Enforcement of the 2024 Mental Health Parity Rules Temporarily Suspended

In a significant development for employer-sponsored health plans, the U.S. Departments of Labor, Health and Human Services, and the Treasury have announced a temporary non-enforcement policy concerning specific provisions of the 2024 Final Rule under the Mental Health Parity and Addiction Equity Act (“MHPAEA”). This decision stems from ongoing litigation initiated by the ERISA Industry Committee (“ERIC”), challenging the Departments’ authority in implementing certain aspects of the rule.

Understanding the Non-Enforcement Policy

The non-enforcement policy specifically targets the new requirements introduced in the 2024 Final Rule that differ from the 2013 final regulations. Key elements under non-enforcement include:

• Enhanced comparative analysis requirements for nonquantitative treatment limitations (“NQTLs”).
• Fiduciary certification obligations related to NQTL analyses.
• Mandates for collecting and analyzing outcomes data to assess parity in access to mental health and substance use disorder (“MH/SUD”) benefits.

It’s crucial to note that this non-enforcement is temporary, lasting until the resolution of the ERIC lawsuit plus an additional 18 months. During this period, the Departments will also reexamine their enforcement strategies under MHPAEA.

Continued Compliance Obligations

Despite the pause on enforcing new provisions, employers must continue to adhere to existing MHPAEA requirements:

• The core MHPAEA statute, including amendments from the Consolidated Appropriations Act (“CAA”) of 2021, remains in full effect.
• Employers are still required to conduct and document comparative analyses of their NQTLs to ensure parity between MH/SUD benefits and medical/surgical benefits.
• These analyses must be made available upon request to relevant authorities, plan participants, and beneficiaries.

Failure to comply with these ongoing obligations can result in audits, corrective actions, and potential legal challenges from plan participants.

State-Level Enforcement Considerations

While federal enforcement is on hold for certain provisions, state insurance regulators may continue to enforce both federal and state mental health parity laws. Employers should be aware of their specific state requirements and ensure compliance accordingly.

Recommendations for Employers

To navigate this complex regulatory landscape, employers should:

• Review and Update NQTL Analyses: Ensure that existing analyses are comprehensive and reflect current plan designs.
• Engage with Service Providers: Collaborate with third-party administrators and other service providers to gather necessary data and documentation.
• Monitor Regulatory Developments: Stay informed about changes in federal and state enforcement policies related to MHPAEA.
• Consult Legal and Compliance Experts: Seek guidance to ensure that your health plans meet all applicable requirements and to prepare for potential audits or inquiries.

Conclusion

The temporary non-enforcement of certain aspects of the 2024 MHPAEA Final Rule provides a window for employers to assess and strengthen their compliance strategies. However, the fundamental obligations under MHPAEA remain unchanged. Proactive measures taken now can safeguard against future enforcement actions and ensure that employees receive equitable access to mental health and substance use disorder benefits.

If you need assistance in reviewing your health plan’s compliance with MHPAEA or have questions about the non-enforcement policy, feel free to reach out to our team of experts.