H.R. 10908: Ending Patient Runaround Act

This bill would make several changes to federal tax law and health insurance rules.

Universal Savings Accounts

The bill would create a new type of tax-advantaged account called a Universal Savings Account. These accounts would work somewhat like retirement accounts in that:

• Money could be contributed only in cash.
• Annual contributions would be capped at $10,000 per person, with the cap adjusted for inflation after 2026.
• Money in the account would grow tax-free.
• Withdrawals would generally not count as taxable income.

The account would have to be held by a bank or another approved trustee, and the assets would need to be kept separate from other property. The bill also prohibits investing these accounts in life insurance contracts.

There would be special rules for rolling money from one Universal Savings Account to another, and for what happens if the account holder dies. If the account passes to a surviving spouse, the spouse could continue treating it as the same account. In other cases, the account would be treated as distributed at death.

The bill also creates penalties for excess contributions and prohibited transactions, and requires reporting to the IRS. These provisions would generally apply to taxable years beginning after December 31, 2024.

Health insurance transparency

The bill would require health plans and insurers to give written and secure electronic decisions on prior authorization requests within 30 days. If a request is denied and a peer-to-peer review is requested, the insurer would have to provide a peer in the same specialty as the medical provider.

It would also require insurers to include more information with insurance contracts and benefit documents, including:

• procedure codes for covered services,
• the amount charged for each procedure, and
• a full list of covered services and procedures.

Health plan competition rules

The bill would limit some changes insurers can make during the term of coverage. In general, they could not make a prescription drug tier more restrictive or change the list of services not covered by the plan during the coverage period.

It would also require plans to pay out-of-network providers at least as much as they would have paid an in-network provider for the same covered service, and it would bar plans from restricting in-network providers from treating people who are not enrolled in the plan.

For catastrophic health plans, the bill would change federal rules so these plans would only need to cover at least three primary care visits and could otherwise withhold coverage until the enrollee reaches the annual out-of-pocket limit, subject to certain existing preventive care rules. This change would take effect for plan years beginning in 2027.

Patient rights

The bill would require insurers to give each enrollee the name of 1 to 3 contact people based in the United States and proficient in English.

It would also require monetary compensation when a plan, insurer, or provider bills someone more than the correct amount. The compensation would be based on how long it takes to return the overcharge, with larger payments required if the error is not fixed quickly. The bill directs the Secretary of Health and Human Services to set penalties for providers who do not comply.

Effective date

Unless a section says otherwise, the bill’s health care changes would take effect on January 1, 2029.

Relevant Companies

• UNH - UnitedHealth Group could be affected by new rules on prior authorization, billing corrections, plan transparency, and payment requirements.
• HUM - Humana could be affected by changes to insurer disclosure rules, prior authorization timelines, and coverage/payment requirements.
• CI - The Cigna Group could be affected by the bill’s rules on prior authorization, plan documents, and reimbursement standards.
• CVS - CVS Health, through its insurance operations, could be affected by new insurer requirements and billing-related penalties.
• ELV - Elevance Health could be affected by the bill’s changes to prior authorization, plan transparency, and out-of-network reimbursement rules.