"SEC. 3103. SEEKING THE BEST MEDICAL ADVICE.

(a) SEEKING THE BEST MEDICAL ADVICE.-The Secretary, in consultation with medical experts at the Na-tional Institutes of Health, the Centers for Disease Con-trol and Prevention, and other centers of excellence, shall-

(1) establish a council to be known as the Medical Advisory Council (referred to in this section as the Council) to make recommendations to the Secretary on the matters described in subsections (h) and (i); or

(2) contract with the Institute of Medicine of the National Academies of Science to establish the Council described in paragraph (1). (b) COMPOSITION.-

(1) IN GENERAL.-The Council shall be com-posed of members with appropriate expertise in order to carry out subsections (h) and (i).

(2) TERMS.-Each member appointed to the Council shall serve for a term of 3 years, except that an individual appointed to fill a vacancy on the Council shall serve for the unexpired term of the va-cancy for which such individual is appointed. A member may be reappointed to the Council.

(3) APPOINTMENT.-The members of the Council shall be appointed by the Secretary. (c) ADMINISTRATIVE PROVISIONS.-

(1) QUORUM.-A majority of the members of the Council shall constitute a quorum for purposes of conducting business, and the affirmative vote of a majority of members shall be necessary and suffi-cient for any action taken. No vacancy in the mem-bership of the Council shall impair the right of a quorum to exercise all the rights and duties of the Council.

(2) COMPENSATION AND EXPENSES.-Mem-bers of the Council shall serve without compensation, except that while serving away from home and the members regular place of business, such a member may be allowed travel expenses, as authorized by the Chairperson of the Council.

(3) STAFF, ETC..-The Council shall have the authority to employ such staff as may be necessary to carry out its duties under this section.

(4) DETAIL OF FEDERAL GOVERNMENT EM-PLOYEES.-An employee of the Federal Government may be detailed to the Council without reimburse-ment. The detail of the employee shall be without interruption or loss of civil service status or privi-lege.

(5) HEARINGS.-The Council may hold such hearings, sit and act at such times and places, take such testimony, and receive such evidence as the Council considers advisable to carry out this title. (d) SUBMISSION OF REPORTS.-Not later than 180

days after the date of enactment of this title, and annually

thereafter, the Council shall submit to the Secretary a re

port containing the recommendations described in sub

section (a). (e) REVIEW OF REPORTS BY SECRETARY.- (1) SCIENTIFIC AND MEDICAL VALIDITY.-Not later than 30 days after receiving a report under subsection (d), the Secretary, in consultation with medical experts at the National Institutes of Health, the Centers for Disease Control and Prevention, and other centers of excellence, shall review such report for scientific and medical validity. (2) REVISION REQUESTED.-If the Secretary determines that any recommendation contained in a report received under subsection (d) is not scientif-ically or medically valid, the Secretary may request revisions to such report. (3) REVISED REPORT.-Not later than 30 days after the receipt of a request for revisions from the Secretary, as described in paragraph (2), the Council shall submit a report which may contain modifications to the recommendations made by the Council in response to such request. (f) SUBMISSION OF REPORT TO CONGRESS.-Not

later than 30 days after receipt of a report as described

in subsection (e)(1)(B) or subsection (e)(3), the Secretary

shall formally submit such report to-

(1) the Committee on Education and Labor, the Committee on Energy and Commerce, and the Committee on Ways and Means of the House Representatives; and

(2) the Committee on Health, Education, Labor, and Pensions and the Committee on Finance of the Senate. (g) CONGRESSIONAL REVIEW.-

(1) RESOLUTION OF DISAPPROVAL.-For plan years beginning in the year described in paragraph (3), the recommendations contained in a report sub-mitted under subsection (f) shall be considered to be applicable unless, within 90 calendar days after the date on which Congress receives such report, there is enacted into law a joint resolution disapproving such report in its entirety.

(2) CONTENTS.-For the purpose of this sec-tion, the term joint resolution means only a joint resolution-

(A) that is introduced not later than 45

calendar days after the date on which the re

port referred to in subsection (f) are received by

Congress;

(B) which does not have a preamble;

(C) the title of which is as follows: [insert title language (Joint resolution relating to the disapproval of lll)]; and

(D) the matter after the resolving clause of which is as follows: That Congress dis-approves the recommendations submitted by the lllllll. (3) YEAR DESCRIBED.-

(A) TRANSMISSION BEFORE JUNE 30.-If a report is submitted to Congress under sub-section (f) not later than June 30, then the year described in this paragraph is the year fol-lowing the year in which the report is sub-mitted.

(B) TRANSMISSION AFTER JUNE 30.-If the report is submitted to Congress under sub-section (f) after June 30, then the year de-scribed in this paragraph is the second year fol-lowing the year in which the report is trans-mitted. (4) EFFECT OF DISAPPROVAL.-

(A) GENERAL RULE.-If Congress dis-approves a report submitted under subsection (f), then the recommendations contained in the most previous report that was not disapproved under this subsection shall continue to apply.

(B) DISAPPROVAL OF INITIAL REPORT.- If Congress disapproves the initial report sub-mitted under subsection (f) in accordance with this subsection, the Council shall issue a revised report (and this section shall apply to such re-port).

(h) ELEMENTS OF REPORT.-

(1) IN GENERAL.-The report of the Council described in subsection (d) shall contain rec-ommendations on at least the following:

(A) Subject to paragraph (2), the essential health care benefits eligible for credits under section 3111, where such benefits shall include at least the following general categories:

(i) Ambulatory patient services. (ii) Emergency services. (iii) Hospitalization. (iv) Maternity and newborn care. (v) Mental health and substance

abuse services. (vi) Prescription drugs. (vii) Rehabilitative, habilitative, and

laboratory services.

(viii) Preventive and wellness serv

ices.

(ix) Pediatric services, including oral

and vision care as determined appropriate

by the Council.

(B) The criteria that coverage must meet to be considered minimum qualifying coverage.

(C) The conditions under which coverage shall be considered affordable and available cov-erage for individuals and families at different income levels. (2) LIMITATION.-

(A) IN GENERAL.-In establishing the es-sential health care benefits described in para-graph (1)(A), the Council shall ensure that the actuarial gross value of the benefits is equal to the actuarial gross value of the benefits pro-vided under a typical employer plan, as deter-mined by the Secretary.

(B) EFFECT OF ADDITIONAL SERVICES.- The inclusion in the essential health care bene-fits described in paragraph (1) of items and services described in clauses (i) through (x) of paragraph (1)(A), or not described in such

paragraphs, shall not affect the limitation de-scribed in subparagraph (A). (i) REQUIRED ELEMENTS FOR CONSIDERATION.-

(1) ESSENTIAL HEALTH CARE BENEFITS.-In issuing recommendations on the matter described in subsection (h)(1), the Council shall-

(A) ensure that recommendations on the matter described in subsection (h)(1) reflect an appropriate balance among the categories de-scribed in such subsection, so that benefits are not unduly weighted toward any category; and

(B) take into account the health care needs of diverse segments of the population, in-cluding women, children, persons with disabil-ities, and other groups. (2) MINIMUM QUALIFYING COVERAGE.-In

considering the matter described in subsection (h)(2), the Council- (A) shall- (i) exclude from meeting such cri-teria any coverage that- (I) provides reimbursement for the treatment or mitigation of- (aa) a single disease or condition; or

(bb) an unreasonably limited set of diseases or conditions; or (II) has an out of pocket limit

that exceeds the amount described in section 223 of the Internal Revenue Code of 1986 for the year involved; and (ii) establish such criteria (taking

into account the requirements established under clause (i)) in a manner that results in the least practicable disruption of the health care marketplace, consistent with the goals and activities under this title; and (B) may provide for the application of

different criteria with respect to young adults.