Non-Federal governmental plans are regulated by HHS.
However, the Affordable Care Act builds on MHPAEA and requires coverage of mental health and substance use disorder services as one of ten EHB categories in non-grandfathered individual and small group plans.
Key changes made by MHPAEA, which is generally effective for plan years beginning after October 3, 2009, include the following: Note, these exceptions do not apply to those non-grandfathered plans in the individual and small group markets that are required by Affordable Care Act regulations to provide EHB that comply with the requirements of the MHPAEA regulations.
Although the law requires a general equivalence in the way MH/SUD and medical/surgical benefits are treated with respect to annual and lifetime dollar limits, financial requirements and treatment limitations, MHPAEA does NOT require large group health plans or health insurance issuers to cover MH/SUD benefits.
The law's requirements apply only to large group health plans and health insurance issuers that choose to include MH/SUD benefits in their benefit packages.
The provisions of the regulation include the following: Medicare, Medicaid, and the Children's Health Insurance Program (CHIP) are not group health plans or issuers of health insurance.