HouseH.R. 10908119th Congress
Ending Patient Runaround Act
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[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10908 Introduced in House (IH)]
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119th CONGRESS
2d Session
H. R. 10908
To implement Universal Savings Accounts and expand transparency,
competition, and patient rights in health care.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 26, 2026
Mr. Cloud introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To implement Universal Savings Accounts and expand transparency,
competition, and patient rights in health care.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Ending Patient Runaround Act''.
SEC. 2. UNIVERSAL SAVINGS ACCOUNTS.
(a) In General.--Subchapter F of chapter 1 of the Internal Revenue
Code of 1986 is amended by adding at the end the following new part:
``PART IX--UNIVERSAL SAVINGS ACCOUNTS
``SEC. 530A. UNIVERSAL SAVINGS ACCOUNTS.
``(a) General Rule.--A Universal Savings Account shall be exempt
from taxation under this subtitle. Notwithstanding the preceding
sentence, such account shall be subject to the taxes imposed by section
511 (relating to imposition of tax on unrelated business income of
charitable organizations).
``(b) Universal Savings Account.--For purposes of this section, the
term `Universal Savings Account' means a trust created or organized in
the United States for the exclusive benefit of an individual and which
is designated (in such manner as the Secretary shall prescribe) at the
time of the establishment of the trust as a Universal Savings Account,
but only if the written governing instrument creating the trust meets
the following requirements:
``(1) Except in the case of a qualified rollover
contribution described in subsection (d)--
``(A) no contribution will be accepted unless it is
in cash, and
``(B) contributions will not be accepted for the
calendar year in excess of the contribution limit
specified in subsection (c)(1).
``(2) The trustee is a bank (as defined in section 408(n))
or another person who demonstrates to the satisfaction of the
Secretary that the manner in which that person will administer
the trust will be consistent with the requirements of this
section or who has so demonstrated with respect to any
individual retirement plan.
``(3) The interest of an individual in the balance of his
account is nonforfeitable.
``(4) The assets of the trust shall not be commingled with
other property except in a common trust fund or common
investment fund.
``(5) No part of the trust funds will be invested in life
insurance contracts.
``(c) Treatment of Contributions and Distributions.--
``(1) Contribution limit.--
``(A) In general.--The aggregate amount of
contributions (other than qualified rollover
contributions described in subsection (d)) for any
calendar year to all Universal Savings Accounts
maintained for the benefit of an individual shall not
exceed $10,000.
``(B) Inflation adjustment.--In the case of any
calendar year after 2026, the $10,000 amount under
subparagraph (A) shall be increased by an amount equal
to--
``(i) such dollar amount, multiplied by
``(ii) the cost-of-living adjustment
determined under section 1(f)(3) for the
calendar year, determined by substituting
`calendar year 2026' for `calendar year 2016'
in subparagraph (A)(ii) thereof.
If any increase under this clause is not a multiple of
$100, such amount shall be rounded to the next lower
multiple of $100.
``(2) Distributions.--
``(A) In general.--Except as provided in
subparagraph (B), any distribution from a Universal
Savings Account shall not be includible in gross
income.
``(B) Net income attributable to excess
contributions.--Any distribution of net income
described in section 4973(i)(2) shall be includible in
the gross income of the account holder in the taxable
year in which the contribution to which such net income
relates was made.
``(d) Qualified Rollover Contribution.--For purposes of this
section, the term `qualified rollover contribution' means a
contribution to a Universal Savings Account from another such account
of the same beneficiary, but only if such amount is contributed not
later than the 60th day after the distribution from such other account.
``(e) Treatment of Account Upon Death.--Upon death of any account
holder of a Universal Savings Account--
``(1) Spouse.--In the case of the account holder's
surviving spouse acquiring such account holder's interest in
such account by reason of the death of the account holder, such
account shall be treated as if the spouse were the account
holder.
``(2) Other cases.--In any other case--
``(A) all amounts in such account shall be treated
as distributed on the date of such individual's death,
and
``(B) such account shall cease to be treated as a
Universal Savings Account.
``(f) Custodial Accounts.--For purposes of this section, a
custodial account shall be treated as a trust under this section if the
assets of such account are held by a bank (as defined in section
408(n)) or another person who demonstrates, to the satisfaction of the
Secretary, that the manner in which he will administer the account will
be consistent with the requirements of this section, and if the
custodial account would, except for the fact that it is not a trust,
constitute a trust which meets the requirements of subsection (b). For
purposes of this title, in the case of a custodial account treated as a
trust by reason of the preceding sentence, the custodian of such
account shall be treated as the trustee thereof.
``(g) Reports.--The trustee of a Universal Savings Account shall
make such reports regarding such account to the Secretary and to the
beneficiary of the account with respect to contributions,
distributions, and such other matters as the Secretary may require. The
reports required by this subsection shall be filed at such time and in
such manner and furnished to such individuals at such time and in such
manner as may be required.''.
(b) Tax on Excess Contributions.--
(1) In general.--Section 4973(a) is amended by striking
``or'' at the end of paragraph (5), by inserting ``or'' at the
end of paragraph (6), and by inserting after paragraph (6) the
following new paragraph:
``(7) a Universal Savings Account (as defined in section
530U),''.
(2) Excess contribution.--Section 4973 is amended by adding
at the end the following new subsection:
``(i) Excess Contributions to Universal Savings Accounts.--For
purposes of this section--
``(1) In general.--In the case of Universal Savings
Accounts (within the meaning of section 530U), the term `excess
contributions' means the sum of--
``(A) the amount (if any) by which the amount
contributed for the taxable year to such accounts
(other than qualified rollover contributions (as
defined in section 530U(d))) exceeds the contribution
limit under section 530U(c)(2) for such taxable year,
and
``(B) the amount determined under this subsection
for the preceding taxable year, reduced by the sum of--
``(i) the distributions out of the account
for the taxable year, and
``(ii) the amount (if any) by which the
maximum amount allowable as a contribution
under section 530U(c)(2) for the taxable year
exceeds the amount contributed to the accounts
for the taxable year.
``(2) Special rule.--A contribution shall not be taken into
account under paragraph (1) if such contribution (together with
the amount of net income attributable to such contribution) is
distributed to the account holder on or before the due date of
the account holder's return of tax for such taxable year.''.
(c) Tax on Excess Contributions.--
(1) In general.--Subsection (a) of section 4973 of the
Internal Revenue Code of 1986 is amended by striking ``or'' at
the end of paragraph (5), by inserting ``or'' at the end of
paragraph (6), and by inserting after paragraph (6) the
following new paragraph:
``(7) a Universal Savings Account (as defined in section
530A),''.
(2) Excess contribution.--Section 4973 of such Code is
amended by adding at the end the following new subsection:
``(i) Excess Contributions to Universal Savings Accounts.--For
purposes of this section--
``(1) In general.--In the case of Universal Savings
Accounts (within the meaning of section 530A), the term `excess
contributions' means the sum of--
``(A) the amount (if any) by which the amount
contributed for the taxable year to such accounts
(other than qualified rollover contributions (as
defined in section 530A(d))) exceeds the contribution
limit under section 530A(c)(1) for such taxable year,
and
``(B) the amount determined under this subsection
for the preceding taxable year, reduced by the sum of--
``(i) the distributions out of the account
for the taxable year, and
``(ii) the amount (if any) by which the
maximum amount allowable as a contribution
under section 530A(c)(1) for the taxable year
exceeds the amount contributed to the accounts
for the taxable year.
``(2) Special rule.--A contribution shall not be taken into
account under paragraph (1) if such contribution (together with
the amount of net income attributable to such contribution) is
distributed to the account holder on or before the due date of
the account holder's return of tax for such taxable year.''.
(d) Tax on Prohibited Transactions.--Section 4975(e)(1) of the
Internal Revenue Code of 1986 is amended by striking ``or'' at the end
of subparagraph (F), by striking the period at the end of subparagraph
(G) and inserting ``, or'', and by adding at the end the following new
subparagraph:
``(H) a Universal Savings Account (as defined in
section 530A).''.
(e) Failure To Provide Reports on Universal Savings Accounts.--
Paragraph (2) of section 6693(a) of the Internal Revenue Code of 1986
is amended by striking ``and'' at the end of subparagraph (E), by
striking the period at the end of subparagraph (F) and inserting ``,
and'', and by adding at the end the following new subparagraph:
``(G) section 530A(g) (relating to Universal
Savings Accounts).''.
(f) Conforming Amendment.--The table of parts for subchapter F of
chapter 1 of the Internal Revenue Code of 1986 is amended by adding at
the end the following new item:
``Part IX. Universal Savings Accounts''.
(g) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2024.
SEC. 3. TRANSPARENCY.
(a) Requirements Relating to Provision of Prior Authorization
Approval or Denial.--Subpart II of part A of title XXVII of the Public
Health Service Act (42 U.S.C. 300gg-11 et seq.) is amended by adding at
the end the following new section:
``SEC. 2730. REQUIREMENTS RELATING TO PROVISION OF PRIOR AUTHORIZATION
APPROVAL OR DENIAL.
``A group health plan and a health insurance issuer offering group
or individual health insurance coverage that receives a request to
authorize a procedure or the provision of a service or item under the
plan or coverage shall--
``(1) issue the approval or denial of the request--
``(A) in writing to the medical provider and
patient;
``(B) through a secure portal; and
``(C) within 30 days after receipt of the request;
and
``(2) in the case a procedure or provision of service is
denied and a peer to peer review is invoked, shall provide a
peer that is in the same specialty as the medical provider.''.
(b) Prohibition on Changing the Tier List of a Drug To Be More
Restrictive, or a Service Not Covered by the Insurer.--Subpart II of
part A of title XXVII of the Public Health Service Act (42 U.S.C.
300gg-11 et seq.) is further amended by adding at the end the following
new section:
``SEC. 2731. PROHIBITION ON CHANGING THE TIER LIST OF A DRUG TO BE MORE
RESTRICTIVE, OR A SERVICE NOT COVERED BY THE INSURER.
``A group health plan and a health insurance issuer offering group
or individual health insurance coverage may not, during the term of the
coverage, change--
``(1) the tier in which a prescription drug is listed to be
more restrictive; or
``(2) the list of services not covered by the plan or
coverage.''.
(c) Information Required To Be Provided With Insurance Contract.--
Subpart II of part A of title XXVII of the Public Health Service Act
(42 U.S.C. 300gg-11 et seq.) is further amended by adding at the end
the following new section:
``SEC. 2732. INFORMATION REQUIRED TO BE PROVIDED WITH INSURANCE
CONTRACT.
``A group health plan and a health insurance issuer offering group
or individual health insurance coverage shall include, with any copy of
the contract of insurance or benefits that is provided by the plan or
issuer to any person, the following:
``(1) The procedure code for each procedure covered by the
plan or coverage.
``(2) The amount the plan or coverage will charge for each
such procedure.
``(3) A full list of the services and procedures covered by
the plan or coverage.''.
SEC. 4. COMPETITION.
(a) Requiring Equivalent Reimbursement Rates for In-Network and
Out-of-Network Providers.--Subpart II of part A of title XXVII of the
Public Health Service Act (42 U.S.C. 300gg-11 et seq.) is further
amended by adding at the end the following new section:
``SEC. 2733. REQUIRING EQUIVALENT REIMBURSEMENT RATES FOR IN-NETWORK
AND OUT-OF-NETWORK PROVIDERS.
``A group health plan and a health insurance issuer offering group
or individual health insurance coverage--
``(1) may not restrict the ability of participating
providers to furnish items or services to individuals who are
not enrolled in the plan or coverage; and
``(2) in the case that a nonparticipating provider
furnishes items or services for which benefits are provided
under the plan or coverage to an individual enrolled in the
plan or coverage, shall pay such provider with respect to such
items or services in an amount that is not less than the amount
that the plan or issuer would have paid if such items or
services had been furnished by a participating provider.''.
(b) Exemption of Catastrophic Health Plans From Federal
Regulation.--
(1) In general.--Section 1302(e) of the Patient Protection
and Affordable Care Act (42 U.S.C. 18022) is amended to read as
follows:
``(e) Basic Plans.--A health plan not providing a bronze, silver,
gold, or platinum level of coverage shall be treated as meeting the
requirements of subsection (d) with respect to any plan year if the
plan provides--
``(1) coverage for at least 3 primary care visits; and
``(2) no other benefits in any plan year until the
individual has incurred cost-sharing expenses in an amount
equal to the annual limitation in effect under subsection
(c)(1) of this section for the plan year, except as provided
for in section 2713 of the Public Health Service Act.''.
(2) Conforming amendment.--Section 1312(d)(3)(C) of the
Patient Protection and Affordable Care Act (42 U.S.C.
18032(c)(3)(C)) is amended by striking ``, except that in the
case of a catastrophic plan described in section 1302(e), a
qualified individual may enroll in the plan only if the
individual is eligible to enroll in the plan under section
1302(e)(2)''.
(3) Effective date.--The amendments made by this subsection
shall take effect with respect to plans and coverage beginning
in calendar year 2027.
SEC. 5. PATIENT RIGHTS.
(a) Requirement To Provide Enrollees With Point of Contact
Information.--Subpart II of part A of title XXVII of the Public Health
Service Act (42 U.S.C. 300gg-11 et seq.) is further amended by adding
at the end the following new section:
``SEC. 2734. REQUIREMENT TO PROVIDE ENROLLEES WITH POINT OF CONTACT
INFORMATION.
``A group health plan and a health insurance issuer offering group
or individual health insurance coverage shall provide each individual
enrolled in the plan or coverage with the identity of at least 1 and at
most 3 individuals who will serve as the point of contact for the
individual with the plan or coverage, each of whom shall be based in
the United States and proficient in English.''.
(b) Requirement To Provide Monetary Compensation for Billing
Errors.--Subpart II of part A of title XXVII of the Public Health
Service Act (42 U.S.C. 300gg-11 et seq.) is further amended by adding
at the end the following new section:
``SEC. 2735. REQUIREMENT TO PROVIDE MONETARY COMPENSATION FOR BILLING
ERRORS.
``A group health plan a health insurance issuer offering group or
individual health insurance coverage, and a health care provider shall
provide monetary compensation to an individual enrolled in the plan or
coverage for any error made by the plan, issuer, or provider,
respectively, in billing the individual more than the correct amount
owed by the individual. Such compensation shall be equal to 110 percent
of the excess charge if the amount is returned to the individual within
30 days, 150 percent of such excess if the amount is returned to the
individual after 30 days but before 60 days, and 150 percent plus a
number of percentage points equal to the product of 25 and the number
of 30-day periods occurring after 60 days. The Secretary shall be
regulation prescribed penalties in the case of a health care provider
that fails to comply with the preceding sentence.''.
SEC. 6. EFFECTIVE DATE.
Except as otherwise provided in this Act, the amendments made by
this Act shall take effect on January 1, 2029.
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