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Mental health coverage rules could change business of therapy

The federal government has just released a new rule, requiring insurers to cover mental health conditions just like they would physical problems. So there should be no difference between how your insurance company pays for treatment of depression, or, say, a broken arm.  It’s called parity. 

The rule is pretty clear. Everything -- co-payments, deductibles -- has to be the same for mental or physical care. So you’d think Walter Teague would want to celebrate. He’s been a therapist in private practice for 32 years. And he’s had lots of run-ins with insurance companies.

"Therapists have been burned," he says.

Teague says therapists like him who run their own practices have spent lots of time filing claims and appealing denials. Some have stopped accepting insurance. They want to see if the new rule on parity will be enforced.

"They’re going to hold back," he explains, "and wait and see how it develops."

That might be wise. Because there is no guarantee that waves of insured, new patients will suddenly materialize. Dr. Alexander Blount teaches psychiatry at the University of Massachusetts. He also has a private practice.  He says there’s still a stigma against mental health care. 

"It’s very hard," he says, "to get around the implication that somehow getting help for something like depression indicates weakness."

Dr. Blount says patients will do therapy if it’s part of a visit to their doctor’s office -- if, say, a therapist on staff automatically checks in with a diabetes patient to ask about depression. 

Now, the new parity rule could be a boon for counselors who work in rehab clinics for alcoholism or drug addiction. David Staten is president-elect of the American Rehabilitation Counseling Association.  And he has a private counseling practice.  He says his industry will see a landslide of new patients.  And he wonders if it’s prepared. 

"They’ve been talking about this for years," he says. "But now that it’s actually happened we’re going to have to act pretty fast."

Staten already has three therapists on staff.  He will hire at least two more.

About the author

Nancy Marshall-Genzer is a senior reporter for Marketplace based in Washington, D.C. covering daily news.

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