The Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury announced on May 15, 2025 that they will not enforce the portions of the 2024 final rule implementing the nonquantitative treatment limitation (NQTL) comparative analyses requirements under the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA), as amended by the Consolidated Appropriations Act, 2021 (CAA, 2021). During this period of nonenforcement as the departments “revisit the 2024 final rule, the departments remain committed to ensuring that individuals receive protections under the law in a way that is not unduly burdensome for plans and issuers,” the statement said. In the meantime, group health plans can refer to several compliance documents released between 2013 and 2021. To the extent that plans and/or their service providers are already complying with the 2024 final rule, that can continue voluntarily as a best practice.
What’s New?
DOL, HHS and Treasury will not enforce the 2024 final rule and will reconsider what to do next, including whether to propose rescinding or modifying the rule. The departments announced this now to meet a court deadline for responding to a legal challenge. Both parties agreed to pause the litigation. DOL with the other agencies will not “pursue enforcement actions, based on a failure to comply that occurs prior to a final decision in the litigation, plus an additional 18 months,” the statement said.
Why Now?
In addition to the legal challenge to the 2024 final rule alleging regulatory overreach, executive orders directed agencies to repeal regulations that conflict with recent U.S. Supreme Court decisions like Loper Bright that define the limits on agency authority, and to use enforcement relief when rules impose undue burdens on small businesses or significant costs upon private parties that are not outweighed by public benefits.
The Legal Challenge
The case of The ERISA Industry Committee v. Departments of Labor, Health and Human Services and the Treasury was filed January 17, 2025. The timing coincided with the transition to a new presidential administration and a shift in regulatory priorities. The rule was finalized under the Biden administration and now under consideration for recission or modification under the Trump administration. On May 9, 2025, the parties agreed it was appropriate to pause the case pending the completion of that reconsideration process. On May 12, 2025, the court ordered that this case is stopped/suspended until further order of the court. Looking ahead, August 7, 2025 is the deadline for a status report on the governments’ progress of reconsidering the rule at issue.
How Nonenforcement Impacts Compliance
The law (MHPAEA of 2008 with CAA, 2021 amendments) remains in effect. Group health plans and health insurers may refer to the following rules and informal guidance until further notice.
- The departments’ 2013 final rule about NQTLs (as it appeared in the Federal Register on November 13, 2013)
- DOL FAQs Part 45 about comparative analysis (informal guidance released April 2, 2021)
- DOL MHPAEA Self-Compliance Tool (section F) which outlines steps for conducting comparative analysis that should be applied to each NQTL identified under the plan or coverage
- DOL “Warning Signs” Tool with example provisions and sample language of NQTLs that could be impermissible and require additional analysis to determine mental health parity compliance
Conclusion
MHPAEA provides critical protections for workers and their families who need treatment for mental health conditions and substance use disorders. By law, MHPAEA as amended by CAA 21, NQTL compliance and comparative analysis are required unless repealed by Congress. DOL issued a non-enforcement policy covering the 2024 final rule that was implementing the NQTL comparative analysis provisions of MHPAEA. Plan sponsors are required to follow the law even though regulations aren’t being enforced. While federal agencies reexamine the mental health parity enforcement program more broadly, there are compliance resources available. In addition to the 2013 final rule and recent informal guidance, the International Foundation will be tracking updates and breaking down what plan sponsors need to know.
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Developed by International Foundation Information Center staff. This does not constitute legal advice. Please consult your plan professionals for legal advice.
