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 | * The following article was archived on 09/30/2010.
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New federal mental health and substance abuse parity mandate
Posted: 07/01/2009 | |
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| An upcoming Mental Health Parity and Addiction Equity Act for mental health and substance abuse benefits may affect your patients. A summary of the mandate is below to help prepare you for questions that your patients may have.
Mental Health Parity and Addiction Equity Act
The Mental Health Parity and Addiction Equity Act, which is part of the Emergency Economic Stabilization Act of 2008 that President George W. Bush signed late last year, applies to members who are covered by group health plans with 51 or more employees. It requires that mental health and substance abuse benefits, if they are provided, be in parity with (or equal to) medical and surgical benefits.
As a result of the mandate, members may experience some benefits changes, including the removal of limits on inpatient days and outpatient visits as well as differences in cost-sharing (e.g., deductibles, copayments, coinsurance, and out-of-pocket expenses) for mental health and substance abuse services. Please note that current medical management (e.g., precertification) will not be affected by the mandate. Members will be notified about how the mandate may affect them before any benefits changes take place.
The mandate will go into effect for new and renewing groups on or after October 15, 2009, and it applies to all commercial managed care (HMO, POS, Direct POS [PA only], and PPO) plans.
If you have questions about the Mental Health Parity and Addiction Equity Act, please contact Customer Service at 1-800-275-2583, prompt 2 for Provider Services. If your patients have questions, please refer them to Customer Service.
* This article was featured in the July 2009 edition of Partners in Health Update.
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