Washington D.C. – New federal guidance aimed at promoting greater consistency in the enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA) has been issued in a Field Assistance Bulletin No. 2026-03 (FAB) and compliance guidance, Identifying Potential Problems: If You See the Following in Written Plan Provisions or Plan Operations, Think Twice about Possible MHPAEA Compliance Problems by the Department of Labor’s (DOL) Employee Benefits Security Administration (EBSA). The bulletin provides updated guidance on MHPAEA enforcement priorities and compliance practices related to nonquantitative treatment limitations (NQTLs). The guidance is intended to provide a clearer and more consistent roadmap for MHPAEA compliance and enforcement.
The FAB identifies three priority areas for EBSA’s MHPAEA enforcement, providing a more focused approach: mental health and substance use disorder treatment exclusions; medical necessity and utilization management processes; and network adequacy and provider reimbursement.
ABHW’s health plan members have long supported strong and consistent enforcement of federal mental health and substance use disorder parity requirements. However, they have experienced variation across federal reviews in how requirements are interpreted, evidence is assessed, and compliance determinations are reached. By providing greater clarity around EBSA’s enforcement priorities and expectations, this guidance can help reduce uncertainty and support more consistent approaches to MHPAEA compliance.
“We are pleased to see the Departments take this important step toward greater predictability, and reducing some of the ambiguity surrounding MHPAEA enforcement,” said Debbie Witchey, President and CEO of ABHW. “Clear and consistent expectations across federal offices will help health plans better understand and meet their parity obligations and, most importantly, help ensure patients have access to the mental health and substance use disorder care they need.”
Greater consistency at the federal level can also support more uniform parity enforcement nationwide, including at the state level, where regulators often look to federal guidance and standards when conducting their own parity reviews.
MEDIA CONTACT:
Kathryn Cohen
cohen@abhw.org
617-515-8066
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ABOUT THE ASSOCIATION FOR BEHAVIORAL HEALTH AND WELLNESS
ABHW is the leading health plan association working to improve access and quality of care for mental health and substance use disorders. ABHW’s members include national and regional health plans who care for approximately 200 million people. Together, we work to reduce stigma and advance federal policy on mental health and substance use disorder care. ABHW member companies include Aetna Behavioral Health, Elevance Health, Centene Corporation, Evernorth, a Cigna company, Health Care Service Corporation, Kaiser Permanente, Lucet, Magellan Health, Molina Healthcare, Optum, and PerformCare, a subsidiary of AmeriHealth Caritas. To learn more, visit www.abhw.org and follow us on BlueSky and LinkedIn.
