Mental Health Parity Rules and Requirements for Plan Sponsors and Administrators

Mr. Malone helps health care organizations navigate the most complex regulatory, transactional, and strategic issues in managed care and delivery system reform. Managed care organizations, provider groups, value-based enablement companies, and trade associations seek his advice on matters involving, among other things: Medicare Advantage, SNPs, Medicaid managed care organizations, commercial insurers, participants in the Program of All-Inclusive Care for the Elderly (PACE), Medicare Shared Savings Program and ACO REACH entities, self-funded group health plans, third-party administrators, and pharmacy benefit managers. With a distinguished body of work on dual-eligible delivery systems and the Mental Health Parity and Addiction Equity Act, Mr. Malone is also a trusted counselor on value-based payment arrangements, risk-bearing structures, and corporate governance for integrated care models. His practice bridges regulatory compliance, business strategy, and dispute resolution, allowing clients to operate confidently in a fast-evolving health care environment. Before entering private practice, Mr. Malone served in senior policy roles at the CMS, where he developed financing and delivery models for dual-eligible beneficiaries, advanced PACE expansion, and shaped Medicaid policy for medically frail populations. He is a frequent speaker and author on managed care law and policy. He also serves as an accreditation reviewer for URAC’s Mental Health Parity Accreditation Program, assessing compliance with federal parity requirements and industry best practices, and teaches Managed Care Law & Policy as an adjunct professor at The George Washington University Law School.

Ms. Summers practice focuses on all aspects of labor, employment, and employee benefit matters. She gained invaluable experience as a federal law clerk for the Honorable Roger L. Wollman of the U.S. Court of Appeals for the Eighth Circuit and uses that insight to aid clients through her litigation practice.

Ms. Watson focuses on ERISA and employee benefits. She concentrates on a wide array of areas including, pension and profit sharing plans, health and welfare benefit plans, including COBRA, HIPAA and the Affordable Care Act, ERISA fiduciary decision-making, Employee Stock Ownership Plans, benefits litigation backup, benefits aspects of mergers and acquisitions, employee benefits aspects of family law, labor laws affecting employee benefits, other employee benefits and deferred Compensation, and employee benefit disputes and employee benefits claims.