Docket: IRS-2009-0008 

Request for Information for Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 

2008 

Comment On: IRS-2009-0008-0001 

Request for Information Regarding the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction 

Equity Act of 2008 

Document: IRS-2009-0008-0057 

Comment on FR Doc # E9-09629 

Submitter Information 

Name: David C. Brose 

Address: 

Tacoma, WA, 

Submitter's Representative: Norm Dicks 

Organization: Sound Psychological Associates 

General Comment 

Mental health parity is essential to provision of general health in our population. 

The majority of presentations for primary care have mental health issues, either as 

a primary or secondary condition. Biofeedback and Neurofeedback are evidence 

based and are well documented in the major refereed journals. My attachment 

documents this. There must be mental health parity to preserve our population in 

their behavioral health and welfare. 

Attachments 

PUBLIC SUBMISSION 

As of: May 28, 2009 

Tracking No. 809b40c9 

Comments Due: May 28, 2009

IRS-2009-0008-0057.1 Comment on FR Doc # E9-09629

IRS-2009-0008-0057.2 Comment on FR Doc # E9-09629

IRS-2009-0008-0057.3 Comment on FR Doc # E9-09629
My comments are regarding: regulatory guidance ID: IRS-2009-0001. 

And USCG-209 -0001. Is 

 Also federal register document number: E9-9629. 

 Also, volume 74: number 80 of April 28, 2009, page 19154 federal register to 19158. 

I am a clinical psychologist who provides EEG biofeedback treatment to individuals with attention 

deficit hyperactivity disorder and mood disorders. EEG biofeedback is an empirically validated 

and widely recognized effective non--medication treatment for ADHD as well as other conditions. 

There are over 50 studies evaluating the effectiveness of EEG biofeedback in the treatment of 

ADHD, substance abuse disorders and autism. A recent review of this literature concluded "EEG 

biofeedback meets the American Academy of Child and adolescent psychiatry criteria for 

the treatment of ADHD." This means that EEG biofeedback meets the same criteria as 

medication for treating ADHD, and that EEG biofeedback "should always be considered as 

an intervention for this disorder by the convention."

This service has been denied by Georgia Medicaid, Aetna, and United Behavioral Health, Blue 

Cross, CIGNA and Amerigroup. And it is being considered by other health care insurance 

agencies. 

This is a limitation of an effective and validated treatment for a serious mental health problem. 

The reasons given by the insurance companies for this denial fall into two categories: one 

parentheses are company does not cover biofeedback for mental health problems or argue there 

is not yet sufficient evidence for the efficacy of EEG biofeedback. As such, they are using 

evidence-based criteria that are far more restrictive for mental health services than the criteria 

which are used for medical/surgical services. There are many routine medical and surgical 

procedures which have far fewer controlled studies about their excellent efficacy than does EEG 

biofeedback. These medical and surgical procedures are generally not limited, because of 

concerns about how many controlled studies have been performed about them. Furthermore, 

double blind controlled studies are not applicable to behavioral health issues, since it means 

denying services for some of the disabled being studied. 

I, as a psychologist of many years, Biofeedback is evidence based, with documented and 

computerized observations of behvioral and autonomicchanges, as reguIated by the brain, which 

is also empirically documented. I Believe that the parity regulations, based on legal reviews of 

the parity statute should require that employers and clients pay for the same range and scope of 

services for behavioral treatments as they do for med surge benefits and that a plan cannot be 

more restrictive in their managed care criteria and reviewed for mental health disorders when 

compared to med surge. Today, plans are being more restrictive in how they review evidencebased mental health and substance abuse treatment, when compared to med surge treatments. 

This violates both the intent and letter of the parity statute and I hope that the regulations will 

clarify that this cannot continue. 

Respectfully and hopefully 

David C. Brose, Ph.D.