The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA, P.L. 110-343) requires insurers that provide behavioral health benefits to cover mental health and substance use disorder (SUD) services in a manner that is no more restrictive than the coverage generally available for medical and surgical benefits. The law was intended to ensure that behavioral health services would be treated similarly to physical health services in terms of utilization management policies and other limits.
This issue brief examines MHPAEA implementation in Medicaid and the State Children’s Health Insurance Program (CHIP). It provides a background on federal parity laws, describes Medicaid and CHIP requirements under MHPAEA, and includes findings from interviews with state Medicaid officials, managed care organizations (MCOs) and beneficiary advocates in three states, as well as officials from the Centers for Medicare & Medicaid Services (CMS) and representatives from other national organizations.
Despite state efforts to identify inequities in treatment limitations for behavioral health services, we found that MHPAEA does not appear to have substantially improved access to behavioral health care for Medicaid and CHIP beneficiaries. In addition, states and MCOs found required parity analyses to be complex and time consuming.