- Posts by Kevin J. Malone
Member of the Firm"My work in government gave me a ground-level view of how policy actually plays out for health plans and providers. I bring that perspective to every matter I handle." —Kevin J. Malone
Health plans, provider organizations, and ...
On May 9, 2025, the Departments of Labor, Health and Human Services, and Treasury (collectively, “the Departments”) asked the D.C. federal court to suspend a lawsuit to challenge the legality of the 2024 Rule on the Mental Health Parity and Addiction Equity Act (MHPAEA) while the Departments consider whether to rescind or modify the 2024 Rule.[1] On May 15, 2025, the Departments released a public statement that they will not enforce the 2024 Final Rule prior to a final decision in the litigation, plus an additional 18 months after the decision.
The public statement on May 15 provides further details regarding the scope of the non-enforcement policy, including clarification that the 2013 MHPAEA rules remain in effect, as does plans’ obligation to develop comparative analyses of non-quantitative treatment limits (“NQTLs”). However, the Departments have not yet provided any indication of the timeline for publishing a notice of proposed rulemaking to rescind or modify the 2024 Rule, and most likely it will take some time for the Departments to determine how exactly the new rule should be designed to better implement the statutory requirements.
On February 1, 2024, the Substance Abuse and Mental Health Services Administration (SAMHSA) issued a final rule revising 42 CFR Part 8, which regulates opioid treatment programs (OTPs). The final rule is the first update to the OTP regulations in over 20 years, and significantly increases access to lifesaving medication while easing operational restrictions.
The agency eased admission requirements and cemented some of the telehealth and take-home dose flexibilities put in place during the COVID-19 pandemic. Other changes streamline OTP operations, reduce restrictions on ...
On January 18th, the Centers for Medicare & Medicaid Services (CMS) announced a new demonstration model called the Innovation in Behavioral Health (IBH) Model, which is designed to improve outcomes for adults with mental health and substance use disorders (MH/SUD) by enhancing behavioral health provider capacity to integrate physical health care into their practice settings and services. The new demonstration model will be run out of the Centers for Medicare and Medicaid Innovation (CMMI) under the funding authority of Section 3021 of the Affordable Care Act and demonstration ...
Recent Updates
- CMS Receives Its Exclusion Authority: What Happens Now?
- GLOBE Model Final Rule Drops — but Will It Work on a Smaller Scale?
- Congressional Action on Health Care Cybersecurity: HISAA Is Re-Introduced and the Health Care Cybersecurity and Resiliency Act Moves Forward
- DOJ Corporate Fraud Enforcement Memo: What Health Care Companies Need to Know Now
- Attorneys General of Three States File Two Sweeping Lawsuits Targeting Telehealth Abortion Providers and State Shield Laws