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Advancing Mental Health Equity: Biden Administration Releases Interim Rule to Enforce Mental Health Parity and Addiction Equity Act

Biden Administration Takes Action to Ensure Mental Health Parity

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The Biden Administration releases an interim final rule to enforce the Mental Health Parity and Addiction Equity Act.

Addressing Disproportionate Treatment Limitations

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The rule aims to curtail treatment limitations that unfairly impact mental health and substance use disorder benefits within group health plans.

Prohibiting Unfair Access Limits

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The proposed rule seeks to prohibit the use of nonquantitative treatment limitations (NQTLs) that restrict access to mental health and substance use disorder benefits.

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Data Collection and Analysis

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Plans and issuers must collect and analyze data to ensure NQTLs do not impose more restrictive limits on mental health and substance use disorder benefits than on medical or surgical benefits.

Mitigating Disparities

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If significant discrepancies are found, plans must take reasonable measures to address disparities in access to mental health and substance use disorder treatment benefits.

Network Composition Standards

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The rule also addresses NQTLs impacting network composition, with plans required to evaluate utilization rates, network adequacy metrics, and provider reimbursement rates.

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Technical Release for Guidance

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A technical release provides additional guidance on data collection and evaluation related to NQTLs and mentions potential safe harbor provisions for compliant plans.

Public Comment Period

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The proposed rule is open for a 60-day public comment period for stakeholders to provide feedback on the implementation of mental health parity.

Enforcement Efforts to Date

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The Departments have presented a report to Congress highlighting prior enforcement efforts regarding NQTLs, demonstrating an ongoing commitment to parity.

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Anticipated Future Guidance

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Further guidance on the MHPAEA is expected in the future, indicating continued efforts to ensure equal access to mental health and substance use disorder treatments.

Monitoring Compliance

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Stakeholders, including plans and issuers, are advised to monitor ongoing developments and assess their provisions for compliance with MHPAEA requirements.

Promoting Equitable Access

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The Biden Administration’s rulemaking aims to promote equitable access to mental health and substance use disorder treatments, addressing disparities in the healthcare system.

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