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Mental Health Parity Updates

On July 25, 2023, the Departments of Treasury, Labor and Health and Human Services (“Tri-Agencies”) issued proposed rules regarding the Mental Health Parity and Addiction Equity Act (MHPAEA), the 2023 Comparative Analysis Report to Congress, and a Technical Release signaling future data collection regarding compliance with MHPAEA.

It’s been no secret that Department of Labor has considered MHPAEA compliance as a key priority but, as the 2023 Comparative Analysis Report indicates, many health plans continue to struggle with providing sufficient documentation proving compliance with the parity requirement. The proposed rules provide for a 3- part analysis to determine whether a plan’s non-quantitative treatment limitations on Mental Health and Substance Abuse benefits meet the parity requirements. This 3-part analysis will require a robust examination of plan data involving claims administration and cooperation from the plan’s service providers to provide the applicable data.

In addition, the proposed rules provide more clarity regarding the minimum standards for the comparative analysis and additional guidance as to the content requirements for the analysis. One important addition is the certification requirement from a plan fiduciary certifying the findings and conclusions of the comparative analysis.

However, it remains to be seen whether the proposed rules will resolve the difficulties many health plans have faced with preparing their analyses. As the 2023 Comparative Analysis Report shows, none of the plans that were under review were able to provide a comparative analysis that was sufficient without further requests for specific information from the DOL. More than likely, it will take a continued effort from plans and service providers, plus even more guidance from the Departments, to demonstrate parity effectively when it comes to medical/surgical benefits and mental health/substance abuse benefits.

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