202 
amended by the previous sections, is further amend-
ed by adding at the end the following new sections: 
‘‘SEC. 9817. CONTINUITY OF CARE. 
‘‘(a) ENSURING CONTINUITY OF CARE WITH RE-
SPECT
TO TERMINATIONS
OF CERTAIN CONTRACTUAL 
RELATIONSHIPS RESULTING IN CHANGES IN PROVIDER 
NETWORK STATUS.— 
‘‘(1) IN GENERAL.—In the case of an individual 
with benefits under a group health plan and with re-
spect to a health care provider or facility that has 
a contractual relationship with such plan for fur-
nishing items and services under such plan, if, while 
such individual is a continuing care patient (as de-
fined in subsection (b)) with respect to such provider 
or facility— 
‘‘(A) such contractual relationship is termi-
nated (as defined in paragraph (b)); 
‘‘(B) benefits provided under such plan 
with respect to such provider or facility are ter-
minated because of a change in the terms of the 
participation of such provider or facility in such 
plan; or 
‘‘(C) a contract between such group health 
plan and a health insurance issuer offering 
health insurance coverage in connection with 
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203 
such plan is terminated, resulting in a loss of 
benefits provided under such plan with respect 
to such provider or facility; 
the plan shall meet the requirements of paragraph 
(2) with respect to such individual. 
‘‘(2) REQUIREMENTS.—The requirements of 
this paragraph are that the plan— 
‘‘(A) notify each individual enrolled under 
such plan who is a continuing care patient with 
respect to a provider or facility at the time of 
a termination described in paragraph (1) affect-
ing such provider on a timely basis of such ter-
mination and such individual’s right to elect 
continued transitional care from such provider 
or facility under this section; 
‘‘(B) provide such individual with an op-
portunity to notify the plan of the individual’s 
need for transitional care; and 
‘‘(C) permit the patient to elect to continue 
to have benefits provided under such plan, 
under the same terms and conditions as would 
have applied and with respect to such items and 
services as would have been covered under such 
plan had such termination not occurred, with 
respect to the course of treatment furnished by 
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204 
such provider or facility relating to such indi-
vidual’s status as a continuing care patient dur-
ing the period beginning on the date on which 
the notice under subparagraph (A) is provided 
and ending on the earlier of— 
‘‘(i) the 90-day period beginning on 
such date; or 
‘‘(ii) the date on which such individual 
is no longer a continuing care patient with 
respect to such provider or facility. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) CONTINUING CARE PATIENT.—The term 
‘continuing care patient’ means an individual who, 
with respect to a provider or facility— 
‘‘(A) is undergoing a course of treatment 
for a serious and complex condition from the 
provider or facility; 
‘‘(B) is undergoing a course of institu-
tional or inpatient care from the provider or fa-
cility; 
‘‘(C) is scheduled to undergo nonelective 
surgery from the provider or facility, including 
receipt of postoperative care from such provider 
or facility with respect to such a surgery; 
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205 
‘‘(D) is pregnant and undergoing a course 
of treatment for the pregnancy from the pro-
vider or facility; or 
‘‘(E) is or was determined to be terminally 
ill (as determined under section 1861(dd)(3)(A) 
of the Social Security Act) and is receiving 
treatment for such illness from such provider or 
facility. 
‘‘(2) SERIOUS AND COMPLEX CONDITION.—The 
term ‘serious and complex condition’ means, with re-
spect to a participant, beneficiary, or enrollee under 
a group health plan— 
‘‘(A) in the case of an acute illness, a con-
dition that is serious enough to require special-
ized medical treatment to avoid the reasonable 
possibility of death or permanent harm; or 
‘‘(B) in the case of a chronic illness or con-
dition, a condition that— 
‘‘(i) is life-threatening, degenerative, 
potentially disabling, or congenital; and 
‘‘(ii) requires specialized medical care 
over a prolonged period of time. 
‘‘(3) TERMINATED.—The term ‘terminated’ in-
cludes, with respect to a contract, the expiration or 
nonrenewal of the contract, but does not include a 
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206 
termination of the contract for failure to meet appli-
cable quality standards or for fraud. 
‘‘SEC. 9818. INFORMATION REQUIRED TO BE INCLUDED ON 
HEALTH INSURANCE MEMBERSHIP CARDS. 
‘‘In the case of a group health plan that provides a 
physical or electronic card indicating membership in such 
plan to an individual enrolled under such plan, such group 
health plan shall include on such card each of the fol-
lowing: 
‘‘(1) The nearest hospital to the primary resi-
dence of such individual that has in effect a contrac-
tual relationship with such plan for furnishing items 
and services under such plan. 
‘‘(2) A telephone number or Internet website 
address through which such individual may seek con-
sumer assistance information, such as information 
related to hospitals and urgent care facilities that 
have in effect a contractual relationship with such 
plan for furnishing items and services under such 
plan. 
‘‘(3) Any deductible applicable to such indi-
vidual. 
‘‘(4) Any out-of-pocket maximum applicable to 
such individual. 
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207 
‘‘(5) Any cost-sharing obligation applicable to 
such individual for a visit at an emergency depart-
ment, or urgent care facility, that has in effect a 
contractual relationship with such plan for fur-
nishing items and services under such plan. 
‘‘SEC. 9819. MAINTENANCE OF PRICE COMPARISON TOOL. 
‘‘In connection with the offering of a group health 
plan in a geographic region for a plan year, a plan sponsor 
shall employ an individual to offer price comparison guid-
ance, or make available on an Internet website a price 
comparison tool, that (to the extent practicable) allows an 
individual enrolled under such plan, with respect to such 
plan year and such geographic region, to compare the 
amount (determined by historic claims data of partici-
pating providers with respect to such plan) of cost-sharing 
(including deductibles, copayments, and coinsurance) that 
the individual would be responsible for paying under such 
plan with respect to the furnishing of a specific item or 
service by any such provider.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
9815(a) of the Internal Revenue Code of 1986, as 
amended by section 2(b), is further amended— 
(A) in paragraph (1), by striking ‘‘section 
2719A’’ and inserting ‘‘section 2719A, 2730, 
2731, or 2732’’; and 
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kjohnson on DSK79L0C42PROD with BILLS
208 
(B) in paragraph (2), by striking ‘‘section 
2719A’’ and inserting ‘‘section 2719A, 2730, 
2731, or 2732’’. 
(3) CLERICAL AMENDMENT.—The table of sec-
tions for such subchapter, as amended by section 
2(b), is further amended by adding at the end the 
following new items: 
‘‘Sec. 9817. Continuity of care. 
‘‘Sec. 9818. Information required to be included on health insurance member-
ship cards. 
‘‘Sec. 9819. Maintenance of price comparison tool.’’. 
(c) EMPLOYEE
RETIREMENT
INCOME
SECURITY 
ACT.— 
(1) IN GENERAL.—Subpart B of part 7 of sub-
title B of title I of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1185 et seq.), as 
amended by section 2(c), is further amended by add-
ing at the end the following new sections: 
‘‘SEC. 717. CONTINUITY OF CARE. 
‘‘(a) ENSURING CONTINUITY OF CARE WITH RE-
SPECT
TO TERMINATIONS
OF CERTAIN CONTRACTUAL 
RELATIONSHIPS RESULTING IN CHANGES IN PROVIDER 
NETWORK STATUS.— 
‘‘(1) IN GENERAL.—In the case of an individual 
with benefits under a group health plan or health in-
surance coverage offered by a health insurance 
issuer in connection with a group health plan and 
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209 
with respect to a health care provider or facility that 
has a contractual relationship with such plan or 
such issuer (as applicable) for furnishing items and 
services under such plan or such coverage, if, while 
such individual is a continuing care patient (as de-
fined in subsection (b)) with respect to such provider 
or facility— 
‘‘(A) such contractual relationship is termi-
nated (as defined in paragraph (b)); 
‘‘(B) benefits provided under such plan or 
such health insurance coverage with respect to 
such provider or facility are terminated because 
of a change in the terms of the participation of 
the provider or facility in such plan or coverage; 
or 
‘‘(C) a contract between such group health 
plan and a health insurance issuer offering 
health insurance coverage in connection with 
such plan is terminated, resulting in a loss of 
benefits provided under such plan with respect 
to such provider or facility; 
the plan or issuer, respectively, shall meet the re-
quirements of paragraph (2) with respect to such in-
dividual. 
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210 
‘‘(2) REQUIREMENTS.—The requirements of 
this paragraph are that the plan or issuer— 
‘‘(A) notify each individual enrolled under 
such plan or coverage who is a continuing care 
patient with respect to a provider or facility at 
the time of a termination described in para-
graph (1) affecting such provider or facility on 
a timely basis of such termination and such in-
dividual’s right to elect continued transitional 
care from such provider or facility under this 
section; 
‘‘(B) provide such individual with an op-
portunity to notify the plan or issuer of the in-
dividual’s need for transitional care; and 
‘‘(C) permit the patient to elect to continue 
to have benefits provided under such plan or 
such coverage, under the same terms and condi-
tions as would have applied and with respect to 
such items and services as would have been cov-
ered under such plan or coverage had such ter-
mination not occurred, with respect to the 
course of treatment furnished by such provider 
or facility relating to such individual’s status as 
a continuing care patient during the period be-
ginning on the date on which the notice under 
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211 
subparagraph (A) is provided and ending on the 
earlier of— 
‘‘(i) the 90-day period beginning on 
such date; or 
‘‘(ii) the date on which such individual 
is no longer a continuing care patient with 
respect to such provider or facility. 
‘‘(b) DEFINITIONS.—In this section: 
‘‘(1) CONTINUING CARE PATIENT.—The term 
‘continuing care patient’ means an individual who, 
with respect to a provider or facility— 
‘‘(A) is undergoing a course of treatment 
for a serious and complex condition from the 
provider or facility; 
‘‘(B) is undergoing a course of institu-
tional or inpatient care from the provider or fa-
cility; 
‘‘(C) is scheduled to undergo nonelective 
surgery from the provide or facility, including 
receipt of postoperative care from such provider 
or facility with respect to such a surgery; 
‘‘(D) is pregnant and undergoing a course 
of treatment for the pregnancy from the pro-
vider or facility; or 
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212 
‘‘(E) is or was determined to be terminally 
ill (as determined under section 1861(dd)(3)(A) 
of the Social Security Act) and is receiving 
treatment for such illness from such provider or 
facility. 
‘‘(2) SERIOUS AND COMPLEX CONDITION.—The 
term ‘serious and complex condition’ means, with re-
spect to a participant, beneficiary, or enrollee under 
a group health plan or health insurance coverage— 
‘‘(A) in the case of an acute illness, a con-
dition that is serious enough to require special-
ized medical treatment to avoid the reasonable 
possibility of death or permanent harm; or 
‘‘(B) in the case of a chronic illness or con-
dition, a condition that— 
‘‘(i) is life-threatening, degenerative, 
potentially disabling, or congenital; and 
‘‘(ii) requires specialized medical care 
over a prolonged period of time. 
‘‘(3) TERMINATED.—The term ‘terminated’ in-
cludes, with respect to a contract, the expiration or 
nonrenewal of the contract, but does not include a 
termination of the contract for failure to meet appli-
cable quality standards or for fraud. 
VerDate Sep 11 2014 
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213 
‘‘SEC. 718. INFORMATION REQUIRED TO BE INCLUDED ON 
HEALTH INSURANCE MEMBERSHIP CARDS. 
‘‘In the case of a group health plan or health insur-
ance issuer offering group health insurance coverage that 
provides a physical or electronic card indicating member-
ship in such plan or coverage to an individual enrolled 
under such plan or coverage, such group health plan or 
issuer shall include on such card each of the following: 
‘‘(1) The nearest hospital to the primary resi-
dence of such individual that has in effect a contrac-
tual relationship with such plan or coverage for fur-
nishing items and services under such plan or cov-
erage. 
‘‘(2) A telephone number or Internet website 
address through which such individual may seek con-
sumer assistance information, such as information 
related to hospitals and urgent care facilities that 
have in effect a contractual relationship with such 
plan or coverage for furnishing items and services 
under such plan or coverage. 
‘‘(3) Any deductible applicable to such indi-
vidual. 
‘‘(4) Any out-of-pocket maximum applicable to 
such individual. 
‘‘(5) Any cost-sharing obligation applicable to 
such individual for a visit at an emergency depart-
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