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Biden administration finalizes rule to strengthen mental health parity law
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Biden administration finalizes rule to strengthen mental health parity law
Sep 9, 2024 2:47 AM

NEW YORK, Sept 9 (Reuters) - The Biden Administration on

Monday said it had finalized regulation to help ensure the 175

million Americans with private health insurance have access to

affordable mental health services.

The 2008 Mental Health Parity and Addiction Equity Act

already requires insurers and corporate-backed health plans to

provide access and payment structures for mental health care

services on par with other medical services.

In practice, that is often not the case, with less than half

of U.S. adults with mental illness able to access care in 2020,

while nearly 70 percent of children cannot receive treatment,

according to studies cited by the administration.

That is partly due to a lack of mental health providers

being sufficiently covered by insurance plans, leading patients

to pay high out-of-pocket costs or to give up on care.

The final rule, proposed last summer, is aimed at closing

the gaps by requiring health insurers to evaluate which mental

health providers' services are covered by their plans, how much

those providers are paid as well as on how often they require or

deny prior authorizations for coverage.

Where needed, such requirements may push health plans to add

mental health providers to networks, according to a senior

administration official. Most of the new regulation will take

effect in 2026.

Patients enrolled in private health plans paid an average

$1,500 per year in out-of-pocket costs for mental health care,

double the amount paid by those without mental health

conditions, White House Domestic Policy Advisor Neera Tanden

said in a briefing.

Often that is because they seek coverage from out-of-network

providers, she said.

"It shouldn't be harder for you to find a provider that can

treat your eating disorder than it is to find a provider who can

treat your ulcer," said Lisa Gomez, Assistant Secretary at the

U.S. Department of Labor.

The Department of Labor regulates corporate-sponsored health

plans under the 1974 Employee Retirement Income Security Act, or

ERISA.

The ERISA Industry Committee, a trade council representing

U.S. employers sponsoring large health plans, in October,

submitted comments to the Department of Labor, claiming the rule

would create an additional cost burden for employer-sponsored

health plans and increase healthcare costs for enrollees.

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