Definition


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This page lists some of the action toward parity compliance undertaken by state regulatory agencies since 2008.

Are we missing any actions taken by state regulatory agencies? Let us know at info@paritytrack.org

Action in the Regulatory Arena

Every year all insurance plans besides individual plans are required to submit a form called the Alabama Group Mental Health Parity Cost Report (pdf | Get Adobe® Reader®) that certifies that they meet the requirements of the section of the insurance law about parity. It also requires insurers to provide a cost comparison between their plans that cover mental health services and their plans that do not. Plans must submit this form by April 30 each year.

7/2017

Primary Focus Mandated Benefit: Provider
Agency Medicaid
Title/Description Service Delivery Network Requirements
Citation Ala. Admin. Code r. 560-X-64-.17
Summary The Integrated Care Network (ICN) must establish agreements with the Alabama Department of Mental Health (ADMH) to ensure that each ICN establishes and maintains an adequate network of ADMH certified behavioral health providers to appropriately address the needs of enrollees who have mental illnesses and substance abuse disorders. The ICN provider network must include ADMH-certified mental health and substance abuse providers.
Effective Date July 14, 2017

1/2016

Primary Focus Mandated Benefit: Provider
Agency Medicaid
Title/Description Covered Services: Details on Selected Services
Citation Ala. Admin. Code r. 560-X-6-.13
Summary Group Therapy shall be a covered service when a psychiatric diagnosis is present and the therapy is prescribed, performed, and billed by the physician personally. Group Therapy is included in the annual office visit limit. Family Therapy shall be a covered service when a psychiatric diagnosis is present and the physician providing the service supplies documentation which justifies the medical necessity of the therapy for each family member. Family therapy is not covered unless the patient is present. Family Therapy is included in the annual office visit limit. Family Therapy is not covered when performed by a case worker, social service worker, mental health worker, or any counseling professional other than a physician.
Effective Date October 1, 1982; Last amended January 11, 2016

8/2014

Primary Focus Medicaid
Agency Medicaid
Title/Description Service Delivery Network Requirements
Citation Ala. Admin. Code r. 560-X-62-.12
Summary

The Regional Care Organization/Alternative Care Provider (RCO/ACP) members must establish agreements with the Alabama Department of Mental Health (ADMH) to ensure that each RCO/ACP establishes and maintains an adequate network of ADMH certified behavioral health providers to appropriately address the needs of beneficiaries in the demonstration populations who have mental illnesses and substance abuse disorders. The RCO/ACP provider network must include ADMH-certified mental health and substance abuse providers.

Effective Date August 22, 2014

2009

The Alabama Department of Insurance (DOI) issued a bulletin (pdf | Get Adobe® Reader®) informing insurance plans that they have to comply with the Federal Parity Law or the plan will not be approved for issuance in the state of Alabama.

2/1999

Primary Focus Mandated Benefit: Provider
Agency Department of Public Health
Title/Description Basic Health Care Services
Citation Ala. Admin. Code r. 420-5-6-.04
Summary

A health maintenance organization may provide, in addition to basic health services, other health services such as outpatient substance abuse services, residential treatment for substance abuse or mental health at recommended levels of 30 days for adults and 60 days for adolescents.

Effective Date March 31, 1987; Last amended February 24, 1999

State Parity Reports

View the state parity reports to learn about legislation, regulation, and litigation related to parity implementation

State Parity Reports

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Common Violations

In seeking care or services, be aware of the common ways parity rights can be violated.