Federal departments publish final rules to improve access to mental health and substance use care

On Sept. 9, the Department of Health and Human Services, Department of Labor, and Department of the Treasury published final rules amending federal regulations to improve access to care for mental health and substance use services. The final rules implement the Paul Wellstone and Pete Dominici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and add new regulations implementing the nonquantitative treatment limitation (NQTL) requirements under MHPAEA.

These modifications aim to ensure that individuals in group health plans or with group or individual health insurance coverage who seek treatment for covered mental health conditions or substance use disorders do not face greater burdens on access to benefits for those conditions or disorders than they would face when seeking coverage for the treatment of a medical condition or a surgical procedure.

Key highlights of the final rules include:

• Requiring health plans to make changes when they are providing inadequate access to mental health and substance use care
• Making it clear what health plans can and cannot do, including limiting the use of medical management techniques to make it more difficult for consumers to access mental health and substance use disorder benefits
• Closing existing loopholes, requiring more than 200 additional health plans to comply with MHPAEA requirements, providing critical protections to 120,000 consumers

Members may send any questions about these final rules to coding@aasm.org.