Sec. 3. Process for applications with inconsistencies
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/bill/114/s/42/is/section-3A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
The Secretary of Health and Human Services (referred to in this section as the Secretary ) shall make public the steps that the Centers for Medicare & Medicaid Services and the Federal Exchange will take to clear any inconsistencies that arose on or before the date of enactment of this Act and to ensure that the systems used by the Centers for Medicare & Medicaid Services to determine or assess eligibility for premium tax credits, cost-sharing reductions, Medicaid, and the State Children's Health Insurance Program
(CHIP)can resolve such inconsistencies not later than 30 days after the date of enactment of this Act. Not later than 30 days after the date of enactment of this Act, the Secretary shall make public the methods that the Centers for Medicare & Medicaid Services use to monitor, track, and measure the progress of the Federal Exchange and State Exchanges in resolving inconsistencies. Premium assistance tax credits under section 36B of the Internal Revenue Code of 1986 and the reduced cost-sharing program under section 1402 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18071 ) shall not be available for plan year 2015. Such premium tax credit and cost-sharing programs shall resume only after— the Commissioner of the Social Security Administration affirmatively declares that all inconsistencies related to invalid social security numbers have been resolved; and the Inspector General of the Department of Health and Human Services determines that all inconsistencies, as defined in section 4(1), have been resolved. If applicant information provided by an individual seeking to enroll in a qualified health plan on a State or Federal Exchange contains inconsistencies, the Secretary shall request additional information from the individual, and the individual shall have 90 days to provide such information. During the inconsistency period, an individual may be enrolled in qualified health plan, but may not participate in the premium assistance credit program under section 36B of the Internal Revenue Code of 1986 or the reduced cost-sharing program under section 1402 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18071 ). An individual who cooperates with a request for additional information and whom the Secretary later determines to be eligible for such programs, shall retroactively receive the benefits of such programs that such individual was eligible to receive for the inconsistency period. If the applicant does not submit additional information requested under subparagraph (A)— the applicant shall be withdrawn from the premium assistance credit program under section 36B of the Internal Revenue Code of 1986 and the reduced cost-sharing program under section 1402 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18071 ), as applicable, at the end of the inconsistency period; and the Secretary shall send notification of such disenrollment to the applicable health insurance issuer; and the applicant shall re-enroll in a qualified health plan with appropriate and accurate information during the next open enrollment period.
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Sec. 3
Process for applications with inconsistencies
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