Behavioral Health Coverage Transparency Act of 2016 2016-03-07 Introduced in Senate 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 specified information regarding compliance of plans or coverage with requirements for parity between mental health and substance use disorder benefits and medical and surgical benefits. Information that must be disclosed includes the specific analyses performed to ensure parity, findings and conclusions regarding parity in applying nonquantitative treatment limitations (e.g., tiered benefits, step therapy, or preauthorization), and a comparison of denials of claims between types of 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, and (2) conduct audits of plans and insurers to determine compliance with parity requirements and publish information from those audits.

HHS must establish a consumer parity unit to collect and respond to complaints and provide information to consumers on parity. Plans and insurers must respond to consumer complaints received by the unit.

State health insurance commissioners must report on compliance of plans and insurers with parity requirements and include a comparison of benefits.

The Government Accountability Office must report on HHS, Labor, and Treasury efforts to enforce parity.]]> text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain. Congressional Research Service, Library of Congress This file contains bill summaries for federal legislation. A bill summary describes the most significant provisions of a piece of legislation and details the effects the legislative text may have on current law and federal programs. Bill summaries are authored by the Congressional Research Service (CRS) of the Library of Congress. As stated in Public Law 91-510 (2 USC 166 (d)(6)), one of the duties of CRS is "to prepare summaries and digests of bills and resolutions of a public general nature introduced in the Senate or House of Representatives". For more information, refer to the User Guide that accompanies this file.