EBSA Faced Challenges Enforcing Compliance with Mental Health Parity Laws and Requirements

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Title Full

Date Issued

Wednesday, February 19, 2025

Submitting OIG

Department of Labor OIG

Agencies Reviewed/Investigated

Department of Labor

Report Number

09-25-001-12-001

Report Type

Audit

Agency Wide

Yes

Questioned Costs

Funds for Better Use

Report updated under NDAA 5274

Open Recommendations

This report has 5 open recommendations.

Recommendation Number	Significant Recommendation	Recommended Questioned Costs	Recommended Funds for Better Use
001	Yes	$0	$0
We recommend the Assistant Secretary for the Employee Benefits Security Administration pursue legislative changes regarding the authority to impose civil monetary penalties for Mental Health Parity Addiction and Equity Act violations to increase compliance with Part 7 of ERISA, which include the mental health parity provisions.
002	Yes	$0	$0
We recommend the Assistant Secretary for the Employee Benefits Security Administration pursue legislative changes regarding the authority to enforce the group health plan requirements of Part 7 of ERISA against service providers, including insurance issuers and third-party administrators for violations such as designing and applying impermissible non-quantitative treatment limitations.
003	Yes	$0	$0
We recommend the Assistant Secretary for the Employee Benefits Security Administration pursue legislative changes regarding provisions that specify remedies available for violations of Part 7 of ERISA, including the ability to force the re-adjudication of wrongfully denied claims or other remedies to restore losses resulting from Mental Health Parity and Addiction Equity Act violations.
004	Yes	$0	$0
We recommend the Assistant Secretary for the Employee Benefits Security Administration develop processes to utilize enforcement tools available to the agency, including referring health plans to the U.S. Department of the Treasury to levy the excise tax for Mental Health Parity and Addiction Equity Act violations, as appropriate.
005	Yes	$0	$0
We recommend the Assistant Secretary for the Employee Benefits Security Administration develop and issue additional guidance to support the implementation of the 2021 Consolidated Appropriations Act non-quantitative treatment limitation comparative analysis requirements and the September 2024 Mental Health Parity and Addiction Equity Act final rule, such as an updated Mental Health Parity and Addiction Equity Act Self-Compliance Tool or Frequently Asked Questions document(s).