Issue link: https://blog.providence.org/i/1035653
Evaluating State Mental Health and Addiction Parity Statutes: A Technical Report 4 Introduction T he Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (the Federal Parity Law) requires insurers to treat illnesses of the brain, such as depression or substance use disorders, the same way they treat illnesses of the body, such as diabetes or cancer. Large group health plans are required to cover mental health and substance use disorders (MH/SUD) in a way that is no more restrictive than coverage for physical or other medical conditions. Under the Federal Parity Law, insurers may not impose higher co- pays, higher out-of-pocket costs, or different coverage limits on MH/SUD services when compared to services for the treatment of physical illnesses such as diabetes or hypertension. The Patient Protection and Affordable Care Act (ACA) of 2010 expanded these requirements to small group and individual health plans by mandating parity and mental health and addiction services as an essential health benefit. For parity to be achieved, state legislatures must do their part by enacting legislation that establishes clear pathways for parity monitoring, reporting, and enforcement activities. Strong state parity laws are foundational to robust parity enforcement, because without such laws, there often is little transparency or accountability relating to health plans' parity compliance and regulator agencies' enforcement activities. Every state in the country, except for Wyoming, has adopted one or more laws supporting parity (see www.paritytrack.org). While many state statutes and regulations were initially enacted in 2008 and 2010, immediately after enactment of the Federal Parity Act, many states also have updated their parity laws in recent years. In fact, state laws and regulations can be even more rigorous or have a broader scope than the protections of the Federal Parity Law. These laws also help state regulatory agencies promulgate additional guidance through administrative rulemaking and other forms of sub-regulatory guidance. This report is a result of research assessing the strength and quality of state statutes using a quantitative and systematic coding methodology that was applied to all 50 states. This report is a result of research assessing the strength and quality of state statutes using a quantitative and systematic coding methodology that was applied to all 50 states.