The Departments of Health and Human Services, Labor, and Treasury recently released new guidance on the Mental Health Parity and Addiction Equity Act (the “MHPAEA”). The MHPAEA was designed to ensure the same level of benefits for mental and substance use disorders as for medical and surgical care in group health plans. This latest guidance introduces significant requirements for health plan sponsors that add to the existing requirement for a nonquantitative treatment limitation (“NQTL”) analysis.
One of the additional proposed requirements is a plan fiduciary certification requirement, a move likely to increase not only the compliance burden on plan sponsors but also the costs and risks they must shoulder. Legal firm Davis Wright Tremaine LLP suggests this change will bring more complexity and financial ramifications for those responsible for managing health benefits within their organizations.
While the aim of the guidance is to strengthen parity in mental health care, it has raised some concerns in the industry. The new directives, by virtue of increasing the obligations and potential financial exposure of plan sponsors, may have unintended consequences, particularly for those operating small to medium-sized businesses.
At this point, the full extent and impact of these changes are yet to be seen. It can be expected that health plan sponsors will need to diligently review their obligation under the updated guidance to ensure compliance and minimize risk. Legal professionals navigating these changes will need to stay sharp and sustain a comprehensive understanding of the new regulations and its ramifications.
For a complete understanding of the new guidance and its potential impact, a thorough read of the official publication is advisable. The full document can be accessed here.