1.Short title; table of
contents
(a)This Act may be cited
as the Patient-Controlled Healthcare
Protection Act of 2009
.
(b)The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
Title I—Health Savings Account Reform
Sec. 101. Advantage HSA.
Sec. 102. Health Savings Account reform.
Sec. 103. Advantage HSA grant program.
Sec. 104. Health Savings Account debit card.
Sec. 105. HSA Healthcare Panel.
Title II—Transparency related to health care provider
charges
Sec. 201. Transparency requirements related to health care
provider charges.
Title III—Immigration-related provisions
Sec. 301. Requirement for immigrant to be covered under high
deductible health plan and HSA.
Sec. 302. Reentry of removed alien who received emergency
medical assistance.
<enum>I</enum><header>Health Savings
Account Reform</header>
<section id="HB698088BF453404693216167624394A8"><enum>101.</enum><header>Advantage
HSA</header>
<subsection id="HD5736241455E4444BAF8120F6E738E6"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Part III of
subchapter B of chapter 1 of the Internal Revenue Code of 1986 is amended by
inserting after section 138 the following new section:</text>
<quoted-block display-inline="no-display-inline" id="H8979B96DC11941F99E577791C6DD7432" style="OLC">
<section id="H40B5DFC8AB2949C4B4E300C098C54C8C"><enum>138A.</enum><header>Advantage
HSA</header>
<subsection id="HDA2E4431E319434500B568DB07F4C64B"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">Gross income shall
not include any payment to the Advantage HSA of an individual by the Secretary
of the Treasury under section 103 of Patient-Controlled Healthcare Protection
Act of 2009 or any premium payment under such section for the high deductible
health plan with respect to which such Advantage HSA relates.</text>
</subsection><subsection id="H3A045D1EF97D4047AC88A22300396300"><enum>(b)</enum><header>Advantage
HSA</header><text>For purposes of this section, the term <term>Advantage
HSA</term> means a health savings account (as defined in section
223(d))—</text>
<paragraph id="HFF12255066A94DB5AB483E13202546C2"><enum>(1)</enum><text>which is
designated as an Advantage HSA,</text>
</paragraph><paragraph id="H0333C6F9E3244D609692B28165BB3500"><enum>(2)</enum><text>with respect to
which no contribution may be made other than—</text>
<subparagraph id="H37BE640A2240428DB378D30C3DB63B3"><enum>(A)</enum><text>a contribution
described in subsection (a),</text>
</subparagraph><subparagraph id="HD631AEB42B42483F9445C2AFA7B15500"><enum>(B)</enum><text>a contribution in
cash without limitation as to amount, or</text>
</subparagraph><subparagraph id="H9A6C59D3AA07484CAA797FD9A8345074"><enum>(C)</enum><text>a
trustee-to-trustee transfer described in subsection (d), and</text>
</subparagraph></paragraph><paragraph id="H853B24A110D24BF9BB0077537024C338"><enum>(3)</enum><text>the governing
instrument of which provides that trustee-to-trustee transfers described in
subsection (d) may be made to and from such account.</text>
</paragraph></subsection><subsection id="H3414CC4834DD4FE797C155C3F631D536"><enum>(c)</enum><header>Ten percent
bonus distribution</header>
<paragraph id="H0E7CA125A5C140F3B33F227A57BE2512"><enum>(1)</enum><header>In
general</header><text>Section 223(f)(2) shall not apply to any bonus
distribution from a health savings account.</text>
</paragraph><paragraph id="H465AB619D2AB429A92616C1BBA55F45"><enum>(2)</enum><header>Distributions</header><text display-inline="yes-display-inline">An eligible Advantage HSA participant may
receive 10 percent of excess funds that have been contributed to the individual
or household HSA over the deductible in a calendar year. The funds will be
directly deposited into the desired account of the participant.</text>
</paragraph><paragraph id="H1791760C91B1444686D095B48CEC2B4E"><enum>(3)</enum><header>Bonus
distribution</header><text display-inline="yes-display-inline">For purposes of
this subsection, the term <term>bonus distribution</term> means any
distribution which is made during the 30-day period beginning on the first day
of the calendar year to the extent such distribution does not exceed an amount
equal to the excess (if any) of—</text>
<subparagraph id="H795FE21E4FE74B0FB7C387AADA4C0545"><enum>(A)</enum><text>the fair market
value of the assets in such health savings account as of the close of the
preceding calendar year, over</text>
</subparagraph><subparagraph id="H85973397ECB34875911286EAF00F0666"><enum>(B)</enum><text display-inline="yes-display-inline">the sum of the annual deductible required
to be paid under the plan for covered benefits for the calendar year.</text>
</subparagraph></paragraph></subsection><subsection id="H1E5D96D5009F470EB6628D5399D0D13"><enum>(d)</enum><header>State
certification for high deductible health plans</header><text display-inline="yes-display-inline">For purposes of this section—</text>
<paragraph id="HD92674E5A3D648ABAF41B3EF90F77863"><enum>(1)</enum><header>In
general</header><text>For purposes of determining whether or not an individual
is an eligible individual, a health plan shall not be treated as a high
deductible health plan (as defined under section 223(c)(2)) unless such plan is
certified by the State within which the individual’s principal place of abode
is located.</text>
</paragraph><paragraph id="HB9AB0D0F918A4D1DA7DF800A50064F3"><enum>(2)</enum><header>Insurance
bidding</header><text>If an insurance company is based in the United States,
they may offer and sell policies in all States and they may bid on other
policies across State lines.</text>
</paragraph></subsection><subsection id="HB090F9EB8B3D48EF8FB6135143BA589"><enum>(e)</enum><header>Trustee-to-Trustee
transfer</header><text>Section 223(f)(2) shall not apply to any
trustee-to-trustee transfer from an Advantage HSA of an account holder to
another Advantage HSA or health savings account of such account holder.</text>
</subsection><subsection id="HD31F1C37A851457B8EF231A259C1A8B6"><enum>(f)</enum><header>Associations</header><text display-inline="yes-display-inline">Employers who choose to participate in the
Advantage HSA Program may join together in associations in an effort to
purchase less expensive insurance for their
employees.</text>
</subsection></section><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="HF95F817200044AD798DF25C0041C8B4"><enum>(b)</enum><header>Conforming
amendment</header><text display-inline="yes-display-inline">The table of
sections for part III of subchapter B of chapter 1 of such Code is amended by
inserting after the item relating to section 138 the following new item:</text>
<quoted-block display-inline="no-display-inline" id="H08886D9DF5C24C8AA9F50436B868C15D" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">138A. Advantage
HSA.</toc-entry>
</toc>
<after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H991D9DA3524447E38DD2FDB9696E240"><enum>(c)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to taxable
years beginning after December 31, 2009.</text>
</subsection></section><section id="HD81E05389105433680B977AE687EF388"><enum>102.</enum><header>Health Savings
Account reform</header>
<subsection id="HE5357BD73A6041D7A3E14D9B5D19A295"><enum>(a)</enum><header>Account-to-Account
transfers</header>
<paragraph id="HFCD657020AF44CCDA31E76644E8125D0"><enum>(1)</enum><header>In
general</header><text>Subparagraph (A) of section 223(f)(5) of the Internal
Revenue Code of 1986 is amended by striking <quote>a health savings account for
the benefit of such beneficiary</quote> and inserting <quote>any health savings
account</quote>.</text>
</paragraph><paragraph id="HE781477AC76841898BA37F9C6C060916"><enum>(2)</enum><header>Limitation</header><text display-inline="yes-display-inline">Subparagraph (B) of section 223(f)(5) of
such Code is amended—</text>
<subparagraph id="H076D163D3818477695542FF4055FF892"><enum>(A)</enum><text>by striking
<quote><header-in-text level="subparagraph" style="OLC">Limitation.—</header-in-text>This paragraph</quote> and inserting
the following:</text>
<quoted-block display-inline="no-display-inline" id="H96157D27428D4930A2A16C061E0072AE" style="OLC">
<subparagraph id="H028E2BEEB8494D378D642F4DAC8D7CDB"><enum>(B)</enum><header>Limitations</header>
<clause id="HBE2AE417AD0D40E19D5277BE71BC81C7"><enum>(i)</enum><header>In
general</header><text display-inline="yes-display-inline">This
paragraph</text>
</clause></subparagraph><after-quoted-block>,
and</after-quoted-block></quoted-block>
</subparagraph><subparagraph id="H6F94CF3A17F34D45AB39FFE176A928C"><enum>(B)</enum><text>by adding at the
end of subparagraph (B), as so amended, the following new clause:</text>
<quoted-block display-inline="no-display-inline" id="HBBB192F7BAF84FFDA326E76677F752E" style="OLC">
<clause id="HEC1B9129CD694A3FA1492032E2044F7B"><enum>(ii)</enum><header>Transfers to
other account beneficiaries</header><text display-inline="yes-display-inline">This paragraph shall not apply to any
amount described in subparagraph (A) to the extent that immediately after such
distribution the fair market value of the account is less than the annual
deductible required to be paid under the plan for the calendar year within
which the distribution is
made.</text>
</clause><after-quoted-block>.</after-quoted-block></quoted-block>
</subparagraph></paragraph></subsection><subsection id="H96BEED33EB5A4348985193858E2F04E1"><enum>(b)</enum><header>Migrant worker
HSA</header><text>Section 223 of such Code is amended by adding at the end the
following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="H4DD6A57C033645470017A49428932F62" style="OLC">
<subsection id="H5182C5595A2E4E4EB7BA55413F118286"><enum>(i)</enum><header>Migrant worker
HSA</header>
<paragraph id="HF3E49DF230994C75871F7F7E50880091"><enum>(1)</enum><header>In
general</header><text display-inline="yes-display-inline">An employer may
establish for the benefit of any eligible employee a health savings
account.</text>
</paragraph><paragraph id="HCD44AF94D10244478DBE7452362F2200"><enum>(2)</enum><header>Eligible
employee</header><text>For purposes of this subsection, the term <term>eligible
employee</term> means any individual (other than a citizen or resident of the
United States)—</text>
<subparagraph id="HC78227F5BA0F499DAAA174D642E006B1"><enum>(A)</enum><text>with respect to
whom the employee provides remuneration for employment, and</text>
</subparagraph><subparagraph id="H66FBF0D265794AE7B9089804A5F1300"><enum>(B)</enum><text>who is lawfully
present in the United States and has been granted authorization to engage in
employment in the United
States.</text>
</subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</subsection><subsection id="H2FC904C8BE7D4233BDFF5DD7612612F2"><enum>(c)</enum><header>Other
reforms</header><text>Section 223 of such Code is amended as follows:</text>
<paragraph id="HDD9A791568A041B8BDA8C12360D8E6B1"><enum>(1)</enum><text>By striking
paragraphs (1) through (4) and (6) through (8) of subsection (b) and by
redesignating paragraph (5) as paragraph (1).</text>
</paragraph><paragraph id="H3160FEBF8E82431386ABD4EFCC0F6DFD"><enum>(2)</enum><text>By inserting after
paragraph (1), as so redesignated, the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H85EE47AF3D1548B9BF9E0D1FEA1C9CA9" style="OLC">
<paragraph id="H4C6876D03290410FB9C518C1C948C7DC"><enum>(2)</enum><header>Household
HSA</header><text display-inline="yes-display-inline">In the case of health
savings accounts with respect to which individuals who are members of the same
household are the account beneficiaries, upon filing the return of tax for any
taxable year, each such individual shall include on the return each social
security number of all participating members of such individual’s
household.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H4A2C1CF40B39443AB8441BB741BC20A6"><enum>(3)</enum><text>By amending
paragraph (1) of subsection (c) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H44DDBA0A4192491E9C3CBAAAD5D17218" style="OLC">
<paragraph id="H63EA9DE160954B41A9744BEEFBD5352B"><enum>(1)</enum><header>Eligible
individual</header><text display-inline="yes-display-inline">The term
<quote>eligible individual</quote> means any
individual.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HB391362C872D43A6807CC455D927B5DB"><enum>(4)</enum><text>By amending
subsection (c)(2)(A) to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="HCB41D68F00E049B8B9123F93BDC582AE" style="OLC">
<subparagraph id="H1133D41C4FCE45CB99A7BB4ED7312B26"><enum>(A)</enum><header>In
general</header><text display-inline="yes-display-inline">The term <quote>high
deductible health plan</quote> means a health plan which has an annual
deductible which is not less than—</text>
<clause id="HF75EDD44161346D7AAFFA3B61D185D51"><enum>(i)</enum><text>$2,500 for
self-only coverage, and</text>
</clause><clause id="H605FEABF65954971A5C0B1036360F4A5"><enum>(ii)</enum><text>$3,500 for family
or household
coverage.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H942C99992FAD49F2BB90AE9BF527F418"><enum>(5)</enum><text>By striking
subparagraph (B) of subsection (c)(2) and redesignating subparagraphs (C) and
(D) thereof as subparagraphs (B) and (C), respectively.</text>
</paragraph><paragraph id="H5E9078F29D664B52A9FAEA59584E5982"><enum>(6)</enum><text>By adding at the
end of subsection (c)(2), as so amended, the following new subparagraph:</text>
<quoted-block display-inline="no-display-inline" id="H6AFBFBE9A26B4491AFAD72C3303DB587" style="OLC">
<subparagraph id="HA329291FFA8D465697DDED624F03035D"><enum>(D)</enum><header>Other
requirements</header><text display-inline="yes-display-inline">An Advantage HSA
plan will offer the following to the individual or household
participants—</text>
<clause id="HC8E58C4066634397894C746BE2790FAB"><enum>(i)</enum><text>the plan shall not
require that an individual see a general physician prior to a seeing
specialist, and</text>
</clause><clause id="H4530F27D5907489FA619F2168819D426"><enum>(ii)</enum><text>coverage may not
be denied based on a pre-existing condition of an
individual.</text>
</clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="HA30A3E10BED246439AFE007BEA7FBBC2"><enum>(7)</enum><text>By adding at the
end of subparagraph (A) of subsection (d)(2) the following: <quote>Such term
shall include any expense which is on the list of eligible healthcare expenses
most recently submitted by the HSA Healthcare Panel under section 105(b)(2) of
the Patient-Controlled Healthcare Protection Act of 2009.</quote>.</text>
</paragraph><paragraph id="H2B72FD89FF2747E592DEB87E26114516"><enum>(8)</enum><text>By striking
<quote>the individual</quote> in subsection (d)(3) and inserting <quote>an
individual</quote>.</text>
</paragraph><paragraph id="HE04EAD7534A14034BA7C5D0568D15324"><enum>(9)</enum><text>By adding at the
end of subsection (e) the following new paragraph:</text>
<quoted-block display-inline="no-display-inline" id="H9B123D88F7F546C987A72F06D235E8D1" style="OLC">
<paragraph id="HB1D1FC344DA4466891AA3AFC582130FA"><enum>(3)</enum><header>Exception</header><text display-inline="yes-display-inline">In the case of a termination occurring
after the date of the enactment of the Patient-Controlled Healthcare Protection
Act of 2009, in lieu of being treated as a distribution not used to pay
qualified medical expenses, such amounts shall be transferred by the account
beneficiaries to another health savings
account.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H9FCC94A7F13A4EFBB81BDE4BEBCE45B1"><enum>(10)</enum><text>In subsection
(f), by striking paragraphs (2), (3), (5), and (8) of and redesignating
paragraphs (4), (6), and (7) as paragraphs (2), (3), and (4),
respectively.</text>
</paragraph><paragraph id="H2A0E996B554A4BFF8545AEB9D923E706"><enum>(11)</enum><text>By amending
paragraph (2) of subsection (f), as so redesignated, to read as follows:</text>
<quoted-block display-inline="no-display-inline" id="H06B2A61D00AF4195ACC5C7D0450CE48A" style="OLC">
<paragraph id="H7E38638040334733A55C829C590A2539"><enum>(2)</enum><header>Amounts not used
for qualified medical expenses</header><text display-inline="yes-display-inline">Any amount paid or distributed out of a
health savings account which is not used exclusively to pay the qualified
medical expenses of an account beneficiary shall be recontributed by the
beneficiary to such health savings
account.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph><paragraph id="H92646AB5840A437BA88815BF4CCD6578"><enum>(12)</enum><text>By adding at the
end (as amended by this Act) the following new subsection:</text>
<quoted-block display-inline="no-display-inline" id="HE44D836BC07B454D90ECE1E29790F2A8" style="OLC">
<subsection id="H0399CD951D5342E8B3B43CC5D72B8B74"><enum>(j)</enum><header>Other special
rules</header><text display-inline="yes-display-inline">For purposes of this
section—</text>
<paragraph id="H82FCDEDAA8F4476AB5FC7C2C542BF5D5"><enum>(1)</enum><header>Investment of
HSA funds</header><text>Account beneficiaries may invest any amount in their
health savings account in excess of their deductible in inflation-proof United
States bonds.</text>
</paragraph><paragraph id="H8FC99922E9E44A24B1027CABB5D31F5B"><enum>(2)</enum><header>Termination of
household</header><text display-inline="yes-display-inline">Any account
beneficiaries of a household HSA shall sign an agreement as to distribution of
amounts from such HSA prior to termination of the HSA, which will be kept on
file with the entity in which the HSA funds are being held.</text>
</paragraph><paragraph id="H3FB8539BD1634A68B4B4CDA420AD400"><enum>(3)</enum><header>Portability</header><text display-inline="yes-display-inline">An individual or household participant owns
their HSA and insurance policy (if they choose to have one) and therefore the
policies are
portable.</text>
</paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></subsection><subsection id="H703CE99F00B64D44A28E2CE1E4691A11"><enum>(d)</enum><header>Effective
date</header><text>The amendments made by this section shall apply to taxable
years beginning after December 31, 2009.</text>
</subsection></section><section id="H0E415B62FE27488CBAFA9429A9F67676"><enum>103.</enum><header>Advantage HSA
payment program</header>
<subsection id="HBFF47260354A4CA2B79786366BE6C068"><enum>(a)</enum><header>In
general</header><text>The Advantage HSA payment program provided under this
section shall be in lieu of entitlement to, and eligibility for, benefits and
assistance described in subsection (d)(2). Effective on the date the Advantage
HSA payment program is established, titles XVIII, XIX, and XXI of the Social
Security Act are repealed, except for purposes of determining whether an
individual is an Advantage eligible individual under this section.</text>
</subsection><subsection id="HE8B6EE5F40EE4AEAA18DBDBBE7000058"><enum>(b)</enum><header>HSA
contributions</header><text display-inline="yes-display-inline">In the case of
an individual or household who is eligible for an Advantage HSA, the Secretary
of Treasury, in consultation with the Secretary of Health and Human Services,
shall pay an annual amount to the Advantage HSA of the individual or
household.</text>
</subsection><subsection id="HF49C86FC21D74CDA957F7BD99D2E4560"><enum>(c)</enum><header>HSA premium
assistance</header><text>The Secretary of the Treasury, in consultation with
the Secretary of Health and Human Services, shall establish a program under
which the Secretary of the Treasury shall pay the premiums for the high
deductible health plan with respect to the Advantage HSA of such individual.
Such program shall provide for prorated payment of such premiums in the case
that such individual is not an Advantage eligible individual for a full
calendar year.</text>
</subsection><subsection id="HEA9211DCA4FC4EA2977800E25252BCFD"><enum>(d)</enum><header>Advantage
eligible individual</header><text>For purposes of this section—</text>
<paragraph id="HAD506D7453974044BFEC2304B47951D8"><enum>(1)</enum><header>In
general</header><text>The term <term>Advantage eligible individual</term>
means, with respect to any month, any individual—</text>
<subparagraph id="HC246BFB9D95248C38B189B95D3CAC9EE"><enum>(A)</enum><text>who is an eligible
individual (as defined in section 223(c) of the Internal Revenue Code of 1986);
and</text>
</subparagraph><subparagraph id="HEE84EE499F8E43F900ABAA37EF99B2"><enum>(B)</enum><clause commented="no" display-inline="yes-display-inline" id="H9E0D28A2006C4CA7B094CEE6EE30C500"><enum>(i)</enum><text>who is Advantage
eligible; or</text>
</clause><clause id="HDB146D6EA1474D5CA1EE6B508C3DBEBA" indent="up1"><enum>(ii)</enum><text>whose dependent (within the
meaning of section 152 of the Internal Revenue Code of 1986) or spouse is
Advantage eligible (but only if an election under this section is in effect
with respect to such spouse or dependent).</text>
</clause></subparagraph></paragraph><paragraph id="H8ED60E87E46548AEA8E4A861B971FC95"><enum>(2)</enum><header>Advantage
eligible</header><text>The term <term>Advantage eligible</term> means, with
respect to any month—</text>
<subparagraph id="H899A2488B85541D4A761341E4CB91DF6"><enum>(A)</enum><text>entitled, as of
the 1st day of such month, to benefits under part A of title XVIII of the
Social Security Act or to enroll under part B of such title, or</text>
</subparagraph><subparagraph id="H3423607E1BD14954B1F556FA9147A888"><enum>(B)</enum><text>eligible, as of
the 1st day of such month, for medical or child health assistance under title
XIX or XXI of such Act (other than under section 1928 of such Act).</text>
</subparagraph></paragraph></subsection><subsection id="H69ECBD7B72F147F10090C46B152E3FC8"><enum>(e)</enum><header>Applicable
annual amount</header><text display-inline="yes-display-inline">For purposes of
this section—</text>
<paragraph id="H6ABE99683F914F12B86619B9FD4BF24D"><enum>(1)</enum><header>In
general</header><text>The term <term>applicable annual amount</term> means
$2,500.</text>
</paragraph><paragraph id="HBB4AC85E8AB5415D00076756C650BC2"><enum>(2)</enum><header>Additional
amount</header><text display-inline="yes-display-inline">In the case of an
Advantage HSA eligible household, $3,500.</text>
</paragraph></subsection><subsection id="HF5700362A56E4844A152DA263317007D"><enum>(f)</enum><header>Definitions</header><text>Except
as otherwise provided, terms used in this section shall have the same
respective meanings as when used in sections 138A and 223 of the Internal
Revenue Code of 1986.</text>
</subsection><subsection id="HB95A021BCA24480592D61E3A31CE6A"><enum>(g)</enum><header>Regulations</header><text>The
Secretary of the Treasury shall prescribe such regulations as may be necessary
or appropriate to carry out the purposes of this section, including regulations
providing for the following:</text>
<paragraph id="H230D4575E17A4FAD93B88B3638039420"><enum>(1)</enum><text>Recapture of
amounts paid under subsection (a) (and any earnings attributable thereto) which
are distributed out of an Advantage HSA and not used exclusively to pay
qualified medical expenses of the account beneficiary.</text>
</paragraph><paragraph id="HFE862E17F47542398515E215FFC8F1C0"><enum>(2)</enum><text display-inline="yes-display-inline">Ensuring that not more than the applicable
annual amount under paragraph (1) of subsection (d) (and any additional amount
under paragraph (2) of such subsection) shall be paid with respect to any
individual, the spouse of such individual, and all dependents with respect to
such individual.</text>
</paragraph><paragraph id="H3DD57F74CC004BF6A6D04A0822D98525"><enum>(3)</enum><text>Ensuring that all
individuals with respect to whom an election has been made under this section
are covered under the high deductible plan to which the applicable Advantage
HSA relates.</text>
</paragraph></subsection></section><section id="H155556FA628B49E68B884E750A4BD86A"><enum>104.</enum><header>Health Savings
Account debit card</header>
<subsection id="H123469E5F414441EABD7232079ADDCAD"><enum>(a)</enum><header>In
general</header><text display-inline="yes-display-inline">The Secretary of the
Treasury, in consultation with the Secretary of Health and Human Services,
shall establish a program under which trustees of health savings accounts can
issue debit cards with which account beneficiaries may pay for qualified
medical expenses (as defined in section 223 of the Internal Revenue Code of
1986). Such program shall provide for the following:</text>
<paragraph id="H42D38A80BDFE4667B9ECB24C6EE8C2C4"><enum>(1)</enum><text>Participation from
health care providers and vendors of products the purchase of which qualifies
as a qualified medical expense (as so defined).</text>
</paragraph><paragraph id="HB9AB150E93AF479480B73CB1DD512D3D"><enum>(2)</enum><text>A
uniform coding system implemented by such providers and vendors such that such
debit cards may not be used to purchase services or products which are not
qualified medical expenses (as so defined).</text>
</paragraph><paragraph id="H147490F8100840E190ADB3CED180D09B"><enum>(3)</enum><text display-inline="yes-display-inline">That prior to payment with such card such
providers and vendors require presentation an identification card that matches
the individual identified on the debit card and provides a photograph and is
issued by a State or the Federal Government, or a document that, with respect
to identification of the individual identified on the debit card, is considered
acceptable for purposes of sections 274a.2(b)(1)(v)(A) and 274a.2(b)(1)(v)(B)
of title 8, Code of Federal Regulations (as in effect on or after the date of
the enactment of this Act).</text>
</paragraph><paragraph id="H727F64FCD0A5437AA3B98FC21DF69CC6"><enum>(4)</enum><text display-inline="yes-display-inline">That the individual presenting such debit
card for payment sign a statement that affirms payment is for a qualified
medical expense with respect to such individual and which acknowledges that use
of such debit card for any other expense constitutes a false statements or
misrepresentations which may subject the purchaser to criminal penalties under
section 1001 of title 18, United States Code, which notice specifies the
maximum fine and term of imprisonment under such section.</text>
</paragraph></subsection><subsection id="H35876BD762844FCF8B5E62EADF63ABB6"><enum>(b)</enum><header>Submission of
information</header><text>Each trustee of a health savings account shall submit
to the HSA Healthcare Panel (established under section 105) a report detailing
all purchases made with debit cards from health savings accounts of the
trustee. Such report shall not contain any personal information of the account
beneficiaries of such health savings accounts.</text>
</subsection><subsection id="H1E718AAA9B0347A4A2B0C5B87B896D80"><enum>(c)</enum><header>Health savings
account; Qualified medical expenses</header><text display-inline="yes-display-inline">For purposes of this section, the terms
<term>health savings account</term> and <term>qualified medical expenses</term>
shall have the respective meanings given such terms by section 223 of the
Internal Revenue Code of 1986.</text>
</subsection></section><section id="HEDDDFF4BE0094C67AB33A102DDCDDF1"><enum>105.</enum><header>HSA Healthcare
Panel</header>
<subsection id="HF3B64C54E9DB4A73B49FF97000691875"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">There is established a Panel to be known as
the <quote>HSA Healthcare Panel</quote> (in this section referred to as the
<quote>Panel</quote>).</text>
</subsection><subsection id="H3B921093C7E740A3B5A51BAFA8A41177"><enum>(b)</enum><header>Duties</header>
<paragraph id="HF1041304CDA9477A904BCEB925CD9D00"><enum>(1)</enum><header>Review of
qualified medical expenses</header><text display-inline="yes-display-inline">The Panel shall review the reports and
other information submitted to the Panel under section 104 or requested by the
Panel and review appropriate information regarding the healthcare treatments,
services, and products that are potentially treatable as qualified medical
expenses for purposes of section 223 of the Internal Revenue Code of
1986.</text>
</paragraph><paragraph id="H8F98C7FBC7074116AEF63DAD6F22D7C7"><enum>(2)</enum><header>Report</header><text display-inline="yes-display-inline">The Panel shall, not later than 1 year
after the date of enactment of this Act and annually thereafter submit a report
to Congress providing a new list of eligible healthcare expenses.</text>
</paragraph></subsection><subsection id="HAA54E784FA9441159CE5D9BBE9CBA0"><enum>(c)</enum><header>Membership</header>
<paragraph id="H57A8C550031C419D9D87F8B3B6E6D0C7"><enum>(1)</enum><header>In
general</header><text>The Panel shall be comprised of 101 members.</text>
</paragraph><paragraph id="HC8F2BA6151C2443E96284807EF9D22C6"><enum>(2)</enum><header>Appointments</header>
<subparagraph id="H716A7002E4B9416C8C9709BF064423F"><enum>(A)</enum><header>Voting member and
chair</header><text>The Surgeon General of the United States shall be a voting
member of the Panel, and shall be the chairperson.</text>
</subparagraph><subparagraph id="H1181A2BF7FC94A1884A0C1C68191A5A4"><enum>(B)</enum><header>Other voting
members</header><text>The Governor of each State shall appoint 2 voting members
to the Panel, one of whom shall be a health care specialist and one of whom
shall not be a health care specialist.</text>
</subparagraph></paragraph><paragraph id="H8B2FA146A2A84CA7B03FB153F88B131B"><enum>(3)</enum><header>Date of
appointments</header><text>The appointment of a members of the Panel shall be
made not later than 60 days after the date of the enactment of this Act.</text>
</paragraph><paragraph id="H8BAA2C4A59364C448415777CF84D0069"><enum>(4)</enum><header>Term</header><text display-inline="yes-display-inline">Members shall be appointed for 1-year
terms.</text>
</paragraph><paragraph id="H879A262B5F94442B9446F2E652FEDEEF"><enum>(5)</enum><header>Vacancies</header><text>A
vacancy in the Panel shall be filled not later than 60 days after such vacancy
occurs and in the manner in which the original appointment was made.</text>
</paragraph></subsection><subsection display-inline="no-display-inline" id="H5E7DBB2B82F44030B2D9CCDF5ECC3737"><enum>(d)</enum><header>Powers of
panel</header>
<paragraph id="H50A9A7C30DEC441084002933147E9E78"><enum>(1)</enum><header>Meetings and
hearings</header>
<subparagraph id="HE064CF6C591949F092E354E71079D264"><enum>(A)</enum><header>In
general</header><text>The Panel shall meet upon the call of the chairperson or
a majority of its voting members. Such meetings, to the extent practicable, may
be conducted over the internet or in person.</text>
</subparagraph><subparagraph id="H16F4CCE34B0A497BBDBF48DE12D759EF"><enum>(B)</enum><header>Hearings</header><text>The
Panel may, for the purpose of carrying out this section, hold hearings, sit and
act at times and places, take testimony, and receive evidence to carry out its
duties under this section. The Panel may administer oaths or affirmations to
witnesses appearing before it.</text>
</subparagraph></paragraph><paragraph id="HDE61058D8A134235829C342182DF52F0"><enum>(2)</enum><header>Obtaining
official information</header>
<subparagraph id="H270DBD4DC7A34F6E96C75A001F5889B"><enum>(A)</enum><header>Requirement to
furnish</header><text>Except as provided in subparagraph (B), if the Panel
submits a request to a Federal department or agency for information necessary
to enable the Panel to carry out this section, the head of that department or
agency shall furnish that information to the Panel.</text>
</subparagraph><subparagraph id="H810FF7EBFBF04E099E251964750074F"><enum>(B)</enum><header>Exception for
national security</header><text>If the head of a Federal department or agency
determines that it is necessary to withhold requested information from
disclosure to protect the national security interests of the United States, the
department or agency head shall not furnish that information to the
Panel.</text>
</subparagraph></paragraph><paragraph id="HB0EBF2735CB64F7CBAD6C790FFD3723D"><enum>(3)</enum><header>Mails</header><text>The
Panel may use the United States mails in the same manner and under the same
conditions as other departments and agencies of the United States.</text>
</paragraph><paragraph id="H607F414F9F704921B2AD8558CAC9FDF1"><enum>(4)</enum><header>Contracts</header><text>The
Panel may contract with and compensate persons and government agencies for
supplies and services, without regard to section 3709 of the Revised Statutes
(41 U.S.C. 5).</text>
</paragraph></subsection><subsection display-inline="no-display-inline" id="HC1CBBA9AE0504B3D9FDA3EB1E99F9466"><enum>(e)</enum><header>Pay and
Reimbursement</header>
<paragraph id="HC3C0DFAA815F41D29B2692217BC5BFB"><enum>(1)</enum><header>No compensation
for members of Panel</header><text>Except as provided in paragraph (2), a
member of the Panel may not receive pay, allowances, or benefits by reason of
the member’s service on the Panel.</text>
</paragraph><paragraph commented="no" id="H78D2DAF8F03442AC88CA5C267F3E7DE4"><enum>(2)</enum><header>Travel
Expenses</header><text>Each member shall receive travel expenses, including per
diem in lieu of subsistence under subchapter I of chapter 57 of title 5, United
States Code.</text>
</paragraph></subsection><subsection id="H0CAE8ECFB0AA44179794B738A84EC9B5"><enum>(f)</enum><header>Quorum</header><text>Thirty
members of the Panel shall constitute a quorum, but a lesser number may hold
hearings.</text>
</subsection></section><enum>II</enum><header>Transparency
related to health care provider charges</header>
<section id="HC9197FC19C194AB19EF9ED239018C824"><enum>201.</enum><header>Transparency
requirements related to health care provider charges</header>
<subsection id="HDD6C6ABE3B7441789E7DE9BD5504C73C"><enum>(a)</enum><header>In
general</header><text>Notwithstanding any other provision of law, a health care
provider shall provide to an individual who is scheduled to receive a service
or treatment the following:</text>
<paragraph id="HC9B6146F6A3E426BB5273E23F8060046"><enum>(1)</enum><header>Actual prices to
be charged</header><text>The actual price that the health care provider will
charge for the service or treatment.</text>
</paragraph><paragraph id="HF5F0B00DF43548AA9F279D5174816C26"><enum>(2)</enum><header>Payment rates
applicable to other entities</header><text>In the case such charge amount for
the service or treatment is different from—</text>
<subparagraph id="HC7DA2D599F7043819E102B4D98404E3C"><enum>(A)</enum><text>the rate of
payment for the service or treatment to the health care provider that has been
negotiated by or on behalf of the provider with a network plan or managed care
plan;</text>
</subparagraph><subparagraph id="HC0E38B74834C4B3CA6338CE10C57592"><enum>(B)</enum><text>the rate of payment
for the service or treatment applicable to the provider under the Medicare
program under title XVIII; or</text>
</subparagraph><subparagraph id="H87822A258FB746D7A223FACFF656538"><enum>(C)</enum><text>such charge amount
or payment rate that is applicable with respect to any other entity;</text>
</subparagraph><continuation-text continuation-text-level="paragraph">the amount
of such different rate of payment or charge amount and a description of the
type of entity to which such rate or charge applies (without naming such
entity).</continuation-text></paragraph></subsection><subsection id="H7FDD733DAEFE4327ACD5A3C8A5445157"><enum>(b)</enum><header>Application of
requirement on request</header><text display-inline="yes-display-inline">A
health care provider is required to provide the applicable information under
subsection (a) for a service or treatment when requested by anyone in person,
or by phone, fax, or email.</text>
</subsection><subsection id="H4DF43FD3D86E4084BE42A1779315AE32"><enum>(c)</enum><header>Clarification</header><text display-inline="yes-display-inline">Nothing in this section shall be construed
as preventing a health care provider from providing a service or treatment free
of charge as a charitable gesture without publicly disclosing the individual to
whom such charitable service or treatment has been provided.</text>
</subsection><subsection id="H5F0B0AED7F6C49EAABF9819907747BC"><enum>(d)</enum><header>Effective
date</header><text>The requirement under subsection (a) shall apply with
respect to services and treatments provided on or after the date that is 60
days after the date of the enactment of this Act.</text>
</subsection></section><enum>III</enum><header>Immigration-related
provisions</header>
<section id="H9A2BCC1C6BAB4D3A833D988993F7E804"><enum>301.</enum><header>Requirement for
immigrant to be covered under high deductible health plan and HSA</header><text display-inline="no-display-inline">Notwithstanding any other provision of law,
a consular officer (as defined in section 101(a) of the Immigration and
Nationality Act (8 U.S.C. 1101(a)) may not issue or renew an immigrant visa to
an alien unless the alien presents evidence (which may be in the form of an
attestation by a sponsoring employer or individual United States citizen in
whose household the alien intends to reside who will be responsible for
providing the requisite coverage) that the alien (and the alien’s spouse and
children who are accompanying or following to join the alien) will be covered
under a high deductible health plan (as defined in section 223 of the Internal
Revenue Code of 1986) and will be an account beneficiary of a health savings
account under such section after the alien’s admission to the United States as
an immigrant and for the duration of the alien’s residence in the United
States, or be subject to removal.</text>
</section><section id="H1519EBFB0A28451FABF52B25D2E5829B"><enum>302.</enum><header>Reentry of
removed alien who received emergency medical assistance</header><text display-inline="no-display-inline">Section 276(b) of the Immigration and
Nationality Act (8 U.S.C. 1326(b)) is amended—</text>
<paragraph id="H893BAB0F9E5A440085B3391067B071F5"><enum>(1)</enum><text>in paragraph (3),
by striking <quote>. or</quote> at the end;</text>
</paragraph><paragraph id="H110E557F5B4F426292615B2C03E7CDAC"><enum>(2)</enum><text>in paragraph (4),
by striking the period at the end and inserting <quote>; or</quote>; and</text>
</paragraph><paragraph id="HABCCCFBBBCCE41FDBC5864C9B6D1E876"><enum>(3)</enum><text>by adding at the
end the following:</text>
<quoted-block display-inline="no-display-inline" id="H0E8381F5B00944BC9EA3FB63CA94CB39" style="OLC">
<paragraph id="H8D3CB4D72CE74264BA5CD0C35845E828"><enum>(5)</enum><text display-inline="yes-display-inline">whose removal was subsequent to the
provision of medical assistance pursuant to section 401(b)(1)(A) of the
Personal Responsibility and Work Opportunity Act of 1996 (8 U.S.C.
1611(b)(1)(A)), such alien shall be fined under title 18, United States Code,
imprisoned not more than 10 years, or
both.</text>
</paragraph><after-quoted-block>.</after-quoted-block></quoted-block>
</paragraph></section>