The Biden administration is taking steps to strengthen mental health parity requirements to ensure that Americans with private health insurance have better access to mental health benefits. Despite bipartisan efforts since the enactment of the Mental Health Parity and Addiction Equity Act (MHPAEA) in 2008, many Americans still struggle to find and afford mental health care. The proposed rule aims to reinforce MHPAEA's goal of providing equivalent access to mental health and substance use benefits as medical benefits. Click here for article.
Proposed Rule Details:
Evaluation of Access:
Health plans must conduct meaningful comparative analyses to ensure equivalent access between mental health and medical benefits, including evaluating provider networks, out-of-network payments, and prior authorization requirements.
Restrictions on Health Plans:
Health plans cannot use more restrictive prior authorization or narrower networks for mental health and substance use benefits compared to medical benefits.
Closing Loopholes:
More than 200 additional health plans, including non-federal governmental plans, will be required to comply with MHPAEA, benefiting 90,000 consumers.
Expected Impact:
Increased Utilization:
The proposed rule is expected to increase utilization of mental health and substance use care, ensuring comparable payment for mental health professionals and incentivizing more people to join the mental health workforce.
Additional Administration Actions:
Medicare Access:
Proposed rules aim to expand access to mental health and substance use care in Medicare.
Crisis Response:
Nearly $1 billion has been invested in strengthening and expanding the 9-8-8 suicide and crisis lifeline, with efforts to provide specialized services for LGBTQI+, veterans, and deaf and hard of hearing individuals.
School-Based Services:
Updates to Medicaid School Claiming and Administrative Guide and proposed rules aim to facilitate billing for mental health services in schools.
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