|The 21st Century Cures Act set the stage for additional guidance to be issued under the Mental Health Parity and Addiction Equity Act (MHPAEA) and increased enforcement of its requirements. In a recent set of proposed frequently asked questions and answers, the Departments of Labor, Health and Human Services, and the Treasury provided examples of practices that meet or fail to meet the MHPAEA’s nondiscrimination standards.
At nearly the same time, the Department of Labor (DOL) reported that, in 2017, it completed more than 180 investigations on MHPAEA compliance issues, resulting in 92 identified violations. A majority of these violations involved failures to comply with non-quantitative treatment limitations. The enforcement actions particularly affected insurers and other plan vendors, who were required to make global changes to documents and claims procedures, affecting thousands of employer plans.
The recently released guidance focuses on coverage limitations that are non-quantitative in nature and offers instruction on a number of issues. Below are a few key points:
Assuming that these FAQs are finalized in substantially the same form, they will set standards that are used in future enforcement efforts under the MHPAEA. These efforts may be carried out by a new enforcement team created by the DOL to undertake MHPAEA investigations.
In view of the new guidance and enforcement activity, health plan sponsors, insurers, and administrators should review plan provisions and practices to confirm their compliance with current MHPAEA rules.
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