Latest PPACA Compliance Update, Mental Health Parity Rules

The MHPAEA's purpose is to prohibit large employer and group health plans from trying to apply financial requirements or quantitative treatment limitations for mental health or substance use disorder benefits more restrictively than for all medical and surgical benefits.

The Employee Benefit Security Administration (EBSA) of the U.S. Department of Labor (DOL) released an updated version of its Compliance Assistance Guide -- Health Benefits Coverage Under Federal Law on November 19, 2014.  Designed to help employers and insurers comply with current law, the guide was updated to reflect changes attributable to the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).

The MHPAEA's purpose is to prohibit large employer and group health plans from trying to apply financial requirements or quantitative treatment limitations, for instance, limit the number of outpatient visits or inpatient days covered for mental health or substance use disorder benefits, more restrictively than the predominant financial requirements or treatment limitations that apply to substantially all medical and surgical benefits.

Final regulations released in November 2013, apply to plan and policy years ( for grandfathered and non-grandfathered plans) beginning on and after July 1, 2014 (January 1, 2015 for most calendar year plans.)

General descriptions of the various health care laws and FAQs, self-compliance tools and tips, charts summarizing the notices a plan must provide and model notices are included in the guide. 

The November 19 update reflects changes to the mental health parity portion of the self-compliance tool section and the mental health parity provisions FAQs section.

Source: NBCH 11/20/14
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