The US Department of Labor Employee Benefit Security Administration recently updated its Mental Health Parity and Addiction Equity Act Self- Compliance tool. This tool is provided to enable group health insurance plan administrators, large employers, health insurance issuers and other interested parties determine whether a health plan is in compliance with the federal parity act. After release of the updated tool, US DOL in conjunction with HHS and the Treasury Department presented a webinar where they walked through how to use the tool and answered questions.
Of note in the tool and webinar:
- DOL reaffirmed that if an insurer denies a claim on the basis of medical necessity, they have 30 days to disclose the medical necessity criteria for medical/surgical benefits and mental health/addiction benefits
- Treasury confirmed that they are able to impose a tax penalty of $100 a day for noncompliance
- There is still no timetable for the release of final regulations
Download the compliance tool at http://www.dol.gov/ebsa/pdf/cagappa.pdf (parity information begins on page 22)
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