NAIC Fall Meeting Update: Mental Health Parity and Addiction Equity Act (B) Working Group

The Mental Health Parity and Addiction Equity Act (B) Working Group (the “Working Group”) monitors developments related to the Mental Health Parity and Addiction Equity Act, and makes related recommendations regarding NAIC and state regulatory strategy and coordinates with and provides input to the Market Regulation and Consumer Affairs (D) Committee. On December 10, 2025, the Working Group met to hear the following presentations:

1. Presentation on the Development and Use of Reporting Templates by States (Jane Beyer (WA); Leanette Henagan (AZ); Viara Ianakieva (NM))

The first set of presentations provided an overview of how states have developed and utilized reporting templates to strengthen oversight, promote consistency, and enhance the clarity of parity compliance submissions. Given the variety of issues states are facing, the Working Group decided not to put out one unified template, but rather the sharing of information.

Leanette Henagan of Arizona presented on S.B. 1523 (Jake’s Law), stating that the law gave the division clear authority to enforce MHPAEA. Ms. Henagan stated that Arizona approached the reporting process “as a market conduct but with a twist,” conducting entrance meetings with each insurer to explain the process and answer questions and exit meetings to review the insurers’ findings and give recommendations. Some commonly observed trends were: (1) “lumping” together multiple NQTLs into one analysis and (2) definition clarity (e.g., insurers were not clear on how factors are defined or when they might be triggered). Submissions for this year’s report are due March 15, 2026.

Viara Ianakieva presented on New Mexico’s mental health coverage program, which she stated is fully operational, data-verified, and an enforceable mental health parity regulatory system. She described the distinguishing factors of New Mexico’s program to be: expanded state authority over mental health coverage, comprehensive multi-phase filings, raw data-driven enforcement, documented outcomes, transparency and education infrastructure, and a dedicated staff with deep subject matter expertise. She discussed raw data requests including: prior authorization indicators, concurrent review indicators, urgent indicators, recommended clinical review indicators and other relevant information. Some of New Mexico’s findings included: some instances of under-provision of data, as well as carriers interpreting the applicable law narrowly regarding NQTLs, provider reimbursement, and network adequacy standards. In 2025, New Mexico put forth 537 potential compliance questions in 131 objection letters. Further, New Mexico had over 100 total claims reprocessed or corrected by insurers after the MH Parity Team objections.

2. Presentation on Health Plan Perspectives on Parity Reporting Templates (Jane Beyer (WA), Lisa Campbell (Groom Law Group))

Lisa Campbell gave a presentation titled “Lessons Learned: State NQTL Templates and Instructions.” The presentation discussed (a) state NQTL Templates and Instructions, (b) plans’ perspectives, and (c) MHPAEA compliance. Regarding the State NQTL templates, Ms. Campbell stated that states are highly varied in how they approach MHPAEA NQTL reporting: some states require very detailed reporting using state-specific templates; whereas, other states reference federal law and require reporting, but do not supply state-specific template, while some states rely on certification only. She highlighted some of the key issues relating to state reporting, as follows: lack of explicit instructions on information being requested and review criteria; excessive burdens if detailed reporting is required at individual item, service or drug levels; small datasets including differing assumptions and related benchmarking or comparisons complications; inconsistency in templates vis a vis Federal law; and gaps in templates and instructions creating the need for several rounds of detailed follow-up inquiries.