Page:United States Statutes at Large Volume 124.djvu/223

 124 STAT. 197 PUBLIC LAW 111–148—MAR. 23, 2010 (2) QUALIFIED ENTITY.—To be qualified to be selected by the Secretary to offer a community health insurance option, an entity shall— (A) meet the criteria established under section 1874A(a)(2) of the Social Security Act; (B) be a nonprofit entity for purposes of offering such option; (C) meet the solvency standards applicable under sub- section (b)(7); (D) be eligible to offer health insurance or health bene- fits coverage; (E) meet quality standards specified by the Secretary; (F) have in place effective procedures to control fraud, abuse, and waste; and (G) meet such other requirements as the Secretary may impose. Procedures described under subparagraph (F) shall include the implementation of procedures to use beneficiary identifiers to identify individuals entitled to benefits so that such an individ- ual’s social security account number is not used, and shall also include procedures for the use of technology (including front-end, prepayment intelligent data-matching technology similar to that used by hedge funds, investment funds, and banks) to provide real-time data analysis of claims for payment under this title to identify and investigate unusual billing or order practices under this title that could indicate fraud or abuse. (3) TERM.—A contract provided for under paragraph (1) shall be for a term of at least 5 years but not more than 10 years, as determined by the Secretary. At the end of each such term, the Secretary shall conduct a competitive bidding process for the purposes of renewing existing contracts or selecting new qualified entities with which to enter into con- tracts under such paragraph. (4) LIMITATION.—A contract may not be renewed under this subsection unless the Secretary determines that the con- tracting administrator has met performance requirements established by the Secretary in the areas described in para- graph (7)(B). (5) AUDITS.—The Inspector General shall conduct periodic audits with respect to contracting administrators under this subsection to ensure that the administrator involved is in compliance with this section. (6) REVOCATION.—A contract awarded under this subsection shall be revoked by the Secretary, upon the recommendation of the Inspector General, only after notice to the contracting administrator involved and an opportunity for a hearing. The Secretary may revoke such contract if the Secretary determines that such administrator has engaged in fraud, deception, waste, abuse of power, negligence, mismanagement of taxpayer dollars, or gross mismanagement. An entity that has had a contract revoked under this paragraph shall not be qualified to enter into a subsequent contract under this subsection. (7) FEE FOR ADMINISTRATION.— (A) IN GENERAL.—The Secretary shall pay the con- tracting administrator a fee for the management, adminis- tration, and delivery of the benefits under this section. Notification. Determination.