Mental Health and Substance Use Disorder Parity

What is Mental Health Parity?

In March of 2016 the Centers for Medicare and Medicaid Services (CMS) finalized a rule to strengthen access to mental health and substance use disorder services for people with Medicaid, Children’s Health Insurance Program (CHIP), or Alternative Benefit Plan (ABP) coverage, similar to the requirements that were already in place for private health insurance plans. In summary, the rule requires that Medicaid, CHIP, and ABP Managed Care Plans not impose more restrictive benefit limitations on mental health and substance use disorder (MH/SUD) benefits than on medical and surgical (M/S) benefits. Health plans must ensure that financial requirements (such as co-pays and deductibles) and treatment limitations that apply to MH/SUD benefits are no more restrictive than the predominant requirements or limitations applied to medical and surgical benefits.

Relevant Georgia Documents

Mental Health Parity Monitoring Databook - posted 08/03/20

Mental Health Parity CMO Questions & State Answers - posted 08/03/20

Additional Resources

• Mental Health Parity and Equity Addiction Act (MHPAEA) Fact Sheet
• Department of Health and Human Services, Mental Health and Substance Use Disorder Parity website
• Substance Abuse and Mental Health Services Administration, Know Your Rights