amount of such grant to ensure the adequate train-
ing of personnel carrying out such activities. To re-
ceive amounts under this subsection, an eligible enti-
ty shall provide consumer assistance services, includ-
ing— 
(A) the operation of a toll-free telephone 
hotline to respond to consumer requests; 
(B) the dissemination of appropriate edu-
cational materials on available health insurance 
products and on how best to access health care 
and the rights and responsibilities of health 
care consumers; 
(C) the provision of education on effective 
methods to promptly and efficiently resolve 
questions, problems, and grievances; 
(D) the coordination of educational and 
outreach efforts with health plans, health care 
providers, payers, and governmental agencies; 
(E) referrals to appropriate private and 
public entities to resolve questions, problems 
and grievances; and 
(F) the provision of information and as-
sistance, including acting as an authorized rep-
resentative, regarding internal, external, or ad-
ministrative grievances or appeals procedures in
nonlitigative settings to appeal the denial, ter-
mination, or reduction of health care services, 
or the refusal to pay for such services, under a 
group health plan or health insurance coverage 
offered by a health insurance issuer. 
(2) CONFIDENTIALITY AND ACCESS TO INFOR-
MATION.— 
(A) STATE
ENTITY.—With respect to a 
State that directly establishes a health care con-
sumer assistance office, such office shall estab-
lish and implement procedures and protocols in 
accordance with applicable Federal and State 
laws. 
(B) CONTRACT ENTITY.—With respect to a 
State that, through contract, establishes a 
health care consumer assistance office, such of-
fice shall establish and implement procedures 
and protocols, consistent with applicable Fed-
eral and State laws, to ensure the confiden-
tiality of all information shared by a partici-
pant, beneficiary, enrollee, or their personal 
representative and their health care providers, 
group health plans, or health insurance insurers 
with the office and to ensure that no such infor-
mation is used by the office, or released or dis-
closed to State agencies or outside persons or 
entities without the prior written authorization 
(in accordance with section 164.508 of title 45, 
Code of Federal Regulations) of the individual 
or personal representative. The office may, con-
sistent with applicable Federal and State con-
fidentiality laws, collect, use or disclose aggre-
gate information that is not individually identi-
fiable (as defined in section 164.501 of title 45, 
Code of Federal Regulations). The office shall 
provide a written description of the policies and 
procedures of the office with respect to the 
manner in which health information may be 
used or disclosed to carry out consumer assist-
ance activities. The office shall provide health 
care providers, group health plans, or health in-
surance issuers with a written authorization (in 
accordance with section 164.508 of title 45, 
Code of Federal Regulations) to allow the office 
to obtain medical information relevant to the 
matter before the office. 
(3) AVAILABILITY
OF
SERVICES.—The health 
care consumer assistance office of a State shall not 
discriminate in the provision of information, refer-
rals, and services regardless of the source of the in-
dividual’s health insurance coverage or prospective 
coverage, including individuals covered under a 
group health plan or health insurance coverage of-
fered by a health insurance issuer, the medicare or 
medicaid programs under title XVIII or XIX of the 
Social Security Act (42 U.S.C. 1395 and 1396 et 
seq.), or under any other Federal or State health 
care program. 
(4) DESIGNATION OF RESPONSIBILITIES.— 
(A) WITHIN EXISTING STATE ENTITY.—If 
the health care consumer assistance office of a 
State is located within an existing State regu-
latory agency or office of an elected State offi-
cial, the State shall ensure that— 
(i) there is a separate delineation of 
the funding, activities, and responsibilities 
of the office as compared to the other 
funding, activities, and responsibilities of 
the agency; and 
(ii) the office establishes and imple-
ments procedures and protocols to ensure 
the 
confidentiality 
of 
all 
information 
shared by a participant, beneficiary, or en-
rollee or their personal representative and 
their health care providers, group health
plans, or health insurance issuers with the 
office and to ensure that no information is 
disclosed to the State agency or office 
without the written authorization of the in-
dividual or their personal representative in 
accordance with paragraph (2). 
(B) CONTRACT ENTITY.—In the case of an 
entity that enters into a contract with a State 
under subsection (a)(3), the entity shall provide 
assurances that the entity has no conflict of in-
terest in carrying out the activities of the office 
and that the entity is independent of group 
health plans, health insurance issuers, pro-
viders, payers, and regulators of health care. 
(5) SUBCONTRACTS.—The health care con-
sumer assistance office of a State may carry out ac-
tivities and provide services through contracts en-
tered into with 1 or more nonprofit entities so long 
as the office can demonstrate that all of the require-
ments of this section are complied with by the office. 
(6) TERM.—A contract entered into under this 
subsection shall be for a term of 3 years. 
(c) REPORT.—Not later than 1 year after the Sec-
retary first awards grants under this section, and annually 
thereafter, the Secretary shall prepare and submit to the