Overview
Title
To amend title XXVII of the Public Health Service Act and title 5, United States Code, to require group health plans, health insurance issuers offering group or individual health insurance coverage, and Federal Employees Health Benefits Program health benefits plans to meet certain requirements with respect to medical child support orders, and for other purposes.
ELI5 AI
In this bill, they want to make sure that children of divorced parents can easily get health care benefits. This means allowing the parent who takes care of the kids to ask for these benefits and get help from the insurance company more easily.
Summary AI
H.R. 9352, titled the “Ensuring Child Health Coverage Compensation in Divorce Act of 2024,” aims to ensure that children receive health insurance benefits through medical child support orders. It mandates that group health plans, health insurance providers, and the Federal Employees Health Benefits Program allow custodial parents to access necessary information to obtain benefits for their children. The bill also permits custodial parents to submit claims directly without needing approval from the noncustodial parent, and it requires payment to be made directly to the custodial parent or provider. This legislation is set to be effective for plan years starting on or after January 1, 2024.
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AnalysisAI
General Summary of the Bill
The bill, titled the "Ensuring Child Health Coverage Compensation in Divorce Act of 2024," is designed to amend existing legislation to ensure that children can obtain healthcare benefits through the health plans of noncustodial parents. This includes group health plans, individual health insurance coverages, and federal programs. The bill mandates that health plans must share necessary information with custodial parents, allow them to submit claims, and make payments directly to custodial parents or providers. The aim is to simplify the process for custodial parents to access necessary healthcare for their children following a divorce.
Summary of Significant Issues
Several key issues arise from the bill. First, there is a lack of oversight or specific accountability measures, which might open up the system for potential misuse, such as fraudulent claims. Second, the bill does not define what is meant by "benefits," which could lead to confusion about what is covered. Additionally, there are concerns about privacy and confidentiality as the bill lacks specific protections for sharing noncustodial parents' information with custodial parents. The procedures for submitting claims without the noncustodial parent's approval are not clearly defined, potentially leading to disputes. Finally, there is no outlined mechanism for resolving conflicts that could arise over claims, potentially leading to bureaucratic challenges.
Impact on the Public Broadly
For the general public, especially those involved in family law and child support matters, the bill could offer a streamlined process for ensuring children's healthcare is maintained post-divorce. By making it easier for custodial parents to access health benefits without needing consent from the noncustodial parent, it could simplify healthcare access for many children and relieve custodial parents from administrative hurdles.
Impact on Specific Stakeholders
Custodial Parents: The bill is generally beneficial for custodial parents, as it simplifies their ability to access necessary health coverage for their children. However, due to the lack of clear procedures and oversight, there could be challenges and delays.
Noncustodial Parents: Noncustodial parents might be concerned about privacy and the potential for claims being made without their knowledge or consent, which could lead to disputes and a sense of loss of control over financial responsibilities.
Healthcare Providers: For healthcare providers, the bill could facilitate quicker payments and clearer processes when dealing with child healthcare claims, yet the lack of clear guidelines might still lead to confusion and additional administrative tasks.
Health Insurance Companies and Federal Programs: These entities will need to adjust their processes to comply with the new requirements, which might involve additional efforts to ensure privacy protection and proper communication channels. If not managed well, this could incur extra administrative costs.
Overall, the bill seeks to address a meaningful issue in divorce-related child support, but it might require further refinement to address the notable gaps and issues identified.
Issues
The bill lacks clear oversight or accountability measures in the Medical Child Support Order Requirements section (Section 2), which could lead to misuse or misinterpretation of the provision for direct payments to custodial parents or providers, potentially making it easier for fraudulent claims to occur.
Neither Section 2730 nor Section 1150D provides a definition of 'benefits' under a group health plan, which may create uncertainty about what specific benefits are covered, affecting the ability of custodial parents to fully access support.
Both Section 2730 and Section 1150D do not specify privacy or confidentiality protections for noncustodial parents' information when it is shared with custodial parents, raising concerns over data protection and personal privacy.
The procedure for custodial parents to submit claims without the noncustodial parent's approval in Sections 2730 and 1150D is not thoroughly defined, which may lead to operational confusion and disputes.
Any dispute resolution mechanism for conflicts between noncustodial and custodial parents over claims is missing in Sections 2730 and 1150D, potentially leading to administrative difficulties and unresolved conflicts.
Section 1150D lacks specific details on how children's benefits information will be communicated securely to custodial parents, raising concerns about implementation and data security.
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 first section of this act states that the official name of the legislation is the “Ensuring Child Health Coverage Compensation in Divorce Act of 2024.”
2. Medical child support order requirements Read Opens in new tab
Summary AI
The section outlines requirements for providing health benefits for a child through the insurance of a noncustodial parent. It mandates that health plans, including Federal programs, must give necessary information to the custodial parent, allow claim submissions without the noncustodial parent's approval, and make direct payments to the custodial parent or provider starting in 2024.
2730. Coverage pursuant to medical child support orders Read Opens in new tab
Summary AI
In cases where a child receives health benefits from a noncustodial parent's health plan, the plan must share information with the custodial parent to access those benefits, allow the custodial parent to file claims, and make payments directly to the custodial parent or the service provider.
1150D. Coverage pursuant to medical child support orders Read Opens in new tab
Summary AI
The section outlines that when a child receives health benefits from a federal program through a noncustodial parent, the program must provide necessary information to the custodial parent, allow the custodial parent to submit claims, and pay the claims directly to the custodial parent or a state agency.