David Shillcutt, Member of the Firm in the Health Care & Life Sciences practice, in the firm’s Washington, DC, office, was quoted in Law360, in “3 Atty Takeaways on Mental Health Parity Final Rules,” by Kellie Mejdrich. (Read the full version – subscription required.)
Following is an excerpt:
Federal agencies' recently finalized rules for how employer health plans must analyze their coverage of mental health and substance use disorder treatments impose significant reporting and disclosure requirements, although regulators backed off more sweeping proposed network design changes, attorneys say.
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 requires that employer health plans' limitations on mental health and substance use disorder treatments be no more stringent than what's applied in other contexts, such as medical or surgical care. But the law sat on the books for more than a decade before Congress decided federal regulators needed greater authority to ensure insurers and health plans were complying. Congress gave the U.S. Department of Labor sweeping new enforcement authority in 2020 in a law that also set the analysis requirements on nonquantitative treatment limitations subject to the final rules.
Here are three key takeaways from attorneys on the final mental health parity rules — what made it in, what's out and what to watch for next. …
Compliance Deadline Changes
Attorneys also highlighted a shift in the applicability date to 2026 for some new requirements under the final rules that were originally proposed to go into effect in 2025.
The DOL said in a fact sheet on the final rules that the delay applies to what the rules call a meaningful benefits standard, which relates to how plans have to compare the depth of their medical and surgical coverage to the behavioral health side. Some data evaluation requirements also have delayed applicability in 2026, along with a prohibition in the rules on plans applying certain discriminatory factors when designing treatment limitations. …
But David Shillcutt, a behavioral healthcare attorney and member of the firm at Epstein Becker Green, said that while there's been a focus on the delays to 2026, he thought it was more notable that "the compliance date for almost all of the requirements is just three months away" under the final rules.
"I think that really misses the practical takeaway for plans and issuers, which is that almost all of these requirements are due in 2025," Shillcutt said.
