Biden Administration Releases Mental Health Parity Proposed Regulations, Targeting Compliance - Bim Group

Biden Administration Releases Mental Health Parity Proposed Regulations, Targeting Compliance


On July 25, 2023, the U.S. Departments of Treasury, Labor, and Health and Human Services (the “Departments”) released proposed rules on the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), ensuring that health plans provide coverage for mental health and substance use disorder treatments (such as those for anxiety) at the same level as physical health care coverage (such as medical and surgical benefits related to heart disease or diabetes).

Specifically, these proposed regulations:

  • Propose new standards for determining network composition and out-of-network reimbursement rates
  • Sunset the ability for non-federal government plans to opt out of federal parity requirements
  • Codify standards for non-quantitative treatment limitations (NQTLs) requirements, such as medical management techniques like prior authorizations
  • Require that health plans acknowledge and address any differences in access to mental health and substance use disorder benefits from medical or surgical benefits
  • Request feedback on proposed data requirements related to a health plan’s NQTLs and network composition

Once these proposed regulations are published in the Federal Register, the agencies will accept comments for 60 days.

When the MHPAEA was amended by the Consolidated Appropriations Act, 2021 (CAA), a provision was added to the law, requiring health plans and issuers to document comparative analyses of both the design and application of their NQTLs. Health plans and issuers must then provide these analyses to the Departments and any applicable state agency, upon request.

The Secretaries of the Departments must then report these results to Congress annually, known as the MHPAEA Comparative Analysis Report to Congress (Report). A Report has been submitted for both 2022 and 2023, satisfying the CAA’s requirements.

Among other things, these Reports address MHPAEA enforcement priorities and activities. Most recently, the 2023 Report explicitly stated that mental health parity enforcement is a top priority for the Employee Benefits Security Administration (EBSA), the employee benefits enforcement arm of the U.S. Department of Labor (DOL). Specifically, in its 2023 Report, the EBSA has announced that it will devote almost 25 percent of its enforcement work to MHPAEA NQTLs.

Over the past year, the EBSA increased staff specialization in its dedicated NQTL Task Force, developed new investigative tools specifically for MHPAEA investigations as well as hired and consulted with subject matter experts on mental health and substance use disorder (MH/SUD) diagnoses, treatments, review processes, and certain types of NQTLs.

Bracing for yet another regulatory responsibility, employers offering group health plans are responsible for ensuring that their health plan complies with the MHPAEA, including these newly proposed regulations.

Employers should keep these best practices in mind:

  • Review the MHPAEA Self-Compliance Tool from the DOL annually, helping you navigate your legal responsibilities.
  • Discuss the proposed regulations with your broker and third-party administrator, ensuring compliance with the MHPAEA comparative analyses rules.
  • Consider whether you need to hire a qualified consultant to prepare your comparative analyses if your third-party administrator does not prepare the report (or only prepares part of the report).
  • Consult with legal counsel if you’ve identified any MHPAEA concerns that may lead to non-compliance.



This information has been prepared for UBA by Fisher & Phillips LLP. It is general information and provided for educational purposes only. It is not intended to provide legal advice. You should not act on this information without consulting legal counsel or other knowledgeable advisors.

Recent Insights

July 9, 2024
News, Webinar

Webinar: Keep it Classy – Identifying Employees Properly

Tuesday, August 13, 2024 1 – 2PM CST Register Now Registration Code:UBA410EW   Attend this month’s webinar to learn how to properly classify employees for benefit eligibility. ​ Gain insights into:​​ Allowable employment-based classifications for benefits and contributions Risks arising from misclassifying or discriminating against employees Offering benefits to 1099 employees and related tax implications […]
Read more
July 9, 2024

EEOC Issues Final Regulations for the Pregnant Workers Fairness Act

READ TIME: 6 MINUTES The Equal Employment Opportunity Commission (EEOC) has recently released extensive final regulations under the Pregnant Workers Fairness Act (PWFA). The regulations were published in the federal register on April 19, 2024, and will take effect on June 18, 2024. Here’s what employers need to know. Overview of PWFA The PWFA took […]
Read more
July 9, 2024

Group Health Plan Fiduciaries are the Subject of New ERISA Class Actions

READ TIME: 5 MINUTES Retirement plan fiduciaries are no stranger to ERISA class action lawsuits. These lawsuits typically allege that imprudent processes and lack of oversight led to excessive fees for investment options, recordkeeping services, and investment management services. Similar class actions are beginning to find their way to group health plan fiduciaries thanks to […]
Read more
June 26, 2024

HIPAA Privacy Rule to Support Reproductive Health Care Privacy

READ TIME: 6 MINUTES Following the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade and its constitutional protection of abortion, many states adopted extreme abortion bans and other restrictions on reproductive health care. Along with these new laws came concerns from both patients and providers that protected health […]
Read more