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On May 9th, 2025, the Departments of Labor (DOL), Treasury, and Health and Human Services (HHS) filed a motion to suspend enforcement of specific mental health provisions. Specifically, these provisions involved nonquantitative treatment limitations (NQTL) issued in September 2024. Altogether, the provisions were known as the “Substance Use Disorder and Mental Health Benefits Final Rules.” Recently, the DOL stopped efforts to restore the 2024 Overtime Protections Minimum Salary Rule.
Background on the Substance Use Disorder and Mental Health Benefits Final Rules
Overall, the rules were built on the three departments’ commitment to achieving the full promise of a previously created rule. Specifically, that rule is the Mental Health Parity and Addiction Equity Act of 2008 (the Act). That Act requires group health plans and health insurance issuers offering group and individual health insurance coverage that provides substance use disorder or mental health benefits to cover those benefits in parity with medical and surgical benefits. However, this coverage must occur without imposing more significant restrictions on mental health or substance use disorder benefits. Additionally, more than 15 years after the Act’s enactment, the departments’ enforcement efforts have shown that many still encounter barriers to accessing mental health and substance use disorder care under their health plan or coverage.
Overview of the Now Defunct Final Rules
Specifically, the new rules added protections against more restrictive, nonquantitative treatment limitations for substance use disorder and mental health benefits. “Nonquantitative treatment limitations” are requirements that limit the scope or duration of benefits. Markedly, such limitations include:
- prior authorization requirements,
- step therapy, and
- standards for provider admission to participate in a network.
The final rules also would have prohibited plans from using biased or non-objective information. For example, these could be sources that might negatively impact access to substance use disorder and mental health benefits. Moreover, this negative impact usually occurs when designing and applying a nonquantitative treatment limitation.
Finally, the final rules made it clear that health plans and insurers must evaluate the impact of their nonquantitative treatment limitations on access to mental health and substance use disorder benefits. Indeed, this evaluation must be compared to current medical and surgical benefits. The newly issued rules would have required plans and issuers to collect and evaluate data related to the nonquantitative treatment limitations they place on mental health and substance use disorder care. Likewise, changes must have occurred if the data shows they provide insufficient access. For the most part, this would help pinpoint harmful limitations in individuals’ health coverage and remove barriers to access. Additionally, the rules emphasize the management of provider networks to strengthen access to mental health and substance use disorder care.
Overview of the Recent Mental Health Parity Verdict
Earlier, the Substance Use Disorder and Mental Health Benefits Final Rules had been challenged in federal court by the ERISA Industry Committee (ERIC) last year. According to Jackson Lewis, the three departments’ answer to ERIC’s complaint was due May 12th, 2025. In a motion filed May 9, the departments instead asked the federal court to suspend the legal proceedings while they “reconsider the 2024 Rule at issue … including whether to issue a notice of proposed rulemaking rescinding or modifying the regulation.” The court granted the motion.
Employer Takeaways
In conclusion, even though this final rule will no longer go into effect, recent studies indicate that employees are suffering from increased stress, anxiety, and depression due to divisive political issues and civil unrest. Subsequently, mental health issues can directly impact employee productivity and engagement in the workplace. To assist employers, WorkWise Compliance created the Mental Health in the Workplace eLearning Modules. This product includes:
- two interactive trainings on mental health in the workplace,
- guidance for employers to navigate legal issues, and
- training for employees to improve their mental health, productivity, and morale.
However, it is essential to recognize that one aspect of workplace mental health and well-being involves providing reasonable accommodations. In some situations, granting a reasonable accommodation to the employee could assist in their mental health struggles. Before fulfilling a request, however, employers need to know the basic steps of the reasonable accommodation process.
