Mental Health Coverage Test Slammed as Undermining Cost Controls

A new test embedded in Biden administration mental health parity rule proposals has caused trepidation within the health-care industry that common techniques used to control costs for employee health plans could soon be eliminated.

The near-finalized proposal’s “substantially all” test says that under the Mental Health Parity and Addiction Equity Act, “non-quantitative treatment limitations” must be applied at similar levels to medical and surgical benefits if they are applied to mental health benefits.

The Departments of Health and Human Services, Labor, and the Treasury have said in the proposal that NQTLs can include requirements such as prior authorization for care, ...