Pennsylvania Launches New Examinations to Ensure Insurer Compliance with Mental Health and Substance Use Disorder Parity Laws

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PENNSYLVANIA — The Pennsylvania Insurance Department (PID) is taking action to ensure insurers comply with mental health and substance use disorder parity laws. In a bid to improve compliance, Pennsylvania Acting Insurance Commissioner Michael Humphreys is launching a fresh wave of investigations. This comes after previous examinations revealed worrying levels of non-compliance among the state’s largest health insurers. As part of a market conduct exam that began in 2016, more than 60,000 Pennsylvanians received a total of $5.89 million in compensation. Commissioner Humphreys has pledged to hold insurers accountable through a new round of examinations.

“These are critical protections for consumers. Access to both mental health and substance use disorder treatment are crucial for the overall wellbeing of Pennsylvanians, and we will not rest until all insurers are covering these benefits fairly,” said Humphreys. “Under Governor Shapiro’s leadership, we will continue to hold insurers accountable through examinations as well as through our front-end policy review process. We expect substantial improvements in realizing the promise that is mental health parity.”

Throughout Mental Health Awareness Month, PID is emphasizing the significance of comprehending insurance coverage parity and ensuring proper implementation of parity requirements.

“The Insurance Department’s examinations for mental health and substance use disorder parity compliance are just one way we are working to evaluate insurers’ practices in the Commonwealth and address the need to protect these critical rights for all Pennsylvanians,” said Humphreys. “These examinations have gone a long way in finding areas for improvement in expanding access and affordability for consumers through parity compliance.”

The Department is also urging consumers and providers to contact the department if they think a health plan is not meeting parity requirements for mental health and substance use disorder coverage or if a consumer has questions about the benefits to which they are entitled.

For more information on mental health and substance use disorder parity requirements, or to file a complaint or ask a question, visit the department’s Bureau of Consumer Services at www.insurance.pa.gov/consumers or call 1-877-881-6388.

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