Amy Gordon Discusses Mental Health Parity Requirements in Bloomberg Law

Winston & Strawn Employee Benefits Partner Amy Gordon was recently quoted in a Bloomberg Law article discussing regulatory compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) and nonquantitative treatment limitations (NQTLs).

The article addressed the Department of Labor’s pending proposed rule RIN 1210-AC11. The rule, according to Bloomberg, provides expanded guidance on “how health plans must comply with standards for showing why their mental health coverage differs from other coverage.”

The additional guidance is necessary, Amy said, as “health plans are grappling with a lack of mental health providers, and they need more specific guidance to comply with the parity requirements” under the MHPAEA.

“It’s not a clear apples-to-apples comparison to medical-surgical,” she added. “There are different categories of care that somebody who is in need of mental health services are going to utilize versus somebody who just broke their leg.”

The recent Dobbs v. Jackson decision has also evoked new questions under the MHPAEA. “[I]f we don’t also provide these travel benefits to individuals who need to travel for mental health care that might not be readily available in close proximity to their homes or work, are we now violating the mental health parity [rules],” posed Amy.

Read the full article here.