The Down and Dirty on Cleaning in Virus Season
Industry Report Reveals Burnout Prevalence Among Cleaning Professionals
How Surfactant Use is Expanding in Commercial Cleaning
Clean Buildings Conference
To ensure more than 150 million people with private health coverage have greater access to mental health and substance use disorder care, the departments of Labor, Health and Human Services and the Treasury took issued final rules to clarify and strengthen protections to expand equitable access to these benefits as compared to medical and surgical benefits and reduce barriers to accessing these services.
The rules build on the departments’ commitment to achieving the full promise of the Mental Health Parity and Addiction Equity Act of 2008. The act requires group health plans and health insurance issuers offering group and individual health insurance coverage that offer mental health or substance use disorder benefits to cover those benefits in parity with medical and surgical benefits, without imposing greater restrictions on mental health or substance use disorder benefits as compared to medical and surgical benefits.
More than 15 years after the law’s enactment, the departments’ enforcement efforts have shown that many still encounter barriers to accessing mental health and substance use disorder care as compared to medical and surgical care under their health plan or coverage.
The new rules add additional protections against more restrictive, nonquantitative treatment limitations for mental health and substance use disorder benefits as compared to medical or surgical benefits. Nonquantitative treatment limitations are requirements that limit the scope or duration of benefits, such as prior authorization requirements, step therapy and standards for provider admission to participate in a network.
The final rules also prohibit plans from using biased or non-objective information and sources that might negatively impact access to mental health and substance use disorder care when designing and applying a non-quantitative treatment limitation.
The final rules make clear that health plans and insurers must evaluate the impact of their non-quantitative treatment limitations on access to mental health and substance use disorder benefits as compared to medical/surgical benefits and provide additional clarity regarding documentation requirements added to MHPAEA by the Consolidated Appropriations Act of 2021.
The newly issued rules also require plans and issuers to collect and evaluate data related to the nonquantitative treatment limitations they place on mental health and substance use disorder care and make changes if the data shows they are providing insufficient access. This change will help pinpoint harmful limitations in individuals’ health coverage and remove barriers to access. In addition, the rules give special emphasis to the careful design and management of provider networks to strengthen access to mental health and substance use disorder care.