Issue link: https://blog.providence.org/i/1035653
Evaluating State Mental Health and Addiction Parity Statutes: A Technical Report 19 International Classification of Disease (ICD): A document created by the World Health Organization that is the international standard for the diagnosis of medical conditions. It contains a section on behavioral health disorders. Large Group Plan: Generally, these are health plans with 51 or more employees. However, in some states, this number was changed to 101 or more after January 1, 2016. These plans are regulated either by a state department of insurance or the federal Department of Labor. Medicare: The federal health insurance program for people who are 65 or older, some people below age 65 with disabilities, and individuals with end-stage renal disease. The Medicare program does not have to comply with the Federal Parity Law. Medicaid: A joint federal and state program that provides health insurance for low-income families and individuals. Medication Assisted Treatment (MAT): An evidence-based treatment that combines behavioral therapy with medication to treat substance use disorders. The three medications used in the treatment of substance use disorder are buprenorphine, methadone, naltrexone. Mental Health Parity and Addiction Equity Act (the Federal Parity Law): Singed into law in 2008, the Federal Parity Law requires many insurance plans that offer behavioral health coverage to provide these benefits under the same terms and conditions as other health benefits. This law does not require health insurance plans to offer behavioral health services. Non-Quantitative Treatment Limitations (NQTL): A medical management practice that cannot be quantified. Examples include geographic restrictions, prior authorization requirements, medical necessity review, and fail-first protocols. Outpatient Care: Treatment delivered to an individual where they can go home after care without being admitted to a hospital or a residential treatment facility. Patient Protection and Affordable Care Act (ACA): The national health reform law that was signed into law in 2010. The ACA requires that behavioral health services are an essential health benefit and therefore must be covered by health benefit plans sold in the individual market. Public Health Service Act: A United States federal law that contains many provisions, including important components of the federal laws that govern mental health parity.