‘‘(2) INFORMATION.—With respect to informa-
tion required to be provided or made available under
section 121, in the case of a group health plan that
provides benefits in the form of health insurance
coverage through a health insurance issuer, the Sec-
retary shall determine the circumstances under
which the plan is not required to provide or make
available the information (and is not liable for the
issuer’s failure to provide or make available the in-
formation), if the issuer is obligated to provide and
make available (or provides and makes available)
such information.
‘‘(3) GRIEVANCE
AND
INTERNAL
APPEALS.—
With respect to the grievance system and internal
appeals process required to be established under sec-
tions 131 and 132, in the case of a group health
plan that provides benefits in the form of health in-
surance coverage through a health insurance issuer,
the Secretary shall determine the circumstances
under which the plan is not required to provide for
such system and process (and is not liable for the
issuer’s failure to provide for such system and proc-
ess), if the issuer is obligated to provide for (and
provides for) such system and process.
‘‘(4) EXTERNAL APPEALS.—Pursuant to rules
of the Secretary, insofar as a group health plan en-
ters into a contract with a qualified external appeal
entity for the conduct of external appeal activities in
accordance with section 133, the plan shall be treat-
ed as meeting the requirement of such section and
is not liable for the entity’s failure to meet any re-
quirements under such section.
‘‘(5) APPLICATION TO PROHIBITIONS.—Pursu-
ant to rules of the Secretary, if a health insurance
issuer offers health insurance coverage in connection
with a group health plan and takes an action in vio-
lation of any of the following sections, the group
health plan shall not be liable for such violation un-
less the plan caused such violation:
‘‘(A) Section 141 (relating to prohibition of
interference with certain medical communica-
tions).
‘‘(B) Section 142 (relating to prohibition
against transfer of indemnification or improper
incentive arrangements).
‘‘(C) Section 144 (relating to prohibition
on retaliation).
‘‘(D) Section 151 (relating to promoting
good medical practice).
‘‘(6) CONSTRUCTION.—Nothing in this sub-
section shall be construed to affect or modify the re-
sponsibilities of the fiduciaries of a group health
plan under part 4 of subtitle B.
‘‘(7) APPLICATION TO CERTAIN PROHIBITIONS
AGAINST RETALIATION.—With respect to compliance
with the requirements of section 144(b)(1) of the
Managed Care Reform Act of 1999, for purposes of
this subtitle the term ‘group health plan’ is deemed
to include a reference to an institutional health care
provider.
‘‘(c) ENFORCEMENT OF CERTAIN REQUIREMENTS.—
‘‘(1) COMPLAINTS.—Any protected health care
professional who believes that the professional has
been retaliated or discriminated against in violation
of section 144(b)(1) of the Managed Care Reform
Act of 1999 may file with the Secretary a complaint
within 180 days of the date of the alleged retaliation
or discrimination.
‘‘(2) INVESTIGATION.—The Secretary shall in-
vestigate such complaints and shall determine if a
violation of such section has occurred and, if so,
shall issue an order to ensure that the protected
health care professional does not suffer any loss of
position, pay, or benefits in relation to the plan,
issuer, or provider involved, as a result of the viola-
tion found by the Secretary.
‘‘(d) CONFORMING REGULATIONS.—The Secretary
may issue regulations to coordinate the requirements on
group health plans under this section with the require-
ments imposed under the other provisions of this title.’’.
(b) SATISFACTION OF ERISA CLAIMS PROCEDURE
REQUIREMENT.—Section 503 of such Act (29 U.S.C.
1133) is amended by inserting ‘‘(a)’’ after ‘‘SEC. 503.’’
and by adding at the end the following new subsection:
‘‘(b) In the case of a group health plan (as defined
in section 733) compliance with the requirements of sub-
title D (and section 111) of title I of the Managed Care
Reform Act of 1999 in the case of a claims denial shall
be deemed compliance with subsection (a) with respect to
such claims denial.’’.
(c) CONFORMING AMENDMENTS.—(1) Section 732(a)
of such Act (29 U.S.C. 1185(a)) is amended by striking
‘‘section 711’’ and inserting ‘‘sections 711 and 714’’.
(2) The table of contents in section 1 of such Act
is amended by inserting after the item relating to section
712 the following new item:
‘‘Sec. 714. Patient protection standards.’’.
(3) Section 502(b)(3) of such Act (29 U.S.C.
1132(b)(3)) is amended by inserting ‘‘(other than section
144(b))’’ after ‘‘part 7’’.
SEC. 302. ERISA PREEMPTION NOT TO APPLY TO CERTAIN
ACTIONS INVOLVING HEALTH INSURANCE
POLICYHOLDERS.
(a) IN GENERAL.—Section 514 of the Employee Re-
tirement Income Security Act of 1974 (29 U.S.C. 1144)
is amended by adding at the end the following subsection:
‘‘(e) PREEMPTION NOT TO APPLY TO CERTAIN AC-
TIONS ARISING OUT OF PROVISION OF HEALTH BENE-
FITS.—
‘‘(1) NON-PREEMPTION OF CERTAIN CAUSES OF
ACTION.—
‘‘(A) IN GENERAL.—Except as provided in
this subsection, nothing in this title shall be
construed to invalidate, impair, or supersede
any cause of action brought by a plan partici-
pant or beneficiary (or the estate of a plan par-
ticipant or beneficiary) under State law to re-
cover damages resulting from personal injury or
for wrongful death against any person—
‘‘(i) in connection with the provision
of insurance, administrative services, or
medical services by such person to or for
a group health plan (as defined in section
733), or
‘‘(ii) that arises out of the arrange-
ment by such person for the provision of
such insurance, administrative services, or
medical services by other persons.
‘‘(B) LIMITATION
ON
PUNITIVE
DAM-
AGES.—The plan or issuer is not liable for any
punitive, exemplary, or similar damages in the
case of a cause of action brought under sub-
paragraph (A) if—
‘‘(i) it relates to an externally appeal-
able decision (as defined in subsection
(a)(2) of section 133 of the Managed Care
Reform Act of 1999);
‘‘(ii) an external appeal with respect
to such decision was completed under such
section 133;
‘‘(iii) in the case such external appeal
was initiated by the plan or issuer filing
the request for the external appeal, the re-
quest was filed on a timely basis before the
date the action was brought or, if later,
within 30 days after the date the exter-
nally appealable decision was made;
‘‘(iv) the plan or issuer promptly fol-
lowed the recommendation of the qualified
external appeal entity involved; and
‘‘(v) such recommendation is not va-
cated under subsection (d)(3) of such sec-
tion based upon an action of the plan or
issuer.
The provisions of this subparagraph supersede
any State law or common law to the contrary.
‘‘(C) PERSONAL
INJURY
DEFINED.—For
purposes of this subsection, the term ‘personal
injury’ means a physical injury and includes an
injury arising out of the treatment (or failure
to treat) a mental illness or disease.
‘‘(2) EXCEPTION FOR EMPLOYERS AND OTHER
PLAN SPONSORS.—
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), paragraph (1) does not authorize—
‘‘(i) any cause of action against an
employer or other plan sponsor maintain-
ing the group health plan (or against an
employee of such an employer or sponsor
acting within the scope of employment), or
‘‘(ii) a right of recovery or indemnity
by a person against an employer or other
plan sponsor (or such an employee) for
damages assessed against the person pur-
suant to a cause of action under paragraph
(1).
‘‘(B) SPECIAL RULE.—Subparagraph (A)
shall not preclude any cause of action described
in paragraph (1) against an employer or other
plan sponsor (or against an employee of such
an employer or sponsor acting within the scope
of employment) if—
‘‘(i) such action is based on the em-
ployer’s or other plan sponsor’s (or em-
ployee’s) exercise of discretionary authority
to make a decision on a claim for benefits
covered under the plan or health insurance
coverage in the case at issue; and
‘‘(ii) the exercise by such employer or
other plan sponsor (or employee) of such
authority resulted in personal injury or
wrongful death.
‘‘(3) CONSTRUCTION.—Nothing in this sub-
section shall be construed as permitting a cause of
action under State law for the failure to provide an
item or service which is specifically excluded under
the group health plan involved.’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall apply to acts and omissions occurring
on or after the date of the enactment of this Act from
which a cause of action arises.
TITLE 
IV—EFFECTIVE 
DATES;
COORDINATION 
IN 
IMPLE-
MENTATION
SEC. 401. EFFECTIVE DATES.
(a) GROUP HEALTH COVERAGE.—
(1) IN GENERAL.—Subject to paragraph (2),
the amendments made by sections 201(a) and 301
(and title I insofar as it relates to such sections)
shall apply with respect to group health plans, and
health insurance coverage offered in connection with
group health plans, for plan years beginning on or
after October 1, 2000 (in this section referred to as
the ‘‘general effective date’’).
(2) TREATMENT OF COLLECTIVE BARGAINING
AGREEMENTS.—In the case of a group health plan
maintained pursuant to 1 or more collective bargain-
ing agreements between employee representatives
and 1 or more employers ratified before the date of
enactment of this Act, the amendments made by sec-
tions 201(a) and 301 (and title I insofar as it re-
lates to such sections) shall not apply to plan years
beginning before the later of—
(A) the date on which the last collective
bargaining agreements relating to the plan ter-
minates (determined without regard to any ex-
tension thereof agreed to after the date of en-
actment of this Act), or
(B) the general effective date.
For purposes of subparagraph (A), any plan amend-
ment made pursuant to a collective bargaining
agreement relating to the plan which amends the
plan solely to conform to any requirement added by
this Act shall not be treated as a termination of
such collective bargaining agreement.
(b) INDIVIDUAL HEALTH INSURANCE COVERAGE.—
The amendments made by section 202 shall apply with
respect to individual health insurance coverage offered,
sold, issued, renewed, in effect, or operated in the individ-
ual market on or after the general effective date.
SEC. 402. COORDINATION IN IMPLEMENTATION.
The Secretary of Health and Human Services and the
Secretary of Labor shall ensure, through the execution of
an interagency memorandum of understanding among
such Secretaries, that—
(1) regulations, rulings, and interpretations
issued by such Secretaries relating to the same mat-
ter over which two or more such Secretaries have re-
sponsibility under title I (and the amendments made
by titles II and III) are administered so as to have
the same effect at all times; and
(2) coordination of policies relating to enforcing
the same requirements through such Secretaries in
order to have a coordinated enforcement strategy
that avoids duplication of enforcement efforts and
assigns priorities in enforcement.
Æ