A Guide to the Federal Parity Law for Substance Abuse and Mental Disorders

The Legal Action Center has published Health Insurance for Addiction and Mental Health Care: A Guide to the Federal Parity Law. The Guide explains patients’ and providers’ rights to insurance coverage for substance use and mental disorders. Although written for a New York audience, much of the Guide can be used anywhere in the country.

Think you know all there is to know about the ACA?

President Barack Obama became the first sitting President of the United States to publish a scholarly article this week, when he wrote in JAMA - The Journal of the American Medical Academy, an article entitled "United States Health Care Reform - Progress to Date and Next Steps" . In it, he summarizes the importance, objectives, findings and relevance of the Affordable Care Act since its passage. He concludes that "although partisanship and special interest opposition remain, experience with the Affordable Care Act demonstrates that positive change is achievable on some of the nation’s most complex challenges."

As you might imagine, the pundits had a field day with this, and you can read a collection of the praise and potshots taken at his effort on Politico. 

So, if you think you know as much about the ACA as the President - here's a little crossword puzzle for you. We'll post the answers here next week.

Inaccurate Provider Lists a Major Barrier to Care

A recent study in California, published in the journal Health Affairs, closely echoes a study that Consumer Health First published last year, in which secret shoppers were deployed to examine access to primary care providers using insurance provider network directories.

In the California study, “secret shoppers” posing as patients were able to schedule an appointment with a primary care physician less than 30% of the time out of the 743 providers contacted.

Our results were similar, and for the same reason. Our report found that of 1,493 OBGYN providers listed in MD, only 22.5% were able to provide a well woman exam within four weeks. 

The answer in both cases lies mainly in the inaccuracy of the data that is in the online directory consumers use. As the California study reports, this results in consumers having “access to health insurance is not necessarily synonymous with access to health care services.”

In Maryland, Consumer Health First worked during the most recent General Assembly to get legislation passed to address this issue. That legislation has resulted in the creation of a Task Force at the Maryland Insurance Administration to put regulations regarding Network Adequacy into effect.

HSCRC Creating Behavioral Performance Measurement Subgroup

HSCRC is putting together a Behavioral Health Performance Measurement Subgroup to advise the Commission.  Specifically, the purpose of the Behavioral Health Performance Measurement Subgroup (BHPMS) is to provide advice to HSCRC on the measures of performance that should be used for persons with mental health or substance use disorders in Maryland’s population-based rate setting system, as well as supporting the development of linkages to improve care delivery. 

Here is the most recent document containing more details about the scope and charge for this subgroup.

The HSCRC wants to identify a broad stakeholder group for participation; in addition, please indicate if you are able and willing to participate or if you recommend others the HSCRC should consider inviting to participate. 

Please respond to hscrc.quality@maryland.gov and advise HSCRC staff on your interest in participating or nominate others to participate on the group by July 8, 2016.

SCOTUS Strikes Down Major Abortion Restriction Ruling

The Supreme Court struck down abortion restrictions that have been widely duplicated in other states, a resounding win for abortion rights advocates in the court’s most important consideration of the controversial issue in 25 years.

In the 5 to 3 decision, the justice's ruled that the clinic restrictions meant to protect women’s health were simply a cover for making if more difficult to obtain an abortion.

The Texas provisions required doctors who perform abortions at clinics to have admitting privileges at a nearby hospital and said that clinics must meet hospital-like standards of surgical centers.

Nominations for Consumer Standing Advisory Committee

HSCRC is issuing a call for nominations to a Consumer Standing Advisory Committee (CSAC) they are newly establishing based on the recommendation of the HSCRC Consumer Engagement Task Force (CETF) which completed its work and issued its report in September 2015.

We applaud HSCRC for putting in place one of the recommendations from the Consumer Engagement Task Force, chaired by Consumer First President, Leni Preston.  A link to the CETF full report issued in September 2015 may be found on the HSCRC Consumer Engagement web page.

Any interested party can nominate themselves or others for the CSAC membership.  Nominee information in the nomination form included in this call for nominations must be sent via email to HSCRC.Quality@maryland.gov, and include “CSAC Nomination” in the Subject line.  This call for nominations is open until July 15, 2016. 

Questions regarding this call for nominations may be sent to HSCRC.Quality@maryland.gov , and include "CSAC Nomination Question" in the Subject line.