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-2009-0008-0109 

Comment on FR Doc # E9-09629 

Submitter Information 

Name: Susan Jacoby 

Address: 

Easton, CT, 

Submitter's Representative: NA 

Organization: MindFit 

General Comment 

Comments regarding Regulatory Guidance USCG-2007-27022 

Page 19157, II B specific areas 1 and 4 

I am a board certified psychiatric nurse practitioner who provides EEG 

biofeedback treatment to individuals with Mood Disorders, Substance Abuse, 

PTSD and ADHD. EEG biofeedback is an empirically validated and widely 

recognized effective non-medication treatment for mood disorders, as well as other 

conditions. There are numerous studies evaluating the effectiveness of EEG 

biofeedback in the treatment of ADHD, Mood Disorders, Substance Abuse 

disorders and Autism. For example, 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”. 

PUBLIC SUBMISSION 

As of: May 29, 2009 

Tracking No. 809bcaf8 

Comments Due: May 28, 2009
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 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 Surgical 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 Surgery. Today plans are being more 

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

Abuse Treatments when compared to Med 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.