Mental Health Parity and Addiction Equity Act (MHPAEA) Compliance.

Schedule an audit to understand your legal position and next steps to ensure Mental Health Parity and Addiction Equity Act (MHPAEA) Compliance

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Get a free consultation for MHPAEA compliance, and a health benefits review : 952-952-2135

Ensure Your Health Plan Is Compliant with Mental Health Parity Requirements : 952-952-2135

If your business offers health insurance benefits, you're required to comply with the Mental Health Parity and Addiction Equity Act (MHPAEA). This federal law mandates that mental health and substance use disorder (MH/SUD) benefits be no more restrictive than medical and surgical benefits. Noncompliance can lead to audits, penalties, or employee disputes — but we're here to help you avoid all of that.

Here’s what your organization should be doing:

  • Review Financial Requirements: Make sure that copayments, coinsurance, and deductibles for MH/SUD benefits are no more restrictive than those for medical/surgical benefits.
  • Evaluate Treatment Limitations: Check that things like session limits, preauthorization rules, and step therapy requirements are applied equally across both mental health and medical services.
  • Analyze Nonquantitative Treatment Limitations (NQTLs): Conduct comparative analyses of factors such as network adequacy, provider reimbursement rates, and medical necessity criteria to ensure they are not more stringent for mental health services.
  • Maintain and Update Compliance Documentation: Keep detailed, up-to-date records to prove compliance. This is particularly important when you implement new health programs or make plan changes.
  • Leverage Government Tools: The Department of Labor provides a self-compliance tool to help assess your plans. But navigating this process alone can be overwhelming.

How We Help

We assist employers and healthcare purchasers with end-to-end MHPAEA compliance support. From reviewing your current health plans to identifying and correcting any parity violations, we ensure your documentation is audit-ready and fully aligned with federal standards. Whether you work with a TPA, a broker, or handle benefits internally — we’ll coordinate with your team to meet and maintain compliance.

Let’s ensure your business is protected and your employees are supported. Reach out today to schedule a compliance review.

Why Compliance Matters: The Risks of Ignoring Mental Health Parity

Failing to comply with the Mental Health Parity and Addiction Equity Act isn’t just a legal issue — it can significantly impact your finances, operations, & reputation. Here’s what’s at stake if you do not meet parity standards:

Avoid Fines and penalties

Non-compliant employers and insurance providers may face substantial financial penalties. Government agencies are increasingly auditing health plans, and violations can result in steep fines per affected employee, per violation. In some cases, penalties are assessed for each day the plan remains out of compliance. For self-insured employers, this risk is even higher since you’re directly responsible for plan design and administration.

Legal Action

The Department of Labor (DOL), Department of Health and Human Services (HHS), and the Treasury Department all have enforcement authority. These agencies can launch investigations, demand corrective action, and even file lawsuits against employers, insurers, and third-party administrators. With increasing regulatory scrutiny and a national focus on mental health, enforcement activity is on the rise — and it's not limited to large corporations.

Plan corrections

If a violation is discovered, employers may be required to take corrective actions — often retroactively. This could mean reimbursing employees for previously denied mental health or substance use disorder claims and adjusting plan designs to meet parity requirements. These corrections can be time-consuming, costly, and disruptive, especially if documentation has not been maintained properly.

Public scrutiny

As mental health becomes a central focus in workplace wellness and public policy, companies found out of compliance risk more than just fines. Non-compliance can lead to negative press, employee dissatisfaction, and reputational damage — especially if legal actions or complaints become public. Demonstrating a commitment to mental health parity not only ensures legal compliance but also strengthens your brand as a responsible, employee-focused organization.

Quick & Painless Audit. Let us do all the dirty work!

Call for a free consult : 952-952-2135

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