S.Amdt. 2896

SA 2896. Mr. UDALL of New Mexico submitted an amendment intended to
be proposed to amendment SA 2786 proposed by Mr. Reid (for himself, Mr.
Baucus, Mr. Dodd, and Mr. Harkin) to the bill H.R. 3590, to amend the
Internal Revenue Code of 1986 to modify the first-time homebuyers
credit in the case of members of the Armed Forces and certain other
Federal employees, and for other purposes; which was ordered to lie on
the table; as follows:

On page 128, between lines 6 and 7, insert the following:
(e) Medical Loss Ratio.--The Secretary shall develop a
definition for the term ``medical loss ratio'', and provide
standards for such term, including methods for calculating
loss ratios and determinations of what constitutes an
administrative cost.

SEC. 1305. HEALTH INSURANCE REPORT CARDS.

(a) In General.--Not later than one year after the date of
enactment of this Act, the Secretary shall develop a
standardized health insurance report card.
(b) Standards.--The report card described in subsection (a)
shall provide measures of the performance of qualified health
plans with regard to--
(1) the adequacy of the provider network;
(2) the timeliness and accuracy of payment of claims,
measured with regard to claims overall and claims associated
with selected health conditions and medical services;
(3) appeals and grievance procedures;
(4) adherence to fair marketing practices;
(5) satisfaction of minimum medical loss ratios;
(6) non-discrimination on the basis of health status;
(7) quality measures, as determined by the Secretary;
(8) renewal rate increases; and
(9) other factors, as the Secretary determines appropriate.
(c) Data Collection.--The Secretary shall, in cooperation
with State insurance regulators, collect data for the purpose
of determining the performance of qualified health plans with
regard to the standards described in subsection (b).
(d) Report Cards.--The data collected under subsection (c)
shall be compiled into a standardized health insurance report
card, described in subsection (a), and shall be made
available to consumers for the purpose of facilitating health
plan comparison and choice, including by making such report
cards available through the Internet portal established under
section 1103(a).
(e) Use of Health Plan Report Cards by the Secretary.--The
Secretary--
(1) may use the data collected under subsection (c) for
administrative purposes;
(2) shall use such data to determine unreasonable increases
in premiums for health insurance coverage, which may trigger
action by the Secretary, such as imposing premium rebates or
other sanctions, as appropriate; and
(3) may share such data with State insurance regulators,
the Secretary of the Treasury, and the Secretary of Labor,
for purposes of oversight and enforcement of the requirements
under this title, including sharing such data with
administrators of the Exchanges and using such data in
negotiations with health insurance issuers over the terms of
participation in such Exchanges.
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