In the first half of 2025, several pivotal developments involving the Mental Health Parity and Addiction Equity Act (MHPAEA) have emerged that carry significant implications for employers, including tribes and middle-market organizations. A high-profile lawsuit by the ERISA Industry Committee (ERIC), a request by federal agencies to pause enforcement, and ongoing litigation involving Anthem all signal a period of rapid change. Swift adaptation and informed compliance strategies are essential.

MHPAEA & the 2024 Final Rule

MHPAEA, initially enacted in 2008, ensures that coverage for mental health and substance use disorder (MH/SUD) benefits be on par with medical/surgical benefits in employer-sponsored plans. In September 2024, the Departments of Labor, Health and Human Services, and Treasury issued a new final rule that expanded requirements—most notably around non-quantitative treatment limitations (NQTLs), comparative analysis, fiduciary standards, and “meaningful benefits” across benefit classifications.

Event #1 – ERIC Files Lawsuit

On January 17, 2025, ERIC filed suit in the U.S. District Court for the District of Columbia against the Departments, contending that the 2024 Final Rule exceeded agency authority under MHPAEA and the Consolidated Appropriations Act of 2021, violated the Administrative Procedure Act (APA), and imposed standards not authorized by Congress. The complaint asserts that:

• Elements like the fiduciary certification requirement and the “meaningful benefits” mandate exceed statutory authority.
• The regulations are burdensome to plan sponsors and could lead to reduced access to MH/SUD benefits.
• The rule fails to meet APA procedural standards and improperly interprets congressional intent.

ERIC’s position is that the agencies overstepped their legal bounds and created obligations that jeopardize plan sustainability. The lawsuit invokes recent Supreme Court precedent limiting judicial deference to agency interpretations, shifting the compliance landscape further into question.

Event #2 – Federal Enforcement Paused

On May 9, 2025, the Departments jointly requested a stay of litigation, indicating a willingness to reconsider the final rule. The court granted the request on May 12, 2025. Following that, the Departments issued a formal non-enforcement policy covering the 2025 and 2026 plan years.

• Enforcement is suspended for newly introduced provisions in the 2024 rule, including the “meaningful benefits” mandate, expanded NQTL documentation requirements, fiduciary certification, and revised definitions.
• The pause will last through 18 months after the court issues a final ruling on the case.
• Employers must still comply with the 2013 MHPAEA rule and 2021 Consolidated Appropriations Act amendments.
• State-level MHPAEA enforcement remains unaffected—particularly for fully insured plans where state insurance departments retain jurisdiction.

Event #3 – Anthem Litigation Highlights Ongoing Enforcement

In July 2025, Anthem and associated self-funded plan sponsors were named in a lawsuit alleging underpayment of MH/SUD claims, violating the MHPAEA. This case is distinct from the ERIC litigation and underscores that parity enforcement continues—particularly regarding benefit design, reimbursement structures, and network adequacy for mental health services.

What Employers Should Do Now

The current compliance environment is fluid. While the 2024 rule is paused, core MHPAEA obligations still apply. HR and benefits leaders should consider these key actions:

• Continue with 2013 Rule compliance: Maintain detailed NQTL comparative analyses, documentation, and record retention policies.
• Pause new rule implementation—not all efforts: Delay rule-specific mandates, but keep preparing for potential future requirements.
• Stay alert to regulatory updates: New Notices of Proposed Rulemaking (NPRMs) may revise or reintroduce select provisions.
• Coordinate with legal and TPA partners: Review mental health reimbursement strategies and ensure plan language reflects compliance safeguards.

Broader Implications for Employers

For tribal enterprises, public agencies, and mid-sized companies, mental health parity is no longer just a compliance concern—it is a key component of workforce strategy. The current stay provides breathing room to reevaluate MH/SUD access, benefit structure, and claims performance without rushing implementation under uncertain rules.

• Strategic planning: Evaluate whether existing mental health access meets employee needs and parity benchmarks.
• Claims audits: Conduct retrospective reviews of MH/SUD claims to identify discrepancies or compliance gaps.
• Cross-jurisdictional vigilance: Ensure consistency across state-regulated and self-funded lines of coverage.

Atria’s Advisory Role

Atria supports employers in navigating MHPAEA compliance—particularly during regulatory uncertainty. We work with legal advisors, third-party administrators, and plan sponsors to:

• Validate and update existing MHPAEA comparative analyses.
• Design benefits strategies that meet both legal requirements and workforce needs.
• Prepare for future rule reinstatement or revisions based on litigation outcomes.

Need guidance on MHPAEA documentation, litigation risk, or rule transition strategy? Connect with Atria’s benefits and compliance team today to protect your plans and serve your employees better.

This article is for informational purposes only and should not be considered legal or tax advice.