In the intricate web of healthcare, where preventative measures for the body are often promoted as an essential public health priority, it’s time to ensure that the mind receives the same consideration. Imagine a system that puts the head back on the body while also recognizing the importance of mental health before mental illness. Maryland Senate Bill 124 (Annual Behavioral Health Wellness Visits- Coverage and Reimbursement) aims to do just that, heralding a new era of mental health parity and prevention where the importance of mental illness prevention is recognized at the same level of other preventative health services for men, women, and children. Preventive behavioral healthcare visits have the potential to revolutionize our approach to mental health. By catching issues earlier, before they escalate into more severe conditions, we not only reduce stigma but also pave the way for cost savings compared to traditional treatment models. A shift in focus from reactive to proactive mental health care is not just a moral imperative but a pragmatic approach to building healthier communities.

At the heart of the matter lies the stark contrast in how insurance providers handle preventive appointments for somatic health care and mental health care. For example, in somatic healthcare, preventative annual visits are conducted by general practitioners within various fields (e.g., primary care physician, general dentist, optometrist, gynecologist). On the contrary, there isn’t an establishment of a preventative annual behavioral health visit conducted by a licensed behavioral health professional. Instead, Insurers fund screenings by companies or doctors..

Screenings are preventive but lack depth. They don’t cover 300 mental health diagnoses or offer personalized recommendations. To better prevent and address mental health crises, a comprehensive assessment by a licensed and trained mental health professional is necessary.  One would not expect to go to their primary care for a comprehensive eye exam. The same is true for mental health. While primary care doctors may screen for mental wellness as part of an annual physical, they may not have the specialized training to provide comprehensive behavioral health wellness visits.

To further illustrate the parity concerns between somatic and mental healthcare, the difference between prevention and treatment is important. Annual somatic healthcare visits are fully covered by insurance without consumer cost-sharing or a required diagnosis. These visits remove financial barriers to preventative care and increase access to healthcare. They are designed to screen, assess, offer interventions, and/or provide recommendations for preventing, intervening early in, or slowing down/stopping illness progression. However, mental health visits are categorized as treatment. Meaning, medical necessity must be established and an illness or condition must be present to justify payment for an assessment from a behavioral health practitioner. This practice supports the stigma that if you see a behavioral health professional you must be “crazy.” Current medical necessity policies and practice requires mental health practitioners to make and report a formal mental illness diagnosis to the insurance company for all visits– sometimes raising ethical dilemmas for mental health practitioners and creating more barriers to care. 

As seen in somatic preventative healthcare, It’s time to dismantle medical necessity criteria and the need for a diagnosis when it comes to behavioral healthcare. The essence of Maryland Senate Bill 124 lies in its vision to establish a stronger behavioral health continuum of care. It seeks to normalize behavioral healthcare by requiring health insurers to provide coverage and reimbursement for annual behavioral health visits with no cost-sharing for the consumer and without the necessity of a formal diagnosis. In essence, someone can leave their annual visit with “Good job, your mental health is great, keep it up and see you next year if nothing changes.”

Critics may argue that the proposed policy might lead to an increase in insurance premiums. However, analyses in other states where similar legislation has been passed and implemented (i.e. Colorado, Delaware, Illinois, Massachusetts, and Connecticut) reveal that the age-old adage, “An ounce of prevention is worth a pound of cure” is accurate. At the time of this writing, five other states have passed similar legislation. This provides evidence that Maryland Senate Bill 124 is not an isolated experiment but part of a broader national trend toward recognizing the integral role mental health plays in our overall well-being. This groundbreaking initiative acknowledges that mental health does not equate to mental illness and underscores the importance of addressing mental well-being proactively.

If you are interested in supporting Maryland Senate Bill 124 and advocating for an Annual Behavioral Health Visit, I am happy to assist you in preparing your impactful testimony! Please feel free to direct any queries to, mentalhealthpolicy@eyeinme.com, I look forward to and value your support.