We have a once-in-a-decade opportunity to influence the laws insurance companies are required to follow.
The Mental Health Parity and Addiction Equity Act – MHPAEA – is a US nationwide law passed over 10 years ago to stop insurance from refusing to pay for people to get care for Mental Health and Substance Abuse – MH/SA – conditions, including eating disorders.
It didn’t work. Insurance found all the loopholes and continues to deny, deny, deny.
The government is trying to close the loopholes by clarifying what the law meant. They’ve written over 100 pages of clarifications, but there are still loopholes insurance can wriggle through to deny eating disorder nutrition counseling. WE CAN CLOSE THESE LOOPHOLES IF WE ACT BEFORE OCTOBER 2nd.
Note that this is totally different than when you email your legislators and you get a form email back because they really don’t care. It’s different from talking to legislators’ aides but then nothing changes. The government is ASKING for our comments to make the law better. The changes are GUARANTEED to go into effect since the law has already passed.
They offer 60 days for people to send in comments online. We are in that 60-day period right now.
If you or someone you know with an eating disorder has had trouble getting insurance to pay, it’s time to share your experience with the regulators who enforce insurance through this online form: https://www.regulations.gov/commenton/EBSA-2023-0010-0001.
First type your own experiences and then add anything you think should be different. It can be as simple as explaining the problems you’ve had getting insurance to pay for your treatment, or the problems you’ve observed among your patients, family member or friend with an eating disorder.
**It is ESPECIALLY helpful to mention any inconsistencies or contradictions you’ve experienced, frustrations and things that make no sense. For example:
Insurance pays your therapist but not your dietitian, or covers the emergency room but not your dietitian
On the phone they said nutrition counseling is covered, but later it’s denied
Sometimes your sessions are covered and sometimes they’re not, even though you didn’t do anything differently
They tell you something that proves they don’t know anything about eating disorders like “your policy only covers 3 sessions” or “wellness coaching is not a covered benefit”
Here is a sample comment so you can see how simple it can be:
Thank you for the opportunity to comment on the Requirements Related to the Mental Health Parity and Addiction Equity Act.
I have experienced significant problems getting treatment for my eating disorder, especially my nutrition counseling sessions with my eating disorder dietitian. Being told on the phone that nutrition counseling is covered and then getting the denials in the mail is incredibly disappointing and frustrating. I don’t understand why they say one thing and do something else, and I’m hoping you will be able to change it. I happen to have a job where I can make phone calls during the day, wait on hold for an insurance customer service person, and try to get things straightened out, but I know a lot of people don’t. Another thing I was frustrated by is that now that I’ve met my deductible, I can see my dermatologist as many times as I want all year for free. But my acne isn’t going to kill me. Why allow unlimited dermatologist visits and deny my dietitian who is trying to save my life?
Thank you for enforcing the law to help people like me.
Here is another example:
Thank you for the opportunity to comment on the Requirements Related to the Mental Health Parity and Addiction Equity Act.
As an eating disorder therapist for 12 years, I am shocked at all the roadblocks my patients have when trying to get coverage to see a dietitian. I require anyone I treat for an eating disorder to also have a dietitian on their team because otherwise how are they expected to recover? So why do insurance denials say “wellness coaching isn’t a covered benefit” when the patient is going for eating disorder treatment? If my services are covered, dietitian services should be covered, because they are providing nutrition therapy. Period.
Thank you for clarifying and enforcing the law.
There is value in being emotional and raw if you can do so safely. Write about the financial cost, the emotional cost, the frustration, the feeling victimized, the feeling undeserving of care and not sick enough, the feeling that you have paid into a system that has no intention of helping you. Use words quoted from your insurance denial and from your insurance plan that contradict each other. Total up the hours you’ve spent on the phone or the times you’ve cried over this. If you have had to stop getting treatment because of insurance denials, or if you went to the emergency room because you couldn’t see your dietitian… name any and all problems you feel comfortable sharing. If you’re a professional, write about the severe consequences you see when someone cannot access care. Write about patients who rearrange their lives to go to higher levels of care and then when they go home they can’t get coverage for outpatient services. Write about the burnout, the hours spent on the phone with insurance, getting single case agreements, getting denials overturned. The online form fits only 5000 characters, but you can send a letter as an attachment if you need more space.
Here is a link to detailed comments prepared by someone very knowledgeable about the law that you can cut and paste: https://docs.google.com/document/d/1jqZREYFeugl0rJDqUqGFYRnJPPrbLLR4/edit.
Please do what feels right for you. Every comment counts, no matter how simple or complex.
We recommend typing your thoughts in a document or email first, then copying it into the online form, so there’s no chance you lose it in an internet glitch.
Note: DO NOT include any personal health information or anything you don’t want public, as comments will be posted online. You CAN post your comment anonymously if you want to.
If you are unsure of what you write and want someone to look it over, or if you are willing to share a copy of your submission so that we can follow up with you and possibly help, email us at CARE@IFEDD.org.
{If you want to read the full proposal of revised regulations, you can find it here. https://www.federalregister.gov/documents/2023/08/03/2023-15945/requirements-related-to-the-mental-health-parity-and-addiction-equity-act . You don’t have to read the document in order to comment.}
THANK YOU for using your voice to make a difference.