I 
115TH CONGRESS 
2D SESSION 
H. R. 4778 
To strengthen parity in mental health and substance use disorder benefits. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 11, 2018 
Mr. KENNEDY (for himself, Ms. MATSUI, Mr. TONKO, Mr. BEN RAY LUJA´N 
of New Mexico, Mr. ENGEL, Ms. SCHAKOWSKY, Mrs. DINGELL, and Mr. 
RUSH) introduced the following bill; which was referred to the Committee 
on Energy and Commerce, and in addition to the Committees on Edu-
cation and the Workforce, and Ways and Means, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such 
provisions as fall within the jurisdiction of the committee concerned 
A BILL 
To strengthen parity in mental health and substance use 
disorder benefits. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Behavioral Health Cov-
erage Transparency Act of 2018’’. 
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SEC. 2. STRENGTHENING PARITY IN MENTAL HEALTH AND 
SUBSTANCE USE DISORDER BENEFITS. 
(a) 
PUBLIC
HEALTH
SERVICE
ACT.—Section 
2726(a) of the Public Health Service Act (42 U.S.C. 
300gg–26(a)) is amended by adding at the end the fol-
lowing new paragraph: 
‘‘(8) DISCLOSURE
AND
ENFORCEMENT
RE-
QUIREMENTS.— 
‘‘(A) DISCLOSURE REQUIREMENTS.— 
‘‘(i) REGULATIONS.—Not later than 6 
months after the date of enactment of this 
paragraph, the Secretary, in cooperation 
with the Secretaries of Labor and the 
Treasury, shall issue regulations for car-
rying out this section, including an expla-
nation of documents that group health 
plans and health insurance issuers offering 
group or individual health insurance cov-
erage shall disclose in accordance with 
clause (ii), the process governing the dis-
closure of such documents, and analyses 
that such plans and issuers shall conduct 
in order to demonstrate compliance with 
this section. 
‘‘(ii) DISCLOSURE REQUIREMENTS.— 
The documents required to be disclosed by 
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a group health plan or a health insurance 
issuer offering group or individual health 
insurance under clause (i) shall include an 
annual report that details the specific anal-
yses performed to ensure compliance of 
such plan or issuer with this section, in-
cluding any regulation promulgated pursu-
ant to this section. At a minimum, with re-
spect to the application of nonquantitative 
treatment limitations (in this paragraph 
referred to as ‘NQTLs’) to benefits under 
the plan or coverage, such report shall— 
‘‘(I) identify the specific factors 
the plan or issuer used in performing 
its NQTLs analysis; 
‘‘(II) identify and define the spe-
cific evidentiary standards relied on to 
evaluate such factors; 
‘‘(III) describe how the evi-
dentiary standards are applied to each 
service category for mental health 
benefits, substance use disorder bene-
fits, medical benefits, and surgical 
benefits; 
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‘‘(IV) disclose the results of the 
analyses of the specific evidentiary 
standards in each service category; 
and 
‘‘(V) disclose the specific findings 
of the plan or issuer in each service 
category and the conclusions reached 
with respect to whether the processes, 
strategies, evidentiary standards, or 
other factors used in applying the 
NQTLs to mental health or substance 
use disorder benefits are comparable 
to, and applied no more stringently 
than, the processes, strategies, evi-
dentiary standards, or other factors 
used in applying the NQTLs to med-
ical and surgical benefits in the same 
classification. 
‘‘(iii) GUIDANCE.—Not later than 6 
months after the date of enactment of this 
paragraph, the Secretary, in cooperation 
with the Secretaries of Labor and the 
Treasury, shall issue guidance to group 
health plans and health insurance issuers 
offering group or individual health insur-
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ance coverage on how to satisfy the re-
quirements of this section, with respect to 
making information available to current 
and 
potential 
participants 
and 
bene-
ficiaries. Such information shall include— 
‘‘(I) certificate of coverage docu-
ments and instruments under which 
the plan or coverage involved is ad-
ministered and operated that specify, 
include, or refer to procedures, for-
mulas, and methodologies applied to 
determine a participant’s or bene-
ficiary’s benefit under the plan or cov-
erage, regardless of whether such in-
formation is contained in a document 
designated as the ‘plan document’; 
and 
‘‘(II) a disclosure of how the plan 
or issuer involved has provided that 
processes, 
strategies, 
evidentiary 
standards, and other factors used in 
applying the NQTLs to mental health 
or substance use disorder benefits are 
comparable to, and applied no more 
stringently than, the processes, strate-
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gies, evidentiary standards, or other 
factors used in applying the NQTLs 
to medical and surgical benefits in the 
same classification. 
‘‘(iv) DEFINITIONS.—In this para-
graph and paragraph (7), the terms ‘non-
quantitative treatment limitations’, ‘com-
parable to’, and ‘applied no more strin-
gently than’ have the meanings given such 
terms in sections 146.136 and 147.160 of 
title 45, Code of Federal Regulations (or 
any successor regulation). 
‘‘(B) ENFORCEMENT.— 
‘‘(i) PROCESS FOR COMPLAINTS.—Not 
later than 6 months after the date of en-
actment of this paragraph, the Secretary, 
in cooperation with the Secretaries of 
Labor and the Treasury, shall, with re-
spect to group health plans and health in-
surance issuers offering group or indi-
vidual health insurance coverage, issue 
guidance to clarify the process and 
timeline for current and potential partici-
pants and beneficiaries (and authorized 
representatives and health care providers 
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of such participants 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. 
‘‘(ii) AUDITS.— 
‘‘(I) RANDOMIZED AUDITS.—Be-
ginning 1 year after the date of enact-
ment of this paragraph, the Secretary, 
in cooperation with the Secretaries of 
Labor and the Treasury, as applica-
ble, shall conduct randomized audits 
of group health plans and health in-
surance issuers offering group or indi-
vidual health insurance coverage to 
determine compliance with this sec-
tion. Such audits shall be conducted 
on no fewer than 12 plans or cov-
erages per plan year. 
‘‘(II) ADDITIONAL AUDITS.—Be-
ginning 1 year after the date of enact-
ment of this paragraph, in the case of 
a group health plan or health insur-
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ance issuer offering group or indi-
vidual health insurance coverage with 
respect to which any claim has been 
filed during a plan year, the Sec-
retary, in cooperation with the Secre-
taries of Labor and the Treasury, as 
applicable, may audit the books and 
records of such plan or issuer to de-
termine compliance with this section. 
‘‘(iii) DENIAL RATES.—The Secretary, 
in cooperation with the Secretaries of 
Labor and the Treasury, shall collect infor-
mation on the rates of and reasons for de-
nial by group health plans and health in-
surance issuers offering group or indi-
vidual health insurance coverage of claims 
for outpatient and inpatient mental health 
and substance use disorder benefits com-
pared to the rates of and reasons for de-
nial of claims for medical and surgical ben-
efits. For the first plan year that begins on 
or after the date that is 2 years after the 
date of enactment of this paragraph, and 
each subsequent plan year, the Secretary, 
in such cooperation, shall submit to the 
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Committee on Energy and Commerce of 
the House of Representatives and the 
Committee on Health, Education, Labor, 
and Pensions of the Senate the informa-
tion collected under the previous sentence 
with respect to the previous plan year. 
‘‘(C) EFFECTIVE
DATE.—Any require-
ments of group health plans and health insur-
ance issuers offering group or individual health 
insurance coverage that are included in the reg-
ulations issued under subparagraph (A)(i), in-
cluding the requirement described in subpara-
graph (A)(ii) to disclose documents, shall have 
an effective date of 1 year after the date of en-
actment of this paragraph.’’. 
(b) EMPLOYEE RETIREMENT INCOME SECURITY ACT 
OF 1974.—Section 712(a) of the Employee Retirement In-
come Security Act of 1974 (29 U.S.C. 1185a(a)) is 
amended by adding at the end the following new para-
graph: 
‘‘(6) DISCLOSURE
AND
ENFORCEMENT
RE-
QUIREMENTS.— 
‘‘(A) DISCLOSURE REQUIREMENTS.— 
‘‘(i) REGULATIONS.—Not later than 6 
months after the date of enactment of this 
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paragraph, the Secretary, in cooperation 
with the Secretaries of Health and Human 
Services and the Treasury, shall issue reg-
ulations for carrying out this section, in-
cluding an explanation of documents that a 
group health plan (or health insurance 
issuer offering health insurance coverage in 
connection with such a plan) shall disclose 
in accordance with clause (ii), the process 
governing the disclosure of such docu-
ments, and analyses that such plans and 
issuers shall conduct in order to dem-
onstrate compliance with this section. 
‘‘(ii) DISCLOSURE REQUIREMENTS.— 
The documents required to be disclosed by 
a group health plan (or a health insurance 
issuer offering health insurance coverage in 
connection with such a plan) under clause 
(i) shall include an annual report that de-
tails the specific analyses performed to en-
sure compliance of such plan or issuer with 
this section, including any regulation pro-
mulgated pursuant to this section. At a 
minimum, with respect to the application 
of nonquantitative treatment limitations 
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(in this paragraph referred to as ‘NQTLs’) 
to benefits under the plan or coverage, 
such report shall— 
‘‘(I) identify the specific factors 
the plan or issuer used in performing 
its NQTLs analysis; 
‘‘(II) identify and define the spe-
cific evidentiary standards relied on to 
evaluate such factors; 
‘‘(III) describe how the evi-
dentiary standards are applied to each 
service category for mental health 
benefits, substance use disorder bene-
fits, medical benefits, and surgical 
benefits; 
‘‘(IV) disclose the results of the 
analyses of the specific evidentiary 
standards in each service category; 
and 
‘‘(V) disclose the specific findings 
of the plan or issuer in each service 
category and the conclusions reached 
with respect to whether the processes, 
strategies, evidentiary standards, or 
other factors used in applying the 
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NQTLs to mental health or substance 
use disorder benefits are comparable 
to, and applied no more stringently 
than, the processes, strategies, evi-
dentiary standards, or other factors 
used in applying the NQTLs to med-
ical and surgical benefits in the same 
classification. 
‘‘(iii) GUIDANCE.—Not later than 6 
months after the date of enactment of this 
paragraph, the Secretary, in cooperation 
with the Secretaries of Health and Human 
Services and the Treasury, shall issue 
guidance to group health plans (and health 
insurance issuers offering health insurance 
coverage in connection with such plans) on 
how to satisfy the requirements of this sec-
tion, with respect to making information 
available to current and potential partici-
pants and beneficiaries. Such information 
shall include— 
‘‘(I) certificate of coverage docu-
ments and instruments under which 
the plan or coverage involved is ad-
ministered and operated that specify, 
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include, or refer to procedures, for-
mulas, and methodologies applied to 
determine a participant’s or bene-
ficiary’s benefit under the plan or cov-
erage, regardless of whether such in-
formation is contained in a document 
designated as the ‘plan document’; 
and 
‘‘(II) a disclosure of how the plan 
or issuer involved has provided that 
processes, 
strategies, 
evidentiary 
standards, and other factors used in 
applying the NQTLs to mental health 
or substance use disorder benefits are 
comparable to, and applied no more 
stringently than, the processes, strate-
gies, evidentiary standards, or other 
factors used in applying the NQTLs 
to medical and surgical benefits in the 
same classification. 
‘‘(iv) DEFINITIONS.—In this para-
graph, the terms ‘nonquantitative treat-
ment limitations’, ‘comparable to’, and ‘ap-
plied no more stringently than’ have the 
meanings given such terms in sections 
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146.136 and 147.160 of title 45, Code of 
Federal Regulations (or any successor reg-
ulation). 
‘‘(B) ENFORCEMENT.— 
‘‘(i) PROCESS FOR COMPLAINTS.—Not 
later than 6 months after the date of en-
actment of this paragraph, the Secretary, 
in cooperation with the Secretaries of 
Health and Human Services and the 
Treasury, shall, with respect to group 
health plans (and health insurance issuers 
offering health insurance coverage in con-
nection with such plans), issue guidance to 
clarify the process and timeline for current 
and potential participants and beneficiaries 
(and authorized representatives and health 
care providers of such participants 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. 
‘‘(ii) AUDITS.— 
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‘‘(I) RANDOMIZED AUDITS.—Be-
ginning 1 year after the date of enact-
ment of this paragraph, the Secretary, 
in cooperation with the Secretaries of 
Health and Human Services and the 
Treasury, as applicable, shall conduct 
randomized audits of group health 
plans (and health insurance issuers 
offering health insurance coverage in 
connection with such plans) to deter-
mine compliance with this section. 
Such audits shall be conducted on no 
fewer than 12 plans or coverages per 
plan year. 
‘‘(II) ADDITIONAL AUDITS.—Be-
ginning 1 year after the date of enact-
ment of this paragraph, in the case of 
a group health plan (or health insur-
ance issuer offering health insurance 
coverage in connection with such a 
plan) with respect to which any claim 
has been filed during a plan year, the 
Secretary, in cooperation with the 
Secretaries of Health and Human 
Services and the Treasury, as applica-
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ble, may audit the books and records 
of such plan or issuer to determine 
compliance with this section. 
‘‘(iii) DENIAL RATES.—The Secretary, 
in cooperation with the Secretaries of 
Health and Human Services and the 
Treasury, shall collect information on the 
rates of and reasons for denial by group 
health plans (and health insurance issuers 
offering health insurance coverage in con-
nection with such plans) of claims for out-
patient and inpatient mental health and 
substance use disorder benefits compared 
to the rates of and reasons for denial of 
claims for medical and surgical benefits. 
For the first plan year that begins on or 
after the date that is 2 years after the date 
of enactment of this paragraph, and each 
subsequent plan year, the Secretary, in 
such cooperation, shall submit to the Com-
mittee on Energy and Commerce of the 
House of Representatives and the Com-
mittee on Health, Education, Labor, and 
Pensions of the Senate the information col-
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lected under the previous sentence with re-
spect to the previous plan year. 
‘‘(C) EFFECTIVE
DATE.—Any require-
ments of group health plans (or health insur-
ance issuers offering health insurance coverage 
in connection with such plans) that are included 
in the regulations issued under subparagraph 
(A)(i), including the requirement described in 
subparagraph (A)(ii) to disclose documents, 
shall have an effective date of 1 year after the 
date of enactment of this paragraph.’’. 
(c) INTERNAL REVENUE CODE OF 1986.—Section 
9812(a) of the Internal Revenue Code of 1986 is amended 
by adding at the end the following new paragraph: 
‘‘(6) DISCLOSURE
AND
ENFORCEMENT
RE-
QUIREMENTS.— 
‘‘(A) DISCLOSURE REQUIREMENTS.— 
‘‘(i) REGULATIONS.—Not later than 6 
months after the date of enactment of this 
paragraph, the Secretary, in cooperation 
with the Secretaries of Health and Human 
Services and Labor, shall issue regulations 
for carrying out this section, including an 
explanation of documents that group 
health plans shall disclose in accordance 
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with clause (ii), the process governing the 
disclosure of such documents, and analyses 
that such plans shall conduct in order to 
demonstrate compliance with this section. 
‘‘(ii) DISCLOSURE REQUIREMENTS.— 
The documents required to be disclosed by 
a group health plan under clause (i) shall 
include an annual report that details the 
specific analyses performed to ensure com-
pliance of such plan with this section, in-
cluding any regulation promulgated pursu-
ant to such section. At a minimum, with 
respect to the application of nonquantita-
tive treatment limitations (in this para-
graph referred to as ‘NQTLs’) to benefits 
under the plan, such report shall— 
‘‘(I) identify the specific factors 
the plan used in performing its 
NQTLs analysis; 
‘‘(II) identify and define the spe-
cific evidentiary standards relied on to 
evaluate such factors; 
‘‘(III) describe how the evi-
dentiary standards are applied to each 
service category for mental health 
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benefits, substance use disorder bene-
fits, medical benefits, and surgical 
benefits; 
‘‘(IV) disclose the results of the 
analyses of the specific evidentiary 
standards in each service category; 
and 
‘‘(V) disclose the specific findings 
of the plan in each service category 
and the conclusions reached with re-
spect to whether the processes, strate-
gies, evidentiary standards, or other 
factors used in applying the NQTLs 
to mental health or substance use dis-
order benefits are comparable to, and 
applied no more stringently than, the 
processes, 
strategies, 
evidentiary 
standards, or other factors used in ap-
plying the NQTLs to medical and sur-
gical benefits in the same classifica-
tion. 
‘‘(iii) GUIDANCE.—Not later than 6 
months after the date of enactment of this 
paragraph, the Secretary, in cooperation 
with the Secretaries of Health and Human 
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Services and Labor, shall issue guidance to 
group health plans on how to satisfy the 
requirements of this section, with respect 
to making information available to current 
and 
potential 
participants 
and 
bene-
ficiaries. Such information shall include— 
‘‘(I) certificate of coverage docu-
ments and instruments under which 
the plan involved is administered and 
operated that specify, include, or refer 
to procedures, formulas, and meth-
odologies applied to determine a par-
ticipant’s 
or 
beneficiary’s 
benefit 
under the plan, regardless of whether 
such information is contained in a 
document designated as the ‘plan doc-
ument’; and 
‘‘(II) a disclosure of how the plan 
involved has provided that processes, 
strategies, evidentiary standards, and 
other factors used in applying the 
NQTLs to mental health or substance 
use disorder benefits are comparable 
to, and applied no more stringently 
than, the processes, strategies, evi-
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dentiary standards, or other factors 
used in applying the NQTLs to med-
ical and surgical benefits in the same 
classification. 
‘‘(iv) DEFINITIONS.—In this para-
graph, the terms ‘nonquantitative treat-
ment limitations’, ‘comparable to’, and ‘ap-
plied no more stringently than’ have the 
meanings given such terms in sections 
146.136 and 147.160 of title 45, Code of 
Federal Regulations (or any successor reg-
ulation). 
‘‘(B) ENFORCEMENT.— 
‘‘(i) PROCESS FOR COMPLAINTS.—Not 
later than 6 months after the date of en-
actment of this paragraph, the Secretary, 
in cooperation with the Secretaries of 
Health and Human Services and Labor, 
shall, with respect to group health plans, 
issue guidance to clarify the process and 
timeline for current and potential partici-
pants and beneficiaries (and authorized 
representatives and health care providers 
of such participants and beneficiaries) with 
respect to such plans to file formal com-
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plaints of such plans 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. 
‘‘(ii) AUDITS.— 
‘‘(I) RANDOMIZED AUDITS.—Be-
ginning 1 year after the date of enact-
ment of this paragraph, the Secretary, 
in cooperation with the Secretaries of 
Health and Human Services and 
Labor, as applicable, shall conduct 
randomized audits of group health 
plans to determine compliance with 
this section. Such audits shall be con-
ducted on no fewer than 12 plans per 
plan year. 
‘‘(II) ADDITIONAL AUDITS.—Be-
ginning 1 year after the date of enact-
ment of this paragraph, in the case of 
a group health plan with respect to 
which any claim has been filed during 
a plan year, the Secretary, in coopera-
tion with the Secretaries of Health 
and Human Services and Labor, as 
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applicable, may audit the books and 
records of such plan to determine 
compliance with this section. 
‘‘(iii) DENIAL RATES.—The Secretary, 
in cooperation with the Secretaries of 
Health and Human Services and Labor, 
shall collect information on the rates of 
and reasons for denial by group health 
plans of claims for outpatient and inpa-
tient mental health and substance use dis-
order benefits compared to the rates of 
and reasons for denial of claims for med-
ical and surgical benefits. For the first 
plan year that begins on or after the date 
that is 2 years after the date of enactment 
of this paragraph, and each subsequent 
plan year, the Secretary, in such coopera-
tion, shall submit to the Committee on En-
ergy and Commerce of the House of Rep-
resentatives and the Committee on Health, 
Education, Labor, and Pensions of the 
Senate the information collected under the 
previous sentence with respect to the pre-
vious plan year. 
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‘‘(C) EFFECTIVE
DATE.—Any require-
ments of group health plans that are included 
in the regulations issued under subparagraph 
(A)(i), including the requirement described in 
subparagraph (A)(ii) to disclose documents, 
shall have an effective date of 1 year after the 
date of enactment of this paragraph.’’. 
SEC. 3. CONSUMER PARITY UNIT FOR MENTAL HEALTH 
AND SUBSTANCE USE DISORDER PARITY VIO-
LATIONS. 
(a) DEFINITIONS.—In this section: 
(1) APPLICABLE STATE AUTHORITY.—The term 
‘‘applicable State authority’’ has the meaning given 
the term in section 2791 of the Public Health Serv-
ice Act (42 U.S.C. 300gg–91). 
(2) COVERED PLAN.—The term ‘‘covered plan’’ 
means any creditable coverage that is subject to any 
of the mental health parity laws. 
(3) CREDITABLE COVERAGE.—The term ‘‘cred-
itable coverage’’ has the meaning given the term in 
section 2704(c) of the Public Health Service Act (42 
U.S.C. 300gg–3(c)). 
(4) MENTAL HEALTH PARITY LAWS.—The term 
‘‘mental health parity laws’’ means— 
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(A) section 2726 of the Public Health 
Service Act (42 U.S.C. 300gg–26); 
(B) section 712 of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 
1185a); 
(C) section 9812 of the Internal Revenue 
Code of 1986; or 
(D) any other law that applies the require-
ments under any of the sections described in 
subparagraph (A), (B), or (C), or requirements 
that are substantially similar to those provided 
under any such section, as determined by the 
Secretary, to creditable coverage. 
(5) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
(b) ESTABLISHMENT.—Not later than 6 months after 
the date of enactment of this Act, the Secretary, in con-
sultation with the Secretary of Labor, the Secretary of the 
Treasury, and the head of any other applicable agency, 
shall establish a consumer parity unit with functions that 
include— 
(1) facilitating the centralized collection of, 
monitoring of, and response to consumer complaints 
regarding violations of mental health parity laws 
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through developing and administering, in accordance 
with subsection (d)— 
(A) a single, toll-free telephone number; 
and 
(B) a public website portal, which may in-
clude enhancing a website portal in existence on 
the date of enactment of this Act; and 
(2) providing information to health care con-
sumers regarding the disclosure requirements and 
enforcement under section 2726(a)(8) of the Public 
Health Service Act, section 712(a)(6) of the Em-
ployee Retirement Income Security Act of 1974, and 
section 9812(a)(6) of the Internal Revenue Code of 
1986, as added by section 2. 
(c) WEBSITE PORTAL.—The Secretary, in consulta-
tion with the Secretary of Labor, the Secretary of the 
Treasury, and the head of any other applicable agency, 
shall make available on the website portal established 
under subsection (b)(1)(B)— 
(1) any guidance and any reports issued by the 
Secretary, the Secretary of Labor, or the Secretary 
of the Treasury, under section 2726 of the Public 
Health Service Act, section 712 of the Employee Re-
tirement Income Security Act of 1974, or section 
9812 of the Internal Revenue Code of 1986, respec-
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tively, including the amendments to such sections 
made by section 2; 
(2) de-identified information on the results of, 
or progress on, any concluded or ongoing audits or 
investigations of the Secretary, the Secretary of 
Labor, or the Secretary of the Treasury, as applica-
ble, under such section 2726, 712, or 9812, respec-
tively; and 
(3) any information on rates of or reasons for 
denial collected by the Secretary, the Secretary of 
Labor, or the Secretary of the Treasury, pursuant to 
subsection (a)(8)(B)(iii) of such section 2726, sub-
section (a)(6)(B)(iii) of such section 712, or sub-
section (a)(6)(B)(iii) of such section 9812, respec-
tively. 
(d) RESPONSE TO CONSUMER COMPLAINTS AND IN-
QUIRIES.— 
(1) TIMELY RESPONSE TO CONSUMERS.—The 
Secretary, in consultation with the Secretary of 
Labor, the Secretary of the Treasury, and the head 
of any other applicable agency, shall establish rea-
sonable procedures for the consumer parity unit es-
tablished under this section to provide a timely re-
sponse (in writing if appropriate) to consumers re-
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garding complaints received by the unit against, or 
inquiries concerning, a covered plan, including— 
(A) steps that have been taken by the ap-
propriate State or Federal enforcement agency 
in response to the complaint or inquiry of the 
consumer; 
(B) any responses received by the appro-
priate State or Federal enforcement agency 
from the covered plan; 
(C) any follow-up actions or planned fol-
low-up actions by the appropriate State or Fed-
eral enforcement agency in response to the com-
plaint or inquiry of the consumer; and 
(D) contact information of the appropriate 
enforcement agency for the consumer to follow 
up on the complaint or inquiry. 
(2) TIMELY
RESPONSE
TO
REGULATORS.—A 
covered plan shall provide a timely response (in writ-
ing if appropriate) to the appropriate State or Fed-
eral enforcement agency having jurisdiction over 
such plan concerning a consumer complaint or in-
quiry submitted to the consumer parity unit estab-
lished under this section including— 
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(A) steps that have been taken by the plan 
to respond to the complaint or inquiry of the 
consumer; 
(B) any responses received by the plan 
from the consumer; and 
(C) follow-up actions or planned follow-up 
actions by the plan in response to the complaint 
or inquiry of the consumer. 
(3) PROVISION
OF
INFORMATION
TO
CON-
SUMERS.— 
(A) IN GENERAL.—A covered plan shall, in 
a timely manner, comply with a consumer re-
quest for information in the control or posses-
sion of such covered plan concerning the cov-
erage the consumer obtained from such covered 
plan. 
(B) EXCEPTIONS.—Notwithstanding sub-
paragraph (A), a covered plan, and any agency 
or entity having jurisdiction over a covered 
plan, may not be required by this paragraph to 
make available to the consumer any information 
required to be kept confidential by any other 
provision of law. 
(e) REPORTS.— 
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(1) IN GENERAL.—Not later than March 31 of 
each year, the Secretary, in consultation with the 
Secretary of Labor, the Secretary of the Treasury, 
and the head of any other applicable agency, shall 
submit a report to Congress on the complaints re-
ceived by the consumer parity unit established under 
this section in the prior year regarding covered 
plans. 
(2) CONTENTS.—Each such report shall include 
information and analysis about complaint numbers, 
complaint types, and, where applicable, information 
about the resolution of complaints. 
(3) CONSUMER
PARITY
UNIT
POSTING.—The 
Secretary shall submit such reports to the consumer 
parity unit established under this section, and such 
unit shall post the reports on the website portal es-
tablished under subsection (b)(1)(B). 
(f) DATA SHARING.—Subject to any applicable stand-
ards for Federal or State agencies with respect to pro-
tecting personally identifiable information and data secu-
rity and integrity— 
(1) the consumer parity unit established under 
this section shall share consumer complaint informa-
tion with the Secretary, and the head of any other 
applicable Federal or State agency; and 
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(2) the Secretary, and the head of any other 
applicable Federal or State agency, shall share data 
relating to consumer complaints regarding covered 
plans with such unit. 
(g) PRIVACY CONSIDERATIONS.— 
(1) IN GENERAL.—In carrying out this section, 
the consumer parity unit established under this sec-
tion and the Secretary, in consultation with the Sec-
retary of Labor, the Secretary of the Treasury, and 
the head of any other applicable agency, shall take 
measures to ensure that proprietary, personal, or 
confidential consumer information that is protected 
from public disclosure under section 552(b) or 552a 
of title 5, United States Code, or any other provision 
of law, is not made public under this section. 
(2) EXCEPTIONS.—The consumer parity unit 
established under this section may not obtain from 
a covered plan any personally identifiable informa-
tion about a consumer from the records of the cov-
ered plan, except— 
(A) if the records are reasonably described 
in a request by the consumer parity unit estab-
lished under this section, and the consumer pro-
vides appropriate permission for the disclosure 
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of such information by the covered plan to such 
unit; or 
(B) as may be specifically permitted or re-
quired under other applicable provisions of law, 
including HIPAA privacy and security law as 
defined in section 3009(a) of the Public Health 
Service Act (42 U.S.C. 300jj–19(a)). 
(h) COLLABORATION.— 
(1) AGREEMENTS
WITH
OTHER
AGENCIES.— 
The Secretary, the Secretary of Labor, the Secretary 
of the Treasury, and the head of any other applica-
ble agency, shall enter into a memorandum of under-
standing with any affected Federal regulatory agen-
cy regarding procedures by which any covered plan, 
and any other agency having jurisdiction over a cov-
ered plan, shall comply with this section. 
(2) AGREEMENTS WITH STATES.—To the ex-
tent practicable, an applicable State authority may 
receive appropriate complaints from the consumer 
parity unit established under this section, if— 
(A) the applicable State authority has the 
functional capacity to receive calls or electronic 
reports routed by the unit; 
(B) the applicable State authority has sat-
isfied any conditions of participation that the 
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