I 

118TH CONGRESS 

2D SESSION H. R. 7140 

To amend the Public Health Service Act, the Employee Retirement Income 

Security Act of 1974, and the Internal Revenue Code of 1986 to require 

group health plans and health insurance issuers offering group or individual health insurance coverage to disclose the percentage of in-network 

participation for certain provider types, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 30, 2024 

Mr. HORSFORD introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on 

Ways and Means, and Education and the Workforce, for a period to be 

subsequently determined by the Speaker, in each case for consideration 

of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal 

Revenue Code of 1986 to require group health plans 

and health insurance issuers offering group or individual 

health insurance coverage to disclose the percentage of 

in-network participation for certain provider types, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Mental Health Trans3 parency Act’’. 

4 SEC. 2. REQUIRING DISCLOSURE OF PERCENTAGE OF IN5 NETWORK PARTICIPATION FOR CERTAIN 

6 PROVIDER TYPES. 

7 (a) PHSA.—Part D of title XXVII of the Public 

8 Health Service Act (42 U.S.C. 300g–111 et seq.) is 

9 amended by adding at the end the following new section: 

10 ‘‘SEC. 2799A–11. REQUIRED DISCLOSURE OF PERCENTAGE 

11 OF IN-NETWORK PARTICIPATION FOR CER12 TAIN PROVIDER TYPES. 

13 ‘‘(a) IN GENERAL.—A group health plan and a health 

14 insurance issuer offering group or individual health insur15 ance coverage shall, along with any summary of benefits 

16 and coverage provided under section 2715 (and in accord17 ance with the timing and manner specified under such sec18 tion and the implementing regulations of such section), 

19 and on the public website of such plan or issuer, make 

20 available the following information with respect to each 

21 type of provider specified in subsection (b): 

22 ‘‘(1) The number and percentage of providers 

23 of such type located in the service area of such plan 

24 or coverage that have a contractual relationship (as 

25 defined by the Secretary) in effect with such plan or 

26 coverage for furnishing items and services under 


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1 such plan or coverage, determined in accordance 

2 with information made available by the Secretary 

3 under subsection (d). 

4 ‘‘(2) The designation established by the Sec5 retary under subsection (c) corresponding to the per6 centage described in paragraph (1). 

7 ‘‘(b) SPECIFIED PROVIDERS.—For purposes of this 

8 section, the types of providers and facilities specified in 

9 this subsection are the following (as defined by the Sec10 retary and broken down by subspecialty as specified by 

11 the Secretary): 

12 ‘‘(1) Behavioral health care providers and facili13 ties. 

14 ‘‘(2) Substance use disorder treatment pro15 viders and facilities. 

16 ‘‘(c) ESTABLISHMENT OF DESIGNATIONS OF IN-NET17 WORK PARTICIPATION.— 

18 ‘‘(1) IN GENERAL.—Not later than 1 year after 

19 the date of the enactment of this section, the Sec20 retary, in consultation with the Secretaries of Labor 

21 and of the Treasury, shall establish a system of des22 ignations (such as ‘high’, ‘medium’, and ‘low’, a star 

23 rating, or such other designation determined appro24 priate by the Secretary) that correspond to ranges of 

25 percentages (from 0 to 100) described in subsection 


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1 (a)(1) to qualitatively reflect the breadth of the net2 works of group health plans and group and indi3 vidual health insurance coverage with respect to 

4 each type of provider specified in subsection (b). 

5 ‘‘(2) VARIATION PERMITTED.—Designations 

6 corresponding to percentage ranges established 

7 under paragraph (1) may vary by type of service 

8 area (such as rural or urban), size of service area, 

9 and other factors determined appropriate by the 

10 Secretary in consultation with the Secretaries of 

11 Labor and of the Treasury. 

12 ‘‘(d) INFORMATION ON PROVIDERS.— 

13 ‘‘(1) IN GENERAL.—Not later than June 30, 

14 2026, the Secretary, in consultation with the Secre15 taries of Labor and of the Treasury, shall, based on 

16 information submitted under section 2799B–10, post 

17 on the public website of the Department of Health 

18 and Human Services, a list of each specified pro19 vider in the country, including— 

20 ‘‘(A) the location of each such provider in 

21 which such provider furnishes items and serv22 ices; 

23 ‘‘(B) each specialty designation (if any) of 

24 each such provider; 


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1 ‘‘(C) whether such provider treats individ2 uals under the age of 19; and 

3 ‘‘(D) whether such provider accepts tele4 health appointments. The Secretary shall up5 date the information published under the pre6 vious sentence not less frequently than annu7 ally. 

8 The Secretary shall update the information pub9 lished under this paragraph not less frequently than 

10 annually. 

11 ‘‘(2) TREATMENT OF GROUP PRACTICES.—For 

12 purposes of the list described in paragraph (1), the 

13 Secretary shall list each individual health care pro14 vider separately, regardless of whether such provider 

15 is part of a group practice. 

16 ‘‘(e) SERVICE AREA DEFINITION.—For purposes of 

17 this section, the term ‘service area’ means, with respect 

18 to a group health plan and group or individual health in19 surance coverage, the area or areas in which in-person 

20 participants and beneficiaries are covered, as determined 

21 by the plan or issuer of such coverage in accordance with 

22 rules specified by the Secretary in consultation with the 

23 Secretaries of Labor and of the Treasury.’’. 

24 (b) ERISA.— 


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1 (1) IN GENERAL.—Subpart B of part 7 of sub2 title B of title I of the Employee Retirement Income 

3 Security Act of 1974 is amended by adding at the 

4 end the following new section: 

5 ‘‘SEC. 726. REQUIRED DISCLOSURE OF PERCENTAGE OF IN6 NETWORK PARTICIPATION FOR CERTAIN 

7 PROVIDER TYPES. 

8 ‘‘(a) IN GENERAL.—A group health plan and a health 

9 insurance issuer offering group health insurance coverage 

10 shall, along with any summary of benefits and coverage 

11 provided under section 2715 of the Public Health Service 

12 Act (and in accordance with the timing and manner speci13 fied under such section and the implementing regulations 

14 of such section), and on the public website of such plan 

15 or issuer, make available the following information with 

16 respect to each type of provider specified in subsection (b): 

17 ‘‘(1) The number and percentage of providers 

18 of such type located in the service area of such plan 

19 or coverage that have a contractual relationship (as 

20 defined by the Secretary) in effect with such plan or 

21 coverage for furnishing items and services under 

22 such plan or coverage, determined in accordance 

23 with information made available by the Secretary 

24 under subsection (d). 


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1 ‘‘(2) The designation established by the Sec2 retary under subsection (c) corresponding to the per3 centage described in paragraph (1). 

4 ‘‘(b) SPECIFIED PROVIDERS.—For purposes of this 

5 section, the types of providers and facilities specified in 

6 this subsection are the following (as defined by the Sec7 retary and broken down by subspecialty as specified by 

8 the Secretary): 

9 ‘‘(1) Behavioral health care providers and facili10 ties. 

11 ‘‘(2) Substance use disorder treatment pro12 viders and facilities. 

13 ‘‘(c) ESTABLISHMENT OF DESIGNATIONS OF IN-NET14 WORK PARTICIPATION.— 

15 ‘‘(1) IN GENERAL.—Not later than 1 year after 

16 the date of the enactment of this section, the Sec17 retary, in consultation with the Secretaries of Health 

18 and Human Services and of the Treasury, shall es19 tablish a system of designations (such as ‘high’, ‘me20 dium’, and ‘low’, a star rating, or such other des21 ignation determined appropriate by the Secretary) 

22 that correspond to ranges of percentages (from 0 to 

23 100) described in subsection (a)(1) to qualitatively 

24 reflect the breadth of the networks of group health 

25 plans and group health insurance coverage with reVerDate Sep 11 2014 19:20 Feb 02, 2024 Jkt 049200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H7140.IH H7140

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1 spect to each type of provider specified in subsection 

2 (b). 

3 ‘‘(2) VARIATION PERMITTED.—Designations 

4 corresponding to percentage ranges established 

5 under paragraph (1) may vary by type of service 

6 area (such as rural or urban), size of service area, 

7 and other factors determined appropriate by the 

8 Secretary in consultation with the Secretaries of 

9 Health and Human Services and of the Treasury. 

10 ‘‘(d) INFORMATION ON PROVIDERS.— 

11 ‘‘(1) IN GENERAL.—Not later than June 30, 

12 2026, the Secretary, in consultation with the Secre13 taries of Health and Human Services and of the 

14 Treasury, shall, based on information submitted 

15 under section 2799B–10, post on the public website 

16 of the Department of Labor, a list of each specified 

17 provider in the country, including— 

18 ‘‘(A) the location of each such provider in 

19 which such provider furnishes items and serv20 ices; 

21 ‘‘(B) each specialty designation (if any) of 

22 each such provider; 

23 ‘‘(C) whether such provider treats individ24 uals under the age of 19; and 


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1 ‘‘(D) whether such provider accepts tele2 health appointments. The Secretary shall up3 date the information published under the pre4 vious sentence not less frequently than annu5 ally. 

6 The Secretary shall update the information pub7 lished under this paragraph not less frequently than 

8 annually. 

9 ‘‘(2) TREATMENT OF GROUP PRACTICES.—For 

10 purposes of the list described in paragraph (1), the 

11 Secretary shall list each individual health care pro12 vider separately, regardless of whether such provider 

13 is part of a group practice. 

14 ‘‘(e) SERVICE AREA DEFINITION.—For purposes of 

15 this section, the term ‘service area’ means, with respect 

16 to a group health plan and group health insurance cov17 erage, the area or areas in which in-person participants 

18 and beneficiaries are covered, as determined by the plan 

19 or issuer of such coverage in accordance with rules speci20 fied by the Secretary in consultation with the Secretaries 

21 of Health and Human Services and of the Treasury.’’. 

22 (2) TECHNICAL AMENDMENT.—The table of 

23 contents in section 1 of such Act is amended by in24 serting after the item relating to section 725 the fol25 lowing new item: 


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‘‘Sec. 726. Required disclosure of percentage of in-network participation for 

certain provider types.’’. 

1 (c) IRC.— 

2 (1) IN GENERAL.—Subchapter B of chapter 

3 100 of the Internal Revenue Code of 1986 is amend4 ed by adding at the end the following new section: 

5 ‘‘SEC. 9826. REQUIRED DISCLOSURE OF PERCENTAGE OF 

6 IN-NETWORK PARTICIPATION FOR CERTAIN 

7 PROVIDER TYPES. 

8 ‘‘(a) IN GENERAL.—A group health plan shall, along 

9 with any summary of benefits and coverage provided 

10 under section 2715 of the Public Health Service Act (and 

11 in accordance with the timing and manner specified under 

12 such section and the implementing regulations of such sec13 tion), and on the public website of such plan, make avail14 able the following information with respect to each type 

15 of provider specified in subsection (b): 

16 ‘‘(1) The number and percentage of providers 

17 of such type located in the service area of such plan 

18 that have a contractual relationship (as defined by 

19 the Secretary) in effect with such plan for furnishing 

20 items and services under such plan, determined in 

21 accordance with information made available by the 

22 Secretary under subsection (d). 


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1 ‘‘(2) The designation established by the Sec2 retary under subsection (c) corresponding to the per3 centage described in paragraph (1). 

4 ‘‘(b) SPECIFIED PROVIDERS.—For purposes of this 

5 section, the types of providers and facilities specified in 

6 this subsection are the following (as defined by the Sec7 retary and broken down by subspecialty as specified by 

8 the Secretary): 

9 ‘‘(1) Behavioral health care providers and facili10 ties. 

11 ‘‘(2) Substance use disorder treatment pro12 viders and facilities. 

13 ‘‘(c) ESTABLISHMENT OF DESIGNATIONS OF IN-NET14 WORK PARTICIPATION.— 

15 ‘‘(1) IN GENERAL.—Not later than 1 year after 

16 the date of the enactment of this section, the Sec17 retary, in consultation with the Secretaries of Health 

18 and Human Services and of Labor, shall establish a 

19 system of designations (such as ‘high’, ‘medium’, 

20 and ‘low’, a star rating, or such other designation 

21 determined appropriate by the Secretary) that cor22 respond to ranges of percentages (from 0 to 100) 

23 described in subsection (a)(1) to qualitatively reflect 

24 the breadth of the networks of group health plans 


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1 with respect to each type of provider specified in 

2 subsection (b). 

3 ‘‘(2) VARIATION PERMITTED.—Designations 

4 corresponding to percentage ranges established 

5 under paragraph (1) may vary by type of service 

6 area (such as rural or urban), size of service area, 

7 and other factors determined appropriate by the 

8 Secretary in consultation with the Secretaries of 

9 Health and Human Services and of Labor. 

10 ‘‘(d) INFORMATION ON PROVIDERS.— 

11 ‘‘(1) IN GENERAL.—Not later than June 30, 

12 2026, the Secretary, in consultation with the Secre13 taries of Health and Human Services and of Labor, 

14 shall, based on information submitted under section 

15 2799B–10, post on the public website of the Depart16 ment of the Treasury, a list of each specified pro17 vider in the country, including— 

18 ‘‘(A) the location of each such provider in 

19 which such provider furnishes items and serv20 ices; 

21 ‘‘(B) each specialty designation (if any) of 

22 each such provider; 

23 ‘‘(C) whether such provider treats individ24 uals under the age of 19; and 


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1 ‘‘(D) whether such provider accepts tele2 health appointments. The Secretary shall up3 date the information published under the pre4 vious sentence not less frequently than annu5 ally. 

6 The Secretary shall update the information pub7 lished under this paragraph not less frequently than 

8 annually. 

9 ‘‘(2) TREATMENT OF GROUP PRACTICES.—For 

10 purposes of the list described in paragraph (1), the 

11 Secretary shall list each individual health care pro12 vider separately, regardless of whether such provider 

13 is part of a group practice. 

14 ‘‘(e) SERVICE AREA DEFINITION.—For purposes of 

15 this section, the term ‘service area’ means, with respect 

16 to a group health plan, the area or areas in which in-per17 son participants and beneficiaries are covered, as deter18 mined by the plan in accordance with rules specified by 

19 the Secretary in consultation with the Secretaries of 

20 Health and Human Services and of Labor.’’. 

21 (2) TECHNICAL AMENDMENT.—The table of 

22 sections for such subchapter is amended by adding 

23 at the end the following new item: 

‘‘Sec. 9826. Required disclosure of percentage of in-network participation for 

certain provider types.’’. 


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1 (d) PROVIDER REQUIREMENTS.—Part E of title 

2 XXVII of the Public Health Service Act (42 U.S.C. 

3 300gg–131 et seq.) is amended by adding at the end the 

4 following new section: 

5 ‘‘SEC. 2799B–10. PROVISION OF CERTAIN INFORMATION TO 

6 THE SECRETARY. 

7 ‘‘(a) IN GENERAL.—Subject to subsection (b), in the 

8 case of a health care provider or health care facility that 

9 is a specified provider (as described in subsection (b) of 

10 section 2799A–11), such provider or facility shall, annu11 ally at a time and in a manner specified by the Secretary, 

12 provide to the Secretary such information as the Secretary 

13 determines necessary to carry out subsection (d) of such 

14 section. 

15 ‘‘(b) EXCEPTION.—Subsection (a) shall not apply in 

16 the case of a specified provider that has not, during the 

17 1-year period ending on the date that information de18 scribed in subsection (a) would be required to be sub19 mitted to the Secretary by such provider without applica20 tion of this subsection, submitted any claim for an item 

21 or service under a Federal health care program (as defined 

22 in section 1128B of the Social Security Act), the program 

23 established under chapter 89 of title 5, United States 

24 Code, or a group health plan or group or individual health 

25 insurance coverage.’’. 


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1 (e) REPORT.—Not later than December 31, 2027, 

2 and annually thereafter, the Secretary of Health and 

3 Human Services shall submit to Congress a report on the 

4 participation of behavioral health care and substance use 

5 disorder treatment providers in networks established by 

6 group health plan and health insurance issuers offering 

7 group or individual health insurance coverage (as such 

8 terms are defined in section 2791 of the Public Health 

9 Service Act (42 U.S.C. 300gg–91)). Each such report 

10 shall include data and analysis relating to service areas 

11 (as defined in section 2799A–11 of such Act) of such plans 

12 and issuers that the Secretary has identified as having low 

13 participation rates with respect to such providers’ partici14 pation in such networks. 

15 (f) IMPLEMENTATION.—The Secretaries of Labor, 

16 Health and Human Services, and the Treasury may imple17 ment the amendments made by this section through in18 terim final rule, subregulatory guidance, program instruc19 tion, or otherwise. 

20 (g) FUNDING.—In addition to amounts otherwise 

21 available for such purposes, there is appropriated 

22 $15,000,000, to remain available until expended, for pur23 poses of carrying out this section. 


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1 (h) EFFECTIVE DATE.—The amendments made by 

2 this section shall apply with respect to plan years begin3 ning on or after January 1, 2027. 

Æ 


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