Compliance April 28, 2009

Feds Ask for Help on Mental Health Coverage Rules

April 27, 2009 (PLANSPONSOR.com) - Three federal agencies on Tuesday put out a formal call for public comment about how best to formulate rules governing coverage of mental health issues by group health plans.
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A news release said the request for information (RFI) came from the U.S. Departments of Labor, Treasury, and Health and Human Services as regulators prepare to issue rules implementing The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).

The MHPAEA governs cost-sharing or treatment limitations on mental health and substance use disorders so they are no more restrictive than limits places on other medical or surgical coverage provided by he plan. MHPAEA also reauthorized several provisions relating to parity in annual and lifetime dollar limits for group health plan coverage enacted as part of the Mental Health Parity Act of 1996.

The RFI seeks public comments on the:

  • Types of financial requirements or treatment limits plans currently impose,
  • Terms in the statute that require additional clarification to facilitate compliance,
  • Current disclosure practices by plans regarding medical necessity determinations and denials of mental health benefits, and
  • Current practices regarding out-of-network coverage for mental health benefits.

Written comments responding to the MHPAEA RFI may be addressed to the U.S. Department of Labor, Office of Health Plan Standards and Compliance Assistance, Employee Benefits Security Administration, N-5653, 200 Constitution Ave. N.W., Washington, D.C.  20210, Attn: MHPAEA Comments. The public also may submit comments electronically by email to E-OHPSCA.EBSA@dol.gov or through the federal e-rulemaking portal at www.regulations.gov .

The RFI is available  here .

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