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New Proposed Rule on Mental Health Parity in Medicaid

April 30, 2015

The Centers for Medicare & Medicaid Services (CMS) released a proposed rule in April 2015 that applies mental health parity requirements to publicly-funded health plans. The rule would eliminate hard limits on coverage (such as caps on the number of mental health visits in a year) and require insurers to provide an explanation if they deny coverage for mental health or substance disorder treatment. The proposed rule will impact the majority of the 70 million people in Medicaid managed care plans and all 8 million children covered under Children’s Health Insurance Program (CHIP) plans, but not those covered by Medicare or Medicaid fee-for-service plans. The rule will apply even for states that already offer separate behavioral health benefits. Mental health-related services include employmentspecific supports, as well as ongoing treatments that can enable people with psychiatric disabilities to maintain employment. Previously, CMS only described how the mental health parity law applies to commercial insurance, including private employerprovided plans. Following the announcement of the proposed rule, CMS will be seeking public comment before releasing a revised final rule.

Read more about the new mental health parity rule.