David Shillcutt, Senior Counsel in the Health Care & Life Sciences practice, in the firm’s Washington, DC, office, was quoted in Law360, in “Calls for Detail Emerge as Theme in Parity Rule Comments,” by Kellie Mejdrich. (Read the full version – subscription required.)
Following is an excerpt:
Recently proposed federal regulations aimed at expanding employer health plans' coverage of mental health treatments drew about 9,500 comments before Tuesday's deadline for public input, with many stakeholders arguing that any final rules need to include more specific examples.
Here, Law360 looks at four takeaways identified by attorneys among the flood of criticism. …
Network Adequacy a Potential Problem
Another key takeaway from attorneys was the variety of responses to the agencies' request for comments on proposed regulations related to network adequacy, including a safe harbor enforcement mechanism related to network composition, which the agencies explained in more detailed guidance also released in July.
Putting together standards on network composition is something that patient advocates have been calling for as the industry struggles with a shortage of behavioral health providers. But while patient and provider advocates urged the agencies to adopt regulations on network adequacy, many industry groups broadly opposed them.
For example, the Mental Health Liaison Group, a coalition of behavioral health provider and patient advocacy organizations, praised the development of a safe harbor on network composition as a "strong requirement" that should be maintained in the final rule. The safe harbor would allow plans to determine they're in compliance with the law's network composition requirements in exchange for meeting certain standards. Groups that are part of the MHLG include the Kennedy Forum, the American Psychiatric Association, the American Society of Addiction Medicine and National Alliance on Mental Illness.
"MHLG believes that inadequate networks are one of the most significant barriers to individuals accessing needed MH/SUD care," the groups said. …
Attorneys representing plans and issuers also kept an eye out for the network adequacy debate, including David Shillcutt, a behavioral health care attorney and senior counsel at Epstein Becker Green. Shillcutt said he took note of "very strong comments from advocates and providers that current network adequacy requirements are insufficient."
But Shillcutt was skeptical that more regulation under the federal mental health parity laws would be the right vehicle to address the problem.
"There's a lot of lessons learned and opportunities to have smarter and more nuanced approaches to determining network adequacy," Shillcutt said. "But I think it's really misguided to use MHPAEA as the Trojan horse to try to accomplish that policy goal."
