II 

118TH CONGRESS 

2D SESSION S. 4023 

To further protect patients and improve the accuracy of provider directory 

information by eliminating ghost networks. 

IN THE SENATE OF THE UNITED STATES 

MARCH 21, 2024 

Ms. SMITH (for herself and Mr. WYDEN) introduced the following bill; which 

was read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

A BILL 

To further protect patients and improve the accuracy of 

provider directory information by eliminating ghost networks. 

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Behavioral Health Network and Directory Improvement 

6 Act’’. 

7 (b) TABLE OF CONTENTS.—The table of contents for 

8 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Protecting patients and improving the accuracy of provider directory information. 


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Sec. 3. Provider requirements to protect patients and improve the accuracy of 

provider directory information. 

Sec. 4. Strengthening mental health and substance use disorder parity requirements. 

Sec. 5. State and Tribal ombudsman programs relating to mental health and 

substance use disorder parity. 

Sec. 6. Report to Congress. 

Sec. 7. Authorization of appropriations. 

1 SEC. 2. PROTECTING PATIENTS AND IMPROVING THE AC2 CURACY OF PROVIDER DIRECTORY INFOR3 MATION. 

4 (a) PHSA.—Section 2799A–5 of the Public Health 

5 Service Act (42 U.S.C. 300gg–115) is amended— 

6 (1) in subsection (a)— 

7 (A) in paragraph (1)— 

8 (i) by striking ‘‘For plan years begin9 ning on or after January 1, 2022, each’’ 

10 and inserting ‘‘Each’’; 

11 (ii) in subparagraph (C), by striking 

12 ‘‘; and’’ and inserting a semicolon; 

13 (iii) in subparagraph (D), by striking 

14 the period and inserting ‘‘; and’’; and 

15 (iv) by adding at the end the fol16 lowing: 

17 ‘‘(E) ensure that any directory, including 

18 the database described in subparagraph (C), 

19 containing provider directory information with 

20 respect to such plan or such coverage complies 

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1 priate agencies in accordance with paragraph 

2 (6) in order to ensure that participants, bene3 ficiaries, and enrollees are able to identify ac4 tively participating health care providers and 

5 health care facilities.’’; 

6 (B) in paragraph (3)— 

7 (i) in the matter preceding subpara8 graph (A), by striking ‘‘, in the case such 

9 request is made through a telephone call’’; 

10 and 

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

12 ‘‘call is received, through a written elec13 tronic or print (as requested by such indi14 vidual) communication’’ and inserting ‘‘a 

15 request is received, by telephone, or 

16 through a written electronic or print com17 munication (as requested by such indi18 vidual)’’; 

19 (C) in paragraph (4)— 

20 (i) in subparagraph (A), by striking 

21 ‘‘and’’ at the end; 

22 (ii) in subparagraph (B), by striking 

23 the period and inserting ‘‘; and’’; and 

24 (iii) by adding at the end the fol25 lowing: 


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1 ‘‘(C) information, in plain language, con2 cerning the rights of the participant, bene3 ficiary, or enrollee to cost-sharing protections 

4 pursuant to subsection (b) in the event of reli5 ance on inaccurate provider network informa6 tion supplied by a group health plan or health 

7 insurance issuer, and contact information for, 

8 as appropriate, the State consumer assistance 

9 program or ombudsman or the Employee Bene10 fits Security Administration for more informa11 tion.’’; 

12 (D) in paragraph (5), by adding at the end 

13 the following: ‘‘Such information shall include a 

14 statement, in plain language, concerning the 

15 rights of the participant, beneficiary, or enrollee 

16 to cost-sharing protections pursuant to sub17 section (b) in the event of reliance on inac18 curate provider directory information supplied 

19 by a group health plan or health insurance 

20 issuer, and contact information for, as appro21 priate, the State consumer assistance program 

22 or ombudsman or the Employee Benefits Secu23 rity Administration for more information.’’; 

24 (E) by redesignating paragraphs (6) and 

25 (7) as paragraphs (8) and (9), respectively; 


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1 (F) by inserting after paragraph (5) the 

2 following: 

3 ‘‘(6) PROTECTING PARTICIPANTS, BENE4 FICIARIES, AND ENROLLEES FROM GHOST NET5 WORKS.—The Secretary, in collaboration with the 

6 Secretary of Labor and the Secretary of the Treas7 ury, shall— 

8 ‘‘(A) not later than 4 years after the date 

9 of enactment of the Behavioral Health Network 

10 and Directory Improvement Act, issue final reg11 ulations further defining the term ‘ghost net12 work’ (as defined in paragraph (8)); and 

13 ‘‘(B) not later than 4 years after the date 

14 of enactment of the Behavioral Health Network 

15 and Directory Improvement Act, issue final reg16 ulations, subregulatory guidance, or program 

17 instruction on how to assess ghost networks in 

18 health plan directories including reasonable as19 sumptions related to statistics and research 

20 methods. 

21 ‘‘(7) DATABASE REPORTING AND AUDITING TO

22 PROTECT AGAINST GHOST NETWORKS.— 

23 ‘‘(A) REPORTING REQUIREMENTS.—Begin24 ning not later than 3 years after the date of en25 actment of the Behavioral Health Network and 


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1 Directory Improvement Act, each group health 

2 plan and health insurance issuer offering group 

3 or individual health insurance coverage shall 

4 submit to the Secretary, at such time as the 

5 Secretary, in coordination with the Secretary of 

6 Labor and the Secretary of the Treasury, shall 

7 require, but not less frequently than annually, 

8 the directory data described in paragraph 

9 (a)(4), in a machine readable format (as de10 fined in section 147.210(a)(2)(xiv) of title 45, 

11 Code of Federal Regulations (or any successor 

12 regulations)). A health insurance issuer or a 

13 third party administrator of a group health 

14 plan may submit such information for all health 

15 insurance coverage or all group health plans, 

16 collectively, that such issuer or administrator 

17 administers. The Secretary, in coordination 

18 with the Secretary of Labor and the Secretary 

19 of the Treasury, shall make data submitted 

20 under this subparagraph available on a public 

21 website. 

22 ‘‘(B) PROVIDER DIRECTORY INDEPENDENT

23 AUDIT REQUIREMENTS.— 

24 ‘‘(i) IN GENERAL.—Beginning not 

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1 ment of the Behavioral Health Network 

2 and Directory Improvement Act, each 

3 group health plan and health insurance 

4 issuer offering group or individual health 

5 insurance coverage shall conduct an annual 

6 directory audit, through an independent 

7 entity not associated with the health plan 

8 or issuer, that considers the factors de9 scribed in clause (ii)(I)(aa) and follows the 

10 guidelines developed under clause 

11 (ii)(I)(bb). 

12 ‘‘(ii) INFORMATION TO BE IN13 CLUDED.— 

14 ‘‘(I) IN GENERAL.—For purposes 

15 of carrying out the audits under this 

16 subparagraph, the Secretary shall— 

17 ‘‘(aa) develop a list of infor18 mation required to be included; 

19 and 

20 ‘‘(bb) provide guidelines for 

21 carrying out such audits, for use 

22 by group health plans and health 

23 insurance issuers, on— 

24 ‘‘(AA) the reasonable 

25 assumptions and research 


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1 methods to select a reason2 able sample in order to as3 sess provider directory infor4 mation accuracy; and 

5 ‘‘(BB) determining the 

6 criteria of an eligible audi7 tor. 

8 ‘‘(II) CONTENTS.—The informa9 tion listed under subclause (I)(aa) 

10 shall include the following: 

11 ‘‘(aa) The proportion of di12 rectory listings of the plan or 

13 coverage with inaccurate infor14 mation, including incorrect con15 tact information, as specified by 

16 the Secretary, during the audit 

17 period. 

18 ‘‘(bb) The number of in-net19 work items or services paid on 

20 behalf of participants, bene21 ficiaries, and enrollees in the plan 

22 or coverage to providers or facili23 ties who have a network provider 

24 contract with the health plan or 

25 issuer and were not listed in the 


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1 directory of the health plan or 

2 health insurance coverage for the 

3 audit period. 

4 ‘‘(cc) The resources of the 

5 plan or issuer to help partici6 pants, beneficiaries, and enrollees 

7 locate an accurately listed in-net8 work provider who is accepting 

9 new patients. 

10 ‘‘(dd) The proportion of par11 ticipants, beneficiaries, and en12 rollees using out-of-network pro13 viders for mental health and sub14 stance use disorder services, and 

15 the proportion of participants, 

16 beneficiaries, and enrollees using 

17 out-of-network providers and fa18 cilities for medical and surgical 

19 services. 

20 ‘‘(ee) Documentation that 

21 the plan or issuer verifies the ac22 curacy of the provider directory 

23 information every 90 days. 

24 ‘‘(ff) Other factors as deter25 mined by the Secretary. 


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1 ‘‘(iii) STANDARDS FOR REPORTING.— 

2 An audit under this subparagraph is com3 plete if all of the following conditions are 

4 met: 

5 ‘‘(I) The audit report includes 

6 the following: 

7 ‘‘(aa) A statement by the 

8 independent auditor that, to the 

9 best of the auditor’s knowledge, 

10 the report is complete and accu11 rate, and that reasonable as12 sumptions related to statistics 

13 and research methods have been 

14 complied with. 

15 ‘‘(bb) A statement explain16 ing the assumptions, statistics, 

17 and methods used to select the 

18 sample and assess provider direc19 tory information accuracy. 

20 ‘‘(cc) Such other require21 ments as the Secretary deter22 mines necessary. 

23 ‘‘(II) The group health plan or 

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1 pendent audit available on a public 

2 website. 

3 ‘‘(iv) RULEMAKING.—The Secretary, 

4 the Secretary of Labor, and the Secretary 

5 of the Treasury shall issue interim final 

6 regulations (without prior notice and com7 ment as generally required under section 

8 553 of title 5, United States Code) con9 cerning the national standards for con10 ducting audits under this subparagraph, 

11 not later than 2 years after the date of en12 actment of the Behavioral Health Network 

13 and Directory Improvement Act. 

14 ‘‘(C) AUDITS BY THE SECRETARY.— 

15 ‘‘(i) IN GENERAL.—Beginning not 

16 later than the fourth plan year after the 

17 date of enactment of the Behavioral 

18 Health Network and Directory Improve19 ment Act, the Secretary shall conduct an20 nual audits to ensure compliance with the 

21 auditing requirements under subparagraph 

22 (B). 

23 ‘‘(ii) SELECTION OF PLANS AND

24 ISSUERS.—The Secretary, the Secretary of 

25 Labor, and the Secretary of the Treasury 


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1 (referred to in this clause as the ‘Secre2 taries’), jointly, shall conduct annual au3 dits of the submissions under subpara4 graph (B) of a total of not fewer than 10 

5 group health plans or health insurance 

6 issuers offering group or individual health 

7 insurance coverage, as determined by the 

8 Secretaries, that are the subjects of com9 plaints about ghost networks or other com10 plaints, or that are randomly selected by 

11 the Secretaries.’’; and 

12 (G) in paragraph (8), as so redesignated— 

13 (i) in the paragraph heading, by strik14 ing ‘‘DEFINITION’’ and inserting ‘‘DEFINI15 TIONS’’; 

16 (ii) by striking ‘‘For purposes of this 

17 subsection, the term’’ and inserting the fol18 lowing: ‘‘For purposes of this subsection: 

19 ‘‘(A) PROVIDER DIRECTORY INFORMA20 TION.—The term’’; 

21 (iii) by striking ‘‘health insurance cov22 erage, the name, address’’ and inserting 

23 ‘‘health insurance coverage— 

24 ‘‘(i) the name, address where the pro25 vider regularly sees patients’’; 


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1 (iv) by striking the period and insert2 ing ‘‘; and’’; and 

3 (v) by adding at the end the following: 

4 ‘‘(ii) with respect to each such pro5 vider or facility— 

6 ‘‘(I) whether such provider or fa7 cility is accepting new patients; 

8 ‘‘(II) the languages spoken and 

9 the availability of language translators 

10 for specified languages at each health 

11 care facility listed in the directory; 

12 ‘‘(III) whether the provider or fa13 cility offers medication-assisted treat14 ment for opioid use disorder; 

15 ‘‘(IV) the State license number; 

16 ‘‘(V) the national provider identi17 fier; 

18 ‘‘(VI) the age groups served by 

19 the provider or facility, such as pedi20 atric, adolescent, adult, or geriatric 

21 populations; 

22 ‘‘(VII) whether such provider or 

23 facility offers in-person services, tele24 health services, or both; 


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1 ‘‘(VIII) the cost-sharing tier, if 

2 applicable; and 

3 ‘‘(IX) health insurance plans ac4 cepted (including the plan identifier 

5 and type of plan). 

6 ‘‘(B) GHOST NETWORK.—The term ‘ghost 

7 network’ means a group health plan or group or 

8 individual health insurance coverage for which 

9 the provider directory information describing 

10 the network of such plan or coverage— 

11 ‘‘(i) includes inaccurate contact infor12 mation with respect to a substantial share 

13 of included listings and providers who are 

14 part of the network; 

15 ‘‘(ii) includes a substantial number of 

16 providers and facilities (as specified by the 

17 Secretary, in coordination with the Sec18 retary of Labor and the Secretary of the 

19 Treasury) in a specialty who are not ac20 cepting new patients within a time period 

21 specified by such secretaries; 

22 ‘‘(iii) includes a substantial number of 

23 providers and facilities that are not part of 

24 the network; or 


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1 ‘‘(iv) omits a substantial number of 

2 providers and facilities that are part of the 

3 network.’’; and 

4 (2) in subsection (b)— 

5 (A) in paragraph (1), by striking ‘‘and if 

6 either of the criteria described in paragraph (2) 

7 applies with respect to such participant, bene8 ficiary, or enrollee and item or service’’; and 

9 (B) by striking paragraph (2) and insert10 ing the following: 

11 ‘‘(2) RECONCILIATION REQUIREMENT.—If a 

12 nonparticipating provider was listed as a partici13 pating provider in the posted provider directory 

14 database, the group health plan or health insurance 

15 issuer shall, not later than 30 days after receiving 

16 the request for payment, notify the participant, ben17 eficiary, or enrollee, in plain language, that the par18 ticipant, beneficiary, or enrollee may be eligible for 

19 a refund from the group health plan or health insur20 ance issuer if such participant, beneficiary, or en21 rollee paid the out of network cost-sharing and did 

22 not receive a refund under section 2799B–9(b).’’. 

23 (b) ERISA.— 


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1 (1) IN GENERAL.—Section 720 of the Employee 

2 Retirement Income Security Act of 1974 (29 U.S.C. 

3 1185i) is amended— 

4 (A) in subsection (a)— 

5 (i) in paragraph (1)— 

6 (I) by striking ‘‘For plan years 

7 beginning on or after January 1, 

8 2022, each’’ and inserting ‘‘Each’’; 

9 (II) in subparagraph (C), by 

10 striking ‘‘; and’’ and inserting a semi11 colon; 

12 (III) in subparagraph (D), by 

13 striking the period and inserting ‘‘; 

14 and’’; and 

15 (IV) by adding at the end the fol16 lowing: 

17 ‘‘(E) ensure that any directory, including 

18 the database described in subparagraph (C), 

19 containing provider directory information with 

20 respect to such plan or such coverage complies 

21 with the requirements developed by the appro22 priate agencies in accordance with paragraph 

23 (6) in order to ensure that participants, bene24 ficiaries, and enrollees are able to identify acVerDate Sep 11 2014 02:07 Apr 06, 2024 Jkt 049200 PO 00000 Frm 00016 Fmt 6652 Sfmt 6201 E:\BILLS\S4023.IS S4023

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1 tively participating health care providers and 

2 health care facilities.’’; 

3 (ii) in paragraph (3)— 

4 (I) in the matter preceding sub5 paragraph (A), by striking ‘‘, in the 

6 case such request is made through a 

7 telephone call’’; and 

8 (II) in subparagraph (A), by 

9 striking ‘‘call is received, through a 

10 written electronic or print (as re11 quested by such individual) commu12 nication’’ and inserting ‘‘a request is 

13 received, by telephone, or through a 

14 written electronic or print communica15 tion (as requested by such indi16 vidual)’’; 

17 (iii) in paragraph (4)— 

18 (I) in subparagraph (A), by strik19 ing ‘‘and’’ at the end; 

20 (II) in subparagraph (B), by 

21 striking the period and inserting ‘‘; 

22 and’’; and 

23 (III) by adding at the end the 

24 following: 


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1 ‘‘(C) information, in plain language, con2 cerning the rights of the participant, bene3 ficiary, or enrollee to cost-sharing protections 

4 pursuant to subsection (b) in the event of reli5 ance on inaccurate provider network informa6 tion supplied by a group health plan or health 

7 insurance issuer, and contact information for, 

8 as appropriate, the State consumer assistance 

9 program or ombudsman or the Employee Bene10 fits Security Administration for more informa11 tion.’’; 

12 (iv) in paragraph (5), by adding at 

13 the end the following: ‘‘Such information 

14 shall include a statement, in plain lan15 guage, concerning the rights of the partici16 pant, beneficiary, or enrollee to cost-shar17 ing protections pursuant to subsection (b) 

18 in the event of reliance on inaccurate pro19 vider directory information supplied by a 

20 group health plan or health insurance 

21 issuer, and contact information for, as ap22 propriate, the State consumer assistance 

23 program or ombudsman or the Employee 

24 Benefits Security Administration for more 

25 information.’’; 


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1 (v) by redesignating paragraphs (6) 

2 and (7) as paragraphs (8) and (9), respec3 tively; 

4 (vi) by inserting after paragraph (5) 

5 the following: 

6 ‘‘(6) PROTECTING PARTICIPANTS, BENE7 FICIARIES, AND ENROLLEES FROM GHOST NET8 WORKS.—The Secretary, in collaboration with the 

9 Secretary of Labor and the Secretary of the Treas10 ury, shall— 

11 ‘‘(A) not later than 4 years after the date 

12 of enactment of the Behavioral Health Network 

13 and Directory Improvement Act, issue final reg14 ulations further defining the term ‘ghost net15 work’ (as defined in paragraph (8)); and 

16 ‘‘(B) not later than 4 years after the date 

17 of enactment of the Behavioral Health Network 

18 and Directory Improvement Act, issue final reg19 ulations, subregulatory guidance, or program 

20 instruction on how to assess ghost networks in 

21 health plan directories including reasonable as22 sumptions related to statistics and research 

23 methods. 

24 ‘‘(7) DATABASE REPORTING AND AUDITING TO

25 PROTECT AGAINST GHOST NETWORKS.— 


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1 ‘‘(A) REPORTING REQUIREMENTS.—Begin2 ning not later than 3 years after the date of en3 actment of the Behavioral Health Network and 

4 Directory Improvement Act, each group health 

5 plan and health insurance issuer offering group 

6 health insurance coverage shall submit to the 

7 Secretary, at such time as the Secretary, in co8 ordination with the Secretary of Health and 

9 Human Services and the Secretary of the 

10 Treasury, shall require, but not less frequently 

11 than annually, the directory data described in 

12 paragraph (a)(4), in a machine readable format 

13 (as defined in section 147.210(a)(2)(xiv) of title 

14 45, Code of Federal Regulations (or any suc15 cessor regulations)). A health insurance issuer 

16 or a third party administrator of a group health 

17 plan may submit such information for all health 

18 insurance coverage or all group health plans, 

19 collectively, that such issuer or administrator 

20 administers. The Secretary, in coordination 

21 with the Secretary of Health and Human Serv22 ices and the Secretary of the Treasury, shall 

23 make data submitted under this subparagraph 

24 available on a public website. 


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1 ‘‘(B) PROVIDER DIRECTORY INDEPENDENT

2 AUDIT REQUIREMENTS.— 

3 ‘‘(i) IN GENERAL.—Beginning not 

4 later than 3 years after the date of enact5 ment of the Behavioral Health Network 

6 and Directory Improvement Act, each 

7 group health plan and health insurance 

8 issuer offering group health insurance cov9 erage shall conduct an annual directory 

10 audit, through an independent entity not 

11 associated with the health plan or issuer, 

12 that considers the factors described in 

13 clause (ii)(I)(aa) and follows the guidelines 

14 developed under clause (ii)(I)(bb). 

15 ‘‘(ii) INFORMATION TO BE IN16 CLUDED.— 

17 ‘‘(I) IN GENERAL.—For purposes 

18 of carrying out the audits under this 

19 subparagraph, the Secretary shall— 

20 ‘‘(aa) develop a list of infor21 mation required to be included; 

22 and 

23 ‘‘(bb) provide guidelines for 

24 carrying out such audits, for use 


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1 by group health plans and health 

2 insurance issuers, on— 

3 ‘‘(AA) the reasonable 

4 assumptions and research 

5 methods to select a reason6 able sample in order to as7 sess provider directory infor8 mation accuracy; and 

9 ‘‘(BB) determining the 

10 criteria of an eligible audi11 tor. 

12 ‘‘(II) CONTENTS.—The informa13 tion listed under subclause (I)(aa) 

14 shall include the following: 

15 ‘‘(aa) The proportion of di16 rectory listings of the plan or 

17 coverage with inaccurate infor18 mation, including incorrect con19 tact information, as specified by 

20 the Secretary, during the audit 

21 period. 

22 ‘‘(bb) The number of in-net23 work items or services paid on 

24 behalf of participants, bene25 ficiaries, and enrollees in the plan 


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1 or coverage to providers or facili2 ties who have a network provider 

3 contract with the health plan or 

4 issuer and were not listed in the 

5 directory of the health plan or 

6 health insurance coverage for the 

7 audit period. 

8 ‘‘(cc) The resources of the 

9 plan or issuer to help partici10 pants, beneficiaries, and enrollees 

11 locate an accurately listed in-net12 work provider who is accepting 

13 new patients. 

14 ‘‘(dd) The proportion of par15 ticipants, beneficiaries, and en16 rollees using out-of-network pro17 viders for mental health and sub18 stance use disorder services, and 

19 the proportion of participants, 

20 beneficiaries, and enrollees using 

21 out-of-network providers and fa22 cilities for medical and surgical 

23 services. 

24 ‘‘(ee) Documentation that 

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1 curacy of the provider directory 

2 information every 90 days. 

3 ‘‘(ff) Other factors as deter4 mined by the Secretary. 

5 ‘‘(iii) STANDARDS FOR REPORTING.— 

6 An audit under this subparagraph is com7 plete if all of the following conditions are 

8 met: 

9 ‘‘(I) The audit report includes 

10 the following: 

11 ‘‘(aa) A statement by the 

12 independent auditor that, to the 

13 best of the auditor’s knowledge, 

14 the report is complete and accu15 rate, and that reasonable as16 sumptions related to statistics 

17 and research methods have been 

18 complied with. 

19 ‘‘(bb) A statement explain20 ing the assumptions, statistics, 

21 and methods used to select the 

22 sample and assess provider direc23 tory information accuracy. 


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1 ‘‘(cc) Such other require2 ments as the Secretary deter3 mines necessary. 

4 ‘‘(II) The group health plan or 

5 health insurer issuer makes the inde6 pendent audit available on a public 

7 website. 

8 ‘‘(iv) RULEMAKING.—The Secretary, 

9 the Secretary of Health and Human Serv10 ices, and the Secretary of the Treasury 

11 shall issue interim final regulations (with12 out prior notice and comment as generally 

13 required under section 553 of title 5, 

14 United States Code) concerning the na15 tional standards for conducting audits 

16 under this subparagraph, not later than 2 

17 years after the date of enactment of the 

18 Behavioral Health Network and Directory 

19 Improvement Act. 

20 ‘‘(C) AUDITS BY THE SECRETARY.— 

21 ‘‘(i) IN GENERAL.—Beginning not 

22 later than the fourth plan year after the 

23 date of enactment of the Behavioral 

24 Health Network and Directory Improve25 ment Act, the Secretary shall conduct anVerDate Sep 11 2014 02:07 Apr 06, 2024 Jkt 049200 PO 00000 Frm 00025 Fmt 6652 Sfmt 6201 E:\BILLS\S4023.IS S4023

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1 nual audits to ensure compliance with the 

2 auditing requirements under subparagraph 

3 (B). 

4 ‘‘(ii) SELECTION OF PLANS AND

5 ISSUERS.—The Secretary, the Secretary of 

6 Health and Human Services, and the Sec7 retary of the Treasury (referred to in this 

8 clause as the ‘Secretaries’), jointly, shall 

9 conduct annual audits of the submissions 

10 under subparagraph (B) of a total of not 

11 fewer than 10 group health plans or health 

12 insurance issuers offering group health in13 surance coverage, as determined by the 

14 Secretaries, that are the subjects of com15 plaints about ghost networks or other com16 plaints, or that are randomly selected by 

17 the Secretaries.’’; and 

18 (vii) in paragraph (8), as so redesig19 nated— 

20 (I) in the paragraph heading, by 

21 striking ‘‘DEFINITION’’ and inserting 

22 ‘‘DEFINITIONS’’; 

23 (II) by striking ‘‘For purposes of 

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1 ing the following: ‘‘For purposes of 

2 this subsection: 

3 ‘‘(A) PROVIDER DIRECTORY INFORMA4 TION.—The term’’; 

5 (III) by striking ‘‘health insur6 ance coverage, the name, address’’ 

7 and inserting ‘‘health insurance cov8 erage— 

9 ‘‘(i) the name, address where the pro10 vider regularly sees patients’’; 

11 (IV) by striking the period and 

12 inserting ‘‘; and’’; and 

13 (V) by adding at the end the fol14 lowing: 

15 ‘‘(ii) with respect to each such pro16 vider or facility— 

17 ‘‘(I) whether such provider or fa18 cility is accepting new patients; 

19 ‘‘(II) the languages spoken and 

20 the availability of language translators 

21 for specified languages at each health 

22 care facility listed in the directory; 

23 ‘‘(III) whether the provider or fa24 cility offers medication-assisted treat25 ment for opioid use disorder; 


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1 ‘‘(IV) the State license number; 

2 ‘‘(V) the national provider identi3 fier; 

4 ‘‘(VI) the age groups served by 

5 the provider or facility, such as pedi6 atric, adolescent, adult, or geriatric 

7 populations; 

8 ‘‘(VII) whether such provider or 

9 facility offers in-person services, tele10 health services, or both; 

11 ‘‘(VIII) the cost-sharing tier, if 

12 applicable; and 

13 ‘‘(IX) health insurance plans ac14 cepted (including the plan identifier 

15 and type of plan). 

16 ‘‘(B) GHOST NETWORK.—The term ‘ghost 

17 network’ means a group health plan or group 

18 health insurance coverage for which the pro19 vider directory information describing the net20 work of such plan or coverage— 

21 ‘‘(i) includes inaccurate contact infor22 mation with respect to a substantial share 

23 of included listings and providers who are 

24 part of the network; 


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1 ‘‘(ii) includes a substantial number of 

2 providers and facilities (as specified by the 

3 Secretary, in coordination with the Sec4 retary of Health and Human Services and 

5 the Secretary of the Treasury) in a spe6 cialty who are not accepting new patients 

7 within a time period specified by such sec8 retaries; 

9 ‘‘(iii) includes a substantial number of 

10 providers and facilities that are not part of 

11 the network; or 

12 ‘‘(iv) omits a substantial number of 

13 providers and facilities that are part of the 

14 network.’’; and 

15 (B) in subsection (b)— 

16 (i) in paragraph (1), by striking ‘‘and 

17 if either of the criteria described in para18 graph (2) applies with respect to such par19 ticipant, beneficiary, or enrollee and item 

20 or service’’; and 

21 (ii) by striking paragraph (2) and in22 serting the following: 

23 ‘‘(2) RECONCILIATION REQUIREMENT.—If a 

24 nonparticipating provider was listed as a partici25 pating provider in the posted provider directory 


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1 database, the group health plan or health insurance 

2 issuer shall, not later than 30 days after receiving 

3 the request for payment, notify the participant, ben4 eficiary, or enrollee, in plain language, that the par5 ticipant, beneficiary, or enrollee may be eligible for 

6 a refund from the group health plan or health insur7 ance issuer if such participant, beneficiary, or en8 rollee paid the out of network cost-sharing and did 

9 not receive a refund under section 2799B–9(b) of 

10 the Public Health Service Act (42 U.S.C. 300gg– 

11 139).’’. 

12 (2) CIVIL MONETARY PENALTIES FOR VIOLA13 TIONS.— 

14 (A) CIVIL MONETARY PENALTIES RELAT15 ING TO PROVIDER DIRECTORY REQUIRE16 MENTS.—Section 502(c)(10) of the Employee 

17 Retirement Income Security Act of 1974 (29 

18 U.S.C. 1132(c)(10)(A)) is amended— 

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

20 OF GENETIC INFORMATION’’ and inserting 

21 ‘‘USE OF GENETIC INFORMATION AND PRO22 VIDER DIRECTORY REQUIREMENTS’’; and 

23 (ii) in subparagraph (A)— 

24 (I) by inserting ‘‘plan adminis25 trator of a group health plan (includVerDate Sep 11 2014 02:07 Apr 06, 2024 Jkt 049200 PO 00000 Frm 00030 Fmt 6652 Sfmt 6201 E:\BILLS\S4023.IS S4023

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1 ing a third party administrator),’’ 

2 after ‘‘plan sponsor of a group health 

3 plan,’’; 

4 (II) by inserting ‘‘, adminis5 trator,’’ after ‘‘such sponsor’’; and 

6 (III) by striking ‘‘for any failure’’ 

7 and all that follows through ‘‘in con8 nection with the plan.’’ and inserting 

9 ‘‘for any failure by such plan sponsor, 

10 plan administrator, or health insur11 ance issuer, in connection with the 

12 plan— 

13 ‘‘(i) to meet the requirements of sub14 section (a)(1)(F), (b)(3), (c), or (d) of sec15 tion 702 or section 701 or 702(b)(1) with 

16 respect to genetic information; or 

17 ‘‘(ii) to meet the requirements of sec18 tion 720 with respect to provider directory 

19 information.’’. 

20 (B) EXCEPTION TO THE GENERAL PROHI21 BITION ON ENFORCEMENT.—Section 502 of 

22 such Act (29 U.S.C. 1132) is amended— 

23 (i) in subsection (a)(6), by striking 

24 ‘‘or (9)’’ and inserting ‘‘(9), or (10)’’; and 

25 (ii) in subsection (b)(3)— 


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1 (I) by striking ‘‘subsections 

2 (c)(9) and (a)(6)’’ and inserting ‘‘sub3 sections (c)(9), (c)(10), and (a)(6)’’; 

4 (II) by striking ‘‘under sub5 section (c)(9))’’ and inserting ‘‘under 

6 subsections (c)(9) and (c)(10)), and 

7 except with respect to enforcement by 

8 the Secretary of section 720’’; and 

9 (III) by striking ‘‘706(a)(1)’’ and 

10 inserting ‘‘733(a)(1)’’. 

11 (c) IRC.—Section 9820 of the Internal Revenue Code 

12 of 1986 is amended— 

13 (1) in subsection (a)— 

14 (A) in paragraph (1)— 

15 (i) by striking ‘‘For plan years begin16 ning on or after January 1, 2022, each’’ 

17 and inserting ‘‘Each’’; 

18 (ii) in subparagraph (C), by striking 

19 ‘‘; and’’ and inserting a semicolon; 

20 (iii) in subparagraph (D), by striking 

21 the period and inserting ‘‘; and’’; and 

22 (iv) by adding at the end the fol23 lowing: 

24 ‘‘(E) ensure that any directory, including 

25 the database described in subparagraph (C), 


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1 containing provider directory information with 

2 respect to such plan complies with the require3 ments developed by the appropriate agencies in 

4 accordance with paragraph (6) in order to en5 sure that participants, beneficiaries, and enroll6 ees are able to identify actively participating 

7 health care providers and health care facili8 ties.’’; 

9 (B) in paragraph (3)— 

10 (i) in the matter preceding subpara11 graph (A), by striking ‘‘, in the case such 

12 request is made through a telephone call’’; 

13 and 

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

15 ‘‘call is received, through a written elec16 tronic or print (as requested by such indi17 vidual) communication’’ and inserting ‘‘a 

18 request is received, by telephone, or 

19 through a written electronic or print com20 munication (as requested by such indi21 vidual)’’; 

22 (C) in paragraph (4)— 

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

24 ‘‘and’’ at the end; 


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1 (ii) in subparagraph (B), by striking 

2 the period and inserting ‘‘; and’’; and 

3 (iii) by adding at the end the fol4 lowing: 

5 ‘‘(C) information, in plain language, con6 cerning the rights of the participant, bene7 ficiary, or enrollee to cost-sharing protections 

8 pursuant to subsection (b) in the event of reli9 ance on inaccurate provider network informa10 tion supplied by a group health plan, and con11 tact information for, as appropriate, the State 

12 consumer assistance program or ombudsman or 

13 the Employee Benefits Security Administration 

14 for more information.’’; 

15 (D) in paragraph (5), by adding at the end 

16 the following: ‘‘Such information shall include a 

17 statement, in plain language, concerning the 

18 rights of the participant, beneficiary, or enrollee 

19 to cost-sharing protections pursuant to sub20 section (b) in the event of reliance on inac21 curate provider directory information supplied 

22 by a group health plan, and contact information 

23 for, as appropriate, the State consumer assist24 ance program or ombudsman or the Employee 


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1 Benefits Security Administration for more in2 formation.’’; 

3 (E) by redesignating paragraphs (6) and 

4 (7) as paragraphs (8) and (9), respectively; 

5 (F) by inserting after paragraph (5) the 

6 following: 

7 ‘‘(6) PROTECTING PARTICIPANTS, BENE8 FICIARIES, AND ENROLLEES FROM GHOST NET9 WORKS.—The Secretary, in collaboration with the 

10 Secretary of Labor and the Secretary of Health and 

11 Human Services, shall— 

12 ‘‘(A) not later than 4 years after the date 

13 of enactment of the Behavioral Health Network 

14 and Directory Improvement Act, issue final reg15 ulations further defining the term ‘ghost net16 work’ (as defined in paragraph (8)); and 

17 ‘‘(B) not later than 4 years after the date 

18 of enactment of the Behavioral Health Network 

19 and Directory Improvement Act, issue final reg20 ulations, subregulatory guidance, or program 

21 instruction on how to assess ghost networks in 

22 health plan directories including reasonable as23 sumptions related to statistics and research 

24 methods. 


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1 ‘‘(7) DATABASE REPORTING AND AUDITING TO

2 PROTECT AGAINST GHOST NETWORKS.— 

3 ‘‘(A) REPORTING REQUIREMENTS.—Begin4 ning not later than 3 years after the date of en5 actment of the Behavioral Health Network and 

6 Directory Improvement Act, each group health 

7 plan shall submit to the Secretary, at such time 

8 as the Secretary, in coordination with the Sec9 retary of Labor and the Secretary of Health 

10 and Human Services, shall require, but not less 

11 frequently than annually, the directory data de12 scribed in paragraph (a)(4), in a machine read13 able format (as defined in section 

14 147.210(a)(2)(xiv) of title 45, Code of Federal 

15 Regulations (or any successor regulations)). A 

16 third party administrator of a group health 

17 plan may submit such information for all group 

18 health plans, collectively, that such adminis19 trator administers. The Secretary, in coordina20 tion with the Secretary of Labor and the Sec21 retary of Health and Human Services, shall 

22 make data submitted under this subparagraph 

23 available on a public website. 

24 ‘‘(B) PROVIDER DIRECTORY INDEPENDENT

25 AUDIT REQUIREMENTS.— 


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1 ‘‘(i) IN GENERAL.—Beginning not 

2 later than 3 years after the date of enact3 ment of the Behavioral Health Network 

4 and Directory Improvement Act, each 

5 group health plan shall conduct an annual 

6 directory audit, through an independent 

7 entity not associated with the health plan, 

8 that considers the factors described in 

9 clause (ii)(I)(aa) and follows the guidelines 

10 developed under clause (ii)(I)(bb). 

11 ‘‘(ii) INFORMATION TO BE IN12 CLUDED.— 

13 ‘‘(I) IN GENERAL.—For purposes 

14 of carrying out the audits under this 

15 subparagraph, the Secretary shall— 

16 ‘‘(aa) develop a list of infor17 mation required to be included; 

18 and 

19 ‘‘(bb) provide guidelines for 

20 carrying out such audits, for use 

21 by group health plans, on— 

22 ‘‘(AA) the reasonable 

23 assumptions and research 

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1 sess provider directory infor2 mation accuracy; and 

3 ‘‘(BB) determining the 

4 criteria of an eligible audi5 tor. 

6 ‘‘(II) CONTENTS.—The informa7 tion listed under subclause (I)(aa) 

8 shall include the following: 

9 ‘‘(aa) The proportion of di10 rectory listings of the plan with 

11 inaccurate information, including 

12 incorrect contact information, as 

13 specified by the Secretary, during 

14 the audit period. 

15 ‘‘(bb) The number of in-net16 work items or services paid on 

17 behalf of participants, bene18 ficiaries, and enrollees in the plan 

19 to providers or facilities who have 

20 a network provider contract with 

21 the health plan and were not list22 ed in the directory of the health 

23 plan for the audit period. 

24 ‘‘(cc) The resources of the 

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1 ficiaries, and enrollees locate an 

2 accurately listed in-network pro3 vider who is accepting new pa4 tients. 

5 ‘‘(dd) The proportion of par6 ticipants, beneficiaries, and en7 rollees using out-of-network pro8 viders for mental health and sub9 stance use disorder services, and 

10 the proportion of participants, 

11 beneficiaries, and enrollees using 

12 out-of-network providers and fa13 cilities for medical and surgical 

14 services. 

15 ‘‘(ee) Documentation that 

16 the plan verifies the accuracy of 

17 the provider directory informa18 tion every 90 days. 

19 ‘‘(ff) Other factors as deter20 mined by the Secretary. 

21 ‘‘(iii) STANDARDS FOR REPORTING.— 

22 An audit under this subparagraph is com23 plete if all of the following conditions are 

24 met: 


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1 ‘‘(I) The audit report includes 

2 the following: 

3 ‘‘(aa) A statement by the 

4 independent auditor that, to the 

5 best of the auditor’s knowledge, 

6 the report is complete and accu7 rate, and that reasonable as8 sumptions related to statistics 

9 and research methods have been 

10 complied with. 

11 ‘‘(bb) A statement explain12 ing the assumptions, statistics, 

13 and methods used to select the 

14 sample and assess provider direc15 tory information accuracy. 

16 ‘‘(cc) Such other require17 ments as the Secretary deter18 mines necessary. 

19 ‘‘(II) The group health plan 

20 makes the independent audit available 

21 on a public website. 

22 ‘‘(iv) RULEMAKING.—The Secretary, 

23 the Secretary of Labor, and the Secretary 

24 of Health and Human Services shall issue 

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1 tice and comment as generally required 

2 under section 553 of title 5, United States 

3 Code) concerning the national standards 

4 for conducting audits under this subpara5 graph, not later than 2 years after the 

6 date of enactment of the Behavioral 

7 Health Network and Directory Improve8 ment Act. 

9 ‘‘(C) AUDITS BY THE SECRETARY.— 

10 ‘‘(i) IN GENERAL.—Beginning not 

11 later than the fourth plan year after the 

12 date of enactment of the Behavioral 

13 Health Network and Directory Improve14 ment Act, the Secretary shall conduct an15 nual audits to ensure compliance with the 

16 auditing requirements under subparagraph 

17 (B). 

18 ‘‘(ii) SELECTION OF PLANS.—The 

19 Secretary, the Secretary of Labor, and the 

20 Secretary of Health and Human Services 

21 (referred to in this clause as the ‘Secre22 taries’), jointly, shall conduct annual au23 dits of the submissions under subpara24 graph (B) of a total of not fewer than 10 

25 group health plans, as determined by the 


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1 Secretaries, that are the subjects of com2 plaints about ghost networks or other com3 plaints, or that are randomly selected by 

4 the Secretaries.’’; and 

5 (G) in paragraph (8), as so redesignated— 

6 (i) in the paragraph heading, by strik7 ing ‘‘DEFINITION’’ and inserting ‘‘DEFINI8 TIONS’’; 

9 (ii) by striking ‘‘For purposes of this 

10 subsection, the term’’ and inserting the fol11 lowing: ‘‘For purposes of this subsection: 

12 ‘‘(A) PROVIDER DIRECTORY INFORMA13 TION.—The term’’; 

14 (iii) by striking ‘‘group health plan, 

15 the name, address’’ and inserting ‘‘group 

16 health plan— 

17 ‘‘(i) the name, address where the pro18 vider regularly sees patients’’; 

19 (iv) by striking the period and insert20 ing ‘‘; and’’; and 

21 (v) by adding at the end the following: 

22 ‘‘(ii) with respect to each such pro23 vider or facility— 

24 ‘‘(I) whether such provider or fa25 cility is accepting new patients; 


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1 ‘‘(II) the languages spoken and 

2 the availability of language translators 

3 for specified languages at each health 

4 care facility listed in the directory; 

5 ‘‘(III) whether the provider or fa6 cility offers medication-assisted treat7 ment for opioid use disorder; 

8 ‘‘(IV) the State license number; 

9 ‘‘(V) the national provider identi10 fier; 

11 ‘‘(VI) the age groups served by 

12 the provider or facility, such as pedi13 atric, adolescent, adult, or geriatric 

14 populations; 

15 ‘‘(VII) whether such provider or 

16 facility offers in-person services, tele17 health services, or both; 

18 ‘‘(VIII) the cost-sharing tier, if 

19 applicable; and 

20 ‘‘(IX) health insurance plans ac21 cepted (including the plan identifier 

22 and type of plan). 

23 ‘‘(B) GHOST NETWORK.—The term ‘ghost 

24 network’ means a group health plan for which 


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1 the provider directory information describing 

2 the network of such plan— 

3 ‘‘(i) includes inaccurate contact infor4 mation with respect to a substantial share 

5 of included listings and providers who are 

6 part of the network; 

7 ‘‘(ii) includes a substantial number of 

8 providers and facilities (as specified by the 

9 Secretary, in coordination with the Sec10 retary of Labor and the Secretary of 

11 Health and Human Services) in a specialty 

12 who are not accepting new patients within 

13 a time period specified by such secretaries; 

14 ‘‘(iii) includes a substantial number of 

15 providers and facilities that are not part of 

16 the network; or 

17 ‘‘(iv) omits a substantial number of 

18 providers and facilities that are part of the 

19 network.’’; and 

20 (2) in subsection (b)— 

21 (A) in paragraph (1), by striking ‘‘and if 

22 either of the criteria described in paragraph (2) 

23 applies with respect to such participant, bene24 ficiary, or enrollee and item or service’’; and 


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1 (B) by striking paragraph (2) and insert2 ing the following: 

3 ‘‘(2) RECONCILIATION REQUIREMENT.—If a 

4 nonparticipating provider was listed as a partici5 pating provider in the posted provider directory 

6 database, the group health plan shall, not later than 

7 30 days after receiving the request for payment, no8 tify the participant, beneficiary, or enrollee, in plain 

9 language, that the participant, beneficiary, or en10 rollee may be eligible for a refund from the group 

11 health plan if such participant, beneficiary, or en12 rollee paid the out of network cost-sharing and did 

13 not receive a refund under section 2799B–9(b) of 

14 the Public Health Service Act (42 U.S.C. 300gg– 

15 139).’’. 

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

17 subsections (a), (b), and (c) shall apply with respect to 

18 group health plans, or any health insurance issuer offering 

19 health insurance coverage in connection with such plan, 

20 for plan years beginning after the date that is 1 year after 

21 the date of enactment of this Act. 


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1 SEC. 3. PROVIDER REQUIREMENTS TO PROTECT PATIENTS 

2 AND IMPROVE THE ACCURACY OF PROVIDER 

3 DIRECTORY INFORMATION. 

4 Section 2799B–9 of the Public Health Service Act 

5 (42 U.S.C. 300gg–139) is amended— 

6 (1) in subsection (a)— 

7 (A) in paragraph (3), by striking ‘‘; and’’ 

8 and inserting a semicolon; 

9 (B) by redesignating paragraph (4) as 

10 paragraph (6); and 

11 (C) by inserting after paragraph (3) the 

12 following: 

13 ‘‘(4) subject to paragraph (5), when a provider 

14 or facility that is not accepting new patients deter15 mines that it has the ability to accept new patients, 

16 within 5 business days of such determination; 

17 ‘‘(5) when a solo practitioner or small provider, 

18 as determined by the Secretary, determines that it 

19 has the ability to accept new patients, within 10 

20 business days of such determination; and’’; and 

21 (2) by amending subsection (d) to read as fol22 lows: 

23 ‘‘(d) DEFINITION.—For purposes of this section, the 

24 term ‘provider directory information’ includes— 

25 ‘‘(1) the name, address, specialty, telephone 

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1 dividual health care provider contracted to partici2 pate in any of the networks of the group health plan 

3 or health insurance coverage involved; 

4 ‘‘(2) the name, address, specialty, telephone 

5 number, and digital contact information of each 

6 medical group, clinic, or facility contracted to par7 ticipate in any of the networks of the group health 

8 plan or health insurance coverage involved; and 

9 ‘‘(3) with respect to each such provider, medical 

10 group, clinic, or facility— 

11 ‘‘(A) whether such provider, medical group, 

12 clinic, or facility is accepting new patients; 

13 ‘‘(B) the languages spoken and the avail14 ability of language translators for specified lan15 guages at each provider, medical group, clinic, 

16 or facility listed in the directory; 

17 ‘‘(C) whether the provider, medical group, 

18 clinic, or facility offers medication-assisted 

19 treatment for opioid use disorder; 

20 ‘‘(D) the State license number; 

21 ‘‘(E) the national provider identifier; 

22 ‘‘(F) the age groups served by such pro23 vider, group, clinic, or facility, such as pedi24 atric, adolescent, adult, or geriatric populations; 


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1 ‘‘(G) whether such provider, group, clinic, 

2 or facility offers in-person services, telehealth 

3 services, or both; and 

4 ‘‘(H) the cost-sharing tier, if applicable.’’. 

5 SEC. 4. STRENGTHENING MENTAL HEALTH AND SUB6 STANCE USE DISORDER PARITY REQUIRE7 MENTS. 

8 (a) PHSA.— 

9 (1) NETWORK ADEQUACY REQUIREMENTS.— 

10 Section 2726(a) of the Public Health Service Act 

11 (42 U.S.C. 300gg–26(a)) is amended by adding at 

12 the end the following: 

13 ‘‘(9) NETWORK ADEQUACY REQUIREMENTS.— 

14 ‘‘(A) IN GENERAL.—The Secretary, the 

15 Secretary of Labor, and the Secretary of the 

16 Treasury shall issue regulations establishing na17 tional quantitative standards for mental health 

18 and substance use disorder network adequacy. 

19 Such standards shall consider— 

20 ‘‘(i) the ratio of in-network mental 

21 health providers who submitted claims 

22 under the plan or coverage in the previous 

23 plan year, separated by professional type 

24 of mental health provider, to participants, 


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1 beneficiaries, and enrollees in a group 

2 health plan or health insurance coverage; 

3 ‘‘(ii) the ratio of in-network substance 

4 use disorder providers who submitted 

5 claims under the plan or coverage in the 

6 previous plan year, separated by profes7 sional type of substance use disorder pro8 vider, to participants, beneficiaries, and en9 rollees in a group health plan or health in10 surance coverage; 

11 ‘‘(iii) separately, for mental health 

12 services and substance use disorder serv13 ices— 

14 ‘‘(I) geographic accessibility of 

15 providers; 

16 ‘‘(II) geographic variation and 

17 population dispersion; 

18 ‘‘(III) waiting times for appoint19 ments with participating providers; 

20 ‘‘(IV) hours of operation for par21 ticipating providers; 

22 ‘‘(V) the ability of the network to 

23 meet the needs of participants, bene24 ficiaries, and enrollees, including low25 income individuals, individuals who 


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1 are members of a racial or ethnic mi2 nority, individuals who live in a health 

3 professional shortage area, children 

4 and adults with serious, chronic, and 

5 complex health conditions, individuals 

6 with physical or mental disabilities or 

7 substance use disorders, pediatric 

8 populations, and individuals with lim9 ited English proficiency; 

10 ‘‘(VI) the availability of in-person 

11 services, telehealth services, and hy12 brid services to serve the needs of par13 ticipants, beneficiaries, and enrollees; 

14 and 

15 ‘‘(VII) the percentage of in-net16 work providers who have submitted a 

17 claim for payment during a previous 

18 6-month period, as determined by the 

19 Secretary, the Secretary of Labor, 

20 and the Secretary of the Treasury; 

21 and 

22 ‘‘(iv) other standards as determined 

23 by the Secretary, the Secretary of Labor, 

24 and the Secretary of the Treasury. 

25 ‘‘(B) TIMING.— 


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1 ‘‘(i) ISSUANCE.—The Secretary, the 

2 Secretary of Labor, and the Secretary of 

3 the Treasury shall— 

4 ‘‘(I) issue proposed regulations 

5 required under subparagraph (A) not 

6 later than 2 years after the date of 

7 enactment of the Behavioral Health 

8 Network and Directory Improvement 

9 Act; and 

10 ‘‘(II) issue final regulations 

11 under subparagraph (A) not later 

12 than 1 year thereafter. 

13 ‘‘(ii) EFFECTIVE DATE.—The regula14 tions promulgated under this paragraph 

15 shall take effect in the first plan year that 

16 begins after the date on which such final 

17 regulations are issued. 

18 ‘‘(C) AUDITS.—The Secretary, the Sec19 retary of Labor, and the Secretary of the 

20 Treasury (referred to in this subparagraph as 

21 the ‘Secretaries’), jointly, shall conduct annual, 

22 targeted audits of not fewer than 10 group 

23 health plans and health insurance issuers offer24 ing group or individual health insurance cov25 erage that the Secretaries select based upon the 


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1 number of complaints about mental health and 

2 substance use disorder network adequacy to en3 sure compliance with the requirements of this 

4 paragraph. Such audits shall begin not earlier 

5 than one year after the final regulations imple6 menting this paragraph begin to apply to group 

7 health plans and health insurance issuers.’’. 

8 (2) DEFINITIONS.—Paragraphs (4) and (5) of 

9 section 2726(e) of the Public Health Service Act (42 

10 U.S.C. 300gg–26(e)) are amended to read as fol11 lows: 

12 ‘‘(4) MENTAL HEALTH BENEFITS.—The term 

13 ‘mental health benefits’ means benefits with respect 

14 to services related to a mental health condition, de15 fined consistently with generally recognized inde16 pendent standards of current medical practice, such 

17 as the Diagnostic and Statistical Manual of Mental 

18 Disorders of the American Psychiatric Association. 

19 ‘‘(5) SUBSTANCE USE DISORDER BENEFITS.— 

20 The term ‘substance use disorder benefits’ means 

21 benefits with respect to services related to a sub22 stance use disorder, defined consistently with gen23 erally recognized independent standards of current 

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1 tical Manual of Mental Disorders of the American 

2 Psychiatric Association.’’. 

3 (3) STANDARDS FOR PARITY IN REIMBURSE4 MENT RATES.—Section 2726(a) of the Public Health 

5 Service Act (42 U.S.C. 300gg–26(a)), as amended 

6 by paragraph (1), is further amended by adding at 

7 the end the following: 

8 ‘‘(10) STANDARDS FOR PARITY IN REIMBURSE9 MENT RATES.— 

10 ‘‘(A) IN GENERAL.—Not later than 2 years 

11 after the date of enactment of the Behavioral 

12 Health Network and Directory Improvement 

13 Act, the Secretary, the Secretary of Labor, and 

14 the Secretary of the Treasury shall issue regu15 lations on a standard for parity in reimburse16 ment rates for mental health or substance use 

17 disorder benefits and medical and surgical bene18 fits, based on a comparative analysis conducted 

19 by such Secretaries using data submitted by 

20 group health plans and health insurance 

21 issuers, provider associations, and other experts 

22 related to the cost of care delivery for mental 

23 health and substance use disorder benefits. 

24 ‘‘(B) REQUESTS FOR DATA.—Group health 

25 plans and health insurance issuers shall comply 


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•S 4023 IS

1 with any request for data issued by the Sec2 retary, the Secretary of Labor, and the Sec3 retary of the Treasury for purposes of devel4 oping the standards under subparagraph (A), in 

5 a manner that avoids unnecessary duplication. 

6 ‘‘(C) EFFECTIVE DATE.—The regulations 

7 promulgated under subparagraph (A) shall 

8 apply to group health plans and health insur9 ance issuers offering group or individual health 

10 insurance coverage beginning in the first plan 

11 year that begins after issuance of the final reg12 ulations.’’. 

13 (b) ERISA.— 

14 (1) NETWORK ADEQUACY REQUIREMENTS.— 

15 Section 712(a) of the Employee Retirement Income 

16 Security Act of 1974 (29 U.S.C. 1185a(a)) is 

17 amended by adding at the end the following: 

18 ‘‘(9) NETWORK ADEQUACY REQUIREMENTS.— 

19 ‘‘(A) IN GENERAL.—The Secretary, the 

20 Secretary of Health and Human Services, and 

21 the Secretary of the Treasury shall issue regu22 lations establishing national quantitative stand23 ards for mental health and substance use dis24 order network adequacy. Such standards shall 

25 consider— 


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1 ‘‘(i) the ratio of in-network mental 

2 health providers who submitted claims 

3 under the plan or coverage in the previous 

4 plan year, separated by professional type 

5 of mental health provider, to participants, 

6 beneficiaries, and enrollees in a group 

7 health plan or health insurance coverage; 

8 ‘‘(ii) the ratio of in-network substance 

9 use disorder providers who submitted 

10 claims under the plan or coverage in the 

11 previous plan year, separated by profes12 sional type of substance use disorder pro13 vider, to participants, beneficiaries, and en14 rollees in a group health plan or health in15 surance coverage; 

16 ‘‘(iii) separately, for mental health 

17 services and substance use disorder serv18 ices— 

19 ‘‘(I) geographic accessibility of 

20 providers; 

21 ‘‘(II) geographic variation and 

22 population dispersion; 

23 ‘‘(III) waiting times for appoint24 ments with participating providers; 


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1 ‘‘(IV) hours of operation for par2 ticipating providers; 

3 ‘‘(V) the ability of the network to 

4 meet the needs of participants, bene5 ficiaries, and enrollees, including low6 income individuals, individuals who 

7 are members of a racial or ethnic mi8 nority, individuals who live in a health 

9 professional shortage area, children 

10 and adults with serious, chronic, and 

11 complex health conditions, individuals 

12 with physical or mental disabilities or 

13 substance use disorders, pediatric 

14 populations, and individuals with lim15 ited English proficiency; 

16 ‘‘(VI) the availability of in-person 

17 services, telehealth services, and hy18 brid services to serve the needs of par19 ticipants, beneficiaries, and enrollees; 

20 and 

21 ‘‘(VII) the percentage of in-net22 work providers who have submitted a 

23 claim for payment during a previous 

24 6-month period, as determined by the 

25 Secretary, the Secretary of Health 


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1 and Human Services, and the Sec2 retary of the Treasury; and 

3 ‘‘(iv) other standards as determined 

4 by the Secretary, the Secretary of Health 

5 and Human Services, and the Secretary of 

6 the Treasury. 

7 ‘‘(B) TIMING.— 

8 ‘‘(i) ISSUANCE.—The Secretary, the 

9 Secretary of Health and Human Services, 

10 and the Secretary of the Treasury shall— 

11 ‘‘(I) issue proposed regulations 

12 required under subparagraph (A) not 

13 later than 2 years after the date of 

14 enactment of the Behavioral Health 

15 Network and Directory Improvement 

16 Act; and 

17 ‘‘(II) issue final regulations 

18 under subparagraph (A) not later 

19 than 1 year thereafter. 

20 ‘‘(ii) EFFECTIVE DATE.—The regula21 tions promulgated under this paragraph 

22 shall take effect in the first plan year that 

23 begins after the date on which such final 

24 regulations are issued. 


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1 ‘‘(C) AUDITS.—The Secretary, the Sec2 retary of Health and Human Services, and the 

3 Secretary of the Treasury (referred to in this 

4 subparagraph as the ‘Secretaries’), jointly, shall 

5 conduct annual, targeted audits of not fewer 

6 than 10 group health plans and health insur7 ance issuers offering group health insurance 

8 coverage that the Secretaries select based upon 

9 the number of complaints about mental health 

10 and substance use disorder network adequacy 

11 to ensure compliance with the requirements of 

12 this paragraph. Such audits shall begin not ear13 lier than one year after the final regulations im14 plementing this paragraph begin to apply to 

15 group health plans and health insurance 

16 issuers.’’. 

17 (2) DEFINITIONS.—Paragraphs (4) and (5) of 

18 section 712(e) of the Employee Retirement Income 

19 Security Act of 1974 (29 U.S.C. 1185a(e)) are 

20 amended to read as follows: 

21 ‘‘(4) MENTAL HEALTH BENEFITS.—The term 

22 ‘mental health benefits’ means benefits with respect 

23 to services related to a mental health condition, de24 fined consistently with generally recognized inde25 pendent standards of current medical practice, such 


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•S 4023 IS

1 as the Diagnostic and Statistical Manual of Mental 

2 Disorders of the American Psychiatric Association. 

3 ‘‘(5) SUBSTANCE USE DISORDER BENEFITS.— 

4 The term ‘substance use disorder benefits’ means 

5 benefits with respect to services related to a sub6 stance use disorder, defined consistently with gen7 erally recognized independent standards of current 

8 medical practice, such as the Diagnostic and Statis9 tical Manual of Mental Disorders of the American 

10 Psychiatric Association.’’. 

11 (3) STANDARDS FOR PARITY IN REIMBURSE12 MENT RATES.—Section 712(a) of the Employee Re13 tirement Income Security Act of 1974 (29 U.S.C. 

14 1185a(a)), as amended by paragraph (1), is further 

15 amended by adding at the end the following: 

16 ‘‘(10) STANDARDS FOR PARITY IN REIMBURSE17 MENT RATES.— 

18 ‘‘(A) IN GENERAL.—Not later than 2 years 

19 after the date of enactment of the Behavioral 

20 Health Network and Directory Improvement 

21 Act, the Secretary, the Secretary of Health and 

22 Human Services, and the Secretary of the 

23 Treasury shall issue regulations on a standard 

24 for parity in reimbursement rates for mental 

25 health or substance use disorder benefits and 


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1 medical and surgical benefits, based on a com2 parative analysis conducted by such Secretaries 

3 using data submitted by group health plans and 

4 health insurance issuers, provider associations, 

5 and other experts related to the cost of care de6 livery for mental health and substance use dis7 order benefits. 

8 ‘‘(B) REQUESTS FOR DATA.—Group health 

9 plans and health insurance issuers shall comply 

10 with any request for data issued by the Sec11 retary, the Secretary of Health and Human 

12 Services, and the Secretary of the Treasury for 

13 purposes of developing the standards under 

14 subparagraph (A), in a manner that avoids un15 necessary duplication. 

16 ‘‘(C) EFFECTIVE DATE.—The regulations 

17 promulgated under subparagraph (A) shall 

18 apply to group health plans and health insur19 ance issuers offering group health insurance 

20 coverage beginning in the first plan year that 

21 begins after issuance of the final regulations.’’. 

22 (c) IRC.— 

23 (1) NETWORK ADEQUACY REQUIREMENTS.— 

24 Section 9812(a) of the Internal Revenue Code of 

25 1986 is amended by adding at the end the following: 


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1 ‘‘(9) NETWORK ADEQUACY REQUIREMENTS.— 

2 ‘‘(A) IN GENERAL.—The Secretary, the 

3 Secretary of Health and Human Services, and 

4 the Secretary of Labor shall issue regulations 

5 establishing national quantitative standards for 

6 mental health and substance use disorder net7 work adequacy. Such standards shall consider— 

8 ‘‘(i) the ratio of in-network mental 

9 health providers who submitted claims 

10 under the plan in the previous plan year, 

11 separated by professional type of mental 

12 health provider, to participants, bene13 ficiaries, and enrollees in a group health 

14 plan; 

15 ‘‘(ii) the ratio of in-network substance 

16 use disorder providers who submitted 

17 claims under the plan in the previous plan 

18 year, separated by professional type of sub19 stance use disorder provider, to partici20 pants, beneficiaries, and enrollees in a 

21 group health plan; 

22 ‘‘(iii) separately, for mental health 

23 services and substance use disorder serv24 ices— 


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1 ‘‘(I) geographic accessibility of 

2 providers; 

3 ‘‘(II) geographic variation and 

4 population dispersion; 

5 ‘‘(III) waiting times for appoint6 ments with participating providers; 

7 ‘‘(IV) hours of operation for par8 ticipating providers; 

9 ‘‘(V) the ability of the network to 

10 meet the needs of participants, bene11 ficiaries, and enrollees, including low12 income individuals, individuals who 

13 are members of a racial or ethnic mi14 nority, individuals who live in a health 

15 professional shortage area, children 

16 and adults with serious, chronic, and 

17 complex health conditions, individuals 

18 with physical or mental disabilities or 

19 substance use disorders, pediatric 

20 populations, and individuals with lim21 ited English proficiency; 

22 ‘‘(VI) the availability of in-person 

23 services, telehealth services, and hy24 brid services to serve the needs of parVerDate Sep 11 2014 02:07 Apr 06, 2024 Jkt 049200 PO 00000 Frm 00062 Fmt 6652 Sfmt 6201 E:\BILLS\S4023.IS S4023

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1 ticipants, beneficiaries, and enrollees; 

2 and 

3 ‘‘(VII) the percentage of in-net4 work providers who have submitted a 

5 claim for payment during a previous 

6 6-month period, as determined by the 

7 Secretary, the Secretary of Health 

8 and Human Services, and the Sec9 retary of Labor; and 

10 ‘‘(iv) other standards as determined 

11 by the Secretary, the Secretary of Health 

12 and Human Services, and the Secretary of 

13 Labor. 

14 ‘‘(B) TIMING.— 

15 ‘‘(i) ISSUANCE.—The Secretary, the 

16 Secretary of Health and Human Services, 

17 and the Secretary of Labor shall— 

18 ‘‘(I) issue proposed regulations 

19 required under subparagraph (A) not 

20 later than 2 years after the date of 

21 enactment of the Behavioral Health 

22 Network and Directory Improvement 

23 Act; and 


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1 ‘‘(II) issue final regulations 

2 under subparagraph (A) not later 

3 than 1 year thereafter. 

4 ‘‘(ii) EFFECTIVE DATE.—The regula5 tions promulgated under this paragraph 

6 shall take effect in the first plan year that 

7 begins after the date on which such final 

8 regulations are issued. 

9 ‘‘(C) AUDITS.—The Secretary, the Sec10 retary of Health and Human Services, and the 

11 Secretary of Labor (referred to in this subpara12 graph as the ‘Secretaries’), jointly, shall con13 duct annual, targeted audits of not fewer than 

14 10 group health plans that the Secretaries se15 lect based upon the number of complaints about 

16 mental health and substance use disorder net17 work adequacy to ensure compliance with the 

18 requirements of this paragraph. Such audits 

19 shall begin not earlier than one year after the 

20 final regulations implementing this paragraph 

21 begin to apply to group health plans.’’. 

22 (2) DEFINITIONS.—Paragraphs (4) and (5) of 

23 section 9812(e) of the Internal Revenue Code of 

24 1986 are amended to read as follows: 


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1 ‘‘(4) MENTAL HEALTH BENEFITS.—The term 

2 ‘mental health benefits’ means benefits with respect 

3 to services related to a mental health condition, de4 fined consistently with generally recognized inde5 pendent standards of current medical practice, such 

6 as the Diagnostic and Statistical Manual of Mental 

7 Disorders of the American Psychiatric Association. 

8 ‘‘(5) SUBSTANCE USE DISORDER BENEFITS.— 

9 The term ‘substance use disorder benefits’ means 

10 benefits with respect to services related to a sub11 stance use disorder, defined consistently with gen12 erally recognized independent standards of current 

13 medical practice, such as the Diagnostic and Statis14 tical Manual of Mental Disorders of the American 

15 Psychiatric Association.’’. 

16 (3) STANDARDS FOR PARITY IN REIMBURSE17 MENT RATES.—Section 9812(a) of the Internal Rev18 enue Code of 1986, as amended by paragraph (1), 

19 is further amended by adding at the end the fol20 lowing: 

21 ‘‘(10) STANDARDS FOR PARITY IN REIMBURSE22 MENT RATES.— 

23 ‘‘(A) IN GENERAL.—Not later than 2 years 

24 after the date of enactment of the Behavioral 

25 Health Network and Directory Improvement 


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1 Act, the Secretary, the Secretary of Health and 

2 Human Services, and the Secretary of Labor 

3 shall issue regulations on a standard for parity 

4 in reimbursement rates for mental health or 

5 substance use disorder benefits and medical and 

6 surgical benefits, based on a comparative anal7 ysis conducted by such Secretaries using data 

8 submitted by group health plans, provider asso9 ciations, and other experts related to the cost of 

10 care delivery for mental health and substance 

11 use disorder benefits. 

12 ‘‘(B) REQUESTS FOR DATA.—Group health 

13 plans shall comply with any request for data 

14 issued by the Secretary, the Secretary of Health 

15 and Human Services, and the Secretary of 

16 Labor for purposes of developing the standards 

17 under subparagraph (A), in a manner that 

18 avoids unnecessary duplication. 

19 ‘‘(C) EFFECTIVE DATE.—The regulations 

20 promulgated under subparagraph (A) shall 

21 apply to group health plans beginning in the 

22 first plan year that begins after issuance of the 

23 final regulations.’’. 


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1 SEC. 5. STATE AND TRIBAL OMBUDSMAN PROGRAMS RE2 LATING TO MENTAL HEALTH AND SUB3 STANCE USE DISORDER PARITY. 

4 Part C of title XXVII of the Public Health Service 

5 Act (42 U.S.C. 300gg–91 et seq.) is amended— 

6 (1) by redesignating section 2794 (42 U.S.C. 

7 300gg–95) (regarding uniform fraud and abuse re8 ferral format), as added by section 6603 of the Pa9 tient Protection and Affordable Care Act (Public 

10 Law 111–148), as section 2795; and 

11 (2) by adding at the end the following: 

12 ‘‘SEC. 2796. STATE AND TRIBAL OMBUDSMAN PROGRAMS 

13 RELATING TO MENTAL HEALTH AND SUB14 STANCE USE DISORDER PARITY. 

15 ‘‘(a) IN GENERAL.—The Secretary shall make grants 

16 to eligible entities, designated by a State, Indian Tribe, 

17 or Tribal organization, as described in subsection (b), for 

18 the purpose of— 

19 ‘‘(1) establishing or supporting State and Trib20 al mental health and substance use disorder parity 

21 ombudsman programs to— 

22 ‘‘(A) educate consumers about the mental 

23 health and substance use disorder coverage in 

24 individual plans, group health plans, self-in25 sured plans, and State Medicaid managed care 

26 plans; 


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1 ‘‘(B) assist consumers in understanding 

2 their rights as health benefits plan members, 

3 including appeal processes and how to use such 

4 benefits, and how to access appropriate medical 

5 information; 

6 ‘‘(C) assist consumers in exercising their 

7 rights under the provisions of part D, including 

8 resolving problems related to a group health 

9 plan or health insurance issuer erroneously 

10 charging a consumer out-of-network rates for 

11 services listed in-network on the group health 

12 plan or health insurance issuer’s provider direc13 tory; 

14 ‘‘(D) identify, investigate, and help resolve 

15 complaints related to mental health and sub16 stance use disorder coverage (including poten17 tial violations of the mental health and sub18 stance use disorder parity laws) on behalf of 

19 consumers; 

20 ‘‘(E) maintain a toll-free hotline and 

21 website for consumers; 

22 ‘‘(F) collect, track, and quantify problems 

23 and inquiries encountered by consumers; and 

24 ‘‘(G) other activities as defined by the Sec25 retary; and 


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1 ‘‘(2) provide support and training for such 

2 State and Tribal mental health parity ombudsman 

3 programs (such as through the establishment of a 

4 mental health parity ombudsman program resource 

5 center). 

6 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

7 under this section, a State, Indian Tribe, or Tribal organi8 zation shall designate an ombudsman or consumer assist9 ance program or other independent entity that— 

10 ‘‘(1) has specialized knowledge of mental health 

11 conditions and substance use disorders and experi12 ence resolving inquiries and complaints; and 

13 ‘‘(2) directly, or in coordination with depart14 ments of insurance, and consumer assistance organi15 zations, receives and responds to inquiries and com16 plaints concerning access to mental health and sub17 stance use disorder services. 

18 ‘‘(c) CRITERIA.—A State, Indian Tribe, or Tribal or19 ganization that receives a grant under this section shall 

20 comply with criteria established by the Secretary for car21 rying out activities under such grant. 

22 ‘‘(d) DATA COLLECTION.—As a condition of receiving 

23 a grant, an eligible entity shall agree to— 

24 ‘‘(1) collect and report data to the Secretary, 

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1 cluding the departments of insurance and the State 

2 attorney general, on the numbers and types of prob3 lems and inquiries encountered by individuals with 

4 respect to access to behavioral health services; and 

5 ‘‘(2) report to the Secretary on how identified 

6 problems were addressed, including through prom7 ising practices related to responding to mental 

8 health and substance use disorder coverage issues, 

9 including appeals and education. 

10 ‘‘(e) REPORT TO CONGRESS.—Not later than 4 years 

11 after the date of the enactment of the Behavioral Health 

12 Network and Directory Improvement Act, the Secretary 

13 shall submit to Congress a report on the data collected 

14 under subsection. 

15 ‘‘(f) DEFINITIONS.—In this section, the terms ‘In16 dian Tribe’ and ‘Tribal organization’ have the meanings 

17 given such terms in section 4 of the Indian Self-Deter18 mination and Education Assistance Act. 

19 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—To 

20 carry out this section, there are authorized to be appro21 priated $20,000,000 for fiscal year 2025 and $10,000,000 

22 for fiscal year 2026 and each fiscal year thereafter.’’. 

23 SEC. 6. REPORT TO CONGRESS. 

24 (a) IN GENERAL.—Not later than 6 years after the 

25 date of enactment of this Act and every 2 years for the 


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1 next 10 years, the Secretary of Health and Human Serv2 ices, the Secretary of Labor, and the Secretary of the 

3 Treasury (collectively referred to in this section as the 

4 ‘‘Secretaries’’) shall jointly submit to Congress and make 

5 publicly available a report to assess the prevalence of ghost 

6 networks and the adequacy of mental health and sub7 stance use disorder networks, in accordance with section 

8 2726(a)(9) of the Public Health Service Act, section 

9 712(a)(9) of the Employee Retirement Income Security 

10 Act of 1974, and section 9812(a)(9) of the Internal Rev11 enue Code of 1986, as amended by section 4. Such report 

12 shall include the following: 

13 (1) Aggregate information about group health 

14 plans and health insurance issuers determined by 

15 the Secretaries to be out of compliance with the pro16 vider directory requirements under section 2799A–5 

17 of the Public Health Service Act, section 720 of the 

18 Employee Retirement Income Security Act of 1974, 

19 and section 9820 of the Internal Revenue Code of 

20 1986, as amended by section 2. 

21 (2) Aggregate information about group health 

22 plans and health insurance issuers determined by 

23 the Secretaries to be out of compliance with the re24 quirements for parity in mental health and sub25 stance use disorder benefits under section 2726 of 


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1 the Public Health Service Act (42 U.S.C. 300gg– 

2 26), section 712 of the Employee Retirement Income 

3 Security Act of 1974 (29 U.S.C. 1185a), and section 

4 9812 of the Internal Revenue Code of 1986, as 

5 amended by section 4. 

6 (3) A summary of findings through audits, in 

7 the aggregate, under section 2799A–5(a)(7)(C) of 

8 the Public Health Service Act, section 720(a)(7)(C) 

9 of the Employee Retirement Income Security Act of 

10 1974, and section 9820(a)(7)(C) of the Internal 

11 Revenue Code of 1986, as amended by section 2, in12 cluding— 

13 (A) the accuracy of provider directory in14 formation, sectioned out by accuracy of the pro15 vider’s name, address, specialty, telephone num16 ber, digital contact information, whether the 

17 providers are accepting new patients, in-net18 work status, linguistic- and cultural-com19 petency, and availability of medications for 

20 opioid use disorder; 

21 (B) the number of plans and individuals 

22 enrolled in a group health plan or group or in23 dividual health insurance coverage that offers a 

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1 ards under, as applicable, section 2799A–5 of 

2 the Public Health Service Act, section 720 of 

3 the Employee Retirement Income Security Act 

4 of 1974, or section 9820 of the Internal Rev5 enue Code of 1986, as amended by section 2; 

6 and 

7 (C) the number of individuals enrolled in a 

8 group health plan or group or individual health 

9 insurance coverage with a ghost network. 

10 (4) A comparative analysis of in-network and 

11 out-of-network reimbursement rates for mental 

12 health and substance use disorder services compared 

13 to medical and surgical services by group health 

14 plans and health insurance issuers. 

15 (b) DEFINITION.—In this section, the term ‘‘ghost 

16 network’’ has the meaning given such term in section 

17 2799A–5(a)(8) of the Public Health Service Act, section 

18 720(a)(8) of the Employee Retirement Income Security 

19 Act of 1974, and section 9820(a)(8) of the Internal Rev20 enue Code of 1986, as amended by section 2. 

21 SEC. 7. AUTHORIZATION OF APPROPRIATIONS. 

22 (a) ADMINISTRATIVE FUNCTIONS.—To carry out sec23 tions 4, 5, and 6, including the amendments made by such 

24 sections, there are authorized to be appropriated to the 

25 Secretary of Health and Human Services, the Secretary 


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1 of Labor, and the Secretary of the Treasury such sums 

2 as may be necessary. 

3 (b) PROTECTING PATIENTS AND IMPROVING THE AC4 CURACY OF PROVIDER DIRECTORY INFORMATION.—To 

5 carry out section 2, including the amendments made by 

6 such section, in addition to amounts otherwise made avail7 able for such purposes, there are authorized to be appro8 priated— 

9 (1) to the Secretary of Health and Human 

10 Services, for purposes of carrying out the amend11 ments made by subsection (a) of such section— 

12 (A) $15,200,000 for each of fiscal years 

13 2025 and 2026; 

14 (B) $17,000,000 for fiscal year 2027; and 

15 (C) $10,000,000 for fiscal year 2028 and 

16 each fiscal year thereafter; and 

17 (2) to the Secretary of Labor, for purposes of 

18 carrying out the amendments made by subsection 

19 (b) of such section, $22,000,000 for fiscal year 2025 

20 and each fiscal year thereafter. 

Æ 


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