The Department of Health and Human Services, Department of Labor, and the Treasury today jointly issued a final rule increasing parity between mental health and substance use disorder benefits and medical/surgical benefits in group and individual health plans.
The final rule issued today implements the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act 2008 (MHPAEA) which is a federal law that generally prevents group health plans and health insurance issuers that provide mental health and substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical and/or surgical coverage.
The rule would ensure that health plans's co-payments, deductibles, and limits on visits to health care providers are not more restrictive or less generous for behavioral health benefits than for medical and/or surgical benefits. In addition, the rule would clarify how parity applies to residential and outpatient treatment services which serve the most vulnerable populations living with addiction and/or mental illness. Although Asian Americans, Native Hawaiians, and Pacific Islanders face additional barriers to substance use disorder treatment due to language barriers and a dearth of culturally competent providers, this final rule significantly increases access of AANHPI consumers to crucial behavioral health treatment services.
While we at the Children's Mental Health Network are pleased that a rule has finally been released let's remember that celebration is good but there are still many questions to be answered. First, we need to wade through the 206-page document to better understand what it says. Second, there are still gaping questions about what this means for individuals receiving Medicaid. The rules don’t include details on how the act affects Medicaid managed care plans. The administration said those details will come later.
So let's celebrate this step in the right direction but also remind ourselves that we need to be hyper-vigilant to what this will actually mean in terms of fairness for families who have youth with emotional challenges. The devil is in the details... Download the rule below and let us know what you think.