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Summary of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 Benefits Covered –Mental Health Conditions –Substance.

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Presentation on theme: "Summary of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 Benefits Covered –Mental Health Conditions –Substance."— Presentation transcript:

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2 Summary of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 Benefits Covered –Mental Health Conditions –Substance Use Disorders Parity Requirement –Financial Requirements –Treatment Limitations

3 Who Does The New Law Apply To Group Health Plans and Health Insurers That Provide Coverage to Group Health Plans (employers with over 50 employees) Medicaid Managed Care Plans State Children’s Health Insurance Program Non-Federal Governmental Plans Federal Employees Health Benefits Plans

4 Summary of the Law Continued Out-of-Network Benefits Management Transparency Small Employer Exemption Cost Exemption Compliance Report GAO Study Consumer Assistance State Laws Effective Date Enforcement/Regulations

5 Regulations Departments of Labor, Health and Human Services and Treasury to Issue Regulations 1 Year After the Date of Enactment RFI released April 28 th – 30 days to Comment (due May 28 th ) Expect Interim Final Regulation to be Issued in June or July Final Regulation Sometime in 2010

6 Areas That Need Clarification in the Regulations Ensure Management of the Benefit Define “or Other Similar Limits on the Scope or Duration of Treatment” Define No More Restrictive than the Predominant Financial/Treatment Limitations Applied to Substantially All Medical and Surgical Benefits Ensure Ability to Have Separate but Equal Deductibles

7 American Psychiatric Association Partnership for Workplace Mental Health Survey More Than 70% of Respondents Said That Their Company is Not Considering Dropping MH or SUD Because of the New Federal Parity Law 28% or More Said Their Company Will Increase Promotion/Use of EAP Services, Disease Management and Wellness Programs


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