Insurance providers could be scratching their heads in bewilderment about how to comply with a new federal law that puts mental health benefits on equal terms with other medical benefits.

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act takes effect Jan.1 for most insurance plans, but the federal government has yet to issue the regulations to implement the law. Seventy-three members of Congress, including Democratic U.S. Rep. Steve Cohen of Memphis, recently sent a letter to three top cabinet secretaries with concerns about the delay.

The regulations were supposed to be issued by Oct. 3, according to the letter, which was sent to U.S. Secretary of Health and Human Services Kathleen Sebelius, Secretary of the Treasury Timothy Geithner and Secretary of Labor Hilda Solis.

The members of Congress who signed the letter are pushing for stringent interepretation.

“To avoid misrepresentation of the law and to ensure access to critical mental health and substance use disorder services, we hope you will issue timely and specific regulation in accordance with congressional intent,” the letter states.

Disease in disguise

The legislation, which mental health advocacy organizations had sought for years, was bundled with the Emergency Economic Stabilization Act of 2008 – the bailout of the U.S. financial system.

The Mental Health Parity and Addiction Equity Act requires insurance plans to pay for visits to psychiatrists at the same scale as they pay for visits to cardiologists – when mental health benefits are offered. The plans also have to provide parity for visits to psychologists and mental health counselors as well as addiction treatment. The law exempts businesses with 50 or fewer employees.

In the letter, the members of Congress said they had concerns about the interpretations of these guidelines as they relate to scope of services and treatment limitations. They also urged against separate deductible caps for medical/surgical benefits and mental benefits.

Pete Conerly, the executive director of Synergy Treatment Centers in Memphis, said the passage of the federal law is a significant step in public awareness about mental health and addiction issues.

“I think that historically when someone has had a mental health problem and a drug abuse problem, we have seen that as very different than if somebody had a medical problem,” Conerly said. “I think it is looked at very differently by insurance companies and what have you. I think that it’s been well documented drug dependence as well as mental illness is a disease process.

“(Those patients) deserve as the same parity, if you will, as with other chronic illnesses, such as diabetes and hypertension, etc. There’s a wide body of knowledge and research that’s done that effective drug treatment and effective mental health services can be just as successful in terms of treating individuals with these disorders.”

Most people who suffer from mental illness and addiction problems are full-time workers, he said.

“Oft time, when we look at drug addition, what we see is the man out in the street and he’s smoking crack cocaine,” Conerly said. “That’s only sort of a subgroup of alcoholics and drug addicts. A vast majority of people are working people.”

In the cross-hairs

No exact timetable has been set for when the regulations will be issued. Secretary of Health and Human Services Sebelius did send a response letter to U.S. Sen. Al Franken, D-Minn. She said her department was working closely with the other two federal agencies with jurisdiction over the legislation.

“As your letter noted, the departments received more than 400 written comments in response to a joint notice published this spring to request information from the public on key issues associated with the legislation,” Sebelius wrote.

“HHS has been carefully evaluating the comments, along with the Department of Labor and the Department of Treasury, as we concurrently develop the regulations needed to implement the statutory requirements. We are committed to ensuring access to these critical services and it is our goal to issue regulations by January 2010.”