Governor Wolf Announces Guidelines for Consumers and Industry on Parity in Mental Health and Substance Use Disorder Coverage

October 27, 2016

Harrisburg, PA – Governor Tom Wolf today announced that the Pennsylvania Insurance Department has issued a notice outlining how health insurance companies are expected to apply parity laws for mental health and substance use disorder coverage. This notice was announced alongside a consumer guide to mental health and substance use disorder treatment designed to help Pennsylvanians understand their rights and the benefits to which they are entitled. The guide details what is required to be covered by different types of insurance and where help can be found, if necessary. The full guide is available at PID’s website here.

“This guidance will help ensure that all parties – consumers and insurance companies – understand how the federal and state laws relating to mental health and substance use disorder treatments interact so they may be properly implemented,” said Governor Tom Wolf. “Ensuring that Pennsylvanians have access to the mental health and substance use care that they need is a priority for my administration, and I urge all insurance companies subject to these regulations to take implementation very seriously.”

The Insurance Department drafted the notice as a part of its ongoing comprehensive strategy to ensure the parity law is correctly implemented in Pennsylvania and in response to concerns surrounding the implementation and enforcement of existing laws governing mental health parity and substance use disorder coverage. Standards for applying parity laws outlined in the notice will continue to be enforced going forward.

“Accessing the right kind of treatment for mental health and substance use disorders can be critical for many Pennsylvanians,” said Insurance Commissioner Teresa Miller. “My department is committed to ensuring that Pennsylvanians have access to the coverage requirements that they are guaranteed under state and federal laws, and we are taking enforcement of these requirements very seriously.”

The notice clarifies requirements for mental health and substance used disorder coverage under both state and federal law. Commissioner Miller urged consumers to contact the department’s Bureau of Consumer Services if they have any questions or if they think their plan is not in compliance with parity or other requirements for mental health and substance use disorder coverage.

“Hearing from consumers who utilize these benefits can be an invaluable resource in enforcing parity requirements,” said Commissioner Miller. “Not only can our department potentially help resolve your case, you may also help us find an area where stronger enforcement is necessary.”

For more information or to file a complaint or ask a question, visit www.insurance.pa.gov or call 1-877-881-6388.

To view the department notice, visit www.pabulletin.com on Saturday, October 29th.

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