Mental Health Parity Law Successes and Challenges

The Mental Health Parity and Addiction Equity Act of 2008 was passed to ensure that insurers and health plans offer mental health and substance abuse benefits comparable to coverage of medical and surgical care. It has heralded some positive trends, but there are still areas in need of improvement, experts say.

Other than the 2008 act and its precursor in 1996, there has been no legislation in America regarding mental health care, said Mary Kay O’Neill, partner at Mercer.

Also read: The Mental Health Parity Challenge

Until recently, “We didn’t have the resources or cultural language to talk about this,” she said. “How we talk about behavioral health now is completely different than seven year ago.”

Tom Sondergold, vice president, global HRIS, Benefits and Mobility at Walgreens Boots Alliance, said that while his organization has always strived for parity, having the law on their side has helped a lot. The Mental Health Parity Act has highlighted that there aren’t enough providers, he said.

“The parity law has allowed us to have a little bit more weight in working with our carrier partners to make sure they strive to secure more providers,” he added.

Employers should not assume that their insurers or plan administrators are in compliance with parity, said Henry Harbin, a psychiatrist with over 40 years of experience in the behavioral health field.

Employers that have been sued for parity non-compliance include Microsoft Corporation, Marriott International, Indiana University and Boeing Corporation.

Self-insured employers are regulated under the parity law and a liability target. Financial and quantitative requirements — for example, that behavioral health copays must be comparable to medical copays — have been reasonably in compliance with health plans and employers, he said. But non-quantitative requirements are where most litigation is happening for failing to comply with the law because there aren’t numbers or data to directly compare, putting self-insured employers at risk.

These non-quantitative treatment limitations include areas like reimbursement rates and admissions standards to the provider network. While it’s generally clear if the health plan is complying with the quantitative parity requirements, with non-quantitative requirements, it’s harder to tell if the health plan is complying with the law.