Vitale-Buono Bill To Expand Coverage For Mental, Nervous Disorders And Substance Abuse Approved In Committee

TRENTON – A bill sponsored by Senators Joseph F. Vitale and Barbara Buono which would expand health insurance coverage for treatment of mental and nervous disorders, as well as alcoholism and substance abuse disorders, was approved by the Senate Health, Human Services and Senior Citizens Committee today by a vote of 7-0.

A second bill, sponsored by Senator Vitale, which would require health insurers who already cover behavioral health care services to provide certain information to their insureds about what exact services are covered, what the insured has to do to be eligible, and how reimbursement for services works, was also approved by a vote of 7-0.

Quality mental health care and chemical dependency treatment have become Statewide issues of concern, due in large part to Governor Codey’s advocacy in these areas, but also due to the realization that mental health is just as important as physical health,” said Senator Vitale, D-Middlesex, the Chairman of the Senate Health Committee. “There needs to be insurance coverage parity for mental health and substance abuse disorders, to ensure that everyone has access to the necessary treatment. We cannot allow those suffering from mental health disorders to continue without care.”

The first bill, S-544, would expand mandated health insurance coverage for mental health and nervous disorders, regardless of whether or not they are biologically-based mental illnesses, caused by chemical imbalance, or not. The bill would also require health insurance parity for alcohol and substance abuse, and would only require coverage for medically-necessary treatment. Under the bill, all mental health and chemical dependency disorders would be covered under the same terms and conditions for other illnesses.

Under current law, only biologically-based disorders that reach dangerous levels are covered, but the Senators argued that catching mental health illness early substantially increases the chances of success for treatment.

“Early treatment for mental health illnesses could make all the difference in terms of success rate, but not everyone has access to expensive psychiatric and psychological treatment,” said Senator Vitale. “Under the current law, we draw a distinction between different causes of the disease, but the effects are the same. We must put quality mental health care within reach of every citizen in New Jersey, and mental health insurance parity is necessary to do just that.”

The second bill, S-1993, would amend current law to ensure that health care insurance providers that cover behavioral health care make available to their customers certain information pertaining to their coverage. The insurer would be required to notify customers with the specific behavioral health care services the insurer provides, as well as the insured person’s responsibilities for obtaining services, how reimbursement works with the insurer, and a list of participating care providers of behavioral health care services. Senator Vitale argued that the information is necessary to allow customers to make informed decisions about the mental health care they receive, as well as the health insurance for which they pay.

“In any other purchase of goods or services, the customer always knows what they’re paying for, but in health insurance, when it comes to what’s covered, many insurance customers are left in the dark,” said Senator Vitale. “When the insured person needs services the most, many times with behavioral health care, various regulations and company policies which the insured was in no way aware beforehand kick in, and the customer is left holding the bill. Keeping insurance policyholders notified of the services to which they’re entitled is a positive consumer protection which will allow the policyholders to make informed decisions about their health and the insurance carrier they choose.”

The first bill, S-544, now goes before the Senate Budget and Appropriations Committee before going to the full Senate for consideration. The second bill, S-1993, heads to the full Senate.