Recently the White House Behavioral Health Parity Task Force issued guidance on the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (Parity Law). The Task Force could not have known, though, that on November 8th, the election may have changed the direction of the Task Force report and subsequent implementation.
The Task Force was to provide a series of actions and recommendations for improving implementation of the Parity Law. The Task Force noted that one in five American adults experienced some form of mental illness in 2016. Slightly more than 20 million adults report some form of substance use disorder. The report also notes that statistically, during their lifetimes, 50 percent of all Americans will need some form of behavioral health services.
The change of Presidents could have an immediate effect on the proposed Final Benefits Rule requiring equivalent cost sharing between medical, surgical and behavioral healthcare offered under the TRICARE programs. The compliance date for the final Regulations requiring parity in Medicaid Manage Care Organizations, Medicaid Alternative Benefits Plans and the Children’s Health Insurance Programs is set for October 2, 2017. The compliance date could be extended. The Parity enforcement actions by the Department of Labor could have reduced significance under new leadership in the new Administration. The number of citations issued for violation of the Parity Law could be changed by a reduction of the number of investigations being conducted.
The Department of Health and Human Services (HHS) has enforcement authority of the Parity Law in group health plans for employees of state and local governments. The degree to which enforcement continues in a new administration will depend on the person appointed to fill the role of Secretary of HHS. HHS also has primary enforcement authority over health insurers being required to comply with the Parity Law. In October of 2016 HHS was conducting enforcement actions in Missouri, Oklahoma, Texas and Wyoming where HHS reviews all insurer policy forms for individual and group markets to assess compliance with the Parity Law. The Task Force recommended that the Centers for Medicare and Medicaid Services provide grants totaling $9.3 million to states to support Parity implementation. Under a new Administration the grants could be reduced or terminated. The Task Force recommended that the capacity to audit health plans for parity Compliance by federal agencies be increased and recommended that Congress provide the Department of Labor with authority to assess Civil Momentary Penalties for parity violations. The new Administration may choose to not adopt or not move forward either of these recommendations.
All Providers of mental health services should be made aware of the recommendations of the Task Force and should consider action through state and national Associations to insure that the recommendations of the Task Force survive in the new Administration and are implemented.