WASHINGTON — Today, U.S. Senators Mark Warner and Tim Kaine joined U.S. Senators Kelly Ayotte (R-NH), Chris Murphy (D-CT) and a bipartisan group of 20 other Senators in calling on the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Labor (DOL) to take immediate, overdue action to fully implement and enforce the Mental Health Parity and Addiction Equity Act (MHPAEA). In a letter addressed to HHS Secretary Sylvia Mathews Burwell and DOL Secretary Thomas E. Perez, the Senators emphasized that implementation of MHPAEA – a law enacted more than seven years ago to ensure that health insurance plans cover behavioral and physical health equally – has been incomplete and inconsistent. The Senators warned that parity is still not a reality for individuals living with mental illness and addiction, and that health plans routinely refuse to disclose medical management information making it impossible for consumers and providers to determine if the plans are treating behavioral and physical health equally. Noting that HHS and DOL are chiefly responsible for implementation and enforcement of the law, Warner, Kaine and the 22 other Senators requested that the agencies conduct thorough audits and issue additional parity guidance so that individuals seeking recovery and treatment for mental health disorders and substance abuse can access the benefits promised to them under MHPAEA.

U.S. Senators John Barrasso (R-WY), Richard Blumenthal (D-CT), Sherrod Brown (D-OH), Chris Coons (D-DE), Joe Donnelly (D-IN), Dianne Feinstein (D-CA), Al Franken (D-MN), Kirsten Gillibrand (D-NY), Chuck Grassley (R-IA), Heidi Heitkamp (D-ND), Angus King (I-ME), Amy Klobuchar (D-MN), Ed Markey (D-MA), Bob Menendez (D-NJ), Jeff Merkley (D-OR), Barbara Mikulski (D-MD), Rob Portman (R-OH), Jack Reed (D-RI), Bernie Sanders (I-VT) and Sheldon Whitehouse (D-RI) also signed onto the letter.

The Senators wrote, “We are writing to urge you to take immediate action to implement and enforce the MHPAEA. It has now been over 7 years since MHPAEA was passed and signed into law by President Bush, but our constituents continue to report denials of care and great difficulties in accessing substance use and mental health disorder treatment and services. We look forward to working together to ensure individuals in and seeking recovery from substance use and mental health disorders can access the benefits promised to them under the law.”

The full text of the letter is below:

The Honorable Sylvia Mathews Burwell

Secretary

United States Department of Health & Human Services

200 Independence Avenue, SW

Washington, D.C. 20201

The Honorable Thomas E. Perez

Secretary

United States Department of Labor

200 Constitution Avenue, NW

Washington, D.C. 20210

Dear Secretary Burwell and Secretary Perez,

We are writing to urge you to take immediate and overdue action to implement and enforce the Mental Health Parity and Addiction Equity Act (MHPAEA).

It has now been over 7 years since MHPAEA was passed and signed into law by

President Bush. This important legislation was enacted to ensure that health insurance plans cover behavioral and physical health equally. However, parity is still not a reality for individuals living with mental illness and addiction today. Our constituents from across the country continue to report denials of care and great difficulties in accessing substance use and mental health disorder treatment and services.

One of the primary complaints we receive is the failure of health plans to disclose how they make coverage decisions. As you know, consumers and providers have the right to request information on medical management practices and criteria from their health insurance plans for both behavioral and medical and surgical care. Without this information, it is impossible to determine if the plan is in compliance with the law or if a parity violation has occurred. Yet, consumers and providers report that plans routinely refuse to give this information or simply refer consumers to a website or provide a general statement that lacks specificity with respect to how criteria are applied to both medical and surgical and behavioral health.

As your agencies are chiefly responsible for the implementation and enforcement of

MHPAEA, we request that you report to us on the following:

1)      How many audits has your Department conducted to determine compliance with MHPAEA? What were the results of those audits? Will de-identified results of the audits be made available on your website? If audits have not been conducted, will your Agencies be conducting them in the future?

2)      Does your Department plan to issue additional parity guidance to health plans and issuers on what documents and analyses they must conduct and disclose in order to demonstrate compliance with MHPAEA? If so, by what date?

3)      When will Medicaid parity final regulations be released? When will enforcement for parity under Medicaid and the Children’s Health Insurance Program begin?

We look forward to working together to ensure individuals in and seeking recovery from substance use and mental health disorders can access the benefits promised to them under the law. Please have your staff contact our staff with any questions. Thank you very much for your attention to this matter.

Sincerely,