Update as of 5/15/2025
Following the date of this publication, in May 2025, under President Trump, the Departments announced a non-enforcement policy with respect to the requirements of the 2024 Final Regulations discussed herein, as issued under President Biden. Until the final resolution of ERISA Industry Committee v. Dep’t of Health and Human Services, et al., U.S. District Court for the District of Columbia, Case No. 1:25-cv-00136 (complaint filed January 17, 2025), which challenges the 2024 Final Regulations, and for 18 months thereafter, the Departments will not enforce the 2024 Final Regulations pending their evaluation for enforceability. Notably, the non-enforcement policy applies only to the 2024 Final Regulations, not to the prior requirements of the MHPAEA. As such, until the Departments finalize the rules, plans must still comply with their obligations under the MHPAEA as in place prior to the issuance of the 2024 Final Regulations.
On September 9, 2024, the U.S. Departments of Health and Human Services (HHS), Labor, and the Treasury (HHS, Labor, and the Treasury, collectively, the Departments) issued final rules (the 2024 Final Regulations) to implement the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, as amended (the MHPAEA). Included in the 2024 Final Regulations are new rules regarding the nonquantitative treatment limitation (NQTL) comparative analysis requirements under MHPAEA, as amended by the Consolidated Appropriations Act, 2021 (the CAA 2021).
This NQTL comparative analysis requirement has created a significant level of angst among plan fiduciaries as they will now have to certify that they have engaged in a prudent process to select and monitor one or more qualified service providers to perform and document their NQTL comparative analyses in connection with the imposition of any NQTLs that apply to mental health and substance use disorder (MH/SUD) benefits under the plan in accordance with MHPAEA and its implementing regulations.
This column provides an overview of Non-Quantitative Treatment Limitation (NQTL) comparative analyses and outlines the steps fiduciaries must take to ensure compliance.