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Jul-18-2006 00:02printcomments

Governor Kulongoski Calls For New Mental Health Parity Rules

Mental health coverage to become more affordable, accessible under plan.

Photo by: Tim King

(SALEM) - Governor Kulongoski directed the Department of Consumer and Business Services Monday to adopt new mental health parity administrative rules that require health insurance policies to cover the treatment of chemical dependency, mental or nervous conditions at the same level as other medical conditions.

"This action will make mental health services more affordable, accessible and available – and lead to healthier citizens and families. We’re not only moving Oregon to the forefront of states recognizing the broad social benefits of mental health parity, we’re also looking out for Oregon’s bottom line – greater mental health coverage will prevent more costly responses for the state down the road," the Governor said.

The new rules are a product of Senate Bill 1, the Mental Health Parity Bill, championed by the Governor and Senator Peter Courtney during the 2005 Legislative session.

Prior to passage of SB 1, Oregon law included "caps" that limited what group health insurers were required to cover for mental health conditions and chemical dependency. No such limits existed for coverage of other medical conditions.

DCBS appointed an advisory committee to help draft the administrative rules. The committee, which met eight times this year, consisted of representatives from mental health and consumer advocacy organizations, health care providers, employers and insurers.

"This diverse group represented a wide variety of interests," said DCBS Director Cory Streisinger. "The committee developed rules that balance the Legislature’s intent to cover services with giving insurers the flexibility to manage costs."

Key provisions of the new administrative rules require:

Group health insurance policies to cover a broad range of disorders identified in the comprehensive "Diagnostic and Statistical Manual of Mental Disorders" published by the American Psychiatric Association. Examples include childhood developmental disorders such as autism, eating disorders, dementia and other cognitive disorders, substance-related disorders, schizophrenia and other psychotic disorders.

Group policies to include language stating that medical, mental or nervous conditions and chemical dependency will be treated the same as other health conditions.

Health insurers to have claims handling and operational procedures in place to ensure uniform application of coverage.

The Insurance Division to review the rules within two years to determine if they are being effectively implemented by health insurers.


Comments are Closed on this story.

Health man March 29, 2007 10:42 pm (Pacific time)

Diagnosing 'mental disorders' is NOT an exact science. That's what makes it dangerous sometimes. I worked with 'autistic' kids in a hospital setting, and the 'Psychiatrist' had intense psychotropic ordered for 'acting out behaviors.' WBR LeoP

Daniel Haszard August 12, 2006 2:07 pm (Pacific time)

Well said,i applaud your blog, mental health consumers are the least capable of self advocacy,my doctors made me take zyprexa for 4 years which was ineffective for my symptoms.I now have a victims support page against Eli Lilly for it's Zyprexa product causing my diabetes.--Daniel Haszard

Robin Turk July 19, 2006 8:10 am (Pacific time)

Hello I am Member of Confedarated Tribes Umatilla Reservation in Pendleton, Oregon. I have a grandson that has Autism; I am so glad that Governor kulongosksi is going to do some thing to help my grandson and others that have other conditions with little or no help to cover them with health coverage; I know it is frustrating for my Son and Daughter in law when they hear that is not covered. Thank you very much for making a change Governor Kulongoski, Robin Turk

The Truth July 18, 2006 8:45 pm (Pacific time)

At least this is a start. Most physical conditions prior to old age are caused by emotions of one sort or another,ie. heart and digestive problems, headaches, insomnia, obesity. Take care of the human mind and the body will follow. It just took the stupid world a few thousand years to begin to acknowledge this reality.

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