The DOL released an updated tool to help employer-sponsored group health plans comply with the federal Mental Health Parity and Addiction Equity Act (“MHPAEA”). In general, the MHPAEA requires that financial requirements under a group health plan (such as copays) and treatment limitations (such as prior authorization) on mental health and substance use disorder benefits be comparable to, and applied no more stringently than, those that apply to medical and surgical benefits under the plan. The DOL last updated the tool in 2018. This updated version includes FAQs issued in 2019, additional compliance examples, best practices for establishing an internal compliance plan, and examples of plan provisions that may indicate a potential MHPAEA violation. In particular, the concept of the “internal compliance plan” is new, and although not required under the MHPAEA, the DOL’s goal for the internal compliance plan was to show how an internal compliance strategy can assist health plans with MHPAEA compliance. In addition, the DOL provided examples of the types of records that a plan should be prepared to provide in the event of a DOL investigation or audit. Employers may want to review this self-compliance tool with their benefits counsel or other advisors to ensure their group health plans are compliant and maintain appropriate documentation.
The MHPAEA Self-Compliance Tool is available here.