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Connecticut Legal Rights Project

Testimony of Kathleen Flaherty, Esq.

Executive Director, Connecticut Legal Rights Project

Public Stakeholder Listening Session on Strategies for Improving Parity for Mental Health and Substance Use Disorder Coverage

July 27, 2017

Good morning. My name is Kathy Flaherty and I’m the Executive Director of Connecticut Legal Rights Project (CLRP), a statewide non-profit agency that provides legal services to low income adults with serious mental health conditions. CLRP was established in 1990 pursuant to a Consent Order which mandated that the state provide funding for CLRP to protect the civil rights of clients of the State of Connecticut Department of Mental Health and Addictions Services. CLRP currently employs 10 full time employees who are offered health insurance as part of their benefits package. I am also a person living in recovery from a diagnosis of bipolar disorder. I have experience with mental health parity issues as a patient, an advocate, and an employer.

I appreciate the opportunity to speak here today because I believe it is most important for patients to have a voice in the process of improving parity for mental health and substance use disorder coverage. We are the people who utilize these services. We are the people whose lives are most impacted when we are unable to access the services we want and need to recover and more importantly, maintain recovery. We know where the system has gaps. I hope that you will listen to us and use our input to implement a system that works best for the people who use the system, rather than the people who operate the system.

In the days before the passage of mental health parity laws on the federal and state level, I experienced a host of the problems that these laws are intended to address. While in law school, I had coverage under a student health insurance plan with fairly generous benefits for inpatient psychiatric hospitalization, but very little coverage for outpatient care. I have gone to the pharmacy to pick up maintenance medications and been surprised by a significantly higher co- pay because the insurance company suddenly required "prior authorization" for the brand-name medication that I needed to take because we had already discovered that the generic medication didn’t work for me.

Connecticut has been working on mental health parity for a long time, since enacting its state parity law in 2000. In 2013, the state Insurance Department issued a report on parity implementation.1

Connecticut’s Insurance Department convened a Behavioral Health Working Group to make recommendations for behavioral health utilization and data collection. The group included representatives from the state Office of Healthcare Advocate, the Comptroller, the Departments of Social Services, Public Health, Mental Health and Addiction Services, Children and Families and Developmental Services, and representatives from health insurance companies, behavioral health providers and the consumer community. I believe that our two reports contributed to helping the state of Connecticut improve its measurements of quality control and compliance so that Connecticut residents have access to behavioral health treatment.2

Connecticut’s Office of the Healthcare Advocate is an independent agency that assists consumers with healthcare issues, including enforcing parity complaints.3 Friends who live in other states do not have such an agency to assist them.

Too many people do not understand their rights under the law. Health care is complicated. Mental health is intertwined with physical health; it does not make sense for insurance coverage of treatment of one part of the body to be subject to different rules than the rest. I am concerned that health care reform writ large will undo any progress that has been made in the implementation of parity; coverage for mental health and substance use disorders must remain an essential health benefit.

It is a task of federal government to ensure compliance with parity laws by issuing guidance to insurers. Information for consumers must be in plain language, understandable to ordinary users, who may not have a medical degree or a law degree – or even if they do, still cannot understand plan documents. People need accurate information about what their plans cover, or don’t cover, so they can make informed choices about what plan to choose. Insurance companies should be more transparent, and not make their customers jump through hoops to get information that should be readily available.

Agencies that take enforcement action related to mental health parity and addiction equity requirements should make the results of those actions available to the public. Insurance plans found to be in violation of the law should not be able to hide behind the veil of patient privacy.

I encourage you to keep the promise of the law named for Paul Wellstone and Pete Domenici.

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1 "A Report on Mental Health Parity and Commercial Health Insurance Compliance," December 31, 2013, available at http://ct.gov/cid/lib/cid/2013CIDMentalHealthParityReport.pdf
2 "Protecting Behavioral Health For Consumers in Connecticut: Report of the Behavioral Health Working Group On Recommendations for Utilization and Quality Measures Data Collection," February 23, 2016, available at http://www.ct.gov/cid/lib/cid/2016-Behavioral-Health-Working-Group-Report.pdf and "Protecting Behavioral Health For Consumers in Connecticut: Report of the Behavioral Health Working Group On Recommendations for Utilization and Quality Measures Data Collection," December 22, 2016, available at http://www.ct.gov/cid/lib/cid/2017-Behavioral-Health-Working-Group-Report.pdf
3 Office of the Healthcare Advocate, 2016 Annual Report, available at http://www.ct.gov/oha/lib/oha/oha_2016_annual_report.pdf


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Content last reviewed on October 17, 2017