To require certain preconditions for allowing premium tax credits, reductions in cost-sharing, and funding of Navigators and related Exchange enrollment activities, and for other purposes.

To require certain preconditions for allowing premium tax credits, reductions in cost-sharing, and funding of Navigators and related Exchange enrollment activities, and for other purposes. 1. Preconditions for premium tax credits, reductions in cost-sharing, and funding of Navigators and related Exchange enrollment activities (a) In general Notwithstanding any other provision of law, no premium tax credit shall be allowed under section 36B of the Internal Revenue Code of 1986, no reduction in cost-sharing shall be allowed under section 1402 of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18071 42 U.S.C. 18031 (1) 1 year after the date the Secretary certifies to Congress that the ACA verification methods (as defined in subsection (c)(1))— (A) have been tested to verify their accuracy; and (B) have safeguards in place to protect personally identifiable information; and (2) the Inspector General of the Department of Health and Human Services reviews such verification methods and certifies to Congress— (A) the quality, accuracy, response time, and integrity of such verification methods; and (B) that the level of improper subsidy payments is not likely to exceed 3 percent of the level of the total subsidy payments (as defined in subsection (c)(3)). (b) Subsequent annual certification of verification methods (1) In general The Inspector General of the Department of Health and Human Services shall annually review the quality, accuracy, response time, and integrity of the ACA verification methods in order to determine the level of improper subsidy payments as a percentage of the level of total subsidy payments. (2) Suspension if excessive improper subsidy payments If the Inspector General determines for a year as a result of such review that the level of improper subsidy payments is projected to exceed 3 percent of the level of total subsidy payments, for years beginning after the date of such determination awards shall be suspended until such time as the Secretary and the Inspector General certify that the level of improper subsidy payments is not likely to exceed 3 percent of the level of total subsidy payment. (c) Definitions In this section: (1) The term ACA verification methods (2) The term Secretary 42 U.S.C. 18081 (3) The term subsidy payments 42 U.S.C. 18071

Summary: Disallows specified subsidy payments under the Patient Protection and Affordable Care Act (PPACA), including the tax credit for health care coverage premium assistance and reduction in cost-sharing, or any funding for the operation of a PPACA Navigator Program until: (1) the Secretary of Health and Human Services (HHS) certifies to Congress that verification methods under PPACA to determine eligibility for subsidies have been tested to verify their accuracy and have safeguards in place to protect personally identifiable information; and (2) the Inspector General of HHS reviews such verification methods and certifies to Congress the quality, accuracy, response time, and integrity of such methods and that the level of improper subsidy payments is not likely to exceed 3% of the level of the total subsidy payment. Requires the Inspector General of HHS to review verification methods annually to determine the level of improper subsidy payments and suspend such subsidies in years in which they exceed 3% of the total subsidy payment.