In October, the President’s Mental Health and Substance Use Disorder Parity Task Force released its final report on the state of mental health and substance use parity following the passage of the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act (MHPAEA). The task force recognized that there is “more work to be done” to ensure that patients living with mental illness and addiction face fewer barriers to behavioral health care coverage.
According to the report, statistical trends indicate that insurance coverage for behavioral health conditions results in positive outcomes. Since the passage of ACA and MHPAEA, the percentage of adults using mental health services has grown from 13.8 percent to nearly 15 percent, and there has been a steady decline in indicators of financial burden associated with treatment for mental health.
Over the past seven months, the task force received 1,161 public comments from patients, families, advocates, insurance providers, state regulators and others. The commenters expressed the need for expanded awareness and education of parity requirements, emphasis on compliance with non-quantitative treatment limitations like disparate requirements for mental health coverage, and guidance from federal agencies on stronger enforcement of parity regulations at the state level.
The task force executed several actions in response to the recommendations from commenters.
- The Center for Medicare and Medicaid Services will award $9.3 million to states to aid in parity protection and enforcement.
- A new government website will direct consumers to the right agency and resources to file parity complaints and appeals.
- The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Department of Labor will release a Consumer Guide to Disclosure Rights as a consumer-friendly tool to help individuals understand their parity rights and identify whether they’re experiencing a parity violation.
The task force recommendations will serve as a “road map for future efforts to improve understanding of parity protections, clarify parity requirements, and improve monitoring and enforcement efforts.”
Key recommendations include:
- Create a one-stop consumer web portal where consumers can find the appropriate entry point for assistance or the correct resource to help them solve their coverage issue, file a complaint or submit an appeal. A beta version of the site is being tested.
- Increase the capacity of federal agencies to audit health plans for parity compliance.
- Provide federal support for state efforts to enforce parity through trainings, resources and new implementation tools.
What is Maryland doing to improve mental health parity?
Here in Maryland, stakeholders have been working to improve enforcement mechanisms that limit the number of parity violations in the state. In April, Governor Hogan signed HB1318-Health Benefit Plans-Network Access Standards and Provider Network Directories, which enables the Maryland Insurance Administration (MIA) to enforce network adequacy requirements. MHAMD played a significant role in the passage of this legislation, and continues its involvement in the process to develop regulations pursuant to the bill. We co-authored and submitted comments in mid-November that included specific recommendations for addressing appointment wait times, geographic time and distance standards, essential community providers, confidentiality of access plans, telehealth and other technology, and enforcement and annual reporting. The comments were co-signed by fifty organizations. You can read the full comments here.
While the task force recommendations are comprehensive, much work is still needed to improve parity enforcement for individuals living with mental illness and substance use disorders. The burden of navigating parity regulations and reporting violations still falls to the consumer, who often is met with a parity concern when most in need of help. Tools to simplify the process for consumers is a step in the right direction, but more oversight is needed to ensure parity violations are identified as early as possible.