Index for HR3962: Affordable Health Care for America Act

ACCEPTABLE coverage ;   Secretary developing procedures to provide for transition of eligible individuals enrolled in health insurance coverage offered through high-risk pool established under section to be enrolled in

ACCOUNT special circumstances of smaller plans, different types of plans and newer plans ;   Methodolology to be designed to take into

ACCOUNT ;   Participating employment-based plan taking into

ACCOUNT under subsection ;   Purposes of section, costs paid or incurred by employer for food or health insurance not to be taken into

ACTUARIAL value of benefit package being greater than 5 percent ;   Term substantial meaning increase in total premium share or decrease in

ADMINISTRATIVE simplification provisions of part and Health Insurance Portability and Accountability Act of 1996 ;   Secretary promulgating annual audit and certification process to ensure that health plans and clearinghouses being syntactically and functionally compliant standard transactions mandated pursuant to

ASSESSMENT against issuers for pool losses ;   Case of State required health insurance issuers to contribute to State high-risk pool or similar arrangement for

COBRA continations coverage extended under section to State health benefits risking pool recognized by Commissioner for purposes of section solely by reason of extension of coverage beyond date on which coverage otherwise to have expired ;   Provision having effect of limiting or precluding access by qualified beneficiary whose

EMPLOYEES' beneficiary association or committee or board of individuals appointed to administer plan ;   Former employers or employee organizations or associations or voluntary

BENEFICIARY identification card or similar mechanism ;   Including whether individual being eligible for specific service with specific physician at specific facility including utilization of machine-readable health plan

JURISDICTION ;   Enforcement process including timely investigation of complaints, random audits to ensure compliance, civil monetary and programmatic penalties for noncompliance consistent with existing laws and regulations and fair and reasonable appeals processing building off of enforcement provisions under part and concurrent State enforcement

ADMINISTRATIVE simplification provisions of part and Health Insurance Portability and Accountability Act of 1996 ;   Secretary promulgating annual audit and certification process to ensure that health plans and clearinghouses being syntactically and functionally compliant standard transactions mandated pursuant to

COBRA continations coverage after date of enactment of Act ;   Cobra continations coverage provision covered under

COBRA continations coverage after date of enactment of Act ;   Cobra continations coverage provision covered under

COBRA continations provision meaning provisions of law described in paragraph ;   Term

COINSURANCE or other out-of-pocket costs for plan participants and beneficiaries ;   Amounts paid to participating employment-based plan under subsection only to be used to reduce costs of health care provided by plan by reducing premium costs for employer or employee association maintaining plan and reducing premium contributions, deductibles, copayments,

ROBUST requiring minimal augmentation by paper transactions or clarifiations by further communications ;   Efficient and

CIVIL monetary and programmatic penalties for noncompliance consistent with existing laws and regulations and fair and reasonable appeals processing building off of enforcement provisions under part and concurrent State enforcement jurisdiction ;   Enforcement process including timely investigation of complaints, random audits to ensure compliance,

CONSTRAINTS for electronic transactions including companion guides ;   Permitting no additions or

CONTRACT health care service purchasing options for group plan sponsors ;   Business and consumer collaborative providing direct

CONTRACT health care service purchasing options for group plan sponsors ;   Business and consumer collaborative providing direct

DEFICIT ;   Secretary making adjustments as necessary to eliminate

DISENROLL from health benefiting coverage prior to enrolling in program ;   Issuer or employment-based health plan to be responsible for reimbursing program for medical expenses incurred by program for individual Secretary finds encouraged by issuer to

DOCUMENTATION of actual costs of items and services For which claim submitted ;   Participating employment-based plan submitting claims for reimbursement to Secretary containing

ELECTRONIC funds transferring under section 1173a ;   Payment being other than electronic funds transferring so long as Secretary adopting and implementing standard for

ELIGIBILITY for health plan and health claiming status under section to be adopted not later than October 1, 2011 ;   Including operating rules for transactions for

ELIGIBILITY determinations making by Secretary under section ;   Respect to

COLLECTIVE bargaining agreements between employee representatives and 1 or more employers ratified before date of enactment of Act ;   Case of group health plan maintained pursuant to 1 or more

CONTRIBUTIONS to fund plan ;   Active employee of employer maintaining plan or employer making making substantial

COINSURANCE or other out-of-pocket costs for plan participants and beneficiaries ;   Amounts paid to participating employment-based plan under subsection only to be used to reduce costs of health care provided by plan by reducing premium costs for employer or employee association maintaining plan and reducing premium contributions, deductibles, copayments,

PLANNING, onsite delivery, evaluation and improvement efforts ;   Employee engagement component providing for active engagement of employees in worksite wellness programs through worksite assessments and program

EMPLOYEES' beneficiary association or committee or board of individuals appointed to administer plan ;   Former employers or employee organizations or associations or voluntary

HEALTH outcomes ;   Including strategies focusing on prevention and support for employee populations at risk of poor

FINANCIAL consideations for disenrolling from coverage ;   Provision by employer, group health plan or issuer of money or other

GENERAL revenues by employer or employee association maintaining plan or other purposes ;   Amounts paid to plan under subsection not to be used as

ACCOUNT under subsection ;   Purposes of section, costs paid or incurred by employer for food or health insurance not to be taken into

HEALTH literacy curricula, instructional programs and effective intervention strategies ;   Requiring Secretaries to compile and disseminate to employer health planing information on model

HEALTH promotion and wellness programs ;   Consistent with evidence-based research and best practices as identified by persons with expertise in employer

EMPLOYMENT-based health plan ;   Person in waiting period as defined in section 2701(b)(4) of Public Health Service Act not to be considered to be eligible for coverage under

EXPENDITURES under reinsurance program not exceeding funds available under subsection ;   Secretary having authority to stop taking applications for participation in program or taking other steps in reducing expenditures under reinsurance program in order to ensure that

FINANCIAL hardship in complying with requirement ;   Secretary waiving requirement of subparagraph if State demonstrating to Secretary

FINANCIAL reward for participation of individual in program so long as reward not tying to premium or cost-sharing of individual under health benefiting plan ;   Providing

FRAUD, waste and abuse under program ;   Establishing procedures to protect against

FRAUD, waste and abuse under program ;   Procedures to protect against

GENERAL revenues by employer or employee association maintaining plan or other purposes ;   Amounts paid to plan under subsection not to be used as

HEALTH benefiting coverage prior to enrolling in program ;   Issuer or employment-based health plan to be responsible for reimbursing program for medical expenses incurred by program for individual Secretary finds encouraged by issuer to disenroll from

HEALTH benefiting plan ;   Providing financial reward for participation of individual in program so long as reward not tying to premium or cost-sharing of individual under

HEALTH flexible spending arrangement under cafeteria plan within meaning of section 125 of Internal Revenue Code of 1986 ;   Term not including coverage under

HEALTH claiming attachment transaction described in section 1173(a)(2)(b) of Social Security Act 42 USC 1320d-2(a)(2)(b) and coordination of benefits ;   Final rule to establish standard for

HEALTH care coverage for uninsured populations in State in manner consistent with reforms to take effect under division in Y1 ;   Secretary of Health and Human Services providing grants to States to establish programs to expand access to affordable

HEALTH care payment and remittance advice ;   Order to allow automated reconciliation with related

HEALTH coverage being part of plan at time of retirement ;   Nothing in section prohibiting plan from enforcing total aggregate cap on amounts paid for retiree

HEALTH outcomes ;   Including strategies focusing on prevention and support for employee populations at risk of poor

ELECTRONIC transactions provided in part ;   Requiring use of standard electronic transaction with health care providers quickly and efficiently enrolling with health plan to conduct other

EMPLOYMENT-based health plan for 6-month period immediately preceding date of individual's application for high-risk pool coverage under section ;   Health insurance coverage or coverage under

HEALTH care providers and other interested parties ;   Secretary of Health and Human Services promulgating interim final rule to establish unique health plan identifier described in section 1173(b) of Social Security Act 42 USC 1320d-2(b) based on input of National Committee of Vital and Health Statistics and consulations with health plans,

HEALTH problems and referrals for appropriate following up measures ;   Opportunity for periodic screenings for

HEALTH reform coverage expansions under division beginning in Y1 ;   State receiving grant under section submitting to Secretary report on best practices and lessons learned through grant to inform

IMPLEMENTATION plan ;   Estimate of total funds needed to ensure timely completion of