[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4331 Introduced in Senate (IS)]

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118th CONGRESS
  2d Session
                                S. 4331

To amend the Public Health Service Act, the Employee Retirement Income 
Security Act of 1974, and the Internal Revenue Code of 1986 to require 
that group health plans and health insurance issuers offering group or 
  individual health insurance that provide coverage for mental health 
  services and substance use disorder services provide such services 
without the imposition of cost-sharing from the diagnosis of pregnancy 
   through the 1-year period following such pregnancy, and for other 
                               purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                              May 14, 2024

  Mrs. Shaheen (for herself and Ms. Baldwin) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act, the Employee Retirement Income 
Security Act of 1974, and the Internal Revenue Code of 1986 to require 
that group health plans and health insurance issuers offering group or 
  individual health insurance that provide coverage for mental health 
  services and substance use disorder services provide such services 
without the imposition of cost-sharing from the diagnosis of pregnancy 
   through the 1-year period following such pregnancy, and for other 
                               purposes.

    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 ``Mental Health and Making Access More 
Affordable Act of 2024'' or the ``Mental Health and MAMA Act of 2024''.

SEC. 2. COST-SHARING WITH RESPECT TO MENTAL HEALTH SERVICES AND 
              SUBSTANCE USE DISORDER SERVICES FOR PREGNANT AND 
              POSTPARTUM INDIVIDUALS.

    (a) PHSA.--
            (1) In general.--Part D of title XXVII of the Public Health 
        Service Act (42 U.S.C. 300gg-111 et seq.) is amended by adding 
        at the end the following new section:

``SEC. 2799A-11. COST-SHARING REQUIREMENTS WITH RESPECT TO MENTAL 
              HEALTH SERVICES AND SUBSTANCE USE DISORDER SERVICES FOR 
              PREGNANT AND POSTPARTUM INDIVIDUALS.

    ``(a) In General.--In the case of a group health plan or a health 
insurance issuer offering group or individual health insurance coverage 
that provides a benefit for mental health services or substance use 
disorder services (including such services which are telehealth 
services and are provided under such plan or coverage) with respect to 
plan years beginning on or after the date that is 2 years after the 
date of enactment of this section, the plan or coverage shall not 
impose any cost-sharing requirement for such services that are 
furnished by an in-network provider to a participant, beneficiary, or 
enrollee under the plan or coverage from the diagnosis of pregnancy (as 
defined by the Secretary) through the 1-year period beginning on the 
day after the last day of such pregnancy of such participant, 
beneficiary, or enrollee (or, in the case of an individual enrolled in 
such plan or coverage for a portion of such period, during such 
portion).
    ``(b) Definitions.--In this section:
            ``(1) The terms `mental health services' and `substance use 
        disorder services' have the meaning given such terms for 
        purposes of section 2726.
            ``(2) The term `telehealth service' means a service that is 
        furnished through telehealth technologies (as defined in 
        section 330I(a)).''.
            (2) Continuity of care.--Section 2799A-3 of the Public 
        Health Service Act (42 U.S.C. 300gg-113) is amended--
                    (A) in subsection (a)(2)(C), by inserting ``, in 
                the case of a continuing care patient described in 
                subsection (b)(1)(D)(ii), the date on which such 
                individual is no longer such a continuing care patient 
                with respect to such provider or facility, or in the 
                case of a continuing care patient described in 
                subsection (b)(1) other than in subparagraph (D)(ii) of 
                such subsection,'' after ``is provided and ending on''; 
                and
                    (B) by amending subsection (b)(1)(D) to read as 
                follows:
                    ``(D)(i) is pregnant and undergoing a course of 
                treatment for the pregnancy from the provider or 
                facility; or
                    ``(ii)(I) requires mental health services or 
                substance use disorder services from a provider or 
                facility following a pregnancy;
                    ``(II) received a course of mental health or 
                substance use disorder treatment from such provider or 
                facility while pregnant; and
                    ``(III) the last day of such pregnancy occurred 
                during the previous 1-year period; or''.
    (b) ERISA.--
            (1) In general.--Subpart B of part 7 of subtitle B of title 
        I of the Employee Retirement Income Security Act of 1974 is 
        amended by adding at the end the following new section:

``SEC. 726. COST-SHARING REQUIREMENTS WITH RESPECT TO MENTAL HEALTH 
              SERVICES AND SUBSTANCE USE DISORDER SERVICES FOR PREGNANT 
              AND POSTPARTUM INDIVIDUALS.

    ``(a) In General.--In the case of a group health plan or a health 
insurance issuer offering group health insurance coverage that provides 
a benefit for mental health services or substance use disorder services 
(including such services which are telehealth services and are provided 
under such plan or coverage) with respect to plan years beginning on or 
after the date that is 2 years after the date of enactment of this 
section, the plan or coverage shall not impose any cost-sharing 
requirement for such services that are furnished by an in-network 
provider to a participant or beneficiary under the plan or coverage 
from the diagnosis of pregnancy (as defined by the Secretary) through 
the 1-year period beginning on the day after the last day of such 
pregnancy of such participant or beneficiary (or, in the case of an 
individual enrolled in such plan or coverage for a portion of such 
period, during such portion).
    ``(b) Definitions.--In this section:
            ``(1) The terms `mental health services' and `substance use 
        disorder services' have the meaning given such terms for 
        purposes of section 712.
            ``(2) The term `telehealth service' means a service that is 
        furnished through telehealth technologies (as defined in 
        section 330I(a) of the Public Health Service Act).''.
            (2) Continuity of care.--Section 718 of the Employee 
        Retirement Income Security Act of 1974 (29 U.S.C. 1185g) is 
        amended--
                    (A) in subsection (a)(2)(C), by inserting ``, in 
                the case of a continuing care patient described in 
                subsection (b)(1)(D)(ii), the date on which such 
                individual is no longer such a continuing care patient 
                with respect to such provider or facility, or in the 
                case of a continuing care patient described in 
                subsection (b)(1) other than in subparagraph (D)(ii) of 
                such subsection,'' after ``is provided and ending on''; 
                and
                    (B) by amending subsection (b)(1)(D) to read as 
                follows:
                    ``(D)(i) is pregnant and undergoing a course of 
                treatment for the pregnancy from the provider or 
                facility; or
                    ``(ii)(I) requires mental health services or 
                substance use disorder services from a provider or 
                facility following a pregnancy;
                    ``(II) received a course of mental health or 
                substance use disorder treatment from such provider or 
                facility while pregnant; and
                    ``(III) the last day of such pregnancy occurred 
                during the previous 1-year period; or''.
            (3) Clerical amendment.--The table of contents in section 1 
        of the Employee Retirement Income Security Act of 1974 (29 
        U.S.C. 1001 et seq.) is amended by inserting after the item 
        relating to section 725 the following new item:

``Sec. 726. Cost-sharing requirements with respect to mental health 
                            services and substance use disorder 
                            services for pregnant and postpartum 
                            individuals.''.
    (c) IRC.--
            (1) In general.--Subchapter B of chapter 100 of the 
        Internal Revenue Code of 1986 is amended by adding at the end 
        the following new section:

``SEC. 9826. COST-SHARING REQUIREMENTS WITH RESPECT TO MENTAL HEALTH 
              SERVICES AND SUBSTANCE USE DISORDER SERVICES FOR PREGNANT 
              AND POSTPARTUM INDIVIDUALS.

    ``(a) In General.--In the case of a group health plan that provides 
a benefit for mental health services or substance use disorder services 
(including such services which are telehealth services and are provided 
under such plan) with respect to plan years beginning on or after the 
date that is 2 years after the date of enactment of this section, the 
plan shall not impose any cost-sharing requirement for such services 
that are furnished by an in-network provider to a participant or 
beneficiary under the plan from the diagnosis of pregnancy (as defined 
by the Secretary) through the 1-year period beginning on the day after 
the last day of such pregnancy of such participant or beneficiary (or, 
in the case of an individual enrolled in such plan for a portion of 
such period, during such portion).
    ``(b) Definitions.--In this section:
            ``(1) The terms `mental health services' and `substance use 
        disorder services' have the meaning given such terms for 
        purposes of section 9812.
            ``(2) The term `telehealth service' means a service that is 
        furnished through telehealth technologies (as defined in 
        section 330I(a) of the Public Health Service Act).''.
            (2) Continuity of care.--Section 9818 of the Internal 
        Revenue Code of 1986 is amended--
                    (A) in subsection (a)(2)(C), by inserting ``, in 
                the case of a continuing care patient described in 
                subsection (b)(1)(D)(ii), the date on which such 
                individual is no longer such a continuing care patient 
                with respect to such provider or facility, or in the 
                case of a continuing care patient described in 
                subsection (b)(1) other than in subparagraph (D)(ii) of 
                such subsection,'' after ``is provided and ending on''; 
                and
                    (B) by amending subsection (b)(1)(D) to read as 
                follows:
                    ``(D)(i) is pregnant and undergoing a course of 
                treatment for the pregnancy from the provider or 
                facility; or
                    ``(ii)(I) requires mental health services or 
                substance use disorder services from a provider or 
                facility following a pregnancy;
                    ``(II) received a course of mental health or 
                substance use disorder treatment from such provider or 
                facility while pregnant; and
                    ``(III) the last day of such pregnancy occurred 
                during the previous 1-year period; or''.
            (3) Clerical amendment.--The table of sections for 
        subchapter B of chapter 100 of the Internal Revenue Code of 
        1986 is amended by adding at the end the following new item:

``Sec. 9826. Cost-sharing requirements with respect to mental health 
                            services and substance use disorder 
                            services for pregnant and postpartum 
                            individuals.''.
    (d) Effective Date.--The amendments made by subsections (a), (b), 
and (c) shall apply with respect to plan years beginning on or after 
the date that is 2 years after the date of enactment of this Act.
    (e) FEHBP.--
            (1) In general.--Section 8902(p) of title 5, United States 
        Code, is amended--
                    (A) by striking ``and 2799A-7'' and inserting 
                ``2799A-7, and 2799A-11'';
                    (B) by striking ``and 722'' and inserting ``722, 
                and 726''; and
                    (C) by striking ``and 9822'' and inserting ``9822, 
                and 9826''.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall apply with respect to contracts entered into or renewed 
        for contract years beginning on or after the date that is 2 
        years after the date of enactment of this Act.
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