[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6011 Introduced in House (IH)]

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114th CONGRESS
  2d Session
                                H. R. 6011

  To require that the Centers for Medicare & Medicaid Services has in 
place adequate verification procedures to ensure that advance payments 
under the Patient Protection and Affordable Care Act are made for only 
  enrollees under qualified health plans who have paid their premiums.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 13, 2016

Mr. Bilirakis introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   Ways and Means, for a period to be subsequently determined by the 
  Speaker, in each case for consideration of such provisions as fall 
           within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
  To require that the Centers for Medicare & Medicaid Services has in 
place adequate verification procedures to ensure that advance payments 
under the Patient Protection and Affordable Care Act are made for only 
  enrollees under qualified health plans who have paid their premiums.

    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 ``ACA Premium Payment Verification 
Act''.

SEC. 2. REQUIRING ADEQUATE CMS VERIFICATION PROCEDURES TO ENSURE 
              ADVANCE PAYMENTS UNDER THE AFFORDABLE CARE ACT ARE MADE 
              FOR ONLY ENROLLEES UNDER QUALIFIED HEALTH PLANS WHO HAVE 
              PAID THEIR PREMIUMS.

    (a) In General.--Notwithstanding any other provision of law, no 
advance payment under section 1412 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18082) may be made before such date that 
the Secretary of Health and Human Services certifies to Congress that 
the Centers for Medicare & Medicaid Services has in place an adequate 
process, in accordance with subsection (b), to independently verify if 
an individual is enrolled under a qualified health plan and has paid 
the premium under such plan.
    (b) Adequate Procedures.--For purposes of subsection (a), a 
process, with respect to the verifications described in such 
subsection, shall not be treated as an adequate process--
            (1) unless such process--
                    (A) is an automated process under which such 
                verifications are made on a policy basis and not on an 
                aggregate basis;
                    (B) has been tested by the Inspector General of the 
                Department of Health and Human Services and determined 
                by the Inspector General pursuant to such test as being 
                effective; and
                    (C) includes the provision by the Administrator of 
                the Centers for Medicare & Medicaid Services to the 
                Secretary of the Treasury of such payment information 
                as needed by the Secretary for verification of 
                eligibility of individuals for purposes of advance 
                payments under section 1412 of the Patient Protection 
                and Affordable Care Act (42 U.S.C. 18082); and
            (2) to the extent such process includes any procedures that 
        rely on assurances or attestations made by the issuer of the 
        qualified health plan involved.
    (c) Report on Cost-sharing Subsidies Allowed for Certain 
Individuals Enrolling in Qualified Health Plans.--Not later than one 
year after the date of the enactment of this Act, the Secretary of 
Health and Human Services shall submit to Congress a report on the 
extent to which adequate procedures are in place with respect to cost-
sharing reductions allowed under section 1402 of the Patient Protection 
and Affordable Care Act (42 U.S.C. 18071).
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