4357 
to medical or surgical benefits in the bene-
fits classification. 
‘‘(v) The specific findings and conclu-
sions reached by the group health plan or 
health insurance issuer with respect to the 
health insurance coverage, including any re-
sults of the analyses described in this sub-
paragraph that indicate that the plan or 
coverage is or is not in compliance with 
this section. 
‘‘(B) SECRETARY REQUEST PROCESS.— 
‘‘(i) SUBMISSION
UPON
REQUEST.— 
The Secretary shall request that a group 
health plan or a health insurance issuer of-
fering group or individual health insurance 
coverage submit the comparative analyses 
described in subparagraph (A) for plans 
that involve potential violations of this sec-
tion or complaints regarding noncompli-
ance with this section that concern NQTLs 
and any other instances in which the Sec-
retary determines appropriate. The Sec-
retary shall request not fewer than 20 such 
analyses per year. 
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4358 
‘‘(ii) ADDITIONAL
INFORMATION.—In 
instances in which the Secretary has con-
cluded that the group health plan or health 
insurance issuer with respect to health in-
surance coverage has not submitted suffi-
cient information for the Secretary to re-
view the comparative analyses described in 
subparagraph (A), as requested under clause 
(i), the Secretary shall specify to the plan 
or issuer the information the plan or issuer 
must submit to be responsive to the request 
under clause (i) for the Secretary to review 
the comparative analyses described in sub-
paragraph (A) for compliance with this sec-
tion. Nothing in this paragraph shall re-
quire the Secretary to conclude that a group 
health plan or health insurance issuer is in 
compliance with this section solely based 
upon the inspection of the comparative 
analyses described in subparagraph (A), as 
requested under clause (i). 
‘‘(iii) REQUIRED ACTION.— 
‘‘(I) IN
GENERAL.—In instances 
in which the Secretary has reviewed 
the comparative analyses described in 
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4359 
subparagraph (A), as requested under 
clause (i), and determined that the 
group health plan or health insurance 
issuer is not in compliance with this 
section, the plan or issuer— 
‘‘(aa) shall specify to the Sec-
retary the actions the plan or 
issuer will take to be in compli-
ance with this section and provide 
to the Secretary additional com-
parative analyses described in 
subparagraph 
(A) 
that 
dem-
onstrate compliance with this sec-
tion not later than 45 days after 
the initial determination by the 
Secretary that the plan or issuer 
is not in compliance; and 
‘‘(bb) following the 45-day 
corrective action period under 
item (aa), if the Secretary makes 
a final determination that the 
plan or issuer still is not in com-
pliance with this section, not later 
than 7 days after such determina-
tion, shall notify all individuals 
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4360 
enrolled in the plan or applicable 
health insurance coverage offered 
by the issuer that the plan or 
issuer, with respect to such cov-
erage, has been determined to be 
not in compliance with this sec-
tion. 
‘‘(II) EXEMPTION FROM DISCLO-
SURE.—Documents or communications 
produced in connection with the Sec-
retary’s recommendations to a group 
health plan or health insurance issuer 
shall not be subject to disclosure pursu-
ant to section 552 of title 5, United 
States Code. 
‘‘(iv) REPORT.—Not later than 1 year 
after the date of enactment of this para-
graph, and not later than October 1 of each 
year thereafter, the Secretary shall submit 
to Congress, and make publicly available, a 
report that contains— 
‘‘(I) a summary of the compara-
tive analyses requested under clause 
(i), including the identity of each 
group health plan or health insurance 
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4361 
issuer, with respect to particular health 
insurance coverage that is determined 
to be not in compliance after the final 
determination by the Secretary de-
scribed in clause (iii)(I)(bb); 
‘‘(II) the Secretary’s conclusions 
as to whether each group health plan 
or health insurance issuer submitted 
sufficient information for the Secretary 
to review the comparative analyses re-
quested under clause (i) for compliance 
with this section; 
‘‘(III) for each group health plan 
or health insurance issuer that did sub-
mit sufficient information for the Sec-
retary to review the comparative anal-
yses requested under clause (i), the Sec-
retary’s conclusions as to whether and 
why the plan or issuer is in compli-
ance with the requirements under this 
section; 
‘‘(IV) the Secretary’s specifica-
tions described in clause (ii) for each 
group health plan or health insurance 
issuer that the Secretary determined 
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did not submit sufficient information 
for the Secretary to review the com-
parative 
analyses 
requested 
under 
clause (i) for compliance with this sec-
tion; and 
‘‘(V) the Secretary’s specifications 
described in clause (iii) of the actions 
each group health plan or health insur-
ance issuer that the Secretary deter-
mined is not in compliance with this 
section must take to be in compliance 
with this section, including the reason 
why the Secretary determined the plan 
or issuer is not in compliance. 
‘‘(C) 
COMPLIANCE
PROGRAM
GUIDANCE 
DOCUMENT UPDATE PROCESS.— 
‘‘(i) IN GENERAL.—The Secretary shall 
include instances of noncompliance that the 
Secretary discovers upon reviewing the com-
parative analyses requested under subpara-
graph (B)(i) in the compliance program 
guidance document described in paragraph 
(6), as it is updated every 2 years, except 
that such instances shall not disclose any 
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4363 
protected health information or individually 
identifiable information. 
‘‘(ii) GUIDANCE AND REGULATIONS.— 
Not later than 18 months after the date of 
enactment of this paragraph, the Secretary 
shall finalize any draft or interim guidance 
and regulations relating to mental health 
parity under this section. Such draft guid-
ance shall include guidance to clarify the 
process and timeline for current and poten-
tial participants and beneficiaries (and au-
thorized representatives and health care 
providers of such participants and bene-
ficiaries) with respect to plans to file com-
plaints of such plans or issuers being in 
violation of this section, including guidance, 
by plan type, on the relevant State, re-
gional, or national office with which such 
complaints should be filed. 
‘‘(iii) STATE.—The Secretary shall 
share information on findings of compliance 
and noncompliance discovered upon review-
ing the comparative analyses requested 
under subparagraph (B)(i) shall be shared 
with the State where the group health plan 
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4364 
is located or the State where the health in-
surance issuer is licensed to do business for 
coverage offered by a health insurance issuer 
in the group market, in accordance with 
paragraph (6)(B)(iii)(II).’’. 
(2) ERISA.—Section 712(a) of the Employee 
Retirement Income Security Act of 1974 (29 U.S.C. 
1185a(a)) is amended by adding at the end the fol-
lowing: 
‘‘(6) COMPLIANCE
PROGRAM
GUIDANCE
DOCU-
MENT.— 
‘‘(A) IN GENERAL.—The Secretary, the Sec-
retary of Health and Human Services, and the 
Secretary of the Treasury, in consultation with 
the Inspector General of the Department of 
Health and Human Services, the Inspector Gen-
eral of the Department of Labor, and the Inspec-
tor General of the Department of the Treasury, 
shall issue a compliance program guidance docu-
ment to help improve compliance with this sec-
tion, section 2726 of the Public Health Service 
Act, and section 9812 of the Internal Revenue 
Code of 1986, as applicable. In carrying out this 
paragraph, the Secretaries may take into consid-
eration the 2016 publication of the Department 
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4365 
of Health and Human Services and the Depart-
ment of Labor, entitled ‘Warning Signs - Plan 
or Policy Non-Quantitative Treatment Limita-
tions (NQTLs) that Require Additional Analysis 
to Determine Mental Health Parity Compliance’. 
‘‘(B) EXAMPLES ILLUSTRATING COMPLIANCE 
AND NONCOMPLIANCE.— 
‘‘(i) IN
GENERAL.—The compliance 
program guidance document required under 
this paragraph shall provide illustrative, 
de-identified examples (that do not disclose 
any protected health information or indi-
vidually identifiable information) of pre-
vious findings of compliance and non-
compliance with this section, section 2726 of 
the Public Health Service Act, or section 
9812 of the Internal Revenue Code of 1986, 
as applicable, based on investigations of 
violations of such sections, including— 
‘‘(I) examples illustrating require-
ments for information disclosures and 
nonquantitative treatment limitations; 
and 
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4400 
to Congress, and make publicly available, a 
report that contains— 
‘‘(I) a summary of the compara-
tive analyses requested under clause 
(i), including the identity of each 
group plan that is determined to be 
not in compliance after the final deter-
mination by the Secretary described in 
clause (iii)(I)(bb); 
‘‘(II) the Secretary’s conclusions 
as to whether each group health plan 
submitted sufficient information for the 
Secretary to review the comparative 
analyses requested under clause (i) for 
compliance with this section; 
‘‘(III) for each group health plan 
that did submit sufficient information 
for the Secretary to review the com-
parative 
analyses 
requested 
under 
clause (i), the Secretary’s conclusions 
as to whether and why the plan is in 
compliance with the disclosure require-
ments under this section; 
‘‘(IV) the Secretary’s specifica-
tions described in clause (ii) for each 
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4401 
group health plan that the Secretary 
determined did not submit sufficient 
information for the Secretary to review 
the comparative analyses requested 
under clause (i) for compliance with 
this section; and 
‘‘(V) the Secretary’s specifications 
described in clause (iii) of the actions 
each group health plan that the Sec-
retary determined is not in compliance 
with this section must take to be in 
compliance with this section, including 
the reason why the Secretary deter-
mined the plan is not in compliance. 
‘‘(C) 
COMPLIANCE
PROGRAM
GUIDANCE 
DOCUMENT UPDATE PROCESS.— 
‘‘(i) IN GENERAL.—The Secretary shall 
include instances of noncompliance that the 
Secretary discovers upon reviewing the com-
parative analyses requested under subpara-
graph (B)(i) in the compliance program 
guidance document described in paragraph 
(6), as it is updated every 2 years, except 
that such instances shall not disclose any 
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