,i  #aai? ,,congress  #b;d ,session  ,h4
 ,r4 #idhf  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,june #be1 #bjbf,mr4  
,takano introduc$ ! foll[+ bill2 :i* 0  
ref]r$ to ! ,committee on ,education &  
,work=ce  ,a ,,bill  ,to am5d !         
,employee ,retirem5t ,income ,security  
,act ( #aigd to increase transp>5cy (   
gr\p heal? plan data1 prev5t            
discrim9ation1 & = o!r purposes4  #a4   
,%ort title ,?is ,act may be cit$ z !   
,heal? ,data ,access1 ,transp>5cy1 &    
,af=dability ,act ( #bjbf or ,heal?     
,,data ,act ( #bjbf4  #b4 ,increas+     
transp>5cy ( gr\p heal? plan data  7a7  
,gr\p heal? plan audit rights  7#a7 ,9  
g5]al ,section #djh7;b77#b7 ( !         
,employee ,retirem5t ,income ,security  
,act ( #aigd 7#bi ,u4,s4,c4             
#aajh7;b77#b77 is am5d$ by ins]t+ aft]  
subp>agraph 7,c7 ! foll[+3  7,d7 ,no    
contract or arrangem5t = s]vices1 & no  
ext5sion or r5ewal ( su* a contract or  
arrangem5t1 betwe5 a gr\p heal? plan 7z 
def9$ 9 section #gcc7;a77 & any o!r     

entity1 includ+ a heal? c>e provid]     
7includ+ a heal? c>e facility71 network 
or association ( provid]s1 s]vice       
provid] (f]+ access to a network (      
provid]s1 ?ird-p>ty adm9i/rator1 or     
entity provid+ ph>macy b5efit managem5t 
s]vices1 is reasonable )9 ! mean+ ( ?is 
p>agraph unless su* contract or         
arrangem5t-- 7i7 all[s ! gr\p heal? plan
 to audit all de-id5tifi$ claims &      
enc\nt] in=mation or data describ$ 9    
section #gbd7;a77#a77;,b71 provid$ t su*
 in=mation or data has be5 deid5tifi$ 9 
accordance ) section #afd4ead ( title   
#de1 ,code ( ,f$]al ,regulations 7or    
successor regulations71 to--  7,i7      
ensure t su* entity complies ) ! t]ms ( 
! plan1 ! t]ms ( ! contract or          
arrangem5t = s]vices1 & ! requirem5ts ( 
?is title2 &  7,,ii7 det]m9e !          
reasonabl5ess ( comp5sation receiv$ by  
su* entity2 &  7ii7 does n-- 7,i7       
unreasonably limit ! numb] ( audits     
p]mitt$ dur+ a giv5 p]iod ( "t2  7,,ii7 
limit ! numb] ( de-id5tifi$ claims &    

enc\nt] in=mation or data t ! gr\p heal?
 plan may access dur+ an audit2  7,,iii7
 limit ! disclosure ( pric+ t]ms =      
value-bas$ paym5t arrangem5ts or        
capitat$ paym5t arrangem5ts1 includ+--  
7aa7 paym5t calculations & =mulas2  7bb7
 quality measures2  7cc7 contract t]ms2 
7dd7 paym5t am\nts2  7ee7 measurem5t    
p]iods = all inc5tives2 &  7ff7 o!r     
paym5t me?odologies us$ by an entity1   
includ+ a heal? c>e provid] 7includ+ a  
heal? c>e facility71 network or         
association ( provid]s1 s]vice provid]  
(f]+ access to a network ( provid]s1    
?ird-p>ty adm9i/rator1 or entity provid+
 ph>macy b5efit managem5t s]vices2      
7,,iv7 limit ! disclosure ( ov]paym5ts &
 ov]paym5t recov]y t]ms2  7,v7 limit !  
"r ( ! gr\p heal? plan to select an     
auditor2  7,,vi7 o!rwise limit or unduly
 delay by great] ?an #fj cal5d> days    
aft] ! date ( reque/ ! gr\p heal? plan f
 audit+ any su* de-id5tifi$ claims &    
enc\nt] in=mation or data2 or  7,,vii7  
p]mit ! entity to *>ge a fee beyond !   

reasonable direct co/s to provide !     
requir$ in=mation & o!rwise comply &    
assi/ ) an audit reque/4  4  7#b7       
,privacy requirem5ts  7,a7 ,9 g5]al     
,section #djh7;b77#b7 ( ! ,employee     
,retirem5t ,income ,security ,act (     
#aigd 7#bi ,u4,s4,c4 #aajh7;b77#b771 z  
am5d$ by p>agraph 7#a71 is fur!r am5d$  
by add+ at ! end ! foll[+3  7,e7        
,privacy requirem5ts  7i7 ,9 g5]al ,an  
entity %all--  7,i7 provide data or     
in=mation "u subp>agraph 7,d7 9 a mann] 
consi/5t )-- 7aa7 ! privacy regulations 
promulgat$ "u section #acdjb7;a7 ( !    
,heal? ,in=mation ,te*nology = ,cl9ical 
,heal? ,act 7#db ,u4,s4,c4 #agicb7;a772 
&  7bb7 ! privacy regulations promulgat$
 "u ! ,heal? ,insurance ,portability &  
,acc\ntability ,act ( #aiif 9 "p #afj & 
subp>ts ,a & ,e ( "p #afd ( title #de1  
,code ( ,f$]al ,regulations 7or         
successor regulations72 &  7,,ii7 to !  
ext5t su* data or in=mation con/itutes  
protect$ heal? in=mation1 re/rict ! use 
& disclosure ( su* in=mation = purposes 

( su* privacy regulations4  7ii7        
,re/riction ,a gr\p heal? plan %all     
comply ) section #afd4ejd7;f7 ( title   
#de1 ,code ( ,f$]al ,regulations 7or a  
successor regulation71 & a plan sponsor 
%all act 9 accordance ) ! t]ms ( !      
agreem5t describ$ 9 su* section4  4  7b7
 ,civil en=cem5t  7#a7 ,9 g5]al         
,subsection 7c7 ( section #ejb ( su*    
,act 7#bi ,u4,s4,c4 #aacb7 is am5d$ by  
add+ at ! end ! foll[+3  7#ad7 ,9 ! case
 ( an agreem5t betwe5 a gr\p heal? plan 
& a heal? c>e provid] 7includ+ a heal?  
c>e facility71 network or association ( 
provid]s1 s]vice provid] (f]+ access to 
a network ( provid]s1 ?ird-p>ty         
adm9i/rator1 entity provid+ ph>macy     
b5efit managem5t s]vices1 or o!r s]vice 
provid] t violates ! provisions (       
section #gbd1 ! ,secret>y may assess a  
civil p5alty aga9/ su* provid]1 network 
or association ( provid]s1 s]vice       
provid] (f]+ access to a network (      
provid]s1 ?ird-p>ty adm9i/rator1 entity 
provid+ ph>macy b5efit managem5t        

s]vices1 or o!r s]vice provid] 9 ! am\nt
 ( #aj1jjj = ea* day dur+ :i* su*       
violation cont9ues4 ,su* p5alty %all be 
9 addition to o!r p5alties z may be     
prescrib$ by law4  4  7#b7 ,p5alty      
collection ,p>agraph 7#f7 ( section     
#ejb7;a7 ( su* ,act1 is am5d$ to read z 
foll[s3  7#f7 by ! ,secret>y to collect 
any civil p5alty t ! ,secret>y has      
impos$ or assess$ pursuant to ?is title2
  4  7c7 ,improv+ collection ( gag      
clause atte/ations  7#a7 ,9 g5]al       
,section #ejf ( su* ,act 7#bi ,u4,s4,c4 
#aacf7 is am5d$ by add+ at ! end !      
foll[+3  7d7 ,atte/ations relat+ to gr\p
 heal? plan data ,not)/&+ subsection 7a7
 ( ?is section1 ! ,secret>y %all collect
 ! atte/ations requir$ to be submitt$ "u
 section #gbd7;a77#c74 ,! ,secret>y %all
 ensure t any s]vice provid] submitt+   
su* an atte/ation on behalf ( a gr\p    
heal? plan does n h any conflicts (     
int]e/ ) reg>d to su* atte/ation4  4    
7#b7 ,con=m+ am5dm5t ,section #ejf7;a7 (
 su* ,act 7#bi ,u4,s4,c4 #aacf7;a77 is  

am5d$ by /rik+ ,9 ord] & ins]t+ ,subject
 to subsection 7d71 9 ord]4  #c4        
,fiduci>y duty ) respect to plan data   
,section #c7ba77;,a77iii7 ( ! ,employee 
,retirem5t ,income ,security ,act 7#bi  
,u4,s4,c4 #ajjb7ba77;,a77iii77 is am5d$ 
by /rik+ su* plan4 & ins]t+ ! foll[+3   
su* plan1 includ+ any au?ority ov] !    
use1 managem5t1 disposition1 or         
safegu>d+ ( data g5]at$1 us$1 or ma9ta9$
 by ! plan or a s]vice provid] to ! plan
 9 connection ) ! adm9i/ration ( b5efits
 or managem5t ( plan assets44  #d4      
,prev5t+ discrim9ation bas$ on plan data
  7a7 ,9 g5]al ,"p #e ( subtitle ,b (   
title ,i ( ! ,employee ,retirem5t       
,income ,security ,act ( #aigd 7#bi     
,u4,s4,c4 #aaca et seq47 is am5d$ by    
add+ at ! end ! foll[+3  #ebd4 ,prev5t+ 
discrim9ation bas$ on plan data  7a7 ,9 
g5]al ,x %all be unlawful = a p]son     
specifi$ 9 subsection 7c7 to dis*>ge1   
f9e1 susp5d1 expel1 discipl9e1 or       
discrim9ate aga9/1 includ+ by fail+ to  
meet ! requirem5ts ( subsection 7a7 or  

7b7 ( section #gjb 7relat$ to           
discrim9ation 9 eligibility & premiums =
 p>ticipation 9 gr\p heal? plans71 a    
p>ticipant or b5efici>y on ! basis (    
in=mation or data describ$ 9 section    
#gbd4  7b7 ,en=cem5t  7#a7 ,9 g5]al ,!  
provisions ( section #ejb %all be       
applicable 9 ! en=cem5t ( ?is section1  
except t 9 any action br\ght "u         
subsection 7a77#a77;,b7 ( su* section 9 
relation to data or in=mation describ$ 9
 section #gbd1 a p>ticipant or b5efici>y
 may n be requir$ to exhau/ adm9i/rative
 rem$ies prior to br++ su* action4  7#b7
 ,equitable relief ,9 apply+ section    
#ejb = ! purposes ( ?is section1 ! t]m  
equitable relief %all include any relief
 necess>y to re/ore a p>ticipant or     
b5efici>y to ! position !y w\ld h       
occupi$ b = a violation ( subsection    
7a74  7#c7 ,civil monet>y p5alty  7,a7  
,9 g5]al ,9 ! case ( a violation (      
subsection 7a7 by a p]son1 ! ,secret>y  
may assess a civil monet>y p5alty aga9/ 
su* p]son4  7,b7 ,am\nt ,! am\nt ( !    

civil monet>y p5alty impos$ by          
subp>agraph 7,a7 %all be #ajj = ea* day 
9 ! noncompliance p]iod ) respect to ea*
 p>ticipant or b5efici>y to :om su*     
violation ( subsection 7a7 relates4     
7,c7 ,noncompliance p]iod ,= ! purposes 
( ?is subp>agraph1 ! t]m noncompliance  
p]iod means1 ) respect to any violation 
( subsection 7a71 ! p]iod--  7i7 beg9n+ 
on ! date su* violation occurs2 &  7ii7 
end+ on ! date su* violation is         
correct$4  7c7 ,specifi$ p]son ,a p]son 
specifi$ 9 ?is subsection is any ( !    
foll[+3 7#a7 ,an employ]4  7#b7 ,a plan 
sponsor4  7#c7 ,a plan adm9i/rator4     
7#d7 ,a plan fiduci>y4  4  7b7 ,rule (  
con/ruction ,no?+ 9 ?is ,act1 or !      
am5dm5ts made by ?is ,act1 %all be      
con/ru$ to limit ! application ( any    
,f$]al or ,/ate privacy or civil rights 
law1 includ+ ! ,,hipaa privacy          
regulations1 ! ,g5etic ,in=mation       
,nondiscrim9ation ,act ( #bjjh 7,public 
,law #aaj-bcc7 7includ+ ! am5dm5ts made 
by su* ,act71 ! ,am]icans )             

,disabilities ,act ( #aiij 7#db         
,u4,s4,c4 #abaja et seq471 section #ejd 
( ! ,rehabilitation ,act ( #aigc 7#bi   
,u4,s4,c4 #gid71 section #aeeg ( !      
,pati5t ,protection & ,af=dable ,c>e    
,act 7#db ,u4,s4,c4 #ahaaf71 title ,,vi 
( ! ,civil ,rights ,act ( #aifd 7#db    
,u4,s4,c4 #bjjj;d71 & title ,,vii ( !   
,civil ,rights ,act ( #aifd 7#db        
,u4,s4,c4 #bjjj;e74  7c7 ,cl]ical       
am5dm5t ,! table ( cont5ts 9 section #a 
( ! ,employee ,retirem5t ,income        
,security ,act ( #aigd 7#bi ,u4,s4,c4   
#ajja et seq47 is am5d$ by ins]t+ aft] !
 item relat+ to section #ebc ! foll[+3  
,sec4 #ebd4 ,prev5t+ discrim9ation bas$ 
on plan data4  4