[Congressional Bills 118th Congress] [From the U.S. Government Publishing Office] [H.R. 9572 Introduced in House (IH)] <DOC> 118th CONGRESS 2d Session H. R. 9572 To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. _______________________________________________________________________ IN THE HOUSE OF REPRESENTATIVES September 12, 2024 Mr. Murphy (for himself, Mr. Ruiz, Mr. Joyce of Pennsylvania, Ms. Schrier, and Mr. Panetta) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and the Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned _______________________________________________________________________ A BILL To amend title XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to increase penalties for group health plans and health insurance issuers for practices that violate balance billing requirements, and for other purposes. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Enhanced Enforcement of Health Coverage Act''. SEC. 2. INCREASING PENALTIES FOR GROUP HEALTH PLANS AND HEALTH INSURANCE ISSUERS FOR PRACTICES THAT VIOLATE BALANCE BILLING REQUIREMENTS. (a) PHSA.--Section 2723(b)(2)(C) of the Public Health Service Act (42 U.S.C. 300gg-22(b)(2)(C)) is amended-- (1) in clause (i), by inserting ``(or, in the case of such a failure with respect to a provision specified in clause (iv), $10,000 per failure)'' after ``$100''; and (2) by adding at the end the following new clause: ``(iv) Provisions specified.--For purposes of clause (i), the provisions specified in this clause are the following: ``(I) Subparagraphs (A) and (B) of section 2799A-1(a)(1). ``(II) Clauses (i), (ii), (iii), and (v) of section 2799A-1(a)(1)(C). ``(III) Subparagraphs (A), (B), and (E) of section 2799A-1(b)(1). ``(IV) Paragraphs (1) and (2) of section 2799A-2(a).''. (b) ERISA.--Section 502 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1131) is amended-- (1) in subsection (a)(6), by striking ``or (9)'' and inserting ``(9), or (12)''; (2) in subsection (b)(3)-- (A) by inserting ``, (c)(12),'' after ``subsections (c)(9)''; and (B) by inserting ``or (c)(12)'' after ``under subsection (c)(9)''; and (3) in subsection (c), by adding at the end the following new paragraph: ``(12) The Secretary may assess a civil penalty against any group health plan or health insurance issuer offering group health insurance coverage of not more than $10,000 for each violation for each individual with respect to which such plan or coverage fails to comply with one of the following provisions: ``(A) Subparagraphs (A) and (B) of section 716(a)(1). ``(B) Clauses (i), (ii), (iii), and (v) of section 716(a)(1)(C). ``(C) Subparagraphs (A), (B), and (E) of section 716(b)(1). ``(D) Paragraphs (1) and (2) of section 717(a).''. (c) IRC.--Section 4980D(b) of the Internal Revenue Code of 1986 is amended-- (1) in paragraph (1), by inserting ``(or, in the case of such a failure with respect to a provision specified in paragraph (4), $10,000 per failure)'' after ``$100''; and (2) by adding at the end the following new paragraph: ``(4) Provisions specified.--For purposes of paragraph (1), the provisions specified in this paragraph are the following: ``(A) Subparagraphs (A) and (B) of section 9816(a)(1). ``(B) Clauses (i), (ii), (iii), and (v) of section 9816(a)(1)(C). ``(C) Subparagraphs (A), (B), and (E) of section 9816(b)(1). ``(D) Paragraphs (1) and (2) of section 9817(a).''. SEC. 3. ADDITIONAL PENALTIES FOR LATE PAYMENT OR NON-PAYMENT AFTER IDR ENTITY PAYMENT DETERMINATION. (a) PHSA.-- (1) Emergency and nonemergency services.--Section 2799A- 1(c)(6) of the Public Health Service Act (42 U.S.C. 300gg- 111(c)(6)) is amended-- (A) in the paragraph heading, by inserting ``; penalty for late payment or non-payment'' after ``payment''; (B) by striking ``The total plan'' and inserting the following: ``(A) Timing of payment.--The total plan''; and (C) by adding at the end the following new subparagraphs: ``(B) Notification.--In the case of a plan or coverage required to make a payment pursuant to a determination described in subparagraph (A), such plan or coverage shall submit to the Secretary a notification of such payment as of the date such payment is made in a manner specified by the Secretary. ``(C) Penalty for late payment or non-payment.-- ``(i) In general.--In the case of a plan or coverage that has not made the required payment described in subparagraph (A) with respect to an item or service in the time period described in such subparagraph, in addition to making such payment, such plan or coverage shall also pay to the nonparticipating provider or facility an amount that is three times the difference between-- ``(I) the initial payment (or, in the case of a notice of denial of payment, $0) described in subsection (a)(1)(C)(iv)(I) or (b)(1)(C), as applicable; and ``(II) the out-of-network rate (as defined in subsection (a)(3)(K)) for such item or service (less any cost sharing required to be paid by the individual receiving such item or service). ``(ii) Interest.--Such late payment or non- payment (as applicable) shall also be subject to interest in a manner specified by the Secretary.''. (2) Air ambulance services.--Section 2799A-2(b)(6) of the Public Health Service Act (42 U.S.C. 300gg-112(b)(6)) is amended-- (A) in the paragraph heading, by inserting ``; penalty for late payment or non-payment'' after ``payment''; (B) by striking ``The total plan'' and inserting the following: ``(A) Timing of payment.--The total plan''; and (C) by adding at the end the following new subparagraphs: ``(B) Notification.--In the case of a plan or coverage required to make a payment pursuant to a determination described in subparagraph (A), such plan or coverage shall submit to the Secretary a notification of such payment as of the date such payment is made in a manner specified by the Secretary. ``(C) Penalty for late payment or non-payment.-- ``(i) In general.--In the case of a plan or coverage that has not made the required payment described in subparagraph (A) with respect to an item or service in the time period described in such subparagraph, in addition to making such payment, such plan or coverage shall also pay to the nonparticipating provider an amount that is three times the difference between-- ``(I) the initial payment (or, in the case of a notice of denial of payment, $0) described in subsection (a)(3)(A); and ``(II) the out-of-network rate (as defined in section 2799-1(a)(3)(K)) for such item or service (less any cost sharing required to be paid by the individual receiving such item or service). ``(ii) Interest.--Such late payment or non- payment (as applicable) shall also be subject to interest in a manner specified by the Secretary.''. (b) ERISA.-- (1) Emergency and nonemergency services.--Section 716(c)(6) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185e(c)(6)) is amended-- (A) in the paragraph heading, by inserting ``; penalty for late payment or non-payment'' after ``payment''; (B) by striking ``The total plan'' and inserting the following: ``(A) Timing of payment.--The total plan''; and (C) by adding at the end the following new subparagraphs: ``(B) Notification.--In the case of a plan or coverage required to make a payment pursuant to a determination described in subparagraph (A), such plan or coverage shall submit to the Secretary a notification of such payment as of the date such payment is made in a manner specified by the Secretary. ``(C) Penalty for late payment or non-payment.-- ``(i) In general.--In the case of a plan or coverage that has not made the required payment described in subparagraph (A) with respect to an item or service in the time period described in such subparagraph, in addition to making such payment, such plan or coverage shall also pay to the nonparticipating provider or facility an amount that is three times the difference between-- ``(I) the initial payment (or, in the case of a notice of denial of payment, $0) described in subsection (a)(1)(C)(iv)(I) or (b)(1)(C), as applicable; and ``(II) the out-of-network rate (as defined in subsection (a)(3)(K)) for such item or service (less any cost sharing required to be paid by the individual receiving such item or service). ``(ii) Interest.--Such late payment or non- payment (as applicable) shall also be subject to interest in a manner specified by the Secretary.''. (2) Air ambulance services.--Section 717(b)(6) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185f(b)(6)) is amended-- (A) in the paragraph heading, by inserting ``; penalty for late payment or non-payment'' after ``payment''; (B) by striking ``The total plan'' and inserting the following: ``(A) Timing of payment.--The total plan''; and (C) by adding at the end the following new subparagraphs: ``(B) Notification.--In the case of a plan or coverage required to make a payment pursuant to a determination described in subparagraph (A), such plan or coverage shall submit to the Secretary a notification of such payment as of the date such payment is made in a manner specified by the Secretary. ``(C) Penalty for late payment or non-payment.-- ``(i) In general.--In the case of a plan or coverage that has not made the required payment described in subparagraph (A) with respect to an item or service in the time period described in such subparagraph, in addition to making such payment, such plan or coverage shall also pay to the nonparticipating provider an amount that is three times the difference between-- ``(I) the initial payment (or, in the case of a notice of denial of payment, $0) described in subsection (a)(3)(A); and ``(II) the out-of-network rate (as defined in section 716(a)(3)(K)) for such item or service (less any cost sharing required to be paid by the individual receiving such item or service). ``(ii) Interest.--Such late payment or non- payment (as applicable) shall also be subject to interest in a manner specified by the Secretary.''. (c) IRC.-- (1) Emergency and nonemergency services.--Section 9816(c)(6) of the Internal Revenue Code of 1986 is amended-- (A) in the paragraph heading, by inserting ``; penalty for late payment or non-payment'' after ``payment''; (B) by striking ``The total plan'' and inserting the following: ``(A) Timing of payment.--The total plan''; and (C) by adding at the end the following new subparagraphs: ``(B) Notification.--In the case of a plan required to make a payment pursuant to a determination described in subparagraph (A), such plan shall submit to the Secretary a notification of such payment as of the date such payment is made in a manner specified by the Secretary. ``(C) Penalty for late payment or non-payment.-- ``(i) In general.--In the case of a plan that has not made the required payment described in subparagraph (A) with respect to an item or service in the time period described in such subparagraph, in addition to making such payment, such plan shall also pay to the nonparticipating provider or facility an amount that is three times the difference between-- ``(I) the initial payment (or, in the case of a notice of denial of payment, $0) described in subsection (a)(1)(C)(iv)(I) or (b)(1)(C), as applicable; and ``(II) the out-of-network rate (as defined in subsection (a)(3)(K)) for such item or service (less any cost sharing required to be paid by the individual receiving such item or service). ``(ii) Interest.--Such late payment or non- payment (as applicable) shall also be subject to interest in a manner specified by the Secretary.''. (2) Air ambulance services.--Section 9817(b)(6) of the Internal Revenue Code of 1986 is amended-- (A) in the paragraph heading, by inserting ``; penalty for late payment or non-payment'' after ``payment''; (B) by striking ``The total plan'' and inserting the following: ``(A) Timing of payment.--The total plan''; and (C) by adding at the end the following new subparagraphs: ``(B) Notification.--In the case of a plan required to make a payment pursuant to a determination described in subparagraph (A), such plan shall submit to the Secretary a notification of such payment as of the date such payment is made in a manner specified by the Secretary. ``(C) Penalty for late payment or non-payment.-- ``(i) In general.--In the case of a plan that has not made the required payment described in subparagraph (A) with respect to an item or service in the time period described in such subparagraph, in addition to making such payment, such plan shall also pay to the nonparticipating provider an amount that is three times the difference between-- ``(I) the initial payment (or, in the case of a notice of denial of payment, $0) described in subsection (a)(3)(A); and