The three federal agencies tasked with enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) — the Departments of Labor, Health & Human Services (through CMS), and Treasury (the Departments) — issued their Final Rule to implement the MHPAEA on September 9, 2024, to mixed reviews.
Groups composed of providers, such as the American Medical Association and American Hospital Association, responded with support for the Final Rule and welcomed any infusion of certainty that such guidance could provide. However, representatives of the large employer benefit plan sponsor industry and the insurance industry, such as the ERISA Industry Committee and America’s Health Insurance Plans, expressed grave concerns about the Final Rule’s unintended consequences, including raised costs and, ironically, the potential decrease in access to mental health and substance use services. Litigation regarding the Final Rule is considered likely.
A comprehensive review of the 536-page Final Rule is beyond the scope of this blog, but we highlight here some of the Rule’s most significant impacts on health plans, including guidance regarding NQTLs and comparative analyses, the role of third-party administrators (TPAs) in MHPAEA compliance, and an expansion of the statute’s scope.