Product Description

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that prevents most group health plans and health insurers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits. This program provides an overview of the requirements of the MHPAEA, the practical implications for employees, and tips for the unwary for employers.

Plans must apply comparable copays for mental health (MH) and substance use disorder (SUD) care and physical health care. For example, there can be no limit on the number of visits for outpatient MH/SUD care, if there is no visit limit for outpatient physical healthcare. Parity also applies to rules related to how MH/SUD treatment is accessed and under what conditions treatment is covered. The following are subject to parity: Copayments, deductibles, yearly visit limits, prior authorization requirements, and proof of medical necessity. Parity requires that the processes related to plan benefit determinations be comparable.

Attend to hear a detailed analysis of the Act’s implications for employer benefits so you can better field client questions about this complex area.

Agenda & Materials

• 12:00 - 12:20 pm

  Overview of the Mental Health Parity and Addiction Equity Act (MHPAEA)

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  • Equity in the provision of mental health and substance abuse disorder benefits and benefits for physical conditions
  • Who is exempt from the provisions of the MHPAEA?

  Mala M. Rafik, Esq., Rosenfeld & Rafik, PC , Boston
  
• 12:20 - 12:40 pm

  MHPAEA Requirements for Group Health Plans

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  • Provision of information regarding coverage
  • An explanation of the basis for denial
  • Disclosure of information supporting the basis for the denial
  • Recent developments in the law
• 12:40 - 12:50 pm

  For Employers: Is Your Plan Compliant and What Is Your Liability if It Is Not?

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  • What is an employer’s role and liability under the MHPAEA?
  • The Department of Labor’s Self-Compliance Tool

  Mala M. Rafik, Esq., Rosenfeld & Rafik, PC , Boston
  

Please Note

MCLE on demand programs are delivered completely online, underscoring their convenience and appeal. There are no published print materials. All written materials are available electronically only through a link included on the on demand program page.

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