From: Peder H. FagerhoH Fagerholm [mailto:dr.pete@juno.com] 

Sent: Friday, May 29, 2009 9:55 PM 

To: EBSA, E-OHPSCA - EBSA 

Subject: Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 

2008

I am a clinical psychophysiologist 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. Thank you//Peder 

 

 

Peder H. Fagerholm, PhD, BCIAC/BCIA-EEG 

CDR USN (Retired) 

 
Clinical Psychophysiology

Biofeedback - Neurofeedback - Neurotechnology 

 

Attention Development Programs 

2947 Owens Point Trail 

Kennesaw, GA 30152-6511 

770-974-5610 

Dr.Pete@Juno.com

 

*************** 

Associate Professor (adjunct) - Aviation Science 

Embry Riddle Aeronautical University 

Atlanta Center 

Marietta, GA 30060 

770-426-9990 

Associate Professor (adjunct) - Graduate Studies 

Central Michigan University 

Atlanta Center 

Atlanta, GA