 About me |
The Matthias Chronicles |
Contact me at |
About me |
The Matthias Chronicles |
Contact me at |
|
Subscribe to RSS feed.
Click to buy the Aramaic Bible Government waste exposed! Click to buy now! Website thumbnails generously provided by ShrinkTheWeb |
Thursday, October 2, 2008, 3:00 AM H.R. 1424: Bailout Bill, Part 12
19 (3) Heading 9902.51.14 (relating to wool fiber,
20 waste, garnetted stock, combed wool, or wool top).
21 (4) Heading 9902.51.15 (relating to fabrics of
22 combed wool).
23 (5) Heading 9902.51.16 (relating to fabrics of
24 combed wool).
296
1 (b) EXTENSION OF DUTY REFUNDS AND WOOL RE-
2 SEARCH TRUST FUND.--
3 (1) IN GENERAL.--Section 4002(c) of the Wool
4 Suit and Textile Trade Extension Act of 2004 (Pub-
5 lic Law 108429; 118 Stat. 2603) is amended--
6 (A) in paragraph (3)(C), by striking
7 ``2010'' and inserting ``2015''; and
8 (B) in paragraph (6)(A), by striking
9 ``through 2009'' and inserting ``through 2014''.
10 (2) SUNSET.--Section 506(f) of the Trade and
11 Development Act of 2000 (Public 106200; 114
12 Stat. 303 (7 U.S.C. 7101 note)) is amended by
13 striking ``2010'' and inserting ``2015''.
14 TITLE IV--EXTENSION OF TAX
15 ADMINISTRATION PROVISIONS
16 SEC. 401. PERMANENT AUTHORITY FOR UNDERCOVER OP-
17 ERATIONS.
18 (a) IN GENERAL.--Section 7608(c) (relating to rules
19 relating to undercover operations) is amended by striking
20 paragraph (6).
21 (b) EFFECTIVE DATE.--The amendment made by
22 this section shall apply to operations conducted after the
23 date of the enactment of this Act.
297
1 SEC. 402. PERMANENT AUTHORITY FOR DISCLOSURE OF
2 INFORMATION RELATING TO TERRORIST AC-
3 TIVITIES.
4 (a) DISCLOSURE OF RETURN INFORMATION TO AP -
5 PRISE APPROPRIATE OFFICIALS OF TERRORIST ACTIVI-
6 TIES.--Subparagraph (C) of section 6103(i)(3) is amend-
7 ed by striking clause (iv).
8 (b) DISCLOSURE UPON REQUEST OF INFORMATION
9 RELATING TO TERRORIST ACTIVITIES.--Paragraph (7) of
10 section 6103(i) is amended by striking subparagraph (E).
11 (c) EFFECTIVE DATE.--The amendments made by
12 this section shall apply to disclosures after the date of the
13 enactment of this Act.
14 TITLE V--ADDITIONAL TAX RE-
15 LIEF AND OTHER TAX PROVI-
16 SIONS
17 Subtitle A--General Provisions
18 SEC. 501. $8,500 INCOME THRESHOLD USED TO CALCULATE
19 REFUNDABLE PORTION OF CHILD TAX CRED-
20 IT.
21 (a) IN GENERAL.--Section 24(d) is amended by add-
22 ing at the end the following new paragraph:
23 ``(4) SPECIAL RULE FOR 2008.--Notwith-
24 standing paragraph (3), in the case of any taxable
25 year beginning in 2008, the dollar amount in effect
298
1 for such taxable year under paragraph (1)(B)(i)
2 shall be $8,500.''.
3 (b) EFFECTIVE DATE.--The amendment made by
4 this section shall apply to taxable years beginning after
5 December 31, 2007.
6 SEC. 502. PROVISIONS RELATED TO FILM AND TELEVISION
7 PRODUCTIONS.
8 (a) EXTENSION OF EXPENSING RULES FOR QUALI-
9 FIED FILM AND TELEVISION PRODUCTIONS.--Section
10 181(f) (relating to termination) is amended by striking
11 ``December 31, 2008'' and inserting ``December 31,
12 2009''.
13 (b) MODIFICATION OF LIMITATION ON EXPENS-
14 ING.--Subparagraph (A) of section 181(a)(2) is amended
15 to read as follows:
16 ``(A) IN GENERAL.--Paragraph (1) shall
17 not apply to so much of the aggregate cost of
18 any qualified film or television production as ex-
19 ceeds $15,000,000.''.
20 (c) MODIFICATIONS TO DEDUCTION FOR DOMESTIC
21 ACTIVITIES.--
22 (1) DETERMINATION OF W2 WAGES.--Para-
23 graph (2) of section 199(b) is amended by adding at
24 the end the following new subparagraph:
299
1 ``(D) SPECIAL RULE FOR QUALIFIED
2 FILM.--In the case of a qualified film, such
3 term shall include compensation for services
4 performed in the United States by actors, pro-
5 duction personnel, directors, and producers.''.
6 (2) DEFINITION OF QUALIFIED FILM.--Para-
7 graph (6) of section 199(c) is amended by adding at
8 the end the following: ``A qualified film shall include
9 any copyrights, trademarks, or other intangibles
10 with respect to such film. The methods and means
11 of distributing a qualified film shall not affect the
12 availability of the deduction under this section.''.
13 (3) PARTNERSHIPS.--Subparagraph (A) of sec-
14 tion 199(d)(1) is amended by striking ``and'' at the
15 end of clause (ii), by striking the period at the end
16 of clause (iii) and inserting ``, and'', and by adding
17 at the end the following new clause:
18 ``(iv) in the case of each partner of a
19 partnership, or shareholder of an S cor-
20 poration, who owns (directly or indirectly)
21 at least 20 percent of the capital interests
22 in such partnership or of the stock of such
23 S corporation--
24 ``(I) such partner or shareholder
25 shall be treated as having engaged di-
300
1 rectly in any film produced by such
2 partnership or S corporation, and
3 ``(II) such partnership or S cor-
4 poration shall be treated as having en-
5 gaged directly in any film produced by
6 such partner or shareholder.''.
7 (d) CONFORMING AMENDMENT.--Section
8 181(d)(3)(A) is amended by striking ``actors'' and all that
9 follows and inserting ``actors, production personnel, direc-
10 tors, and producers.''.
11 (e) EFFECTIVE DATES.--
12 (1) IN GENERAL.--Except as otherwise pro-
13 vided in this subsection, the amendments made by
14 this section shall apply to qualified film and tele-
15 vision productions commencing after December 31,
16 2007.
17 (2) DEDUCTION.--The amendments made by
18 subsection (c) shall apply to taxable years beginning
19 after December 31, 2007.
20 SEC. 503. EXEMPTION FROM EXCISE TAX FOR CERTAIN
21 WOODEN ARROWS DESIGNED FOR USE BY
22 CHILDREN.
23 (a) IN GENERAL.--Paragraph (2) of section 4161(b)
24 is amended by redesignating subparagraph (B) as sub-
301
1 paragraph (C) and by inserting after subparagraph (A)
2 the following new subparagraph:
3 ``(B) EXEMPTION FOR CERTAIN WOODEN
4 ARROW SHAFTS.--Subparagraph (A) shall not
5 apply to any shaft consisting of all natural
6 wood with no laminations or artificial means of
7 enhancing the spine of such shaft (whether sold
8 separately or incorporated as part of a finished
9 or unfinished product) of a type used in the
10 manufacture of any arrow which after its as-
11 sembly--
12 ``(i) measures 5/16 of an inch or less in
13 diameter, and
14 ``(ii) is not suitable for use with a bow
15 described in paragraph (1)(A).''.
16 (b) EFFECTIVE DATE.--The amendments made by
17 this section shall apply to shafts first sold after the date
18 of enactment of this Act.
19 SEC. 504. INCOME AVERAGING FOR AMOUNTS RECEIVED IN
20 CONNECTION WITH THE EXXON VALDEZ LITI-
21 GATION.
22 (a) INCOME AVERAGING OF AMOUNTS RECEIVED
23 FROM THE EXXON VALDEZ LITIGATION.--For purposes
24 of section 1301 of the Internal Revenue Code of 1986--
302
1 (1) any qualified taxpayer who receives any
2 qualified settlement income in any taxable year shall
3 be treated as engaged in a fishing business (deter-
4 mined without regard to the commercial nature of
5 the business), and
6 (2) such qualified settlement income shall be
7 treated as income attributable to such a fishing busi-
8 ness for such taxable year.
9 (b) CONTRIBUTIONS OF AMOUNTS RECEIVED TO RE -
10 TIREMENT ACCOUNTS.--
11 (1) IN GENERAL.--Any qualified taxpayer who
12 receives qualified settlement income during the tax-
13 able year may, at any time before the end of the tax-
14 able year in which such income was received, make
15 one or more contributions to an eligible retirement
16 plan of which such qualified taxpayer is a bene-
17 ficiary in an aggregate amount not to exceed the
18 lesser of--
19 (A) $100,000 (reduced by the amount of
20 qualified settlement income contributed to an
21 eligible retirement plan in prior taxable years
22 pursuant to this subsection), or
23 (B) the amount of qualified settlement in-
24 come received by the individual during the tax-
25 able year.
303
1 (2) TIME WHEN CONTRIBUTIONS DEEMED
2 MADE.--For purposes of paragraph (1), a qualified
3 taxpayer shall be deemed to have made a contribu-
4 tion to an eligible retirement plan on the last day of
5 the taxable year in which such income is received if
6 the contribution is made on account of such taxable
7 year and is made not later than the time prescribed
8 by law for filing the return for such taxable year
9 (not including extensions thereof).
10 (3) TREATMENT OF CONTRIBUTIONS TO ELIGI-
11 BLE RETIREMENT PLANS.--For purposes of the In-
12 ternal Revenue Code of 1986, if a contribution is
13 made pursuant to paragraph (1) with respect to
14 qualified settlement income, then--
15 (A) except as provided in paragraph (4)--
16 (i) to the extent of such contribution,
17 the qualified settlement income shall not
18 be included in taxable income, and
19 (ii) for purposes of section 72 of such
20 Code, such contribution shall not be con-
21 sidered to be investment in the contract,
22 (B) the qualified taxpayer shall, to the ex-
23 tent of the amount of the contribution, be treat-
24 ed--
304
1 (i) as having received the qualified
2 settlement income--
3 (I) in the case of a contribution
4 to an individual retirement plan (as
5 defined under section 7701(a)(37) of
6 such Code), in a distribution described
7 in section 408(d)(3) of such Code,
8 and
9 (II) in the case of any other eligi-
10 ble retirement plan, in an eligible roll-
11 over distribution (as defined under
12 section 402(f)(2) of such Code), and
13 (ii) as having transferred the amount
14 to the eligible retirement plan in a direct
15 trustee to trustee transfer within 60 days
16 of the distribution,
17 (C) section 408(d)(3)(B) of the Internal
18 Revenue Code of 1986 shall not apply with re-
19 spect to amounts treated as a rollover under
20 this paragraph, and
21 (D) section 408A(c)(3)(B) of the Internal
22 Revenue Code of 1986 shall not apply with re-
23 spect to amounts contributed to a Roth IRA (as
24 defined under section 408A(b) of such Code) or
25 a designated Roth contribution to an applicable
305
1 retirement plan (within the meaning of section
2 402A of such Code) under this paragraph.
3 (4) SPECIAL RULE FOR ROTH IRAS AND ROTH
4 401(k)S.--For purposes of the Internal Revenue
5 Code of 1986, if a contribution is made pursuant to
6 paragraph (1) with respect to qualified settlement
7 income to a Roth IRA (as defined under section
8 408A(b) of such Code) or as a designated Roth con-
9 tribution to an applicable retirement plan (within
10 the meaning of section 402A of such Code), then--
11 (A) the qualified settlement income shall
12 be includible in taxable income, and
13 (B) for purposes of section 72 of such
14 Code, such contribution shall be considered to
15 be investment in the contract.
16 (5) ELIGIBLE RETIREMENT PLAN.--For pur-
17 pose of this subsection, the term ``eligible retirement
18 plan'' has the meaning given such term under sec-
19 tion 402(c)(8)(B) of the Internal Revenue Code of
20 1986.
21 (c) TREATMENT OF QUALIFIED SETTLEMENT IN-
22 COME UNDER EMPLOYMENT TAXES.--
23 (1) SECA.--For purposes of chapter 2 of the
24 Internal Revenue Code of 1986 and section 211 of
25 the Social Security Act, no portion of qualified set-
306
1 tlement income received by a qualified taxpayer shall
2 be treated as self-employment income.
3 (2) FICA.--For purposes of chapter 21 of the
4 Internal Revenue Code of 1986 and section 209 of
5 the Social Security Act, no portion of qualified set-
6 tlement income received by a qualified taxpayer shall
7 be treated as wages.
8 (d) QUALIFIED TAXPAYER.--For purposes of this
9 section, the term ``qualified taxpayer'' means--
10 (1) any individual who is a plaintiff in the civil
11 action In re Exxon Valdez, No. 89095CV (HRH)
12 (Consolidated) (D. Alaska); or
13 (2) any individual who is a beneficiary of the
14 estate of such a plaintiff who--
15 (A) acquired the right to receive qualified
16 settlement income from that plaintiff; and
17 (B) was the spouse or an immediate rel-
18 ative of that plaintiff.
19 (e) QUALIFIED SETTLEMENT INCOME.--For pur-
20 poses of this section, the term ``qualified settlement in-
21 come'' means any interest and punitive damage awards
22 which are--
23 (1) otherwise includible in taxable income, and
24 (2) received (whether as lump sums or periodic
25 payments) in connection with the civil action In re
307
1 Exxon Valdez, No. 89095CV (HRH) (Consoli-
2 dated) (D. Alaska) (whether pre- or post-judgment
3 and whether related to a settlement or judgment).
4 SEC. 505. CERTAIN FARMING BUSINESS MACHINERY AND
5 EQUIPMENT TREATED AS 5-YEAR PROPERTY.
6 (a) IN GENERAL.--Section 168(e)(3)(B) (defining 5-
7 year property) is amended by striking ``and'' at the end
8 of clause (v), by striking the period at the end of clause
9 (vi)(III) and inserting ``, and'', and by inserting after
10 clause (vi) the following new clause:
11 ``(vii) any machinery or equipment
12 (other than any grain bin, cotton ginning
13 asset, fence, or other land improvement)
14 which is used in a farming business (as de-
15 fined in section 263A(e)(4)), the original
16 use of which commences with the taxpayer
17 after December 31, 2008, and which is
18 placed in service before January 1, 2010.''.
19 (b) ALTERNATIVE SYSTEM.--The table contained in
20 section 168(g)(3)(B) (relating to special rule for certain
21 property assigned to classes) is amended by inserting after
22 the item relating to subparagraph (B)(iii) the following:
(B)(vii) ................................................................................... 10''.
308
1 (c) EFFECTIVE DATE.--The amendments made by
2 this section shall apply to property placed in service after
3 December 31, 2008.
4 SEC. 506. MODIFICATION OF PENALTY ON UNDERSTATE-
5 MENT OF TAXPAYER'S LIABILITY BY TAX RE-
6 TURN PREPARER.
7 (a) IN GENERAL.--Subsection (a) of section 6694 is
8 amended to read as follows:
9 ``(a) UNDERSTATEMENT DUE TO UNREASONABLE
10 POSITIONS.--
11 ``(1) IN GENERAL.--If a tax return preparer--
12 ``(A) prepares any return or claim of re-
13 fund with respect to which any part of an un-
14 derstatement of liability is due to a position de-
15 scribed in paragraph (2), and
16 ``(B) knew (or reasonably should have
17 known) of the position,
18 such tax return preparer shall pay a penalty with re-
19 spect to each such return or claim in an amount
20 equal to the greater of $1,000 or 50 percent of the
21 income derived (or to be derived) by the tax return
22 preparer with respect to the return or claim.
23 ``(2) UNREASONABLE POSITION.--
24 ``(A) IN GENERAL.--Except as otherwise
25 provided in this paragraph, a position is de-
309
1 scribed in this paragraph unless there is or was
2 substantial authority for the position.
3 ``(B) DISCLOSED POSITIONS.--If the posi-
4 tion was disclosed as provided in section
5 6662(d)(2)(B)(ii)(I) and is not a position to
6 which subparagraph (C) applies, the position is
7 described in this paragraph unless there is a
8 reasonable basis for the position.
9 ``(C) TAX SHELTERS AND REPORTABLE
10 TRANSACTIONS.--If the position is with respect
11 to a tax shelter (as defined in section
12 6662(d)(2)(C)(ii)) or a reportable transaction
13 to which section 6662A applies, the position is
14 described in this paragraph unless it is reason-
15 able to believe that the position would more
16 likely than not be sustained on its merits.
17 ``(3) REASONABLE CAUSE EXCEPTION.--No
18 penalty shall be imposed under this subsection if it
19 is shown that there is reasonable cause for the un-
20 derstatement and the tax return preparer acted in
21 good faith.''.
22 (b) EFFECTIVE DATE.--The amendment made by
23 this section shall apply--
24 (1) in the case of a position other than a posi-
25 tion described in subparagraph (C) of section
310
1 6694(a)(2) of the Internal Revenue Code of 1986
2 (as amended by this section), to returns prepared
3 after May 25, 2007, and
4 (2) in the case of a position described in such
5 subparagraph (C), to returns prepared for taxable
6 years ending after the date of the enactment of this
7 Act.
8 Subtitle B--Paul Wellstone and
9 Pete Domenici Mental Health
10 Parity and Addiction Equity Act
11 of 2008
12 SEC. 511. SHORT TITLE.
13 This subtitle may be cited as the ``Paul Wellstone and
14 Pete Domenici Mental Health Parity and Addiction Eq-
15 uity Act of 2008''.
16 SEC. 512. MENTAL HEALTH PARITY.
17 (a) AMENDMENTS TO ERISA.--Section 712 of the
18 Employee Retirement Income Security Act of 1974 (29
19 U.S.C. 1185a) is amended--
20 (1) in subsection (a), by adding at the end the
21 following:
22 ``(3) FINANCIAL REQUIREMENTS AND TREAT-
23 MENT LIMITATIONS.--
24 ``(A) IN GENERAL.--In the case of a group
25 health plan (or health insurance coverage of-
311
1 fered in connection with such a plan) that pro-
2 vides both medical and surgical benefits and
3 mental health or substance use disorder bene-
4 fits, such plan or coverage shall ensure that--
5 ``(i) the financial requirements appli-
6 cable to such mental health or substance
7 use disorder benefits are no more restric-
8 tive than the predominant financial re-
9 quirements applied to substantially all
10 medical and surgical benefits covered by
11 the plan (or coverage), and there are no
12 separate cost sharing requirements that
13 are applicable only with respect to mental
14 health or substance use disorder benefits;
15 and
16 ``(ii) the treatment limitations applica-
17 ble to such mental health or substance use
18 disorder benefits are no more restrictive
19 than the predominant treatment limita-
20 tions applied to substantially all medical
21 and surgical benefits covered by the plan
22 (or coverage) and there are no separate
23 treatment limitations that are applicable
24 only with respect to mental health or sub-
25 stance use disorder benefits.
312
1 ``(B) DEFINITIONS.--In this paragraph:
2 ``(i) FINANCIAL REQUIREMENT.--The
3 term `financial requirement' includes
4 deductibles, copayments, coinsurance, and
5 out-of-pocket expenses, but excludes an ag-
6 gregate lifetime limit and an annual limit
7 subject to paragraphs (1) and (2),
8 ``(ii) PREDOMINANT.--A financial re-
9 quirement or treatment limit is considered
10 to be predominant if it is the most com-
11 mon or frequent of such type of limit or
12 requirement.
13 ``(iii) TREATMENT LIMITATION.--The
14 term `treatment limitation' includes limits
15 on the frequency of treatment, number of
16 visits, days of coverage, or other similar
17 limits on the scope or duration of treat-
18 ment.
19 ``(4) AVAILABILITY OF PLAN INFORMATION.--
20 The criteria for medical necessity determinations
21 made under the plan with respect to mental health
22 or substance use disorder benefits (or the health in-
23 surance coverage offered in connection with the plan
24 with respect to such benefits) shall be made avail-
25 able by the plan administrator (or the health insur-
313
1 ance issuer offering such coverage) in accordance
2 with regulations to any current or potential partici-
3 pant, beneficiary, or contracting provider upon re-
4 quest. The reason for any denial under the plan (or
5 coverage) of reimbursement or payment for services
6 with respect to mental health or substance use dis-
7 order benefits in the case of any participant or bene-
8 ficiary shall, on request or as otherwise required, be
9 made available by the plan administrator (or the
10 health insurance issuer offering such coverage) to
11 the participant or beneficiary in accordance with
12 regulations.
13 ``(5) OUT-OF-NETWORK PROVIDERS.--In the
14 case of a plan or coverage that provides both med-
15 ical and surgical benefits and mental health or sub-
16 stance use disorder benefits, if the plan or coverage
17 provides coverage for medical or surgical benefits
18 provided by out-of-network providers, the plan or
19 coverage shall provide coverage for mental health or
20 substance use disorder benefits provided by out-of-
21 network providers in a manner that is consistent
22 with the requirements of this section.'';
23 (2) in subsection (b), by amending paragraph
24 (2) to read as follows:
314
1 ``(2) in the case of a group health plan (or
2 health insurance coverage offered in connection with
3 such a plan) that provides mental health or sub-
4 stance use disorder benefits, as affecting the terms
5 and conditions of the plan or coverage relating to
6 such benefits under the plan or coverage, except as
7 provided in subsection (a).'';
8 (3) in subsection (c)--
9 (A) in paragraph (1)(B)--
10 (i) by inserting ``(or 1 in the case of
11 an employer residing in a State that per-
12 mits small groups to include a single indi-
13 vidual)'' after ``at least 2'' the first place
14 that such appears; and
15 (ii) by striking ``and who employs at
16 least 2 employees on the first day of the
17 plan year''; and
18 (B) by striking paragraph (2) and insert-
19 ing the following:
20 ``(2) COST EXEMPTION.--
21 ``(A) IN GENERAL.--With respect to a
22 group health plan (or health insurance coverage
23 offered in connection with such a plan), if the
24 application of this section to such plan (or cov-
25 erage) results in an increase for the plan year
315
1 involved of the actual total costs of coverage
2 with respect to medical and surgical benefits
3 and mental health and substance use disorder
4 benefits under the plan (as determined and cer-
5 tified under subparagraph (C)) by an amount
6 that exceeds the applicable percentage described
7 in subparagraph (B) of the actual total plan
8 costs, the provisions of this section shall not
9 apply to such plan (or coverage) during the fol-
10 lowing plan year, and such exemption shall
11 apply to the plan (or coverage) for 1 plan year.
12 An employer may elect to continue to apply
13 mental health and substance use disorder parity
14 pursuant to this section with respect to the
15 group health plan (or coverage) involved regard-
16 less of any increase in total costs.
17 ``(B) APPLICABLE PERCENTAGE.--With re-
18 spect to a plan (or coverage), the applicable
19 percentage described in this subparagraph shall
20 be--
21 ``(i) 2 percent in the case of the first
22 plan year in which this section is applied;
23 and
24 ``(ii) 1 percent in the case of each
25 subsequent plan year.
316
1 ``(C) DETERMINATIONS BY ACTUARIES.--
2 Determinations as to increases in actual costs
3 under a plan (or coverage) for purposes of this
4 section shall be made and certified by a quali-
5 fied and licensed actuary who is a member in
6 good standing of the American Academy of Ac-
7 tuaries. All such determinations shall be in a
8 written report prepared by the actuary. The re-
9 port, and all underlying documentation relied
10 upon by the actuary, shall be maintained by the
11 group health plan or health insurance issuer for
12 a period of 6 years following the notification
13 made under subparagraph (E).
14 ``(D) 6-MONTH DETERMINATIONS.--If a
15 group health plan (or a health insurance issuer
16 offering coverage in connection with a group
17 health plan) seeks an exemption under this
18 paragraph, determinations under subparagraph
19 (A) shall be made after such plan (or coverage)
20 has complied with this section for the first 6
21 months of the plan year involved.
22 ``(E) NOTIFICATION.--
23 ``(i) IN GENERAL.--A group health
24 plan (or a health insurance issuer offering
25 coverage in connection with a group health
317
1 plan) that, based upon a certification de-
2 scribed under subparagraph (C), qualifies
3 for an exemption under this paragraph,
4 and elects to implement the exemption,
5 shall promptly notify the Secretary, the ap-
6 propriate State agencies, and participants
7 and beneficiaries in the plan of such elec-
8 tion.
9 ``(ii) REQUIREMENT.--A notification
10 to the Secretary under clause (i) shall in-
11 clude--
12 ``(I) a description of the number
13 of covered lives under the plan (or
14 coverage) involved at the time of the
15 notification, and as applicable, at the
16 time of any prior election of the cost-
17 exemption under this paragraph by
18 such plan (or coverage);
19 ``(II) for both the plan year upon
20 which a cost exemption is sought and
21 the year prior, a description of the ac-
22 tual total costs of coverage with re-
23 spect to medical and surgical benefits
24 and mental health and substance use
25 disorder benefits under the plan; and
318
1 ``(III) for both the plan year
2 upon which a cost exemption is sought
3 and the year prior, the actual total
4 costs of coverage with respect to men-
5 tal health and substance use disorder
6 benefits under the plan.
7 ``(iii) CONFIDENTIALITY.--A notifica-
8 tion to the Secretary under clause (i) shall
9 be confidential. The Secretary shall make
10 available, upon request and on not more
11 than an annual basis, an anonymous
12 itemization of such notifications, that in-
13 cludes--
14 ``(I) a breakdown of States by
15 the size and type of employers submit-
16 ting such notification; and
17 ``(II) a summary of the data re-
18 ceived under clause (ii).
19 ``(F) AUDITS BY APPROPRIATE AGEN-
20 CIES.--To determine compliance with this para-
21 graph, the Secretary may audit the books and
22 records of a group health plan or health insur-
23 ance issuer relating to an exemption, including
24 any actuarial reports prepared pursuant to sub-
25 paragraph (C), during the 6 year period fol-
319
1 lowing the notification of such exemption under
2 subparagraph (E). A State agency receiving a
3 notification under subparagraph (E) may also
4 conduct such an audit with respect to an ex-
5 emption covered by such notification.'';
6 (4) in subsection (e), by striking paragraph (4)
7 and inserting the following:
8 ``(4) MENTAL HEALTH BENEFITS.--The term
9 `mental health benefits' means benefits with respect
10 to services for mental health conditions, as defined
11 under the terms of the plan and in accordance with
12 applicable Federal and State law.
13 ``(5) SUBSTANCE USE DISORDER BENEFITS.--
14 The term `substance use disorder benefits' means
15 benefits with respect to services for substance use
16 disorders, as defined under the terms of the plan
17 and in accordance with applicable Federal and State
18 law.'';
19 (5) by striking subsection (f);
20 (6) by inserting after subsection (e) the fol-
21 lowing:
22 ``(f) SECRETARY REPORT.--The Secretary shall, by
23 January 1, 2012, and every two years thereafter, submit
24 to the appropriate committees of Congress a report on
25 compliance of group health plans (and health insurance
320
1 coverage offered in connection with such plans) with the
2 requirements of this section. Such report shall include the
3 results of any surveys or audits on compliance of group
4 health plans (and health insurance coverage offered in
5 connection with such plans) with such requirements and
6 an analysis of the reasons for any failures to comply.
7 ``(g) NOTICE AND ASSISTANCE.--The Secretary, in
8 cooperation with the Secretaries of Health and Human
9 Services and Treasury, as appropriate, shall publish and
10 widely disseminate guidance and information for group
11 health plans, participants and beneficiaries, applicable
12 State and local regulatory bodies, and the National Asso-
13 ciation of Insurance Commissioners concerning the re-
14 quirements of this section and shall provide assistance
15 concerning such requirements and the continued operation
16 of applicable State law. Such guidance and information
17 shall inform participants and beneficiaries of how they
18 may obtain assistance under this section, including, where
19 appropriate, assistance from State consumer and insur-
20 ance agencies.'';
21 (7) by striking ``mental health benefits'' and in-
22 serting ``mental health and substance use disorder
23 benefits'' each place it appears in subsections
24 (a)(1)(B)(i), (a)(1)(C), (a)(2)(B)(i), and (a)(2)(C);
25 and
321
1 (8) by striking ``mental health benefits'' and in-
2 serting ``mental health or substance use disorder
3 benefits'' each place it appears (other than in any
4 provision amended by the previous paragraph).
5 (b) AMENDMENTS TO PUBLIC HEALTH SERVICE
6 ACT.--Section 2705 of the Public Health Service Act (42
7 U.S.C. 300gg5) is amended--
8 (1) in subsection (a), by adding at the end the
9 following:
10 ``(3) FINANCIAL REQUIREMENTS AND TREAT-
11 MENT LIMITATIONS.--
12 ``(A) IN GENERAL.--In the case of a group
13 health plan (or health insurance coverage of-
14 fered in connection with such a plan) that pro-
15 vides both medical and surgical benefits and
16 mental health or substance use disorder bene-
17 fits, such plan or coverage shall ensure that--
18 ``(i) the financial requirements appli-
19 cable to such mental health or substance
20 use disorder benefits are no more restric-
21 tive than the predominant financial re-
22 quirements applied to substantially all
23 medical and surgical benefits covered by
24 the plan (or coverage), and there are no
25 separate cost sharing requirements that
322
1 are applicable only with respect to mental
2 health or substance use disorder benefits;
3 and
4 ``(ii) the treatment limitations applica-
5 ble to such mental health or substance use
6 disorder benefits are no more restrictive
7 than the predominant treatment limita-
8 tions applied to substantially all medical
9 and surgical benefits covered by the plan
10 (or coverage) and there are no separate
11 treatment limitations that are applicable
12 only with respect to mental health or sub-
13 stance use disorder benefits.
14 ``(B) DEFINITIONS.--In this paragraph:
15 ``(i) FINANCIAL REQUIREMENT.--The
16 term `financial requirement' includes
17 deductibles, copayments, coinsurance, and
18 out-of-pocket expenses, but excludes an ag-
19 gregate lifetime limit and an annual limit
20 subject to paragraphs (1) and (2).
21 ``(ii) PREDOMINANT.--A financial re-
22 quirement or treatment limit is considered
23 to be predominant if it is the most com-
24 mon or frequent of such type of limit or
25 requirement.
323
1 ``(iii) TREATMENT LIMITATION.--The
Top 10 Tags: plan, health, section, coverage, paragraph, benefits, qualified, mental, income, year
PermaLink Home All comments are moderated to the best of the administrator's ability. Do you agree with this article? Perhaps disagree?
|
Last 300 EntreCard Visitors (My drop list) Our Friends:
|
|
![[Valid RSS]](http://matthiaschronicles.tanaya.net/valid-rss.png "Validate my RSS feed")
