104 STAT. 1388-134 PUBLIC LAW 101-508—NOV. 5, 1990 rebate or credit or the disllowance ^^ of premium increases, for policies that fail to meet the requirements of this subsection (relating to loss-ratios). Such report shall include a list of the policies that failed to comply with such loss-ratio requirements or other requirements of this section. "(5)(A) The Comptroller General shall periodically, not less often than once every 3 years, perform audits with respect to the compliance of medicare supplemental policies with the loss ratio requirements of this subsection and shall report the results of such audits to the State involved and to the Secretary. "(B) The Secretary may independently perform such compliance audits. "(6)(A) A person who issues a policy in violation of the loss ratio requirements of this subsection is subject to a civil money penalty of not to exceed $25,000 for each such violation. The provisions of section 1128A (other than the first sentence of subsection (a) and other than subsection (b)) shall apply to a civil money penalty under the previous sentence in the same manner as such provisions apply to a penalty or proceeding under section 1128A(a). "(B) Each issuer of a policy subject to the requirements of paragraph (I)(B) shall be liable to policyholders for credits required under such paragraph.". (b) ASSURING ACCESS TO Loss RATIO INFORMATION.— Section 1882(b)(l)(C) (42 U.S.C. 1395ss(b)(l)(C)) is amended by striking the semicolon at the end and inserting a comma and the following: "and that a copy of each such policy, the most recent premium for each such policy, and a listing of the ratio of benefits provided to premiums collected for the most recent 3-year period for each su6h policy issued or sold in the State is maintained and made available to interested persons;". (c) IMPLEMENTATION OF PROCESS TO APPROVE PREMIUM IN- CREASES. —Section 1882(b)(l) (42 U.S.C. 1395ss(b)(l)) is further amended— (1) by striking "and" at the end of subparagraph (E); (2) by adding "and" at the end of subparagraph (F); (3) by adding at the end thereof the following new subparagraph: "(G) provides for a process for approving or disapproving proposed premium increases with respect to such policies, and establishes a policy for the holding of public hearings prior to approval of a premium increase,". 42 USC 1395SS (d) EFFECTIVE DATE. —The amendments made by this section shall note. apply to policies sold or issued more than 1 year after the date of the enactment of this Act. SEC. 4356. CLARIFICATION OF TREATMENT OF PLANS OFFERED BY HEALTH MAINTENANCE ORGANIZATIONS. (a) IN GENERAL. —The first sentence of section 1882(g)(1) is amended by inserting before the period at the end the following: "and does not include a policy or plan of a health maintenance organization or other direct service organization which offers benefits under this title, including such services under a contract under under section 1876 or an agreement under section 1833". 42 USC 1395SS (b) EFFECTIVE DATE.— The amendment made by subsection (a) note. shall take effect on the date of the enactment of this Act. 28 So in original. Probably should be "disallowance"
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