From: Jane Kingston [mailto:jane@igc.org] 

Sent: Saturday, May 23, 2009 2:43 PM 

To: EBSA, E-OHPSCA - EBSA 

Subject: Wellstone- Domenici Parity Act - RFI

I am a licensed California Marriage and Family therapist who provides 

neurofeedback treatment to individuals with Attention Deficit Hyperactivity 

Disorder and Mood Disorders. Neurofeedback 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 

neurofeedback in the treatment of ADHD, substance use disorders and 

Autism. A recent review of this literature concluded "Neurofeedback meets the 

American Academy of Child and Adolescent Psychiatry criteria for Clinical 

Guidelines for treatment of ADHD." This means that neurofeedback meets the 

same criteria as medication for treating ADHD, of which 60% of prescriptions 

are in fact prescribed "off label," and that neurofeedback "should always be 

considered as an intervention for this disorder by the clinician." 

 

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

Health, Blue Cross, Cigna, and Amerigroup. 

 

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

problem. The reasons given by the insurance companies for this denial fell into 

two categories: 1) our company does not cover biofeedback for mental health 

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

neurofeedback. 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 efficacy than 

does neurofeedback. These medical and surgical procedures are generally not 

limited because of concerns about how many controlled studies have been 

performed about them. 

 We believe that the parity regulations, based on legal reviews of the parity 

statute should require that employers and plans pay for the same range and 

scope of services for behavioral treatments as they do for medical surgical 

benefits and that a plan cannot be more restrictive in their managed care 

criteria and reviews for mental health and substance abuse disorders when 

compared to medical surgery. Today plans are being more restrictive in how 

they review evidenced-based mental health and Substance Abuse Treatments 

when compared to medical surgical treatments. This violates both the intent 

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

that this can't continue. 

Jane Kingston, Psy.D., MFT. BCIA-EEG 

650-726-6774 
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