,i #aafth ,,congress #b;d ,session ,h4 ,r4 #fijf ,,in ,,the ,,house ,,of ,,representatives ,may #ae1 #bjbj,ms4 ,jayapal 7for herself1 ,ms4 ,bass1 ,ms4 ,bonamici1 ,mr4 ,de,fazio1 ,mrs4 ,dingell1 ,mr4 ,espaillat1 ,mr4 ,garca of ,illinois1 ,mr4 ,kennedy1 ,mr4 ,khanna1 ,ms4 ,meng1 ,ms4 ,norton1 ,ms4 ,ocasio-,cortez1 ,ms4 ,omar1 ,mr4 ,pocan1 ,ms4 ,pressley1 ,mr4 ,raskin1 ,ms4 ,tlaib1 ,mr4 ,cohen1 and ,mr4 ,blumenauer7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committees on ,ways and ,means1 ,veterans' ,affairs1 ,armed ,services1 ,oversight and ,reform1 and ,natural ,resources1 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 provide reimbursements for certain costs of health care items and services1 including prescription drugs1 furnished during the public health emergency declared with respect to ,,covid-#ai4 #a4 ,short title ,this ,act may be cited as the ,health ,care ,emergency ,guarantee ,act4 #b4 ,reimbursements for certain costs of health care items and services including prescription drugs furnished during public health emergency 7a7 ,in general ,during the period beginning on the date of enactment of this ,act and ending on the date the ,secretary certifies to ,congress that a vaccine approved by the ,food and ,drug ,administration for ,,covid-#ai is widely available to the public1 the ,secretary shall make payments to qualified providers with respect to applicable health care items and services as defined in subsection 7b7 that are furnished to an applicable individual an amount equal to-- 7#a7 in the case of any portion of such period in which an applicable individual is enrolled in a public or private health insurance plan1 the amount of any cost-sharing1 including any deductibles1 copayments1 coinsurance or similar charges1 that would otherwise be applicable under such plan1 including with respect to prescription drug coverage under the plan2 and 7#b7 in the case of any portion of such period in which an applicable individual is uninsured1 an amount equal to the amount that would be paid to the qualified provider for the same or equivalent items or services1 including with respect to any inpatient or physician-administered drugs 7and excluding outpatient prescription drugs or biologicals with respect to which coverage is provided under subsection 7e771 under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 7b7 ,applicable health care items and services2 applicable individual defined ,in this section3 7#a7 ,applicable health care items and services ,the term applicable health care items and services means1 with respect to an applicable individual1 any health care items and services that are medically necessary or appropriate for the maintenance of health or for the diagnosis1 treatment1 or rehabilitation of a health condition of the applicable individual1 including-- 7,a7 any testing services and treatments for ,,covid-#ai or related complications1 including vaccines1 diagnostic tests1 drugs and biologicals1 and therapies2 and 7,b7 in the case of an applicable individual who is enrolled in a public or private health insurance plan1 any health care items and services covered by such plan as of ,march #a1 #bjbj1 or in the case of an applicable individual who enrolls in such plan after the date1 any health care items and services covered by such plan as of the date of such enrollment4 7#b7 ,applicable individual ,the term applicable individual means an individual who is a resident of the ,united ,states4 7c7 ,requirements 7#a7 ,no effect on applicable cost-sharing requirements ,nothing in this section shall affect the application of any requirements applicable under ,federal or ,state law with respect to coverage of health care items and services without any cost-sharing4 7#b7 ,maintenance of ,effort 7,a7 ,in general ,during the period described in subsection 7a71 a public or private health plan shall not increase cost-sharing1 decrease benefits1 or otherwise make coverage less generous than the benefits offered on the date of enactment of this ,act4 7,b7 ,new ,items and ,services ,during such period1 a public or private health plan shall provide coverage of new items and services1 including those related to ,,covid-#ai1 as appropriate1 at a minimum1 at a level consistent with the prior coverage practices and formularies of the plan4 7#c7 ,limitation on out-of-pocket expenses ,during such period1 in order to be eligible to receive payments under this section1 a qualified provider shall agree not to impose on an applicable individual any charge for applicable health care items and services furnished to the applicable individual4 7#d7 ,permissible billing of plans2 limitation on balance billing ,during such period1 in order to be eligible to receive payments under this section1 a qualified provider shall agree1 with respect to applicable health care items and services furnished to an applicable individual when such individual is enrolled in a public or private health insurance plan-- 7,a7 not to impose any charge on the plan for such items and services beyond the amount otherwise payable by the plan2 and 7,b7 not to bill the applicable individual for any amounts in excess of the amount described in subparagraph 7,a74 7#e7 ,medical debt collection ,a qualified provider shall agree-- 7,a7 to immediately halt all medical debt collection1 including collection activities carried out by third parties1 during such period and shall not collect medical debt or have third parties collect medical debt for applicable health care items and services furnished during such period2 and 7,b7 to refrain from pursuing medical debt collection1 including collection activities carried out by third parties1 after such period with respect to items and services related to the diagnosis or treatment of ,,covid-#ai 7regardless of whether such services were furnished before1 during1 or after such period7 and shall not collect medical debt or have third parties collect medical debt for such items or services after such period4 7#f7 ,submission of bills and documentation ,a qualified provider shall agree to submit bills and any required supporting documentation relating to the provision of applicable health care items and services within #cj days after the date of providing such services1 in such manner as the ,secretary determines appropriate4 7d7 ,waiver of late enrollment penalties under ,medicare ,during the period described in subsection 7a71 no increase in the monthly premium of an individual pursuant to section #ahah7;c71 #ahci7;b71 or #ahfj;,d-#ac of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;i-#b7;c71 #acier7b71 #aciew-#aac7 shall be effected in the case of any individual who enrolls for benefits under title ,,xviii of such ,act with respect to any period prior to the date of such enrollment4 7e7 ,coverage with respect to outpatient prescription drugs 7#a7 ,in general ,during the period described in subsection 7a71 with respect to outpatient prescription drugs or biologicals described in subsection 7b77#a77;,a7 that are dispensed to uninsured individuals1 the ,secretary shall establish procedures under which-- 7,a7 such drugs or biologicals are dispensed at no cost to such individuals2 7,b7 pharmacies that dispense such drugs or biologicals-- 7i7 are reimbursed by the ,secretary for such drugs or biologicals dispensed to such individuals at an amount equal to the price paid by the ,secretary of ,veterans ,affairs to procure the drug or biological under the laws administered by the ,secretary of ,veterans ,affairs2 and 7ii7 agree not to charge such individuals for any difference between the amount reimbursed under clause 7i7 and the cost to the pharmacy for the drug2 and 7,c7 manufacturers of such drugs or biologicals reimburse pharmacies for any difference described in subparagraph 7,b77ii7 with respect to drugs or biologicals of the manufacturer that are dispensed to such individuals4 7#b7 ,condition of coverage under ,medicare ,during the period described in subsection 7a71 no coverage may be provided under part ,b or ,d of title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;j et seq41 #aciew-#aja et seq47 with respect to a drug or biological of a manufacturer if the manufacturer does not enter into an agreement with the ,secretary to carry out the requirements applicable with respect to such manufacturers under this subsection4 7#c7 ,requirement for participating pharmacies ,during the period described in subsection 7a71 a prescription drug plan under part ,d of title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#aja et seq47 may not contract with a pharmacy if the pharmacy does not enter into an agreement with the ,secretary to carry out the requirements applicable with respect to pharmacies under this subsection4 7f7 ,other definitions 7#a7 ,public or private health insurance plan 7,a7 ,in general ,the term public or private health insurance plan means any of the following3 7i7 ,a group health plan1 or group health insurance coverage1 as such terms are defined in section #bgia of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ia74 7ii7 ,a qualified health plan1 as defined in section #acja of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjba74 7iii7 ,subject to subparagraph 7,b71 any health insurance coverage 7other than a plan described in clause 7ii77 offered in the individual market1 as such terms are defined in section #bgia of the ,public ,health ,service ,act1 including any short-term limited duration insurance4 7iv7 ,a health plan offered under chapter #hi of title #e1 ,united ,states ,code4 7v7 ,a ,federal health care program 7as defined under section #aabh;,b7f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;b7f771 including-- 7,i7 health benefits furnished under the ,,tricare program 7as defined in section #ajgb of title #aj1 ,united ,states ,code72 7,,ii7 health benefits furnished to veterans under the laws administered by the ,secretary of ,veterans ,affairs2 and 7,,iii7 health benefits furnished to ,indians 7as defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 receiving health services through the ,indian ,health ,service1 including through an ,urban ,indian ,organization1 regardless of whether such benefits are for items or services that have been authorized under the purchased_/referred care system funded by the ,indian ,health ,service or are covered as a health service of the ,indian ,health ,service4 7,b7 ,limitation on individual health insurance coverage ,the term public or private health insurance coverage includes the health insurance coverage described in clause 7iii7 of subparagraph 7,a7 only with respect to an individual who is enrolled in such coverage on ,march #a1 #bjbj4 7#b7 ,qualified provider ,the term qualified provider means a health care provider who is a participating provider under the ,medicare program under title ,,xviii of the ,social ,security ,act 7#db ,u4,s4,c4 #acie et seq474 ,such term includes a health care provider who is not a participating provider under such program if the health care provider would meet the criteria for such participation and1 if the ,state requires the health care provider to be licensed by the ,state1 is licensed by the ,state in which the items or services are furnished4 7#c7 ,secretary ,the term ,secretary means the ,secretary of ,health and ,human ,services4 7g7 ,implementation 7#a7 ,in general ,the ,secretary1 in coordination with the ,secretary of the ,treasury1 the ,commissioner of ,social ,security1 and the ,secretary of ,labor1 shall implement the provisions of this section not later than the date that is #g days after the date of the enactment of this ,act4 7#b7 ,ensuring timely payment ,the ,secretary shall establish a process and issue such guidance as is necessary to ensure a qualified provider receives payments under this section in a timely manner4 7#c7 ,ensuring collection of data on disparities ,the ,secretary shall implement this section in a manner and issue such guidance as is necessary to allow for the ongoing1 accurate1 and timely collection and analysis of data on disparities in accordance with subsection 7h74 7h7 ,collection of data on disparities 7#a7 ,in ,general ,during the period described in subsection 7a71 the ,secretary shall collect data on disparities across race1 ethnicity1 primary language1 gender1 sexual orientation1 disability status1 age1 geographic area1 insurance status1 and socioeconomic status-- 7,a7 in health outcomes and access to heath care related to the ,,covid-#ai outbreak1 including data on ,,covid-#ai cases1 treatment1 and deaths2 and 7,b7 in patient access to applicable health care items and services under this section4 7#b7 ,public availability ,the ,secretary shall-- 7,a7 make data collected under this subsection publicly available on the internet website of the ,department of ,health and ,human ,services as soon as is practicable1 but not later than #cj days after the date of enactment of this ,act1 in a manner that allows researchers1 scholars1 health care providers1 and others to access and analyze such data1 without compromising patient privacy2 and 7,b7 update such data on a weekly basis thereafter for the duration of the period described in subsection 7a74 7i7 ,weekly reports to ,congress 7#a7 ,in general ,on a weekly basis during the period described in subsection 7a71 the ,secretary shall report to ,congress on-- 7,a7 the implementation of this section1 including information on the amount1 type1 and geographic distribution of payments to qualified providers under this section2 and 7,b7 any disparities in health and access to health care related to the ,,covid-#ai outbreak or patient access to applicable health care items and services under this section1 as identified through the collection and analysis of data collected under subsection 7h74 7#b7 ,public availability ,the ,secretary shall make each report submitted under paragraph 7#a7 publicly available on the internet website of the ,department of ,health and ,human ,services4 7j7 ,funding ,there are authorized to be appropriated such sums as are necessary to carry out this section4