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HHS/CMS

RIN: 0938-AR81

Publication ID: Fall 2013

Title: HIPAA Mental Health Parity and Addiction Equity Act of 2008 Amendments (CMS-4140-F)
Abstract: This rule implements the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), which requires parity between mental health or substance use disorder benefits and medical/surgical benefits with respect to financial requirements and treatment limitations under group health plans and health insurance coverage offered in connection with a group health plan.
Agency: Department of Health and Human Services(HHS)	Priority: Economically Significant
RIN Status: Previously published in the Unified Agenda	Agenda Stage of Rulemaking: Completed Actions
Major: Yes	Unfunded Mandates: No
CFR Citation: 45 CFR 146
Legal Authority: 42 USC 300gg to 300gg-63 42 USC 300gg-91 42 USC 300gg-92

Legal Deadline: None

Statement of Need: The rule is needed to finalize provisions under MHPAEA and ensure that the rights provided to participants, beneficiaries, and other individuals are fully realized.

Summary of the Legal Basis: MHPAEA requires group health plans and group health insurance issuers to ensure that financial requirements (e.g., copayments, deductibles) and treatment limitations (e.g., visit limits) applicable to mental health or substance use disorder benefits are no more restrictive than the predominant financial requirements or treatment limitations applied to substantially all medical/surgical benefits. Additionally, there can be no separate cost-sharing requirements or treatment limitations applicable only with respect to mental health or substance use disorder benefits. The statute does not mandate coverage for either mental health or substance use disorder benefits.

Alternatives: NONE. Rule is a statutory requirement.

Anticipated Costs and Benefits: The total estimated costs and benefits that were included in the February 2, 2010 interim final rule will be updated in this final rule.

Risks: One of Congress' primary objectives in enacting MHPAEA was to improve access to mental health and substance use disorder benefits by eliminating discrimination that existed with respect to these benefits after MHPA 1996. This rule finalizes the provisions implemented in the interim final rule and responds to public comments.

Timetable:

Action	Date	FR Cite
Final Action	11/13/2013	78 FR 68240

Regulatory Flexibility Analysis Required: No	Government Levels Affected: State
Small Entities Affected: Businesses, Governmental Jurisdictions	Federalism: Yes
Included in the Regulatory Plan: Yes
RIN Data Printed in the FR: No
Related RINs: Previously reported as 0938-AP65	Related Agencies: Joint: TREAS, DOL;
Agency Contact: James Mayhew Director, Market Rules Division Department of Health and Human Services Centers for Medicare & Medicaid Services Center for Consumer Information and Insurance Oversight, MS: AR-20-54, 7500 Security Boulevard, Baltimore, MD 21244 Phone:410 786-9244 Email: james.mayhew@cms.hhs.gov