Mental health parity is an ethical imperative for health plans. Accreditation is an excellent way for health care leaders to ensure their organization meets parity standards. Discover who accredits health plans for mental health parity compliance and what the process entails.
What Is Mental Health Parity?
The Mental Health Parity and Addiction Equity Act (MHPAEA) protects people by requiring health plans to provide mental health and substance use disorder (MH/SUD) benefits that are no more restrictive than the plan’s medical or surgical benefits.
Parity also applies to financial requirements, including copayments and treatment limitations. Although benefits may vary across plans, parity means ensuring that the plans use similar processes for approving mental and physical health benefits.
The U.S. Department of Labor is the primary enforcer of MHPAEA for private-sector, employment-based group health plans. The Department of Health and Human Services holds immediate enforcement authority over non-federal governmental plans, like those sponsored by state and local governments.
Proper access to care and treatment is essential for over one in five U.S. adults living with a mental illness. Even among people with health insurance, issues like inadequate coverage, costs and lack of available providers persist.
Why Do Health Plans Need Accreditation for Mental Health Parity Compliance?
Accreditation provides third-party validation that your health plan is meeting the MHPAEA standards. It involves a thorough review of policies, procedures and practices to ensure insurers enjoy equal benefits. An accrediting organization can identify gaps that may impede access to mental health care, including network inadequacy, fail-first solutions and arbitrary medical necessity standards.
Many state and federal agencies may also require or incentivize companies with mental health parity accreditation. More importantly, it shows a company’s dedication to providing equitable health access. Members are more likely to trust an accredited organization, knowing their mental health needs are taken seriously.
Who Accredits Health Plans for Mental Health Parity Compliance?
URAC is the only organization that offers an accreditation program for mental health parity. It’s one of the leading nationwide accrediting organizations in the country, ensuring the highest standards of care are implemented and executed. The company champions equity and inclusion to elevate health care standards for every individual. Every client gets a committed client relations manager and accreditor to help give them personalized attention and advice.
The organization’s MH/SUD Parity Accreditation Program provides the following benefits for stakeholder groups:
- Alignment with industry standards: The criteria provide a consistent approach for companies to comply with the requirements of the federal MHPAEA. This is especially essential as regulations can shift over time. In 2024, provisions were made to prior regulations from 2013.
- A solid roadmap for health plan issuers: URAC’s accreditation program offers a roadmap to help you create true parity between medical/surgical and MH/SUD benefits, ensuring all policy owners get quality care.
- Risk mitigation: Being accredited decreases the likelihood of parity-related litigation and regulatory fines.
- Employer confidence: Many employers value health plans that comply with mental health parity. For that reason, purchasers may prioritize health plans that are URAC-accredited to show their adherence to MH/SUD parity.
- Improved outcomes: Accredited programs deliver measurable results. Mental health parity compliance ensures individuals get adequate treatment, leading to healthier members and lower health care expenditures.
Who May Apply for URAC’s MH/SUD Parity Accreditation Program?
Third-party administrators, health plans and other managed care companies with extensive responsibility for benefits related to medical, surgical, mental health and substance use disorder treatment may apply for this program.
What’s the Accreditation Process Look Like?
Here’s a step-by-step guide to health plan accreditation for mental health parity compliance:
- Application Submission
Submit your company’s scope of services and corporate governance. You must also include documentation of how your organization complies with URAC’s standards, which may include policies, procedures, program descriptions and reports.
- Deadline Implementation
URAC will establish a deadline for submission to ensure timely accreditation. You will be partnered with a client relations manager, who will provide training materials and answer your questions.
- Initial Review
Your application undergoes a desktop review by a lead reviewer. URAC’s team examines your submission, asks clarifying questions and ensures your documentation demonstrates compliance with URAC’s standards before moving on to validation review.
- Validation Review
URAC conducts an in-person or virtual review to look at additional documents, interview people in your organization or take a tour of your facility.
- Adjudication
Your application will be stripped of identifying information and sent to the accreditation committee, which comprises volunteer health care representatives from various industries. They will assess your documents, ultimately awarding one of the accreditation statuses — full, conditional or provisional — or the non-accredited statuses, which are corrective action or denial. The process takes around 30 days to complete.
Get Mental Health Parity Accreditation From URAC
As awareness around mental health continues to grow, so will the demand for health plans that champion equitable access to care. Seek accreditation from URAC to offer a plan that truly supports the overall well-being of your members.
