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Agencies Publish Mental Health Parity Regulations


February 8, 2010

Signed into law in October 2008, the Mental Health Parity and Addiction Equity Act of 2008 (Pub. L. No. 110-343) requires group health plans that offer mental health benefits to treat those benefits in the same way medical benefits are treated in terms of access to care, expensing, and administration. The law applies to all group health plans with more than 50 participants, except for self-funded plans offered by non-federal government employers that have elected to exempt their plans under Section 2721 of the Public Health Service Act.

On February 2, 2010, the Departments of Labor, Treasury, and Health and Human Services published interim final regulations implementing the Mental Health Parity Act. The interim final regulations are found here. The regulations require parity in a variety of areas including out-of-pocket expenses, benefit limits, and practices such as prior authorization and utilization review. The regulations identify six classes of benefits to which parity must be applied:

  1. Inpatient, in network;
  2. Inpatient, out of network;
  3. Outpatient, in network;
  4. Outpatient, out of network;
  5. Emergency care; and
  6. Prescription drugs.

On April 5, 2010, the final interim regulations will take effect. Plan years beginning on or after July 1, 2010, will be subject to the requirements set forth in the regulations. Calendar year plans will have until January 1, 2011, to comply with the regulations. Interested parties have until May 3, 2010, to file comments on the interim final regulations with the issuing agencies. The comments may lead to future revisions of the regulations.

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