2019 Testimony on Parity

TESTIMONY IN FAVOR OF H.B. 7125

AN ACT CONCERNING PARITY FOR MENTAL HEALTH AND SUBSTANCE USE DISORDER BENEFITS, NONQUANTITATIVE TREATMENT LIMITATIONS, DRUGS PRESCRIBED FOR THE TREATMENT OF SUBSTANCE USE DISORDERS, AND SUBSTANCE ABUSE SERVICES.

Good Afternoon. My name is Shaukat Khan. I am a psychiatrist and president of the Connecticut Psychiatric Society, an organization representing over 800 psychiatrists in this state. Psychiatrists are medical doctors, specializing in the treatment of mental and substance use disorders.

We support House Bill 7125 and I would like to give you a few examples from our perspective of why it is necessary.

As man speakers will tell you, a major difficult with implementing parity laws is the benefits that are “non-quantifiable.” Those are differences in care that can’t be easily identified except through comparing statistics across large populations.

From a psychiatric perspective, we see several problems that appear discriminatory. Probably the most prominent is the lack of referral to appropriate care after a patient has left a hospital. Patients are typically admitted to a hospital only for the most extreme conditions. They are very ill, and at risk of harming themselves or others. Some of them are trying to overcome substance use disorders. But third party payers often will not authorize follow-up residential programs and instead mandate treatment on an outpatient basis. This is like saying to a patient with a medical condition “yes you had a serious medical event and your doctor is recommending a skilled nursing facility for aftercare, but we will only authorize physical therapy a few times a week on an outpatient basis.”

Another example is mandating that patients “fail” on cheaper medications or treatments before more expensive medications or treatments are authorized. If someone had a serious medical condition, would we make them wait until they went through noneffective treatments?

Another disturbing example is the lack of appropriately trained practitioners in third party networks. The effect of not having enough treaters in network is both a huge expense to the patient for care they are already paying for in their premiums and delay in receiving the care they need, thus risking that an illness spirals out of control.

We also experience what we see as discrimination in requirements for prior authorization. Psychiatrists are required to submit prior authorizations for medication that seem out of proportion to what medical patients are subject to. The result of this is more overhead for psychiatrists and fewer hours of actual patient care.

We understand that you don’t approve laws based on anecdotes. Our request is that this law be passed so data can be gathered that back up what we and our patients are experiencing
For many years Connecticut led the way to parity. We hope that you will continue that practice so we can deliver on the promises parity makes to patients.

Thank you for your attention.

I would also point out that we have submitted written testimony on H.B. 7261, AN ACT PROHIBITING REQUIREMENTS FOR PRESCRIBING CLINICALLY INAPPROPRIATE QUANTITIES OF OUTPATIENT PSYCHOTROPIC DRUGS. I will be here if you have any questions on our testimony in favor of that bill.

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