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What Is All the Fuss About Mental Health Parity?
The first federal law attempting to get health insurance coverage parity between mental health/substance use disorder (MH/SUD) benefits and medical/surgical (M/S) benefits was enacted almost 30 years ago. Since then, the
law now known as the Mental Health Parity and Addiction Equity Act has been updated several times, most recently via the Consolidated Appropriations Act of 2021. MHPAEA enforcement has always been a challenge, but the most recent legal changes make what plans need to do to stay compliant clearer, and they also have given the federal Department of Labor more parity enforcement resources than ever before.

Under the MHPAEA, parity analyses must be performed separately on quantitative treatment limitations (QTLs) and non-quantitative treatment limitations (NQTLs). What are QTLs and NQTLs? Both analyses seek to ensure that more restrictive limitations are not being placed on mental health/substance use disorder (MH/SUD) benefits than they are on medical/surgical (M/S) benefits. Quantitative treatment limitation (QTLs) calculations include items like copayments and annual visit limits and are based on real claims experience. Non-quantitative treatment limitation (NQTLs) analyses are performed on more abstract limitations, such as prior authorization requirements or formulary design. If that sounded like gibberish and you got lost two sentences ago… You’re not alone. Thirty years of lawmaking is a lot to wrap your head around, but we are here to help!

This webinar will take a deep dive into the world of Mental Health Parity compliance and explain what an NQTL analysis is, what a QTL calculation is, who is subject to these provisions, how reporting works, and many more nuanced pieces of this Mental Health Parity puzzle.

Mar 30, 2023 01:00 PM in Eastern Time (US and Canada)

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Speakers

Jennifer Berman, Esq.
Chief Executive Officer @MZQ Consulting
Jennifer S. Berman is a leading Employee Benefits attorney and compliance consultant whose insight and experience has helped dozens of employers, large and small, navigate the complex and ever-changing world of employee benefit plan rules and statutes. She is CEO and co-founder of MZQ Consulting, LLC, a benefits compliance and ACA reporting firm that also specializes in ERISA, COBRA, HIPAA, IRS Code, the ACA, and more. An expert on healthcare reform developments and legislation, Berman is a sought-after speaker and commentator on a wide variety of healthcare reform and employee benefits issues, especially ones related to the Affordable Care Act and the coronavirus pandemic. As a wife and mother living with Ehlers-Danlos Syndrome, a rare musculoskeletal disease that causes her to use a wheelchair some of the time, she brings a unique perspective and advocacy to her work on behalf of others managing complicated medical needs in the healthcare marketplace.
Jessica Waltman
Vice President, Compliance @MZQ Consulting
Jessica Waltman leads our compliance consulting and services team, providing subject matter expertise and spearheading a variety of business initiatives. She has more than twenty years of experience in health insurance markets and is considered an industry-wide expert on all of the complex laws and regulations essential to maintaining a compliant employee benefits arrangement. In 2015, Jessica launched Forward Health Consulting where she’s advised dozens of brokers, employers, associations, and benefit technology firms about health reform and business strategy issues. Prior to that, Jessica served the National Association of Health Underwriters (NAHU) for sixteen years, including eight years as their Senior Vice President of Government Affairs. Jessica earned her degree in political science and non-fiction writing magna cum laude from Drew University. She serves her industry as a member of the Board of Trustees of the National Insurance Producers Registry.