CMS Issues Letter to States Clarifying Parity Requirements for Medicaid
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In early January, CMS issued a letter to State Medicaid Directors confirming that all Medicaid MCOs must be compliant with federal parity law. The letter also directed Medicaid Directors to ensure that the new Medicaid expansion population and the Children’s Health Insurance Plan recipients would also receive parity compliant Medicaid plans no matter the delivery …
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Maryland Parity Project Assists in Winning Appeal
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In September we worked with a family who had been denied reimbursement for residential treatment provided to their son. The insurance policy holder was a federal employee, and while the employee’s plan included a benefit for residential treatment it required that the treatment be deemed medically necessary. The plan initially approved a short stay, but …
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Maryland Changes Essential Health Benefit Selection
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Based on new HHS guidance, Maryland’s HCRCC met on December 17, 2012 and reversed its selection of the state employee plan as the state’s Essential Health Benefit Benchmark. On Monday, the HCRCC voted to select the Small Employer Plan as the EHB Benchmark. The small employer plan will serve as the EHB for both small …
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Maryland Selects Its Essential Health Benefit Plan
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The Selection On September 27, 2012 The Maryland health Care Reform Coordinating Council voted to select the State Employee Health Plan as its benchmark for the Essential Health Benefit Plan. Of course, because nothing can be simple, the HCRCC included in their motion a support for flexibility around the in vitro fertilization benefit. There was …
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Massachusetts New Law Requires Demonstration of Compliance with Mental Health Parity
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A new Massachusetts law signed by Governor Deval Patrick on August 6, 2012 requires insurance carriers to submit an annual report to the Attorney General demonstrating their compliance with the Mental Health Parity and Addiction Equity Act. The law requires the Insurance Commissioner to promulgate regulations by July 2012 to facilitate this process. Highlights of …
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DOL Releases New Parity Self-Compliance Tool
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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. …
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Maryland Parity Project Assists With Winning Appeal
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A Virginia insurer overturned their decision to deny reimbursement for 6 outpatient sessions, originally not deemed medically necessary. Recently, the Maryland Parity Project assisted a Maryland psychologist file an appeal in an attempt to secure reimbursement for 6 outpatient sessions that took place in 2011. The insurer in the case denied authorization for the sessions, …
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DC Metro Parity Forum: A Huge Success
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Guest Post by The National Parity Implementation Coalition www.parityispersonal.org Last night 250 people attended the Parity Forum in Friendship Heights Maryland. The forum was chaired by Rep. Chris Van Hollen (D-MD) and attended by former Reps. Patrick Kennedy and Jim Ramstad and current Members Moran (D-VA) and Tonko (D-NY). Three panels of witnesses made a …
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US DOL Presentation on Mental Health Parity Implementation
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The Maryland Parity Project was proud to host three presenters from the US DOL Employee Benefit Security Administration on June 11th. The presenters gave a comprehensive overview of the current federal mental health parity regulations, using concrete examples to make the regulations understandable. Presenters did their best to answer questions about insurers compliance with non …
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Class Action Lawsuit Filed in California Alleging Violation of State Parity Law
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Press Release of the Los Angeles Law Firm of Cohen Mckeon, May 21, 2012 A class-action lawsuit was filed against United Healthcare Insurance Company, US Behavioral Plan, and California United Behavioral Health, which contracts with employers such as the University of California to provide mental health services to policyholders. The class-action suit alleges that these companies, …
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New York Fines 15 Insurance Companies for Noncompliance With Mental Health Parity Law
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New York Recently, 15 insurance companies were fined a combined $2.7 million dollars for failure to comply with Timothy’s Law, New York’s mental health parity law. Read Rep Tonkos Response Oregon Regence Blue Cross Blue Shield of Oregon has slashed mental health benefits and raised deductibles for medical care. Michigan Advocates “walk a mile” to …
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DOL Releases New FAQ on Mental Health Parity and Addiction Equity Act
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The US Department of Labor released new FAQ on Implementation of the Mental Health Parity and Addiction Equity Act of 2008 on May 9, 2012. The FAQ are fairly general and contain little new or not previously released information. A few noteworthy items include- Q6 asks if nonquantitative treatment limits (NQTL) are analyzed as quantitative …
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