KFF September 29, 2023
New proposed updates to the regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) seek to strengthen the law’s implementation by employer plan sponsors and insurers in the group and individual insurance market. If finalized as proposed, it would establish a new three-part framework for plans and insurers (collectively, “plans”) to show that certain treatment limits on behavioral health coverage comply with the parity law. The proposal would require plans to apply a new mathematical test to determine whether certain limits on behavioral health coverage are no more restrictive than limits on medical coverage. In addition, plans have to document that the “processes, strategies, evidentiary standards and other factors” used to design and apply specific limits on behavioral...
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