Sec. 6. Report to Congress
525 words·~2 min read·
/bill/117/s/5093/is/section-6·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Not later than 6 years after the date of enactment of this Act and every 2 years for the next 10 years, the Secretary of Health and Human Services, the Secretary of Labor, and the Secretary of the Treasury (collectively referred to in this section as the Secretaries ) shall jointly submit to Congress and make publicly available a report to assess the prevalence of ghost networks and the adequacy of mental health and substance use disorder networks, in accordance with section 2726(a)(9) of the Public Health Service Act, section 712(a)(9) of the Employee Retirement Income Security Act of 1974, and section 9812(a)(9) of the Internal Revenue Code of 1986, as amended by section 4.
Such report shall include the following: Aggregate information about group health plans and health insurance issuers determined by the Secretaries to be out of compliance with the provider directory requirements under section 2799A–5 of the Public Health Service Act, section 720 of the Employee Retirement Income Security Act of 1974, and section 9820 of the Internal Revenue Code of 1986, as amended by section 2. Aggregate information about group health plans and health insurance issuers determined by the Secretaries to be out of compliance with the requirements for parity in mental health and substance use disorder benefits under section 2726 of the Public Health Service Act ( 42 U.S.C. 300gg–26 ), section 712 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185a ), and section 9812 of the Internal Revenue Code of 1986, as amended by section 4.
A summary of findings through audits, in the aggregate, under section 2799A–5(a)(7)(C) of the Public Health Service Act, section 720(a)(7)(C) of the Employee Retirement Income Security Act of 1974, and section 9820(a)(7)(C) of the Internal Revenue Code of 1986, as amended by section 2, including— the provider directory accuracy rating assigned by the Secretaries; the accuracy of provider directory information, sectioned out by accuracy of the provider’s name, address, specialty, telephone number, digital contact information, whether the providers are accepting new patients, in-network status, linguistic- and cultural-competency, and availability of medications for opioid use disorder; the number of plans and individuals enrolled in a group health plan or group or individual health insurance coverage that offers a mental health and substance use disorder network that meets the network adequacy standards under, as applicable, section 2799A–5 of the Public Health Service Act, section 720 of the Employee Retirement Income Security Act of 1974, or section 9820 of the Internal Revenue Code of 1986, as amended by section 2; and the number of individuals enrolled in a group health plan or group or individual health insurance coverage with a ghost network.
A comparative analysis of in-network and out-of-network reimbursement rates for mental health and substance use disorder services compared to medical and surgical services by group health plans and health insurance issuers. In this section, the term ghost network has the meaning given such term in section 2799A–5(a)(8) of the Public Health Service Act, section 720(a)(8) of the Employee Retirement Income Security Act of 1974, and section 9820(a)(8) of the Internal Revenue Code of 1986, as amended by section 2.
Connectionstraces to 1
Traces to 1 document
1 reference not yet in our index
- 42 USC 300gg–26
Citation graph
cites case law
Cites 2Cited by 0 across 0 sources