The U.S. Department of Labor has issued new guidance outlining where it will focus enforcement of federal mental health parity requirements. The guidance highlights three areas of particular concern: exclusions that limit access to treatment; medical necessity and review processes, including prior authorization and utilization review; and network adequacy, including how providers are admitted to networks and reimbursed. The Department also makes clear that enforcement will look at how these policies work in practice, not only how they appear on paper.
For health plans and payers, the message is straightforward: people should be able to access mental health and substance use disorder care on terms comparable to medical and surgical care, and plans need to be able to show that their policies and practices support that goal. URAC supports organizations working toward parity compliance through Mental Health and Substance Use Disorder Parity Accreditation and ParityManager®. Together, they provide a framework for evaluating parity practices, analyzing treatment limitations and organizing the documentation needed to support ongoing compliance.
- Read the Department of Labor guidance here(opens in new tab)
- Learn more about URAC Mental Health Parity Accreditation and ParityManager here(opens in new tab)
