Identify generally accepted standards of MH/SUD care

The Department of Health and Human Services should assist in elevating the standards of MH/SUD care that are generally accepted by MH/SUD clinicians by examining peer-reviewed scientific studies and medical literature, recommendations from nonprofit clinical specialty associations, recommendations from federal agencies, and drug labeling approved by the U.S. Food and Drug Administration.This database of generally accepted standards of care could be utilized by federal and state insurance regulators in their enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) and other health coverage requirements. The Department of Health and Human Services should further identify guidelines and criteria that are consistent with generally accepted standards of MH/SUD care to help improve the quality of MH/SUD service delivery and coverage. The Department could consult with the New York State Office of Mental Health, which has put out “Guiding Principles” for clinical review criteria for mental health services and a “Best Practices Manual for Utilization Review for Adult and Child Mental Health Services. In its reviews, OMH found that no health plans’ submitted criteria met these Guiding Principles.[1][2]