CHA News Article

CMS Issues Final Rule on Mental Health Parity for Medicaid MCOs

The Centers for Medicare & Medicaid Services (CMS) issued the attached final rule that applies certain requirements of the Mental Health Parity and Addiction Equity Act of 2008 to coverage offered by Medicaid managed care organizations (MCOs), Medicaid alternative benefit plans (ABPs) and the Children’s Health Insurance Program (CHIP). The final rule requires that all beneficiaries who receive services through Medicaid MCOs, ABPs, or CHIP be provided access to mental health and substance use disorder benefits that comply with parity standards, regardless of whether these services are provided through the MCO or another service delivery system.

Under the final rule, states are required to include contract provisions requiring compliance with parity standards in applicable contracts, including prepaid inpatient health plans and prepaid ambulatory health plans. The final rule also requires the state to disclose the reason for any denial of reimbursement for mental health and substance use disorder benefits. In a modification of the proposed rule, the final rule extends the parity protections to long-term care services for mental health and substance abuse disorders.

CHA is reviewing the final rule and will provide members with a more detailed summary in the coming weeks. More information is available in a CMS fact sheet and frequently asked questions document. The final rule is effective May 31.