,,ii #aai? ,,congress #a/ ,session ,s4 #bdbj ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,july #bc1 #bjbe ,mr4 ,m>%all 7= himself & ,mr4 ,b5net7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to am5d title ,,xxvii ( ! ,public ,heal? ,s]vice ,act1 ! ,employee ,retirem5t ,income ,security ,act ( #aigd1 & ! ,int]nal ,rev5ue ,code ( #aihf to increase p5alties = gr\p heal? plans1 heal? insurance issu]s1 & nonp>ticipat+ provid]s or facilities = practices t violate balance bill+ requirem5ts1 & = o!r purposes4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,no ,surprises ,act ,en=cem5t ,act4 #b4 ,increas+ p5alties = gr\p heal? plans & heal? insurance issu]s = practices t violate balance bill+ requirem5ts 7a7 ,,phsa ,section #bgbc7;b77#b77;,c7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#bb7;b77#b77;,c77 is am5d$-- 7#a7 9 clause 7i71 by ins]t+ 7or1 9 ! case ( su* a failure ) respect to a provision specifi$ 9 clause 7iv71 #aj1jjj p] violation7 aft] #ajj2 & 7#b7 by add+ at ! end ! foll[+ new clause3 7iv7 ,provisions specifi$ ,= purposes ( clause 7i71 ! provisions specifi$ 9 ?is clause are ! foll[+3 7,i7 ,subp>agraphs 7,a7 & 7,b7 ( section #bgii;,a-#a7;a77#a74 7,,ii7 ,clauses 7i71 7ii71 7iii71 & 7v7 ( section #bgii;,a-#a7;a77#a77;,c74 7,,iii7 ,subp>agraphs 7,a71 7,b71 & 7,e7 ( section #bgii;,a-#a7;b77#a74 7,,iv7 ,p>agraphs 7#a7 & 7#b7 ( section #bgii;,a-#b7;a74 4 7b7 ,,erisa ,section #ejb ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aaca7 is am5d$-- 7#a7 9 subsection 7a77#f71 by /rik+ or 7#i7 & ins]t+ 7#i71 or 7#ab72 7#b7 9 subsection 7b77#c7-- 7,a7 by ins]t+ 1 7c77#ab71 aft] subsections 7c77#i72 & 7,b7 by ins]t+ or 7c77#ab7 aft] "u subsection 7c77#i72 & 7#c7 9 subsection 7c71 by add+ at ! end ! foll[+ new p>agraph3 7#ab7 ,! ,secret>y may assess a civil p5alty aga9/ any gr\p heal? plan or heal? insurance issu] (f]+ gr\p heal? insurance cov]age ( n m ?an #aj1jjj p] violation = ea* individual ) respect to :i* su* plan or cov]age fails to comply ) "o ( ! foll[+ provisions3 7,a7 ,subp>agraphs 7,a7 & 7,b7 ( section #gaf7;a77#a74 7,b7 ,clauses 7i71 7ii71 7iii71 & 7v7 ( section #gaf7;a77#a77;,c74 7,c7 ,subp>agraphs 7,a71 7,b71 & 7,e7 ( section #gaf7;b77#a74 7,d7 ,p>agraphs 7#a7 & 7#b7 ( section #gag7;a74 4 7c7 ,,irc ,section #dihj;,d7b7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$-- 7#a7 9 p>agraph 7#a71 by ins]t+ 7or1 9 ! case ( su* a failure ) respect to a provision specifi$ 9 p>agraph 7#d71 #aj1jjj7 aft] #ajj2 & 7#b7 by add+ at ! end ! foll[+ new p>agraph3 7#d7 ,provisions specifi$ ,= purposes ( p>agraph 7#a71 ! provisions specifi$ 9 ?is p>agraph are ! foll[+3 7,a7 ,subp>agraphs 7,a7 & 7,b7 ( section #ihaf7;a77#a74 7,b7 ,clauses 7i71 7ii71 7iii71 & 7v7 ( section #ihaf7;a77#a77;,c74 7,c7 ,subp>agraphs 7,a71 7,b71 & 7,e7 ( section #ihaf7;b77#a74 7,d7 ,p>agraphs 7#a7 & 7#b7 ( section #ihag7;a74 4 #c4 ,additional p5alties = late paym5t or non-paym5t aft] ,,idr entity paym5t det]m9ation 7a7 ,,phsa 7#a7 ,em]g5cy & nonem]g5cy s]vices ,section #bgii;,a-#a7;c77#f7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aaa7;c77#f77 is am5d$-- 7,a7 9 ! p>agraph head+1 by ins]t+ 2 p5alty = late paym5t or non-paym5t aft] paym5t2 7,b7 by /rik+ ,! total plan & ins]t+ ! foll[+3 7,a7 ,tim+ ( paym5t ,! total plan 2 7,c7 9 subp>agraph 7,a71 z s ins]t$1 by add+ at ! end ! foll[+ new s5t5ce3 ,9 ! case su* det]m9ation is an am\nt less ?an ! sum ( ! initial paym5t = su* item or s]vice & any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice1 ! nonp>ticipat+ provid] or facility furni%+ su* item or s]vice %all pay to su* plan or cov]age ! diff]5ce betwe5 su* det]m9ation & su* sum n lat] ?an #cj days aft] ! date on :i* su* det]m9ation is made42 & 7,d7 by add+ at ! end ! foll[+ new subp>agraphs3 7,b7 ,notification ,9 ! case ( a plan or cov]age1 or a nonp>ticipat+ provid] or facility1 requir$ to make a paym5t pursuant to a det]m9ation describ$ 9 subp>agraph 7,a71 su* plan or cov]age or nonp>ticipat+ provid] or facility %all submit to ! ,secret>y a notification ( su* paym5t z ( ! date su* paym5t is made 9 a mann] specifi$ by ! ,secret>y4 7,c7 ,p5alty = late paym5t or non-paym5t 7i7 ,9 g5]al ,9 ! case ( a plan or cov]age1 or a nonp>ticipat+ provid] or facility1 t has n made ! requir$ paym5t describ$ 9 subp>agraph 7,a7 ) respect to an item or s]vice 9 ! "t p]iod describ$ 9 su* subp>agraph1 9 addition to mak+ su* paym5t1 su* plan or cov]age or nonp>ticipat+ provid] or facility %all also pay to ! nonp>ticipat+ provid] or facility or plan or cov]age 7z applicable7 an am\nt t is ?ree times ! diff]5ce betwe5-- 7,i7 ! initial paym5t 7or1 9 ! case ( a notice ( d5ial ( paym5t1 #j7 describ$ 9 subsection 7a77#a77;,c77iv77,i7 or 7b77#a77;,c71 z applicable2 & 7,,ii7 ! out-(-network rate 7z def9$ 9 subsection 7a77#c77,k77 = su* item or s]vice 7less any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice74 7ii7 ,int]e/ ,a late paym5t p5alty "u clause 7i7 %all also be subject to int]e/ 9 a mann] specifi$ by ! ,secret>y4 4 7#b7 ,air ambulance s]vices ,section #bgii;,a-#b7;b77#f7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aab7;b77#f77 is am5d$-- 7,a7 9 ! p>agraph head+1 by ins]t+ 2 p5alty = late paym5t or non-paym5t aft] paym5t2 7,b7 by /rik+ ,! total plan & ins]t+ ! foll[+3 7,a7 ,tim+ ( paym5t ,! total plan 2 7,c7 9 subp>agraph 7,a71 z s ins]t$1 by add+ at ! end ! foll[+ new s5t5ce3 ,9 ! case su* det]m9ation is an am\nt less ?an ! sum ( ! initial paym5t = su* item or s]vice & any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice1 ! nonp>ticipat+ provid] or facility furni%+ su* item or s]vice %all pay to su* plan or cov]age ! diff]5ce betwe5 su* det]m9ation & su* sum n lat] ?an #cj days aft] ! date on :i* su* det]m9ation is made42 & 7,d7 by add+ at ! end ! foll[+ new subp>agraphs3 7,b7 ,notification ,9 ! case ( a plan or cov]age1 or a nonp>ticipat+ provid] or facility1 requir$ to make a paym5t pursuant to a det]m9ation describ$ 9 subp>agraph 7,a71 su* plan or cov]age or nonp>ticipat+ provid] or facility %all submit to ! ,secret>y a notification ( su* paym5t z ( ! date su* paym5t is made 9 a mann] specifi$ by ! ,secret>y4 7,c7 ,p5alty = late paym5t or non-paym5t 7i7 ,9 g5]al ,9 ! case ( a plan or cov]age1 or a nonp>ticipat+ provid] or facility1 t has n made ! requir$ paym5t describ$ 9 subp>agraph 7,a7 ) respect to an item or s]vice 9 ! "t p]iod describ$ 9 su* subp>agraph1 9 addition to mak+ su* paym5t1 su* plan or cov]age or nonp>ticipat+ provid] or facility %all also pay to ! nonp>ticipat+ provid] or facility or plan or cov]age 7z applicable7 an am\nt t is ?ree times ! diff]5ce betwe5-- 7,i7 ! initial paym5t 7or1 9 ! case ( a notice ( d5ial ( paym5t1 #j7 describ$ 9 subsection 7a77#c77;,a72 & 7,,ii7 ! out-(-network rate 7z def9$ 9 section #bgii-a7;a77#c77,k77 = su* item or s]vice 7less any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice74 7ii7 ,int]e/ ,a late paym5t p5alty "u clause 7i7 %all also be subject to int]e/ 9 a mann] specifi$ by ! ,secret>y4 4 7b7 ,,erisa 7#a7 ,em]g5cy & nonem]g5cy s]vices ,section #gaf7;c77#f7 ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aahe;e7c77#f77 is am5d$-- 7,a7 9 ! p>agraph head+1 by ins]t+ 2 p5alty = late paym5t or non-paym5t aft] paym5t2 7,b7 by /rik+ ,! total plan & ins]t+ ! foll[+3 7,a7 ,tim+ ( paym5t ,! total plan 2 7,c7 9 subp>agraph 7,a71 z s ins]t$1 by add+ at ! end ! foll[+ new s5t5ce3 ,9 ! case su* det]m9ation is an am\nt less ?an ! sum ( ! initial paym5t = su* item or s]vice & any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice1 ! nonp>ticipat+ provid] or facility furni%+ su* item or s]vice %all pay to su* plan or cov]age ! diff]5ce betwe5 su* det]m9ation & su* sum n lat] ?an #cj days aft] ! date on :i* su* det]m9ation is made42 & 7,d7 by add+ at ! end ! foll[+ new subp>agraphs3 7,b7 ,notification ,9 ! case ( a plan or cov]age1 or a nonp>ticipat+ provid] or facility1 requir$ to make a paym5t pursuant to a det]m9ation describ$ 9 subp>agraph 7,a71 su* plan or cov]age or nonp>ticipat+ provid] or facility %all submit to ! ,secret>y a notification ( su* paym5t z ( ! date su* paym5t is made 9 a mann] specifi$ by ! ,secret>y4 7,c7 ,p5alty = late paym5t or non-paym5t 7i7 ,9 g5]al ,9 ! case ( a plan or cov]age1 or a nonp>ticipat+ provid] or facility1 t has n made ! requir$ paym5t describ$ 9 subp>agraph 7,a7 ) respect to an item or s]vice 9 ! "t p]iod describ$ 9 su* subp>agraph1 9 addition to mak+ su* paym5t1 su* plan or cov]age or nonp>ticipat+ provid] or facility %all also pay to ! nonp>ticipat+ provid] or facility or plan or cov]age 7z applicable7 an am\nt t is ?ree times ! diff]5ce betwe5-- 7,i7 ! initial paym5t 7or1 9 ! case ( a notice ( d5ial ( paym5t1 #j7 describ$ 9 subsection 7a77#a77;,c77iv77,i7 or 7b77#a77;,c71 z applicable2 & 7,,ii7 ! out-(-network rate 7z def9$ 9 subsection 7a77#c77,k77 = su* item or s]vice 7less any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice74 7ii7 ,int]e/ ,a late paym5t p5alty "u clause 7i7 %all also be subject to int]e/ 9 a mann] specifi$ by ! ,secret>y4 4 7#b7 ,air ambulance s]vices ,section #gag7;b77#f7 ( ! ,employee ,retirem5t ,income ,security ,act ( #aigd 7#bi ,u4,s4,c4 #aahe;f7b77#f77 is am5d$-- 7,a7 9 ! p>agraph head+1 by ins]t+ 2 p5alty = late paym5t or non-paym5t aft] paym5t2 7,b7 by /rik+ ,! total plan & ins]t+ ! foll[+3 7,a7 ,tim+ ( paym5t ,! total plan 2 7,c7 9 subp>agraph 7,a71 z s ins]t$1 by add+ at ! end ! foll[+ new s5t5ce3 ,9 ! case su* det]m9ation is an am\nt less ?an ! sum ( ! initial paym5t = su* item or s]vice & any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice1 ! nonp>ticipat+ provid] or facility furni%+ su* item or s]vice %all pay to su* plan or cov]age ! diff]5ce betwe5 su* det]m9ation & su* sum n lat] ?an #cj days aft] ! date on :i* su* det]m9ation is made42 & 7,d7 by add+ at ! end ! foll[+ new subp>agraphs3 7,b7 ,notification ,9 ! case ( a plan or cov]age1 or a nonp>ticipat+ provid] or facility1 requir$ to make a paym5t pursuant to a det]m9ation describ$ 9 subp>agraph 7,a71 su* plan or cov]age or nonp>ticipat+ provid] or facility %all submit to ! ,secret>y a notification ( su* paym5t z ( ! date su* paym5t is made 9 a mann] specifi$ by ! ,secret>y4 7,c7 ,p5alty = late paym5t or non-paym5t 7i7 ,9 g5]al ,9 ! case ( a plan or cov]age1 or a nonp>ticipat+ provid] or facility1 t has n made ! requir$ paym5t describ$ 9 subp>agraph 7,a7 ) respect to an item or s]vice 9 ! "t p]iod describ$ 9 su* subp>agraph1 9 addition to mak+ su* paym5t1 su* plan or cov]age or nonp>ticipat+ provid] or facility %all also pay to ! nonp>ticipat+ provid] or facility or plan or cov]age 7z applicable7 an am\nt t is ?ree times ! diff]5ce betwe5-- 7,i7 ! initial paym5t 7or1 9 ! case ( a notice ( d5ial ( paym5t1 #j7 describ$ 9 subsection 7a77#c77;,a72 & 7,,ii7 ! out-(-network rate 7z def9$ 9 section #gaf7;a77#c77,k77 = su* item or s]vice 7less any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice74 7ii7 ,int]e/ ,a late paym5t p5alty "u clause 7i7 %all also be subject to int]e/ 9 a mann] specifi$ by ! ,secret>y4 4 7c7 ,,irc 7#a7 ,em]g5cy & nonem]g5cy s]vices ,section #ihaf7;c77#f7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$-- 7,a7 9 ! p>agraph head+1 by ins]t+ 2 p5alty = late paym5t or non-paym5t aft] paym5t2 7,b7 by /rik+ ,! total plan & ins]t+ ! foll[+3 7,a7 ,tim+ ( paym5t ,! total plan 2 7,c7 9 subp>agraph 7,a71 z s ins]t$1 by add+ at ! end ! foll[+ new s5t5ce3 ,9 ! case su* det]m9ation is an am\nt less ?an ! sum ( ! initial paym5t = su* item or s]vice & any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice1 ! nonp>ticipat+ provid] or facility furni%+ su* item or s]vice %all pay to su* plan ! diff]5ce betwe5 su* det]m9ation & su* sum n lat] ?an #cj days aft] ! date on :i* su* det]m9ation is made42 & 7,d7 by add+ at ! end ! foll[+ new subp>agraphs3 7,b7 ,notification ,9 ! case ( a plan1 or a nonp>ticipat+ provid] or facility1 requir$ to make a paym5t pursuant to a det]m9ation describ$ 9 subp>agraph 7,a71 su* plan or nonp>ticipat+ provid] or facility %all submit to ! ,secret>y a notification ( su* paym5t z ( ! date su* paym5t is made 9 a mann] specifi$ by ! ,secret>y4 7,c7 ,p5alty = late paym5t or non-paym5t 7i7 ,9 g5]al ,9 ! case ( a plan1 or a nonp>ticipat+ provid] or facility1 t has n made ! requir$ paym5t describ$ 9 subp>agraph 7,a7 ) respect to an item or s]vice 9 ! "t p]iod describ$ 9 su* subp>agraph1 9 addition to mak+ su* paym5t1 su* plan or nonp>ticipat+ provid] or facility %all also pay to ! nonp>ticipat+ provid] or facility or plan 7z applicable7 an am\nt t is ?ree times ! diff]5ce betwe5-- 7,i7 ! initial paym5t 7or1 9 ! case ( a notice ( d5ial ( paym5t1 #j7 describ$ 9 subsection 7a77#a77;,c77iv77,i7 or 7b77#a77;,c71 z applicable2 & 7,,ii7 ! out-(-network rate 7z def9$ 9 subsection 7a77#c77,k77 = su* item or s]vice 7less any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice74 7ii7 ,int]e/ ,a late paym5t p5alty "u clause 7i7 %all also be subject to int]e/ 9 a mann] specifi$ by ! ,secret>y4 4 7#b7 ,air ambulance s]vices ,section #ihag7;b77#f7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$-- 7,a7 9 ! p>agraph head+1 by ins]t+ 2 p5alty = late paym5t or non-paym5t aft] paym5t2 7,b7 by /rik+ ,! total plan & ins]t+ ! foll[+3 7,a7 ,tim+ ( paym5t ,! total plan 2 7,c7 9 subp>agraph 7,a71 z s ins]t$1 by add+ at ! end ! foll[+ new s5t5ce3 ,9 ! case su* det]m9ation is an am\nt less ?an ! sum ( ! initial paym5t = su* item or s]vice & any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice1 ! nonp>ticipat+ provid] or facility furni%+ su* item or s]vice %all pay to su* plan ! diff]5ce betwe5 su* det]m9ation & su* sum n lat] ?an #cj days aft] ! date on :i* su* det]m9ation is made42 & 7,d7 by add+ at ! end ! foll[+ new subp>agraphs3 7,b7 ,notification ,9 ! case ( a plan1 or a nonp>ticipat+ provid] or facility1 requir$ to make a paym5t pursuant to a det]m9ation describ$ 9 subp>agraph 7,a71 su* plan or nonp>ticipat+ provid] or facility %all submit to ! ,secret>y a notification ( su* paym5t z ( ! date su* paym5t is made 9 a mann] specifi$ by ! ,secret>y4 7,c7 ,p5alty = late paym5t or non-paym5t 7i7 ,9 g5]al ,9 ! case ( a plan1 or a nonp>ticipat+ provid] or facility1 t has n made ! requir$ paym5t describ$ 9 subp>agraph 7,a7 ) respect to an item or s]vice 9 ! "t p]iod describ$ 9 su* subp>agraph1 9 addition to mak+ su* paym5t1 su* plan or nonp>ticipat+ provid] or facility %all also pay to ! nonp>ticipat+ provid] or facility or plan 7z applicable7 an am\nt t is ?ree times ! diff]5ce betwe5-- 7,i7 ! initial paym5t 7or1 9 ! case ( a notice ( d5ial ( paym5t1 #j7 describ$ 9 subsection 7a77#c77;,a72 & 7,,ii7 ! out-(-network rate 7z def9$ 9 section #ihaf7;a77#c77,k77 = su* item or s]vice 7less any co/ %>+ requir$ to be paid by ! individual receiv+ su* item or s]vice74 7ii7 ,int]e/ ,a late paym5t p5alty "u clause 7i7 %all also be subject to int]e/ 9 a mann] specifi$ by ! ,secret>y4 4 #d4 ,transp>5cy report+ requirem5ts 7a7 ,,phsa ,section #bgii;,a-#a7;a77#b77;,a77iii7 ( ! ,public ,heal? ,s]vice ,act 7#db ,u4,s4,c4 #cjj;gg-#aaa7;a77#b77;,a77iii77 is am5d$ to read z foll[s3 7iii7 ,report+ 7,i7 ,initial report+ ,beg9n+ = #bjbb & end+ on ,decemb] #ca ( ! cal5d> ye> 9 :i* ! ,no ,surprises ,act ,en=cem5t ,act is enact$1 ! ,secret>y %all annually submit to ,congress a report on ! numb] ( plans & issu]s ) respect to :i* audits 7 conduct$ dur+ su* ye> pursuant to ?is subp>agraph4 7,,ii7 ,subsequ5t report+ 7aa7 ,9 g5]al ,) respect to ! fir/ cal5d> ye> foll[+ ! date ( ! enactm5t ( ! ,no ,surprises ,act ,en=cem5t ,act1 n lat] ?an ,febru>y #a ( su* ye>1 & e #f mon?s !reaft]1 ! ,secret>y1 9 coord9ation ) ! ,secret>y ( ,labor & ! ,secret>y ( ! ,treasury1 %all submit to ! ,committee on ,ways & ,means1 ! ,committee on ,en]gy & ,comm]ce1 & ! ,committee on ,education & ! ,work=ce ( ! ,h\se ( ,repres5tatives1 & ! ,committee on ,f9ance & ! ,committee on ,heal?1 ,education1 ,labor & ,p5sions ( ! ,s5ate1 a report on any audits conduct$ pursuant to ?is subp>agraph dur+ ! applicable report+ p]iod1 & any en=cem5t actions tak5 dur+ su* p]iod 9 accordance ) ! provisions ( ?is "p1 includ+-- 7,,aa7 ! total numb] ( audits conduct$ "u ?is subp>agraph2 7,,bb7 ! numb] ( audits conduct$ pursuant to clause 7ii77,i72 7,,cc7 ! numb] ( compla9ts submitt$ by provid]s & by p>ticipants1 b5efici>ies1 & enrollees ) respect to a violation ( ?is "p2 7,,dd7 any en=cem5t actions tak5 z a result ( a compla9t submitt$ by a provid] or by a p>ticipant1 a b5efici>y1 or an enrollee1 ) respect to ! provisions ( ?is "p2 7,,ee7 ! total numb] (1 & ! aggregate doll> am\nt (1 any civil monet>y p5alties issu$ 9 accordance ) ?is "p2 7,,ff7 a summ>y ( any non-monet>y corrective action tak5 aga9/ a gr\p heal? plan or heal? insurance issu] (f]+ gr\p or individual heal? insurance cov]age = a violation ( ?is "p2 & 7,,gg7 a description ( ! #c mo/ commonly report$ violations ( ?is "p4 7bb7 ,applicable report+ p]iod ,= purposes ( ?is subclause1 ! t]m applicable report+ p]iod means ! #f mon? p]iod prior to ea* report submitt$ "u item 7aa74 4 7b7 ,,irc ,section #ihaf7;a77#b77;,a77iii7 ( ! ,int]nal ,rev5ue ,code ( #aihf is am5d$ to read z foll[s3 7iii7 ,report+ 7,i7 ,initial report+ ,beg9n+ = #bjbb & end+ on ,decemb] #ca ( ! cal5d> ye> 9 :i* ! ,no ,surprises ,act ,en=cem5t ,act is enact$1 ! ,secret>y %all annually submit to ,congress a report on ! numb] ( plans ) respect to :i* audits 7 conduct$ dur+ su* ye> pursuant to ?is subp>agraph4 7,,ii7 ,subsequ5t report+ 7aa7 ,9 g5]al ,) respect to ! fir/ cal5d> ye> foll[+ ! date ( ! enactm5t ( ! ,no ,surprises ,act ,en=cem5t ,act1 n lat] ?an ,febru>y #a ( su* ye>1 & e #f mon?s !reaft]1 ! ,secret>y1 9 coord9ation ) ! ,secret>y ( ,labor & ! ,secret>y ( ,heal? & ,human ,s]vices1 %all submit to ! ,committee on ,ways & ,means1 ! ,committee on ,en]gy & ,comm]ce1 & ! ,committee on ,education & ,work=ce ( ! ,h\se ( ,repres5tatives1 & ! ,committee on ,f9ance & ! ,committee on ,heal?1 ,education1 ,labor & ,p5sions ( ! ,s5ate1 a report on audits p]=m$ pursuant to ?is subp>agraph dur+ ! applicable report+ p]iod1 & any en=cem5t actions tak5 dur+ su* p]iod 9 accordance ) ! provisions ( an applicable section1 includ+-- 7,,aa7 ! total numb] ( audits conduct$ "u ?is subp>agraph2 7,,bb7 ! numb] ( audits conduct$ pursuant to clause 7ii77,i72 7,,cc7 ! numb] ( compla9ts submitt$ by provid]s & by p>ticipants & b5efici>ies ) respect to a violation ( an applicable section2 7,,dd7 any en=cem5t actions tak5 pursuant to a violation ( an applicable section2 7,,ee7 ! total numb] (1 & ! aggregate doll> am\nt (1 any civil monet>y p5alties issu$ 9 accordance ) an applicable section2 7,,ff7 a summ>y ( any non-monet>y corrective action tak5 aga9/ a gr\p heal? plan = a violation ( an applicable section2 & 7,,gg7 a description ( ! #c mo/ commonly report$ violations ( an applicable section4 7bb7 ,def9itions ,9 ?is subclause3 7,,aa7 ,applicable report+ p]iod ,! t]m applicable report+ p]iod means ! #f mon? p]iod prior to ea* report submitt$ "u item 7aa74 7,,bb7 ,applicable section ,! t]m applicable section means ?is section & ea* ( sections #ihag ?r\gh #ihbe4 4