Annapolis, MD / July 20, 2017 – ClearHealth Quality Institute™ (CHQI) – a new accreditation organization that develops standards incorporating the next generation of quality and outcome measures – is establishing comprehensive accreditation standards to promote compliance with mental health parity laws. Parity means that health insurance plans must cover mental health and substance use disorder (SUD) treatment the same way they cover treatment for physical health conditions.
To meet a pressing social need, the CHQI Parity Accreditation Standards Committee is forging the country’s first standalone parity accreditation program. The Committee – composed of experts representing varied stakeholder perspectives including providers, regulators, payers, and consumer advocates – has been meeting regularly since April 2017, and CHQI anticipates that the standards will be completed by this fall.
“CHQI Parity Accreditation will provide a much-needed focus and framework to give consumers and providers alike greater confidence about health plan and insurer compliance at a time when there is concern about parity violations and inconsistent regulatory enforcement,” states Steve Daviss, M.D., CEO of Fuse Health Strategies LLC, and chair of the CHQI Parity Accreditation Standards Committee. Dr. Daviss represents the provider perspective and previously helped develop mental health parity compliance standards for health plans.
The Federal Parity Law – which was enacted almost ten years ago – and related state parity laws have received much attention recently as Americans call for greater access to treatment due to the opioid epidemic and expanding mental health needs. The parity laws have focused public attention on how health insurance companies set benefits and member cost-sharing obligations, and make medical necessity and coverage determinations, for mental health and addiction treatment.
“We welcome the CHQI multi-stakeholder process used to develop consensus for the parity accreditation standards,” states Committee Vice Chair Brad Lerner, J.D., Associate General Counsel and Director, Parity Compliance for Beacon Health Options. He adds, “As a leader in managed behavioral health care, my organization is proud to be part of this important work effort to make sure that MHPAEA continues to be implemented in a workable manner.” Beacon is a prominent national advocate for quality behavioral health care, and Mr. Lerner is recognized for his expertise on mental health parity analysis and compliance.
“Parity definitely needs to be addressed,” states Garry Carneal, J.D., M.A., CHQI Founder. “CHQI is leading the work on developing parity accreditation standards in part because the current regulatory framework has not adequately achieved the public policy goals of promoting real change. CHQI’s new Parity Accreditation Program will help organizations demonstrate to regulators and others that they have implemented a meaningful parity compliance framework.” Carneal has supervised the development and launch of 22 healthcare accreditation programs since 1995.
The CHQI Parity Accreditation Program will establish a quality assurance framework to address gaps in existing parity compliance programs, by creating standards for organizations administering mental health and addiction treatment benefits. The Program will require applicants to document compliance with specific standards that address key parity issues such as benefit design, cost-sharing obligations, limitations on treatment such as utilization review, and disclosures. CHQI’s goal is to translate complex laws and regulations into a concise set of robust but workable standards that educate payers and provide them with a clear roadmap to compliance.
Growing complexity in today’s health insurance functions and provider services have resulted in systems that are no longer easily or appropriately regulated due to the complexity of those operations. CHQI was established in part to find new ways to update the traditional approach to accreditation in health care so that regulations and accreditation standards keep pace with rapid innovation in health care. CHQI is dedicated to creating new pathways to establish national measurement-based standards for existing healthcare services and emerging solutions in the market. The organization is also committed to an educational approach in promoting quality operations by helping to assess, track and report on trends to enhance key insurance and provider outcomes.
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About ClearHealth Quality Institute™ (CHQI) (www.CHQI.com)
ClearHealth Quality Institute’s (CHQI) mission is to promote quality-based practices for health plans, providers and other stakeholders across the United States and its territories. Our accreditation and certification programs help assess, track and report on trends to enhance key insurance and provider outcomes. CHQI also offers educational programs, publishes issue briefs and underwrites research to raise awareness of patient safety issues and promote best practices. The organization is governed by an independent board and committee system, which is open to a wide-range of volunteers to ensure transparency and accountability. CHQI provides resources to serve patients, providers, payers, government agencies, and other stakeholder groups. To learn more about CHQI, please contact us at (410) 696-7634 or info@CHQI.com.