Does the MHP Act define mental health and substance use disorder benefits?
The MHP Act defines mental health and substance use disorder benefits as those “defined under the terms of the plan and in accordance with applicable Federal and State law.” This means that the law defers to group health plans to define mental and substance use disorders and their coverage. As previously noted however, where state law either defines or mandates coverage of specific mental illnesses or services, those definitions will continue to apply to plans subject to state regulation. How does this law differ from the 1996 federal parity law? The key differences between the new MHP Act and the 1996 federal parity act are as follows: The new MHP Act: • Includes substance use disorders • Requires out of network coverage for mental health and substance use disorders if out of network is covered for medical surgical benefits • Prohibits more restrictive cost-sharing features for behavioral health than those applied to medical/surgical benefits • Prohibits more restrictive day and visit
