Healthcare Privacy and Anti-Fraud Act

Bill: 113-s-1666
Sponsor: full_name: Sen. Rubio, Marco [R-FL]
Introduced: 2013-11-07
Policy area: Health
Subjects: Administrative law and regulatory procedures

Civil actions and liability

Comprehensive health care

Consumer affairs

Department of Health and Human Services

Employee hiring

Fraud offenses and financial crimes

Government information and archives

Health care costs and insurance

Health care coverage and access

Health information and medical records

Health programs administration and funding

Licensing and registrations

Personnel records

Right of privacy

Sales and excise taxes
Latest action: action_date: 2013-11-07
text: Read twice and referred to the Committee on Health, Education, Labor, and Pensions.

Summaries:
action_date: 2013-11-07
action_desc: Introduced in Senate
text: <p>Healthcare Privacy and Anti-Fraud Act - Amends the Patient Protection and Affordable Care Act to require the Secretary of Health and Human Services (HHS) to issue guidance (including concerning liability) to protect the privacy of individually identifiable information submitted to, or accessed by, health care exchange navigators.</p> <p>Requires entities receiving grants under the navigator program to ensure that their employees undergo background checks, take an oath not to disclose individually identifiable information, and meet educational and licensure requirements comparable to those applicable to health insurance agents and brokers in the state.</p> <p>Imposes criminal penalties for disclosure of individually identifiable information and misrepresentation as a navigator.</p> <p>Directs the Secretary to annually make available a list of entities providing navigator services and a list of those determined to be ineligible or convicted of offenses described in this Act. <p>Amends the Internal Revenue Code to exempt individuals from the penalty for not maintaining minimum essential coverage for any month if the failure resulted from advice of a navigator or a person purporting to provide such services.

tv_txt: II 113th CONGRESS 1st Session S. 1666 IN THE SENATE OF THE UNITED STATES November 7, 2013 Mr. Rubio (for himself, Mr. Boozman , Mr. Cochran , Mr. Inhofe , Mr. McConnell , Mr. Roberts , and Mr. Flake ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Patient Protection and Affordable Care Act to improve the patient navigator program.

1. Short title This Act may be cited as the Healthcare Privacy and Anti-Fraud Act . 2. Training, background checks, and nondisclosure for patient navigators (a) In general Section 1311(i) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18031(i) ) is amended by adding at the end the following: (7) Security and nondisclosure (A) Guidance by secretary Not later than 90 days after the date of enactment of this paragraph, the Secretary shall issue guidance on the implementation of this paragraph in order to protect the privacy of individually identifiable information submitted to, or accessed by, navigators under this subsection. (B) Background checks (i) In general An entity that receives a grant under this subsection shall ensure that universal background checks are conducted on all employees of the entity prior to such employees providing navigator services to individuals, or prior to such employees having access to individually identifiable information as a result of providing such services. Such background checks shall, at minimum, include a criminal background check, fingerprinting, and credit report. (ii) Limitation An individual who has been found guilty of a felony, or guilty of a misdemeanor involving deceit or dishonestly (including identity theft, fraud, or perjury), under Federal or State law shall not be employed by an entity described in clause (i). (C) Oath (i) In general Prior to commencing employment with an entity that receives a grant under this subsection, an individual described in clause (ii) shall have sworn or taken an oath that he or she will not disclose any individually identifiable information obtained in the course of their employment (except information relevant to the commission of a felony when provided to an appropriate law enforcement authority). (ii) Individual described An individual is described in this clause if such individual is being employed by an entity described in clause (i) as a navigator, a non-navigator assistant, or as an employee with access to individually identifiable information. (D) Educational, training, and licensure requirements Prior to conducting navigation services for an entity under this subsection, an individual shall meet educational and licensure requirements that are identical or comparable to those currently applicable to health insurance agents and brokers within the State in which they seek to provide navigation services, including the completion of at least 30 hours of training (including training on privacy rights under this Act and other relevant Federal laws). (E) Liability Not later than 90 days after the date of the enactment of this paragraph, the Secretary— (i) shall issue guidance concerning how liability and penalties will be applied by the Secretary in instances of failure to comply with requirements of this paragraph, including where consumer outreach and enrollment assistance causes harm to an individual as a result of misuse or negligence in protection and privacy of individually identifiable information; (ii) shall determine whether such liability lies with the navigator or non-navigator assistance personnel involved or whether liability lies with the entity that received the grant under this subsection; and (iii) shall determine whether the individuals or entities identified under clause (ii) are required to obtain professional liability coverage. (F) Penalties (i) In general Whoever having sworn or taken the oath described under subparagraph (C), publishes or communicates any individually identifiable information which comes into his or her possession by reason of his or her being employed (or otherwise providing services) under this subsection, shall be fined not more than $5,000 or imprisoned not more than 5 years, or both. (ii) Misrepresentation Any person who knowingly and falsely represents that such person is, or holds himself or herself out as, a navigator under this subsection shall be fined not more than $5,000 or imprisoned not more than 5 years, or both. (iii) Enhanced penalty for sale or transfer A person who commits the offense described under clause (i) with the intent to sell, transfer, or use individually identifiable information for commercial advantage, personal gain, or malicious harm shall be fined not more than $250,000, imprisoned for not more than 10 years, or both. (G) Greater protections Nothing in subparagraphs (A), (B), (C) or (D) shall be construed to prohibit States from imposing additional standards and protections to protect consumer information. (8) List of navigators Not later than 90 days after the date of enactment of this paragraph, and annually thereafter, the Secretary shall make available a list of entities providing navigator services in accordance with this subsection and a list of entities that have been determined to be ineligible to provide such services or who have been convicted of a violation under paragraph (7). . (b) Limitation on liability Section 5000A(e) of the Internal Revenue Code of 1986 is amended by adding at the end the following: (6) Reliance on navigator advice Any applicable individual who for any month failed to obtain minimum essential coverage as a result of the good faith reliance on the advice of a patient navigator, counselor, or other employee of an entity receiving a grant under section 1311(i) of the Patient Protection and Affordable Care Act (or a person purporting to be such a navigator, counselor, or other employee). . (c) Effective date The amendment made by subsection (a) shall take effect on the date of the enactment of this Act and shall apply to grants made before, on, or after the date of the enactment of this Act. The Secretary of Health and Human Services shall provide for the prompt modification of such grants made before the date of the enactment of this Act in order to comply with the requirement imposed by such amendment.