S. 558, The Mental Health Parity Act of 2007 (11 comments ↓)
- This item is from the 110th Congress (2007-2008) and is no longer current. Comments, voting, and wiki editing have been disabled, and the cost/savings estimate has been frozen.
S. 558 would provide parity between health insurance coverage of mental health benefits and benefits for medical and surgical services.
Mental Health Parity Act of 2007 - (Sec. 2) Amends the Employee Retirement Income Security Act (ERISA) and the Public Health Service Act to require a group health plan that provides both medical and surgical benefits and mental health benefits to ensure that: (1) the financial requirements applicable to such mental health benefits are no more restrictive than those of substantially all medical and surgical benefits covered by the plan, including deductibles and copayments; and (2) the treatment limitations applicable to such mental health benefits are no more restrictive than those applied to substantially all medical and surgical benefits covered by the plan, including limits on the frequency of treatments or similar limits on the scope or duration of treatment. Prohibits the plan from establishing separate cost sharing requirements that are applicable only with respect to mental health benefits.
Requires that such a plan ensure that the requirements of this Act are applied to both in- and out-of-network services, if offered, by comparing in-network medical and surgical benefits to in-network mental health benefits and out-of network medical and surgical benefits to out-of-network mental health benefits.
Excludes from the requirements of this Act any group health plan: (1) for an employer with not more than 50 employees; or (2) whose costs of compliance with this Act increase the total costs of coverage by more than a specified percentage. Requires that determinations as to increases in actual costs under a plan be made by a qualified actuary and be made available to the public.
(Sec. 4) Supersedes any provision of state law that establishes, implements, or continues in effect any standard or requirement that differs from the requirements of this Act, except for laws relating to the individual insurance market or small employers.
(Sec. 5) Requires the Secretary of Labor and the Secretary of Health and Human Services to designate an individual within their departments as the group health plan ombudsman to serve as an initial point of contact to permit individuals to obtain information and provide assistance concerning coverage of mental health services under group health plans in accordance with this Act. Requires the Secretaries to provide for the conduct of random audits of group health plans to ensure compliance with this Act.
Requires the Comptroller General to study the effect of this Act on the cost of health insurance coverage, access to such coverage, the quality of health care, and the impact on benefits and coverage for mental health and substance abuse.
Status of the Legislation
Latest Major Action: 9/19/2007: Referred to House committee. Status: Referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and Labor, 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.
Points in Favor
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