The Washington Report
If you elect to comment or engage with our content via third-party social media websites, you authorize Aon to have access to certain social media profile information. Please click here to learn more about information that may be collected when using these tools on Aon.com
July 26, 2023
Note to Subscribers
While we do our best to provide timely updates, it is possible that the information shared in the newsletter may change after our publication deadline.
Health
Departments Release Proposed MHPAEA Regulations, Guidance, and Report to Congress
On July 25, 2023, the Departments of Labor, Health and Human Services (HHS) and the Treasury (the Departments) released proposed regulations amending rules implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) and proposed new regulations implementing the nonquantitative treatment limitation (NQTL) comparative analyses requirements under MHPAEA, as amended by the Consolidated Appropriations Act, 2021.
The proposed regulations would amend the existing NQTL standard to prevent plans and issuers from using NQTLs to place greater limits on access to mental health and substance use disorder benefits as compared to medical/surgical benefits. As part of these changes, these proposed regulations would require plans and issuers to collect and evaluate relevant data in a manner reasonably designed to assess the impact of NQTLs on access to mental health and substance use disorder benefits and medical/surgical benefits, and would set forth a special rule with regard to network composition. The proposed regulations would also amend existing examples and add new examples on the application of the rules for NQTLs to clarify and illustrate the protections of MHPAEA. Additionally, the proposed regulations would set forth the content requirements for NQTL comparative analyses and specify how plans and issuers must make these comparative analyses available to the Departments, as well as to an applicable state authority, and participants, beneficiaries, and enrollees. HHS is also proposing regulatory amendments to implement the sunset provision for self-funded, non-federal governmental plan elections to opt out of compliance with MHPAEA, as adopted in the Consolidated Appropriations Act, 2023. Finally, the Departments are requesting comments on whether there are ways to improve the coverage of mental health and substance use disorder benefits through other provisions of federal law. Comments are due no later than 60 days after the proposed regulations are published in the Federal Register (date unknown).
On the same day, the Departments also issued:
- Technical Release 2023-01P that requests public feedback on proposed new data requirements for limitations related to the composition of a health plan’s or issuer’s network. The Technical Release seeks public comment to inform guidance for proposed data collection and evaluation requirements for NQTLs related to network composition and requests input on the development of an enforcement safe harbor for plans and issuers that submit data indicating that their networks of mental health and substance use disorder providers are comparable to networks for medical/surgical providers.
- The second MHPAEA Comparative Analysis Report to Congress, July 2023.
- A joint Fiscal Year (FY) 2022 MHPAEA Enforcement Fact Sheet that provides enforcement results for cases closed in FY 2022.
Please refer to the news release, proposed regulations, and associated resources for additional information.
The news release is available here.
The proposed regulations are available here.
(Federal Register Note: This document has been approved by the Departments of Labor, Health and Human Services, and the Treasury and is in the process of being submitted to the Office of the Federal Register (OFR) for publication, but has not yet been placed on public display or published in the Federal Register. The document may vary slightly from the published document if minor editorial changes have been made during the OFR review process. The document published in the Federal Register is the official approved document.)
Technical Release 2023-01P is available here.
The MHPAEA Comparative Analysis Report to Congress, July 2023, is available here.
The FY 2022 MHPAEA Enforcement Fact Sheet is available here.
An Appendix is available here.
A White House Fact Sheet is available here.
Retirement
IRS Releases Notice on Transition Relief and Guidance Relating to Certain RMDs
On July 17, 2023, the Internal Revenue Service (IRS) released Notice 2023-54, which provides transition relief for plan administrators, payors, plan participants, IRA owners, and beneficiaries in connection with the change in the required beginning date for required minimum distributions (RMDs) under Section 401(a)(9) of the Internal Revenue Code pursuant to Section 107 of the SECURE 2.0 Act of 2022, enacted on December 29, 2022, as Division T of the Consolidated Appropriations Act, 2023, P. L. 117-328, 136 Stat. 4459 (2022). The Notice also provides guidance related to certain specified RMDs for 2023. Additionally, Notice 2023-54 announces that the final regulations that the Treasury Department and IRS intend to issue related to RMDs will apply for purposes of determining RMDs for calendar years beginning no earlier than 2024.
IRS Notice 2023-54 is available here.
Aon Publications
Departments Propose Taxing Fixed Payments From Employer-Paid Fixed Indemnity Policies
Proposed regulations issued by the Departments of Labor, Health and Human Services, and Treasury (the Departments) would clarify and implement certain changes to the treatment of short-term, limited-duration insurance policies, hospital indemnity or fixed indemnity insurance (fixed indemnity policies) in the group and individual markets, and to the income tax treatment of fixed benefit payments received under employer-provided fixed indemnity policies.
The Aon bulletin is available here.