On hold
- New 2024 regulatory text: meaningful benefits standard, data evaluation detail, the six-element analysis format
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Insight · Mental health parity
MHPAEA enforcement timeline, 2026 to 2027: what is paused and what is not
Short answer: the Departments stopped enforcing the 2024 parity rule on May 15, 2025, until a court decision plus 18 months. The statute, the 2013 rule and the CAA, 2021 comparative analysis duty kept running.
2013 rule · 78 FR 68240 · still law
2024 rule · 89 FR 77586 · not enforced
CAA, 2021 NQTL analysis duty · in force
Paused
2024 rule, new parts
In effect
Statute · 2013 rule
Clock
Decision + 18 months
Analysis
10 business days
Elements
6 per NQTL
Audience
BH billing teams
Two clocks, 2013 to 2026
One clock is the 2024 final rule, not enforced while Labor, HHS and the Treasury reconsider it. The other is the statute, as amended by the CAA, 2021, which continues [1]. "Parity is paused" collapses the two. It is not.
- 1Nov 13, 2013Original MHPAEA final rule, 78 FR 68240 [1]
- 2CAA, 2021Statute adds the NQTL comparative analysis duty [1]
- 3Sep 9, 20242024 final rule issued; 89 FR 77586 on Sep 23 [1]
- 4Nov 22, 20242024 rule effective date [1]
- 5Jan 1, 2025First applicability date, plan years on or after [2]
- 6Jan 17, 2025ERISA Industry Committee sues in the D.C. district court [1]
- 7May 15, 2025Nonenforcement statement; litigation in abeyance [1]
- 8Jan 1, 2026Second applicability date: meaningful benefits, data evaluation [2]
The 2024 rule's provisions by applicability date [2]
| Provision | Applies from | Status after May 15, 2025 |
|---|---|---|
| General requirements for group plans and coverage | Plan years on or after Jan 1, 2025 | New portions: not enforced by the Departments |
| Meaningful benefits in every classification where M/S benefits exist | Plan years on or after Jan 1, 2026 | Not enforced by the Departments |
| Prohibition on discriminatory factors and evidentiary standards | Plan years on or after Jan 1, 2026 | Not enforced by the Departments |
| Relevant data evaluation for each NQTL | Plan years on or after Jan 1, 2026 | Not enforced by the Departments |
| Six required elements of the comparative analysis | Staged across 2025 and 2026 | Regulatory detail not enforced; statutory duty remains |
| Individual market coverage | Policy years on or after Jan 1, 2026 | HHS asks states to take a similar approach |
The procedural clocks a plan faces once a regulator asks, in days
Every NQTL comparative analysis needs six elements [2].
Produce the comparative analysisafter a request
10 business days22% of the response clock
Answer an initial noncompliance determination
45 calendar days100%
Notify participantsafter a final determination
7 business days16%
01045 days
ProductionResponseNotice
Two pages, one narrow sentence
The Departments will not enforce the 2024 final rule for a failure before a final ERIC decision plus 18 months. Two limits: only what is new relative to the 2013 rule, and the statutory obligations under the CAA, 2021 continue [1].
Still law
- The 2013 rule, the statutory parity requirement, and the CAA, 2021 duty to prepare and produce NQTL comparative analyses on request
Still available
- FAQs Part 45 and other subregulatory guidance, which the statement says plans may continue to rely on
Open question
- Whether the Departments issue a proposed rule rescinding or modifying the 2024 rule; the statement says they are considering it
Takeaway
Nonenforcement is a promise about federal audits of plans. It is not a change to your contract, your remittance, or the state insurance law your commercial payers answer to.
Four events, none dated: watch the docket, the Federal Register, your state regulator
1
A final decision in the ERIC case
The 18-month nonenforcement tail runs from that decision. Until there is one, the tail has not started [1].
2
A proposed rule from the Departments
Reconsidering the 2024 rule, including whether to propose rescinding or modifying it through notice and comment [1].
3
State action on issuers
HHS encouraged states, as primary enforcers for issuers, to adopt a similar approach and will not treat them as failing to enforce if they do. States are not required to follow [1].
4
Updated FAQs
Subregulatory guidance, including FAQs Part 45, may be updated during reconsideration [1].
Five moves this quarter
Keep documenting NQTL harmAuthorization denials, concurrent review frequency, network status, rate gaps between therapy codes and comparable medical visits. The plans' duty to analyze those NQTLs did not pause.
Ask for the comparative analysis in writingWhen a plan's NQTL stops your claims. Participants and representatives can request it; 10 business days when a regulator asks [2].
Check your top commercial payers and your state's postureAgainst the behavioral health payer matrix before you cite the federal rule in a dispute.
Separate the two arguments in every appealContract or fee schedule underpayment first, parity pattern second. The parity claims playbook walks through both.
Put the four restart events on a quarterly calendarOur behavioral health billing services team runs the fee-schedule reconciliation that turns suspicion into a dated exhibit; mental health billing services covers the monthly reconciliation; the November Mental Health Operator covers it for owners.
Frequently asked questions
Is the Mental Health Parity and Addiction Equity Act suspended?
No. The May 15, 2025 statement covers the 2024 final rule only, and only the parts that are new relative to the 2013 rule. It says MHPAEA's statutory obligations, as amended by the CAA, 2021, continue to have effect.
How long does the nonenforcement period last?
The Departments will not enforce the 2024 rule for failures that occur before a final decision in the ERIC litigation plus an additional 18 months. No final decision had been published when this page was checked, so the 18-month tail has not started.
Do plans still have to prepare NQTL comparative analyses?
Yes. The comparative analysis requirement comes from the Consolidated Appropriations Act, 2021, and the statement says statutory obligations continue to apply. What is paused is the 2024 rule's detailed content and data standards for those analyses.
Does the pause bind state insurance regulators?
No. HHS encouraged states that enforce MHPAEA against issuers to adopt a similar approach and said it will not treat them as failing to enforce if they do. A state may still enforce the federal statute and its own parity law.
- Departments of Labor, HHS and the Treasury: Statement Regarding Enforcement of the Final Rule on Requirements Related to MHPAEA (May 15, 2025)
- DOL EBSA fact sheet: Final Rules under the Mental Health Parity and Addiction Equity Act (September 2024)
Checked October 25, 2026. Confirm against the source; items marked proposed may change in the final rule.
Think a payer is underpaying your therapy codes?
We reconcile 24 months of 835s against your contracted rates by CPT and month, and show where the parity argument is strong enough to send.