dreamproit/uscode huggingface dataset:
42 U.S.C. § 18062 (THE PUBLIC HEALTH AND WELFARE)
§ 18062. Establishment of risk corridors for plans in individual and small group markets
(a) In general
The Secretary shall establish and administer a program of risk corridors for calendar years 2014, 2015, and 2016 under which a qualified health plan offered in the individual or small group market shall participate in a payment adjustment system based on the ratio of the allowable costs of the plan to the plan’s aggregate premiums. Such program shall be based on the program for regional participating provider organizations under part D of title XVIII of the Social Security Act [42 U.S.C. 1395w–101 et seq.].
(b) Payment methodology
(1) Payments out
The Secretary shall provide under the program established under subsection (a) that if—
(A) a participating plan’s allowable costs for any plan year are more than 103 percent but not more than 108 percent of the target amount, the Secretary shall pay to the plan an amount equal to 50 percent of the target amount in excess of 103 percent of the target amount; and
(B) a participating plan’s allowable costs for any plan year are more than 108 percent of the target amount, the Secretary shall pay to the plan an amount equal to the sum of 2.5 percent of the target amount plus 80 percent of allowable costs in excess of 108 percent of the target amount.
(2) Payments in
The Secretary shall provide under the program established under subsection (a) that if—
(A) a participating plan’s allowable costs for any plan year are less than 97 percent but not less than 92 percent of the target amount, the plan shall pay to the Secretary an amount equal to 50 percent of the excess of 97 percent of the target amount over the allowable costs; and
(B) a participating plan’s allowable costs for any plan year are less than 92 percent of the target amount, the plan shall pay to the Secretary an amount equal to the sum of 2.5 percent of the target amount plus 80 percent of the excess of 92 percent of the target amount over the allowable costs.
(c) Definitions
In this section:
(1) Allowable costs
(A) In general
The amount of allowable costs of a plan for any year is an amount equal to the total costs (other than administrative costs) of the plan in providing benefits covered by the plan.
(B) Reduction for risk adjustment and reinsurance payments
Allowable costs shall 1 reduced by any risk adjustment and reinsurance payments received under section 2 18061 and 18063 of this title.
(2) Target amount
The target amount of a plan for any year is an amount equal to the total premiums (including any premium subsidies under any governmental program), reduced by the administrative costs of the plan.
(Pub. L. 111–148, title I, § 1342, Mar. 23, 2010, 124 Stat. 211.)
heading: Editorial Notes
heading: References in Text
text: The Social Security Act, referred to in subsec. (a), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Part D of title XVIII of the Act is classified generally to part D (§ 1395w–101 et seq.) of subchapter XVIII of chapter 7 of this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables.
42 U.S.C. § 18063 (THE PUBLIC HEALTH AND WELFARE)
§ 18063. Risk adjustment
(a) In general
(1) Low actuarial risk plans
Using the criteria and methods developed under subsection (b), each State shall assess a charge on health plans and health insurance issuers (with respect to health insurance coverage) described in subsection (c) if the actuarial risk of the enrollees of such plans or coverage for a year is less than the average actuarial risk of all enrollees in all plans or coverage in such State for such year that are not self-insured group health plans (which are subject to the provisions of the Employee Retirement Income Security Act of 1974 [29 U.S.C. 1001 et seq.]).
(2) High actuarial risk plans
Using the criteria and methods developed under subsection (b), each State shall provide a payment to health plans and health insurance issuers (with respect to health insurance coverage) described in subsection (c) if the actuarial risk of the enrollees of such plans or coverage for a year is greater than the average actuarial risk of all enrollees in all plans and coverage in such State for such year that are not self-insured group health plans (which are subject to the provisions of the Employee Retirement Income Security Act of 1974).
(b) Criteria and methods
The Secretary, in consultation with States, shall establish criteria and methods to be used in carrying out the risk adjustment activities under this section. The Secretary may utilize criteria and methods similar to the criteria and methods utilized under part C or D of title XVIII of the Social Security Act [42 U.S.C. 1395w–21 et seq., 1395w–101 et seq.]. Such criteria and methods shall be included in the standards and requirements the Secretary prescribes under section 18041 of this title.
(c) Scope
A health plan or a health insurance issuer is described in this subsection if such health plan or health insurance issuer provides coverage in the individual or small group market within the State. This subsection shall not apply to a grandfathered health plan or the issuer of a grandfathered health plan with respect to that plan.
(Pub. L. 111–148, title I, § 1343, Mar. 23, 2010, 124 Stat. 212.)
heading: Editorial Notes
heading: References in Text
text: The Employee Retirement Income Security Act of 1974, referred to in subsec. (a), is Pub. L. 93–406, Sept. 2, 1974, 88 Stat. 829, which is classified principally to chapter 18 (§ 1001 et seq.) of Title 29, Labor. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of Title 29 and Tables.
The Social Security Act, referred to in subsec. (b), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Parts C and D of title XVIII of the Act are classified generally to parts C (§ 1395w–21 et seq.) and D (§ 1395w–101 et seq.), respectively, of subchapter XVIII of chapter 7 of this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables.
42 U.S.C. § 18084 (THE PUBLIC HEALTH AND WELFARE)
§ 18084. Premium tax credit and cost-sharing reduction payments disregarded for Federal and federally-assisted programs
For purposes of determining the eligibility of any individual for benefits or assistance, or the amount or extent of benefits or assistance, under any Federal program or under any State or local program financed in whole or in part with Federal funds—
(1) any credit or refund allowed or made to any individual by reason of section 36B of title 26 (as added by section 1401) 1 shall not be taken into account as income and shall not be taken into account as resources for the month of receipt and the following 2 months; and
(2) any cost-sharing reduction payment or advance payment of the credit allowed under such section 36B that is made under section 18071 or 18082 of this title shall be treated as made to the qualified health plan in which an individual is enrolled and not to that individual.
(Pub. L. 111–148, title I, § 1415, Mar. 23, 2010, 124 Stat. 237.)
heading: Editorial Notes
heading: References in Text
text: Section 1401, referred to in par. (1), means section 1401 of Pub. L. 111–148.
42 U.S.C. § 18101 (THE PUBLIC HEALTH AND WELFARE)
§ 18101. Repealed. Pub. L. 112–10, div. B, title VIII, § 1858(a), Apr. 15, 2011, 125 Stat. 168
text: Section, Pub. L. 111–148, title X, § 10108(a)–(e), Mar. 23, 2010, 124 Stat. 912, 913, related to free choice vouchers.
heading: Statutory Notes and Related Subsidiaries
heading: Effective Date of Repeal
text: Repeal by Pub. L. 112–10 effective as if included in the provisions of, and the amendments made by, the provisions of Pub. L. 111–148 to which it relates, see section 1858(d) of Pub. L. 112–10, set out as an Effective Date of 2011 Amendment note under section 36B of Title 26, Internal Revenue Code.
42 U.S.C. § 18111 (THE PUBLIC HEALTH AND WELFARE)
§ 18111. Definitions
Unless specifically provided for otherwise, the definitions contained in section 300gg–91 of this title shall apply with respect to this title.1
(Pub. L. 111–148, title I, § 1551, Mar. 23, 2010, 124 Stat. 258.)
heading: Editorial Notes
heading: References in Text
text: This title, where footnoted in text, is title I of Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 130, which enacted this chapter and enacted, amended, and transferred numerous other sections and notes in the Code. For complete classification of title I to the Code, see Tables.
42 U.S.C. § 18112 (THE PUBLIC HEALTH AND WELFARE)
§ 18112. Transparency in Government
Not later than 30 days after March 23, 2010, the Secretary of Health and Human Services shall publish on the Internet website of the Department of Health and Human Services, a list of all of the authorities provided to the Secretary under this Act (and the amendments made by this Act).
(Pub. L. 111–148, title I, § 1552, Mar. 23, 2010, 124 Stat. 258.)
heading: Editorial Notes
heading: References in Text
text: This Act, referred to in text, is Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 119, known as the Patient Protection and Affordable Care Act. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of this title and Tables.
42 U.S.C. § 18113 (THE PUBLIC HEALTH AND WELFARE)
§ 18113. Prohibition against discrimination on assisted suicide
(a) In general
The Federal Government, and any State or local government or health care provider that receives Federal financial assistance under this Act (or under an amendment made by this Act) or any health plan created under this Act (or under an amendment made by this Act), may not subject an individual or institutional health care entity to discrimination on the basis that the entity does not provide any health care item or service furnished for the purpose of causing, or for the purpose of assisting in causing, the death of any individual, such as by assisted suicide, euthanasia, or mercy killing.
(b) Definition
In this section, the term “health care entity” includes an individual physician or other health care professional, a hospital, a provider-sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization, or plan.
(c) Construction and treatment of certain services
Nothing in subsection (a) shall be construed to apply to, or to affect, any limitation relating to—
(1) the withholding or withdrawing of medical treatment or medical care;
(2) the withholding or withdrawing of nutrition or hydration;
(3) abortion; or
(4) the use of an item, good, benefit, or service furnished for the purpose of alleviating pain or discomfort, even if such use may increase the risk of death, so long as such item, good, benefit, or service is not also furnished for the purpose of causing, or the purpose of assisting in causing, death, for any reason.
(d) Administration
The Office for Civil Rights of the Department of Health and Human Services is designated to receive complaints of discrimination based on this section.
(Pub. L. 111–148, title I, § 1553, Mar. 23, 2010, 124 Stat. 259.)
heading: Editorial Notes
heading: References in Text
text: This Act, referred to in subsec. (a), is Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 119, known as the Patient Protection and Affordable Care Act. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of this title and Tables.
42 U.S.C. § 18114 (THE PUBLIC HEALTH AND WELFARE)
§ 18114. Access to therapies
Notwithstanding any other provision of this Act, the Secretary of Health and Human Services shall not promulgate any regulation that—
(1) creates any unreasonable barriers to the ability of individuals to obtain appropriate medical care;
(2) impedes timely access to health care services;
(3) interferes with communications regarding a full range of treatment options between the patient and the provider;
(4) restricts the ability of health care providers to provide full disclosure of all relevant information to patients making health care decisions;
(5) violates the principles of informed consent and the ethical standards of health care professionals; or
(6) limits the availability of health care treatment for the full duration of a patient’s medical needs.
(Pub. L. 111–148, title I, § 1554, Mar. 23, 2010, 124 Stat. 259.)
heading: Editorial Notes
heading: References in Text
text: This Act, referred to in text, is Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 119, known as the Patient Protection and Affordable Care Act. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of this title and Tables.
42 U.S.C. § 18115 (THE PUBLIC HEALTH AND WELFARE)
§ 18115. Freedom not to participate in Federal health insurance programs
No individual, company, business, nonprofit entity, or health insurance issuer offering group or individual health insurance coverage shall be required to participate in any Federal health insurance program created under this Act (or any amendments made by this Act), or in any Federal health insurance program expanded by this Act (or any such amendments), and there shall be no penalty or fine imposed upon any such issuer for choosing not to participate in such programs.
(Pub. L. 111–148, title I, § 1555, Mar. 23, 2010, 124 Stat. 260.)
heading: Editorial Notes
heading: References in Text
text: This Act, referred to in text, is Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 119, known as the Patient Protection and Affordable Care Act. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of this title and Tables.
42 U.S.C. § 18117 (THE PUBLIC HEALTH AND WELFARE)
§ 18117. Oversight
The Inspector General of the Department of Health and Human Services shall have oversight authority with respect to the administration and implementation of this title 1 as it relates to such Department.
(Pub. L. 111–148, title I, § 1559, Mar. 23, 2010, 124 Stat. 261.)
heading: Editorial Notes
heading: References in Text
text: This title, referred to in text, is title I of Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 130, which enacted this chapter and enacted, amended, and transferred numerous other sections and notes in the Code. For complete classification of title I to the Code, see Tables.
42 U.S.C. § 18118 (THE PUBLIC HEALTH AND WELFARE)
§ 18118. Rules of construction
(a) No effect on antitrust laws
Nothing in this title 1 (or an amendment made by this title) 1 shall be construed to modify, impair, or supersede the operation of any of the antitrust laws. For the purposes of this section, the term “antitrust laws” has the meaning given such term in subsection (a) of section 12 of title 15, except that such term includes section 45 of title 15 to the extent that such section 45 applies to unfair methods of competition.
(b) Rule of construction regarding Hawaii’s Prepaid Health Care Act
Nothing in this title 1 (or an amendment made by this title) 1 shall be construed to modify or limit the application of the exemption for Hawaii’s Prepaid Health Care Act (Haw. Rev. Stat. §§ 393–1 et seq.) as provided for under section 1144(b)(5) of title 29.
(c) Student health insurance plans
Nothing in this title 1 (or an amendment made by this title) 1 shall be construed to prohibit an institution of higher education (as such term is defined for purposes of the Higher Education Act of 1965 [20 U.S.C. 1001 et seq.]) from offering a student health insurance plan, to the extent that such requirement is otherwise permitted under applicable Federal, State or local law.
(d) No effect on existing requirements
Nothing in this title 1 (or an amendment made by this title,1 unless specified by direct statutory reference) shall be construed to modify any existing Federal requirement concerning the State agency responsible for determining eligibility for programs identified in section 18083 of this title.
(Pub. L. 111–148, title I, § 1560, Mar. 23, 2010, 124 Stat. 261.)
heading: Editorial Notes
heading: References in Text
text: This title, where footnoted in text, is title I of Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 130, which enacted this chapter and enacted, amended, and transferred numerous other sections and notes in the Code. For complete classification of title I to the Code, see Tables.
The Higher Education Act of 1965, referred to in subsec. (c), is Pub. L. 89–329, Nov. 8, 1965, 79 Stat. 1219, which is classified generally to chapter 28 (§ 1001 et seq.) of Title 20, Education. For complete classification of this Act to the Code, see Short Title note set out under section 1001 of Title 20 and Tables.
42 U.S.C. § 18119 (THE PUBLIC HEALTH AND WELFARE)
§ 18119. Small business procurement
Part 19 of the Federal Acquisition Regulation, section 644 of title 15, and any other applicable laws or regulations establishing procurement requirements relating to small business concerns (as defined in section 632 of title 15) may not be waived with respect to any contract awarded under any program or other authority under this Act or an amendment made by this Act.
(Pub. L. 111–148, title I, § 1563, as added Pub. L. 111–148, title X, § 10107(b)(2), Mar. 23, 2010, 124 Stat. 912.)
heading: Editorial Notes
heading: References in Text
text: This Act, referred to in text, is Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 119, known as the Patient Protection and Affordable Care Act. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of this title and Tables.
heading: Codification
text: Another section 1563 of Pub. L. 111–148 enacted section 18120 of this title, section 9815 of Title 26, Internal Revenue Code, and section 1185d of Title 29, Labor, and amended sections 300gg–1 to 300gg–3, 300gg–9, 300gg–11, 300gg–12, 300gg–21 to 300gg–23, 300gg–25 to 300gg–28, 300gg–62, and 300gg–91 of this title.
42 U.S.C. § 18120 (THE PUBLIC HEALTH AND WELFARE)
§ 18120. Application
Notwithstanding any other provision of the Patient Protection and Affordable Care Act, nothing in such Act (or an amendment made by such Act) shall be construed to—
(1) prohibit (or authorize the Secretary of Health and Human Services to promulgate regulations that prohibit) a group health plan or health insurance issuer from carrying out utilization management techniques that are commonly used as of March 23, 2010; or
(2) restrict the application of the amendments made by this subtitle.
(Pub. L. 111–148, title I, § 1563(d), formerly § 1562(d), title X, § 10107(b)(1), Mar. 23, 2010, 124 Stat. 269, 911.)
heading: Editorial Notes
heading: References in Text
text: The Patient Protection and Affordable Care Act, referred to in text, is Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 119. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of this title and Tables.
The amendments made by this subtitle, referred to in par. (2), mean the amendments made by subtitle G (§§ 1551–1563) of title I of Pub. L. 111–148, which enacted section 300jj–51 of this title, sections 4980H, 5000A, 6055, 6056, and 9815 of Title 26, Internal Revenue Code, and sections 218a to 218c and 1185d of Title 29, Labor, amended sections 300gg–1 to 300gg–3, 300gg–9, 300gg–11, 300gg–12, 300gg–21 to 300gg–23, 300gg–25 to 300gg–28, 300gg–62, and 300gg–91 of this title, sections 125 and 6724 of Title 26, and sections 921 and 932 of Title 30, Mineral Lands and Mining.
heading: Codification
text: Another section 1563 of Pub. L. 111–148 is classified to section 18119 of this title.
42 U.S.C. § 18121 (THE PUBLIC HEALTH AND WELFARE)
§ 18121. Implementation funding
(a) In general
There is hereby established a Health Insurance Reform Implementation Fund (referred to in this section as the “Fund”) within the Department of Health and Human Services to carry out the Patient Protection and Affordable Care Act and this Act (and the amendments made by such Acts).
(b) Funding
There is appropriated to the Fund, out of any funds in the Treasury not otherwise appropriated, $1,000,000,000 for Federal administrative expenses to carry out such Act 1 (and the amendments made by such Acts).
(Pub. L. 111–152, title I, § 1005, Mar. 30, 2010, 124 Stat. 1036.)
heading: Editorial Notes
heading: References in Text
text: The Patient Protection and Affordable Care Act, referred to in subsec. (a), is Pub. L. 111–148, Mar. 23, 2010, 124 Stat. 119. For complete classification of this Act to the Code, see Short Title note set out under section 18001 of this title and Tables.
This Act, referred to in subsec. (a), is Pub. L. 111–152, Mar. 30, 2010, 124 Stat. 1029, known as the Health Care and Education Reconciliation Act of 2010. For complete classification of this Act to the Code, see Short Title of 2010 Amendment note under section 1305 of this title and Tables.
heading: Codification
text: Section was enacted as part of the Health Care and Education Reconciliation Act of 2010, and not as part of the Patient Protection and Affordable Care Act which comprises this chapter.
42 U.S.C. § 18311 (THE PUBLIC HEALTH AND WELFARE)
§ 18311. United States human space flight policy
(a) Use of non-United States human space flight transportation services
(1) In general
The Federal Government may not acquire human space flight transportation services from a foreign entity unless—
(A) no United States Government-operated human space flight capability is available;
(B) no United States commercial provider is available; and
(C) it is a qualified foreign entity.
(2) Definitions
In this subsection:
(A) Commercial provider
The term “commercial provider” means any person providing human space flight transportation services, primary control of which is held by persons other than the Federal Government, a State or local government, or a foreign government.
(B) Qualified foreign entity
The term “qualified foreign entity” means a foreign entity that is in compliance with all applicable safety standards and is not prohibited from providing space transportation services under other law.
(C) United States commercial provider
The term “United States commercial provider” means a commercial provider, organized under the laws of the United States or of a State, that is more than 50 percent owned by United States nationals.
(3) Arrangements with foreign entities
Nothing in this subsection shall prevent the Administrator from negotiating or entering into human space flight transportation arrangements with foreign entities to ensure safety of flight and continued ISS operations.
(b) United States human space flight capabilities
Congress reaffirms the policy stated in section 70501(a) of title 51, that the United States shall maintain an uninterrupted capability for human space flight and operations in low-Earth orbit, and beyond, as an essential instrument of national security and of the capacity to ensure continued United States participation and leadership in the exploration and utilization of space.
(Pub. L. 111–267, title II, § 201, Oct. 11, 2010, 124 Stat. 2811; Pub. L. 115–10, title III, § 302(d), Mar. 21, 2017, 131 Stat. 25.)
heading: Editorial Notes
heading: Codification
text: In subsec. (b), “section 70501(a) of title 51” substituted for “section 501(a) of the National Aeronautics and Space Administration Authorization Act of 2005 (42 U.S.C. 16761(a))” on authority of Pub. L. 111–314, § 5(e), Dec. 18, 2010, 124 Stat. 3443, which Act enacted Title 51, National and Commercial Space Programs.
heading: Amendments
text: 2017—Subsec. (a). Pub. L. 115–10 amended subsec. (a) generally. Prior to amendment, text read as follows: “It is the policy of the United States that reliance upon and use of non-United States human space flight capabilities shall be undertaken only as a contingency in circumstances where no United States-owned and operated human space flight capability is available, operational, and certified for flight by appropriate Federal agencies.”