We created several resources that promote parity compliance. The resources target a variety of actors that are critical to full parity implementation, including legislators, regulators, advocates, and health plans. If you would like to learn more about any of the resources below, contact David Lloyd at david@thekennedyforum.org.
The Kennedy Forum features two model bills to promote mental health parity at the state level:
The Model State Parity Bill provides a template for legislation that would increase parity implementation. The legislation targets the most critical areas of need to help achieve true parity implementation. This version is a streamlined draft of our previous iteration of model legislation. The current legislation is primarily focused on increased insurer transparency and enhanced regulatory agency enforcement.
The Jim Ramstad Model State Legislation to Advance Mental Health and Addiction Equity by Requiring Compliance with Generally Accepted Standards of Care requires health insurers to follow generally accepted standards of behavioral health care when making medical necessity decisions, and use criteria consistent with these standards). By putting these critical requirements in place, states can improve access to mental health and addiction care at a time of rapidly escalating needs. The legislation was developed in partnership with the American Psychiatric Association, the American Psychological Association, NAMI, Mental Health America, the National Council for Behavioral Health, and more than 30 additional national organizations. The American Psychiatric Association is currently working to tailor it to all 50 states’ unique codes so that advocates can work rapidly to enact its requirements across the country.
If you are interested in more details regarding either model bill, please contact David Lloyd at david@thekennedyforum.org.
The “Six-Step” Parity Compliance Guide for Non-Quantitative Treatment Limitation (NQTL) Requirements developed by parity experts to address a gap in regulatory guidance regarding an aspect of assessing whether non-quantitative treatment limitations (NQTLs) applied by health plans and health insurers comply with MHPAEA. The publication describes steps for identifying NQTLs and for conducting comparative analyses of NQTLs, as written and in operation. The Guide also lists types of documentation that may be helpful to review in conducting these analyses.
The Guide (and the accompanying Worksheet) is limited to creating a framework for plans and issuers to demonstrate compliance with the requirements specified for the NQTL subparagraph of the final MHPAEA regulations.[i] This Guide is intended to support audits that focus on the design an application of NQTLs as well as for use as part of the certification and form review processes if demonstration of NQTL compliance is sought in the pre-market phase.
*We recommend that regulators choose several NQTL worksheets for plans or issuers to complete and submit and not attempt to require a plan or issuer to complete all the worksheets at once.
[i] See 26 CFR 54.9812-1(c) (4)(i); 29 CFR 2590.712(c)(4)(i); 45 CFR 146.136(c)(4)(i)
For background regarding the Federal Parity Law, please see the Parity Resource Guide for Addiction & Mental Health Consumers, Providers and Advocates. This Guide provides a regulatory overview of the Federal Parity Law, which was published in by The Kennedy Forum and the Parity Leadership Coalition.
For background on how to improve the health insurance appeals system, check out The Kennedy Forum’s Issue Brief entitled Filing an Appeal Based on a Parity Violation. Ten action steps are identified on how to improve the appeals process.
For information about the Federal Parity Law published by the: