From: MCA1970@aol.com [mailto:MCA1970@aol.com] 

Sent: Saturday, May 23, 2009 10:51 AM 

To: EBSA, E-OHPSCA - EBSA 

Subject: Parity for Biofeedback\Neurofeedback Treatment

Comments regarding Regulatory Guidance USCG-2007-27022 

page 19157, II B specific areas 1 and 4

I am a Practice Manager in Myrtle Beach, South Carolina for a large group practice that 

provides EEG biofeedback treatment to individuals with Attention Deficit Hyperactivity 

Disorder, Mood Disorders, Brain Injury, etc.. EEG biofeedback is an empirically 

validated and widely recognized effective non medication treatment for these disorders, 

as well as many other conditions. 

 

There are over 50 studies evaluating the effectiveness of EEG biofeedback in the 

treatment of ADHD, Substance Use disorders and Autism alone. 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 inaccurately 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. Neither positions are any longer true. 

 

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. 

I 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. There remain far too many politics in healthcare at 

the detriment to consumers. 
 

Carolyn G. McCarthy, BS 

Practice Manager 

 

McCarthy Counseling Associates, PA 

4603 Oleander Drive, Suite #1 

Myrtle Beach, SC 29577 

Phone: 843-497-5240 

Web page: www.mccarthycounselingassociatespa.com 

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