Parity Compliance
MENTAL HEALTH PARITY & ADDICTION EQUITY ACT (MHPAEA)
The Mental Health Parity & Addiction Equity Act was signed into law over 10 years ago. It remains a challenge for most states.
If insurance agencies offer coverage for substance use and mental health disorders (“behavioral health”), the parity law requires that access to and treatment for both are provided on a par with those for physical health conditions. For more than a decade, SAE’s parity experience has encompassed the following:
- Working directly with attorneys general offices in The Commonwealth of Massachusetts and New York State to assess and enforce parity compliance on the part of health insurance companies doing business in their states.
- Consultations with state regulators about ways to evaluate parity compliance by the state’s health insurers.
- Parity compliance assessments on behalf of health insurance companies responding to state regulators’ questions and concerns regarding the implementation of their regional health plans.
- Parity compliance assessments on behalf of self-insuring employers who proactively respond to provisions contained in the Consolidated Appropriations Act of 2021 (CAA) that require them to demonstrate parity compliance within their employees’ health plans.
HOW THE SAE PARITY COMPLIANCE TEAM HELPS:
Offices of State Attorneys General
- Providing assistance in gathering both pertinent information and data metric solutions to evaluate the current degree of Parity compliance of a Health plan and its behavioral health vendor – a Discovery phase
- Functioning as an external parity compliance administrator, assessing the Health Plan’s movement toward compliance as defined by terms of a settlement, and
- Functioning as an external reviewer of a Health Plan’s internal parity compliance efforts either voluntarily initiated by the Health Plan or mandated by a settlement derived from litigation
State Insurance Commissioners - State Insurance Commissioners/State Departments of Labor
- Guiding them in forming the standards and requirements to which Health Plans must demonstrate compliance
- Collecting data and analyzing health plan policy and practice, as they relate to the requirements of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA)
- Utilizing a sophisticated data metrics approach to measure compliance against both Quantitative Treatment Limitation (QTL) and Non-Quantitative Treatment Limitation (NQTL) Parity requirements, and
- Determining the information and data needed to begin an overview of a Health Plan’s structure and design
Individual Health Plans
- Providing external parity compliance monitoring of their efforts to meet parity requirements
- Helping Health Plans organize their data, and
- Refining their approach and putting a robust structure in place to ensure parity compliance is not only met, but also sustained
Medium to Large Corporations Offering Staff Health Plans
- Providing external parity compliance monitoring of their efforts to meet parity requirements
- Helping Health Plans organize their data, and
- Refining their approach and putting a robust structure in place to ensure parity compliance is not only met, but also sustained
- Providing this information to the companies’ HR Department and Sr. management team.
SAE Public Comment on MH/SUD Implementation and Cures Act
SAE White Paper on Health Literacy and the 2008 MHPAEA Act
SAE White Paper on Current State Of Parity Implementation in 2016
SAE Webinar on Measuring and Ensuring Compliance
SAE Public Comment on MH/SUD Implementation and Cures Act
SAE White Paper on Health Literacy and the 2008 MHPAEA Act
SAE White Paper on Current State Of Parity Implementation in 2016
SAE Webinar on Measuring and Ensuring Compliance
SAE Webinar Presentation – Mental Health Parity and Addiction Equity Act (MHPAEA): Measuring and Ensuring Compliance, 2016
