Insurance Transparency
March 15, 2019 02:15 PM to All House Members
Circulated By
Representative Aaron Kaufer
R House District 120
Memo
Serious alcohol and drug problems afflict 1 in 4 families in all of our legislative districts to devastating effect. The problem destroys families, drives up crime and destabilizes whole neighborhoods. In 2017, 5,456 Pennsylvanians died of overdoses.
In the face of this continuing death and destruction, we must continue our work together to help our struggling families and to ensure that individuals and families are able to access treatment for addiction through their health care coverage.
The legislation I am proposing will simply assure that purchasers of insurance are able to access coverage for addiction treatment already included in the health plan.
In 2008, the Federal Mental Health Parity & Addiction Equity Act was enacted into law. Under its provisions, health policies that include treatment for alcohol and drug addiction and/or treatment for mental illnesses must provide that coverage in parity with other illnesses.
Despite this federal law, families and individuals struggling with alcohol and other drug problems are often unable to access that coverage or even to know if their plan is in compliance with the law in the first place.
To address this problem and to ensure compliance with the Federal Mental Health Parity & Addiction Equity Act, I am proposing three bills.
Let’s make certain that Pennsylvanians can access treatment for addiction and get help for their families.
In the face of this continuing death and destruction, we must continue our work together to help our struggling families and to ensure that individuals and families are able to access treatment for addiction through their health care coverage.
The legislation I am proposing will simply assure that purchasers of insurance are able to access coverage for addiction treatment already included in the health plan.
In 2008, the Federal Mental Health Parity & Addiction Equity Act was enacted into law. Under its provisions, health policies that include treatment for alcohol and drug addiction and/or treatment for mental illnesses must provide that coverage in parity with other illnesses.
Despite this federal law, families and individuals struggling with alcohol and other drug problems are often unable to access that coverage or even to know if their plan is in compliance with the law in the first place.
To address this problem and to ensure compliance with the Federal Mental Health Parity & Addiction Equity Act, I am proposing three bills.
Let’s make certain that Pennsylvanians can access treatment for addiction and get help for their families.
Legislation
Document 1 - Introduced as HB 1438
The first requires insurers to certify that they are in compliance with the Federal Mental Health Parity & Addiction Equity Act through certification by an officer of the plan. Currently, certification to the Insurance Department can be made by “an authorized representative” of the plan and the current certification of compliance applies only to policy forms and documents, not to compliance with the actual delivery of services or handling of claims.
Document 2 - Introduced as HB 1440
The second bill requires health plans to notify subscribers of the addiction treatment coverage available to them in the plan and how to access it.
Document 3 - Introduced as HB 1439
The third bill provides for standardized reporting by insurers on the provision of alcohol and other drug addiction treatment with copies of the report submitted to the General Assembly and made available to the public. The reports would include data such as: numbers treated, numbers in each level of care, average lengths of stay, denials and other adverse benefit determinations.
Last updated on May 7, 2019 01:18 PM
Insurance Transparency
March 15, 2019 02:15 PM to All House Members
Circulated By
KAUFER
Memo
Serious alcohol and drug problems afflict 1 in 4 families in all of our legislative districts to devastating effect. The problem destroys families, drives up crime and destabilizes whole neighborhoods. In 2017, 5,456 Pennsylvanians died of overdoses.
In the face of this continuing death and destruction, we must continue our work together to help our struggling families and to ensure that individuals and families are able to access treatment for addiction through their health care coverage.
The legislation I am proposing will simply assure that purchasers of insurance are able to access coverage for addiction treatment already included in the health plan.
In 2008, the Federal Mental Health Parity & Addiction Equity Act was enacted into law. Under its provisions, health policies that include treatment for alcohol and drug addiction and/or treatment for mental illnesses must provide that coverage in parity with other illnesses.
Despite this federal law, families and individuals struggling with alcohol and other drug problems are often unable to access that coverage or even to know if their plan is in compliance with the law in the first place.
To address this problem and to ensure compliance with the Federal Mental Health Parity & Addiction Equity Act, I am proposing three bills.
Let’s make certain that Pennsylvanians can access treatment for addiction and get help for their families.
In the face of this continuing death and destruction, we must continue our work together to help our struggling families and to ensure that individuals and families are able to access treatment for addiction through their health care coverage.
The legislation I am proposing will simply assure that purchasers of insurance are able to access coverage for addiction treatment already included in the health plan.
In 2008, the Federal Mental Health Parity & Addiction Equity Act was enacted into law. Under its provisions, health policies that include treatment for alcohol and drug addiction and/or treatment for mental illnesses must provide that coverage in parity with other illnesses.
Despite this federal law, families and individuals struggling with alcohol and other drug problems are often unable to access that coverage or even to know if their plan is in compliance with the law in the first place.
To address this problem and to ensure compliance with the Federal Mental Health Parity & Addiction Equity Act, I am proposing three bills.
Let’s make certain that Pennsylvanians can access treatment for addiction and get help for their families.
Document 1
The first requires insurers to certify that they are in compliance with the Federal Mental Health Parity & Addiction Equity Act through certification by an officer of the plan. Currently, certification to the Insurance Department can be made by “an authorized representative” of the plan and the current certification of compliance applies only to policy forms and documents, not to compliance with the actual delivery of services or handling of claims.
Introduced as HB 1438
Document 2
The second bill requires health plans to notify subscribers of the addiction treatment coverage available to them in the plan and how to access it.
Introduced as HB 1440
Document 3
The third bill provides for standardized reporting by insurers on the provision of alcohol and other drug addiction treatment with copies of the report submitted to the General Assembly and made available to the public. The reports would include data such as: numbers treated, numbers in each level of care, average lengths of stay, denials and other adverse benefit determinations.
Introduced as HB 1439
Last Updated
May 7, 2019 01:18 PM
Generated 09/24/2025 02:51 PM