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-0110 

Comment on FR Doc # E9-9629 

Submitter Information 

Name: Frank Harbin 

Address: 

1 East 5th Ave 

Rome, GA, 30161 

Email: fharbin@harbinclinic.com 

General Comment 

Comments regarding CMS-4140-NC 

page 19157, II B specific areas 1 and 4 

I am a Clinical Psychologist in Rome, Georgia who provides EEG biofeedback 

treatment to individuals with Attention Deficit Hyperactivity Disorder and Mood 

Disorders. EEG biofeedback is an empirically validated and widely recognized 

effective nonmedication 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 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. 

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 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 

PUBLIC SUBMISSION 

As of: May 26, 2009 

Received: May 26, 2009 

Status: Pending_Post 

Tracking No. 809b6a89 

Comments Due: May 28, 2009

Submission Type: Web
the criteria which are used for medical/surgical services. These surgical 

procedures are generally not limited because of concerns about how many 

controlled studies have been performed about them. A recent article in the Journal 

of the American Medical Association (JAMA. 2009;301(8):831-841 

(doi:10.1001/jama.2009.205) ) documented that fewer than 20% of recommended 

cardiac procedures were based on any controlled studies. These procedures have 

clearly not been limited because of a presumed lack of evidence. 

I believe that the Parity bill regulations should require that employers and plans 

pay for the same range services for mental health treatment as for 

medical/surgical procedures and that plans cannot be more restricted in their 

managed care criteria for mental health disorders as compared to medical/surgical 

problems. Currently, insurance plans are clearly more restrictive in how they 

review evidence-based mental health and substance abuse treatments when 

compared to medical surgical treatments. This violates the intent and letter of the 

parity statute and I hope that the regulations will clarify that this can’t continue.