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Shapiro Administration Launches New Round of Exams to Enforce Mental Health Parity Compliance

05/12/2023

Harrisburg, PA – In honor of Mental Health Awareness Month, Pennsylvania Acting Insurance Commissioner Michael Humphreys announced the Pennsylvania Insurance Department (PID) is launching a new round of examinations targeting insurer compliance with mental health and substance use disorder parity laws. 

This new round of examinations comes after a series of recent market conduct examinations on Pennsylvania's largest health insurers found widespread compliance challenges. The comprehensive market conduct exams, which began in 2016, resulted in more than 60,000 Pennsylvanian consumers receiving a cumulative $5.89 million in restitution. Now, Commissioner Humphreys announced he will begin a new round of examinations as a follow-up to these exams to hold insurers accountable.

"These are critical protections for consumers. Access to both mental health and substance use disorder treatment are crucial for the overall wellbeing of Pennsylvanians, and we will not rest until all insurers are covering these benefits fairly," said Humphreys. "Under Governor Shapiro's leadership, we will continue to hold insurers accountable through examinations as well as through our front-end policy review process. We expect substantial improvements in realizing the promise that is mental health parity."

PID is highlighting the importance of understanding parity in insurance coverage and proper implementation of parity requirements throughout the month of May, which is recognized nationally as Mental Health Awareness Month.

"The Insurance Department's examinations for mental health and substance use disorder parity compliance are just one way we are working to evaluate insurers' practices in the Commonwealth and address the need to protect these critical rights for all Pennsylvanians," said Humphreys. "These examinations have gone a long way in finding areas for improvement in expanding access and affordability for consumers through parity compliance."

In his Budget Address, Governor Josh Shapiro voiced concern over the effective enforcement and compliance of mental health parity laws in this country. The Governor has made mental health and substance use disorder treatment parity a priority in his administration and has directed Commissioner Humphreys to make mental health parity a reality here in Pennsylvania. 

The Department is also urging consumers and providers to contact the department if they think a health plan is not meeting parity requirements for mental health and substance use disorder coverage or if a consumer has questions about the benefits to which they are entitled. 

For more information on mental health and substance use disorder parity requirements, or to file a complaint or ask a question, visit the department's Bureau of Consumer Services at www.insurance.pa.gov/consumers or call 1-877-881-6388.


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