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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

8/2017

Primary Focus Mandated Benefit: Provider
Agency Texas Department of Insurance
Title/Description Basic Health Care Services and Mandatory Benefit Standards: Group, Individual, and Conversion Agreements
Citation

28 Tex. Admin. Code § 11.508 per 42 TEXREG 2169

Summary

Each evidence of coverage providing basic health care services must provide coverage for outpatient mental health services complying with the mental health parity requirements in Chapter 21, Subchapter P, of this title (relating to Mental Health Parity).

Effective Date August 1, 2017
Primary Focus Mandated Benefit: Provider
Agency Texas Department of Insurance
Title/Description Minimum Standards—Mental Health and Chemical Dependency Services and Benefits
Citation

28 Tex. Admin. Code § 11.2405 per 42 TEXREG 2169

Summary

Each limited service HMO providing coverage for mental health and chemical dependency services and benefits must comply with Chapter 21, Subchapter P, of this title (relating to Mental Health Parity) and provide primary mental health and chemical dependency services and benefits.

Effective Date August 1, 2017

2014

The Texas Department of Insurance (TDI) released a chart (pdf | Get Adobe® Reader®) that shows the benefits that must be provided by health plans in Texas. The document shows which mental health and substance use disorder benefits must be offered by individual, small employer, and large employer plans (pages 2, 4, and 5). It clearly demonstrates that all plans must offer mental health benefits in parity with physical health benefits (page 5).

3/2011

Primary Focus Mandated Benefit: Provider
Agency Texas Department of Insurance
Title/Description Small Employer Health Plan Parity Requirements
Citation

28 Tex. Admin. Code § 21.2404 per 36 TEXREG 1291

Summary

Unless exempted by this subsection, an issuer of a group health plan to a small employer must offer coverage or serious mental illness as described in § 1355.004. The employer may reject the coverage, but if the employer accepts the coverage, such coverage must meet the requirements of § 1355.004.

Effective Date March 2, 2011

1/1999

Primary Focus Mandated Benefit: Provider
Agency Texas Department of Insurance
Title/Description Large Employer Health Plan Parity Requirements
Citation

28 Tex. Admin. Code § 21.2403 per 24 TEXREG 393

Summary

Coverage that provides both medical/surgical benefits and mental health or substance use disorder benefits must apply substantially the same following limits to mental health benefits as it does to medical/surgical benefits:

(1) Aggregate lifetime limit or an annual limit;

(2) Financial requirements; and

(3) Treatment limitations

Separate cost-sharing requirements or separate treatment limitations that are applicable only with respect to mental health or substance use disorder benefits are prohibited.

Effective Date January 31, 1999

2008

The Texas Department of Insurance (TDI) issued a bulletin notifying constituents that the Texas Attorney General issued an opinion finding that group health plans in Texas are required to provide the same number of outpatient visits for serious mental illness as they do for physical illness. In the bulletin, TDI stated that they planned to conduct reviews of forms of carriers on file for parity compliance. The bulletin also noted that TDI would issue regulations to implement the Federal Parity Law, which it did in 2011 (see above).

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.