Saturday, June 12, 2010

Mental health parity regulations in effect beginning July 1

According to the Interim Final Rule published on February 2, 2010, the Federal Mental Health Parity Addiction and Equity Act (MHPAEA) will be effective on the first day of the plan year beginning on or after July 1, 2010. The implementation of these regulations comes nearly two years after MHPAEA was originally signed into law in October of 2008.

MHPAEA applies to groups that meet the Federal definition of “large group”, which includes:
• All fully insured and self-funded groups with 51 or more employees
• Groups with 2-50 employees if they had an average of 51 or more total employees during the prior calendar year (including seasonal and/or part-time employees)

The general requirement of MHPAEA states that plans must ensure that the financial requirements and treatment limitations applied to mental health and substance use disorder benefits are no more restrictive than those applied to medical or surgical benefits.

The Interim Final Rule updates the prior 1996 federal mental health parity law to now apply to both mental health and substance abuse disorder benefits. The 1996 law applied to annual and lifetime dollar maximums for benefits for mental health disorders only.

The Interim Final Rule does not mandate coverage of any mental health and substance use disorder benefits. However, a group plan must be in compliance with MHPAEA if it chooses to provide coverage for mental health and substance use disorder benefits. The group plan may define which conditions will and will not be covered, subject to state law mandates for fully insured plans.

For more information, click to access the Interim Final Rule or the MHPAEA Factsheet from The National Council for Community Behavioral Healthcare.

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