Increasing penalties for group health plans and health insurance issuers for practices that violate balance billing requirements

(a) PHSA Section 2723(b)(2)(C) of the Public Health Service Act (42 U.S.C. 300gg–22(b)(2)(C)) is amended— (1) in clause (i), by inserting (or, in the case of such a failure with respect to a provision specified in clause (iv), $10,000 per violation) after $100; and (2) by adding at the end the following new clause: (iv) Provisions specified For purposes of clause (i), the provisions specified in this clause are the following: (I) Subparagraphs (A) and (B) of section 2799A–1(a)(1). (II) Clauses (i), (ii), (iii), and (v) of section 2799A–1(a)(1)(C). (III) Subparagraphs (A), (B), and (E) of section 2799A–1(b)(1). (IV) Paragraphs (1) and (2) of section 2799A–2(a).. (b) ERISA Section 502 of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1131) is amended— (1) in subsection (a)(6), by striking or (9) and inserting (9), or (12); (2) in subsection (b)(3)— (A) by inserting, (c)(12), after subsections (c)(9); and (B) by inserting or (c)(12) after under subsection (c)(9); and (3) in subsection (c), by adding at the end the following new paragraph: (12) The Secretary may assess a civil penalty against any group health plan or health insurance issuer offering group health insurance coverage of not more than $10,000 per violation for each individual with respect to which such plan or coverage fails to comply with one of the following provisions: (A) Subparagraphs (A) and (B) of section 716(a)(1). (B) Clauses (i), (ii), (iii), and (v) of section 716(a)(1)(C). (C) Subparagraphs (A), (B), and (E) of section 716(b)(1). (D) Paragraphs (1) and (2) of section 717(a).. (c) IRC Section 4980D(b) of the Internal Revenue Code of 1986 is amended— (1) in paragraph (1), by inserting (or, in the case of such a failure with respect to a provision specified in paragraph (4), $10,000) after $100; and (2) by adding at the end the following new paragraph: (4) Provisions specified For purposes of paragraph (1), the provisions specified in this paragraph are the following: (A) Subparagraphs (A) and (B) of section 9816(a)(1). (B) Clauses (i), (ii), (iii), and (v) of section 9816(a)(1)(C). (C) Subparagraphs (A), (B), and (E) of section 9816(b)(1). (D) Paragraphs (1) and (2) of section 9817(a)..