H.R. 3666, Dept. Of Veterans Affairs and HUD, & Independent Agencies Appropriations Act, 1997, eventually became PL 104-204, was introduced by Representative Jerry Lewis R-CA. Title VII of the Act covered Parity in the Application of Certain Limits to Mental Health Benefits. The Mental Health Parity Act of 1996 amended ERISA and the Public Health Service Act to require group health plans, if they choose to offer mental health benefits, to provide the same financial conditions for such mental health benefits that they provide for medical and surgical benefits, including the same aggregate lifetime limits and the same annual limits, if any. Makes such parity requirements inapplicable to: (1) substance abuse or chemical dependency treatment; (2) employers of fewer than 50 employees; or (3) any group health plan (or for health insurance coverage offered in connection with such a plan) if this title results in an increase in cost of at least one percent.
S. 2031, the Mental Health Parity Act Of 1996, was sponsored on August 2, 1996 by Senator Pete V. Domenici R-NM. His Act, simply put was to require a group health plan that applied an aggregate lifetime (or annual) limit for medical or surgical services, if the plan also provided a mental health benefit, to include mental health payments in that limit or establish a separate aggregate lifetime (or annual) limit for mental health services, with the mental health limit not less than the medical or surgical limit. It prohibited a group health plan that does not apply a medical or surgical limit from applying a mental health limit. It exempted employers with fewer than 26 employees.
Representative Pete Stark sponsored H.R. 4045, National Mental Health Parity Act of 1996, on September 10, 1996. His Act had two sections: Title I: Parity for Treatment of Mental Illness and Title II: Medicare Mental Health Improvement. Title I: Parity for Treatment of Mental Illness amended the Internal Revenue Code to impose on the applicable issuer a tax equal to 25 percent of a health plan'spremiums received during the calendar year if the plan imposed limitations or financial requirements on the coverage of benefits provided with respect to any of specified psychiatric conditions (described in the DSM), while similar limitations or requirements are not imposed on coverage of benefits with respect to other conditions. It provided similar obligations and sanctions with respect to group health plan parity for treatment of mental illness.
Title II amended title XVIII (Medicare) of the Social Security Act to restructure the mental health benefit, including: (1) coverage under Medicare part A (Hospital Insurance) of inpatient hospital services furnished primarily for the diagnosis or treatment of mental illness or substance abuse for up to 60 days during a year, as well as coverage of intensive residential services furnished to an individual for up to 120 days during a year; (2) lower co-payments for certain out-patient mental health and substance abuse services; (3) waiver of co-payment for case management services furnished to a seriously mentally ill adult, a seriously emotionally disturbed child, or an adult or child with serious substance abuse disorder; (4) case management services for an unlimited duration for such individuals; (5) provision of items and services furnished under Medicare part B (Supplementary Medical Insurance) for the treatment of mental illness or emotional disturbances according to standards established by the Secretary of Health and Human Services; (6) a new category of intensive community- based services covering, among other services, current partial hospitalization services as well as psychiatric rehabilitation services, in-home services, and day treatment for substance abuse for individuals of any age and for other mental health services for individuals under age 19; (7) mandatory authorization under State law or certification by an appropriate accreditation entity (approved by the State in consultation with the Secretary) for intensive community- based services programs (whether facility-based or freestanding); and (8) supervision of individualized treatment programs by non-physician mental health professionals to the extent permitted under State law.
Representative Marge Roukema R-NJ also sponsored a Mental Health Parity Act, H.R. 4058, on September 11, 1996. Her version was similar to Domenici's. Her version of the Mental Health Parity Act of 1996 required a group health plan that applied an aggregate lifetime (or annual) limit for medical or surgical services, if the plan also provides a mental health benefit, to include mental health payments in that limit or establish a separate aggregate lifetime (or annual) limit for mental health services, with the mental health limit not less than the medical or surgical limit. Prohibits a group health plan that does not apply a medical or surgical limit from applying a mental health limit. It too exempted employers with fewer than 26 employees. Her Act was ineffective after September 30, 2001. It also exempted a purchaser from this Act if the Act's provisions result in a 1 percent or greater increase in the cost of a group health plan's premiums.
HR 4135 was a bill sponsored by Representative William M. Thomas R-CA on September 24, 1996 . His bill was intended to add the Newborns' and Mothers' Health Protection and Mental Health Parity Implementation Amendments of 1996 by amending the Internal Revenue Code (as amended by the Health Insurance Portability and Accountability Act of 1996) with respect to group health plan requirements to: (1) provide standards for benefits to mothers and newborns; and ( 2) provide for parity of specified mental health benefits with surgical and medical benefits.
1997
Introduced on June 20, 1997 by Senator William V. Roth R-DE, S. 949, the Revenue Reconciliation Act Of 1997. On June 26, the Senate adopted Wellstone Amendment No. 592, to provide for full mental health parity with respect to health plans purchased.
June 24, 1997, the Senate adopted Wellstone/Domenici Amendment No. 449, to provide for full mental health parity with respect to health plans purchased through the use of amounts provided under a block grant to States, by voice vote On September 5, in S 915, the Balanced Budget Act, the Senate adopted Domenici/Wellstone Amendment No. 5194, to provide health plan protections for individuals with a mental illness, by a recorded vote of 82 yeas and 15 nays (R 36-15; D 46-0).
For a fuller history of parity in federal legislation see the chapter in Mental Health Parity: National and State Perspectives . [under construction]
Back to Parity Homepage.
mounted by the Louis de la Parte Florida Mental Health Institute
University of South Florida
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