The 2024 Parity Rule's Enforcement Pause: What Still Applies

If you have read that the 2024 mental health parity rule was "paused" or "rolled back," the reality is narrower. The rule is still published in the Code of Federal Regulations. What changed is enforcement, and only for the parts that were new in 2024. For a therapist or psychiatrist building a network dispute, that distinction decides which arguments carry weight in 2026.

What did the 2024 rule do?

The Departments of Labor, Health and Human Services and the Treasury published the final rule, "Requirements Related to the Mental Health Parity and Addiction Equity Act," at 89 Fed. Reg. 77586 on September 23, 2024. According to the Departments' later statement, it "amended the 2013 final rule" and "added new rules implementing the nonquantitative treatment limitation (NQTL) comparative analyses requirements" added by the Consolidated Appropriations Act, 2021. It "became effective on November 22, 2024," with applicability for plan years beginning on or after January 1, 2025, and some provisions from plan years beginning on or after January 1, 2026.

The regulation text shows the staggered dates: the data collection and evaluation requirements in 29 CFR 2590.712(c)(4)(iii), among others, apply "on the first day of the first plan year beginning on or after January 1, 2026."

Which parts were paused?

The Departments' statement dated May 15, 2025 says:

• On January 17, 2025, the ERISA Industry Committee sued in the U.S. District Court for the District of Columbia, challenging parts of the rule.
• The Departments asked that the case be held in abeyance while they reconsider the rule, "including whether to issue a notice of proposed rulemaking rescinding or modifying the regulation."
• "The Departments will not enforce the 2024 Final Rule or otherwise pursue enforcement actions, based on a failure to comply that occurs prior to a final decision in the litigation, plus an additional 18 months."
• "This enforcement relief applies only with respect to those portions of the 2024 Final Rule that are new in relation to the 2013 final rule."
• HHS "encourages states that are the primary enforcers of MHPAEA with respect to issuers to adopt a similar approach."

As of October 10, 2026, a search of the Federal Register returned no proposed or final rule rescinding or modifying the 2024 rule. That can change, so check before relying on it.

Is anything still enforced?

• The statute. The statement says "MHPAEA's statutory obligations, as amended by the CAA, 2021, continue to have effect." That includes the duty to "perform and document comparative analyses of the design and application of NQTLs" and make them available to the Secretary on request (29 U.S.C. 1185a(a)(8)(A)).
• The 2013 rule. Plans "may continue to refer to the 2013 final rule," which already listed "standards for provider admission to participate in a network, including reimbursement rates" as an NQTL and required comparable, no-more-stringent standards.
• State enforcement. States enforce parity for insurers. Some may follow HHS's encouragement to pause; others may not. Ask your state insurance department.

What does that mean for a network dispute?

Arguments that depend on the 2024 additions, such as the requirement to collect network composition data like "time and distance data, and data on providers accepting new patients" and to take "reasonable action" when data shows "material differences in access," carry less weight with federal regulators until the pause ends.

Arguments built on the 2013 framework still stand: the plan's behavioral health admission standards should be comparable to and applied no more stringently than its medical standards, and the plan should have a comparative analysis that shows it. The underlying facts are also unchanged. A documented gap, where listed therapists are not taking patients and members wait or travel, remains persuasive to a plan's network team and to a state regulator reviewing network adequacy. See mental health parity and network admission standards for how to frame the comparison, and documenting an access gap for the evidence.

Should you still mention the 2024 rule at all?

Carefully. Citing the rule's network composition text as a description of what plans are expected to measure is accurate. Claiming the federal government will enforce it against the plan right now is not. A letter that gets this right reads as informed, which helps it get read.

How we help

We track the status of the rule and the litigation as part of our research, and we prepare dispute letters and regulator complaint drafts that cite only what is in force. You sign and send them. We do not give legal advice; if you want an opinion on whether a specific plan violates federal parity law, ask a healthcare attorney. A Network Rejection Review is $249 and a Payer Network Dispute is $799 per payer; see pricing, and the behavioral health closed panels overview for the other levers therapists have.