The Mental Health Matters Act Advances in the House

As the nation continues to face a mental health crisis, the U.S. House of Representatives recently passed H.R. 7780¹, the Mental Health Matters Act of 2022, advancing the bill to the U.S. Senate on a vote of 220-205. The bill proceeds with the support of the Biden administration as a part of the administration’s Unity Agenda that prioritizes mental health. H.R. 7780 would significantly increase the U.S. Department of Labor’s (“DOL”) ability to enforce compliance with the Mental Health Parity and Addiction Equity Act (“MHPAEA”) of 2008² that requires employer-sponsored healthcare benefit plans to treat mental health and substance use disorder services in parity with traditional, medical services. Further, H.R. 7780 would establish grants increasing the number of school-based mental health services providers, establish requirements for educational institutions concerning students with disabilities, prohibit arbitration and discretionary clauses in employer-sponsored healthcare benefit plans, and establish an occupational research program on mental health.

Significantly, Title VI of the bill, the “Strengthening Behavioral Health Benefits Act” would amend ERISA § 502(c)(10)³ to permit the Secretary of Labor to assess penalties against plan sponsors, plan administrators, and plan issuers for their failure to meet the parity requirements for mental health and substance use disorder benefits. This title would also amend § 502(a)(3) of ERISA to specifically provide that “re-adjudication and repayment of benefits” is now an available remedy under this section of ERISA that can be sought by plan participants, beneficiaries, and fiduciaries. This title would also appropriate significantly increased funding for the Employee Benefits Security Administration (“EBSA”) and the Office of the Solicitor at DOL.

Another substantial change to be brought by H.R. 7780 is with Title VII of the bill, the “Employee and Retiree Access to Justice Act.” This title provides that, notwithstanding any other provision of law, arbitration provisions contained within a healthcare benefit plan are unenforceable. Similarly, any provision that would prevent a plan participant or beneficiary from participating in class action litigation would be unenforceable. Also, except for multiemployer plans, any plan provision that confers discretionary authority as to benefit claim determinations, plan provision interpretation, or provide for anything other than de novo review of such determinations by the courts would be invalid and unenforceable. This is particularly significant with regard to potential ERISA benefits litigation as de novo review permits the courts much greater freedom in assessing benefits decisions and plan interpretations on claims and would likewise permit courts greater freedom in considering matters outside of the administrative record in making such determinations.

The other Titles of H.R. 7780 would provide substantial benefits to students — elementary, secondary, and post-secondary — for mental health support and give reasonable accommodations for students with disabilities. These titles play a significant role in providing student benefits, however the amendments to ERISA under Titles VI and VII of H.R. 7780 have the largest impact on the future of ERISA litigation and claims brought to enforce the rights of plan members and beneficiaries.

[1] Sponsored by Rep. Mark DeSaulnier [D-CA-11], co-sponsored by Rep. Robert C. Scott [D-VA-3]. Rep. Sheila Cherfilus-McCormick [D-FL-20], and Del. Gregorio Kilili Camacho Sablan [D-MP-At large].

[2] MHPAEA amended the Employee Retirement Income Security Act of 1974 (“ERISA”), the Public Health Service Act, and the Internal Revenue Code of 1986.

[3] 29 U.S.C. § 1132(c)(10)(A).