Employer-sponsored health plans would come under increased scrutiny to cover mental health and substance abuse disorders at the same level as physical healthcare under proposed rules introduced Tuesday by the departments of Labor, Health and Human Services and the Treasury.
The proposed rules could be especially significant for workers in long-term care. As McKnight’s Senior Living previously reported, a 2021 KFF / Washington Post Frontline Health Care Workers Survey showed that 47% of assisted living and nursing home workers reported feeling anxious due to the stresses of the pandemic. More than half (58%) of senior living and nursing home employees taking the survey also said that their employers were “falling short” in supporting them. With a 50% turnover rate in the industry, polled direct care workers cited a need for increased focus on employee wellness and mental health.
“Mental healthcare is as important to the well-being of America’s workers as medical care, and we must eliminate barriers to getting people the lifesaving care that they often need,” Acting Secretary of Labor Julie Su stated Tuesday.
The proposed rules would build on the Mental Health Parity and Addiction Equity Act, enacted in 2008, to try to ensure that people seeking mental health and substance use disorder care do not face greater barriers to treatment than those faced by people seeking treatment for medical and surgical conditions. Under that act, private health insurance companies are barred from imposing co-payments, prior authorization and other requirements on mental health or substance use disorder benefits that are more restrictive than those imposed on medical and surgical benefits.
“Despite the law’s existence, people seeking coverage for mental health and substance use disorder care continue to face greater barriers when seeking benefits for that than when seeking medical or surgical benefits,” according to the Labor Department.
The agencies also issued a technical release that addresses the relevant data that group health plans and health insurance issuers would be required to collect and evaluate for nonquantitative treatment limitations related to network composition to demonstrate compliance with the Mental Health Parity and Addiction Equity Act. Additionally, the technical release seeks public comments on the proposed rules.
“With the proposed rules and technical release, the departments aim to promote changes in network composition and plans’ and issuers’ medical management techniques to make mental health and substance use disorder provider networks more accessible and create parity in treatment limitations, such as network composition standards and prior authorizations, for people seeking mental health and substance use disorder treatment,” according to the Labor Department.
