The Washington Report

September 11, 2024

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 Final Rules on MHPAEA
On September 9, 2024, the Departments of Treasury, Health and Human Services, and Labor (Departments) released final rules amending regulations implementing the Mental Health Parity and Addiction Equity Act (MHPAEA) and adding new regulations implementing the nonquantitative treatment limitation (NQTL) comparative analyses requirements under MHPAEA, as amended by the Consolidated Appropriations Act, 2021 (CAA, 2021). The final rules amend the existing NQTL standard to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from using NQTLs that place greater restrictions on access to mental health and substance use disorder benefits as compared to medical/surgical benefits. As part of these changes, the final rules require plans and issuers to collect and evaluate relevant data in a manner reasonably designed to assess the impact of NQTLs on relevant outcomes related to access to mental health and substance use disorder benefits and medical/surgical benefits and to take reasonable action, as necessary, to address material differences in access to mental health or substance use disorder benefits as compared to medical/surgical benefits.

The final rules also amend existing examples and add new examples on the application of the rules for NQTLs to clarify and illustrate the requirements of MHPAEA. Additionally, the final rules 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 to participants, beneficiaries, and enrollees. Finally, the Department of Health and Human Services finalizes 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.

The final rules generally apply to group health plans and group health insurance coverage on the first day of the first plan year beginning on or after January 1, 2025. However, the meaningful benefits standard, the prohibition on discriminatory factors and evidentiary standards, the relevant data evaluation requirements, and the related requirements in the provisions for comparative analyses apply on the first day of the first plan year beginning on or after January 1, 2026. The final rules apply to health insurance issuers offering individual health insurance coverage for policy years beginning on or after January 1, 2026. Until the applicability date, plans and issuers are required to continue to comply with the existing requirements, including the CAA, 2021 amendments to MHPAEA.

Please refer to the Aon bulletin, Departments Issue Final Rules Under Mental Health Parity and Addiction Equity Act, in the Publications section of this newsletter.

The news release is available here.

The final rules are temporarily available here.

A Fact Sheet is available here.

Resource: New Mental Health and Substance Use Disorder Parity Rules: What They Mean for Participants and Beneficiaries, is available here.

Resource: New Mental Health and Substance Use Disorder Parity Rules: What They Mean for Providers, is available here.

Resource: New Mental Health and Substance Use Disorder Parity Rules: What They Mean for Plans and Issuers, is available here.

IRS Releases Draft of 2024 Instructions for Forms 1094-B and 1095-B
On September 4, 2024, the Internal Revenue Service (IRS) released the draft form of instructions for the following:

• Form 1094-B Transmittal of Health Coverage Information Returns; and
• Form 1095-B Health Coverage.

The text of the draft 2024 Instructions for IRS Forms 1094-B and 1095-B is available here.

Aon Publications

 

Departments Issue Final Rules Under Mental Health Parity and Addiction Equity Act
On September 9, 2024, the Departments of Health and Human Services, Labor, and Treasury (the Departments) issued the final version of the proposed Mental Health Parity and Addiction Equity Act (MHPAEA) rules released last summer. The final rules amend certain provisions of existing MHPAEA regulations and add new regulations regarding content requirements and response timeframes for nonquantitative treatment limitation comparative analysis requests.

The Aon bulletin is available here.