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PUBLIC SUBMISSION 

As of: May 28,2009 

Tracking No. 809ocaef 

Comments Due: May 28,2009 

Docket: BS:2fl09-13008 

Request for Inibrmat ion for Y aul Wellstone and Pete Domenici Mentai Health Parity and 

Addiction Equity Act of 2008 

Comment On: IRS-2009-OUC!K-t1001 

Request for Information Regarding the Paul Wcllstonc and Pete Ihmenici Mmtal Health Parity 

and Addiction Equity Act of 2008 

Document: lRS-2009-005)8~@0C~~ 

Comment on FR Doc # E9-09629 

Submitter Information 

Name: David P Davis 

Address: 

Kurtistown, HI, 

General Comment 

Commcnts regarding Regulatory Guidance USCG-2007-27022 

page 191 57.11 B speciiic arcas 1 and 4 

J know of many clinical psychologists who providcs EEG biofeedback treatment to 

individuals with Attention Deficit Hyperactivity Disurda and Mood Disorders. 

EEG biofeedback is an empirically validated and widely rcwgnized etTcct ivc 

non-medication treatmmt for AUHU, as well as other conditions. There are ovcr 

50 studies evaluating the efft:~t:tiveness of EEG biofeedhncli in the treatment of 

ADHD. Substance Use disorders and Autism. A rcccnt review of this literature 

concf iidcd "EEG biofeedback meets the American Academy of Child and Adolescent 

Psychiatry critcria for" C'linical Guidelines "for treatment of ADHD." This meatls 

that EEG biofeedback trieets the same criteria a medication for treating ADHD, 

and that EEG biofeedback "should always be cu tlsidered as an intervention for 

this disorder by the clinician". 

This service has bcen denied by Georgia Medicaid, Aetna, United Bdlavioral 

Hoalth, Hlue Cross, Ciga, and Amerigmup. 

This is limitation nf an effective and validated trealmcnt for a mental health 

problem. 'The reaoiis given by the insuranct: cornpanics for this denial fell into 

two categclries: 1 ) our company does not cover biofccdback for Mental Health 

problems or 2) there is not yet sufficient evidcncc for the efficacy of EEG 

hiofeedhnck. As such, they are using evidence-bawl critcria that ate far more 
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restnctivc for mental health services than the criteria which arc uscd for 

medicalfsurgical services. Thcrc are many routine medical and surgical 

procedures which have far fewer controlled studics about their efficacy than 

does EEG biofeedback. These medical and surgical pro~edures arc gcncrally not 

limited because of concerns about how many mntrnlled studies have been 

performed about them. 

We believe that thc parity regulations, based on legal reviews of ~hc parity 

statute should requirc that employers and planspay for the same range and scope 

of services for Behavioral Treatrncnts as they do for Med Surg benefits and that 

a plan cannot be more restrictive in their managed care criteria and reviews for 

MH m~d SA disorders when compared to h4ed Surg. Today pl,ms are being more 

restriclive in how they review evidenced-based Mental Health and Substance Abuse 

Treatments when compared to Med Surg treatments. Thls violates both thc intent 

and letter of' the parity statute and we hope that the regulations will clarify 

thot this can't continue. 

It is well docummtcd that eighty to ninety percent of the health conccrns for 

which people seek the verviccs of their primary care provider are stress 

related. 1 have over the last thirty years ptovided behavinral health care and 

training in stress management to hundreds, even thousands of patients for 

mutiunal, bchavioral u~d physical conditions that were stress rclated and tliatly 

times averted the need for fi~rthcr more extensive treatment, including disasters 

such as suicides, etc. The savings in tenns of additional health care wsts 

that are achieved by behavioral hcalth care provider T'm sure easily total in 

thc millions of dollars, if not billions, annually. Thc payn~ent we receive for 

our serviccs by governmental programs su~h as Medicarc is not only lacking in 

parity with medial practitioners, its insulting. Payment for behavioral carc 

services is not on par with general mcdical care anywhere in the industry and 

it's definitely time for a change!!