Fair Care Act of 2020

I 116TH CONGRESS 2D SESSION H. R. 8527 To address the high costs of health care services, prescription drugs, and health insurance coverage in the United States, and for other purposes. IN THE HOUSE OF REPRESENTATIVES OCTOBER 2, 2020 Mr. WESTERMAN (for himself, Mr. BURCHETT, Mr. SMUCKER, and Mr. RIGGLEMAN) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Education and Labor, the Judiciary, Oversight and Reform, House Administration, Rules, the Budget, and Armed Services, 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 address the high costs of health care services, prescription drugs, and health insurance coverage in the United States, 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 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Fair Care Act of 2020’’. 5 (b) TABLE OF CONTENTS.—The table of contents for 6 this Act is as follows: 7 VerDate Sep 11 2014 22:58 Nov 05, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H8527.IH H8527 pamtmann on DSKBC07HB2PROD with BILLS 2 •HR 8527 IH Sec. 1. Short title; table of contents. TITLE I—MEDISAVE Subtitle A—Medisave Accounts and Contributions Sec. 101. Establishment of Medisave accounts. Sec. 102. Consolidation of HSAs, HRAs, FSAs, and MSAs into Medisave ac- counts. Sec. 103. Health Reimbursement Arrangements and Other Account-Based Group Health Plans. Sec. 104. Cost-sharing reduction payments as eligible contributions. Sec. 105. Direct Primary Care. Subtitle B—Assistance to Medisave Accounts Sec. 111. Support in implementation. Sec. 112. New corporations required to use Medisave. Sec. 113. Federal employee health benefits and Medisave. Sec. 114. Grants to States for consumer assistance. TITLE II—IMPROVING PRIVATE HEALTH INSURANCE Subtitle A—Maintaining Protections for Patients With Preexisting Conditions Sec. 201. Guaranteed availability of coverage; prohibiting discrimination. Subtitle B—Expanding Coverage Options Sec. 211. Rules governing association health plans. Sec. 212. Clarification of treatment of single employer arrangements. Sec. 213. Enforcement provisions relating to association health plans. Sec. 214. Cooperation between Federal and State authorities. Sec. 215. Effective date and transitional and other rules. Sec. 216. Short-term limited duration insurance. Subtitle C—Improving Commercial Health Insurance Sec. 221. Invisible Guaranteed Coverage Pool Reinsurance Program; tax on ex- change plans. Sec. 222. Employer health insurance mandate repeal. Sec. 223. Refundable credits for coverage under a qualified health plan for indi- viduals offered employer-sponsored insurance. Sec. 224. Inclusion in income of certain costs of employer-provided coverage under health plans. Sec. 225. Change in permissible age variation in health insurance premium rates. Sec. 226. Premium assistance adjustment to reflect age. Sec. 227. Premium assistance. Sec. 228. Adding copper plans to Exchanges. Sec. 229. Copper and bronze plans. Sec. 230. Waivers for State innovation. Sec. 231. Enrollment periods. Sec. 232. State-operated Exchanges flexibility for open enrollment periods. Sec. 233. Promoting health plans that cover individuals in more than one State. TITLE III—COMPETITION, TRANSPARENCY AND ACCOUNTABILITY VerDate Sep 11 2014 22:58 Nov 05, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6211 E:\BILLS\H8527.IH H8527 pamtmann on DSKBC07HB2PROD with BILLS 3 •HR 8527 IH Subtitle A—Provider and Insurer Competition Sec. 301. Hospital consolidation. Sec. 302. Authority of Federal Trade Commission over certain tax-exempt or- ganizations. Sec. 303. Restoring the application of antitrust laws to the business of health insurance. Sec. 304. Leveling the playing field between payers and providers. Sec. 305. Increasing transparency by removing gag clauses on price and quality information. Sec. 306. Banning anticompetitive terms in facility and insurance contracts that limit access to higher quality, lower cost care. Sec. 307. Repealing eligibility of certain ACOs. Sec. 308. Repeal of health care reform provisions limiting Medicare exception to the prohibition on certain physician referrals for hospitals. Sec. 309. Alternative payment model for certain shoppable procedures. Subtitle B—Price Transparency Sec. 321. Price transparency. Sec. 322. Price transparency requirements. Sec. 323. Designation of nongovernmental, nonprofit transparency organiza- tions to lower Americans’ health care costs. Sec. 324. Protecting patients and improving the accuracy of provider directory information. Sec. 325. Ensuring enrollee access to cost-sharing information. Sec. 326. Access of individuals to protected health information. Sec. 327. Timely bills for patients. Sec. 328. Advisory group on reducing burden of hospital administrative require- ments. Sec. 329. Data reporting to improve the transparency regarding how 340B hos- pital covered entities provide care for patients. Sec. 330. Requiring 340B drug discount program reports by DSH hospital cov- ered entities on low-income utilization rate of outpatient hos- pital services. Sec. 331. Employer benefits reports. Sec. 332. Group health plan reporting requirements. Sec. 333. Government Accountability Office study on profit- and revenue-shar- ing in health care. Subtitle C—Prescription Drug Competition and Innovation Sec. 341. Expedited development and priority review for generic complex drug products. Sec. 342. Preventing blocking of generic drugs. Sec. 343. Ensuring timely access to generics. Sec. 344. Preemption of State barriers to the substitution of biosimilar prod- ucts. Sec. 345. Increasing pharmaceutical options to treat an unmet medical need. Sec. 346. Provisional approval of new human drugs. Sec. 347. Consolidating exclusivity periods for drugs treating rare diseases and conditions. Sec. 348. Exclusivity period for brand name biological products. Sec. 349. Protecting access to biological products. Sec. 350. Streamlining the transition of biological products. Sec. 351. Regulation of manufacturer-sponsored copay contributions. VerDate Sep 11 2014 22:58 Nov 05, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6211 E:\BILLS\H8527.IH H8527 pamtmann on DSKBC07HB2PROD with BILLS 4 •HR 8527 IH Sec. 352. Antitrust exemption for private health insurer issuers to negotiate wholesale acquisition prices of prescription drugs purchased from drug manufacturers. Sec. 353. Biological product innovation. Sec. 354. Clarifying the meaning of new chemical entity. Sec. 355. Prompt approval of drugs related to safety information. Sec. 356. Conditions of use for biosimilar biological products. Sec. 357. Education on biological products. Sec. 358. Congressional review of the Food and Drug Administration rule- making. Sec. 359. Government Accountability Office study of rules. Subtitle D—Prescription Drug and Pharmacy Benefit Manager Transparency Sec. 361. Patent disclosure requirements. Sec. 362. Biological product patent transparency. Sec. 363. Orange Book modernization. Sec. 364. Modernizing the labeling of certain generic drugs. Sec. 365. Requirements with respect to prescription drug benefits. Sec. 366. PBM transparency and elimination of DIR fees. Sec. 367. Health plan oversight of pharmacy benefit manager services. Sec. 368. Study by Comptroller General of United States. Subtitle E—Medicare and Medicaid Prescription Drug Reforms Sec. 371. Medicare part B rebate by manufacturers for drugs or biologicals with prices increasing faster than inflation. Sec. 372. Market based part B pricing index. Sec. 373. Innovation model testing of Medicare drug payments. Sec. 374. Modification of maximum rebate amount under Medicaid drug rebate program. Subtitle F—Medical Malpractice Reform Sec. 381. Definitions. Sec. 382. Encouraging speedy resolution of claims. Sec. 383. Compensating patient injury. Sec. 384. Maximizing patient recovery. Sec. 385. Authorization of payment of future damages to claimants in health care lawsuits. Sec. 386. Product liability for health care providers. Sec. 387. Effect on other laws. Sec. 388. Limitation on expert witness testimony. Sec. 389. Expert witness qualifications. Sec. 390. Communications following unanticipated outcome. Sec. 391. Affidavit of merit. Sec. 392. Notice of intent to commence lawsuit. Sec. 393. Limitation on liability for volunteer health care professionals. Sec. 394. Rules of construction. Sec. 395. Effective date. TITLE IV—MEDICARE AND MEDICAID REFORMS Subtitle A—Medicaid Reforms Sec. 401. Medicaid payment reform. VerDate Sep 11 2014 22:58 Nov 05, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6211 E:\BILLS\H8527.IH H8527 pamtmann on DSKBC07HB2PROD with BILLS 5 •HR 8527 IH Sec. 402. Income limitations for refundable credits for coverage under a quali- fied health plan. Sec. 403. Medicaid eligibility determinations. Sec. 404. Lowering safe harbor threshold with respect to State taxes on health care providers. Sec. 405. Providing for State approval and implementation of specified waivers under the Medicaid program. Sec. 406. Deduction for qualified charity care. Subtitle B—Medicare Reforms Sec. 411. Off-campus provider-based department Medicare site neutral pay- ment. Sec. 412. Eliminating FEHBP eligibility for annuitants. Sec. 413. Elimination of Medicare eligibility for certain individuals. Sec. 414. Medicare part D tax deduction. Sec. 415. Repeal of net investment income tax. Sec. 416. Medicare coverage of bad debt. Subtitle C—Medicare Choice and Competition Sec. 421. Competitive bidding and premiums under unified Medicare. Sec. 422. New unified eligibility and enrollment rules. Sec. 423. New benefit structure under unified Medicare. Sec. 424. Late enrollment penalty not to apply for months of any health cov- erage. Sec. 425. Medigap reform. Sec. 426. ACO revision. Sec. 427. Primary care options. Sec. 428. General provisions; effective date. Subtitle D—Telehealth Improvements and Expansion Sec. 431. Expansion of coverage of telehealth services. Sec. 432. Expanding the use of telehealth through the waiver of certain re- quirements. Sec. 433. Expanding the use of telehealth for mental health services. Sec. 434. Use of telehealth in emergency medical care. Sec. 435. Improvements to the process for adding telehealth services. Sec. 436. Rural health clinics and Federally qualified health centers. Sec. 437. Native American health facilities. Sec. 438. Waiver of telehealth restrictions during national emergencies. Sec. 439. Use of telehealth in recertification for hospice care. Sec. 440. Clarification for fraud and abuse laws regarding technologies pro- vided to beneficiaries. Sec. 441. Study and report on increasing access to telehealth services in the home. Sec. 442. Analysis of telehealth waivers in alternative payment models. Sec. 443. Model to allow additional health professionals to furnish telehealth services. Sec. 444. Testing of models to examine the use of telehealth under the Medi- care program. VerDate Sep 11 2014 22:58 Nov 05, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6211 E:\BILLS\H8527.IH H8527 pamtmann on DSKBC07HB2PROD with BILLS 6 •HR 8527 IH TITLE I—MEDISAVE 1 Subtitle A—Medisave Accounts and 2 Contributions 3 SEC. 101. ESTABLISHMENT OF MEDISAVE ACCOUNTS. 4 (a) IN GENERAL.—Part VIII of subchapter F of 5 chapter 1 of the Internal Revenue Code of 1986 is amend- 6 ed by adding at the end the following new section: 7 ‘‘SEC. 530A. MEDISAVE ACCOUNTS. 8 ‘‘(a) MEDISAVE ACCOUNT.—For purposes of this sec- 9 tion— 10 ‘‘(1) IN GENERAL.—The term ‘Medisave ac- 11 count’ means a trust created or organized in the 12 United States as a Medisave account exclusively for 13 the purpose of paying the qualified medical expenses 14 of the account beneficiary, but only if the written 15 governing instrument creating the trust meets the 16 following requirements: 17 ‘‘(A) Except in the case of a rollover con- 18 tribution described in subparagraph (A) or (B) 19 of subsection (e)(5), no contribution will be ac- 20 cepted— 21 ‘‘(i) unless it is in cash, 22 ‘‘(ii) to the extent such contribution, 23 when added to previous contributions to 24 the trust for the calendar year, exceeds the 25 VerDate Sep 11 2014 22:58 Nov 05, 2020 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H8527.IH H8527 pamtmann on DSKBC07HB2PROD with BILLS 7 •HR 8527 IH limitation amount specified in subsection 1 (b)(1), or 2 ‘‘(iii) to the extent such contribution, 3 when added to the balance of the account, 4 exceeds the limitation amount specified in 5 subsection (b)(2). 6 ‘‘(B) The trustee is a bank (as defined in 7 section 408(n)), an insurance company (as de- 8 fined in section 816), or another person who 9 demonstrates to the satisfaction of the Sec- 10 retary that the manner in which such person 11 will administer the trust will be consistent with 12 the requirements of this section. 13 ‘‘(C) No part of the trust assets will be in- 14 vested in life insurance contracts. 15 ‘‘(D) The assets of the trust will not be 16 commingled with other property except in a 17 common trust fund or common investment 18 fund. 19 ‘‘(E) The interest of an individual in the 20 balance in his account is nonforfeitable. 21 ‘‘(2) QUALIFIED MEDICAL EXPENSES.— 22 ‘‘(A) IN GENERAL.—The term ‘qualified 23 medical expenses’ means, with respect to an ac- 24 count beneficiary, amounts paid by such bene- 25 VerDate Sep 11 2014 22:58 Nov 05, 2020 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H8527.IH H8527 pamtmann on DSKBC07HB2PROD with BILLS 8 •HR 8527 IH ficiary for medical care, but only to the extent 1 such amounts are not compensated for by in- 2 surance or otherwise— 3 ‘‘(i) for— 4 ‘‘(I) such individual, 5 ‘‘(II) the spouse of such indi- 6 vidual, 7 ‘‘(III) any dependent (as defined 8 in section 152, determined without re- 9 gard to subsections (b)(1), (b)(2), and 10 (d)(1)(B) thereof) of such individual, 11 and 12 ‘‘(IV) any individual who bears a 13 relationship to the account beneficiary 14 that is described in subparagraph (C) 15 or (D) of section 152(d) if the ac- 16 count beneficiary is or was a depend- 17 ent of such individual for any taxable 18 year ending before or with the taxable 19 year in which the individual attained 20 18 years of age, and 21 ‘‘(ii) if, on the date such medical care 22 was provided, such individual, spouse or 23 dependent to whom such care was provided 24 VerDate Sep 11 2014 22:58 Nov 05, 2020 Jkt 0192 [Text truncated for display. 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