Proposed MHPAEA Rules for Medicaid and CHIP

Delighted to see proposed MHPAEA rules for Medicaid and CHIP.  They are available here.  Still working through them, but on the whole definitely more good news than bad.

At the moment these are only proposed rules, and we do not know when interim final rules or final rules will be issued.  So now seems a good time to point out that enforcing federal laws does not require the presence of final rules or even interim final rules.  MHPAEA has been a requirement for CHIP plans (or at least CHIP plans that provide mental health and mental health/substance use disorder benefits) since at least 2009.  And CMS acknowledged that MHPAEA applies to certain Medicaid plans back in 2013.  (The CMS letter confirming this is here.)

We must not forget the frustrating history of the MHPAEA final rules.  Five years passed between the passage of MHPAEA and the issuance of final rules, and many (incorrectly) assumed that vigorous enforcement had to wait for final rules.  There was no need to wait for the core MHPAEA final rules, and there is no need to wait for the Medicaid and CHIP final rules.

There is a lot of evidence that CHIP and Medicaid plans have routinely violated MHPAEA in recent years, and far too little has been done to enforce MHPAEA or address those violations.  Let’s not let the proposed rules become an excuse for further delay We don’t need final CHIP/Medicaid rules to vigorously enforce this law!