On May 15, 2025, the Departments of Labor, Health and Human Services, and the Treasury issued a statement regarding the enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) Final Rules, which were released on September 9, 2024. The enforcement of the 2024 Final Rule will be delayed until a court has made a decision on the lawsuit filed by the ERISA Industry Committee (ERIC) earlier this year. ERIC’s complaint, filed on January 18, 2025, challenges the validity of the rule and several new requirements it imposes, including the meaningful benefits requirement, outcomes data evaluations, and fiduciary certifications of non-quantitative treatment limitations (NQTL) comparative analysis reports for plans subject ERISA. Please refer to our earlier blog for further details. Once the court issues a final ruling, the enforcement delay will continue for an additional 18 months. Although, a final court decision is expected to take some time.
What does this mean for employers, particularly those that sponsor self-insured or level-funded medical plans and are primarily responsible for compliance, including the mental health parity rules? In essence, very little changes. Despite the delay in enforcing certain stricter parity standards, it remains crucial for group health plan sponsors to monitor their plan designs for compliance and maintain a written comparative analysis of NQTLs. The requirements of the 2013 MHPAEA final rule, the Consolidated Appropriations Act,2021 (CAA), which introduced the NQTL comparative analysis requirement, and its implementing FAQs will remain in effect. Therefore, this non-enforcement policy should not be interpreted as a reason to delay preparing an NQTL comparative analysis report.
Employers are encouraged to continue their compliance efforts in anticipation of potential agency audits, participant inquiries, or plaintiff attorney requests related to the NQTL comparative analysis report, until clear guidance to the contrary is provided by Congress or the relevant agencies. AssuredPartners is closely monitoring the situation and will provide updates as necessary.
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