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Texas Still Working On Mental Health Parity Rule Implementation

By: Kelly Dempsey, Esq.
 

Texas House Bill 10 was passed in 2017. The House Bill 10 “Study of Mental Health Parity to Better Understand Consumer Experiences with Accessing Care” was published in August of 2018. On June 16, 2020, the Texas Department of Insurance (TDI) published an informal draft rule to implement House Bill 10. Before we dive into the requirements, you’re probably wondering why I’m writing about this topic. My motivation is to draw attention to these requirements as they impact self-funded non-ERISA plans.
 

There are four division to the Bill which are summarized here:

  • Division 1: Imposes mental health parity requirements that essentially mirror the federal requirements. The goal is a single unified standard for assessing parity.
  • Division 2: Imposes requirements to submit reporting to the state on utilization review outcomes. The TDI notes that this data will not always be evidence of a violation, but this information will help TDI further assess the need to investigate potential issues and monitor benchmarking and changes over time.
  • Division 3: Imposes requirements to analyze quantitative and non-quantitative treatment limitations for compliance with parity rules, and retain the analysis to make available to the state upon request. The goal is to have a standardized reporting format.
  • Division 4: Replaces the existing Autism mandate with the goal of harmonizing the Autism mandates with mental health parity. This clarifies that Autism Spectrum Disorder treatment is within the scope of mental health parity requirements.

So what does this all mean? A self-funded health plan that is following federal mental health parity rules shouldn’t have any new substantive parity requirements to take into consideration, but there may be new recordkeeping and reporting requirements on the horizon.

TDI held a stakeholder meeting on July 10, 2020. Significant concern from stakeholders was raised regarding the undue burden of the reporting requirements and a request for TDI to work with health plans further to refine the data reporting parameters. It was specifically noted that the reimbursement reporting requirement would create issues related to the confidentiality of reimbursement rates as well. Other concerns included the definitions in the statute straying from federal statutory definitions and the frustration with the limited time to respond to the informal draft rule in light of the COVID-19 pandemic and already strained resources. In light of the feedback, the TDI has much to consider when revising and finalizing House Bill 10.

As one may glean from the issuances of the “informal draft rule,” the TDI is still early in the process of formalizing this rule so we can certainly expect some changes before a final rule is issued and implemented.  


The various pieces of this legislation and the recording of the stakeholder meeting can be found here: https://www.tdi.texas.gov/health/hb10.html.