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DOL, State Regulators Step Up Enforcement Around Mental Health Parity

DOL, State Regulators Step Up Enforcement Around Mental Health Parity

The U.S. Department of Labor (DOL) and state insurance regulators are stepping up enforcement actions relating to the Mental Health Parity and Addiction Equity Act, which prevents group health plans that provide mental health or substance abuse benefits from imposing stricter limits on those benefits than on medical/surgical benefits. The recent actions have focused on what the law, which took effect in 2008, terms non-quantitative treatment limitations (NQTLs), as opposed to quantitative limits such as paying for the same number of visits whether for mental or physical health treatment.The Consolidated Appropriations Act, 2021, also amended the Mental Health Parity and Addiction Equity Act to require group health plans and issuers to complete an analysis that explains whether the factors used to justify NQTLs for mental health coverage differ from limits imposed for medical and surgical benefits. The analysis must be provided to the DOL on the agency’s request.Among recent NQTL actions, in August the DOL announced a $15.6 million settlement in a case involving United Healthcare and its affiliates. The insurers, served with separate enforcement lawsuits by the DOL and the New York Attorney General, were charged with reducing reimbursements for certain out-of-network mental health treatments depending on the type of license held by the service provider, but not doing so for those providing medical services.The settlement included $13.6 million to affected participants and beneficiaries and $2.08 million in penalties.”Plans and insurance companies cannot place special hurdles in the paths of workers and their families when they seek mental health and substance use disorder benefits,” said Acting Assistant Secretary for Employee Benefits Security Ali Khawar. “The law requires parity between these benefits and medical benefits. We are committed to vigorously enforcing the law’s requirement and making sure workers in need of help are treated fairly.”The DOL created a self-compliance tool that plans can use to meet the law’s requirements, Khawar noted.The stepped-up enforcement actions “highlight the continued scrutiny by regulators and law enforcement on issues relating to mental health parity” according to a Sept. 14 post by Los Angeles and San Francisco-based attorneys at law firm Manatt. While the recent actions have been brought against insurance companies, “it is possible that regulators and law enforcement may target other payers that engage in similar practices” such as employers that sponsor mental health benefits. These payers “should carefully examine their practices relating to … out-of-network reimbursement for compliance with parity requirements,” the firm advised.Bloomberg Law similarly reported on Sept. 22 that “health insurance companies are now in the crosshairs of the Department of Labor’s aggressive enforcement of mental health parity, but it’s unlikely to mean employers will escape scrutiny.”New Penalties ProposedThe Biden administration also “has made mental health parity enforcement a high priority, going so far as to ask Congress for additional authority to fine violators, including employers,” Bloomberg reported. In the Democrats’ 2022 budget reconciliation measure, for instance, the House Education and Labor Committee “included a provision to allow the Labor Department to impose civil monetary penalties on plan sponsors, insurers, and …

5 Common Mental Health Challenges in the Workplace

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5 Common Mental Health Challenges in the Workplace

​You can’t see mental health challenges, but they are happening all around you.Speaking during a session at the recent SHRM Annual Conference & Expo 2021, Andrea Sides Herron, SHRM-CP, told the plight of her sister, who has struggled with mental health issues for nearly her entire life. Then COVID-19 made them worse. Herron’s sister initially hid how she was feeling from friends and family, but eventually the warning signs became clearly visible and she asked for help.Mental health issues are afflicting people in your office, too, Herron said. Pre-pandemic, 1 in 5 people in the U.S. had some form of mental disorder; the numbers have skyrocketed since then. Identifying Employees Who Are Experiencing Mental Health Challenges”Many of you are being squished by mental illness,” Herron said. “You have more than you can handle.”One way HR teams and supervisors can identify staff members experiencing mental health challenges, she said, is by paying attention to each person’s base lines. What is the person’s typical behavior? Learning this becomes more difficult with remote workers, she said, but there are signs that should cause concern.”Have you noticed that a person’s appearance has shifted?” she asked. “Are they choosing not to have their camera on during videoconference meetings when they usually did? Is there evidence that they’re drinking too much or [have] picked up smoking again? Maybe they’ve told you about the 12 Amazon deliveries that show up at their house each day. These are signs.”Herron, a seasoned HR executive, author and host of the HR Scoop podcast, advised HR and managers to be careful when reacting or responding to an employee’s changed behavior. “Do not add to the shame that can come with mental health’s stigma,” she said. Addressing Struggling EmployeesHerron described five fictional employees, explored some of their behaviors and suggested ways of dealing with those behaviors. Masa: He’s been an employee at the company for three years. He’s been a solid performer, but his manager has noticed changes in his behavior and there are rumors that he’s getting a divorce.Check in with him. Managers should keep an open-door policy and let employees know they are there for support, Herron said. “Employers should never make that first one-on-one meeting … because an employee did something wrong,” she said. “Try to meet earlier on with employees under friendly terms to help to establish a better relationship.” Carlyn: She’s been working at the company for two years. She’s a high-performer, and she has asked for an off-cycle raise. You sense that she’s under financial strain.It turns out her partner was fired and her household is lacking income. She’s become uncharacteristically angry at her co-workers.”We know there is a strong link between financial stress and mental health,” Herron said.Herron suggested that the employer might:Offer her a promotion with more responsibilities since she is a high-performer, if it makes business sense.Think about whether the company is doing enough to offer resources that support financial wellness.Consider offering tuition reimbursement or student loan payoffs or other benefits in addition to a traditional 401(k).Employees can be high-performers and have mental …

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