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. In response to provisions
of the Cures Act requires the Departments of Labor (DOL), Health
and Human Services, and the Treasury (collectively, the
Departments), are providing a model form that participants,
enrollees, or their authorized representatives could use to request
information from their health plan or issuer regarding NQTLs that
may affect their MH/SUD benefits, or to obtain documentation after
an adverse benefit determination involving MH/SUD benefits to
support an appeal.
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
The increase in burden of
20,751 hours is related to the optional disclosure request form.
The form is due to the 21st Century Cures Act Related to MHPAEA
Disclosures, which requires the Department to obtain feedback from
the public on how the disclosure request process for documents
containing information that health plans and health insurance
issuers are required under Federal or State law to disclose to
participants, beneficiaries, contracting providers or authorized
representatives to ensure compliance with existing mental health
parity and addiction equity requirements can be improved while
continuing to ensure consumers’ rights to access all information
required by Federal or State law to be disclosed. Other estimates
were updated to reflect current data.
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.
Table of Comments for MHPAEA Model Template 09-03-2019.xlsx
FAQ 39 Compare - Track Changes - 9-3-19.docx
aca-part-39-proposed.pdf
Mental Health and Substance Abuse Disorder Parity Disclosure Request, Model Notice