On May 15, 2025, the Departments of Health and Human Services, Treasury and Labor (the “Departments”) released a nonenforcement policy for portions of the final mental health parity rules they issued in September 2024. This nonenforcement policy means that key provisions of those 2024 rules – including the “meaningful benefits” rule, the outcomes data rule, and the fiduciary certification requirement – are currently not being enforced. However, health plans must still prepare the comparative analyses of their nonquantitative treatment limitations.

Our prior Client Alert provides background regarding the Mental Health Parity and Addiction Equity Act (“MHPAEA”) and the final rules the Departments issued in September 2024 (the “2024 Rule”), which required group health plans and sponsoring employers to take many new significant steps to comply with the MHPAEA.

Litigation Challenging the 2024 Rule

The ERISA Industry Committee (“ERIC”), an industry advocacy group for large employers, sued the Departments alleging the 2024 Rule illegally expands the Departments’ statutory authority and violates the Administrative Procedures Act’s procedural requirements.

Specifically, ERIC highlighted the following provisions of the 2024 Rule:

• Meaningful Benefits. The 2024 Rule requires health plans to provide “meaningful” coverage for each mental health and substance use disorder (“MH/SUD”) condition in each classification for which a group health plan provides medical/surgical (“M/S”) benefits. The 2024 Rule defines “meaningful” as coverage including one core or primary treatment for the condition. ERIC alleges this creates a benefits mandate for plan sponsors, directly contradicting the MHPAEA’s statutory language that “the statute is not intended to mandate any particular MH/SUD benefits.”
  
  
• Outcomes Data. The 2024 Rule requires plans to collect and evaluate data that may indicate disparate participant access or use between M/S benefits and MH/SUD benefits and take reasonable action steps to address any differences. ERIC alleges this presumption of a violation based on outcomes goes far beyond the statutory requirements of the MHPAEA, which merely requires parity in plan terms and the application of those terms, not in the outcomes they produce. 
  
  
• Fiduciary Certification. The 2024 Rule requires plan fiduciaries to certify that they have engaged in a prudent process in preparing and evaluating their plan’s comparative analyses of its nonquantitative treatment limitations. ERIC alleges this requirement violates the Due Process Clause of the United States Constitution, as the Departments’ guidance is vague as to what the comparative analyses require, giving the plan sponsor no clear way to comply. 

Nonenforcement Policy

In response to the ERIC lawsuit, the Departments issued a nonenforcement policy that applies only with respect to those portions of the 2024 Rule that are new in relation to final mental health parity rules that were issued in 2013. The Departments will not enforce the 2024 Rule or otherwise pursue enforcement actions, based on a failure to comply that occurs prior to a final decision in the litigation, plus an additional 18 months. The Departments make clear that MHPAEA’s statutory obligations, as amended, continue to have effect and indicate plan sponsors may continue to refer to the final 2013 rules, FAQs, and other sub-regulatory guidance issued by the Departments under the MHPAEA, subject to updates by the Departments.

Action Steps

• The comparative analyses of a plan’s nonquantitative treatment limitations are statutorily required under the MHPAEA, so plan fiduciaries should continue to prepare comparative analyses, keep them updated, and be ready to provide them upon request by regulators and participants.
  
  
• Plan fiduciaries should continue to ensure nonquantitative treatment limitations are applied no more restrictively for MH/SUD benefits than for M/S benefits in the same classification.
  
  
• As a best practice, plan fiduciaries should document their actions in complying with the MHPAEA and its implementing regulations and ensure prudent processes are practiced in the preparation and evaluation of comparative analyses, although a fiduciary certification is not currently being enforced. 

If you have questions or need assistance with MHPAEA compliance, please contact a member of our Employee Benefits and Executive Compensation Group.