EBSA Releases Annual Enforcement Report on MHPAEA

Mar 25, 2020

The DOL’s Employee Benefits Security Administration (EBSA) released its annual enforcement report on the Mental Health Parity and Addiction Equity Act (MHPAEA) for 2019. According to EBSA, vigorous enforcement of MHPAEA is one of its top enforcement priorities.

MHPAEA is a federal law that prevents group health plans and health insurance issuers that provide mental health or substance use disorder benefits from imposing less favorable benefit limitations on those benefits than medical and surgical benefits.

In fiscal year 2019, EBSA closed 186 health plan investigations, 183 of which included reviews of MHPAEA compliance. These investigations resulted in 12 citations for MHPAEA violations. As an example of the size and scope of these investigations, in the course of one investigation involving a service provider, the service provider reported providing services to 99 self-insured and 210 fully insured plans, covering 67,724 participants.

When EBSA identifies MHPAEA violations, it asks the plan to make necessary changes to any noncompliant plan provision and to pay any improperly denied benefit claims. EBSA may also require the plan or service provider to provide notice to potentially affected participants and beneficiaries.

Click here for more information on MHPAEA.

Posted In: Benefits & HR

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