The U.S. Departments of Labor, Health and Human Services, and the Treasury have issued a set of Frequently Asked Questions and Answers that, among other things, implement certain of the recommendations included in a report issued by the White House Mental Health and Substance Use Disorder Parity Task Force. This guidance manifests the administration’s continuing interest in clarifying and enhancing enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) and related legal rules. The new guidance:

•           Generally requires group health plans to use their own data in the quantitative and financial tests under the MHPAEA; however, if a qualified actuary determines that such data does not provide a reasonable basis for projecting claim costs, a plan may use credible data collected from similar plans;

•           Addresses certain questions about non-quantitative treatment limits that present parity issues; and

•           Focuses attention on the application of the parity rules to medication for the treatment of opioid use disorders.

The FAQs also address updated recommendations on the coverage of behavioral and drug interventions for tobacco cessation, specifically soliciting comments on the application of medical management limits to tobacco cessation services and products.

As the federal health care reform effort gained steam, Ballard Spahr attorneys established the Health Care Reform Initiative to monitor and analyze legislative developments. With federal health care reform now a reality, our attorneys are assisting health care entities and employers in understanding the relevant changes and planning for the future. They also have launched the Health Care Reform Dashboard, an online resource center for news and analysis on developments under the Affordable Care Act.