a group health plan or health insurance coverage of-
fered in connection with such 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 
termination of the contract for failure to meet appli-
cable quality standards or for fraud.’’. 
(B) CONFORMING
AMENDMENT.—Section 
715(a) of the Employee Retirement Income Se-
curity Act of 1974 (29 U.S.C. 1185d(a)) is 
amended— 
(i) in paragraph (1), by striking ‘‘(as 
amended by the Patient Protection and Af-
fordable Care Act)’’ and inserting ‘‘(other 
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than the provisions of section 2730 of such 
Act)’’; and 
(ii) in paragraph (2), by inserting 
‘‘(other than the provisions of section 2730 
of such Act)’’ after the first occurrence of 
‘‘such part A’’. 
(C) CLERICAL AMENDMENT.—The table of 
contents in section 1 of the Employee Retire-
ment Income Security Act of 1974 is amended 
by inserting after the item relating to section 
714 the following new items: 
‘‘Sec. 715. Additional market reforms. 
‘‘Sec. 716. Continuity of care.’’. 
(D) EFFECTIVE DATE.—The amendments 
made by this paragraph shall apply with respect 
to plan years beginning on or after January 1, 
2022. 
(b) HEALTH CARE PROVIDERS.—Part A of title XI 
of the Social Security Act (42 U.S.C. 1301 et seq.), as 
amended by subsection (a), is further amended by adding 
at the end the following new sections: 
‘‘SEC. 1150C. CONTINUITY OF CARE. 
‘‘(a) IN GENERAL.—A health care provider or health 
care facility shall, in the case of an individual furnished 
items and services by such provider or facility for which 
coverage is provided under a group health plan or group 
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or individual health insurance coverage pursuant to sec-
tion 2730 of such Act, section 9816 of the Internal Rev-
enue Code of 1986, or section 716 of the Employee Retire-
ment Income Security Act of 1974— 
‘‘(1) accept payment from such plan or such 
issuer (as applicable) (and cost-sharing from such 
individual, if applicable, in accordance with sub-
section (a)(2)(C) of such section 2730, 9817, or 
717) for such items and services as payment in full 
for such items and services; and 
‘‘(2) continue to adhere to all policies, proce-
dures, and quality standards imposed by such plan 
or issuer with respect to such individual and such 
items and services in the same manner as if such 
termination had not occurred. 
‘‘(b) PENALTY.— 
‘‘(1) IN GENERAL.—Each health care provider 
or health care facility that violates a provision of 
subsection (a) shall be subject to a civil monetary 
penalty in an amount not to exceed $10,000 for each 
such violation. 
‘‘(2) APPLICATION OF PROVISIONS.—The provi-
sions of section 1128A (other than subsection (a), 
subsection (b), the first sentence of subsection 
(c)(1), and subsection (o)) shall apply with respect 
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to a civil monetary penalty imposed under this sub-
section in the same manner as such provisions apply 
with respect to a penalty or proceeding under sub-
section (a) of such section. 
‘‘(c) DEFINITIONS.—In this section, the terms ‘health 
insurance issuer’, ‘group health plan’, ‘group health insur-
ance coverage’, and ‘individual health insurance coverage’ 
have the meaning given such terms, respectively, in section 
2791 of the Public Health Service Act.’’. 
Æ 
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