Title: Health Share Transparency Act of 2022
Policy area: Health

Summary:
Health Share Transparency Act of 2022
This bill requires a health care sharing ministry (HCSM) to disclose specific information to individuals enrolling in the HCSM and to designated government agencies. (An HCSM is a faith-based organization with members who share a common set of ethical or religious beliefs and who contribute regular payments to cover the medical expenses of other members.)
The bill requires an HCSM to disclose to an enrolling individual information such as (1) the average out-of-pocket expenses an enrollee incurs, (2) how to file a complaint or appeal a coverage determination, and (3) a list of the HCSM's non-reimbursable items and services.
The bill also requires that an HCSM submit annual financial disclosures and program information to the Department of Health and Human Services (HHS), the Internal Revenue Service, and the Consumer Financial Protection Bureau. HHS is required to publicly post this information.
Additionally, health insurance brokers contracting with an HCSM are required to provide an enrolling individual with information about health insurance coverage that is available through Medicare, Medicaid, or a health insurance exchange, as appropriate.
HHS may apply civil monetary penalties to an HCSM that fails to comply with the bill's requirements.
Further, the bill requires the Federal Trade Commission to publicly disclose information about consumer complaints regarding HCSMs.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 8324 Introduced in House (IH)]

<DOC>






117th CONGRESS
  2d Session
                                H. R. 8324

  To amend title XXVII of the Public Health Service Act to establish 
  requirements for the disclosure of certain information relating to 
        health care sharing ministries, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 11, 2022

 Mr. Huffman (for himself, Ms. Kuster, and Mr. Raskin) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend title XXVII of the Public Health Service Act to establish 
  requirements for the disclosure of certain information relating to 
        health care sharing ministries, 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 ``Health Share Transparency Act of 
2022''.

SEC. 2. ESTABLISHING REQUIREMENTS FOR THE DISCLOSURE OF CERTAIN 
              INFORMATION RELATING TO HEALTH CARE SHARING MINISTRIES.

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

                ``PART F--HEALTH CARE SHARING MINISTRIES

``SEC. 2799C-1. DISCLOSURE OF INFORMATION.

    ``(a) In General.--A health care sharing ministry (as defined in 
section 5000A(d)(2)(B)(ii) of the Internal Revenue Code of 1986)--
            ``(1) shall, not less frequently than annually, submit to 
        the Secretary, the Commissioner of Internal Revenue, and the 
        Director of the Bureau of Consumer Financial Protection the 
        information described in subsection (b);
            ``(2) shall disclose to each individual seeking to enroll 
        in the ministry, and each individual so enrolled, the 
        information described in paragraph (1) of subsection (c) in the 
        manner specified in paragraph (2) of such subsection; and
            ``(3) may not enter into a contract with an entity for 
        purposes of enrolling an individual in such ministry, or 
        otherwise provide remuneration to such an entity in exchange 
        for enrolling an individual in such ministry, unless such 
        entity meets the requirements described in subsection (d).
    ``(b) Disclosure of Financial and Appeals Information.--
            ``(1) In general.--For purposes of subsection (a)(1), the 
        information described in this subsection is, with respect to a 
        health care sharing ministry, the following:
                    ``(A) The amount of financial reserves held by such 
                ministry.
                    ``(B) The ratio of the amount of money collected 
                from enrollees for purposes of reimbursing enrollees 
                for medical claims that is expended by such ministry on 
                costs described in paragraphs (1) and (2) of section 
                2718(a) to the total amount of money so collected for 
                the preceding year.
                    ``(C) The number of individuals enrolled in such 
                ministry.
                    ``(D) The total amount paid by individuals enrolled 
                in such ministry for coverage under such ministry over 
                the preceding year.
                    ``(E) The total amount paid by such ministry for 
                items and services for which benefits were available 
                under such ministry over the preceding year.
                    ``(F) The average out-of-pocket expenses incurred 
                by individuals enrolled under such ministry for items 
                and services for which benefits are available under 
                such ministry over the preceding year.
                    ``(G) A list of each State and county in which 
                individuals who reside in such State or county may 
                enroll in such ministry.
                    ``(H) The percentage of claims made under such 
                ministry during the preceding year which were denied.
                    ``(I) Contact information for the operator (or a 
                representative of the operator) of such ministry.
                    ``(J) A specification of each health care provider 
                with which such ministry has in effect a contractual 
                relationship for furnishing items and services under 
                such ministry.
                    ``(K) The average amount of time such ministry took 
                to reimburse a claim once submitted to such ministry 
                during the preceding year.
            ``(2) Publication.--The Secretary shall publish the 
        information submitted under subsection (a)(1) on a public 
        website.
    ``(c) Disclosure of Information to Prospective and Current 
Enrollees.--
            ``(1) In general.--For purposes of subsection (a)(2), the 
        information described in this paragraph is, with respect to a 
        health care sharing ministry, the following:
                    ``(A) How an enrollee may file a complaint or 
                appeal a coverage determination, including a disclaimer 
                that appeals may not be available to any entity other 
                than such ministry.
                    ``(B) Whether an enrollee must use arbitration in 
                appealing a coverage determination or has other legal 
                recourse.
                    ``(C) An explanation that, unlike a group health 
                plan or health insurance coverage, there is no 
                guarantee that an enrollee will be reimbursed for any 
                portion of claims submitted to such ministry, as well 
                as a specification of whether any lifetime caps on 
                health care sharing per enrollee are imposed under such 
                ministry.
                    ``(D) The information described in subsection 
                (b)(1)(F).
                    ``(E) The average amount paid per enrollee to such 
                ministry for membership under such ministry over the 
                preceding year.
                    ``(F) With respect to claims made during the 
                preceding year for items and services for which 
                benefits were available under such ministry, the total 
                amount paid by such ministry for such claims compared 
                and the total amount for which individuals enrolled 
                under such ministry were responsible in cost sharing.
                    ``(G) A list of all items and services for which 
                reimbursement is not available under such ministry, as 
                well as, with respect to each item or service for which 
                such reimbursement is so available, a specification of 
                any conditions that would render such item or service 
                nonreimbursable.
                    ``(H) A list of any other requirements imposed on 
                claims submitted for health care sharing under such 
                ministry.
            ``(2) Manner of disclosure.--For purposes of subsection 
        (a)(2), information described in paragraph (1) shall be--
                    ``(A) disclosed in a prominent manner;
                    ``(B) made available in multiple langauges;
                    ``(C) provided immediately before enrollment of any 
                individual in a health care sharing ministry; and
                    ``(D) be written in at least 14 point font (or, if 
                such enrollment is being made over the phone, be read 
                out loud).
    ``(d) Entity Requirements.--For purposes of subsection (a)(3), the 
requirements described in this subsection are, with respect to an 
entity with a contract in effect with a health care sharing ministry 
for purposes of enrolling an individual in such ministry (or otherwise 
receiving remuneration from such ministry in exchange for enrolling an 
individual in such ministry), that such entity provides to such 
individual--
            ``(1) an explanation of any tax credit that may be 
        available to such individual under section 36B of the Internal 
        Revenue Code of 1986 to purchase a qualified health plan (as 
        defined in section 1301(a) of the Patient Protection and 
        Affordable Care Act) through an Exchange established pursuant 
        to such Act;
            ``(2) if such individual qualifies to enroll under a State 
        plan (or waiver of such plan) under title XIX of the Social 
        Security Act, or if such individual is entitled to benefits 
        under part A or eligible to enroll under part B of title XVIII 
        of such Act, an explanation of such qualification, entitlement, 
        or eligibility;
            ``(3) an explanation of the types of benefits required to 
        be provided under such plans and other protections applicable 
        under such plans (such as limitations on cost sharing) compared 
        to the benefits provided, and cost-sharing requirements 
        imposed, under such ministry; and
            ``(4) an explanation that such ministry is not a group 
        health plan or health insurance coverage and that benefits 
        provided under such ministry are not guaranteed.
    ``(e) Enforcement.--In the case that the Secretary determines that 
a health care sharing ministry has failed to meet a requirement of this 
section, the Secretary may impose a civil monetary penalty on such 
ministry in an amount not to exceed $100 for each day for each 
individual with respect to which such a failure occurs. The provisions 
of subparagraphs (C) through (G) of paragraph (2) of section 2723 shall 
apply to a civil monetary penalty imposed under this subsection in the 
same manner as such provisions apply to a civil monetary penalty 
imposed under such section.
    ``(f) Definitions.--For purposes of this section, the Secretary may 
specify the meaning of any term used in relation to a health care 
sharing ministry and clarify the applicability of such term to such a 
ministry.''.
    (b) Disclosures by Federal Trade Commission Regarding Consumer 
Complaints.--
            (1) In general.--Not later than January 1 and July 1 of 
        each year, the Federal Trade Commission shall publicly disclose 
        on the internet website of the Commission, and transmit to the 
        Secretary of Health and Human Services and the Commissioner of 
        Internal Revenue--
                    (A) the number of consumer complaints regarding 
                health care sharing ministries (as defined in section 
                5000A(d)(2)(B)(ii) of the Internal Revenue Code of 
                1986) received by the Commission during the period 
                covered by the disclosure;
                    (B) the general categories (as determined by the 
                Commission) of the complaints described in subparagraph 
                (A); and
                    (C) with respect to each complaint described in 
                subparagraph (A)--
                            (i) the name of the health care sharing 
                        ministry against which the complaint was made; 
                        and
                            (ii) such details as the Commission 
                        considers appropriate regarding the ownership, 
                        operation, and executive leadership of such 
                        ministry.
            (2) Timing of initial disclosure.--Paragraph (1) shall 
        apply beginning on the January 1 or July 1 that first occurs 
        after the date that is 90 days after the date of the enactment 
        of this Act.
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