S.Amdt. 2397

SA 2397. Ms. WARREN submitted an amendment intended to be proposed by
her to the bill H.R. 1, to provide for reconciliation pursuant to title
II of H. Con. Res. 14; which was ordered to lie on the table; as
follows:

[[Page S3973]]

At the appropriate place, insert the following:

SEC. ___. MANDATORY REPORTING WITH RESPECT TO CERTAIN HEALTH-
RELATED OWNERSHIP INFORMATION.

Part A of title XI of the Social Security Act (42 U.S.C.
1301 et seq.) is amended by adding at the end the following
new section:

``SEC. 1150D. MANDATORY REPORTING WITH RESPECT TO CERTAIN
HEALTH-RELATED OWNERSHIP INFORMATION.

``(a) Mandatory Reporting With Respect Certain Health-
related Ownership Information.--
``(1) Reporting.--Not later than January 1, 2026 (or in the
case of a specified entity formed after January 1, 2026, not
later than 60 days after formation of the specified entity),
and each year thereafter, each specified entity shall submit
to the Secretary of Health and Human Services, in a form and
manner specified by the Secretary, a report containing the
following information, subject to paragraph (3)(B):
``(A) Data on mergers, acquisitions, changes in ownership,
changes in control, transactions to form new affiliations,
changes in partnerships, joint ventures, and/or management
services agreements, to which such specified entity is a
party for the previous 1-year period, including--
``(i) the primary reason the reporting entity completed the
acquisition; and
``(ii) a description of how the acquirer obtained control
of the acquiree, and the percentage of ownership acquired
(i.e., voting equity interests).
``(B) As applicable, the name, address, tax or health plan
identification numbers (including, without limitation, the
tax identification number, National Association of Insurance
Commissioners identification number, State insurance
identification number, Medicare provider number, and the
standard unique health identifier (as described in section
1173(b)) of all health care providers within the specified
entity that furnish items or services.
``(C) Business structure of any controlling entity,
including the business type and the tax identification number
of such entity, other affiliates under common control,
subsidiaries, and management services entities of such
specified entity, as of the date of the submission of this
report.
``(D) Information relating to--
``(i) the debt-to-earnings ratio of the specified entity;
``(ii) the amount of debt incurred--

``(I) by each hospital or separate entity within the health
system; and
``(II) by the entire specified entity;

``(iii) real estate leases and purchases for property used,
or intended to be used, to furnish or otherwise support the
provision of health care services, including expenditures on
rents and maintenance, property taxes paid, and the name of
the company leased from;
``(iv) details of other companies' revenue sharing
arrangement;
``(v) fees charged or dividends paid to investors;
``(vi) in the case of a non-profit hospital, a subsidiary
of a non-profit hospital, or a 501(c)(3) entity that shares
common ownership with a non-profit hospital, capital gains
investments (disaggregated by the type of investment) and any
taxes paid on such gains from such investments; and
``(vii) information with respect to any controlling entity
of such specified entity.
``(E) The value of quality payments received for
performance under any value-based or other performance-based
program such as the shared savings program under section
1899.
``(F) Any other information with respect to ownership or
control of a specified entity, as determined by the
Secretary.
``(G) Any changes to the health care providers within the
specified entity that furnish items or services during the
previous 1-year period, identified by the National Provider
identifier described in section 1173(b).
``(H) The domicile and business registration information
for any controlling entity or subsidiary of such controlling
entity that is domiciled outside of the United States.
``(2) Avoiding duplicate reporting.--If a specified entity
is owned or controlled by an entity described in subparagraph
(G) of subsection (e)(8), only the entity described in such
subparagraph (G) shall be required to submit reports under
this subsection with respect to such entity and any specified
entity owned or controlled by the entity.
``(3) Availability of information and public reporting.--
``(A) In general.--Not later than January 1, 2027, and
annually thereafter, subject to subparagraph (B), the
Secretary shall post on a publicly available website of the
Department of Health and Human Services the information
reported under this subsection with respect to the previous
1-year period for which the information was collected.
``(B) Requirement.--In making information reported under
this subsection publicly available under subparagraph (A),
the Secretary shall do so in a manner that does not disclose
any personally identifiable information of any individual
provider of services or supplier.
``(b) Audits.--The Secretary shall conduct an annual audit
consisting of a random sample of specified entities to verify
compliance with the requirements of this section and the
accuracy of information submitted pursuant to this section.
``(c) Penalty for Failure to Report.--If a specified entity
fails to provide a complete report under subsection (a), or
submits a report containing false information, such entity
shall be subject to a civil monetary penalty of not more than
$5,000,000 for each such report not provided or containing
false information. Such penalty shall be imposed and
collected in the same manner as civil money penalties under
subsection (a) of section 1128A are imposed and collected
under that section.
``(d) Inapplicability of Paperwork Reduction Act.--Chapter
35 of title 44, United States Code, shall not apply to
collections of information made under this section.
``(e) Definitions.--In this section:
``(1) Control.--The term `control' means the direct or
indirect power through ownership, contractual agreement, or
otherwise--
``(A) to vote more than 5 percent of any class of voting
securities of a specified entity; or
``(B) to direct the actions of the specified entity.
``(2) Controlling entity.--
``(A) In general.--The term `controlling entity' means,
with respect to any specified entity, a parent company or
other entity that owns or controls the specified entity
through ownership, contractual agreement, or otherwise.
``(B) Inclusion of reits.--Such term includes, with respect
to a specified entity, a real estate investment trust (as
defined in section 856 of the Internal Revenue Code of 1986)
that owns property where the specified entity furnishes
health care items or services.
``(3) Health plan.--The term `health plan' has the meaning
given such term in section 1128C(c).
``(4) Health system.--The term `health system' means a
group of health care organizations (such as physician
practices, hospitals, skilled nursing facilities) that are
jointly owned or managed.
``(5) Hospital.--The term `hospital' has the meaning given
such term in section 1861(e).
``(6) Independent freestanding emergency department.--The
term `independent freestanding emergency department' has the
meaning given such term in section 2799A-1(a)(3)(D) of the
Public Health Service Act.
``(7) Private fund.--The term `private fund' means a
corporation that--
``(A) would be considered an investment company under
section 3 of the Investment Company Act of 1940 (15 U.S.C.
80a-3) but for the application of paragraph (1) or (7) of
subsection (c) of such section 3;
``(B) is not a venture capital fund, as defined in section
275.203(l)-1 of title 17, Code of Federal Regulations, as in
effect on the date of enactment of this section; and
``(C) is not an institution selected under section 107 of
the Community Development Banking and Financial Institutions
Act of 1994 (12 2 U.S.C. 4706).
``(8) Specified entity.--The term `specified entity'
means--
``(A) a hospital or health system;
``(B) a physician-owned physician practice (other than a
practice described in subparagraph (C)) that is enrolled in
the Medicare program under title XVIII under section 1866(j);
``(C) a physician practice owned, controlled, under common
control, or under management agreement by a hospital, health
system, a health plan, a private fund, a venture capital
fund, a public or private corporation, or any subsidiaries or
entities under common control thereof;
``(D) an ambulatory surgical center meeting the standards
specified under section 1832(a)(2)(F)(i);
``(E) an independent freestanding emergency department;
``(F) a behavioral health treatment facility, a hospice
program (as defined in section 1861(dd)(2)), a home health
agency, a provider of services or renal dialysis facility
that furnishes renal dialysis services, or an assisted living
facility;
``(G) any other entity specified by the Secretary that
furnishes health care items and services; and
``(H) any entity that owns or controls 1 or more specified
entities.
``(9) Venture capital fund.--The term `venture capital
fund' has the meaning given in section 275.203(l)-1 of title
17, Code of Federal Regulations.''.
______