COORDINATION.

— VerDate Nov 24 2008 12:51 Jul 14, 2009 Jkt 000000 PO 00000
Frm 00046 Fmt 6652 Sfmt 6201 C:\TEMP\AAHCA0~1.XML HOLCPC July 14, 2009
(12:51 p.m.) F:\P11\NHI\TRICOMM\AAHCA09_001.XML
f:\VHLC\071409\071409.140.xml (444390|2) 47 1 (1) IN GENERAL.—In
carrying out the func2 tions of the Commissioner, including with respect
to 3 the enforcement of the provisions of this division, 4 the Commissioner
shall work in coordination with 5 existing Federal and State entities to
the maximum 6 extent feasible consistent with this division and in a 7
manner that prevents conflicts of interest in duties 8 and ensures
effective enforcement. 9 (2) UNIFORM STANDARDS.—The Commissioner, 10 in
coordination with such entities, shall seek to 11 achieve uniform
standards that adequately protect 12 consumers in a manner that does not
unreasonably 13 affect employers and insurers. 14 SEC. 144. HEALTH
INSURANCE OMBUDSMAN. 15 (a) IN GENERAL.—The Commissioner shall appoint
16 within the Health Choices Administration a Qualified 17 Health Benefits
Plan Ombudsman who shall have exper18 tise and experience in the fields
of health care and edu19 cation of (and assistance to) individuals. 20
(b) DUTIES.—The Qualified Health Benefits Plan 21 Ombudsman shall, in
a linguistically appropriate man22 ner— 23 (1) receive complaints,
grievances, and requests 24 for information submitted by individuals;
VerDate Nov 24 2008 12:51 Jul 14, 2009 Jkt 000000 PO 00000 Frm 00047 Fmt
6652 Sfmt 6201 C:\TEMP\AAHCA0~1.XML HOLCPC July 14, 2009 (12:51 p.m.)
F:\P11\NHI\TRICOMM\AAHCA09_001.XML f:\VHLC\071409\071409.140.xml
(444390|2) 48 1 (2) provide assistance with respect to com2 plaints,
grievances, and requests referred to in para3 graph (1), including— 4
(A) helping individuals determine the rel5 evant information needed to
seek an appeal of 6 a decision or determination; 7 (B) assistance to such
individuals with any 8 problems arising from disenrollment from such 9
a plan; 10 (C) assistance to such individuals in choos11 ing a qualified
health benefits plan in which to 12 enroll; and 13 (D) assistance to such
individuals in pre14 senting information under subtitle C (relating 15
to affordability credits); and 16 (3) submit annual reports to Congress
and the 17 Commissioner that describe the activities of the Om18 budsman
and that include such recommendations for 19 improvement in the
administration of this division as 20 the Ombudsman determines
appropriate. The Om21 budsman shall not serve as an advocate for any in22
creases in payments or new coverage of services, but 23 may identify issues
and problems in payment or cov24 erage policies. VerDate Nov 24 2008 12:51
Jul 14, 2009 Jkt 000000 PO 00000 Frm 00048 Fmt 6652 Sfmt 6201
C:\TEMP\AAHCA0~1.XML HOLCPC July 14, 2009 (12:51 p.m.)
F:\P11\NHI\TRICOMM\AAHCA09_001.XML f:\VHLC\071409\071409.140.xml
(444390|2) 49 1 Subtitle F—Relation to Other 2 Requirements;
Miscellaneous 3 SEC. 151. RELATION TO OTHER REQUIREMENTS. 4 (a) COVERAGE
NOT OFFERED THROUGH EX5 CHANGE.— 6 (1) IN GENERAL.—In the case of health