AHIP: Proposed Mental Health Parity Rule Should Not Be Finalized

AHIP, an advocacy organization for insurers, believes that the mental health parity rule proposed in July has several “flaws” and should not be finalized, it wrote in a Tuesday comment letter to the Departments of Health and Human Services, Treasury and Labor.

The proposed rule builds on the Mental Health Parity and Addiction Equity Act (MHPAEA), which went into effect in 2008. It requires health plans to cover mental health benefits at the same level as physical health benefits. The proposed rule would mandate insurers to analyze the outcomes of their coverage policies, such as how much out-of-network providers are paid and the frequency of prior authorization denials.

AHIP noted that it agrees that “coverage of mental health and substance use disorder care must be on par with medical and surgical care.” However, the proposed rule would not improve access to mental health care, the organization argued in the letter. AHIP laid out several recommendations for the federal government in regards to the proposed rule, including withdrawing the proposed rule altogether and restarting the process by engaging with stakeholders.

“The proposed regulations have significant legal, policy, and operational flaws and should not be finalized. Perhaps more importantly, the proposed rules will not achieve the goals of increasing access to mental health care or substance use disorder treatment,” AHIP said. “Instead, we urge the Departments to take this opportunity to gather stakeholder feedback about the areas that remain unclear for achieving effective compliance with MHPAEA and use that feedback to inform a future [notice of proposed rulemaking] that adheres to statutory authority while avoiding the unintended consequence of hindering the availability, affordability, or safety of mental health care and substance use disorder treatment.”

Blue Cross Blue Shield Association also came out against the mental health parity rule, arguing that it “could push us in the wrong direction by forcing health plans to remove important protections that ensure patients are receiving safe, medically necessary, effective care,” said David Merritt, BCBSA’s senior vice president of policy and advocacy, in a statement.

BCBSA also made several recommendations, including expanding access to telemental health services and allowing behavioral health providers to practice across state lines.

While many insurers are against the proposed rule, other organizations are in favor of it. The American Medical Association came out in support of the rule when it was first announced.

“The American Medical Association strongly supports the Biden administration’s commitment to addressing insurers’ continued failures to comply with the Mental Health Parity and Addiction Equity Act (MHPAEA),” said Dr. Jesse Ehrenfeld, president of the AMA, in a statement. “For more than 15 years, the combined lack of enforcement and compliance with MHPAEA has been a significant factor driving the nation’s mental health crisis and substance use disorder epidemic, which have both been exacerbated by the pandemic.”

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