Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act
Bill: H.R.8886 | Sponsor: Rep. Moore, Gwen (D-WI)
Policy area: Health

Summary:
Promoting Clarity in Mental Health and Substance Use Disorder Treatment Act
This bill requires health insurance plans to define their coverage of mental health conditions and substance use disorder based on specified external benchmarks.

To amend the Public Health Service Act, Internal Revenue Code of 1986, 
 and Employee Retirement Income Security Act of 1974 to ensure mental 
  health and substance use disorder benefits are defined pursuant to 
     external benchmarks based on nationally recognized standards.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Promoting Clarity in Mental Health 
and Substance Use Disorder Treatment Act''.

SEC. 2. ENSURING MENTAL HEALTH AND SUBSTANCE USE DISORDER BENEFITS ARE 
              DEFINED PURSUANT TO EXTERNAL BENCHMARKS BASED ON 
              NATIONALLY RECOGNIZED STANDARDS.

    (a) PHSA.--Section 2726(e) of the Public Health Service Act (42 
U.S.C. 300gg-26(e)) is amended--
            (1) in paragraph (4), by adding at the end the following 
        new sentence: ``Any definition of the term `mental health 
        condition' applied for purposes of the previous sentence shall 
        include at least the conditions (other than a substance use 
        disorder) that fall under any of the diagnostic categories 
        listed in the mental and behavioral disorders chapter of the 
        most recent edition of the World Health Organization's 
        International Statistical Classification of Diseases and 
        Related Health Problems, or that is listed in the most recent 
        version of the American Psychiatric Association's Diagnostic 
        and Statistical Manual of Mental Disorders.''; and
            (2) in paragraph (5), by adding at the end the following 
        new sentence: ``Any definition of the term `substance use 
        disorder' applied for purposes of the previous sentence shall 
        include at least the disorders that fall under any of the 
        diagnostic categories listed in the mental and behavioral 
        disorders chapter of the most recent edition of the World 
        Health Organization's International Statistical Classification 
        of Diseases and Related Health Problems as a mental and 
        behavioral disorder due to psychoactive substance use (or 
        equivalent category), or that is listed in the most recent 
        version of the American Psychiatric Association's Diagnostic 
        and Statistical Manual of Mental Disorders as a substance-
        related and addictive disorder (or equivalent category).''.
    (b) IRC.--Section 9812(e) of the Internal Revenue Code of 1986 is 
amended--
            (1) in paragraph (4), by adding at the end the following 
        new sentence: ``Any definition of the term `mental health 
        condition' applied for purposes of the previous sentence shall 
        include at least the conditions (other than a substance use 
        disorder) that fall under any of the diagnostic categories 
        listed in the mental and behavioral disorders chapter of the 
        most recent edition of the World Health Organization's 
        International Statistical Classification of Diseases and 
        Related Health Problems, or that is listed in the most recent 
        version of the American Psychiatric Association's Diagnostic 
        and Statistical Manual of Mental Disorders.''; and
            (2) in paragraph (5), by adding at the end the following 
        new sentence: ``Any definition of the term `substance use 
        disorder' applied for purposes of the previous sentence shall 
        include at least the disorders that fall under any of the 
        diagnostic categories listed in the mental and behavioral 
        disorders chapter of the most recent edition of the World 
        Health Organization's International Statistical Classification 
        of Diseases and Related Health Problems as a mental and 
        behavioral disorder due to psychoactive substance use (or 
        equivalent category), or that is listed in the most recent 
        version of the American Psychiatric Association's Diagnostic 
        and Statistical Manual of Mental Disorders as a substance-
        related and addictive disorder (or equivalent category).''.
    (c) ERISA.--Section 712(e) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1185a(e)) is amended--
            (1) in paragraph (4), by adding at the end the following 
        new sentence: ``Any definition of the term `mental health 
        condition' applied for purposes of the previous sentence shall 
        include at least the conditions (other than a substance use 
        disorder) that fall under any of the diagnostic categories 
        listed in the mental and behavioral disorders chapter of the 
        most recent edition of the World Health Organization's 
        International Statistical Classification of Diseases and 
        Related Health Problems, or that is listed in the most recent 
        version of the American Psychiatric Association's Diagnostic 
        and Statistical Manual of Mental Disorders.''; and
            (2) in paragraph (5), by adding at the end the following 
        new sentence: ``Any definition of the term `substance use 
        disorder' applied for purposes of the previous sentence shall 
        include at least the disorders that fall under any of the 
        diagnostic categories listed in the mental and behavioral 
        disorders chapter of the most recent edition of the World 
        Health Organization's International Statistical Classification 
        of Diseases and Related Health Problems as a mental and 
        behavioral disorder due to psychoactive substance use (or 
        equivalent category), or that is listed in the most recent 
        version of the American Psychiatric Association's Diagnostic 
        and Statistical Manual of Mental Disorders as a substance-
        related and addictive disorder (or equivalent category).''.
    (d) Implementation.--The Secretaries of Labor, Health and Human 
Services, and the Treasury may implement the provisions of, including 
the amendments made by, this section through interim final rule, sub-
regulatory guidance, program instruction, or otherwise.
    (e) Effective Date.--The amendments made by this section shall 
apply with respect to plan years beginning on or after the date that is 
6 months after the date of the enactment of this Act.
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