Mental Health Reform Is Ready To Go!
The Mental Health Parity Act of 2009
While National Healthcare Reform is still be debated, MHP is already in place and making a difference for those seeking mental health and substance abuse care, especially when utilizing out-of-network options.
Here are some of the provisions of the new mental health (MHP) law:
- Requires the having the same rules and benefits for mental health as all other medical treatment.
- Mandatory for group health plans of 51 or more employees.
- Forbids employers and insurers from placing stricter limits (for example, higher co-payments or covering fewer doctor’s visits) on mental health care than on other health conditions.
- Applies to out-of-network coverage so that plans that offer out-of-network coverage for medical conditions also must provide out-of-network coverage for mental conditions.
- Individual state parity measures are still in place.
Employers are no longer be permitted to require separate deductibles for mental health and medical treatment under the new MHP law which took effect in October 2009, however the new regulations give employers until the first plan year beginning on or after July 1, 2010, to meet the requirements.
MHP law requires that mental health and substance abuse treatment must be equivalent to that provided for medical and surgical care within benefit classifications and coverage tiers, such as in-network and out-of-network care, emergency care and prescription drugs. The law is mandatory for group health care plans and employers with 50+ employees. In addition, employee assistance programs cannot serve as gatekeepers, restricting or directing mental health care, unless a similar form of medical management is applied to medical and surgical benefits, according to benefit consultants’ preliminary interpretations of the new regulations.
In effect, you no longer have to jump through different or additional “hoops” or red tape in order to seek and arrange for mental health and substance abuse treatment. The regulations also prohibit charging higher “specialist” copayments for mental health providers. The extended effective date also could give plan administrators time to develop systems for determining the value of mental health/substance abuse and medical/surgical treatment, something that is not always done when the two benefit programs are administered separately.
