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Parity Fast Facts

  • The Paul Wellstone & Pete Domenici Mental Health Parity & Addiction Equity Act (MHPAEA) was signed into law on October 3, 2008
  • MHPAEA applies to employer-sponsored health plans with 50 or more employees
  • MHPAEA applies to Medicaid managed care plans
  • Interim final regulations implementing the law were published in February 2010 and went into effect for all plans on January 1, 2011
  • Under MHPAEA, plans are not mandated to offer addiction & mental health benefits but, if they offer the benefits, they must do so in a non-discriminatory manner.  That means:
    • Same co-pays, deductibles and annual and lifetime caps on the medical/surgical benefits and mental health/addiction benefits covered by the plan
    • Health plans cannot medically manage the mental health/addiction benefit more “stringently” than they manage the medical benefit
  • Health plans must provide medical necessity criteria to plan participants upon request
  • If out-of-network benefits are extended to medical/surgical benefits under the plan, out-of-network benefits must be extended to mental health/addiction benefits too

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