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)