MHPAEA Enforcement Agencies
| Agency | Jurisdiction | Enforcement Tools |
|---|---|---|
| DOL (EBSA) | ERISA-covered group health plans | Audits, civil penalties, plan correction |
| HHS (CMS) | Non-federal governmental plans; state-regulated plans | Audits, civil penalties |
| State insurance regulators | Fully insured plans | Market conduct exams, fines, license revocation |
| DOJ | Federal criminal violations | Criminal prosecution (rare) |
DOL Audit Response
Plans that receive a DOL request for the MHPAEA comparative analysis must respond within 30 days. The response must include the complete comparative analysis, supporting documentation, and outcomes data. Plans that cannot produce a complete comparative analysis within 30 days are at significant risk of enforcement action.
Proactive Compliance Strategy
Compliance Note
The best defense against MHPAEA enforcement is proactive compliance: maintain a current comparative analysis, conduct annual QTL and NQTL audits, monitor outcomes data for parity disparities, and document remediation efforts. Plans that can demonstrate a good-faith compliance effort are treated more favorably in enforcement actions than those that cannot.