Federal Mental Health and Substance Use Disorder Parity Task Force

Mental Health and Substance Use Disorder Parity Task Force Releases Final Report; Issues “Roadmap” for Short, Long-Term Federal Actions

Earlier today, the White House convened a conference call of the Federal Mental Health and Substance Use Disorder Parity Task Force to discuss to release of its final report. The call was led by: Director of National Drug Control Policy, Michael P. Botticelli; White House Domestic Policy Council Director, Cecilia Muñoz; Department of Health and Human Services (HHS) Acting Assistant Secretary for Planning and Evaluation, Katie Martin; and Assistant Secretary of Labor of the Employee Benefits Security Administration (EBSA) Phyllis Borzi.

The Task Force, established by Presidential Memorandum in March of 2016, focused key Federal agencies on the work of developing new actions and recommendations to ensure that insurance coverage for mental health and substance use disorder services is comparable to, or at “parity” with, general surgical and medical care pursuant to ongoing the implementation of such protections by the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act  and Affordable Care Act. Task Force officials said the resulting recommendations in the report were informed by input they received through a series of listening sessions between March and October, and the more than 1,100 public comments from individuals with mental health and substance use disorders, families, their providers, advocates, and other stakeholders.

As delineated in the report and presented on today’s call, the Task Force announced a number of near-term actions being taken by various Federal agencies. Highlights include:

  • The Centers for Medicare & Medicaid Services (CMS) is awarding $9.3 million to States to help enforce parity protections, and help State insurance regulators to ensure issuer compliance with the mental health and substance use disorder parity protections.
  • HHS, the Department of Labor (DOL), and other Task Force agencies, released the beta version of a new parity website to help consumers find the appropriate Federal or State agency to assist with their parity complaints, appeals, and other actions. The Task force is inviting public comment on the beta site and intends to build out additional functionality in the future.
  • The Substance Abuse and Mental Health Services Administration (SAMHSA) and DOL released the Consumer Guide to Disclosure Rights: Making the Most of Your Mental Health and Substance Use Disorder Benefits (PDF) to help consumers, their representatives, and providers when inquiring about a plan’s compliance with parity and to explain the various Federal disclosure laws.
  • DOL is announcing that it will release annual data on closed Federal parity investigations and will report on the findings, including the violations cited to ensure parity compliance and inform future policymaking efforts.  This effort builds on the 1,515 investigations related to the Mental Health Parity and Addiction Equity Act and 171 violations cited by DOL since October of 2010.
  • CMS has added Mental Health Parity and Addiction Equity Act compliance to its review of plans subject to the essential health benefits requirement under the ACA, and expects State regulators to follow suit.
  • DOL, HHS, and the Department of Treasury (Treasury) today issued an FAQ providing guidance on parity and opioid use disorder treatment (PDF) to address specific questions the Departments have received related to issues such as the application of parity to opioid treatment access and coverage of court-ordered treatment.  Additionally, there is a new Parity Compliance Assistance Materials Index (PDF) to assist with navigating the available FAQ.
  • SAMHSA announced that it will host two State Policy Academies on Parity Implementation for State Officials in 2017, including one focused on the commercial market and one on parity in Medicaid and the Children’s Health Insurance Program.
  • CMS will undertake a review of mental health and substance use disorder benefits in Medicare Advantage plans and identify any necessary improvements to advance parity protections.

The Task Force also announced the following long-term recommendations:

  • Increase Federal agencies’ capacity to audit health plans for parity compliance;
  • Undertake a detailed review of the non-quantitative treatment limits applicable to substance use disorder benefits in the Federal Employees Health Benefits (FEHB) Program;
  • Allow the Department of Labor to assess civil monetary penalties for parity violations;
  • Develop examples of parity compliance best practices and of potential warning signs of non-compliance;
  • Provide Federal support for State efforts to enforce parity through trainings, resources, and new implementation tools, including model compliance templates;
  • Provide simplified disclosure tools to provide consistent information for consumers, plans and issuers;
  • Expand consumer education about parity protections;
  • Clarify that health plan disclosure requirements include medical and surgical benefits;
  • Implement the Medicaid and Children’s Health Insurance Program (CHIP) parity final rule in a robust manner;
  • Expand access to mental health and substance use disorder services in TRICARE;
  • Eliminate the lifetime day limit on Medicare Part A treatment in psychiatric hospitals;
  • Update guidance to address the applicability of parity to opioid use disorder services; and
  • Eliminate the parity opt-out process for self-funded non-Federal governmental plans.

Katie Martin stated during the call that the Task Force and Administration will continue to act on the recommendations – “as many as we can” – in the remaining period of President Obama’s term. For more detailed information on each of the Task Force’s recommendations, see the White House press release here.