On September 5, the Departments of Labor, the Treasury, and Health & Human Services (collectively, the Departments) published an advance copy of the long-awaited and much anticipated mental health parity final regulations. The publication spans some 536 pages and the final regulations hew closely to a 2023 proposed regulation that garnered 9,503 public comments from diverse stakeholders. The stated purpose of the final regulations is to ensure that participants and beneficiaries in a group health plan or in group health insurance coverage offered by a health insurance issuer that offers mental health or substance use disorder (MH/SUD) benefits are not subject to greater restrictions when seeking those benefits than when seeking medical/surgical (M/S) benefits under the terms of the plan or coverage. 

While the rule's primary impact is on employer sponsored group health plans, it is not clear that health plans' voices were heard, based on the content of the rule. While some of the more objectionable features of the proposed regulations were not finalized, their basic structure remains fully intact, including provisions that employers found most burdensome. Specifically, the final regulations: 

• Require plans and issuers to collect and evaluate NQTL data on relevant outcomes related to access to MH/SUD benefits and M/S benefits and to take reasonable action, as necessary, to address material differences in access to MH/SUD benefits as compared to M/S benefits.
• Amend examples and add new examples on the application of the rules for NQTLs to clarify and illustrate the requirements of MHPAEA. 
• Set forth the content requirements for NQTL comparative analyses and specify how plans and issuers must make these comparative analyses available to the Departments, applicable state authorities, participants, beneficiaries and enrollees.