The federal government just released the interim final regulations covering the Mental Health Parity Act. That means you have about 60 days before the regs become official.
The act becomes effective April 5, and there have been a lot of misinterpretations about its intent. So, let’s go over —
- What the act doesn’t do. The act does not mandate that your health plan must offer coverage for treatment of mental health or substance abuse. Employers still have the option of including or excluding those types of benefits so long as they offer or don’t offer them on an equal basis to all employees.
- What the act does do. It mandates that if you have a health plan that offers mental health benefits or coverage for substance-abuse treatment, you have to offer those benefits on the same level as is covered by treatment of any other illness.
The reg states, for example, that group health plans cannot impose higher deductibles or caps on hospital-room stays for mental health or substance-abuse treatment. Nor can plans impose tougher preauthorization requirements for such treatments.
In all, the reg — and the mandate for parity — affects six categories of care:
- inpatient in-network
- inpatient out-of-network
- outpatient in-network
- outpatient out-of-network
- emergency care
- prescription drugs
