; and (E) in subsection (g)(1), by inserting and subpart 2 of part E and paragraphs (4) and (5) . (3) Section 1882(a)(2) of such Act is amended by striking No medicare and inserting Subject to section 1860E–24(c), no medicare . 424. Late enrollment penalty not to apply for months of any health coverage (a) In general Section 1839(b) of the Social Security Act ( 42 U.S.C. 1395r ) is amended in the second sentence, by inserting before the period at the end the following: or months during which the individual has any other health coverage . (b) Effective date The amendment made by paragraph (1) shall apply for months of coverage beginning after the date of the enactment of this Act. 425. Medigap reform Notwithstanding any provision of section 1882 of the Social Security Act ( 42 U.S.C. 1395ss ), as of the date of the enactment of this Act, no policy may be offered under such section that does not provide guaranteed coverage (without regard to an individual’s preexisting conditions, if any) to all individuals eligible to enroll under such policy. 426. ACO revision (a) Enrollment Enrollment in such an ACO under such title shall be based on the method established under part E of such title. Such a network shall bear full risk in the event payments under such title do not equal or exceed liabilities under such network. (b) Direction of payment An ACO may direct that any payments under such title be made to a centralized entity rather than to an individual provider or supplier. (c) Bids The Secretary of Health and Human Services shall establish a process whereby such networks compete using a bidding process similar to that described in part E of such title for Medicare Advantage plans. 427. Primary care options (a) Selection of primary care physician The Secretary shall establish a mechanism under which an individual enrolled under part B of title XVIII of the Social Security Act may select such individual’s primary care physician. Such an individual shall not be liable for more than $5 for each visit to such selected