In the August issue, we delved into the proposed regulations under the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (“MHPAEA”), as amended by.
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The initial intent was to review the medical necessity of hospital stays, various procedures, and tests. Companies created "guidelines" to determine if medical decisions were made appropriately and if services were utilized correctly. If they were deemed "unnecessary," the people and places performing them would not be paid.