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Joanne Roskey Discusses Significance of Recent Appellate Court Decision on Mental Health Parity Behavioral Health Claims in Behavioral Health Business

"Court Sets New Parity Standard; United Behavioral Appeals to Supreme Court"

Behavioral Health Business

Joanne Roskey, a former Division Chief in the Department of Labor's (DOL) Employee Benefits Security Administration (EBSA), Office of Enforcement, commented on behavioral health parity following a November 25 decision by the court articulating for the first time at the appellate level a standard to judge whether or not a plaintiff has appropriately brought a legal claim under Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). In this case, E.W., et al v. Health Net Life Insurance Co., the 10th U.S. Circuit Court of Appeals established four elements that must be satisfied to state a prima facie MHPAEA claim in court. Roskey acknowledges the larger underlying Employee Retirement Income Security Act (ERISA) issues that remain unresolved, and that other courts may well disregard the standard that the 10th U.S. Circuit Court of Appeals established. Some argue that ERISA and MHPAEA do not articulate a way for people to sue plans for benefits for parity violations. But historically, those arguments have largely failed, and courts have assumed that people were allowed to bring lawsuits without much analysis on the matter, Roskey said.  Because it's the first appellate case "to set forth criteria for stating a MHPAEA violation," Roskey said, "you would think now that a lot of other individuals and attorneys that are bringing these lawsuits will look to this case when they prepare their complaint."