‘‘SEC. 9816. COVERAGE FOR TREATMENT FOR EATING DIS-
ORDERS. 
‘‘(a) COVERAGE.—A group health plan that provides 
medical and surgical benefits shall provide coverage for 
treatment for eating disorders consistent with the provi-
sions of this section. 
‘‘(b) PROHIBITIONS.—A group health plan shall 
not— 
‘‘(1) deny to an individual eligibility, or contin-
ued eligibility, to enroll or to renew coverage under 
the terms of the plan, solely for the purpose of 
avoiding the requirement of this section; 
‘‘(2) deny coverage for treatment of eating dis-
orders, including coverage for residential treatment 
of eating disorders, if such treatment is medically 
necessary in accordance with the Practice Guidelines 
for the Treatment of Patients with Eating Dis-
orders, as most recently published by the American 
Psychiatric Association; 
‘‘(3) provide monetary payments, rebates, or 
other benefits to individuals to encourage such indi-
viduals to accept less than the minimum protections 
available under this section; 
‘‘(4) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
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provided care to an individual participant or bene-
ficiary in accordance with this section; 
‘‘(5) provide incentives (monetary or otherwise) 
to a provider to induce such provider to provide care 
to an individual participant or beneficiary in a man-
ner inconsistent with this section; or 
‘‘(6) deny to an individual participant or bene-
ficiary continued eligibility to enroll or to renew cov-
erage under the terms of the plan, solely because the 
individual was previously found to have an eating 
disorder or to have received treatment for an eating 
disorder. 
‘‘(c) OUT-OF-NETWORK PROVIDERS.—In the case of 
a group health plan that provides both medical and sur-
gical benefits and coverage for treatment for eating dis-
orders, if the plan provides coverage for medical or sur-
gical benefits provided by out-of-network providers, the 
plan or coverage shall provide coverage for treatment for 
eating disorders provided by out-of-network providers in 
a manner that is consistent with the requirements of this 
section. 
‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed as preventing a group health plan 
or issuer from imposing deductibles, coinsurance, or other 
cost-sharing in relation to treatment for eating disorders, 
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except that such deductibles, coinsurance, or other cost- 
sharing may not be greater than the deductibles, coinsur-
ance, or other cost-sharing imposed on other comparable 
medical or surgical services covered under the plan. 
‘‘(e) EATING DISORDERS DEFINED.—For purposes 
of this section, the term ‘eating disorder’ includes anorexia 
nervosa, bulimia nervosa, binge eating disorder, and eat-
ing disorders not otherwise specified (EDNOS), as defined 
in the fifth edition of ‘Diagnostic and Statistical Manual 
of Mental Disorders’ or, if applicable, the most recent suc-
cessor edition.’’. 
(2) CLERICAL AMENDMENT.—The table of sec-
tions of such subchapter is amended by adding at 
the end the following new items: 
‘‘Sec. 9815. Additional market reforms. 
‘‘Sec. 9816. Coverage for treatment for eating disorders.’’. 
(3) 
CONFORMING
AMENDMENT.—Section 
4980D(d)(1) of the Internal Revenue Code of 1986 
is amended by striking ‘‘section 9811’’ and inserting 
‘‘sections 9811 and 9816’’. 
(d) APPLICATION UNDER FEDERAL EMPLOYEES 
HEALTH BENEFITS PROGRAM (FEHBP).—Section 8902 
of title 5, United States Code, is amended by adding at 
the end the following new subsection: 
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‘‘(p) A contract may not be made or a plan approved 
which does not comply with the requirements of section 
2729 of the Public Health Service Act.’’. 
(e) EFFECTIVE DATES.—The amendments made by 
this section shall apply with respect to group health plans 
and health benefit plans for plan years beginning on or 
after the date that is 6 months after the date of the enact-
ment of this Act, and with respect to health insurance cov-
erage offered, sold, issued, renewed, in effect, or operated 
in the individual market on or after such date that is 6 
months after such date of enactment. 
(f) COORDINATION OF ADMINISTRATION.—The Sec-
retary of Labor, the Secretary of Health and Human Serv-
ices, and the Secretary of the Treasury 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 the provisions of this section (and 
the amendments made thereby) 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 
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that avoids duplication of enforcement efforts and 
assigns priorities in enforcement. 
TITLE 
IV—IMPROVING 
AVAIL-
ABILITY 
AND 
ACCESS 
TO 
TREATMENT 
SEC. 401. MEDICAID COVERAGE FOR EATING DISORDER 
TREATMENT SERVICES. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d(a)), as amended by section 
2301(a)(1) of the Patient Protection and Affordable Care 
Act (Public Law 111–148) and section 1202(b) of the 
Health Care and Education Reconciliation Act of 2010 
(Public Law 111–152), is amended— 
(1) in subsection (a)— 
(A) in paragraph (28), by striking ‘‘and’’ 
at the end; 
(B) by redesignating paragraph (29) as 
paragraph (30); and 
(C) by inserting after paragraph (28) the 
following new paragraph: 
‘‘(29) eating disorder treatment services (as de-
fined in subsection (ee)(1)); and’’; 
and 
(2) by adding at the end the following new sub-
section: 
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