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The Effects of Federal Parity on Substance Use Disorder Treatment | Page 4

Published Online: January 23, 2014
Susan H. Busch, PhD; Andrew J. Epstein, PhD; Michael O. Harhay, MPH; David A. Fiellin, MD; Hyong Un, MD; Deane Leader Jr, DBA, MBA; and Colleen L. Barry, PhD, MPP
Finally, this study examined only the first year after MHPAEA took effect. The interim final regulations of MHPAEA, which were released in February 2010 and took effect for most plans in 2011, prohibited plans from using so-called nonquantitative treatment limits for mental health and SUD benefits unless these limits were comparable to those used for general medical services.24 Nonquantitative treatment limits include medical management standards, prior authorization, utilization review, prescription drug formulary design, standards for provider admission to participate in a network, and provider reimbursement. It is possible that these regulations could lead to different effects of the law; therefore, it is critical for future research to examine use and spending in response to MHPAEA in subsequent years.

Take-Away Points

Federal parity, as implemented in 2010, is unlikely to lead to large increases in total healthcare spending. 
  • In 1 national health plan, federal parity led to a small increase in spending on substance use disorder treatment per enrollee ($9.99, 95% confidence interval, 2.54-18.21) in 2010, the first year after the policy took effect.
  • This increase was not due to more individuals initiating treatment.
  • Future work should consider the effects of the law in subsequent years after regulations affecting the management of care (eg, utilization review, network access) take effect
Author Affiliations: From Perelman School of Medicine, University of Pennsylvania (AJE, MOH), Philadelphia, PA; Yale School of Public Health (SHB, DAF), New Haven, CT; Yale School of Medicine (DAF), New Haven, CT; Aetna (HU, DL), Hartford, CT; John Hopkins Bloomberg School of Public Health (CLB), Baltimore, MD.

Funding Source: This study was funded by the National Institute on Drug Abuse (grant DA 026414).

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (SHB, AJE, DAF, CLB); acquisition of data (SHB, DL, CLB); analysis and interpretation of data (SHB, AJE, MOH, DAF, HU, DL, CLB); drafting of the manuscript (SHB, CLB); critical revision of the manuscript for important intellectual content (SHB, AJE, MOH, DAF, HU, DL, CLB); statistical analysis (SHB, AJE, MOH, CLB); obtaining funding (SHB, DAF, CLB), administrative, technical, or logistic support (SHB, AJE, MOH, DL, CLB); and supervision (SHB, CLB).

Address correspondence to: Susan H. Busch, PhD, Yale School of Public Health, 60 College St, New Haven CT 06520-8034.
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Issue: January 2014
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