; (2) for each State in the region, a deputy director; and (3) one deputy director to represent the Native American and Alaska Native tribes in the region. (c) Regional office duties Regional offices shall be responsible for— (1) providing an annual State health care needs assessment report to the Secretary, after a thorough examination of health needs, in consultation with public health officials, clinicians, patients, and patient advocates; (2) recommending changes in provider reimbursement or payment for delivery of health services in the States within the region; and (3) establishing a quality assurance mechanism in the State in order to minimize both under-utilization and over-utilization and to ensure that all providers meet high quality standards. 404. Beneficiary ombudsman (a) In general The Secretary shall appoint a Beneficiary Ombudsman who shall have expertise and experience in the fields of health care and education of, and assistance to, individuals entitled to benefits under this Act. (b) Duties The Beneficiary Ombudsman shall— (1) receive complaints, grievances, and requests for information submitted by individuals entitled to benefits under this Act with respect to any aspect of the Universal Medicare Program; (2) provide assistance with respect to complaints, grievances, and requests referred to in subparagraph (a), including— (A) assistance in collecting relevant information for such individuals, to seek an appeal of a decision or determination made by a regional office or the Secretary; and (B) assistance to such individuals in presenting information under relating to cost-sharing