U.S. Department of Labor
Health Benefits Advisor for Employers
Determining Compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) and Mental Health Parity Act (MHPA) Provisions in Part 7 of ERISA
Does the plan comply with the mental health parity provisions requiring the availability of plan information regarding the reason for a denial of reimbursement or payment?
The plan administrator (or health insurance issuer) must make available the reason for any denial under a group health plan (or health insurance coverage) of reimbursement or payment for services with respect to mental health or substance use disorder benefits to any participant or beneficiary in a form and manner consistent with the rules in 2560.503-1(The Claims Procedure Rule). See 29 CFR 2590.712(d)(2).
