Penalty for Violating Ban on Pre-Existing Conditions is $100 per day (42 U.S.C. § 300gg–22(b)(2)(C)(i))

The Patient Protection and Affordable Care Act, Bill Number H.R. 3590, prohibits insurance companies from using pre-existing conditions to underwrite, reject, or rescind health insurance policies.  Yet, H.R. 3590 itself lacks an enforcement mechanism to deter and punish health insurance corporations for violations of the prohition on pre-existing condition exclusions and other discrimination.

Any health insurance corporation that violates the prohition on pre-existing condition exclusions and other discrimination in Section 2704 of the Patient Protection and Affordable Care Act, is subject to “civil money penalties” (e.g., fines) under 42 U.S.C. § 300gg–22(b)(2)(C)(i) of the Public Health Service Act (42 U.S.C. §§ 300gg et seq.), which stipulates that the maximum amount of financial penalty imposed under for violations is $100 for each day for each individual with respect to which such a failure occurs. (Notably, there are no criminal penalties and the statute enables health insurers to obtain administrative and judicial review before any civil money penalties can actually be collected.) (more…)

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