Strengthening Behavioral Health Benefits Act

To amend the Employee Retirement Income Security Act of 1974 to provide for the enforcement of mental health and substance abuse disorder parity requirements, and for other purposes. 1. Short title This Act may be cited as the Strengthening Behavioral Health Benefits Act 2. Enforcement of Mental Health and Substance Use Disorder Requirements (a) In general Section 502(a) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1132(a) (1) in paragraph (10), by striking or (2) in paragraph (11), by striking the period at the end and inserting ; or (3) by adding at the end the following: (12) in any case relating to the provision of mental health benefits and substance use disorder benefits under a group health plan or under group health insurance coverage offered by a health insurance issuer in connection with a group health plan (as such terms are defined in section 733), by the Secretary, or by a participant, beneficiary, or fiduciary, to enforce any provision of this title or the terms of the plan or coverage relating to such benefits against a group health plan, a health insurance issuer, a fiduciary of a plan, or any other person that contracts with a group health plan to provide group health insurance coverage or assistance in the administration of a group health plan (including a third party administrator, managed behavioral health organization, and a pharmacy benefit manager), if such person participates in or conceals a violation of any requirement of part 7 relating to such benefits or a wrongful denial of a claim for mental health benefits or substance use disorder benefits under the terms of the plan or coverage, to obtain appropriate relief, in addition to any other relief otherwise available under this section, including— (A) to recover all losses to participants and beneficiaries; (B) to reform impermissible plan or coverage terms and policies (as written or in operation) in accordance with the requirements of this title and its implementing regulations; or (C) to ensure the readjudication of claims and payment of benefits in accordance with the plan or coverage terms without any impermissible limitation, plan or coverage term, or policy. . (b) Clarification of general enforcement authorities (1) Actions brought by a participant, beneficiary, or fiduciary Section 502(a)(3) of such Act ( 29 U.S.C. 1132(a)(3) (A) by striking or (B) (B) (B) by inserting before the semicolon at the end the following: , or (C) to require re-adjudication and payment of benefits to remedy violations of this title notwithstanding the availability of relief under other provisions of this title (2) Actions brought by the Secretary Section 502(a)(5) of such Act ( 29 U.S.C. 1132(a)(5) (A) by striking or (B) (B) (B) by inserting before the semicolon at the end the following: , or (C) to require re-adjudication and payment of benefits to remedy violations of this title notwithstanding the availability of relief under other provisions of this title (c) Exception to the general prohibition on enforcement Section 502(b)(3) of such Act ( 29 U.S.C. 1132(b)(3) (1) by inserting , and except with respect to enforcement by the Secretary of section 712 or any other provision of part 7 in any case relating to mental health benefits and substance use disorder benefits under subsection (c)(9)) (2) by striking 706(a)(1) 733(a)(1) (d) Definitions Part 7 of title I of such Act ( 29 U.S.C. 1181 et seq. (1) in section 712(e), in the matter preceding paragraph (1), by inserting and section 502(a)(12) this section (2) in section 733— (A) in subsection (a), in the matter preceding paragraph (1), by inserting and section 502(a)(12) this part (B) in subsection (b), in the matter preceding paragraph (1), by inserting and section 502(a)(12) this part (e) Funding (1) In general In addition to amounts otherwise available, there are appropriated (out of any money in the Treasury not otherwise appropriated) to the Department of Labor for fiscal year 2023, to remain available until September 30, 2032, $275,000,000, of which— (A) $240,000,000 shall be for the Employee Benefits Security Administration; and (B) $35,000,000 shall be for the Solicitor of Labor. (2) Use of appropriated funds Amounts made available under paragraph (1) may be used for audits and investigations, enforcement actions, litigation expenses, issuance of regulations or guidance, and any other Departmental activities relating to section 712 of the Employee Retirement Income Security Act of 1974 and any other provision of title I of such Act relating to mental health and substance use disorder benefits.

Summary: Strengthening Behavioral Health Benefits Act This bill provides additional statutory authority and funding to enforce the mental health and substance use disorder parity requirements that apply to group and individual health insurance plans.