<nobr>Feb 4, 2010</nobr>

Agencies Release Interim Final Rules on Mental Health Parity Act

The Departments of Labor, Health and Human Services (HHS), and Treasury on February 2 jointly published in the Federal Register interim final rules implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).

In general, the Act requires parity between mental health or substance-use disorder benefits and medical/surgical benefits with respect to financial requirements and treatment limitations under group health plans and health insurance coverage offered in connection with a group health plan.

The interim final rules prohibit group health insurance plans from restricting access to care by limiting benefits and requiring higher patient costs than those that apply to general medical or surgical benefits. MHPAEA requires that any group health plan that includes mental health and substance use disorder benefits along with standard medical and surgical coverage must treat them equally in terms of out-of-pocket costs, benefit limits and practices such as prior authorization and utilization review.

MHPAEA applies to employers with 50 or more workers whose group health plans choose to offer mental health or substance-use disorder benefits. The interim final regulations are effective April 5, 2010, and generally apply to group health plans and group health insurance issuers for plan years beginning on or after July 1, 2010.

According to a release, the agencies are seeking comments on the interim final rules, including in the specific areas of so-called "non quantitative" treatment limits such as those that pertain to the scope and duration of covered benefits, how covered drugs are determined (formularies) and the coverage of step-therapies. Comments are also being requested on the regulation's section on "scope of benefits" or continuum of care.

Comments on the interim final rules are due by May 3, 2010.

Questions or comments on the rules should be addressed to Gretchen Young, gyoung@eric.org, or Adam Solander, asolander@eric.org.

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Websites:

Interim Final Rules on Mental Health Parity

DOL Fact Sheet

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