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Court Weighs In on Mental Parity Suit

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A federal trial court will be letting the Obama administration proceed with efforts to implement Mental Health Parity and Addition Equity Act interim final rules.

U.S. District Judge Colleeen Kollar-Kotelly, a judge in the U.S. District Court for the District of Columbia, has ruled against efforts by the Coalition for Parity Inc., Washington, to keep the U.S. Treasury Department, the U.S. Labor Department and the U.S. Department of Health and Human Services from enforcing the MHPAEA interim rules July 1.

The MHPAEA, a statute signed into law by President Bush October 2008, will require group health plans with 50 or more employees that offer mental or substance abuse benefits to provide the benefits “in parity with” medical and surgical benefits.

The parity law now in effect allows plans to distinguish between behavioral health and general medical benefits in some ways. Under the new statute and interim rules, financial requirements such as deductibles, co-payments and limits on number of visits may be no more restrictive for behavioral health care than for general medical care.

The federal agencies released the interim rules implementing the MHPAEA Feb. 2, and the Coalition for Parity, a group organized by managed behavioral health organizations, filed a complaint April 1.

The coalition at first tried to get a temporary restraining order. When the judge denied the request for the restraining order, the coalition agreed to accept an expedited schedule and ask the judge to consider a motion to dismiss the case or a motion for summary judgment against enforcement of the MHPAEA rules.

The agencies decided they would issue interim rules, rather than final rules, because they believed they needed more time to review and consider comments, Kollar-Kotelly writes in the opinion explaining her decision.

The coalition argued that the federal agencies had taken too long to get started with developing the interim rules and then had allowed too short of a comment time for it help the agencies understand the coalition’s concerns about the rules.

The federal agencies said Congress had authorized them to promulgate interim final rules to carry out MHPAEA provisions and had expressed a clear intent to free them from the usual notice and comment rules.

The MHPAEA interim rules provision supports a finding that the agencies had a “good cause” to proceed without following the usual notice and comment procedures, the judge says.

The need for the agencies to provide guidance while meeting statutory deadlines imposed by Congress also supports a finding of “good cause,” the judge says.

“The need for prompt regulatory guidance is … reflected by the letters signed by members of Congress urging the secretaries [of the federal agencies] to promulgate implementing regulations,” the judge says.

“Based on the totality of the circumstances surrounding defendants’ promulgation of interim final rules to implement the MHPAEA, the court finds that defendants properly invoked the ‘good cause’ exception to the notice and comment requirements,” the judge says.


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