Mental health coverage law: On again, for now

January 18, 1994|By Patrick Gilbert | Patrick Gilbert,Staff Writer

The on-again, off-again implementation of a new Maryland law requiring health insurers to offer better mental health care benefits appears to be on again -- for the time being.

Yesterday, a three-judge panel of the Maryland Court of Special Appeals lifted an injunction that had held up enforcement of the law but postponed the effect of its order until 4 p.m. today, giving insurers a chance to take the case before the full court.

If it stands, the decision would give patients seeking mental treatment under health insurance coverage the right to make claims for that treatment -- at least until a Circuit Court hands down a decision on merits of the law during the first week of February.

Chief Judge Alan M. Wilner of the Court of Special Appeals granted the latest injunction against the law on Friday, pending yesterday's hearing.

After listening to nearly two hours of arguments from attorneys representing the insurance industry on one side and mental health patients on the other, Judges Wilner, Paul E. Albert and Diana J. Gibbon Motz ultimately agreed to lift the injunction.

Because of yesterday's snow and rain, the hearing was held in Towson instead of the court's headquarters in Annapolis.

Judge Wilner indicated that the 24-hour delay would give attorneys representing the industry time to appeal the panel's ruling to the full 13-member special appeals court.

"We're very disappointed with the decision, but we will have to discuss with our clients whether or not an appeal is taken to the full court," said Charles S. Fax, one of the industry's attorneys .

The new law, which requires insurers to offer mental health benefits comparable to those for other illnesses, was to have taken effect Jan. 1. Lawyers for insurers and a policyholder filed suit to block it Dec. 28, claiming the law was vague if not unconstitutional.

Baltimore Circuit Judge Thomas Ward granted a temporary injunction Dec. 30, but that injunction was lifted Thursday by Circuit Judge David Ross, who said the law was "crystal clear." A trial on the merits of the case is now scheduled before Judge Ross on Feb. 2.

The law, sometimes called the "parity" law, was passed by the legislature last year and signed into law May 27. It requires insurance companies to offer those with mental illnesses benefits comparable to those for other diseases. Health maintenance organizations, which have less experience with mental health coverage, were given more time to develop benefits and rates.

Some indemnity insurers offer limited mental health coverage. Most HMOs do not.

Under the law, Marylanders insured by commercial carriers and nonprofit companies such as Blue Cross and Blue Shield of Maryland are entitled to certain levels of mental health coverage. However, few insurers have outlined the benefits, set their rates or developed waivers for policyholders who wish to decline mental health coverage.

Dennis W. Carroll, an assistant attorney general representing the Maryland Insurance Administration, and Randall M. Lutz, representing some mental health patients, argued yesterday that if the temporary injunction was not lifted, patients might be harmed.

"Patients might not seek services they need because they fear with the temporary injunction still in place they ultimately might be forced to pay the full cost of the service," Mr. Lutz said.

Mr. Fax and James J. Doyle III, the industry lawyers, argued that if the injunction is lifted and the law takes effect, it will be hard to process claims for mental health benefits, since most insurers don't have new policies to conform with the new law.

Judge Wilner argued that in any case, claims made by patients under the new law probably won't be processed until after a decision by Judge Ross.

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