Page:United States Statutes at Large Volume 124.djvu/922

 124 STAT. 896 PUBLIC LAW 111–148—MAR. 23, 2010 ‘‘(1) the extent to which self-insured group health plans can offer less costly coverage and, if so, whether lower costs are due to more efficient plan administration and lower over- head or to the denial of claims and the offering very limited benefit packages; ‘‘(2) claim denial rates, plan benefit fluctuations (to evaluate the extent that plans scale back health benefits during economic downturns), and the impact of the limited recourse options on consumers; and ‘‘(3) any potential conflict of interest as it relates to the health care needs of self-insured enrollees and self-insured employer’s financial contribution or profit margin, and the impact of such conflict on administration of the health plan. ‘‘(c) REPORT.—Not later than 1 year after the date of enactment of this Act, the Secretary shall submit to the appropriate committees of Congress a report concerning the results of the study conducted under subsection (a).’’. SEC. 10104. AMENDMENTS TO SUBTITLE D. (a) Section 1301(a) of this Act is amended by striking paragraph (2) and inserting the following: ‘‘(2) INCLUSION OF CO–OP PLANS AND MULTI-STATE QUALI- FIED HEALTH PLANS.—Any reference in this title to a qualified health plan shall be deemed to include a qualified health plan offered through the CO–OP program under section 1322, and a multi-State plan under section 1334, unless specifically pro- vided for otherwise. ‘‘(3) TREATMENT OF QUALIFIED DIRECT PRIMARY CARE MED- ICAL HOME PLANS.—The Secretary of Health and Human Serv- ices shall permit a qualified health plan to provide coverage through a qualified direct primary care medical home plan that meets criteria established by the Secretary, so long as the qualified health plan meets all requirements that are other- wise applicable and the services covered by the medical home plan are coordinated with the entity offering the qualified health plan. ‘‘(4) VARIATION BASED ON RATING AREA.—A qualified health plan, including a multi-State qualified health plan, may as appropriate vary premiums by rating area (as defined in section 2701(a)(2) of the Public Health Service Act).’’. (b) Section 1302 of this Act is amended— (1) in subsection (d)(2)(B), by striking ‘‘may issue’’ and inserting ‘‘shall issue’’; and (2) by adding at the end the following: ‘‘(g) PAYMENTS TO FEDERALLY-QUALIFIED HEALTH CENTERS.— If any item or service covered by a qualified health plan is provided by a Federally-qualified health center (as defined in section 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 1396d(l)(2)(B)) to an enrollee of the plan, the offeror of the plan shall pay to the center for the item or service an amount that is not less than the amount of payment that would have been paid to the center under section 1902(bb) of such Act (42 U.S.C. 1396a(bb)) for such item or service.’’. (c) Section 1303 of this Act is amended to read as follows: ‘‘SEC. 1303. SPECIAL RULES. ‘‘(a) STATE OPT-OUT OF ABORTION COVERAGE.— 42 USC 18023. 42 USC 18022. Criteria. 42 USC 18021.