2019 -- H 5965

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LC002361

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2019

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H O U S E   R E S O L U T I O N

RESPECTFULLY REQUESTING THE RHODE ISLAND DEPARTMENT OF BEHAVIORAL

HEALTHCARE, DEVELOPMENTAL DISABILITIES AND HOSPITALS (BHDDH) TO

FULLY ADDRESS ALL PREVIOUS VIOLATIONS AND TAKE ALL NECESSARY

ACTIONS TO ENSURE ONGOING COMPLIANCE WITH THE FEDERAL MENTAL

HEALTH PARITY AND ADDICTION EQUITY ACT OF 2008

     Introduced By: Representatives McNamara, Kislak, Jackson, Corvese, and Cortvriend

     Date Introduced: April 05, 2019

     Referred To: House Health, Education & Welfare

     WHEREAS, One in five American adults in the United States experience a mental health

disorder and one in thirteen individuals aged twelve or older experience a substance use disorder;

and

     WHEREAS, Fewer than half of American adults with a mental health disorder receive

treatment, and fewer than one in ten individuals aged twelve or older with a substance use

disorder receive treatment; and

     WHEREAS, Cost is a principle barrier to attaining mental health treatment, and lack of

health care coverage and cost are the top two reasons for not attaining substance use disorder

treatment; and

     WHEREAS, The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction

Equity Act of 2008 was enacted to end insurer discrimination against people with mental health

and substance use disorders; and

     WHEREAS, Fatal drug overdoses in Rhode Island were 28 percent higher in 2018 than in

2013, with nearly 300 deaths last year; and

     WHEREAS, The suicide rate in Rhode Island increased 34 percent from 1999 to 2016;

and

     WHEREAS, Ending insurer discrimination against mental health and substance use

disorder coverage will result in greater treatment and fewer deaths; and

     WHEREAS, In Wit v. United Healthcare Insurance Company, a landmark mental health

ruling issued on March 5, 2019, a federal court held that United Behavioral Health (UBH), which

serves over 60 million members and is owned by UnitedHealth Group, used flawed internal

guidelines to unlawfully deny mental health and substance use treatment to insurance plan

members across the United States; and

     WHEREAS, The federal court concluded that UBH developed its own medical necessity

criteria to evaluate outpatient, intensive outpatient, and residential treatment mental health and

substance use disorder claims that were inconsistent with generally accepted standards of

behavioral health care; and

     WHEREAS, The federal court found that UBH's internally-developed guidelines were

intended to limit coverage to "acute" episodes or crises, such as when patients are actively

suicidal or suffering from severe withdrawal, rather than for ongoing care for chronic and co-

existing conditions; and

     WHEREAS, The federal court found that UBH's guidelines improperly required reducing

the level of care by removing patients from residential treatment to some form of outpatient

therapy, even when treating providers - consistent with generally accepted clinical standards -

believed maintaining a higher level of care was more effective; and

     WHEREAS, The federal court found that, from July 10, 2015, through June 1, 2017,

UBH violated R.I.G.L. § 27-38.2-l(g), which requires that insurers use criteria consistent with the

criteria from the American Society of Addiction Medicine (ASAM) for substance use disorder

claims, and instead used its own criteria that were inconsistent with the ASAM criteria; and

     WHEREAS, No health plan subject to the jurisdiction of the State of Rhode Island should

be permitted to improperly reduce the level of care for people needing mental health and

substance use treatment or limit treatment to only acute care, denying people with chronic mental

health and substance use conditions ongoing treatment; now, therefore be it

     RESOLVED, That this House of Representatives of the State of Rhode Island and

Providence Plantations hereby supports taking the necessary actions and respectfully requests the

Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals

(BHDDH) to fully address all previous violations of the federal Mental Health Parity and

Addiction Equity Act of 2008, Rhode Island parity law, and R.I.G.L. § 27-38.2-l(g); and be it

further

     RESOLVED, That this House hereby requests the BHDDH to take all necessary actions

to ensure ongoing compliance with the federal Mental Health Parity and Addiction Equity Act of

2008, Rhode Island parity law, and R.I.G.L. § 27-38.2-l(g); and be it further

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     RESOLVED, That the Secretary of State be and hereby is authorized and directed to

transmit duly certified copies of this resolution to the Honorable Gina Raimondo, Governor of the

State of Rhode Island and Rebecca Ross, Director of the Rhode Island Department of Behavioral

Healthcare, Developmental Disabilities and Hospitals.

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LC002361

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