URAC Addresses Parity Challenges with Accreditation

| URAC Staff
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The word parity is defined by Merriam-Webster’s dictionary as “the quality or state of being equal or equivalent.” Sounds simple, right?

However, after moving past the basic definition, parity becomes a decidedly more elusive concept. Just ask those struggling to comply with the Mental Health Parity and Addiction Equity Act (MHPAEA), a federal law that requires employers, benefit administrators, insurers, and certain Medicaid plans who offer mental health and substance use disorder (MH/SUD) services to offer them at parity with medical benefits. While this law has been in effect for over a decade, there continues to be variation in implementation by market and jurisdiction. 

“Many don’t know for certain if they are in compliance,” says Brittany McCullough, health policy specialist, URAC. “Or in some cases, they may be in compliance, but can’t easily document the fact to the satisfaction of various regulators,” she adds.     

McCullough will be joined by Kevin J. Malone, senior counsel, Epstein Becker Green, to offer expert insight and analysis as well as a snapshot of the current regulatory landscape at a webinar on March 31.

Compliance is not easy, McCullough stresses. “Many are struggling to comply, in part because of lack of consistency with state demands and requirements,” she says. “Some are shelling out millions of dollars for failing to comply with the law,” she adds.

A comprehensive recent report from Milliman spells out some of the challenges facing covered entities. “Our findings indicate that disparities exist in both network use and provider reimbursement level when comparing behavioral healthcare to medical/surgical healthcare. While MHPAEA federal rules state that disparate results are not in and of themselves definitive evidence of noncompliance, significant disparities, such as high out-of-network use of behavioral health providers and/or lower reimbursement for behavioral providers, could point to compliance problems. Health plans should carefully review their processes in order to ensure compliance.”

McCullough will also outline how URAC’s MH/SUD Parity Accreditation program can help entities with compliance efforts and improve overall operations. The MH/SUD Parity Accreditation Program is comprised of three components:

  • ParityManager™ is an enterprise software solution designed to help health plans and other organizations build, implement and manage an effective parity compliance program. Can be used by applicants during their application process, or as a stand-alone tool.
  • The MH/SUD Parity Compliance Guide is a comprehensive compliance tool that summarizes key regulations under MHPAEA. The Guide aggregates the key federal regulatory and sub-regulatory guidance into topic areas and provides practical insights and guidance on how to ensure compliance.
  • The MH/SUD Parity Accreditation Program allows organizations to show their commitment to developing and maintaining their parity compliance programs.

URAC’s compliance guide, software tool and accreditation serve as a roadmap for improved compliance with federal parity regulations and provide independent third-party validation of parity compliance program practices and performance.

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