The 2025 Mental Health Parity Act
In general, the Mental Health Parity Act (MHPA) prohibits health plans and health insurance companies from imposing greater restrictions on mental health (MH) benefits than on medical or surgical (MS) benefits. This includes financial requirements, such as copays, and treatment limitations, including visit limits or prior authorization requirements.
Hence, we can expect health plans and health insurance companies to define MH conditions consistently with the most current version of the International Classification of Diseases (ICD) or the Diagnostic and Statistical Manual of Mental Disorders (DSM).
In addition, we can expect that MH coverage will no longer be designed using information, evidence, sources, and standards that discriminate against MH conditions. Moreover, we can expect reasonable action as necessary from plans and companies if data, such as claims denials, in-network and out-of-network utilization rates, and provider reimbursement rates, that insurance companies collect show material differences in access to MH benefits as compared to MS benefits.
Changes to improve access to MH providers may include:
strengthening efforts to recruit a broad range of available providers,
expanding the availability of telehealth arrangements,
providing outreach and assistance to help individuals find available in-network providers, and
ensuring that provider directories are accurate and reliable.
We can expect plans and companies to cover meaningful benefits (including a core treatment) for each covered MH condition if benefits are covered for medical conditions or surgical procedures in the same benefit classification (e.g., inpatient, in-network; outpatient, in-network; emergency).
(This verbiage came entirely from DoL’s website). See a history of the MHPA.
