DOL Releases Mental Health Parity Guidance

On June 16, 2017, the DOL, HHS and the Treasury (“the Departments”) released “FAQs About Mental Health and Substance Use Disorder Parity Implementation and the 21st Century Cures Act Part 38.” As background, the Mental Health Parity and Addiction Equity Act (MHPAEA) requires that the financial requirements and treatment limitations imposed on mental health and substance use disorder (MH/SUD) benefits cannot be more restrictive than the predominant financial requirements and treatment limitations that apply to substantially all medical and surgical benefits. MHPAEA also imposes several disclosure requirements on group health plans and health insurance issuers.

Specifically, the 21st Century Cures Act (enacted Dec. 13, 2016) contains provisions that are intended to improve compliance with MHPAEA by requiring the Departments to solicit feedback from the public on how to improve disclosure of the information required under MHPAEA and other laws. After requesting comments on the disclosure requirements for nonquantitative treatment limitations (NQTLs), the Departments received feedback seeking additional guidance on ways to streamline, simplify and create uniformity in the disclosure procedures. In fact, various stakeholders recommended the use of model forms that would be used to request relevant disclosures.

While the Departments are still accepting comments on MHPAEA’s disclosure requirements, they also released a draft model form that participants, enrollees or their authorized representatives could use to request information from their health plan regarding NQTLs that may affect their MH/SUD benefits. Comments on the disclosures (and on the draft model form) will be accepted until Sept. 13, 2017.

The FAQ confirms that the MHPAEA applies to benefits provided for treatment of an eating disorder. Specifically, eating disorders are mental health conditions, and treatment of an eating disorder is a mental health benefit for purposes of MHPAEA. Finally, the Departments are also seeking comments on how MHPAEA applies to eating disorder treatment.

FAQ Part 38 »
Draft Model Form »