For instance, ERIC lambastes the agencies’ focus on specific treatments as a regulatory overreach. They demand the agencies to reconsider their approach, alleging that these proposals essentially rewrite the MHPAEA statute.
A Fight for Interpretation
The Association for Behavioral Health and Wellness, representing payers of behavioral health care, highlights issues related to the Administrative Procedure Act and cautions against arbitrary and capricious enforcement activity by the DOL, as well as potential violations of the APA.
A top House of Representatives GOP committee leader fiercely criticizes the Biden administration proposal, emphasizing that it exceeds the statutory authority of the tri-agencies.
Network Adequacy Dilemma
Another contentious battlefield emerges in the form of network adequacy. While patient advocates champion regulations to ensure network adequacy, many industry groups vehemently oppose them.
Patient advocates hail the safe harbor on network composition as a “strong requirement.” However, the industry contends that such regulations could impact their ability to deny coverage and generate profits, although it’s a lifeline for ERISA plan participants in dire need of essential care.
Theme In Parity Rule Comments : A Fight for Equity
In yet another twist in the saga, patient and provider advocates warn against exceptions in the rules, concerned that they could undermine the overarching objective of the new rules. These exceptions are intended to ensure that “benefit structures that apply limitations reflecting independent professional medical or clinical standards or guard against indicators of fraud, waste, and abuse” continue to be permitted.
