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MHPAEA Background

MHPAEA Background

Background

Laws

Generally, there are two laws that work together to create a framework for mental health and substance use disorder coverage in Ohio.

  1. State Law: A state law was enacted in 2006 requiring coverage for the diagnosis and treatment of specifically biologically based mental illness. 
  2. Federal Law: The federal parity law, the Mental Health Parity and Addiction Equity Act (MHPAEA), was enacted in 2008, generally requires health plans that provide coverage for mental health and substance use disorder benefits to provide that coverage in the same or similar manner for as physical health benefits in the same plan. 

MHPAEA and state law work together to help achieve parity among mental health and substance use disorder benefits and medical and surgical benefits:

Regulation and Enforcement

The Ohio Department of Insurance (ODI) is tasked with regulating and enforcing laws relating to the business of insurance. ODI oversees insurance policies, premium rates, company solvency, and helps consumers that have questions or complaints.

Specifically related to mental health and substance use disorder benefits, ODI reviews health insurance products to ensure that health plans are complying with MHPAEA and applicable state mental health law. ODI also helps consumers understand their mental health and substance use disorder benefits and resolve complaints against insurance companies. Finally, ODI tracks trends in consumer complaints and other data to determine if further investigation of company practices is needed.

ODI only regulates about 14% of the health insurance plans in Ohio. This chart offers a breakdown of Ohio’s health insurance market and different types of plans providing coverage to Ohioans. 

To learn more about how the department regulates and enforces these laws, check out our Regulating MHPAEA Guide.