Division III · Health and Welfare
Part 15. Health Plan Parity, CAA, and Transparency
This Part covers MHPAEA parity and NQTL comparative analyses (including the 2024 final rule's nonenforcement posture), the No Surprises Act and federal IDR (QPA, TMA litigation, the 2026 IDR operations rule), gag-clause attestations (GCPCA), RxDC reporting, Transparency in Coverage machine-readable files and the price-comparison tool, provider directories and the other CAA patient protections, ERISA §408(b)(2)(B) covered-service-provider compensation disclosure (brokers and consultants, and since the Consolidated Appropriations Act, 2026 also PBMs, TPAs, and other listed service providers), the CAA 2026 PBM provisions (ERISA §726/Code §9826 PBM reporting to plans, the §502(c)(13) penalties, and the §408(b)(2)(C) rebate pass-through), and health-plan fee fiduciary litigation and governance.
Chapters
Chapter 1. MHPAEA Parity and NQTL Comparative Analyses
This chapter covers the Mental Health Parity and Addiction Equity Act as amended by the CAA 2021: scope, the quantitative parity rules, nonquantitative treatment limitations (NQTLs), the statutory NQTL comparative-analysis requirement, and the 2024 final rule and its current nonenforcement posture — the central currency item in this area.
Law stated as of October 3, 2026
Chapter 2. The No Surprises Act
This chapter, written from the plan/plan-sponsor side, covers the No Surprises Act (CAA 2021, Division BB, Title I): the balance-billing protections and plan cost-sharing/payment rules, the QPA, the federal IDR process (including the June 2026 IDR operations final rule), the TMA litigation line (including the Fifth Circuit's August 11, 2026 en banc decision on the QPA-methodology rules), and the adjacent CAA patient-protection obligations (ID cards, continuity of care, provider directories, advanced EOBs).
Law stated as of October 3, 2026
Chapter 3. CAA Transparency, Reporting, and Fee Disclosure
This chapter covers the recurring-deliverable layer of CAA/transparency-era compliance: the gag clause prohibition and annual attestation, RxDC reporting, the Transparency in Coverage machine-readable files and price-comparison tool, the §408(b)(2)(B) broker/consultant compensation disclosure, and the health-plan fee fiduciary litigation wave these transparency rules are fueling.
Law stated as of October 3, 2026
Also in this Part
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