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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 effective October 3, 2009
Posted: 10/01/2009 | |
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| * This article was featured in the October 2009 edition of Partners in Health Update.
The Federal Mental Health Parity and Addiction Equity Act was signed into law on October 3, 2008. The law becomes effective October 3, 2009, and applies to groups when either the group contract renews or upon issuance of a contract to a new group. It is important for you to understand these changes so you can answer questions that your patients may have.
The law applies to members who are covered by group health plans with 51 or more employees, and 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 new law, 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 law. Members were notified about how the law may affect them.
The law applies to all commercial managed care (HMO, HMO Split [NJ only] HMO Plus [NJ only], HMO Coinsurance [NJ only], POS, Direct POS [PA only], POS Plus [NJ only], POS Plus Coinsurance [NJ only], POS Split [NJ only], POS Split Coinsurance [NJ 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. If your patients have questions, please refer them to Customer Service.
* This article was featured in the October 2009 edition of Partners in Health Update. | |
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