The Biden administration on Monday finalized several modifications to the existing legal framework governing mental healthcare. These changes aim to close loopholes in existing laws and enhance access to healthcare for mental illness and addiction.
One of the key updates mandates that healthcare companies must “evaluate their provider networks, how much they pay out-of-network providers, and how often they require—and deny—prior authorizations.” This data will be instrumental in ensuring healthcare companies comply with rules set out in the Mental Health Parity and Addiction Equity Act (MHPAEA).
Passed in 2008, the MHPAEA requires that healthcare companies provide equal access to mental health and addiction services as they do to traditional medical care. Under the new rules, if data indicates non-compliance, companies will be legally required to “take reasonable action, as necessary to address material differences in access.”
Additionally, the new rules close a loophole that previously exempted state government healthcare plans from the requirements of the MHPAEA. Other key changes include restricting healthcare management practices such as prior authorization, which has often been used to limit access to mental health and addiction benefits. Prior authorization requires patients to get permission from their insurance before accessing healthcare services, often resulting in delays and denials.
This new regulation marks the first substantial update to the MHPAEA’s implementing regulations since 2013, and the Biden-Harris administration hopes this will ensure that mental health and addiction care are treated on par with physical health care coverage.
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