Federal Agencies Halt Enforcement of Mental Health Parity Rule

​ ​Updated May 15,⁢ 2025
⁤

The U.S.Departments of⁤ Labor, Health⁢ and Human Services, and Treasury⁣ announced⁢ on May 15, 2025, they will‌ not enforce ‍specific ⁢sections of the 2024 final rule regarding the Mental Health Parity ⁤and Addiction Equity Act ⁣(MHPAEA). This decision provides relief‍ to plan ‍sponsors, employers, and health plans who ⁢voiced concerns about new reporting requirements ‍and ambiguous guidance.

More significantly,the agencies plan to re-evaluate broader aspects of mental health parity,including their enforcement strategy ⁤for MHPAEA,especially as amended by the 2021 Consolidated Appropriations Act​ (CAA). this move comes after ⁣criticism‍ that the 2024 rule ‍imposed ‌undue burdens and costs.

The MHPAEA, initially enacted to⁤ ensure parity between mental health and medical ​benefits, ​has undergone several revisions. The 1996 Mental Health Parity Act (MHPA) set a basic standard for mental health ​benefits. Then, in 2008, the MHPAEA expanded thes ‍protections to include substance use disorder (SUD)‌ benefits, requiring parity in ‍financial requirements and treatment limitations.

Implementing regulations from HHS, Treasury, and DOL further defined these requirements, distinguishing between quantitative treatment limitations (QTLs) and nonquantitative ⁢treatment limitations (NQTLs). The 2013 final ⁤rules established methods for assessing parity, with NQTLs subject‍ to stricter ‌comparability standards.

The‌ 2021 CAA amendments codified NQTL parity criteria, ​mandating that ​plans document and provide comparative analyses demonstrating‌ that NQTLs applied to​ mental health and substance use disorder benefits are no more stringent than those applied to medical/surgical​ benefits. These ‍analyses ​must ‌be kept up-to-date and made available to the departments upon request.

The 2024 final rule introduced additional requirements, including a “meaningful benefits” standard and changes to NQTL assessments. It ​stipulated⁣ that if a plan offers ​any mental health or SUD benefits, it must provide ‍meaningful benefits in⁣ every classification ⁣where⁤ medical/surgical benefits⁤ are offered. The rule also set specific criteria for demonstrating that NQTLs ⁣are no more restrictive than those applied to medical/surgical benefits,⁣ including‍ data ⁣collection and analysis to address any material differences in access.

Though, the ERISA​ Industry committee (ERIC) challenged the 2024 final rule, arguing that the new requirements exceeded ⁣the departments’‌ statutory authority and violated the‍ Administrative Procedures ‌Act. ERIC contended that the ⁤ruleS ⁢mandates regarding meaningful​ benefits, material ‍differences in ‍access, and⁤ fiduciary certification were overly burdensome‍ and⁤ ambiguous.

Instead of defending⁤ the rule in ⁢court, the departments opted for a ‍non-enforcement policy, citing Executive Order 14219, which directs agencies to review regulations that may⁢ undermine the ​national ⁢interest. The departments will now reconsider the 2024 final rule, potentially ⁣rescinding or modifying it. The agencies‌ emphasized that ⁣existing statutory obligations, including those established by the CAA, remain in effect.

The non-enforcement policy is⁤ a welcome⁢ development for health⁤ plans and ​issuers,many of whom found the 2024 rule’s⁣ requirements impractical. ‌while employers support​ the goals of ensuring parity and increasing access to mental health and substance use disorder benefits, they ⁣viewed the 2024 final rule as ambiguous,⁢ burdensome, and potentially discouraging ⁢the offering of such​ benefits.

What’s next

Plan sponsors and​ health plans will ⁢closely monitor the departments’ ​reconsideration of the 2024 final rule and their broader ⁣approach to enforcing MHPAEA, particularly in light of the ⁣2021 legislation. ⁢Further guidance is anticipated to clarify ​the path ⁤forward for mental health parity compliance.