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Consolidated Appropriations Act and Mental Health Parity FAQs

The Consolidated Appropriations Act, 2021 (CAA), which was signed on December 27, 2020, included modifications to the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). The modifications enhance protections under the law and requires group health plans and issuers that cover mental health/substance use disorder (MH/SUD) and medical/surgical (M/S) benefits to prepare a comparative analysis of any nonquantitative treatment limits (NQTLs) that may apply. Beginning February 10, 2021, plans must supply this analysis and other information if requested the Departments of Labor (DOL) and Health and Human Services (HHS) or Treasury Department

On April 2, 2021, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) jointly issued Frequently Asked Questions (FAQs) to clarify the modifications. The FAQs address the following:

  • When plans and issuers must make their NQTL comparative analyses available
  • What information plans and issuers must make available
  • Reasons why documentation of comparative analyses of NQTLs might be insufficient
  • What types of documentation should be made available
  • What actions the Departments might take for noncompliance

Self-insured plan sponsors that have not yet conducted a NQTL comparative analysis should prepare one as soon as possible in case the agencies request this information. This analysis is typically performed by the plan sponsor’s third-party administrator and/or Pharmacy Benefits Manager (PBM). Plan sponsors should contact these partners, or work with their health plan advisors to start this analysis. You may also consider a compliance plan to “promote the prevention, detection and resolution of potential MHPAEA violations,” as recommended in DOL’s self-compliance tool. In addition, plan sponsors should keep apprised of litigation developments and additional regulatory guidance.

Read the Legal Update.

Contact your Cowden representative for more information on this or other compliance issues.