Mental Health Parity

Overview

As mental health parity laws continue to evolve, health insurance plans and medical providers contend with compliance and regulatory issues on a daily basis. Specifically, these laws impose new obligations on insurers, administrators, and group health care plans to prevent discrimination against consumers regarding their health insurance benefits.

While the mental health parity laws apply to nearly every insurance market nationwide, they reflect a sweeping new approach to the regulations associated with managed care.

Health care plan sponsors often face considerable challenges when ensuring compliance with the Mental Health Parity and Addiction Equity Act. At Epstein Becker Green, we work with health insurance carriers and clients in the managed care industry to develop and implement compliance procedures amid the ever-changing regulatory landscape.

Our Services

The mental health parity laws are some of the most complex regulations imposed on health insurance carriers. Previously, the regulatory focus concerned oversight efforts regarding documentation of compliance with non-quantitative treatment limits. However, with the issuance of U.S. Department of Labor (DOL) guidance, the importance of implementing formal compliance programs has been emphasized at both the state and federal levels.

Our experienced attorneys help health care plan administrators and insurers incorporate the necessary regulatory requirements into their parity compliance programs by assisting them with the following:

reviewing existing parity compliance programs;
conducting comparative analyses of non-quantitative treatment limitations;
implementing utilization review policies;
ensuring compliance with written notification requirements;
developing remediation plans;
monitoring for and detecting improper practices;
creating a methodology for developing and applying provider reimbursement rates; and
implementing system configurations.

In addition to ensuring compliance with the DOL’s regulatory requirements, we assist clients with addressing the guidance set forth by the U.S. Department of Health and Human Services, the U.S. Department of the Treasury, and state enforcement authorities. Whether your business is a startup or an established company, our lawyers will work with you to develop a thorough and effective plan for parity compliance.

Insight and Innovation

According to regulations, insurers must not only have detailed written policies and procedures in place but also establish a system to assess ongoing parity compliance. As the insurance industry continues to tackle the largely uninterpreted compliance requirements, our clients know they can trust us to help them navigate this unchartered territory.

Offering an innovative approach and strategic insight, Epstein Becker Green is on the cutting edge in the field of health care regulatory compliance. Providing comprehensive support and effective solutions, we work closely with our clients to develop mental health parity compliance programs to reduce risk and mitigate costs. Not only do our attorneys assist insurers and plan providers with implementing new programs, but we also offer end-to-end legal services to ensure continued compliance.

Practical Guidance and Sophisticated Solutions

Epstein Becker Green is among the most well-regarded firms in the legal field for matters concerning health care regulatory compliance. Our clients value our knowledge, acumen, and extensive experience and have confidence in our wide-ranging capabilities, practical guidance, and ability to offer sophisticated solutions. Understanding the many regulatory questions our clients face, we are committed to providing high-quality legal services and trusted counsel as new mental health parity laws take effect.

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