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The departments of the Treasury, Labor, and Health and Human Services have released a proposed rule to improve access to mental health services by requiring health plans to make changes when inadequate access is provided.
The proposed rule reinforces the Mental Health Parity and Addiction Equity Act of 2008, which requires health plans to ensure that access to mental health (MH) or substance use disorder (SUD) care is not more restrictive than access to medical and surgical benefits.
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 take action to address differences in access to MH/SUD 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 non-quantitative treatment limitations (NQTL) in coverage
The agencies also issued a request for feedback on proposed new data requirements related to a health plan’s network composition and NQTLs, and released their second annual report to Congress examining health plan compliance with NQTL requirements and associated enforcement actions.
Comments on the rule will be due 60 days after its publication in the Federal Register.