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Required Changes for Mental Health and Substance Use Disorder Coverage
Apr 01, 2016
March 18, 2016
UnitedHealthcare of California (HMO) has carefully reviewed its Mental Health and Substance Use Disorder coverage for Small and Large Group employers in response to a comprehensive survey conducted by the Department of Managed Health Care (DMHC). DMHC has surveyed all health care service plans in California regarding their Mental Health and Substance Use Disorder coverage and compliance with state and federal laws. As a result of this DMHC survey, the following changes have been made to UnitedHealthcare’s coverage effective January 1, 2016, regardless of group’s renewal date:
- Partial Hospitalization/Day Treatment and Intensive Outpatient Treatment benefits for Mental Health and Substance Use Disorder have been moved from Inpatient Services to All Other Outpatient Treatment resulting in changes to the cost-sharing from this move.
- Cost-sharing information for Mental Health benefits has been expanded on the Medical Schedule of Benefits to include Partial Hospitalization/Day Treatment and Intensive Outpatient Treatment as an outpatient benefit. Previously, these benefits were included on the US Behavioral Health Plan California Supplement to the EOC.
- Cost-sharing information for Substance Use Disorder benefits, when covered, has been added to the Medical Schedule of Benefits.
- Changes have been made to the Medical EOC including the addition of Mental Health and Substance Use Disorder benefit language and definitions that were previously included in the US Behavioral Health Plan California Supplement to the EOC.
UnitedHealthcare is issuing notices to employers to distribute to their employees and dependents advising them of significant changes, such as the cost-sharing changes and the EOC language changes. The member notice will include an overview of the changes, an EOC Addendum, and a benefits grid highlighting the cost-sharing changes from Inpatient to Outpatient Services.