What’s happening: The departments of the Treasury, Labor, and Health and Human Services have finalized rules to improve access to mental health services by requiring health plans to make changes when inadequate access is provided.
What else to know: The final rule reinforces the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), which requires health plans to ensure that access to mental health or substance use disorder care is not more restrictive than access to medical and surgical benefits.
The rules also add new regulations to set forth content requirements and time frames for responding to requests for nonquantitative treatment limitation (NQTL) comparative analyses required under MHPAEA as amended by the Consolidated Appropriations Act (2021).
Key provisions include:
- Examples of prohibited prior authorization and other medical management techniques
- Standards for determining network composition and out-of-network reimbursement rates
- Requiring plans to assess and address differences in access to mental health/substance use disorder care and medical/surgical services
- Sunsetting the ability of non-federal government plans to opt out of federal parity requirements
- Codifying standards for comparing the use of NQTLs in coverage
A fact sheet is available with additional information.
