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New law boosts insurance coverage for mental health, substance abuse treatment

Chicago Tribune - 8/22/2018

Aug. 22--Gov. Bruce Rauner signed a bill Wednesday that strengthens insurance coverage for mental health conditions and addiction treatment -- a measure that advocates say is one of the strongest of its kind in the nation.

Federal and state laws already prohibit insurers from covering mental health and substance use disorders at lower levels than physical medical conditions, but advocacy and other groups have expressed concerns that insurance coverage for treatment was stillgetting short shrift. They considered the issue especially pertinent given the current epidemic of opioid addiction.

The new law will bar private insurers from requiring prior authorization for medications to treat addiction and prohibit them from requiring patients to try less pricey medications for addiction before stepping up to more expensive ones. Those requirements already apply to Medicaid managed care organizations.

The law also will require insurers to put medications approved for addiction treatment on low tiers of prescription formularies, limiting patients' out-of-pocket costs. Insurers also will have to submit analyses of their compliance with parity laws to state regulators, among other things.

The Illinois Association of Medicaid Health Plans did not take a position on the bill, but Executive Director Samantha Olds Frey has said the group has worked closely with advocates to ensure equitable coverage levels.

Former Rep. Patrick Kennedy called the new law "a tremendous victory in the ongoing fight for mental health equity" in a statement. Kennedy founded the national Kennedy Forum, an advocacy group that seeks to end mental health and addiction stigma and discrimination, after his own experience with drug and alcohol addiction. The Kennedy Forum Illinois was a driving force behind the new law.


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