State Resources

6 Step Parity Compliance Guide

The “Six-Step” Parity Compliance Guide for Non-Quantitative Treatment Limitation (NQTL) Requirements developed by parity experts to address a gap in regulatory guidance regarding an aspect of assessing whether non-quantitative treatment limitations (NQTLs) applied by health plans and health insurers comply with MHPAEA. The publication describes steps for identifying NQTLs and for conducting comparative analyses of NQTLs, as written and in operation. The Guide also lists types of documentation that may be helpful to review in conducting these analyses.

The Guide (and the accompanying Worksheet) is limited to creating a framework for plans and issuers to demonstrate compliance with the requirements specified for the NQTL subparagraph of the final MHPAEA regulations.[i] This Guide is intended to support audits that focus on the design an application of NQTLs as well as for use as part of the certification and form review processes if demonstration of NQTL compliance is sought in the pre-market phase.

External Review Process by State from the Kaiser Family Foundation

Kennedy Forum & Scattergood Foundation "ParityTrack"

State insurance commissioners oversee insured plans. The Parity Resource Guide includes a list in Appendix C of State Insurance Regulators

Web map of state insurance commissioners. National Association of Insurance Commissioners (NAIC)

Model State Parity Legislation

State regulatory agencies are largely responsible for ensuring compliance with MHPAEA, and MHPAEA does not preempt state parity laws that offer greater protections. Therefore, state legislation can build upon MHPAEA and existing state laws to ensure fairness in health benefit coverage.

This model bill was created by the ParityTrack policy staff in collaboration with Community Catalyst, Mental Health America, and the National Alliance on Mental Illness. It addresses some of the most critical issues in parity at basic levels, including regulatory agency accountability, health benefit plan transparency, definitional clarity for mental health conditions and substance use disorders, consumer and provider education, and coverage for medications that address the opioid crisis.

Because the legislative climate is different in each state and the needs of each legislator are unique, additional versions of each title of the bill are available upon request. More extensive language is available for each provision of the bill. Less extensive language is also available for any provision that seems infeasible in a given state. Other targeted model bills that address a wide array of issues regarding MH/SUD health benefits are available upon request as well.

ParityTrack Summary of Model State Parity Legislation

ParityTrack Model State Parity Legislation

Please contact ParityTrack Policy Director, Tim Clement at for additional resources and technical assistance.

State Snapshots on Parity Implementation

The PIC prepares bimonthly state profiles of promising practices in state implementation of MHPAEA and the parity provisions of the Affordable Care Act (ACA).


New York