In July 2023, President Biden released a proposed rule that would strengthen the Mental Health Parity and Addiction Equity Actopens in new window (MHPAEA), which was enacted in 2008 but is still not uniformly enforced. This proposed rule looks to expand access to mental health and substance use disorders services so that such services are on par with medical and surgical services and aims to improve compliance with the parity law. At a time of national mental health and substance use disorder crises, this is an issue of access to life-saving care for children, adolescents, and adults.
APA Services recently submitted comments (PDF, 1.3MB)opens in new window on the proposed rule emphasizing the need to prioritize patients over insurance plans or third-party administrators who are legally obligated to deliver mental health care on par with medical and surgical care. The comments support the Biden administration’s proposed rule to address network composition, striving for more accurate directory information, and to build networks that work for, not against, patients gaining access to care.
The association emphasized five key points:
- Urge the Department of Health and Human Services, Employee Benefits Security Administration (Labor Department), and the Internal Revenue Service (Treasury Department) to eliminate the proposed overbroad exceptions for clinical standards and fraud, waste and abuse exceptions that threaten to engulf the benefits of the proposed rule.
- Applaud the required use of outcomes data and the special rule for network composition (also known as network adequacy) but urge the removal of the undefined requirement that differences must be “material” before an insurer must take reasonable action or be deemed noncompliant.
- Support consideration of specific data elements relevant to network composition, such as wait times and whether providers are available to take new patients.
- Recommend that plans that use Third Party Administrators (TPAs) be required to contractually obligate the TPAs to assist with providing required information to patients and regulators; and recommend that plans have the option to make the TPAs responsible for parity compliance on matters the TPA controls.
- Urge the Departments to delay any “safe harbor” proposal around network adequacy (insurers would not be subject to enforcement if they met certain network metrics) until they have fully analyzed and validated that the new data requested demonstrates fair access to mental health benefits.
In addition to submitting comments, the association led a grassroots campaign to engage our advocacy network in submitting comments on the proposed rule. Nearly 1,500 comments, out of the 9,500 total, were submitted by psychologists. We also leveraged social media to direct attention to various portals, including allies of psychology, to submit comments to the Biden administration.
In addition, APA Services played a leadership role in a large coalition effort to submit a joint comment letter (PDF, 298KB)opens in new window from nearly 80 national organizations in support of the proposed rule’s overarching goal to increase access to mental health and substance use disorder treatment by addressing treatment limitations that place a greater burden on participants and beneficiaries’ access to mental health and substance use disorder treatment than to medical and surgical treatment. The agencies will now review the nearly 10,000 comments they received.
For more information, contact Julio C. Abreu.
