Analysis of Mental Health Parity in the Oregon Health Plan
42 CFR §438 Subpart K requires Medicaid managed care plans to demonstrate mental health parity. This means that mental health and substance use disorder services are treated generally the same as, or better than, medical and surgical services.
This means Oregon's coordinated care organizations (CCOs) must show that limitations (such as day limits, prior authorization requirements or general provider availability) for mental health and substance use disorder services are not substantially different or more limiting than those for medical and surgical services.
Resources
2025
Frequently Asked Questions and
Evaluation Protocol
2024 Frequently Asked Questions
The Oregon Mapping Guide maps Oregon Medicaid benefits to the classifications required for parity analysis.
CMS resources for applying mental health parity requirements
Mental health parity overview from CMS
Information for consumers is on the National Alliance on Mental Illness website.
Reports
Since 2018, Oregon Health Authority (OHA) has required review and analysis of CCO and fee-for-service (FFS) compliance with mental health parity regulations. Since 2020, Health Services Advisory Group has conducted annual follow-up analysis across the Medicaid delivery system. The follow-up analysis determines if existing benefits and any non-quantitative treatment limitations (NQTLs) still comply with mental health parity regulations.