Administration won’t enforce 2024 mental health parity rule  

The departments of Labor, Health and Human Services and Treasury have announced that they will not enforce the 2024 final mental health parity rule for any compliance failure that occurs before a final decision in the ERISA Industry Committee’s lawsuit challenging the rule (or in the subsequent 18 months). A final decision is not imminent. On May 12, a federal court granted the departments’ request to pause the litigation while they reconsider whether to modify or rescind the 2024 rule through new proposed rulemaking. This is positive news for many employers, as the 2024 rule imposes significant new compliance obligations on group health plan sponsors including the meaningful benefits requirement, fiduciary certifications for ERISA plans and outcomes data evaluations.

It is important to note that employers are still required to comply with the Mental Health Parity and Addiction Equity Act, which includes the obligation to have a written Nonquantitative Treatment Limitation comparative analysis as mandated by the Consolidated Appropriations Act, 2021.  

The departments’ enforcement relief is limited to “those portions of the 2024 Final Rule that are new in relation to the 2013 Final Rule.” MHPAEA, as amended by the CAA, is still in effect. Plan sponsors may continue to refer to: 

• The 2013 final rule 
• FAQs about mental health and substance use disorder parity implementation and the CAA part 45, and 
• Other subregulatory guidance issued under MHPAEA.   

However, the departments intend to reexamine their enforcement approach under MHPAEA , and may update FAQs part 45 (which includes detailed information about the content requirements for the comparative analysis) and other subregulatory guidance as part of that process.

ERIC’s complaint, filed earlier this year, alleged that the 2024 rule is unlawful in numerous respects and asked the court to invalidate the rule, or in the alternative, to invalidate those provisions identified as particularly problematic such as the meaningful benefits requirement, the material differences in access standard, and the fiduciary certification.  

The complaint did not challenge the requirement to conduct an NQTL comparative analysis but alleged that the 2024 rule offers little guidance on what specific information a plan must provide in the written comparative analysis and uses vague and undefined terms. Accordingly, the complaint contended that the 2024 rule’s comparative analysis requirements are arbitrary and capricious and violate due process.

Plan sponsors should ensure that they continue to comply with MHPAEA during the nonenforcement period and monitor participant complaints and litigation regarding access to mental health and substance use disorder coverage under group health plans. Mental health parity has traditionally had bipartisan support, and the departments stress that they remain committed to ensuring that individuals receive MHPAEA’s protections during the nonenforcement period. However, the departments will undertake their commitment “in a way that is not unduly burdensome for plans and issuers.”