The US Department of Labor (USDOL) released FAQS About Affordable Care Act Implementation Part VII and Mental Health Parity Implementation on November 17, 2011. While these FAQs do not address all of the issues identified and aren’t everything advocates asked for, they do offer more clarity on Non Quantitative Treatment Limitations, (NQTL) specifically utilization review requirements.
In Question 3 and Question 5 US DOL uses examples to clarify that a plan may not have more stringent prior authorization processes for mental health/substance use disorder treatment than they do for medical/surgical treatment. This clarification and the example used should help investigators make determinations on the complaints MPP filed regarding prior authorization policies. We will also be able to point to these FAQs in future NQTL complaints.
We are pleased that MHPAEA continues to be of importance to US DOL and we are glad to have this subregulatory guidance, but we can’t be sure plans are in full compliance with the law until final regulations have been promulgated. We continue to urge regulators (link to cong. Del blog post) to finalize these regulations.
Call or write your legislator to ask that he or she contact DHHS to push for final regulations for the Mental Health Parity and Addiction Equity Act of 2008. Be sure to include a personal story about why this is important to you or and/or share any difficulties you are having in getting mental health or addiction treatment for yourself or a client. Here is a Sample Letter to Legislators you can personalize.