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June 19, 2017 at 01:53 PM
Trump administration officials say a new federal law, the 21st Century Cures Act, clearly extends the Mental Health Parity and Addiction Equity Act of 2008 to anorexia, bulimia and other eating disorders.
Officials write in a new batch of guidance that they believe the MHPAEA itself applies to coverage for eating disorder treatment.
The MHPAEA requires providers of individual coverage, and large group health plans, to provide parity for any mental health services they cover, officials write in an answer to frequently asked questions about the MHPAEA.
“Eating disorders are mental health conditions, and therefore treatment of an eating disorder is a ‘mental health benefit’ within the meaning of that term as defined by MHPAEA,” officials write.
(Related: AMA Calls for Expanded Eating Disorder Coverage)
The agencies are asking members of the public to send them comments on whether the 21st Century Cures Act will affect MHPAEA rules for eating disorder coverage by Sept. 13.
Three departments helped prepare the answer: the U.S. Department of Labor, the U.S. Department of Health and Human Services, and the U.S. Treasury Department.
Officials at DOL, HHS and the Treasury Department often team up to handle federal health coverage matters. Observers sometimes refer to the three-agency group as “the tri agencies.”
MHPAEA
The MHPAEA does not require an insurer or health plan to cover mental health care.
If, however, a provider of individual or family coverage, or a large employer plan, chooses to cover mental health services, then the coverage for mental health services must be about as rich as the coverage for “substantially all” medical and surgical benefits.
The coverage provider cannot use quantitative treatment limits, such as deductibles, that are more restrictive for mental health care than for surgical care.
Similarly, the coverage provider cannot use nonquantitative treatment limits, such as care preapproval requirements or care review requirements, that are more restrictive.
Under the administration of former President Barack Obama, HHS approved regulations that pushed insurers to build mental health services coverage into most individual and small-group policies.
Insurers can now sell two types of individual or small-group major medical coverage. They can sell coverage that qualifies as the kind of solid health coverage that helps people avoid paying the Affordable Care Act penalty imposed on people who lack solid health coverage. They can also sell coverage that does not qualify as solid health coverage, or “minimum essential coverage.”
