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On October 3

signed into law the “Paul Wellstone and Pete Domenici Mental Health Parity and Addiction

Equity Act of 2008.” This new law, Public Law 110-343, will require group health plans that

currently offer coverage for drug and alcohol addiction and mental illness to provide those

benefits in the same way as all other medical and surgical procedures covered by the plan;

therefore co-pays, deductibles and annual and lifetime caps on addiction and mental health

treatment benefits will be required to be the same as those on medical and surgical benefits.

Passage of the “Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity

Act of 2008” will:

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million Americans with alcohol or drug problems in 2007, only 2.4 million—roughly one

in ten—received treatment at a specialty treatment facility, leaving 20.8 million

untreated. Over thirty percent of the people who needed treatment but didn’t receive it

cited lack of health insurance coverage or other cost factors as a major reason for not

receiving care.

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untreated addiction from receiving critically important treatment services. Providing

parity will help to eliminate stigma for alcohol and drug addiction, by treating addiction

similarly to other chronic health conditions like diabetes, asthma, and hypertension.

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Report, public funding provides the vast majority of drug addiction treatment

expenditures, increasing from 62 percent in 1991 to 76 percent in 2001. Private

insurance represented only 13 percent of addiction treatment expenditures in 2001, while

it covered 36 percent of all health care expenditures.

Specifically, Public Law 110-343 will:

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plans, and to those who are covered by managed-care Medicaid programs

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there is out-of-network coverage for medical and surgical conditions

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available to participants and beneficiaries upon request

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necessity criteria and the scope of coverage; although a prior version of the legislation

would have required that all conditions and disorders in the Diagnostic Statistical Manual

of Mental Disorders (DSM-IV) be covered, this requirement was not included in Public

Law 110-343.

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after that; plans who meet the cost exemption criteria and drop coverage are

required to inform plan participants of the change in benefits

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of enactment; for most plans, the effective date will be January 1, 2010

The full text of Public Law 110-343 can be found at:

and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008” can be found

beginning in Section 511 of Public Law 110-343.