Consolidated Appropriations Act, 2021: Mental Health and Substance Use Disorder Reporting

Miller Johnson

Under the Consolidated Appropriations Act, 2021 (signed into law on December 27, 2020) (the CAA) employers that sponsor self-funded group health plans that cover mental health or substance use disorder benefits must perform a “comparative analysis” to ensure that any non-quantitative treatment limitations (NQTLs) imposed on those mental health or substance use disorder benefits comply with the Mental Health Parity and Addiction Equity Act (MPHAEA). Fully insured group health plans are subject to the same requirement, but the obligation to perform the comparative analysis falls on the insurer, not the employer.

Beginning February 10, 2021, the Departments of Labor, Treasury and Health and Human Services (depending on which agency has jurisdiction over the plan) may request this comparative analysis and related documents to ensure compliance with the MPHAEA’s requirements on NQTLs. If an employer fails to provide the comparative analysis or the agency determines the plan is not compliant with the MPHAEA’s requirements on NQTLs, the agency will notify all participants in the plan that it doesn’t comply with the MPHAEA. The plan will also be identified on an annual report to Congress.

In this session, we explore the requirements under the CAA related to the comparative analysis and what steps employers should be taking to ensure compliance. Individuals who are responsible for their organization’s group health plan, whether fully insured or self-funded, do not want to miss this session of our monthly Employee Benefits Lunch Break series!

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