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Mental Health Parity Sample Clauses

Mental Health Parity. The Contractor and its providers must comply with the Mental Health Parity and Addiction Equity Act of 2008 and 42 CFR 438 Subpart K, including the requirements that treatment limitations applicable to mental health or substance use disorder benefits are no more restrictive than the predominant treatment limitations applied to substantially all medical and surgical benefits covered by the Contractor and there are no separate treatment limitations that are applicable only with respect to mental health or substance use disorder benefits.
Mental Health Parity. 15.1 Humana and Hospital must comply with applicable requirements of the Mental Health Parity and Addiction Equity Act of 2008 and 42 C.F.R. 438 Subpart K, including the requirements that treatment limitations applicable to mental health or substance abuse disorder benefits are no more restrictive than the predominant treatment limitations applied to substantially all medical and surgical benefits covered by Humana and there are no separate treatment limitations that are applicable only with respect to mental health or substance use disorder benefits.
Mental Health ParityEffective January 1, 2007, Swedish's self insured benefit plans shall include mental health benefits that are at least equal to the terms and conditions of member health benefits as mandated by the Mental Health Parity Law of 2005, substitute House Xxxx 1154. LETTER OF UNDERSTANDING
Mental Health ParityEffective January 1, 2007, Swedish's self-insured benefit plans shall include mental health benefits that are at least equal to the terms and conditions of member health benefits as mandated by the Mental Health Parity Law of 2005, substitute House Xxxx 1154. (a) if Swedish Medical Center builds or opens a new facility and Swedish Medical Center is the legal employer of the employees, the employees at that facility who perform the same or similar work to that which is covered by this Agreement will be covered by the terms of this Agreement and will be included in the bargaining unit covered by this Agreement; (b) if Swedish Medical Center acquires an existing operation and some of the employees at that facility are represented by SEIU Healthcare 1199NW, then all such employees at that facility who perform the same or similar work to that which is covered by this Agreement will be covered by the terms of this Agreement and will be included in the bargaining unit covered by this Agreement if the acquired operation is in King, Snohomish, or Xxxxxx, County. The parties will promptly meet to bargain the terms and conditions of employment of employees at that facility who are represented by SEIU Healthcare 1199NW who do not perform the same or similar work to that which is covered by this Agreement. In the event the acquired operation is located elsewhere, Swedish Medical Center agrees to immediately recognize SEIU Healthcare 1199NW as the representative for the employees already represented by the Union, and will promptly meet to bargain the terms of employment for covered employees; (c) if Swedish Medical Center acquires an existing operation and some of the employees at that facility are represented by another union or are unrepresented, the Employer will cooperate fully with the Union to determine promptly and efficiently whether accretion is appropriate under established principles of labor law, and if so, to effectuate it. Following an accretion the parties will promptly meet to bargain any outstanding issues; (d) if Swedish Medical Center acquires an existing operation and some of the employees at that facility are represented by another union or are unrepresented and an accretion is not appropriate, the parties agree to be bound by the Neutrality Agreement below. In the event the Union files a representation petition with the NLRB, Swedish Medical Center will agree to have the case processed through the NLRB Consent Election procedures; (e) The preceding...
Mental Health Parity. Contractor shall adhere to CMS guidelines regarding Mental Health Parity detailed below: a. If Contractor does not include an aggregate lifetime or annual dollar limit on any medical/surgical benefits or includes an aggregate lifetime or annual dollar limit that applies to less than one-third of all medical/surgical benefits provided to Members, it may not impose an aggregate lifetime or annual dollar limit, respectively, on mental health or substance use disorder benefits; b. If Contractor includes an aggregate lifetime or annual dollar limit on at least two-thirds of all medical/surgical benefits provided to Members, it must either apply the aggregate lifetime or annual dollar limit both to the medical/surgical benefits to which the limit would otherwise apply and to mental health or substance use disorder benefits in a manner that does not distinguish between the medical/surgical benefits and mental health or substance use disorder benefits; or not include an aggregate lifetime or annual dollar limit on mental health or substance use disorder benefits that is more restrictive than the aggregate lifetime or annual dollar limit, respectively, on medical/surgical benefits; c. If Contractor includes an aggregate lifetime limit or annual dollar amount that applies to one-third or more but less than two-thirds of all medical/surgical benefits provided to Members, it must either impose no aggregate lifetime or annual dollar limit on mental health or substance use disorder benefits; or impose an aggregate lifetime or annual dollar limit on mental health or substance use disorder benefits that is no more restrictive than an average limit calculated for medical/surgical benefits in accordance with 42 CFR § 438.905(e)(ii); d. Contractor shall not apply any financial requirement or treatment limitation to mental health or substance use disorder benefits in any classification that is more restrictive than the predominant financial requirement or treatment limitation of that type applied to substantially all e. If a Member is provided mental health or substance use disorder benefits in any classification of benefits (inpatient, Outpatient, emergency care, or prescription drugs), mental health or substance use disorder benefits must be provided to the Member in every classification in which medical/surgical benefits are provided; f. Contractor may not apply any cumulative financial requirements for mental health or substance use disorder benefits in a classification (...
Mental Health ParityThe parties acknowledge and agree that Employer is solely responsible for complying with all applicable provisions of ERISA and other laws applicable to Employer’s Plan, including the Mental Health Parity and Addiction Equity Act and its implementing regulations, as amended from time to time (“MHPAEA”). XxxxXxxxx agrees to cooperate with Employer in providing information reasonably requested by Employer or its designee in order for Employer to comply with these obligations.
Mental Health ParityPursuant to the Mental Health Parity and Addiction Equity Act of 2008, this Plan applies its terms uniformly and enforces parity between covered health care benefits and covered mental health and substance disorder benefits relating to financial cost-sharing restrictions and treatment-duration limitations. For further details, please contact the Plan Administrator.
Mental Health Parity. The terms and conditions of Section 22, Exhibit E in the Medicaid Contract are incorporated by reference and have the same force and effect as though they are fully set forth herein.
Mental Health Parity. Provider shall comply with the Mental Health Parity and Addiction Equity Act of 2008 and 42 C.F.R. 438 Subpart K, including the requirements that treatment limitations applicable to mental health or substance use disorder benefits are no more restrictive than the predominant treatment limitations applied to substantially all medical and surgical benefits covered by the Contractor and there are no separate treatment limitations that are applicable only with respect to mental health or substance use disorder benefits.
Mental Health Parity. 2.3.11.1 The Contractor shall comply with the Xxxx Xxxxxxxxx and Xxxx Xxxxxxxx Mental Health Parity and Addiction Equity Act of 2008, which requires parity between mental health or substance use disorder benefits and medical/surgical benefits with respect to financial requirements and treatment limitations. The Contractor shall comply with all requirements set forth in 42 C.F.R. Part 438 Subpart K, for all Medicaid managed care enrollees. 2.3.11.1.1 The Contractor must comply with parity requirements for aggregate lifetime or annual dollar limits on mental health or substance use disorder benefits, including prescription drugs as specified in 42 C.F.R. §438.905. 2.3.11.1.2 All financial requirements or treatment limitations, including nonquantitative treatment limitations (NQTL), to mental health or substance use disorder benefits shall not be more restrictive than the predominant financial requirement or treatment limitation applied to substantially all medical/surgical benefits, in accordance with 42 C.F.R. §438.910. Financial requirements cannot accumulate separately for medical/surgical benefits and mental health/SUD benefits. 2.3.11.2 The Contractor shall develop and maintain internal controls to ensure mental health parity. The Contractor’s utilization practices such as prior authorization, standards for medical necessity determination, and network policy, procedures, and practices shall comply with the federal regulations referenced above. 2.3.11.2.1 The Contractor shall conduct an initial parity analysis as part of its readiness review process and at other times as directed by LDH, based on benefit classifications for parity as defined by LDH. If an enrollee is provided mental health or substance use disorder benefits in any classification of benefits, mental health and substance use disorder benefits must be provided to the enrollee in every classification in which medical/surgical benefits are provided. 2.3.11.2.2 The Contractor shall cover, in addition to State Plan required services, any service necessary for compliance with the requirements for parity in mental health and substance use disorder benefits based on parity analysis. As directed by LDH as part of ongoing parity review, the Contractor may be required to cover or change services necessary for compliance including type and amount, duration and scope of services and change policy or operational procedures in order to achieve and maintain compliance with parity requirements. 2.3.11.2.3 ...