On September 5, 2019, the U.S. Department of Health and Human Services, Department of Labor, and Treasury jointly issued a guidance document titled FAQs About Mental Health And Substance Use Disorder Parity Implementation and the 21st Century Cures Act Part 39. This document contains the government’s responses to frequently asked questions regarding the implementation of mental health and substance use disorder (MH/SUD) parity regulations that were promulgated pursuant to the Mental Health Parity and Addiction Equity Act (MHPAEA). The FAQs are designed to help stakeholders understand the requirements of MHPAEA, as amended by the Patient Protection and Affordable Care Act, 21st Century Cures Act, and the SUPPORT Act. In general, MHPAEA requires that “the financial requirements (such as coinsurance and copays) and treatment limitations (such as visit limits) imposed on MH/SUD benefits cannot be more restrictive than the predominant financial requirements and treatment limitations that apply to substantially all medical/surgical benefits in a classification.” These classifications include inpatient in-network care, inpatient out-of-network care, outpatient in-network care, outpatient out-of-network care, emergency care, and prescription drugs. Health Affairs recently published an article discussing the implementation of the law’s parity requirements, which found that an overall lack of public awareness about the law’s requirements is a driver of noncompliance. Ensuring that health care stakeholders understand these requirements will promote compliance with the law, which will hopefully reduce incidences of consumers experiencing discriminatory treatment limitations or being unable to access treatment due to a mental health or substance use diagnosis.
For more information please see: https://www.dol.gov/sites/dolgov/files/EBSA/about-ebsa/our-activities/resource-center/faqs/aca-part-39-final.pdf