Health plans and issuers need to ramp up compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) in response to the new proposed rules from the Departments of Labor, Health and Human Services. The proposed rules represent a significant shift in compliance measures, and plans will need to re-review their non-quantitative treatment limitation (NQTL) comparative analyses to assess if they can demonstrate compliance under the new requirements.
If the rules are adopted, achieving compliance will become more challenging and costlier. Stricter and more extensive requirements for NQTL content and designs will be in place, and specific data will be required to be constructed, maintained, and reported by plans and issuers. If finalized as proposed, the new rules take effect on the first day of the plan year beginning on or after January 1, 2025.
Prior regulatory audits have revealed that few, if any, plans and issuers met MHPAEA requirements, and it’s anticipated that the additional guidance will help plans understand what’s necessary to satisfy regulators. However, new regulations can create operational challenges and are often costly to implement. The proposed regulations also place higher expectations on plan sponsor oversight and validation of their administrators.