Mental Health Parity and Addiction Equity Act (MHPAEA): A Scoping Review

Abstract

Introduction:  The Mental Health Parity and Addiction Equity Act (MHPAEA) requires group health plans and health insurance issuers provide mental health and substance use disorder financial requirements and treatment limitations that are no more restrictive than the predominant financial requirements or treatment limitations applied to substantially all medical/surgical benefits.

Methods:  Information databases (i.e., PubMed, PsycINFO, CINAHL, PBSC, Business Source Premier) were systematically searched to identify studies evaluating MPHAEA effects on employer-sponsored health plans, employers, employees, and employee dependents.

Results:  In total, n=15 studies and surveys were included.  MHPAEA effects were predominately assessed in terms of behavioral health products, contracting, and coverage, and scope of service, quantitative financial requirements/treatment limitations, non-quantitative treatment limitations, service use, out-of-pocket spending, and total spending.

Conclusion:  The distribution of products offered by health plans remained stable, and the most frequent change to services included expansion of benefits.  More restrictive quantitative and non-quantitative financial requirements and treatment limitations generally declined.  Service use and out-of-pocket spending findings were somewhat variable, although total spending generally increased modestly.  Taken together, current evidence may represent conservative findings, because interim final regulations have primarily been evaluated, and not final regulations.  Additional research may enhance ongoing Affordable Care Act (ACA) policy evaluations, while enhancing the ability of policymakers to implement efficient and effective health care practices.