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Equal Insurance (Mental Health Parity)


Mental Health Parity Tip of the Month

Another Step towards Parity: CMS’s Final Rule Strengthens Access to Mental Health and Substance Use Disorder Services for Medicaid and Children’s Health Insurance Program Enrollees

The Centers for Medicare & Medicaid Services (CMS) issued its final rule on March 30, 2016. This final rule requires Medicaid and the Children’s Health Insurance Program (CHIP) to comply with certain mental health parity requirements added to the Public Health Service Act (PHS Act) by Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).

MHPAEA is a federal law that generally prevents group health plans that provide mental health or substance use disorder benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits. For example, under MHPAEA, if an insurance company requires co-payments for doctor visits, or wants to limit the number of visits to a specialist, then they must have the same or similar requirements for both mental health and physical health. In California, all commercial plans issued in the state, including individual and small group health insurance products, must comply with MHPAEA. Because of the final rule, MHPAEA now applies to Medicaid (Medi-Cal in California) and CHIP enrollees.

This is an important step for parity because it requires Medicaid and CHIP to comply with MHPAEA. By doing so, mental health services and care for low income individuals in the Medicaid program will improve. This final rule will benefit over 23 million people enrolled in Medicaid managed care organizations, Medicaid alternative benefit plans, and CHIP.


The Parity Tip of the Month is funded by a grant from the California Mental Health Services Authority.

Archive of Past Tips of the Month


Parity Fact Sheets

Parity Project Overview (rtf) (pdf)

Accessing Mental Health Services using Telehealth (pdf) (rtf) (pub #CM64.01, June 2015)

California Mental Health Parity Act: A Way to Expand Mental Health Services for Children and Youth (pdf) a Mental Health Advocacy Services publication

Ensure Your Health Insurance Provides Equal Coverage For Mental Health Benefits (pdf) (rtf) (pub #CM32.01, February 2014)

Ensure Your Medi-Cal Managed Care Plan Provides Equal Coverage For Mental Health And Substance Use Disorder Benefits (pdf) (rtf) (pub #CM31.01, February 2014)

Excellence in Mental Health Act (pdf) (rtf) (pub #CM67.01, June 2016)

The Essentials on: Essential Health Benefits (pdf) (rtf) (pub #CM39.01, April 2014)

Final Regulations Implementing Federal Mental Health Parity and Addiction Equity Act of 2008 (pdf) (rtf) (pub #CM33.01, February 2014)

Medi-Cal Managed Care Plans, Mental Health And Substance Use Disorder Benefits And Your Right To Equal Coverage (pdf) (rtf) (pub #CM30.01, February 2014)

Recent Decision on the California Mental Health Parity Law: Health Plans Must Cover All Medically Necessary Treatment (pdf) (rtf) (pub #CM50.01, July 2014)

Source-of-Injury Exclusions in Health Insurance Plans (pdf) (rtf) (pub #CM65.01, June 2015)

Tips for Working with Your Insurance: Keep Asking, (Politely!) (pdf) (rtf) (pub #CM40.01, April 2014)

What is Mental Health Parity? (pdf) (rtf) (pub #CM29.01, July 2014)


Other Publications

DRC Video: California Mental Health Parity Act

The California Mental Health Parity Act Toolkit: A Guide to Appealing Health Plan Mental Health Care Denials (pdf) (rtf) (pub #CM54.01, November 2014)
Español / Spanish (pub #CM54.02, December 204)

Mental Health Parity poster imageMental Health Parity Infographic Poster (pdf) Accessible (rtf) (pub #CM56.01, December 2014) Español / Spanish (pub #CM56.02, March 2015)

For additional fact sheets and more information from Mental Health Advocacy Services visit http://www.mhas-la.org/stigma-reduction.html

 

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Policy & Legal Work

Amicus Brief Fradenburg v. United Healthcare Ins. (pdf)

Amicus Brief Rea v. Blue Cross (pdf)

Appeals court agrees with DRC and supports parity of mental health coverage, including medically necessary residential care

DRC is happy to provide materials in alternative formats to accommodate the needs of people with disabilities. If you need materials in an alternative format, please contact info@disabilityrightsca.org

 

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