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

The Ohio Department of Insurance (ODI) has a page on its website about parity. On this page is a link to a frequently asked questions page about parity. There is also a link to a chart (pdf | Get Adobe® Reader®) that lists different kinds of insurance plans and whether the Federal Parity Law applies to them and which parity sections of the state insurance law apply. It also includes a hotline for the Consumer Services Division within ODI.

These pages contain very useful information that address many questions and concerns consumers may have about parity. Unfortunately, some of the information is out-of-date. It links to the 2010 Interim Final Rule issued for the Federal Parity law instead of the Final Rule, (pdf | Get Adobe® Reader®) released in 2013. It also does not mention that the Affordable Care Act applies the Federal Parity Law to many individual plans and small employer fully-insured plans thereby creating the false impression that none of these plans are covered by federal law.

ACA Form Filing Checklist

The ODI requires plans to fill out checklists to demonstrate that they comply with the Affordable Care Act and relevant sections of the state insurance law. Here is an example (pdf | Get Adobe® Reader®) of one of those checklists. One of the requirements is that plans demonstrate that they comply with the Federal Parity Law and parity sections of the state insurance law (page 8 and page 11).

05/2018

Primary Focus Medicaid
Agency Medicaid Services
Title/Descriptions Coverage and Limitations of Behavioral Health Services
Citation Ohio Admin. Code 5160-27-02
Summary

Medicaid will reimburse behavioral health services, but that reimbursement is subject to several limitations, including ICD-10 coding, prior authorization requirements, medically necessary requirements, time spent with the patient/client, provider requirements, etc.
Effective Date 5/3/2018

01/2018

Primary Focus Medicaid
Agency Medicaid Services
Title/Description MyCare Ohio Plans: Covered Services
Citation Ohio Admin. Code 5160-58-03
Summary

A MyCare Ohio plan must ensure members have access to all medically-necessary medical, drug, behavioral health, nursing facility and home and community-based services covered by Ohio Medicaid.
Effective Date 1/1/2018

11/2017

Primary Focus Medicaid
Agency Medicaid Services
Title/Description Healthchek: Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Covered Services
Citation Ohio Admin. Code 5160-1-14
Summary

For Medicaid-eligible individuals younger than 21, Healthchek covers a comprehensive health and developmental history, including assessment of both physical and mental health development, as well as substance abuse disorders, as well as other screening services.
Effective Date 11/1/2017

07/2017

Primary Focus Medicaid
Agency Medicaid Services
Title/Description Services Authorized for Medicaid Coverage That Can Be Provided By Medicaid School Program (MSP) Providers
Citation Ohio Admin. Code 5160-35-05
Summary

A Medicaid School Program provider may provide skilled services, and these services are authorized for Medicaid coverage, such as occupational therapy services, physical therapy services, speech-language pathology services, audiology services, nursing services, mental health services, and assessments and evaluations.
Effective Date 7/1/2017

National Parity Map

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

National Parity Map

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Common Violations

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

Common Violations