Employee Benefits & Executive Compensation Blog

The View from Proskauer on Developments in the World of Employee Benefits, Executive Compensation & ERISA Litigation

Tag Archives: MHPAEA

Limitation To Restorative Speech Therapy Does Not Violate MHPAEA

A federal district court in Massachusetts concluded that a health insurance plan did not violate the Mental Health Parity and Addiction Equity Act by denying coverage for speech therapy to a plan beneficiary who required speech therapy in connection with autism spectrum disorder. The plan denied coverage because the speech therapy sought was for non-restorative … Continue Reading

EBSA FY 2019 MHPAEA Enforcement

The Employee Benefits Security Administration (EBSA) is charged with ensuring that plans comply with ERISA, including the Mental Health Parity and Addiction Equity Act (MHPAEA).  EBSA recently released its MHPAEA report for Fiscal Year (FY) 2019.  We provide below highlights from EBSA’s report and also note some comparisons to FY 2018. In FY 2019, EBSA … Continue Reading

District Court Denies Motion to Dismiss Mental Health Parity Act Putative Class Action

In the latest volley between participants and group health plans over mental health services coverage, a federal district court in California denied United Healthcare’s motion to dismiss a putative class action challenging the reimbursement rates for out-of-network mental health services.  In this case, the plaintiffs alleged that UHC reduced reimbursement rates for out-of-network services by … Continue Reading

Proposed Mental Health Parity Guidance Focuses on Nonquantitative Treatment Limitations

On April 23, 2018, the Departments of Labor (DOL), Health and Human Services (HHS) and Treasury (together, the “Agencies”) released proposed frequently asked questions (“FAQs”) related to nonquantitative treatment limitations (“NQTLs”) under the Mental Health Parity and Addiction Equity Act (“MHPAEA”).  The Agencies also provided guidance on new disclosure requirements (which were described in our … Continue Reading

Proposed Mental Health Parity Guidance Would Impose Burdensome Disclosure Requirements

On April 23, 2018, the Departments of Labor (DOL), Health and Human Services (HHS) and Treasury (together, the “Agencies”) released proposed frequently asked questions (“FAQs”) related to required disclosures and nonquantitative treatment limitations (“NQTLs”) under the Mental Health Parity and Addiction Equity Act (“MHPAEA”).  The Agencies also released a self-compliance tool to help plans, plan … Continue Reading

New Class Action Lawsuits Asserting Violations of the MHPAEA

Banner Health and the Kaiser Foundation  were recently hit with separate class action lawsuits challenging their denials of certain mental health care coverage. In the case against Banner Health, plaintiffs challenge Banner Health’s exclusion of applied behavior analysis therapy from coverage for autism spectrum disorder as “experimental or investigational.” Plaintiffs allege that the failure to … Continue Reading

Mental Health Parity Act: A Litigation Update

The Federal Mental Health Parity and Addiction Equity Act (the “Federal Parity Act”), like many similar state parity laws, mandates that financial requirements (e.g., copayments, coinsurance, or deductibles) and treatment limitations (e.g., limitations on the frequency of treatment, number of out-patient visits, or amount of days covered for in-patient stays) applicable to mental health benefits … Continue Reading

New FAQs Provide Guidance Regarding Effect of ACA on the MHPAEA

As previously reported, the federal agencies responsible for drafting the rules implementing the Affordable Care Act (“ACA”) (the U.S. Department of Labor, the U.S. Department of Health and Human Services, and the U.S. Treasury Department) recently issued FAQ Part XVIII, regarding implementation of the market reform provisions of the ACA. Question 12 in FAQ Part … Continue Reading

New FAQs on ACA Extend Fully-Insured Expatriate Health Plan Transitional Relief by “At Least” Another Plan Year and Clarify Scope, 6-Month Requirement

As reported, the U.S. Labor Department, the U.S. Department of Health and Human Services and the U.S. Treasury Department (together, the “Departments”) recently issued additional FAQs regarding implementation of the market reform provisions of the Affordable Care Act (ACA). FAQs 6 and 7 include new guidance on the temporary transitional relief issued last year (discussed … Continue Reading

Departments Release New FAQ Guidance on ACA and MHPAEA Implementation Issues

On January 9, 2014, the Departments of Treasury, Labor, and Health and Human Services (collectively, the “Departments”) published the eighteenth installment of a series of answers to Frequently Asked Questions regarding implementation of the Affordable Care Act (ACA) and the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The FAQ provides guidance on … Continue Reading
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