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Legal Alert: Mental Health Parity Final Rule
Compliance News
Thursday, November 07 2024
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Are You Prepared to Comply With the New Mental Health Parity Final Rule in 2025?

On September 9, 2024, the DOL, IRS and HHS released a final rule for the Requirements Related to the Mental Health Parity and Addiction Equity Act (MHPAEA Final Rule).  The MHPAEA Final Rule is similar to the proposed rule released on July 25, 2023, with some marked differences.  While the MHPAEA Final Rule is effective as of November 22, 2024, the requirements become enforceable at different times. Most apply to plan years beginning on or after January 1, 2025, with other requirements becoming enforceable for plan years beginning on or after January 1, 2026.

MHPAEA Proposed Rule

The MHPAEA Proposed Rule released last year sought to clarify and solidify requirements for group health plans and health insurance issuers (plans and issuers) to perform comparative analyses of the nonquantitative treatment limitations (NQTLs) imposed under their plans through the collection and evaluation of data to: (a) reasonably assess the impact of NQTLs on access to mental health and substance use disorder (MH/SUD) benefits and medical/surgical (Med/Surg) benefits; and (b) demonstrate compliance with the MHPAEA as written and in operation. The Proposed Rule focused on the following:

Applying a similar “substantially all” standard to NQTLs as that which applies to quantitative treatment limitations (QTLs);

Revising comparative analysis requirements; Enhancing definitions to better assist plans;

Solidifying compliance deadlines.

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