Bill > HR4276

This bill, the Behavioral Health Coverage Transparency Act of 2015, aims to strengthen the equal treatment of mental health and substance use disorder benefits compared to medical and surgical benefits within health insurance plans. It mandates that health plans and insurance issuers must provide detailed annual reports explaining how they apply "non-quantitative treatment limitations" (NQTLs), which are restrictions on benefits that aren't based on dollar amounts, to mental health and substance use disorder services. These reports must specify the factors used in NQTL analyses, the evidentiary standards relied upon, how these standards are applied across different service categories, and the results of these analyses, ensuring that NQTLs for behavioral health are comparable to and not more stringent than those for medical and surgical benefits. The bill also establishes a "Consumer Parity Portal" website for submitting complaints, provides for randomized and additional audits of plans and issuers to ensure compliance, and requires the collection and public reporting of denial rates for behavioral health claims compared to medical and surgical claims. Furthermore, it mandates a study by the Government Accountability Office (GAO) on enforcement efforts and authorizes appropriations for these activities.