Agencies release final rule requiring mental health coverage parity

The departments of Labor, Health and Human Services and the Treasury Sept. 9 released a final rule ensuring commercial health plans comply with the Mental Health Parity and Addiction Equity Act of 2008 and require mental health and substance use disorder benefits at the same level as medical and surgical benefits. The rule finalizes standards for determining network composition and out-of-network reimbursement rates; adds protections against more restrictive, Non-Quantitative Treatment Limitations in coverage; and prohibits plans from using biased or non-objective information and sources that may negatively impact access to MH/SUD care when designing and applying an NQTL.

“The AHA is pleased that the Biden-Harris Administration has taken decisive action to remove barriers to vital mental health and substance use disorder services,” said Ashley Thompson, AHA senior vice president of public policy. “We are pleased the Administration is providing clear guidance on how health plans may and may not apply administrative restrictions to behavioral health services. Thus, patients are more likely to get the care they need and to which they are entitled under the law, and providers can spend less time on burdensome and unnecessary paperwork. We recognize the challenges that exist to establish networks of behavioral health providers considering the dire shortages but encourage the Administration to work with AHA and other stakeholders to alleviate those challenges without compromising on the goals of parity and access.”