Sec. 7. Report on moral injury in health care
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Not later than 3 years after the date of enactment of this Act, the Inspector General of the Department of Health and Human Services shall— conduct a study that evaluates profit-driven practices, including cost-cutting practices and revenue-enhancing practices, in health care delivery; and submit to Congress a report describing the results of such study. The study conducted under subsection (a)(1) shall include— an evaluation of profit-driven and revenue-maximization practices in health care delivery, including— overbilling or up-coding; inflated patient severity or patient risk scores; executive and provider compensation designed to increase revenue or profits, such as bonuses based on productivity, relative value units, or service volume; reductions in staff and substitution of patient care staff with technology; changes in the mix of services provided in order to maximize revenue; efforts by private health insurers that are designed to restrict, delay, deny, or discourage health care access services, such as prior authorization or utilization review mechanisms; and efforts by private health insurers, private equity firms, and other corporate entities to evade state Corporate Practice of Medicine laws; an evaluation of the impact of such practices on— the quality, safety, and outcomes of patient care; the well-being of personnel providing health care services; the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ); the Medicaid program under title XIX of such Act ( 42 U.S.C. 1396 et seq. ); health care furnished under the laws administered by the Secretary of Veterans Affairs; the health insurance program carried out under chapter 89 of title 5, United States Code; qualified health plans offered through American Health Benefit Exchanges established under section 1311 or 1321 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031 , 18041); and group health plans and group and individual health insurance coverage, including managed care plans; an estimate of the financial returns accruing to parties that benefit from such practices, including investors and other entities; and an evaluation of the adequacy of Federal policies designed to prevent and penalize health care fraud and abuse, given health care consolidation and integration, including the transparency of health care entities’ financial practices, the enforcement resources of Federal agencies, and the adequacy of financial and other penalties as deterrents.
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