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Governor Whitmer, DIFS Announce Support for Expanded Insurance Coverage of Mental Health Services
October 24, 2023
FOR IMMEDIATE RELEASE: October 24, 2023
(LANSING, MICH) The Michigan Department of Insurance and Financial Services has submitted comments to the U.S. Department of Labor’s Employee Benefits Security Administration expressing support for newly proposed federal rules that will help improve access to timely high-quality mental health and substance use disorder treatments.
"Every Michiganders deserves access to quality affordable health care, which includes coverage for mental health and substance use disorders,” said Governor Gretchen Whitmer. “These proposed rules from the Biden-Harris Administration will help more Michiganders get the care they need to get better and prioritize their overall wellbeing. We will keep working with our federal and state partners, including insurers and other stakeholders, to lower costs, expand coverage, and build a healthier, safer Michigan.”
"Mental health care is just as important as physical health care, and we will continue to do everything within our power to ensure that Michiganders can get coverage for the treatments they need to stay healthy,” said Michigan Department of Insurance and Financial Services (DIFS) Director Anita Fox. “I am pleased to offer the Department’s support for these important rules and to make suggestions to further strengthen consumer protections to ensure that those who need these services have coverage on the same basis as other covered benefits such as cancer screenings and office visits.”
First passed in 2008, and later expanded in 2010 and 2021, the Mental Health Parity and Addiction Equity Act (MHPAEA) requires most health insurers and plans to cover mental health and substance use disorder treatments without cost or use restrictions that are more restrictive than those applied to other covered treatments. The expanded law also put into place testing and data reporting requirements to help state agencies, including DIFS, and the federal government implement these rules.
The newly proposed rules further strengthen the consumer protections under MHPAEA by adding additional controls to the use of treatment limitations, such as prior authorization requirements, standards for provider admission to insurance networks, and methodologies for determining provider reimbursement rates. The proposed rules would also put into place an additional data reporting requirement that would have insurers collect and evaluate relevant outcomes data, identify any material differences between the types of benefits, and remedy any identified differences.
If finalized, the new requirements will go into effect on January 1, 2025, for group health plans, and on January 1, 2026, for individual health plans.
DIFS is reminding Michiganders that Health Insurance Marketplace open enrollment will begin on November 1, 2023. During this open enrollment period, consumers can change their current plan or enroll in a new plan for coverage beginning January 1, 2024, by visiting the Health Insurance Marketplace or by calling 800-318-2596 (TTY: 1-855-889-4325). Additional information, including links to find free local help from navigators, is available on the DIFS website or by calling DIFS 8 a.m. to 5 p.m. Monday through Friday at 877-999-6442.
The mission of the Michigan Department of Insurance and Financial Services is to ensure access to safe and secure insurance and financial services fundamental for the opportunity, security, and success of Michigan residents, while fostering economic growth and sustainability in both industries. In addition, the Department provides consumer protection, outreach, and financial literacy and education services to Michigan residents. For more information, visit Michigan.gov/DIFS or follow the Department on Facebook, Twitter, or LinkedIn.