The Department of Health and Human Services (HHS) proposed a new rule to ensure plans and issuers treat mental health and substance use disorder (SUD) care the same as physical health care.
The new rule, issued with the Department of Labor and Department of the Treasury, aims to reinforce the Mental Health Parity and Addiction Equity Act, which requires that consumers have the same access to mental health and SUD benefits as they do physical health benefits.
If finalized, the proposed rule will update examples to clarify that plans and issuers cannot use more restrictive prior authorization and other medical management techniques for mental health and SUD benefits. Plans and issuers also would need to compare their provider networks and how much they reimburse out-of-network providers to ensure they are comparable.
The proposed rule also would require plans and issuers to analyze outcome data on access to these benefits and take corrective action when necessary, with a specific focus on provider networks.
Contact Senior Director of Policy Erin O’Malley at firstname.lastname@example.org or 202.585.0127 with questions.