The Mental Health Parity and Addiction Equity Act (Parity Act) provides a framework intended to ease access to long-blocked addiction care by guaranteeing insurance coverage of addiction treatment equal to that provided for other medical conditions.
This study, conducted as a part of the Addiction Solutions Campaign — a consortium of the leading policy, advocacy, education and technical assistance organizations in the addiction field — highlights significant barriers to front-line enforcement for the Parity Act.
Data from this study suggest that the enactment of the Parity Act has not put an end to restrictive coverage and limited reimbursement for substance use treatment in either private insurance or Medicaid. Findings include the following:
For insurance providers and regulatory agencies:
The research team designed a data gathering template that tracks all plan design features regulated by the Parity Act, including financial requirements, quantitative treatment limitations and non-quantitative treatment limitations (NQTLs), with the exception of network admission standards, reimbursement rates and network adequacy, which were outside the scope of this review. The team then conducted an analysis of publicly available documents for seven health plans offered in the small and large group markets in New York or Maryland. In addition to reviewing the plan documents
provided to regulators, the study team sought to obtain additional information from publicly available documents via simple internet searches (i.e., medical necessity criteria/medical policies).