Mental Health Parity Act of 2007

Bill: 110-s-558
Sponsor: Sen. Domenici, Pete V. [R-NM]
Introduced: 2007-02-12 in the Senate
Policy area: Health
Subjects: Administrative procedure
Auditing
Civil Rights and Liberties, Minority Issues
Commerce
Congress
Congressional investigations
Congressional reporting requirements
Department of Health and Human Services
Department of Labor
Discrimination in medical care
Employee health benefits
Executive reorganization
Federal preemption
Finance and Financial Sector
Government Operations and Politics
Government publicity
Health insurance
Insurance premiums
Labor and Employment
Law
Mental health services
Ombudsman
Small business
Standards
State laws

Summary:
action_date: 2007-02-12
text: 
Mental Health Parity Act of 2007 - Amends the Employee Retirement Income Security Act (ERISA) and the Public Health Service Act to require a group health plan that provides both medical and surgical benefits and mental health benefits to ensure that: (1) the financial requirements applicable to such mental health benefits are no more restrictive than those of substantially all medical and surgical benefits covered by the plan, including deductibles and copayments; and (2) the treatment limitations applicable to such mental health benefits are no more restrictive than those applied to substantially all medical and surgical benefits covered by the plan, including limits on the frequency of treatments or similar limits on the scope or duration of treatment. Prohibits the plan from establishing separate cost sharing requirements that are applicable only with respect to mental health benefits.

Excludes from the requirements of this Act any group health plan: (1) for an employer with not more than 50 employees; or (2) whose costs of compliance with this Act increase the total costs of coverage by more than a specified percentage.

Supersedes any provision of state law that establishes, implements, or continues in effect any standard or requirement that differs from the requirements of this Act, except for laws relating to the individual insurance market or small employers.

Requires the Comptroller General to study the effect of this Act on the cost of health insurance coverage, access to such coverage, the quality of health care, and the impact on benefits and coverage for mental health and substance abuse.

action_date: 2007-03-27
text: 
Mental Health Parity Act of 2007 - (Sec. 2) Amends the Employee Retirement Income Security Act (ERISA) and the Public Health Service Act to require a group health plan that provides both medical and surgical benefits and mental health benefits to ensure that: (1) the financial requirements applicable to such mental health benefits are no more restrictive than those of substantially all medical and surgical benefits covered by the plan, including deductibles and copayments; and (2) the treatment limitations applicable to such mental health benefits are no more restrictive than those applied to substantially all medical and surgical benefits covered by the plan, including limits on the frequency of treatments or similar limits on the scope or duration of treatment. Prohibits the plan from establishing separate cost sharing requirements that are applicable only with respect to mental health benefits.

Requires that such a plan ensure that the requirements of this Act are applied to both in- and out-of-network services, if offered, by comparing in-network medical and surgical benefits to in-network mental health benefits and out-of network medical and surgical benefits to out-of-network mental health benefits.

Excludes from the requirements of this Act any group health plan: (1) for an employer with not more than 50 employees; or (2) whose costs of compliance with this Act increase the total costs of coverage by more than a specified percentage. Requires that determinations as to increases in actual costs under a plan be made by a qualified actuary and be made available to the public.

(Sec. 4) Supersedes any provision of state law that establishes, implements, or continues in effect any standard or requirement that differs from the requirements of this Act, except for laws relating to the individual insurance market or small employers.

(Sec. 5) Requires the Secretary of Labor and the Secretary of Health and Human Services to designate an individual within their departments as the group health plan ombudsman to serve as an initial point of contact to permit individuals to obtain information and provide assistance concerning coverage of mental health services under group health plans in accordance with this Act. Requires the Secretaries to provide for the conduct of random audits of group health plans to ensure compliance with this Act.

Requires the Comptroller General to study the effect of this Act on the cost of health insurance coverage, access to such coverage, the quality of health care, and the impact on benefits and coverage for mental health and substance abuse.

action_date: 2007-09-18
text: 
Mental Health Parity Act of 2007 - (Sec. 2) Amends the Employee Retirement Income Security Act (ERISA) and the Public Health Service Act to require a group health plan that provides both medical and surgical benefits and mental health benefits to ensure that: (1) the financial requirements applicable to such mental health benefits are no more restrictive than those of substantially all medical and surgical benefits covered by the plan, including deductibles and copayments; and (2) the treatment limitations applicable to such mental health benefits are no more restrictive than those applied to substantially all medical and surgical benefits covered by the plan, including limits on the frequency of treatments or similar limits on the scope or duration of treatment. Prohibits the plan from establishing separate cost sharing requirements that are applicable only with respect to mental health benefits.
 
Requires that such a plan ensure that the requirements of this Act are applied to both in- and out-of-network services, if offered, by comparing in-network medical and surgical benefits to in-network mental health benefits and out-of network medical and surgical benefits to out-of-network mental health benefits.
 
Excludes from the requirements of this Act any group health plan: (1) for an employer with not more than 50 employees; or (2) whose costs of compliance with this Act increase the total costs of coverage by more than a specified percentage. Requires that determinations as to increases in actual costs under a plan be made and certified by a qualified and licensed actuary. Sets forth procedures for seeking a cost exemption, and authorizes audits of books and records relating to such an exemption.
 
(Sec. 4) Requires the Secretary of Labor and the Secretary of Health and Human Services to designate an individual within their departments as the group health plan ombudsman to serve as an initial point of contact to permit individuals to obtain information and provide assistance concerning coverage of mental health services under group health plans in accordance with this Act. Requires the Secretaries to provide for the conduct of random audits of group health plans to ensure compliance with this Act.
 
Requires the Comptroller General to study the effect of this Act on the cost of health insurance coverage, access to such coverage, the quality of health care, and the impact on benefits and coverage for mental health and substance use disorders.


Legislative actions:
action_date: 2007-10-17
text: Referred to the Subcommittee on Health, Employment, Labor, and Pensions.
action_date: 2007-09-19
text: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2007-09-19
text: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2007-09-19
text: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
action_date: 2007-09-19
text: Referred to the Subcommittee on Health.
action_date: 2007-09-19
text: Message on Senate action sent to the House.
action_date: 2007-09-19
text: Received in the House.
action_date: 2007-09-18
text: Passed Senate with an amendment by Unanimous Consent.
action_date: 2007-09-18
text: Passed/agreed to in Senate: Passed Senate with an amendment by Unanimous Consent.
action_date: 2007-09-18
text: The committee substitute as amended agreed to by Unanimous Consent.
action_date: 2007-09-18
text: Measure laid before Senate by unanimous consent. (consideration: CR S11679-11684; text of measure as reported in Senate: CR S11679-11680)
action_date: 2007-04-11
text: By Senator Kennedy from Committee on Health, Education, Labor, and Pensions filed written report. Report No. 110-53.
action_date: 2007-04-11
text: By Senator Kennedy from Committee on Health, Education, Labor, and Pensions filed written report. Report No. 110-53.
action_date: 2007-03-27
text: Placed on Senate Legislative Calendar under General Orders. Calendar No. 93.
action_date: 2007-03-27
text: Committee on Health, Education, Labor, and Pensions. Reported by Senator Kennedy with an amendment in the nature of a substitute. Without written report.
action_date: 2007-03-27
text: Committee on Health, Education, Labor, and Pensions. Reported by Senator Kennedy with an amendment in the nature of a substitute. Without written report.
action_date: 2007-02-14
text: Committee on Health, Education, Labor, and Pensions. Ordered to be reported with an amendment favorably.
action_date: 2007-02-12
text: Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (text of measure as introduced: CR S1865-1867)
action_date: 2007-02-12
text: Introduced in Senate