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New Attention Falls on Mental Health Parity Regulations

Mental health is receiving more attention across healthcare and as President Biden unveils broad changes in his budget bill released in March. Many see the pandemic as both a crisis and an opportunity to strengthen the nation’s mental health system.

Some strategies under consideration include payers being required to offer three behavioral health sessions at no charge to patients in private health plans. Another shift would be to apply the 2008 Mental Health Parity and Addiction Equity Act to Medicare. Recent administration moves seek larger networks of behavioral health providers built into benefit plan design and training for the mental health workforce.

Parity is a hot topic in Congress. Payers are required to cover mental health to the same extent they cover physical health under the Parity Act. However, three federal agencies recently reported to Congress that 30 health plans and issuers were out of compliance with the law.

Provider shortages contribute to this picture, with mental health professionals remaining out of network at a rate of five times higher than other provider types. Consumers are often discouraged by delays in getting first appointments or in facing out-of-network fees. Payers say they need more guidance on mental health parity rules and clarity on how to document compliance to the satisfaction of regulatory agencies.

The Senate Finance Committee may be the driver of change as members of both parties search for ways to strengthen access to care, especially post-pandemic. Levers for change could come through the modification of Medicare and Medicaid policies. Other momentum could come from pandemic advances in the use of telehealth and a trend to integrating primary care with behavioral healthcare. While there are issues in prescribing medications to parse, most parties agree that the telehealth flexibilities of the pandemic should be extended. Legislation may come as early as this summer, potentially creating a bipartisan win. Previous mental health parity bills have largely been supported by both parties.

Mental healthcare may be having its moment as the nation appears to unwind from the prolonged pandemic. Experts have expressed concern about the nation’s total health after events that are unprecedented in the modern era.