READ MORE ABOUT HB 2173, A BILL TO ENFORCE PARITY IN PENNSYLVANIA, HERE


Enforcement of the Parity law has been left up to each individual state, usually through their Insurance Department, or state-level Parity laws.

Primary Colors = Primary Responsibility

It's up to each state to enforce parity. In Pennsylvania, the three branches of state government can each play a role in enforcing parity.

  • The Insurance Commissioner, who is appointed by the Governor, can issue guidelines and regulations to enforce parity.
  • The State Legislature (in Pennsylvania, it's called the General Assembly) can issue legislation creating a state-level parity obligation, and authorizing the enforcement of parity by a state-level agency, usually the Department of Insurance.
  • The Attorney General can bring suit or investigate parity violations
  • The Commonwealth Court System can hear suits brought against insurers for violations of the law (assuming the state legislature has passed legislation creating a parity obligation)
As of 2016, the Pennsylvania Department of Insurance and the Pennsylvania General Assembly have started to take concrete steps to develop a process and guidelines for enforcing Parity in the Commonwealth, including the introduction of a state parity legislative proposal.

As of 2016, the Pennsylvania Department of Insurance and the Pennsylvania General Assembly have started to take concrete steps to develop a process and guidelines for enforcing Parity in the Commonwealth, including the introduction of a state parity legislative proposal.

 

Secondary colors = secondary responsibility

The federal government still has a role to play if the state government is unable/unwilling to enforce parity.

  • Depending on the type of insurance plan, consumers can file a grievance with one of the following federal agencies:
    • Department of Health & Human Services
    • Department of Labor
    • Treasury Department

In January 2013, the Centers for Medicare and Medicaid Services issued guidance, indicating that Medicaid and Medicare plans were subject to parity rules.

  • In 2010, Congress passed the Affordable Care Act, which defined Essential Health Benefits for all insurance plans. These EHBs included behavioral healthcare, which meant that plans with more than 50 people must be parity compliant. 
    • Congress also has the option of passing further legislation to enforce parity. 
  • The Federal Court System can hear suits brought against insurers for violations of the law. There have been a number of suits in federal courts (for more info see Parity Across the Nation.