This is the first in a four-part series from MZQ Consulting Benefits Compliance that will appear each Tuesday on BenefitsPRO. The series examines the long and ongoing journey to achieving better outcomes for mental health and addiction in the U.S. health care systems. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that generally prevents group health plans and health insurance issuers that provide mental health and substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical coverage.
As easy as that is to articulate, achieving those objectives continues to be challenging. In particular, it can be daunting and confusing for employers and plans to understand and to report on, especially since the process seems to be ever-changing.
In 2008, when the Mental Health Parity and Addiction Equity Act (MHPAEA) was enacted, it was considered a breakthrough victory in a decades-long fight for clearer and fairer pathways to mental health and substance use disorder care. Yet despite that initial victory, a lot of work remains to be done. The primary purpose of the Act was to bring benefits for mental health and substance use disorders in line with medical/surgical benefits. The law requires that mental health benefits must not be more difficult for someone to access and utilize than their medical or surgical care. The simple principle is this: It should be just as easy for someone to get treated for a substance use disorder, anxiety, depression, PTSD, or any other behavioral condition as it is for them to get treated for a broken wrist, diabetes, asthma, or any other common ailment.
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