{"id":30414,"date":"2016-01-15T15:35:44","date_gmt":"2016-01-15T23:35:44","guid":{"rendered":"http:\/\/www.goodtherapy.org\/blog\/?page_id=30414"},"modified":"2016-04-08T11:12:05","modified_gmt":"2016-04-08T18:12:05","slug":"mental-health-parity-and-addiction-equity-act-mhpaea","status":"publish","type":"page","link":"https:\/\/www.goodtherapy.org\/blog\/mental-health-parity-and-addiction-equity-act-mhpaea\/","title":{"rendered":"Mental Health Parity and Addiction Equity Act (MHPAEA)"},"content":{"rendered":"

\"Doctor<\/a><\/strong>The Mental Health Parity and Addiction Equity Act (MHPAEA)<\/strong> is a federal law requiring\u00a0group health care plans to offer mental health and\/or substance abuse<\/a> (MH\/SUD) benefits on par with the medical and surgical benefits offered. This legislation\u00a0does not require health plans to offer mental health and\/or substance abuse (MH\/SUD) benefits, but if such benefits are offered, they must be no less restrictive than the medical\/surgical benefits in the plan.<\/p>\n

How Does the MHPAEA Work?<\/h2>\n

The MHPAEA was originally enacted to prevent health insurers from placing more treatment limitations (such as number of visits) or financial requirements (such as\u00a0amount of co-pay) on services related to mental health and substance abuse. Prior to the MHPAEA, a health plan might\u00a0 offer an unlimited number of medically necessary appointments with a dermatologist but only cover five psychiatrist appointments per year. With the MHPAEA in place, health plans\u00a0should cover psychiatric services in the same way they\u00a0cover other necessary health care\u00a0services.<\/p>\n

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Find a Therapist<\/a><\/h2>\n\t
\n\n\t\t\t\n\n\n\t\t\t\n\t\tAdvanced Search<\/a>\n\t<\/form>\n<\/div>Basic information about the implementation of the MHPAEA can be found on the\u00a0Centers for Medicaid and Medicare Services (CMS) website. The basic premise of the law is fairly\u00a0straightforward, but a number of\u00a0required regulations may make implementation of the law somewhat more complicated.<\/p>\n

The MHPAEA affects several aspects of health coverage, including financial requirements such as co-pays and deductibles and treatment limitations such as number of visits and types of treatment.\u00a0If a group health plan includes both MH\/SUD and medical\/surgical benefits, the MH\/SUD benefits \u201cmust be no more restrictive than the predominant financial requirements or treatment limitations that apply to substantially all medical\/surgical benefits.\u201d\u00a0This simply\u00a0means the same financial requirements and treatment limitations of more than half of the medical services covered should be applied toward mental health services.<\/p>\n

The following examples may help illustrate how\u00a0the MHPAEA looks in practice:<\/p>\n