NEW: Parity provisions are included in the 21st Century Cures Act, which was signed into law (P.L.114-255) on December 13, 2016.
On October 27, 2016, the White House Mental Health and Substance Use Disorder Parity Task Force sent its final report to the President. Also see a fact sheet with recommendations, a blog, and www.hhs.gov/parity for more information.
On March 30, 2016, the Centers for Medicare & Medicaid Services (CMS) published a final rule outlining how the federal parity law will be applied to Medicaid, to the Medicaid expansion population through alternative benefit plans, and to the Children’s Health Insurance Program (CHIP).
On December 6, 2013, NAPHS participated in a summit on “Achieving Parity: Moving Forward after the Final Rule” hosted by former Rep. Patrick Kennedy (left photo) with a group of 25 key national health and mental health organizations to focus on how collective efforts can help ensure effective implementation of mental health parity. NAPHS President/CEO Mark Covall (2nd photo, right) joined Neil Kirschner of the American College of Physicians on a panel discussion.
VICTORY! Federal law (the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008) now addresses longstanding discrimination against those who rely on their health plans for coverage of mental and addictive disorders. And a final rule was issued November 8, 2013. The law:
- extends equal coverage to an estimated 113 million Americans who work for employers with 51 employees or more
- for the first time, this includes workers in companies that are self-insured
- establishes visit and day limits that cannot be more restrictive than those for medical/surgical services
- establishes copays and deductibles that cannot be more restrictive than those for medical/surgical services
- requires that if a health plan offers out-of-network coverage, it must also include out-of-network parity for mental health
- establishes a floor, but state parity laws can go beyond the federal law
- allows management of the benefit
- becomes effective one year after enactment (effective October 2009)
Mental health parity has won unprecedented support from consumers, providers, hospitals, employers, and health insurers. With millions of Americans experiencing psychiatric and addictive conditions, having coverage that is on par with that of other medical conditions is a win for America.
Mental health parity:
- Saves lives. Mental illnesses constitute the second leading cause of disability and premature death in the United States. As the President’s New Freedom Commission on Mental Health noted, however, about one out of every two people who needs mental health treatment in this country does not receive it.
- Saves money. Providing equal coverage for all illnesses makes good economic sense. When mental illnesses go untreated, costs begin to escalate.
- Is cost-effective. Providing parity for mental illnesses is affordable. Research and actual industry experiences indicate that parity can be implemented without substantially increasing premiums. Studies have concluded that parity would increase premiums less than 2%.
- Is fair. Mental health parity is the right thing to do. Mental health parity is a win for America!
NAPHS was a founding member of the Coalition for Fairness in Mental Illness Coverage, which helped to win passage of this landmark legislation.
Today NAPHS serves as a Steering Committee member of the Parity Implementation Coalition.
NAPHS is working with Congress and federal agencies to implement and clarify the federal parity regulations. The association is also working to end remaining vestiges of discrimination, including eliminating the Medicare 190-day lifetime limit.
Learn about how NAPHS is working on scope-of-service issues.
6/20/2017 | Employee Benefits Security Administration notice: "Proposed Revision of Information Collection Request Submitted for Public Comment; Draft Model Non-Quantitative Treatment Limitations Form" |
6/7/2017 | Parity Implementation Coalition letter to President's Commission on Combatting Drug Addiction and the Opioid Crisis |
1/23/2017 | Release: "NY Attorney General Announces [State Parity] Settlement With Cigna That Eliminates Policies Which Barred Coverage for Testing of Psychiatric Conditions and Autism Spectrum Disorder" |
1/20/2017 | CMS Center for Medicaid and CHIP Services: "State Guide to CMS Criteria for Medicaid Managed Care Contract Review and Approval" |
1/19/2017 | Release: "NY Attorney General Announces National Settlement With Anthem To Discontinue Pre-Authorization For Opioid Addiction Treatment Drugs" |
1/18/2017 | CMS Center for Medicaid and CHIP Services: "An Implementation Roadmap for State Policymakers Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs" |
1/17/2017 | CMS Center for Medicaid and CHIP Services: "Parity Compliance Toolkit Applying Mental Health and Substance Use Disorder Parity Requirements to Medicaid and Children’s Health Insurance Programs" (for Medicaid directors) |
1/11/2017 | Employee Benefits Security Administration (EBSA) / Labor Department: FY2016 MHPAEA [Parity] Enforcement Fact Sheet |
12/13/2016 | President signs 21st Century Cures Act which includes mental health reforms and addiction funding |
11/28/2016 | Parity Implementation Coalition release: "Parity Implementation Coalition Applauds Inclusion of Parity Provisions in 21st Century Cures Bill." See bill excerpts. |
11/2/2016 | Parity Implementation Coalition: "Summary of the White House Parity Task Force Report and Accompanying Action Items" |
10/27/2016 | PIC release: "Parity Implementation Coalition Applauds Release of White House Parity Task Force Recommendations" |
10/27/2016 | Joint statement (43 organizations) on release of Mental Health and Substance Use Disorder Parity Task Force report |
10/27/2016 | White House Mental Health and Substance Use Disorder Parity Task Force final report to the President. Also see fact sheet/recommendations, a blog, and www.hhs.gov/parity for more information. |
10/27/2016 | Labor/HHS/Treasury FAQ guidance on parity and opioid use disorder treatment (including discussion of the application of parity to opioid treatment access and coverage of court-ordered treatment) |
10/27/2016 | Labor/HHS/Treasury: "Parity Compliance Assistance Materials Index" (a summary as of October 2016 to assist with navigating/locating all previously-issued parity FAQ guidances) |
10/27/2016 | SAMHSA/Labor Department: "Consumer Guide to Disclosure Rights: Making the Most of Your Mental Health and Substance Use Disorder Benefits" |
10/21/2016 | Release: "NY Attorney General Announces National Settlement With Cigna To Discontinue Pre-Authorization For Opioid Addiction Treatment Drugs" |
10/5/2016 | Parity Implementation Coalition: Maryland State Snapshot on Parity Implementation |
9/8/2016 | Coalition letter to Members of Congress urging passage of mental health reform legislation with strong parity protections |
8/31/2016 | Coalition for Whole Health (CWH) comment letter to White House Mental Health & Substance Use Disorder Parity Task Force |
8/31/2016 | Parity Implementation Coalition comment letter to White House Mental Health & Substance Use Disorder Parity Task Force |
8/30/2016 | Psych-Appeal, Parity Implementation Coalition, Kennedy Forum, and APA letter to Labor/HHS/Treasury on expedited external review subject to the ACA (shared with White House Mental Health & Substance Use Disorder Parity Task Force) |
7/14/2016 | 18 Senators' letter offering parity suggestions to White House Parity Task Force |
6/10/2016 | Consumer flyer from Department of Labor and SAMHSA: "Know Your Rights: Parity for Mental Health and Substance Use Disorder Benefits" (also see printable version) |
6/1/2016 | Department of Labor/HHS fact sheet: "Warning Signs – Plan or Policy Non-Quantitative Treatment Limitations (NQTLs) that Require Additional Analysis to Determine Mental Health Parity Compliance" |
5/26/2016 | Class-action lawsuit vs. Magellan/Blue Shield of California alleges improper denial of care to teens. See complaint. |
5/23/2016 | Parity "Hot Topics" references: "Disclosures, Claims, and Appeals" (speaker: Meiram Bendat, J.D.) |
4/22/2016 | Parity Implementation Coalition release: "Parity Implementation Coalition Applauds Release of Clarifying Guidance on Plan Disclosure Requirements of the Federal Parity Law" |
4/20/2016 | Departments of Labor, Treasury, and HHS: "FAQs about Affordable Care Act Implementation Part 31, Mental Health Parity Implementation...etc." (See Q8-Q11 on parity disclosure and more) |
3/31/2016 | NAPHS comment letter on Defense Department's proposed rule on "TRICARE: Mental Health and Substance Use Disorder Treatment" |
3/31/2016 | Parity Implementation Coalition letter on Defense Department's proposed rule on "TRICARE: Mental Health and Substance Use Disorder Treatment" |
3/31/2016 | Parity Implementation Coalition: “Summary of Key Provisions in Medicaid Parity Final Rule” |
3/30/2016 | CMS final rule: "Medicaid and Children’s Health Insurance Programs (CHIP): The Application of Mental Health Parity (MHPAEA) Requirements to Coverage Offered by Medicaid Managed Care Organizations, CHIP, and Alternative Benefit Plans." Also see a fact sheet, FAQs, and a CMS news release. |
2/29/2016 | MEMBERS: Background for today's Hot Topics call on "Keeping Parity on Par": Powerpoint and Parity Implementation Coalition's Parity Resource Guide |
1/30/2016 | Department of Labor "Report to Congress: Improving Health Coverage for Mental Health and Substance Use Disorder Patients, Including Compliance with the Federal Mental Health and Substance Use Disorder Parity Provisions" |
1/29/2016 | HHS/Labor/SAMHSA consumer pamphlet: "Parity of Mental Health and Substance Use Benefits with Other Benefits: Using Your Employer-Sponsored Health Plan to Cover Services." |
1/14/2016 | Parity Implementation Coalition: Washington State Snapshot on Parity Implementation |
11/20/2015 | Parity Implementation Coalition release: “PIC applauds Supreme Court ruling and new regulatory guidance on the Mental Health Parity and Addiction Equity Act” |
11/20/2015 | NAPHS release: "NAPHS Applauds Final Passage of Bipartisan Legislation To Extend and Expand the Medicaid Emergency Psychiatric Demonstration Project; Bill Next Goes to President for Signature." [NOTE: Signed into law 12.11.15 as P.L.114-97.] |
10/23/2015 | Department of Labor: "FAQs about Affordable Care Act Implementation (Part XXIX) and Mental Health Parity Implementation" |
10/15/2015 | 24 Senators send letter to HHS and Labor Secretaries urging "immediate and overdue action" to implement the Mental Health Parity and Addiction Equity Act |
9/1/2015 | Parity Implementation Coalition: Connecticut State Snapshot on Parity Implementation |
8/20/2015 | U.S. Court of Appeals for the Second Circuit rules that behavioral health claims administrators (rather than employers or plan administrators) can be sued for fiduciary breaches under ERISA, including those related to the federal parity law. |
7/22/2015 | NAPHS comment letter to CMS on IMD exclusion provision in proposed rule on "Medicaid & Children’s Health Insurance Program (CHIP) Programs; Medicaid Managed Care, etc." |
6/10/2015 | Parity Implementation Coalition releases updated “Parity Resource Guide.” See PIC news release |
6/9/2015 | Web-based ParityTrack is a central site for mental health and substance use disorder parity information produced by the Kennedy Forum, Scattergood Foundation, and Treatment Research Institute. Reports analyze legislation, regulatory actions, and litigation at the federal and state levels. |
6/1/2015 | Parity Implementation Coalition: New York State Snapshot on Parity Implementation |
5/6/2015 | Group letter to Labor, IRS, and HHS requesting additional guidance related to the full implementation and enforcement of the federal parity law |
4/15/2015 | Parity Implementation Coalition release: "Release of Medicaid Parity Proposed Rule Lauded as Important Step for Those with Addiction and Mental Illness" |
4/10/2015 | CMS proposed rule on "Mental Health Parity for Medicaid and CHIP." Also see CMS fact sheet. |
3/25/2015 | Psych-Appeal, Inc. release: "Federal court rules that exclusion of residential treatment may violate federal Parity Act" (Craft et al. v. Health Care Service Corporation) |
1/26/2015 | American Psychiatric Foundation & Partnership for Workplace Mental Health: Updated version of the Employer Guide for Compliance with the Mental Health Parity and Addiction Equity Act (prepared by Milliman, Inc.) |
1/2/2015 | Parity Implementation Coalition: California State Snapshot on Parity Implementation |
12/18/2014 | Parity Implementation Coalition comment letter to CMS on ACA's "2016 Benefit and Payment Parameters" |
12/15/2014 | Parity Implementation Coalition news release: "Parity Implementation Coalition Seeks Federal Action on Parity in Response to 60 Minutes Report." Watch 60 Minutes. |
11/19/2014 | Department of Labor: Updated Mental Health Parity Part of the Self Compliance Tool (to assist health plans and others determine compliance with the federal parity law) |
11/19/2014 | Department of Labor: Mental Health Parity Provisions Questions and Answers in the updated Compliance Assistance Guide |
1/8/2014 | Parity Implementation Coalition comments to Department of Labor on need for transparency and compliance with MHPAEA disclosure rule |
1/3/2014 | Parity Implementation Coalition: Detailed summary of parity final rule |
11/13/2013 | Final rule on federal parity law (the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008) |
11/8/2013 | Parity Implementation Coalition release: "Release of Final Regulations Lauded as landmark Step for those With Addiction and Mental Illness" |
11/8/2013 | NAPHS release: "Final Rule Governing the Federal Mental Health and Substance Use Parity Law Adds Important Health Insurance Protections for All Americans, Says NAPHS." See final rule. |
11/8/2013 | Departments of Labor, HHS, and Treasury: "FAQS About ACA (Part XVII) and Parity Implementation" |
11/8/2013 | HHS study: "Consistency of Large Employer and Group Health Plan Benefits with Requirements of the Paul Wellstone annd Pete Domenici Mental Health Parity and Addiction Equity Act" |
9/30/2013 | Mental Health Liaison Group (MHLG) comment letter responding to Senate Finance Committee open letter seeking input on how to improve the US mental health system |
9/27/2013 | Parity Implementation Coalition comment letter responding to HHS Office of Civil Rights "request for information regarding nondiscrimination in certain health programs or activities" |
9/20/2013 | NAPHS comment letter responding to Senate Finance Committee open letter seeking input on how to improve the US mental health system |
8/14/2013 | Coalition for Whole Health (CWH): Toolkit for state-level advocates working on implementation and oversight of the Affordable Care Act’s (ACA’s) essential health benefits, parity, and network adequacy protections. See an overview of key issues and short guides for working with state legislatures and insurance commissioners. |
2/25/2013 | HHS final rule: Standards related to essential health benefits (published in 2.25.13 Federal Register) |
2/21/2013 | NAPHS comment letter on proposed rule on Medicaid, CHIP expansion under ACA. NAPHS urges clarification that IMD restrictions should not apply. |
2/20/2013 | NAPHS statement on release of essential health benefits final rule |
2/20/2013 | ASPE Research Brief: "Affordable Care Act will expand mental health and substance use disorder benefits and parity protections for 62 million Americans" |
2/1/2013 | Department of Labor notice: "Agency information collection/submission for OMB review; comment request: notice of medical necessity criteria under the Mental Health Parity and Addiction Equity Act of 2008" |
1/24/2013 | NAPHS / NAMI ad to the President and Congress (as seen in Politico): "Thank you...for committing to fully implementing the Mental Health Parity and Addiction Equity Act this year." |
1/16/2013 | NAPHS statement: "NAPHS applauds commitment by President Obama to issue final parity rules" |
1/16/2013 | President Obama issues a plan to reduce gun violence and takes executive actions committing to (among other things) issuing a final parity rule, Medicaid guidance on parity, and guidance on essential health benefits and parity requirements within Affordable Care Act exchanges. Also see a letter to healthcare providers. |
1/10/2013 | NAPHS letter to Vice President Biden on Newtown Task Force; NAPHS calls for a focus on coverage, access, and resources. |
1/2/2013 | House letter to the Secretaries of Treasury, Labor, and Health & Human Services urging a parity final rule. Signed by 32 representatives. |
12/21/2012 | Senate letter to President Obama urging a final parity rule. Signed by 26 Senators. |
12/21/2012 | NAPHS comment letter on essential health benefits proposed rule |
12/21/2012 | Parity Implementation Coalition comment letter on essential health benefits proposed rule. |
12/21/2012 | Parity Implementation Coalition recommends issuance of a final parity rule. |
12/20/2012 | NAPHS ad as seen in Politico: "It's time to address the need for access to all levels of behavioral health care in a final parity rule." |
12/17/2012 | NAPHS release: "Americans support all levels of care for mental and addictive disorders, national internet survey finds." View key findings. |
12/12/2012 | Parity Implementation Coalition and OptumHealth: Letter to HHS, Labor, and Treasury requesting issuance of a final rule on parity |
11/26/2012 | HHS proposed rule on ACA "Standards Related to Essential Health Benefits, Actuarial Value, and Accreditation." EHBs include "mental health and substance use disorder services, including behavioral health treatment" as one of the 10 core essential health benefits. Also see HHS fact sheet. |
10/18/2012 | House letter (59 representatives) to the Secretaries of Labor, Treasury, and Health & Human Services requesting an update on the status of parity regulations |
7/12/2012 | Department of Labor: Updated "Self-compliance tool for Part 7 of ERISA: HIPAA and other healthcare-related provisions (including mental health parity)" [View] |
7/11/2012 | Medicare Payment Advisory Commission (MedPAC) letter to CMS on dual-eligible demonstrations, recommending, among other things, limiting the demonstrations to only a few states [View] |
5/31/2012 | GAO Correspondence: "Mental Health and Substance Use: Treatment Exclusions in Employers' Health Insurance Coverage" [View] |
5/9/2012 | Department of Labor Employee Benefits Security Administration: Frequently Asked Questions: "Understanding Implementation of the Mental Health Parity and Addiction Equity Act of 2008" [View] |
3/27/2012 | HHS final rule (and interim final rule for some sections): "Affordable Care Act: establishment of exchanges and qualified health plans; exchange standards for employers" (also see 5.29.12 corrections) |
2/17/2012 | HHS Frequently Asked Questions on essential health benefits under the Affordable Care Act [View] |
2/9/2012 | Parity Implementation Coalition applauds new URAC parity standards [View] |
2/8/2012 | HHS/ASPE issues Rand report on "Short-Term Analysis to Support Mental Health and Substance Use Disorder Parity Implementation." [View] |
1/31/2012 | Coalition for Whole Health comment letter on essential health benefits, including consensus principles and service recommendations |
1/30/2012 | NAPHS comment letter to HHS on "Essential Health Benefits Bulletin" [View] |
12/16/2011 | HHS Essential Health Benefits Bulletin outlining proposal to give states flexibility in implementing essential health benefits. Comments are due 1/31/12. Also see an ASPE Research Brief on "Comparing Benefits in Small Group Products and State and Federal Employee Plans" and a fact sheet on individual market coverage. |
11/17/2011 | Department of Labor Employee Benefits Security Administration: Frequently Asked Questions about ACA Implementation Part VII and Mental Health Parity Implementation [View] |
10/31/2011 | NAPHS comment letter to CMS on proposed rule (with extension of comment period) on "Establishment of Exchanges and Qualified Health Plans" |
10/1/2011 | Parity Implementation Coalition: "Recommendations on Guidance to Insurers/Plans for NQTL Disclosure" [View] |
12/1/2010 | Department of Labor Self-Compliance Tool (Form M-1: Report for Multiple Employer Welfare Arrangements and Certain Entities Claiming Exception) [View] |
10/8/2010 | Frequently Asked Questions (Part 2) about the Affordable Care Act Implementation -- jointly issued by Departments of Labor, Treasury, & HHS [View] |
9/20/2010 | Frequently Asked Questions (Part 1) about the Affordable Care Act Implementation -- jointly issued by Departments of Labor, Treasury, & HHS [View] |
9/20/2010 | Congressional Research Service Report to Congress: Mental Health Parity and the Patient Protection and Affordable Care Act of 2010 [View] |
7/6/2010 | Parity Implementation Coalition release: "Coalition hails administration's enforcement of parity law" [View] |
7/1/2010 | Employee Benefits Security Administration (EBSA) guidance on the classification of outpatient benefits (federal agencies will not take enforcement action against any plan or insurer that distinguishes between office visits and all other outpatient services while they complete final regulations on the law) [View] |
4/30/2010 | NAPHS comment letter: Interim final rules under the Mental Health Parity and Addiction Equity Act [View] |
4/30/2010 | Parity Implementation Coalition comment letter: Interim final rules under the Mental Health Parity and Addiction Equity Act. (NAPHS is a member of the Parity Implementation Coalition Steering Committee.) [View] |
4/1/2010 | Summary of behavioral health provisions in The Patient Protection and Affordable Care Act (Public Laws 111-148, 111-152) [View] |
3/23/2010 | NAPHS statement: Reform law includes provisions important to Americans facing mental and addictive disorders. Includes IMD/EMTALA demonstration on emergency psychiatric care. [View] |
2/2/2010 | Federal parity regulations published in the Federal Register. Also see IRS notice. (First issued 1/29/10 by HHS, Labor, and Treasury). |
10/3/2008 | NAPHS statement on passage of mental health parity legislation [View] |
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