12 2 STA T .38 88 PUBLIC LA W 11 0– 3 4 3 —O CT. 3 , 2008 (4)insub s ect i o n (e) , b y st r i k in gpa ragrap h (4) an d inserting the f o l lo w ing
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‘(4) MENTALH EALTH B ENE FI T S.—T he ter m ‘mental health benefits ’ means benefits with respect to ser v ices for mental health conditions, as defined under the terms of the plan and in accordance with applicable F ederal and S tate law. ‘‘( 5 )S U BSTAN C E USE D IS OR DER BENEFITS.—The term ‘sub - stance use disorder benefits’ means benefits with respect to services for substance use disorders, as defined under the terms of the plan and in accordance with applicable Federal and State law.’’
(5) by striking subsection (f); ( 6 ) by striking ‘‘mental health benefits’’ and inserting ‘‘mental health and substance use disorder benefits’’ each place it appears in subsections (a)( 1 )( B )(i), (a)(1)( C ), (a)( 2 )(B)(i), and (a)(2)(C); and ( 7 ) by striking ‘‘mental health benefits’’ and inserting ‘‘mental health or substance use disorder benefits’’ each place it appears (other than in any provision amended by the previous paragraph). (c) AM ENDMENTS TO I NTERNAL R E V ENUE CODE.—Section 98 12 of the Internal Revenue Code of 1986 is amended— (1) in subsection (a), by adding at the end the following: ‘‘( 3 ) FINANCIAL RE Q UIREMENTS AND TREATMENT LIMITA- TIONS.— ‘‘(A) IN G ENERAL.—In the case of a group health plan that provides both medical and surgical benefits and mental health or substance use disorder benefits, such plan shall ensure that— ‘‘(i) the financial re q uirements applicable to such mental health or substance use disorder benefits are no more restrictive than the predominant financial requirements applied to substantially all medical and surgical benefits covered by the plan, and there are no separate cost sharing requirements that are applicable only with respect to mental health or sub- stance use disorder benefits; and ‘‘(ii) the treatment limitations applicable to such mental health or substance use disorder benefits are no more restrictive than the predominant treatment limitations applied to substantially all medical and surgical benefits covered by the plan and there are no separate treatment limitations that are applicable only with respect to mental health or substance use disorder benefits. ‘‘(B) D EFINITIONS.—In this paragraph: ‘‘(i) FINANCIAL REQUIREMENT.—The term ‘financial requirement’ includes deductibles, copayments, coinsurance, and out-of-pocket e x penses, but excludes an aggregate lifetime limit and an annual limit sub j ect to paragraphs (1) and (2), ‘‘(ii) P REDOMINANT.—A financial requirement or treatment limit is considered to be predominant if it is the most common or frequent of such type of limit or requirement. ‘‘(iii) TREATMENT LIMITATION.—The term ‘treat- ment limitation’ includes limits on the frequency of 26USC981 2 .
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