Presentation is loading. Please wait.

Presentation is loading. Please wait.

Bob Gebbia Chief Executive Officer American Foundation for Suicide Prevention.

Similar presentations


Presentation on theme: "Bob Gebbia Chief Executive Officer American Foundation for Suicide Prevention."— Presentation transcript:

1 Bob Gebbia Chief Executive Officer American Foundation for Suicide Prevention

2 Why Mental Health Care is Important to Suicide Prevention What About Mental Health Parity Under the ACA How AFSP is Helping Consumers in the Marketplace

3 Why Mental Health Care is Important to Suicide Prevention 90% of those that die by suicide have a diagnosable and treatable mental health disorder As many as two thirds of people with depression do not seek treatment Only 50% of persons diagnosed with major depression receive any kind of treatment

4 Mental Health Parity

5 AFSP advocated for MH Parity, passed in October 2008 Seeks to eliminate discriminatory access to mental health (MH) and substance use disorder (SUD) benefits Incorporated into ACA, final rules issued November 2013 Plans subject to federal parity law precluded from offering MH and SUD benefits in a more restrictive way than other covered medical and surgical benefits

6 ACA builds on the Mental Health Parity and Addiction Equity Act of 2008 by including mental health, substance use disorder benefits in the Essential Health Benefits By applying federal parity protections to mental health and substance use disorder benefits in the individual and small group markets By expanding parity requirements to millions of Americans whose coverage did not previously comply with these requirements

7 Copays, coinsurance, and out-of-pocket maximums Limits on services utilization, such as number of inpatient days or outpatient visits that are covered Coverage for out-of-network providers Mental Health Parity Applies to:

8 Employer-funded plans with more than 50 insured employeesNon-grandfathered employer-funded plans with 50 or fewer employeesIndividual market plansMedicaid managed-care programs Who Must Provide Equal Coverage?

9 Small employer plans created before March 2010 (these are grandfathered and exempt from the requirements) Church-sponsored plans and self-insured plans sponsored by state and local governments Retiree-only plansTriCareMedicareTraditional Medicaid (fee-for-service, non-managed care) Parity does not apply to:

10 Who is responsible for implementation? States have primary authority for implementation Center for Medicare / Medicaid has authority over compliance

11

12 Individuals who will gain mental health, substance use disorder, benefits under the ACA Individuals with existing mental health and substance use disorder benefits who will benefit from federal parity protections Total individuals who will benefit from federal parity protections Individuals currently in individual plans 3.9 million7.1 million11 million Individuals currently in small group plans 1.2 million23.3 million24.5 million Individuals currently uninsured 27 millionn/a27 million Total32.1 million30.4 million62.5 million

13

14 Visit to view an interactive map to review the status of state action on state health insurance marketplaces, also called exchanges, and view key aspects of state-run marketplaceswww.commonwealthfund.org

15 AFSP is Collaborating with the National Council for Behavioral Health

16 Mental Health Consumer Tools

17

18 Mental Health Parity and the ACA: Mental Health Services in the New Insurance Marketplace This tool: Provides consumers with information about mental health parity and key things to consider when selecting a plan

19

20 Your Mental Health Needs and the New Insurance Marketplace! This tool: Provides consumers with information about how insurance plans work, basic components, coverage levels available to them, and how to select a plan that meets their mental health needs

21

22 Appeals and Exceptions: How to Access Mental Health Services in Qualified Plans This tool: Provides consumers with information about how to request services or meds not covered by using:  Prior Authorization Requests  Exceptions  Appeals

23 By early March: Final design will completed The new consumer tools will be on the AFSP and NCBH websites, and linked to other sites


Download ppt "Bob Gebbia Chief Executive Officer American Foundation for Suicide Prevention."

Similar presentations


Ads by Google