1.This Act may be cited as
the Consumer Health Education and
Transparency Act of 2008
.
2.Office of
Consumer Health Education and Information
(a)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)The Office shall be headed by a Director
who shall be appointed by the Secretary,
(c)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)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 appropriationsThere is authorized to be appropriated, such
sums as may be necessary to carry out this section.
3.Development and
utilization of uniform summary of benefits explanation
(a)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)The
standards for the summary of benefits explanation developed under subsection
(a) shall provide for the following:
(1)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)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)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)
(1)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)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)
(1)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)
(A)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)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)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)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.
4.Consumer Health
Education and Outreach Initiative
(a)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)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)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)The
initiative under subsection (a) shall be at least 6 months in duration.
(e)Authorization
of appropriationsThere is authorized to be appropriated,
$10,000,000 to carry out this section.
5.Report
Concerning End-of-Life Care Education and Spending
(a)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)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)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.
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)In
this section:
(1)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)The
term Secretary means the Secretary of Education.
(b)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)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)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)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 appropriationThere are authorized to be appropriated to carry
out this section $500,000 for each of the fiscal years 2009 through
2014.