Protect the Uninsured Act of 2019

I 116TH CONGRESS 1ST SESSION H. R. 3386 To amend title XI of the Social Security Act to require hospitals and critical access hospitals to provide uninsured individuals with access to the lowest negotiated rate for items and services furnished to such individuals. IN THE HOUSE OF REPRESENTATIVES JUNE 20, 2019 Mr. COLLINS of New York introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Com- mittee on Ways and Means, 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 XI of the Social Security Act to require hospitals and critical access hospitals to provide unin- sured individuals with access to the lowest negotiated rate for items and services furnished to such individuals. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Protect the Uninsured 4 Act of 2019’’. 5 VerDate Sep 11 2014 04:16 Jun 26, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3386.IH H3386 kjohnson on DSK79L0C42 with BILLS 2 •HR 3386 IH SEC. 2. REQUIRING HOSPITALS AND CRITICAL ACCESS 1 HOSPITALS TO PROVIDE UNINSURED INDI- 2 VIDUALS WITH ACCESS TO THE LOWEST NE- 3 GOTIATED RATE FOR ITEMS AND SERVICES 4 FURNISHED TO SUCH INDIVIDUALS. 5 Section 1128A of the Social Security Act (42 U.S.C. 6 1320a–7a) is amended by adding at the end the following 7 new subsection: 8 ‘‘(t)(1) Any hospital or critical access hospital that, 9 with respect to an item or service furnished by such hos- 10 pital or critical access hospital to an uninsured individual 11 (as defined in paragraph (2)) on or after the date that 12 is 6 months after the date of the enactment of this sub- 13 section, holds such individual liable for an amount in ex- 14 cess of the lowest negotiated price (as defined in such 15 paragraph) with respect to such item or service shall be 16 subject to a civil monetary penalty in an amount equal 17 to the difference between the amount such hospital or crit- 18 ical access hospital held such individual liable for with re- 19 spect to such item or service and such lowest negotiated 20 price. The provisions of subsections (c), (d), (g), and (h) 21 shall apply to a civil monetary penalty under the preceding 22 sentence in the same manner as such provisions apply to 23 a penalty, assessment, or proceeding under subsection (a). 24 ‘‘(2) In this subsection: 25 VerDate Sep 11 2014 04:16 Jun 26, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3386.IH H3386 kjohnson on DSK79L0C42 with BILLS 3 •HR 3386 IH ‘‘(A) The term ‘lowest negotiated price’ means, 1 with respect to a hospital or critical access hospital 2 and an item or service, the lowest recognized amount 3 such hospital or critical access hospital has nego- 4 tiated with any health insurance issuer or group 5 health plan (as such terms are defined in section 6 2791 of the Public Health Service Act) with which 7 such hospital or critical access hospital contracts for 8 such item or service. 9 ‘‘(B) The term ‘uninsured individual’ means an 10 individual who is not enrolled or otherwise covered 11 under any health insurance coverage, group health 12 plan, or Federal health care program (as defined in 13 section 1128B(f)), or under the health insurance 14 program under chapter 89 of title 5, United States 15 Code.’’. 16 Æ VerDate Sep 11 2014 04:16 Jun 26, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6301 E:\BILLS\H3386.IH H3386 kjohnson on DSK79L0C42 with BILLS