The Department Shifted their focus internally, preparing for more complete investigations into Group Health Plans which includes mental health around late 2013 and 2014.

The Department has always had enforcement authority and jurisdiction over retirement plans and group health plans.

Prior to the ACA and specifically prior to 2013, the focus for the agency was more fully on retirement plans. 2007 and 2008, the agency would do internal enforcement project to verify if the group plans were following HIPAA compliance. Many plans were not since the establishment of HIPAA in 1996.

With the advent of ACA (affordable care act) the review of health plans became more than just HIPAA check sheets. The agency had actual health plan initiatives they wanted to make sure were in compliance. In 2013 the agency received the necessary funding to hire the investigative staff to do so.

That is what caused the shift. Once hired, they began training the staff to look more deeply into group health plans and how they were being administered and how they were functioning as a plan.

It started with the ACA Funding, bringing in more staff, and training that staff to do more than just surface-level HIPAA checks.