Mental Health Parity and Addiction Equity Regs/Prior Approval
The ERISA section of the interim final regs published on 2/2/10, 75 Fed. Reg.5410 have two examples in which a prior approval requirement for mental health benefits is deemed an unlawful "nonquantitative" treatment limitation. The statutory ERISA amendments at 29 U.S.C.A. 1185a (3)(B)(iii) defines "treatment limitation" without any distinction between "quantitative" and "nonquantitative" limitiations, and doesn't suggest anywhere that a prior authorization is a"limit on the scope or duration of treatment." Has anyone considered whether the regulation exceeds statutory authority by making two cateogies of treatment limitations when the statutory definition seems limited to quantitative limits? Is a preauthorization requirement arguably within the catchall "limits on the scope or duration of treatment" that should not be allowed?