The Department of Labor’s Employee Benefits Security Administration issued Field Assistance Bulletin No. 2026-03 on September 8, 2026, reshaping how it enforces mental health parity rules.
The bulletin establishes a focused enforcement approach under the Mental Health Parity and Addiction Equity Act, commonly known as MHPAEA, as amended by the Consolidated Appropriations Act, 2021.
EBSA confirmed it will concentrate enforcement efforts on three categories presenting “the highest potential for significant harm to participants and beneficiaries.”
Those three priority areas are separate treatment limitations including blanket exclusions, medical necessity standards and review processes, and network adequacy standards covering admission criteria and provider reimbursement methodologies.
The bulletin also confirms that EBSA will not pursue enforcement of those portions of the 2024 Final Rule that are new relative to the 2013 Final Rule, maintaining a policy established earlier.
On May 15, 2025, the Departments of Labor, Health and Human Services, and Treasury issued a broad non-enforcement policy tied to ongoing litigation challenging the 2024 Final Rule.
Despite that relief, group health plans must still comply with the underlying MHPAEA and CAA, 2021 statutory obligations, including preparing comparative analyses of nonquantitative treatment limitations.
Plans must be ready to provide those comparative analyses to regulators within 10 days of a request, a requirement that remains firmly in place regardless of the enforcement shift.
On network adequacy specifically, EBSA said it will ensure plans consider all available options and assist participants in accessing covered mental health and substance use disorder treatments without exposure to out-of-network costs caused by insufficient in-network availability.
Regarding medical necessity, EBSA will examine whether the processes, strategies, evidentiary standards, and other factors used to create clinical guidelines are comparable to those applied for medical and surgical benefits.
Plan sponsors and fiduciaries are cautioned not to interpret the narrowed enforcement focus as permission to scale back their broader compliance programmes across other nonquantitative treatment limitation categories.
EBSA noted it may still investigate other categories of nonquantitative treatment limitations “as issues arise, particularly when responding to participant complaints,” leaving the door open for wider scrutiny.
The non-enforcement relief tied to the 2024 Final Rule remains conditional on the outcome of the pending litigation, meaning regulatory obligations could shift significantly if courts rule against challengers.
Plan sponsors are advised to monitor both the litigation progress and any further regulatory developments, including the possibility that the DOL will propose new regulations as early as this year.
EBSA acknowledged the complexity of its enforcement priorities and stated it will strive to provide additional clarity and guidance as warranted while continuing to welcome input from stakeholders.