Mental Health Parity Act Effective Date Delayed
Update: Mental Health Parity Changes Take Effect January 1, 2010
Congress deferred the effective date of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 to January 2010 for plans that otherwise would have been covered in 2009.
The Mental Health Parity and Addiction Equity Act amends the Employee Retirement Income Security Act (ERISA) and the Public Health Service Act to prohibit employers’ health plans from imposing any caps or limitations on mental health treatment or substance use disorder benefits that aren’t applied to medical and surgical benefits.
The Mental Health Parity and Addiction Equity Act does not require health insurance plans to provide mental health or substance use disorder benefits. However, for group health plans with 50 or more employees that choose to provide mental health and substance use disorder benefits, the Act does require parity with medical and surgical benefits.
Thus, group health plans that provide both medical and surgical benefits and mental health and substance use disorder benefits may not impose financial requirements and treatment limitations applicable to mental health and substance use disorder benefits that are more restrictive than the financial requirements and treatment limitations applied to medical and surgical benefits. Requirements such as co-payments and deductibles and limitations such as number of visits or frequency of treatments can be no more restrictive on mental health and substance use disorder benefits than the requirements or limitations imposed on medical and surgical benefits.
Federal Employment Law Insider is a monthly newsletter written by attorneys at the law firms of McGuireWoods LLP and Fortney & Scott, LLC and provides an insider’s guide to changes affecting federal employment laws and enforcement.
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Wednesday, February 18th, 2009 at 7:49 pm under
It is unfair that this law applies only to employers with 50 or more employees. I work for a federally-funded organization with 23 employees. We are federally funded, yet my group insurance can discriminate against my family member. When she becomes 18, I will try to get her covered by Medicaid. This is a waste of taxpayer money since I can afford to cover her, yet the coverage I have will not afford her the care she needs.
June 18th, 2009 at 2:16 amHi this is very wrong and this should not be happening!!
August 31st, 2009 at 1:41 amExcluding employers with 50 or fewer employees from the benefits outlined in the Mental Health Parity Act is discrimination! By disallowing coverage for mental health and substance use benefits to be covered in the same manner as “medical and surgical benefits”, (example copayment, deductibles, limitations on the number of visits and frequency of treatments) as employers with 51+ employees implies that the employees of the “smaller” employer are not allowed the same treatment as those of the “larger” employer. What makes the “larger” employer and it’s employees privileged to better treatment and coverage then the smaller employer and it’s employees? Does the “larger” employer have more political pull? What is the deal? This is definitely discrimination against the “small” business owner. Everyone should be treated the same. This country’s political leaders should be ashamed.
September 2nd, 2009 at 4:44 pmThis is so unfair - this should be part of Obama’s health care reform. Mental Health should be treated just like any other physcial illness - it is a physical illness.
September 21st, 2009 at 5:45 pmAre you guys kidding, this is HUGE! I couldn’t be happier my son can now get the mental care he needs (autism) and I no longer have to pay $52,000 a year! There are ways for companies with fewer than 50 employees to get around this. And by the way “Obama care” is the biggest sham out there! You think it’s bad now….. Just wait if “obama care” passes we’ll all have much bigger problems than this!
September 25th, 2009 at 3:30 pmhey kate: obama made sure the parity thing went through & saved you $52 grand a year. so now why don’t you want other children with autism, or anyone suffering from any ailment, disease, condition or disorder, to have medical coverage. few small companies and lots of people don’t know they need to try to “go around” laws that are unfair? who has you scared of a public health option? fear is the enemy.
October 19th, 2009 at 5:24 pmmy daughter is dying from a serious eating disorder. because our ins policy is a nj state ins plan,her “lifetime” benefits are exhausted,we can not affored treatment any longer.we have paid out of pocket costs for 2 years now,we are in financial ruin.eating disorders are now being considered biological based illnesses,but not if you have a state employee plan!!?? dear god,talk about unfair? anyone have any ideas?
October 25th, 2009 at 12:52 amCheryl,
Sorry to disappoint you, but President Obama didn’t have anything to do with the new Mental Health Parity rules. They were signed into law by President Bush in October 2008.
Our fear is based on rational outcomes expected to result from the Public Option. Canada started with a Government/Public Option in 1957 and their system spiraled downward to single payor…what began as freedom of choice evolved into no-choice.
October 29th, 2009 at 8:42 pmIts unfortunate this act was put in place. The act allows plans to eliminate mental/nervous/substance abuse coverage. I think you will find most plans will now exclude coverage from their plans, expecially give current economic conditions. Clearly, our government did not thinking when they put this law into effect.
November 4th, 2009 at 4:37 pmI am a Mental health provider and I see everyday the shortcomings of mental health coverage. Why should this be needed if we were equal to all other coverage . The paperwork for mental health also is a full time job !!!
November 14th, 2009 at 3:52 pmThe mental health act states the co-pay is whatever a medical and surgical co-pay is. Which one is it? I pay $20 to see my doctor and $45 for a surgeon visit. If it is the latter than my copay for therapy just more than doubled. How is this helpful? If this is the case I will be paying $540 a month in co-pays as a fully insured person.
November 26th, 2009 at 12:35 am