NEW: Parity provisions are included in the 21st Century Cures Act, which was signed into law (P.L.114-255) on December 13, 2016.
On October 27, 2016, the White House Mental Health and Substance Use Disorder Parity Task Force sent its final report to the President. Also see a fact sheet with recommendations, a blog, and www.hhs.gov/parity for more information.
On March 30, 2016, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining how the federal parity law will be applied to Medicaid, to the Medicaid expansion population through alternative benefit plans, and to the Children’s Health Insurance Program (CHIP).
On December 6, 2013, NABH participated in a summit on “Achieving Parity: Moving Forward after the Final Rule” hosted by former Rep. Patrick Kennedy (left photo) with a group of 25 key national health and mental health organizations to focus on how collective efforts can help ensure effective implementation of mental health parity. NABH President/CEO Mark Covall (2nd photo, right) joined Neil Kirschner of the American College of Physicians on a panel discussion.
VICTORY! Federal law (the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008) now addresses longstanding discrimination against those who rely on their health plans for coverage of mental and addictive disorders. And a final rule was issued November 8, 2013. The law:
- extends equal coverage to an estimated 113 million Americans who work for employers with 51 employees or more
- for the first time, this includes workers in companies that are self-insured
- establishes visit and day limits that cannot be more restrictive than those for medical/surgical services
- establishes copays and deductibles that cannot be more restrictive than those for medical/surgical services
- requires that if a health plan offers out-of-network coverage, it must also include out-of-network parity for mental health
- establishes a floor, but state parity laws can go beyond the federal law
- allows management of the benefit
- becomes effective one year after enactment (effective October 2009)
Mental health parity has won unprecedented support from consumers, providers, hospitals, employers, and health insurers. With millions of Americans experiencing psychiatric and addictive conditions, having coverage that is on par with that of other medical conditions is a win for America.
Mental health parity:
- Saves lives. Mental illnesses constitute the second leading cause of disability and premature death in the United States. As the President’s New Freedom Commission on Mental Health noted, however, about one out of every two people who needs mental health treatment in this country does not receive it.
- Saves money. Providing equal coverage for all illnesses makes good economic sense. When mental illnesses go untreated, costs begin to escalate.
- Is cost-effective. Providing parity for mental illnesses is affordable. Research and actual industry experiences indicate that parity can be implemented without substantially increasing premiums. Studies have concluded that parity would increase premiums less than 2%.
- Is fair. Mental health parity is the right thing to do. Mental health parity is a win for America!
NABH was a founding member of the Coalition for Fairness in Mental Illness Coverage, which helped to win passage of this landmark legislation.
Today NABH serves as a Steering Committee member of the Parity Implementation Coalition.
NABH is working with Congress and federal agencies to implement and clarify the federal parity regulations. The association is also working to end remaining vestiges of discrimination, including eliminating the Medicare 190-day lifetime limit.
Learn about how NABH is working on scope-of-service issues.
Labor, Treasury, & HHS FAQs on parity disclosure (and more) issued 4.20.16 (See Q8-Q11 on parity disclosure)
Final rule on application of parity to Medicaid and CHIP (published in the 3.30.16 Federal Register). Also see a fact sheet and FAQs.
Final rule on parity (published in the 11.13.13 Federal Register).
Parity Implementation Coalition: Detailed summary of parity final rule
Final rule governing the federal menal health and substance use parity law adds important health insurance protections for all Americans, says NABH.
KEY RESOURCE: See PIC’s “Parity Resource Guide for Addiction & Mental Health Consumers, Providers, and Advocates: Simplifying the Appeals Process: Strategies for Winning Disputes with Your Health Plan”
Parity Implementation Coalition letter to President’s Commission on Combatting Drug Addiction and the Opioid Crisis
Employee Benefits Security Administration notice: “Proposed Revision of Information Collection Request Submitted for Public Comment; Draft Model Non-Quantitative Treatment Limitations Form”