Over half of all MHPAEA violations in 2016 concerned annual dollar limits

According to the Department of Labor’s Employee Benefits Security Administration (EBSA), 54.55 percent of Mental Health Parity and Addiction Equity Act (MHPAEA) violations in 2016 concerned the annual dollar limits. The FY 2016 MHPAEA Enforcement Fact Sheet noted that 22.73 percent of violations concerned financial limits and quantitative treatment limitations (QTLs); 13.64 percent concerned cumulative financial requirements/treatment limitations; 6.82 percent concerned benefits in all classifications; and 2.27 percent concerned nonquantitative treatment limitations (NQTLs).

The EBSA is charged with enforcing the MHPAEA and relies on its 460 investigators to review plans for compliance with ERISA and the MHPAEA. The Fact Sheet provided the following facts:

• EBSA closed 330 health investigations in FY 2016 (and 3,100 health investigations since FY 2011).
• Of these 330 closed investigations in FY 2016, 191 involved plans subject to MHPAEA and were, therefore, reviewed for MHPAEA compliance.
• Of these 191 investigations where MHPAEA applied, EBSA cited 44 violations for MHPAEA noncompliance.
• EBSA Benefits Advisors answered over 112 public inquiries in FY 2016 related to MHPAEA (and have answered 1,191 inquiries related to MHPAEA since FY 2011).

SOURCE: https://www.dol.gov/sites/default/files/ebsa/about-ebsa/our-activities/resource-center/fact-sheets/mhpaea-enforcement-2016.pdf

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