The regulatory agencies responsible for enforcing mental health parity have established a temporary safe harbor that will allow plans that have copayments for office visits and coinsurance for other outpatient services to comply more easily with the regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA).
Until the issuance of final regulations, the regulatory agencies have determined that they will establish an enforcement safe harbor under which the agencies will not take enforcement action against a plan that divides its benefits furnished on an outpatient basis into two sub-classifications for purposes of applying the financial requirement under MHPAEA: (1) office visits, and (2) all other outpatient items and services. The plan may not impose any financial requirement or treatment limitation on mental health or substance use disorder benefits in any sub-classification that is more restrictive than the predominant financial requirement or treatment limitation that applies to substantially all medical/surgical benefits in the sub-classification. When applying the financial requirement and treatment limitation rules under MHPAEA, sub-classifications are only permitted for tiered prescription drug plans and under this policy for outpatient services and office visits.
