Quality & Science

ASAM, AMA and APA Release New Tool to Help Payers and Regulators Uphold the Mental Health Parity and Addiction Equity Act

by | December 12, 2019

 

On December 12, ASAM, in collaboration with the American Medical Association (AMA) and the American Psychiatric Association (APA) published an “Enhanced Attestation” form that payers and regulators can use to increase compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA).

 

The form contains a list of questions and required documents that should streamline the process of demonstrating compliance with the law. The form is designed to be made available to a state department of insurance upon request for its own regulatory review. The form requires issuers to attest that they have performed analyses in each of the categories of compliance covered by the federal parity law:

 

• Defining mental health and substance use disorder benefits and medical/surgical benefits

• Assigning benefits into classifications

• Financial requirements and quantitative treatment limitations (QTLs)

• Cumulative financial requirements and QTLs

• Nonquantitative treatment limitations (NQTLs)

• Disclosure requirements

• Vendor coordination

 

ASAM, the AMA, and APA believe that the obligation of demonstrating compliance with the law is something payers can and should do. Because the MHPAEA is a comparative law—payers should do the comparisons to analyze whether they are in compliance with the law. Requiring prior comparative analysis can help streamline oversight, can help payers identify gaps, and most important—may help ensure patients have the coverage required by the law.

 

Read more about the "Enhanced Attestation" form here.

 

Access the ""Enhanced Attestation" form here