State laws mandating or regulating mental health benefits

There is strong evidence that mental health benefits legislation that includes parity requirements increases appropriate utilization of mental health services (CG-Mental health) and increases substance use disorder treatment (Friedman 2017, Wen H, Cummings JR, Hockenberry JM, Gaydos LM, Druss BG. Link to original source (journal subscription may be required for access)Harwood JM, Azocar F, Thalmayer A, et al. Link to original source (journal subscription may be required for access)Wen H, Cummings JR, Hockenberry JM, Gaydos LM, Druss BG. Link to original source (journal subscription may be required for access)Harwood JM, Azocar F, Thalmayer A, et al. Link to original source (journal subscription may be required for access)), and increase outpatient and inpatient care for patients diagnosed with substance use disorder (Friedman 2017).

State parity laws and access to treatment for substance use disorder in the United States: Implications for federal parity legislation. The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral health care utilization and spending among carve-in enrollees. State parity laws and access to treatment for substance use disorder in the United States: Implications for federal parity legislation. The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral health care utilization and spending among carve-in enrollees. Such legislation may also increase access and utilization of mental health services for children with autism spectrum disorder (Stuart EA, Mc Ginty EE, Kalb L, et al. Link to original source (journal subscription may be required for access)Grazier KL, Eisenberg D, Jedele JM, Smiley ML. Link to original source (journal subscription may be required for access)Ettner SL, Harwood JM, Thalmayer A, et al. Link to original source (journal subscription may be required for access)).

Increased service use among children with autism spectrum disorder associated with mental health parity law. Effects of mental health parity on high utilizers of services: Pre-post evidence from a large, self-insured employer. The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral health utilization and expenditures among “carve-out” enrollees. Such laws appear to reduce out-of-pocket spending for bipolar disorder, major depression, and adjustment disorders (Busch 2013), families whose children have the highest cost for mental health care (Barry 2013), and mental health and substance abuse treatment for adults with severe mental illness (Mc Connell KJ. Link to original source (journal subscription may be required for access)Stuart EA, Mc Ginty EE, Kalb L, et al. Link to original source (journal subscription may be required for access)Harwood JM, Azocar F, Thalmayer A, et al. Link to original source (journal subscription may be required for access)).

The effect of parity on expenditures for individuals with severe mental illness. Increased service use among children with autism spectrum disorder associated with mental health parity law. The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral health care utilization and spending among carve-in enrollees. Overall, mental health parity requirements do not appear to significantly increase insurers’ annual cost per health plan member (Jacob 2015, CG-Mental health).

Employment-related group health plans may be either “insured” (purchasing insurance from an issuer in the group market) or “self-funded.” The insurance that is purchased, whether by an insured group health plan or in the individual market, is regulated by the State’s insurance department.

Group health plans that pay for coverage directly, without purchasing health insurance from an issuer, are called self-funded group health plans.

An Oregon-based study, however, indicates insurer spending for patients with severe mental illness increased post-parity (Mc Connell KJ. Link to original source (journal subscription may be required for access)Ettner SL, Harwood JM, Thalmayer A, et al. Link to original source (journal subscription may be required for access)Harwood JM, Azocar F, Thalmayer A, et al. Link to original source (journal subscription may be required for access)).

Litigation provides clues to ongoing challenges in implementing insurance parity. The federal Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) prohibits insurance plans that offer mental health services from restricting this coverage any more than coverage for physical health services; this includes the Children’s Health Insurance Program (CHIP) and Medicaid managed care organizations (MCOs) (Medicaid-MHPAEA).

Plans that cover fewer than 50 employees, or do not offer mental health benefits, are exempt from this act (CMS-CCIIO-MHPAEA).

As of 2015, every state and the District of Columbia had enacted some form of mental health benefits legislation (NCSL-Mental health). Jacob 2015 - Jacob V, Qu S, Chattopadhyay S, et al. Grazier 2016* - Grazier KL, Eisenberg D, Jedele JM, Smiley ML. Ettner 2016* - Ettner SL, Harwood JM, Thalmayer A, et al. Harwood 2017* - Harwood JM, Azocar F, Thalmayer A, et al. Friedman 2017 - Friedman S, Xu H, Harwood JM, et al. Berry 2017* - Berry KN, Huskamp HA, Goldman HH, Rutkow L, Barry CL.

Group, employer plans with 50 or fewer employees may impose an annual maximum benefit of ,500.

Employer plans with 51 or more employees may impose an annual maximum of 8 inpatient days and 40 outpatient visits. Broad-based mental health disorders and substance use disorders.

State parity laws and access to treatment for substance use disorder in the United States: Implications for federal parity legislation.

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State laws mandating or regulating mental health benefits introduction

State laws mandating or regulating mental health benefits

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