Internal Revenue Service to collect taxes through a levy on certain federal payments.
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