![]() The rules also clarified that parity is required not only for benefit design features (or “quantitative treatment limitations”) but also for a wider set of health plan practices that affect access, now known as “nonquantitative treatment limitations” (NQTLs). Interim final rules, released in January 2010, clarified how comparisons should be made when employers have multiple general medical or behavioral health plans. The legislation deferred many details of implementation to the federal rulemaking process. MHPAEA prohibits health plans that cover behavioral health conditions from imposing more restrictive financial requirements (for example, copayments) or treatment limitations on behavioral health care than on general medical care. Recent lawsuits indicate lack of clarity in the legislation and challenges in making parity determinations between behavioral health care and general medical care. Since release of initial regulations in 2010, the law has been evolving. The law is expected to transform behavioral health care delivery by expanding access and improving financial protection ( 2). The law required important changes to private health insurance, with the goal of equalizing coverage of behavioral health and general medical conditions ( 3). Congressional enactment of the Mental Health Parity and Addiction Equity Act (MHPAEA) (PL 110–343) in 2008 was a landmark. ![]() Insurance coverage for mental and substance use disorders (behavioral health disorders) has historically been more limited than coverage for general medical conditions ( 1, 2), contributing to high rates of untreated disease and significant costs to individuals and society.
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