Mental Health Parity Act: Final Rule Changes and Implications for Group Health Plans

 On September 9, the US Departments of Labor, Treasury, and Health and Human Services (the Departments) jointly released a final rule to ensure that group health plans comply with the Mental Health Parity and Addiction Equity Act (MHPAEA). The final rule, which spans over 530 pages, limits the ability of group health plans to restrict coverage for mental health and substance use disorders compared to medical and surgical care. The final rule largely tracks the Departments’ July 2023 joint proposed rule but includes some changes.

A link to the final rule is here.
 
As detailed in a prior alert addressing the proposed rule, the final rule outlines the requirements for group health plans to collect and analyze data related to nonquantitative treatment limitations (NQTLs). NQTLs refer to the nonnumerical tools that plans may use to limit access to care and benefits for mental health and substance use disorders. Examples of NQTLs include prior authorization requirements, step therapy, and standards for provider network participation admission.

Source(s): ArentFox Schiff, LLP, received on September 16, 2024.