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Mental Health Parity under the Microscope

August 08, 2023 (3 min read)

It’s been 15 years since the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) (110-343, Title V) was enacted, regulating behavioral health benefits provided through group health plans and policies, and requiring general equivalence between mental health and substance use disorder benefits (MH/SUDs) to those provided under the plan for other health and surgical benefits. Compliance appears to require a nudge forward.

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    See how the MHPAEA generally prevents health plans and policies that cover MH/SUD benefits from imposing less favorable terms on those benefits than on medical and surgical benefits. Section 203 of Div. BB of the Consolidated Appropriations Act, 2021 (Pub. L. No. 116-260) imposed requirements on certain group health plans to perform compliance analyses to ensure they do not impose a Non-Quantitative Treatment Limitation (NQTL) (i.e., a process, strategy, evidentiary standard, or other criteria that may limit the scope or duration of benefits for plan services provided) that imposes a condition that is more restrictive than the terms for medical or surgical benefit.

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