HR Policy urged the Office of Management and Budget, which oversees federal rulemaking processes, to include useful compliance examples in the forthcoming proposed rule regarding health plan mental health parity obligations because of alleged deficiencies the Labor Department had previously identified.
Background: The Mental Health Parity and Addiction Equity Act prohibits coverage limitations in employer health plans that apply more restrictively to mental health and substance use disorder benefits than for medical/surgical benefits. Such limitations may include higher copayments, separate deductibles, and stricter preauthorization or medical necessity reviews. The law also requires employer plans to perform and document very complicated comparative analyses of any nonquantitative treatment limitations they may have in their health plans for mental health benefits and to submit those analyses to DOL upon request.
In 2021, Congress required DOL to publish comprehensive guidance to implement the complicated mental health parity requirements for nonquantitative treatment limitations. OMB is now reviewing DOL’s proposed guidance prior to publication.
HR Policy noted in its letter to OMB that “when not one employer plan has a sufficient comparative analysis, it is not because none of them want to comply. It is because they do not know how to comply, which makes comprehensive compliance guidance critical.”
The letter stated that to achieve mental health parity compliance, OMB should:
- Instruct DOL to publish the comprehensive guidance required by the CAA and provide additional de-identified examples of comparative parity analyses that are compliant under a final determination letter; and
- Urge DOL to consider adding a “safe harbor” or model parity analysis/template that creates a less burdensome way to achieve good faith compliance with the law.
Outlook: The proposed guidance could be published in the near future and the Association plans to submit comments on the proposal.
