Compliance Stuff

At a Glance DOL/HHS/Treasury have announced an enforcement pause of the MHPAEA 2024 Final Rule. Certain pre-2024 requirements still apply. The U.S. Departments of Labor, Health and Human Services, and Treasury have announced that they will pause enforcement of the 2024 Mental Health Parity and Addiction Equity Act (MHPAEA) Final Rule (the “2024 Final Rule”) for 18 months. 1   This action, prompted by litigation brought by the ERISA Industry Committee (“ERIC”), complicates compliance obligations of plan sponsors (employers) and health insurers, who must now contend with both the paused Final Rule and continuing MHPAEA obligations. The MHPAEA Framework: Understanding the Layers MHPAEA, enacted in 2008, requires certain group health plans and health insurers offering mental health/substance use disorder (MH/SUD) benefits to ensure parity with medical/surgical (M/S) benefits across six benefit classifications. The statute addresses financial elements (copays, deductibles, coinsurance,...

  On September 9, the US Departments of Labor, Treasury, and Health and Human Services (the Departments) jointly r eleased 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 ...