Parity, Coverage, & Equitable Access
The landmark 2008 Mental Health Parity and Addiction Equity was intended to ensure equal coverage for mental health and substance use care. Some 15 years later, Americans continue to face parity violations and inequitable access. The following recommendations serve to help realize the full promise of parity, both through enforcement of the Federal Parity Act and through other systemic changes made to ensure appropriate health coverage and overall access to care.
Browse the Featured Recommendations
Extend Medicaid coverage to 12 months postpartum
Congress should require states to extend Medicaid coverage for 12 months postpartum.
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Make mobile crisis services mandatory under Medicaid
Congress should make mobile crisis services mandatory under Medicaid. At a minimum, these services should be made a permanent state option available to states eligible for enhanced federal Medicaid match funding.[1]
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Apply the federal Parity Law to all health coverage
The Mental Health Parity and Addiction Equity Act (MHPAEA) should apply to all health coverage in the United States. Existing major gaps in MHPAEA’s protections include Medicare Fee-for-Service, Medicare Advantage, Medicaid Fee-for-Service, TRICARE, and the Indian Health Service (IHS).[1][2][3] Additionally, the federal government should strengthen MHPAEA’s existing protections by finalizing its proposed rule released in July 2023.
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Improve Medicare coverage of peer support specialists
Congress should improve Medicare coverage of peer support specialists by allowing them to bill in a variety of settings where they are most often employed.
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Standardize the MTSS framework
The Department of Education (DOE) should build a standardized framework for schools to implement the Multi-Tiered Systems of Support (MTSS) framework, establish dashboards for data collection and resources libraries on the MTSS framework, establish a certification program that recognizes districts that have implemented MTSS best practices, and establish a permanent position for school-based Medicaid services to support state education agencies in implementation.The Centers for Medicare & Medicaid Services (CMS) should also clarify that Tier 1 supports under MTSS include prevention and early intervention services under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.
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Create a common MH/SUD data model
Federal departments and agencies should make mental health and substance use disorder (MH/SUD) data collection and reporting a top priority by finalizing a proposed rule to require states to report on MH/SUD measures in Medicaid, creating a common MH/SUD data model and reporting portal that all recipients of federal MH/SUD funds must use, reestablishing the Department of Health and Human Services (HHS) Data Council, and adding new MH/SUD vital statistics records to the National Vital Statistics System (NVSS) that are updated monthly.