For many states the effective date marks the beginning of implementation, which occurs as each insurance contract is renewed. States that have limited parity to specific diagnoses are listed here as having SMI parity. Interestingly, such limitations, thought to limit excessive costs of these mandates, are often not administered by diagnosis by insurers or health plans because their reimbursement codes do not proceed by diagnosis. Some states make offering benefits optional. Many states exempt small businesses from the parity statute.
Some small businesses comply voluntarily, even if exempted.
A state may have a mental health or substance abuse coverage mandate without having a parity requirement. It may also mandate that behavioral health practitioners be considered eligible for reimbursement under the same terms and conditions as other providers. While a state may prohibit limits on inpatient days or outpatient visits that are specific to mental health or substance abuse only, the statute may explicitly permit design differences in other plan features such as co-payments, deductibles or other forms of cost sharing. This level of detail is not included here. This table does not include this level of detail.