I 

116TH CONGRESS 

1ST SESSION H. R. 4379 

To amend the Patient Protection and Affordable Care Act to require qualified 

health plans to have in place a process to remove from publicly accessible 

provider directories of such plans providers that are no longer within 

the network of such plans, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

SEPTEMBER 18, 2019 

Mrs. AXNE (for herself, Ms. STEVENS, Ms. MUCARSEL-POWELL, Mrs. LEE of 

Nevada, Ms. WILD, Ms. FINKENAUER, Ms. TORRES SMALL of New Mexico, and Ms. HOULAHAN) introduced the following bill; which was referred 

to the Committee on Energy and Commerce 

A BILL 

To amend the Patient Protection and Affordable Care Act 

to require qualified health plans to have in place a process to remove from publicly accessible provider directories 

of such plans providers that are no longer within the 

network of such plans, and for other purposes. 

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 ‘‘Under Performing Di5 rectories that Affect Treating Emergencies Act’’ or the 

6 ‘‘UPDATE Act’’. 


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1 SEC. 2. REQUIREMENT FOR QUALIFIED HEALTH PLANS TO 

2 HAVE IN PLACE A PROCESS TO REMOVE 

3 FROM PUBLICLY ACCESSIBLE PROVIDER DI4 RECTORIES OF SUCH PLANS PROVIDERS 

5 THAT ARE NO LONGER WITHIN THE NET6 WORK OF SUCH PLANS. 

7 (a) IN GENERAL.—Section 1311(c) of the Patient 

8 Protection and Affordable Care Act (42 U.S.C. 18031(c)) 

9 is amended— 

10 (1) in paragraph (1)(B)— 

11 (A) by striking ‘‘and provide’’ and insert12 ing ‘‘, provide’’; and 

13 (B) by inserting before the semicolon at 

14 the end the following: ‘‘, and have in place the 

15 process described in paragraph (7) to remove 

16 from any publicly accessible provider directory 

17 of such plan providers that are no longer within 

18 the network of such plan’’; and 

19 (2) by adding at the end the following new 

20 paragraph: 

21 ‘‘(7) PROCESS TO REMOVE FROM PUBLICLY AC22 CESSIBLE PROVIDER DIRECTORIES PROVIDERS THAT

23 ARE NO LONGER IN-NETWORK.—For purposes of 

24 paragraph (1)(B), the process described in this para25 graph, with respect to a qualified health plan, is a 

26 process through which such plan does the following 


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1 with respect to each provider listed in a publicly ac2 cessible provider directory of such plan that does not 

3 submit any claims to such plan for at least a six4 month period in a calendar year: 

5 ‘‘(A) Sends an inquiry to such provider re6 quiring such provider to verify, not later than 

7 the date that is 30 days after such plan sends 

8 such inquiry, whether such provider is still a 

9 provider within the network of such plan. 

10 ‘‘(B) In the case that such plan— 

11 ‘‘(i) receives a response to such in12 quiry by the date described in subpara13 graph (A) that such provider is no longer 

14 a provider within the network of such plan, 

15 removes such provider from such publicly 

16 accessible provider directory; or 

17 ‘‘(ii) does not receive any response to 

18 such inquiry by such date— 

19 ‘‘(I) sends a subsequent inquiry 

20 described in such subparagraph to 

21 such provider; and 

22 ‘‘(II) removes such provider from 

23 such publicly accessible provider direc24 tory if such provider either submits to 

25 such plan, not later than the date that 


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1 is 30 days after such plan sends such 

2 subsequent inquiry, a response de3 scribed in clause (i), or does not re4 spond to such subsequent inquiry by 

5 such date.’’. 

6 (b) EFFECTIVE DATE.—The amendments made by 

7 subsection (a) shall apply with respect to plan years begin8 ning on or after January 1, 2021. 

Æ 


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