45 CFR 146.136 - Parity in mental health and substance use disorder benefits

Cite as45 CFR 146.136
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29 practice notes
  • Securing Updated and Necessary Statutory Evaluations Timely
    • United States
    • Centers For Medicare And Medicaid Services,Public Health Service,The Inspector General Office
    • Invalid date
    ...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......
  • Regulatory Agenda Semiannual Regulatory Agenda, The Regulatory Plan
    • United States
    • Federal Register December 07, 2009
    • December 7, 2009
    ...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......
  • Smith v. U.S. Office of Pers. Mgmt., Civil Action No. 2:13–cv–5235.
    • United States
    • United States District Courts. 3th Circuit. United States District Court (Eastern District of Pennsylvania)
    • February 26, 2014
    ...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......
  • A.F. v. Providence Health Plan, Case No. 3:13–cv–00776–SI.
    • United States
    • United States District Courts. 9th Circuit. United States District Court (Oregon)
    • August 8, 2014
    ...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
  • Smith v. U.S. Office of Pers. Mgmt., Civil Action No. 2:13–cv–5235.
    • United States
    • United States District Courts. 3th Circuit. United States District Court (Eastern District of Pennsylvania)
    • February 26, 2014
    ...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......
  • A.F. v. Providence Health Plan, Case No. 3:13–cv–00776–SI.
    • United States
    • United States District Courts. 9th Circuit. United States District Court (Oregon)
    • August 8, 2014
    ...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......
  • A.F. ex rel. Legaard v. Providence Health Plan, Case No. 3:13–cv–00776–SI.
    • United States
    • United States District Courts. 9th Circuit. United States District Court (Oregon)
    • August 8, 2014
    ...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......
  • Smith v. Golden Rule Ins. Co., No. 1:20-cv-02066-JMS-TAB
    • United States
    • United States District Courts. 7th Circuit. United States District Court (Southern District of Indiana)
    • March 11, 2021
    ...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
  • Health Care Update - December 2014 #4
    • United States
    • JD Supra United States
    • December 19, 2014
    ...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......
  • ERISA Newsletter - Fourth Quarter 2017
    • United States
    • Mondaq United States
    • January 5, 2018
    ...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......
  • ERISA Newsletter - Fourth Quarter 2017
    • United States
    • JD Supra United States
    • January 9, 2018
    ...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......
  • Under New Rules, Plans Offering Mental Health And Substance Use Disorder Benefits Must Ensure Parity In Member Costs And Access To Care
    • United States
    • Mondaq United States
    • February 10, 2010
    ...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......

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