CHA News Article

DHCS Submits Mental Health Parity State Compliance Plan to CMS

The California Department of Health Care Services (DHCS) has submitted to the Centers for Medicare & Medicaid Services (CMS) a State Compliance Plan, as required under the Medicaid Mental Health Parity Rule. The rule, which took effect May 31, 2016, applies certain requirements of the Mental Health Parity and Addiction Equity Act of 2008 to coverage offered by Medicaid managed care organizations, Medicaid alternative benefit plans and the Children’s Health Insurance Program (CHIP). The final rule requires that all beneficiaries who receive services through these payers be provided access to mental health and substance use disorder benefits that comply with parity standards, regardless of the service delivery site. 

The final rule mandates that states include contract provisions requiring compliance with parity standards in applicable contracts. It 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.

DHCS has completed the parity analysis and will issue guidance to Medi-Cal managed care health plans, county mental health plans, Drug Medi-Cal plans and Drug Medi-Cal Organized Delivery System plans. A summary of the compliance plan is posted on the DHCS website.