U.S. Department of Labor Issues Proposed 2020 Self-Compliance Tool To Further Mental Health and Substance Use Disorder Parity Compliance

WASHINGON, DC – The U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) today released a proposed Self-Compliance Tool intended to help improve compliance with the Mental Health Parity and Addiction Equity Act (MHPAEA) and additional related requirements under the Employee Retirement Income Security Act of 1974 (ERISA).

The tool will enable group health plans, plan sponsors, plan administrators, health insurance issuers and other parties determine whether a group health plan or a health insurance issuer complies with the provisions in both laws.

EBSA is requesting public comments on the MHPAEA’s Self-Compliance Tool proposed revisions by July 24, 2020. Submit comments to EBSA. After considering all feedback, the Department will issue a Final 2020 MHPAEA Self-Compliance Tool with any necessary clarifications. The Department last issued the MHPAEA Self-Compliance Tool in 2018.

 “This Self-Compliance tool will help give the user a basic understanding of the Mental Health Parity and Addition Equity Act to assist in evaluating compliance with its requirements,” said Acting Assistant Secretary for the Employee Benefits Security Administration Jeanne Klinefelter Wilson. “The Employee Benefits Security Administration will continue to provide compliance assistance to group health plans, plan sponsors, plan administrators and health insurance issuers to help them meet their responsibilities under the law.”

 In general, MHPAEA requires that the financial requirements imposed by a group health plan or health insurance issuer on mental health and substance use disorder benefits are applied in parity with financial requirements and treatment limitations that apply to medical and surgical benefits. Financial requirements include cost-sharing requirements such as copays and treatment limitations include limits on the scope and duration of treatment, such as visit limits or prior authorization.

The 21st Century Cures Act directs the U.S. Departments of Labor, Health and Human Services and Treasury to make a compliance program guidance document publicly available to improve compliance with MHPAEA, and to update this guidance document every two years. Consistent with this directive, the proposed 2020 MHPAEA Self-Compliance Tool provides additional guidance on MHPAEA compliance and a number of examples to demonstrate how a plan or issuer may comply with the law.

EBSA’s mission is to assure the security of the retirement, health and other workplace related benefits of America’s workers and their families. EBSA accomplishes this by developing effective regulations; assisting and educating workers, plan sponsors, fiduciaries and service providers; and vigorously enforcing the law.

The mission of the Department of Labor is to foster, promote and develop the welfare of the wage earners, job seekers and retirees of the United States; improve working conditions; advance opportunities for profitable employment; and assure work-related benefits and rights.