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On January 17, 2025, the ERISA Industry Committee (ERIC) filed a lawsuit in the U.S. District Court for the District of Columbia, claiming that the 2024 Mental Health Parity and Addiction Equity Act (MHPAEA) Final Rule oversteps legal bounds, breaches the Administrative Procedure Act (APA), improperly delegates the Departments of Labor, Health and Human Services and Treasury’s (Departments) executive power to private entities, and violates the Due Process Clause. ERIC argues that under the Mental Health Parity Act of 1996, the plan was not obligated to assess any disparate impact that a term, applicable to both medical/surgical (M/S) and mental health and substance use disorder (MH/SUD) benefits, might have had on access to MH/SUD benefits. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) similarly maintained the disparate treatment standard of liability, rather than the disparate impact standard. Moreover, the Departments acknowledged in the 2013 regulations that “disparate results alone” did not constitute a parity violation.

ERIC stresses that “[n]othing in the 2010 interim final rule or 2013 final regulation required parity in access to MH/SUD benefits, nor did they mandate any specific benefits.” However, the “meaningful benefits” requirement in the 2024 Final Rule imposes a benefits mandate, ERIC argues, exceeding the Departments’ statutory authority under MHPAEA. This mandate essentially removes the plans’ discretion in determining which benefits provide affordable, high-quality coverage. Additionally, ERIC contends that it is arbitrary and capricious to subject plans to the whims of third-party clinical literature—and the Departments’ interpretation of that literature—in defining what qualifies as a “core treatment.” For example, the Departments tie the definition of MH/SUD benefits to the Diagnostic and Statistical Manual of Mental Disorders (DSM)—a handbook written and published by the American Psychiatric Association (APA).

ERIC also contends that the finalized certification requirement is unlawful, asserting that it exceeds statutory authority, and the Department of Labor (DOL) failed to provide proper notice regarding the fiduciary certification requirement. This imposition, according to ERIC, was made in violation of the agency’s notice-and-comment obligations under the Administrative Procedure Act (APA). Furthermore, ERIC claims that the comparative analysis requirements are both arbitrary and capricious. Throughout the 2024 Final Rule, the Departments indicate that they will issue “further guidance” on how plans should perform the comparative analysis. ERIC argues that, in the 2024 Final Rule, the Departments failed to clearly specify what the comparative analysis must entail, relying on vague and undefined terms.

ERIC also underscores the potential administrative load the Final Rule places on plan sponsors. The mandate for comprehensive documentation and ongoing compliance monitoring may result in heightened expenses and operational hurdles for employers. ERIC contends that these challenges could ultimately dissuade employers from providing extensive MH/SUD benefits, thus undermining the very objective of fostering parity in health coverage.

In its filing, ERIC calls for the U.S. District Court to invalidate the Final Rule on the grounds of overreach and non-compliance with statutory and regulatory frameworks. The Departments have 60 days to file responsive pleadings.

ERIC’s lawsuit underscores the ongoing legal tension surrounding the interpretation and implementation of mental health parity laws. The outcome of this case could have significant implications for health plan administrators and beneficiaries alike, as it challenges the scope of regulatory authority and the balance between ensuring mental health parity and preserving plan flexibility. The court’s decision will likely influence future regulatory actions and guidelines, potentially reshaping the landscape of behavioral health benefits and coverage standards.

For questions about this or other behavioral health topics, please contact Natasha Sumner, Taylor Crossley, Noreen Vergara or another member of our Behavioral Health Regulatory team.

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Photo of Natasha Sumner Natasha Sumner

Natasha co-leads the firms’ Psychedelics and Emerging Therapies Practice Group and is also part of the product liability team. She focuses her practice on assisting clients in navigating the regulatory scheme for conducting clinical trials on psychedelics and other controlled substances and litigating

Natasha co-leads the firms’ Psychedelics and Emerging Therapies Practice Group and is also part of the product liability team. She focuses her practice on assisting clients in navigating the regulatory scheme for conducting clinical trials on psychedelics and other controlled substances and litigating product liability claims.

Natasha is well-versed in historical and current psychedelic research including recent FDA-approved studies on MDMA and psilocybin use for mental health and end-of-life issues, the legalization and decriminalization of psylocibin in numerous cities and states, and biotech and pharmaceutical research. Natasha’s interest in this area keeps her at the forefront of assisting clients in navigating regulatory uncertainty, legislative advocacy, corporate transactions, and ­­­­­­­­­­litigation in this rapidly evolving complex area. Natasha is also dedicated to insuring diversity, equity, and inclusion and recognizing and preserving indigenous knowledge.

Academic institutions, product manufacturers and commercial businesses are among the clients relying on Natasha’s broad experience. Natasha has defended clients against claims of mold, asbestos, and benzene exposure, including landlords and housing authorities in disputes regarding habitability. She has represented clients alleging violations under the Food, Drug, and Cosmetic (FD&C) Act, and counseled clients regarding California’s Proposition 65 warning requirements, among other state and federal laws.

While in law school, Natasha interned with the California Attorney General Energy Task Force, working on antitrust issues related to the state’s 2001 energy crisis. Her inside view of regulatory issues is appreciated by clients as she navigates them through various complex litigation and compliance.

Photo of Taylor Crossley Taylor Crossley

Taylor focuses on healthcare regulatory matters. At Husch Blackwell, she focuses on matters such as healthcare privacy, confidentiality, and mental health law (including 42 C.F.R. Part 2, the Mental Health Parity and Addiction Equity Act, the SUPPORT for Patients & Communities Act, and

Taylor focuses on healthcare regulatory matters. At Husch Blackwell, she focuses on matters such as healthcare privacy, confidentiality, and mental health law (including 42 C.F.R. Part 2, the Mental Health Parity and Addiction Equity Act, the SUPPORT for Patients & Communities Act, and emerging therapy). She also assists with issues relating to healthcare quality, including adverse event reporting, licensure and certification questions, and the Health Care Quality Improvement Act.

Photo of Noreen Vergara Noreen Vergara

As a Healthcare Regulatory Attorney and former executive, Noreen is a transparent communicator and innovative problem solver with a deep background in operations and risk management.

Noreen’s career in healthcare operations, healthcare compliance and executive leadership began as a behavioral health admissions representative

As a Healthcare Regulatory Attorney and former executive, Noreen is a transparent communicator and innovative problem solver with a deep background in operations and risk management.

Noreen’s career in healthcare operations, healthcare compliance and executive leadership began as a behavioral health admissions representative – she understands the day-to-day regulatory hurdles facing healthcare clients. Most recently, Noreen served as Acting CEO, General Counsel and Chief Human Resources Executive for a national managed behavioral health venture with employees across 50 states. In this position, Noreen leveraged her experience in strategic planning, corporate governance, complex contracts, employment law and compliance. Noreen navigated tough decisions including guiding 500 percent growth over 6 years, moving online quickly during COVID-19 and helping secure the largest contract in company history. Earlier in her career, Noreen collaborated in-house at the National Association of Insurance Commissioners (NAIC), where oversight, peer review, best practices and standards are established by state regulators.