AMA joins MSD and broad coalition to call for strong parity law
The AMA joined the Medical Society of Delaware (MSD) and a broad array of patient advocacy organizations and state government officials in calling for the Delaware General Assembly to enact Senate Bill 22 (S.B. 22), “Fair Standards in Mental Health Care.”
In a hearing on May 23, the AMA joined MSD’s Cedric Barnes, MD, and many others urging passage of S.B. 22, including:
Inseparable (PDF)
Representatives from NAMI-Delaware, Mental Health Association-Delaware, Delaware Behavioral Health Consortium
Representatives from the state department of insurance, state department of health and social services and the state public health association
AHIP and the Blue Cross Blue Shield Association of Delaware oppose the bill.
The bill, which passed the Delaware Senate, would strengthen Delaware’s mental health and substance use disorder parity laws by:
Requiring coverage of the full continuum of medically necessary care for mental health and substance use conditions, consistent with generally accepted clinical standards
Ensuring that medical necessity determinations are based on independent, evidence-based clinical guidelines, rather than insurers’ internal criteria
Improving timely access to care by setting clear standards for network adequacy and requiring coverage of out-of-network care when in-network providers are not available
Strengthening protections against restrictive utilization management practices that can delay or disrupt care, including limits on prior authorization and concurrent review in key circumstances
Expanding access to life-saving medications and ensuring they are available without unnecessary barriers
“MSD supports SB 22 because it offers practical and meaningful solutions to close existing gaps in coverage, improve access to care, and ensure that patients receive true value for their premium dollars,” wrote (PDF) MSD President Brian J. Galinat, MD, MBA, and MSD Chair of the Government Affairs Committee Richard Henderson, MD. “This legislation helps ensure that insurance coverage functions as intended—supporting, rather than obstructing, medically necessary care.”
“SB 22 is about fairness,” said David Lloyd, chief policy officer at Inseparable. "Mental health and substance use conditions are health conditions, and Delaware law should make sure people can access medically necessary care without unnecessary barriers.”
“This legislation is especially critical at a time when demand for behavioral health services continues to rise,” wrote AMA CEO John Whyte, MD, MPH, in a letter (PDF) to the Delaware House Health & Human Development Committee. “Delaware already requires use of the ASAM Criteria for substance use disorders. Yet no equivalent protection exists for other mental health conditions. S.B. 22 brings that same transparency and accountability to every patient, regardless of diagnosis. By aligning coverage with clinical best practices, this bill will improve outcomes while supporting a more efficient and effective healthcare system.”
