So, whatever happened to the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)?
The federal departments in charge of implementing the MHPAEA — the U.S. Department of Health and Human Services, the U.S. Labor Department and the U.S. Treasury Department — put the law into effect with temporary regulations back in July 2010.
For federal agencies, implementation of the MHPAEA has been a kind of dress rehearsal for the even more sweeping Patient Protection and Affordable Care Act of 2010 (PPACA).
Two former House members who helped shepherd the MHPAEA bill through Congress — Patrick Kennedy, a Rhode Island Democrat, and Jim Ramstad, a Minnesota Republican — say they will be pushing for the agencies to release final MHPAEA regulations, and also holding a series of “parity field hearings” to hear testimony about how the law is really working.
The lawmakers plan to start the road show April 26 in Kalamazoo, Mich., and end it in September in New York.
President Bush signed the bill into law during his last year in office.
The law does not require an employer to offer coverage for mental health or substance use disorders.
But, if an employer with 50 or more employees does offer mental health or substance abuse benefits, then the financial requirements and treatment limits for the behavioral health benefits can be no more restrictive than the typical requirements for benefits for other types of disorders. The law applies to self-insured plans as well as to insured plans.
A plan can apply for an exemption if it can show that complying with the law will increase its costs by more than 2% during the first year or by more than 1% in later years.
Lawmakers intended for the MHPAEA to be tougher and more specific than the earlier federal parity law, the Mental Health Parity Law (MHP) of 1996.
If the minimum benefits portions of PPACA survive challenges in the Supreme Court and elsewhere, PPACA will require individual and small group plans to offer parity in behavioral health benefits and other types of health benefits, according to the Parity Implementation Coalition, Washington, a group that supports the MHPAEA.
The coalition contends that implementation of the law has been weak and that many plans have been evading its requirements by arguing that behavioral health treatments have no medical analogue or that they still have no legal obligation to pay for the same scope of behavioral treatments and medical treatments.