,i  #aad? ,,congress  #b;d ,session  ,h4
 ,r4 #dhja  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,m>* #ag1 #bjaf ,ms4  
,mi*elle ,lujan ,gri%am ( ,new ,mexico  
7= h]self & ,ms4 ,s*ak[sky7 introduc$ ! 
foll[+ bill2 :i* 0 ref]r$ to !          
,committee on ,en]gy & ,comm]ce1 & 9    
addition to ! ,committee on ,ways &     
,means1 = a p]iod to be subsequ5tly     
det]m9$ by ! ,speak]1 9 ea* case =      
consid]ation ( su* provisions z fall )9 
! jurisdiction ( ! committee conc]n$  ,a
 ,,bill  ,to am5d title ,,xxvii ( !     
,public ,heal? ,s]vice ,act1 & title    
,,xviii ( ! ,social ,security ,act1 to  
direct ! ,secret>y ( ,heal? & ,human    
,s]vices to conduct audits ( m$ical loss
 ratio reports submitt$ by heal?        
insurance issu]s1 & = o!r purposes4  #a4
 ,%ort title ,?is ,act may be cit$ z !  
,m$ical ,loss ,ratio ,acc\ntability ,act
 ( #bjaf4  #b4 ,audits ( m$ical loss    
ratio reports submitt$ ) respect to gr\p
 or individual heal? insurance cov]age  
,section #bgah ( ! ,public ,heal?       

,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#ah7
 is am5d$--  7#a7 9 subsection 7b77#c71 
by ins]t+ 1 includ+ ) respect to !      
submission ( any in=mation t1 pursuant  
to an audit conduct$ "u subsection 7f71 
is f\nd to be untru?ful or inaccurate   
aft] p5alties2 &  7#b7 by add+ at ! end 
! foll[+ new subsection3  7f7 ,audits   
7#a7 ,9 g5]al ,beg9n+ ) ! fir/ plan ye> 
t beg9s aft] ! date ( ! enactm5t ( !    
,m$ical ,loss ,ratio ,acc\ntability ,act
 ( #bjaf1 ! ,secret>y %all1 ) respect to
 a /ati/ically significant p]c5tage ( ! 
reports submitt$ "u ?is section by heal?
 insurance issu]s (f]+ gr\p or          
individual heal? insurance cov]age      
7includ+ gr&fa!r$ heal? plans71 conduct 
audits ( ! books & records 7or su* o!r  
in=mation z may be necess>y7 ( su* heal?
 insurance issu]s to v]ify t ! in=mation
 conta9$ 9 ea* su* report is tru?ful &  
accurate4  7#b7 ,selection ( reports =  
audits ,9 select+ reports to be audit$  
"u p>agraph 7#a71 ! ,secret>y %all      
ensure t1 = a plan ye>1 ! heal?         

insurance issu]s ^: reports are select$ 
= su* audits are repres5tative ( ! heal?
 insurance issu]s t submitt$ su* reports
 = su* plan ye>4  7#c7 ,au?ority to ent]
 into contracts or coop]ative agreem5ts 
,! ,secret>y may1 = purposes ( conduct+ 
audits "u p>agraph 7#a71 ent] into a    
contract or coop]ative agreem5t ) a     
private entity4  7#d7 ,report to        
,congress ,beg9n+ #ah mon?s aft] ! date 
( ! enactm5t ( ! ,m$ical ,loss ,ratio   
,acc\ntability ,act ( #bjaf & ea* ye>   
!reaft]1 ! ,secret>y %all submit to     
,congress a report on ! results ( audits
 conduct$ "u ?is section ) respect to ! 
previ\s plan ye>4  4  #c4 ,application  
to p>ts ,c & ,d ( ! ,m$ic>e program     
,section #aheg7;e77#d7 ( ! ,social      
,security ,act 7#db ,u4,s4,c4           
#aciew-#bg7;e77#d77 is am5d$ by add+ at 
! end ! foll[+ new flu% s5t5ce3  ,9 !   
case t audits h be5 conduct$ by !       
,secret>y 7su* z ! audits conduct$ "u   
section #bgah7;f7 ( ! ,public ,heal?    
,s]vice ,act7 ( ! books & records 7or ( 

su* o!r in=mation z may be necess>y7 (  
an ,,ma plan = a contract ye> t beg9s on
 or aft] ! date ( ! enactm5t ( ! ,m$ical
 ,loss ,ratio ,acc\ntability ,act (     
#bjaf1 a det]m9ation t is made "u ?is   
p>agraph = su* ,,ma plan = su* contract 
ye> %all be bas$ ^u "o or m reports 7or 
o!r submissions ( in=mation7 by ! ,,ma  
plan ) respect to :i* ! ,secret>y has   
v]ifi$1 ?r\gh su* audits ( su* ,,ma     
plan1 t ! in=mation conta9$ 9 su*       
reports 7or o!r submissions7 is tru?ful 
& accurate4 4