July 13: ACAP Quality Roundtable on Mental Health Parity

July 13, 2017
3:00 p.m. ET

1-800-326-0013 ID 1933125.

Compliance Officers, COOs and CMOs (copy to QM Managers)

ACAP will host a follow-up networking call on the status of implementing the mental health parity requirements.

On March 30, 2016, CMS published the final rule on the Application of Mental Health Parity Requirements to Coverage Offered by Medicaid Managed Care Organizations, the Children’s Health Insurance Program (CHIP), and Alternative Benefit Plans (see attached).

The final Medicaid/CHIP parity rule applies most provisions of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) to coverage provided to enrollees of Medicaid managed care organizations (MCOs) and coverage provided by Medicaid alternative benefit plans (ABPs) and Children’s Health Insurance Programs (CHIPs).  Parity requirements do not apply to mental health (MH) or substance use disorder (SUD) benefits for beneficiaries who receive only Medicaid non-ABP fee-for-service (FFS) state plan services. Under the final rule, states have up to 18 months after the date of the publication of the final rule to comply with the finalized provisions. According to CMS, this timeframe allows states sufficient time to take any actions needed to comply with the final rule, which may include budget requests to add new services or additional service units, contract changes to their Medicaid managed care organizations, prepaid inpatient health plans and prepaid ambulatory health plans contracts, and obtaining approval from CMS to make changes to their non-ABP state plan for services delivered through fee-for-service (if they so choose).  As a reminder, attached is the implementation toolkit that CMS released to states earlier this year.