Public Policy Insight: CASAColumbia Releases Parity Recommendations
New Resource for Policymakers:
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires that if a health plan offers addiction treatment benefits, the plan must offer coverage at the same level as coverage for medical and surgical benefits. For example:
- A health plan can’t require a co-pay for a visit to an addiction treatment provider that is higher than the co-pay charged for most medical specialists
- A plan can’t require patients to get office visits for addiction care pre-approved more often than it requires pre-approval for other medical visits
The federal government released the final rule for MHPAEA in November 2013, and it goes into effect in July 2014. Also, the Affordable Care Act (ACA) requires certain health plans to follow parity even though MHPAEA didn’t originally apply to these plans. The likely result is that many more people will be in health plans that have to follow parity.
The final rule is an important step forward in making the promise of MHPAEA a reality. But the final rule doesn’t mention what kind of benefits health plans should offer for addiction and it doesn’t explain why limiting addiction treatment benefits can be bad for addiction care.
To fill this gap, CASAColumbia® has created a guide for state regulators of private health plans. The guide contains:
- The critical addiction benefits that health plans should offer
- Examples of how limits on benefits can disrupt addiction care and why they should not be used
- Summary of MHPAEA and the final rule requirements
The recommendations in the guide come from our report, Addiction Medicine: Closing the Gap between Science and Practice, which examined the science of addiction and how to prevent and treat it effectively.