In the final week of July, a joint effort between the Treasury Department, Department of Labor, and Department of Health and Human Services produced some analysis and guidance to help companies comply with the Mental Health Parity and Addiction Equity Act (MHPAEA).
While these proposed regulations crafted in support of the MHPAEA are still in flux and will likely evolve some in response to the stakeholder feedback and comments that will be collected over the coming months, the guidance in its current form reveals a great deal about the regulators’ intent, focus, and framework for addressing these issues, much of which will likely carry over to the final rule.
One of the main thrusts of the guidance as it stands is improving employee access to treatment for mental health and substance abuse. It’s clear the interdepartmental group tasked with creating these regulatory guidelines identified access issues as a key barrier to current mental health care delivery, especially in the wake of the pandemic, which exacerbated these issues for many Americans.
The guidance-producing body also focused its efforts on ensuring that those mental health and substance abuse treatment options are comparable in availability and quality of care for all employees. The proposed regulations include a new rule that should help ensure there will be a sufficient number of providers within each plan’s network - a hugely important factor in terms of access to care, which can also be severely impacted in a negative way by low-reimbursement rates combined with demand that outpaces supply. Regulators are particularly interested in hearing public comment about these particular issues in order to devise a minimally intrusive, optimized-parity-achieving system.
Further, in order to better evaluate access and parity issues with regard to mental health care and substance abuse facilities from a macro perspective, the new guidelines emphasize the importance of employers’ obligation to produce satisfactory Nonquantitative Treatment Limitation (NQTL) comparative analysis reports. A lack of data about access and parity has hindered many an analysis and regulatory response in the past, which is why the new rules mandate plans and issuers gather and assess relevant information before imposing any NQTLs, including minimum data collection requirements as well as standards for when and how that data must be submitted.
The new rules will also likely include definitions and guidance to help better address areas that need special attention, including Applied Behavior Analysis (ABA) Therapy, which has historically encountered treatment limitations in some plans (a practice that will now be prohibited) even though ABA is one of the main forms of treatment for people on the autism spectrum.
While the proposed regulations have yet to be formalized, and can not in fact be adopted prior to the public and stakeholder comment period, given how closely the final rules will likely mimic the announced guidelines, employers would be wise to begin working with advisors and subject matter experts in order to ensure their compliance with the ultimate regulations, especially when it comes to network provider provisions.
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