Enforcement of the MHPAEA (parity) through expanded state attorney general authority
The Ohio Department of Insurance (ODOI) has primary responsibility to enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) for state-regulated private insurance plans. Pursuant to a mandatory reporting requirement included in the State’s 2017 operating budget, ODOI identified the strategies it pursues to enforce MHPAEA. It (1) conducts form review for plan compliance with state and federal laws; (2) helps consumers understand their parity rights and resolve complaints against insurance companies; and (3) tracks consumer complaints and other data to determine if further investigation of carrier practices is needed through market conduct examinations (MCE). ODOI’s MHPAEA enforcement data suggest that a far greater level of consumer education and state oversight and enforcement are needed to ensure that health plans comply with federal law and state insurance mandates for the coverage of mental health and substance use disorder benefits.
Full Policy Brief: