I 111th CONGRESS 1st Session H. R. 3051 IN THE HOUSE OF REPRESENTATIVES June 25, 2009 Mr. Braley of Iowa (for himself, Mr. Teague, Mr. Schauer, Mr. Peters, Mr. Massa, Mr. Welch, and Ms. Sutton) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To enhance citizen awareness of insurance information and services by establishing that insurance documents issued to the public must be written clearly, and for other purposes.

1.

Short title

This Act may be cited as the Plain Language in Health Insurance Act of 2009.

2.

Purpose

The purpose of this Act is to improve the effectiveness and accountability of health insurance issuers, health plans, and Federal health care programs by promoting clear communication that the public can understand and use.

3.

Definitions

In this Act: (1)

Covered document

The term covered document means any publicly distributed document issued by a health insurance issuer, health plan, or Federal health care program. (2)

Plain language

The term plain language means language that the intended audience can readily understand and use because that language is clear, concise, well organized, and follows other best practices of plain language writing.

4.

Responsibilities of health insurance issuers, health plans, and federal health care programs

(a)

Requirement To Use Plain Language in New Documents

Not later than 1 year after the date of enactment of this Act, any health insurance issuer, health plan, and Federal health care program shall use plain language in any covered document of the plan issued or substantially revised. (b)

Guidance

(1)

In general

(A)

Development

Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services (in this Act referred to as the Secretary) shall develop guidance on implementing the requirements of subsection (a). (B)

Issuance

The Secretary shall issue the guidance developed under subparagraph (A) to health insurance issuers, health plans, and Federal health care programs. (2)

Interim guidance

Before the issuance of guidance under paragraph (1), any health insurance issuer, health plan, or Federal health care program may follow the— (A)guidance of the writing guidelines developed by the Plain Language Action and Information Network; or (B)guidance provided by the head of the agency that is consistent with the guidelines referred to under subparagraph (A). (c)

Enforcement

(1)

Health Insurance Issuers and Health Plans

(A)

Corrective action plan

If the Secretary finds that a health insurance issuer or health plan is in violation of subsection (a), the Secretary shall issue an order requiring the issuer or plan to submit a corrective action plan within 90 days for review and approval by the Secretary. (B)

Civil penalties

Any health insurance issuer or health plan that violates an order under subparagraph (A) or any provision of a corrective action plan approved by the Secretary pursuant to subparagraph (A) shall be liable to the United States for a civil penalty in an amount not to exceed $10,000 for each such violation, and not to exceed $50,000 for all such violations adjudicated in a single proceeding. (2)

Federal health care programs

The Secretary, in consultation with other appropriate Federal departments and agencies, shall establish mechanisms to ensure that Federal health care programs meet the requirements of subsection (a).

5.

Reports to congress

(a)

Initial Report

Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report that describes how the agency intends to meet the following objectives: (1)Communicating the requirements of this Act to health insurance issuers, health plans, and Federal health care programs. (2)Training Federal health care program employees to write in plain language. (3)Meeting the requirement under section 4(a). (4)Ensuring ongoing compliance with the requirements of this Act. (5)Enforcing the requirements of this Act pursuant to section 4(c). (6)Designating a senior official to be responsible for implementing the requirements of this Act. (b)

Annual and Other Reports

The Secretary shall submit reports on compliance with this Act to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate— (1)annually for the first 2 years after the date of enactment of this Act; and (2)once every 3 years thereafter.