Docket: EBSA-2009-0010 

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

Equity Act of 2008 

Comment On: EBSA-2009-0010-0001 

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

Equity Act of 2008 

Document: EBSA-2009-0010-DRAFT-0257 

Comment on FR Doc # E9-9629 

Submitter Information 

Name: Pamela Bell 

Address: 

30 Alcalde Rd. 

Santa Fe, NM, 87508 

Email: drbell@optimalbodybrain.com 

Phone: 505-466-9800 

Organization: Dr. Pamela Bell 

General Comment 

Comments regarding Regulatory Guidance USCG-2007-27022 

page 19157, II B specific areas 1 and 4 

I am a licensed psychotherapist and certified eeg-biofeedback provider who provides 

EEG biofeedback treatment to individuals with Attention Deficit Hyperactivity Disorder, 

Anxiety, PTSD, 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, 

PUBLIC SUBMISSION 

As of: May 28, 2009 

Received: May 28, 2009 

Status: Pending_Post 

Tracking No. 809bcd3e 

Comments Due: May 28, 2009

Submission Type: Web
Blue Cross, Cigna, and Amerigroup. 

This is a 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 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. 

Respectfully submitted, 

Dr. Pamela Bell, EdD, LPCC, CBT, BCIA-Fellow