Docket: CMS-2009-0040 

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 

Comment On: CMS-2009-0040-0048 

Interim Final Rules under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act 

of 2008 

Document: CMS-2009-0040-DRAFT-0065 

VA-Julie Clements 

Submitter Information 

Name: Julie Clements 

Address: 

Alexandria, VA, 22314 

Organization: American Mental Health Counselors Association 

General Comment 

1) As is provided by Section 2607 of H.R. 3590, the Patient Protection and Affordable Care Act, the Mental Health 

Parity and Addictions Equity Act shall not arbitrarily discriminate against any cadre of professional licensed to 

deliver mental health services in his/her state. A provider licensed in his/her state to deliver mental health services 

shall be eligible for acceptance on insurance plans’ provider panels. 

2) Any Mental Health Parity and Addictions Equity Act definition of “provider of mental health and substance use 

services” shall include all persons licensed within their states, by their states’ licensure boards, as “mental health 

professionals.” 

3) With enactment of the Mental Health Parity and Addictions Equity Act, mental health/substance use benefits 

and medical/surgical benefits shall accumulate to satisfy a single combined deductible. 

4) The Mental Health Parity and Addictions Equity Act will mandate that any denial of mental health/substance 

use claims, for persons enrolled in health plans with 50 or more enrollees, be immediately communicated by way 

of written notice to the consumer of mental health/substance use services at no cost to the consumer. 

5) The Mental Health Parity and Addictions Equity Act shall require that any denial of a licensed mental health 

professional’s reimbursement for a mental health/substance use claim he/she performed be immediately 

communicated to the licensed mental health professional in writing, expressly stating why reimbursement was 

PUBLIC SUBMISSION 

As of: April 27, 2010 

Received: April 26, 2010 

Status: Pending_Post 

Category: Association - Other

Tracking No. 80ae0925 

Comments Due: May 03, 2010

Submission Type: Web
denied, at no cost to the licensed provider filing with the insurer for reimbursement of a performed mental 

health/substance use service. 

6) The scope of services offered by medical/surgical providers within any one of the six service classification 

categories delineated by the Mental Health Parity and Addictions Equity Act shall also be the permitted scope of 

services for mental health/substance use providers delivering services within the same classification. (ie 

Medical/surgical providers’ scope of services for out-of-network and in-network/outpatient services to enrollees of 

a plan covered by the Mental Health Parity and Addictions Equity Act shall mirror the scope of services mental 

health/substance use providers are permitted to offer in out-of-network and in-network/outpatient settings). 

7) The term “specialist” shall be employed for mental health/substance use providers in a way that is at parity with 

the term’s use for medical/surgical health care providers delivering care within the same classification of services 

as mental health/substance use providers. 

8) The Mental Health Parity and Addictions Equity Act shall not impose non-quantitative treatment limitations, 

such as authorization, supervision, referral, and case management, for mental health/substance use providers where 

such non-quantitative treatment limitations are not imposed on medical/surgical providers, within the same health 

plan, delivering health care services which fall within the same classification as those delivered by mental 

health/substance use providers. 

Attachments 

CMS-2009-0040-DRAFT-0065.1: VA
 To whom it may concern: 

As the only organization to exclusively represent the profession of licensed mental health 

counselors, the American Mental Health Counselors Association (“AMHCA”) wishes to submit 

comments to the Mental Health Parity Addictions and Equity Act which promote and protect the 

mental health counseling profession. AMHCA asks the Departments of Health & Human 

Services, Treasury, and Labor to consider the following comments as they embark upon 

implementing final rules, specifically with respect to the non-quantitative treatment limitations, of 

the Mental Health Parity and Addictions Equity Act. 

1) As is provided by Section 2607 of H.R. 3590, the Patient Protection and Affordable Care 

Act, the Mental Health Parity and Addictions Equity Act shall not arbitrarily discriminate 

against any cadre of professional licensed to deliver mental health services in his/her 

state. A provider licensed in his/her state to deliver mental health services shall be 

eligible for acceptance on insurance plans’ provider panels. 

2) Any Mental Health Parity and Addictions Equity Act definition of “provider of mental 

health and substance use services” shall include all persons licensed within their states, 

by their states’ licensure boards, as “mental health professionals.” 

3) With enactment of the Mental Health Parity and Addictions Equity Act, mental 

health/substance use benefits and medical/surgical benefits shall accumulate to satisfy a 

single combined deductible. 

4) The Mental Health Parity and Addictions Equity Act will mandate that any denial of 

mental health/substance use claims, for persons enrolled in health plans with 50 or more 

enrollees, be immediately communicated by way of written notice to the consumer of 

mental health/substance use services at no cost to the consumer. 

5) The Mental Health Parity and Addictions Equity Act shall require that any denial of a 

licensed mental health professional’s denial of reimbursement for a mental 

health/substance use claim he/she performed be immediately communicated to the 

licensed mental health professional in writing, expressly stating why reimbursement was 

denied, at no cost to the licensed provider filing with the insurer for reimbursement of a 

performed mental health/substance use service. 

6) The scope of services offered by medical/surgical providers within any one of the six 

service classification categories delineated by the Mental Health Parity and Addictions 

Equity Act shall also be the permitted scope of services for mental health/substance use 

providers delivering services within the same classification. (ie Medical/surgical 

providers’ scope of services for out-of-network and in-network/outpatient services to 

enrollees of a plan covered by the Mental Health Parity and Addictions Equity Act shall 

mirror the scope of services mental health/substance use providers are permitted to offer 

in out-of-network and in-network/outpatient settings). 

7) The term “specialist” shall be employed for mental health/substance use providers in a 

way that is at parity with the term’s use for medical/surgical health care providers 

delivering care within the same classification of services as mental health/substance use 

providers. 

8) The Mental Health Parity and Addictions Equity Act shall not impose non-quantitative 

treatment limitations, such as authorization, supervision, referral, and case management, 

for mental health/substance use providers where such non-quantitative treatment 

limitations are not imposed on medical/surgical providers, within the same health plan, 
delivering health care services which fall within the same classification as those delivered 

by mental health/substance use providers. 

AMHCA appreciates the departments’ consideration of these eight comments and hope’s their 

substance may be incorporated into the Final Rule for the Wellstone-Domenici Mental Health 

Parity and Addictions Equity Act of 2008. 

Thank you, 

Julie A. Clements 

Julie A. Clements, J.D.

Director of Legislative Affairs

American Mental Health Counselors Association

The only organization working exclusively for mental health counselors

801 N. Fairfax St., Suite 304

Alexandria, VA 22314

Phone: 800-326-2642 x 105

Fax: 703-548-4775

Website: www.amhca.org

E-mail: jclements@amhca.org