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-0229 

Comment on FR Doc # E9-9629 

Submitter Information 

Name: Steven Cary Kassel 

Address: 

23560 Lyons Ave, 204 

Newhall, CA, 91321 

Email: s@kassel.us 

Phone: 661-259-3704 

General Comment 

Comments regarding Regulatory Guidance USCG-2007-27022 

page 19157, II B specific areas 1 and 4 

I am a licensed Marriage and Family Therapist and hold Certification from the Biofeedback 

Certification Institute of America since 1985. I provide 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. I also use other forms of biofeedback to help with patient in pain, 

anxiety and stress related disorders. 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 to 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. At times, managed plans do pay, but it is not an amount to 

PUBLIC SUBMISSION 

As of: May 28, 2009 

Received: May 28, 2009 

Status: Pending_Post 

Tracking No. 809bc162 

Comments Due: May 28, 2009

Submission Type: Web
cover the costs of state-of-the-art equipment, supplies and continuing education... in essence, I 

would be putting money out to treat a patient with biofeedback if I was paid the same amount I 

am paid to treat them with psychotherapy. Reimbursement from 3rd party payors need to go up 

and biofeedback and neurofeedback needs to be reimbursed. 

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 statue 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.