Mental Health Parity Survey

The Department initiated a focused survey project in 2005 to begin the effort to address concerns surrounding the implementation and the effectiveness of how mental health services mandated by Section 1374.72 of the Knox-Keene Act (the "Act") are administered and delivered. This provision, known as "mental health parity," requires health care service plans to provide services for designated serious mental illnesses under the same terms and conditions as other medical conditions. The surveys are the first step in an overall Mental Health Parity project to correct any specific compliance issues and to identify areas where the additional Department activities can assist enrollees, providers, patients, facilities and health plans effectively deliver mental health services.

The surveys gathered a baseline level of information from the largest health plans on how the arrange and deliver behavioral services and assessed compliance with existing requirements of the Act. Planning for the surveys began in November 2004 and included obtaining extensive stakeholder input to gather comments and identify issues as well as developing a survey tool ("Technical Assistance Guide"). Individual survey reports have been issued to evaluate each plan's performance in four broad areas:

Ensuring Access and Availability of Services
Administering Benefits and Managing Utilization of Services
Ensuring Continuity and Coordination of Care Among Providers
Oversight of Specialty Mental Health Plans to Which Responsibilities Are Delegated

The Department continues to receive comments, input and suggestions on the Mental Health Parity Project with other state agencies, from ongoing research and developments in the delivery of managed behavioral services and in on-going discussions with diverse stakeholder groups. While the overall project may lead to additional regulatory or statutory provisions and clarifications, it is believed that there are a number of "best practices" along with areas of common concern that can be brought forward via these reports that will allow all stakeholders to resolve some common issues and problems.