,i  #aaf? ,,congress  #a/ ,session  ,h4 
,r4 #bhgd  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,may #ba1 #bjai,mr4   
,k5n$y 7= himself1 ,mr4 ,tonko1 ,mr4    
,mi*ael ,f4 ,doyle ( ,p5nsylvania1 ,ms4 
,cl>ke ( ,new ,york1 ,mr4 ,engel1 ,mr4  
,soto1 ,mr4 ,crd5as1 ,mrs4 ,d+ell1 ,ms4 
,ca/or ( ,florida1 ,mr4 ,deut*1 ,mr4    
,cr[1 ,ms4 ,s*ak[sky1 & ,mr4            
,de,saulnier7 introduc$ ! foll[+ bill2  
:i* 0 ref]r$ to ! ,committee on ,en]gy &
 ,comm]ce1 & 9 addition to ! ,committees
 on ,ways & ,means1 & ,education &      
,labor1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to /r5g!n p>ity 9 m5tal heal? 
& sub/ance use disord] b5efits4  #a4    
,%ort title ,?is ,act may be cit$ z !   
,behavioral ,heal? ,cov]age ,transp>5cy 
,act4  #b4 ,/r5g!n+ p>ity 9 m5tal heal? 
& sub/ance use disord] b5efits  7a7     
,public ,heal? ,s]vice ,act ,section    
#bgbf7;a7 ( ! ,public ,heal? ,s]vice    

,act 7#db ,u4,s4,c4 #cjj;gg-#bf7;a77 is 
am5d$ by add+ at ! end ! foll[+ new     
p>agraph3  7#h7 ,disclosure & en=cem5t  
requirem5ts  7,a7 ,disclosure           
requirem5ts  7i7 ,regulations ,n lat]   
?an #f mon?s aft] ! date ( enactm5t (   
?is p>agraph1 ! ,secret>y1 9 coop]ation 
) ! ,secret>ies ( ,labor & ! ,treasury1 
%all issue regulations = c>ry+ out ?is  
section1 includ+ an explanation (       
docum5ts t gr\p heal? plans & heal?     
insurance issu]s (f]+ gr\p or individual
 heal? insurance cov]age %all disclose 9
 accordance ) clause 7ii71 ! process    
gov]n+ ! disclosure ( su* docum5ts1 &   
analyses t su* plans & issu]s %all      
conduct 9 ord] to demon/rate compliance 
) ?is section4  7ii7 ,disclosure        
requirem5ts ,! docum5ts requir$ to be   
disclos$ by a gr\p heal? plan or a heal?
 insurance issu] (f]+ gr\p or individual
 heal? insurance cov]age "u clause 7i7  
%all include an annual report t details 
! specific analyses p]=m$ to ensure     
compliance ( su* plan or issu] ) ?is    

section1 includ+ any regulation         
promulgat$ pursuant to ?is section4 ,at 
a m9imum1 ) respect to ! application (  
nonquantitative treatm5t limitations 79 
?is p>agraph ref]r$ to z ,n,q,t,ls7 to  
b5efits "u ! plan or cov]age1 su* report
 %all--  7,i7 id5tify ! specific factors
 ! plan or issu] us$ 9 p]=m+ its        
,n,q,t,ls analysis2  7,,ii7 id5tify &   
def9e ! specific evid5ti>y /&>ds reli$  
on to evaluate su* factors2  7,,iii7    
describe h[ ! evid5ti>y /&>ds are appli$
 to ea* s]vice category = m5tal heal?   
b5efits1 sub/ance use disord] b5efits1  
m$ical b5efits1 & surgical b5efits2     
7,,iv7 disclose ! results ( ! analyses (
 ! specific evid5ti>y /&>ds 9 ea* s]vice
 category2 &  7,v7 disclose ! specific  
f9d+s ( ! plan or issu] 9 ea* s]vice    
category & ! conclusions rea*$ ) respect
 to :e!r ! processes1 /rategies1        
evid5ti>y /&>ds1 or o!r factors us$ 9   
apply+ ! ,n,q,t,ls to m5tal heal? or    
sub/ance use disord] b5efits are        
comp>able to1 & appli$ no m /r+5tly ?an1

 ! processes1 /rategies1 evid5ti>y      
/&>ds1 or o!r factors us$ 9 apply+ !    
,n,q,t,ls to m$ical & surgical b5efits 9
 ! same classification4  7iii7 ,guidance
 ,n lat] ?an #f mon?s aft] ! date (     
enactm5t ( ?is p>agraph1 ! ,secret>y1 9 
coop]ation ) ! ,secret>ies ( ,labor & ! 
,treasury1 %all issue guidance to gr\p  
heal? plans & heal? insurance issu]s    
(f]+ gr\p or individual heal? insurance 
cov]age on h[ to satisfy ! requirem5ts (
 ?is section1 ) respect to mak+         
in=mation available to curr5t & pot5tial
 p>ticipants & b5efici>ies4 ,su*        
in=mation %all include--  7,i7          
c]tificate ( cov]age docum5ts &         
in/rum5ts "u :i* ! plan or cov]age      
involv$ is adm9i/]$ & op]at$ t specify1 
include1 or ref] to proc$ures1 =mulas1 &
 me?odologies appli$ to det]m9e a       
p>ticipant's or b5efici>y's b5efit "u ! 
plan or cov]age1 reg>dless ( :e!r su*   
in=mation is conta9$ 9 a docum5t        
designat$ z ! plan docum5t2 &  7,,ii7 a 
disclosure ( h[ ! plan or issu] involv$ 

has provid$ t processes1 /rategies1     
evid5ti>y /and>ds1 & o!r factors us$ 9  
apply+ ! ,n,q,t,ls to m5tal heal? or    
sub/ance use disord] b5efits are        
comp>able to1 & appli$ no m /r+5tly ?an1
 ! processes1 /rategies1 evid5ti>y      
/&>ds1 or o!r factors us$ 9 apply+ !    
,n,q,t,ls to m$ical & surgical b5efits 9
 ! same classification4  7iv7           
,def9itions ,9 ?is p>agraph & p>agraph  
7#g71 ! t]ms nonquantitative treatm5t   
limitations1 comp>able to1 & appli$ no m
 /r+5tly ?an h ! mean+s giv5 su* t]ms 9 
sections #adf4acf & #adg4afj ( title    
#de1 ,code ( ,f$]al ,regulations 7or any
 successor regulation74  7,b7 ,en=cem5t 
7i7 ,process = compla9ts ,n lat] ?an #f 
mon?s aft] ! date ( enactm5t ( ?is      
p>agraph1 ! ,secret>y1 9 coop]ation ) ! 
,secret>ies ( ,labor & ! ,treasury1     
%all1 ) respect to gr\p heal? plans &   
heal? insurance issu]s (f]+ gr\p or     
individual heal? insurance cov]age1     
issue guidance to cl>ify ! process &    
timel9e = curr5t & pot5tial p>ticipants 

& b5efici>ies 7& au?oriz$ repres5tatives
 & heal? c>e provid]s ( su* p>ticipants 
& b5efici>ies7 ) respect to su* plans & 
cov]age to file =mal compla9ts ( su*    
plans or issu]s be+ 9 violation ( ?is   
section1 includ+ guidance1 by plan type1
 on ! relevant ,/ate1 regional1 &       
national (fices ) :i* su* compla9ts %\ld
 be fil$4  7ii7 ,audits  7,i7 ,r&omiz$  
audits ,beg9n+ #a ye> aft] ! date (     
enactm5t ( ?is p>agraph1 ! ,secret>y1 9 
coop]ation ) ! ,secret>ies ( ,labor & ! 
,treasury1 z applicable1 %all conduct   
r&omiz$ audits ( gr\p heal? plans &     
heal? insurance issu]s (f]+ gr\p or     
individual heal? insurance cov]age to   
det]m9e compliance ) ?is section4 ,su*  
audits %all be conduct$ on no few] ?an  
#ab plans or cov]ages p] plan ye>4      
7,,ii7 ,additional audits ,beg9n+ #a ye>
 aft] ! date ( enactm5t ( ?is p>agraph1 
9 ! case ( a gr\p heal? plan or heal?   
insurance issu] (f]+ gr\p or individual 
heal? insurance cov]age ) respect to :i*
 any claim has be5 fil$ dur+ a plan ye>1

 ! ,secret>y1 9 coop]ation ) !          
,secret>ies ( ,labor & ! ,treasury1 z   
applicable1 may audit ! books & records 
( su* plan or issu] to det]m9e          
compliance ) ?is section4  7iii7 ,d5ial 
rates ,! ,secret>y1 9 coop]ation ) !    
,secret>ies ( ,labor & ! ,treasury1 %all
 collect in=mation on ! rates ( &       
reasons = d5ial by gr\p heal? plans &   
heal? insurance issu]s (f]+ gr\p or     
individual heal? insurance cov]age (    
claims = outpati5t & inpati5t m5tal     
heal? & sub/ance use disord] b5efits    
comp>$ to ! rates ( & reasons = d5ial ( 
claims = m$ical & surgical b5efits4 ,= !
 fir/ plan ye> t beg9s on or aft] ! date
 t is #b ye>s aft] ! date ( enactm5t (  
?is p>agraph1 & ea* subsequ5t plan ye>1 
! ,secret>y1 9 su* coop]ation1 %all     
submit to ! ,committee on ,en]gy &      
,comm]ce ( ! ,h\se ( ,repres5tatives & !
 ,committee on ,heal?1 ,education1      
,labor1 & ,p5sions ( ! ,s5ate !         
in=mation collect$ "u ! previ\s s5t5ce )
 respect to ! previ\s plan ye>4  7,c7   

,effective date ,any requirem5ts ( gr\p 
heal? plans & heal? insurance issu]s    
(f]+ gr\p or individual heal? insurance 
cov]age t are includ$ 9 ! regulations   
issu$ "u subp>agraph 7,a77i71 includ+ ! 
requirem5t describ$ 9 subp>agraph       
7,a77ii7 to disclose docum5ts1 %all h an
 effective date ( #a ye> aft] ! date (  
enactm5t ( ?is p>agraph4  4  7b7        
,employee ,retirem5t ,income ,security  
,act ( #aigd ,section #gab7;a7 ( !      
,employee ,retirem5t ,income ,security  
,act ( #aigd 7#bi ,u4,s4,c4 #aahe;a7a77 
is am5d$ by add+ at ! end ! foll[+ new  
p>agraph3  7#f7 ,disclosure & en=cem5t  
requirem5ts  7,a7 ,disclosure           
requirem5ts  7i7 ,regulations ,n lat]   
?an #f mon?s aft] ! date ( enactm5t (   
?is p>agraph1 ! ,secret>y1 9 coop]ation 
) ! ,secret>ies ( ,heal? & ,human       
,s]vices & ! ,treasury1 %all issue      
regulations = c>ry+ out ?is section1    
includ+ an explanation ( docum5ts t a   
gr\p heal? plan 7or heal? insurance     
issu] (f]+ heal? insurance cov]age 9    

connection ) su* a plan7 %all disclose 9
 accordance ) clause 7ii71 ! process    
gov]n+ ! disclosure ( su* docum5ts1 &   
analyses t su* plans & issu]s %all      
conduct 9 ord] to demon/rate compliance 
) ?is section4  7ii7 ,disclosure        
requirem5ts ,! docum5ts requir$ to be   
disclos$ by a gr\p heal? plan 7or a     
heal? insurance issu] (f]+ heal?        
insurance cov]age 9 connection ) su* a  
plan7 "u clause 7i7 %all include an     
annual report t details ! specific      
analyses p]=m$ to ensure compliance (   
su* plan or issu] ) ?is section1 includ+
 any regulation promulgat$ pursuant to  
?is section4 ,at a m9imum1 ) respect to 
! application ( nonquantitative treatm5t
 limitations 79 ?is p>agraph ref]r$ to z
 ,n,q,t,ls7 to b5efits "u ! plan or     
cov]age1 su* report %all--  7,i7 id5tify
 ! specific factors ! plan or issu] us$ 
9 p]=m+ its ,n,q,t,ls analysis2  7,,ii7 
id5tify & def9e ! specific evid5ti>y    
/&>ds reli$ on to evaluate su* factors2 
7,,iii7 describe h[ ! evid5ti>y /&>ds   

are appli$ to ea* s]vice category =     
m5tal heal? b5efits1 sub/ance use       
disord] b5efits1 m$ical b5efits1 &      
surgical b5efits2  7,,iv7 disclose !    
results ( ! analyses ( ! specific       
evid5ti>y /&>ds 9 ea* s]vice category2 &
  7,v7 disclose ! specific f9d+s ( !    
plan or issu] 9 ea* s]vice category & ! 
conclusions rea*$ ) respect to :e!r !   
processes1 /rategies1 evid5ti>y /&>ds1  
or o!r factors us$ 9 apply+ ! ,n,q,t,ls 
to m5tal heal? or sub/ance use disord]  
b5efits are comp>able to1 & appli$ no m 
/r+5tly ?an1 ! processes1 /rategies1    
evid5ti>y /&>ds1 or o!r factors us$ 9   
apply+ ! ,n,q,t,ls to m$ical & surgical 
b5efits 9 ! same classification4  7iii7 
,guidance ,n lat] ?an #f mon?s aft] !   
date ( enactm5t ( ?is p>agraph1 !       
,secret>y1 9 coop]ation ) ! ,secret>ies 
( ,heal? & ,human ,s]vices & !          
,treasury1 %all issue guidance to gr\p  
heal? plans 7& heal? insurance issu]s   
(f]+ heal? insurance cov]age 9          
connection ) su* plans7 on h[ to satisfy

 ! requirem5ts ( ?is section1 ) respect 
to mak+ in=mation available to curr5t & 
pot5tial p>ticipants & b5efici>ies4 ,su*
 in=mation %all include--  7,i7         
c]tificate ( cov]age docum5ts &         
in/rum5ts "u :i* ! plan or cov]age      
involv$ is adm9i/]$ & op]at$ t specify1 
include1 or ref] to proc$ures1 =mulas1 &
 me?odologies appli$ to det]m9e a       
p>ticipant's or b5efici>y's b5efit "u ! 
plan or cov]age1 reg>dless ( :e!r su*   
in=mation is conta9$ 9 a docum5t        
designat$ z ! plan docum5t2 &  7,,ii7 a 
disclosure ( h[ ! plan or issu] involv$ 
has provid$ t processes1 /rategies1     
evid5ti>y /and>ds1 & o!r factors us$ 9  
apply+ ! ,n,q,t,ls to m5tal heal? or    
sub/ance use disord] b5efits are        
comp>able to1 & appli$ no m /r+5tly ?an1
 ! processes1 /rategies1 evid5ti>y      
/&>ds1 or o!r factors us$ 9 apply+ !    
,n,q,t,ls to m$ical & surgical b5efits 9
 ! same classification4  7iv7           
,def9itions ,9 ?is p>agraph1 ! t]ms     
nonquantitative treatm5t limitations1   

comp>able to1 & appli$ no m /r+5tly ?an 
h ! mean+s giv5 su* t]ms 9 sections     
#adf4acf & #adg4afj ( title #de1 ,code (
 ,f$]al ,regulations 7or any successor  
regulation74  7,b7 ,en=cem5t  7i7       
,process = compla9ts ,n lat] ?an #f     
mon?s aft] ! date ( enactm5t ( ?is      
p>agraph1 ! ,secret>y1 9 coop]ation ) ! 
,secret>ies ( ,heal? & ,human ,s]vices &
 ! ,treasury1 %all1 ) respect to gr\p   
heal? plans 7& heal? insurance issu]s   
(f]+ heal? insurance cov]age 9          
connection ) su* plans71 issue guidance 
to cl>ify ! process & timel9e = curr5t &
 pot5tial p>ticipants & b5efici>ies 7&  
au?oriz$ repres5tatives & heal? c>e     
provid]s ( su* p>ticipants &            
b5efici>ies7 ) respect to su* plans &   
cov]age to file =mal compla9ts ( su*    
plans or issu]s be+ 9 violation ( ?is   
section1 includ+ guidance1 by plan type1
 on ! relevant ,/ate1 regional1 &       
national (fices ) :i* su* compla9ts %\ld
 be fil$4  7ii7 ,audits  7,i7 ,r&omiz$  
audits ,beg9n+ #a ye> aft] ! date (     

enactm5t ( ?is p>agraph1 ! ,secret>y1 9 
coop]ation ) ! ,secret>ies ( ,heal? &   
,human ,s]vices & ! ,treasury1 z        
applicable1 %all conduct r&omiz$ audits 
( gr\p heal? plans 7& heal? insurance   
issu]s (f]+ heal? insurance cov]age 9   
connection ) su* plans7 to det]m9e      
compliance ) ?is section4 ,su* audits   
%all be conduct$ on no few] ?an #ab     
plans or cov]ages p] plan ye>4  7,,ii7  
,additional audits ,beg9n+ #a ye> aft] !
 date ( enactm5t ( ?is p>agraph1 9 !    
case ( a gr\p heal? plan 7or heal?      
insurance issu] (f]+ heal? insurance    
cov]age 9 connection ) su* a plan7 )    
respect to :i* any claim has be5 fil$   
dur+ a plan ye>1 ! ,secret>y1 9         
coop]ation ) ! ,secret>ies ( ,heal? &   
,human ,s]vices & ! ,treasury1 z        
applicable1 may audit ! books & records 
( su* plan or issu] to det]m9e          
compliance ) ?is section4  7iii7 ,d5ial 
rates ,! ,secret>y1 9 coop]ation ) !    
,secret>ies ( ,heal? & ,human ,s]vices &
 ! ,treasury1 %all collect in=mation on 

! rates ( & reasons = d5ial by gr\p     
heal? plans 7& heal? insurance issu]s   
(f]+ heal? insurance cov]age 9          
connection ) su* plans7 ( claims =      
outpati5t & inpati5t m5tal heal? &      
sub/ance use disord] b5efits comp>$ to !
 rates ( & reasons = d5ial ( claims =   
m$ical & surgical b5efits4 ,= ! fir/    
plan ye> t beg9s on or aft] ! date t is 
#b ye>s aft] ! date ( enactm5t ( ?is    
p>agraph1 & ea* subsequ5t plan ye>1 !   
,secret>y1 9 su* coop]ation1 %all submit
 to ! ,committee on ,en]gy & ,comm]ce ( 
! ,h\se ( ,repres5tatives & ! ,committee
 on ,heal?1 ,education1 ,labor1 &       
,p5sions ( ! ,s5ate ! in=mation collect$
 "u ! previ\s s5t5ce ) respect to !     
previ\s plan ye>4  7,c7 ,effective date 
,any requirem5ts ( gr\p heal? plans 7or 
heal? insurance issu]s (f]+ heal?       
insurance cov]age 9 connection ) su*    
plans7 t are includ$ 9 ! regulations    
issu$ "u subp>agraph 7,a77i71 includ+ ! 
requirem5t describ$ 9 subp>agraph       
7,a77ii7 to disclose docum5ts1 %all h an

 effective date ( #a ye> aft] ! date (  
enactm5t ( ?is p>agraph4  4  7c7        
,int]nal ,rev5ue ,code ( #aihf ,section 
#ihab7;a7 ( ! ,int]nal ,rev5ue ,code (  
#aihf is am5d$ by add+ at ! end ! foll[+
 new p>agraph3  7#f7 ,disclosure &      
en=cem5t requirem5ts  7,a7 ,disclosure  
requirem5ts  7i7 ,regulations ,n lat]   
?an #f mon?s aft] ! date ( enactm5t (   
?is p>agraph1 ! ,secret>y1 9 coop]ation 
) ! ,secret>ies ( ,heal? & ,human       
,s]vices & ,labor1 %all issue           
regulations = c>ry+ out ?is section1    
includ+ an explanation ( docum5ts t gr\p
 heal? plans %all disclose 9 accordance 
) clause 7ii71 ! process gov]n+ !       
disclosure ( su* docum5ts1 & analyses t 
su* plans %all conduct 9 ord] to        
demon/rate compliance ) ?is section4    
7ii7 ,disclosure requirem5ts ,! docum5ts
 requir$ to be disclos$ by a gr\p heal? 
plan "u clause 7i7 %all include an      
annual report t details ! specific      
analyses p]=m$ to ensure compliance (   
su* plan ) ?is section1 includ+ any     

regulation promulgat$ pursuant to su*   
section4 ,at a m9imum1 ) respect to !   
application ( nonquantitative treatm5t  
limitations 79 ?is p>agraph ref]r$ to z 
,n,q,t,ls7 to b5efits "u ! plan1 su*    
report %all--  7,i7 id5tify ! specific  
factors ! plan us$ 9 p]=m+ its ,n,q,t,ls
 analysis2  7,,ii7 id5tify & def9e !    
specific evid5ti>y /&>ds reli$ on to    
evaluate su* factors2  7,,iii7 describe 
h[ ! evid5ti>y /&>ds are appli$ to ea*  
s]vice category = m5tal heal? b5efits1  
sub/ance use disord] b5efits1 m$ical    
b5efits1 & surgical b5efits2  7,,iv7    
disclose ! results ( ! analyses ( !     
specific evid5ti>y /&>ds 9 ea* s]vice   
category2 &  7,v7 disclose ! specific   
f9d+s ( ! plan 9 ea* s]vice category & !
 conclusions rea*$ ) respect to :e!r !  
processes1 /rategies1 evid5ti>y /&>ds1  
or o!r factors us$ 9 apply+ ! ,n,q,t,ls 
to m5tal heal? or sub/ance use disord]  
b5efits are comp>able to1 & appli$ no m 
/r+5tly ?an1 ! processes1 /rategies1    
evid5ti>y /and>ds1 or o!r factors us$ 9 

apply+ ! ,n,q,t,ls to m$ical & surgical 
b5efits 9 ! same classification4  7iii7 
,guidance ,n lat] ?an #f mon?s aft] !   
date ( enactm5t ( ?is p>agraph1 !       
,secret>y1 9 coop]ation ) ! ,secret>ies 
( ,heal? & ,human ,s]vices & ,labor1    
%all issue guidance to gr\p heal? plans 
on h[ to satisfy ! requirem5ts ( ?is    
section1 ) respect to mak+ in=mation    
available to curr5t & pot5tial          
p>ticipants & b5efici>ies4 ,su*         
in=mation %all include--  7,i7          
c]tificate ( cov]age docum5ts &         
in/rum5ts "u :i* ! plan involv$ is      
adm9i/]$ & op]at$ t specify1 include1 or
 ref] to proc$ures1 =mulas1 &           
me?odologies appli$ to det]m9e a        
p>ticipant's or b5efici>y's b5efit "u ! 
plan1 reg>dless ( :e!r su* in=mation is 
conta9$ 9 a docum5t designat$ z ! plan  
docum5t2 &  7,,ii7 a disclosure ( h[ !  
plan involv$ has provid$ t processes1   
/rategies1 evid5ti>y /&>ds1 & o!r       
factors us$ 9 apply+ ! ,n,q,t,ls to     
m5tal heal? or sub/ance use disord]     

b5efits are comp>able to1 & appli$ no m 
/r+5tly ?an1 ! processes1 /rategies1    
evid5ti>y /&>ds1 or o!r factors us$ 9   
apply+ ! ,n,q,t,ls to m$ical & surgical 
b5efits 9 ! same classification4  7iv7  
,def9itions ,9 ?is p>agraph1 ! t]ms     
nonquantitative treatm5t limitations1   
comp>able to1 & appli$ no m /r+5tly ?an 
h ! mean+s giv5 su* t]ms 9 sections     
#adf4acf & #adg4afj ( title #de1 ,code (
 ,f$]al ,regulations 7or any successor  
regulation74  7,b7 ,en=cem5t  7i7       
,process = compla9ts ,n lat] ?an #f     
mon?s aft] ! date ( enactm5t ( ?is      
p>agraph1 ! ,secret>y1 9 coop]ation ) ! 
,secret>ies ( ,heal? & ,human ,s]vices &
 ,labor1 %all1 ) respect to gr\p heal?  
plans1 issue guidance to cl>ify !       
process & timel9e = curr5t & pot5tial   
p>ticipants & b5efici>ies 7& au?oriz$   
repres5tatives & heal? c>e provid]s (   
su* p>ticipants & b5efici>ies7 ) respect
 to su* plans to file =mal compla9ts (  
su* plans be+ 9 violation ( ?is section1
 includ+ guidance1 by plan type1 on !   

relevant ,/ate1 regional1 & national    
(fices ) :i* su* compla9ts %\ld be fil$4
  7ii7 ,audits  7,i7 ,r&omiz$ audits    
,beg9n+ #a ye> aft] ! date ( enactm5t ( 
?is p>agraph1 ! ,secret>y1 9 coop]ation 
) ! ,secret>ies ( ,heal? & ,human       
,s]vices & ,labor1 z applicable1 %all   
conduct r&omiz$ audits ( gr\p heal?     
plans to det]m9e compliance ) ?is       
section4 ,su* audits %all be conduct$ on
 no few] ?an #ab plans p] plan ye>4     
7,,ii7 ,additional audits ,beg9n+ #a ye>
 aft] ! date ( enactm5t ( ?is p>agraph1 
9 ! case ( a gr\p heal? plan ) respect  
to :i* any claim has be5 fil$ dur+ a    
plan ye>1 ! ,secret>y1 9 coop]ation ) ! 
,secret>ies ( ,heal? & ,human ,s]vices &
 ,labor1 z applicable1 may audit ! books
 & records ( su* plan to det]m9e        
compliance ) ?is section4  7iii7 ,d5ial 
rates ,! ,secret>y1 9 coop]ation ) !    
,secret>ies ( ,heal? & ,human ,s]vices &
 ,labor1 %all collect in=mation on !    
rates ( & reasons = d5ial by gr\p heal? 
plans ( claims = outpati5t & inpati5t   

m5tal heal? & sub/ance use disord]      
b5efits comp>$ to ! rates ( & reasons = 
d5ial ( claims = m$ical & surgical      
b5efits4 ,= ! fir/ plan ye> t beg9s on  
or aft] ! date t is #b ye>s aft] ! date 
( enactm5t ( ?is p>agraph1 & ea*        
subsequ5t plan ye>1 ! ,secret>y1 9 su*  
coop]ation1 %all submit to ! ,committee 
on ,en]gy & ,comm]ce ( ! ,h\se (        
,repres5tatives & ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions (
 ! ,s5ate ! in=mation collect$ "u !     
previ\s s5t5ce ) respect to ! previ\s   
plan ye>4  7,c7 ,effective date ,any    
requirem5ts ( gr\p heal? plans t are    
includ$ 9 ! regulations issu$ "u        
subp>agraph 7,a77i71 includ+ !          
requirem5t describ$ 9 subp>agraph       
7,a77ii7 to disclose docum5ts1 %all h an
 effective date ( #a ye> aft] ! date (  
enactm5t ( ?is p>agraph4  4  #c4        
,consum] p>ity unit = m5tal heal? &     
sub/ance use disord] p>ity violations   
7a7 ,def9itions ,9 ?is section3 7#a7    
,applicable ,/ate au?ority ,! t]m       

applicable ,/ate au?ority has ! mean+   
giv5 ! t]m 9 section #bgia ( ! ,public  
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;gg-#ia74  7#b7 ,cov]$ plan ,! t]m  
cov]$ plan means any cr$itable cov]age t
 is subject to any ( ! m5tal heal? p>ity
 laws4  7#c7 ,cr$itable cov]age ,! t]m  
cr$itable cov]age has ! mean+ giv5 ! t]m
 9 section #bgjd7;c7 ( ! ,public ,heal? 
,s]vice ,act 7#db ,u4,s4,c4             
#cjj;gg-#c7;c774  7#d7 ,m5tal heal?     
p>ity laws ,! t]m m5tal heal? p>ity laws
 means-- 7,a7 section #bgbf ( ! ,public 
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;gg-#bf72  7,b7 section #gab ( !    
,employee ,retirem5t ,income ,security  
,act ( #aigd 7#bi ,u4,s4,c4 #aahe;a72   
7,c7 section #ihab ( ! ,int]nal ,rev5ue 
,code ( #aihf2 or  7,d7 any o!r law t   
applies ! requirem5ts "u any ( !        
sections describ$ 9 subp>agraph 7,a71   
7,b71 or 7,c71 or requirem5ts t are     
sub/antially simil> to ^? provid$ "u any
 su* section1 z det]m9$ by ! ,secret>y1 
to cr$itable cov]age4  7#e7 ,secret>y ,!

 t]m ,secret>y means ! ,secret>y (      
,heal? & ,human ,s]vices4  7b7          
,e/abli%m5t ,n lat] ?an #f mon?s aft] ! 
date ( enactm5t ( ?is ,act1 ! ,secret>y1
 9 consultation ) ! ,secret>y ( ,labor1 
! ,secret>y ( ! ,treasury1 & ! head (   
any o!r applicable ag5cy1 %all e/abli% a
 consum] p>ity unit ) functions t       
include--  7#a7 facilitat+ ! c5traliz$  
collection (1 monitor+ (1 & response to 
consum] compla9ts reg>d+ violations (   
m5tal heal? p>ity laws ?r\gh develop+ & 
adm9i/]+1 9 accordance ) subsection     
7d7--  7,a7 a s+le1 toll-free telephone 
numb]2 &  7,b7 a public website portal1 
:i* may include enhanc+ a website portal
 9 exi/5ce on ! date ( enactm5t ( ?is   
,act2 &  7#b7 provid+ in=mation to heal?
 c>e consum]s reg>d+ ! disclosure       
requirem5ts & en=cem5t "u section       
#bgbf7;a77#h7 ( ! ,public ,heal? ,s]vice
 ,act1 section #gab7;a77#f7 ( !         
,employee ,retirem5t ,income ,security  
,act ( #aigd1 & section #ihab7;a77#f7 ( 
! ,int]nal ,rev5ue ,code ( #aihf1 z add$

 by section #b4  7c7 ,website portal ,! 
,secret>y1 9 consultation ) ! ,secret>y 
( ,labor1 ! ,secret>y ( ! ,treasury1 & !
 head ( any o!r applicable ag5cy1 %all  
make available on ! website portal      
e/abli%$ "u subsection 7b77#a77;,b7--   
7#a7 any guidance & any reports issu$ by
 ! ,secret>y1 ! ,secret>y ( ,labor1 or !
 ,secret>y ( ! ,treasury1 "u section    
#bgbf ( ! ,public ,heal? ,s]vice ,act1  
section #gab ( ! ,employee ,retirem5t   
,income ,security ,act ( #aigd1 or      
section #ihab ( ! ,int]nal ,rev5ue ,code
 ( #aihf1 respectively1 includ+ !       
am5dm5ts to su* sections made by section
 #b2  7#b7 de-id5tifi$ in=mation on !   
results (1 or progress on1 any conclud$ 
or ongo+ audits or inve/igations ( !    
,secret>y1 ! ,secret>y ( ,labor1 or !   
,secret>y ( ! ,treasury1 z applicable1  
"u su* section #bgbf1 #gab1 or #ihab1   
respectively2 &  7#c7 any in=mation on  
rates ( or reasons = d5ial collect$ by !
 ,secret>y1 ! ,secret>y ( ,labor1 or !  
,secret>y ( ! ,treasury1 pursuant to    

subsection 7a77#h77;,b77iii7 ( su*      
section #bgbf1 subsection               
7a77#f77;,b77iii7 ( su* section #gab1 or
 subsection 7a77#f77;,b77iii7 ( su*     
section #ihab1 respectively4  7d7       
,response to consum] compla9ts &        
inquiries  7#a7 ,timely response to     
consum]s ,! ,secret>y1 9 consultation ) 
! ,secret>y ( ,labor1 ! ,secret>y ( !   
,treasury1 & ! head ( any o!r applicable
 ag5cy1 %all e/abli% reasonable         
proc$ures = ! consum] p>ity unit        
e/abli%$ "u ?is section to provide a    
timely response 79 writ+ if appropriate7
 to consum]s reg>d+ compla9ts receiv$ by
 ! unit aga9/1 or inquiries conc]n+1 a  
cov]$ plan1 includ+--  7,a7 /eps t h be5
 tak5 by ! appropriate ,/ate or ,f$]al  
en=cem5t ag5cy 9 response to ! compla9t 
or inquiry ( ! consum]2  7,b7 any       
responses receiv$ by ! appropriate ,/ate
 or ,f$]al en=cem5t ag5cy f ! cov]$     
plan2  7,c7 any foll[-up actions or     
plann$ foll[-up actions by ! appropriate
 ,/ate or ,f$]al en=cem5t ag5cy 9       

response to ! compla9t or inquiry ( !   
consum]2 &  7,d7 contact in=mation ( !  
appropriate en=cem5t ag5cy = ! consum]  
to foll[ up on ! compla9t or inquiry4   
7#b7 ,timely response to regulators ,a  
cov]$ plan %all provide a timely        
response 79 writ+ if appropriate7 to !  
appropriate ,/ate or ,f$]al en=cem5t    
ag5cy hav+ jurisdiction ov] su* plan    
conc]n+ a consum] compla9t or inquiry   
submitt$ to ! consum] p>ity unit        
e/abli%$ "u ?is section includ+--  7,a7 
/eps t h be5 tak5 by ! plan to respond  
to ! compla9t or inquiry ( ! consum]2   
7,b7 any responses receiv$ by ! plan f !
 consum]2 &  7,c7 foll[-up actions or   
plann$ foll[-up actions by ! plan 9     
response to ! compla9t or inquiry ( !   
consum]4  7#c7 ,provision ( in=mation to
 consum]s  7,a7 ,9 g5]al ,a cov]$ plan  
%all1 9 a timely mann]1 comply ) a      
consum] reque/ = in=mation 9 ! control  
or possession ( su* cov]$ plan conc]n+ !
 cov]age ! consum] obta9$ f su* cov]$   
plan4  7,b7 ,exceptions ,not)/&+        

subp>agraph 7,a71 a cov]$ plan1 & any   
ag5cy or entity hav+ jurisdiction ov] a 
cov]$ plan1 may n be requir$ by ?is     
p>agraph to make available to ! consum] 
any in=mation requir$ to be kept        
confid5tial by any o!r provision ( law4 
7e7 ,reports  7#a7 ,9 g5]al ,n lat] ?an 
,m>* #ca ( ea* ye>1 ! ,secret>y1 9      
consultation ) ! ,secret>y ( ,labor1 !  
,secret>y ( ! ,treasury1 & ! head ( any 
o!r applicable ag5cy1 %all submit a     
report to ,congress on ! compla9ts      
receiv$ by ! consum] p>ity unit e/abli%$
 "u ?is section 9 ! prior ye> reg>d+    
cov]$ plans4  7#b7 ,cont5ts ,ea* su*    
report %all include in=mation & analysis
 ab\t compla9t numb]s1 compla9t types1  
&1 :]e applicable1 in=mation ab\t !     
resolution ( compla9ts4  7#c7 ,consum]  
p>ity unit po/+ ,! ,secret>y %all submit
 su* reports to ! consum] p>ity unit    
e/abli%$ "u ?is section1 & su* unit %all
 po/ ! reports on ! website portal      
e/abli%$ "u subsection 7b77#a77;,b74    
7f7 ,data %>+ ,subject to any applicable

 /&>ds = ,f$]al or ,/ate ag5cies )      
respect to protect+ p]sonally           
id5tifiable in=mation & data security & 
integrity--  7#a7 ! consum] p>ity unit  
e/abli%$ "u ?is section %all %>e consum]
 compla9t in=mation ) ! ,secret>y1 & !  
head ( any o!r applicable ,f$]al or     
,/ate ag5cy2 &  7#b7 ! ,secret>y1 & !   
head ( any o!r applicable ,f$]al or     
,/ate ag5cy1 %all %>e data relat+ to    
consum] compla9ts reg>d+ cov]$ plans )  
su* unit4  7g7 ,privacy consid]ations   
7#a7 ,9 g5]al ,9 c>ry+ out ?is section1 
! consum] p>ity unit e/abli%$ "u ?is    
section & ! ,secret>y1 9 consultation ) 
! ,secret>y ( ,labor1 ! ,secret>y ( !   
,treasury1 & ! head ( any o!r applicable
 ag5cy1 %all take measures to ensure t  
propriet>y1 p]sonal1 or confid5tial     
consum] in=mation t is protect$ f public
 disclosure "u section #eeb7;b7 or      
#eeb;a ( title #e1 ,unit$ ,/ates ,code1 
or any o!r provision ( law1 is n made   
public "u ?is section4  7#b7 ,exceptions
 ,! consum] p>ity unit e/abli%$ "u ?is  

section may n obta9 f a cov]$ plan any  
p]sonally id5tifiable in=mation ab\t a  
consum] f ! records ( ! cov]$ plan1     
except--  7,a7 if ! records are         
reasonably describ$ 9 a reque/ by !     
consum] p>ity unit e/abli%$ "u ?is      
section1 & ! consum] provides           
appropriate p]mission = ! disclosure (  
su* in=mation by ! cov]$ plan to su*    
unit2 or  7,b7 z may be specifically    
p]mitt$ or requir$ "u o!r applicable    
provisions ( law1 includ+ ,,hipaa       
privacy & security law z def9$ 9 section
 #cjji7;a7 ( ! ,public ,heal? ,s]vice   
,act 7#db ,u4,s4,c4 #cjj;jj-#ai7;a774   
7h7 ,collaboration  7#a7 ,agreem5ts )   
o!r ag5cies ,! ,secret>y1 ! ,secret>y ( 
,labor1 ! ,secret>y ( ! ,treasury1 & !  
head ( any o!r applicable ag5cy1 %all   
ent] into a memor&um ( und]/&+ ) any    
affect$ ,f$]al regulatory ag5cy reg>d+  
proc$ures by :i* any cov]$ plan1 & any  
o!r ag5cy hav+ jurisdiction ov] a cov]$ 
plan1 %all comply ) ?is section4  7#b7  
,agreem5ts ) ,/ates ,to ! ext5t         

practicable1 an applicable ,/ate        
au?ority may receive appropriate        
compla9ts f ! consum] p>ity unit        
e/abli%$ "u ?is section1 if--  7,a7 !   
applicable ,/ate au?ority has !         
functional capacity to receive calls or 
electronic reports r\t$ by ! unit2  7,b7
 ! applicable ,/ate au?ority has        
satisfi$ any conditions ( p>ticipation t
 ! unit may e/abli%1 includ+ treatm5t ( 
p]sonally id5tifiable in=mation & %>+ ( 
in=mation on compla9t resolution or     
relat$ compliance proc$ures & res\rces2 
&  7,c7 p>ticipation by ! applicable    
,/ate au?ority includes measures        
necess>y to protect p]sonally           
id5tifiable in=mation 9 accordance )    
/&>ds t apply to ,f$]al ag5cies )       
respect to protect+ p]sonally           
id5tifiable in=mation & data security & 
integrity4