Fair Insurance Coverage: It’s The Law
Federal law is clear that insurers can no longer discriminate against patients with mental illness, including substance use disorders. But how many people know what constitutes a violation under the Mental Health Parity and Addiction Equity Act (MHPAEA)? Patients who know their rights are better equipped to protect their rights.
That's why APA created the "Fair Insurance Coverage: It's the Law" poster (.pdf) to help enforce the parity law and end discrimination (available in both English and Spanish).
The poster clearly and simply explains the law and the steps to take when a violation is suspected. Print it out and post it (in physicians' offices, clinics, break rooms at workplaces) and share the link.
How to File a Complaint
If you believe any of these rights on the poster have been violated, here is how to file a complaint:
- Identify your type of insurance coverage from the chart below
- Complete your complaint letter using the templates
- Submit to the responsible agency
| Step 1: Identify your type of insurance coverage from the list below | Step 2: Complete your complaint letter using the templates | Step 3: Submit to the responsible agency |
|---|---|---|
| Insurance plans (plans purchased by employers, or by individuals) | Template complaint letter to state insurance commissioner | State insurance commissioner. Find your commissioner. |
| Employer pays for coverage (Self-funded plan) | Template complaint letter to Department of Labor | U.S. Department of Labor |
| Insurance through state/local government employers | Template complaint letter to Department of Health and Human Services | U.S. Department of Health and Human Services |
APA Members: How to Report a Problem
To report problems with parity or for other practice management issues, APA members may call the Practice Management HelpLine at 800-343-4671 or send an email to [email protected]. Please include the following information:
- a brief statement of problem
- your name and contact information (email/phone)
- health plan's name
- type of health plan (group health plan, self-funded health plan, etc.)
- state where insurance is issued
- whether the employer employs 50 or more employees
- if health insurance is provide by an employer
For CPT coding changes and insurance parity issues around the new codes: If you still have “how to” questions or if you are having issues with reimbursement, let us know.
For questions about regulatory guidance, contact the Department of Government Relations at [email protected].
Non Members: How to Report Problems to the Parity Implementation Coalition
Send an email to [email protected] or call 866-882-6227. Information provided will remain confidential. Please include the following information:
- a brief statement of problem
- your name and contact information (email/phone)
- health plan's name
- type of health plan (e.g., group health plan, self-funded health plan, etc.)
- state where insurance is issued
- whether the employer employs 50 or more employees
- If health insurance is provide by an employer