The Biden administration’s mental health parity rule proposals are causing concern in the health-care industry due to a new test that could potentially eliminate common cost-control techniques for employee health plans. While the proposal includes a “substantially all” test which mandates that “non-quantitative treatment limitations” (NQTLs) must be applied equally to mental health benefits as they are to medical and surgical benefits under the Mental Health Parity and Addiction Equity Act, it is not yet clear how this will impact the industry.
According to the Departments of Health and Human Services, Labor, and the Treasury, NQTLs can include requirements like prior authorization for care. This means that any restrictions or requirements imposed on mental health benefits must be similar to those imposed on medical and surgical benefits. However, there is no indication of what specific NQTLs will be required in order to comply with this new rule.
The health-care industry is worried that this new test could restrict their ability to control costs for employee health plans, as they may no longer be able to implement certain cost-cutting measures that are commonly used. This could have a significant impact on how mental health services are provided and accessed within employee health plans. It also raises concerns about potential increases in costs for employers who provide these benefits.
While the proposals are not yet finalized, many in the health-care industry are closely watching the developments and preparing for potential changes to how mental health benefits are managed within employee health plans. Some experts predict that this new rule could lead to increased demand for mental health services, as well as changes in how providers bill for their services.