With federal businesses getting ready to replace parity rules and Congress contemplating reforms, our new report explains current parity necessities, together with who they apply to and the way their enforced, and highlights key coverage points raised by regulators and advocates that might be addressed sooner or later.
These points embody:
- Simplifying parity requirements to make it simpler for apples-to-apples comparisons between habits well being and medical advantages wanted to evaluate compliance.
- Taking a more in-depth take a look at how insurers are utilizing medical necessity standards to make habits well being protection choices that doubtlessly might have an effect on individuals’s capacity to entry care.
- Growing enforceable requirements to find out the adequacy of supplier networks throughout the complete spectrum of behavioral well being wants from screening to inpatient therapy, together with the potential and limits for telehealth suppliers to supply protection.
- Evaluating enforcement instruments to permit regulators to higher assess and implement parity compliance, doubtlessly together with extra data-reporting necessities or incentives for employers or different plan sponsors to watch their behavioral well being protection.
In weighing doable adjustments to handle such points, different elements to contemplate embody the potential elevated prices ensuing from expanded habits well being protection in addition to an current workforce scarcity and different structural issues.
The transient is a part of KFF’s ongoing work analyzing what shoppers and sufferers face as they navigate the well being care system, together with monetary boundaries, administrative complexity, lack of transparency, and issues accessing suppliers.