Compliance Calendar
The federal government has relaxed part of the 2024 mental health parity rule and narrowed its enforcement focus. The older law is fully in force, and the written comparative analysis is still required. Here is what that means for a plan sponsor.
Key takeaways
- The statute and its 2013 rules still apply, and plans must still have a written comparative analysis of their non-quantitative treatment limits.
- In May 2025 the agencies announced they would not enforce the new provisions of the 2024 final rule, and in September 2026 the Department of Labor issued guidance setting three enforcement priorities.
- The priorities are blanket exclusions of mental health or substance use treatment, medical necessity and prior authorization practices, and network adequacy.
What parity requires
The Mental Health Parity and Addiction Equity Act says a group health plan that covers mental health or substance use disorder benefits cannot apply financial requirements or treatment limits to them that are more restrictive than those on comparable medical and surgical benefits. The hard part is the non-quantitative limits: prior authorization, step therapy, medical necessity criteria, network admission standards and reimbursement rates. Since 2021, plans have had to prepare a written comparative analysis showing that these limits are applied comparably in practice, and to give it to regulators on request.
What has relaxed, and what has not
In 2024 the agencies finalized a rule adding new requirements, including a meaningful-benefits standard and a rule against using discriminatory factors in designing limits. In May 2025 they announced they would not enforce those new provisions while litigation proceeds and for 18 months afterward. The rule has not been rescinded in the sources we have seen, so check the current status with counsel.
On September 8, 2026, the Department of Labor issued Field Assistance Bulletin 2026-03, with an enforcement guidance tool, describing where investigators will focus. Three areas stand out: separate treatment limits or exclusions that apply only to mental health or substance use benefits; medical necessity and utilization review, including prior authorization and concurrent or retrospective review, with proprietary criteria permitted if applied comparably and produced on request; and network adequacy, including admission standards, reimbursement and helping participants avoid out-of-network costs when no in-network provider is available. The statute’s comparative analysis requirement is unaffected.
What to have on file
- The written comparative analysis for each plan, dated and updated when benefits or vendors change
- Your carrier or administrator’s written statement that it performed the analysis, and a copy you can produce on request
- A list of every mental health and substance use exclusion or limit in the plan, checked against medical and surgical counterparts
- The prior authorization and medical necessity criteria used for behavioral health and the data showing comparable denial rates where available
- The network directory and an access analysis: appointment wait times, out-of-network usage rates and any ghost-network complaints
If you are self-funded, the analysis is your responsibility as plan sponsor even if your administrator prepares it. If you are fully insured, the carrier prepares it, but you should still receive it.
Questions we get
Does a small employer have to worry about this?
Yes. Parity applies to group health plans that offer mental health benefits, including most small-group plans. Fully insured small groups rely on the carrier’s compliance, and the 2013 rules also apply.
Is an employee assistance program covered?
A free-standing EAP can be treated as an excepted benefit if it meets conditions. If it provides significant medical benefits it may be subject to parity. Ask your vendor.
Should I wait for the litigation to end?
The statutory analysis is required now. Waiting only leaves you without documentation if the Department of Labor asks.
Sources: Mental Health Parity and Addiction Equity Act; tri-agency enforcement statement (May 2025); Department of Labor Field Assistance Bulletin 2026-03 (September 8, 2026) as summarized by law firms. This is general information and not legal advice.
Related Reading
Do you have the comparative analysis in hand? Send us your renewal and we will request it from your carrier and tell you what is missing.
