Require GAO report on MH/SUD reimbursement rates

Parity, Coverage, & Equitable Access
Diverse Workforce
social determinants of health
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Coverage & Standards
Employer Sponsored Plans
Individual ACA Plans
Federal Employee Health Plans
Federal department
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house committees
House Education and Workforce Committee
House Energy and Commerce Committee
House Armed Services Committee
House Ways and Means Committee
House Oversight and Accountability Committee
House Veterans' Affairs Committee
senate committees
Senate Finance Committee
Senate Health, Education, Labor, and Pensions Committee
Senate Armed Services Committee
Senate Homeland Security and Governmental Affairs Committee
Senate Veterans' Affairs Committee


Congress should require the Government Accountability Office (GAO) to report to Congress on current reimbursement rates paid for mental health and substance use disorder (MH/SUD) services by Medicare, Medicaid, individual and group health plans, and other types of health coverage, both in and out of network. Rates should be assessed for their sufficiency to increase in the supply of participating providers and pipeline for clinicians entering MH/SUD fields, as well as compared to physical health reimbursement.[1]


Millions of individuals with MH/SUDs are unable to access the services they need. A significant part of the problem is that reimbursement rates for MH/SUD services are often lower than those for physical health services, which can discourage providers from participating in certain insurance networks or accepting insured patients.[2] Conversely, higher reimbursement rates can incentivize providers to join insurer networks and encourage more people to become MH/SUD clinicians, increasing access to care.[3] Reimbursement rates also vary widely across payers and markets.[4] This variation can create challenges for providers to navigate complex billing and payment systems and for patients to afford and access quality care. The GAO can play an important role in increasing transparency of reimbursement rates paid and disparities that exist that inhibit access to care.


1. Giliberti, Mary. Fix the Foundation: Unfair Rate Setting Leads to Inaccessible Mental Health Care. Mental Health America. Last Updated February 10, 2023.

2. Melek, Steve, Stoddard Davenport, and T.J. Gray. Addiction and Mental Health vs. Physical Health: Widening Disparities in Network Use and Provider Reimbursement. Milliman Research Report. Last Updated November 19, 2019.

3. U.S. Government Accountability Office. Access Challenges for Covered Consumers and Relevant Federal Efforts. Last Updated March 2022.

4. Mann, Cindy and Adam Striar. How Differences in Medicaid, Medicare, and Commercial Health Insurance Payment Rates Impact Access, Health Equity, and Cost. The Commonwealth Fund. Last Updated August 17, 2022.