The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) signed into law in October 2008, requires health insurance plans to provide equity between medical/surgical benefits and mental health and addiction benefits when such policies offer coverage for both.  It also eliminates the sunset provision of the original Mental Health Parity Act enacted in 1996, modifies the definition of mental health benefits plans, adds a definition of substance use disorder benefits and imposes several new parity requirements.

Specifically, the MHPAEA requires group plans to ensure that: 1) the financial requirements (i.e., deductibles, co-payments, coinsurance, out-of-pocket expenses, lifetime limits, etc.) applied to mental health and addiction benefits are not more restrictive than those applied to medical and surgical benefits covered by group health plans; 2) cost-sharing requirements are not made applicable only to mental health and substance use disorder benefits; 3) treatment limitations (i.e., frequency of treatment, number of visits and days of coverage) are not more restrictive than the treatment limitations applied to medical and surgical benefits; and 4) if out-of-network coverage is provided for medical/surgical benefits, it must also be provided, at parity, for mental health and substance use disorder benefits.  

As a result of the Act being signed into law, the U.S. Departments of Labor, Treasury, and Health and Human Services have issued a request for information (RFI), published in the April 28 Federal Register, to solicit public comments in advance of developing rulemakings on group health plans. 

The RFI seeks public comments on such issues as:

• The types of financial requirements or treatment limits plans currently impose;
• The terms in the statute that require additional clarification to facilitate compliance;
• Current disclosure practices by plans regarding medical necessity determinations and denials of mental health and substance use disorder benefits; and 
• Current practices regarding out-of-network coverage for mental health and substance use disorder benefits.

Written comments responding to the MHPAEA RFI must be submitted by May 28 and addressed to the U.S. Department of Labor, Office of Health Plan Standards and Compliance Assistance, Employee Benefits Security Administration, N-5653, 200 Constitution Ave. N.W., Washington, D.C. 20210, Attn: MHPAEA Comments. The public also may submit comments electronically by email to E-OHPSCA.EBSA@dol.gov or through the Federal e-rulemaking portal at www.regulations.gov.