[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 3402 Introduced in Senate (IS)]







110th CONGRESS
  2d Session
                                S. 3402

  To provide information and education to consumers concerning health 
              care services and health insurance coverage.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             July 31, 2008

  Mr. Salazar introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To provide information and education to consumers concerning health 
              care services and health insurance coverage.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Consumer Health Education and 
Transparency Act of 2008''.

SEC. 2. OFFICE OF CONSUMER HEALTH EDUCATION AND INFORMATION.

    (a) Establishment.--The Secretary of Health and Human Services 
(referred to in this Act as the ``Secretary'') shall establish within 
the Department of Health and Human Services an office to be known as 
the ``Office of Consumer Health Education and Information'' (referred 
to in this Act as the ``Office'') to provide consumers of health care 
services and health insurance with information, through education and 
outreach, concerning personal health and wellness and health insurance 
coverage.
    (b) Director.--The Office shall be headed by a Director who shall 
be appointed by the Secretary,
    (c) Duties.--The Office shall--
            (1) collect and organize personal health and wellness 
        information from private and public sources and disseminate 
        such information to members of the general public to improve 
        personal health awareness and behaviors;
            (2) collect and organize information on available health 
        insurance options and consumer health insurance protections in 
        each of the 50 States and United States territories and 
        disseminate such information to the general public through the 
        Internet website established under paragraph (8) and the 
        Federal Citizen Information Center hotline established under 
        paragraph (5);
            (3) coordinate the public health education and outreach 
        efforts of organizations and offices within the Department of 
        Health and Human Services, including the Centers for Medicare & 
        Medicaid Services, the Health Resources and Services 
        Administration, the National Institutes of Health, the Centers 
        for Disease Control and Prevention, and the Administration on 
        Aging, to increase the effectiveness of such efforts;
            (4) enter into interagency agreements with the Federal 
        Trade Commission, the Department of Labor, and other Federal 
        agencies determined appropriate by the Secretary to facilitate 
        the coordination of personal health and wellness or health 
        insurance information provided to consumers;
            (5) enter into an interagency agreement with the General 
        Services Administration to operate directly or indirectly, 
        through grant or contract, a 24-hour, toll-free telephone 
        hotline at the Federal Citizen Information Center to provide 
        consumer information regarding health insurance and personal 
        health and wellness behaviors as well as direct consumers to 
        geographically appropriate resources;
            (6) identify and develop methods to increase the quality 
        and amount of information available to consumers regarding the 
        cost, quality, and availability of health care services and 
        health insurance plans;
            (7) develop partnership agreements with public and private 
        organizations to improve the education of the general public 
        regarding personal health and wellness and health insurance;
            (8) develop and maintain a consumer education Internet 
        website to provide information concerning personal health and 
        wellness and health insurance; and
            (9) develop and disseminate relevant information for 
        employers purchasing health insurance coverage for employees 
        and their families.
    (d) Annual Report.--Not later than 1 year after the date of 
enactment of this Act, and annually thereafter, the Secretary shall 
submit to Congress a report that includes--
            (1) a detailed review of the Office's activities, 
        operations, and achievements during the year for which the 
        report is being prepared;
            (2) a description of the Office's goals for the year 
        following the year for which the report is being prepared and a 
        strategic plan for the operation and activities of the Office 
        to achieve such goals; and
            (3) a detailed request for additional appropriations needed 
        for the implementation of such plan, as appropriate.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated, such sums as may be necessary to carry out this section.

SEC. 3. DEVELOPMENT AND UTILIZATION OF UNIFORM SUMMARY OF BENEFITS 
              EXPLANATION.

    (a) In General.--The Secretary shall request the National 
Association of Insurance Commissioners (referred to as the ``NAIC'') to 
develop, and submit to the Secretary not later than 12 months after the 
date of enactment of this Act, standards for use by health insurance 
issuers in compiling and providing to enrollees a summary of benefits 
explanation that accurately represents the benefits and coverage 
provided by the issuer under the applicable health insurance plan. In 
developing such standards, the NAIC shall consult with a working group 
composed of representatives of health insurance-related consumer 
advocacy organizations, issuers of health insurance plans, and other 
qualified individuals.
    (b) Requirements.--The standards for the summary of benefits 
explanation developed under subsection (a) shall provide for the 
following:
            (1) Appearance.--The standards shall ensure that the 
        summary is presented in a uniform format that does not exceed 4 
        pages in length and does not include print smaller than 12-
        point font.
            (2) Language.--The standards shall ensure that the language 
        used in the summary is presented in a manner determined to be 
        understandable by the average health plan enrollee.
            (3) Contents.--The standards shall ensure that the summary 
        includes--
                    (A) information determined to be essential to a 
                consumer's understanding of the applicable health 
                insurance plan benefits;
                    (B) uniform definitions of standard insurance 
                terms;
                    (C) examples to illustrate common benefits 
                scenarios; and
                    (D) illustrations that enhance consumer 
                understanding of the explanation.
    (c) Regulations.--
            (1) Submission.--If, not later than 12 months after the 
        date of enactment of this Act, the NAIC submits to the 
        Secretary the standards provided for under subsection (a), the 
        Secretary shall, not later than 60 days after the date on which 
        such standards are submitted, promulgate regulations to apply 
        such standards to entities described in subsection (c)(2).
            (2) Failure to submit.--If the NAIC fails to submit to the 
        Secretary the standards under subsection (a) within the 12-
        month period provided for in paragraph (1), the Secretary 
        shall, not later than 90 days after the expiration of such 12-
        month period, promulgate regulations providing for the 
        application of Federal standards for the summary of benefit 
        explantion to entities described in subsection (d)(2).
    (d) Requirement To Provide.--
            (1) In general.--Not later than 24 months after the date of 
        enactment of the Act, each entity described in paragraph (2) 
        shall, prior to the effective date of any health insurance 
        coverage provided by the entity to an individual, provide to 
        such individual a summary of benefits explanation pursuant to 
        the standards promulgated by the Secretary under subsection 
        (c).
            (2) Entities.--
                    (A) In general.--An entity is described in this 
                paragraph is--
                            (i) a health insurance issuer (including a 
                        group health plan) offering health insurance 
                        coverage within the United States (including 
                        carriers under the Federal Employee Health 
                        Benefits Program under chapter 89 of title 5, 
                        United States Code);
                            (ii) the Secretary with respect to coverage 
                        under the Medicare, Medicaid, and SCHIP 
                        programs under titles XVIII, XIX, and XXI of 
                        the Social Security Act (42 U.S.C. 1395, 1396, 
                        1397aa et seq.);
                            (iii) the Secretary of Veterans Affairs 
                        with respect to coverage provided through the 
                        Department of Veterans Affairs; and
                            (iv) the Secretary of Defense with respect 
                        to military health program coverage under 
                        chapter 55 of title 10, United States Code, 
                        including under the TRICARE program (as defined 
                        in section 1072(7) of such title).
                    (B) Limitation.--An entity described in the 
                paragraph shall not include a self-funded group health 
                plan to which the Employee Retirement Income Security 
                Act of 1974 applies.
    (e) Preemption.--The standards promulgated under subsection (c) 
shall preempt any related State standards that require summary of 
benefits health plan explanations that provide less information to 
consumers, as determined by the Secretary.
    (f) Failure To Provide.--An entity described in subsection (d)(2) 
that willfully fails to provide the information required under this 
section shall be subject to a fine of not more than $1,000 for each 
such failure. Such failure with respect to each enrollee shall 
constitute a separate offense for purposes of this subsection.

SEC. 4. CONSUMER HEALTH EDUCATION AND OUTREACH INITIATIVE.

    (a) Establishment.--Not later than 12 months after the date of 
enactment of this Act, the Secretary, acting through the Director of 
the Office, shall establish and implement a consumer health education 
and outreach initiative through the use of print, Internet, television, 
and radio media.
    (b) Required Information.--The initiative established under 
subsection (a) shall provide consumers with information concerning the 
following:
            (1) The importance of adopting responsible personal health 
        and wellness behaviors.
            (2) The important role of health insurance coverage in 
        maintaining personal health and wellness behaviors.
            (3) The impact of individuals without health insurance on 
        the general health care market and costs of health care 
        services.
            (4) The importance of utilizing preventive health services 
        and how to access such services.
            (5) The operation of health insurance plans.
            (6) Common health care terminology.
            (7) The information that a consumer should obtain about 
        health care services and health insurance plans prior to 
        participating.
            (8) The availability of, and eligibility for, Federal 
        health care programs and assistance.
            (9) The format and content of the summary of benefits 
        explanation required under section 3.
            (10) The resources available through the Office and how to 
        access those resources, including the Internet website and toll 
        free hotline.
    (c) Languages.--The Secretary shall provide information through the 
initiative under subsection (a) in multiple languages and in an 
accessible format for individuals with sight and hearing disabilities.
    (d) Duration.--The initiative under subsection (a) shall be at 
least 6 months in duration.
    (e) Authorization of Appropriations.--There is authorized to be 
appropriated, $10,000,000 to carry out this section.

SEC. 5. REPORT CONCERNING END-OF-LIFE CARE EDUCATION AND SPENDING.

    (a) Study.--The Secretary, in consultation with the representatives 
described in subsection (c), shall conduct a comprehensive study of 
matters related to improved consumer education on end-of-life care 
decisions and spending. Such study shall evaluate issues including--
            (1) consumer attitudes and questions regarding end-of-life 
        care decisions;
            (2) effective outreach methods to increase consumer 
        understanding of end-of-life care considerations and tools for 
        making end-of-life care decisions;
            (3) methods for empowering consumers to ensure that their 
        end-of-life care instructions are properly executed;
            (4) the appropriate timing and venues for end-of-life care 
        discussions between health care consumers and providers;
            (5) ethical and legal considerations considered by 
        consumers when making end-of-life care decisions;
            (6) trends in end-of-life care spending and the impact of 
        such spending on overall health care costs; and
            (7) potential strategies for addressing any identified end-
        of-life care spending issues.
    (b) Report.--Not later than 18 months after the date of enactment 
of this Act, the Secretary shall submit to Congress, a report 
concerning the study conducted under subsection (a) together with the 
recommendations of the Secretary for legislative or administrative 
action where appropriate.
    (c) Representatives.--The representatives described in this 
subsection include representatives from the following groups, 
organizations, or associations:
            (1) A senior citizen advocacy organization.
            (2) A hospice organization.
            (3) A physician-based hospice and palliative care 
        organization.
            (4) A home-health organization.
            (5) A long-term care advocacy organization.
            (6) A cancer research organization.
            (7) A patient advocacy organization.
            (8) A faith-based health care organization.
            (9) A nurse-based medical association.
            (10) A geriatrician-based medical association.
            (11) An academic medical institution.
            (12) A caregiver advocacy organization.
            (13) A chronic disease advocacy organization.
            (14) A disability rights advocacy organization.
            (15) A social work association.
            (16) A pediatric palliative care organization.
            (17) A veterans health care organization.

SEC. 6. ESTABLISHMENT OF DEPARTMENT OF EDUCATION GRANTS TO LOCAL 
              EDUCATIONAL AGENCIES FOR DEVELOPMENT AND IMPLEMENTATION 
              OF PERSONAL HEALTH AND NUTRITION PROGRAMS IN GRADES K-12.

    (a) Definitions.--In this section:
            (1) Local educational agency.--The term ``local educational 
        agency'' has the meaning given the term in section 9101 of the 
        Elementary and Secondary Education Act of 1965 (20 U.S.C. 
        7801).
            (2) Secretary.--The term ``Secretary'' means the Secretary 
        of Education.
    (b) Program Authorized.--The Secretary shall establish a 5-year 
pilot program awarding grants, on a competitive basis, to not more than 
25 local educational agencies to allow the local educational agencies 
to develop and implement a personal health and nutrition curriculum in 
elementary schools or secondary schools.
    (c) Application.--A local educational agency that desires to 
receive a grant under this section shall submit an application to the 
Secretary at such time, in such manner, and accompanied by such 
information as the Secretary may require. The application shall contain 
a plan for the proposed curriculum and for the use of the grant funds 
by the local educational agency, including a description of the 
population of children to be targeted by the program assisted under the 
grant.
    (d) Award Basis.--In awarding grants under this section, the 
Secretary shall consider whether the curriculum proposal submitted by 
the local educational agency in the application--
            (1) is age-appropriate for, and appealing to, children in 
        the targeted population described in the application;
            (2) incorporates evidence-based health and nutrition 
        standards as the basis for instruction;
            (3) integrates classroom instruction with physical activity 
        to demonstrate the benefits of adopting good personal health 
        and nutrition habits;
            (4) incorporates communication with parents and includes 
        family learning activities outside of the classroom; and
            (5) promotes school staff health and wellness.
    (e) Use of Funds.--A local educational agency receiving a grant 
under this section shall use such funds to develop and implement a 
personal health and nutrition curriculum for elementary or secondary 
school students.
    (f) Authorization of Appropriation.--There are authorized to be 
appropriated to carry out this section $500,000 for each of the fiscal 
years 2009 through 2014.
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