II 

113TH CONGRESS 

1ST SESSION S. 1666 

To amend the Patient Protection and Affordable Care Act to improve the 

patient navigator program. 

IN THE SENATE OF THE UNITED STATES 

NOVEMBER 7, 2013 

Mr. RUBIO (for himself, Mr. BOOZMAN, Mr. COCHRAN, Mr. INHOFE, Mr. 

MCCONNELL, Mr. ROBERTS, and Mr. FLAKE) introduced the following 

bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Patient Protection and Affordable Care Act 

to improve the patient navigator program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Healthcare Privacy 

5 and Anti-Fraud Act’’. 


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1 SEC. 2. TRAINING, BACKGROUND CHECKS, AND NON2 DISCLOSURE FOR PATIENT NAVIGATORS. 

3 (a) IN GENERAL.—Section 1311(i) of the Patient 

4 Protection and Affordable Care Act (42 U.S.C. 18031(i)) 

5 is amended by adding at the end the following: 

6 ‘‘(7) SECURITY AND NONDISCLOSURE.— 

7 ‘‘(A) GUIDANCE BY SECRETARY.—Not 

8 later than 90 days after the date of enactment 

9 of this paragraph, the Secretary shall issue 

10 guidance on the implementation of this para11 graph in order to protect the privacy of individ12 ually identifiable information submitted to, or 

13 accessed by, navigators under this subsection. 

14 ‘‘(B) BACKGROUND CHECKS.— 

15 ‘‘(i) IN GENERAL.—An entity that re16 ceives a grant under this subsection shall 

17 ensure that universal background checks 

18 are conducted on all employees of the enti19 ty prior to such employees providing navi20 gator services to individuals, or prior to 

21 such employees having access to individ22 ually identifiable information as a result of 

23 providing such services. Such background 

24 checks shall, at minimum, include a crimi25 nal background check, fingerprinting, and 

26 credit report. 


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1 ‘‘(ii) LIMITATION.—An individual who 

2 has been found guilty of a felony, or guilty 

3 of a misdemeanor involving deceit or dis4 honestly (including identity theft, fraud, or 

5 perjury), under Federal or State law shall 

6 not be employed by an entity described in 

7 clause (i). 

8 ‘‘(C) OATH.— 

9 ‘‘(i) IN GENERAL.—Prior to com10 mencing employment with an entity that 

11 receives a grant under this subsection, an 

12 individual described in clause (ii) shall 

13 have sworn or taken an oath that he or she 

14 will not disclose any individually identifi15 able information obtained in the course of 

16 their employment (except information rel17 evant to the commission of a felony when 

18 provided to an appropriate law enforce19 ment authority). 

20 ‘‘(ii) INDIVIDUAL DESCRIBED.—An in21 dividual is described in this clause if such 

22 individual is being employed by an entity 

23 described in clause (i) as a navigator, a 

24 non-navigator assistant, or as an employee 


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1 with access to individually identifiable in2 formation. 

3 ‘‘(D) EDUCATIONAL, TRAINING, AND LI4 CENSURE REQUIREMENTS.—Prior to conducting 

5 navigation services for an entity under this sub6 section, an individual shall meet educational 

7 and licensure requirements that are identical or 

8 comparable to those currently applicable to 

9 health insurance agents and brokers within the 

10 State in which they seek to provide navigation 

11 services, including the completion of at least 30 

12 hours of training (including training on privacy 

13 rights under this Act and other relevant Fed14 eral laws). 

15 ‘‘(E) LIABILITY.—Not later than 90 days 

16 after the date of the enactment of this para17 graph, the Secretary— 

18 ‘‘(i) shall issue guidance concerning 

19 how liability and penalties will be applied 

20 by the Secretary in instances of failure to 

21 comply with requirements of this para22 graph, including where consumer outreach 

23 and enrollment assistance causes harm to 

24 an individual as a result of misuse or negVerDate Mar 15 2010 02:01 Nov 08, 2013 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1666.IS S1666

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1 ligence in protection and privacy of individ2 ually identifiable information; 

3 ‘‘(ii) shall determine whether such li4 ability lies with the navigator or non-navi5 gator assistance personnel involved or 

6 whether liability lies with the entity that 

7 received the grant under this subsection; 

8 and 

9 ‘‘(iii) shall determine whether the in10 dividuals or entities identified under clause 

11 (ii) are required to obtain professional li12 ability coverage. 

13 ‘‘(F) PENALTIES.— 

14 ‘‘(i) IN GENERAL.—Whoever having 

15 sworn or taken the oath described under 

16 subparagraph (C), publishes or commu17 nicates any individually identifiable infor18 mation which comes into his or her posses19 sion by reason of his or her being em20 ployed (or otherwise providing services) 

21 under this subsection, shall be fined not 

22 more than $5,000 or imprisoned not more 

23 than 5 years, or both. 

24 ‘‘(ii) MISREPRESENTATION.—Any per25 son who knowingly and falsely represents 


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1 that such person is, or holds himself or 

2 herself out as, a navigator under this sub3 section shall be fined not more than 

4 $5,000 or imprisoned not more than 5 

5 years, or both. 

6 ‘‘(iii) ENHANCED PENALTY FOR SALE

7 OR TRANSFER.—A person who commits the 

8 offense described under clause (i) with the 

9 intent to sell, transfer, or use individually 

10 identifiable information for commercial ad11 vantage, personal gain, or malicious harm 

12 shall be fined not more than $250,000, im13 prisoned for not more than 10 years, or 

14 both. 

15 ‘‘(G) GREATER PROTECTIONS.—Nothing in 

16 subparagraphs (A), (B), (C) or (D) shall be 

17 construed to prohibit States from imposing ad18 ditional standards and protections to protect 

19 consumer information. 

20 ‘‘(8) LIST OF NAVIGATORS.—Not later than 90 

21 days after the date of enactment of this paragraph, 

22 and annually thereafter, the Secretary shall make 

23 available a list of entities providing navigator serv24 ices in accordance with this subsection and a list of 

25 entities that have been determined to be ineligible to 


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1 provide such services or who have been convicted of 

2 a violation under paragraph (7).’’. 

3 (b) LIMITATION ON LIABILITY.—Section 5000A(e) of 

4 the Internal Revenue Code of 1986 is amended by adding 

5 at the end the following: 

6 ‘‘(6) RELIANCE ON NAVIGATOR ADVICE.—Any 

7 applicable individual who for any month failed to ob8 tain minimum essential coverage as a result of the 

9 good faith reliance on the advice of a patient navi10 gator, counselor, or other employee of an entity re11 ceiving a grant under section 1311(i) of the Patient 

12 Protection and Affordable Care Act (or a person 

13 purporting to be such a navigator, counselor, or 

14 other employee).’’. 

15 (c) EFFECTIVE DATE.—The amendment made by 

16 subsection (a) shall take effect on the date of the enact17 ment of this Act and shall apply to grants made before, 

18 on, or after the date of the enactment of this Act. The 

19 Secretary of Health and Human Services shall provide for 

20 the prompt modification of such grants made before the 

21 date of the enactment of this Act in order to comply with 

22 the requirement imposed by such amendment. 

Æ 


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