(a) In General- Subsection (c) of section 833 of the Internal Revenue Code of 1986 is amended by adding at the end the following new paragraph: (11765)
"(5) NONAPPLICATION OF SECTION IN CASE OF LOW MEDICAL LOSS RATIO- Notwithstanding the preceding paragraphs, this section shall not apply to any organization unless such organization"s percentage of total premium revenue expended on reimbursement for clinical services provided to enrollees under its policies during such taxable year (as reported under section 2718 of the Public Health Service Act) is not less than 85 percent.". (11766)
(b) Effective Date- The amendment made by this section shall apply to taxable years beginning after December 31, 2009. (11767)
(a) In General- Subtitle D of the Internal Revenue Code of 1986, as amended by this Act, is amended by adding at the end the following new chapter: (11769)
CHAPTER 49--ELECTIVE COSMETIC MEDICAL PROCEDURES (11770)
"Sec. 5000B. Imposition of tax on elective cosmetic medical procedures. (11771)
SEC. 5000B. IMPOSITION OF TAX ON ELECTIVE COSMETIC MEDICAL PROCEDURES. (11772)
"(a) In General- There is hereby imposed on any cosmetic surgery and medical procedure a tax equal to 5 percent of the amount paid for such procedure (determined without regard to this section), whether paid by insurance or otherwise. (11773)
"(b) Cosmetic Surgery and Medical Procedure- For purposes of this section, the term "cosmetic surgery and medical procedure" means any cosmetic surgery (as defined in section 213(d)(9)(B)) or other similar procedure which-- (11774)
"(1) is performed by a licensed medical professional, and (11775)
"(2) is not necessary to ameliorate a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or disfiguring disease. (11776)
"(c) Payment of Tax- (11777)
"(1) IN GENERAL- The tax imposed by this section shall be paid by the individual on whom the procedure is performed. (11778)
"(2) COLLECTION- Every person receiving a payment for procedures on which a tax is imposed under subsection (a) shall collect the amount of the tax from the individual on whom the procedure is performed and remit such tax quarterly to the Secretary at such time and in such manner as provided by the Secretary. (11779)
"(3) SECONDARY LIABILITY- Where any tax imposed by subsection (a) is not paid at the time payments for cosmetic surgery and medical procedures are made, then to the extent that such tax is not collected, such tax shall be paid by the person who performs the procedure.". (11780)
(b) Clerical Amendment- The table of chapters for subtitle D of the Internal Revenue Code of 1986, as amended by this Act, is amended by inserting after the item relating to chapter 48 the following new item: (11781)
Chapter 49--Elective Cosmetic Medical Procedures". (11782)
(c) Effective Date- The amendments made by this section shall apply to procedures performed on or after January 1, 2010. (11783)
(a) In General- Part III of subchapter B of chapter 1 of the Internal Revenue Code of 1986 is amended by inserting after section 139C the following new section: (11786)
SEC. 139D. INDIAN HEALTH CARE BENEFITS. (11787)
"(a) General Rule- Except as otherwise provided in this section, gross income does not include the value of any qualified Indian health care benefit. (11788)
"(b) Qualified Indian Health Care Benefit- For purposes of this section, the term "qualified Indian health care benefit" means-- (11789)
"(1) any health service or benefit provided or purchased, directly or indirectly, by the Indian Health Service through a grant to or a contract or compact with an Indian tribe or tribal organization, or through a third-party program funded by the Indian Health Service, (11790)
"(2) medical care provided or purchased by, or amounts to reimburse for such medical care provided by, an Indian tribe or tribal organization for, or to, a member of an Indian tribe, including a spouse or dependent of such a member, (11791)
"(3) coverage under accident or health insurance (or an arrangement having the effect of accident or health insurance), or an accident or health plan, provided by an Indian tribe or tribal organization for medical care to a member of an Indian tribe, include a spouse or dependent of such a member, and (11792)
"(4) any other medical care provided by an Indian tribe or tribal organization that supplements, replaces, or substitutes for a program or service relating to medical care provided by the Federal government to Indian tribes or members of such a tribe. (11793)
"(c) Definitions- For purposes of this section-- (11794)
"(1) INDIAN TRIBE- The term "Indian tribe" has the meaning given such term by section 45A(c)(6). (11795)
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