Test Your Parity IQ:
Has your insurance plan denied coverage of addictions treatment services?
Are your clients unable to access psychiatric medications because of restrictive insurance policies?
Do you know whether these denials constitute a violation of the 2008 Mental Health Parity and Addictions Equity Act?
Click the button below to test your knowledge!
Mental Health & Addictions Parity
On October 3, 2008, President George W. Bush signed the Emergency Economic Stabilization Act of 2008, which included the Paul Wellstone and Pete Domenici Mental Health Parity & Addiction Equity Act. Parity was also included as a central component of the Patient Protection and Affordable Care Act. As the provisions of the healthcare reform law are gradually rolled out over the coming years, the National Council and other advocacy groups are working to ensure that parity is included in all levels of implementation.
- Summary of 2008 Wellstone-Domenici Parity Law
- Top-line summary of 2010 regulations providing details and guidance on how parity must be implemented
- Slides and recording from Jan. 2011 National Council webinar: “What the Federal Parity Law Means for You”
- Mental Health Parity in the News: Washington Post Express publishes Summary of Parity Law (page 35)
What does all of this mean for me?
Our Frequently Asked Questions document provides answers to questions about specific examples of noncompliance with parity. Examples fall into the following categories:
- Refusal to pay for or provide coverage for specific types of MH/SUD treatment or levels of care
- Application of parity to medical management
- Discrimination in reimbursement practices
- Application of parity to Medicaid managed care plans
- Discrimination in any cost containment practices
- Application of parity to psychiatric and addictions medicines
- Need for compliance with all aspects of parity if an insurance plan provides 1 or more MH/SUD treatments
- Requirement to use a national clinical standard when using more restrictive cost containment practices
Learn about clinical and organizational approaches to prepare your organization for parity and health reform implementation in this National Council LIVE Webinar with David Lloyd and Sandy Myers.
Parity Violations: What to Do When Your Claim is Denied
Parity Appeals Toolkit for Providers, Consumers, and Advocates: With the Parity Implementation Coalition, the National Council has assembled a Toolkit to provide resources and guidance for filing an insurance appeal under the parity law. The toolkit includes:
- Overview of the Appeals Process
- When Should You File an Appeal?
- Critical information for Filing an Appeal
- Checklist for Your Health Plan Coverage
- Information on Internal and External Appeals
- Checklist for Keeping Track of Your Appeal
- Tips for Successful Appeals
- How Can the Federal or your State Government Help?
- Model letters for your and your providers to use throughout the steps of the appeals process
- And much more!
File an Official Complaint: The U.S. Department of Health and Human Services has set up a Help Line to answer your questions or hear your concerns about your health plan’s compliance with the law. The number for the Help Line is:1-877-267-2323 ext. 6-5511. In addition, Department of Labor benefits advisors are available to answer your questions about the parity law and provide assistance in obtaining your benefits. Call 1-866-444-3272 or use this online form.
Tell us your stories! The National Council wants to make sure that health plans are complying with the parity law – but for us to monitor what is going on in the states and be strong advocates for parity, we need to hear from you. Please email StaceyL@thenationalcouncil.org to share with us:
- Instances where you suspect an insurance plan has improperly denied coverage of behavioral health services
- Examples of plan benefits statements that may not meet the terms of parity
- Other incidences where behavioral health benefits are restricted
Examples from the States
Coming soon: Many states are taking proactive steps to ensure that parity is fully implemented in their state, both for the individuals it currently affects and for those who will be included when the health reform expansions begin in 2014. Stay tuned to this page to find links to educational documents, advocacy materials, and lessons learned from other states.
Recent Blog Posts on Parity
Looking for recent posts on this topic? Click here to view everything we’ve written about parity.