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Code · BILL · 117th Congress · H.R. 7780 (Reported in House) — To support the behavioral needs of students and youth, invest in the school-based behavioral health workforce, and en... · Sec. 602

Sec. 602. Enforcement of Mental Health and Substance Use Disorder Requirements

674 words·~3 min read·/bill/117/hr/7780/rh/section-602

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Section 502(a) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1132(a) ) is amended— in paragraph (10), by striking or at the end; in paragraph (11), by striking the period at the end and inserting ; or ; and by adding at the end the following: in any case relating to the provision of mental health benefits and substance use disorder benefits under a group health plan or under group health insurance coverage offered by a health insurance issuer in connection with a group health plan (as such terms are defined in section 733), by the Secretary, or by a participant, beneficiary, or fiduciary, to enforce any provision of this title or the terms of the plan or coverage relating to such benefits against a group health plan, a health insurance issuer, a fiduciary of a plan, or any other person that contracts with a group health plan to provide group health insurance coverage or assistance in the administration of a group health plan (including a third party administrator, managed behavioral health organization, and a pharmacy benefit manager), if such person participates in or conceals a violation of any requirement of part 7 relating to such benefits or a wrongful denial of a claim for mental health benefits or substance use disorder benefits under the terms of the plan or coverage, to obtain appropriate relief, in addition to any other relief otherwise available under this section, including— to recover all losses to participants and beneficiaries; to reform impermissible plan or coverage terms and policies (as written or in operation) in accordance with the requirements of this title and its implementing regulations; or to ensure the readjudication of claims and payment of benefits in accordance with the plan or coverage terms without any impermissible limitation, plan or coverage term, or policy. .
Section 502(a)(3) of such Act ( 29 U.S.C. 1132(a)(3) ) is amended— by striking or
(B)and inserting
(B); and by inserting before the semicolon at the end the following: , or
(C)to require re-adjudication and payment of benefits to remedy violations of this title notwithstanding the availability of relief under other provisions of this title . Section 502(a)(5) of such Act ( 29 U.S.C. 1132(a)(5) ) is amended— by striking or
(B)and inserting
(B); and by inserting before the semicolon at the end the following: , or
(C)to require re-adjudication and payment of benefits to remedy violations of this title notwithstanding the availability of relief under other provisions of this title . Section 502(b)(3) of such Act ( 29 U.S.C. 1132(b)(3) ) is amended— by inserting , and except with respect to enforcement by the Secretary of section 712 or any other provision of part 7 in any case relating to mental health benefits and substance use disorder benefits after under subsection (c)(9)) ; and by striking 706(a)(1) and inserting 733(a)(1) . Part 7 of title I of such Act ( 29 U.S.C. 1181 et seq. ) is amended— in section 712(e), in the matter preceding paragraph (1), by inserting and section 502(a)(12) after this section ; and in section 733— in subsection (a), in the matter preceding paragraph (1), by inserting and section 502(a)(12) after this part ; and in subsection (b), in the matter preceding paragraph (1), by inserting and section 502(a)(12) after this part . In addition to amounts otherwise available, there are appropriated (out of any money in the Treasury not otherwise appropriated) to the Department of Labor for fiscal year 2023, to remain available until September 30, 2032, $275,000,000, of which— $240,000,000 shall be for the Employee Benefits Security Administration; and $35,000,000 shall be for the Solicitor of Labor. Amounts made available under paragraph
(1)may be used for audits and investigations, enforcement actions, litigation expenses, issuance of regulations or guidance, and any other Departmental activities relating to section 712 of the Employee Retirement Income Security Act of 1974 and any other provision of title I of such Act relating to mental health and substance use disorder benefits.
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Sec. 602
Enforcement of Mental Health and Substance Use Disorder Requirements
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