A group representing large employers is suing to block the implementation of a rule that would more strictly enforce requirements for insurers to cover mental health care.
The ERISA Industry Committee filed a lawsuit in federal court in Washington, D.C., Jan. 17. Attorneys for the group argue the regulation exceeds the authority of HHS and the departments of Labor and Treasury.
Many of the new rules took effect Jan. 1. The committee argued this was not enough time for employers and insurers to make sense of the new regulations.
In a Jan. 17 statement, Tom Christina, executive director of the committee's legal center said its member employees offer mental health and substance use benefits to employees on par with the health benefits they offer.
"The new regulations issued by the Biden administration exceed the Tri-Departments’ statutory authority under the laws that Congress passed, and threaten the ability of employers to offer high-quality, affordable coverage for the mental health and substance use disorder needs of employees and their families," Mr. Christina said.
The new rules, finalized in September, are meant to strengthen enforcement of the 2008 Mental Health Parity and Addiction Equity Act. The rules bar insurers from implementing stricter prior authorizations for mental health services than for other medical care.
Health plans will also be required to study their mental health networks, payment rates and prior authorization policies to ensure they are not more restrictive than for medical care.
In a complaint, attorneys for the committee argued that the mental health parity act only requires parity in plan terms applied to medical and mental health benefits, not parity in access between mental health and other medical care.
Insurer groups have also opposed the rule. In October 2023, the Blue Cross Blue Shield Association said the rules could lead to an increase in non-clincally recommended care.
In a Jan. 17 statement, Debbie Witchey, president and CEO of the Association for Behavioral Health and Wellness, said though the association was not involved in the committee's lawsuit, the challenge "demonstrates concerns with the workability" of the rule.
The ABHW represents several large insurers on behavioral health issues, including Aetna, Elevance Health and Centene.
"ABHW strongly supports behavioral health parity and was a leader in the passage of [the mental health parity act] in 2008," Ms. Witchey said. "However, the final rule imposes vague guidelines and extensive new requirements that overlook critical factors like the quality of care. This rule emphasizes any kind of access to care, even if it is not evidence-based or the appropriate level of care needed."