U.S. Senators Chris Murphy (D-Conn.), a member of the U.S. Senate Health, Education, Labor, and Pensions Committee, and Richard Blumenthal (D-Conn.) joined 12 of their Senate colleagues in reintroducing the Behavioral Health Coverage Transparency Act, legislation that would strengthen oversight and enforcement of federal parity laws.
"Insurance companies often set up bureaucratic hurdles that make it near impossible for patients to access mental health care. That's against the law and why I've long been pushing for stronger enforcement of our federal parity laws. This legislation would take important steps to make sure insurers using red tape to deny coverage are held accountable and that patients are well-informed on their right to mental health care. I'm continuing to push for further improvements to make parity a reality," said Murphy.
"While mental health parity has been the law for many years, Connecticut families have been continually denied benefits for critical health diagnostic and treatment services. This vital legislation will help break down one of the biggest barriers to accessing mental and behavioral health care -- insurer refusal to cover the cost of such care -- through much needed transparency and accountability," Blumenthal said.
This Congress, the legislation has been updated to account for improvements passed in the Consolidated Appropriations Act of 2021 (CAA), which were spearheaded by Murphy. The CAA granted the Departments of Health and Human Services (HHS), Labor (DOL), and Treasury increased oversight authority to help provide new insights into insurance companies' compliance with federal parity laws.
In February of this year, the Departments issued their first report following the implementation of these new provisions and documented significant gaps in compliance, confirming that more needs to be done to strengthen enforcement and protect consumers.
The updated legislation, which builds on the provisions passed in the CAA, would:
Increase transparency by requiring insurance plans and third-party administrators to submit annual reports with information on any non-quantitative treatment limitations and to disclose additional data on denial rates, reimbursement rates, and network adequacy;
Encourage compliance by ensuring that HHS, DOL, and Treasury conduct a review of no fewer than 100 plans per year, including 40 randomized audits;
Establish a toll-free telephone number and an online Consumer Parity Portal to offer patients and providers a centralized website hosting information on patients' rights, findings from oversight efforts, and resources to ensure that health care consumers receive the protections they are guaranteed by law; and
Support consumers by encouraging collaboration across federal agencies and with states, including by awarding grants to establish, expand, or provide support for offices of health insurance consumer assistance and health insurance ombudsman programs.