Lawmaker wants better coverage for mental health, drug addiction treatments

Posted at 5:46 PM, Feb 21, 2019
and last updated 2019-02-21 18:54:21-05

NASHVILLE, Tenn. (WTVF) — A state lawmaker proposed a resolution urging insurance companies to provide better coverage for people looking to treat their mental health issues or substance abuse disorders.

Senator Richard Briggs(R-Knoxville), said in the resolution that despite the rampant opioid crisis, there is an "undeniable difference in coverage for mental health and substance abuse services for Tennesseans suffering from substance use disorder or opioid use disorder versus the way all other traditional diseases are covered and insured."

While the resolution is only a proclamation, he hopes that it would encourage insurance companies to take action. Experts view drug addiction to coincide with mental health issues.

"Mental illness is an illness just like any other medical illness, and should be treated and reimbursed to physicians in the same manner," Briggs told NewsChannel 5. "Some insurance companies have recognized mental illness as a serious medical issue and do reimburse it properly and cover mental illnesses properly, some don't offer to businesses in particular, they don't offer the mental health coverage."

There are federal mental health parity laws that require companies to provide equal treatment. However, Briggs said artificial barriers to treatment are often put in place, which include prior authorization requirements or denial of preventative or follow-up care by health insurers when those services are offered by a primary care physician or no referral is given.

His resolution comes as fewer resources are available to treat addiction in recent years.

"We don't have enough of those, particularly if they're not reimbursed in an appropriate manner that they can't afford to take too many patients, that they're not going to get paid for," Briggs added.

Recovering heroin addicts like Karen Green said it is important to think of easier access for patients. She is recovering through a medically-assisted treatment at Samaritan Recovery Community in east Nashville.

"I was wanting to get better. I've been homeless, I've ate out of dumpsters," Green said. "I haven't had my kids in 11 years, I just felt incomplete, I felt like I didn't mean anything."

Her counselor Sherri McKenzie said insurance companies should get on board as far as covering medically-assisted treatments despite the stigma.

"This is an illness, no one would volunteer to put themselves through what addiction puts a person through. These people are sick people trying to get better, not bad people trying to get good," McKenzie said.

The Tennessee Department of Commerce & Insurance reviews mental health benefits to ensure benefits are on par with those for medical conditions.

A spokesperson said outside of filed and approved policy, the departments responds to complaints as they are received.

A new law that just took effect requires companies to submit compliance attestations to TDCI.

Briggs said his resolution is a reminder that legislatures are keeping a close eye on insurance providers and what's being offered to people seeking treatment.

"We would really like to see some action on their part for the insurance companies that aren't providing equal coverage for mental illness," Briggs said.