Issue link: https://blog.providence.org/i/1035653
Evaluating State Mental Health and Addiction Parity Statutes: A Technical Report 21 Appendix B: Statutory Coding Instrument C oders scored state statutes and regulations using a point-based system. The highest possible score was 100, with the total value for each question ranging from 0-10 points. The 10 questions below were used to determine point assignments. For each question, justification for the importance of asking the question and limited examples are provided. 1. Is there statutory language stating that coverage provided for behavioral health services must be on the same terms and conditions as it is for other medical coverage? (10 points available; only one answer may be selected) a. Yes (10 points) b. Yes, but explicitly allows certain things to be different (e.g., medical management, geographic restrictions, etc.) (5 points) c. No (0 points) This question addresses the foundation of parity. Some states make it clear that the language, "same terms and conditions" or "no more restrictive," encompasses all aspects of benefit design and delivery. Some states have "same terms and conditions" language but then have exceptions in place such as numerical impositions (e.g. allowing health plans to only cover 28 days of residential treatment) or language exempting medical management practices from the "same terms and conditions" requirement. Several states have no language to the effect of "same terms and conditions." For coding purposes, states received the full 10 points if any state statute related to behavioral health insurance benefits included a parity clause, defined as requiring comparable coverage for behavioral health treatment and physical health or medical treatment. Only two states received 5 points for this question (Florida and Arizona) and Wyoming is the only state that received 0 points.