vidual, third party payor, or other entity is liable for 
payment for designated health services for which a 
claim is presented in violation of such subsection.’’; 
and 
(4) in subsection (g)(3), by striking ‘‘for which 
payment may not be made under paragraph (1)’’ 
and inserting ‘‘for which such a claim may not be 
presented under subsection (a)(1)’’. 
TITLE IV—ADMINISTRATION 
Subtitle A—General Administrative 
Provisions 
SEC. 
401. 
AMERICAN 
HEALTH 
SECURITY 
STANDARDS 
BOARD. 
(a) ESTABLISHMENT.—There is hereby established 
an American Health Security Standards Board. 
(b) APPOINTMENT AND TERMS OF MEMBERS.— 
(1) IN
GENERAL.—The Board shall be com-
posed of— 
(A) the Secretary of Health and Human 
Services; and 
(B) 6 other individuals (described in para-
graph (2)) appointed by the President with the 
advice and consent of the Senate. 
The President shall first nominate individuals under 
subparagraph (B) on a timely basis so as to provide
for the operation of the Board by not later than 
January 1, 2006. 
(2) SELECTION
OF
APPOINTED
MEMBERS.— 
With respect to the individuals appointed under 
paragraph (1)(B): 
(A) They shall be chosen on the basis of 
backgrounds in health policy, health economics, 
the healing professions, and the administration 
of health care institutions. 
(B) They shall provide a balanced point of 
view with respect to the various health care in-
terests and at least 2 of them shall represent 
the interests of individual consumers. 
(C) Not more than 3 of them shall be from 
the same political party. 
(D) To the greatest extent feasible, they 
shall represent the various geographic regions 
of the United States and shall reflect the racial, 
ethnic, and gender composition of the popu-
lation of the United States. 
(3) TERMS OF APPOINTED MEMBERS.—Individ-
uals appointed under paragraph (1)(B) shall serve 
for a term of 6 years, except that the terms of 5 of 
the individuals initially appointed shall be, as des-
ignated by the President at the time of their ap-
pointment, for 1, 2, 3, 4, and 5 years. During a 
term of membership on the Board, no member shall 
engage in any other business, vocation or employ-
ment. 
(c) VACANCIES.— 
(1) IN GENERAL.—The President shall fill any 
vacancy in the membership of the Board in the same 
manner as the original appointment. The vacancy 
shall not affect the power of the remaining members 
to execute the duties of the Board. 
(2) VACANCY
APPOINTMENTS.—Any member 
appointed to fill a vacancy shall serve for the re-
mainder of the term for which the predecessor of the 
member was appointed. 
(3) REAPPOINTMENT.—The President may re-
appoint an appointed member of the Board for a 
second term in the same manner as the original ap-
pointment. A member who has served for 2 consecu-
tive 6-year terms shall not be eligible for reappoint-
ment until 2 years after the member has ceased to 
serve. 
(4) REMOVAL FOR CAUSE.—Upon confirmation, 
members of the Board may not be removed except 
by the President for cause.
(d) CHAIR.—The President shall designate 1 of the 
members of the Board, other than the Secretary, to serve 
at the will of the President as Chair of the Board. 
(e) COMPENSATION.—Members of the Board (other 
than the Secretary) shall be entitled to compensation at 
a level equivalent to level II of the Executive Schedule, 
in accordance with section 5313 of title 5, United States 
Code. 
(f) GENERAL DUTIES OF THE BOARD.— 
(1) IN
GENERAL.—The Board shall develop 
policies, procedures, guidelines, and requirements to 
carry out this Act, including those related to— 
(A) eligibility; 
(B) enrollment; 
(C) benefits; 
(D) provider participation standards and 
qualifications, as defined in title III; 
(E) national and State funding levels; 
(F) methods for determining amounts of 
payments to providers of covered services, con-
sistent with subtitle B of title VI; 
(G) the determination of medical necessity 
and appropriateness with respect to coverage of 
certain services;
(H) assisting State health security pro-
grams with planning for capital expenditures 
and service delivery; 
(I) planning for health professional edu-
cation funding (as specified in title VI); 
(J) allocating funds provided under title 
VII; and 
(K) encouraging States to develop regional 
planning mechanisms (described in section 
404(a)(3)). 
(2) REGULATIONS.—Regulations authorized by 
this Act shall be issued by the Board in accordance 
with the provisions of section 553 of title 5, United 
States Code. 
(g) UNIFORM REPORTING STANDARDS; ANNUAL RE-
PORT; STUDIES.— 
(1) UNIFORM REPORTING STANDARDS.— 
(A) IN GENERAL.—The Board shall estab-
lish uniform reporting requirements and stand-
ards to ensure an adequate national data base 
regarding health services practitioners, services 
and finances of State health security programs, 
approved plans, providers, and the costs of fa-
cilities and practitioners providing services.
Such standards shall include, to the maximum 
extent feasible, health outcome measures. 
(B) REPORTS.—The Board shall analyze 
regularly information reported to it, and to 
State health security programs pursuant to 
such requirements and standards. 
(2) ANNUAL REPORT.—Beginning January 1, 
of the second year beginning after the date of the 
enactment of this Act, the Board shall annually re-
port to Congress on the following: 
(A) The status of implementation of the 
Act. 
(B) Enrollment under this Act. 
(C) Benefits under this Act. 
(D) Expenditures and financing under this 
Act. 
(E) 
Cost-containment 
measures 
and 
achievements under this Act. 
(F) Quality assurance. 
(G) Health care utilization patterns, in-
cluding any changes attributable to the pro-
gram. 
(H) Long-range plans and goals for the de-
livery of health services.
(I) Differences in the health status of the 
populations of the different States, including in-
come and racial characteristics. 
(J) Necessary changes in the education of 
health personnel. 
(K) Plans for improving service to medi-
cally underserved populations. 
(L) Transition problems as a result of im-
plementation of this Act. 
(M) Opportunities for improvements under 
this Act. 
(3) STATISTICAL ANALYSES AND OTHER STUD-
IES.—The Board may, either directly or by con-
tract— 
(A) make statistical and other studies, on 
a nationwide, regional, state, or local basis, of 
any aspect of the operation of this Act, includ-
ing studies of the effect of the Act upon the 
health of the people of the United States and 
the effect of comprehensive health services upon 
the health of persons receiving such services; 
(B) develop and test methods of providing 
through payment for services or otherwise, ad-
ditional incentives for adherence by providers to 
standards of adequacy, access, and quality;