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Complying With the New Mental Health Parity Law: What It Means for Your Organization

Complying With the New Mental Health Parity Law: What It Means for Your Organization. November 2008. Objectives. Develop an understanding of the scope of the Paul Wellstone and Pete Domenici Mental Health Parity & Addiction Equity Act of 2008 and what is required of employers

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Complying With the New Mental Health Parity Law: What It Means for Your Organization

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  1. Complying With the New Mental Health Parity Law: What It Means for Your Organization November 2008

  2. Objectives • Develop an understanding of the scope of the Paul Wellstone and Pete Domenici Mental Health Parity & Addiction Equity Act of 2008 and what is required of employers • Provide information so that you can make decisions related to your current mental health/substance abuse benefit and evaluate any benefit and/or cost this law may have on your organization

  3. Agenda Part 1: Introduction • Current Law • History Part 2: Specifics of the Law • Who does the law affect? • What benefits does the law affect? • When does the law take effect? Part 3: Implications of the Law • What does the law do?

  4. Agenda (continued) Part 4: What Companies Need to Do • Internal and external actions • Financial requirements Part 5: Summary and Questions

  5. Current Law • October 1, 2008: The Senate Passes H.R. 1424, The Emergency Economic Stabilization Act • Vote: 74 to 25 • October 3, 2008: The House Passes H.R. 1424 • Vote: 263 to 171 • H.R. 1424 Included the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008

  6. Who Does The Law Affect? • Group health plans and health insurers that provide coverage to group health plans (employers with over 50 employees) • Medicaid managed care plans • State children’s health insurance programs • Federal employees’ health benefits plans

  7. Summary of the Law • Benefits covered: • mental health conditions • substance use disorders • Parity requirement: • financial requirements • treatment limitations

  8. Summary of the Law (cont.) • out-of-network benefits • management • transparency • small employer exemption • cost exemption • compliance report • GAO study • consumer assistance • enforcement/ regulations • state laws • effective date

  9. What’s Next • Departments of Labor, Health and Human Services and Treasury to issue regulations 1 year after the date of enactment

  10. What’s Next (cont.) • Areas that may need clarifications in regulations include: • predominant financial/treatment limitations applied to substantially all medical and surgical benefits • pre-emption of state laws • management of the benefit • out-of-network • cost-exemption

  11. Importance of the Behavioral Health Benefit • Indirect costs associated with mental illness (MI) and substance use (SU) disorders • Research regarding relationship of MI and SU with lost productivity and absenteeism • Disability costs related to psychiatric disorders • Access to specialty behavioral healthcare • Efficacy of treatment for MI and SU disorders is well documented Source:  An Employer’s Guide to Behavioral Health Services; National Business Group on Health, 2005

  12. Questions?

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