In this episode, with mental health trending as a national discussion, Chase Cannon and Suzanne Spradley discuss mental health parity in health insurance coverage. As background, the federal Mental Health Parity and Addiction Equity Act (MHPAEA) requires that the financial requirements and treatment limitations imposed on mental health and substance abuse disorder benefits be no more restrictive than the predominant financial requirements and treatment limitations that apply to substantially all medical and surgical benefits. Chase quizzes Suzanne on some details relating to quantitative treatment limits (dollar and limit visits) and non-quantitative treatment limits (pre-authorization, reimbursement rates, cost sharing, etc.), including some examples outlined in recent federal guidance on MHPAEA. Suzanne outlines several examples of NQTL treatment limits. The two then discuss two recent cases involving mental health coverage issues, one of which ends in favor of the plan and one of which ends in favor of a participant.
