WASHINGTON, DC – January 28, 2019 – 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. The fragmentation of enforcement and varying interpretations across jurisdictions has made it difficult for health plans and insurers to create and implement effective parity compliance programs. Tapping into a diverse network of experienced professionals, Epstein Becker Green’s affiliate consultancy EBG Advisors, Inc., is announcing a new consulting service that will provide the industry-leading support necessary for payers to build a modern parity compliance program and, if desired, navigate the newly available ClearHealth Quality Institute (CHQI) parity accreditation process.
In order to support the field and help facilitate the consistent and effective implementation of parity, CHQI recently launched the first-ever Online Parity Tool and Mental Health and Substance Use Disorder Parity Accreditation Program for health insurers, third-party administrators, and Medicaid managed care plans. The CHQI Online Parity Tool and Accreditation Program is based on two years of intensive work by a multisector committee of national experts, including representatives from leading consumer and provider advocacy organizations and across the health insurance industry.
EBG Advisors is prepared to help payers maximize these new resources and programs from CHQI, which help payers develop modern parity compliance programs in order to confidently and effectively manage their behavioral health benefits while minimizing legal and compliance risks and reducing the operational burden of responding to audits, investigations, and market conduct examinations.
“CHQI is thrilled to recognize EBG Advisors as the first endorsed consultancy for payers interested in pursuing CHQI’s Mental Health and Substance Use Disorder Parity Accreditation,” notes Michael Gomes, CHQI’s CEO. “EBG Advisors has assembled a team with exceptional depth and experience, including former federal parity policy makers, experienced managed care attorneys, and former health plan clinical and managerial executives. For this reason, we are happy to discount the CHQI Parity Accreditation fees for payers that work with EBG Advisors. We are confident that working with the EBG Advisors team will help any payer develop an effective parity compliance program and CHQI Parity Accreditation application.”
Achieving CHQI’s Parity Accreditation is a complex multistep process, involving projects such as preliminary program and policy assessment, a review of applicable policies and procedures, testing and analysis, and often remediation and retesting, as well as other measurement and support. The process requires advisors with a mix of legal, regulatory, and business acumen.
“Given the current environment, we have assembled a team of consultants with extensive public- and private-sector experience who stand ready to help 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,” said Mark Lutes, Strategic Advisor with EBG Advisors and Chair of Epstein Becker Green’s Board of Directors. “Robust parity laws and regulations should not be a barrier to the implementation of efficient medical and network management, and an effective enterprise-wide parity compliance program provides the framework for confident, responsive, and streamlined operations.”
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. EBG Advisors offers end-to-end support to help payers improve speed to market, reduce risk, decrease product development and compliance costs, and improve overall care management effectiveness through its Mental Health Parity and Addiction Equity Act (MHPAEA) Certification offering.
EBG Advisors’ approach is rooted in an understanding that full MHPAEA compliance requires a comprehensive assessment of the governance and oversight of an insurer or health plans, with an eye not only to ensuring regulatory compliance and avoiding costly audits and litigation, but also to developing market leadership and achieving operational excellence.