Feds investigate 191 employers for mental parity compliance

By Allison Bell

January 12, 2017 at 09:45 AM

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The federal Employee Benefits Security Administration reviewed 191 of the 2.2 million private group health plans it regulates for mental health parity compliance during federal fiscal year 2016.

EBSA, an arm of the U.S. Department of Labor, ended up citing 44 of the plans reviewed for violations of the federal Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, according to a new enforcement activities summary.

EBSA says it completed a total of 330 group health plan compliance reviews in fiscal year 2016, which ended Sept. 30, 2016.

EBSA officials investigated about one in every 6,700 plans that they regulate.

Officials look at MHPAEA compliance at one in every 12,000 plans they regulate.

The MHPAEA requires group plans that offer both medical benefits and behavioral health benefits to make the benefits comparable. Deductibles, co-payments and other quantitative features are supposed to be comparable, and other, "nonquantitative treatment limits," such as rules governing how easily enrollees can get access to providers or medications, are also supposed to be comparable.

About 55 percent of the violations found through the EBSA compliance reviews involved annual dollar limits on benefits, and 23 percent involved financial limits and other quantitative limits, officials say.

EBSA Answers Mental Parity Preauthorization Questions

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