WBT Flipbooks

Evaluating State Mental Health and Addiction Parity Statutes: A Technical Report 16 Conclusions T his Report presents a framework to evaluate state parity statutes that advance the public policy goals underpinning the Federal Parity Law. Key issues and recommendations for legislative actions based on frequent deficiencies found in our analysis of state statutes include: For many individuals directly impacted by mental illness or substance use disorders, the promise of parity remains elusive. They are denied care when they need it most and have few resources to advocate on their own behalf. These individuals cannot rely on legislative solutions alone, and fortunately, other actions can be taken that advance the goals of parity. In fact, in many states whose parity statute were assessed as having a low score on the SCI, policymakers and advocates have leveraged other tools to help advance parity. Conversely, some states whose statutes were assessed as having a higher score are experiencing a high rate of parity violations and poor access to care. This reflects the reality of how laws are enforced. Key Issue Legislative Recommendation How mental health & substance use disorders are defined Mental health and substance use disorders (MH/SUD) must be seen as broad as physical health conditions. As such, states should define MH/SUD to include all disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD) with no exclusions. How mental health & substance use disorders are covered Conditions that share the same characteristics should be treated in the same way. As such, co-pays and out-of-pocket costs, along with insurer medical management requirements must be the same for MH/SUD services as those for physical illnesses. States should require that insurance benefit management processes and treatment limitations, specifically both for quantitative treatment limitations (QTL) and non- quantitative treatment limitations, (NQTL) ensure parity in coverage. How compliance with the parity law is monitored and enforced States should strengthen enforcement and compliance activities by empowering regulatory agencies to enforce parity laws, including the Federal Parity Law, and require monitoring agencies to regularly report on steps taken to enforce compliance. In addition, states should mandate that all health benefit plans submit regular (e.g., annual) analyses demonstrating compliance with the relevant laws.

• Cover