In 2008, Congress passed the Mental Health Parity and Addiction Equity Act (MHPAEA), reports the U.S. Department of Labor.  MHPAEA requires group health plans and health insurance issuers to ensure that financial requirements and treatment limitations applicable to mental health or substance use disorder benefits are no more restrictive than the predominant requirements or limitations applied to substantially all medical/surgical benefits.

As a follow-up to that statute, the Department of Health and Human Services (HHS) was to pass a final regulation providing further details on how these requirements were to be implemented and enforced.  According to USA Today, this rule has finally been published, five years after the law was passed.  The rule requires insurers to charge similar co-payments for mental health treatment as they would for physical ailments. It also makes clear that deductible and visit limits are generally not more restrictive for mental health and substance abuse care.  The rule also includes several other consumer protections, including ensuring that parity is applied to care received in residential treatment and intensive outpatient settings, and clarifying that parity applies to all health care plan standards, including geographic limits and facility-type limits.

This final regulation was needed to provide further guidance after a 2010 interim final rule, reports Behavioral Healthcare.  The guidelines in the interim final rule could be manipulated by insurance companies to continue to discriminate, but not run afoul of the new rule.  In particular, mental health patients were required to first “fail” in outpatient treatment before inpatient treatment would be authorized, putting them at risk for devastating consequences.

The National Alliance on Mental Illness (NAMI) describes mental illness as a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others and daily functioning.  Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD) and borderline personality disorder.

According to a fact sheet from NAMI, one in four American adults (or 61.5 million people,) experiences mental illness in a given year.  Additionally, approximately one-fifth of youths between the ages of 13 and 18 also experience severe mental disorders.  Though mental disorder cannot be diagnosed in younger populations, it is estimated that 13 percent of Americans between 8 and 15 experience severe mental disorders.  Serious mental illness costs America $193.2 billion in lost earnings every year and serious mental illness is compounded with an increased risk of chronic health conditions.