Defending Mental Health Parity and Addiction Equity Act Claims

Strafford

This CLE webinar will provide benefits counsel and advisers guidance on overcoming challenges in defending claims under the Mental Health Parity and Addiction Equity Act (MHPAEA) and ensuring compliance for plan sponsors and insurers. The panel will discuss the requirements of MHPAEA for health plans that provide mental health and substance abuse disorder benefits, recent DOL enforcement actions regarding NQTL and parity violations, ERISA disclosure requirements, and best practices and tactics for litigating claims.

Description

The 2008 Mental Health Parity and Addiction Equity Act (“Parity Act”) has become a regular presence in class actions and individual claims seeking mental health benefits under, or challenging the administrative of, group health plans. Alongside this litigation, the Department of Labor has been aggressively auditing group health plans (and the third parties that administer them) to ensure compliance with the DOL’s interpretation of the Parity Act. And health plan administrators and insurers regularly face administrative claims for group health plan benefits that assert Parity Act claims, the complexity and novelty of which often challenge existing procedures for reviewing administrative claims. State Parity Act analogues along with traditional ERISA litigation principles add additional complexity.

In this presentation, experienced ERISA litigators Andrew Holly and Nicholas Pappas will provide background on the Parity Act itself, as well as the complex “Non-Quantitative Treatment Limitations” found in the DOL’s Parity Act regulations. They will describe existing case decisions interpreting the Parity Act statute and its regulations. And they will provide advice for plan sponsors, third party administrators, and insurers on how to successfully defend against Parity Act Claims in litigation, during DOL audits, and at the administrative stage.

Outline

1. Overview of MHPAEA requirements and exceptions for plans providing MH/SUD benefits
2. The new Parity Act rules under the Consolidated Appropriations Act (“CAA”)
3. How the CAA’s new disclosure rules and regulations could affect Parity Act litigation
4. Comparative analysis requirements and navigating NQTL requirements
5. DOL’s Parity Act interpretations, priorities, and enforcement actions

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