OIG Finds Kansas Failed to Enforce Mental Health Parity Rules for MCO Prior Authorization

The HHS Office of Inspector General determined that Kansas did not ensure its Medicaid managed care organizations complied with federal mental health and substance use disorder parity requirements related to prior authorization. The audit found Kansas MCOs applied more restrictive prior authorization requirements for behavioral health services than for medical/surgical services, violating parity rules. OIG recommended Kansas implement oversight mechanisms to ensure MCO compliance with parity requirements and recover inappropriate payments if applicable. This represents federal enforcement action against a state's failure to monitor MCO compliance with long-standing but frequently unenforced parity rules.

Behavioral Health · Managed Care