,i  #aafth ,,congress  #ast ,session    
,h4 ,r4 #ddeg  ,,in ,,the ,,house ,,of  
,,representatives  ,september #bd1      
#bjai,ms4 ,underwood introduced the     
following bill2 which was referred to   
the ,committee on ,energy and ,commerce1
 and in addition to the ,committees on  
,education and ,labor1 and ,ways and    
,means1 for a period to be subsequently 
determined by the ,speaker1 in each case
 for consideration of such provisions as
 fall within the jurisdiction of the    
committee concerned  ,a ,,bill  ,to     
amend the ,employee ,retirement ,income 
,security ,act of #aigd1 title ,,xxvii  
of the ,public ,health ,service ,act1   
and the ,internal ,revenue ,code of     
#aihf to require group health plans and 
health insurance issuers offering group 
or individual health insurance coverage 
to provide coverage for additional      
preventive care for individuals with    
chronic conditions without the          
imposition of cost sharing requirement1 
and for other purposes4  #a4 ,short     

title ,this ,act may be cited as the    
,chronic ,condition ,copay ,elimination 
,act4  #b4 ,coverage of additional      
preventive care for individuals with    
chronic conditions without imposition of
 cost sharing requirements  7a7 ,,erisa 
7#a7 ,in general ,subpart ,b of part #g 
of subtitle ,b of title ,i of the       
,employee ,retirement ,income ,security 
,act of #aigd 7#bi ,u4,s4,c4 #aahe et   
seq47 is amended by adding at the end   
the following new section3  #gaf4       
,coverage of additional preventive care 
for individuals with chronic conditions 
without imposition of cost sharing      
requirements  7a7 ,in general ,in       
addition to any item or service         
described in section #bgac7;a7 of the   
,public ,health ,service ,act1 a group  
health plan and a health insurance      
issuer offering group health insurance  
coverage shall1 at a minimum1 provide   
coverage for1 and shall not impose any  
cost sharing requirements for1 with     
respect to individuals with chronic     

conditions 7as defined in subsection    
7b771 such additional preventive care   
and screenings not described in         
paragraph 7#a7 of such section #bgac7;a7
 that are determined by the ,secretary  
to meet the criteria specified in       
subsection 7c7 with respect to the      
chronic condition involved4  7b7        
,chronic condition defined ,in this     
section1 the term chronic condition has 
the meaning given such term by the      
,secretary and1 at a minimum1 includes  
the following conditions3  7#a7 ,heart  
disease1 including congestive heart     
failure and coronary artery disease4    
7#b7 ,diabetes4  7#c7 ,osteoporosis and 
osteopenia4  7#d7 ,hypertension4  7#e7  
,asthma4  7#f7 ,liver disease4  7#g7    
,bleeding disorders4  7#h7 ,depression4 
7c7 ,criteria specified ,for purposes of
 subsection 7a71 the criteria specified 
in this subsection1 with respect to an  
item or service and a chronic condition1
 are the following3  7#a7 ,the item or  
service is low-cost4  7#b7 ,there is    

medical evidence supporting high-cost   
efficiency1 or a large expected impact1 
of the item or service in preventing    
exacerbation of the chronic condition or
 the development of a secondary         
condition4  7#c7 ,there is a strong     
likelihood1 documented by clinical      
evidence1 that the item or service will 
prevent the exacerbation of the chronic 
condition or the development of a       
secondary condition that requires       
significantly higher-cost treatments4   
7d7 ,updates  7#a7 ,in general ,once    
every three years1 the ,secretary shall 
review and update-- 7,a7 the list of    
conditions included within the meaning  
of the term chronic condition under     
subsection 7b72 and  7,b7 the items and 
services determined to meet the criteria
 specified in subsection 7c7 for        
purposes of subsection 7a74  7#b7       
,application of updates ,the requirement
 under subsection 7a7 shall apply with  
respect to an update made under         
paragraph 7#a7 beginning with the first 

plan year beginning after the date of   
such update4  4  7#b7 ,clerical         
amendment ,the table of contents in     
section #a of such ,act is amended by   
inserting after the item relating to    
section #gad the following new items3   
#gae4 ,additional market reforms4 #gaf4 
,coverage of additional preventive care 
for individuals with chronic conditions 
without imposition of cost sharing      
requirements4  4  7b7 ,,phsa ,subpart   
,,ii of part ,a of title ,,xxvii of the 
,public ,health ,service ,act 7#db      
,u4,s4,c4 #cjj;gg-#aa et seq47 is       
amended by adding at the end the        
following new section3  #bgcj4 ,coverage
 of additional preventive care for      
individuals with chronic conditions     
without imposition of cost sharing      
requirements  7a7 ,in general ,in       
addition to any item or service         
described in section #bgac7;a71 a group 
health plan and a health insurance      
issuer offering group or individual     
health insurance coverage shall1 at a   

minimum1 provide coverage for1 and shall
 not impose any cost sharing            
requirements for1 with respect to       
individuals with chronic conditions 7as 
defined in subsection 7b771 such        
additional preventive care and          
screenings not described in paragraph   
7#a7 of section #bgac7;a7 that are      
determined by the ,secretary to meet the
 criteria specified in subsection 7c7   
with respect to the chronic condition   
involved4  7b7 ,chronic condition       
defined ,in this section1 the term      
chronic condition has the meaning given 
such term by the ,secretary and1 at a   
minimum1 includes the following         
conditions3  7#a7 ,heart disease1       
including congestive heart failure and  
coronary artery disease4  7#b7          
,diabetes4  7#c7 ,osteoporosis and      
osteopenia4  7#d7 ,hypertension4  7#e7  
,asthma4  7#f7 ,liver disease4  7#g7    
,bleeding disorders4  7#h7 ,depression4 
7c7 ,criteria specified ,for purposes of
 subsection 7a71 the criteria specified 

in this subsection1 with respect to an  
item or service and a chronic condition1
 are the following3  7#a7 ,the item or  
service is low-cost4  7#b7 ,there is    
medical evidence supporting high-cost   
efficiency1 or a large expected impact1 
of the item or service in preventing    
exacerbation of the chronic condition or
 the development of a secondary         
condition4  7#c7 ,there is a strong     
likelihood1 documented by clinical      
evidence1 that the item or service will 
prevent the exacerbation of the chronic 
condition or the development of a       
secondary condition that requires       
significantly higher-cost treatments4   
7d7 ,updates  7#a7 ,in general ,once    
every three years1 the ,secretary shall 
review and update-- 7,a7 the list of    
conditions included within the meaning  
of the term chronic condition under     
subsection 7b72 and  7,b7 the items and 
services determined to meet the criteria
 specified in subsection 7c7 for        
purposes of subsection 7a74  7#b7       

,application of updates ,the requirement
 under subsection 7a7 shall apply with  
respect to an update made under         
paragraph 7#a7 beginning with the first 
plan year beginning after the date of   
such update4  4  7c7 ,,irc  7#a7 ,in    
general ,subchapter ,b of chapter #ajj  
of subtitle ,k of the ,internal ,revenue
 ,code of #aihf is amended by adding at 
the end the following new section3      
#ihaf4 ,coverage of additional          
preventive care for individuals with    
chronic conditions without imposition of
 cost sharing requirements  7a7 ,in     
general ,in addition to any item or     
service described in section #bgac7;a7  
of the ,public ,health ,service ,act1 a 
group health plan shall1 at a minimum1  
provide coverage for1 and shall not     
impose any cost sharing requirements    
for1 with respect to individuals with   
chronic conditions 7as defined in       
subsection 7b771 such additional        
preventive care and screenings not      
described in paragraph 7#a7 of such     

section #bgac7;a7 that are determined by
 the ,secretary to meet the criteria    
specified in subsection 7c7 with respect
 to the chronic condition involved4  7b7
 ,chronic condition defined ,in this    
section1 the term chronic condition has 
the meaning given such term by the      
,secretary and1 at a minimum1 includes  
the following conditions3  7#a7 ,heart  
disease1 including congestive heart     
failure and coronary artery disease4    
7#b7 ,diabetes4  7#c7 ,osteoporosis and 
osteopenia4  7#d7 ,hypertension4  7#e7  
,asthma4  7#f7 ,liver disease4  7#g7    
,bleeding disorders4  7#h7 ,depression4 
7c7 ,criteria specified ,for purposes of
 subsection 7a71 the criteria specified 
in this subsection1 with respect to an  
item or service and a chronic condition1
 are the following3  7#a7 ,the item or  
service is low-cost4  7#b7 ,there is    
medical evidence supporting high-cost   
efficiency1 or a large expected impact1 
of the item or service in preventing    
exacerbation of the chronic condition or

 the development of a secondary         
condition4  7#c7 ,there is a strong     
likelihood1 documented by clinical      
evidence1 that the item or service will 
prevent the exacerbation of the chronic 
condition or the development of a       
secondary condition that requires       
significantly higher-cost treatments4   
7d7 ,updates  7#a7 ,in general ,once    
every three years1 the ,secretary shall 
review and update-- 7,a7 the list of    
conditions included within the meaning  
of the term chronic condition under     
subsection 7b72 and  7,b7 the items and 
services determined to meet the criteria
 specified in subsection 7c7 for        
purposes of subsection 7a74  7#b7       
,application of updates ,the requirement
 under subsection 7a7 shall apply with  
respect to an update made under         
paragraph 7#a7 beginning with the first 
plan year beginning after the date of   
such update4  4  7#b7 ,clerical         
amendment ,the table of contents for    
subchapter ,b of chapter #ajj of        

subtitle ,k of such ,code is amended by 
adding at the end the following new     
item3  #ihaf4 ,coverage of additional   
preventive care for individuals with    
chronic conditions without imposition of
 cost sharing requirements4  4  7#c7    
,high deductible health plans ,section  
#bbc7;c77#b77;,c7 of the ,internal      
,revenue ,code of #aihf is amended by   
inserting or for additional preventive  
care for individuals with chronic       
conditions described in section #ihaf   
before the period4  7d7 ,effective date 
,the amendments made by this section    
shall apply with respect to plan years  
beginning on or after the date that is  
one year after the date of the enactment
 of this ,act4