EBIA Weekly Newsletter

Interagency Task Force to Focus on Mental Health and Substance Use Disorder Parity

   June 23, 2016

HHS Webpage: Mental Health and Substance Use Disorder Parity Task Force

Available at http://www.hhs.gov/about/agencies/advisory-committees/parity/index.html

HHS, DOL, IRS, and other federal agencies have formed a task force on mental health and substance use disorder parity. One mission of the task force, which was created by a Presidential Memorandum in March 2016, is to identify and address gaps in guidance with regard to substance use disorder parity. Other objectives include providing support, resources, and tools to health plans and insurers to ensure coverage complies with the mental health and substance use disorder parity requirements. (The Mental Health Parity Act (MHPA) and the Mental Health Parity and Addiction Equity Act (MHPAEA) require parity between medical or surgical benefits and mental health or substance use disorder benefits in the application of (1) annual and lifetime dollar limits; (2) financial requirements (such as deductibles, copayments, coinsurance, and out-of-pocket maximums); (3) quantitative treatment limitations (such as number of treatments, visits, or days of coverage); and (4) nonquantitative treatment limitations (such as restrictions based on facility type).) The findings and recommendations of the task force are to be reported before November 2016.

EBIA Comment: This task force accompanies a flood of recent federal actions focused on mental health and substance use disorders, including agency guidance on covering medication-assisted treatment for opioid use disorder (see our Checkpoint article), DOL guidance on plan provisions that may violate mental health parity (see our Checkpoint
article), and DOL information for participants on their mental health parity rights. The formation of the task force may lead to further guidance on mental health parity requirements—especially as applied to substance use disorders—as well as additional audit and enforcement activity directed at health plans and insurers. For more information, see EBIA’s Group Health Plan Mandates manual at Section IX (“Mental Health Parity”) and EBIA’s Self-Insured Health Plans manual at Section XIII.C.2 (“MHPA and MHPAEA: Mental Health Parity”).

Contributing Editors: EBIA Staff.