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GAO-12-761R 1 (2012-05-31)

handle is hein.gao/gaobacgct0001 and id is 1 raw text is: Accountabiliy - Integrity - Reliability United States Government Accountability Office Washington, DC 20548 May 31, 2012 The Honorable George Miller Ranking Member Committee on Education and the Workforce House of Representatives Subject: Mental Health and Substance Use: Treatment Exclusions in Employers' Health Insurance Coverage Dear Mr. Miller: On November 30, 2011, we issued a report entitled Mental Health and Substance Use: Employers' Insurance Coverage Maintained or Enhanced Since Parity Act, but Effect of Coverage on Enrollees Varied.1 The report was written to fulfill a mandate in the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) that required us to examine trends in coverage for mental health conditions and substance use disorders (MH/SU).2 As a follow-up to the report, you asked us to provide additional information about plans' treatment exclusions for MH/S U.3 The information about treatment exclusions for MH/SU was based on survey data that we collected for our report to determine the extent to which employers covered MH/SU during the plan year in effect at the time of our survey-either 2011 or 2010-and in 2008. We surveyed a stratified random sample of small, medium, large, and very large employers about their most popular health plans for either the 2011 or 2010 plan year, as well as for 2008. We fielded our web-based survey between May 18, 2011, and July 1, 2011, to 707 employers, selected from the sampling frame we developed using the Lexis Nexis corporate database.4 We received usable responses from 168 employers, after following up with nonrespondents to encourage their participation, for a 24 percent response rate. All 168 employers offered coverage of mental health conditions, substance use 1See GAO-1 2-63, Nov. 30, 2011. 2pub. L. No. 110-343, Div. C, Tit. V, Sub. B, § 512, 122 Stat. 3765, 3892 (Oct. 3, 2008). 3This follow-up information was initially provided to you on December 16, 2011. 4 To develop our sampling frame, we used the Dossier function of the Lexis Nexis corporate database to select 32,431 U.S.-based companies on January 18, 2011. We selected privately held and publicly traded parent companies with between 51 to 100,000 employees that were headquartered in the United States. We drew our random sample of employers from this sampling frame. We excluded employers from our survey that had 50 or fewer employees because MHPAEA did not apply to them. GAO-12-761R Treatment Exclusions

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