Session 020: Provider Reimbursement and Mental Health Parityclosely follow federal law. The Sherman Act, is the primary U.S. antitrust law pertaining to association activities ... NQTLs directly relate to plan’s payments to health care providers: • Coding Edits • UCR Determination ...
Description: MHPAEA prohibits health plans from imposing financial requirements or treatment limitations on behavioral health benefits that are more restrictive than those applied to medical and surgical benefits. MHPAEA's regulations define treatment limitations to include nonquantitative treatment limitations (NQTLs), which are benefit design features that are not numerical, but otherwise limit the scope or duration of benefits.Hide
- Authors: Kristi Bohn, Rebecca Owen, Irvin Muszynski
- Date: Jan 2020
- Competency: Technical Skills & Analytical Problem Solving
- Topics: Health & Disability; Public Policy; Health & Disability>Provider networks