On November 8, 2013 the Obama administration released final regulations implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The MHPAEA is designed to make sure mental health and substance use disorder benefits offered by health plans are in parity with the medical and surgical benefits the plans offer.
The new regulations have been highly anticipated since Congress passed the MHPAEA in October, 2008. The law amended and expanded a variety of previously enacted parity provisions in the Employee Retirement Income Security Act (ERISA), the Public Health Service Act (PHSA), and the Internal Revenue Code. In February 2010, the U.S. Department of the Treasury, the U.S. Department of Labor (DOL), and the U.S. Department of Health and Human Services (HHS) jointly issued interim final regulations to aid employers and group health insurers in implementing the MHPAEA’s requirements.
In general, the MHPAEA requires group health plans that offer mental health or substance use disorder benefits to ensure that the benefits are equivalent to the medical and surgical benefits offered by the plans. This concept is referred to as “parity of benefits.” Some of the areas in which parity is required include financial obligations (e.g., deductibles, copayments, and coinsurance percentages), treatment limitations (e.g., annual number of office visits covered), and the level of coverage offered for treatment by out-of-network providers.