STUDY OF BARRIERS TO INSURANCE COVERAGE OF TREATMENT FOR MENTAL ILLNESS AND SUBSTANCE ABUSE.

SEC. 704. STUDY OF BARRIERS TO INSURANCE COVERAGE OF TREATMENT FOR MENTAL ILLNESS AND SUBSTANCE ABUSE. (a) In General.—The Secretary of Health and Human Services, acting through the Director of the National Institute of Mental Health and in consultation with the Administrator of the Health Care Financing Administration, shall conduct a study of the barriers to insurance coverage for the treatment of mental illness and substance abuse. The study shall include— (1) an assessment of the effect of managed care on the quality and financing of such treatment; (2) an assessment of the appropriateness and cost effectiveness of treatment provided in non-profit, non-hospital settings; and (3) an assessment of the need for equitable coverage of severe mental illnesses as part of national health care reform. (b) Assessment Regarding Mental Illness.—In making an assessment under paragraph (3) of subsection (a), the study required in such subsection shall provide for the following: (1) The clarification of what is meant by mental health coverage differentiating between the need of individuals with severe, long-term mental illnesses and individuals with mental health problems of situational nature. (2) Identification of the particular treatments and services required by persons with severe mental illnesses to maintain optimum functioning in the community. (3) Evaluation of various approaches to providing equitable coverage of severe mental illnesses in private insurance and public health care financing programs. These approaches should include the following: 106 STAT. 438 (A) The diagnostic approach as exemplified by certain State legislation (e.g., California State Code, section 101123.15; Texas Employers Uniform Group Insurance Benefits Act, section 11.106.11.113 (Insurance for Serious Mental Illnesses); and Maine, H.P. 1064: An Act to provide equitable insurance coverage for mental illnesses). (B) The Service-Based Approach, as exemplified in the Model Mental Health Benefit developed the auspices of NIMH Grant MH43703. (C) The Functional (Severity of Disability) Approach. (4) Evaluation of the cost benefit to insurers and the Federal Government of providing equal coverage for severe mental illness. (5) Financing mechanisms for coverage of the rehabilitative and long-term care needs of persons with severe mental illnesses. (c) Report to Congress.—Not later than October 1, 1993, the Secretary shall complete the study required in subsection (a) and submit to the Committee on Energy and Commerce of the House of Representatives, and to the Committee on Labor and Human Resources of the Senate, a report describing the findings made as a result of the study.