S.Amdt. 3032

SA 3032. Mrs. BOXER 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 36, strike line 23 and insert the following: ``be
necessary to carry out this section.

``SEC. 2793A. IMPROVING OVERSIGHT OF INSURER SERVICE TO
BENEFICIARIES.

``(a) Definitions.--In this section--
``(1) the term `database' means the database established
under subsection (b); and
``(2) the term `NAIC' means the National Association of
State Insurance Commissioners.
``(b) Monitoring Insurer Handling of Requests for Coverage
of Medical Care.--
``(1) Establishment.--The Secretary shall, in consultation
with the NAIC, establish and maintain a nationally consistent
database that, using standardized definitions, tracks claims
handling performance by--
``(A) all group health plans (and health insurance issuers
offering group health insurance coverage in connection with a
group health plan) and health insurance issuers that offer
health insurance coverage in the individual market; and
``(B) external review organizations that consider and
resolve external appeals from such plans and issuers.
``(2) Content.--The database shall include information on
the nature, timing, final disposal, and other relevant
details (as determined by the Secretary) of claims, appeals,
reviews, and requests for or denials of treatment by the
entities described in paragraph (1). The Secretary may limit
the content of the database to those claims that are
monetarily significant, as determined by the Secretary.
``(3) Collection of data.--The Secretary shall have the
authority to collect and audit data from entities described
in paragraph (1) necessary to implement the database, except
that, in the case of such plans and issuers subject to the
Employee Retirement Income Security Act of 1974, such data
shall be collected by the Secretary of Labor for use by the
Secretary. At the discretion of the Secretary, such data
collection authority may be delegated to State insurance
regulators.
``(4) Data protection and privacy.--The Secretary and the
Secretary of Labor shall ensure the confidentiality and
privacy of any claims data submitted pursuant to this
section. Within 1 year of the date of enactment of this
section, the Secretary shall promulgate a proposed regulation
to ensure that such data is protected against any violation
of the privacy and confidentiality of an individual's medical
records. Within 180 days of such promulgation, the
Comptroller General shall publish a report on the adequacy of
such regulation to ensure such protection. The database shall
not include names, unencrypted Social Security numbers,
addresses, or other information that may uniquely identify an
individual.
``(5) Tabulation; classification.--The Secretary shall work
with the NAIC to develop a procedure for centralized
tabulation and classification of consumer complaints related
to claims handling, appeals, and reviews by the entities
described in paragraph (1).
``(c) Implementation.--The Secretary shall implement the
database not later than 2 years after the date of enactment
of this section.
``(d) Dissemination.--The Secretary shall make the database
available to State insurance regulators, health exchanges,
and consumer assistance ombudsmen, provided that such
entities ensure the confidentiality and privacy of medical
records and comply with all existing privacy laws, and shall
update the database on a quarterly basis.
``(e) Reporting.--Not later than January 1, 2013, and on an
annual basis thereafter, the Secretary shall issue a public
report assessing the performance of the plans and issuers
described in subsection (b)(1)(A) regarding claims handling,
appeals, and reviews. Such report shall assess whether there
is any evidence of a pattern of denial or delay of medically
necessary claims or appeals.''.
______