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-2009-0008-0082 

Comment on FR Doc # E9-09629 

Submitter Information 

Name: Joseph E Barr 

Address: 

Deerfield, IL, 

Government Agency Type: Federal 

Government Agency: DOL 

General Comment 

Comments regarding Regulatory Guidance USCG-2007-27022 

page 19157, II B specific areas 1 and 4 

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 Use disorders and Autism. A recent review of this literature 

concluded “EEG biofeedback meets the American Academy of Child and Adolescent 

Psychiatry criteria for” Clinical Guidelines “for 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 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

PUBLIC SUBMISSION 

As of: May 29, 2009 

Tracking No. 809baa14 

Comments Due: May 28, 2009
problems or 2) 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 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. 

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 Med Surg benefits and that 

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

MH and SA disorders when compared to Med Surg. Today plans are being more 

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

Treatments when compared to Med Surg 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. 

Regards, 

Dr Joseph Barr, Illinois Licensed Psychologist 

707 Lake Cook Road, Suite 135 

Deerfield, IL 60015