I 
117TH CONGRESS 
2D SESSION 
H. R. 8512 
To amend title XXVII of the Public Health Service Act, the Employee 
Retirement Income Security Act of 1974, and the Internal Revenue 
Code of 1986 to strengthen parity in mental health and substance use 
disorder benefits. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 26, 2022 
Ms. PORTER (for herself, Mr. CA´RDENAS, Mr. FITZPATRICK, Mr. TRONE, Mr. 
DOGGETT, Mr. RASKIN, Ms. BARRAGA´N, Mr. BUTTERFIELD, Mr. 
MCEACHIN, Mrs. NAPOLITANO, Ms. JACKSON LEE, Ms. JAYAPAL, Mr. 
MICHAEL F. DOYLE of Pennsylvania, Mr. DEUTCH, and Ms. KUSTER) in-
troduced the following bill; which was referred to the Committee on En-
ergy and Commerce, and in addition to the Committees on Education and 
Labor, Ways and Means, and Oversight and Reform, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
of such provisions as fall within the jurisdiction of the committee con-
cerned 
A BILL 
To amend title XXVII of the Public Health Service Act, 
the Employee Retirement Income Security Act of 1974, 
and the Internal Revenue Code of 1986 to strengthen 
parity in mental health and substance use disorder bene-
fits. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Behavioral Health Cov-
erage Transparency Act of 2022’’. 
SEC. 2. STRENGTHENING PARITY IN MENTAL HEALTH AND 
SUBSTANCE USE DISORDER BENEFITS. 
(a) 
PUBLIC
HEALTH
SERVICE
ACT.—Section 
2726(a)(8) of the Public Health Service Act (42 U.S.C. 
300gg–26(a)(8)) is amended— 
(1) in subparagraph (A), in the matter pre-
ceding clause (i)— 
(A) by inserting ‘‘(including entities that 
provide administrative services in connection 
with a group health plan, such as third party 
administrators)’’ after ‘‘insurance coverage’’; 
and 
(B) by striking ‘‘and, beginning 45 days 
after’’ and all that follows through ‘‘upon re-
quest,’’ and inserting ‘‘and submit to the Sec-
retary (or the Secretary of Labor or the Sec-
retary of the Treasury, as applicable), on an 
annual basis (and at any other time upon re-
quest of the Secretary), and to the applicable 
State authority upon request,’’; 
(2) in subparagraph (B)— 
(A) in the heading, by striking ‘‘REQUEST’’ 
and inserting ‘‘REVIEW’’; 
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(B) in clause (i)— 
(i) in the heading, by striking ‘‘SUB-
MISSION
UPON
REQUEST’’ and inserting 
‘‘IN GENERAL’’; 
(ii) by striking ‘‘shall request’’ and all 
that follows through ‘‘coverage submit’’ 
and insert ‘‘shall conduct a review of’’; and 
(iii) by striking ‘‘shall request not 
fewer than 20’’ and inserting ‘‘shall con-
duct a review of not fewer than 60’’; 
(C) in clause (ii)— 
(i) in the first sentence, by striking 
‘‘as requested under clause (i)’’ and insert-
ing ‘‘as submitted under such subpara-
graph’’; 
(ii) in the first sentence, by striking 
‘‘to be responsive to the request under 
clause (i) for’’ and inserting ‘‘to enable’’; 
and 
(iii) in the second sentence, by strik-
ing ‘‘, as requested under clause (i)’’; 
(D) in clause (iii)— 
(i) in subclause (I), by striking ‘‘, as 
requested under clause (i),’’; and 
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(ii) by adding at the end of subclause 
(II) the following new sentence: ‘‘The pre-
ceding sentence shall not apply with re-
spect to disclosures made on or after the 
date of the enactment of this sentence.’’; 
and 
(E) in clause (iv)— 
(i) in subclause (I)— 
(I) by striking ‘‘requested under 
clause (i)’’ and inserting ‘‘reviewed 
under clause (i)’’; and 
(II) by striking ‘‘after the final 
determination by the Secretary de-
scribed in clause (iii)(I)(bb)’’ and in-
serting ‘‘by the Secretary as described 
in clause (iii)(I)’’; 
(ii) in subclause (II), by striking ‘‘the 
comparative 
analyses 
requested 
under 
clause (i)’’ and inserting ‘‘such compara-
tive analyses’’; 
(iii) in subclause (III), by striking 
‘‘the comparative analyses requested under 
clause (i)’’ and inserting ‘‘such compara-
tive analyses’’; 
(iv) in subclause (IV)— 
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(I) by striking ‘‘the comparative 
analyses requested under clause (i)’’ 
and inserting ‘‘such comparative anal-
yses’’; and 
(II) by striking ‘‘and’’ at the end; 
(v) in subclause (V), by striking the 
period and inserting a semicolon; and 
(vi) by adding at the end the fol-
lowing: 
‘‘(VI) the name of each group 
health plan or health insurance issuer 
found not to have submitted compara-
tive analyses in accordance with sub-
paragraph (A); 
‘‘(VII) the name of each group 
health plan or health insurance issuer 
whose comparative analyses were re-
viewed under clause (i) and found not 
to have submitted sufficient informa-
tion for the Secretary to review; and 
‘‘(VIII) the name of any plan or 
coverage with respect to which a com-
plaint has been submitted under sub-
paragraph (C) and for which a final 
review finding has been issued. 
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The requirements of this clause with re-
spect to plans or issuers shall also apply to 
entities that provide administrative services 
in connection with a group health plan, 
such as third party administrators, if ap-
plicable.’’; 
(3) in subparagraph (C)(i), by striking ‘‘re-
quested’’; and 
(4) by adding at the end the following new sub-
paragraphs: 
‘‘(D) AUDIT PROCESS.—Beginning 1 year 
after the date of enactment of this subpara-
graph, the Secretary, in cooperation with the 
Secretaries of Labor and the Treasury, as ap-
plicable, shall, in addition to conducting reviews 
in accordance with subparagraph (B), conduct 
randomized audits of group health plans, health 
insurance issuers offering group or individual 
health insurance coverage, and entities that 
provide administrative services in connection 
with a group health plan, such as third party 
administrators, to determine compliance with 
this section. Such audits shall be conducted on 
no fewer than 40 plans or coverages per cal-
endar year (not including any reviews con-
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ducted under such subparagraph). In addition, 
the Secretary may, in cooperation with the Sec-
retaries of Labor and the Treasury, as applica-
ble, and in consultation with the Inspector Gen-
eral of the Department of Health and Human 
Services, the Inspector General of the Depart-
ment of Labor, and the Inspector General of 
the Department of the Treasury, as applicable, 
conduct audits on any such plan or coverage 
with respect to which a complaint has been sub-
mitted under subparagraph (E) to determine 
compliance with this section. 
‘‘(E) COMPLAINT
PROCESS.—Not later 
than 6 months after the date of enactment of 
this subparagraph, the Secretary, in coopera-
tion with the Secretary of Labor and the Sec-
retary of the Treasury, shall, with respect to 
group health plans and health insurance issuers 
offering group or individual health insurance 
coverage (including entities that provide admin-
istrative services in connection with a group 
health plan, such as third party administra-
tors), issue guidance to clarify the process and 
timeline for current and potential participants 
and beneficiaries (and authorized representa-
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tives and health care providers of such partici-
pants and beneficiaries) with respect to such 
plans and coverage to file formal complaints of 
such plans or issuers being in violation of this 
section, including guidance, by plan type, on the 
relevant State, regional, and national offices 
with which such complaints should be filed. 
‘‘(F) 
COVERAGE
DISPARITY
INFORMA-
TION.—For the first calendar year that begins 
on or after the date that is 2 years after the 
date of the enactment of this subparagraph, 
and for each subsequent calendar year, the Sec-
retary, in cooperation with the Secretaries of 
Labor and the Treasury, shall submit to the 
Committee on Energy and Commerce of the 
House of Representatives and the Committee 
on Health, Education, Labor, and Pensions of 
the Senate the following information with re-
spect to the preceding calendar year: 
‘‘(i) DENIAL RATES.—Data comparing 
the rates of and reasons for denial by 
group health plans and health insurance 
issuers offering group or individual health 
insurance coverage (including entities that 
provide administrative services in connec-
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tion with a group health plan, such as 
third party administrators) of claims for 
mental health benefits, substance use dis-
order benefits, and medical and surgical 
benefits, disaggregated by the following 
categories: 
‘‘(I) Inpatient, in-network claims. 
‘‘(II) Inpatient, out-of-network 
claims. 
‘‘(III) 
Outpatient, 
in-network 
claims. 
‘‘(IV) Outpatient, out-of-network 
claims. 
‘‘(V) Emergency services. 
‘‘(VI) Prescription drug claims. 
‘‘(ii) NETWORK
ADEQUACY
DATA.— 
Data comparing the network adequacy of 
group health plans and health insurance 
issuers offering group or individual health 
insurance coverage (including entities that 
provide administrative services in connec-
tion with a group health plan, such as 
third party administrators) based on 
claims for outpatient and inpatient mental 
health benefits, substance use disorder 
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benefits, and medical and surgical benefits, 
including out-of-network utilization rates, 
the number and percentage of in-network 
providers accepting new patients, and aver-
age wait times between receiving initial 
treatment and diagnosis and follow-up 
treatment. 
‘‘(iii) REIMBURSEMENT RATES.—Data 
comparing the reimbursement rates of 
group health plans and health insurance 
issuers offering group or individual health 
insurance coverage (including entities that 
provide administrative services in connec-
tion with a group health plan, such as 
third party administrators) for the 10 
most commonly billed mental health serv-
ices, substance use services, and medical 
and surgical services, each as a percentage 
of rates payable for such services under 
title XVIII of the Social Security Act, 
disaggregated by the following categories: 
‘‘(I) Inpatient, in-network claims. 
‘‘(II) Inpatient, out-of-network 
claims. 
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‘‘(III) 
Outpatient, 
in-network 
claims. 
‘‘(IV) Outpatient, out-of-network 
claims. 
‘‘(V) Emergency services. 
‘‘(VI) Prescription drug claims.’’. 
(b) EMPLOYEE RETIREMENT INCOME SECURITY ACT 
OF 1974.—Section 712(a)(8) of the Employee Retirement 
Income Security Act of 1974 (29 U.S.C. 1185a(a)(8)) is 
amended— 
(1) in subparagraph (A), in the matter pre-
ceding clause (i)— 
(A) by inserting ‘‘(including entities that 
provide administrative services in connection 
with a group health plan, such as third party 
administrators)’’ after ‘‘insurance coverage’’; 
and 
(B) by striking ‘‘and, beginning 45 days 
after’’ and all that follows through ‘‘upon re-
quest,’’ and inserting ‘‘and submit to the Sec-
retary (or the Secretary of Health and Human 
Services or the Secretary of the Treasury, as 
applicable), on an annual basis (and at any 
other time upon request of the Secretary),’’; 
(2) in subparagraph (B)— 
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(A) in the heading, by striking ‘‘REQUEST’’ 
and inserting ‘‘REVIEW’’; 
(B) in clause (i)— 
(i) in the heading, by striking ‘‘SUB-
MISSION
UPON
REQUEST’’ and inserting 
‘‘IN GENERAL’’; 
(ii) by striking ‘‘shall request’’ and all 
that follows through ‘‘coverage submit’’ 
and insert ‘‘shall conduct a review of’’; and 
(iii) by striking ‘‘shall request not 
fewer than 20’’ and inserting ‘‘shall con-
duct a review of not fewer than 60’’; 
(C) in clause (ii)— 
(i) in the first sentence, by striking 
‘‘as requested under clause (i)’’ and insert-
ing ‘‘as submitted under such subpara-
graph’’; 
(ii) in the first sentence, by striking 
‘‘to be responsive to the request under 
clause (i) for’’ and inserting ‘‘to enable’’; 
and 
(iii) in the second sentence, by strik-
ing ‘‘, as requested under clause (i)’’; 
(D) in clause (iii)— 
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(i) in subclause (I), by striking ‘‘, as 
requested under clause (i),’’; and 
(ii) by adding at the end of subclause 
(II) the following new sentence: ‘‘The pre-
ceding sentence shall not apply with re-
spect to disclosures made on or after the 
date of the enactment of this sentence.’’; 
and 
(E) in clause (iv)— 
(i) in subclause (I)— 
(I) by striking ‘‘requested under 
clause (i)’’ and inserting ‘‘reviewed 
under clause (i)’’; and 
(II) by striking ‘‘after the final 
determination by the Secretary de-
scribed in clause (iii)(I)(bb)’’ and in-
serting ‘‘by the Secretary as described 
in clause (iii)(I)’’; 
(ii) in subclause (II), by striking ‘‘the 
comparative 
analyses 
requested 
under 
clause (i)’’ and inserting ‘‘such compara-
tive analyses’’; 
(iii) in subclause (III), by striking 
‘‘the comparative analyses requested under 
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clause (i)’’ and inserting ‘‘such compara-
tive analyses’’; 
(iv) in subclause (IV)— 
(I) by striking ‘‘the comparative 
analyses requested under clause (i)’’ 
and inserting ‘‘such comparative anal-
yses’’; and 
(II) by striking ‘‘and’’ at the end; 
(v) in subclause (V), by striking the 
period and inserting a semicolon; and 
(vi) by adding at the end the fol-
lowing: 
‘‘(VI) the name of each group 
health plan or health insurance issuer 
found not to have submitted compara-
tive analyses in accordance with sub-
paragraph (A); 
‘‘(VII) the name of each group 
health plan or health insurance issuer 
whose comparative analyses were re-
viewed under clause (i) and found not 
to have submitted sufficient informa-
tion for the Secretary to review; and 
‘‘(VIII) the name of any plan or 
coverage with respect to which a com-
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plaint has been submitted under sub-
paragraph (C) and for which a final 
review finding has been issued. 
The requirements of this clause with re-
spect to plans or issuers shall also apply to 
entities that provide administrative services 
in connection with a group health plan, 
such as third party administrators, if ap-
plicable.’’; 
(3) in subparagraph (C)(i), by striking ‘‘re-
quested’’; and 
(4) by adding at the end the following new sub-
paragraphs: 
‘‘(D) AUDIT PROCESS.—Beginning 1 year 
after the date of enactment of this subpara-
graph, the Secretary, in cooperation with the 
Secretaries of Health and Human Services and 
the Treasury, as applicable, shall, in addition to 
conducting reviews in accordance with subpara-
graph (B), conduct randomized audits of group 
health plans, health insurance issuers offering 
group health insurance coverage, and entities 
that provide administrative services in connec-
tion with a group health plan, such as third 
party administrators, to determine compliance 
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pamtmann on DSKBC07HB2PROD with BILLS
with this section. Such audits shall be con-
ducted on no fewer than 40 plans or coverages 
per calendar year (not including any reviews 
conducted under such subparagraph). In addi-
tion, the Secretary may, in cooperation with the 
Secretaries of Health and Human Services and 
the Treasury, as applicable, and in consultation 
with the Inspector General of the Department 
of Health and Human Services, the Inspector 
General of the Department of Labor, and the 
Inspector General of the Department of the 
Treasury, as applicable, conduct audits on any 
such plan or coverage with respect to which a 
complaint has been submitted under subpara-
graph (E) to determine compliance with this 
section. 
‘‘(E) COMPLAINT
PROCESS.—Not later 
than 6 months after the date of enactment of 
this subparagraph, the Secretary, in coopera-
tion with the Secretary of Health and Human 
Services and the Secretary of the Treasury, 
shall, with respect to group health plans and 
health insurance issuers offering group health 
insurance coverage (including entities that pro-
vide administrative services in connection with a 
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group health plan, such as third party adminis-
trators), issue guidance to clarify the process 
and timeline for current and potential partici-
pants and beneficiaries (and authorized rep-
resentatives and health care providers of such 
participants and beneficiaries) with respect to 
such plans and coverage to file formal com-
plaints of such plans or issuers being in viola-
tion of this section, including guidance, by plan 
type, on the relevant State, regional, and na-
tional offices with which such complaints should 
be filed. 
‘‘(F) 
COVERAGE
DISPARITY
INFORMA-
TION.—For the first calendar year that begins 
on or after the date that is 2 years after the 
date of the enactment of this subparagraph, 
and for each subsequent calendar year, the Sec-
retary, in cooperation with the Secretaries of 
Health and Human Services and the Treasury, 
shall submit to the Committee on Energy and 
Commerce of the House of Representatives and 
the Committee on Health, Education, Labor, 
and Pensions of the Senate the following infor-
mation with respect to the preceding calendar 
year: 
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‘‘(i) DENIAL RATES.—Data comparing 
the rates of and reasons for denial by 
group health plans and health insurance 
issuers offering group health insurance 
coverage (including entities that provide 
administrative services in connection with 
a group health plan, such as third party 
administrators) of claims for mental health 
benefits, substance use disorder benefits, 
and 
medical 
and 
surgical 
benefits, 
disaggregated by the following categories: 
‘‘(I) Inpatient, in-network claims. 
‘‘(II) Inpatient, out-of-network 
claims. 
‘‘(III) 
Outpatient, 
in-network 
claims. 
‘‘(IV) Outpatient, out-of-network 
claims. 
‘‘(V) Emergency services. 
‘‘(VI) Prescription drug claims. 
‘‘(ii) NETWORK
ADEQUACY
DATA.— 
Data comparing the network adequacy of 
group health plans and health insurance 
issuers offering group health insurance 
coverage (including entities that provide 
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administrative services in connection with 
a group health plan, such as third party 
administrators) based on claims for out-
patient and inpatient mental health bene-
fits, substance use disorder benefits, and 
medical and surgical benefits, including 
out-of-network utilization rates, the num-
ber and percentage of in-network providers 
accepting new patients, and average wait 
times between receiving initial treatment 
and diagnosis and follow-up treatment. 
‘‘(iii) REIMBURSEMENT RATES.—Data 
comparing the reimbursement rates of 
group health plans and health insurance 
issuers offering group health insurance 
coverage (including entities that provide 
administrative services in connection with 
a group health plan, such as third party 
administrators) for the 10 most commonly 
billed mental health services, substance use 
services, and medical and surgical services, 
each as a percentage of rates payable for 
such services under title XVIII of the So-
cial Security Act, disaggregated by the fol-
lowing categories: 
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‘‘(I) Inpatient, in-network claims. 
‘‘(II) Inpatient, out-of-network 
claims. 
‘‘(III) 
Outpatient, 
in-network 
claims. 
‘‘(IV) Outpatient, out-of-network 
claims. 
‘‘(V) Emergency services. 
‘‘(VI) Prescription drug claims.’’. 
(c) INTERNAL REVENUE CODE OF 1986.—Section 
9812(a)(8) of the Internal Revenue Code of 1986 is 
amended— 
(1) in subparagraph (A), in the matter pre-
ceding clause (i)— 
(A) by inserting ‘‘(including entities that 
provide administrative services in connection 
with a group health plan, such as third party 
administrators)’’ after ‘‘In the case of a group 
health plan’’; and 
(B) by striking ‘‘and, beginning 45 days 
after’’ and all that follows through ‘‘upon re-
quest,’’ and inserting ‘‘and submit to the Sec-
retary (or the Secretary of Health and Human 
Services or the Secretary of Labor, as applica-
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ble), on an annual basis (and at any other time 
upon request of the Secretary),’’; 
(2) in subparagraph (B)— 
(A) in the heading, by striking ‘‘REQUEST’’ 
and inserting ‘‘REVIEW’’; 
(B) in clause (i)— 
(i) in the heading, by striking ‘‘SUB-
MISSION
UPON
REQUEST’’ and inserting 
‘‘IN GENERAL’’; 
(ii) by striking ‘‘shall request’’ and all 
that follows through ‘‘plan submit’’ and in-
sert ‘‘shall conduct a review of’’; and 
(iii) by striking ‘‘shall request not 
fewer than 20’’ and inserting ‘‘shall con-
duct a review of not fewer than 60’’; 
(C) in clause (ii)— 
(i) in the first sentence, by striking 
‘‘as requested under clause (i)’’ and insert-
ing ‘‘as submitted under such subpara-
graph’’; 
(ii) in the first sentence, by striking 
‘‘to be responsive to the request under 
clause (i) for’’ and inserting ‘‘to enable’’; 
and 
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(iii) in the second sentence, by strik-
ing ‘‘, as requested under clause (i)’’; 
(D) in clause (iii)— 
(i) in subclause (I), by striking ‘‘, as 
requested under clause (i),’’; and 
(ii) by adding at the end of subclause 
(II) the following new sentence: ‘‘The pre-
ceding sentence shall not apply with re-
spect to disclosures made on or after the 
date of the enactment of this sentence.’’; 
and 
(E) in clause (iv)— 
(i) in subclause (I)— 
(I) by striking ‘‘requested under 
clause (i)’’ and inserting ‘‘reviewed 
under clause (i)’’; and 
(II) by striking ‘‘after the final 
determination by the Secretary de-
scribed in clause (iii)(I)(bb)’’ and in-
serting ‘‘by the Secretary as described 
in clause (iii)(I)’’; 
(ii) in subclause (II), by striking ‘‘the 
comparative 
analyses 
requested 
under 
clause (i)’’ and inserting ‘‘such compara-
tive analyses’’; 
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(iii) in subclause (III), by striking 
‘‘the comparative analyses requested under 
clause (i)’’ and inserting ‘‘such compara-
tive analyses’’; 
(iv) in subclause (IV)— 
(I) by striking ‘‘the comparative 
analyses requested under clause (i)’’ 
and inserting ‘‘such comparative anal-
yses’’; and 
(II) by striking ‘‘and’’ at the end; 
(v) in subclause (V), by striking the 
period and inserting a semicolon; and 
(vi) by adding at the end the fol-
lowing: 
‘‘(VI) the name of each group 
health plan found not to have sub-
mitted comparative analyses in ac-
cordance with subparagraph (A); 
‘‘(VII) the name of each group 
health plan whose comparative anal-
yses were reviewed under clause (i) 
and found not to have submitted suf-
ficient information for the Secretary 
to review; and 
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