This blog is written by Mr. Steven C. Schurr, Esq. and focuses on health care law matters that pertain to food and drug law, regulatory compliance, privacy rights, insurance coverage, state and federal disability coverage, patient advocacy issues, and mental health coverage and treatment.

Thursday, October 25, 2012

Contents of Obamacare - Part 4- Mental Health

Mental Health Parity. The Mental Health Parity Act (see my December 4, 1209 blog) applies to health care plans that are qualified under this law. This requires health plans that are governed by to offer equivalent levels of coverage for mental health and physical ailments. As stated in my October 23, 2012 blog (Contents of Obamacare - Part 2), one of the 10 essential benefits required of plans is described as "“mental health and substance use disorder services, including behavorial health treatment”. Not only do plans have to cover these services, the have to do so in a manner that is actuarially equivalent to coverage for physical ailments. Definitions: The law goes on to define various terms, such as group markets, individual markets, large employers and small employers. A large employer is one with 100 or more employees. A small employer is one with at least one employee and less than 100. The state can chose to define a small employer as 50 or less employees. Federal Grants to States for Health Benefit Exchanges. The law goes further to create Federal grants to the States to establish Health Benefit Changes in 2013. The Health Benefit Changes are to become self-funded in 2015 via user fees. Rewarding Quality Through Market-Based Incentives: The law’s strategy is to improve health care through quality reporting, effective case management, care coordination, chronic disease management, medication and care compliance initiatives, including the medical home model. It also includes the prevention of re-admission to the hospital for a prior condition through patient education and planning, discharge counseling and post-discharge enforcement. The law is designed to promote activities to improve patient safety and reduce medical errors through the appropriate us of “best clinical practice”, evidence based medicine, and health information technology. Finally, the law promotes the implementation of wellness and health promotion activities. Requirements for Hospitals. Hospitals are required to operate a patient safety evaluation system. Hospital discharge must include education and planning, a comprehensive discharge plan, and post-discharge enforcement of the plan. NEXT: DO THE PROVISIONS OF OBAMACARE APPLY TO THE MEMBERS OF THE HOUSE AND THE SENATE, and CAN ILLEGAL ALIENS BENEFIT FROM THE LAW?????

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