California’s protection & advocacy system
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The Centers for Medicare & Medicaid Services (CMS) issued its final rule on March 30, 2016. This final rule requires Medicaid and the Children’s Health Insurance Program (CHIP) to comply with certain mental health parity requirements added to the Public Health Service Act (PHS Act) by Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).
MHPAEA is a federal law that generally prevents group health plans that provide mental health or substance use disorder benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits. For example, under MHPAEA, if an insurance company requires co-payments for doctor visits, or wants to limit the number of visits to a specialist, then they must have the same or similar requirements for both mental health and physical health. In California, all commercial plans issued in the state, including individual and small group health insurance products, must comply with MHPAEA. Because of the final rule, MHPAEA now applies to Medicaid (Medi-Cal in California) and CHIP enrollees.
This is an important step for parity because it requires Medicaid and CHIP to comply with MHPAEA. By doing so, mental health services and care for low income individuals in the Medicaid program will improve. This final rule will benefit over 23 million people enrolled in Medicaid managed care organizations, Medicaid alternative benefit plans, and CHIP.
The Parity Tip of the Month is funded by a grant from the California Mental Health Services Authority.
California Mental Health Parity Act: A Way to Expand Mental Health Services for Children and Youth (pdf) a Mental Health Advocacy Services publication
DRC Video: California Mental Health Parity Act
For additional fact sheets and more information from Mental Health Advocacy Services visit http://www.mhas-la.org/stigma-reduction.html
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