Addiction Policy News

ASAM Encourages Stakeholders to Highlight Tool for Prospective Review of Parity Compliance

August 3, 2020


On August 3, ASAM and 11 other organizations submitted a letter to Katie Dzurec and Jane Beyer, the chair and vice chair respectively of the Mental Health Parity and Addiction Equity Act Working Group of the National Association of Insurance Commissioners. In the letter, the organizations urged the Working Group to highlight the quantitative treatment limitations (QTL) / financial requirements (FR) template and instructions, which the Pennsylvania Insurance Department presented to the Working Group, to health insurance regulators across the country. Furthermore, the organizations encouraged the Working Group to move forward with efforts to develop a non-quantitative treatment limitations (NQTL) template.


Specifically, the organizations noted it is vital that insurers prospectively demonstrate compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) to ensure that patients receive the benefit of their premium dollars. The QTL/FR template and instructions makes all the necessary calculations required for insurers and regulators to prospectively determine whether a plan’s QTL and FR are consistent across its mental health/substance use disorder benefits and its medical/surgical benefits. The letter concluded by encouraging the Working Group to develop a similar tool for evaluating a plan’s NQTL. 


Read the letter here