News & Analysis as of

Substance Abuse Health Insurance

Nelson Mullins Riley & Scarborough LLP

Biden Administration Finalizes Stronger Rules On Mental Health Coverage Parity

Summary: Under a final rule released by the Biden administration on Sept. 9, 2024, health insurers will be required to cover mental health care and addiction services on par with other medical conditions. This rule is part of...more

Troutman Pepper

White House Finalizes New Mental Health Parity Rule

Troutman Pepper on

The White House has finalized the new Mental Health Parity rule, which focuses on increasing access to mental health/substance use disorder treatment through nonquantitative treatment limitations (NQTL) data and reporting,...more

Epstein Becker & Green

Three Things That Employer Health Plan Sponsors Should Do When the New MHPAEA Rules Are Published

Epstein Becker & Green on

The U.S. Departments of Labor (DOL), Health and Human Services, and the Treasury (collectively, the “Tri-Departments”) published a Notice of Proposed Rulemaking (NPRM) on August 3, 2023, to propose new regulations for the...more

Quarles & Brady LLP

The Winding Road to a Recovery Home

Quarles & Brady LLP on

Without stable housing, recovery for substance use disorder is nearly impossible. “Recovery housing” (or more commonly referred to as a “sober home” or a “sober living residence”) is a broad term that describes a safe,...more

Manatt, Phelps & Phillips, LLP

What States Should Know Before Applying to CMMI’s Innovation in Behavioral Health NOFO

Summary On June 17, 2024, the Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare and Medicaid Services (CMS) released a notice of funding opportunity (NOFO) for Innovation in Behavioral Health...more

Ogletree, Deakins, Nash, Smoak & Stewart,...

HIPAA Privacy Rules Get a Post-Dobbs Refresh on Reproductive Health Care

Employers will soon see the national debate about abortion popping up in some unexpected places: the HIPAA privacy policies and procedures and notices of privacy practices they use for their health benefit plans....more

Ogletree, Deakins, Nash, Smoak & Stewart,...

The Ninth Circuit Speaks Out on Mental Health Parity

On April 11, 2024, the U.S. Court of Appeals for the Ninth Circuit, in Ryan S. v. UnitedHealth Group, Inc., set a very broad pleading standard to allege a violation of the Paul Wellstone and Pete Domenici Mental Health Parity...more

Arnall Golden Gregory LLP

Appeals Court Revives AGG Class Action Against UnitedHealth Group for Federal Mental Health Parity Law Violations

The United States Court of Appeals for the Ninth Circuit ruled on April 11, 2024, that AGG’s class action lawsuit against UnitedHealth Group and its subsidiaries for the wrongful and systematic denial of mental health and...more

Arnall Golden Gregory LLP

California Federal District Court Rules That AGG Clients’ Case Against Cigna for Institutional Practice of Under-Reimbursing...

U.S. District Court Judge David O. Carter ruled in favor of AGG’s clients on March 18, 2024, in a case involving “matters of widescale public concern” and a strong “public interest in access” to some of Cigna’s most coveted...more

Husch Blackwell LLP

Mental Health Parity and Addiction Equity Act: Comprehensive Final Rule Expected in 2024

Husch Blackwell LLP on

In the United States, mental health (“MH”) and substance use disorder (“SUD”) (collectively “MH/SUD”) have continued to represent areas of intense concern. During the COVID-19 pandemic, the MH struggles of essential workers...more

Manatt, Phelps & Phillips, LLP

New CMMI Innovation Models Support Digitally Enabled Care

With the recent announcements of two new innovation models, the Centers for Medicare & Medicaid Services (CMS) is recognizing the role of digitally enabled care in improving access and outcomes. ...more

Manatt, Phelps & Phillips, LLP

CMS Approves Montana’s Reentry Services, Contingency Management, and Tenancy Supports 1115 Waiver

On February 26, 2024, Montana received Centers for Medicare and Medicaid Services (CMS) approval to provide contingency management, tenancy supports, and Reentry Initiative services under its Section 1115 Healing and Ending...more

Manatt, Phelps & Phillips, LLP

[Webinar] Mental Health Parity Update 2024: The Latest Regulatory and Litigation Trends - March 26th, 1:00 pm - 2:00 pm ET

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans and insurers to offer mental health coverage in “parity” with a plan’s medical or surgical coverage. In 2024, as the post-COVID era brings a...more

ArentFox Schiff

NYS Insurance Regulators to Health Insurers: Ensure Your Networks Are Adequate

ArentFox Schiff on

On February 21, Superintendent Adrienne A. Harris of the New York State Department of Financial Services (DFS) unveiled a proposed regulation, 11 NYCRR 38. If adopted, this regulation, would establish network adequacy...more

Epstein Becker & Green

CMS Announces New Primary and Behavioral Health Care Integration Demonstration Model

Epstein Becker & Green on

On January 18th, the Centers for Medicare & Medicaid Services (CMS) announced a new demonstration model called the Innovation in Behavioral Health (IBH) Model, which is designed to improve outcomes for adults with mental...more

Maynard Nexsen

Mental Health Benefits: 2023 Year-End Update

Maynard Nexsen on

In the August issue, we delved into the proposed regulations under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”), as amended by the Affordable Care Act. By way of...more

Manatt, Phelps & Phillips, LLP

Leveraging Medicaid to Support Children and Youth Living With Complex Behavioral Health Needs - Framework and Strategies

Executive Summary - The COVID-19 pandemic exacerbated the already-growing mental health and substance use disorder (SUD) (behavioral health) crisis gripping children and youth in the United States. It has spurred federal,...more

Manatt, Phelps & Phillips, LLP

[Webinar] Leveraging Medicaid to Support Children and Youth Living With Complex Behavioral Health Needs - November 8th, 1:00 pm -...

The COVID-19 pandemic exacerbated the serious and growing mental health and substance use disorder crisis gripping children and youth in the United States. The situation is particularly serious for young people who are stuck...more

McDermott Will & Emery

The “Meaningful Benefit” Requirement for NQTLs Under the Proposed MHPAEA Regulations

McDermott Will & Emery on

In previous posts, we reported on proposed regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA) issued by the Departments of Labor, Health and Human Services, and the Treasury (collectively, the...more

Manatt, Phelps & Phillips, LLP

Access to Care for Justice-Involved Pregnant People With a Substance Use Disorder

There is a critical need to increase access to evidence-based care for justice-involved pregnant people with a substance use disorder (SUD)—and connect them to continued coverage and care upon release—according to national...more

Manatt, Phelps & Phillips, LLP

[Webinar] Mental Health Parity Update: Key Takeaways From the Newest Regulatory Guidance and Litigation Trends - September 19th,...

The Mental Health Parity and Addiction Equity Act (MHPAEA) requires health plans to provide mental health benefits, including coverage for substance use disorders (SUDs), that are in “parity” with medical and surgical...more

King & Spalding

HHS, the Department of Labor, and the Department of the Treasury Release Proposed Rules and a Report to Congress regarding Mental...

King & Spalding on

On July 25, 2023, HHS, the Department of Labor, and the Department of the Treasury (the Departments) issued proposed rules (Proposed Rules) and other information regarding health plan and issuer compliance with mental health...more

Manatt, Phelps & Phillips, LLP

First Look at Proposed New Federal Mental Health Parity Rules

Last week, the departments of the Treasury, Labor and Health and Human Services (collectively, the Departments) published long-awaited proposed regulations intended to clarify and improve compliance with the federal mental...more

Jackson Lewis P.C.

What Employers Need to Know about the Mental Health Parity Proposed Regulations

Jackson Lewis P.C. on

On July 25, 2023, the tri-agencies of the Departments of Treasury, Labor, and Health and Human Services (the Departments) issued a compendium of guidance designed to facilitate compliance with the Nonquantitative Treatment...more

Manatt, Phelps & Phillips, LLP

[Webinar] Medicaid Coverage Opportunities for Justice-Involved Populations: CMS Guidance and States’ Approaches - July 13th, 3:00...

Individuals leaving incarceration have disproportionately higher rates of physical and behavioral health diagnoses and are at higher risk for injury and death compared with people who have not been incarcerated. Race...more

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