Title: Behavioral Health Coverage Transparency Act
Policy area: Health

Summary:
Behavioral Health Coverage Transparency Act
This bill requires the Departments of Health and Human Services (HHS), Labor, and the Treasury to (1) cooperatively issue regulations to require group health plans and health insurance issuers to annually disclose the analyses performed to ensure compliance with mental health parity laws, and (2) conduct annual random audits of group health plans and health insurance issuers to determine compliance. (Mental health parity laws prohibit health insurance plans that cover mental health and substance use disorder services from imposing less favorable limitations on those benefits than are placed on medical and surgical benefits under that plan.)
Additionally, HHS must establish a consumer parity unit: (1) to facilitate the collection of, monitoring of, and response to consumer complaints; and (2) to provide consumers information about the disclosure requirements and enforcement of the mental health parity laws.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1576 Introduced in Senate (IS)]

<DOC>






116th CONGRESS
  1st Session
                                S. 1576

   To strengthen parity in mental health and substance use disorder 
                               benefits.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 21, 2019

  Ms. Warren (for herself, Mr. Markey, Mr. Brown, Mr. Blumenthal, Ms. 
 Baldwin, Ms. Smith, Mr. Booker, Mr. Sanders, Ms. Stabenow, Mr. Kaine, 
Ms. Harris, Ms. Hassan, Mrs. Shaheen, Mr. Van Hollen, Mrs. Gillibrand, 
Ms. Klobuchar, and Mr. Murphy) introduced the following bill; which was 
 read twice and referred to the Committee on Health, Education, Labor, 
                              and Pensions

_______________________________________________________________________

                                 A BILL


 
   To strengthen parity in mental health and substance use disorder 
                               benefits.

    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 ``Behavioral Health Coverage 
Transparency Act''.

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 following new paragraph:
            ``(8) Disclosure and enforcement requirements.--
                    ``(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 carrying out this 
                        section, including an explanation of documents 
                        that group health plans and health insurance 
                        issuers offering group or individual health 
                        insurance coverage shall disclose in accordance 
                        with clause (ii), the process governing the 
                        disclosure 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 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 analyses performed to 
                        ensure compliance of such plan or issuer with 
                        this section, including any regulation 
                        promulgated pursuant to this section. At a 
                        minimum, with respect 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 
                                specific evidentiary standards relied 
                                on to evaluate such factors;
                                    ``(III) describe how the 
                                evidentiary standards are applied to 
                                each service category for mental health 
                                benefits, substance use disorder 
                                benefits, 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 NQTLs to mental health or 
                                substance use disorder benefits are 
                                comparable to, and applied no more 
                                stringently than, the processes, 
                                strategies, evidentiary standards, or 
                                other factors used in applying the 
                                NQTLs to medical 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 insurance coverage on how to satisfy the 
                        requirements of this section, with respect to 
                        making information available to current and 
                        potential participants and beneficiaries. Such 
                        information shall include--
                                    ``(I) certificate of coverage 
                                documents and instruments under which 
                                the plan or coverage involved is 
                                administered and operated that specify, 
                                include, or refer to procedures, 
                                formulas, and methodologies applied to 
                                determine a participant's or 
                                beneficiary's benefit under the plan or 
                                coverage, regardless of whether such 
                                information 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, 
                                strategies, evidentiary standards, or 
                                other factors used in applying the 
                                NQTLs to medical and surgical benefits 
                                in the same classification.
                            ``(iv) Definitions.--In this paragraph and 
                        paragraph (7), the terms `nonquantitative 
                        treatment limitations', `comparable to', and 
                        `applied 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 regulation).
                    ``(B) Enforcement.--
                            ``(i) Process for complaints.--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, with respect to group health plans and 
                        health insurance issuers offering group or 
                        individual health insurance coverage, 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.--
                                    ``(I) Randomized audits.--Beginning 
                                1 year after the date of enactment of 
                                this paragraph, the Secretary, in 
                                cooperation with the Secretaries of 
                                Labor and the Treasury, as applicable, 
                                shall conduct randomized audits of 
                                group health plans and health insurance 
                                issuers offering group or individual 
                                health insurance coverage to determine 
                                compliance with this section. Such 
                                audits shall be conducted on no fewer 
                                than 12 plans or coverages per plan 
                                year.
                                    ``(II) Additional audits.--
                                Beginning 1 year after the date of 
                                enactment of this paragraph, in the 
                                case of a group health plan or health 
                                insurance issuer offering group or 
                                individual health insurance coverage 
                                with respect to which any claim has 
                                been filed during a plan year, the 
                                Secretary, in cooperation with the 
                                Secretaries of Labor and the Treasury, 
                                as applicable, 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 Labor and 
                        the Treasury, shall collect information on the 
                        rates of and reasons for denial by group health 
                        plans and health insurance issuers offering 
                        group or individual health insurance coverage 
                        of claims for outpatient 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 Committee on 
                        Energy and Commerce of the House of 
                        Representatives and the Committee on Health, 
                        Education, Labor, and Pensions of the Senate 
                        the information collected under the previous 
                        sentence with respect to the previous plan 
                        year.
                    ``(C) Effective date.--Any requirements of group 
                health plans and health insurance issuers offering 
                group or individual health insurance coverage 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.''.
    (b) Employee Retirement Income Security Act of 1974.--Section 
712(a) of the Employee Retirement Income Security Act of 1974 (29 
U.S.C. 1185a(a)) is amended by adding at the end the following new 
paragraph:
            ``(6) Disclosure and enforcement requirements.--
                    ``(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 
                        the Treasury, shall issue regulations for 
                        carrying out this section, including 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 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 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 details the 
                        specific analyses performed to ensure 
                        compliance of such plan or issuer with this 
                        section, including any regulation promulgated 
                        pursuant to this section. At a minimum, with 
                        respect 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 
                                specific evidentiary standards relied 
                                on to evaluate such factors;
                                    ``(III) describe how the 
                                evidentiary standards are applied to 
                                each service category for mental health 
                                benefits, substance use disorder 
                                benefits, 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 NQTLs to mental health or 
                                substance use disorder benefits are 
                                comparable to, and applied no more 
                                stringently than, the processes, 
                                strategies, evidentiary standards, or 
                                other factors used in applying the 
                                NQTLs to medical 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 section, with respect 
                        to making information available to current and 
                        potential participants and beneficiaries. Such 
                        information shall include--
                                    ``(I) certificate of coverage 
                                documents and instruments under which 
                                the plan or coverage involved is 
                                administered and operated that specify, 
                                include, or refer to procedures, 
                                formulas, and methodologies applied to 
                                determine a participant's or 
                                beneficiary's benefit under the plan or 
                                coverage, regardless of whether such 
                                information 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, 
                                strategies, evidentiary standards, or 
                                other factors used in applying the 
                                NQTLs to medical and surgical benefits 
                                in the same classification.
                            ``(iv) Definitions.--In this paragraph, the 
                        terms `nonquantitative treatment limitations', 
                        `comparable to', and `applied 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 regulation).
                    ``(B) Enforcement.--
                            ``(i) Process for complaints.--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, with respect 
                        to group health plans (and health insurance 
                        issuers offering health insurance coverage in 
                        connection 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.--
                                    ``(I) Randomized audits.--Beginning 
                                1 year after the date of enactment 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 determine 
                                compliance with this section. Such 
                                audits shall be conducted on no fewer 
                                than 12 plans or coverages per plan 
                                year.
                                    ``(II) Additional audits.--
                                Beginning 1 year after the date of 
                                enactment of this paragraph, in the 
                                case of a group health plan (or health 
                                insurance 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 
                                applicable, 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 connection with such plans) of 
                        claims for outpatient 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 Committee on 
                        Energy and Commerce of the House of 
                        Representatives and the Committee on Health, 
                        Education, Labor, and Pensions of the Senate 
                        the information collected under the previous 
                        sentence with respect to the previous plan 
                        year.
                    ``(C) Effective date.--Any requirements of group 
                health plans (or health insurance 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 requirements.--
                    ``(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 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 compliance of such 
                        plan with this section, including any 
                        regulation promulgated pursuant to such 
                        section. At a minimum, with respect to the 
                        application of nonquantitative treatment 
                        limitations (in this paragraph 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 
                                specific evidentiary standards relied 
                                on to evaluate such factors;
                                    ``(III) describe how the 
                                evidentiary standards are applied to 
                                each service category for mental health 
                                benefits, substance use disorder 
                                benefits, 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 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, evidentiary 
                                standards, or other factors used in 
                                applying the NQTLs to medical 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 
                        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 beneficiaries. Such 
                        information shall include--
                                    ``(I) certificate of coverage 
                                documents and instruments under which 
                                the plan involved is administered and 
                                operated that specify, include, or 
                                refer to procedures, formulas, and 
                                methodologies applied to determine a 
                                participant's or beneficiary's benefit 
                                under the plan, regardless of whether 
                                such information is contained in a 
                                document designated as the `plan 
                                document'; 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, evidentiary 
                                standards, or other factors used in 
                                applying the NQTLs to medical and 
                                surgical benefits in the same 
                                classification.
                            ``(iv) Definitions.--In this paragraph, the 
                        terms `nonquantitative treatment limitations', 
                        `comparable to', and `applied 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 regulation).
                    ``(B) Enforcement.--
                            ``(i) Process for complaints.--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, with respect to 
                        group health 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 to 
                        file formal complaints 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.--Beginning 
                                1 year after the date of enactment 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 conducted on no 
                                fewer than 12 plans per plan year.
                                    ``(II) Additional audits.--
                                Beginning 1 year after the date of 
                                enactment 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 cooperation with the 
                                Secretaries of Health and Human 
                                Services and Labor, as 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 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 Committee on Energy and Commerce of the 
                        House of Representatives and the Committee on 
                        Health, Education, Labor, and Pensions of the 
                        Senate the information collected under the 
                        previous sentence with respect to the previous 
                        plan year.
                    ``(C) Effective date.--Any requirements 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 VIOLATIONS.

    (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 Service 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 ``creditable 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--
                    (A) section 2726 of the Public Health Service Act 
                (42 U.S.C. 300gg-26);
                    (B) section 712 of the Employee Retirement 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 requirements 
                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 consultation 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 through developing and administering, 
        in accordance with subsection (d)--
                    (A) a single, toll-free telephone number; and
                    (B) a public website portal, which may include 
                enhancing a website portal in existence on the date of 
                enactment of this Act; and
            (2) providing information to health care consumers 
        regarding the disclosure requirements and enforcement under 
        section 2726(a)(8) of the Public Health Service Act, section 
        712(a)(6) of the Employee 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 consultation 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 Retirement Income Security Act of 1974, or section 
        9812 of the Internal Revenue Code of 1986, respectively, 
        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 applicable, under such section 2726, 712, or 
        9812, respectively; 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, subsection (a)(6)(B)(iii) 
        of such section 712, or subsection (a)(6)(B)(iii) of such 
        section 9812, respectively.
    (d) Response to Consumer Complaints and Inquiries.--
            (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 reasonable procedures for the consumer parity unit 
        established under this section to provide a timely response (in 
        writing if appropriate) to consumers regarding complaints 
        received by the unit against, or inquiries concerning, a 
        covered plan, including--
                    (A) steps that have been taken by the appropriate 
                State or Federal enforcement agency in response to the 
                complaint or inquiry of the consumer;
                    (B) any responses received by the appropriate State 
                or Federal enforcement agency from the covered plan;
                    (C) any follow-up actions or planned follow-up 
                actions by the appropriate State or Federal enforcement 
                agency in response to the complaint 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 writing if appropriate) to the 
        appropriate State or Federal enforcement agency having 
        jurisdiction over such plan concerning a consumer complaint or 
        inquiry submitted to the consumer parity unit established under 
        this section including--
                    (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 consumers.--
                    (A) In general.--A covered plan shall, in a timely 
                manner, comply with a consumer request for information 
                in the control or possession of such covered plan 
                concerning the coverage the consumer obtained from such 
                covered plan.
                    (B) Exceptions.--Notwithstanding subparagraph (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.--
            (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 
        received 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 established under subsection (b)(1)(B).
    (f) Data Sharing.--Subject to any applicable standards for Federal 
or State agencies with respect to protecting personally identifiable 
information and data security and integrity--
            (1) the consumer parity unit established under this section 
        shall share consumer complaint information with the Secretary, 
        and the head of any other applicable Federal or State agency; 
        and
            (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 section and the Secretary, 
        in consultation with the Secretary 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 information about a consumer from the records of 
        the covered plan, except--
                    (A) if the records are reasonably described in a 
                request by the consumer parity unit established under 
                this section, and the consumer provides appropriate 
                permission for the disclosure of such information by 
                the covered plan to such unit; or
                    (B) as may be specifically permitted or required 
                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 applicable agency, shall enter into a memorandum 
        of understanding with any affected Federal regulatory agency 
        regarding procedures by which any covered plan, and any other 
        agency having jurisdiction over a covered plan, shall comply 
        with this section.
            (2) Agreements with states.--To the extent 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 satisfied 
                any conditions of participation that the unit may 
                establish, including treatment of personally 
                identifiable information and sharing of information on 
                complaint resolution or related compliance procedures 
                and resources; and
                    (C) participation by the applicable State authority 
                includes measures necessary to protect personally 
                identifiable information in accordance with standards 
                that apply to Federal agencies with respect to 
                protecting personally identifiable information and data 
                security and integrity.
                                 <all>