,i  #aaf? ,,congress  #b;d ,session  ,h4
 ,r4 #gbfg  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,june #ah1 #bjbj ,ms4 
,port] 7= h]self & ,ms4 ,de,lauro7      
introduc$ ! foll[+ bill2 :i* 0 ref]r$ to
 ! ,committee on ,en]gy & ,comm]ce1 & 9 
addition to ! ,committees on ,ways &    
,means1 & ,education & ,labor1 = 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 ! ,employee ,retirem5t ,income   
,security ,act ( #aigd1 & ! ,int]nal    
,rev5ue ,code ( #aihf to prohibit a gr\p
 heal? plan & a heal? insurance issu]   
(f]+ gr\p or individual heal? insurance 
cov]age f r$uc+ contract$ rates1 or     
t]m9at+ contracts1 ) heal? c>e provid]s 
dur+ a public heal? em]g5cy4  #a4 ,%ort 
title ,?is ,act may be cit$ z ! ,pati5ts
 ,be=e ,pr(its ,act ( #bjbj4  #b4       
,prohibit+ a gr\p heal? plan & a heal?  
insurance issu] (f]+ gr\p or individual 

heal? insurance cov]age f r$uc+         
contract$ rates1 or t]m9at+ contracts1 )
 heal? c>e provid]s dur+ a public heal? 
em]g5cy  7a7 ,,phsa ,subp>t ,,ii ( "p ,a
 ( title ,,xxvii ( ! ,public ,heal?     
,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aa 
et seq47 is am5d$ by add+ at ! end !    
foll[+ new section3  #bgcj4 ,prohibition
 on r$uction ( rates & t]m9ation (      
contracts dur+ public heal? em]g5cies   
7a7 ,9 g5]al ,a gr\p heal? plan & a     
heal? insurance issu] (f]+ gr\p or      
individual heal? insurance cov]age may  
n1 ) respect to a heal? c>e provid]     
locat$ 9 an em]g5cy area dur+ an em]g5cy
 p]iod t1 z ( ! day be=e ! date ( !     
beg9n+ ( su* p]iod1 _h 9 effect a       
contractual relation%ip = furni%+ items 
& s]vices "u su* plan or cov]age-- 7#a7 
provide = an am\nt ( reimbursem5t = any 
su* item or s]vice furni%$ by su*       
provid] dur+ su* p]iod t is less ?an !  
am\nt ( su* reimbursem5t t w\ld h be5   
payable "u su* plan or cov]age _h su*   
item or s]vice be5 furni%$ by su*       

provid] on su* day2 or  7#b7 t]m9ate su*
 relation%ip dur+ su* p]iod2  unless su*
 less] reimbursem5t or su* t]m9ation is 
bas$ on fraud1 abuse1 or o!r quality    
conc]ns ) respect to su* provid] or su* 
provid] be+ plac$ on ! exclusion li/    
ma9ta9$ by ! ,inspector ,g5]al ( !      
,dep>tm5t ( ,heal? & ,human ,s]vices4   
7b7 ,def9itions ,= purposes ( ?is       
section1 an em]g5cy area is a           
geographical area 9 :i*1 & an em]g5cy   
p]iod is ! p]iod dur+ :i*1 !re exi/s a  
public heal? em]g5cy decl>$ by !        
,secret>y pursuant to section #cai4  4  
7b7 ,,erisa  7#a7 ,9 g5]al ,subp>t ,b ( 
"p #g ( subtitle ,b ( title ,i ( !      
,employee ,retirem5t ,income ,security  
,act ( #aigd 7#bi ,u4,s4,c4 #aahe et    
seq47 is am5d$ by add+ at ! end ! foll[+
 new section3  #gaf4 ,prohibition on    
r$uction ( rates & t]m9ation ( contracts
 dur+ public heal? em]g5cies  7a7 ,9    
g5]al ,a gr\p heal? plan & a heal?      
insurance issu] (f]+ gr\p heal?         
insurance cov]age may n1 ) respect to a 

heal? c>e provid] locat$ 9 an em]g5cy   
area dur+ an em]g5cy p]iod t1 z ( ! day 
be=e ! date ( ! beg9n+ ( su* p]iod1 _h 9
 effect a contractual relation%ip =     
furni%+ items & s]vices "u su* plan or  
cov]age--  7#a7 provide = an am\nt (    
reimbursem5t = any su* item or s]vice   
furni%$ by su* provid] dur+ su* p]iod t 
is less ?an ! am\nt ( su* reimbursem5t t
 w\ld h be5 payable "u su* plan or      
cov]age _h su* item or s]vice be5       
furni%$ by su* provid] on su* day2 or   
7#b7 t]m9ate su* relation%ip dur+ su*   
p]iod2  unless su* less] reimbursem5t or
 su* t]m9ation is bas$ on fraud1 abuse1 
or o!r quality conc]ns ) respect to su* 
provid] or su* provid] be+ plac$ on !   
exclusion li/ ma9ta9$ by ! ,inspector   
,g5]al ( ! ,dep>tm5t ( ,heal? & ,human  
,s]vices4  7b7 ,def9itions ,= purposes (
 ?is section1 an em]g5cy area is a      
geographical area 9 :i*1 & an em]g5cy   
p]iod is ! p]iod dur+ :i*1 !re exi/s a  
public heal? em]g5cy decl>$ by !        
,secret>y pursuant to section #cai4  4  

7#b7 ,cl]ical am5dm5t ,! table ( cont5ts
 9 section #a ( ! ,employee ,retirem5t  
,income ,security ,act ( #aigd is am5d$ 
by ins]t+ aft] ! item relat+ to section 
#gad ! foll[+ new items3  ,sec4 #gae4   
,additional m>ket re=ms4 ,sec4 #gaf4    
,prohibition on r$uction ( rates &      
t]m9ation ( contracts dur+ public heal? 
em]g5cies4  4  7c7 ,,irc  7#a7 ,9 g5]al 
,sub*apt] ,b ( *apt] #ajj ( ! ,int]nal  
,rev5ue ,code ( #aihf is am5d$ by add+  
at ! end ! foll[+ new section3  #ihaf4  
,prohibition on r$uction ( rates &      
t]m9ation ( contracts dur+ public heal? 
em]g5cies  7a7 ,9 g5]al ,a gr\p heal?   
plan may n1 ) respect to a heal? c>e    
provid] locat$ 9 an em]g5cy area dur+ an
 em]g5cy p]iod t1 z ( ! day be=e ! date 
( ! beg9n+ ( su* p]iod1 _h 9 effect a   
contractual relation%ip = furni%+ items 
& s]vices "u su* plan--  7#a7 provide = 
an am\nt ( reimbursem5t = any su* item  
or s]vice furni%$ by su* provid] dur+   
su* p]iod t is less ?an ! am\nt ( su*   
reimbursem5t t w\ld h be5 payable "u su*

 plan _h su* item or s]vice be5 furni%$ 
by su* provid] on su* day2 or  7#b7     
t]m9ate su* relation%ip dur+ su* p]iod2 
unless su* less] reimbursem5t or su*    
t]m9ation is bas$ on fraud1 abuse1 or   
o!r quality conc]ns ) respect to su*    
provid] or su* provid] be+ plac$ on !   
exclusion li/ ma9ta9$ by ! ,inspector   
,g5]al ( ! ,dep>tm5t ( ,heal? & ,human  
,s]vices4  7b7 ,def9itions ,= purposes (
 ?is section1 an em]g5cy area is a      
geographical area 9 :i*1 & an em]g5cy   
p]iod is ! p]iod dur+ :i*1 !re exi/s a  
public heal? em]g5cy decl>$ by !        
,secret>y pursuant to section #cai4  4  
7#b7 ,cl]ical am5dm5t ,! table (        
sections = su* sub*apt] is am5d$ by add+
 at ! end ! foll[+ new items3  ,sec4    
#ihae4 ,additional m>ket re=ms4 ,sec4   
#ihaf4 ,prohibition on r$uction ( rates 
& t]m9ation ( contracts dur+ public     
heal? em]g5cies4  4  7d7 ,effective date
 ,! am5dm5t made by ?is section %all    
apply ) respect to public heal?         
em]g5cies decl>$ by ! ,secret>y ( ,heal?

 & ,human ,s]vices on or aft] ,janu>y   
#ca1 #bjbj1 & items & s]vices furni%$1 &
 t]m9ations occurr+1 on or aft] ! date (
 ! enactm5t ( ?is ,act4