On Monday, September 9, 2024, the Departments of Health and Human Services, Labor and Treasury (the “Departments”) issued their final rule regarding the nonquantitative treatment limitation (NQTL) comparative analysis required under the Mental Health Parity and Addiction Equity Act (MHPAEA). (These acronyms roll right off the tongue, don’t they?) The Departments note that final rules reflect thousands of comments they received after publishing their proposed rules last August 2023. They remark that through these rules they “aim to further MHPAEA’s fundamental purpose – to ensure that individuals in group health plans or group or individual health insurance coverage who seek treatment for covered MH conditions or SUDs do not face greater burdens on access to benefits for those conditions or disorders than they would face when seeking coverage for the treatment of a medical condition or a surgical procedure. These final rules are critical to addressing barriers to access to MH/SUD benefits.”
While laudable, the rules seek to implement that goal by imposing fairly burdensome requirements on sponsors of self-funded medical plans who have been left to sort through the NQTL requirements without a clear roadmap and at considerable expense.
The final rules appear to make discreet changes to the proposed rules. Your Seyfarth EB team is busy digesting the guidance and will issue a Legal Update shortly analyzing the final rule, and most importantly what this means for sponsors and administrators of self-funded plans.
