H. R. 34—242 
of the Patient Protection and Affordable Care Act (42 U.S.C. 1396a 
note), collect from each such State information on the following: 
(1) The number of institutions for mental diseases (as 
defined in section 1905(i) of the Social Security Act (42 U.S.C. 
1396d(i))) and beds in such institutions that received payment 
for the provision of services to individuals who receive medical 
assistance under a State plan under the Medicaid program 
under title XIX of the Social Security Act (42 U.S.C. 1396 
et seq.) (or under a waiver of such plan) through the demonstra-
tion project in each such State as compared to the total number 
of institutions for mental diseases and beds in the State. 
(2) The extent to which there is a reduction in expenditures 
under the Medicaid program under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.) or other spending on 
the full continuum of physical or mental health care for individ-
uals who receive treatment in an institution for mental diseases 
under 
the 
demonstration 
project, 
including 
outpatient, 
inpatient, emergency, and ambulatory care, that is attributable 
to such individuals receiving treatment in institutions for 
mental diseases under the demonstration project. 
(3) The number of forensic psychiatric hospitals, the 
number of beds in such hospitals, and the number of forensic 
psychiatric beds in other hospitals in such State, based on 
the most recent data available, to the extent practical, as deter-
mined by such Administrator. 
(4) The amount of any disproportionate share hospital pay-
ments under section 1923 of the Social Security Act (42 U.S.C. 
1396r–4) that institutions for mental diseases in the State 
received during the period beginning on July 1, 2012, and 
ending on June 30, 2015, and the extent to which the dem-
onstration project reduced the amount of such payments. 
(5) The most recent data regarding all facilities or sites 
in the State in which any adults with a serious mental illness 
who are receiving medical assistance under a State plan under 
the Medicaid program under title XIX of the Social Security 
Act (42 U.S.C. 1396 et seq.) (or under a waiver of such plan) 
are treated during the period referred to in paragraph (4), 
to the extent practical, as determined by the Administrator, 
including— 
(A) the types of such facilities or sites (such as an 
institution for mental diseases, a hospital emergency 
department, or other inpatient hospital); 
(B) the average length of stay in such a facility or 
site by such an individual, disaggregated by facility type; 
and 
(C) the payment rate under the State plan (or a waivers 
of such plan) for services furnished to such an individual 
for that treatment, disaggregated by facility type, during 
the period in which the demonstration project is in oper-
ation. 
(6) The extent to which the utilization of hospital emer-
gency departments during the period in which the demonstra-
tion project was is in operation differed, with respect to individ-
uals who are receiving medical assistance under a State plan 
under the Medicaid program under title XIX of the Social 
Security Act (42 U.S.C. 1396 et seq.) (or under a waiver of 
such plan), between—
H. R. 34—243 
(A) those individuals who received treatment in an 
institution for mental diseases under the demonstration 
project; 
(B) those individuals who met the eligibility require-
ments for the demonstration project but who did not receive 
treatment in an institution for mental diseases under the 
demonstration project; and 
(C) those adults with a serious mental illness who 
did not meet such eligibility requirements and did not 
receive treatment for such illness in an institution for 
mental diseases. 
(b) REPORT.—Not later than 2 years after the date of the 
enactment of this Act, the Secretary of Health and Human Services 
shall submit to Congress a report that summarizes and analyzes 
the information collected under subsection (a). Such report may 
be submitted as part of the report required under section 2707(f) 
of the Patient Protection and Affordable Care Act (42 U.S.C. 1396a 
note) or separately. 
SEC. 12005. PROVIDING EPSDT SERVICES TO CHILDREN IN IMDS. 
(a) IN GENERAL.—Section 1905(a)(16) of the Social Security 
Act (42 U.S.C. 1396d(a)(16)) is amended— 
(1) by striking ‘‘effective January 1, 1973’’ and inserting 
‘‘(A) effective January 1, 1973’’; and 
(2) by inserting before the semicolon at the end the fol-
lowing: ‘‘, and, (B) for individuals receiving services described 
in subparagraph (A), early and periodic screening, diagnostic, 
and treatment services (as defined in subsection (r)), whether 
or not such screening, diagnostic, and treatment services are 
furnished by the provider of the services described in such 
subparagraph’’. 
(b) EFFECTIVE DATE.—The amendments made by subsection 
(a) shall apply with respect to items and services furnished in 
calendar quarters beginning on or after January 1, 2019. 
SEC. 12006. ELECTRONIC VISIT VERIFICATION SYSTEM REQUIRED FOR 
PERSONAL CARE SERVICES AND HOME HEALTH CARE 
SERVICES UNDER MEDICAID. 
(a) IN GENERAL.—Section 1903 of the Social Security Act (42 
U.S.C. 1396b) is amended by inserting after subsection (k) the 
following new subsection: 
‘‘(l)(1) Subject to paragraphs (3) and (4), with respect to any 
amount expended for personal care services or home health care 
services requiring an in-home visit by a provider that are provided 
under a State plan under this title (or under a waiver of the 
plan) and furnished in a calendar quarter beginning on or after 
January 1, 2019 (or, in the case of home health care services, 
on or after January 1, 2023), unless a State requires the use 
of an electronic visit verification system for such services furnished 
in such quarter under the plan or such waiver, the Federal medical 
assistance percentage shall be reduced— 
‘‘(A) in the case of personal care services— 
‘‘(i) for calendar quarters in 2019 and 2020, by .25 
percentage points; 
‘‘(ii) for calendar quarters in 2021, by .5 percentage 
points; 
‘‘(iii) for calendar quarters in 2022, by .75 percentage 
points; and
H. R. 34—244 
‘‘(iv) for calendar quarters in 2023 and each year there-
after, by 1 percentage point; and 
‘‘(B) in the case of home health care services— 
‘‘(i) for calendar quarters in 2023 and 2024, by .25 
percentage points; 
‘‘(ii) for calendar quarters in 2025, by .5 percentage 
points; 
‘‘(iii) for calendar quarters in 2026, by .75 percentage 
points; and 
‘‘(iv) for calendar quarters in 2027 and each year there-
after, by 1 percentage point. 
‘‘(2) Subject to paragraphs (3) and (4), in implementing the 
requirement for the use of an electronic visit verification system 
under paragraph (1), a State shall— 
‘‘(A) consult with agencies and entities that provide per-
sonal care services, home health care services, or both under 
the State plan (or under a waiver of the plan) to ensure that 
such system— 
‘‘(i) is minimally burdensome; 
‘‘(ii) takes into account existing best practices and elec-
tronic visit verification systems in use in the State; and 
‘‘(iii) is conducted in accordance with the requirements 
of HIPAA privacy and security law (as defined in section 
3009 of the Public Health Service Act); 
‘‘(B) take into account a stakeholder process that includes 
input from beneficiaries, family caregivers, individuals who fur-
nish personal care services or home health care services, and 
other stakeholders, as determined by the State in accordance 
with guidance from the Secretary; and 
‘‘(C) ensure that individuals who furnish personal care 
services, home health care services, or both under the State 
plan (or under a waiver of the plan) are provided the oppor-
tunity for training on the use of such system. 
‘‘(3) Paragraphs (1) and (2) shall not apply in the case of 
a State that, as of the date of the enactment of this subsection, 
requires the use of any system for the electronic verification of 
visits conducted as part of both personal care services and home 
health care services, so long as the State continues to require 
the use of such system with respect to the electronic verification 
of such visits. 
‘‘(4)(A) In the case of a State described in subparagraph (B), 
the reduction under paragraph (1) shall not apply— 
‘‘(i) in the case of personal care services, for calendar quar-
ters in 2019; and 
‘‘(ii) in the case of home health care services, for calendar 
quarters in 2023. 
‘‘(B) For purposes of subparagraph (A), a State described in 
this subparagraph is a State that demonstrates to the Secretary 
that the State— 
‘‘(i) has made a good faith effort to comply with the require-
ments of paragraphs (1) and (2) (including by taking steps 
to adopt the technology used for an electronic visit verification 
system); and 
‘‘(ii) in implementing such a system, has encountered 
unavoidable system delays. 
‘‘(5) In this subsection:
H. R. 34—245 
‘‘(A) The term ‘electronic visit verification system’ means, 
with respect to personal care services or home health care 
services, a system under which visits conducted as part of 
such services are electronically verified with respect to— 
‘‘(i) the type of service performed; 
‘‘(ii) the individual receiving the service; 
‘‘(iii) the date of the service; 
‘‘(iv) the location of service delivery; 
‘‘(v) the individual providing the service; and 
‘‘(vi) the time the service begins and ends. 
‘‘(B) The term ‘home health care services’ means services 
described in section 1905(a)(7) provided under a State plan 
under this title (or under a waiver of the plan). 
‘‘(C) The term ‘personal care services’ means personal care 
services provided under a State plan under this title (or under 
a waiver of the plan), including services provided under section 
1905(a)(24), 1915(c), 1915(i), 1915(j), or 1915(k) or under a 
wavier under section 1115. 
‘‘(6)(A) In the case in which a State requires personal care 
service and home health care service providers to utilize an elec-
tronic visit verification system operated by the State or a contractor 
on behalf of the State, the Secretary shall pay to the State, for 
each quarter, an amount equal to 90 per centum of so much of 
the sums expended during such quarter as are attributable to 
the design, development, or installation of such system, and 75 
per centum of so much of the sums for the operation and mainte-
nance of such system. 
‘‘(B) Subparagraph (A) shall not apply in the case in which 
a State requires personal care service and home health care service 
providers to utilize an electronic visit verification system that is 
not operated by the State or a contractor on behalf of the State.’’. 
(b) COLLECTION AND DISSEMINATION OF BEST PRACTICES.—Not 
later than January 1, 2018, the Secretary of Health and Human 
Services shall, with respect to electronic visit verification systems 
(as defined in subsection (l)(5) of section 1903 of the Social Security 
Act (42 U.S.C. 1396b), as inserted by subsection (a)), collect and 
disseminate best practices to State Medicaid Directors with respect 
to— 
(1) training individuals who furnish personal care services, 
home health care services, or both under the State plan under 
title XIX of such Act (or under a waiver of the plan) on such 
systems and the operation of such systems and the prevention 
of fraud with respect to the provision of personal care services 
or home health care services (as defined in such subsection 
(l)(5)); and 
(2) the provision of notice and educational materials to 
family caregivers and beneficiaries with respect to the use 
of such electronic visit verification systems and other means 
to prevent such fraud. 
(c) RULES OF CONSTRUCTION.— 
(1) NO EMPLOYER-EMPLOYEE RELATIONSHIP ESTABLISHED.— 
Nothing in the amendment made by this section may be con-
strued as establishing an employer-employee relationship 
between the agency or entity that provides for personal care 
services or home health care services and the individuals who, 
under a contract with such an agency or entity, furnish such
H. R. 34—246 
services for purposes of part 552 of title 29, Code of Federal 
Regulations (or any successor regulations). 
(2) 
NO
PARTICULAR
OR
UNIFORM
ELECTRONIC
VISIT 
VERIFICATION SYSTEM REQUIRED.—Nothing in the amendment 
made by this section shall be construed to require the use 
of a particular or uniform electronic visit verification system 
(as defined in subsection (l)(5) of section 1903 of the Social 
Security Act (42 U.S.C. 1396b), as inserted by subsection (a)) 
by all agencies or entities that provide personal care services 
or home health care under a State plan under title XIX of 
the Social Security Act (or under a waiver of the plan) (42 
U.S.C. 1396 et seq.). 
(3) NO
LIMITS
ON
PROVISION
OF
CARE.—Nothing in the 
amendment made by this section may be construed to limit, 
with respect to personal care services or home health care 
services provided under a State plan under title XIX of the 
Social Security Act (or under a waiver of the plan) (42 U.S.C. 
1396 et seq.), provider selection, constrain beneficiaries’ selec-
tion of a caregiver, or impede the manner in which care is 
delivered. 
(4) NO PROHIBITION ON STATE QUALITY MEASURES REQUIRE-
MENTS.—Nothing in the amendment made by this section shall 
be construed as prohibiting a State, in implementing an elec-
tronic visit verification system (as defined in subsection (l)(5) 
of section 1903 of the Social Security Act (42 U.S.C. 1396b), 
as inserted by subsection (a)), from establishing requirements 
related to quality measures for such system. 
TITLE XIII—MENTAL HEALTH PARITY 
SEC. 13001. ENHANCED COMPLIANCE WITH MENTAL HEALTH AND SUB-
STANCE USE DISORDER COVERAGE REQUIREMENTS. 
(a) COMPLIANCE
PROGRAM
GUIDANCE
DOCUMENT.—Section 
2726(a) of the Public Health Service Act (42 U.S.C. 300gg–26(a)) 
is amended by adding at the end the following: 
‘‘(6) COMPLIANCE PROGRAM GUIDANCE DOCUMENT.— 
‘‘(A) IN GENERAL.—Not later than 12 months after the 
date of enactment of the Helping Families in Mental Health 
Crisis Reform Act of 2016, the Secretary, the Secretary 
of Labor, and the Secretary of the Treasury, in consultation 
with the Inspector General of the Department of Health 
and Human Services, the Inspector General of the Depart-
ment of Labor, and the Inspector General of the Depart-
ment of the Treasury, shall issue a compliance program 
guidance document to help improve compliance with this 
section, section 712 of the Employee Retirement Income 
Security Act of 1974, and section 9812 of the Internal 
Revenue Code of 1986, as applicable. In carrying out this 
paragraph, the Secretaries may take into consideration 
the 2016 publication of the Department of Health and 
Human Services and the Department of Labor, entitled 
‘Warning Signs - Plan or Policy Non-Quantitative Treat-
ment Limitations (NQTLs) that Require Additional Anal-
ysis to Determine Mental Health Parity Compliance’. 
‘‘(B) EXAMPLES ILLUSTRATING COMPLIANCE AND NON-
COMPLIANCE.—
H. R. 34—248 
section, section 712 of the Employee Retirement Income 
Security Act of 1974, or section 9812 of the Internal Rev-
enue Code of 1986, as applicable, in relation to nonquantita-
tive treatment limitations on medical and surgical benefits. 
‘‘(D) UPDATING THE COMPLIANCE PROGRAM GUIDANCE 
DOCUMENT.—The Secretary, the Secretary of Labor, and 
the Secretary of the Treasury, 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, shall update the compliance program guidance 
document every 2 years to include illustrative, de-identified 
examples (that do not disclose any protected health 
information or individually identifiable information) of pre-
vious findings of compliance and noncompliance with this 
section, section 712 of the Employee Retirement Income 
Security Act of 1974, or section 9812 of the Internal Rev-
enue Code of 1986, as applicable.’’. 
(b) ADDITIONAL
GUIDANCE.—Section 2726(a) of the Public 
Health Service Act (42 U.S.C. 300gg–26(a)), as amended by sub-
section (a), is further amended by adding at the end the following: 
‘‘(7) ADDITIONAL GUIDANCE.— 
‘‘(A) IN GENERAL.—Not later than 12 months after the 
date of enactment of the Helping Families in Mental Health 
Crisis Reform Act of 2016, the Secretary, the Secretary 
of Labor, and the Secretary of the Treasury shall issue 
guidance to group health plans and health insurance 
issuers offering group or individual health insurance cov-
erage to assist such plans and issuers in satisfying the 
requirements of this section, section 712 of the Employee 
Retirement Income Security Act of 1974, or section 9812 
of the Internal Revenue Code of 1986, as applicable. 
‘‘(B) DISCLOSURE.— 
‘‘(i) GUIDANCE FOR PLANS AND ISSUERS.—The guid-
ance issued under this paragraph shall include clari-
fying information and illustrative examples of methods 
that group health plans and health insurance issuers 
offering group or individual health insurance coverage 
may use for disclosing information to ensure compli-
ance with the requirements under this section, section 
712 of the Employee Retirement Income Security Act 
of 1974, or section 9812 of the Internal Revenue Code 
of 1986, as applicable, (and any regulations promul-
gated pursuant to such sections, as applicable). 
‘‘(ii) DOCUMENTS FOR PARTICIPANTS, BENEFICIARIES, 
CONTRACTING PROVIDERS, OR AUTHORIZED REPRESENTA-
TIVES.—The guidance issued under this paragraph 
shall include clarifying information and illustrative 
examples of methods that group health plans and 
health insurance issuers offering group or individual 
health insurance coverage may use to provide any 
participant, 
beneficiary, 
contracting 
provider, 
or 
authorized representative, as applicable, with docu-
ments containing information that the health plans 
or issuers are required to disclose to participants, bene-
ficiaries, contracting providers, or authorized rep-
resentatives to ensure compliance with this section,
H. R. 34—249 
section 712 of the Employee Retirement Income Secu-
rity Act of 1974, or section 9812 of the Internal Rev-
enue Code of 1986, as applicable, compliance with any 
regulation issued pursuant to such respective section, 
or compliance with any other applicable law or regula-
tion. Such guidance shall include information that is 
comparative in nature with respect to— 
‘‘(I) nonquantitative treatment limitations for 
both medical and surgical benefits and mental 
health and substance use disorder benefits; 
‘‘(II) the processes, strategies, evidentiary 
standards, and other factors used to apply the 
limitations described in subclause (I); and 
‘‘(III) 
the 
application 
of 
the 
limitations 
described in subclause (I) to ensure that such 
limitations are applied in parity with respect to 
both medical and surgical benefits and mental 
health and substance use disorder benefits. 
‘‘(C) NONQUANTITATIVE TREATMENT LIMITATIONS.—The 
guidance issued under this paragraph shall include clari-
fying information and illustrative examples of methods, 
processes, strategies, evidentiary standards, and other fac-
tors that group health plans and health insurance issuers 
offering group or individual health insurance coverage may 
use regarding the development and application of non-
quantitative treatment limitations to ensure compliance 
with this section, section 712 of the Employee Retirement 
Income Security Act of 1974, or section 9812 of the Internal 
Revenue Code of 1986, as applicable, (and any regulations 
promulgated 
pursuant 
to 
such 
respective 
section), 
including— 
‘‘(i) examples of methods of determining appro-
priate types of nonquantitative treatment limitations 
with respect to both medical and surgical benefits and 
mental health and substance use disorder benefits, 
including nonquantitative treatment limitations per-
taining to— 
‘‘(I) medical management standards based on 
medical necessity or appropriateness, or whether 
a treatment is experimental or investigative; 
‘‘(II) limitations with respect to prescription 
drug formulary design; and 
‘‘(III) use of fail-first or step therapy protocols; 
‘‘(ii) examples of methods of determining— 
‘‘(I) network admission standards (such as 
credentialing); and 
‘‘(II) factors used in provider reimbursement 
methodologies (such as service type, geographic 
market, demand for services, and provider supply, 
practice size, training, experience, and licensure) 
as such factors apply to network adequacy; 
‘‘(iii) examples of sources of information that may 
serve as evidentiary standards for the purposes of 
making determinations regarding the development and 
application of nonquantitative treatment limitations; 
‘‘(iv) examples of specific factors, and the evi-
dentiary standards used to evaluate such factors, used
H. R. 34—250 
by such plans or issuers in performing a nonquantita-
tive treatment limitation analysis; 
‘‘(v) examples of how specific evidentiary standards 
may be used to determine whether treatments are 
considered experimental or investigative; 
‘‘(vi) examples of how specific evidentiary stand-
ards may be applied to each service category or classi-
fication of benefits; 
‘‘(vii) examples of methods of reaching appropriate 
coverage determinations for new mental health or sub-
stance use disorder treatments, such as evidence-based 
early intervention programs for individuals with a 
serious mental illness and types of medical manage-
ment techniques; 
‘‘(viii) examples of methods of reaching appropriate 
coverage determinations for which there is an indirect 
relationship between the covered mental health or sub-
stance use disorder benefit and a traditional covered 
medical and surgical benefit, such as residential treat-
ment or hospitalizations involving voluntary or invol-
untary commitment; and 
‘‘(ix) additional illustrative examples of methods, 
processes, strategies, evidentiary standards, and other 
factors for which the Secretary determines that addi-
tional guidance is necessary to improve compliance 
with this section, section 712 of the Employee Retire-
ment Income Security Act of 1974, or section 9812 
of the Internal Revenue Code of 1986, as applicable. 
‘‘(D) PUBLIC COMMENT.—Prior to issuing any final guid-
ance under this paragraph, the Secretary shall provide 
a public comment period of not less than 60 days during 
which any member of the public may provide comments 
on a draft of the guidance.’’. 
(c) AVAILABILITY OF PLAN INFORMATION.— 
(1) SOLICITATION
OF
PUBLIC
FEEDBACK.—Not later than 
6 months after the date of enactment of this Act, the Secretary 
of Health and Human Services, the Secretary of Labor, and 
the Secretary of the Treasury shall solicit feedback from the 
public on how the disclosure request process for documents 
containing information that health plans or health insurance 
issuers are required under Federal or State law to disclose 
to participants, beneficiaries, contracting providers, or author-
ized representatives to ensure compliance with existing mental 
health parity and addiction equity requirements can be 
improved while continuing to ensure consumers’ rights to access 
all information required by Federal or State law to be disclosed. 
(2) PUBLIC AVAILABILITY.—Not later than 12 months after 
the date of the enactment of this Act, the Secretary of Health 
and Human Services, the Secretary of Labor, and the Secretary 
of the Treasury shall make such feedback publicly available. 
(3) NAIC.—The Secretary of Health and Human Services, 
the Secretary of Labor, and the Secretary of the Treasury 
shall share feedback obtained pursuant to paragraph (1) 
directly with the National Association of Insurance Commis-
sioners to the extent such feedback includes recommendations 
for the development of simplified information disclosure tools 
to provide consistent information for consumers. Such feedback
H. R. 34—251 
may be taken into consideration by the National Association 
of Insurance Commissioners and other appropriate entities for 
the voluntary development and voluntary use of common tem-
plates and other sample standardized forms to improve con-
sumer access to plan information. 
(d) IMPROVING COMPLIANCE.— 
(1) IN GENERAL.—In the case that the Secretary of Health 
and Human Services, the Secretary of Labor, or the Secretary 
of the Treasury determines that a group health plan or health 
insurance issuer offering group or individual health insurance 
coverage has violated, at least 5 times, section 2726 of the 
Public Health Service Act (42 U.S.C. 300gg–26), section 712 
of the Employee Retirement Income Security Act of 1974 (29 
U.S.C. 1185a), or section 9812 of the Internal Revenue Code 
of 1986, respectively, the appropriate Secretary shall audit 
plan documents for such health plan or issuer in the plan 
year following the Secretary’s determination in order to help 
improve compliance with such section. 
(2) RULE OF CONSTRUCTION.—Nothing in this subsection 
shall be construed to limit the authority, as in effect on the 
day before the date of enactment of this Act, of the Secretary 
of Health and Human Services, the Secretary of Labor, or 
the Secretary of the Treasury to audit documents of health 
plans or health insurance issuers. 
SEC. 13002. ACTION PLAN FOR ENHANCED ENFORCEMENT OF MENTAL 
HEALTH AND SUBSTANCE USE DISORDER COVERAGE. 
(a) PUBLIC MEETING.— 
(1) IN GENERAL.—Not later than 6 months after the date 
of enactment of this Act, the Secretary of Health and Human 
Services shall convene a public meeting of stakeholders 
described in paragraph (2) to produce an action plan for 
improved Federal and State coordination related to the enforce-
ment of section 2726 of the Public Health Service Act (42 
U.S.C. 300gg–26), section 712 of the Employee Retirement 
Income Security Act of 1974 (29 U.S.C. 1185a), and section 
9812 of the Internal Revenue Code of 1986, and any comparable 
provisions of State law (in this section such sections and provi-
sions are collectively referred to as ‘‘mental health parity and 
addiction equity requirements’’). 
(2) STAKEHOLDERS.—The stakeholders described in this 
paragraph shall include each of the following: 
(A) The Federal Government, including representatives 
from— 
(i) the Department of Health and Human Services; 
(ii) the Department of the Treasury; 
(iii) the Department of Labor; and 
(iv) the Department of Justice. 
(B) State governments, including— 
(i) State health insurance commissioners; 
(ii) appropriate State agencies, including agencies 
on public health or mental health; and 
(iii) State attorneys general or other representa-
tives of State entities involved in the enforcement of 
mental health parity and addiction equity require-
ments.
H. R. 34—252 
(C) Representatives from key stakeholder groups, 
including— 
(i) the National Association of Insurance Commis-
sioners; 
(ii) health insurance issuers; 
(iii) providers of mental health and substance use 
disorder treatment; 
(iv) employers; and 
(v) patients or their advocates. 
(b) ACTION PLAN.—Not later than 6 months after the conclusion 
of the public meeting under subsection (a), the Secretary of Health 
and Human Services shall finalize the action plan described in 
such subsection and make it plainly available on the Internet 
website of the Department of Health and Human Services. 
(c) CONTENT.—The action plan under this section shall— 
(1) take into consideration the recommendations of the 
Mental Health and Substance Use Disorder Parity Task Force 
in its final report issued in October of 2016, and any subsequent 
Federal and State actions in relation to such recommendations; 
(2) reflect the input of the stakeholders participating in 
the public meeting under subsection (a); 
(3) identify specific strategic objectives regarding how the 
various Federal and State agencies charged with enforcement 
of mental health parity and addiction equity requirements will 
collaborate to improve enforcement of such requirements; 
(4) provide a timeline for implementing the action plan; 
and 
(5) provide specific examples of how such objectives may 
be met, which may include— 
(A) providing common educational information and 
documents, such as the Consumer Guide to Disclosure 
Rights, to patients about their rights under mental health 
parity and addiction equity requirements; 
(B) facilitating the centralized collection of, monitoring 
of, and response to patient complaints or inquiries relating 
to mental health parity and addiction equity requirements, 
which may be through the development and administration 
of— 
(i) a single, toll-free telephone number; and 
(ii) a new parity website— 
(I) to help consumers find the appropriate Fed-
eral or State agency to assist with their parity 
complaints, appeals, and other actions; and 
(II) that takes into consideration, but is not 
duplicative of, the parity beta site being tested, 
and released for public comment, by the Depart-
ment of Health and Human Services as of the 
date of the enactment of this Act; 
(C) Federal and State law enforcement agencies 
entering into memoranda of understanding to better coordi-
nate 
enforcement 
responsibilities 
and 
information 
sharing— 
(i) including whether such agencies should make 
the results of enforcement actions related to mental 
health parity and addiction equity requirements pub-
licly available; and
H. R. 34—253 
(ii) which may include State Policy Academies on 
Parity Implementation for State Officials and other 
forums to bring together national experts to provide 
technical assistance to teams of State officials on 
strategies to advance compliance with mental health 
parity and addiction equity requirements in both the 
commercial market, and in the Medicaid program 
under title XIX of the Social Security Act and the 
State Children’s Health Insurance Program under title 
XXI of such Act; and 
(D) recommendations to the Congress regarding the 
need for additional legal authority to improve enforcement 
of mental health parity and addiction equity requirements, 
including the need for additional legal authority to ensure 
that nonquantitative treatment limitations are applied, and 
the extent and frequency of the applications of such limita-
tions, both to medical and surgical benefits and to mental 
health and substance use disorder benefits in a comparable 
manner. 
SEC. 13003. REPORT ON INVESTIGATIONS REGARDING PARITY IN 
MENTAL HEALTH AND SUBSTANCE USE DISORDER BENE-
FITS. 
(a) IN GENERAL.—Not later than 1 year after the date of enact-
ment of this Act, and annually thereafter for the subsequent 5 
years, the Assistant Secretary of Labor of the Employee Benefits 
Security Administration, in collaboration with the Administrator 
of the Centers for Medicare & Medicaid Services and the Secretary 
of 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 a report 
summarizing the results of all closed Federal investigations com-
pleted during the preceding 12-month period with findings of any 
serious violation regarding compliance with mental health and sub-
stance use disorder coverage requirements under section 2726 of 
the Public Health Service Act (42 U.S.C. 300gg–26), section 712 
of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 
1185a), and section 9812 of the Internal Revenue Code of 1986. 
(b) CONTENTS.—Subject to subsection (c), a report under sub-
section (a) shall, with respect to investigations described in such 
subsection, include each of the following: 
(1) The number of closed Federal investigations conducted 
during the covered reporting period. 
(2) Each benefit classification examined by any such inves-
tigation conducted during the covered reporting period. 
(3) Each subject matter, including compliance with require-
ments for quantitative and nonquantitative treatment limita-
tions, of any such investigation conducted during the covered 
reporting period. 
(4) A summary of the basis of the final decision rendered 
for each closed investigation conducted during the covered 
reporting period that resulted in a finding of a serious violation. 
(c) LIMITATION.—Any individually identifiable information shall 
be excluded from reports under subsection (a) consistent with 
protections under the health privacy and security rules promulgated 
under section 264(c) of the Health Insurance Portability and 
Accountability Act of 1996 (42 U.S.C. 1320d–2 note).
H. R. 34—254 
SEC. 13004. GAO STUDY ON PARITY IN MENTAL HEALTH AND SUB-
STANCE USE DISORDER BENEFITS. 
Not later than 3 years after the date of enactment of this 
Act, the Comptroller General of the United States, in consultation 
with the Secretary of Health and Human Services, the Secretary 
of Labor, and the Secretary of the Treasury, shall submit to the 
Committee on Energy and Commerce of the House of Representa-
tives and the Committee on Health, Education, Labor, and Pensions 
of the Senate a report detailing the extent to which group health 
plans or health insurance issuers offering group or individual health 
insurance coverage that provides both medical and surgical benefits 
and mental health or substance use disorder benefits, medicaid 
managed care organizations with a contract under section 1903(m) 
of the Social Security Act (42 U.S.C. 1396b(m)), and health plans 
provided under the State Children’s Health Insurance Program 
under title XXI of the Social Security Act (42 U.S.C. 1397aa et 
seq.) comply with section 2726 of the Public Health Service Act 
(42 U.S.C. 300gg–26), section 712 of the Employee Retirement 
Income Security Act of 1974 (29 U.S.C. 1185a), and section 9812 
of the Internal Revenue Code of 1986, including— 
(1) how nonquantitative treatment limitations, including 
medical necessity criteria, of such plans or issuers comply with 
such sections; 
(2) how the responsible Federal departments and agencies 
ensure that such plans or issuers comply with such sections, 
including an assessment of how the Secretary of Health and 
Human Services has used its authority to conduct audits of 
such plans to ensure compliance; 
(3) a review of how the various Federal and State agencies 
responsible for enforcing mental health parity requirements 
have improved enforcement of such requirements in accordance 
with the objectives and timeline described in the action plan 
under section 13002; and 
(4) recommendations for how additional enforcement, edu-
cation, and coordination activities by responsible Federal and 
State departments and agencies could better ensure compliance 
with such sections, including recommendations regarding the 
need for additional legal authority. 
SEC. 13005. INFORMATION AND AWARENESS ON EATING DISORDERS. 
(a) INFORMATION.—The Secretary of Health and Human Serv-
ices, acting through the Director of the Office on Women’s Health, 
may— 
(1) update information, related fact sheets, and resource 
lists related to eating disorders that are available on the public 
Internet website of the National Women’s Health Information 
Center sponsored by the Office on Women’s Health, to include— 
(A) updated findings and current research related to 
eating disorders, as appropriate; and 
(B) information about eating disorders, including 
information related to males and females; 
(2) incorporate, as appropriate, and in coordination with 
the Secretary of Education, information from publicly available 
resources into appropriate obesity prevention programs devel-
oped by the Office on Women’s Health; and 
(3) make publicly available (through a public Internet 
website or other method) information, related fact sheets, and
H. R. 34—255 
resource lists, as updated under paragraph (1), and the informa-
tion incorporated into appropriate obesity prevention programs 
under paragraph (2). 
(b) AWARENESS.—The Secretary of Health and Human Services 
may advance public awareness on— 
(1) the types of eating disorders; 
(2) the seriousness of eating disorders, including preva-
lence, comorbidities, and physical and mental health con-
sequences; 
(3) methods to identify, intervene, refer for treatment, and 
prevent behaviors that may lead to the development of eating 
disorders; 
(4) discrimination and bullying based on body size; 
(5) the effects of media on self-esteem and body image; 
and 
(6) the signs and symptoms of eating disorders. 
SEC. 13006. EDUCATION AND TRAINING ON EATING DISORDERS. 
The Secretary of Health and Human Services may facilitate 
the identification of model programs and materials for educating 
and training health professionals in effective strategies to— 
(1) identify individuals with eating disorders; 
(2) provide early intervention services for individuals with 
eating disorders; 
(3) refer patients with eating disorders for appropriate 
treatment; 
(4) prevent the development of eating disorders; and 
(5) provide appropriate treatment services for individuals 
with eating disorders. 
SEC. 13007. CLARIFICATION OF EXISTING PARITY RULES. 
If a group health plan or a health insurance issuer offering 
group or individual health insurance coverage provides coverage 
for eating disorder benefits, including residential treatment, such 
group health plan or health insurance issuer shall provide such 
benefits consistent with the requirements of section 2726 of the 
Public Health Service Act (42 U.S.C. 300gg–26), section 712 of 
the Employee Retirement Income Security Act of 1974 (29 U.S.C. 
1185a), and section 9812 of the Internal Revenue Code of 1986. 
TITLE XIV—MENTAL HEALTH AND SAFE 
COMMUNITIES 
Subtitle A—Mental Health and Safe 
Communities 
SEC. 14001. LAW ENFORCEMENT GRANTS FOR CRISIS INTERVENTION 
TEAMS, MENTAL HEALTH PURPOSES. 
(a) EDWARD BYRNE MEMORIAL JUSTICE ASSISTANCE GRANT PRO-
GRAM.—Section 501(a)(1) of title I of the Omnibus Crime Control 
and Safe Streets Act of 1968 (42 U.S.C. 3751(a)(1)) is amended 
by adding at the end the following: 
‘‘(H) Mental health programs and related law enforce-
ment and corrections programs, including behavioral pro-
grams and crisis intervention teams.’’.
H. R. 34—256 
(b) COMMUNITY ORIENTED POLICING SERVICES PROGRAM.—Sec-
tion 1701(b) of title I of the Omnibus Crime Control and Safe 
Streets Act of 1968 (42 U.S.C. 3796dd(b)) is amended— 
(1) in paragraph (17), by striking ‘‘and’’ at the end; 
(2) by redesignating paragraph (18) as paragraph (22); 
(3) by inserting after paragraph (17) the following: 
‘‘(18) to provide specialized training to law enforcement 
officers to— 
‘‘(A) recognize individuals who have a mental illness; 
and 
‘‘(B) properly interact with individuals who have a 
mental illness, including strategies for verbal de-escalation 
of crises; 
‘‘(19) to establish collaborative programs that enhance the 
ability of law enforcement agencies to address the mental 
health, behavioral, and substance abuse problems of individuals 
encountered by law enforcement officers in the line of duty; 
‘‘(20) to provide specialized training to corrections officers 
to recognize individuals who have a mental illness; 
‘‘(21) to enhance the ability of corrections officers to address 
the mental health of individuals under the care and custody 
of jails and prisons, including specialized training and strategies 
for verbal de-escalation of crises; and’’; and 
(4) in paragraph (22), as redesignated, by striking ‘‘through 
(17)’’ and inserting ‘‘through (21)’’. 
(c) MODIFICATIONS TO THE STAFFING FOR ADEQUATE FIRE AND 
EMERGENCY RESPONSE GRANTS.—Section 34(a)(1)(B) of the Federal 
Fire Prevention and Control Act of 1974 (15 U.S.C. 2229a(a)(1)(B)) 
is amended by inserting before the period at the end the following: 
‘‘and to provide specialized training to paramedics, emergency med-
ical services workers, and other first responders to recognize individ-
uals who have mental illness and how to properly intervene with 
individuals with mental illness, including strategies for verbal de- 
escalation of crises’’. 
SEC. 14002. ASSISTED OUTPATIENT TREATMENT PROGRAMS. 
(a) IN GENERAL.—Section 2201 of title I of the Omnibus Crime 
Control and Safe Streets Act of 1968 (42 U.S.C. 3796ii) is amended 
in paragraph (2)(B), by inserting before the semicolon the following: 
‘‘, or court-ordered assisted outpatient treatment when the court 
has determined such treatment to be necessary’’. 
(b) DEFINITIONS.—Section 2202 of title I of the Omnibus Crime 
Control and Safe Streets Act of 1968 (42 U.S.C. 3796ii—1) is 
amended— 
(1) in paragraph (1), by striking ‘‘and’’ at the end; 
(2) in paragraph (2), by striking the period at the end 
and inserting a semicolon; and 
(3) by adding at the end the following: 
‘‘(3) the term ‘court-ordered assisted outpatient treatment’ 
means a program through which a court may order a treatment 
plan for an eligible patient that— 
‘‘(A) requires such patient to obtain outpatient mental 
health treatment while the patient is not currently residing 
in a correctional facility or inpatient treatment facility; 
and