Court Decision – MHPAEA Enforcement

A recent federal district court’s ruling in Perrone v. Blue Cross Blue Shield of Michigan reinforces that health plan participants can pursue Mental Health Parity & Addiction Equity Act (MHPAEA) claims under ERISA, making clear that mental health parity violations are judicially enforceable. This decision contributes to a growing body of case law showing that courts are willing to entertain MHPAEA lawsuits claiming a lack of parity in how a plan treats mental health or substance use disorder (MH/SUD) benefits compared to medical/surgical ones. The case highlights the growing importance of proactively auditing any financial requirements or treatment limitations imposed on MH/SUD benefits—particularly non-quantitative treatment limitations (NQTLs) like network restrictions and utilization management—and thoroughly documenting these reviews as part of the required NQTL written comparative analysis. The full text of the court opinion can be found here.