Departments Issue 2024 MHPAEA Report to Congress and FY 2023 Enforcement Fact Sheet

Published January 17, 2025

The Departments of Labor (DOL) Employee Benefits Security Administration (EBSA), Health and Human Services (HHS), and the Treasury issued the 2024 Report to Congress on the Mental Health Parity and Addiction Equity Act (MHPAEA) enforcement and implementation, which suggests that group health plans and health insurers are making progress complying with the MHPAEA, but restrictions for mental health and substance use disorder benefits persist.

A fiscal year 2023 MHPAEA enforcement fact sheet highlights enforcement data and significant results from MHPAEA investigations closed by EBSA and CMS.

As part of the report, the departments are releasing an unredacted 2024 settlement agreement between EBSA and a health plan that describes the actions the plan agreed to undertake to correct alleged violations of MHPAEA and illustrates the types of activities plans and issuers can undertake to monitor and address disparities in access to providers. The report also includes several examples that are based upon enforcement experience showing how plans and issuers can make corrections to comply with the law.

Appendix A – Sample Settlement Agreement between EBSA and a group health plan to address MHPAEA violations related to an NQTL relating to network composition and network adequacy. The terms of this settlement agreement address the specific violation and facts of this case. Other plans and issuers should take note of the types of activities this plan is undertaking to monitor and address disparities in access to providers.

Attachment A

Table 1: Out-of-Network (OON) Utilization
- Sample chart format with OON categories to track separately
Table 2: Network Providers Actively Submitting Claims
Table 3: Wait Times for New and Existing Patients
- Data to report based on participant/patient surveys
Table 4: Time & Distance Measurements
Table 5: Provider-To-Member Ratios
Table 6: Network Retention/Loss Analysis