injury’ means a physical injury and includes an
injury arising out of the treatment (or failure
to treat) a mental illness or disease.
‘‘(2) EXCEPTION FOR EMPLOYERS AND OTHER
PLAN SPONSORS.—
‘‘(A) IN
GENERAL.—Subject to subpara-
graph (B), paragraph (1) does not authorize—
‘‘(i) any cause of action against an
employer or other plan sponsor maintain-
ing the group health plan (or against an
employee of such an employer or sponsor
acting within the scope of employment), or
‘‘(ii) a right of recovery or indemnity
by a person against an employer or other
plan sponsor (or such an employee) for
damages assessed against the person pur-
suant to a cause of action under paragraph
(1).
‘‘(B) SPECIAL RULE.—Subparagraph (A)
shall not preclude any cause of action described
in paragraph (1) against an employer or other
plan sponsor (or against an employee of such
an employer or sponsor acting within the scope
of employment) if—
100
‘‘(i) such action is based on the em-
ployer’s or other plan sponsor’s (or em-
ployee’s) exercise of discretionary authority
to make a decision on a claim for benefits
covered under the plan or health insurance
coverage in the case at issue; and
‘‘(ii) the exercise by such employer or
other plan sponsor (or employee) of such
authority resulted in personal injury or
wrongful death.
‘‘(C) EXCEPTION.—The exercise of discre-
tionary authority described in subparagraph
(B)(i) shall not be construed to include—
‘‘(i) the decision to include or exclude
from the plan any specific benefit;
‘‘(ii) any decision to provide extra-con-
tractual benefits; or
‘‘(iii) any decision not to consider the
provision of a benefit while internal or ex-
ternal review is being conducted.
‘‘(3) FUTILITY OF EXHAUSTION.—An individual
bringing an action under this subsection is not re-
quired to exhaust administrative processes under
section 102 or 103 of the Bipartisan Consensus
Managed Care Improvement Act of 1999 where the
101
injury to or death of such individual has occurred
before the completion of such processes.’’.
‘‘(4) CONSTRUCTION.—Nothing in this sub-
section shall be construed as—
‘‘(A) permitting a cause of action under
State law for the failure to provide an item or
service which is specifically excluded under the
group health plan involved; or
‘‘(B) as preempting a State law which re-
quires an affidavit or certificate of merit in a
civil action.’’.
(b) EFFECTIVE DATE.—The amendment made by
subsection (a) shall apply to acts and omissions occurring
on or after the date of the enactment of this Act from
which a cause of action arises.
TITLE 
IV—APPLICATION 
TO
GROUP 
HEALTH 
PLANS
UNDER THE INTERNAL REV-
ENUE CODE OF 1986
SEC. 401. AMENDMENTS TO THE INTERNAL REVENUE CODE
OF 1986.
Subchapter B of chapter 100 of the Internal Revenue
Code of 1986 is amended—
102
(1) in the table of sections, by inserting after
the item relating to section 9812 the following new
item:
‘‘Sec. 9813. Standard relating to patient freedom of choice.’’;
and
(2) by inserting after section 9812 the fol-
lowing:
‘‘SEC. 9813. STANDARD RELATING TO PATIENTS’ BILL OF
RIGHTS.
‘‘A group health plan shall comply with the require-
ments of title I of the Bipartisan Consensus Managed
Care Improvement 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
103
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-
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.
104
(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
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 such 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—HEALTH CARE
PAPERWORK SIMPLIFICATION
SEC. 601. HEALTH CARE PAPERWORK SIMPLIFICATION.
(a) ESTABLISHMENT OF PANEL.—
105
(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.
(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 shall de-
termine the number of members and the com-
position of the Panel. Such Panel shall include
equal numbers of representatives of private in-
surance organizations, consumer groups, State
insurance commissioners, State medical soci-
eties, 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.
106
(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.
(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 Bipartisan Consensus
Managed Care Improvement 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.
107
(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.
(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.
108
(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 the form under para-
graph (6).
(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.
Æ