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MHPAEA Opt-Out Expires for Nonfederal Government Plans - What Employers Need to Know

The Consolidated Appropriations Act, 2023 (CAA, 2023), enacted on December 29, 2022, includes a sunset provision for the self-funded, non-Federal governmental group health plan election under section 2722(a)(2) of the Public Health Service Act (PHS Act) to opt out of compliance with the requirements of PHS Act section 2726, the Mental Health Parity and Addiction Equity Act (MHPAEA). Under the CAA, for affected plans, as of June 27, 2023, and moving forward, they may not elect out of MHPAEA and will be obligated to comply with the MHPAEA's provisions upon expiration of their current opt-out elections.

Once their opt-out election has expired, affected government plans must align their mental health and substance use disorder (MH/SUD) benefits with the MHPAEA's guidelines to ensure equitable coverage comparable to medical and surgical conditions. For additional guidance: Insurance Standards Bulletin Series – INFORMATION (

Contact your Boutwell Fay attorney if you have any questions on this topic or email us at


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