AMBHA Data Shows Claims & Costs are Negligible for DSM-IV Mental Disorders Under Attack.

Business Editors/Health & Medical Writers

WASHINGTON--(BW HealthWire)--July 23, 2002

At the House Energy and Commerce Health Subcommittee hearing on "Insurance Coverage of Mental Health Benefits" the American Managed Behavioral Healthcare Association (AMBHA) released evidence that providers rarely bill for several of the mental disorders in the DSM-IV that have come under attack as increasing costs in the mental health parity debate.

The AMBHA calendar year 2001 membership data released today represents over 45 million covered lives and 11.5 million billed mental health claims totaling $3 billion. The data reveals that a miniscule .006 percent of mental health claims, that is 58 claims per 1,000,000 mental health claims, were billed for jet lag, nightmare disorder, sleep terror disorder and sleepwalking disorder.

This translates to a mere .003 percent of total mental health dollars billed or a minimal $32 per $1,000,000 in billed mental health claims. Out of $3 billion billed for mental health claims a total of a meager $95,000 was billed for jet lag, nightmare disorder, sleep terror disorder and sleepwalking disorder in calendar year 2001 for over 45 million covered lives.

The concern that coverage for these disorders will eat up medical costs is clearly unfounded.

"For months we have asserted that these DSM-IV disorders under attack, although covered today, are rarely, if ever, billed for and have an insignificant impact on the overall cost of pending federal mental health parity legislation. Now the members of AMBHA have provided the data to unmistakably back-up this assertion," said Pamela Greenberg, M.P.P., executive director of AMBHA. "The facts are in - parity for these and other mental health disorders is indeed affordable. H.R. 4066 and S. 543, the Mental Health Equitable Treatment Act, has minimal financial impact on health care premiums.

"Mental health parity legislation has the support of 240 Members of the House, 67 Senators and 223 national organizations. Passage of this legislation has been upheld for far too long - let's not wait any longer," Greenberg added.

AMBHA member companies are both national and regional and are collectively responsible for managing mental health and substance abuse services in the public and private sector for over 110 million individuals across the country.

AMBHA was founded in 1994 to enable the leading managed behavioral healthcare organizations in this industry to work together on key issues of public accountability, quality, public policy and communication.

AMBHA Members: Alliance Behavioral Care, Cincinnati, OH; American Psych Systems, Bethesda, MD; Baymeadow Health Services, Glen Burnie, MD; CORPHEALTH, Fort Worth, TX; Horizon Behavioral Services, Lewisville, TX; Magellan Health Services, Columbia, MD; PacifiCare Behavioral Health, Van Nuys, CA; University Behavioral Healthcare, Piscataway, NJ; ValueOptions, Falls Church, VA.