Who is going to enforce the Mental Health Parity and Addiction Equity Act (“MHPAEA”)? This is a pretty big question.
On paper the issue seems clear enough. States have primary enforcement authority over health insurance issuers, with federal regulators stepping in if a State fails to enforce the law. The Department of Labor’s Employee Benefits Security Administration (“EBSA”) has primary enforcement authority over the health plans of private employers, and the Department of Health and Human Services (“HHS”) has primary enforcement authority over the health plans of state and local governments.
But allocating enforcement authority between the States, HHS, and EBSA is turning out to be difficult, and with a couple of notable exceptions (most prominently California and New York), most State regulators are still cutting their teeth on MHPAEA enforcement. The situation is not a whole lot better on the federal level: we have not seen a lot of proactive activity, and HHS has expressly stated that the federal government may address identified violations by simply asking health plans to comply in the future. That’s like a speeding ticket that consists of a polite request to not speed again — more a field day for dangerous drivers than a meaningful enforcement mechanism.
We can’t stand by and do nothing while our patients are harmed by unlawful conduct. This blog will talk about some steps that providers and families can take to address MHPAEA violations and (just as important) protect vulnerable patients from MHPAEA violations.