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PUBLIC SUBMISSION 

Docket: 1RS-2009-01108 

Rqu~st for Information tbr Paul Wellstone and Pctc Domenici Mental Health Parity and 

Addiction Equity Act of 2008 

Comment On: IR S-~009-QNJl8-Cli)l)! 

Requcst for 11-tfomation Regarding the Paul W ellstone and Pete Domenici Mental Health Parity 

and Addiction Equity Act of 2008 

Document: lRS-2.09-01)_1)YI@01_4 

Comment on FR Doc # E9-09629 

Submitter Information 

Name: Marti Elvcbak 

Address: 

Los Altos, CA, 

Organization: Marti Elvebak, MA. MFT 

General Comment 

1 am a psyc hothmpist who provides KEG biofeedhack treatment to individuals with Attention 

Deficit Hypcravtivity Oiwrder and Mood Disorders. EEG biofeedba~k is an e~npirically validated 

and widely rewgnized efikctive not? medication trcatment for ADHD, as we11 as other 

conditions. There are uver 50 studies evaluating the effectiveness of FEG biofeedback in the 

treatment of AUHD, Substance Use di-wrders and Autism. . A recent rcview of this literature 

concluded "EEG biofeedback meets the American Acadcm y of C hiId and AdoIesccnt Psychiatry 

criteria for" Clinical Guidelines "for trcatment of AUHD. " This means that EEG biofeedback 

meets the same criteria as to medication for treating ADHD, and [hat EEG biof&back "sl~ould 

always be consider4 an intetvcntion for this disorder by the clinician". 

In my experience, patients bcing treated for ADHD with EEC biofeedback receivc sustained 

benefits witlmut the side cif'ects of medication for this disorder. The side effects of Ritalin and 

similar drugs are significant, and many patients would like to bc able tn choose EEG 

hiofccdback in order tu avoid the distressing side effects of medication. 

This service has been denied hy Georgia Mcdicaid, Aetna, T-Jritd Behavioral Healtlz, Blue 

Cross, Cips and Arnerigroup. 

'I'his is limitatioa uf an effective and validatd treatment for a mental health ~roblern. The 

rcasons given by the insurance companies for this denial fcll into two categories: I) our 

company does not cover binfecclba~k for Mental Health probIems or 3,) thcre is not yet sufiicient 

evidcnce for the cffi~acy of EEC; bic~Cedback. As such, they are using evidenm-based criteria 

that are far morc rtsstrictive for mental health services than the criteria which are used for 
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medical/surgical services. 'rhm are many routine rnadicd and surgical prudures which have 

far t'ewcr cnntmlled studies about Lheir efficacy than does EEG biofeedback. These medical 

and surgical procedures are generally not limit at becausc oP mnccms about how many 

controlled studies have hecn perfcrrmd about them. 

Wc believe that the parity regulations, basd on legal reviews of thc parity s ta.l ue should 

require that crnployers and plans pay for the sa~ne range aid scope of services for Behaviural 

Treatments as t,hey do for Mod Surg bmefits mid that n plm cannot be rnorc restrictive in their 

managcd are criteria and reviews for MH and SA disorders whm compared to Med Surg. Taduy 

plans are being more resrrictive in how they review evidenced based Mmtal Heallh 

and Substar~ce Abuse Treatments when cimpard to Med Surg treatments. This violates both 

ttt: intent and letter ofthe parity statutc and we hope that the regulativns will clarify that this 

can't continue.