II 

118TH CONGRESS 

2D SESSION S. 5524 

To provide for civil monetary penalties for violations of mental health parity 

requirements. 

IN THE SENATE OF THE UNITED STATES 

DECEMBER 12, 2024 

Mr. MURPHY (for himself, Ms. SMITH, and Mr. LUJA ́N) introduced the following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To provide for civil monetary penalties for violations of 

mental health parity requirements. 

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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Parity Enforcement 

5 Act of 2024’’. 

6 SEC. 2. LIABILITY FOR, ENFORCEMENT OF, AND CIVIL MON7 ETARY PENALTIES FOR PARITY VIOLATIONS. 

8 (a) PHSA.— 


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1 (1) IN GENERAL.—Section 2726(a) of the Pub2 lic Health Service Act (42 U.S.C. 300gg–26(a)) is 

3 amended by adding at the end the following: 

4 ‘‘(9) SERVICE PROVIDER LIABILITY.—In the 

5 case of a violation of this section by a group health 

6 plan or a health insurance issuer offering group or 

7 individual health insurance coverage— 

8 ‘‘(A) a plan sponsor or a service provider, 

9 including any third-party administrator, man10 aged behavioral health organization, or entity 

11 providing pharmacy benefit management serv12 ices, of such plan or coverage that causes or 

13 contributes to such violation shall also be liable 

14 for such violation; and 

15 ‘‘(B) the Secretary shall have the discre16 tion to determine the percentage of liability of 

17 between the plan, issuer, sponsor, and service 

18 provider, as applicable.’’. 

19 (2) ENFORCEMENT.—Section 2723 of the Pub20 lic Health Service Act (42 U.S.C. 300gg–22) is 

21 amended— 

22 (A) in subsection (a)— 

23 (i) in paragraph (1), by adding at the 

24 end the following: ‘‘In the case of the re25 quirements of subsection (a) of section 


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1 2726 with respect to parity in mental 

2 health and substance use disorder benefits, 

3 each State may require that plan sponsors 

4 or service providers, including any third5 party administrator, managed behavioral 

6 health organization, or entity providing 

7 pharmacy benefit management services, of 

8 such coverage meet such requirements.’’; 

9 and 

10 (ii) in paragraph (2), by inserting ‘‘, 

11 plan sponsors, or service providers, includ12 ing any third-party administrator, man13 aged behavioral health organization, or en14 tity providing pharmacy benefit manage15 ment services,’’ after ‘‘health insurance 

16 issuers’’; and 

17 (B) in subsection (b)(3)— 

18 (i) in the heading, by striking ‘‘GE19 NETIC INFORMATION’’ and inserting ‘‘GE20 NETIC INFORMATION AND PARITY IN MEN21 TAL HEALTH AND SUBSTANCE USE DIS22 ORDER BENEFITS’’; and 

23 (ii) in subparagraph (A), by striking 

24 ‘‘any failure’’ and all that follows through 

25 ‘‘in connection with the plan.’’ and insertVerDate Sep 11 2014 19:10 Jan 20, 2025 Jkt 059200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S5524.IS S5524

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1 ing the following: ‘‘any failure of a health 

2 insurance issuer or a plan sponsor or any 

3 participation in such failure by a service 

4 provider, including any third-party admin5 istrator, managed behavioral health organi6 zation, or entity providing pharmacy ben7 efit management services, in connection 

8 with a group health plan— 

9 ‘‘(i) to meet the requirements of sub10 section (a)(1)(F), (b)(3), (c), or (d) of sec11 tion 2702 or section 2701 or 2702(b)(1) 

12 with respect to genetic information; or 

13 ‘‘(ii) to meet the requirements of sub14 section (a) of section 2726 with respect to 

15 parity in mental health and substance use 

16 disorder benefits.’’. 

17 (b) ERISA.— 

18 (1) IN GENERAL.—Section 712(a) of the Em19 ployee Retirement Income Security Act of 1974 (29 

20 U.S.C. 1185a(a)) is amended by adding at the end 

21 the following: 

22 ‘‘(9) SERVICE PROVIDER LIABILITY.—In the 

23 case of a violation of this section by a group health 

24 plan or a health insurance issuer offering group 

25 health insurance coverage— 


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1 ‘‘(A) a plan sponsor or a service provider, 

2 including any third-party administrator, man3 aged behavioral health organization, or entity 

4 providing pharmacy benefit management serv5 ices, of such plan or coverage that causes or 

6 contributes to such violation shall also be liable 

7 for such violation; and 

8 ‘‘(B) the Secretary shall have the discre9 tion to determine the percentage of liability of 

10 between the plan, issuer, sponsor, and service 

11 provider, as applicable.’’. 

12 (2) ENFORCEMENT.—Section 502 of the Em13 ployee Retirement Income Security Act of 1974 (29 

14 U.S.C. 1132) is amended— 

15 (A) in subsection (a), by striking para16 graph (6) and inserting the following: 

17 ‘‘(6) by the Secretary to collect any civil penalty 

18 under this section’’; 

19 (B) in subsection (b)(3)— 

20 (i) by striking ‘‘subsections (c)(9) and 

21 (a)(6)’’ and inserting ‘‘subsections (c)(9), 

22 (c)(10), and (a)(6)’’; and 

23 (ii) by striking ‘‘under subsection 

24 (c)(9))’’ and inserting ‘‘under subsections 

25 (c)(9) and (c)(10)), and except with reVerDate Sep 11 2014 19:10 Jan 20, 2025 Jkt 059200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S5524.IS S5524

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1 spect to enforcement by the Secretary of 

2 section 712’’; and 

3 (C) in subsection (c)(10)— 

4 (i) in the heading, by striking ‘‘USE

5 OF GENETIC INFORMATION’’ and inserting 

6 ‘‘USE OF GENETIC INFORMATION AND PAR7 ITY IN MENTAL HEALTH AND SUBSTANCE

8 USE DISORDER BENEFITS’’; and 

9 (ii) in subparagraph (A)— 

10 (I) by striking ‘‘any plan sponsor 

11 of a group health plan’’ and inserting 

12 ‘‘any plan sponsor or service provider, 

13 including any third-party adminis14 trator, managed behavioral health or15 ganization, or entity providing phar16 macy benefit management services, of 

17 a group health plan’’; and 

18 (II) by striking ‘‘for any failure’’ 

19 and all that follows through ‘‘in con20 nection with the plan.’’ and inserting 

21 the following: ‘‘for any failure by such 

22 sponsor or issuer, or by participation 

23 in such failure by a service provider, 

24 in connection with the plan— ‘‘ 


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1 ‘‘(i) to meet the requirements of sub2 section (a)(1)(F), (b)(3), (c), or (d) of sec3 tion 702 or section 701 or 702(b)(1) with 

4 respect to genetic information; or 

5 ‘‘(ii) to meet the requirements of sub6 section (a) of section 712 with respect to 

7 parity in mental health and substance use 

8 disorder benefits.’’. 

9 (c) IRC.— 

10 (1) IN GENERAL.—Section 9812(a) of the In11 ternal Revenue Code of 1986 is amended by adding 

12 at the end the following: 

13 ‘‘(9) SERVICE PROVIDER LIABILITY.—In the 

14 case of a violation of this section by a group health 

15 plan— 

16 ‘‘(A) a plan sponsor or a service provider, 

17 including any third-party administrator, man18 aged behavioral health organization, or entity 

19 providing pharmacy benefit management serv20 ices, of such plan that causes or contributes to 

21 such violation shall also be liable for such viola22 tion; and 

23 ‘‘(B) the Secretary shall have the discre24 tion to determine the percentage of liability of 


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1 between the plan, sponsor, and service provider, 

2 as applicable.’’. 

3 (2) ENFORCEMENT.—Section 4980D of such 

4 Code is amended by adding at the end the following 

5 new subsection: 

6 ‘‘(g) APPLICATION TO SERVICE PROVIDERS.—In the 

7 case of a failure of a group health plan to meet the re8 quirements of section 9812, any reference in this section 

9 to such group health plan (and the reference in subsection 

10 (e)(1) to the employer) shall be treated as including a ref11 erence to any person made liable for such failure by sec12 tion 9812(a)(9).’’. 

13 (d) EFFECTIVE DATE.—The amendments made by 

14 this section (other than the amendments made by sub15 paragraphs (A) and (B) of subsection (b)(2)) shall apply 

16 with respect to plan years beginning after the date that 

17 is 1 year after the date of enactment of this Act. 

Æ 


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