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and mental health benefits”); or (3) apply a $250,000 limit to mental health benefits and a $250,000 limit to medical/surgical benefits.103 This regulation proceeds to list multiple examples of the various methods of compliance with the MHPA I,104 but in each instance, fails to suggest that a health provider could avoid the scope of the MHPA I entirely by removing all mental health coverage from their health plans. The “Applicability” section of the regulation addresses this confusion, explaining that the MHPA I applies only to group health plans and health insurance insurers offering mental health benefits. 105
Instead of complying with the MHPA I by enacting policies to increase coverage for mental illnesses, employers found loopholes in the statute and exploited them in order to achieve compliance. A 2002 report by the American Psychological Association declared that eighty-seven percent of employers in compliance with the law decreased components
of mental health coverage not controlled by the MHPA
emphasized by Senator Domenici, its original proponent of further federal parity legislation. 107
I, rendering the MHPA I were and a longtime
The Many Mental Health Equitable Treatment Acts
The Mental Health Equitable Treatment Act has been introduced in Congress numerous times and failed to become a law in each instance. Addressing the shortcomings of the Mental Health Parity Act of 1996, the Mental Health Equitable Treatment Act of 1999 (“MHETA I”) intended “[t]o provide for full parity with respect to health insurance coverage for certain severe biologically based mental illnesses and to prohibit limits on the number of mental-illness-related hospital days and outpatient visits that are covered for all mental illnesses.”109 This act 108
Id. §§ 146.136(b)(i)(A)-(C).
Id. at § 146.136(d)(1)-(2) (emphasizing that the criteria of the MHPA I only pertain to
plans and issuers providing both medical/surgical and mental health benefits).
Am. Psychol. Ass’n, Parity Loopholes Should Be Closed for all Mental Illnesses (Feb.
, available at http://www.apa.org/practice/parity2002_2.html.
147 CONG. REC. S2390-01, S2393 (daily ed. Mar. 15, 2001) (statement of Sen. Domenici)
(emphasizing the exploited loopholes of the MPHA and the irony of covering treatments for heart conditions with moderate success rates yet failing to cover mental illness treatments with noticeably
higher success rates).
D&summ1& (last visited July 17, 2008) (chart summarizing history of MHETA). 109. Mental Health Equitable Treatment Act of 1999, S. 796, 106th Cong. pmbl. (1999).