A new federal rule will push employer-sponsored health plans to reevaluate how they provide mental health benefits relative to medical and surgical treatments. Mandated by the departments of Health and Human Services, Labor, and Treasury, the rule is meant to enforce the Mental Health Parity and Addiction Equity Act of 2008 more strictly. This final rule, effective Sept. 9, requires health plans to execute detailed comparisons—known as parity tests—between their mental health and medical coverages. (RIN: 1210-AC11)
Key among these requirements is the introduction of tests for “non-quantitative treatment limitations,” including prior authorization standards and network adequacy. The rule aims to eliminate discrepancies in coverage such as more restrictive practices for mental health services versus general medical care.
However, the rule has been met with criticism from some industry groups who argue that its provisions are vague and exceed regulatory authority. The administration has promised further guidance and assistance to ensure compliance with the new requirements, but for now, the status quo maintained by many health plans is unlikely to meet the tightened standards.
For more information on this development, read the detailed coverage on Bloomberg Law.