Issue link: https://blog.providence.org/i/1035653
Evaluating State Mental Health and Addiction Parity Statutes: A Technical Report 29 Expanded mandated benefits. The Federal Parity Law does not require health plans to offer coverage for behavioral health treatment but does require many plans offering these benefits to ensure they are equivalent to the benefits provided for physical health. Proposed legislation that mandates the offering or coverage of benefits is building upon the Federal Parity Law by increasing the accessibility of mental health and substance use disorder services. A handful of bills do so broadly by extending certain sections or all of state parity statutes to apply to additional types of plans or policies, such as individual plans or short-term limited duration plans. Others do so by strengthening current state parity statutes by creating further requirements, such as requiring coverage or reimbursement of certain mental health and substance use disorder treatment, screenings, or telemedicine benefits. For instance, proposed bills are requiring Medicaid reimbursement eligibility for certain providers or requiring certain provider types' services be offered or covered by commercial plans and policies. These bills concern licensed marital and family counselors, licensed rehabilitation counselors, certified substance use disorder counselors, and certified addiction recovery coaches. Expanding access by restricting managed care techniques. Additionally, proposed legislation is focusing on restricting managed care techniques for both Medicaid and commercial plans and policies. Curbing authorization requirements is increasingly common, such as limiting prerequisite or authorization criteria solely to a qualifying physician's determination of medical necessity or prescription for a treatment or service. Other legislation prohibits prior authorization requirements entirely for identified substance use disorder services, including MAT products and outpatient treatment and diagnosis. Required enforcement and compliance. Bills mandating specific required compliance and enforcement procedures are being introduced in multiple states. Many of these bills incorporate language from The Kennedy Forum Model State Parity Legislation. 19 This model bill reinforces parity provisions within the relevant sections of state laws by adding reporting requirements for insurers and regulators. Tailored versions of the model bill and related compliance and enforcement measures have been introduced across the nation to best suit a state's needs and political climates. Illinois scored 100 on the SCI and is an example of a state that recently adopted language from The Kennedy Forum Model Legislation. Rewritten, new, and past bills are expected to be introduced during the upcoming legislative sessions. Visit ParityTrack.org for the most up to date information. ________________ 19 https://www.paritytrack.org/resources/model-resources/