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This document sets forth EBSA’s updated enforcement guidance under MHPAEA, providing clearer and more streamlined expectations to plans and issuers for NQTL compliance.
The final rules amend certain provisions of the existing MHPAEA regulations and add new regulations to set forth content requirements and timeframes for responding to requests for nonquantitative treatment limitation (NQTL) comparative analyses required under MHPAEA, as amended by the Consolidated Appropriations Act, 2021 (CAA, 2021).
The Departments of Labor, Health and Human Services, and the Treasury released new final rules to strengthen parity between mental health and substance use disorder (MH/SUD) benefits and medical and surgical (M/S) benefits.
The Mental Health Parity and Addiction Equity Act generally prevents most group health plans and health issuers that provide mental health and substance use disorder (MH/SUD) benefits from imposing more restrictive coverage limitations on those benefits than on medical/surgical (M/S) benefits.
Request for Comment on Proposed Relevant Data Requirements for Non- quantitive Treatment Limitations (NQTLs) Related to Network Composition and Enforcement Safe Harbor for Group Health Plans and Health Insurance Issuers Subject to the Mental Health Parity and Addiction Equity Act.
Comments are submitted on individual documents in a docket.
The Health Benefits Advisor is one of a series of elaws (Employment Laws Assistance for Workers and Small Businesses) Advisors developed by the U.S. Department of Labor (DOL) to help employers and employees understand their rights and responsibilities under Federal employment laws.
This tool gives a basic understanding of MHPAEA to assist in evaluating compliance with its requirements. It contains a number of examples that demonstrate how the law applies in certain situations and how a plan or issuer might or might not comply with the law.
This booklet provides an informal explanation of the statutes and the most recent regulations and interpretations
Discusses whether a plan or issuer can establish any sub-classifications to determine parity for outpatient benefits.
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) generally requires employment-based group health plans and health insurance issuers that provide group health coverage for mental health/substance use disorders to maintain parity between such benefits and their medical/surgical benefits.
This page outlines the requirements for health plans under the Affordable Care Act (ACA) regarding internal claims and appeals processes, emphasizing fairness and transparency.
The MHPAEA Interim Final Rule Fact Sheet includes guidance on compliance requirements, the scope of coverage, and details on the enforcement of parity standards, helping employers and plan sponsors understand their obligations under the law.
Regulatory provisions related to MHPAEA that were enacted in April 2021, outlining updated rules and requirements.
Final guidance regarding non-quantitative treatment limitations and disclosure requirements under MHPAEA and the 21st Century Cures Act.
Related resources
Proposed guidance regarding non-quantitative treatment limitations and disclosure requirements under MHPAEA and the 21st Century Cures Act.
Related resources
Revised Draft MHPAEA Disclosure Template
PRA Appendix II: Crosswalk of Changes
Public Comments - Proposed MHPAEA FAQs Part 39
Contains information and requests comments on disclosure requirements and treatment for eating disorders under MHPAEA and the 21st Century Cures Act.
Related resources
Draft MHPAEA Disclosure Template
Clarifies disclosure requirements under MHPAEA, explains quantitative and non-quantitative treatment limitations, and discusses medication-assisted treatment for opioid use disorder.
Offers guidance on Affordable Care Act and MHPAEA topics, such as financial requirements and quantitative treatment limitations.
Provides responses to frequently asked questions about the Affordable Care Act, MHPAEA, and health plan disclosure requirements.
Contains information on topics related to the Affordable Care Act and MHPAEA, such as coverage of preventive services and cost-sharing.
Addresses common questions and provides clarifications on the MHPAEA final rules.
Offers guidance and explanations on what is permissible under MHPAEA.
Provides answers to frequently asked questions regarding the Affordable Care Act and MHPAEA implementation.
