By JoAnn Volk, Justin Giovannelli, and Christina L. Goe

Lack of access for people seeking in-network care for behavioral health conditions is a longstanding issue that has only been further exacerbated by an increased need for these services and a nationwide shortage of behavioral health providers. The Affordable Care Act (ACA) set minimum provider network standards that all marketplace plans must meet in regard to covered services, including behavioral health. Beginning in 2026, states will need to have standards in place that require insurers to satisfy numerical measures of access – maximum time or distance to travel to an appointment, for example – for certain providers, including some behavioral health providers. States can, and have, gone further than the federal standards to ensure access to behavioral health providers. 

In a recent post for the Commonwealth’s Fund To the Point blog, CHIR’s JoAnn Volk and Justin Giovannelli discuss how some states have set more stringent access standards for behavioral health providers by, for example, applying time and distance measures to a broader list of behavioral health providers. Others have incorporated mental health parity requirements into their access standards, by requiring insurers to show they have met parity requirements for provider reimbursement.

You can read the full post here.