On July 31, Last Week Tonight with John Oliver aired an episode on the lack of adequate mental health care. It discussed the workforce shortage and lack of parity enforcement. It highlighted issues including ghost networks, medical necessity denials, inadequate reimbursement rates and high rates of out-of-network care for mental health.
The episode suggested that more professionals need to be recruited and reimbursed adequately, and parity laws at the state and federal level need to be strengthened and enforced. It highlighted California’s parity law, which requires insurers to base medical necessity determinations on generally accepted standards of care, as a model for other states.
The segment reinforced the critical importance of rehearing the Wit v. United Behavioral Health case in the full 9th Circuit Court of Appeals. The Kennedy Forum describes it as “a landmark case, potentially setting a precedent for how care will be covered for Americans seeking treatment for mental health and addiction.”
Rehearing the case would allow the full 9th Circuit Court of Appeals to revisit the panel’s previous ruling that allows insurers to deny coverage of medically necessary treatment by using their own standards that benefit their financial interests, rather than generally accepted standards of care based on patient needs.