White House strengthens legislation on equal access to mental health, substance use care

Key takeaways:

• The new rule reinforces the 2008 Mental Health Parity and Addiction Equality Act, which promotes equal access to mental and physical health.
• HHS will release tools to ensure Medicaid plans comply with MHPAEA.

The White House moved to strengthen the Mental Health Parity and Addiction Equality Act to ensure individuals with private insurance have the same access to mental health services as they do for physical health services.

In a press release, the Biden administration stated that the addition of a new rule within the act, first signed into law in 2008, is intended to remove barriers to access for an estimated 175 million Americans.

The finalized rule has three main components:

• It requires insurers to alter health plans that do not adequately cover mental health and substance use care. For example, they will need to ensure there are enough mental health and substance use providers in their networks.
• It clarifies what a particular health care plan can and cannot do, like use more restricted prior authorization to make it difficult for patients to access care for mental health and substance use disorder.
• It closes an existing loophole, which previously did not require nonfederal governmental health plans to comply with Mental Health Parity and Addiction Equality Act (MHPAEA) requirements.

This new rule requires more than 200 additional health care plans to comply with MHPAEA, protecting about 120,000 enrollees, per the release.

“Mental health care is health care. But for far too many Americans, critical care and treatments are out of reach,” President Joe Biden said in the press release. “There is no reason that breaking your arm should be treated differently than having a mental health condition.”

In a concurrent press release, the American Psychiatric Association stated that the new rule requires insurers to conduct and document comparative analyses for non-quantitative treatment limitations on mental health and substance use disorder services, such as prior authorizations and step therapy. These analyses must be made available to state and federal regulators as well as to plan beneficiaries.

Additionally, according to the APA release, insurers will be expected to make public certain information, such as claims denials and address differences in access to care.

"This is a big step forward to hold insurance plans accountable by ensuring the law’s intent is fulfilled and that more individuals will be able to access the mental health and substance use treatment they need,” APA CEO and Medical Director Marketa M. Wills, MD, MBA, stated in a related release.

Reference:

APA applauds administration for issuing final rules on mental health parity. https://www.psychiatry.org/News-room/News-Releases/APA-Applauds-Administration-for-Issuing-Final-Rule. Published Sept. 9, 2024. Accessed Sept. 9, 2024.