Parity is Paramount: Understanding the New Mental Health Parity Final Regs

IRS, Treasury, DOL, EBSA, HHS, and CMS have jointly issued final mental health and substance use disorder regulations with a focus on improving mental health coverage in group health plans and insured plans so that nonquantitative treatment limitations (NQTLs) are ‘‘no more restrictive’’ than the predominant requirements and limitations that apply under the plan to substantially all medical/surgical benefits. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) expressly requires group health plans and health insurance issuers that provide both medical/surgical benefits and mental health or substance use disorder benefits to perform and document comparative analyses of the design and application of NQTLs that apply to mental health or substance use disorder benefits. See how the final regulations integrate those requirements into the rules.

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Related Content

• Mental Health Parity and Addiction Equity Act Compliance for Employer Health Plans
  Review the CAA’21 (Pub. L. No. 116-260) provisions reflected in the final regulations that mandate performance of NQTL analyses and disclosure. NQTLs refer to any restriction on the scope or duration of a treatment or service that is not expressed numerically, like the need for preauthorization, or a determination of medical necessity, before coverage is allowed.
• Mental Health Parity Act: A Compliance Wake-Up Call
  Browse the requirements of the MHPAEA. The MHPAEA introduced a parity requirement, indicating that plans and insurers that provide mental health or substance use disorder benefits in addition to medical surgical benefits cannot impose less favorable benefit limitations on mental health or substance use disorder benefits. The parity requirement extends to the application of both quantitative treatment limitations — e.g., number of permitted stays in a treatment facility — and NQTLs.

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