Today, the Biden-Harris administration issued final rules that strengthen the 2008 Mental Health Parity and Addiction Equity Act (MHPAEA) with the goal of improving people’s access to quality mental health and substance use disorder care. Issued by the U.S. Departments of Labor, Treasury, and Health and Human Services, the rules reinforce that insurance plans must ensure that mental health care benefits are no more restrictive than those medical and/or surgical benefits.
“APA has always been a strong advocate for mental health parity, and since its enactment, APA has worked tirelessly to advocate for compliance with and enforcement of the federal parity law,” APA CEO and Medical Director Marketa M. Wills, M.D., M.B.A., said in a statement applauding the rules. "This is a big step forward to hold insurance plans accountable by ensuring the law’s intent is fulfilled and that more individuals will be able to access the mental health and substance use treatment they need.”
Specific provisions in the final rules—which represent the first significant update to the MHPAEA in nearly a decade—include:
Health plans must evaluate their provider networks, out-of-network payment rules, and prior authorization policies, and make changes to reach compliance with the MHPAEA where needed—such as adding more mental health care providers or increasing reimbursement rates.
Health plans cannot use more restrictive prior authorization or other medical management techniques, nor make use of any discriminatory information, to reduce access to mental health and substance use disorder benefits relative to other medical benefits.
Non-federal government health plans (e.g., plans offered to state and local government employees) are no longer exempt from MHPAEA compliance. This change will improve parity for around 120,000 individuals across 200 health plans.
Most of these provisions will take effect on January 1, 2025.
For related information, see the Psychiatric News article “Government Proposes New Rules to Strengthen Parity Law.”
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