Impact on Providers
The potential impact of the MHPAEA on mental health and substance abuse disorder providers is anticipated to be a significant increase in the number of patients seeking such treatment. It has been estimated that the MHPAEA, and the Affordable Care Act, will provide increased coverage for mental health and substance abuse disorders to 31.1 million people. These will most likely include: people who have previously not sought treatment due to a lack of insurance coverage and people who previously had sought limited treatment due to coverage limitations.
Providers should be aware that the MHPAEA has not changed the standard of provider care. Providers will still be held to the same high standard for patient care and management. Providers should avoid accepting more new patients than they can properly care for and manage. A provider should be keenly aware of how increased patient loads may adversely impact frequency and/or length of treatment sessions. Cases that have sought to hold a provider responsible for the adverse consequences of a patient’s actions, particularly suicidal or violent acts, often point to these aspects of treatment as falling below the standard of care.
Another factor to be considered in determining the number of new patients a provider can accept is the amount of time required to seek reimbursement from a patent’s insurance plan. The regulations require increased transparency by insurers who decline or limit coverage for mental health or substance abuse disorders. Insurers may require more exhaustive paperwork from providers to ensure that coverage is being properly applied or denied.
In conclusion, the MHPAEA will allow many new patients to seek mental health and substance abuse disorder treatment because insurers will be covering such care and greater levels in order to provide parity with medical and surgical coverage. Providers should be conscientious in deciding how many new patients can be effectively treated and managed in order to avoid increased exposure to potential liability for the actions of patents.
Disclaimer: This article is designed to provide information enraged to the MHPAEA. It is provided with the understanding that the author is not rendering legal advice or services. If legal advice or other expert assistance is required, the services of a competent professional should be sought.