This is the second in a four-part series from MZQ Consulting Benefits Compliance that will appear each Tuesday on BenefitsPRO (read part one here). 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.
As defined in the previous article, non-quantitative treatment limitations (NQTLs) are strategies, standards, processes, and other criteria that an insurer might use to limit the scope of benefits a plan provides.
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