Texas Regulations
Parity Report
This page lists some of the action toward parity compliance undertaken by state regulatory agencies since 2008.
Are we missing any actions taken by state regulatory agencies? Let us know at info@paritytrack.org
Action in the Regulatory Arena
8/2017
Primary Focus | Mandated Benefit: Provider |
Agency | Texas Department of Insurance |
Title/Description | Basic Health Care Services and Mandatory Benefit Standards: Group, Individual, and Conversion Agreements |
Citation | 28 Tex. Admin. Code § 11.508 per 42 TEXREG 2169 |
Summary | Each evidence of coverage providing basic health care services must provide coverage for outpatient mental health services complying with the mental health parity requirements in Chapter 21, Subchapter P, of this title (relating to Mental Health Parity). |
Effective Date | August 1, 2017 |
Primary Focus | Mandated Benefit: Provider |
Agency | Texas Department of Insurance |
Title/Description | Minimum Standards—Mental Health and Chemical Dependency Services and Benefits |
Citation | 28 Tex. Admin. Code § 11.2405 per 42 TEXREG 2169 |
Summary | Each limited service HMO providing coverage for mental health and chemical dependency services and benefits must comply with Chapter 21, Subchapter P, of this title (relating to Mental Health Parity) and provide primary mental health and chemical dependency services and benefits. |
Effective Date | August 1, 2017 |
2014
The Texas Department of Insurance (TDI) released a chart (pdf | Get Adobe® Reader®) that shows the benefits that must be provided by health plans in Texas. The document shows which mental health and substance use disorder benefits must be offered by individual, small employer, and large employer plans (pages 2, 4, and 5). It clearly demonstrates that all plans must offer mental health benefits in parity with physical health benefits (page 5).
3/2011
Primary Focus | Mandated Benefit: Provider |
Agency | Texas Department of Insurance |
Title/Description | Small Employer Health Plan Parity Requirements |
Citation | 28 Tex. Admin. Code § 21.2404 per 36 TEXREG 1291 |
Summary | Unless exempted by this subsection, an issuer of a group health plan to a small employer must offer coverage or serious mental illness as described in § 1355.004. The employer may reject the coverage, but if the employer accepts the coverage, such coverage must meet the requirements of § 1355.004. |
Effective Date | March 2, 2011 |
1/1999
Primary Focus | Mandated Benefit: Provider |
Agency | Texas Department of Insurance |
Title/Description | Large Employer Health Plan Parity Requirements |
Citation | 28 Tex. Admin. Code § 21.2403 per 24 TEXREG 393 |
Summary | Coverage that provides both medical/surgical benefits and mental health or substance use disorder benefits must apply substantially the same following limits to mental health benefits as it does to medical/surgical benefits: (1) Aggregate lifetime limit or an annual limit; (2) Financial requirements; and (3) Treatment limitations Separate cost-sharing requirements or separate treatment limitations that are applicable only with respect to mental health or substance use disorder benefits are prohibited. |
Effective Date | January 31, 1999 |
2008
The Texas Department of Insurance (TDI) issued a bulletin notifying constituents that the Texas Attorney General issued an opinion finding that group health plans in Texas are required to provide the same number of outpatient visits for serious mental illness as they do for physical illness. In the bulletin, TDI stated that they planned to conduct reviews of forms of carriers on file for parity compliance. The bulletin also noted that TDI would issue regulations to implement the Federal Parity Law, which it did in 2011 (see above).
National Parity Map
View the state parity reports to learn about legislation, regulation, and litigation related to parity implementation
National Parity MapGet Support
- Texas Insurance Division
- http://www.mhatexas.org/
- gyl@mhatexas.org
- 512-903-4186
Common Violations
In seeking care or services, be aware of the common ways parity rights can be violated.