What Compliance Teams Need to Know About the Mental Health Parity and Addiction Equity Act Pause

According to an article by attorneys at Husch Blackwell, the Mental Health Parity and Addiction Equity Act (MHPAEA) was enacted to prevent health plans from placing more restrictive limitations on mental health and substance use disorder (MH/SUD) benefits than on medical/surgical (M/S) benefits. 

Over the years, the law evolved, with the 2013 Final Rule and the 2021 Consolidated Appropriations Act (CAA) requiring detailed comparative analyses of non-quantitative treatment limitations (NQTLs). In 2024, a new Final Rule aimed to further tighten these standards, but it now faces legal and regulatory uncertainty.

A lawsuit filed by the ERISA Industry Committee (ERIC) in early 2025 challenged the 2024 Rule, arguing that it overstepped statutory authority, relied on vague standards, and imposed excessive burdens. 

In response, the federal agencies paused enforcement and requested time to reconsider the Rule. While this provides temporary relief, the pause applies only to the new provisions introduced in 2024. Existing requirements under the 2013 Rule and CAA remain fully in effect.

The article suggests that compliance teams must continue to perform and document NQTL comparative analyses, ensuring that financial and treatment limitations for MH/SUD benefits are aligned with those for M/S benefits. Additionally, state enforcement actions may persist regardless of the federal pause, particularly for fully insured plans subject to state regulation.

The final takeaway: Maintain current documentation, align plan designs with the 2013 Rule and CAA, and monitor both federal and state developments. The 2024 Rule of the Mental Health Parity and Addiction Equity Act may resurface in a revised form, and readiness will be critical for future compliance.