Improving Provider Directories Act

I 116TH CONGRESS 1ST SESSION H. R. 4575 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 require group health plans and health insurance issuers offering group or individual health insurance coverage to establish a process to address inaccurate information listed in publicly accessible provider directories of such plans and issuers, and for other purposes. IN THE HOUSE OF REPRESENTATIVES SEPTEMBER 27, 2019 Ms. SCHRIER (for herself and Mr. DAVID P. ROE of Tennessee) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Labor, and 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 XXVII of the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to require group health plans and health insurance issuers offering group or individual health insurance coverage to establish a process to address inaccurate information listed in pub- licly accessible provider directories of such plans and issuers, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 04:35 Oct 03, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H4575.IH H4575 kjohnson on DSK79L0C42 with BILLS 2 •HR 4575 IH SECTION 1. SHORT TITLE. 1 This Act may be cited as the ‘‘Improving Provider 2 Directories Act’’. 3 SEC. 2. REQUIREMENT FOR GROUP HEALTH PLANS AND 4 HEALTH INSURANCE ISSUERS TO ESTABLISH 5 A PROCESS TO ADDRESS INACCURATE IN- 6 FORMATION LISTED IN PUBLICLY ACCES- 7 SIBLE PROVIDER DIRECTORIES OF SUCH 8 PLANS AND ISSUERS. 9 (a) PHSA.— 10 (1) IN GENERAL.—Title XXVII of the Public 11 Health Service (42 U.S.C. 300gg et seq.) is amend- 12 ed by adding at the end the following: 13 ‘‘PART D—OTHER MARKET REFORMS 14 ‘‘SEC. 2796. REQUIREMENT FOR GROUP HEALTH PLANS 15 AND HEALTH INSURANCE ISSUERS TO ESTAB- 16 LISH A PROCESS TO ADDRESS INACCURATE 17 INFORMATION LISTED IN PUBLICLY ACCES- 18 SIBLE PROVIDER DIRECTORIES OF SUCH 19 PLANS AND ISSUERS. 20 ‘‘A group health plan or a health insurance issuer of- 21 fering group or individual health insurance coverage shall 22 establish a process to address inaccurate information list- 23 ed in any publicly accessible provider directory of such 24 plan or issuer. Under such process, the plan or issuer, as 25 the case may be, shall carry out each of the following: 26 VerDate Sep 11 2014 04:35 Oct 03, 2019 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H4575.IH H4575 kjohnson on DSK79L0C42 with BILLS 3 •HR 4575 IH ‘‘(1) Display prominently on each publicly ac- 1 cessible provider directory of such plan or issuer 2 contact information, such as an email address, 3 phone number, or website address, that will allow an 4 individual to notify such plan or issuer of any inac- 5 curate information listed with respect to a provider 6 in such directory. 7 ‘‘(2)(A) Not later than 30 days after receiving 8 a notification pursuant to paragraph (1) that infor- 9 mation listed with respect to a provider in a publicly 10 accessible provider directory of such plan or issuer 11 is inaccurate— 12 ‘‘(i) investigate whether such information 13 is inaccurate; and 14 ‘‘(ii) subject to subparagraph (B), in the 15 case that such plan or issuer determines that 16 such information is inaccurate, correct and up- 17 date such information in such directory. 18 ‘‘(B) In the case that such plan or issuer deter- 19 mines, pursuant to an investigation under clause (i) 20 of subparagraph (A), that information listed with re- 21 spect to a provider in a printed provider directory is 22 inaccurate, such plan or issuer may satisfy the cor- 23 rection and update requirement under clause (ii) of 24 such subparagraph by correcting and updating such 25 VerDate Sep 11 2014 04:35 Oct 03, 2019 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H4575.IH H4575 kjohnson on DSK79L0C42 with BILLS 4 •HR 4575 IH information in each online provider directory of such 1 plan or issuer. 2 ‘‘(3) Submit to the State insurance commis- 3 sioners of the States in which such plan or coverage, 4 as applicable, is offered, and makes publicly avail- 5 able, an annual report on the number of notifica- 6 tions received pursuant to paragraph (1) during the 7 year involved and the corrective actions taken under 8 paragraph (2) with respect to such notifications.’’. 9 (2) CONFORMING AMENDMENTS.— 10 (A) Section 2722 of the Public Health 11 Service Act (42 U.S.C. 300gg–21) is amend- 12 ed— 13 (i) in subsection (a)(1), by inserting 14 ‘‘and part D’’ after ‘‘subparts 1 and 2’’; 15 (ii) in subsection (b), by inserting 16 ‘‘and part D’’ after ‘‘subparts 1 and 2’’; 17 (iii) in subsection (c)(1), by inserting 18 ‘‘and part D’’ after ‘‘subparts 1 and 2’’; 19 (iv) in subsection (c)(2), by inserting 20 ‘‘and part D’’ after ‘‘subparts 1 and 2’’; 21 (v) in subsection (c)(3), by inserting 22 ‘‘and part D’’ after ‘‘this part’’; and 23 VerDate Sep 11 2014 04:35 Oct 03, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H4575.IH H4575 kjohnson on DSK79L0C42 with BILLS 5 •HR 4575 IH (vi) in subsection (d), in the matter 1 preceding paragraph (1), by inserting ‘‘and 2 part D’’ after ‘‘this part’’. 3 (B) Section 2723 of the Public Health 4 Service Act (42 U.S.C. 300gg–22) is amend- 5 ed— 6 (i) in subsection (a)(1), by inserting 7 ‘‘and part D’’ after ‘‘this part’’; 8 (ii) in subsection (a)(2), by inserting 9 ‘‘or part D’’ after ‘‘this part’’; 10 (iii) in subsection (b)(1), by inserting 11 ‘‘or part D’’ after ‘‘this part’’; 12 (iv) in subsection (b)(2)(A), by insert- 13 ing ‘‘or part D’’ after ‘‘this part’’; and 14 (v) in subsection (b)(2)(C)(ii), by in- 15 serting ‘‘and part D’’ after ‘‘this part’’. 16 (C) Section 2724 of the Public Health 17 Service Act (42 U.S.C. 300gg–23) is amend- 18 ed— 19 (i) in subsection (a)(1)— 20 (I) by striking ‘‘this part and 21 part C insofar as it relates to this 22 part’’ and inserting ‘‘this part, part 23 D, and part C insofar as it relates to 24 this part or part D’’; and 25 VerDate Sep 11 2014 04:35 Oct 03, 2019 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H4575.IH H4575 kjohnson on DSK79L0C42 with BILLS 6 •HR 4575 IH (II) by inserting ‘‘or part D’’ 1 after ‘‘requirement of this part’’; 2 (ii) in subsection (a)(2), by inserting 3 ‘‘or part D’’ after ‘‘this part’’; and 4 (iii) in subsection (c), by inserting ‘‘or 5 part D’’ after ‘‘this part (other than sec- 6 tion 2704)’’. 7 (b) ERISA.— 8 (1) IN GENERAL.—Subpart B of part 7 of sub- 9 title B of title I of the Employee Retirement Income 10 Security Act of 1974 (29 U.S.C. 1185 et seq.) is 11 amended by adding at the end the following new sec- 12 tion: 13 ‘‘SEC. 716. REQUIREMENT FOR GROUP HEALTH PLANS AND 14 HEALTH INSURANCE ISSUERS TO ESTABLISH 15 A PROCESS TO ADDRESS INACCURATE IN- 16 FORMATION LISTED IN PUBLICLY ACCES- 17 SIBLE PROVIDER DIRECTORIES OF SUCH 18 PLANS AND ISSUERS. 19 ‘‘A group health plan or a health insurance issuer of- 20 fering group health insurance coverage shall establish a 21 process to address inaccurate information listed in any 22 publicly accessible provider directory of such plan or 23 issuer. Under such process, the plan or issuer, as the case 24 may be, shall carry out each of the following: 25 VerDate Sep 11 2014 04:35 Oct 03, 2019 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H4575.IH H4575 kjohnson on DSK79L0C42 with BILLS 7 •HR 4575 IH ‘‘(1) Display prominently on each publicly ac- 1 cessible provider directory of such plan or issuer 2 contact information, such as an email address, 3 phone number, or website address, that will allow an 4 individual to notify such plan or issuer of any inac- 5 curate information listed with respect to a provider 6 in such directory. 7 ‘‘(2)(A) Not later than 30 days after receiving 8 a notification pursuant to paragraph (1) that infor- 9 mation listed with respect to a provider in a publicly 10 accessible provider directory of such plan or issuer 11 is inaccurate— 12 ‘‘(i) investigate whether such information 13 is inaccurate; and 14 ‘‘(ii) subject to subparagraph (B), in the 15 case that such plan or issuer determines that 16 such information is inaccurate, correct and up- 17 date such information in such directory. 18 ‘‘(B) In the case that such plan or issuer deter- 19 mines, pursuant to an investigation under clause (i) 20 of subparagraph (A), that information listed with re- 21 spect to a provider in a printed provider directory is 22 inaccurate, such plan or issuer may satisfy the cor- 23 rection and update requirement under clause (ii) of 24 such subparagraph by correcting and updating such 25 VerDate Sep 11 2014 04:35 Oct 03, 2019 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H4575.IH H4575 kjohnson on DSK79L0C42 with BILLS 8 •HR 4575 IH information in each online provider directory of such 1 plan or issuer. 2 ‘‘(3) Submit to the State insurance commis- 3 sioners of the States in which such plan or coverage, 4 as applicable, is offered, and makes publicly avail- 5 able, an annual report on the number of notifica- 6 tions received pursuant to paragraph (1) during the 7 year involved and the corrective actions taken under 8 paragraph (2) with respect to such notifications.’’. 9 (2) CLERICAL AMENDMENT.—The table of con- 10 tents in section 1 of such Act is amended by insert- 11 ing after the item relating to section 714 the fol- 12 lowing new items: 13 ‘‘715. Additional market reforms. ‘‘716. Requirement for group health plans and health insurance issuers to estab- lish a process to address inaccurate information listed in pub- licly accessible provider directories of such plans and issuers.’’. (c) IRC.— 14 (1) IN GENERAL.—Subchapter B of chapter 15 100 of the Internal Revenue Code of 1986 is amend- 16 ed by adding at the end the following: 17 VerDate Sep 11 2014 04:35 Oct 03, 2019 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H4575.IH H4575 kjohnson on DSK79L0C42 with BILLS 9 •HR 4575 IH ‘‘SEC. 9816. REQUIREMENT FOR GROUP HEALTH PLANS TO 1 ESTABLISH A PROCESS TO ADDRESS INAC- 2 CURATE INFORMATION LISTED IN PUBLICLY 3 ACCESSIBLE PROVIDER DIRECTORIES OF 4 SUCH PLANS. 5 ‘‘A group health plan shall establish a process to ad- 6 dress inaccurate information listed in any publicly acces- 7 sible provider directory of such plan. Under such process, 8 the plan shall carry out each of the following: 9 ‘‘(1) Display prominently on each publicly ac- 10 cessible provider directory of such plan contact infor- 11 mation, such as an email address, phone number, or 12 website address, that will allow an individual to no- 13 tify such plan of any inaccurate information listed 14 with respect to a provider in such directory. 15 ‘‘(2)(A) Not later than 30 days after receiving 16 a notification pursuant to paragraph (1) that infor- 17 mation listed with respect to a provider in a publicly 18 accessible provider directory of such plan is inac- 19 curate— 20 ‘‘(i) investigate whether such information 21 is inaccurate; and 22 ‘‘(ii) subject to subparagraph (B), in the 23 case that such plan determines that such infor- 24 mation is inaccurate, correct and update such 25 information in such directory. 26 VerDate Sep 11 2014 04:35 Oct 03, 2019 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H4575.IH H4575 kjohnson on DSK79L0C42 with BILLS 10 •HR 4575 IH ‘‘(B) In the case that such plan determines, 1 pursuant to an investigation under clause (i) of sub- 2 paragraph (A), that information listed with respect 3 to a provider in a printed provider directory is inac- 4 curate, such plan may satisfy the correction and up- 5 date requirement under clause (ii) of such subpara- 6 graph by correcting and updating such information 7 in each online provider directory of such plan. 8 ‘‘(3) Submit to the State insurance commis- 9 sioners of the States in which such plan is offered, 10 and makes publicly available, an annual report on 11 the number of notifications received pursuant to 12 paragraph (1) during the year involved and the cor- 13 rective actions taken under paragraph (2) with re- 14 spect to such notifications.’’. 15 (2) CLERICAL AMENDMENT.—The table of sec- 16 tions for subchapter B of chapter 100 of the Inter- 17 nal Revenue Code of 1986 is amended by adding at 18 the end the following new item: 19 ‘‘Sec. 9816. Requirement for group health plans to establish a process to ad- dress inaccurate information listed in publicly accessible pro- vider directories of such plans.’’. (d) EFFECTIVE DATE.—The amendments made by 20 this section shall apply with respect to plan years begin- 21 ning on or after January 1, 2021. 22 Æ VerDate Sep 11 2014 04:35 Oct 03, 2019 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6301 E:\BILLS\H4575.IH H4575 kjohnson on DSK79L0C42 with BILLS