This October marks 10 years since the signing of the Mental Health Parity and Addiction Equity Act (MHPAEA), also known as the Federal Parity Law, which requires insurers to cover illnesses of the brain, such as depression and addiction, no more restrictively than how they cover illnesses of the body, such as diabetes and cancer. Alarmingly, due to a lack of enforcement, many insurers are still not in full compliance.
States are finally beginning to take parity enforcement seriously as a critical component of curbing the opioid crisis and rising suicide rates. Three in particular are leading the way when it comes to protecting their residents and ensuring equal access to care. Illinois, Colorado, and Delaware have all taken major steps to align state law with the MHPAEA, increase health plan transparency, and ensure that state agencies are monitoring compliance.
Today, Illinois Governor Bruce Rauner formally signed SB1707, which requires both commercial insurers and Medicaid-managed care organizations to submit detailed analyses in order to demonstrate compliance with the Illinois Parity Law and the Federal Parity Law – particularly with regard to non-quantitative treatment limitations (NQTLs). SB1707 includes nearly all aspects of The Kennedy Forum’s Model State Parity Legislation. More details:
- Requires health plans to publish their parity analyses on a public website
- Requires state regulators to conduct parity market conduct examinations to verify that plans are in compliance with parity laws
- Breaks down barriers to FDA-approved medication-assisted treatment (MAT) by prohibiting cumbersome and time-consuming prior authorization and step-therapy requirements for FDA-approved medications to treat substance use disorders
- Increases the affordability of MAT by requiring generic FDA-approved medications for substance use disorders must be on lowest tier of prescription formularies, with branded medications on the lowest tier for branded medications
- Requires the Illinois Auditor General to issue a report analyzing state regulators’ parity enforcement efforts
- Applies Illinois Parity Law to Illinois school districts that could, until now, opt out of all parity requirements (thereby discriminating against those with mental health and addiction challenges)
This is a major victory in the ongoing fight for mental health equity. The Kennedy Forum would like to thank the Illinois legislature, Governor Rauner, the The Kennedy Forum Illinois team who led the effort, and members of the Illinois Parity Implementation Workgroup.
As the opioid crisis continues to devastate our nation, legislation such as SB1707 is more important than ever. Other states should follow Illinois’ lead in demanding insurer and regulator transparency and accountability.
Resources from The Kennedy Forum
Parity Registry is a website where consumers can learn to file an appeal with their health plan after being wrongfully denied coverage for mental health or addiction treatment; send a complaint directly to state enforcement officials; access step-by-step appeals guidance; find a comprehensive listing of state and federal regulators who can help with an appeal; and review FAQs. The data shared will help to shape public policy and influence future legislation.
Parity Track is a website where policymakers, journalists, consumers, and others can track legislative, regulatory, and legal parity activities in all 50 states and at the federal level to monitor implementation and best practices.