Massachusetts Behavioral Health Advocacy and Integration Project
What We're Doing:
Although Federal and state laws mandate equal access to behavioral health services in parity with physical health services, we know that it is still more difficult for many in our state to obtain adequate coverage for, and access to, mental health or Substance Use Disorder (SUD) treatment than it is for other types of health care. If we are to truly integrate behavioral and physical health into overall health care, it is critical to document these barriers in a systematic and comprehensive manner. Health Care For All is beginning a 3-5 year phased project to help define new opportunities for advocacy to help ensure better access to care for people with these treatment needs.
To begin the project, HCFA is conducting a comprehensive assessment on access to behavioral health care, including how policies and procedures of lead health plans and MassHealth may be limiting access to behavioral health care. The scan has three components:
Data Review: We are collecting and synthesizing existing state data, reports and recommendations reflecting on the current state of behavioral health in Massachusetts and systemic barriers to care.
Survey, Focus Groups, and Interviews with Community-Based Service Organizations, Behavioral Health Providers and Individuals with Behavioral Health Diagnoses: We are conducting in-depth interviews, focus groups, and a state wide online survey around coverage for, and access to, mental health or addiction services in key regions across the state. This information will help us better document how inadequacies in insurance practices are impeding care. Issues include but are not limited to the following:
- High rates of behavioral health denials and appeals
- Fragmented delivery system
- Low behavioral health provider reimbursement rates
- Cost as a barrier to care
- Stigma as a barrier to care
- Lack of transparency of behavioral health benefits and coverage
Report on the State of Behavioral Health in Massachusetts: In Spring 2017, we will produce an extensive report summarizing our quantitative and qualitative findings on the issues detailed above. As a part of the report, we will also release at least three accessible educational materials to help frame the issue for individuals with behavioral health diagnoses and advocates. This report will inform planning for potential advocacy activities for changes in state policy and programs, as well as in ongoing health care transformation initiatives in 2017 and beyond.
For more information about the Behavioral Health Project, please contact Natalie Litton at firstname.lastname@example.org.
If you’re having issues with coverage of behavioral health services, please call:
- Health Law Advocates at (617) 338-5241
- Division of Insurance (DOI) Consumer Services Unit at (617) 753-6830
- Attorney General’s Office Health Care Division at (617) 830-6277 (for complaints about fully insured plans)
- Department of Labor/Employee Benefits Security Administration (DOL/EBSA) at (866) 444-3272 (for complaints about self-insured plans)
For information on health insurance appeals, please call the Office of Patient Protection at (800) 436-7757
If you’re having trouble accessing care or need help locating services, please call the National Alliance on Mental Illness (NAMI) Massachusetts helpline at (800) 370-9085
The project is funded by the Peter and Elizabeth C. Tower Foundation