Mental Health Parity & Addiction Equity Act — Background

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The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was created to bring insured healthcare benefits for mental health and substance use disorders in line with those for medical/surgical benefits. Historically, health insurance plans have provided more limited benefits for treatment of mental health and substance use disorders, often including calendar year, lifetime, or other quantity limits on coverage. Additionally, it has been common for health insurers to require higher out-of-pocket payments from insured members to access these benefits. The MHPAEA extends the parity requirements that were introduced in the Mental Health Parity Act of 1996 to substance use disorders, and also requires the total integration of mental health and substance abuse disorder coverage with medical/surgical coverage.

Group health plans and insurers must take steps to ensure compliance with the MHPAEA and the IFR. The new rules were effective for group plan renewals beginning July 1, 2010. For group plans that renew every calendar year, the effective date was January 1, 2011.

In addition, under the Affordable Care Act, individual and small group health insurance plans will also need to comply with MHPAEA and the IFR starting in 2014.

Although additional guidance is needed in some key areas, the broad scope of the law is in place and much of the testing, modeling, cost analysis, and administrative preparations can be performed now.

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