Psychotherapy, Parity, and Ethical Utilization Management.

Managed care has long functioned with the assumption of a split in clinical and ethical responsibility for treatment. The insurance company clinician has been seen as owing a primary obligation to the insurance company and its utilization management standards, while the treating clinician is seen as holding primary clinical and ethical responsibility for the patient and the treatment. This article explores the potential impact of mental health parity mandates and recent clarifications of the American Psychiatric Association's ethical code on this split for psychiatrists and other clinicians who develop utilization management standards or serve as utilization reviewers.