New Mental Health Rule Introduces Employer Benefit Parity Test

Bloomberg Government [9/09] - The Biden administration is poised to issue a final rule toughening mandates for employer-sponsored health plans to provide mental health and substance use disorder (SUD) coverage on par with their traditional medical benefits. The rule [...] will require detailed analyses from employers with self-insured plans to determine whether their mental health benefits comply with the Mental Health Parity and Addiction Equity Act. 

Employer plans will be forced to address their use of “non-quantitative treatment limitations” that affect parity between physical and mental health coverage, including “prior authorizations” that require insurer approval before treatment. The rule also eliminates an exemption for non-federal government health plans, and tweaks how plans can measure network adequacy, and gives them more flexibility in measuring the impact of prior authorizations. | CONT