Proposed Rule for Applying Mental Health Parity to Medicaid and Children’s Health Insurance Program

Tue April 07, 2015

For Information Contact:
Glenn O'Neal, 703-907-8640
press@psych.org
Erin Connors, 703-907-8562
econnors@psych.org

ARLINGTON, Va – The American Psychiatric Association welcomes a proposed rule released Monday by the Centers for Medicare and Medicaid Services (CMS) that would require provisions of the Mental Health Parity Act to apply to the majority of Medicaid plans and the Children’s Health Insurance Program (CHIP).

“The proposed rule, by expanding mental health parity, has the potential to greatly improve access to care for mental health and substance use disorders and the equity which our patients need,” said APA President Paul Summergrad, M.D. “We’ve made much progress in recent years under the Mental Health Parity Act and the expansion of its applicability under the Affordable Care Act, and this rule will continue that progress by providing greater opportunity for Medicaid beneficiaries to receive the psychiatric and substance use services they need and deserve.”

Summergrad noted that that the APA is particularly pleased to see the transparency provisions in the rule requiring states to publicly share their compliance with the proposed parity regulations. “This will help hold states and the payors they use accountable and will allow monitoring of the progress and implementation of parity,” he said.

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) requires that mental health benefits be treated on the same level, in parity, with medical and surgical benefits under health plans that offer behavioral health care. The heart of the Mental Health Parity Act is the recognition that treatment for mental disorders should be equivalent to that provided for all other medical conditions under an insurance coverage plan. The Mental Health Parity Act originally applied to group health insurance coverage and was amended by the Affordable Care Act to also apply to individual health insurance coverage.

The proposed rule would create greater consistency between the commercial and Medicaid markets and would help ensure that beneficiaries who receive services through Medicaid or CHIP will have access to mental health and substance use disorder benefits. The proposed rule does not apply to Medicaid fee-for-service plans, but it does encourage states that run such plans to adopt mental health parity rules.

APA is reviewing the proposed rule in detail and will submit comments. Public comments are due on the proposed rule by June 9. Learn more about parity at http://www.psychiatry.org/psychiatrists/practice/parity.

See also the Proposed Rule: Application of Mental Health and Substance Abuse Disorder Parity Requirements to Medicaid Managed Care, CHIP, and Benchmark Coverage and a CMS Fact Sheet on the Proposed Rule.

The American Psychiatric Association is a national medical specialty society whose physician members specialize in the diagnosis, treatment, prevention and research of mental illnesses, including substance use disorders. Visit the APA at www.psychiatry.org.

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