The Biden Administration has finalized rules requiring insurers to cover mental healthcare at the same level as other health services.
The regulations were first proposed in July 2023.
"There is no reason that breaking your arm should be treated differently than having a mental health condition," President Biden said in a Sept. 9 news release. "The steps my Administration is taking today will dramatically expand access to mental healthcare in America."
The White House said the rules are intended to strengthen the 2008 Mental Health Parity and Addiction Equity Act.
Here are five things to know about the final rules:
- The new regulations will bar health plans from using more restrictive prior authorization requirements for mental health than for other forms of care.
- Health plans will be required to study their mental health networks, payment rates and prior authorization policies to ensure they are not more restrictive than for medical care. Under the new rule, plans will also be required to use similar methods to calculate payments for out-of-network mental health providers to those used for out-of-network medical providers.
- The new regulations will close a loophole in the 2008 parity act that excludes non-federal government health plans. According to a White House news release, more than 200 state and local government employee health plans will be required to comply with parity standards
. - Most regulations will take effect Jan. 1, 2025, according to an HHS news release. Some regulations will take effect in 2026.
- Insurers and employers objected to the rules when they were proposed. In October, the Blue Cross Blue Shield Association said the proposed rules could lead to an increase in care that is not clinically recommended. The association recommended increasing the number of mental health providers to address barriers to care. The new regulations are expected to face legal challenges, Politico reported Sept. 9.