Lutheran Services in Iowa Ensure insurance companies don't deny coverage for PMIC residential services to children

Ensure insurance companies don't deny coverage for PMIC residential services to children

Make sure insurance companies can no longer use a loophole in current law to deny coverage of PMIC residential services. House File 773 would close a loophole that insurance companies use to deny PMIC care as being custodial in nature.

Act Now!

Time is of the essence for House File 773 which would deem a child who needs treatment for mental illness and who meets the Medicaid criteria for admission to a PMIC as meeting the acuity criteria for third-party payment of 30 day inpatient benefits. The Insurance industry is working against this bill vehemently despite the fact that this language passed in 2005. The bill now goes to the full House floor for debate and we need your help to ensure passage by the next week’s funnel deadline – Friday, March 27th.

Sample Letter for Campaign

Subject: Make PMIC Care Available to All Children

Dear [ Decision Maker ] ,

HF 773 is a clarification of the 2005 Mental Health Parity law. It will prevent insurance companies from denying coverage to the most severely mentally ill children in the state who receive services at PMIC facilities. The bill would close a loophole that insurance companies use to deny PMIC care as being custodial in nature.

Insurance companies have failed to pay their obligations under the law and as a result have passed the buck to the state, costing Iowa $550,000 annually. When insurance companies deny coverage, many families choose not to get treatment in a PMIC, such as Lutheran Services in Iowa's residential treatment facilities in Ames and Waverly, due to the financial risk.

HF 773 will ensure that children get the services they desperately need with the insurance coverage they are entitled to. It will also save the state over half a million dollars in this difficult economy, with little or no negative impact on the business community; a true win/win solution. Your support is critical.

Thank you for taking the time to read this email and for supporting the important services LSI provides for Iowa's children and families.

Sincerely,

Campaign Launched:
March 20, 2009

Background Information

In 2005, Mental Health Parity passed which provided 30 inpatient days of insurance coverage for PMIC services. This bill is a clarification of existing law despite the mischaracterization of the insurance lobby – simply a scare tactic. This language is already on the books and they were covering the services several years ago. It is simply a clarification of what was intended in 2005 to ensure loopholes no longer exist for the insurance industry to decline coverage of services.

Every vote for House File 773 is crucial as it is very close to not having enough votes at this point. There is a great deal of pressure from Republican leadership on its members to vote against this as it would be against business. We strongly disagree that this is against business, as the total cost to the entire insurance industry would be around one million dollars per year maximum. There is very little chance that insurance premiums would go up at all. The cost savings businesses would get by their employees having access to treatment for their severely mentally ill children would be substantial if increased productivity is taken into account. Several members are on the fence, and hearing from you could make the difference.