Gov. Ted Kulongoski
The Department of Consumer and Business Services is adopting new administrative rules that require health insurance policies to cover the treatment of chemical dependency, mental or nervous conditions at the same level as other medical conditions.
"This action will make mental health services more affordable, accessible and available — and lead to healthier citizens and families," said Gov. Ted Kulongoski. He noted that greater mental health coverage eventually will prevent more costly responses for the state.
The new rules are a product of Senate Bill 1, the Mental Health Parity Bill, introduced during the 2005 legislative session.
Prior to passage of SB 1, Oregon law included "caps" that limited what group health insurers were required to cover for mental health conditions and chemical dependency. No such limits existed for coverage of other medical conditions.
The business services department appointed an advisory committee to help draft the administrative rules. The committee, which met eight times this year, consisted of representatives from mental health and consumer advocacy organizations, health care providers, employers and insurers.
Key provisions of the new administrative rules require:
• Group health insurance policies to cover a broad range of disorders identified in the comprehensive "Diagnostic and Statistical Manual of Mental Disorders" published by the American Psychiatric Association. Examples include childhood developmental disorders such as autism, eating disorders, dementia and other cognitive disorders, substance-related disorders, schizophrenia and other psychotic disorders.
• Group policies to include language stating that medical, mental or nervous conditions and chemical dependency will be treated the same as other health conditions.
• Health insurers to have claims handling and operational procedures in place to ensure uniform application of coverage.
• The Insurance Division to review the rules within two years to determine if they are being effectively implemented by health insurers.