The Biden administration on Monday finalized several modifications to the existing legal framework governing mental healthcare, aiming to close loopholes in the existing law and improve access to treatment for mental illness and addiction.
The new rules mandate that healthcare companies to “evaluate their provider networks, how much they pay out-of-network providers, and how often they require–and deny–prior authorizations”. This data will help determine whether healthcare companies are complying with rules set out in the Mental Health Parity and Addiction Equity Act (MHPAEA).
The MHPAEA, passed in 2008, requires that healthcare companies provide equal access to mental health and addiction services as they do to traditional medical care. Under the new rules, if the data shows companies are not meeting this standard, they will be legally required to “take reasonable action, as necessary to address material differences in access.”
Additionally, the new rules close a loophole which exempted state government healthcare plans from the requirements of the MHPAEA.
Another key change is the restriction of health care management practices, such as prior authorization, which has been used to limit access to mental health and addiction benefits. Previously, prior authorization requires patients to get permission from their insurance before accessing a health service.
This is the first update to the MHPAEA’s implementing regulations since they were published in 2013, following the law’s passage in Congress. The Biden-Harris administration hopes that the amendment marks a significant step forward in ensuring that mental health and addiction care are treated on par with physical health care coverage.