MENTAL HEALTH PARITY

The Mental Health Parity and Addiction Equity Act

The U.S. Departments of Labor, Health and Human Services and the Treasury have answered a question about the implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, as amended by the Affordable Care Act (ACA) and the 21st Century Cures Act (Cures Act).

Q: Does MHPAEA apply to any benefits a plan or issuer may offer for treatment of an eating disorder?

A: Yes. Eating disorders are mental health conditions, and, therefore, treatment of an eating disorder is a “mental health benefit” within the meaning of that term as defined by MHPAEA.

Comments about eating disorders may be sent to e-ohpsca-mhpaea-disclosure@dol.gov by Sept. 13, 2017.

As required by the Cures Act, the departments also indicated they are soliciting comments about:

  • Questions on non-quantitative treatment limitation model forms and steps to improve disclosures, as well as ways to improve state market conduct examinations and/or federal oversight of compliance by plans and issuers. Comments on these disclosure issues and model forms may be sent to e-ohpsca-mhpaea-disclosure@dol.gov by Sept. 13, 2017.
  • A draft model form that participants, enrollees or their authorized representatives could – but would not be required to – use to request information from their health plan or issuer regarding non-quantitative treatment limitations that may affect their mental health and substance abuse disorder benefits or to obtain documentation after an adverse benefit determination to support an appeal. Follow this link for a copy of the draft model form.

For the complete answer to the question about MHPAEA and for more information about the comments being solicited, read “FAQS about Mental Health and Substance Use Disorder Parity Implementation and the 21st Century Cures Act Part 38,” which was released on June 16, 2017.