On top of all the tasks leaders of behavioral health treatment organizations take on, the most forward-thinking administrators always make sure to monitor the policy actions that will affect their patients. Over the coming months, a legal and regulatory drama that continues to unfold in Washington will definitely bear watching.
The latest development in insurers’ lawsuit against federal agencies to challenge the 2024 final rule implementing the landmark insurance parity law could have major implications. The Trump administration announced through a federal court filing in late March that it will move to rewrite the 2024 regulation that the insurance industry has challenged in court as violating the intent of the 2008 Mental Health Parity and Addiction Equity Act.
Groups representing addiction and mental health treatment providers hailed the 2024 final rule as putting regulatory might behind longstanding consumer protections that they say have gone mostly unenforced. Mark Dunn, the public policy director for the National Association of Addiction Treatment Providers (NAATP), issued a statement following the administration’s court filing, stating in part, “NAATP has continuously advocated for full enforcement of the parity law since it would be an enormous step toward providing access to care. For years the law has been subverted and ignored by insurance providers despite the intent of Congress when the law was passed.”
Conversely, insurers have sharply criticized the final rule, calling it an overreach from the original intent of the parity law. The rule’s coverage and documentation mandates, designed to ensure that insurance policies’ nonquantitative treatment limitations for behavioral health (in areas such as provider network composition) are not discriminatory relative to physical health care, are at issue. This is the main focus of the ERISA Industry Committee’s lawsuit against three federal agencies involved in implementing the parity act.
Debbie Witchey, CEO of the Association for Behavioral Health and Wellness, representing managed behavioral health care companies, said in a statement following the latest court filing that it is “critically important to get a rule in place that is workable and achieves the true goals of the parity laws, rather than increasing administrative burden.”
The pursuit of revised federal regulations places the federal governent in largely uncharted territory, since the agencies will be rewriting regulations for a law that has not changed since 2008. Usually a new regulation closely follows Congress’s statement of intent through passage of new legislation. While this adds to the intrigue over how this federal rulemaking process might take shape, observers also will need to keep an eye on what’s happening in state legislatures this year.
That’s because states such as Washington, Colorado and Maryland have moved to codify the existing federal regulations into the state laws that govern state-regulated health plans. So even if the rules governing federally regulated plans change dramatically, some state-regulated plans will likely have to meet the much stricter requirements stated in the 2024 federal rule.
This promises to be one of the most eagerly watched regulatory developments affecting substance use and mental health treatment in a long time.
