BREAKING NEW GROUND: Proposed Regulations to Strengthen Mental Health and Substance Use Disorder Parity Compliance Programs

July 8, 2020

For the last several years, internal teams representing various areas of state government have been meeting together to explore ways the state can enhance its’ compliance with federal and state parity laws.  As you will recall, about three years ago NYS received $1.8 million from the federal government to take a close look at its’ parity enforcement.  The state contracted with Miliman to review its’ current compliance and enforcement efforts, to make recommendations for improvement, and to train staff to enhance surveillance and monitoring activities. The NYS Council also worked alongside other parity advocates to secure additional funding in last year’s state budget that added staff at both DFS and DoH for purposes of enhancing parity surveillance and monitoring activities.  Over the past 6 months the state has also been collecting information from all health plans in the behavioral health space, requiring them to submit their Medical Necessity criteria used to make care determinations.  The state is currently in discussion with those plans where there may be ‘room for improvement’.  

OMH and OASAS have been working with their state partners to formulate proposed regulations that will require health plans to do a better job of self monitoring their compliance with federal and state parity laws, and reporting to the state on the same.   Today the New York State Register includes newly proposed regulations designed to enhance and improve health plan compliance with these important laws (ATTACHED).   This is a big step forward.  We congratulate Governor Cuomo, his staff and all of the state agency representatives who are working on this important initiative.  There is sure to be significant push back from health plans.  The NYS Council will have the backs of our state partners as they continue to move forward to improve parity compliance here in NYS.  We will submit comments based on the proposed regulations.  Ee Will need your help to support the actions being taken by our colleagues on behalf of care recipients and the providers who serve them. They deserve nothing less. 

Please let us know what you think about the attached regulations.