NEW FAQs ON MENTAL HEALTH AND SUBSTANCE USE DISORDER PARITY IMPLEMENTATION

New FAQs on Mental Health and Substance Use Disorder Parity Implementation

On April 2, 2021, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury released guidance on implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the No Surprises Act (Section 203) included in the Consolidated Appropriations Act.

Section 203 established new reporting and oversight requirements related to mental health and substance use disorder parity compliance of non-quantitative treatment limitations (NQTLs). In addition to codifying the comparative analysis approach included in the DOL’s 2020 MHPAEA Self Compliance Tool, the Act included processes for corrective action, a report to Congress on the findings of the federal reviews, and information sharing with states on compliance review findings.

Specific information addressed in the FAQs:

• Plans and issuers that offer both medical/surgical benefits and MH/SUD benefits and impose NQTLs must make their comparative analyses of the design and application of NQTLs available to the Departments or applicable State authorities upon request, beginning 45 days after the date of enactment (i.e., February 10, 2021)
• Plans and issuers that have carefully applied the guidance in the Self-Compliance Tool “should be in a strong position” to submit comparative analyses upon request.

The FAQs provide additional guidance on complying with the new comparative analysis documentation requirements, including the type of information plans and issuers must make available to regulators as well as the specific NQTLs the Departments expect to focus their enforcement on in the near term.