Overview

Title

To amend title XI of the Social Security Act to lower barriers to increase patient access to health care.

ELI5 AI

H.R. 7292 is a plan to make it easier for people to get healthcare by letting doctors and hospitals pay companies that share information, as long as they're honest about how they're doing it and no one gets paid unfairly. They also want to make sure everyone follows the rules and not just push people toward certain choices for money.

Summary AI

H. R. 7292, also known as the "Health ACCESS Act," proposes to amend section 1128B of the Social Security Act to help increase access to healthcare for patients. The bill aims to allow healthcare service providers to compensate information service providers without violating federal anti-kickback rules, provided certain conditions are met. Conditions include transparency about financial arrangements with service providers, ensuring that service selection isn’t steered by compensation, and maintaining fair market value for services. The bill also defines key terms such as "consumer" and "information service provider" to clarify who is impacted by these changes.

Published

2024-02-07
Congress: 118
Session: 2
Chamber: HOUSE
Status: Introduced in House
Date: 2024-02-07
Package ID: BILLS-118hr7292ih

Bill Statistics

Size

Sections:
2
Words:
937
Pages:
5
Sentences:
6

Language

Nouns: 286
Verbs: 75
Adjectives: 33
Adverbs: 5
Numbers: 20
Entities: 28

Complexity

Average Token Length:
4.18
Average Sentence Length:
156.17
Token Entropy:
4.87
Readability (ARI):
79.72

AnalysisAI

General Summary of the Bill

House Resolution 7292, also known as the "Health Accelerating Consumer’s Care by Expediting Self-Scheduling Act" or the "Health ACCESS Act," is proposed legislation aimed at amending Title XI of the Social Security Act. This bill seeks to lower the barriers to healthcare access by allowing financial arrangements between healthcare providers or suppliers and information service providers under specific conditions. Such conditions are designed to prevent these service providers from influencing consumer healthcare choices while offering information that is intended to enhance patient access and self-scheduling capabilities.

Summary of Significant Issues

Several important issues arise from this proposed legislation. The bill's lack of clarity on how compliance will be monitored or enforced could lead to varying interpretations, which may undermine the intent to improve healthcare access. Furthermore, the requirement that the payments do not exceed fair market value is subjective and could result in legal disputes over what constitutes fair compensation. The open-ended nature of the provision allowing the Secretary to impose additional conditions raises concerns about the potential for arbitrary decisions that may not be uniformly applied.

The bill's definitions restrict "information service providers" to web-based platforms, potentially excluding other technologies and users not utilizing such platforms. This limitation might create gaps that can be exploited, counteracting the overall goal of increasing healthcare access. Additionally, the mandate to use "objective, consumer-centric criteria" for providing information lacks specificity, leading to possible inconsistencies in application. Finally, the prohibition on steering or leading consumers without clear guidelines on what those actions entail might not effectively prevent the targeted behavior, leaving room for manipulation.

Impact on the Public

Broadly, this bill intends to enhance patient access to healthcare by facilitating easier self-scheduling and information sharing between consumers and healthcare providers. If successfully implemented, it could empower patients with more direct and informed choices in their healthcare decisions, potentially leading to increased satisfaction and more timely access to needed services.

However, due to the potential for varied interpretations and enforcement issues, there is a risk that the bill might not meet its goals fully. The public could experience confusion if services and compensation models do not adhere consistently to fair market value, or if providers exploit loopholes due to non-web-based technologies not being covered.

Impact on Stakeholders

For healthcare providers and suppliers, the bill presents an opportunity to engage more directly with consumers through compliant information service providers, possibly leading to increased patient volumes and streamlined operations. However, these stakeholders may face challenges in adhering to ill-defined compensation guidelines and establishing new compliance mechanisms.

Information service providers may find new opportunities to partner with healthcare entities, expanding their reach and impact. Nonetheless, the open-ended regulations and the Secretary's potential for imposing additional conditions may present uncertainty and additional compliance costs.

Patients stand to benefit from potentially reduced barriers to scheduling healthcare services and accessing provider information. However, if the stipulations within the bill are not clearly enforced, patients might experience varied levels of service quality and objectivity, affecting their healthcare decisions.

In conclusion, while H.R. 7292 aims to enhance healthcare access by modernizing scheduling and information sharing, significant clarifications and implementation frameworks are necessary to ensure its efficacy and prevent negative consequences for all stakeholders involved.

Issues

  • The amendment to Section 1128B introduces stipulations regarding information service providers without clear guidelines on compliance monitoring or enforcement. This lack of clarity could lead to ambiguity and inconsistent application, potentially undermining the legislation's intent to increase patient access to healthcare.

  • The requirement that compensation to information service providers does not exceed fair market value is subjective, as 'fair market value' can be interpreted in multiple ways. This ambiguity may lead to legal disputes, affecting the efficient implementation of the regulation.

  • The provision allowing the Secretary to determine additional conditions for information service providers is open-ended, which could result in arbitrary or inconsistent application of these conditions. This uncertainty could lead to challenges regarding fairness and transparency in enforcing these conditions.

  • The definition of 'information service provider' and 'consumer' is limited to web-based platforms and users accessing them. This definition could inadvertently exclude other forms of technology and users, potentially creating loopholes that may be exploited, contrary to the bill's purpose of broadening healthcare access.

  • The term 'objective, consumer-centric criteria' used to furnish provider- and supplier-specific information is vague and subject to interpretation. This could result in inconsistencies in how information is provided to consumers, possibly affecting their healthcare choices.

  • The prohibition on steering or leading consumers based on remuneration lacks specific guidelines on what constitutes 'steering' or 'leading.' This lack of specificity could impede enforcement and may not effectively prevent the targeted behavior, thus leaving room for manipulation.

Sections

Sections are presented as they are annotated in the original legislative text. Any missing headers, numbers, or non-consecutive order is due to the original text.

1. Short title Read Opens in new tab

Summary AI

The section states that the official name for this act is the "Health Accelerating Consumer’s Care by Expediting Self-Scheduling Act," which can be abbreviated as the "Health ACCESS Act."

2. Amendments to section 1128B Read Opens in new tab

Summary AI

The amendments to section 1128B of the Social Security Act introduce a new exception where payments from service providers or suppliers to information service providers are allowed, provided these information services meet specific conditions that ensure they don't influence consumer choices or engage in certain types of prohibited activities. Additionally, definitions for "consumer" and "information service provider" are specified to clarify who is covered under these rules.