The Centers for Medicare & Medicaid Services released a set of frequently asked questions (FAQs) related to the Mental Health and Substance Use Disorder Parity final rule for Medicaid and the Children’s Health Insurance Program (CHIP).

The rule, finalized in March 2016, applied certain provisions of the Mental Health Parity and Addiction Equity Act to Medicaid and CHIP enrollees to ensure that limitations for mental health and substance abuse disorder treatment are not more burdensome than limitations for other medical or surgical benefits. The FAQs clarify aspects of the final rule, including:

  • which benefits are subject to parity analysis;
  • managed care organizations’ obligations with respect to parity;
  • how parity relates to long-term services and supports;
  • prior authorization requirements; and
  • documentation of compliance.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.