Sec. 4. Transparency reporting requirements

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Section 2799A–1(a)(2)(A)(iii) of the Public Health Service Act ( 42 U.S.C. 300gg–111(a)(2)(A)(iii) ) is amended to read as follows: Beginning for 2022 and ending on December 31 of the calendar year in which the Enhanced Enforcement of Health Coverage Act is enacted, the Secretary shall annually submit to Congress a report on the number of plans and issuers with respect to which audits were conducted during such year pursuant to this subparagraph. With respect to the first calendar year following the date of the enactment of the Enhanced Enforcement of Health Coverage Act, not later than February 1 of such year, and every 6 months thereafter, the Secretary, in coordination with the Secretary of Labor and the Secretary of the Treasury, shall submit to the Committee on Ways and Means, the Committee on Energy and Commerce, and the Committee on Education and Workforce of the House of Representatives, and the Committee on Finance and the Committee on Health, Education, Labor and Pensions of the Senate, a report on any audits conducted pursuant to this subparagraph during the applicable reporting period, and any enforcement actions taken during such period in accordance with the provisions of this part, including— the total number of audits conducted under this subparagraph; the number of audits conducted pursuant to clause (ii)(I); the number of complaints submitted by providers and by participants, beneficiaries, and enrollees with respect to a violation of this part; any enforcement actions taken as a result of a complaint submitted by a provider or by a participant, a beneficiary, or an enrollee, with respect to the provisions of this part; the total number of, and the aggregate dollar amount of, any civil monetary penalties issued in accordance with this part; a summary of any non-monetary corrective action taken against a group health plan or health insurance issuer offering group or individual health insurance coverage for a violation of this part; and a description of the 3 most commonly reported violations of this part.

For purposes of this subclause, the term applicable reporting period means the 6 month period prior to each report submitted under item (aa). . Section 9816(a)(2)(A)(iii) of the Internal Revenue Code of 1986 is amended to read as follows: Beginning for 2022 and ending on December 31 of the calendar year in which the Enhanced Enforcement of Health Coverage Act is enacted, the Secretary shall annually submit to Congress a report on the number of plans with respect to which audits were conducted during such year pursuant to this subparagraph.

With respect to the first calendar year following the date of the enactment of the Enhanced Enforcement of Health Coverage Act, not later than February 1 of such year, and every 6 months thereafter, the Secretary, in coordination with the Secretary of Labor and the Secretary of Health and Human Services, shall submit to the Committee on Ways and Means, the Committee on Energy and Commerce, and the Committee on Education and Workforce of the House of Representatives, and the Committee on Finance and the Committee on Health, Education, Labor and Pensions of the Senate, a report on audits performed pursuant to this subparagraph during the applicable reporting period, and any enforcement actions taken during such period in accordance with the provisions of an applicable section, including— the total number of audits conducted under this subparagraph; the number of audits conducted pursuant to clause (ii)(I); the number of complaints submitted by providers and by participants and beneficiaries with respect to a violation of an applicable section; any enforcement actions taken pursuant to a violation of an applicable section; the total number of, and the aggregate dollar amount of, any civil monetary penalties issued in accordance with an applicable section; a summary of any non-monetary corrective action taken against a group health plan for a violation of an applicable section; and a description of the 3 most commonly reported violations of an applicable section.

In this subclause: The term applicable reporting period means the 6 month period prior to each report submitted under item (aa). The term applicable section means this section and each of sections 9817 through 9825. .

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42 USC 300gg–111(a)(2)(A)(iii)

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Sec. 4

Transparency reporting requirements

Cite42 USC 300gg–111(a)(2)(A)(iii)

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