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Parity and the use of out-of-network mental health benefits in the FEHB program
Darrel A Regier1, Lynn F Bufka, Tracy Whitaker
1American Psychiatric Institute for Research and Education, Arlington, Virginia, USA. dregier@psych.org
Abstract:
Two current congressional bills mandate parity for benefits for mental disorders with benefits for medical/surgical conditions in private insurance when mental health benefits are provided; the bills differ in regard to benefit levels and access to out-of-network coverage. This study assessed clinicians' and beneficiaries' participation in managed care networks in the national capital area under the Federal Employees Health Benefits (FEHB) parity program. Approximately one-third of the clinicians studied participated in FEHB networks, and only 44 percent of FEHB patients received care from network clinicians. Out-of-network mental health benefits are an important policy consideration to ensure access to mental health treatment under parity proposals.
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