Legal Action Center & Center on Addiction release two new parity reports
Updated: May 26, 2020
As the country continues to grapple with the impact of the COVID-19 crisis, we know that the economic, health and psychological effects will result in a surge of people needing treatment for mental health or substance use problems.
Timely access to affordable, quality care will be critical to meet this need. Now is the time for policymakers, regulators, and advocates to act to ensure that barriers to mental health and substance use care are removed.
One often overlooked path to increased treatment access is better enforcement of the nation’s existing insurance laws, including the 2008 Mental Health Parity and Addiction Equity Act (Parity Act). Our new reports detail two such barriers: prior authorization and inadequate provider networks, and how increased enforcement of the Parity Act could help address these barriers.
The Spotlight on Prior Authorization includes a 50-state survey of statutory standards limiting the use of prior authorization for substance use disorder (SUD) medications and services in both public and private insurance and identifies 22 state legislatures that have stepped in to require system-wide removal of some prior authorization requirements. In addition, the report provides guidance on regulatory and Attorney General actions that have strengthened enforcement of existing requirements under the Parity Act.
The Spotlight on Network Adequacy includes a 50-state survey of quantitative metrics adopted for state-regulated private health plans and offers a “parity assessment” of those state MH and SUD provider metrics. The report also describes the federal and state regulatory framework for defining and monitoring network adequacy for public and private health plans and offers recommendations to improve and enforce network adequacy standards.
We hope that these reports provide useful guidance for policymakers, regulators, and advocates as they anticipate the surge in behavioral health needs arising from the COVID-19 crisis.