U.S. Sen. Chris Murphy brought his victory tour to town this week, celebrating the passing of a bill he helped author that could substantially improve mental health care and substance abuse treatment in the country.
On Wednesday, Murphy stopped at St. Vincent’s Behavioral Health Services in Westport to explain aspects of the Mental Health Reform Act, a bill included in the 21st Century Cures Act, signed into law by President Barack Obama on Dec. 13.
Murphy teamed up with U.S. Sen. Bill Cassidy, R-La., to write the bill. The package received overwhelming bipartisan support in the House and Senate. It includes a $1 billion grant to help states combat the opioid crisis and $4.8 billion for research at the National Institutes of Health. A portion of the NIH money will focus on brain research to uncover new treatments.
The new law updates substandard mental health parity laws, and thus requires insurance plans to provide comparable benefits for mental health and substance abuse as for physical health issues.
“Your statement of benefits today will tell you that you have mental health coverage,” Murphy said to the audience, which included health care professionals. “But as you all know, when you try to go access that benefit, it’s often not there, or you have to go through hurdles and hoops that, frankly, you don’t have to go through when you are trying to get reimbursement for a cancer treatment or for an orthopedic procedure.”
“It’s just a lot harder to get treatment for the part of your body above the neck than the part of your body below the neck,” he said.
The newly passed bill enhances the ability to enforce parity laws by mandating federal agencies to report such violations and provides them with methods by which to crack down on that wrongdoing. If a health plan is found to violate those laws, the government is required to conduct an audit.
An example Murphy gave was if a health plan is found to be rejecting prior authorizations on mental health treatment at a noticeably higher rate than prior authorizations on physical treatment, it is in violation of the law and subject to an investigation.
“There’s a new audit tool that’s automatically triggered after a certain number of consumer complaints. There’s new guidance that’s required to be put out to insurance companies to give them specific examples and guidance on when they are in violation of parity laws and when they are not,” Murphy said.
The senator is confident the guidelines for insurers will open hundreds of millions of dollars in new mental health care authorized by insurance companies. He believes it will make the reimbursement process for patients easier. Murphy said whether the changes will be implemented is dependent on how the Donald Trump administration chooses to proceed.
The bill creates a new position, assistant secretary for mental health and substance use in the U.S. Department of Health and Human Services. The office is responsible for better coordinating mental health services across the federal government, a position that oversees billions of dollars spent on mental health and addiction.
Murphy said the bill did not accomplish everything he wanted, nor does he feel the legislation will cure more than 5 or 10 percent of issues in the system, but it does serve as the foundation for future bipartisan success.
The bill passed 94 to 5 in the Senate and 392 to 26 in the House. But according to the New York Times, it drew criticism for failing to address the high cost of prescription drugs. U.S. Sen. Elizabeth Warren, D-Mass., was one of the five senators who opposed the 21st Century Cures Act because of its concessions to the pharmaceutical industry, the newspaper said.
“This bill didn’t solve every problem,” Murphy said. “Clearly, the pharmaceutical companies have a lot to answer for when it comes to the opioid and heroin epidemic, but this is a really important bill with very significant money to combat the opioid epidemic. No bill is going to get 100 votes. This one got 95, and we still have work to do to hold the drug companies accountable for their decades of pushing pills on the American public.”