Take Action: Increase Access to Mental Health & Substance Use Treatment
3/19/24
Action Required
Help increase access to mental health and substance use treatment! Take a minute to submit a witness slip supporting HB4475 by 11:30 am on Friday, March 22.
Despite advancements in mental health and substance use parity, discriminatory private insurance practices continue—restricting access to treatment. HB4475, the Strengthening Mental Health & Substance Use Parity Act, discourages discriminatory private insurance practices.
Witness slips are a quick and easy way to help show support for the bill. Here are some tips:
In Section I, fill out your information. In the 'Firm/Business or Agency' and 'Title' boxes, enter "Self"
In Section II Representation, enter “Self” into the box
In Section III Position, mark "Proponent"
In Section IV Testimony, mark "Record of Appearance Only"
The Illinois House Mental Health & Addiction Committee will meet Friday, March 22, at 11:30 am to discuss HB4475.
Background
Despite advancements in mental health and substance use (MH/SU) parity, discriminatory private insurance practices continue—restricting access to treatment.
26% of psychiatrists and 21% of therapists are not in-network due to discriminatory insurer practices. This forces patients to go out-of-network and limits access to affordable care.
Patients pay the price: Untimely care, no care, or costly out-of-network care.
Black children under 13 die by suicide at twice the rate of white children.
Rates of depression in youth doubled following the pandemic.
Adult depression and anxiety soared four-fold since 2019.
2,944 Illinoisans lost their lives to an opioid overdose in 2020.
Insurer practices make behavioral health (BH) care inaccessible.
18% of BH visits are out-of-network for Illinoisans, versus 2.8% for other health care, according to a Milliman report, due to insurer practices rather than workforce challenges.
In Illinois, Milliman found that BH care is reimbursed nearly 20% less than other healthcare when benchmarking rates to Medicare: BH care is reimbursed at 97% of Medicare; other medical care is reimbursed at 116% of Medicare.
Healthcare spending would decrease if spending on BH increased because healthcare is 2x–3x higher for people with high BH needs.
Support HB4475/SB2896: Strengthening Mental Health & Substance Use Parity Act
Payment Parity to Incentivize Providers to Join Insurance Networks & Grow Access. Sets a minimum reimbursement from private insurers for in-network & out-of-network MH/SU care based on the Milliman analysis: 141% of the Medicare rate for in-network (Milliman inflation-adjusted); 116% of Medicare for out-of-network; a separate rate benchmark applies to services not covered by Medicare.
Third Party Administrators (TPAs) will be subject to parity & required to treat a patient visit to an in-network provider with the insurer as in-network with the TPA.
Coverage & payment is required for same day MH/SU services; 60-minute therapy.
Permits MH/SU services provided under the supervision of a licensed BH provider, consistent with insurance industry practice.
Timely, transparent process for vetting MH/SU provider credentials to be in-network. Requires a 30-day credentialing process with clear notification requirements by the insurer. If the insurer fails to give notice, the provider becomes an in-network provider at the end of 30 days.
League Position
Insurance companies should be required to offer coverage for mental illness on the same basis as physical illness.