Parity Final Regulations Released

NAMI Texas applauds the release of the final parity regulations from the 2008 MHPAEA law. This will help ensure that health insurance plans components are generally not more restrictive for mental health/substance use disorders benefits than they are for medical/surgical benefits.

-Fact sheet on the new parity regulations:
-New parity regulations:

According to SAMHSA, today’s action also includes specific additional consumer protections, such as:
• Ensuring that parity applies to intermediate levels of care received in residential treatment or intensive outpatient settings
• Clarifying the scope of the transparency required by health plans, including the disclosure rights of plan participants, to ensure compliance with the law
• Clarifying that parity applies to all plan standards, including geographic limits, facility-type limits, and network adequacy
• Eliminating an exception to the existing parity rule that was determined to be confusing, unnecessary, and open to abuse.

This is an incredible, historic moment for our cause. However, this effort is not over, as we must continue to make sure that these regulations are followed and that consumers of mental health services are being treated with equity in the insurance market. Please familiarize yourself with the new regulations and contact NAMI Texas if you hear of any of these regulations not being followed.

Please do make note of NAMI National’s comments on the parity rules (see below):

“Champions of better coverage of mental health services applauded the release on Friday of a final rule that requires insurers to provide mental health benefits on the same level they as benefits for physical illness.

However, those same people were critical that the regulations, implementing the Mental Health Parity and Addiction Equity Act (MHPAEA), don’t extend to Medicaid, Medicare, and the Children’s Health Insurance Program.

“The regulations will cover about 85% of the nation’s population, but gaps in coverage exist, “Michael Fitzpatrick, executive director of the National Alliance on Mental Illness (NAMI), in Arlington, Va., said in a statement, referring to Medicaid and CHIP. “Some of our most vulnerable people are still being left behind.”

The regulations will take effect on July 1, 2014.

NAMI was otherwise supportive of the final regulations, calling them a “crowning achievement” in ending insurance discrimination.”



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