Georgia's New Mental Health Parity Act

Effective July 1, 2022, Georgia enacted the Mental Health Parity Act which signified new sweeping changes for its mental health services. For the first time in Georgia, all health insurance plans must cover mental health conditions on par with physical ones, so patients can no longer be denied medically necessary treatment. The law covers a lot of ground, ranging from the legality of involuntary commitment, oversight of the mental health services system, and service-cancelable loans for people who pursue a career in the mental health services field.

The new law also mandates that insurers collect and report data on compliance with parity to the state. The first published parity reports will be available online by January 1, 2024. The Act includes funding to hire a new mental health parity officer in the state insurance department to oversee the law’s implementation and eventually investigate potential violations of mental health parity.

But what most Georgia residents need to know about is the so-called "parity" provision. This part of the law mandates that insurance companies cover mental health services the same as they do services for physical care. Treatments for substance abuse and addiction must also be treated the same as physical care.

For example: Say a person enrolled in an insurance plan has unlimited doctor visits for a chronic condition like diabetes. Then, under the law, that plan must also offer unlimited visits for a mental health condition such as depression or obsessive-compulsive disorder.

As of the July 1 effective date, insurance companies must cover care that is "medically necessary." Even though federal law already requires that most health insurance plans treat mental health and substance abuse the same as other medical care, many companies find ways to skirt the law. This new law provides a definition of what is "medically necessary" to include the "generally accepted standards of mental health or substance abuse disorder care," so there is no gray area.

The new law gives less leeway to insurance companies to deny mental health coverage arbitrarily. The new law favors the judgment of the mental health professional treating the patient. If an insurance company seeks to deny mental health coverage, the denial must be based on standards that are recognized by mental health professionals, not guidelines developed by or on behalf of the insurance company.

For more information, please contact compliance@benefitmall.com