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On Friday, January 29, the Departments of Health and Human Services, Labor and Treasury jointly issued significant new interim final regulations for implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).
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The regulations are 154 pages long and will require detailed reviews of applicable plan documents and insurance policies, as well as current processes regarding management of mental health benefits, claims, and the relationship Plans have with outside organizations that provide and manage mental health and substance abuse benefits.
These are "interim” final regulations, meaning that they are essentially final but are nonetheless subject to later changes as the result of the official 90-day public comment period.
For purposes of enforcement, regulators have emphasized that they will take into account a health plan’s good faith efforts to comply with a reasonable interpretation of the statute for violations that may occur with implementations by the original Act deadline (plan year renewals on or after October 3, 2009). The interim final regulation generally applies to group health plans and health insurance issuers for plan years beginning on or after July 1, 2010. Collective bargaining entities have a different applicability provision to align with their agreements.
The interim final rules provide substantial clarification as to the definitions and tests that must be used in establishing parity between mental health and substance use and medical/surgical benefits with respect to financial requirements and treatment limitations, as required under MHPAEA.
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