The Mental Health Parity and Addiction Equity Act (MHPAEA) requires many insurance plans to cover mental health or substance use disorders.
Historically, millions of Americans with disorders related to mental health and alcohol, drug and substance abuse, have not had adequate insurance protection to afford the costs of treatment. The Mental Health Parity and Addiction Equity Act (MHPAEA) now makes it easier for those Americans to get the care they need by prohibiting certain discriminatory practices that limit insurance coverage for behavioral health treatment and services. The MHPAEA requires many insurance plans that cover mental health or substance use disorders to offer coverage for those services that is no more restrictive than the coverage for medical/surgical conditions.*
According to Stephen Rose, attorney with Garvey Schubert Barer, “For mental health professionals and health care facilities, the increasing number of clients seeking treatment is a serious matter with far reaching consequences. There are complex issues impacting families, especially parents; governmental agencies and regulatory groups; educational institutions and educators; and medical facilities, mental health professionals and mental illness advocacy organizations. There are also significant legislative ramifications on a state and national level that impact governance of mental health issues.”
Roger Hillman, attorney with Garvey Schubert Barer, said, “There are concerns as to whether the present mental health care system, both public and private organizations, can handle the anticipated increase of patients who can now receive treatment. This could have an adverse impact on the frequency and length of treatment, which may be perceived as impacting its effectiveness.”
There is no assurance that the treatment of individuals for mental health issues will eliminate the possibility of violent crime. Both public and private organizations have been exposed to liability when a mentally ill person—connected to the organization as a patient—committed a violent crime that resulted in a lawsuit.
Most notably in Washington state, there was recent litigation involving a school district and a number of mental health providers who were named as parties to a lawsuit after a violent stabbing was committed by a mentally ill high school student who was actually undergoing treatment around the time she committed the crime. The plaintiffs’ counsel attempted, unsuccessfully, to point to the frequency of treatment and duration of each session, as establishing liability on the part of the mental health providers.
Predicting future violence among criminal offenders is difficult, but predicting violence among the general population who are not criminals and who are simply receiving treatment for a wide range of mental health issues, is nearly impossible.
According to Richard L. Packard, Ph.D., Clinical and Forensic Psychologist, who has extensive expertise doing psychological and forensic evaluations/consulting and many years of experience working with various legal issues and rendering expert opinions in both criminal and civil contexts, “The prediction of violent behavior is not consistent; there is often an inability to predict violence, especially among clients who have no previous history of it. We have no well established, scientific methods to understand whether a mental health client coming in off the street would be violent. There is a huge gray area with people who have never been violent and how to predict whether they will be violent in the future.”
How do public and private institutions protect themselves from liability? More importantly, can caregivers, mental health professionals, health care facilities and many organizations protect themselves from liability and still provide help for those who are in need of mental health treatment?
Richard Packard said, “Among my colleagues, there is awareness of the MHPAEA, but we do not appreciate all of the details of the law yet. There are lawyers around me everyday who specialize in mental health law and we’re having discussions about the MHPAEA. No one really knows what to say yet. It’s important to seek legal counsel and to understand all of the details of the law.”
*MHPAEA information sourced from http://beta.samhsa.gov/health-reform/parity
About Garvey Schubert Barer
Garvey Schubert Barer is a business law firm representing established market leaders and newly launched enterprises, nationally and internationally, with a special focus on health care. The firm’s health care clients include public, tax-exempt and for-profit health care organizations throughout the western United States, including hospitals (including rural and critical access hospitals), long-term care facilities, ambulatory surgery centers, physicians and physician organizations, imaging facilities, local and national clinical laboratory and pathology companies, genomic laboratories, dialysis companies, alternative health care providers, hospital associations, medical device manufacturers, third-party payers and integrated delivery systems. The firm’s health care litigation experiences includes Medicare and Medicaid reimbursement; response to government audits; professional liability defense; the full spectrum of federal, state and local tax controversies and appeals; abuse and neglect; HIPAA; contractual disputes; defense of qui tam and governmental investigative actions; immigration; labor and employment; and certificate of need. Based on its extensive experience and expertise over a wide spectrum of health care law, Garvey Schubert Barer is considered one of the top-tier law firms serving health care clients in the western United States. The firm has offices in Seattle, Portland, Anchorage, Washington, D.C., New York and Beijing. For more information, please see http://www.gsblaw.com.
