Tougher requirements for insurers to cover mental health services at parity with medical care received praise from advocacy groups but could face legal challenges from employers.
On Sept. 9, the Biden administration finalized a set of rules intended to increase enforcement and close loopholes in the Mental Health Parity and Addiction Equity Act.
Melissa Bartlett, senior vice president of health policy for the ERISA Industry Committee, which represents large employers, told Politico the organization is exploring "all possibilities," including litigation, to challenge the new regulations.
The rule could be more vulnerable to a legal challenge because the Supreme Court has overturned Chevron deference, Politico reported. The struck-down precedent granted federal agencies more leeway to interpret legislation.
Here is what three stakeholders had to say about the new regulations:
- A group of 17 mental health organizations, including the American Psychiatric Association, the National Alliance on Mental Illness and Mental Health America, praised the decision.
In a Sept. 9 statement, the groups said the new rules are "critical" to meeting the needs of people with mental health and substance use disorders.
"These changes will narrow the gaps in access by requiring health insurance companies to demonstrate with data that people seeking MH/SUD care have the same access to in-network services — without having to jump through more hoops — as those seeking physical health services," the groups wrote. - The American Medical Association also praised the rule. In a statement, Bruce Scott, MD, president of the AMA, said the association is still evaluating the rule but "strongly supports multiple provisions that will help increase transparency, oversight and enforcement of MHPAEA in areas such as prior authorization and network adequacy."
"Health plans have violated MHPAEA for more than 15 years, and this final rule is a step in the right direction to protect patients and hold health plans accountable for those failures," Dr. Scott said. - Groups representing insurers and large employers pushed back on the rule.
The ERISA Industry Committee and three organizations representing insurers — AHIP, the Blue Cross Blue Shield Association and the Association for Behavioral Health and Wellness — published a joint statement Sept 9. In it, the organizations said the rule will have "severe unintended consequences that will raise costs and jeopardize patients' access to safe, effective, and medically necessary mental health support."
The organizations said they "support the intent of mental health parity" but believe the proposed rule goes beyond the intent of the 2008 legislation.