[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4379 Introduced in House (IH)]

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116th CONGRESS
  1st Session
                                H. R. 4379

  To amend the Patient Protection and Affordable Care Act to require 
   qualified health plans to have in place a process to remove from 
 publicly accessible provider directories of such plans providers that 
are no longer within the network of such plans, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                           September 18, 2019

 Mrs. Axne (for herself, Ms. Stevens, Ms. Mucarsel-Powell, Mrs. Lee of 
 Nevada, Ms. Wild, Ms. Finkenauer, Ms. Torres Small of New Mexico, and 
Ms. Houlahan) introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
  To amend the Patient Protection and Affordable Care Act to require 
   qualified health plans to have in place a process to remove from 
 publicly accessible provider directories of such plans providers that 
are no longer within the network of such plans, and for other purposes.

    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 ``Under Performing Directories that 
Affect Treating Emergencies Act'' or the ``UPDATE Act''.

SEC. 2. REQUIREMENT FOR QUALIFIED HEALTH PLANS TO HAVE IN PLACE A 
              PROCESS TO REMOVE FROM PUBLICLY ACCESSIBLE PROVIDER 
              DIRECTORIES OF SUCH PLANS PROVIDERS THAT ARE NO LONGER 
              WITHIN THE NETWORK OF SUCH PLANS.

    (a) In General.--Section 1311(c) of the Patient Protection and 
Affordable Care Act (42 U.S.C. 18031(c)) is amended--
            (1) in paragraph (1)(B)--
                    (A) by striking ``and provide'' and inserting ``, 
                provide''; and
                    (B) by inserting before the semicolon at the end 
                the following: ``, and have in place the process 
                described in paragraph (7) to remove from any publicly 
                accessible provider directory of such plan providers 
                that are no longer within the network of such plan''; 
                and
            (2) by adding at the end the following new paragraph:
            ``(7) Process to remove from publicly accessible provider 
        directories providers that are no longer in-network.--For 
        purposes of paragraph (1)(B), the process described in this 
        paragraph, with respect to a qualified health plan, is a 
        process through which such plan does the following with respect 
        to each provider listed in a publicly accessible provider 
        directory of such plan that does not submit any claims to such 
        plan for at least a six-month period in a calendar year:
                    ``(A) Sends an inquiry to such provider requiring 
                such provider to verify, not later than the date that 
                is 30 days after such plan sends such inquiry, whether 
                such provider is still a provider within the network of 
                such plan.
                    ``(B) In the case that such plan--
                            ``(i) receives a response to such inquiry 
                        by the date described in subparagraph (A) that 
                        such provider is no longer a provider within 
                        the network of such plan, removes such provider 
                        from such publicly accessible provider 
                        directory; or
                            ``(ii) does not receive any response to 
                        such inquiry by such date--
                                    ``(I) sends a subsequent inquiry 
                                described in such subparagraph to such 
                                provider; and
                                    ``(II) removes such provider from 
                                such publicly accessible provider 
                                directory if such provider either 
                                submits to such plan, not later than 
                                the date that is 30 days after such 
                                plan sends such subsequent inquiry, a 
                                response described in clause (i), or 
                                does not respond to such subsequent 
                                inquiry by such date.''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply with respect to plan years beginning on or after January 1, 2021.
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