The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was enacted on October 3, 2008 as sections 511 and 512 of the Tax Extenders and Alternative Minimum Tax Relief Act of 2008 (Division C of Public Law 110-343). MHPAEA amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act (PHS Act), and the Internal Revenue Code of 1986 (Code). In 1996, Congress enacted the Mental Health Parity Act of 1996, which required parity in aggregate lifetime and annual dollar limits for mental health benefits and medical and surgical benefits. Those mental health parity provisions were codified in section 712 of ERISA, section 2705 of the PHS Act, and section 9812 of the Code. The changes made by MHPAEA are codified in these same sections and consist of new requirements as well as amendments to several of the existing mental health parity provisions applicable to group health plans and health insurance coverage offered in connection with a group health plan. MHPAEA and the interim final regulations do not apply to small employers who have between two and 50 employees. The changes made by MHPAEA are generally effective for plan years beginning after October 3, 2009.
MHPAEA and the final regulations (29 CFR 2590.712(d)) require plan administrators to disclose the criteria for medical necessity determinations with respect to mental health and substance use disorder benefits. These third-party disclosures are information collection requests for purposes of the Paperwork Reduction Act.
US Code:
26 USC 9812
Name of Law: Internal Revenue Code of 1986
US Code:
29 USC 1185a
Name of Law: Employee Retirement Income Security Act of 1974
US Code:
42 USC 300gg-5
Name of Law: Public Health Service Act
PL: Pub.L. 110 - 343 512 Name of Law: The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008
There have been no program changes for this submission. The increase in the number of responses from 629,000 to 955,207 is attributable to an increase in the number of non-grandfathered small group health plans in existence. The decrease in the hour burden from 6,000 hours to 5,544 hours is attributable to a slight decrease in the number of large group health plans, who are the only respondents incurring in-house hour burden. The increase in the cost burden from $1,494,000 to $3,424,759 is primarily attributable to two factors: 1) the increase in the number of responses; and 2) an increase in labor and postage costs. The increase in labor costs results from a change in EBSAâs methodology for incorporating overhead into labor costs since the last submission, as well as wage inflation over the last three years.
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
1210-0138 Supporting Statement 3-2-17.docx
Notice of Medical Necessity Criteria under the Mental Health Parity and Addiction Equity Act of 2008