Sometimes doctors know better than insurers whether it's necessary for someone to stay in the hospital.
A bill that would clarify the nature of mental health services covered by insurance policies is awaiting Governor Dannel Malloy’s review.
Mental health advocates often talk about a lack of parity -- the idea that insurance companies don't pay for mental health services in the same way that they pay for other health issues.
"I think one of the reasons we had to pass the bill is we needed clarification in statute," said state healthcare advocate Vicki Veltri. Her office drafter the bill.
"It's important to lay down in the law that we expect these services to be covered,” she said. “So, for instance, in-home services. They're not routinely covered. There are some pilots going on. And we believe that they have to be covered."
A provision that didn't make the final cut was one that would have required insurers to cover emergency mental health related hospitalizations for at least 14 days. Take, for instance, a patient who is suicidal.
"Once the patient is admitted after two or three days, we have to go through recertification," said Hank Schwartz, psychiatrist in chief at the Institute of Living in Hartford.
"And in the recertification process, the insurer may determine, well, the patient is now saying that he or she is no longer suicidal, so we're not paying anymore," he said.
Schwartz said sometimes doctors know better than insurers whether it’s medically necessary for someone to stay in the hospital.
"We understand that people should not be residing within institutions any longer than they need to be,” he said. “But, currently, they're not able very often to be in the hospital for as long as they should be. And the consequences of that are quite significant."
Schwartz said he's disappointed this provision didn't pass in the final bill. Veltri said that, while she fully supports the notion, it may have run into problems with federal law.
A spokesman for Governor Malloy said the bill is under review.
