CMS finalizes Medicaid, CHIP mental health parity rule

The Centers for Medicare & Medicaid Services today issued a final rule applying certain provisions of the Mental Health Parity and Addiction Equity Act of 2008 to Medicaid managed care organizations, Medicaid alternative benefit plans and the Children’s Health Insurance Program. The MHPAEA requires group health plans that offer mental health or substance use disorder benefits to provide them at parity with their medical/surgical benefits. According to CMS, this final rule applies parity standards to coverage for Medicaid MCO, ABP and CHIP enrollees so that financial requirements (such as copays and coinsurance) and treatment limitations (such as visit limits) on MH/SUD benefits generally are no more restrictive than the requirements and limitations for medical and surgical benefits, among other provisions. In a change from the proposed rule, the final rule extends parity protections to long-term care services for MH and SUDs. The rule also requires that enrollees be provided information about the reasons for any reimbursement denial related to MH/SUD benefits. For more information, see the CMS factsheet. Also today, President Obama created an interagency task force to identify and promote best practices to ensure compliance with parity requirements and determine areas that would benefit from further guidance.