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1. One of the three methods that states typically use so that insurance companies cover behavioral health issues is __________________, which requires insurance for specific behavioral health conditions.
A. Mandated offering
B. Parity
C. Mandated benefits
D. None of the above
2. In general, states address insurance coverage for mental illness and substance use disorders, including inpatient and outpatient benefits, copay amounts, coinsurance requirements, and annual and lifetime dollar limits, all in comparison with the same categories for physical illness.
A. True
B. False
3. Which statement accurately describes the history of state legislative action on mental illness and substance use disorders coverage?
A. Coverage of mental illness and substance use disorders was initially considered by legislatures in 1982 when Florida passed a mandated offering bill on mental illness
B. In 1985, eight states enacted mandated offering laws for substance use disorders, and five passed legislation requiring substance use disorders benefits
C. In 1987, several southern states enacted legislation requiring health insurers to cover 30 days of treatment for all substance abuse disorders
D. Despite activity around mental health issues in a few States, the majority of legislative activity during this time period related to substance use disorders, specifically alcoholism
4. Perhaps the strongest parity law among the States is that of Vermont, which requires equal coverage for physical and mental illness, including substance use disorders.
A. True
B. False
5. In 1991, North Carolina and Texas were the first parity statutes requiring equal insurance coverage for mental and physical illnesses but limited the targeting of benefits to those insured through the State employee health plan.
A. True
B. False
6. A landmark year for state legislation was 1997 when governors in Arkansas, Colorado, Connecticut, and Vermont signed bills requiring parity in health insurance coverage between mental illness and physical conditions.
A. True
B. False
7. After four years of increases in parity legislation, 2001 signaled the first signs of revisions in this trend when:
A. While many legislatures considered parity and 28 states debated bills, only 6 of them actually adopted parity statutes
B. Texas legislators amended coverage provided to State employees to reduce benefits from full parity for serious mental illness to a minimum mandated benefit, and set limitations on inpatient and outpatient treatment
C. Employers from public and private companies began to assert that the heavy rise in insurance costs was preventing them from offering needed coverage
D. All of the above
8. In 2004, as more decline continued to occur in legislative activity considering parity bills, the drop was attributed either to the success of the states who had already enacted parity and/or mandated benefits legislation or suspicion that required benefits were increasing health insurance costs.
A. True
B. False
9. Which of the following in NOT an accurate statement about the Mental Health Parity Act?
A. Since it applied only if mental health benefits were offered in an insurance plan, it was generally considered to be a “mandated offering” law
B. The law did not apply to cost sharing, nor did it include substance use disorders conditions
C. Employers with fewer than 50 employees could be exempt from the law’s provisions if they expected to experience a premium increase of at least 1 percent due to the addition of the benefit
D. The 1996 act applies to all insurers and prohibits them from restricting office visits and hospital stays
10. While the Federal act does not preempt State law, it does require the States to enact it in order for it to take effect.
A. True
B. False
11. State statutes include myriad approaches to the amount of coverage received by an individual, which include the extent of inpatient, outpatient, and residential care, the allowable annual and lifetime dollar limits, and:
A. The minimum scope of benefits required for biologically based mental disorders
B. The requirements for catastrophic mental health benefits
C. The size of copays
D. All of the above
12. While states handle copayments and deductibles in a number of ways, _____ require the same consideration for physical and mental health services.
A. 31
B. 29
C. 27
D. 25
13. The state of Alaska requires mandated coverage in the areas of mental illness, alcoholism, and other substance use disorders
A. True
B. False
14. In 2001, a legislative amendment was passed in Kentucky that called for the following:
A. Small employers of 25 or fewer were exempt from all mental health coverage
B. Exemption of substance abuse disorder services if premiums increased by 3% or more
C. Exemption of all mental health disorders that were not biologically based
D. Amendment of the previous law passed in 2000 to exempt employers of 51 or fewer
15. New Hampshire is unique in that it is the only state that offers parity for biologically based mental illness and minimum mandated benefits for other mental illnesses.
A. True
B. False
16. States that mandate equal treatment for mental illness define it as biologically based or ___________ mental illness.
A. Generalized
B. Maladaptive
C. Serious
D. Comorbid
17. Not only are substance use disorders generally treated differently than physical illness, coverage of substance abuse is required significantly more often than for mental illness.
A. True
B. False
18. Several states have passed legislation that requires parity for developmental disorders and mandated benefits for all DSM diagnoses.
A. True
B. False
19. State “scope of practice” statues and rules that govern health professions specify what procedures and functions are legally within the purview of members of an individual profession and:
A. Define the required educational and training preparation
B. Describe what procedures can be administered and by whom
C. Determine what, if any, tasks can be delegated with supervision
D. All of the above
20. Which of the following is a correct statement about licensing and certification processes for mental health professionals?
A. 48 states have legal regulations governing psychiatrists, psychologists, psychiatric nurses, and social workers, while the other 2 states defer to federal regulations
B. States' licensing processes are established through law and regulation to protect the public
C. Social workers are required to be licensed in all 50 States and in the District of Columbia, while professional counselors have certification mandates in all states
D. When States choose to establish a certifying process, certification must be awarded by a governmental entity that is recognized by state and federal entities
21. Through ____________________ most states require that alcohol and drug professionals meet certain competency standards to provide clinical services.
A. Statutes and regulations
B. Measures and procedures
C. Decrees and codes
D. Provisions and restrictions
22. In some states, individuals are allowed to practice as substance abuse counselors without certification because they work in agencies that are themselves licensed by the State, and the facility license should provide necessary protections for the public.
A. True
B. False
23. Prescriptive authority in the United States for patients with behavioral health problems includes:
A. Psychiatrists are recognized by every jurisdiction, and the psychiatric scope of practice includes full prescriptive authority in 42 states and limited prescriptive authority in 8 states
B. The type of prescriptive authority states grant to advanced practice nurses must be qualified as either supervisory or collaborative
C. As of 2006, nurse practitioners could prescribe in all 50 states plus the District of Columbia, and independently of physicians in at least 14 states
D. Although psychologists have not traditionally prescribed drugs, a legislative campaign has been initiated throughout the country in pursuit of prescriptive authority, and Louisiana, North Dakota, and Kansas have recently enacted such statutes.
24. Advanced practice registered nurses in Hawaii must have ______ hours of specialty clinical experience prior to gaining prescriptive authority.
A. 1000
B. 1500
C. 2000
D. 2500
25. Physician assistants’ (PAs) prescriptive authority is always dependent on delegation by a supervising physician who must be present.
A. True
B. False
26. As attention deficit/hyperactivity disorder (ADHD) diagnoses are increasing in school aged children, some teachers and education officials have advocated for laws or school policy requiring afflicted students to take prescribed medication in order to participate in school activities.
A. True
B. False
27. Recent legislation passed in Connecticut has enabled the Department of Children and Families to take into custody any child whose parent or guardian refuses to administer or consent to administration of a prescribed psychotropic drug.
A. True
B. False
28. As the cost of health care coverage continues to be an increasingly large portion of state and private sector budgets, it is likely that state legislatures will continue to scale back on previously required benefit coverage for mental health and substance use disorders.
A. True
B. False
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