The U.S. Departments of the Treasury, Labor, and Health and Human Services issued final regulations on November 8, 2013, implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). Although interim final rules (IFR) had been in effect since 2010, the industry has been awaiting these final rules in order to gain clarity on how to comply with certain provisions of MHPAEA.

The new rules clarify or revise some aspects of the IFR that had created unusual consequences for employers and health plans. They also make several important changes to the rules regarding nonquantitative treatment limitations (NQTLs); however, a number of important elements of the IFR, such as the basic framework for testing compliance on financial requirements and quantitative treatment limitations, were left unchanged. This briefing paper presents the key changes to the regulations codified in the final rules and discusses the implications for employers and health plans. For an overview of the 2010 IFR, see the Milliman healthcare reform briefing paper, “Implementing Parity: Investing in Behavioral Health.”