On September 9, 2024, the Biden administration issued much-anticipated final regulations under the Mental Health Parity and Addiction Equity Act (MHPAEA). The rules implement a host of complicated new compliance requirements for sponsors and issuers of health plans, instituting new obligations to collect and evaluate plan data, conduct comparative analyses, and act to address material differences in access to mental health and substance abuse benefits as compared to medical and surgical benefits.

McDermott lawyers Alden Bianchi, Jake Mattinson and Sarah Raaii provided a comprehensive overview of the new rules, including compliance deadlines and key takeaways for employers, plan sponsors, and issuers of group health plans. The speakers also addressed how the new rules might impact any ongoing US Department of Labor investigations.

Discussion topics included:

• The rules governing the testing of nonquantitative treatment limitations (NQTLs), including the “design and application” and “data evaluation requirements”
• The “meaningful benefits” standard that effectively imposes a new benefit mandate by requiring plans to provide “core” mental health and substance use disorder benefits in every benefit classification in which medical/surgical benefits are provided
• The obligation to evaluate the impact of NQTLs and to prepare and make available on request a comparative analysis of a plan’s NQTLs
• The requirement for fiduciaries to certify that they have engaged in a prudent selection and monitoring process for selecting a vendor to perform and document an NQTL comparative analysis
• The definitions of key terms (including “medical/surgical benefits,” “mental health benefits,” and “substance use disorder benefits”)
• The consequences of failing to comply with the NQTL substantive and comparative analysis requirement
• Important deadlines for compliance with the new rules

To learn more about the final MHPAEA regulations, read our On the Subject, Landmark Mental Health Parity Final Rule: What Plan Sponsors and Insurers Need to Know.