114 SRES 65 ATS: Supporting efforts to bring an end to violence perpetrated by Boko Haram, and urging the Government of Nigeria to conduct transparent, peaceful, and credible elections.
U.S. Senate
2015-02-04
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

		III
		114th CONGRESS
		1st Session
		S. RES. 65
		IN THE SENATE OF THE UNITED STATES

			February 4, 2015
			Mr. Menendez (for himself, Mrs. Shaheen, Mr. Coons, Mr. Isakson, Mr. Boozman, Mr. Durbin, and Mr. Leahy) submitted the following resolution; which was referred to the Committee on Foreign Relations

		February 24, 2015Committee discharged; considered, amended, and agreed to with an amended preambleRESOLUTION
		Supporting efforts to bring an end to violence perpetrated by Boko Haram, and urging the Government
			 of Nigeria to conduct transparent, peaceful, and credible elections.

 Whereas Nigeria is the most populous nation in Africa, with the largest economy;
 Whereas the Governments of the United States and Nigeria have had a strong bilateral relationship, and Nigeria has been a valued partner of the United States since its transition to civilian rule;
 Whereas the Government of Nigeria is currently confronted with threats to internal security by terrorists, insurgents, and communal violence that have caused considerable population displacement, and at the same time must administer transparent and peaceful elections with a credible outcome;
 Whereas the government and those who aspire to hold office in Nigeria must demonstrate the political will to address both of these challenges in a responsible way, including by ensuring full enfranchisement, with particular emphasis on developing a means for enfranchisement for the hundreds of thousands displaced by violence;
 Whereas the members of Jama'atu Ahlis Sunna Lidda'awati wal-Jihad, commonly known as Boko Haram, have terrorized the people of Nigeria with increasing violence since 2009, targeting military, government, and civilian sites in Nigeria, including schools, mosques, churches, markets, villages, and agricultural centers, and killing thousands and abducting hundreds of civilians in Nigeria and the surrounding countries;
 Whereas the Department of State named several individuals linked to Boko Haram, including its leader, Abubakar Shekau, as Specially Designated Global Terrorists in 2012, and designated Boko Haram as a Foreign Terrorist Organization (FTO) in November 2013;
 Whereas, in May 2014, the United Nations Security Council added Boko Haram to its al Qaeda sanctions list, and on January 19, 2015, the United Nations Security Council issued a presidential statement condemning the recent escalation of attacks in northeastern Nigeria and surrounding countries and expressing concern that the situation was undermining peace and security in West and Central Africa;
 Whereas Boko Haram calls for the universal implementation of what it considers pure Shari’ah law, has called on all Christians to leave northern Nigeria, and perpetrates targeted violent attacks against Christians, churches, schools, mosques, and Muslim critics;
 Whereas the over 200 school girls abducted by Boko Haram on April 14, 2014, from the Government Girls Secondary School in the northeastern state of Borno, whose kidnapping sparked domestic and international outrage spawning the Twitter campaign #BringBackOurGirls, are still missing;
 Whereas the militant group is an increasing menace to the countries along Nigeria's northeastern border, prompting the African Union, the Lake Chad Basin Commission, the European Union, and the United Nations Security Council to recognize that there must be a regional response;
 Whereas the United States Government has stepped forward to offer assistance through intelligence sharing, bilateral and international sanctioning of Boko Haram leaders, counterterrorism assistance through the Global Security Contingency Fund program for countries in the region to counter the militant group, and humanitarian services to populations affected by and vulnerable to Boko Haram violence;
 Whereas Boko Haram emerged partially as a response to underdevelopment in northeastern Nigeria, and inequality, elite impunity, and alleged human rights abuses by security forces may be fueling anti-government sentiment;
 Whereas it is clear that a military approach alone will not eliminate the threat of Boko Haram, and gross human rights abuses and atrocities by security forces causes insecurity and mistrust among the civilian population;
 Whereas it is imperative that the Government of Nigeria implement a comprehensive, civilian security focused plan that prioritizes protecting civilians and also addresses legitimate political and economic grievances of citizens in northern Nigeria;
 Whereas Nigeria is scheduled to hold national elections in the coming weeks, and the elections appear to be the most closely contested in Nigeria since the return to civilian rule;
 Whereas election-related violence has occurred in Nigeria in successive elections, including in 2011, when nearly 800 people died in clashes following the presidential election;
 Whereas President Goodluck Ebele Azikiwe Jonathan, General Muhammadu Buhari, and other presidential candidates pledged to reverse this trend by signing the Abuja Accord on January 14, 2015, in which they committed themselves and their campaigns to refraining from public statements that incite violence, to running issue-based campaigns that do not seek to divide citizens along religious or ethnic lines, and to supporting the impartial conduct of the electoral commission and the security services;
 Whereas Secretary of State John Kerry visited Nigeria on January 25, 2015, to emphasize the importance of ensuring the upcoming elections are peaceful, nonviolent, and credible;
 Whereas despite the Nigerian Independent National Electoral Commission’s (INEC) views that preparations were sufficient to conduct free, fair and credible elections as scheduled, at the repeated urging of security officials, INEC announced on February 7, 2015, the postponement of the elections by six weeks, and elections will now take place on March 28 and April 11, 2015;
 Whereas tensions in the country remain high, and either electoral fraud or violence could undermine the credibility of the upcoming election;
 Whereas the people of Nigeria aspire for a fair, competently executed, and secure electoral process, as well as an outcome that can be accepted peacefully by all citizens; and
 Whereas it is in the best interest of the United States to maintain close ties with a politically stable, democratic and economically sound Nigeria: Now, therefore, be it

 That the Senate— (1)condemns Boko Haram for its violent attacks, particularly the indiscriminate targeting of civilians, especially women and girls, and the use of children as fighters and suicide bombers;
 (2)stands with— (A)the people of Nigeria in their right to live free from fear or intimidation by state or nonstate actors, regardless of their ethnic, religious, or regional affiliation;
 (B)the people of Cameroon, Chad, and Niger who are increasingly at risk of becoming victims of Boko Haram’s violence; and
 (C)the international community in its efforts to defeat Boko Haram; (3)supports the Abuja Accord, and calls on candidates, party officials, and adherents of all political movements to comply with the code of conduct spelled out therein, by refraining from any rhetoric or action that seeks to demonize or delegitimize opponents, sow division among Nigerians, or otherwise inflame tensions;
 (4)condemns any and all abuses of civilians by security forces of the Government of Nigeria;
 (5)urges the Government of Nigeria to— (A)adhere to the new timeline for elections announced by INEC on February 7, 2015;
 (B)refrain from using security concerns as a pretext for impeding the democratic process and using the security apparatus for political purposes in connection with the elections;
 (C)ensure elections are credible, transparent, and peaceful; (D)prioritize the safety and security of Nigerians vulnerable to Boko Haram attacks;
 (E)implement a comprehensive, civilian security-focused response to defeat Boko Haram that addresses political and economic grievances of citizens in the north;
 (F)improve the capacity and conduct of Nigeria’s security forces, including respect for human rights, and take steps to hold accountable through a transparent process those members of the security forces responsible for abuses;
 (G)recognize that security forces are intended to protect the safety and security of all citizens equally; and
 (H)cooperate with regional and international partners to defeat Boko Haram; (6)urges all Nigerians to engage in the electoral process, to insist on full enfranchisement, and to reject inflammatory or divisive rhetoric or actions; and
 (7)reaffirms that the people of the United States will continue to stand with the people of Nigeria in support of peace and democracy.


		II
		109th CONGRESS
		2d Session
		S. 3932
		IN THE SENATE OF THE UNITED STATES

			September 25, 2006
			Mr. Feingold introduced
			 the following bill; which was read twice and referred to the
			 Committee on Commerce, Science, and
			 Transportation

		A BILL
		To limit the amount of funds available to the Aeronautics
		  Research Mission Directorate of the National Aeronautics and Space
		  Administration during fiscal year 2007 and fiscal years
		  thereafter.

		1.Limitation on funds available
			 to Aeronautics Research Mission Directorate of National Aeronautics and Space
			 Administration during fiscal year 2007 and fiscal years
			 thereafterNotwithstanding any
			 other provision of law, the total amount of funds available to the Aeronautics
			 Research Mission Directorate of the National Aeronautics and Space
			 Administration during any fiscal year after fiscal year 2006 may not exceed
			 $724,000,000.


113 HR 3250 IH: Fiscal Sanity Act for Appropriations
U.S. House of Representatives
2013-10-05
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I113th CONGRESS1st SessionH. R. 3250IN THE HOUSE OF REPRESENTATIVESOctober 5, 2013Mr. Grayson introduced the following bill; which was referred to the Committee on AppropriationsA BILLMaking continuing appropriations for all departments and agencies of the Federal Government,
and for other purposes.1.Short titleThis Act may be cited as the Fiscal Sanity Act for Appropriations.2.Continuing appropriationsThere is hereby appropriated for 120 days after the date of enactment of this Act—(1)for each project or activity for which budget authority was provided in the Consolidated and Further Continuing Appropriations Act, 2013 (Public Law 113–6), an amount equal to the budget authority provided in such Act, as reduced pursuant to the Presidential sequestration order dated March 1, 2013, to remain available for a comparable period of availability; and(2)for entitlements and other mandatory payments whose budget authority was provided in appropriations Acts for fiscal year 2013, and for activities under the Food and Nutrition Act of 2008, such amounts as may be necessary to maintain program levels as they existed on September 30, 2013.


115 HR 4422 IH: To amend the Internal Revenue Code of 1986 to provide special rules for purposes of determining if financial guaranty insurance companies are qualifying insurance corporations under the passive foreign investment company rules.
U.S. House of Representatives
2021-07-13
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I117th CONGRESS1st SessionH. R. 4422IN THE HOUSE OF REPRESENTATIVESJuly 13, 2021Ms. Moore of Wisconsin (for herself and Mr. Smith of Nebraska) introduced the following bill; which was referred to the Committee on Ways and MeansA BILLTo amend the Internal Revenue Code of 1986 to provide special rules for purposes of determining if financial guaranty insurance companies are qualifying insurance corporations under the passive foreign investment company rules.1.Treatment of financial guaranty insurance companies as qualifying insurance corporations under passive foreign investment company rules(a)In generalSection 1297(f)(3) of the Internal Revenue Code of 1986 is amended by adding at the end the following new subparagraph:(C)Special rules for financial guaranty insurance companies(i)In generalNotwithstanding subparagraphs (A)(ii) and (B), the applicable insurance liabilities of a financial guaranty insurance company shall include its unearned premium reserves if—(I)such company is prohibited under generally accepted accounting principles from reporting on its applicable financial statements reserves for losses and loss adjustment expenses with respect to a financial guaranty insurance or reinsurance contract except to the extent that losses and loss adjustment expenses are expected to exceed the unearned premium reserves on the contract,(II)the applicable financial statement of such company reports financial guaranty exposure of at least 15-to-1 or State or local bond exposure of at least 9-to-1 (8-to-1 in the case of a taxable year of such company which ends on or before December 31, 2018), and(III)such company includes in its insurance liabilities only its unearned premium reserves relating to insurance written or assumed that is within the single risk limits set forth in subsection (D) of section 4 of the Financial Guaranty Insurance Guideline (modified by using total shareholder’s equity as reported on the applicable financial statement of the company rather than aggregate of the surplus to policyholders and contingency reserves).(ii)Application of alternative facts and circumstances testA financial guaranty insurance company shall be treated as satisfying the requirements of paragraph (2)(B).(iii)Financial guaranty insurance companyFor purposes of this subparagraph, the term financial guaranty insurance company means any insurance company the sole business of which is writing or reinsuring financial guaranty insurance (as defined in subsection (A) of section 1 of the Financial Guaranty Insurance Guideline) which is permitted under subsection (B) of section 4 of such Guideline.(iv)Financial guaranty exposureFor purposes of this subparagraph, the term financial guaranty exposure means the ratio of—(I)the net debt service outstanding insured or reinsured by the company that is within the single risk limits set forth in the Financial Guaranty Insurance Guideline (as reported on such company’s applicable financial statement), to(II)the company’s total assets (as so reported).(v)State or local bond exposureFor purposes of this subparagraph, the term State or local bond exposure means the ratio of—(I)the net unpaid principal of State or local bonds (as defined in section 103(c)(1)) insured or reinsured by the company that is within the single risk limits set forth in the Financial Guaranty Insurance Guideline (as reported on such company’s applicable financial statement), to(II)the company’s total assets (as so reported).”(vi)Financial Guaranty Insurance GuidelineFor purposes of this subparagraph—(I)In generalThe term Financial Guaranty Insurance Guideline means the October 2008 model regulation that was adopted by the National Association of Insurance Commissioners on December 4, 2007.(II)Determinations made by SecretaryThe determination of whether any provision of the Financial Guaranty Insurance Guideline has been satisfied shall be made by the Secretary..(b)Reporting of certain itemsSection 1297(f)(4) of such Code is amended by adding at the end the following new subparagraph:(C)Clarification that certain items on applicable financial statement be separately reported with respect to corporationAn amount described in paragraph (1)(B) or clause (i)(II), (i)(III), (iv)(I), (iv)(II), (v)(I), or (v)(II) of paragraph (3)(C) shall be treated as reported on an applicable financial statement for purposes of this section if—(i)such amount is separately reported on such statement with respect to the corporation referred to in paragraph (1), or(ii)such amount is separately determined for purposes of calculating an amount which is reported on such statement.(D)Authority of Secretary to require reporting(i)In generalEach United States person who owns an interest in a specified non-publicly traded foreign corporation and who takes the position that such corporation is not a passive foreign investment company shall report to the Secretary such information with respect to such corporation as the Secretary may require.(ii)Specified non-publicly traded foreign corporationFor purposes of this subparagraph, the term specified non-publicly traded foreign corporation means any foreign corporation—(I)which would be a passive foreign investment company if subsection (b)(2)(B) did not apply, and(II)no interest in which is traded on an established securities market..(c)Effective date(1)In generalExcept as otherwise provided in this subsection, the amendments made by this section shall take effect as if included in section 14501 of Public Law 115–97.(2)ReportingThe amendment made by subsection (b) shall apply to reports made after the date of the enactment of this Act.


116 S2024 IS: Understanding and Studying American Civics Act of 2019
U.S. Senate
2019-06-27
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

II
116th CONGRESS1st Session
S. 2024
IN THE SENATE OF THE UNITED STATES

June 27, 2019
Mr. Cornyn (for himself and Mr. Coons) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

A BILL
To amend the Higher Education Act of 1965 to improve the American History for Freedom grant program.

1.Short title This Act may be cited as the Understanding and Studying American Civics Act of 2019  or the USA Civics Act of 2019.  2.American Civics Education ProgramSection 805 of the Higher Education Act of 1965 (20 U.S.C. 1161e) is amended—
(1)in the section heading, by striking history for freedom and inserting civics education program;  (2)in subsection (a)—
(A)by striking subsection (f) and inserting subsection (g);  (B)by striking the Secretary is authorized to award three-year grants, on a competitive basis, and inserting the Secretary is authorized to award grants, once every 3 years and on a competitive basis,;
(C)by striking paragraph (1) and inserting the following:  (1)American political thought and history;;
(D)in paragraph (2) by striking or after the semicolon;  (E)by striking paragraph (3) and inserting the following:

(3)the history, achievements, and impact of American representative democracy and constitutional democracies globally; or; and  (F)by adding at the end the following:

(4)the means of participation in political and civic life.;  (3)in subsection (b)—
(A)in paragraph (1), by striking as defined in section 101. and inserting , or a partnership that includes an institution of higher education and one or more nonprofit organizations, whose missions and demonstrated expertise are consistent with the purpose of this section.;  (B)in paragraph (2), by striking that emerged and all that follows through the period at the end and inserting founded on the principles of representative democracy, constitutional government, individual rights, market economics, religious freedom and religious tolerance, and freedom of thought and inquiry.; and
(C)by striking paragraph (3) and inserting the following:  (3)American political thought and historyThe term American political thought and history means—
(A)the significant constitutional, political, intellectual, economic, social, and foreign policy trends and issues that have shaped the course of American history; and  (B)the key episodes, turning points, texts, and figures involved in the constitutional, political, intellectual, diplomatic, social, and economic history of the United States.;
(4)in subsection (c)(2)— (A)in subparagraph (A), by striking traditional and all that follows through the semicolon and inserting American political thought and history, free institutions, the impact of American representative democracy and constitutional democracies globally, or the means of participation in political and civic life;; and
(B)in subparagraph (B), by inserting , which may include the creation or use of open educational resources after subsection (e)(1)(B);  (5)in subsection (d)—
(A)by striking paragraph (1) and inserting the following:  (1)increase access to quality programming that expands knowledge of American political thought and history, free institutions, the impact of American representative democracy and constitutional democracies globally, or the means of participation in political and civic life;; and
(B)in paragraph (2), by striking traditional American history, free institutions, or Western civilization and inserting American political thought and history, free institutions, the impact of American representative democracy and constitutional democracies globally, or the means of participation in political and civic life.;  (6)by striking subsection (e) and inserting the following:

(e)Use of funds
(1)Required use of fundsFunds provided under this section shall be used— (A)to establish or strengthen academic programs or centers focused on American political thought and history, free institutions, the impact of American representative democracy and constitutional democracies globally, or the means of participation in political and civic life, which may include—
(i)design and implementation of programs of study, courses, lecture series, seminars, and symposia;  (ii)development, publication, and dissemination of instructional materials;
(iii)research;  (iv)support for faculty teaching in undergraduate and, if applicable, graduate programs; or
(v)support for graduate and postgraduate fellowships, if applicable; or  (B)for teacher preparation initiatives that stress content mastery regarding American political thought and history, free institutions, the impact of American representative democracy and constitutional democracies globally, or the means of participation in political and civic life;
(C)for collaboration with local educational agencies for the purpose of providing elementary school and secondary school teachers an opportunity to enhance their knowledge of American political thought and history, free institutions, the impact of American representative democracy and constitutional democracies globally, or the means of participation in political and civic life; and  (D)to conduct outreach activities to ensure that information about the activities funded under this section is widely disseminated—
(i)to undergraduate students (including students enrolled in teacher education programs, if applicable);  (ii)to graduate students (including students enrolled in teacher education programs, if applicable);
(iii)to faculty;  (iv)to local educational agencies; and
(v)within the local community.  (2)Allowable uses of fundsFunds provided under this section may be used to support—
(A)collaboration with entities such as— (i)nonprofit organizations whose missions and demonstrated expertise are consistent with the purpose of this section, for assistance in carrying out activities described under subsection (a); and
(ii)Federal or State humanities programs, which may include those funded by the National Endowment for the Humanities;  (B)the creation and use of open educational resources on American political thought and history, free institutions, or the impact of American representative democracy and constitutional democracies globally, or the means of participation in political and civic life; and
(C)other activities that meet the purposes of this section.;   (7)by redesignating subsection (f) as subsection (g);
(8)in subsection (g), as redesignated by paragraph (7), by striking 2009 and inserting 2020; and  (9)by inserting after subsection (e) the following:

(f)Rule of constructionNothing in this section shall be construed to authorize the Secretary to prescribe an American political thought and history curriculum..


114 HR 6353 IH: To amend the Internal Revenue Code of 1986 to extend for two years the credit for new qualified fuel cell motor vehicles.
U.S. House of Representatives
2016-11-17
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I114th CONGRESS2d SessionH. R. 6353IN THE HOUSE OF REPRESENTATIVESNovember 17, 2016Mr. Grayson introduced the following bill; which was referred to the Committee on Ways and MeansA BILLTo amend the Internal Revenue Code of 1986 to extend for two years the credit for new qualified
			 fuel cell motor vehicles.

		1.Extension of credit for new qualified fuel cell motor vehicles
 (a)In generalParagraph (1) of section 30B(k) of the Internal Revenue Code of 1986 is amended by striking December 31, 2016 and inserting December 31, 2018. (b)Effective dateThe amendment made by this section shall apply to property placed in service after December 31, 2016.


116 HR 3762 IH: Dental and Optometric Care Access Act
U.S. House of Representatives
2019-07-15
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I116th CONGRESS1st SessionH. R. 3762IN THE HOUSE OF REPRESENTATIVESJuly 15, 2019Mr. Loebsack (for himself, Mr. Carter of Georgia, Mr. Gosar, Mr. Van Drew, Mr. Simpson, Ms. Clarke of New York, Mr. Ferguson, and Mr. Pocan) introduced the following bill; which was referred to the Committee on Energy and CommerceA BILLTo amend title XXVII of the Public Health Service Act to improve health care coverage under vision
			 and dental plans, and for other purposes.

 1.Short titleThis Act may be cited as the Dental and Optometric Care Access Act of 2019 or the DOC Access Act of 2019. 2.Improving health care coverage under vision and dental plans (a)In generalTitle XXVII of the Public Health Service Act is amended by inserting after section 2719A (42 U.S.C. 300gg–19a) the following new section:

					2719B.Improving coverage under vision and dental plans
 (a)In generalUnder a group health plan or individual or group health insurance coverage (including such a plan or coverage offering limited scope dental or vision benefits), the following shall apply:
							(1)Payment amounts from covered persons
 (A)In generalThe plan or coverage shall provide, with respect to a doctor of optometry, doctor of dental surgery, or doctor of dental medicine that has an agreement to participate in the plan or coverage and that furnishes items or services that are not covered by the plan or coverage to a person enrolled under such plan or coverage that the doctor may charge the enrollee for such items or services any amount determined by the doctor that is equal to, or less than, the usual and customary amount that the doctor charges individuals who are not so enrolled for such items or services.
 (B)Items and services considered covered by a planFor purposes of subparagraph (A), an item or service shall be considered, with respect to a plan or coverage, to be covered by the plan or coverage only if the item or service is an item or service with respect to which the plan or coverage is obligated to pay an amount that is reasonable and is not nominal or de minimis.
 (2)Duration of limited scope vision and dental plansIn the case of an agreement between such a doctor and such a plan or coverage that offers limited scope dental or vision benefits, the agreement may only extend for a term beyond two years with the prior acceptance of the doctor for each term extension.
 (3)No restrictions on choice of laboratoriesThe plan or coverage may not, directly or indirectly, restrict or limit, such a doctor’s choice of laboratories or choice of source and suppliers of services or materials provided by the doctor to an individual who is enrolled under the plan or coverage.
 (b)Private right of actionIn addition to any other remedies under State or Federal law, a person adversely affected by a violation of this subsection may bring action for injunctive relief against a plan described in subsection (a) and, upon prevailing, in addition to such injunctive relief shall recover monetary damages of no more than $1,000 for each day found to be in violation plus attorney’s fees and costs. The district courts of the United States shall have exclusive jurisdiction of civil actions brought under this subsection.
 (c)Relationship to exception for limited, excepted benefitsSection 2722(c)(1) shall not apply with respect to the requirements of this section. (d)DefinitionsIn this section:
 (1)The terms doctor of dental surgery and doctor of dental medicine mean a doctor of dental surgery or of dental medicine, as applicable, who is legally authorized to practice dentistry by the State in which the doctor performs such function and who is acting within the scope of the license of the doctor when performing such functions.
 (2)The term doctor of optometry means a doctor of optometry who is legally authorized to practice optometry by the State in which the doctor so practices..
 (b)Conforming amendmentSection 2722(c)(1) of the Public Health Service Act (42 U.S.C. 300gg–21(c)(1)) is amended by striking The requirements and inserting Subject to section 2719B, the requirements.
 (c)Exclusive applicability of State lawNotwithstanding any provision of this Act, State law, which directly affects any standard or requirement relating to health insurance issuers and dental or vision benefit plans, shall have exclusive application and the provisions of this Act shall not apply. The State shall retain exclusive jurisdiction over health insurance issuers and limited scope dental or vision benefit plans that are directly governed by such State.


113 HRES 66 EH: Providing for consideration of the bill (H.R. 273) to eliminate the 2013 statutory pay adjustment for Federal employees, and for other purposes.
U.S. House of Representatives
2013-02-14
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

IV
113th CONGRESS
1st Session
H. RES. 66
In the House of Representatives, U. S.,

February 14, 2013

RESOLUTION
Providing for consideration of the bill (H.R. 273) to eliminate the 2013 statutory pay adjustment for Federal employees, and for other purposes.

That upon the adoption of this resolution it shall be in order to consider in the House the bill (H.R. 273) to eliminate the 2013 statutory pay adjustment for Federal employees. All points of order against consideration of the bill are waived. The bill shall be considered as read. All points of order against provisions in the bill are waived. The previous question shall be considered as ordered on the bill and on any amendment thereto to final passage without intervening motion except: (1) one hour of debate equally divided and controlled by the chair and ranking minority member of the Committee on Oversight and Government Reform; and (2) one motion to recommit.
2.During any recess or adjournment of not more than three days, if in the opinion of the Speaker the public interest so warrants, then the Speaker or his designee, after consultation with the Minority Leader, may reconvene the House at a time other than that previously appointed, within the limits of clause 4, section 5, article I of the Constitution, and notify Members accordingly.
3.It shall be in order at any time through the legislative day of February 15, 2013, for the Speaker to entertain motions that the House suspend the rules, as though under clause 1 of rule XV, relating to a measure condemning the government of North Korea and its February 12, 2013, test of a nuclear device.
4.On any legislative day during the period from February 16, 2013, through February 22, 2013—
(a) the Journal of the proceedings of the previous day shall be considered as approved; and
(b)the Chair may at any time declare the House adjourned to meet at a date and time, within the limits of clause 4, section 5, article I of the Constitution, to be announced by the Chair in declaring the adjournment.
5.The Speaker may appoint Members to perform the duties of the Chair for the duration of the period addressed by section 4 of this resolution as though under clause 8(a) of rule I.

Karen L. Haas,Clerk.


		I
		112th CONGRESS
		1st Session
		H. R. 371
		IN THE HOUSE OF REPRESENTATIVES

			January 20, 2011
			Mrs. Blackburn (for
			 herself, Mr. Upton,
			 Mr. Pitts,
			 Mr. Barton of Texas,
			 Mr. Burgess,
			 Mrs. Myrick,
			 Mr. Shimkus,
			 Mr. Rogers of Michigan,
			 Mr. Stearns,
			 Mr. Sullivan,
			 Mr. Murphy of Pennsylvania,
			 Mr. Gingrey of Georgia,
			 Mr. Scalise,
			 Mrs. Bono Mack,
			 Mr. Bass of New Hampshire,
			 Mr. Bilbray,
			 Mr. Latta,
			 Mrs. McMorris Rodgers,
			 Mr. Harper,
			 Mr. Lance,
			 Mr. Cassidy,
			 Mr. Guthrie,
			 Mr. Olson,
			 Mr. McKinley,
			 Mr. Gardner,
			 Mr. Pompeo,
			 Mr. Kinzinger of Illinois,
			 Mr. Roe of Tennessee,
			 Mr. Broun of Georgia,
			 Mr. Boustany,
			 Mr. Conaway,
			 Mr. Fleming,
			 Mr. Issa, Mr. Price of Georgia,
			 Mr. Sessions,
			 Mr. Akin, Mr. Bartlett, Mr.
			 Brooks, Mr. Bucshon,
			 Mr. Chabot,
			 Mr. Cole, Mr. Crawford, Mr.
			 DesJarlais, Mr.
			 Farenthold, Mr.
			 Fleischmann, Mr. Flores,
			 Mr. Franks of Arizona,
			 Mr. Gohmert,
			 Ms. Granger,
			 Mr. Guinta,
			 Mr. Harris,
			 Mrs. Hartzler,
			 Mr. King of Iowa,
			 Mr. Lamborn,
			 Mrs. Lummis,
			 Mr. Mack, Mr. Marchant, Mr.
			 McClintock, Mr.
			 Neugebauer, Mr. Nugent,
			 Mr. Pearce,
			 Mr. Paul, Mr. Posey, Mr.
			 Quayle, Mrs. Schmidt,
			 Mr. Schweikert,
			 Mr. Southerland,
			 Mr. Stutzman,
			 Mr. Walberg,
			 Mr. Walsh of Illinois, and
			 Mr. Wilson of South Carolina)
			 introduced the following bill; which was referred to the
			 Committee on Energy and
			 Commerce, and in addition to the Committees on
			 Ways and Means and
			 Education and the
			 Workforce, 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 repeal title I of the Patient Protection and
		  Affordable Care Act and to amend the Public Health Service Act to provide for
		  cooperative governing of individual health insurance coverage offered in
		  interstate commerce.

		1.Short titleThis Act may be cited as Health Care Choice Act of
			 2011.
		2.Specification of
			 constitutional authority for enactment of lawThis Act is enacted pursuant to the power
			 granted Congress under article I, section 8, clause 3, of the United States
			 Constitution.
		3.FindingsCongress finds the following:
			(1)The application of
			 numerous and significant variations in State law and the implementation of the
			 Patient Protection and Affordable Care Act impacts the ability of insurers to
			 offer, and individuals to obtain, affordable individual health insurance
			 coverage, thereby impeding commerce in individual health insurance
			 coverage.
			(2)Mandates for health care coverage
			 established by title I of the Patient Protection and Affordable Care Act will
			 significantly elevate health insurance costs beyond State and Federal ability
			 to pay.
			(3)Individual health
			 insurance coverage is increasingly offered through the Internet, other
			 electronic means, and by mail, all of which are inherently part of interstate
			 commerce.
			(4)In response to
			 these issues, it is appropriate to encourage increased efficiency in the
			 offering of individual health insurance coverage through a collaborative
			 approach by the States in regulating this coverage.
			(5)The establishment
			 of risk-retention groups has provided a successful model for the sale of
			 insurance across State lines, as the acts establishing those groups allow
			 insurance to be sold in multiple States but regulated by a single State.
			4.Repeal of title I
			 of PPACAEffective as of the
			 enactment of the Patient Protection and Affordable Care Act (Public Law
			 111–148), title I of such Act is repealed (and any amendments to such title, or
			 to amendments made by such title, made by the Health Care and Education
			 Reconciliation Act of 2010 (Public Law 111–152) are repealed, and the
			 provisions of law amended or repealed by such title (or amendments) are
			 restored or revived as if such title (and amendments) had not been
			 enacted.
		5.Cooperative
			 governing of individual health insurance coverage
			(a)In
			 GeneralTitle 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:

					DCooperative
				Governing of Individual Health Insurance Coverage
						2795.DefinitionsIn this part:
							(1)Primary
				stateThe term primary State means, with respect to
				individual health insurance coverage offered by a health insurance issuer, the
				State designated by the issuer as the State whose covered laws shall govern the
				health insurance issuer in the sale of such coverage under this part. An
				issuer, with respect to a particular policy, may only designate one such State
				as its primary State with respect to all such coverage it offers. Such an
				issuer may not change the designated primary State with respect to individual
				health insurance coverage once the policy is issued, except that such a change
				may be made upon renewal of the policy. With respect to such designated State,
				the issuer is deemed to be doing business in that State.
							(2)Secondary
				stateThe term secondary State means, with respect
				to individual health insurance coverage offered by a health insurance issuer,
				any State that is not the primary State. In the case of a health insurance
				issuer that is selling a policy in, or to a resident of, a secondary State, the
				issuer is deemed to be doing business in that secondary State.
							(3)Health insurance
				issuerThe term health insurance issuer has the
				meaning given such term in section 2791(b)(2), except that such an issuer must
				be licensed in the primary State and be qualified to sell individual health
				insurance coverage in that State.
							(4)Individual
				health insurance coverageThe term individual health
				insurance coverage means health insurance coverage offered in the
				individual market, as defined in section 2791(e)(1).
							(5)Applicable state
				authorityThe term applicable State authority means,
				with respect to a health insurance issuer in a State, the State insurance
				commissioner or official or officials designated by the State to enforce the
				requirements of this title for the State with respect to the issuer.
							(6)Hazardous
				financial conditionThe term hazardous financial
				condition means that, based on its present or reasonably anticipated
				financial condition, a health insurance issuer is unlikely to be able—
								(A)to meet
				obligations to policyholders with respect to known claims and reasonably
				anticipated claims; or
								(B)to pay other
				obligations in the normal course of business.
								(7)Covered
				laws
								(A)In
				generalThe term covered laws means the laws, rules,
				regulations, agreements, and orders governing the insurance business pertaining
				to—
									(i)individual health
				insurance coverage issued by a health insurance issuer;
									(ii)the offer, sale,
				rating (including medical underwriting), renewal, and issuance of individual
				health insurance coverage to an individual;
									(iii)the provision to
				an individual in relation to individual health insurance coverage of health
				care and insurance related services;
									(iv)the provision to
				an individual in relation to individual health insurance coverage of
				management, operations, and investment activities of a health insurance issuer;
				and
									(v)the provision to
				an individual in relation to individual health insurance coverage of loss
				control and claims administration for a health insurance issuer with respect to
				liability for which the issuer provides insurance.
									(B)ExceptionSuch
				term does not include any law, rule, regulation, agreement, or order governing
				the use of care or cost management techniques, including any requirement
				related to provider contracting, network access or adequacy, health care data
				collection, or quality assurance.
								(8)StateThe
				term State means the 50 States and includes the District of
				Columbia, Puerto Rico, the Virgin Islands, Guam, American Samoa, and the
				Northern Mariana Islands.
							(9)Unfair claims
				settlement practicesThe term unfair claims settlement
				practices means only the following practices:
								(A)Knowingly
				misrepresenting to claimants and insured individuals relevant facts or policy
				provisions relating to coverage at issue.
								(B)Failing to
				acknowledge with reasonable promptness pertinent communications with respect to
				claims arising under policies.
								(C)Failing to adopt
				and implement reasonable standards for the prompt investigation and settlement
				of claims arising under policies.
								(D)Failing to
				effectuate prompt, fair, and equitable settlement of claims submitted in which
				liability has become reasonably clear.
								(E)Refusing to pay
				claims without conducting a reasonable investigation.
								(F)Failing to affirm
				or deny coverage of claims within a reasonable period of time after having
				completed an investigation related to those claims.
								(G)A pattern or
				practice of compelling insured individuals or their beneficiaries to institute
				suits to recover amounts due under its policies by offering substantially less
				than the amounts ultimately recovered in suits brought by them.
								(H)A pattern or
				practice of attempting to settle or settling claims for less than the amount
				that a reasonable person would believe the insured individual or his or her
				beneficiary was entitled by reference to written or printed advertising
				material accompanying or made part of an application.
								(I)Attempting to
				settle or settling claims on the basis of an application that was materially
				altered without notice to, or knowledge or consent of, the insured.
								(J)Failing to provide
				forms necessary to present claims within 15 calendar days of a requests with
				reasonable explanations regarding their use.
								(K)Attempting to
				cancel a policy in less time than that prescribed in the policy or by the law
				of the primary State.
								(10)Fraud and
				abuseThe term fraud and abuse means an act or
				omission committed by a person who, knowingly and with intent to defraud,
				commits, or conceals any material information concerning, one or more of the
				following:
								(A)Presenting,
				causing to be presented or preparing with knowledge or belief that it will be
				presented to or by an insurer, a reinsurer, broker or its agent, false
				information as part of, in support of or concerning a fact material to one or
				more of the following:
									(i)An
				application for the issuance or renewal of an insurance policy or reinsurance
				contract.
									(ii)The rating of an
				insurance policy or reinsurance contract.
									(iii)A claim for
				payment or benefit pursuant to an insurance policy or reinsurance
				contract.
									(iv)Premiums paid on
				an insurance policy or reinsurance contract.
									(v)Payments made in
				accordance with the terms of an insurance policy or reinsurance
				contract.
									(vi)A
				document filed with the commissioner or the chief insurance regulatory official
				of another jurisdiction.
									(vii)The financial
				condition of an insurer or reinsurer.
									(viii)The formation,
				acquisition, merger, reconsolidation, dissolution or withdrawal from one or
				more lines of insurance or reinsurance in all or part of a State by an insurer
				or reinsurer.
									(ix)The issuance of
				written evidence of insurance.
									(x)The reinstatement
				of an insurance policy.
									(B)Solicitation or
				acceptance of new or renewal insurance risks on behalf of an insurer reinsurer
				or other person engaged in the business of insurance by a person who knows or
				should know that the insurer or other person responsible for the risk is
				insolvent at the time of the transaction.
								(C)Transaction of the
				business of insurance in violation of laws requiring a license, certificate of
				authority or other legal authority for the transaction of the business of
				insurance.
								(D)Attempt to commit,
				aiding or abetting in the commission of, or conspiracy to commit the acts or
				omissions specified in this paragraph.
								2796.Application of
				law
							(a)In
				GeneralThe covered laws of the primary State shall apply to
				individual health insurance coverage offered by a health insurance issuer in
				the primary State and in any secondary State, but only if the coverage and
				issuer comply with the conditions of this section with respect to the offering
				of coverage in any secondary State.
							(b)Exemptions From
				Covered Laws in a Secondary StateExcept as provided in this
				section, a health insurance issuer with respect to its offer, sale, rating
				(including medical underwriting), renewal, and issuance of individual health
				insurance coverage in any secondary State is exempt from any covered laws of
				the secondary State (and any rules, regulations, agreements, or orders sought
				or issued by such State under or related to such covered laws) to the extent
				that such laws would—
								(1)make unlawful, or
				regulate, directly or indirectly, the operation of the health insurance issuer
				operating in the secondary State, except that any secondary State may require
				such an issuer—
									(A)to pay, on a
				nondiscriminatory basis, applicable premium and other taxes (including high
				risk pool assessments) which are levied on insurers and surplus lines insurers,
				brokers, or policyholders under the laws of the State;
									(B)to register with
				and designate the State insurance commissioner as its agent solely for the
				purpose of receiving service of legal documents or process;
									(C)to submit to an
				examination of its financial condition by the State insurance commissioner in
				any State in which the issuer is doing business to determine the issuer’s
				financial condition, if—
										(i)the State
				insurance commissioner of the primary State has not done an examination within
				the period recommended by the National Association of Insurance Commissioners;
				and
										(ii)any such
				examination is conducted in accordance with the examiners’ handbook of the
				National Association of Insurance Commissioners and is coordinated to avoid
				unjustified duplication and unjustified repetition;
										(D)to comply with a
				lawful order issued—
										(i)in
				a delinquency proceeding commenced by the State insurance commissioner if there
				has been a finding of financial impairment under subparagraph (C); or
										(ii)in a voluntary
				dissolution proceeding;
										(E)to comply with an
				injunction issued by a court of competent jurisdiction, upon a petition by the
				State insurance commissioner alleging that the issuer is in hazardous financial
				condition;
									(F)to participate, on
				a nondiscriminatory basis, in any insurance insolvency guaranty association or
				similar association to which a health insurance issuer in the State is required
				to belong;
									(G)to comply with any
				State law regarding fraud and abuse (as defined in section 2795(10)), except
				that if the State seeks an injunction regarding the conduct described in this
				subparagraph, such injunction must be obtained from a court of competent
				jurisdiction;
									(H)to comply with any
				State law regarding unfair claims settlement practices (as defined in section
				2795(9)); or
									(I)to comply with the
				applicable requirements for independent review under section 2798 with respect
				to coverage offered in the State;
									(2)require any
				individual health insurance coverage issued by the issuer to be countersigned
				by an insurance agent or broker residing in that Secondary State; or
								(3)otherwise
				discriminate against the issuer issuing insurance in both the primary State and
				in any secondary State.
								(c)Clear and
				Conspicuous DisclosureA health insurance issuer shall provide
				the following notice, in 12-point bold type, in any insurance coverage offered
				in a secondary State under this part by such a health insurance issuer and at
				renewal of the policy, with the 5 blank spaces therein being appropriately
				filled with the name of the health insurance issuer, the name of primary State,
				the name of the secondary State, the name of the secondary State, and the name
				of the secondary State, respectively, for the coverage concerned:

									NoticeThis policy is issued by _____ and is
				governed by the laws and regulations of the State of _____, and it has met all
				the laws of that State as determined by that State’s Department of Insurance.
				This policy may be less expensive than others because it is not subject to all
				of the insurance laws and regulations of the State of _____, including coverage
				of some services or benefits mandated by the law of the State of _____.
				Additionally, this policy is not subject to all of the consumer protection laws
				or restrictions on rate changes of the State of _____. As with all insurance
				products, before purchasing this policy, you should carefully review the policy
				and determine what health care services the policy covers and what benefits it
				provides, including any exclusions, limitations, or conditions for such
				services or
				benefits.
									.
							(d)Prohibition on
				Certain Reclassifications and Premium Increases
								(1)In
				generalFor purposes of this section, a health insurance issuer
				that provides individual health insurance coverage to an individual under this
				part in a primary or secondary State may not upon renewal—
									(A)move or reclassify
				the individual insured under the health insurance coverage from the class such
				individual is in at the time of issue of the contract based on the
				health-status related factors of the individual; or
									(B)increase the
				premiums assessed the individual for such coverage based on a health
				status-related factor or change of a health status-related factor or the past
				or prospective claim experience of the insured individual.
									(2)ConstructionNothing
				in paragraph (1) shall be construed to prohibit a health insurance
				issuer—
									(A)from terminating
				or discontinuing coverage or a class of coverage in accordance with subsections
				(b) and (c) of section 2742;
									(B)from raising
				premium rates for all policy holders within a class based on claims
				experience;
									(C)from changing
				premiums or offering discounted premiums to individuals who engage in wellness
				activities at intervals prescribed by the issuer, if such premium changes or
				incentives—
										(i)are disclosed to
				the consumer in the insurance contract;
										(ii)are based on
				specific wellness activities that are not applicable to all individuals;
				and
										(iii)are not
				obtainable by all individuals to whom coverage is offered;
										(D)from reinstating
				lapsed coverage; or
									(E)from retroactively
				adjusting the rates charged an insured individual if the initial rates were set
				based on material misrepresentation by the individual at the time of
				issue.
									(e)Prior Offering
				of Policy in Primary StateA health insurance issuer may not
				offer for sale individual health insurance coverage in a secondary State unless
				that coverage is currently offered for sale in the primary State.
							(f)Licensing of
				Agents or Brokers for Health Insurance IssuersAny State may
				require that a person acting, or offering to act, as an agent or broker for a
				health insurance issuer with respect to the offering of individual health
				insurance coverage obtain a license from that State, with commissions or other
				compensation subject to the provisions of the laws of that State, except that a
				State may not impose any qualification or requirement which discriminates
				against a nonresident agent or broker.
							(g)Documents for
				Submission to State Insurance CommissionerEach health insurance
				issuer issuing individual health insurance coverage in both primary and
				secondary States shall submit—
								(1)to the insurance
				commissioner of each State in which it intends to offer such coverage, before
				it may offer individual health insurance coverage in such State—
									(A)a copy of the plan
				of operation or feasibility study or any similar statement of the policy being
				offered and its coverage (which shall include the name of its primary State and
				its principal place of business);
									(B)written notice of
				any change in its designation of its primary State; and
									(C)written notice
				from the issuer of the issuer’s compliance with all the laws of the primary
				State; and
									(2)to the insurance
				commissioner of each secondary State in which it offers individual health
				insurance coverage, a copy of the issuer’s quarterly financial statement
				submitted to the primary State, which statement shall be certified by an
				independent public accountant and contain a statement of opinion on loss and
				loss adjustment expense reserves made by—
									(A)a member of the
				American Academy of Actuaries; or
									(B)a qualified loss
				reserve specialist.
									(h)Power of Courts
				To Enjoin ConductNothing in this section shall be construed to
				affect the authority of any Federal or State court to enjoin—
								(1)the solicitation
				or sale of individual health insurance coverage by a health insurance issuer to
				any person or group who is not eligible for such insurance; or
								(2)the solicitation
				or sale of individual health insurance coverage that violates the requirements
				of the law of a secondary State which are described in subparagraphs (A)
				through (H) of section 2796(b)(1).
								(i)Power of
				Secondary States To Take Administrative ActionNothing in this
				section shall be construed to affect the authority of any State to enjoin
				conduct in violation of that State’s laws described in section
				2796(b)(1).
							(j)State Powers To
				Enforce State Laws
								(1)In
				generalSubject to the provisions of subsection (b)(1)(G)
				(relating to injunctions) and paragraph (2), nothing in this section shall be
				construed to affect the authority of any State to make use of any of its powers
				to enforce the laws of such State with respect to which a health insurance
				issuer is not exempt under subsection (b).
								(2)Courts of
				competent jurisdictionIf a State seeks an injunction regarding
				the conduct described in paragraphs (1) and (2) of subsection (h), such
				injunction must be obtained from a Federal or State court of competent
				jurisdiction.
								(k)States’
				Authority To SueNothing in this section shall affect the
				authority of any State to bring action in any Federal or State court.
							(l)Generally
				Applicable LawsNothing in this section shall be construed to
				affect the applicability of State laws generally applicable to persons or
				corporations.
							(m)Guaranteed
				Availability of Coverage to HIPAA Eligible IndividualsTo the
				extent that a health insurance issuer is offering coverage in a primary State
				that does not accommodate residents of secondary States or does not provide a
				working mechanism for residents of a secondary State, and the issuer is
				offering coverage under this part in such secondary State which has not adopted
				a qualified high risk pool as its acceptable alternative mechanism (as defined
				in section 2744(c)(2)), the issuer shall, with respect to any individual health
				insurance coverage offered in a secondary State under this part, comply with
				the guaranteed availability requirements for eligible individuals in section
				2741.
							2797.Primary State
				must meet Federal floor before issuer may sell into secondary
				StatesA health insurance
				issuer may not offer, sell, or issue individual health insurance coverage in a
				secondary State if the State insurance commissioner does not use a risk-based
				capital formula for the determination of capital and surplus requirements for
				all health insurance issuers.
						2798.Independent
				external appeals procedures
							(a)Right to
				External AppealA health insurance issuer may not offer, sell, or
				issue individual health insurance coverage in a secondary State under the
				provisions of this title unless—
								(1)both the secondary
				State and the primary State have legislation or regulations in place
				establishing an independent review process for individuals who are covered by
				individual health insurance coverage, or
								(2)in any case in
				which the requirements of subparagraph (A) are not met with respect to the
				either of such States, the issuer provides an independent review mechanism
				substantially identical (as determined by the applicable State authority of
				such State) to that prescribed in the Health Carrier External Review
				Model Act of the National Association of Insurance Commissioners for
				all individuals who purchase insurance coverage under the terms of this part,
				except that, under such mechanism, the review is conducted by an independent
				medical reviewer, or a panel of such reviewers, with respect to whom the
				requirements of subsection (b) are met.
								(b)Qualifications
				of Independent Medical ReviewersIn the case of any independent
				review mechanism referred to in subsection (a)(2)—
								(1)In
				generalIn referring a denial of a claim to an independent
				medical reviewer, or to any panel of such reviewers, to conduct independent
				medical review, the issuer shall ensure that—
									(A)each independent
				medical reviewer meets the qualifications described in paragraphs (2) and
				(3);
									(B)with respect to
				each review, each reviewer meets the requirements of paragraph (4) and the
				reviewer, or at least 1 reviewer on the panel, meets the requirements described
				in paragraph (5); and
									(C)compensation
				provided by the issuer to each reviewer is consistent with paragraph
				(6).
									(2)Licensure and
				expertiseEach independent medical reviewer shall be a physician
				(allopathic or osteopathic) or health care professional who—
									(A)is appropriately
				credentialed or licensed in 1 or more States to deliver health care services;
				and
									(B)typically treats
				the condition, makes the diagnosis, or provides the type of treatment under
				review.
									(3)Independence
									(A)In
				generalSubject to subparagraph (B), each independent medical
				reviewer in a case shall—
										(i)not be a related
				party (as defined in paragraph (7));
										(ii)not have a
				material familial, financial, or professional relationship with such a party;
				and
										(iii)not otherwise
				have a conflict of interest with such a party (as determined under
				regulations).
										(B)ExceptionNothing
				in subparagraph (A) shall be construed to—
										(i)prohibit an
				individual, solely on the basis of affiliation with the issuer, from serving as
				an independent medical reviewer if—
											(I)a non-affiliated
				individual is not reasonably available;
											(II)the affiliated
				individual is not involved in the provision of items or services in the case
				under review;
											(III)the fact of such
				an affiliation is disclosed to the issuer and the enrollee (or authorized
				representative) and neither party objects; and
											(IV)the affiliated
				individual is not an employee of the issuer and does not provide services
				exclusively or primarily to or on behalf of the issuer;
											(ii)prohibit an
				individual who has staff privileges at the institution where the treatment
				involved takes place from serving as an independent medical reviewer merely on
				the basis of such affiliation if the affiliation is disclosed to the issuer and
				the enrollee (or authorized representative), and neither party objects;
				or
										(iii)prohibit receipt
				of compensation by an independent medical reviewer from an entity if the
				compensation is provided consistent with paragraph (6).
										(4)Practicing
				health care professional in same field
									(A)In
				generalIn a case involving treatment, or the provision of items
				or services—
										(i)by
				a physician, a reviewer shall be a practicing physician (allopathic or
				osteopathic) of the same or similar specialty, as a physician who, acting
				within the appropriate scope of practice within the State in which the service
				is provided or rendered, typically treats the condition, makes the diagnosis,
				or provides the type of treatment under review; or
										(ii)by a
				non-physician health care professional, the reviewer, or at least 1 member of
				the review panel, shall be a practicing non-physician health care professional
				of the same or similar specialty as the non-physician health care professional
				who, acting within the appropriate scope of practice within the State in which
				the service is provided or rendered, typically treats the condition, makes the
				diagnosis, or provides the type of treatment under review.
										(B)Practicing
				definedFor purposes of this paragraph, the term
				practicing means, with respect to an individual who is a physician
				or other health care professional, that the individual provides health care
				services to individual patients on average at least 2 days per week.
									(5)Pediatric
				expertiseIn the case of an external review relating to a child,
				a reviewer shall have expertise under paragraph (2) in pediatrics.
								(6)Limitations on
				reviewer compensationCompensation provided by the issuer to an
				independent medical reviewer in connection with a review under this section
				shall—
									(A)not exceed a
				reasonable level; and
									(B)not be contingent
				on the decision rendered by the reviewer.
									(7)Related party
				definedFor purposes of this section, the term related
				party means, with respect to a denial of a claim under a coverage
				relating to an enrollee, any of the following:
									(A)The issuer
				involved, or any fiduciary, officer, director, or employee of the
				issuer.
									(B)The enrollee (or
				authorized representative).
									(C)The health care
				professional that provides the items or services involved in the denial.
									(D)The institution at
				which the items or services (or treatment) involved in the denial are
				provided.
									(E)The manufacturer
				of any drug or other item that is included in the items or services involved in
				the denial.
									(F)Any other party
				determined under any regulations to have a substantial interest in the denial
				involved.
									(8)DefinitionsFor
				purposes of this subsection:
									(A)EnrolleeThe
				term enrollee means, with respect to health insurance coverage
				offered by a health insurance issuer, an individual enrolled with the issuer to
				receive such coverage.
									(B)Health care
				professionalThe term health care professional means
				an individual who is licensed, accredited, or certified under State law to
				provide specified health care services and who is operating within the scope of
				such licensure, accreditation, or certification.
									2799.Enforcement
							(a)In
				GeneralSubject to subsection (b), with respect to specific
				individual health insurance coverage the primary State for such coverage has
				sole jurisdiction to enforce the primary State’s covered laws in the primary
				State and any secondary State.
							(b)Secondary
				State’s AuthorityNothing in subsection (a) shall be construed to
				affect the authority of a secondary State to enforce its laws as set forth in
				the exception specified in section 2796(b)(1).
							(c)Court
				InterpretationIn reviewing action initiated by the applicable
				secondary State authority, the court of competent jurisdiction shall apply the
				covered laws of the primary State.
							(d)Notice of
				Compliance FailureIn the case of individual health insurance
				coverage offered in a secondary State that fails to comply with the covered
				laws of the primary State, the applicable State authority of the secondary
				State may notify the applicable State authority of the primary
				State.
							.
			(b)Effective
			 DateThe amendment made by subsection (a) shall apply to
			 individual health insurance coverage offered, issued, or sold after the date
			 that is one year after the date of the enactment of this Act.
			(c)GAO Ongoing
			 Study and Reports
				(1)StudyThe
			 Comptroller General of the United States shall conduct an ongoing study
			 concerning the effect of the amendment made by subsection (a) on—
					(A)the number of
			 uninsured and under-insured;
					(B)the availability
			 and cost of health insurance policies for individuals with pre-existing medical
			 conditions;
					(C)the availability
			 and cost of health insurance policies generally;
					(D)the elimination or
			 reduction of different types of benefits under health insurance policies
			 offered in different States; and
					(E)cases of fraud or
			 abuse relating to health insurance coverage offered under such amendment and
			 the resolution of such cases.
					(2)Annual
			 reportsThe Comptroller General shall submit to Congress an
			 annual report, after the end of each of the 5 years following the effective
			 date of the amendment made by subsection (a), on the ongoing study conducted
			 under paragraph (1).
				6.SeverabilityIf any provision of the Act or the
			 application of such provision to any person or circumstance is held to be
			 unconstitutional, the remainder of this Act and the application of the
			 provisions of such to any other person or circumstance shall not be
			 affected.