The Departments of Health and Human Services, Labor, and Treasury jointly issued a final rule last Friday to increase parity between mental health and substance use disorder benefits and other medical benefits. The rule will implement the Mental Health Parity and Addiction Equity Act of 2008.
The mental health parity law prohibits insurance companies from limiting insurance coverage for mental health and substance use disorder services. The law requires that insurance companies issuing mental health benefits offer coverage that is not more restrictive than other benefits with respect to copays, deductibles, and limitations on the number of outpatient visits covered, among other things.
The final rule explains a number of points in the law and includes specific consumer protections, including ensuring the parity applies to certain care received in residential treatment settings, clarifying patients’ privacy rights, ensuring that parity applies to all plan standards, and eliminating certain exceptions [see PDF].
“This final rule breaks down barriers that stand in the way of treatment and recovery services for millions of Americans,” said HHS Secretary Kathleen Sebelius. “Building on these rules, the Affordable Care Act is expanding mental health and substantive use disorder benefits and parity protections to 62 million Americans. This historic expansion will help make treatment more affordable and accessible.”
The Affordable Care Act requires qualified health plans offered on the health insurance marketplaces to include mental health and substance use disorder services as one of ten essential benefits. About one and four adults in the US have a mental health disorder, and 45 percent of those adults suffer from two diagnosable disorders. The new rule issued last week applies to group and individual insurance policies, but, they do not apply to Medicaid or Medicare.
Media Resources: New York Times 11/8/13; National Institute of Mental Health; HHS Press Release