Groups representing insurers are urging CMS not to implement a proposed rule that would toughen mental health parity laws.
In comments submitted to CMS Oct. 17, AHIP, the trade association representing the health insurance industry, said the new rules will "not achieve the goals of increasing access to mental health care or substance use disorder treatment."
The proposed rule, introduced in July, would require plans to study the outcomes of their mental health coverage policies, including network size, out-of-network payment policies and prior authorizations.
"AHIP recognizes there is a necessary role for demonstrating parity, but cautions against an inefficient, vague, and excessive approach that prioritizes analyses of health care coverage over access to health care itself," interim AHIP CEO Julie Simon Miller wrote.
The new rules would clarify that plans cannot have more restrictive prior authorization standards or narrow networks for mental health than they do for physical health.
In an Oct. 17 news release, the Blue Cross Blue Shield Association said the proposed rules could lead to an increase in care that is not clinically recommended.
"This rule could push us in the wrong direction by forcing health plans to remove important protections that ensure patients are receiving safe, medically necessary, effective care. We'll continue to work with our partners, the administration and Congress to improve both access and quality for Americans," David Merritt, senior vice president of policy and advocacy of the BCBSA, said.
The BCBSA said provider shortages is one of the biggest barriers to mental health access and recommended policies expanding access to telemental health and training more mental health workers.
In comments submitted to CMS Oct. 13, the American Hospital Association said the rule will help improve enforcement of mental health parity and improve payers networks.
"The provisions proposed in this rule are likely to help address some of the underlying causes of behavioral health professional shortages, but we also urge the Administration to work with Congress to invest in the behavioral health workforce in tandem with provisions related to network adequacy in this rule," Stacey Hughes, executive vice president of government relations and public policy at the AHA, said.