Federal mental health and substance use disorder parity regulations are some of the most complex and sweeping regulations ever imposed on the health insurance and managed care industry. Both the fragmentation of enforcement and varying interpretations across jurisdictions have made it difficult for health plans and insurers to create and implement effective parity compliance programs. Nonetheless, the parity law and regulations do not have to be a barrier to the implementation of effective medical and network management, and an effective enterprise-wide parity compliance program provides the framework for confident, responsive, and streamlined operations. EBG Advisors stands ready to help health plans and issuers implement a parity compliance program that not only assembles the documentation needed for regulators and protects against litigation but also facilitates the modernization and effective management of behavioral health benefits.

EBG Advisors provides a diverse network of national experts for payers in building a modern parity compliance program and, if desired, navigate the newly available ClearHealth Quality Institute™ (“CHQI”) parity accreditation process. (Attaining accreditation allows payers to fast-track product approvals and differentiate themselves on the basis of their compliance program and accreditation.) The EBG Advisors team includes consultants who have played leadership roles in federal parity policy, former executives for health plans and third-party administrators, and clinicians who have held leadership roles in health plan operations and clinical benefit management.

Parity Compliance and Accreditation Support

The CHQI Mental Health and Substance Use Disorder (MH/SUD) Parity Accreditation Program (“Program”) establishes the nation’s first accreditation standards outlining a logical sequence of steps for health insurers, health benefits administrators, and others to assess their compliance with the Mental Health Parity and Addiction Equity Act. Attaining accreditation allows payers to fast-track product approvals and differentiate themselves on the basis of their compliance program and accreditation.  CHQI will soon offer an Online Parity Compliance Tool, the first and only comprehensive digital resource designed for health plans and other organizations to build, implement, and manage a parity compliance program that meets key regulatory and accreditation requirements. The tool, available totally independently from the accreditation process, will serve as the online application portal for the Program.

EBG Advisors offers end-to-end support to payers building a parity compliance program, including assistance at all stages of the process for payers seeking parity accreditation, and, as part of our support services, we will utilize the CHQI Online Parity Compliance Tool. EBG Advisors helps payers confidently manage their behavioral health benefits, improve speed to market, reduce risk, reduce costs for product development and compliance, and improve overall care management effectiveness.

Specifically, EBG Advisors’ services include:

  • Preliminary program and policy assessment
  • Detailed parity compliance assessment using the CHQI Online Parity Compliance Tool
  • Remediation and testing
  • Final accreditation support