The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that prevents group health plans and health insurance issuers that provide mental health or substance use disorder benefits from limiting benefits less than the plan's medical/surgical benefits.

Mental Health and Addiction Parity Rule for Medicaid and CHIP

Centers for Medicare and Medicaid Services (CMS) has proposed regulation that applies Medicaid and CHIP, preventing inequity between beneficiaries who have mental health or substance use disorder conditions in the commercial market (including the state and federal marketplace) and Medicaid and CHIP. This also promotes greater cross-state consistency for patients. (SAMHSA)

Final MHPAEA Rule

The final rule provides details about the implementation of the MHPAEA, such as:

  • Ensuring that parity applies to intermediate levels of care, such as treatment received in residential or intensive outpatient settings
  • Clarifying the scope of the transparency required by health plans, including the disclosure rights of plan participants, to ensure compliance with the law
  • Clarifying that parity applies to all plan standards, including geographic limits, facility-type limits, and network adequacy
  • Eliminating an exception to the existing parity rule that was determined to be confusing, unnecessary, and open to abuse (SAMHSA)

Further resources on MHPAEA:

https://www.cms.gov/cciio/programs-and-initiatives/other-insurance-protections/mhpaea_factsheet.html

https://www.samhsa.gov/health-financing/implementation-mental-health-parity-addiction-equity-act

https://www.nami.org/Find-Support/Living-with-a-Mental-Health-Condition/Understanding-Health-Insurance/What-is-Mental-Health-Parity

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