H.R. 758House110th Congress (2007-2009)Passed House

Breast Cancer Patient Protection Act of 2008

Introduced January 31, 2007

Legislative Activity

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20 earlier actions
SenateIntro Referral Latest Action

Received in the Senate.

September 25, 2008

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HouseIntro Referral

Introduced in House

January 31, 2007

HouseIntro Referral

Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, and Education and Labor, 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.

January 31, 2007

HouseCommittee

Referred to the Subcommittee on Health.

February 2, 2007

HouseCommittee

Referred to the Subcommittee on Health.

February 20, 2007

HouseCommittee

Referred to the Subcommittee on Health, Employment, Labor, and Pensions.

May 18, 2007

HouseCommittee

Subcommittee Hearings Held.

May 21, 2008

HouseCommittee

Committee Consideration and Mark-up Session Held.

September 17, 2008

HouseCommittee

Ordered to be Reported (Amended) by Voice Vote.

September 17, 2008

HouseCommittee

Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 110-868, Part I.

September 23, 2008

HouseCommittee

Committee on Ways and Means discharged.

September 23, 2008

HouseCommittee

Committee on Education and Labor discharged.

September 23, 2008

HouseCalendars

Placed on the Union Calendar, Calendar No. 564.

September 23, 2008

HouseFloor

Mr. Pallone moved to suspend the rules and pass the bill, as amended.

September 23, 2008 • 7:25 PM

HouseFloor

Considered under suspension of the rules. (consideration: CR H8661-8666)

September 23, 2008 • 7:25 PM

HouseFloor

DEBATE - The House proceeded with forty minutes of debate on H.R. 758.

September 23, 2008 • 7:25 PM

HouseFloor

At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.

September 23, 2008 • 7:43 PM

HouseFloor

Considered as unfinished business. (consideration: CR H9896)

September 25, 2008 • 1:44 PM

HouseFloor

Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 421 - 2 (Roll no. 639).(text: CR 9/23/2008 H8661-8664)

September 25, 2008 • 1:53 PM

HouseFloor

On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 421 - 2 (Roll no. 639). (text: CR 9/23/2008 H8661-8664)

September 25, 2008 • 1:53 PM

HouseFloor

Motion to reconsider laid on the table Agreed to without objection.

September 25, 2008 • 1:53 PM

SenateIntro Referral

Received in the Senate.

September 25, 2008

Floor Debate

21 members

What members said about H.R. 758 on the floor

7 Republicans14 Democrats
Pete Sessions
Rep. Pete SessionsR-TX-32 · Sep 25, 2008

I want to thank the gentleman, my friend, Mr. Arcuri, for the time that he has yielded me, and I yield myself such time as I may consume. ``Mr. Speaker, I rise in strong opposition to this martial…

Greg Walden
Rep. Greg WaldenR-OR-2 · Sep 25, 2008

I thank my colleague and friend from Texas for yielding. I come to the floor today bitterly disappointed that this majority is one more time denying the opportunity to fund county timber payments to…

Michael A. Arcuri
Rep. Michael A. ArcuriD-NY-24 · Sep 25, 2008

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 1490 and ask for its immediate consideration. Mr. Speaker, for the purpose of debate only, I yield the customary 30…

Doc Hastings
Rep. Doc HastingsR-WA-4 · Sep 25, 2008

I want to thank my friend from Texas for yielding me the time. Mr. Speaker, I have been in this body for going on 14 years, and I thought I understood how this system works. We have Republicans and…

Rosa L. DeLauro
Rep. Rosa L. DeLauroD-CT-3 · Sep 23, 2008

I thank the gentleman from New Jersey. After too many long years, this is a historic moment. After too many lost opportunities, this is our chance to make a difference and to take an important step…

Show 8 more
Frank Pallone, Jr.
Rep. Frank Pallone, Jr.D-NJ-6 · Sep 23, 2008

Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 758) to require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node…

Janice D. Schakowsky
Rep. Janice D. SchakowskyD-IL-9 · Sep 25, 2008

Madam Speaker, I rise today in support of a number of bipartisan public health bills to come before this body. These bills are the products of the Energy and Commerce Committee, where my colleagues…

Joe Barton
Rep. Joe BartonR-TX-6 · Sep 23, 2008

Thank you, Dr. Burgess. Mr. Speaker, I want to rise in strongest possible support for H.R. 758, the Breast Cancer Patient Protection Act. As you know, as our distinguished subcommittee chairman…

Edward J. Markey
Rep. Edward J. MarkeyD-MA-7 · Sep 25, 2008

I thank the gentleman very much. President Bush and the Senate Republicans have been given opportunity after opportunity to pass tax credit extensions for renewable energy. In just the past year and…

Sheila Jackson Lee
Rep. Sheila Jackson LeeD-TX-18 · Sep 23, 2008

Mr. Speaker, I speak today on an important bill that I believe in, H.R. 758, The Breast Cancer Patient Protect Action of 2007. This bill is important to people facing this horrible disease, and it is…

Peter Welch
Rep. Peter WelchD-VT · Sep 25, 2008

I thank the gentleman from New York, my colleague on the Rules Committee. I thank my friend from Texas, also a colleague on the Rules Committee. The legislation before us is long overdue. It's about…

Louise McIntosh Slaughter
Rep. Louise McIntosh SlaughterD-NY-28 · Sep 23, 2008

Mr. Speaker, today I rise in support of the Breast Cancer Patient Protection Act and urge its passage. Breast cancer is so pervasive it touches every American family. One in eight women can expect to…

Michael C. Burgess
Rep. Michael C. BurgessR-TX-26 · Sep 23, 2008

Mr. Speaker, I yield such time as he may consume to the ranking member of the full committee, Mr. Barton. (Mr. BARTON of Texas asked and was given permission to revise and extend his remarks.) Mr.…

Show 8 more
Lynn C. Woolsey
Rep. Lynn C. WoolseyD-CA-6 · Sep 23, 2008

Thank you, Mr. Pallone, and to the other side of the aisle, for bringing this wonderful bill before us, H.R. 758, the Breast Cancer Patient Protection Act. Breast cancer is the second leading cause…

Robert E. Andrews
Rep. Robert E. AndrewsD-NJ-1 · Sep 30, 2008

Madam Speaker, I rise today in strong support of Congresswoman Rosa DeLauro' s ``Breast Cancer Patient Protection Act of 2008,'' H.R. 758. On September 25, 2008, I voted in favor of H.R. 758, which…

John B. Larson
Rep. John B. LarsonD-CT-1 · Sep 23, 2008

Mr. Speaker, I rise today in strong support of H.R. 758: the ``Breast Care Patient Protection Act of 2008.'' I would like to commend my colleague, Congresswoman Rosa DeLauro who has fought…

Bob Etheridge
Rep. Bob EtheridgeD-NC-2 · Sep 30, 2008

Madam Speaker, I rise today in strong support of H.R. 758, the Breast Cancer Patient Protection Act of 2007. This important legislation will ensure that patients have the health care they need…

Jeff Miller
Rep. Jeff MillerR-FL-1 · Sep 28, 2008

Madam Speaker, I would like to offer a personal explanation of the reason I missed rollcall votes 637-644 on September 25, 2008. I was in my congressional district attending a funeral for a fallen…

John D. Dingell
Rep. John D. DingellD-MI-15 · Sep 28, 2008

Madam Speaker, H.R. 758, the ``Breast Cancer Patient Protection Act'', would require that insurance companies cover a stay of at least 48 hours in the hospital for women undergoing mastectomy and…

Todd Tiahrt
Rep. Todd TiahrtR-KS-4 · Sep 25, 2008

Mr. Speaker, on rollcall No. 638, I was unavoidably detained. Had I been present, I would have voted ``no.''

Gwen Moore
Rep. Gwen MooreD-WI-4 · Sep 25, 2008

Mr. Speaker, on rollcall No. 637, had I been present, I would have voted ``yea.''

Bill Text

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Received in SenateIssued September 25, 2008

II

110th CONGRESS

2d Session

H. R. 758

IN THE SENATE OF THE UNITED STATES

September 25 (legislative day, September 17), 2008

Received

AN ACT

To require that health plans provide coverage for a minimum hospital stay for mastectomies, lumpectomies, and lymph node dissection for the treatment of breast cancer and coverage for secondary consultations.

1.

Short title

This Act may be cited as the Breast Cancer Patient Protection Act of 2008.

2.

Findings

Congress finds that—

(1)

the offering and operation of health plans affect commerce among the States;

(2)

health care providers located in a State serve patients who reside in the State and patients who reside in other States;

(3)

in order to provide for uniform treatment of health care providers and patients among the States, it is necessary to cover health plans operating in 1 State as well as health plans operating among the several States;

(4)

currently, 20 States mandate minimum hospital stay coverage after a patient undergoes a mastectomy;

(5)

according to the American Cancer Society, there were 40,954 deaths due to breast cancer in women in 2004;

(6)

according to the American Cancer Society, there are currently over 2.0 million women living in the United States who have been treated for breast cancer; and

(7)

according to the American Cancer Society, a woman in the United States has a 1 in 8 chance of developing invasive breast cancer in her lifetime.

3.

Amendments to the Employee Retirement Income Security Act of 1974

(a)

In general

Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1185 et seq.) is amended by adding at the end the following:

714.

Required coverage for minimum hospital stay for mastectomies, lumpectomies, and lymph node dissections for the treatment of breast cancer and coverage for secondary consultations

(a)

Inpatient care

(1)

In general

A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, that provides medical and surgical benefits shall ensure that inpatient (and in the case of a lumpectomy, outpatient) coverage and radiation therapy is provided for breast cancer treatment. Such plan or coverage may not—

(A)

insofar as the attending physician, in consultation with the patient, determines it to be medically necessary—

(i)

restrict benefits for any hospital length of stay in connection with a mastectomy or breast conserving surgery (such as a lumpectomy) for the treatment of breast cancer to less than 48 hours; or

(ii)

restrict benefits for any hospital length of stay in connection with a lymph node dissection for the treatment of breast cancer to less than 24 hours; or

(B)

require that a provider obtain authorization from the plan or the issuer for prescribing any length of stay required under this paragraph.

(2)

Exception

Nothing in this section shall be construed as requiring the provision of inpatient coverage if the attending physician, in consultation with the patient, determines that either a shorter period of hospital stay, or outpatient treatment, is medically appropriate.

(b)

Prohibition on certain modifications

In implementing the requirements of this section, a group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, may not modify the terms and conditions of coverage based on the determination by a participant or beneficiary to request less than the minimum coverage required under subsection (a).

(c)

Notice

A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan shall provide notice to each participant and beneficiary under such plan regarding the coverage required by this section in accordance with regulations promulgated by the Secretary. Such notice shall be in writing and prominently positioned in the summary of the plan made available or distributed by the plan or issuer and shall be transmitted—

(1)

in the next mailing made by the plan or issuer to the participant or beneficiary; or

(2)

as part of any yearly informational packet sent to the participant or beneficiary;

whichever is earlier.
(d)

Secondary consultations

(1)

In general

A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, that provides coverage with respect to medical and surgical services provided in relation to the diagnosis and treatment of cancer shall ensure that coverage is provided for secondary consultations, on terms and conditions that are no more restrictive than those applicable to the initial consultations, by specialists in the appropriate medical fields (including pathology, radiology, and oncology) to confirm or refute such diagnosis. Such plan or issuer shall ensure that coverage is provided for such secondary consultation whether such consultation is based on a positive or negative initial diagnosis. In any case in which the attending physician certifies in writing that services necessary for such a secondary consultation are not sufficiently available from specialists operating under the plan with respect to whose services coverage is otherwise provided under such plan or by such issuer, such plan or issuer shall ensure that coverage is provided with respect to the services necessary for the secondary consultation with any other specialist selected by the attending physician for such purpose at no additional cost to the individual beyond that which the individual would have paid if the specialist was participating in the network of the plan.

(2)

Exception

Nothing in paragraph (1) shall be construed as requiring the provision of secondary consultations where the patient determines not to seek such a consultation.

(e)

Prohibition on penalties or incentives

A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, may not—

(1)

penalize or otherwise reduce or limit the reimbursement of a provider or specialist because the provider or specialist provided care to a participant or beneficiary in accordance with this section;

(2)

provide financial or other incentives to a physician or specialist to induce the physician or specialist to keep the length of inpatient stays of patients following a mastectomy, lumpectomy, or a lymph node dissection for the treatment of breast cancer below certain limits or to limit referrals for secondary consultations; or

(3)

provide financial or other incentives to a physician or specialist to induce the physician or specialist to refrain from referring a participant or beneficiary for a secondary consultation that would otherwise be covered by the plan or coverage involved under subsection (d).

.

(b)

Clerical amendment

The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 is amended by inserting after the item relating to section 713 the following:

Sec. 714. Required coverage for minimum hospital stay for mastectomies, lumpectomies, and lymph node dissections for the treatment of breast cancer and coverage for secondary consultations.

.

(c)

Effective dates

(1)

In general

The amendments made by this section shall apply with respect to plan years beginning on or after the date that is 90 days after the date of enactment of this Act.

(2)

Special rule for collective bargaining agreements

In the case of a group health plan maintained pursuant to 1 or more collective bargaining agreements between employee representatives and 1 or more employers ratified before the date of enactment of this Act, the amendments made by this section shall not apply to plan years beginning before the date on which the last collective bargaining agreements relating to the plan terminates (determined without regard to any extension thereof agreed to after the date of enactment of this Act). For purposes of this paragraph, any plan amendment made pursuant to a collective bargaining agreement relating to the plan which amends the plan solely to conform to any requirement added by this section shall not be treated as a termination of such collective bargaining agreement.

4.

Amendments to the Public Health Service Act relating to the group market

(a)

In general

Subpart 2 of part A of title XXVII of the Public Health Service Act (42 U.S.C. 300gg–4 et seq.) is amended by adding at the end the following:

2707.

Required coverage for minimum hospital stay for mastectomies, lumpectomies, and lymph node dissections for the treatment of breast cancer and coverage for secondary consultations

(a)

Inpatient care

(1)

In general

A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, that provides medical and surgical benefits shall ensure that inpatient (and in the case of a lumpectomy, outpatient) coverage and radiation therapy is provided for breast cancer treatment. Such plan or coverage may not—

(A)

insofar as the attending physician, in consultation with the patient, determines it to be medically necessary—

(i)

restrict benefits for any hospital length of stay in connection with a mastectomy or breast conserving surgery (such as a lumpectomy) for the treatment of breast cancer to less than 48 hours; or

(ii)

restrict benefits for any hospital length of stay in connection with a lymph node dissection for the treatment of breast cancer to less than 24 hours; or

(B)

require that a provider obtain authorization from the plan or the issuer for prescribing any length of stay required under this paragraph.

(2)

Exception

Nothing in this section shall be construed as requiring the provision of inpatient coverage if the attending physician, in consultation with the patient, determines that either a shorter period of hospital stay, or outpatient treatment, is medically appropriate.

(b)

Prohibition on certain modifications

In implementing the requirements of this section, a group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, may not modify the terms and conditions of coverage based on the determination by a participant or beneficiary to request less than the minimum coverage required under subsection (a).

(c)

Notice

A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan shall provide notice to each participant and beneficiary under such plan regarding the coverage required by this section in accordance with regulations promulgated by the Secretary. Such notice shall be in writing and prominently positioned in the summary of the plan made available or distributed by the plan or issuer and shall be transmitted—

(1)

in the next mailing made by the plan or issuer to the participant or beneficiary; or

(2)

as part of any yearly informational packet sent to the participant or beneficiary;

whichever is earlier.
(d)

Secondary consultations

(1)

In general

A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, that provides coverage with respect to medical and surgical services provided in relation to the diagnosis and treatment of cancer shall ensure that coverage is provided for secondary consultations, on terms and conditions that are no more restrictive than those applicable to the initial consultations, by specialists in the appropriate medical fields (including pathology, radiology, and oncology) to confirm or refute such diagnosis. Such plan or issuer shall ensure that coverage is provided for such secondary consultation whether such consultation is based on a positive or negative initial diagnosis. In any case in which the attending physician certifies in writing that services necessary for such a secondary consultation are not sufficiently available from specialists operating under the plan with respect to whose services coverage is otherwise provided under such plan or by such issuer, such plan or issuer shall ensure that coverage is provided with respect to the services necessary for the secondary consultation with any other specialist selected by the attending physician for such purpose at no additional cost to the individual beyond that which the individual would have paid if the specialist was participating in the network of the plan.

(2)

Exception

Nothing in paragraph (1) shall be construed as requiring the provision of secondary consultations where the patient determines not to seek such a consultation.

(e)

Prohibition on penalties or incentives

A group health plan, and a health insurance issuer providing health insurance coverage in connection with a group health plan, may not—

(1)

penalize or otherwise reduce or limit the reimbursement of a provider or specialist because the provider or specialist provided care to a participant or beneficiary in accordance with this section;

(2)

provide financial or other incentives to a physician or specialist to induce the physician or specialist to keep the length of inpatient stays of patients following a mastectomy, lumpectomy, or a lymph node dissection for the treatment of breast cancer below certain limits or to limit referrals for secondary consultations; or

(3)

provide financial or other incentives to a physician or specialist to induce the physician or specialist to refrain from referring a participant or beneficiary for a secondary consultation that would otherwise be covered by the plan or coverage involved under subsection (d).

.

(b)

Effective dates

(1)

In general

The amendments made by this section shall apply to group health plans for plan years beginning on or after 90 days after the date of enactment of this Act.

(2)

Special rule for collective bargaining agreements

In the case of a group health plan maintained pursuant to 1 or more collective bargaining agreements between employee representatives and 1 or more employers ratified before the date of enactment of this Act, the amendments made by this section shall not apply to plan years beginning before the date on which the last collective bargaining agreements relating to the plan terminates (determined without regard to any extension thereof agreed to after the date of enactment of this Act). For purposes of this paragraph, any plan amendment made pursuant to a collective bargaining agreement relating to the plan which amends the plan solely to conform to any requirement added by this section shall not be treated as a termination of such collective bargaining agreement.

5.

Amendment to the Public Health Service Act relating to the individual market

(a)

In general

Subpart 2 of part B of title XXVII of the Public Health Service Act (42 U.S.C. 300gg–51 et seq.) is amended by adding at the end the following new section:

2754.

Required coverage for minimum hospital stay for mastectomies, lumpectomies, and lymph node dissections for the treatment of breast cancer and secondary consultations

The provisions of section 2707 shall apply to health insurance coverage offered by a health insurance issuer in the individual market in the same manner as they apply to health insurance coverage offered by a health insurance issuer in connection with a group health plan in the small or large group market.

.

(b)

Effective date

The amendment made by this section shall apply with respect to health insurance coverage offered, sold, issued, renewed, in effect, or operated in the individual market on or after the date of enactment of this Act.

6.

Amendments to the Internal Revenue Code of 1986

(a)

In general

Subchapter B of chapter 100 of the Internal Revenue Code of 1986 is amended—

(1)

in the table of sections, by inserting after the item relating to section 9812 the following:

Sec. 9813. Required coverage for minimum hospital stay for mastectomies, lumpectomies, and lymph node dissections for the treatment of breast cancer and coverage for secondary consultations.

;

and

(2)

by inserting after section 9812 the following:

9813.

Required coverage for minimum hospital stay for mastectomies, lumpectomies, and lymph node dissections for the treatment of breast cancer and coverage for secondary consultations

(a)

Inpatient care

(1)

In general

A group health plan that provides medical and surgical benefits shall ensure that inpatient (and in the case of a lumpectomy, outpatient) coverage and radiation therapy is provided for breast cancer treatment. Such plan may not—

(A)

insofar as the attending physician, in consultation with the patient, determines it to be medically necessary—

(i)

restrict benefits for any hospital length of stay in connection with a mastectomy or breast conserving surgery (such as a lumpectomy) for the treatment of breast cancer to less than 48 hours; or

(ii)

restrict benefits for any hospital length of stay in connection with a lymph node dissection for the treatment of breast cancer to less than 24 hours; or

(B)

require that a provider obtain authorization from the plan for prescribing any length of stay required under this paragraph.

(2)

Exception

Nothing in this section shall be construed as requiring the provision of inpatient coverage if the attending physician, in consultation with the patient, determines that either a shorter period of hospital stay, or outpatient treatment, is medically appropriate.

(b)

Prohibition on certain modifications

In implementing the requirements of this section, a group health plan may not modify the terms and conditions of coverage based on the determination by a participant or beneficiary to request less than the minimum coverage required under subsection (a).

(c)

Notice

A group health plan shall provide notice to each participant and beneficiary under such plan regarding the coverage required by this section in accordance with regulations promulgated by the Secretary. Such notice shall be in writing and prominently positioned in the summary of the plan made available or distributed by the plan and shall be transmitted—

(1)

in the next mailing made by the plan to the participant or beneficiary; or

(2)

as part of any yearly informational packet sent to the participant or beneficiary;

whichever is earlier.
(d)

Secondary consultations

(1)

In general

A group health plan that provides coverage with respect to medical and surgical services provided in relation to the diagnosis and treatment of cancer shall ensure that coverage is provided for secondary consultations, on terms and conditions that are no more restrictive than those applicable to the initial consultations, by specialists in the appropriate medical fields (including pathology, radiology, and oncology) to confirm or refute such diagnosis. Such plan or issuer shall ensure that coverage is provided for such secondary consultation whether such consultation is based on a positive or negative initial diagnosis. In any case in which the attending physician certifies in writing that services necessary for such a secondary consultation are not sufficiently available from specialists operating under the plan with respect to whose services coverage is otherwise provided under such plan or by such issuer, such plan or issuer shall ensure that coverage is provided with respect to the services necessary for the secondary consultation with any other specialist selected by the attending physician for such purpose at no additional cost to the individual beyond that which the individual would have paid if the specialist was participating in the network of the plan.

(2)

Exception

Nothing in paragraph (1) shall be construed as requiring the provision of secondary consultations where the patient determines not to seek such a consultation.

(e)

Prohibition on penalties

A group health plan may not—

(1)

penalize or otherwise reduce or limit the reimbursement of a provider or specialist because the provider or specialist provided care to a participant or beneficiary in accordance with this section;

(2)

provide financial or other incentives to a physician or specialist to induce the physician or specialist to keep the length of inpatient stays of patients following a mastectomy, lumpectomy, or a lymph node dissection for the treatment of breast cancer below certain limits or to limit referrals for secondary consultations; or

(3)

provide financial or other incentives to a physician or specialist to induce the physician or specialist to refrain from referring a participant or beneficiary for a secondary consultation that would otherwise be covered by the plan involved under subsection (d).

.

(b)

Effective dates

(1)

In general

The amendments made by this section shall apply with respect to plan years beginning on or after the date of enactment of this Act.

(2)

Special rule for collective bargaining agreements

In the case of a group health plan maintained pursuant to 1 or more collective bargaining agreements between employee representatives and 1 or more employers ratified before the date of enactment of this Act, the amendments made by this section shall not apply to plan years beginning before the date on which the last collective bargaining agreements relating to the plan terminates (determined without regard to any extension thereof agreed to after the date of enactment of this Act). For purposes of this paragraph, any plan amendment made pursuant to a collective bargaining agreement relating to the plan which amends the plan solely to conform to any requirement added by this section shall not be treated as a termination of such collective bargaining agreement.

7.

Opportunity for independent, external third party reviews of certain nonrenewals and discontinuations, including rescissions, of individual health insurance coverage

(a)

Clarification regarding application of guaranteed renewability of individual health insurance coverage

Section 2742 of the Public Health Service Act (42 U.S.C. 300gg–42) is amended—

(1)

in its heading, by inserting , continuation in force, including prohibition of rescission, after Guaranteed renewability;

(2)

in subsection (a), by inserting , including without rescission, after continue in force; and

(3)

in subsection (b)(2), by inserting before the period at the end the following: , including intentional concealment of material facts regarding a health condition related to the condition for which coverage is being claimed.

(b)

Opportunity for independent, external third party review in certain cases

Subpart 1 of part B of title XXVII of the Public Health Service Act is amended by adding at the end the following new section:

2746.

Opportunity for independent, external third party review in certain cases

(a)

Notice and review right

If a health insurance issuer determines to nonrenew or not continue in force, including rescind, health insurance coverage for an individual in the individual market on the basis described in section 2742(b)(2) before such nonrenewal, discontinuation, or rescission, may take effect the issuer shall provide the individual with notice of such proposed nonrenewal, discontinuation, or rescission and an opportunity for a review of such determination by an independent, external third party under procedures specified by the Secretary.

(b)

Independent determination

If the individual requests such review by an independent, external third party of a nonrenewal,discontinuation, or rescission of health insurance coverage, the coverage shall remain in effect until such third party determines that the coverage may be nonrenewed, discontinued, or rescinded under section 2742(b)(2).

.

(c)

Effective date

The amendments made by this section shall apply after the date of the enactment of this Act with respect to health insurance coverage issued before, on, or after such date.

Passed the House of Representatives September 25, 2008.

Lorraine C. Miller,

Clerk