Identifying Fee and Reimbursement Discrimination for Mental Health Services 

As part of our efforts to enforce federal mental health parity laws, the New York State Psychiatric Association has prepared two forms for individuals to submit to their health insurance plans to request information about the fees paid for outpatient services including services used in the treatment of mental illness.  NYSPA spearheaded successful efforts to secure mental health parity in New York.  The American Psychiatric Association was a key advocate for enactment of federal law mandating health insurance parity for the treatment of mental illness.  Once state and federal parity laws were passed and became effective, our efforts now must switch to parity enforcement.

One of the most important concerns in parity enforcement is ensuring non-discriminatory reimbursement for the treatment of mental illness.  If health plans provide lower fees for the treatment of mental illness than paid for other illnesses and conditions, patients seeking treatment for mental illness must pay more for care than patients would have to pay for any other illness or condition.  This form of discrimination also impacts psychiatrists who receive lower reimbursement for treatment than other physicians providing treatment for patients with other illnesses and conditions.

The two NYSPA forms are designed to request information to find out if health plans are in fact discriminating in the fees paid for the treatment of mental illness.  

Click the following links for:

Instructions for Completing Outpatient Physician Fees Request Forms
Request for Outpatient Physician Fees - In-Network
Request for Outpatient Physician Fees - Out-of-Network