,,ii  #aaf? ,,congress  #a/ ,session    
,s4 #agcg  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,june #e1 #bjai,mr4    
,murphy 7= himself & ,mr4 ,cassidy7     
introduc$ ! foll[+ bill2 :i* 0 read     
twice & ref]r$ to ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to /r5g!n p>ity 9 m5tal     
heal? & sub/ance use disord] b5efits4   
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,m5tal ,heal? ,p>ity ,compliance ,act4
  #b4 ,/r5g!n+ p>ity 9 m5tal heal? &    
sub/ance use disord] b5efits  7a7       
,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[+3  7#f7  
,compliance requirem5ts  7,a7           
,nonquantitative treatm5t limitation    
7nqtl7 requirem5ts ,9 ! case ( a gr\p   
heal? plan 7or heal? insurance cov]age  
(f]$ 9 connection ) su* a plan7 t       
provides bo? m$ical & surgical b5efits &
 m5tal heal? or sub/ance use disord]    

b5efits1 ! plan or cov]age %all p]=m    
comp>ative analyses ab\t ! design &     
application ( nonquantitative treatm5t  
limitations 7ref]r$ to 9 ?is p>agraph z 
! ,,nqtl7 9 accordance ) ! foll[+       
process1 & make available to ! ,secret>y
 ^u reque/ )9 #fj days beg9n+ ,janu>y   
#a1 #bjbj1 & imm$iately ^u reque/ beg9n+
 ,janu>y #a1 #bjba ! foll[+ in=mation3  
7i7 ,! specific plan or cov]age language
 reg>d+ ! ,,nqtl & a description ( all  
m5tal heal? or sub/ance use disord] &   
m$ical_/surgical s]vices to :i* x       
applies 9 ea* respective b5efits        
classification4  7ii7 ,! factors us$ to 
det]m9e t an ,,nqtl w apply to m5tal    
heal? or sub/ance use disord] b5efits & 
m$ical_/surgical b5efits1 includ+       
factors t 7 consid]$ b reject$4  7iii7  
,! evid5ti>y /&>d 7bo? id5tifi$ &       
deid5tifi$7 = ea* ( ! factors id5tifi$ 9
 clause 7ii7 & any o!r evid5ce reli$ ^u 
to design & apply ! ,,nqtl to m5tal     
heal? or sub/ance use disord] b5efits & 
m$ical_/surgical b5efits4  7iv7 ,!      

comp>ative analyses demon/rat+ t !      
processes & /rategies us$ to design !   
,,nqtl1 z writt51 & ! z writt5 processes
 & /rategies us$ to apply ! ,,nqtl =    
m5tal heal? or sub/ance use disord]     
b5efits are comp>able to1 & are appli$  
no m /r+5tly ?an1 ! processes &         
/rategies us$ to design ! ,,nqtl1 z     
writt51 & ! z writt5 processes &        
/rategies us$ to apply ! ,,nqtl to      
m$ical_/surgical b5efits4  7v7 ,!       
comp>ative analyses demon/rat+ t !      
processes & /rategies us$ to apply !    
,,nqtl1 9 op]ation1 = m5tal heal? &     
sub/ance use disord] b5efits are        
comp>able to1 & are appli$ no m /r+5tly 
?an1 ! processes & /rategies us$ to     
apply ea* ,,nqtl1 9 op]ation1 = m$ical &
 surgical b5efits4  7vi7 ,a disclosure (
 ! specific f9d+s & conclusions rea*$ by
 ! plan or cov]age t ! results ( !      
analyses describ$ 9 ?is subp>agraph     
indicate t ! plan or cov]age is 9       
compliance ) ?is section4  7,b7         
,secret>y reque/ process  7i7           

,submission ^u compla9t ,! ,secret>y    
%all reque/ t a gr\p heal? plan 7or     
heal? insurance cov]age (f]$ 9          
connection ) su* a plan7 submit !       
comp>ative analyses describ$ 9          
subp>agraph 7,a7 if ! ,secret>y has     
receiv$ any compla9ts ab\t su* a plan or
 cov]age t involve m5tal heal? or       
sub/ance use disord] b5efits4  7ii7     
,r&om submissions ,! ,secret>y %all     
reque/ ! comp>ative analyses describ$ 9 
subp>agraph 7,a7 f no few] ?an #ej plans
 or cov]ages select$ at r&om1 annually1 
& su* plans or cov]ages %all n be ! same
 plans or cov]ages = :i* ! comp>ative   
analyses are reque/$ "u clause 7i74     
7iii7 ,additional in=mation ,9 in/ances 
9 :i* ! ,secret>y has conclud$ t ! plan 
or cov]age has n submitt$ suffici5t     
in=mation = ! ,secret>y to review !     
comp>ative analyses describ$ 9          
subp>agraph 7,a71 z reque/$ "u clauses  
7i7 & 7ii71 ! ,secret>y %all specify to 
! plan or cov]age ! additional in=mation
 ! plan or cov]age mu/ submit = !       

,secret>y to review ! comp>ative        
analyses describ$ 9 subp>agraph 7,a7 =  
compliance ) ?is section4  7iv7 ,requir$
 action ,9 in/ances 9 :i* ! ,secret>y   
has review$ ! comp>ative analyses       
describ$ 9 subp>agraph 7,a71 z reque/$  
"u clauses 7i7 & 7ii71 & det]m9$ t !    
plan or cov]age is n 9 compliance ) ?is 
section1 ! ,secret>y %all specify to !  
plan or cov]age ! actions ! plan or     
cov]age mu/ take to be 9 compliance )   
?is section4  7v7 ,report ,n lat] ?an #a
 ye> aft] ! date ( enactm5t ( ?is       
p>agraph1 & annually !reaft]1 !         
,secret>y %all submit to ! ,committee on
 ,education & ,labor ( ! ,h\se (        
,repres5tatives & ! ,committee on       
,heal?1 ,education1 ,labor1 & ,p5sions (
 ! ,s5ate a report t conta9s--  7,i7 ea*
 ( ! comp>ative analyses reque/$ "u     
clauses 7i7 & 7ii71 except t ! id5tity (
 ea* plan or cov]age & any contract$    
entity ( a plan or cov]age %all be      
r$act$2  7,,ii7 ! ,secret>y's           
conclusions z to :e!r ea* plan or       

cov]age submitt$ suffici5t in=mation = !
 ,secret>y to review ! comp>ative       
analyses reque/$ "u clauses 7i7 & 7ii7 =
 compliance ) ?is section2  7,,iii7 =   
ea* plan or cov]age t did submit        
suffici5t in=mation = ! ,secret>y to    
review ! comp>ative analyses reque/$ "u 
clause 7i71 ! ,secret>y's conclusions z 
to :e!r ! plan or cov]age is 9          
compliance ) ?is section2  7,,iv7 !     
,secret>y's specifications describ$ 9   
clause 7iii7 = ea* plan or cov]age t !  
,secret>y det]m9$ did n submit suffici5t
 in=mation = ! ,secret>y to review !    
comp>ative analyses reque/$ "u clauses  
7i7 & 7ii7 = compliance ) ?is section2 &
  7,v7 ! ,secret>y's specifications     
describ$ 9 clause 7iv7 ( ! actions ea*  
plan or cov]age t ! ,secret>y det]m9$ is
 n 9 compliance ) ?is section mu/ take  
to be 9 compliance ) ?is section4  7,c7 
,compliance program guidance docum5t    
update process  7i7 ,9 g5]al ,!         
,secret>y %all include select in/ances (
 noncompliance t ! ,secret>y discov]s ^u

 review+ ! comp>ative analyses reque/$  
"u clauses 7i7 & 7ii7 ( subp>agraph 7,b7
 9 ! compliance program guidance docum5t
 describ$ 9 section #bgbf7;a77#f7 ( !   
,public ,heal? ,s]vice ,act1 z x is     
updat$ e #b ye>s1 except t all in/ances 
%all be deid5tifi$ & su* in/ances %all n
 disclose any protect$ heal? in=mation  
or individually id5tifiable in=mation4  
7ii7 ,inspector g5]al ,any in/ances (   
noncompliance ! ,secret>y discov]s ^u   
review+ ! comp>ative analyses reque/$ "u
 clauses 7i7 & 7ii7 ( subp>agraph 7,b7  
%all be %>$ ) ,inspector ,g5]al ( !     
,dep>tm5t ( ,heal? & ,human ,s]vices1 ! 
,inspector ,g5]al ( ! ,dep>tm5t (       
,labor1 & ! ,inspector ,g5]al ( !       
,dep>tm5t ( ! ,treasury1 9 accordance ) 
section #bgbf7;a77#f77;,b77iii77,i7 ( ! 
,public ,heal? ,s]vice ,act4  7iii7     
,/ate ,any in/ances ( noncompliance !   
,secret>y discov]s ^u review+ !         
comp>ative analyses reque/$ "u clauses  
7i7 & 7ii7 ( subp>agraph 7,b7 %all be   
%>$ ) a ,/ate1 9 accordance ) section   

#bgbf7;a77#f77;,b77iii77,,ii7 ( !       
,public ,heal? ,s]vice ,act4  4  7b7    
,int]nal rev5ue code ( #aihf ,section   
#ihab7;a7 ( ! ,int]nal ,rev5ue ,code (  
#aihf is am5d$ by add+ at ! end !       
foll[+3  7#f7 ,compliance requirem5ts   
7,a7 ,nonquantitative treatm5t          
limitation 7nqtl7 requirem5ts ,9 ! case 
( a gr\p heal? plan t provides bo?      
m$ical & surgical b5efits & m5tal heal? 
or sub/ance use disord] b5efits1 ! plan 
%all p]=m comp>ative analyses ab\t !    
design & application ( nonquantitative  
treatm5t limitations 7ref]r$ to 9 ?is   
p>agraph z ! ,,nqtl7 9 accordance ) !   
foll[+ process1 & make available to !   
,secret>y ^u reque/ )9 #fj days beg9n+  
,janu>y #a1 #bjbj1 & imm$iately ^u      
reque/ beg9n+ ,janu>y #a1 #bjba ! foll[+
 in=mation3  7i7 ,! specific plan       
language reg>d+ ! ,,nqtl & a description
 ( all m5tal heal? or sub/ance use      
disord] & m$ical_/surgical s]vices to   
:i* x applies 9 ea* respective b5efits  
classification4  7ii7 ,! factors us$ to 

det]m9e t an ,,nqtl w apply to m5tal    
heal? or sub/ance use disord] b5efits & 
m$ical_/surgical b5efits1 includ+       
factors t 7 consid]$ b reject$4  7iii7  
,! evid5ti>y /&>d 7bo? id5tifi$ &       
deid5tifi$7 = ea* ( ! factors id5tifi$ 9
 clause 7ii7 & any o!r evid5ce reli$ ^u 
to design & apply ! ,,nqtl to m5tal     
heal? or sub/ance use disord] b5efits & 
m$ical_/surgical b5efits4  7iv7 ,!      
comp>ative analyses demon/rat+ t !      
processes & /rategies us$ to design !   
,,nqtl1 z writt51 & ! z writt5 processes
 & /rategies us$ to apply ! ,,nqtl =    
m5tal heal? or sub/ance use disord]     
b5efits are comp>able to1 & are appli$  
no m /r+5tly ?an1 ! processes &         
/rategies us$ to design ! ,,nqtl1 z     
writt51 & ! z writt5 processes &        
/rategies us$ to apply ! ,,nqtl to      
m$ical_/surgical b5efits4  7v7 ,!       
comp>ative analyses demon/rat+ t !      
processes & /rategies us$ to apply !    
,,nqtl1 9 op]ation1 = m5tal heal? &     
sub/ance use disord] b5efits are        

comp>able to1 & are appli$ no m /r+5tly 
?an1 ! processes & /rategies us$ to     
apply ea* ,,nqtl1 9 op]ation1 = m$ical &
 surgical b5efits4  7vi7 ,a disclosure (
 ! specific f9d+s & conclusions rea*$ by
 ! plan t ! results ( ! analyses        
describ$ 9 ?is subp>agraph indicate t ! 
plan or cov]age is 9 compliance ) ?is   
section4  7,b7 ,secret>y reque/ process 
7i7 ,submission ^u compla9t ,! ,secret>y
 %all reque/ t a gr\p heal? plan submit 
! comp>ative analyses describ$ 9        
subp>agraph 7,a7 if ! ,secret>y has     
receiv$ any compla9ts ab\t su* a plan t 
involve m5tal heal? or sub/ance use     
disord] b5efits4  7ii7 ,r&om submissions
 ,! ,secret>y %all reque/ ! comp>ative  
analyses describ$ 9 subp>agraph 7,a7 f  
no few] ?an #ej plans select$ at r&om1  
annually1 & su* plans %all n be ! same  
plans = :i* ! comp>ative analyses are   
reque/$ "u clause 7i74  7iii7           
,additional in=mation ,9 in/ances 9 :i* 
! ,secret>y has conclud$ t ! plan has n 
submitt$ suffici5t in=mation = !        

,secret>y to review ! comp>ative        
analyses describ$ 9 subp>agraph 7,a71 z 
reque/$ "u clauses 7i7 & 7ii71 !        
,secret>y %all specify to ! plan !      
additional in=mation ! plan mu/ submit =
 ! ,secret>y to review ! comp>ative     
analyses describ$ 9 subp>agraph 7,a7 =  
compliance ) ?is section4  7iv7 ,requir$
 action ,9 in/ances 9 :i* ! ,secret>y   
has review$ ! comp>ative analyses       
describ$ 9 subp>agraph 7,a71 z reque/$  
"u clauses 7i7 & 7ii71 & det]m9$ t !    
plan is n 9 compliance ) ?is section1 ! 
,secret>y %all specify to ! plan !      
actions ! plan mu/ take to be 9         
compliance ) ?is section4  7v7 ,report  
,n lat] ?an #a ye> aft] ! date (        
enactm5t ( ?is p>agraph1 & annually     
!reaft]1 ! ,secret>y %all submit to !   
,committee on ,ways & ,means ( ! ,h\se (
 ,repres5tatives & ! ,committee on      
,f9ance ( ! ,s5ate a report t conta9s-- 
7,i7 ea* ( ! comp>ative analyses reque/$
 "u clauses 7i7 & 7ii71 except t !      
id5tity ( ea* plan & any contract$      

entity ( a plan %all be r$act$2  7,,ii7 
! ,secret>y's conclusions z to :e!r ea* 
plan submitt$ suffici5t in=mation = !   
,secret>y to review ! comp>ative        
analyses reque/$ "u clauses 7i7 & 7ii7 =
 compliance ) ?is section2  7,,iii7 =   
ea* plan t did submit suffici5t         
in=mation = ! ,secret>y to review !     
comp>ative analyses reque/$ "u clause   
7i71 ! ,secret>y's conclusions z to :e!r
 ! plan is 9 compliance ) ?is section2  
7,,iv7 ! ,secret>y's specifications     
describ$ 9 clause 7iii7 = ea* plan t !  
,secret>y det]m9$ did n submit suffici5t
 in=mation = ! ,secret>y to review !    
comp>ative analyses reque/$ "u clauses  
7i7 & 7ii7 = compliance ) ?is section2 &
  7,v7 ! ,secret>y's specifications     
describ$ 9 clause 7iv7 ( ! actions ea*  
plan t ! ,secret>y det]m9$ is n 9       
compliance ) ?is section mu/ take to be 
9 compliance ) ?is section4  7,c7       
,compliance program guidance docum5t    
update process  7i7 ,9 g5]al ,!         
,secret>y %all include select in/ances (

 noncompliance t ! ,secret>y discov]s ^u
 review+ ! comp>ative analyses reque/$  
"u clauses 7i7 & 7ii7 ( subp>agraph 7,b7
 9 ! compliance program guidance docum5t
 describ$ 9 section #bgbf7;a77#f7 ( !   
,public ,heal? ,s]vice ,act1 z x is     
updat$ e #b ye>s1 except t all in/ances 
%all be deid5tifi$ & su* in/ances %all n
 disclose any protect$ heal? in=mation  
or individually id5tifiable in=mation4  
7ii7 ,inspector g5]al ,any in/ances (   
noncompliance ! ,secret>y discov]s ^u   
review+ ! comp>ative analyses reque/$ "u
 clauses 7i7 & 7ii7 ( subp>agraph 7,b7  
%all be %>$ ) ,inspector ,g5]al ( !     
,dep>tm5t ( ,heal? & ,human ,s]vices1 ! 
,inspector ,g5]al ( ! ,dep>tm5t (       
,labor1 & ! ,inspector ,g5]al ( !       
,dep>tm5t ( ! ,treasury1 9 accordance ) 
section #bgbf7;a77#f77;,b77iii77,i7 ( ! 
,public ,heal? ,s]vice ,act4  7iii7     
,/ate ,any in/ances ( noncompliance !   
,secret>y discov]s ^u review+ !         
comp>ative analyses reque/$ "u clauses  
7i7 & 7ii7 ( subp>agraph 7,b7 %all be   

%>$ ) a ,/ate1 9 accordance ) section   
#bgbf7;a77#f77;,b77iii77,,ii7 ( !       
,public ,heal? ,s]vice ,act4  4  7c7    
,public heal? s]vice act ,section #bgbf 
( ! ,public ,heal? ,s]vice ,act 7#db    
,u4,s4,c4 #cjj;gg-#bf7 is am5d$-- 7#a7 9
 subsection 7a71 by add+ at ! end !     
foll[+3  7#h7 ,compliance requirem5ts   
7,a7 ,nonquantitative treatm5t          
limitation 7nqtl7 requirem5ts ,9 ! case 
( a gr\p heal? plan or a heal? insurance
 issu] (f]+ gr\p or individual heal?    
insurance cov]age t provides bo? m$ical 
& surgical b5efits & m5tal heal? or     
sub/ance use disord] b5efits1 ! plan or 
issu] (f]+ gr\p or individual heal?     
insurance cov]age %all p]=m comp>ative  
analyses ab\t ! design & application (  
nonquantitative treatm5t limitations    
7ref]r$ to 9 ?is p>agraph z ! ,,nqtl7 9 
accordance ) ! foll[+ process1 & make   
available to ,/ate1 or to ! ,secret>y z 
p]mitt$ "u subsections 7a77#b7 & 7b77#a7
 ( section #bgbc1 ^u reque/ )9 #fj days 
beg9n+ ,janu>y #a1 #bjbj1 & imm$iately  

^u reque/ beg9n+ ,janu>y #a1 #bjba1 !   
foll[+ in=mation3  7i7 ,! specific plan 
or cov]age language reg>d+ ! ,,nqtl & a 
description ( all m5tal heal? or        
sub/ance use disord] & m$ical_/surgical 
s]vices to :i* x applies 9 ea*          
respective b5efits classification4  7ii7
 ,! factors us$ to det]m9e t an ,,nqtl w
 apply to m5tal heal? or sub/ance use   
disord] b5efits & m$ical_/surgical      
b5efits1 includ+ factors t 7 consid]$ b 
reject$4  7iii7 ,! evid5ti>y /&>d 7bo?  
id5tifi$ & deid5tifi$7 = ea* ( ! factors
 id5tifi$ 9 clause 7ii7 & any o!r       
evid5ce reli$ ^u to design & apply !    
,,nqtl to m5tal heal? or sub/ance use   
disord] b5efits & m$ical_/surgical      
b5efits4  7iv7 ,! comp>ative analyses   
demon/rat+ t ! processes & /rategies us$
 to design ! ,,nqtl1 z writt51 & ! z    
writt5 processes & /rategies us$ to     
apply ! ,,nqtl = m5tal heal? or sub/ance
 use disord] b5efits are comp>able to1 &
 are appli$ no m /r+5tly ?an1 !         
processes & /rategies us$ to design !   

,,nqtl1 z writt51 & ! z writt5 processes
 & /rategies us$ to apply ! ,,nqtl to   
m$ical_/surgical b5efits4  7v7 ,!       
comp>ative analyses demon/rat+ t !      
processes & /rategies us$ to apply !    
,,nqtl1 9 op]ation1 = m5tal heal? &     
sub/ance use disord] b5efits are        
comp>able to1 & are appli$ no m /r+5tly 
?an1 ! processes & /rategies us$ to     
apply ea* ,,nqtl1 9 op]ation1 = m$ical &
 surgical b5efits4  7vi7 ,a disclosure (
 ! specific f9d+s & conclusions rea*$ by
 ! plan or heal? insurance issu] (f]+   
gr\p or individual heal? insurance      
cov]age t ! results ( ! analyses        
describ$ 9 ?is subp>agraph indicate t ! 
plan or cov]age is 9 compliance ) ?is   
section4  7,b7 ,secret>y reque/ process 
7i7 ,submission ^u compla9t ,z p]mitt$  
"u subsections 7a77#b7 & 7b77#a7 (      
section #bgbc1 ! ,secret>y %all reque/ t
 a gr\p heal? plan or a heal? insurance 
issu] (f]+ gr\p or individual heal?     
insurance cov]age submit ! comp>ative   
analyses describ$ 9 subp>agraph 7,a7 if 

! ,secret>y has receiv$ any compla9ts   
ab\t su* a plan or issu] t involve m5tal
 heal? or sub/ance use disord] b5efits4 
7ii7 ,r&om submissions ,z p]mitt$ "u    
subsections 7a77#b7 & 7b77#a7 ( section 
#bgbc1 ! ,secret>y %all reque/ !        
comp>ative analyses describ$ 9          
subp>agraph 7,a7 f no few] ?an #ej plans
 or issu]s select$ at r&om1 annually1 & 
su* plans or issu]s %all n be ! same    
plans or issu]s = :i* ! comp>ative      
analyses are reque/$ "u clause 7i74     
7iii7 ,additional in=mation ,9 in/ances 
9 :i* ! ,secret>y has conclud$ t ! plan 
or issu] has n submitt$ suffici5t       
in=mation = ! ,secret>y to review !     
comp>ative analyses describ$ 9          
subp>agraph 7,a71 z reque/$ "u clauses  
7i7 & 7ii71 ! ,secret>y %all specify to 
! plan or issu] ! additional in=mation !
 plan or issu] mu/ submit = ! ,secret>y 
to review ! comp>ative analyses describ$
 9 subp>agraph 7,a7 = compliance ) ?is  
section4  7iv7 ,requir$ action ,9       
in/ances 9 :i* ! ,secret>y has review$ !

 comp>ative analyses describ$ 9         
subp>agraph 7,a71 z reque/$ "u clauses  
7i7 & 7ii71 & det]m9$ t ! plan or issu] 
is n 9 compliance ) ?is section1 !      
,secret>y %all specify to ! plan or     
issu] ! actions ! plan or issu] mu/ take
 to be 9 compliance ) ?is section4  7v7 
,report ,n lat] ?an #a ye> aft] ! date (
 enactm5t ( ?is p>agraph1 & annually    
!reaft]1 ! ,secret>y %all submit to !   
,committee on ,education & ,labor ( !   
,h\se ( ,repres5tatives & ! ,committee  
on ,heal?1 ,education1 ,labor1 &        
,p5sions ( ! ,s5ate a report t conta9s--
  7,i7 ea* ( ! comp>ative analyses      
reque/$ "u clauses 7i7 & 7ii71 except t 
! id5tity ( ea* plan or issu] & any     
contract$ entity ( a plan or issu] %all 
be r$act$2  7,,ii7 ! ,secret>y's        
conclusions z to :e!r ea* plan or issu] 
submitt$ suffici5t in=mation = !        
,secret>y to review ! comp>ative        
analyses reque/$ "u clauses 7i7 & 7ii7 =
 compliance ) ?is section2  7,,iii7 =   
ea* plan or issu] t did submit suffici5t

 in=mation = ! ,secret>y to review !    
comp>ative analyses reque/$ "u clause   
7i71 ! ,secret>y's conclusions z to :e!r
 ! plan or issu] is 9 compliance ) ?is  
section2  7,,iv7 ! ,secret>y's          
specifications describ$ 9 clause 7iii7 =
 ea* plan or issu] t ! ,secret>y det]m9$
 did n submit suffici5t in=mation = !   
,secret>y to review ! comp>ative        
analyses reque/$ "u clauses 7i7 & 7ii7 =
 compliance ) ?is section2 &  7,v7 !    
,secret>y's specifications describ$ 9   
clause 7iv7 ( ! actions ea* plan or     
issu] t ! ,secret>y det]m9$ is n 9      
compliance ) ?is section mu/ take to be 
9 compliance ) ?is section4  7,c7       
,compliance program guidance docum5t    
update process  7i7 ,9 g5]al ,!         
,secret>y %all include select in/ances (
 noncompliance t ! ,secret>y discov]s ^u
 review+ ! comp>ative analyses reque/$  
"u clauses 7i7 & 7ii7 ( subp>agraph 7,b7
 9 ! compliance program guidance docum5t
 describ$ 9 subsection 7a77#f71 z x is  
updat$ e #b ye>s1 except t all in/ances 

%all be deid5tifi$ & su* in/ances %all n
 disclose any protect$ heal? in=mation  
or individually id5tifiable in=mation4  
7ii7 ,inspector g5]al ,any in/ances (   
noncompliance ! ,secret>y discov]s ^u   
review+ ! comp>ative analyses reque/$ "u
 clauses 7i7 & 7ii7 ( subp>agraph 7,b7  
%all be %>$ ) ,inspector ,g5]al ( !     
,dep>tm5t ( ,heal? & ,human ,s]vices1 ! 
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,dep>tm5t ( ! ,treasury1 9 accordance ) 
subsection 7a77#f77;,b77iii77,i74  7iii7
 ,/ate ,any in/ances ( noncompliance !  
,secret>y discov]s ^u review+ !         
comp>ative analyses reque/$ "u clauses  
7i7 & 7ii7 ( subp>agraph 7,b7 %all be   
%>$ ) a ,/ate1 9 accordance ) subsection
 7a77#f77;,b77iii77,,ii74  4