Title: Improving Provider Directories Act
Policy area: Health

Summary:
Improving Provider Directories Act
This bill requires private health insurance plans, including self-funded employer health plans, to display in online provider directories a method for notifying the plan about inaccurate provider information. Upon such notification, plans must correct and update the provider information in each directory within 30 days and submit an annual report to the state insurance commissioners in each state where the plan is available that contains the all corrective actions taken during the previous year.
Plans that do not comply with this requirement are subject to a tax penalty.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4575 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 4575

  To amend title XXVII of the Public Health Service Act, the Employee 
 Retirement Income Security Act of 1974, and the Internal Revenue Code 
  of 1986 to require group health plans and health insurance issuers 
 offering group or individual health insurance coverage to establish a 
process to address inaccurate information listed in publicly accessible 
provider directories of such plans and issuers, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 27, 2019

Ms. Schrier (for herself and Mr. David P. Roe of Tennessee) introduced 
 the following bill; which was referred to the Committee on Energy and 
Commerce, and in addition to the Committees on Education and Labor, and 
   Ways and Means, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
  To amend title XXVII of the Public Health Service Act, the Employee 
 Retirement Income Security Act of 1974, and the Internal Revenue Code 
  of 1986 to require group health plans and health insurance issuers 
 offering group or individual health insurance coverage to establish a 
process to address inaccurate information listed in publicly accessible 
provider directories of such plans and issuers, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Improving Provider Directories 
Act''.

SEC. 2. REQUIREMENT FOR GROUP HEALTH PLANS AND HEALTH INSURANCE ISSUERS 
              TO ESTABLISH A PROCESS TO ADDRESS INACCURATE INFORMATION 
              LISTED IN PUBLICLY ACCESSIBLE PROVIDER DIRECTORIES OF 
              SUCH PLANS AND ISSUERS.

    (a) PHSA.--
            (1) In general.--Title XXVII of the Public Health Service 
        (42 U.S.C. 300gg et seq.) is amended by adding at the end the 
        following:

                     ``PART D--OTHER MARKET REFORMS

``SEC. 2796. REQUIREMENT FOR GROUP HEALTH PLANS AND HEALTH INSURANCE 
              ISSUERS TO ESTABLISH A PROCESS TO ADDRESS INACCURATE 
              INFORMATION LISTED IN PUBLICLY ACCESSIBLE PROVIDER 
              DIRECTORIES OF SUCH PLANS AND ISSUERS.

    ``A group health plan or a health insurance issuer offering group 
or individual health insurance coverage shall establish a process to 
address inaccurate information listed in any publicly accessible 
provider directory of such plan or issuer. Under such process, the plan 
or issuer, as the case may be, shall carry out each of the following:
            ``(1) Display prominently on each publicly accessible 
        provider directory of such plan or issuer contact information, 
        such as an email address, phone number, or website address, 
        that will allow an individual to notify such plan or issuer of 
        any inaccurate information listed with respect to a provider in 
        such directory.
            ``(2)(A) Not later than 30 days after receiving a 
        notification pursuant to paragraph (1) that information listed 
        with respect to a provider in a publicly accessible provider 
        directory of such plan or issuer is inaccurate--
                    ``(i) investigate whether such information is 
                inaccurate; and
                    ``(ii) subject to subparagraph (B), in the case 
                that such plan or issuer determines that such 
                information is inaccurate, correct and update such 
                information in such directory.
            ``(B) In the case that such plan or issuer determines, 
        pursuant to an investigation under clause (i) of subparagraph 
        (A), that information listed with respect to a provider in a 
        printed provider directory is inaccurate, such plan or issuer 
        may satisfy the correction and update requirement under clause 
        (ii) of such subparagraph by correcting and updating such 
        information in each online provider directory of such plan or 
        issuer.
            ``(3) Submit to the State insurance commissioners of the 
        States in which such plan or coverage, as applicable, is 
        offered, and makes publicly available, an annual report on the 
        number of notifications received pursuant to paragraph (1) 
        during the year involved and the corrective actions taken under 
        paragraph (2) with respect to such notifications.''.
            (2) Conforming amendments.--
                    (A) Section 2722 of the Public Health Service Act 
                (42 U.S.C. 300gg-21) is amended--
                            (i) in subsection (a)(1), by inserting 
                        ``and part D'' after ``subparts 1 and 2'';
                            (ii) in subsection (b), by inserting ``and 
                        part D'' after ``subparts 1 and 2'';
                            (iii) in subsection (c)(1), by inserting 
                        ``and part D'' after ``subparts 1 and 2'';
                            (iv) in subsection (c)(2), by inserting 
                        ``and part D'' after ``subparts 1 and 2'';
                            (v) in subsection (c)(3), by inserting 
                        ``and part D'' after ``this part''; and
                            (vi) in subsection (d), in the matter 
                        preceding paragraph (1), by inserting ``and 
                        part D'' after ``this part''.
                    (B) Section 2723 of the Public Health Service Act 
                (42 U.S.C. 300gg-22) is amended--
                            (i) in subsection (a)(1), by inserting 
                        ``and part D'' after ``this part'';
                            (ii) in subsection (a)(2), by inserting 
                        ``or part D'' after ``this part'';
                            (iii) in subsection (b)(1), by inserting 
                        ``or part D'' after ``this part'';
                            (iv) in subsection (b)(2)(A), by inserting 
                        ``or part D'' after ``this part''; and
                            (v) in subsection (b)(2)(C)(ii), by 
                        inserting ``and part D'' after ``this part''.
                    (C) Section 2724 of the Public Health Service Act 
                (42 U.S.C. 300gg-23) is amended--
                            (i) in subsection (a)(1)--
                                    (I) by striking ``this part and 
                                part C insofar as it relates to this 
                                part'' and inserting ``this part, part 
                                D, and part C insofar as it relates to 
                                this part or part D''; and
                                    (II) by inserting ``or part D'' 
                                after ``requirement of this part'';
                            (ii) in subsection (a)(2), by inserting 
                        ``or part D'' after ``this part''; and
                            (iii) in subsection (c), by inserting ``or 
                        part D'' after ``this part (other than section 
                        2704)''.
    (b) ERISA.--
            (1) In general.--Subpart B of part 7 of subtitle B of title 
        I of the Employee Retirement Income Security Act of 1974 (29 
        U.S.C. 1185 et seq.) is amended by adding at the end the 
        following new section:

``SEC. 716. REQUIREMENT FOR GROUP HEALTH PLANS AND HEALTH INSURANCE 
              ISSUERS TO ESTABLISH A PROCESS TO ADDRESS INACCURATE 
              INFORMATION LISTED IN PUBLICLY ACCESSIBLE PROVIDER 
              DIRECTORIES OF SUCH PLANS AND ISSUERS.

    ``A group health plan or a health insurance issuer offering group 
health insurance coverage shall establish a process to address 
inaccurate information listed in any publicly accessible provider 
directory of such plan or issuer. Under such process, the plan or 
issuer, as the case may be, shall carry out each of the following:
            ``(1) Display prominently on each publicly accessible 
        provider directory of such plan or issuer contact information, 
        such as an email address, phone number, or website address, 
        that will allow an individual to notify such plan or issuer of 
        any inaccurate information listed with respect to a provider in 
        such directory.
            ``(2)(A) Not later than 30 days after receiving a 
        notification pursuant to paragraph (1) that information listed 
        with respect to a provider in a publicly accessible provider 
        directory of such plan or issuer is inaccurate--
                    ``(i) investigate whether such information is 
                inaccurate; and
                    ``(ii) subject to subparagraph (B), in the case 
                that such plan or issuer determines that such 
                information is inaccurate, correct and update such 
                information in such directory.
            ``(B) In the case that such plan or issuer determines, 
        pursuant to an investigation under clause (i) of subparagraph 
        (A), that information listed with respect to a provider in a 
        printed provider directory is inaccurate, such plan or issuer 
        may satisfy the correction and update requirement under clause 
        (ii) of such subparagraph by correcting and updating such 
        information in each online provider directory of such plan or 
        issuer.
            ``(3) Submit to the State insurance commissioners of the 
        States in which such plan or coverage, as applicable, is 
        offered, and makes publicly available, an annual report on the 
        number of notifications received pursuant to paragraph (1) 
        during the year involved and the corrective actions taken under 
        paragraph (2) with respect to such notifications.''.
            (2) Clerical amendment.--The table of contents in section 1 
        of such Act is amended by inserting after the item relating to 
        section 714 the following new items:

``715. Additional market reforms.
``716. Requirement for group health plans and health insurance issuers 
                            to establish a process to address 
                            inaccurate information listed in publicly 
                            accessible provider directories of such 
                            plans and issuers.''.
    (c) IRC.--
            (1) In general.--Subchapter B of chapter 100 of the 
        Internal Revenue Code of 1986 is amended by adding at the end 
        the following:

``SEC. 9816. REQUIREMENT FOR GROUP HEALTH PLANS TO ESTABLISH A PROCESS 
              TO ADDRESS INACCURATE INFORMATION LISTED IN PUBLICLY 
              ACCESSIBLE PROVIDER DIRECTORIES OF SUCH PLANS.

    ``A group health plan shall establish a process to address 
inaccurate information listed in any publicly accessible provider 
directory of such plan. Under such process, the plan shall carry out 
each of the following:
            ``(1) Display prominently on each publicly accessible 
        provider directory of such plan contact information, such as an 
        email address, phone number, or website address, that will 
        allow an individual to notify such plan of any inaccurate 
        information listed with respect to a provider in such 
        directory.
            ``(2)(A) Not later than 30 days after receiving a 
        notification pursuant to paragraph (1) that information listed 
        with respect to a provider in a publicly accessible provider 
        directory of such plan is inaccurate--
                    ``(i) investigate whether such information is 
                inaccurate; and
                    ``(ii) subject to subparagraph (B), in the case 
                that such plan determines that such information is 
                inaccurate, correct and update such information in such 
                directory.
            ``(B) In the case that such plan determines, pursuant to an 
        investigation under clause (i) of subparagraph (A), that 
        information listed with respect to a provider in a printed 
        provider directory is inaccurate, such plan may satisfy the 
        correction and update requirement under clause (ii) of such 
        subparagraph by correcting and updating such information in 
        each online provider directory of such plan.
            ``(3) Submit to the State insurance commissioners of the 
        States in which such plan is offered, and makes publicly 
        available, an annual report on the number of notifications 
        received pursuant to paragraph (1) during the year involved and 
        the corrective actions taken under paragraph (2) with respect 
        to such notifications.''.
            (2) Clerical amendment.--The table of sections for 
        subchapter B of chapter 100 of the Internal Revenue Code of 
        1986 is amended by adding at the end the following new item:

``Sec. 9816. Requirement for group health plans to establish a process 
                            to address inaccurate information listed in 
                            publicly accessible provider directories of 
                            such plans.''.
    (d) Effective Date.--The amendments made by this section shall 
apply with respect to plan years beginning on or after January 1, 2021.
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