Senate Finance Committee Publishes “Mental Health Parity Improvement Act” | Manatt, Phelps & Phillips, LLP

Editor’s Notice: Within the article under, Manatt Well being discusses the important thing insurance policies of the “Psychological Well being Parity Enchancment Act,” the newest invoice from the Senate Finance Committee’s bipartisan psychological well being initiative. . In a current webinar, Manatt shared a information to assist well being plans successfully navigate the complexities of psychological well being parity. This system explored psychological well being parity from three interlocking views—litigation, regulation, and laws—to offer a multifaceted have a look at its influence on well being plans and the sufferers they serve. To view the free, CLE-eligible on-demand webinar and obtain a free copy of the presentation, click on right here.


On December 1, the Senate Finance Committee launched the fifth and remaining dialogue draft of the Committee’s bipartisan psychological well being initiative. This dialogue draft, posted by Chairman Ron Wyden (D-OR), Rating Member Mike Crapo (R-ID), and committee members Michael Bennet (D-CO) and Richard Burr (R-NC), seeks tackle psychological well being protection. in Medicare and Medicaid. Though the Committee describes the invoice such because the “Psychological Well being Parity Enchancment Act,” a number of of its provisions don’t tackle “parity” between psychological well being/substance use dysfunction advantages and medical/surgical advantages, which is how federal legislation defines psychological well being “parity” in the present day. In 21 pages, the proposal consists of 5 insurance policies, representing a comparatively modest set of provisions:

  • Clarification of Outpatient Protection for Medicare Beneficiaries with SUD. The coverage included within the “Medicare Provisions” part would require Medicare to offer steerage to suppliers “detailing the extent to which partial hospitalization providers could also be offered to a person with a analysis of substance use dysfunction” (SUD), in addition to Further details about different types of Medicare-covered outpatient providers for Medicare sufferers with SUD.
  • Require Medicare Benefit (MA) plans to take care of correct and up-to-date supplier directories. The proposal would codify current regulatory necessities for MA plans to take care of correct supplier directories. This part additionally proposes extra necessities for MA plans to inform CMS in a well timed method (inside two days) of modifications in a supplier’s in-network standing and to publish the plan’s supplier directories on a public web site.
  • GAO examine evaluating protection of SUD and psychological well being advantages and SUD and non-mental well being advantages. The proposal would require a examine by the Authorities Accountability Workplace (GAO) to match behavioral well being advantages below MA plans with non-mental and SUD advantages below MA, in addition to psychological well being advantages and SUD below Authentic Medicare. The proposal directs the GAO particularly to investigate the variations within the administration of use and distribution of affiliate prices.
  • Requirement for correct and searchable supplier directories in Medicaid. This part would codify current rules that require Medicaid managed care organizations to take care of “commonly up to date” supplier directories, together with info on whether or not suppliers are accepting new sufferers. The necessities would additionally apply to state Medicaid fee-for-service applications.
  • GAO Report on Disparities in Medicaid Fee Charges for Psychological Well being and SUD Advantages. In parallel with the MA GAO report, this part would require the publication of a GAO report detailing discrepancies in Medicaid fee charges for psychological well being and SUD advantages in comparison with medical and surgical providers in a pattern of states.

Obligatory analytics seem designed to generate info that might inform future, extra focused compliance initiatives.

The Committee beforehand printed proposals on telehealth insurance policies, youth psychological well beingPsychological well being employeesY integrating bodily and psychological well being care suppliers, all of that are summarized in a section-by-section Finance Committee summary. Whereas a number of the provisions within the pediatric behavioral well being and telehealth dialogue drafts have been enacted into the bipartisan Safer Communities Act earlier this 12 months, the trail ahead for lots of the different proposed insurance policies stays unclear as that the management of the Committee grades their “[intent] to construct on” the insurance policies within the “coming months”.


Notice: Extra detailed info on all the Committee’s proposals is offered via Manatt in Well beingManatt’s premium info service. Manatt in Well being offers detailed info and evaluation targeted on the authorized, political and market developments that matter to you, preserving you on the forefront of the traits that form our evolving healthcare ecosystem. Out there by subscription, Manatt in Well being gives an easy-to-use, customized expertise that provides you quick access to Manatt Well being’s industry-leading thought management. For extra info or to schedule a demo, contact Barret Jefferds at bjefferds@manatt.com.

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