,,ii  #aah? ,,congress  #b;d ,session   
,s4 #djbc  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,m>* #ba1 #bjbd,ms4    
,smi? 7= h]self & ,mr4 ,wyd57 introduc$ 
! foll[+ bill2 :i* 0 read twice & ref]r$
 to ! ,committee on ,heal?1 ,education1 
,labor1 & ,p5sions  ,a ,,bill  ,to fur!r
 protect pati5ts & improve ! accuracy ( 
provid] directory in=mation by elim9at+ 
gho/ networks4  #a4 ,%ort title2 table (
 cont5ts  7a7 ,%ort title ,?is ,act may 
be cit$ z ! ,behavioral ,heal? ,network 
& ,directory ,improvem5t ,act 4  7b7    
,table ( cont5ts ,! table ( cont5ts =   
?is ,act is z foll[s3 ,sec4 #a4 ,%ort   
title2 table ( cont5ts4,sec4 #b4        
,protect+ pati5ts & improv+ ! accuracy (
 provid] directory in=mation4,sec4 #c4  
,provid] requirem5ts to protect pati5ts 
& improve ! accuracy ( provid] directory
 in=mation4,sec4 #d4 ,/r5g!n+ m5tal     
heal? & sub/ance use disord] p>ity      
requirem5ts4,sec4 #e4 ,/ate & ,tribal   
ombudsman programs relat+ to m5tal heal?
 & sub/ance use disord] p>ity4,sec4 #f4 

,report to ,congress4,sec4 #g4          
,au?orization ( appropriations4  #b4    
,protect+ pati5ts & improv+ ! accuracy (
 provid] directory in=mation  7a7 ,,phsa
 ,section #bgii;,a-#e ( ! ,public ,heal?
 ,s]vice ,act 7#db ,u4,s4,c4            
#cjj;gg-#aae7 is am5d$-- 7#a7 9         
subsection 7a7-- 7,a7 9 p>agraph 7#a7-- 
7i7 by /rik+ ,= plan ye>s beg9n+ on or  
aft] ,janu>y #a1 #bjbb1 ea* & ins]t+    
,ea*2  7ii7 9 subp>agraph 7,c71 by /rik+
 2 & & ins]t+ a semicolon2  7iii7 9     
subp>agraph 7,d71 by /rik+ ! p]iod &    
ins]t+ 2 &2 &  7iv7 by add+ at ! end !  
foll[+3  7,e7 ensure t any directory1   
includ+ ! database describ$ 9           
subp>agraph 7,c71 conta9+ provid]       
directory in=mation ) respect to su*    
plan or su* cov]age complies ) !        
requirem5ts develop$ by ! appropriate   
ag5cies 9 accordance ) p>agraph 7#f7 9  
ord] to ensure t p>ticipants1           
b5efici>ies1 & enrollees are able to    
id5tify actively p>ticipat+ heal? c>e   
provid]s & heal? c>e facilities4  2     

7,b7 9 p>agraph 7#c7-- 7i7 9 ! matt]    
prec$+ subp>agraph 7,a71 by /rik+ 1 9 ! 
case su* reque/ is made ?r\gh a         
telephone call2 &  7ii7 9 subp>agraph   
7,a71 by /rik+ call is receiv$1 ?r\gh a 
writt5 electronic or pr9t 7z reque/$ by 
su* individual7 communication & ins]t+ a
 reque/ is receiv$1 by telephone1 or    
?r\gh a writt5 electronic or pr9t       
communication 7z reque/$ by su*         
individual72  7,c7 9 p>agraph 7#d7-- 7i7
 9 subp>agraph 7,a71 by /rik+ & at !    
end2  7ii7 9 subp>agraph 7,b71 by /rik+ 
! p]iod & ins]t+ 2 &2 &  7iii7 by add+  
at ! end ! foll[+3  7,c7 in=mation1 9   
pla9 language1 conc]n+ ! rights ( !     
p>ticipant1 b5efici>y1 or enrollee to   
co/-%>+ protections pursuant to         
subsection 7b7 9 ! ev5t ( reliance on   
inaccurate provid] network in=mation    
suppli$ by a gr\p heal? plan or heal?   
insurance issu]1 & contact in=mation =1 
z appropriate1 ! ,/ate consum] assi/ance
 program or ombudsman or ! ,employee    
,b5efits ,security ,adm9i/ration = m    

in=mation4  2  7,d7 9 p>agraph 7#e71 by 
add+ at ! end ! foll[+3 ,su* in=mation  
%all include a /atem5t1 9 pla9 language1
 conc]n+ ! rights ( ! p>ticipant1       
b5efici>y1 or enrollee to co/-%>+       
protections pursuant to subsection 7b7 9
 ! ev5t ( reliance on inaccurate provid]
 directory in=mation suppli$ by a gr\p  
heal? plan or heal? insurance issu]1 &  
contact in=mation =1 z appropriate1 !   
,/ate consum] assi/ance program or      
ombudsman or ! ,employee ,b5efits       
,security ,adm9i/ration = m in=mation42 
7,e7 by r$esignat+ p>agraphs 7#f7 & 7#g7
 z p>agraphs 7#h7 & 7#i71 respectively2 
7,f7 by ins]t+ aft] p>agraph 7#e7 !     
foll[+3  7#f7 ,protect+ p>ticipants1    
b5efici>ies1 & enrollees f gho/ networks
 ,! ,secret>y1 9 collaboration ) !      
,secret>y ( ,labor & ! ,secret>y ( !    
,treasury1 %all-- 7,a7 n lat] ?an #d    
ye>s aft] ! date ( enactm5t ( !         
,behavioral ,heal? ,network & ,directory
 ,improvem5t ,act1 issue f9al           
regulations fur!r def9+ ! t]m gho/      

network 7z def9$ 9 p>agraph 7#h772 &    
7,b7 n lat] ?an #d ye>s aft] ! date (   
enactm5t ( ! ,behavioral ,heal? ,network
 & ,directory ,improvem5t ,act1 issue   
f9al regulations1 subregulatory         
guidance1 or program in/ruction on h[ to
 assess gho/ networks 9 heal? plan      
directories includ+ reasonable          
assumptions relat$ to /ati/ics & rese>* 
me?ods4  7#g7 ,database report+ & audit+
 to protect aga9/ gho/ networks  7,a7   
,report+ requirem5ts ,beg9n+ n lat] ?an 
#c ye>s aft] ! date ( enactm5t ( !      
,behavioral ,heal? ,network & ,directory
 ,improvem5t ,act1 ea* gr\p heal? plan &
 heal? insurance issu] (f]+ gr\p or     
individual heal? insurance cov]age %all 
submit to ! ,secret>y1 at su* "t z !    
,secret>y1 9 coord9ation ) ! ,secret>y (
 ,labor & ! ,secret>y ( ! ,treasury1    
%all require1 b n less frequ5tly ?an    
annually1 ! directory data describ$ 9   
p>agraph 7a77#d71 9 a ma*9e readable    
=mat 7z def9$ 9 section                 
#adg4baj7;a77#b77xiv7 ( title #de1 ,code

 ( ,f$]al ,regulations 7or any successor
 regulations774 ,a heal? insurance issu]
 or a ?ird p>ty adm9i/rator ( a gr\p    
heal? plan may submit su* in=mation =   
all heal? insurance cov]age or all gr\p 
heal? plans1 collectively1 t su* issu]  
or adm9i/rator adm9i/]s4 ,! ,secret>y1 9
 coord9ation ) ! ,secret>y ( ,labor & ! 
,secret>y ( ! ,treasury1 %all make data 
submitt$ "u ?is subp>agraph available on
 a public website4  7,b7 ,provid]       
directory indep5d5t audit requirem5ts   
7i7 ,9 g5]al ,beg9n+ n lat] ?an #c ye>s 
aft] ! date ( enactm5t ( ! ,behavioral  
,heal? ,network & ,directory ,improvem5t
 ,act1 ea* gr\p heal? plan & heal?      
insurance issu] (f]+ gr\p or individual 
heal? insurance cov]age %all conduct an 
annual directory audit1 ?r\gh an        
indep5d5t entity n associat$ ) ! heal?  
plan or issu]1 t consid]s ! factors     
describ$ 9 clause 7ii77,i77aa7 & foll[s 
! guidel9es develop$ "u clause          
7ii77,i77bb74  7ii7 ,in=mation to be    
includ$  7,i7 ,9 g5]al ,= purposes (    

c>ry+ out ! audits "u ?is subp>agraph1 !
 ,secret>y %all-- 7aa7 develop a li/ (  
in=mation requir$ to be includ$2 &  7bb7
 provide guidel9es = c>ry+ out su*      
audits1 = use by gr\p heal? plans &     
heal? insurance issu]s1 on-- 7,,aa7 !   
reasonable assumptions & rese>* me?ods  
to select a reasonable sample 9 ord] to 
assess provid] directory in=mation      
accuracy2 & 7,,bb7 det]m9+ ! crit]ia (  
an eligible auditor4  7,,ii7 ,cont5ts ,!
 in=mation li/$ "u subclause 7,i77aa7   
%all include ! foll[+3 7aa7 ,!          
proportion ( directory li/+s ( ! plan or
 cov]age ) inaccurate in=mation1 includ+
 incorrect contact in=mation1 z specifi$
 by ! ,secret>y1 dur+ ! audit p]iod4    
7bb7 ,! numb] ( 9-network items or      
s]vices paid on behalf ( p>ticipants1   
b5efici>ies1 & enrollees 9 ! plan or    
cov]age to provid]s or facilities :o h a
 network provid] contract ) ! heal? plan
 or issu] & 7 n li/$ 9 ! directory ( !  
heal? plan or heal? insurance cov]age = 
! audit p]iod4  7cc7 ,! res\rces ( !    

plan or issu] to help p>ticipants1      
b5efici>ies1 & enrollees locate an      
accurately li/$ 9-network provid] :o is 
accept+ new pati5ts4  7dd7 ,! proportion
 ( p>ticipants1 b5efici>ies1 & enrollees
 us+ out-(-network provid]s = m5tal     
heal? & sub/ance use disord] s]vices1 & 
! proportion ( p>ticipants1 b5efici>ies1
 & enrollees us+ out-(-network provid]s 
& facilities = m$ical & surgical        
s]vices4  7ee7 ,docum5tation t ! plan or
 issu] v]ifies ! accuracy ( ! provid]   
directory in=mation e #ij days4  7ff7   
,o!r factors z det]m9$ by ! ,secret>y4  
7iii7 ,/&>ds = report+ ,an audit "u ?is 
subp>agraph is complete if all ( !      
foll[+ conditions are met3 7,i7 ,! audit
 report includes ! foll[+3 7aa7 ,a      
/atem5t by ! indep5d5t auditor t1 to !  
be/ ( ! auditor's k1 ! report is        
complete & accurate1 & t reasonable     
assumptions relat$ to /ati/ics & rese>* 
me?ods h be5 compli$ )4  7bb7 ,a /atem5t
 expla9+ ! assumptions1 /ati/ics1 &     
me?ods us$ to select ! sample & assess  

provid] directory in=mation accuracy4   
7cc7 ,su* o!r requirem5ts z ! ,secret>y 
det]m9es necess>y4  7,,ii7 ,! gr\p heal?
 plan or heal? insur] issu] makes !     
indep5d5t audit available on a public   
website4  7iv7 ,rulemak+ ,! ,secret>y1 !
 ,secret>y ( ,labor1 & ! ,secret>y ( !  
,treasury %all issue int]im f9al        
regulations 7)\t prior notice & comm5t z
 g5]ally requir$ "u section #eec ( title
 #e1 ,unit$ ,/ates ,code7 conc]n+ !     
national /&>ds = conduct+ audits "u ?is 
subp>agraph1 n lat] ?an #b ye>s aft] !  
date ( enactm5t ( ! ,behavioral ,heal?  
,network & ,directory ,improvem5t ,act4 
7,c7 ,audits by ! ,secret>y  7i7 ,9     
g5]al ,beg9n+ n lat] ?an ! f\r? plan ye>
 aft] ! date ( enactm5t ( ! ,behavioral 
,heal? ,network & ,directory ,improvem5t
 ,act1 ! ,secret>y %all conduct annual  
audits to ensure compliance ) ! audit+  
requirem5ts "u subp>agraph 7,b74  7ii7  
,selection ( plans & issu]s ,!          
,secret>y1 ! ,secret>y ( ,labor1 & !    
,secret>y ( ! ,treasury 7ref]r$ to 9 ?is

 clause z ! ,secret>ies71 jo9tly1 %all  
conduct annual audits ( ! submissions "u
 subp>agraph 7,b7 ( a total ( n few] ?an
 #aj gr\p heal? plans or heal? insurance
 issu]s (f]+ gr\p or individual heal?   
insurance cov]age1 z det]m9$ by !       
,secret>ies1 t are ! subjects (         
compla9ts ab\t gho/ networks or o!r     
compla9ts1 or t are r&omly select$ by ! 
,secret>ies4  2 &  7,g7 9 p>agraph 7#h71
 z s r$esignat$-- 7i7 9 ! p>agraph      
head+1 by /rik+ ,def9ition & ins]t+     
,def9itions2  7ii7 by /rik+ ,= purposes 
( ?is subsection1 ! t]m & ins]t+ !      
foll[+3 8,= purposes ( ?is subsection3  
7,a7 ,provid] directory in=mation ,! t]m
  2  7iii7 by /rik+ heal? insurance     
cov]age1 ! "n1 address & ins]t+ 8heal?  
insurance cov]age--  7i7 ! "n1 address  
:]e ! provid] regul>ly sees pati5ts  2  
7iv7 by /rik+ ! p]iod & ins]t+ 2 &2 &   
7v7 by add+ at ! end ! foll[+3  7ii7 )  
respect to ea* su* provid] or facility--
 7,i7 :e!r su* provid] or facility is   
accept+ new pati5ts2  7,,ii7 ! languages

 spok5 & ! availability ( language      
translators = specifi$ languages at ea* 
heal? c>e facility li/$ 9 ! directory2  
7,,iii7 :e!r ! provid] or facility (f]s 
m$ication-assi/$ treatm5t = opioid use  
disord]2  7,,iv7 ! ,/ate lic5se numb]2  
7,v7 ! national provid] id5tifi]2       
7,,vi7 ! age gr\ps s]v$ by ! provid] or 
facility1 su* z p$iatric1 adolesc5t1    
adult1 or g]iatric populations2  7,,vii7
 :e!r su* provid] or facility (f]s      
9-p]son s]vices1 teleheal? s]vices1 or  
bo?2  7,,viii7 ! co/-%>+ ti]1 if        
applicable2 &  7,,ix7 heal? insurance   
plans accept$ 7includ+ ! plan id5tifi] &
 type ( plan74  7,b7 ,gho/ network ,!   
t]m gho/ network means a gr\p heal? plan
 or gr\p or individual heal? insurance  
cov]age = :i* ! provid] directory       
in=mation describ+ ! network ( su* plan 
or cov]age-- 7i7 includes inaccurate    
contact in=mation ) respect to a        
sub/antial %>e ( includ$ li/+s &        
provid]s :o are "p ( ! network2  7ii7   
includes a sub/antial numb] ( provid]s &

 facilities 7z specifi$ by ! ,secret>y1 
9 coord9ation ) ! ,secret>y ( ,labor & !
 ,secret>y ( ! ,treasury7 9 a specialty 
:o are n accept+ new pati5ts )9 a "t    
p]iod specifi$ by su* secret>ies2  7iii7
 includes a sub/antial numb] ( provid]s 
& facilities t are n "p ( ! network2 or 
7iv7 omits a sub/antial numb] ( provid]s
 & facilities t are "p ( ! network4  2 &
  7#b7 9 subsection 7b7-- 7,a7 9        
p>agraph 7#a71 by /rik+ & if ei!r ( !   
crit]ia describ$ 9 p>agraph 7#b7 applies
 ) respect to su* p>ticipant1 b5efici>y1
 or enrollee & item or s]vice2 &  7,b7  
by /rik+ p>agraph 7#b7 & ins]t+ !       
foll[+3  7#b7 ,reconciliation requirem5t
 ,if a nonp>ticipat+ provid] 0 li/$ z a 
p>ticipat+ provid] 9 ! po/$ provid]     
directory database1 ! gr\p heal? plan or
 heal? insurance issu] %all1 n lat] ?an 
#cj days aft] receiv+ ! reque/ = paym5t1
 notify ! p>ticipant1 b5efici>y1 or     
enrollee1 9 pla9 language1 t !          
p>ticipant1 b5efici>y1 or enrollee may  
be eligible = a refund f ! gr\p heal?   

plan or heal? insurance issu] if su*    
p>ticipant1 b5efici>y1 or enrollee paid 
! out ( network co/-%>+ & did n receive 
a refund "u section #bgii;,b-#i7;b74  4 
7b7 ,,erisa  7#a7 ,9 g5]al ,section #gbj
 ( ! ,employee ,retirem5t ,income       
,security ,act ( #aigd 7#bi ,u4,s4,c4   
#aahe;i7 is am5d$-- 7,a7 9 subsection   
7a7-- 7i7 9 p>agraph 7#a7-- 7,i7 by     
/rik+ ,= plan ye>s beg9n+ on or aft]    
,janu>y #a1 #bjbb1 ea* & ins]t+ ,ea*2   
7,,ii7 9 subp>agraph 7,c71 by /rik+ 2 & 
& ins]t+ a semicolon2  7,,iii7 9        
subp>agraph 7,d71 by /rik+ ! p]iod &    
ins]t+ 2 &2 &  7,,iv7 by add+ at ! end !
 foll[+3  7,e7 ensure t any directory1  
includ+ ! database describ$ 9           
subp>agraph 7,c71 conta9+ provid]       
directory in=mation ) respect to su*    
plan or su* cov]age complies ) !        
requirem5ts develop$ by ! appropriate   
ag5cies 9 accordance ) p>agraph 7#f7 9  
ord] to ensure t p>ticipants1           
b5efici>ies1 & enrollees are able to    
id5tify actively p>ticipat+ heal? c>e   

provid]s & heal? c>e facilities4  2     
7ii7 9 p>agraph 7#c7-- 7,i7 9 ! matt]   
prec$+ subp>agraph 7,a71 by /rik+ 1 9 ! 
case su* reque/ is made ?r\gh a         
telephone call2 &  7,,ii7 9 subp>agraph 
7,a71 by /rik+ call is receiv$1 ?r\gh a 
writt5 electronic or pr9t 7z reque/$ by 
su* individual7 communication & ins]t+ a
 reque/ is receiv$1 by telephone1 or    
?r\gh a writt5 electronic or pr9t       
communication 7z reque/$ by su*         
individual72  7iii7 9 p>agraph 7#d7--   
7,i7 9 subp>agraph 7,a71 by /rik+ & at !
 end2  7,,ii7 9 subp>agraph 7,b71 by    
/rik+ ! p]iod & ins]t+ 2 &2 &  7,,iii7  
by add+ at ! end ! foll[+3  7,c7        
in=mation1 9 pla9 language1 conc]n+ !   
rights ( ! p>ticipant1 b5efici>y1 or    
enrollee to co/-%>+ protections pursuant
 to subsection 7b7 9 ! ev5t ( reliance  
on inaccurate provid] network in=mation 
suppli$ by a gr\p heal? plan or heal?   
insurance issu]1 & contact in=mation =1 
z appropriate1 ! ,/ate consum] assi/ance
 program or ombudsman or ! ,employee    

,b5efits ,security ,adm9i/ration = m    
in=mation4  2  7iv7 9 p>agraph 7#e71 by 
add+ at ! end ! foll[+3 ,su* in=mation  
%all include a /atem5t1 9 pla9 language1
 conc]n+ ! rights ( ! p>ticipant1       
b5efici>y1 or enrollee to co/-%>+       
protections pursuant to subsection 7b7 9
 ! ev5t ( reliance on inaccurate provid]
 directory in=mation suppli$ by a gr\p  
heal? plan or heal? insurance issu]1 &  
contact in=mation =1 z appropriate1 !   
,/ate consum] assi/ance program or      
ombudsman or ! ,employee ,b5efits       
,security ,adm9i/ration = m in=mation42 
7v7 by r$esignat+ p>agraphs 7#f7 & 7#g7 
z p>agraphs 7#h7 & 7#i71 respectively2  
7vi7 by ins]t+ aft] p>agraph 7#e7 !     
foll[+3  7#f7 ,protect+ p>ticipants1    
b5efici>ies1 & enrollees f gho/ networks
 ,! ,secret>y1 9 collaboration ) !      
,secret>y ( ,labor & ! ,secret>y ( !    
,treasury1 %all-- 7,a7 n lat] ?an #d    
ye>s aft] ! date ( enactm5t ( !         
,behavioral ,heal? ,network & ,directory
 ,improvem5t ,act1 issue f9al           

regulations fur!r def9+ ! t]m gho/      
network 7z def9$ 9 p>agraph 7#h772 &    
7,b7 n lat] ?an #d ye>s aft] ! date (   
enactm5t ( ! ,behavioral ,heal? ,network
 & ,directory ,improvem5t ,act1 issue   
f9al regulations1 subregulatory         
guidance1 or program in/ruction on h[ to
 assess gho/ networks 9 heal? plan      
directories includ+ reasonable          
assumptions relat$ to /ati/ics & rese>* 
me?ods4  7#g7 ,database report+ & audit+
 to protect aga9/ gho/ networks  7,a7   
,report+ requirem5ts ,beg9n+ n lat] ?an 
#c ye>s aft] ! date ( enactm5t ( !      
,behavioral ,heal? ,network & ,directory
 ,improvem5t ,act1 ea* gr\p heal? plan &
 heal? insurance issu] (f]+ gr\p heal?  
insurance cov]age %all submit to !      
,secret>y1 at su* "t z ! ,secret>y1 9   
coord9ation ) ! ,secret>y ( ,heal? &    
,human ,s]vices & ! ,secret>y ( !       
,treasury1 %all require1 b n less       
frequ5tly ?an annually1 ! directory data
 describ$ 9 p>agraph 7a77#d71 9 a ma*9e 
readable =mat 7z def9$ 9 section        

#adg4baj7;a77#b77xiv7 ( title #de1 ,code
 ( ,f$]al ,regulations 7or any successor
 regulations774 ,a heal? insurance issu]
 or a ?ird p>ty adm9i/rator ( a gr\p    
heal? plan may submit su* in=mation =   
all heal? insurance cov]age or all gr\p 
heal? plans1 collectively1 t su* issu]  
or adm9i/rator adm9i/]s4 ,! ,secret>y1 9
 coord9ation ) ! ,secret>y ( ,heal? &   
,human ,s]vices & ! ,secret>y ( !       
,treasury1 %all make data submitt$ "u   
?is subp>agraph available on a public   
website4  7,b7 ,provid] directory       
indep5d5t audit requirem5ts  7i7 ,9     
g5]al ,beg9n+ n lat] ?an #c ye>s aft] ! 
date ( enactm5t ( ! ,behavioral ,heal?  
,network & ,directory ,improvem5t ,act1 
ea* gr\p heal? plan & heal? insurance   
issu] (f]+ gr\p heal? insurance cov]age 
%all conduct an annual directory audit1 
?r\gh an indep5d5t entity n associat$ ) 
! heal? plan or issu]1 t consid]s !     
factors describ$ 9 clause 7ii77,i77aa7 &
 foll[s ! guidel9es develop$ "u clause  
7ii77,i77bb74  7ii7 ,in=mation to be    

includ$  7,i7 ,9 g5]al ,= purposes (    
c>ry+ out ! audits "u ?is subp>agraph1 !
 ,secret>y %all-- 7aa7 develop a li/ (  
in=mation requir$ to be includ$2 &  7bb7
 provide guidel9es = c>ry+ out su*      
audits1 = use by gr\p heal? plans &     
heal? insurance issu]s1 on-- 7,,aa7 !   
reasonable assumptions & rese>* me?ods  
to select a reasonable sample 9 ord] to 
assess provid] directory in=mation      
accuracy2 & 7,,bb7 det]m9+ ! crit]ia (  
an eligible auditor4  7,,ii7 ,cont5ts ,!
 in=mation li/$ "u subclause 7,i77aa7   
%all include ! foll[+3 7aa7 ,!          
proportion ( directory li/+s ( ! plan or
 cov]age ) inaccurate in=mation1 includ+
 incorrect contact in=mation1 z specifi$
 by ! ,secret>y1 dur+ ! audit p]iod4    
7bb7 ,! numb] ( 9-network items or      
s]vices paid on behalf ( p>ticipants1   
b5efici>ies1 & enrollees 9 ! plan or    
cov]age to provid]s or facilities :o h a
 network provid] contract ) ! heal? plan
 or issu] & 7 n li/$ 9 ! directory ( !  
heal? plan or heal? insurance cov]age = 

! audit p]iod4  7cc7 ,! res\rces ( !    
plan or issu] to help p>ticipants1      
b5efici>ies1 & enrollees locate an      
accurately li/$ 9-network provid] :o is 
accept+ new pati5ts4  7dd7 ,! proportion
 ( p>ticipants1 b5efici>ies1 & enrollees
 us+ out-(-network provid]s = m5tal     
heal? & sub/ance use disord] s]vices1 & 
! proportion ( p>ticipants1 b5efici>ies1
 & enrollees us+ out-(-network provid]s 
& facilities = m$ical & surgical        
s]vices4  7ee7 ,docum5tation t ! plan or
 issu] v]ifies ! accuracy ( ! provid]   
directory in=mation e #ij days4  7ff7   
,o!r factors z det]m9$ by ! ,secret>y4  
7iii7 ,/&>ds = report+ ,an audit "u ?is 
subp>agraph is complete if all ( !      
foll[+ conditions are met3 7,i7 ,! audit
 report includes ! foll[+3 7aa7 ,a      
/atem5t by ! indep5d5t auditor t1 to !  
be/ ( ! auditor's k1 ! report is        
complete & accurate1 & t reasonable     
assumptions relat$ to /ati/ics & rese>* 
me?ods h be5 compli$ )4  7bb7 ,a /atem5t
 expla9+ ! assumptions1 /ati/ics1 &     

me?ods us$ to select ! sample & assess  
provid] directory in=mation accuracy4   
7cc7 ,su* o!r requirem5ts z ! ,secret>y 
det]m9es necess>y4  7,,ii7 ,! gr\p heal?
 plan or heal? insur] issu] makes !     
indep5d5t audit available on a public   
website4  7iv7 ,rulemak+ ,! ,secret>y1 !
 ,secret>y ( ,heal? & ,human ,s]vices1 &
 ! ,secret>y ( ! ,treasury %all issue   
int]im f9al regulations 7)\t prior      
notice & comm5t z g5]ally requir$ "u    
section #eec ( title #e1 ,unit$ ,/ates  
,code7 conc]n+ ! national /&>ds =       
conduct+ audits "u ?is subp>agraph1 n   
lat] ?an #b ye>s aft] ! date ( enactm5t 
( ! ,behavioral ,heal? ,network &       
,directory ,improvem5t ,act4  7,c7      
,audits by ! ,secret>y  7i7 ,9 g5]al    
,beg9n+ n lat] ?an ! f\r? plan ye> aft] 
! date ( enactm5t ( ! ,behavioral ,heal?
 ,network & ,directory ,improvem5t ,act1
 ! ,secret>y %all conduct annual audits 
to ensure compliance ) ! audit+         
requirem5ts "u subp>agraph 7,b74  7ii7  
,selection ( plans & issu]s ,!          

,secret>y1 ! ,secret>y ( ,heal? & ,human
 ,s]vices1 & ! ,secret>y ( ! ,treasury  
7ref]r$ to 9 ?is clause z !             
,secret>ies71 jo9tly1 %all conduct      
annual audits ( ! submissions "u        
subp>agraph 7,b7 ( a total ( n few] ?an 
#aj gr\p heal? plans or heal? insurance 
issu]s (f]+ gr\p heal? insurance        
cov]age1 z det]m9$ by ! ,secret>ies1 t  
are ! subjects ( compla9ts ab\t gho/    
networks or o!r compla9ts1 or t are     
r&omly select$ by ! ,secret>ies4  2 &   
7vii7 9 p>agraph 7#h71 z s r$esignat$-- 
7,i7 9 ! p>agraph head+1 by /rik+       
,def9ition & ins]t+ ,def9itions2  7,,ii7
 by /rik+ ,= purposes ( ?is subsection1 
! t]m & ins]t+ ! foll[+3 8,= purposes ( 
?is subsection3  7,a7 ,provid] directory
 in=mation ,! t]m  2  7,,iii7 by /rik+  
heal? insurance cov]age1 ! "n1 address &
 ins]t+ 8heal? insurance cov]age--  7i7 
! "n1 address :]e ! provid] regul>ly    
sees pati5ts  2  7,,iv7 by /rik+ ! p]iod
 & ins]t+ 2 &2 &  7,v7 by add+ at ! end 
! foll[+3  7ii7 ) respect to ea* su*    

provid] or facility-- 7,i7 :e!r su*     
provid] or facility is accept+ new      
pati5ts2  7,,ii7 ! languages spok5 & !  
availability ( language translators =   
specifi$ languages at ea* heal? c>e     
facility li/$ 9 ! directory2  7,,iii7   
:e!r ! provid] or facility (f]s         
m$ication-assi/$ treatm5t = opioid use  
disord]2  7,,iv7 ! ,/ate lic5se numb]2  
7,v7 ! national provid] id5tifi]2       
7,,vi7 ! age gr\ps s]v$ by ! provid] or 
facility1 su* z p$iatric1 adolesc5t1    
adult1 or g]iatric populations2  7,,vii7
 :e!r su* provid] or facility (f]s      
9-p]son s]vices1 teleheal? s]vices1 or  
bo?2  7,,viii7 ! co/-%>+ ti]1 if        
applicable2 &  7,,ix7 heal? insurance   
plans accept$ 7includ+ ! plan id5tifi] &
 type ( plan74  7,b7 ,gho/ network ,!   
t]m gho/ network means a gr\p heal? plan
 or gr\p heal? insurance cov]age = :i* !
 provid] directory in=mation describ+ ! 
network ( su* plan or cov]age-- 7i7     
includes inaccurate contact in=mation ) 
respect to a sub/antial %>e ( includ$   

li/+s & provid]s :o are "p ( ! network2 
7ii7 includes a sub/antial numb] (      
provid]s & facilities 7z specifi$ by !  
,secret>y1 9 coord9ation ) ! ,secret>y (
 ,heal? & ,human ,s]vices & ! ,secret>y 
( ! ,treasury7 9 a specialty :o are n   
accept+ new pati5ts )9 a "t p]iod       
specifi$ by su* secret>ies2  7iii7      
includes a sub/antial numb] ( provid]s &
 facilities t are n "p ( ! network2 or  
7iv7 omits a sub/antial numb] ( provid]s
 & facilities t are "p ( ! network4  2 &
  7,b7 9 subsection 7b7-- 7i7 9 p>agraph
 7#a71 by /rik+ & if ei!r ( ! crit]ia   
describ$ 9 p>agraph 7#b7 applies )      
respect to su* p>ticipant1 b5efici>y1 or
 enrollee & item or s]vice2 &  7ii7 by  
/rik+ p>agraph 7#b7 & ins]t+ ! foll[+3  
7#b7 ,reconciliation requirem5t ,if a   
nonp>ticipat+ provid] 0 li/$ z a        
p>ticipat+ provid] 9 ! po/$ provid]     
directory database1 ! gr\p heal? plan or
 heal? insurance issu] %all1 n lat] ?an 
#cj days aft] receiv+ ! reque/ = paym5t1
 notify ! p>ticipant1 b5efici>y1 or     

enrollee1 9 pla9 language1 t !          
p>ticipant1 b5efici>y1 or enrollee may  
be eligible = a refund f ! gr\p heal?   
plan or heal? insurance issu] if su*    
p>ticipant1 b5efici>y1 or enrollee paid 
! out ( network co/-%>+ & did n receive 
a refund "u section #bgii;,b-#i7;b7 ( ! 
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjj;gg-#aci74  4  7#b7 ,civil
 monet>y p5alties = violations  7,a7    
,civil monet>y p5alties relat+ to       
provid] directory requirem5ts ,section  
#ejb7;c77#aj7 ( ! ,employee ,retirem5t  
,income ,security ,act ( #aigd 7#bi     
,u4,s4,c4 #aacb7;c77#aj77;,a77 is       
am5d$-- 7i7 9 ! head+1 by /rik+ use (   
g5etic in=mation & ins]t+ use ( g5etic  
in=mation & provid] directory           
requirem5ts2 &  7ii7 9 subp>agraph      
7,a7-- 7,i7 by ins]t+ plan adm9i/rator (
 a gr\p heal? plan 7includ+ a ?ird p>ty 
adm9i/rator71 aft] plan sponsor ( a gr\p
 heal? plan12  7,,ii7 by ins]t+ 1       
adm9i/rator1 aft] su* sponsor2 &        
7,,iii7 by /rik+ = any failure & all t  

foll[s ?r\gh 9 connection ) ! plan4 &   
ins]t+ = any failure by su* plan        
sponsor1 plan adm9i/rator1 or heal?     
insurance issu]1 9 connection ) ! plan--
 7i7 to meet ! requirem5ts ( subsection 
7a77#a77;,f71 7b77#c71 7c71 or 7d7 (    
section #gjb or section #gja or         
#gjb7;b77#a7 ) respect to g5etic        
in=mation2 or  7ii7 to meet !           
requirem5ts ( section #gbj ) respect to 
provid] directory in=mation4  4  7,b7   
,exception to ! g5]al prohibition on    
en=cem5t ,section #ejb ( su* ,act 7#bi  
,u4,s4,c4 #aacb7 is am5d$-- 7i7 9       
subsection 7a77#f71 by /rik+ or 7#i7 &  
ins]t+ 7#i71 or 7#aj72 &  7ii7 9        
subsection 7b77#c7-- 7,i7 by /rik+      
subsections 7c77#i7 & 7a77#f7 & ins]t+  
subsections 7c77#i71 7c77#aj71 &        
7a77#f72  7,,ii7 by /rik+ "u subsection 
7c77#i77 & ins]t+ "u subsections 7c77#i7
 & 7c77#aj771 & except ) respect to     
en=cem5t by ! ,secret>y ( section #gbj2 
&  7,,iii7 by /rik+ #gjf7;a77#a7 &      
ins]t+ #gcc7;a77#a74  7c7 ,,irc ,section

 #ihbj ( ! ,int]nal ,rev5ue ,code (     
#aihf is am5d$-- 7#a7 9 subsection 7a7--
 7,a7 9 p>agraph 7#a7-- 7i7 by /rik+ ,= 
plan ye>s beg9n+ on or aft] ,janu>y #a1 
#bjbb1 ea* & ins]t+ ,ea*2  7ii7 9       
subp>agraph 7,c71 by /rik+ 2 & & ins]t+ 
a semicolon2  7iii7 9 subp>agraph 7,d71 
by /rik+ ! p]iod & ins]t+ 2 &2 &  7iv7  
by add+ at ! end ! foll[+3  7,e7 ensure 
t any directory1 includ+ ! database     
describ$ 9 subp>agraph 7,c71 conta9+    
provid] directory in=mation ) respect to
 su* plan complies ) ! requirem5ts      
develop$ by ! appropriate ag5cies 9     
accordance ) p>agraph 7#f7 9 ord] to    
ensure t p>ticipants1 b5efici>ies1 &    
enrollees are able to id5tify actively  
p>ticipat+ heal? c>e provid]s & heal?   
c>e facilities4  2  7,b7 9 p>agraph     
7#c7-- 7i7 9 ! matt] prec$+ subp>agraph 
7,a71 by /rik+ 1 9 ! case su* reque/ is 
made ?r\gh a telephone call2 &  7ii7 9  
subp>agraph 7,a71 by /rik+ call is      
receiv$1 ?r\gh a writt5 electronic or   
pr9t 7z reque/$ by su* individual7      

communication & ins]t+ a reque/ is      
receiv$1 by telephone1 or ?r\gh a writt5
 electronic or pr9t communication 7z    
reque/$ by su* individual72  7,c7 9     
p>agraph 7#d7-- 7i7 9 subp>agraph 7,a71 
by /rik+ & at ! end2  7ii7 9 subp>agraph
 7,b71 by /rik+ ! p]iod & ins]t+ 2 &2 & 
7iii7 by add+ at ! end ! foll[+3  7,c7  
in=mation1 9 pla9 language1 conc]n+ !   
rights ( ! p>ticipant1 b5efici>y1 or    
enrollee to co/-%>+ protections pursuant
 to subsection 7b7 9 ! ev5t ( reliance  
on inaccurate provid] network in=mation 
suppli$ by a gr\p heal? plan1 & contact 
in=mation =1 z appropriate1 ! ,/ate     
consum] assi/ance program or ombudsman  
or ! ,employee ,b5efits ,security       
,adm9i/ration = m in=mation4  2  7,d7 9 
p>agraph 7#e71 by add+ at ! end !       
foll[+3 ,su* in=mation %all include a   
/atem5t1 9 pla9 language1 conc]n+ !     
rights ( ! p>ticipant1 b5efici>y1 or    
enrollee to co/-%>+ protections pursuant
 to subsection 7b7 9 ! ev5t ( reliance  
on inaccurate provid] directory         

in=mation suppli$ by a gr\p heal? plan1 
& contact in=mation =1 z appropriate1 ! 
,/ate consum] assi/ance program or      
ombudsman or ! ,employee ,b5efits       
,security ,adm9i/ration = m in=mation42 
7,e7 by r$esignat+ p>agraphs 7#f7 & 7#g7
 z p>agraphs 7#h7 & 7#i71 respectively2 
7,f7 by ins]t+ aft] p>agraph 7#e7 !     
foll[+3  7#f7 ,protect+ p>ticipants1    
b5efici>ies1 & enrollees f gho/ networks
 ,! ,secret>y1 9 collaboration ) !      
,secret>y ( ,labor & ! ,secret>y (      
,heal? & ,human ,s]vices1 %all-- 7,a7 n 
lat] ?an #d ye>s aft] ! date ( enactm5t 
( ! ,behavioral ,heal? ,network &       
,directory ,improvem5t ,act1 issue f9al 
regulations fur!r def9+ ! t]m gho/      
network 7z def9$ 9 p>agraph 7#h772 &    
7,b7 n lat] ?an #d ye>s aft] ! date (   
enactm5t ( ! ,behavioral ,heal? ,network
 & ,directory ,improvem5t ,act1 issue   
f9al regulations1 subregulatory         
guidance1 or program in/ruction on h[ to
 assess gho/ networks 9 heal? plan      
directories includ+ reasonable          

assumptions relat$ to /ati/ics & rese>* 
me?ods4  7#g7 ,database report+ & audit+
 to protect aga9/ gho/ networks  7,a7   
,report+ requirem5ts ,beg9n+ n lat] ?an 
#c ye>s aft] ! date ( enactm5t ( !      
,behavioral ,heal? ,network & ,directory
 ,improvem5t ,act1 ea* gr\p heal? plan  
%all submit to ! ,secret>y1 at su* "t z 
! ,secret>y1 9 coord9ation ) ! ,secret>y
 ( ,labor & ! ,secret>y ( ,heal? &      
,human ,s]vices1 %all require1 b n less 
frequ5tly ?an annually1 ! directory data
 describ$ 9 p>agraph 7a77#d71 9 a ma*9e 
readable =mat 7z def9$ 9 section        
#adg4baj7;a77#b77xiv7 ( title #de1 ,code
 ( ,f$]al ,regulations 7or any successor
 regulations774 ,a ?ird p>ty adm9i/rator
 ( a gr\p heal? plan may submit su*     
in=mation = all gr\p heal? plans1       
collectively1 t su* adm9i/rator         
adm9i/]s4 ,! ,secret>y1 9 coord9ation ) 
! ,secret>y ( ,labor & ! ,secret>y (    
,heal? & ,human ,s]vices1 %all make data
 submitt$ "u ?is subp>agraph available  
on a public website4  7,b7 ,provid]     

directory indep5d5t audit requirem5ts   
7i7 ,9 g5]al ,beg9n+ n lat] ?an #c ye>s 
aft] ! date ( enactm5t ( ! ,behavioral  
,heal? ,network & ,directory ,improvem5t
 ,act1 ea* gr\p heal? plan %all conduct 
an annual directory audit1 ?r\gh an     
indep5d5t entity n associat$ ) ! heal?  
plan1 t consid]s ! factors describ$ 9   
clause 7ii77,i77aa7 & foll[s ! guidel9es
 develop$ "u clause 7ii77,i77bb74  7ii7 
,in=mation to be includ$  7,i7 ,9 g5]al 
,= purposes ( c>ry+ out ! audits "u ?is 
subp>agraph1 ! ,secret>y %all-- 7aa7    
develop a li/ ( in=mation requir$ to be 
includ$2 &  7bb7 provide guidel9es =    
c>ry+ out su* audits1 = use by gr\p     
heal? plans1 on-- 7,,aa7 ! reasonable   
assumptions & rese>* me?ods to select a 
reasonable sample 9 ord] to assess      
provid] directory in=mation accuracy2 & 
7,,bb7 det]m9+ ! crit]ia ( an eligible  
auditor4  7,,ii7 ,cont5ts ,! in=mation  
li/$ "u subclause 7,i77aa7 %all include 
! foll[+3 7aa7 ,! proportion ( directory
 li/+s ( ! plan ) inaccurate in=mation1 

includ+ incorrect contact in=mation1 z  
specifi$ by ! ,secret>y1 dur+ ! audit   
p]iod4  7bb7 ,! numb] ( 9-network items 
or s]vices paid on behalf ( p>ticipants1
 b5efici>ies1 & enrollees 9 ! plan to   
provid]s or facilities :o h a network   
provid] contract ) ! heal? plan & 7 n   
li/$ 9 ! directory ( ! heal? plan = !   
audit p]iod4  7cc7 ,! res\rces ( ! plan 
to help p>ticipants1 b5efici>ies1 &     
enrollees locate an accurately li/$     
9-network provid] :o is accept+ new     
pati5ts4  7dd7 ,! proportion (          
p>ticipants1 b5efici>ies1 & enrollees   
us+ out-(-network provid]s = m5tal heal?
 & sub/ance use disord] s]vices1 & !    
proportion ( p>ticipants1 b5efici>ies1 &
 enrollees us+ out-(-network provid]s & 
facilities = m$ical & surgical s]vices4 
7ee7 ,docum5tation t ! plan v]ifies !   
accuracy ( ! provid] directory in=mation
 e #ij days4  7ff7 ,o!r factors z       
det]m9$ by ! ,secret>y4  7iii7 ,/&>ds = 
report+ ,an audit "u ?is subp>agraph is 
complete if all ( ! foll[+ conditions   

are met3 7,i7 ,! audit report includes !
 foll[+3 7aa7 ,a /atem5t by ! indep5d5t 
auditor t1 to ! be/ ( ! auditor's k1 !  
report is complete & accurate1 & t      
reasonable assumptions relat$ to        
/ati/ics & rese>* me?ods h be5 compli$  
)4  7bb7 ,a /atem5t expla9+ !           
assumptions1 /ati/ics1 & me?ods us$ to  
select ! sample & assess provid]        
directory in=mation accuracy4  7cc7 ,su*
 o!r requirem5ts z ! ,secret>y det]m9es 
necess>y4  7,,ii7 ,! gr\p heal? plan    
makes ! indep5d5t audit available on a  
public website4  7iv7 ,rulemak+ ,!      
,secret>y1 ! ,secret>y ( ,labor1 & !    
,secret>y ( ,heal? & ,human ,s]vices    
%all issue int]im f9al regulations 7)\t 
prior notice & comm5t z g5]ally requir$ 
"u section #eec ( title #e1 ,unit$      
,/ates ,code7 conc]n+ ! national /&>ds =
 conduct+ audits "u ?is subp>agraph1 n  
lat] ?an #b ye>s aft] ! date ( enactm5t 
( ! ,behavioral ,heal? ,network &       
,directory ,improvem5t ,act4  7,c7      
,audits by ! ,secret>y  7i7 ,9 g5]al    

,beg9n+ n lat] ?an ! f\r? plan ye> aft] 
! date ( enactm5t ( ! ,behavioral ,heal?
 ,network & ,directory ,improvem5t ,act1
 ! ,secret>y %all conduct annual audits 
to ensure compliance ) ! audit+         
requirem5ts "u subp>agraph 7,b74  7ii7  
,selection ( plans ,! ,secret>y1 !      
,secret>y ( ,labor1 & ! ,secret>y (     
,heal? & ,human ,s]vices 7ref]r$ to 9   
?is clause z ! ,secret>ies71 jo9tly1    
%all conduct annual audits ( !          
submissions "u subp>agraph 7,b7 ( a     
total ( n few] ?an #aj gr\p heal? plans1
 z det]m9$ by ! ,secret>ies1 t are !    
subjects ( compla9ts ab\t gho/ networks 
or o!r compla9ts1 or t are r&omly       
select$ by ! ,secret>ies4  2 &  7,g7 9  
p>agraph 7#h71 z s r$esignat$-- 7i7 9 ! 
p>agraph head+1 by /rik+ ,def9ition &   
ins]t+ ,def9itions2  7ii7 by /rik+ ,=   
purposes ( ?is subsection1 ! t]m &      
ins]t+ ! foll[+3 8,= purposes ( ?is     
subsection3  7,a7 ,provid] directory    
in=mation ,! t]m  2  7iii7 by /rik+ gr\p
 heal? plan1 ! "n1 address & ins]t+     

8gr\p heal? plan--  7i7 ! "n1 address   
:]e ! provid] regul>ly sees pati5ts  2  
7iv7 by /rik+ ! p]iod & ins]t+ 2 &2 &   
7v7 by add+ at ! end ! foll[+3  7ii7 )  
respect to ea* su* provid] or facility--
 7,i7 :e!r su* provid] or facility is   
accept+ new pati5ts2  7,,ii7 ! languages
 spok5 & ! availability ( language      
translators = specifi$ languages at ea* 
heal? c>e facility li/$ 9 ! directory2  
7,,iii7 :e!r ! provid] or facility (f]s 
m$ication-assi/$ treatm5t = opioid use  
disord]2  7,,iv7 ! ,/ate lic5se numb]2  
7,v7 ! national provid] id5tifi]2       
7,,vi7 ! age gr\ps s]v$ by ! provid] or 
facility1 su* z p$iatric1 adolesc5t1    
adult1 or g]iatric populations2  7,,vii7
 :e!r su* provid] or facility (f]s      
9-p]son s]vices1 teleheal? s]vices1 or  
bo?2  7,,viii7 ! co/-%>+ ti]1 if        
applicable2 &  7,,ix7 heal? insurance   
plans accept$ 7includ+ ! plan id5tifi] &
 type ( plan74  7,b7 ,gho/ network ,!   
t]m gho/ network means a gr\p heal? plan
 = :i* ! provid] directory in=mation    

describ+ ! network ( su* plan-- 7i7     
includes inaccurate contact in=mation ) 
respect to a sub/antial %>e ( includ$   
li/+s & provid]s :o are "p ( ! network2 
7ii7 includes a sub/antial numb] (      
provid]s & facilities 7z specifi$ by !  
,secret>y1 9 coord9ation ) ! ,secret>y (
 ,labor & ! ,secret>y ( ,heal? & ,human 
,s]vices7 9 a specialty :o are n accept+
 new pati5ts )9 a "t p]iod specifi$ by  
su* secret>ies2  7iii7 includes a       
sub/antial numb] ( provid]s & facilities
 t are n "p ( ! network2 or  7iv7 omits 
a sub/antial numb] ( provid]s &         
facilities t are "p ( ! network4  2 &   
7#b7 9 subsection 7b7-- 7,a7 9 p>agraph 
7#a71 by /rik+ & if ei!r ( ! crit]ia    
describ$ 9 p>agraph 7#b7 applies )      
respect to su* p>ticipant1 b5efici>y1 or
 enrollee & item or s]vice2 &  7,b7 by  
/rik+ p>agraph 7#b7 & ins]t+ ! foll[+3  
7#b7 ,reconciliation requirem5t ,if a   
nonp>ticipat+ provid] 0 li/$ z a        
p>ticipat+ provid] 9 ! po/$ provid]     
directory database1 ! gr\p heal? plan   

%all1 n lat] ?an #cj days aft] receiv+ !
 reque/ = paym5t1 notify ! p>ticipant1  
b5efici>y1 or enrollee1 9 pla9 language1
 t ! p>ticipant1 b5efici>y1 or enrollee 
may be eligible = a refund f ! gr\p     
heal? plan if su* p>ticipant1 b5efici>y1
 or enrollee paid ! out ( network       
co/-%>+ & did n receive a refund "u     
section #bgii;,b-#i7;b7 ( ! ,public     
,heal? ,s]vice ,act 7#db ,u4,s4,c4      
#cjj;gg-#aci74  4  7d7 ,effective date  
,! am5dm5ts made by subsections 7a71    
7b71 & 7c7 %all apply ) respect to gr\p 
heal? plans1 or any heal? insurance     
issu] (f]+ heal? insurance cov]age 9    
connection ) su* plan1 = plan ye>s      
beg9n+ aft] ! date t is #a ye> aft] !   
date ( enactm5t ( ?is ,act4  #c4        
,provid] requirem5ts to protect pati5ts 
& improve ! accuracy ( provid] directory
 in=mation ,section #bgii;,b-#i ( !     
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #cjj;gg-#aci7 is am5d$-- 7#a7 
9 subsection 7a7-- 7,a7 9 p>agraph 7#c71
 by /rik+ 2 & & ins]t+ a semicolon2     

7,b7 by r$esignat+ p>agraph 7#d7 z      
p>agraph 7#f72 &  7,c7 by ins]t+ aft]   
p>agraph 7#c7 ! foll[+3  7#d7 subject to
 p>agraph 7#e71 :5 a provid] or facility
 t is n accept+ new pati5ts det]m9es t x
 has ! ability to accept new pati5ts1 )9
 #e bus9ess days ( su* det]m9ation2     
7#e7 :5 a solo practition] or small     
provid]1 z det]m9$ by ! ,secret>y1      
det]m9es t x has ! ability to accept new
 pati5ts1 )9 #aj bus9ess days ( su*     
det]m9ation2 &  2 &  7#b7 by am5d+      
subsection 7d7 to read z foll[s3  7d7   
,def9ition ,= purposes ( ?is section1 ! 
t]m provid] directory in=mation         
includes-- 7#a7 ! "n1 address1          
specialty1 telephone numb]1 & digital   
contact in=mation ( ea* individual heal?
 c>e provid] contract$ to p>ticipate 9  
any ( ! networks ( ! gr\p heal? plan or 
heal? insurance cov]age involv$2  7#b7 !
 "n1 address1 specialty1 telephone      
numb]1 & digital contact in=mation ( ea*
 m$ical gr\p1 cl9ic1 or facility        
contract$ to p>ticipate 9 any ( !       

networks ( ! gr\p heal? plan or heal?   
insurance cov]age involv$2 &  7#c7 )    
respect to ea* su* provid]1 m$ical gr\p1
 cl9ic1 or facility-- 7,a7 :e!r su*     
provid]1 m$ical gr\p1 cl9ic1 or facility
 is accept+ new pati5ts2  7,b7 !        
languages spok5 & ! availability (      
language translators = specifi$         
languages at ea* provid]1 m$ical gr\p1  
cl9ic1 or facility li/$ 9 ! directory2  
7,c7 :e!r ! provid]1 m$ical gr\p1 cl9ic1
 or facility (f]s m$ication-assi/$      
treatm5t = opioid use disord]2  7,d7 !  
,/ate lic5se numb]2  7,e7 ! national    
provid] id5tifi]2  7,f7 ! age gr\ps s]v$
 by su* provid]1 gr\p1 cl9ic1 or        
facility1 su* z p$iatric1 adolesc5t1    
adult1 or g]iatric populations2  7,g7   
:e!r su* provid]1 gr\p1 cl9ic1 or       
facility (f]s 9-p]son s]vices1 teleheal?
 s]vices1 or bo?2 &  7,h7 ! co/-%>+ ti]1
 if applicable4  4  #d4 ,/r5g!n+ m5tal  
heal? & sub/ance use disord] p>ity      
requirem5ts  7a7 ,,phsa  7#a7 ,network  
adequacy requirem5ts ,section #bgbf7;a7 

( ! ,public ,heal? ,s]vice ,act 7#db    
,u4,s4,c4 #cjj;gg-#bf7;a77 is am5d$ by  
add+ at ! end ! foll[+3  7#i7 ,network  
adequacy requirem5ts  7,a7 ,9 g5]al ,!  
,secret>y1 ! ,secret>y ( ,labor1 & !    
,secret>y ( ! ,treasury %all issue      
regulations e/abli%+ national           
quantitative /&>ds = m5tal heal? &      
sub/ance use disord] network adequacy4  
,su* /&>ds %all consid]-- 7i7 ! ratio ( 
9-network m5tal heal? provid]s :o       
submitt$ claims "u ! plan or cov]age 9 !
 previ\s plan ye>1 sep>at$ by           
pr(essional type ( m5tal heal? provid]1 
to p>ticipants1 b5efici>ies1 & enrollees
 9 a gr\p heal? plan or heal? insurance 
cov]age2  7ii7 ! ratio ( 9-network      
sub/ance use disord] provid]s :o        
submitt$ claims "u ! plan or cov]age 9 !
 previ\s plan ye>1 sep>at$ by           
pr(essional type ( sub/ance use disord] 
provid]1 to p>ticipants1 b5efici>ies1 & 
enrollees 9 a gr\p heal? plan or heal?  
insurance cov]age2  7iii7 sep>ately1 =  
m5tal heal? s]vices & sub/ance use      

disord] s]vices-- 7,i7 geographic       
accessibility ( provid]s2  7,,ii7       
geographic v>iation & population        
disp]sion2  7,,iii7 wait+ times =       
appo9tm5ts ) p>ticipat+ provid]s2       
7,,iv7 h\rs ( op]ation = p>ticipat+     
provid]s2  7,v7 ! ability ( ! network to
 meet ! ne$s ( p>ticipants1 b5efici>ies1
 & enrollees1 includ+ l[-income         
individuals1 individuals :o are memb]s (
 a racial or e?nic m9ority1 individuals 
:o live 9 a heal? pr(essional %ortage   
area1 *ildr5 & adults ) s]i\s1 *ronic1 &
 complex heal? conditions1 individuals )
 physical or m5tal disabilities or      
sub/ance use disord]s1 p$iatric         
populations1 & individuals ) limit$     
,engli% pr(ici5cy2  7,,vi7 !            
availability ( 9-p]son s]vices1         
teleheal? s]vices1 & hybrid s]vices to  
s]ve ! ne$s ( p>ticipants1 b5efici>ies1 
& enrollees2 &  7,,vii7 ! p]c5tage (    
9-network provid]s :o h submitt$ a claim
 = paym5t dur+ a previ\s #f-mon? p]iod1 
z det]m9$ by ! ,secret>y1 ! ,secret>y ( 

,labor1 & ! ,secret>y ( ! ,treasury2 &  
7iv7 o!r /&>ds z det]m9$ by ! ,secret>y1
 ! ,secret>y ( ,labor1 & ! ,secret>y ( !
 ,treasury4  7,b7 ,tim+  7i7 ,issuance  
,! ,secret>y1 ! ,secret>y ( ,labor1 & ! 
,secret>y ( ! ,treasury %all-- 7,i7     
issue propos$ regulations requir$ "u    
subp>agraph 7,a7 n lat] ?an #b ye>s aft]
 ! date ( enactm5t ( ! ,behavioral      
,heal? ,network & ,directory ,improvem5t
 ,act2 &  7,,ii7 issue f9al regulations 
"u subp>agraph 7,a7 n lat] ?an #a ye>   
!reaft]4  7ii7 ,effective date ,!       
regulations promulgat$ "u ?is p>agraph  
%all take effect 9 ! fir/ plan ye> t    
beg9s aft] ! date on :i* su* f9al       
regulations are issu$4  7,c7 ,audits ,! 
,secret>y1 ! ,secret>y ( ,labor1 & !    
,secret>y ( ! ,treasury 7ref]r$ to 9 ?is
 subp>agraph z ! ,secret>ies71 jo9tly1  
%all conduct annual1 t>get$ audits ( n  
few] ?an #aj gr\p heal? plans & heal?   
insurance issu]s (f]+ gr\p or individual
 heal? insurance cov]age t ! ,secret>ies
 select bas$ ^u ! numb] ( compla9ts ab\t

 m5tal heal? & sub/ance use disord]     
network adequacy to ensure compliance ) 
! requirem5ts ( ?is p>agraph4 ,su*      
audits %all beg9 n e>li] ?an "o ye> aft]
 ! f9al regulations implem5t+ ?is       
p>agraph beg9 to apply to gr\p heal?    
plans & heal? insurance issu]s4  4  7#b7
 ,def9itions ,p>agraphs 7#d7 & 7#e7 (   
section #bgbf7;e7 ( ! ,public ,heal?    
,s]vice ,act 7#db ,u4,s4,c4             
#cjj;gg-#bf7;e77 are am5d$ to read z    
foll[s3  7#d7 ,m5tal heal? b5efits ,!   
t]m m5tal heal? b5efits means b5efits ) 
respect to s]vices relat$ to a m5tal    
heal? condition1 def9$ consi/5tly )     
g5]ally recogniz$ indep5d5t /&>ds (     
curr5t m$ical practice1 su* z !         
,diagno/ic & ,/ati/ical ,manual ( ,m5tal
 ,disord]s ( ! ,am]ican ,psy*iatric     
,association4  7#e7 ,sub/ance use       
disord] b5efits ,! t]m sub/ance use     
disord] b5efits means b5efits ) respect 
to s]vices relat$ to a sub/ance use     
disord]1 def9$ consi/5tly ) g5]ally     
recogniz$ indep5d5t /&>ds ( curr5t      

m$ical practice1 su* z ! ,diagno/ic &   
,/ati/ical ,manual ( ,m5tal ,disord]s ( 
! ,am]ican ,psy*iatric ,association4  4 
7#c7 ,/&>ds = p>ity 9 reimbursem5t rates
 ,section #bgbf7;a7 ( ! ,public ,heal?  
,s]vice ,act 7#db ,u4,s4,c4             
#cjj;gg-#bf7;a771 z am5d$ by p>agraph   
7#a71 is fur!r am5d$ by add+ at ! end ! 
foll[+3  7#aj7 ,/&>ds = p>ity 9         
reimbursem5t rates  7,a7 ,9 g5]al ,n    
lat] ?an #b ye>s aft] ! date ( enactm5t 
( ! ,behavioral ,heal? ,network &       
,directory ,improvem5t ,act1 !          
,secret>y1 ! ,secret>y ( ,labor1 & !    
,secret>y ( ! ,treasury %all issue      
regulations on a /&>d = p>ity 9         
reimbursem5t rates = m5tal heal? or     
sub/ance use disord] b5efits & m$ical & 
surgical b5efits1 bas$ on a comp>ative  
analysis conduct$ by su* ,secret>ies us+
 data submitt$ by gr\p heal? plans &    
heal? insurance issu]s1 provid]         
associations1 & o!r exp]ts relat$ to !  
co/ ( c>e deliv]y = m5tal heal? &       
sub/ance use disord] b5efits4  7,b7     

,reque/s = data ,gr\p heal? plans &     
heal? insurance issu]s %all comply ) any
 reque/ = data issu$ by ! ,secret>y1 !  
,secret>y ( ,labor1 & ! ,secret>y ( !   
,treasury = purposes ( develop+ ! /&>ds 
"u subp>agraph 7,a71 9 a mann] t avoids 
unnecess>y duplication4  7,c7 ,effective
 date ,! regulations promulgat$ "u      
subp>agraph 7,a7 %all apply to gr\p     
heal? plans & heal? insurance issu]s    
(f]+ gr\p or individual heal? insurance 
cov]age beg9n+ 9 ! fir/ plan ye> t beg9s
 aft] issuance ( ! f9al regulations4  4 
7b7 ,,erisa  7#a7 ,network adequacy     
requirem5ts ,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#i7 ,network adequacy requirem5ts  7,a7
 ,9 g5]al ,! ,secret>y1 ! ,secret>y (   
,heal? & ,human ,s]vices1 & ! ,secret>y 
( ! ,treasury %all issue regulations    
e/abli%+ national quantitative /&>ds =  
m5tal heal? & sub/ance use disord]      
network adequacy4 ,su* /&>ds %all       

consid]-- 7i7 ! ratio ( 9-network m5tal 
heal? provid]s :o submitt$ claims "u !  
plan or cov]age 9 ! previ\s plan ye>1   
sep>at$ by pr(essional type ( m5tal     
heal? provid]1 to p>ticipants1          
b5efici>ies1 & enrollees 9 a gr\p heal? 
plan or heal? insurance cov]age2  7ii7 !
 ratio ( 9-network sub/ance use disord] 
provid]s :o submitt$ claims "u ! plan or
 cov]age 9 ! previ\s plan ye>1 sep>at$  
by pr(essional type ( sub/ance use      
disord] provid]1 to p>ticipants1        
b5efici>ies1 & enrollees 9 a gr\p heal? 
plan or heal? insurance cov]age2  7iii7 
sep>ately1 = m5tal heal? s]vices &      
sub/ance use disord] s]vices-- 7,i7     
geographic accessibility ( provid]s2    
7,,ii7 geographic v>iation & population 
disp]sion2  7,,iii7 wait+ times =       
appo9tm5ts ) p>ticipat+ provid]s2       
7,,iv7 h\rs ( op]ation = p>ticipat+     
provid]s2  7,v7 ! ability ( ! network to
 meet ! ne$s ( p>ticipants1 b5efici>ies1
 & enrollees1 includ+ l[-income         
individuals1 individuals :o are memb]s (

 a racial or e?nic m9ority1 individuals 
:o live 9 a heal? pr(essional %ortage   
area1 *ildr5 & adults ) s]i\s1 *ronic1 &
 complex heal? conditions1 individuals )
 physical or m5tal disabilities or      
sub/ance use disord]s1 p$iatric         
populations1 & individuals ) limit$     
,engli% pr(ici5cy2  7,,vi7 !            
availability ( 9-p]son s]vices1         
teleheal? s]vices1 & hybrid s]vices to  
s]ve ! ne$s ( p>ticipants1 b5efici>ies1 
& enrollees2 &  7,,vii7 ! p]c5tage (    
9-network provid]s :o h submitt$ a claim
 = paym5t dur+ a previ\s #f-mon? p]iod1 
z det]m9$ by ! ,secret>y1 ! ,secret>y ( 
,heal? & ,human ,s]vices1 & ! ,secret>y 
( ! ,treasury2 &  7iv7 o!r /&>ds z      
det]m9$ by ! ,secret>y1 ! ,secret>y (   
,heal? & ,human ,s]vices1 & ! ,secret>y 
( ! ,treasury4  7,b7 ,tim+  7i7         
,issuance ,! ,secret>y1 ! ,secret>y (   
,heal? & ,human ,s]vices1 & ! ,secret>y 
( ! ,treasury %all-- 7,i7 issue propos$ 
regulations requir$ "u subp>agraph 7,a7 
n lat] ?an #b ye>s aft] ! date (        

enactm5t ( ! ,behavioral ,heal? ,network
 & ,directory ,improvem5t ,act2 &       
7,,ii7 issue f9al regulations "u        
subp>agraph 7,a7 n lat] ?an #a ye>      
!reaft]4  7ii7 ,effective date ,!       
regulations promulgat$ "u ?is p>agraph  
%all take effect 9 ! fir/ plan ye> t    
beg9s aft] ! date on :i* su* f9al       
regulations are issu$4  7,c7 ,audits ,! 
,secret>y1 ! ,secret>y ( ,heal? & ,human
 ,s]vices1 & ! ,secret>y ( ! ,treasury  
7ref]r$ to 9 ?is subp>agraph z !        
,secret>ies71 jo9tly1 %all conduct      
annual1 t>get$ audits ( n few] ?an #aj  
gr\p heal? plans & heal? insurance      
issu]s (f]+ gr\p heal? insurance cov]age
 t ! ,secret>ies select bas$ ^u ! numb] 
( compla9ts ab\t m5tal heal? & sub/ance 
use disord] network adequacy to ensure  
compliance ) ! requirem5ts ( ?is        
p>agraph4 ,su* audits %all beg9 n e>li] 
?an "o ye> aft] ! f9al regulations      
implem5t+ ?is p>agraph beg9 to apply to 
gr\p heal? plans & heal? insurance      
issu]s4  4  7#b7 ,def9itions ,p>agraphs 

7#d7 & 7#e7 ( section #gab7;e7 ( !      
,employee ,retirem5t ,income ,security  
,act ( #aigd 7#bi ,u4,s4,c4 #aahe;a7e77 
are am5d$ to read z foll[s3  7#d7 ,m5tal
 heal? b5efits ,! t]m m5tal heal?       
b5efits means b5efits ) respect to      
s]vices relat$ to a m5tal heal?         
condition1 def9$ consi/5tly ) g5]ally   
recogniz$ indep5d5t /&>ds ( curr5t      
m$ical practice1 su* z ! ,diagno/ic &   
,/ati/ical ,manual ( ,m5tal ,disord]s ( 
! ,am]ican ,psy*iatric ,association4    
7#e7 ,sub/ance use disord] b5efits ,!   
t]m sub/ance use disord] b5efits means  
b5efits ) respect to s]vices relat$ to a
 sub/ance use disord]1 def9$ consi/5tly 
) g5]ally recogniz$ indep5d5t /&>ds (   
curr5t m$ical practice1 su* z !         
,diagno/ic & ,/ati/ical ,manual ( ,m5tal
 ,disord]s ( ! ,am]ican ,psy*iatric     
,association4  4  7#c7 ,/&>ds = p>ity 9 
reimbursem5t rates ,section #gab7;a7 ( !
 ,employee ,retirem5t ,income ,security 
,act ( #aigd 7#bi ,u4,s4,c4 #aahe;a7a771
 z am5d$ by p>agraph 7#a71 is fur!r     

am5d$ by add+ at ! end ! foll[+3  7#aj7 
,/&>ds = p>ity 9 reimbursem5t rates     
7,a7 ,9 g5]al ,n lat] ?an #b ye>s aft] !
 date ( enactm5t ( ! ,behavioral ,heal? 
,network & ,directory ,improvem5t ,act1 
! ,secret>y1 ! ,secret>y ( ,heal? &     
,human ,s]vices1 & ! ,secret>y ( !      
,treasury %all issue regulations on a   
/&>d = p>ity 9 reimbursem5t rates =     
m5tal heal? or sub/ance use disord]     
b5efits & m$ical & surgical b5efits1    
bas$ on a comp>ative analysis conduct$  
by su* ,secret>ies us+ data submitt$ by 
gr\p heal? plans & heal? insurance      
issu]s1 provid] associations1 & o!r     
exp]ts relat$ to ! co/ ( c>e deliv]y =  
m5tal heal? & sub/ance use disord]      
b5efits4  7,b7 ,reque/s = data ,gr\p    
heal? plans & heal? insurance issu]s    
%all comply ) any reque/ = data issu$ by
 ! ,secret>y1 ! ,secret>y ( ,heal? &    
,human ,s]vices1 & ! ,secret>y ( !      
,treasury = purposes ( develop+ ! /&>ds 
"u subp>agraph 7,a71 9 a mann] t avoids 
unnecess>y duplication4  7,c7 ,effective

 date ,! regulations promulgat$ "u      
subp>agraph 7,a7 %all apply to gr\p     
heal? plans & heal? insurance issu]s    
(f]+ gr\p heal? insurance cov]age beg9n+
 9 ! fir/ plan ye> t beg9s aft] issuance
 ( ! f9al regulations4  4  7c7 ,,irc    
7#a7 ,network adequacy requirem5ts      
,section #ihab7;a7 ( ! ,int]nal ,rev5ue 
,code ( #aihf is am5d$ by add+ at ! end 
! foll[+3  7#i7 ,network adequacy       
requirem5ts  7,a7 ,9 g5]al ,! ,secret>y1
 ! ,secret>y ( ,heal? & ,human ,s]vices1
 & ! ,secret>y ( ,labor %all issue      
regulations e/abli%+ national           
quantitative /&>ds = m5tal heal? &      
sub/ance use disord] network adequacy4  
,su* /&>ds %all consid]-- 7i7 ! ratio ( 
9-network m5tal heal? provid]s :o       
submitt$ claims "u ! plan 9 ! previ\s   
plan ye>1 sep>at$ by pr(essional type ( 
m5tal heal? provid]1 to p>ticipants1    
b5efici>ies1 & enrollees 9 a gr\p heal? 
plan2  7ii7 ! ratio ( 9-network sub/ance
 use disord] provid]s :o submitt$ claims
 "u ! plan 9 ! previ\s plan ye>1 sep>at$

 by pr(essional type ( sub/ance use     
disord] provid]1 to p>ticipants1        
b5efici>ies1 & enrollees 9 a gr\p heal? 
plan2  7iii7 sep>ately1 = m5tal heal?   
s]vices & sub/ance use disord] s]vices--
 7,i7 geographic accessibility (        
provid]s2  7,,ii7 geographic v>iation & 
population disp]sion2  7,,iii7 wait+    
times = appo9tm5ts ) p>ticipat+         
provid]s2  7,,iv7 h\rs ( op]ation =     
p>ticipat+ provid]s2  7,v7 ! ability ( !
 network to meet ! ne$s ( p>ticipants1  
b5efici>ies1 & enrollees1 includ+       
l[-income individuals1 individuals :o   
are memb]s ( a racial or e?nic m9ority1 
individuals :o live 9 a heal?           
pr(essional %ortage area1 *ildr5 &      
adults ) s]i\s1 *ronic1 & complex heal? 
conditions1 individuals ) physical or   
m5tal disabilities or sub/ance use      
disord]s1 p$iatric populations1 &       
individuals ) limit$ ,engli% pr(ici5cy2 
7,,vi7 ! availability ( 9-p]son s]vices1
 teleheal? s]vices1 & hybrid s]vices to 
s]ve ! ne$s ( p>ticipants1 b5efici>ies1 

& enrollees2 &  7,,vii7 ! p]c5tage (    
9-network provid]s :o h submitt$ a claim
 = paym5t dur+ a previ\s #f-mon? p]iod1 
z det]m9$ by ! ,secret>y1 ! ,secret>y ( 
,heal? & ,human ,s]vices1 & ! ,secret>y 
( ,labor2 &  7iv7 o!r /&>ds z det]m9$ by
 ! ,secret>y1 ! ,secret>y ( ,heal? &    
,human ,s]vices1 & ! ,secret>y ( ,labor4
  7,b7 ,tim+  7i7 ,issuance ,!          
,secret>y1 ! ,secret>y ( ,heal? & ,human
 ,s]vices1 & ! ,secret>y ( ,labor %all--
 7,i7 issue propos$ regulations requir$ 
"u subp>agraph 7,a7 n lat] ?an #b ye>s  
aft] ! date ( enactm5t ( ! ,behavioral  
,heal? ,network & ,directory ,improvem5t
 ,act2 &  7,,ii7 issue f9al regulations 
"u subp>agraph 7,a7 n lat] ?an #a ye>   
!reaft]4  7ii7 ,effective date ,!       
regulations promulgat$ "u ?is p>agraph  
%all take effect 9 ! fir/ plan ye> t    
beg9s aft] ! date on :i* su* f9al       
regulations are issu$4  7,c7 ,audits ,! 
,secret>y1 ! ,secret>y ( ,heal? & ,human
 ,s]vices1 & ! ,secret>y ( ,labor       
7ref]r$ to 9 ?is subp>agraph z !        

,secret>ies71 jo9tly1 %all conduct      
annual1 t>get$ audits ( n few] ?an #aj  
gr\p heal? plans t ! ,secret>ies select 
bas$ ^u ! numb] ( compla9ts ab\t m5tal  
heal? & sub/ance use disord] network    
adequacy to ensure compliance ) !       
requirem5ts ( ?is p>agraph4 ,su* audits 
%all beg9 n e>li] ?an "o ye> aft] ! f9al
 regulations implem5t+ ?is p>agraph beg9
 to apply to gr\p heal? plans4  4  7#b7 
,def9itions ,p>agraphs 7#d7 & 7#e7 (    
section #ihab7;e7 ( ! ,int]nal ,rev5ue  
,code ( #aihf are am5d$ to read z       
foll[s3  7#d7 ,m5tal heal? b5efits ,!   
t]m m5tal heal? b5efits means b5efits ) 
respect to s]vices relat$ to a m5tal    
heal? condition1 def9$ consi/5tly )     
g5]ally recogniz$ indep5d5t /&>ds (     
curr5t m$ical practice1 su* z !         
,diagno/ic & ,/ati/ical ,manual ( ,m5tal
 ,disord]s ( ! ,am]ican ,psy*iatric     
,association4  7#e7 ,sub/ance use       
disord] b5efits ,! t]m sub/ance use     
disord] b5efits means b5efits ) respect 
to s]vices relat$ to a sub/ance use     

disord]1 def9$ consi/5tly ) g5]ally     
recogniz$ indep5d5t /&>ds ( curr5t      
m$ical practice1 su* z ! ,diagno/ic &   
,/ati/ical ,manual ( ,m5tal ,disord]s ( 
! ,am]ican ,psy*iatric ,association4  4 
7#c7 ,/&>ds = p>ity 9 reimbursem5t rates
 ,section #ihab7;a7 ( ! ,int]nal ,rev5ue
 ,code ( #aihf1 z am5d$ by p>agraph     
7#a71 is fur!r am5d$ by add+ at ! end ! 
foll[+3  7#aj7 ,/&>ds = p>ity 9         
reimbursem5t rates  7,a7 ,9 g5]al ,n    
lat] ?an #b ye>s aft] ! date ( enactm5t 
( ! ,behavioral ,heal? ,network &       
,directory ,improvem5t ,act1 !          
,secret>y1 ! ,secret>y ( ,heal? & ,human
 ,s]vices1 & ! ,secret>y ( ,labor %all  
issue regulations on a /&>d = p>ity 9   
reimbursem5t rates = m5tal heal? or     
sub/ance use disord] b5efits & m$ical & 
surgical b5efits1 bas$ on a comp>ative  
analysis conduct$ by su* ,secret>ies us+
 data submitt$ by gr\p heal? plans1     
provid] associations1 & o!r exp]ts      
relat$ to ! co/ ( c>e deliv]y = m5tal   
heal? & sub/ance use disord] b5efits4   

7,b7 ,reque/s = data ,gr\p heal? plans  
%all comply ) any reque/ = data issu$ by
 ! ,secret>y1 ! ,secret>y ( ,heal? &    
,human ,s]vices1 & ! ,secret>y ( ,labor 
= purposes ( develop+ ! /&>ds "u        
subp>agraph 7,a71 9 a mann] t avoids    
unnecess>y duplication4  7,c7 ,effective
 date ,! regulations promulgat$ "u      
subp>agraph 7,a7 %all apply to gr\p     
heal? plans beg9n+ 9 ! fir/ plan ye> t  
beg9s aft] issuance ( ! f9al            
regulations4  4  #e4 ,/ate & ,tribal    
ombudsman programs relat+ to m5tal heal?
 & sub/ance use disord] p>ity ,"p ,c (  
title ,,xxvii ( ! ,public ,heal? ,s]vice
 ,act 7#db ,u4,s4,c4 #cjj;gg-#ia et     
seq47 is am5d$-- 7#a7 by r$esignat+     
section #bgid 7#db ,u4,s4,c4            
#cjj;gg-#ie7 7reg>d+ uni=m fraud & abuse
 ref]ral =mat71 z add$ by section #ffjc 
( ! ,pati5t ,protection & ,af=dable ,c>e
 ,act 7,public ,law #aaa-adh71 z section
 #bgie2 &  7#b7 by add+ at ! end !      
foll[+3  #bgif4 ,/ate & ,tribal         
ombudsman programs relat+ to m5tal heal?

 & sub/ance use disord] p>ity  7a7 ,9   
g5]al ,! ,secret>y %all make grants to  
eligible entities1 designat$ by a ,/ate1
 ,indian ,tribe1 or ,tribal             
organization1 z describ$ 9 subsection   
7b71 = ! purpose (-- 7#a7 e/abli%+ or   
support+ ,/ate & ,tribal m5tal heal? &  
sub/ance use disord] p>ity ombudsman    
programs to-- 7,a7 educate consum]s ab\t
 ! m5tal heal? & sub/ance use disord]   
cov]age 9 individual plans1 gr\p heal?  
plans1 self-insur$ plans1 & ,/ate       
,m$icaid manag$ c>e plans2  7,b7 assi/  
consum]s 9 und]/&+ _! rights z heal?    
b5efits plan memb]s1 includ+ appeal     
processes & h[ to use su* b5efits1 & h[ 
to access appropriate m$ical in=mation2 
7,c7 assi/ consum]s 9 ex]cis+ _! rights 
"u ! provisions ( "p ,d1 includ+ resolv+
 problems relat$ to a gr\p heal? plan or
 heal? insurance issu] errone\sly *>g+ a
 consum] out-(-network rates = s]vices  
li/$ 9-network on ! gr\p heal? plan or  
heal? insurance issu]'s provid]         
directory2  7,d7 id5tify1 inve/igate1 & 

help resolve compla9ts relat$ to m5tal  
heal? & sub/ance use disord] cov]age    
7includ+ pot5tial violations ( ! m5tal  
heal? & sub/ance use disord] p>ity laws7
 on behalf ( consum]s2  7,e7 ma9ta9 a   
toll-free hotl9e & website = consum]s2  
7,f7 collect1 track1 & quantify problems
 & inquiries enc\nt]$ by consum]s2 &    
7,g7 o!r activities z def9$ by !        
,secret>y2 &  7#b7 provide support &    
tra9+ = su* ,/ate & ,tribal m5tal heal? 
p>ity ombudsman programs 7su* z ?r\gh ! 
e/abli%m5t ( a m5tal heal? p>ity        
ombudsman program res\rce c5t]74  7b7   
,eligibility ,to be eligible to receive 
a grant "u ?is section1 a ,/ate1 ,indian
 ,tribe1 or ,tribal organization %all   
designate an ombudsman or consum]       
assi/ance program or o!r indep5d5t      
entity t-- 7#a7 has specializ$ k ( m5tal
 heal? conditions & sub/ance use        
disord]s & exp]i5ce resolv+ inquiries & 
compla9ts2 &  7#b7 directly1 or 9       
coord9ation ) dep>tm5ts ( insurance1 &  
consum] assi/ance organizations1        

receives & responds to inquiries &      
compla9ts conc]n+ access to m5tal heal? 
& sub/ance use disord] s]vices4  7c7    
,crit]ia ,a ,/ate1 ,indian ,tribe1 or   
,tribal organization t receives a grant 
"u ?is section %all comply ) crit]ia    
e/abli%$ by ! ,secret>y = c>ry+ out     
activities "u su* grant4  7d7 ,data     
collection ,z a condition ( receiv+ a   
grant1 an eligible entity %all agree    
to-- 7#a7 collect & report data to !    
,secret>y1 ,/ate legislature1 & relevant
 ,/ate ag5cies1 includ+ ! dep>tm5ts (   
insurance & ! ,/ate attorney g5]al1 on !
 numb]s & types ( problems & inquiries  
enc\nt]$ by individuals ) respect to    
access to behavioral heal? s]vices2 &   
7#b7 report to ! ,secret>y on h[        
id5tifi$ problems 7 address$1 includ+   
?r\gh promis+ practices relat$ to       
respond+ to m5tal heal? & sub/ance use  
disord] cov]age issues1 includ+ appeals 
& education4  7e7 ,report to congress ,n
 lat] ?an #d ye>s aft] ! date ( !       
enactm5t ( ! ,behavioral ,heal? ,network

 & ,directory ,improvem5t ,act1 !       
,secret>y %all submit to ,congress a    
report on ! data collect$ "u subsection4
  7f7 ,def9itions ,9 ?is section1 ! t]ms
 ,indian ,tribe & ,tribal organization h
 ! mean+s giv5 su* t]ms 9 section #d ( !
 ,indian ,self-,det]m9ation & ,education
 ,assi/ance ,act4  7g7 ,au?orization (  
appropriations ,to c>ry out ?is section1
 !re are au?oriz$ to be appropriat$     
#bj1jjj1jjj = fiscal ye> #bjbe &        
#aj1jjj1jjj = fiscal ye> #bjbf & ea*    
fiscal ye> !reaft]4  4  #f4 ,report to  
,congress  7a7 ,9 g5]al ,n lat] ?an #f  
ye>s aft] ! date ( enactm5t ( ?is ,act &
 e #b ye>s = ! next #aj ye>s1 !         
,secret>y ( ,heal? & ,human ,s]vices1 ! 
,secret>y ( ,labor1 & ! ,secret>y ( !   
,treasury 7collectively ref]r$ to 9 ?is 
section z ! ,secret>ies7 %all jo9tly    
submit to ,congress & make publicly     
available a report to assess ! preval5ce
 ( gho/ networks & ! adequacy ( m5tal   
heal? & sub/ance use disord] networks1 9
 accordance ) section #bgbf7;a77#i7 ( ! 

,public ,heal? ,s]vice ,act1 section    
#gab7;a77#i7 ( ! ,employee ,retirem5t   
,income ,security ,act ( #aigd1 &       
section #ihab7;a77#i7 ( ! ,int]nal      
,rev5ue ,code ( #aihf1 z am5d$ by       
section #d4 ,su* report %all include !  
foll[+3 7#a7 ,aggregate in=mation ab\t  
gr\p heal? plans & heal? insurance      
issu]s det]m9$ by ! ,secret>ies to be   
out ( compliance ) ! provid] directory  
requirem5ts "u section #bgii;,a-#e ( !  
,public ,heal? ,s]vice ,act1 section    
#gbj ( ! ,employee ,retirem5t ,income   
,security ,act ( #aigd1 & section #ihbj 
( ! ,int]nal ,rev5ue ,code ( #aihf1 z   
am5d$ by section #b4  7#b7 ,aggregate   
in=mation ab\t gr\p heal? plans & heal? 
insurance issu]s det]m9$ by !           
,secret>ies to be out ( compliance ) !  
requirem5ts = p>ity 9 m5tal heal? &     
sub/ance use disord] b5efits "u section 
#bgbf ( ! ,public ,heal? ,s]vice ,act   
7#db ,u4,s4,c4 #cjj;gg-#bf71 section    
#gab ( ! ,employee ,retirem5t ,income   
,security ,act ( #aigd 7#bi ,u4,s4,c4   

#aahe;a71 & section #ihab ( ! ,int]nal  
,rev5ue ,code ( #aihf1 z am5d$ by       
section #d4  7#c7 ,a summ>y ( f9d+s     
?r\gh audits1 9 ! aggregate1 "u section 
#bgii;,a-#e7;a77#g77;,c7 ( ! ,public    
,heal? ,s]vice ,act1 section            
#gbj7;a77#g77;,c7 ( ! ,employee         
,retirem5t ,income ,security ,act (     
#aigd1 & section #ihbj7;a77#g77;,c7 ( ! 
,int]nal ,rev5ue ,code ( #aihf1 z am5d$ 
by section #b1 includ+-- 7,a7 ! accuracy
 ( provid] directory in=mation1 section$
 out by accuracy ( ! provid]'s "n1      
address1 specialty1 telephone numb]1    
digital contact in=mation1 :e!r !       
provid]s are accept+ new pati5ts1       
9-network /atus1 l+ui/ic- &             
cultural-compet5cy1 & availability (    
m$ications = opioid use disord]2  7,b7 !
 numb] ( plans & individuals enroll$ 9 a
 gr\p heal? plan or gr\p or individual  
heal? insurance cov]age t (f]s a m5tal  
heal? & sub/ance use disord] network t  
meets ! network adequacy /&>ds "u1 z    
applicable1 section #bgii;,a-#e ( !     

,public ,heal? ,s]vice ,act1 section    
#gbj ( ! ,employee ,retirem5t ,income   
,security ,act ( #aigd1 or section #ihbj
 ( ! ,int]nal ,rev5ue ,code ( #aihf1 z  
am5d$ by section #b2 &  7,c7 ! numb] (  
individuals enroll$ 9 a gr\p heal? plan 
or gr\p or individual heal? insurance   
cov]age ) a gho/ network4  7#d7 ,a      
comp>ative analysis ( 9-network &       
out-(-network reimbursem5t rates = m5tal
 heal? & sub/ance use disord] s]vices   
comp>$ to m$ical & surgical s]vices by  
gr\p heal? plans & heal? insurance      
issu]s4  7b7 ,def9ition ,9 ?is section1 
! t]m gho/ network has ! mean+ giv5 su* 
t]m 9 section #bgii;,a-#e7;a77#h7 ( !   
,public ,heal? ,s]vice ,act1 section    
#gbj7;a77#h7 ( ! ,employee ,retirem5t   
,income ,security ,act ( #aigd1 &       
section #ihbj7;a77#h7 ( ! ,int]nal      
,rev5ue ,code ( #aihf1 z am5d$ by       
section #b4  #g4 ,au?orization (        
appropriations  7a7 ,adm9i/rative       
functions ,to c>ry out sections #d1 #e1 
& #f1 includ+ ! am5dm5ts made by su*    

sections1 !re are au?oriz$ to be        
appropriat$ to ! ,secret>y ( ,heal? &   
,human ,s]vices1 ! ,secret>y ( ,labor1 &
 ! ,secret>y ( ! ,treasury su* sums z   
may be necess>y4  7b7 ,protect+ pati5ts 
& improv+ ! accuracy ( provid] directory
 in=mation ,to c>ry out section #b1     
includ+ ! am5dm5ts made by su* section1 
9 addition to am\nts o!rwise made       
available = su* purposes1 !re are       
au?oriz$ to be appropriat$-- 7#a7 to !  
,secret>y ( ,heal? & ,human ,s]vices1 = 
purposes ( c>ry+ out ! am5dm5ts made by 
subsection 7a7 ( su* section-- 7,a7     
#ae1bjj1jjj = ea* ( fiscal ye>s #bjbe & 
#bjbf2  7,b7 #ag1jjj1jjj = fiscal ye>   
#bjbg2 &  7,c7 #aj1jjj1jjj = fiscal ye> 
#bjbh & ea* fiscal ye> !reaft]2 &  7#b7 
to ! ,secret>y ( ,labor1 = purposes (   
c>ry+ out ! am5dm5ts made by subsection 
7b7 ( su* section1 #bb1jjj1jjj = fiscal 
ye> #bjbe & ea* fiscal ye> !reaft]4