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‘‘SEC. 9813. STANDARD RELATING TO HEALTH CARE QUAL-
ITY AND CHOICE ACT.
‘‘A group health plan shall comply with the require-
ments of title I of the Health Care Quality and Choice
Act of 1999 (as in effect as of the date of the enactment
of such Act), and such requirements shall be deemed to
be incorporated into this section.’’.
TITLE V—EFFECTIVE DATES; CO-
ORDINATION IN IMPLEMEN-
TATION
SEC. 501. EFFECTIVE DATES.
(a) GROUP HEALTH COVERAGE.—
(1) IN GENERAL.—Subject to paragraph (2),
the amendments made by sections 201(a), 301, and
401 (and title I insofar as it relates to such sections)
shall apply with respect to group health plans, and
health insurance coverage offered in connection with
group health plans, for plan years beginning on or
after January 1, 2000 (in this section referred to as
the ‘‘general effective date’’) and also shall apply to
portions of plan years occurring on and after such
date.
(2) TREATMENT OF COLLECTIVE BARGAINING
AGREEMENTS.—In the case of a group health plan
maintained pursuant to 1 or more collective bar-
gaining agreements between employee representa-
116
tives and 1 or more employers ratified before the
date of enactment of this Act, the amendments made
by sections 201(a), 301, and 401 (and title I insofar
as it relates to such sections) shall not apply to plan
years beginning before the later of—
(A) the date on which the last collective
bargaining agreements relating to the plan ter-
minates (determined without regard to any ex-
tension thereof agreed to after the date of en-
actment of this Act), or
(B) the general effective date.
For purposes of subparagraph (A), any plan amend-
ment made pursuant to a collective bargaining
agreement relating to the plan which amends the
plan solely to conform to any requirement added by
this Act shall not be treated as a termination of
such collective bargaining agreement.
(b) INDIVIDUAL HEALTH INSURANCE COVERAGE.—
The amendments made by section 202 shall apply with
respect to individual health insurance coverage offered,
sold, issued, renewed, in effect, or operated in the indi-
vidual market on or after the general effective date.
SEC. 502. COORDINATION IN IMPLEMENTATION.
The Secretary of Labor, the Secretary of Health and
Human Services, and the Secretary of the Treasury shall
117
ensure, through the execution of an interagency memo-
randum of understanding among such Secretaries, that—
(1) regulations, rulings, and interpretations
issued by such Secretaries relating to the same mat-
ter over which both Secretaries have responsibility
under the provisions of this Act (and the amend-
ments made thereby) are administered so as to have
the same effect at all times; and
(2) coordination of policies relating to enforcing
the same requirements through such Secretaries in
order to have a coordinated enforcement strategy
that avoids duplication of enforcement efforts and
assigns priorities in enforcement.
TITLE VI—OTHER PROVISIONS
SEC. 601. HEALTH CARE PAPERWORK SIMPLIFICATION.
(a) ESTABLISHMENT OF PANEL.—
(1) ESTABLISHMENT.—There is established a
panel to be known as the Health Care Panel to De-
vise a Uniform Explanation of Benefits (in this sec-
tion referred to as the ‘‘Panel’’).
(2) DUTIES OF PANEL.—
(A) IN GENERAL.—The Panel shall devise
a single form for use by third-party health care
payers for the remittance of claims to providers.
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(B) DEFINITION.—For purposes of this
section, the term ‘‘third-party health care
payer’’ means any entity that contractually
pays health care bills for an individual.
(3) MEMBERSHIP.—
(A) SIZE
AND
COMPOSITION.—The Sec-
retary of Health and Human Services, in con-
sultation with the Majority Leader of the Sen-
ate and the Speaker of the House of Represent-
atives, shall determine the number of members
and the composition of the Panel. Such Panel
shall include equal numbers of representatives
of private insurance organizations, consumer
groups, State insurance commissioners, State
medical societies, State hospital associations,
and State medical specialty societies.
(B) TERMS OF APPOINTMENT.—The mem-
bers of the Panel shall serve for the life of the
Panel.
(C) VACANCIES.—A vacancy in the Panel
shall not affect the power of the remaining
members to execute the duties of the Panel, but
any such vacancy shall be filled in the same
manner in which the original appointment was
made.
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(4) PROCEDURES.—
(A) MEETINGS.—The Panel shall meet at
the call of a majority of its members.
(B) FIRST
MEETING.—The Panel shall
convene not later than 60 days after the date
of the enactment of the Health Care Quality
and Choice Act of 1999.
(C) QUORUM.—A quorum shall consist of
a majority of the members of the Panel.
(D) HEARINGS.—For the purpose of car-
rying out its duties, the Panel may hold such
hearings and undertake such other activities as
the Panel determines to be necessary to carry
out its duties.
(5) ADMINISTRATION.—
(A) COMPENSATION.—Except as provided
in subparagraph (B), members of the Panel
shall receive no additional pay, allowances, or
benefits by reason of their service on the Panel.
(B) TRAVEL EXPENSES AND PER DIEM.—
Each member of the Panel who is not an officer
or employee of the Federal Government shall
receive travel expenses and per diem in lieu of
subsistence in accordance with sections 5702
and 5703 of title 5, United States Code.
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(C) CONTRACT
AUTHORITY.—The Panel
may contract with and compensate government
and private agencies or persons for items and
services, without regard to section 3709 of the
Revised Statutes (41 U.S.C. 5).
(D) USE OF MAILS.—The Panel may use
the United States mails in the same manner
and under the same conditions as Federal agen-
cies and shall, for purposes of the frank, be
considered a commission of Congress as de-
scribed in section 3215 of title 39, United
States Code.
(E) 
ADMINISTRATIVE
SUPPORT
SERV-
ICES.—Upon the request of the Panel, the Sec-
retary of Health and Human Services shall pro-
vide to the Panel on a reimbursable basis such
administrative support services as the Panel
may request.
(6) SUBMISSION OF FORM.—Not later than 2
years after the first meeting, the Panel shall submit
a form to the Secretary of Health and Human Serv-
ices for use by third-party health care payers.
(7) TERMINATION.—The Panel shall terminate
on the day after submitting its the form under para-
graph (6).
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(b) REQUIREMENT FOR USE OF FORM BY THIRD-
PARTY CARE PAYERS.—A third-party health care payer
shall be required to use the form devised under subsection
(a) for plan years beginning on or after 5 years following
the date of the enactment of this Act.
SEC. 602. PROTECTION FOR CERTAIN INFORMATION.
(a) PROTECTION OF CERTAIN INFORMATION.—Not-
withstanding any other provision of Federal or State law,
health care response information shall be exempt from any
disclosure requirement (regardless of whether the require-
ment relates to subpoenas, discover, introduction of evi-
dence, testimony, or any other form of disclosure), in con-
nection with a civil or administrative proceeding under
Federal or State law, to the same extent as information
developed by a health care provider with respect to any
of the following:
(1) Peer review.
(2) Utilization review.
(3) Quality management or improvement.
(4) Quality control.
(5) Risk management.
(6) Internal review for purposes of reducing
mortality, morbidity, or for improving patient care
or safety.
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(b) NO WAIVER OF PROTECTION THROUGH INTER-
ACTION
WITH
ACCREDITING
BODY.—Notwithstanding
any other provision of Federal or State law, the protection
of health care response information from disclosure pro-
vided under subsection (a) shall not be deemed to be modi-
fied or in any way waived by—
(1) the development of such information in con-
nection with a request or requirement of an accred-
iting body; or
(2) the transfer of such information to an ac-
crediting body.
(c) DEFINITIONS.—For purposes of this section:
(1) ACCREDITING
BODY.—The term ‘‘accred-
iting body’’ means a national, not-for-profit organi-
zation that—
(A) accredits health care providers; and
(B) is recognized as an accrediting body by
statute or by a Federal or State agency that
regulates health care providers.
(2) HEALTH CARE RESPONSE INFORMATION.—
The term ‘‘health care response information’’ means
information (including any data, report, record,
memorandum, analysis, statement, or other commu-
nication) developed by, or on behalf of, a health care
123
provider in response to a serious, adverse, patient
related event—
(A) during the course of analyzing or
studying the event and its causes; and
(B) for the purposes of—
(i) reducing mortality or morbidity; or
(ii) improving patient care or safety
(including the provider’s notification to an
accrediting body and the provider’s plans
of action in response to such event).
(3) HEALTH
CARE
PROVIDER.—The term
‘‘health care provider’’ means a person, who with re-
spect to a specific item of protected health informa-
tion, receives, creates, uses, maintains, or discloses
the information while acting in whole or in part in
the capacity of—
(A) a person who is licensed, certified, reg-
istered, or otherwise authorized by Federal or
State law to provide an item or service that
constitutes health care in the ordinary course of
business, or practice of a profession;
(B) a Federal, State, or employer-spon-
sored or any other privately-sponsored program
that directly provides items or services that con-
stitute health care to beneficiaries; or
124
(C) an officer or employee of a person de-
scribed in subparagraph (A) or (B).
(4) STATE.—The term ‘‘State’’ includes a
State, the District of Columbia, the Northern Mar-
iana Islands, any political subdivisions of a State or
such Islands, or any agency or instrumentality of ei-
ther.
(d) EFFECTIVE DATE.—The provisions of this sec-
tion are effective on the date of the enactment of this Act.
SEC. 603. MEDICARE COMPETITIVE PRICING DEMONSTRA-
TION PROJECT.
(a) FINDING.—The Congress finds that imple-
menting competitive pricing in the medicare program
under title XVIII of the Social Security Act is an impor-
tant goal.
(b) PROHIBITION ON IMPLEMENTATION OF PROJECT
IN CERTAIN AREAS.—Notwithstanding subsection (b) of
section 4011 of the Balanced Budget Act of 1997 (Public
Law 105–33)), the Secretary of Health and Human Serv-
ices may not implement the Medicare Competitive Pricing
Demonstration Project (operated by the Secretary of
Health and Human Services pursuant to such section) in
Kansas City, Missouri or Kansas City, Kansas, or in any
area in Arizona.
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(c) MORATORIUM ON IMPLEMENTATION OF PROJECT
IN
ANY AREA
UNTIL JANUARY, 1, 2001.—Notwith-
standing any provision of section 4011 of the Balanced
Budget Act of 1997 (Public Law 105–33)), the Secretary
of Health and Human Services may not implement the
Medicare Competitive Pricing Demonstration Project in
any area before January 1, 2001.
(d) STUDY AND REPORT TO CONGRESS.—
(1) STUDY.—The Secretary of Health and
Human Services, in conjunction with the Competi-
tive Pricing Advisory Committee, shall conduct a
study on the different approaches of implementing
the Medicare Competitive Pricing Demonstration
Project on a voluntary basis.
(2) REPORT.—Not later than June 30, 2000,
the Secretary of Health and Human Services shall
submit a report to Congress which shall contain a
detailed description of the study conducted under
paragraph (1), together with the recommendations
of the Secretary and the Competitive Pricing Advi-
sory Committee regarding the implementation of the
Medicare 
Competitive 
Pricing 
Demonstration
Project.
Æ