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US Laws | Affordable Health Care Act (HR3950F)
TITLE IX--REVENUE PROVISIONS
Subtitle A--Revenue Offset Provisions

(c) Covered Entity- (11664)

(1) IN GENERAL- For purposes of this section, the term "covered entity" means any entity which provides health insurance for any United States health risk. (11665)

(2) EXCLUSION- Such term does not include-- (11666)

(A) any employer to the extent that such employer self-insures its employees" health risks, or (11667)

(B) any governmental entity (except to the extent such an entity provides health insurance coverage through the community health insurance option under section 1323). (11668)

(3) CONTROLLED GROUPS- (11669)

(A) IN GENERAL- For purposes of this subsection, all persons treated as a single employer under subsection (a) or (b) of section 52 of the Internal Revenue Code of 1986 or subsection (m) or (o) of section 414 of such Code shall be treated as a single covered entity (or employer for purposes of paragraph (2)). (11670)

(B) INCLUSION OF FOREIGN CORPORATIONS- For purposes of subparagraph (A), in applying subsections (a) and (b) of section 52 of such Code to this section, section 1563 of such Code shall be applied without regard to subsection (b)(2)(C) thereof. (11671)

(d) United States Health Risk- For purposes of this section, the term "United States health risk" means the health risk of any individual who is-- (11672)

(1) a United States citizen, (11673)

(2) a resident of the United States (within the meaning of section 7701(b)(1)(A) of the Internal Revenue Code of 1986), or (11674)

(3) located in the United States, with respect to the period such individual is so located. (11675)

(e) Third Party Administration Agreement Fees- For purposes of this section, the term "third party administration agreement fees" means, with respect to any covered entity, amounts received from an employer which are in excess of payments made by such covered entity for health benefits under an arrangement under which such employer self-insures the United States health risk of its employees. (11676)

(f) Tax Treatment of Fees- The fees imposed by this section-- (11677)

(1) for purposes of subtitle F of the Internal Revenue Code of 1986, shall be treated as excise taxes with respect to which only civil actions for refund under procedures of such subtitle shall apply, and (11678)

(2) for purposes of section 275 of such Code shall be considered to be a tax described in section 275(a)(6). (11679)

(g) Reporting Requirement- (11680)

(1) IN GENERAL- Not later than the date determined by the Secretary following the end of any calendar year, each covered entity shall report to the Secretary, in such manner as the Secretary prescribes, the covered entity"s net premiums written with respect to health insurance for any United States health risk and third party administration agreement fees for such calendar year. (11681)

(2) PENALTY FOR FAILURE TO REPORT- (11682)

(A) IN GENERAL- In the case of any failure to make a report containing the information required by paragraph (1) on the date prescribed therefor (determined with regard to any extension of time for filing), unless it is shown that such failure is due to reasonable cause, there shall be paid by the covered entity failing to file such report, an amount equal to-- (11683)

(i) $10,000, plus (11684)

(ii) the lesser of-- (11685)

(I) an amount equal to $1,000, multiplied by the number of days during which such failure continues, or (11686)

(II) the amount of the fee imposed by this section for which such report was required. (11687)

(B) TREATMENT OF PENALTY- The penalty imposed under subparagraph (A)-- (11688)

(i) shall be treated as a penalty for purposes of subtitle F of the Internal Revenue Code of 1986, (11689)

(ii) shall be paid on notice and demand by the Secretary and in the same manner as tax under such Code, and (11690)

(iii) with respect to which only civil actions for refund under procedures of such subtitle F shall apply. (11691)

(h) Additional Definitions- For purposes of this section-- (11692)

(1) SECRETARY- The term "Secretary" means the Secretary of the Treasury or the Secretary"s delegate. (11693)

(2) UNITED STATES- The term "United States" means the several States, the District of Columbia, the Commonwealth of Puerto Rico, and the possessions of the United States. (11694)

(3) HEALTH INSURANCE- The term "health insurance" shall not include insurance for long-term care or disability. (11695)

(i) Guidance- The Secretary shall publish guidance necessary to carry out the purposes of this section. (11696)

(j) Application of Section- This section shall apply to any net premiums written after December 31, 2008, with respect to health insurance for any United States health risk, and any third party administration agreement fees received after such date. (11697)

SEC. 9011. STUDY AND REPORT OF EFFECT ON VETERANS HEALTH CARE. (11698)(Text)

(a) In General- The Secretary of Veterans Affairs shall conduct a study on the effect (if any) of the provisions of sections 9008, 9009, and 9010 on-- (11699)

(1) the cost of medical care provided to veterans, and (11700)

(2) veterans" access to medical devices and branded prescription drugs. (11701)

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