The Obama administration issued an interim final rule that offers guidance on how the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act will be implemented. Passed in 2008, the act requires that any group health plan that includes mental health and substance-use disorder benefits with general medical and surgical benefits must treat both equally.
Interim rule issued on mental health parity
Effective in early April—60 days after publication in the Federal Register—the interim rule applies to plan years beginning on or after July 1, 2010, and prohibits group health insurance plans from restricting access to care by limiting benefits and requiring higher patient costs than those that apply to general medical and surgical benefits. HHS said there were more than 400 public comments about how the parity rule should be written, and the agency is still seeking comments on the scope and duration of covered benefits, how covered drugs are determined, and the coverage of step therapies.
“The rules we are issuing today will, for the first time, help assure that those diagnosed with these debilitating and sometimes life-threatening disorders will not suffer needless or arbitrary limits on their care,” HHS Secretary Kathleen Sebelius said in a news release.
The rule applies to group plans of 50 or more people and divides benefits into the following six categories: inpatient, in-network; inpatient, out-of-network; outpatient, in-network; outpatient, out-of-network; emergency care; and prescription drugs.
HHS will accept public comments for 90 days after the rule's Feb. 2 publication date in the Federal Register.
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