Mental Health/Substance Use Disorder Parity: Improving Access to Behavioral Health Care. Dan Belnap Legal Action Center Families USA Health Action conference January 25, 2014. About LAC and the Coalition for Whole Health. Legal Action Center
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Legal Action Center
Families USA Health Action conference
January 25, 2014
What is the federal mental health (MH) and substance use disorder (SUD) parity law?
What should we look for to determine if coverage meets parity requirements?
What types of plans must comply with parity and which agencies have oversight responsibilities?
What do state-level advocates need to know about parity?
Parity prohibits most private health plans from providing MH and SUD benefits in a more restrictive way than other medical and surgical benefits covered by the plan
Requires comparison of plan coverage for MH and SUD services and medications with coverage for other illnesses
Financial requirements and treatment limitations for MH/SUD must not be more restrictive than what’s applied to the plan’s medical/surgical coverage
Is the plan a type that is required to comply with the federal parity laws?
Does the plan cover MH and SUD benefits in all of the classifications in which it covers medical/surgical benefits?
Are the financial requirements imposed on the MH or SUD benefits more restrictive than those on corresponding medical/surgical benefits?
Are the quantitative treatment limitations imposed on the MH or SUD benefits more restrictive than those imposed on corresponding covered medical/surgical benefits?
Are the non-quantitative treatment limits imposed on the MH or SUD benefits more restrictive than those imposed on corresponding covered medical/surgical benefits?