Moreover, health plans must disclose the "processes, strategies, evidentiary standards, and other factors used by the health plan to determine whether and to what extent a benefit that is subject to a Non-Quantitative Treatment Limitation
(NQTL) be comparable and applied no more stringently for MH/SUD than for medical/surgical."
The MHPAEA requires health insurance plans to provide the same level of coverage for mental health and substance use disorders as for medical or surgical care, including quantitative limitations, such as copays, deductibles, and limits on inpatient or outpatient visits that are covered by the health insurance plan, and Non-Quantitative Treatment Limitations
, such as pre-authorizations, providers available through a plan's network, and what a plan considers "medically necessary".
"If you tell me that insurance companies still aren't paying what they're supposed to be paying, that they still have the non-quantitative treatment limitations
, I'd respond that you're absolutely right," he says.