The twists and turns and ups and downs of mental health parity compliance seem never ending. On January 17, 2025, a lawsuit challenging the mental health parity final regulations, (see Mental Health Parity At Issue, here) was filed by the ERISA Industry Committee. In the lawsuit, the ERISA Industry Committee asserts that the regulations are unlawful and violate the Administrative Procedure Act, exceed the Department’s authority under the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Consolidated Appropriations Act, violate the due process clause of the Fifth Amendment and are arbitrary and capricious. Key provisions of the final rule in the lawsuit include the “meaningful benefits” provisions, the “material differences in access” standard, the requirements related to comparative analysis and fiduciary certification requirement, and the January 1, 2025, applicability date. Of course, it will take quite some time to know how this litigation unfolds. In the meantime, plans must continue to use best efforts to ensure compliance.
Also on January 17, 2025, the DOL issued its Report to Congress, Enforcement Fact Sheet and its News Release as required by the Consolidated Appropriations Act of 2021. Key areas of concern for mental health parity compliance continue to be access to ABA therapy, counseling for eating disorders, network adequacy, cost-share equivalents between medical/surgical services and mental health/substance use disorder services.
The governing agencies say that the compliance tool, found here, last updated in 2020, will be updated in the near future to reflect the mental health parity final rules issued in September 2024. They also indicate that a sample comparative analysis will be made available soon.
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