; (2) by striking at the end or and inserting and ; and (3) by adding at the end the following new subparagraph: (B) beginning not later than January 1, 2022, applies such external review process with respect to any adverse determination by such plan or issuer under subsection (b) of section 2719A, subsection (e) of such section, or subsection (i) of such section, including with respect to whether an item or service that is the subject to such a determination is an item or service to which such subsection (b), (e), or (i) applies; or . 5. Consumer protections through health plan transparency requirements (a) PHSA amendments Section 2719A of the Public Health Service Act ( 42 U.S.C. 300gg–19a ), as amended by sections 2(a) and 3(a), is further amended by inserting before subsection (k) the following new subsections: (f) Provider directory requirements (1) In general Beginning not later than January 1, 2022, each health plan shall— (A) establish the verification process described in paragraph (2); (B) establish the response protocol described in paragraph (3); (C) establish the database described in paragraph (4); and (D) include in any directory (other than the database described in subparagraph (C)) containing provider directory information with respect to such plan the information described in paragraph (5). (2) Verification process The verification process described in this paragraph is, with respect to a health plan, a process— (A) under which such plan verifies and updates the provider directory information included on the database described in paragraph (4) of such plan of— (i) not less frequently than once every 90 days, a random sample of at least 10 percent of health care providers and health care facilities included in such database; and (ii) any such provider or such facility included in such database that has not submitted any claim to such plan during a 12-month period