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The Oregon Health Authority conducted an initial mental health parity analysis of the full Oregon Health Plan delivery system in 2018 to meet requirements in 42 Code of Federal Regulations (CFR) §438 Subpart K. Coordinated care organizations (CCOs) and the Oregon Health Plan fee-for-service program participated in the initial analysis, which included an analysis of limitations and an inventory of all mental health, substance use disorder, and medical and surgical benefits offered to OHP members. Results of the initial analysis were reported in August 2018; and in 2019, the CCOs implemented corrective actions in areas lacking parity.
In 2020, OHA tasked Health Services Advisory Group (HSAG), with conducting a follow-up MHP Analysis across the Medicaid delivery system, in part due to each of the CCOs entering into new five-year contracts with the State, to determine if the existing benefits and any non-quantitative treatment limitations remained compliant with the mental health parity regulations.
To meet the requirements of the CMS final rule
codified in 42 Code of Federal Regulations (CFR) §438 Subpart K.
Oregon's managed care plans must show that limitations (such as day
limits, prior authorization requirements or general provider
mental health and substance use disorder services are not substantially different or more limiting than those for medical and surgical services.
Mental health parity, or MHP, means that mental health and substance use disorder services are treated generally the same as, or better than, medical and surgical services.
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