Such a prohibition is contained in a mental health benefits parity bill approved by the Senate earlier this month, but the House bill goes further.
Under the version of the bill approved by the Ways and Means Committee, “in the case of a group plan that provides any mental health or substance-related disorder benefits, the plan must include benefits for any mental health condition or substance-related disorder included in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Assn.,” according to an analysis of the Ways and Means bill prepared by the staff of the Joint Committee on Taxation.
“Tying the minimum benefit to the DSM is a lightening rod for employer groups because it is very expansive and includes any number of conditions that an employer plan may or may not want to consider as something it would cover, and the Senate bill is very different because it allows the employer health plan to define the terms of the coverage,” said Frank McArdle, a consultant in the Washington office of Hewitt Associates Inc.
The House bill would also be effective Jan. 1, 2008. The Senate bill would not take effect until a year later. Both bills would exempt health plans for companies with fewer than 50 employees.
The bill has not reached its final stop on the way to the House floor, though, Mr. McArdle pointed out.