Sponsors (7)
Expands ERISA civil penalties for parity and genetic-information violations and makes sponsors, service providers, and administrators liable.
The bill strengthens enforcement and accountability for mental-health parity and genetic-information protections, improving patient remedies and oversight, but raises the risk of higher costs for plans, employers, and potentially insured individuals and increases administrative and legal activity.
People with mental health or substance use disorders gain stronger, more enforceable parity protections because civil penalties can be imposed on plan sponsors, administrators, and service providers who violate parity rules.
Patients with chronic conditions or disabilities obtain clearer legal remedies against misuse or improper handling of genetic information because civil penalties explicitly apply to failures to meet genetic-information protections.
Hospitals, health systems, and other organizations that operate or administer plans face greater accountability because the law expands liable parties to include service providers and administrators.
Health plans and issuers may tighten coverage or increase premiums to offset increased enforcement risk and potential penalties, affecting many insured Americans.
Plan sponsors, administrators, and service providers will face higher compliance costs and risk of fines, which could raise administrative expenses for employers and insurers.
Broader enforcement authority for the Secretary and removal of some enforcement prohibitions could lead to increased administrative actions and litigation involving plans and providers, burdening hospitals and plan administrators.
Based on analysis of 2 sections of legislative text.
Official title: To provide for civil monetary penalties for violations of mental health parity requirements.
Introduced February 4, 2025 by Donald Norcross · Last progress February 4, 2025
Makes it easier to fine group health plan actors for violating mental health and substance use disorder parity and related genetic information protections. The bill expands who can be penalized beyond plan sponsors to include service providers and plan administrators, narrows the covered misconduct to failures connected to the plan (including parity and genetic information requirements), creates an exception allowing the Secretary to enforce parity in certain cases, and delays application until plan years beginning more than one year after enactment.