45 CFR 146.136 - Parity in mental health and substance use disorder benefits
| Cite as | 45 CFR 146.136 |
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29 practice notes
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Securing Updated and Necessary Statutory Evaluations Timely
...harm seniors, and retroactive liability for Part B premiums when a beneficiary loses eligibility for a buy-in plan. Provisions found at 45 CFR 146.136 that apply the federal law requiring parity between private health insurance coverage for physical ailments and for mental illness and subst......
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Regulatory Agenda Semiannual Regulatory Agenda, The Regulatory Plan
...Unfunded Mandates: Undetermined Legal Authority: Mental Health Parity and Addication Equity Act of 2008 (P.L.110-343) CFR Citation: 45 CFR 146.136 Page Legal Deadline: Final, Statutory, October 3, 2009, Interim final regulation. Abstract: This rule implements statutory changes to the Public......
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Smith v. U.S. Office of Pers. Mgmt., Civil Action No. 2:13–cv–5235.
...out-of-network; (3) outpatient, in-network; (4) outpatient, out-of-network; (5) emergency care; and (6) prescription drugs. 45 C.F.R. § 146.136(c)(2)(ii)(A)(1)-(6) (2013). The regulations provide that “mental health or substance use disorder benefits must be provided in every classification......
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A.F. v. Providence Health Plan, Case No. 3:13–cv–00776–SI.
...of all benefits for a particular condition or disorder, however, is not a treatment limitation for purposes of this definition.45 C.F.R. § 146.136(a); 29 C.F.R. § 2590.712(a). Included in the regulations is an illustrative list of nonquantitative treatment limitations which include, of part......
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11 cases
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Smith v. U.S. Office of Pers. Mgmt., Civil Action No. 2:13–cv–5235.
...out-of-network; (3) outpatient, in-network; (4) outpatient, out-of-network; (5) emergency care; and (6) prescription drugs. 45 C.F.R. § 146.136(c)(2)(ii)(A)(1)-(6) (2013). The regulations provide that “mental health or substance use disorder benefits must be provided in every classification......
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A.F. v. Providence Health Plan, Case No. 3:13–cv–00776–SI.
...of all benefits for a particular condition or disorder, however, is not a treatment limitation for purposes of this definition.45 C.F.R. § 146.136(a); 29 C.F.R. § 2590.712(a). Included in the regulations is an illustrative list of nonquantitative treatment limitations which include, of part......
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A.F. ex rel. Legaard v. Providence Health Plan, Case No. 3:13–cv–00776–SI.
...of all benefits for a particular condition or disorder, however, is not a treatment limitation for purposes of this definition.45 C.F.R. § 146.136(a) ; 29 C.F.R. § 2590.712(a). Included in the regulations is an illustrative list of nonquantitative treatment limitations which include, of par......
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Smith v. Golden Rule Ins. Co., No. 1:20-cv-02066-JMS-TAB
...treatment limitations, which otherwise limit the scope or duration of benefits for treatment under a plan or coverage." 45 C.F.R. § 146.136(a). Nonquantitative treatment limitations include "[m]edical management standards limiting or excluding benefits based on medical necessity or medical ......
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4 firm's commentaries
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Health Care Update - December 2014 #4
...Use Disorder Benefits in New York’s Health Insurance Market” (hereinafter, “Ins. Circular Letter No. 5”) (June 4, 2014). 15See, e.g., 45 C.F.R. § 146.136(d). In issuing final regulations, the federal government expressed an interest in “transparency” regarding application of nonquantitative......
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ERISA Newsletter - Fourth Quarter 2017
...and after July 1, 2014, and provide guidance on how to evaluate parity. See 29 C.F.R. § 2590.712 (DOL); 26 C.F.R. § 54.9812-1 (IRS); 45 C.F.R. § 146.136 (HHS). Highlights from the regulations include the The regulations state that a type of financial requirement or treatment limitation is c......
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ERISA Newsletter - Fourth Quarter 2017
...and after July 1, 2014, and provide guidance on how to evaluate parity. See 29 C.F.R. § 2590.712 (DOL); 26 C.F.R. § 54.9812-1 (IRS); 45 C.F.R. § 146.136 (HHS). Highlights from the regulations include the The regulations state that a type of financial requirement or treatment limitation is c......
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Under New Rules, Plans Offering Mental Health And Substance Use Disorder Benefits Must Ensure Parity In Member Costs And Access To Care
...2% as a result of application of the parity requirements. Footnotes See 75 Fed. Reg. 5410 (Feb. 2, 2010) (interim final rule). See 45 C.F.R. 146.136; 26 C.F.R. 54.9812-1T; 29 C.F.R. The content of this article is intended to provide a general guide to the subject matter. Specialist advice s......