Parity is a topic that employers should carefully review and discuss with their insurance carriers or Third Party Administrators (TPA). A new report by Milliman identifies key areas of potential concern for employers related to compliance with federal mental health parity laws and regulations. The report, which reviewed claims from 2013-2015, shows significantly higher use of out of network addiction and behavioral health providers than of physical health and surgical providers, demonstrating that across the country networks for mental health and substance use disorders are inadequate. The study additionally compares reimbursement rates for psychiatry verses all other physicians and almost uniformly shows that psychiatrists are paid significantly less than other physicians for comparable work. The report discusses the potential parity implications of this through the lens of the Mental Health Parity and Addiction Equity Act.
Under the federal mental health parity laws, the plan itself is responsible for these violations even when the insurance company or TPA creates the plan design. Employers subject to the Mental Health Parity and Addiction Equity Act should closely review this report, the adequacy of their own plan networks and the reimbursement rates offered to mental health care providers to ensure they are in full compliance with the parity laws.
The Center for Workplace Mental Health released an employer guide to the Mental Health Parity and Addiction Equity Act to provide key information needed to comply with mental health parity laws and regulations.