NEW: On March 30, 2016, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining how the federal parity law will be applied to Medicaid, to the Medicaid expansion population through alternative benefit plans, and to the Children’s Health Insurance Program (CHIP).
On December 6, 2013, NAPHS participated in a summit on “Achieving Parity: Moving Forward after the Final Rule” hosted by former Rep. Patrick Kennedy (left photo) with a group of 25 key national health and mental health organizations to focus on how collective efforts can help ensure effective implementation of mental health parity. NAPHS President/CEO Mark Covall (2nd photo, right) joined Neil Kirschner of the American College of Physicians on a panel discussion.
VICTORY! Federal law (the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008) now addresses longstanding discrimination against those who rely on their health plans for coverage of mental and addictive disorders. And a final rule was issued November 8, 2013. The law:
Mental health parity has won unprecedented support from consumers, providers, hospitals, employers, and health insurers. With millions of Americans experiencing psychiatric and addictive conditions, having coverage that is on par with that of other medical conditions is a win for America.
Mental health parity:
NAPHS was a founding member of the Coalition for Fairness in Mental Illness Coverage, which helped to win passage of this landmark legislation.
Today NAPHS serves as a Steering Committee member of the Parity Implementation Coalition.
NAPHS is working with Congress and federal agencies to implement and clarify the federal parity regulations. The association is also working to end remaining vestiges of discrimination, including eliminating the Medicare 190-day lifetime limit.
Learn about how NAPHS is working on scope-of-service issues.
Consumer flyer from Department of Labor and SAMHSA: "Know Your Rights: Parity for Mental Health and Substance Use Disorder Benefits" (also see printable version)
Department of Labor/HHS fact sheet: "Warning Signs – Plan or Policy Non-Quantitative Treatment Limitations (NQTLs) that Require Additional Analysis to Determine Mental Health Parity Compliance"
Parity "Hot Topics" references: "Disclosures, Claims, and Appeals" (speaker: Meiram Bendat, J.D.)
Parity Implementation Coalition release: "Parity Implementation Coalition Applauds Release of Clarifying Guidance on Plan Disclosure Requirements of the Federal Parity Law"
Departments of Labor, Treasury, and HHS: "FAQs about Affordable Care Act Implementation Part 31, Mental Health Parity Implementation...etc." (See Q8-Q11 on parity disclosure and more)
Mental Health Liaison Group letter to Majority Leader Sen. Mitch McConnell urging Senate to bring mental health reform bill to floor for action
Parity Implementation Coalition letter on Defense Department's proposed rule on "TRICARE: Mental Health and Substance Use Disorder Treatment"
Parity Implementation Coalition: “Summary of Key Provisions in Medicaid Parity Final Rule”
CMS final rule: "Medicaid and Children’s Health Insurance Programs (CHIP): The Application of Mental Health Parity (MHPAEA) Requirements to Coverage Offered by Medicaid Managed Care Organizations, CHIP, and Alternative Benefit Plans." Also see a fact sheet, FAQs, and a CMS news release.
2016 NAPHS Advocacy Agenda: Pass comprehensive mental health reform NOW! Reform should 1) Modify the Medicaid Institutions for Mental Disease (IMD) exclusion; 2) Eliminate the Medicare 190-day lifetime limit; 3) Clarify disclosure and transparency provisions of the federal parity law; 4) Fund health information technology (IT) for behavioral health providers; and 5) Support workforce development.
Department of Labor "Report to Congress: Improving Health Coverage for Mental Health and Substance Use Disorder Patients, Including Compliance with the Federal Mental Health and Substance Use Disorder Parity Provisions"
HHS/Labor/SAMHSA consumer pamphlet: "Parity of Mental Health and Substance Use Benefits with Other Benefits: Using Your Employer-Sponsored Health Plan to Cover Services."
Parity Implementation Coalition: Washington State Snapshot on Parity Implementation
NAPHS release: "NAPHS Applauds Final Passage of Bipartisan Legislation To Extend and Expand the Medicaid Emergency Psychiatric Demonstration Project; Bill Next Goes to President for Signature." [NOTE: Signed into law 12.11.15 as P.L.114-97.]
Department of Labor: "FAQs about Affordable Care Act Implementation (Part XXIX) and Mental Health Parity Implementation"
24 Senators send letter to HHS and Labor Secretaries urging "immediate and overdue action" to implement the Mental Health Parity and Addiction Equity Act
Parity Implementation Coalition: Connecticut State Snapshot on Parity Implementation
U.S. Court of Appeals for the Second Circuit rules that behavioral health claims administrators (rather than employers or plan administrators) can be sued for fiduciary breaches under ERISA, including those related to the federal parity law.
NAPHS comment letter to CMS on IMD exclusion provision in proposed rule on "Medicaid & Children’s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, etc."
Web-based ParityTrack is a central site for mental health and substance use disorder parity information produced by the Kennedy Forum, Scattergood Foundation, and Treatment Research Institute. Reports analyze legislation, regulatory actions, and litigation at the federal and state levels.
Parity Implementation Coalition: New York State Snapshot on Parity Implementation
Group letter to Labor, IRS, and HHS requesting additional guidance related to the full implementation and enforcement of the federal parity law
Parity Implementation Coalition release: "Release of Medicaid Parity Proposed Rule Lauded as Important Step for Those with Addiction and Mental Illness"
American Psychiatric Foundation & Partnership for Workplace Mental Health: Updated version of the Employer Guide for Compliance with the Mental Health Parity and Addiction Equity Act (prepared by Milliman, Inc.)
Parity Implementation Coalition: California State Snapshot on Parity Implementation
Parity Implementation Coalition comment letter to CMS on ACA's "2016 Benefit and Payment Parameters"
Parity Implementation Coalition news release: "Parity Implementation Coalition Seeks Federal Action on Parity in Response to 60 Minutes Report." Watch 60 Minutes.
Department of Labor: Updated Mental Health Parity Part of the Self Compliance Tool (to assist health plans and others determine compliance with the federal parity law)
Parity Implementation Coalition comments to Department of Labor on need for transparency and compliance with MHPAEA disclosure rule
Parity Implementation Coalition: Detailed summary of parity final rule
Final rule on federal parity law (the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008)
Parity Implementation Coalition release: "Release of Final Regulations Lauded as landmark Step for those With Addiction and Mental Illness"
Departments of Labor, HHS, and Treasury: "FAQS About ACA (Part XVII) and Parity Implementation"
HHS study: "Consistency of Large Employer and Group Health Plan Benefits with Requirements of the Paul Wellstone annd Pete Domenici Mental Health Parity and Addiction Equity Act"
Coalition for Whole Health (CWH): Toolkit for state-level advocates working on implementation and oversight of the Affordable Care Act’s (ACA’s) essential health benefits, parity, and network adequacy protections. See an overview of key issues and short guides for working with state legislatures and insurance commissioners.
HHS final rule: Standards related to essential health benefits (published in 2.25.13 Federal Register)
NAPHS statement on release of essential health benefits final rule
ASPE Research Brief: "Affordable Care Act will expand mental health and substance use disorder benefits and parity protections for 62 million Americans"
Department of Labor notice: "Agency information collection/submission for OMB review; comment request: notice of medical necessity criteria under the Mental Health Parity and Addiction Equity Act of 2008"
NAPHS / NAMI ad to the President and Congress (as seen in Politico): "Thank you...for committing to fully implementing the Mental Health Parity and Addiction Equity Act this year."
NAPHS statement: "NAPHS applauds commitment by President Obama to issue final parity rules"
President Obama issues a plan to reduce gun violence and takes executive actions committing to (among other things) issuing a final parity rule, Medicaid guidance on parity, and guidance on essential health benefits and parity requirements within Affordable Care Act exchanges. Also see a letter to healthcare providers.
NAPHS letter to Vice President Biden on Newtown Task Force; NAPHS calls for a focus on coverage, access, and resources.
House letter to the Secretaries of Treasury, Labor, and Health & Human Services urging a parity final rule. Signed by 32 representatives.
Senate letter to President Obama urging a final parity rule. Signed by 26 Senators.
NAPHS comment letter on essential health benefits proposed rule
Parity Implementation Coalition comment letter on essential health benefits proposed rule.
Parity Implementation Coalition recommends issuance of a final parity rule.
NAPHS ad as seen in Politico: "It's time to address the need for access to all levels of behavioral health care in a final parity rule."
Parity Implementation Coalition and OptumHealth: Letter to HHS, Labor, and Treasury requesting issuance of a final rule on parity
HHS proposed rule on ACA "Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation." EHBs include "mental health and substance use disorder services, including behavioral health treatment" as one of the 10 core essential health benefits. Also see HHS fact sheet.
House letter (59 representatives) to the Secretaries of Labor, Treasury, and Health & Human Services requesting an update on the status of parity regulations
Department of Labor: Updated "Self-compliance tool for Part 7 of ERISA: HIPAA and other healthcare-related provisions (including mental health parity)" [View]
Medicare Payment Advisory Commission (MedPAC) letter to CMS on dual-eligible demonstrations, recommending, among other things, limiting the demonstrations to only a few states [View]
GAO Correspondence: "Mental Health and Substance Use: Treatment Exclusions in Employers' Health Insurance Coverage" [View]
Department of Labor Employee Benefits Security Administration: Frequently Asked Questions: "Understanding Implementation of the Mental Health Parity and Addiction Equity Act of 2008" [View]
HHS final rule (and interim final rule for some sections): "Affordable Care Act: establishment of exchanges and qualified health plans; exchange standards for employers" (also see 5.29.12 corrections)
HHS Frequently Asked Questions on essential health benefits under the Affordable Care Act [View]
Parity Implementation Coalition applauds new URAC parity standards [View]
HHS/ASPE issues Rand report on "Short-Term Analysis to Support Mental Health and Substance Use Disorder Parity Implementation." [View]
NAPHS comment letter to HHS on "Essential Health Benefits Bulletin" [View]
HHS Essential Health Benefits Bulletin outlining proposal to give states flexibility in implementing essential health benefits. Comments are due 1/31/12. Also see an ASPE Research Brief on "Comparing Benefits in Small Group Products and State and Federal Employee Plans" and a fact sheet on individual market coverage.
Department of Labor Employee Benefits Security Administration: Frequently Asked Questions about ACA Implementation Part VII and Mental Health Parity Implementation [View]
NAPHS comment letter to CMS on proposed rule (with extension of comment period) on "Establishment of Exchanges and Qualified Health Plans"
Parity Implementation Coalition: "Recommendations on Guidance to Insurers/Plans for NQTL Disclosure" [View]
Department of Labor Self-Compliance Tool (Form M-1: Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception) [View]
Frequently Asked Questions (Part 2) about the Affordable Care Act Implementation -- jointly issued by Departments of Labor, Treasury, & HHS [View]
Frequently Asked Questions (Part 1) about the Affordable Care Act Implementation -- jointly issued by Departments of Labor, Treasury, & HHS [View]
Congressional Research Service Report to Congress: Mental Health Parity and the Patient Protection and Affordable Care Act of 2010 [View]
Parity Implementation Coalition release: "Coalition hails administration's enforcement of parity law" [View]
Employee Benefits Security Administration (EBSA) guidance on the classification of outpatient benefits (federal agencies will not take enforcement action against any plan or insurer that distinguishes between office visits and all other outpatient services while they complete final regulations on the law) [View]
NAPHS comment letter: Interim final rules under the Mental Health Parity and Addiction Equity Act [View]
Parity Implementation Coalition comment letter: Interim final rules under the Mental Health Parity and Addiction Equity Act. (NAPHS is a member of the Parity Implementation Coalition Steering Committee.) [View]
Summary of behavioral health provisions in The Patient Protection and Affordable Care Act (Public Laws 111-148, 111-152) [View]
NAPHS statement: Reform law includes provisions important to Americans facing mental and addictive disorders. Includes IMD/EMTALA demonstration on emergency psychiatric care. [View]
Federal parity regulations published in the Federal Register. Also see IRS notice. (First issued 1/29/10 by HHS, Labor, and Treasury).
NAPHS statement on passage of mental health parity legislation [View]