May 14, 2019
On April 19, 2019, Commissioner Glause issued Bulletin No. 01-2019 to clarify state law regarding mental health parity as it relates to autism spectrum disorder services. As we discussed in the last edition of Compliance Corner, WY passed the Mental Health and Substance User Disorder Insurance Parity Act on February 27, 2019, requiring all individual and group insurance policies to meet the requirements of the Federal Mental Health Parity and Addiction Equity Act of 2008.
This bulletin clarifies that, even though not all non-ACA plans include mental health services, for those that do, treatments for autism spectrum disorder cannot be excluded from the mental health services in an insurance policy. In addition, if the policy includes both medical/surgical benefits and mental health/substance use disorder benefits, the financial requirements and treatment limitations must be no more restrictive for mental health/substance use disorder benefits than medical/surgical benefits. Finally, the bulletin expressly prohibits an exclusion of the applied behavior analysis therapy to treat children with autism spectrum disorder on the basis that such therapy is experimental or investigative treatment.
While this requirement will largely fall on insurers, fully-insured plan sponsors should keep this guidance in mind.
Bulletin No. 01-2019 »