Strategic Services Group (SSG)’s Post

Check out our newest post on the new parity Final Rule.

The U.S. Departments of Labor, Health and Human Services, and Treasury have issued a Final Rule aimed at strengthening access to mental health and substance use disorder benefits under the MHPAEA. This rule impacts compliance requirements for group health plans and insurers, with key deadlines beginning in 2025. 🔗 Read more in Taylor Crossley, Natasha Sumner, Kimberly Chew, and Noreen Vergara's latest blog: https://lnkd.in/gUNqKB-S #HealthLaw #Compliance #EmployeeBenefits

In a revolutionary approach to #behavioralhealth integration, the Centers for Medicare and Medicaid announced today, the Innovation in Behavioral Health Model (IBH). The IBH model's goal is to improve the overall quality of care and outcomes for adults with mental health conditions and/or substance use disorder by connecting them with the physical, behavioral, and social supports needed to manage their care. Read the entire press release below: https://lnkd.in/gDz5vff9

White House finalizes rules for mental health parity: 7 things to know The Biden administration is finalizing rules to strengthen mental health and substance use disorder coverage under the Mental Health Parity and Addiction Equity Act (MHPAEA). The new regulations, issued by the Departments of Labor, HHS, and the Treasury, aim to close loopholes and ensure insurers don't impose stricter limits on mental health benefits compared to medical care. Key highlights: 🔷 Expands MHPAEA compliance to more health plans, protecting an additional 120,000 consumers. 🔷 Prohibits restrictive prior authorization or narrow networks for mental health services. 🔷 Requires insurers to collect data and address gaps in access to mental health care. 🔷 Takes effect for most plans in 2025, with full compliance by 2026. The changes have sparked debate, with insurers voicing concerns about administrative burdens while healthcare groups like AHA support the need for clearer compliance rules. https://lnkd.in/etDzFcFp Blake Zenger, Pointe Consulting LLC, Fiduciary In A Box #healthbenefits, #benefits, #benefitsadministration, #mentalhealth

North Carolina currently ranks 39th in the country for access to mental health treatment. According to an article by FRONTLINE PBS: “On average, North Carolinians who go to an emergency room in crisis, wait 16 days for a state psychiatric hospital bed.” This mental health crisis has been festering since the early 1960s, when President JFK began the “deinstitutionalization” process. “Then in 1999, the Supreme Court ruled that those living with mental illness are entitled to live outside hospitals when they can. By then, many states had been moving long-term patients into the community, said Duke University’s Dr. Marvin S. Swartz.” “It wasn’t that North Carolina was unique,” Swartz said, “it just was we got to the game later and overshot, overestimating our ability to create the community services we needed to create this ecosystem where people weren’t totally dependent on beds.” And access to beds has not gone up in proportion to an increased population in NC. In fact, it’s gone down. “There were 1,572 beds in 2000. Today, there are 894 — and only two-thirds of those are operating due to staff shortages, the state health department said.” The North Carolina legislature is finally making efforts to remediate these issues. “On March 23rd, the North Carolina legislature voted to expand Medicaid. The changes won’t go into effect, however, until the state enacts a budget. Legislative leaders hope that will happen before the end of June.” “When this law takes effect, it will make health care accessible to more than 600,000 North Carolinians,” Gov. Roy Cooper said, “many of them in the grips of mental illness or substance abuse who need health care, not handcuffs.” Read more and follow the story PBS North Carolina / FRONTLINE PBS here: https://lnkd.in/ez4HYj-B

Grateful to be in this field at a time of transformative change. The Biden administration’s new rules ensure that mental health and addiction treatment are covered on par with physical health care, eliminating unfair barriers and improving access. Starting in 2025, health plans will be required to analyze and fix any disparities between how they treat behavioral and physical health. These changes are key to creating a more equitable and supportive healthcare system for all. #MentalHealthMatters #ParityInCare #HealthcareReform #EquitableCare

Looking for a way to empower your patients through individually tailored guidance, coordination, and self-management? Thrive has crafted a tailored Measurement-Based Care journey for patients undergoing mental health treatment, enhancing empowerment, and fostering improved outcomes. Centering patients within their care journeys, our measurement-based care solution helps provide personalized care and collaboration. By meticulously tracking and analyzing patient data over time, we can help improve mental health outcomes for patients, healthcare providers, and families. Thrive Health is proud to be recognized as a Vendor of Record (VOR) by Ontario Health | Santé Ontario to assist as a Measurement-Based Care (MBC) solution for mental health and addiction treatment providers. Interested in implementing this journey in your organization? Email info@thrive.health to book a demo and learn more! #measurementbasedcare #digitalinnovation #healthcaretechnology

𝗧𝗼𝗼𝗵𝗲𝗿-𝗙𝗲𝗿𝗿𝗮𝗿𝗶𝘀 𝗟𝗲𝗴𝗮𝗹 𝗔𝗹𝗲𝗿𝘁: Are You Prepared to Comply with the New Mental Health Parity Final Rule in 2025? 𝗧𝗵𝗶𝘀 𝗮𝗹𝗲𝗿𝘁 𝗶𝘀 𝗼𝗳 𝗶𝗻𝘁𝗲𝗿𝗲𝘀𝘁 𝘁𝗼 𝗺𝗼𝘀𝘁 𝗲𝗺𝗽𝗹𝗼𝘆𝗲𝗿𝘀 𝘄𝗵𝗼 𝘀𝗽𝗼𝗻𝘀𝗼𝗿 𝗴𝗿𝗼𝘂𝗽 𝗺𝗲𝗱𝗶𝗰𝗮𝗹 𝗽𝗹𝗮𝗻𝘀. Below, you will find a link to our legal alert, which provides tips for sponsors of group health plans to consider in anticipation of the upcoming enforcement date for the recently issued MHPAEA Final Rule. Most of the new requirements are enforceable for plan years beginning on or after January 1, 2025, with the remainder becoming enforceable for plan years beginning on or after January 1, 2026. https://lnkd.in/gA4zJypC #HR #TFinsurance #Employeebenefits

#ICYMI - For the past few years, we've been visiting mental health inpatient units in Derbyshire, to gather feedback on what's working well and what could be changed to help patients in their recovery. Take a look at our report to explore patient experiences, and the positive changes as a result of YOUR feedback! 📝💡 https://bit.ly/3IVfBg7 #MentalHealthCare #PatientExperience #Report

Health plans and issuers, are you prepared for the impact of new mental health parity rules on nonquantitative treatment limitations (NQTLs)? Find out more in our comprehensive analysis here: https://bit.ly/3TU03PJ On September 23, 2024, the U.S. Departments of Labor, the Treasury, and Health and Human Services issued final rules under the Mental Health Parity and Addiction Equity Act. These rules mandate that health plans and issuers conduct comparative analyses to ensure that NQTLs—non-financial restrictions on health care benefits that can limit the duration or scope of treatment—are applied to mental health and substance use disorder benefits in a manner that is no more stringent than those applied to medical and surgical benefits. In this Insight, attorneys Kevin Malone, Jackie Selby, David Shillcutt, and Christine Burke Worthen explore how these final rules affect NQTLs related to provider network composition and reimbursement rates. #MentalHealthParity #BehavioralHealth #ManagedCare