December 2009 NewsLetter, "Beyond Compliance with Mental Health Parity and Addiction Equity Act of 2008: An Opportunity to Integrate Behavioral Health and Medical Coverage"

Abstract

Sponsors of group health plans have the opportunity to reexamine their current behavioral health coverage as they prepare to comply with the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). If trustees of multiemployer health funds start soon, they will have sufficient time to conduct a thorough and thoughtful plan review and craft strategies for better management of the coverage for mental health and addiction conditions. These strategies can help keep cost increases under control, while maintaining, and even enhancing, critical benefits.

The Mental Health Parity Act (MHPA) of 1998 required people with mental health conditions, such as depression and bipolar disorder, to have access to benefits similar to those with medical conditions. Although MHPA prohibited group health plans from imposing annual or lifetime dollar limits on mental health benefits that are different from those for medical/surgical benefits, plan sponsors could and did introduce plan designs that limited the scope and duration of covered treatment for mental health benefits. The newer law, the MHPAEA, provides broader protection than MHPA by prohibiting unequal treatment limits and financial requirements and expanding the scope of protection to include benefits for addiction treatment.

It is time for plan sponsors to compare their current mental health and addiction benefits with medical plan design and to work to amend plan documents. In addressing the requirements of the MHPAEA, plan sponsors have an opportunity to go beyond mere compliance and take a fresh approach to behavior health coverage. Through a comprehensive review and redesign initiative, they can promote health more broadly, treat patients more effectively and enhance the overall benefits program.

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