Subtitle E - Governance
Sec. 141: Health Choices Administration; Health Choices Commissioner
There will be an independent executive agency called the Health Choices Administration. The head of the agency is the Commissioner, and will be appointed by the president with the advice and consent of Congress. The Health Choices Administration and Commissioner will be compensated in a similar way to Social Security and its administrator.
Sec. 142: Duties and Authority of Commissioner
The Commissioner will enforce the qualified health benefit standards, establish and operate the health insurance exchange, administrate individual affordability credits and determine eligibility for credits, promote accountability from qualified health care providers, perform compliance examinations and audits, and compensate for the costs of those examinations and audits. The Commissioner will also collect data, and remedy violations made by qualified health care providers. These remedies include civil money penalties, suspension of enrollment, suspension of payment of premiums to the offender, and work to prevent further violation.
The Commissioner will also provide definitions for terms used in health insurance coverage, and work to maintain efficiency in the exchange market and affordability credits.
Sec. 143: Consultation and Coordination
The Commissioner will consult with, when necessary, the National Association of Insurance Commissioners, state attorney generals, and state insurance providers over the standards of qualified health care and enforcement of those standards. The Commissioner will also consult with state agencies concerned with affordability credits, other appropriate Federal agencies, Indian tribes and tribal organizations, and the NAIC to form guidelines concerning the enforcement of Subtitles B and D.
The Commissioner will cooperate with federal and state agencies to ensure maximum operation and prevent conflicts of interest and achieve uniform standards to protect consumers and still prevent unreasonable effects on employers and providers.
Sec. 144: Health Insurance Ombudsman
The Commissioner will appoint an ombudsman for qualified health care providers. This ombudsman will have expertise and experience in health care fields and education of individuals. The ombudsman will recieve complaints, grievances, and requests for information, and provide assistance to solve those problems or provide that information. The ombudsman will submit an annual report to the Commissioner and Congress describing their annual activities and making recommendations to improve the administration of the Health Choices Administration. The ombudsman can identify issues and problems in payment and coverage.
Subtitle F - Relation to Other Requirements; Miscellaneous
Sec. 151: Relation to Other Requirements
Health insurance plans not offered through the exchange market or employer-provided plans must at least adhere to the Public Health Service Act, the Employee Retirement Income Security Act, and state law, except when those acts interfere with the explicit requirements mentioned in earlier subtitles, as determined by the Commissioner.
Coverage offered through the exchange market must adhere to title XXVII of the Public Health Service Act or state law, except when those titles and laws interfere with the explicit requirements mentioned in earlier subtitles, as determined by the Commissioner
Sec. 152: Prohibiting Discrimination in Health Care
All health care and related services covered by this act will be provided regardless of personal characteristics unrelated to the provision of quality health care, except for those explicitly permitted in this act or by subesquent regulations as a result of this act. Regulations to prohibit this discrimination will be established no later than 18 months after the enactment of this bill.
Sec. 153: Whistleblower Protection
Employers may not dismiss or discriminate against employees because the employee provided or is about to provide information to the employer, state or federal agencies about a violation of the act or any order or rule established as a result of the act, testified or is about to testify in a proceeding dealing with a violation, or objected to or refused to participate in a task that violates the act.
An employer who alleges discrimination or was dismissed for these reasons may bring an action goverened by the rules set forth by the Consumer Product Safety Act and section 20109(h) of title 49 of the United States Code.
Sec. 154: Construction Regarding Collective Bargaining
Statutory or other obligations to engage in collective bargaining over the terms and conditions of employment related to health care will not be superseded by this subtitle.
Sec. 155: Severability
If any provision of this act or application of provisions to persons or circumstances is found to be unconsititutional, the remainder of the provisions and application of those provisions will not be affected.
Section G tomorrow.
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