Feds Release Parity Enforcement Tools
Last week, several federal agencies issued guidance to enhance the enforcement of the federal parity law, which requires that insurance coverage of mental health and addiction services be equal to medical/surgical health services. The new guidance is the result of requirements included in the 21st Century Cures Act to improve behavioral health coverage. The guidance released by Health and Human Services (HHS), Departments of Labor and Treasury is intended to help employers and insurers implement parity, improve the coordination of parity enforcement between the agencies and to provide Congress with recommendations for improving parity compliance moving forward.
Federal agencies have released the following resources to improve enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, as required by the 21st Century Cures Act:
- Proposed NQTL FAQs: This document includes proposed guidance from the Department of Labor regarding nonquantitative treatment limitations (NQTLs) and disclosure requirements in connection with the Mental Health Parity and Addiction Equity Act (MHPAEA). NQTLs are non-numerical limits on the scope or duration of treatment benefits, such as preauthorization requirements. Public comments are invited and can be submitted until June 22, 2018 to E-OHPSCA-FAQ39@dol.gov.
- DOL 2018 Report to Congress: Pathway to Full Parity: This report summarizes DOL’s activities to further parity implementation and provides a roadmap of DOL vision for the future to minimize parity violations.
- FY2017 MHPAEA Enforcement Fact Sheet: This fact sheet summarizes the parity enforcement activities of the Employee Benefits Security Administration (EBSA), which relies on its 400 investigators to review health plans for compliance with MHPAEA.
- 2018 MHPAEA Self-Compliance Tool: The goal of this self-compliance tool is to help group health plans, plan sponsors, plan administrators, group and individual market health insurance issuers, state regulators and other parties determine whether a group health plan or health insurance issuer complies with MHPAEA.
- Revised Draft MHPAEA Disclosure Template (issued April 23, 2018): This is a tool to help consumers request information from their employer-sponsored health plan or insurer regarding coverage limitations that may affect their access to mental health or substance use disorder benefits.
- HHS Mental Health and Substance Use Disorder Action Plan: The Action Plan highlights recent activities and planned actions from HHS, DOL and the Treasury Department related to ongoing implementation of MHPAEA based comments from a public listening session held in July 2017.