January 25, 2021:

Mental Health and Substance Use Disorder Benefits Parity

The Consolidated Appropriation Act, 2021 (Appropriations Act) signed into law on December 27, 2020, includes several provisions requiring that group health plans and health insurance insurers provide comparative analysis regarding utilization and compliance with the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (the MHPAEA), with the goal of monitoring and improving access to mental health and substance use disorder benefits. The MHPAEA is a federal law that generally prevents group health plans and group and individual health insurance issuers that provide mental health and substance use disorder benefits from imposing less favorable benefit limitations on those benefits than imposed on major medical coverage. The rules reflect Congress’ intent to have such benefits treated in the same manner as major medical benefits in regard to coverage and limitations. The MHPAEA generally applies to most group health plans and group health insurance coverage. Please also see our Advisors Part 1, Part 2, and Part 3 on the Appropriations Act for an overview of provisions affecting group health plans and group health insurance coverage outside of the MHPAEA.

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Marlborough, Massachusetts