Late last month the White House Mental Health and Substance Use Disorder Parity Task Force released an important and long-awaited report addressing mental health parity in health care plans. The task force is the result of a March 2016, presidential order creating the task force to build on recent changes in federal law and recent actions to improve access to high quality behavioral health care.
The original directive by the President was to: increase awareness of the protections that parity provides; improve understanding of the requirements of parity and of its protections among key stakeholders, including consumers, providers, employers, insurance issuers, and state regulators and increase the transparency of the compliance process and the support, resources, and tools available to ensure that coverage is in compliance with parity, and concurrently improve the monitoring and enforcement process.
The report includes a statement that says in part:
Over the past eight years, our nation has made significant progress in increasing coverage for mental health and substance use disorders…In 2015 the number of Americans with health insurance coverage was at an all-time high with close to 290 million people with health insurance coverage compared to 260 million in 2011. Because people with mental health and substance use disorders were among the most likely to be uninsured, a greater share of the increased access has been for these individuals. The ACA significantly expanded coverage of behavioral health care – mental health and substance use disorder coverage is part of the Essential Health Benefit (EHB) package…”
The report provides an analysis of how mental health parity and access are being carried out and what the landscape looks like across the country. The report also includes several recommendations to go forward:
- Create a one-stop consumer web portal to help consumers navigate parity
- Provide simplified disclosure tools to provide consistent information for consumers, plans and issuers.
- Expand consumer education about parity protections
- Update guidance to address the applicability of parity to opioid use disorder services.
- Implement the Medicaid and Children’s Health Insurance Program parity final rule in a timely manner.
- Conduct a thorough review of how parity principles apply in Medicare.
- Strengthen parity in Medicare Part A benefits.
- Expand access to mental health and substance use disorder services in TRICARE.
- Provide federal support for state efforts to enforce parity through trainings, resources and new implementation tools.
- Develop additional examples of parity compliance best practices and of potential warning signs of non-compliance.
- Increase federal agencies’ capacity to audit health plans for parity compliance.
- Allow the Department of Labor to assess civil monetary penalties for parity violations.
- Clarify that health plan disclosure requirements include medical and surgical benefits.
- Eliminate the HIPAA opt-out process for self-funded non-federal governmental plans.
- Release data annually on closed federal parity investigations, results and violations.
- Ensure parity compliance in state essential health benefit benchmark plans.
- Review substance use disorder benefits in FEHBP.
The report follows each of the recommendations with details on implementation.