April 7, 2015

Rule Would Ban Benefit Limits for Mental Health Care

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A proposed federal rule would prohibit some federally funded medical programs from putting limitations on substance abuse or mental health care benefits that are more restrictive than those on medical care, the federal government announced Monday.

The Centers for Medicare and Medicaid Services announced the rule changes in regard to Medicaid managed care organizations, alternative benefit plans and the Children’s Health Insurance Program, officials said.

The change would apply parts of a 2008 mental health parity law, expanded under the Affordable Care Act, that requires many private insurers not place caps or limits on mental health care.

The rule would require states that contract with managed care organizations to provide any Medicaid benefits to provide mental health parity protections for enrollees who receive services from a managed care organization or other service delivery system.

Around four-fifths of Medicaid recipients in Oklahoma are enrolled in some type of managed care, according to federal numbers.

The proposed rule is scheduled to be published in the Federal Register on Friday, and a public comment period on the rule is open until June 9.

The entire CMS press release is here. The full proposed rule is here.