MHPAEA 2024 Final Rule Enforcement Delay

The Departments of Health and Human Services, Labor, and Treasury (the “Departments”) have announced a delay in enforcement of certain provisions of the 2024 Mental Health Parity and Addiction Equity Act (MHPAEA) Final Rule.

How We Got Here

On September 9, 2024, the Departments issued the 2024 Final Rule titled “Requirements Related to the Mental Health Parity and Addiction Equity Act.” This rule updates and amends the 2013 final rule implementing the MHPAEA of 2008. Among other provisions, the 2024 Final Rule introduced new requirements for comparative analyses of nonquantitative treatment limitations (NQTLs), additional definitions, fiduciary certification requirements, and obligations to examine and provide data related to enforcement actions.

The rule became effective on November 22, 2024, with applicability dates beginning January 1, 2025, for group health plans and January 1, 2026, for individual market plans.

Legal Challenge and Department Response

On January 17, 2025, the ERISA Industry Committee (ERIC) filed a lawsuit in the U.S. District Court for the District of Columbia challenging provisions of the 2024 Final Rule, alleging they are arbitrary and contrary to law under the Administrative Procedure Act.

Following the litigation and Executive Order 14219, the Departments requested on May 12, 2025, that the final rule be put on hold. On May 15, 2025, the Departments announced that the rule would be temporarily non-enforced until 18 months after a final court ruling.

During this interim period, the Departments are conducting a review process and may consider amendments, rescissions, or new rulemaking.

Temporary Nonenforcement Period

The Departments have confirmed:

1. They will not enforce the new provisions of the 2024 Final Rule (those not part of the 2013 rule) for violations until a final decision is reached in the ERIC litigation, plus 18 months thereafter.
2. This relief applies only to new provisions introduced in the 2024 Final Rule. Statutory obligations under MHPAEA as amended by the Consolidated Appropriations Act, 2021, remain in place.

Guidance for Plans and Issuers

During this period, health plans and issuers are advised to:

• Continue relying on the 2013 final rule (published November 13, 2013).
• Utilize the FAQs About Mental Health and Substance Use Disorder Parity Implementation and the Consolidated Appropriations Act, 2021 – Part 45.
• Follow other subregulatory guidance previously issued by the Departments.

The Departments have also noted they may issue updated FAQs or initiate new rulemaking as part of their ongoing reconsideration of the 2024 Final Rule.

Key Point for Employers and Issuers

While the 2024 Final Rule remains in effect, enforcement of its new provisions is on hold. Employers and issuers should maintain compliance with MHPAEA as amended and prepare for potential future regulatory updates.

For more information, the Departments’ non-enforcement statement can be found here.