Mental Health Parity: Three Priorities for Health Plans Heading Into 2027

As employers prepare their health plans for 2027, mental health parity should remain on the year-end checklist. New Department of Labor guidance narrows the agency’s enforcement focus regarding the Mental Health Parity and Addiction Equity Act (MHPAEA), but it does not put compliance on hold. In Field Assistance Bulletin No. 2026-03, issued September 8, 2026, and an accompanying enforcement tool, the Department identifies three priorities: treatment exclusions, medical necessity reviews, and provider networks. (For a history of MHPAEA’s application to employer-sponsored group health plans, view our article here.)

We recommend the following practical steps for plans subject to the MHPAEA:

1. Look closely at treatment exclusions.

Start with exclusions affecting conditions the plan otherwise covers. The Department flags exclusions for autism therapies, medications for opioid use disorder, nutritional counseling for eating disorders, and residential or intensive outpatient treatment, particularly when comparable medical or surgical treatments are covered.

Age limits and other restrictions also deserve attention. A red flag is not automatically a violation, but it is a reason to investigate and document the plan’s justification.

2. Check how claims are actually reviewed for medical necessity.

Ask whether mental health claims face more paperwork, more frequent reviews, shorter authorization periods, or slower approvals than comparable medical claims. Watch for requirements involving parental participation, repeated diagnostic testing, or treatment-plan submissions that have no comparable medical counterpart.

Proprietary clinical guidelines are not automatically prohibited. Their use must satisfy parity standards, and the bulletin emphasizes that applicable guidelines must be available upon request during investigations and to participants and beneficiaries.

3. Make sure the network works for participants.

A provider directory alone does not establish meaningful access. Review whether participants can find available providers, whether behavioral health providers face greater barriers to joining the network, and whether reimbursement methods contribute to access problems.

Compare out-of-network use and access complaints across benefit types. Also examine “network gap” exceptions and single-case agreements: participants seeking mental health care should not face more burdensome procedures than participants seeking comparable medical care.

Bottom line: Use year-end 2026 to check actual access to care, not just plan language. Heading into 2027, the strongest preparation is accurate comparative analyses, informed vendor oversight, and documented action when problems surface. Baird Holm is available to assist you as you review plans for mental health parity compliance into the new year.