Connecticut Department Sets Up Mental Health Provider Co-Pay Procedure

Connecticut health insurers may be able to set the co-payment level for mental health providers at the same level used for medical health specialists.

Thomas Leonardi, the Connecticut insurance commissioner, discusses mental health provider co-payment levels in Bulletin HC-87, an advisory that explains how to handle one issue involving the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).

MHPAEA now requires employers with 51 or more employees that offer mental health benefits along with medical coverage to apply the same financial requirements both to medical care and to mental health care.

Before MHPAEA came along, Connecticut had an even tougher parity law in place that required both individual and group plans to cover the diagnosis and treatment of mental conditions. The Connecticut parity law continues to apply when the Connecticut law is tougher than the federal law.

Connecticut had been letting plans use different co-payment levels for primary care doctors and specialists, and it had been letting plans count mental health providers as specialists, Leonardi says.

Connecticut stopped letting insurers use that approach in July 2010, when MHPAEA started to take effect.