Ensuring Parity Compliance for Individuals with Mental Health or Substance Use Disorders

The public health issue: The Mental Health Parity and Addiction Equity Act (Parity Act) mandates that health insurance plans’ standards for substance use and mental health benefits be comparable to, and be no more restrictive than, the standards for other medical/surgical benefits. One of the key recommendations outlined in the final report of the President’s Commission on Combating Drug Addiction and the Opioid Crisis is the need for greater enforcement of the Federal Parity Act; however, the current enforcement framework primarily relies on consumers to raise issues related to Parity Act compliance.

Our contribution to the solution: With the ultimate goal of ensuring that the law lives up to its promise nationwide, the Parity@10 Compliance Campaign is a three year effort that will unite local and national advocates in 10 states to pursue full enforcement of the Parity Act. We are spearheading the campaign with Legal Action Center (LAC), the Kennedy Forum, The National Center on Addiction and Substance Abuse, and Partnership for Drug-Free Kids.

The Parity@10 Campaign will advocate for state regulators to shift to a pre-market, prospective regulatory review process to ensure that insurance plans are complying with the Parity Act before they are sold, rather than continuing to place the burden on consumers to identify Parity Act violations and assert their right to care in the midst of a health crisis.

PHMC’s Research & Evaluation Group will support broad work in each state, ranging from researching the current treatment and policy landscape to conducting extensive public and provider education about the Parity Act, to working with legislators, regulators and Attorneys General to develop more effective compliance and enforcement frameworks. The initial phase of the Parity@10 Campaign is funded in part by Indivior, Inc., The New York Community Trust, the Open Society U.S. Programs, and the Open Society Institute-Baltimore.

For additional information, please see the Parity@10 press release.