,i  #aai? ,,congress  #a/ ,session  ,h4 
,r4 #fede  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,decemb] #i1 #bjbe,mr4
 ,torres ( ,new ,york introduc$ ! foll[+
 bill2 :i* 0 ref]r$ to ! ,committee on  
,en]gy & ,comm]ce  ,a ,,bill  ,to       
prohibit heal? insur]s1 includ+ ,m$icaid
 manag$ c>e organizations & o!r private 
heal? plans1 f impos+ arbitr>y "t caps  
on reimbursem5t = ane/hesia s]vices & = 
o!r purposes4  #a4 ,%ort title ,?is ,act
 may be cit$ z ! ,ane/hesia = ,all ,act4
  #b4 ,f9d+s ,congress f9ds ! foll[+3   
7#a7 ,ane/hesia c>e is ess5tial & mu/ be
 det]m9$ by m$ical necessity1 n arbitr>y
 limits4  7#b7 ,"t caps on reimbursem5t 
jeop>dize pati5t safety1 impose f9ancial
 burd5s1 & int]f]e ) in=m$ m$ical       
decisions4  7#c7 ,prohibit+ su*         
practices protects pati5ts1 promotes    
fairness1 & ensures equitable access to 
ess5tial heal?c>e s]vices4  #c4         
,prohibition on arbitr>y "t caps =      
ane/hesia s]vices  7a7 ,9 g5]al ,"p ,a (
 title ,,xxvii ( ! ,public ,heal?       

,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg et  
seq47 is am5d$ by add+ at ! end ! foll[+
 new section3  #bgcj4 ,prohibition on   
arbitr>y "t caps = ane/hesia s]vices    
7a7 ,prohibition on "t limits ,a gr\p   
heal? plan1 & a heal? insurance issu]   
(f]+ gr\p or individual heal? insurance 
cov]age1 may n impose arbitr>y "t caps  
on reimbursem5t = ane/hesia s]vices     
provid$ dur+ m$ically necess>y          
proc$ures4  7b7 ,requirem5t =           
reimbursem5t bas$ on m$ical necessity   
,reimbursem5t = ane/hesia s]vices %all  
be det]m9$ bas$ on m$ical necessity z   
assess$ by ! att5d+ ane/hesiologi/1     
c]tifi$ regi/]$ nurse ane/heti/1 or     
lic5s$ ane/hesia provid]4  7c7 ,d5ial ( 
paym5t ,a gr\p heal? plan1 & a heal?    
insurance issu] (f]+ gr\p or individual 
heal? insurance cov]age1 are prohibit$ f
 d5y+ paym5t = ane/hesia s]vices solely 
because ! duration ( c>e exce$$ a       
pre-set "t limit4  4  7b7 ,m$icaid      
,section #aijb7;a7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4 #acif;a7a77 is     

am5d$--  7#a7 9 p>agraph 7#hf71 by /rik+
 & at ! end2  7#b7 9 p>agraph 7#hg71 by 
/rik+ ! p]iod & ins]t+ 2 &2 &  7#c7 by  
ins]t+ aft] p>agraph 7#hg7 ! foll[+ new 
p>agraph3  7#hh7 provide t m$ical       
assi/ance consi/+ ( ane/hesia1 includ+  
su* assi/ance furni%$ ?r\gh a manag$ c>e
 organization1 is n subject to arbitr>y 
"t caps on reimbursem5t :5 furni%$ dur+ 
m$ically necess>y proc$ures 7z det]m9$  
by ! att5d+ ane/hesiologi/1 c]tifi$     
regi/]$ nurse ane/heti/1 or o!r provid] 
( su* ane/hesia7 & t paym5t is n d5i$ = 
su* assi/ance solely because ! duration 
( su* assi/ance exce$$ a pre-set "t     
limit4  4  #d4 ,ov]sight by inspector   
g5]al  7a7 ,monitor+ & audits ,! ,(fice 
( ! ,inspector ,g5]al ( ! ,dep>tm5t (   
,heal? & ,human ,s]vices %all-- 7#a7    
conduct p]iodic audits ( heal? insur]s  
to assess compliance ) ! provisions (   
?is ,act2 &  7#b7 inve/igate allegations
 ( noncompliance submitt$ by pati5ts1   
provid]s1 or o!r /akehold]s4  7b7       
,report+ to congress ,n lat] ?an "o ye> 

aft] ! date ( enactm5t ( ?is ,act1 & e  
#c ye>s !reaft]1 ! ,inspector ,g5]al    
describ$ 9 subsection 7a7 %all submit a 
report to ,congress t includes--  7#a7 !
 f9d+s ( audits conduct$ "u subsection  
7a72  7#b7 ! numb] & nature ( violations
 ref]r$ to ! ,secret>y ( ,heal? & ,human
 ,s]vices2 &  7#c7 recomm5dations1 if   
any1 = improv+ compliance ) ! provisions
 ( ?is ,act4