Behavioral Health Coverage Transparency Act of 2015

Bill: 114-hr-4276
Sponsor: Rep. Kennedy, Joseph P., III [D-MA-4]
Introduced: 2015-12-16 in the House
Policy area: Health
Subjects: Accounting and auditing
Administrative law and regulatory procedures
Administrative remedies
Department of Health and Human Services
Department of Labor
Department of the Treasury
Disability and health-based discrimination
Drug, alcohol, tobacco use
Employee benefits and pensions
Government information and archives
Government studies and investigations
Health care costs and insurance
Health care coverage and access
Mental health

Summary:
action_date: 2015-12-16
text: 

Behavioral Health Coverage Transparency Act of 2015

 
This bill amends the Public Health Service Act, Employee Retirement Income Security Act of 1974 (ERISA), and Internal Revenue Code to direct the Departments of Health and Human Services (HHS), Labor, and the Treasury to require group health plans and health insurers to disclose the analyses performed to ensure compliance of plans or coverage with the law and regulations. Disclosures must include findings and conclusions regarding whether nonquantitative treatment limitations (e.g., tiered benefits, step therapy, or preauthorization) applied to mental health or substance use disorder benefits are comparable to, and applied no more stringently than, such limitations on medical and surgical benefits.
 
HHS, Labor, and Treasury must: (1) issue guidance on the process for current and potential participants and beneficiaries to file formal complaints of plans or insurers being in violation of the requirement for parity between mental health and substance use disorder benefits and medical and surgical benefits, (2) conduct audits of plans and insurers to determine compliance with parity requirements and publish information from those audits, and (3) publish information on denials of claims by plans and insurers for mental health and substance use disorder services compared to denials of claims for medical and surgical services.
 
HHS must establish a consumer parity portal website that allows for submission of complaints and provides information to consumers on parity.
 The Government Accountability Office must report on HHS, Labor, and Treasury efforts to enforce parity.

Legislative actions:
action_date: 2016-03-23
text: Referred to the Subcommittee on Health, Employment, Labor, and Pensions.
action_date: 2015-12-18
text: Referred to the Subcommittee on Health.
action_date: 2015-12-16
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, 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: 2015-12-16
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, 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: 2015-12-16
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, 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: 2015-12-16
text: Referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and the Workforce, and Ways and Means, 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: 2015-12-16
text: Introduced in House
action_date: 2015-12-16
text: Introduced in House