26 U.S.C. § 9824 — Increasing transparency by removing gag

Page 4208 TITLE 26—INTERNAL REVENUE CODE § 9824 1 So in original. There is no subsec. (b). gram, municipality-sponsored program, hos- pital independent partnership (hybrid) pro- gram, independent program, or tribally oper- ated program in Alaska. (C) Whether the transport in which the services were furnished originated in a rural or urban area. (D) The type of aircraft (such as rotor transport or fixed wing transport) used to furnish such services. (E) Whether the provider of such services has a contract with the plan or issuer, as ap- plicable, to furnish such services under the plan or coverage, respectively. (2) Such other information regarding pro- viders of air ambulance services as the Sec- retary may specify. (Added Pub. L. 116–260, div. BB, title I, § 106(b)(3)(A), Dec. 27, 2020, 134 Stat. 2854.) Editorial Notes REFERENCES IN TEXT Section 106(d) of the No Surprises Act, referred to in subsec. (a)(1), is section 106(d) of div. BB of Pub. L. 116–260, which is set out as a note under section 300gg–118 of Title 42, The Public Health and Welfare. § 9824. Increasing transparency by removing gag clauses on price and quality information (a) 1 Increasing price and quality transparency for plan sponsors and consumers (1) In general A group health plan may not enter into an agreement with a health care provider, net- work or association of providers, third-party administrator, or other service provider offer- ing access to a network of providers that would directly or indirectly restrict a group health plan from— (A) providing provider-specific cost or quality of care information or data, through a consumer engagement tool or any other means, to referring providers, the plan spon- sor, participants or beneficiaries, or individ- uals eligible to become participants or bene- ficiaries of the plan; (B) electronically accessing de-identified claims and encounter information or data for each participant or beneficiary in the plan, upon request and consistent with the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Infor- mation Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990, including, on a per claim basis— (i) financial information, such as the al- lowed amount, or any other claim-related financial obligations included in the pro- vider contract; (ii) provider information, including name and clinical designation; (iii) service codes; or (iv) any other data element included in claim or encounter transactions; or (C) sharing information or data described in subparagraph (A) or (B), or directing that such data be shared, with a business asso- ciate as defined in section 160.103 of title 45, Code of Federal Regulations (or successor regulations), consistent with the privacy regulations promulgated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amend- ments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990. (2) Clarification regarding public disclosure of information Nothing in paragraph (1)(A) prevents a health care provider, network or association of providers, or other service provider from placing reasonable restrictions on the public disclosure of the information described in such paragraph (1). (3) Attestation A group health plan shall annually submit to the Secretary an attestation that such plan is in compliance with the requirements of this subsection. (4) Rules of construction Nothing in this section shall be construed to modify or eliminate existing privacy protec- tions and standards under State and Federal law. Nothing in this subsection shall be con- strued to otherwise limit access by a group health plan or plan sponsor to data as per- mitted under the privacy regulations promul- gated pursuant to section 264(c) of the Health Insurance Portability and Accountability Act of 1996, the amendments made by the Genetic Information Nondiscrimination Act of 2008, and the Americans with Disabilities Act of 1990. (Added Pub. L. 116–260, div. BB, title II, § 201(c), Dec. 27, 2020, 134 Stat. 2893.) Editorial Notes REFERENCES IN TEXT Section 264(c) of the Health Insurance Portability and Accountability Act of 1996, referred to in subsec. (a)(1)(B), (C), (4), is section 264 of Pub. L. 104–191, which is set out as a note under section 1320d–2 of Title 42, The Public Health and Welfare. The Genetic Information Nondiscrimination Act of 2008, referred to in subsec. (a)(1)(B), (C), (4), is Pub. L. 110–233, May 21, 2008, 122 Stat. 881. For complete classi- fication of this Act to the Code, see Short Title note set out under section 2000ff of Title 42, The Public Health and Welfare, and Tables. The Americans with Disabilities Act of 1990, referred to in subsec. (a)(1)(B), (C), (4), is Pub. L. 101–336, July 26, 1990, 104 Stat. 327, which is classified principally to chapter 126 (§ 12101 et seq.) of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under sec- tion 12101 of Title 42 and Tables. § 9825. Reporting on pharmacy benefits and drug costs (a) In general Not later than 1 year after the date of enact- ment of the Consolidated Appropriations Act, 2021, and not later than June 1 of each year