; (2) one deputy director appointed by the regional director to represent the Indian and Alaska Native Tribes in the region, if any; and (3) one deputy director appointed by the regional director to oversee home- and community-based services and supports. (d) Duties Each regional director shall— (1) submit an annual regional health care needs assessment report to the Secretary, after a thorough examination of health needs and consultation with public health officials, clinicians, patients, and patient advocates; (2) recommend any changes in provider reimbursement or payment for delivery of items and services covered under the Medicare for All Program determined appropriate by the regional director, subject to the requirements of title VI; and (3) establish a quality assurance mechanism in each such region in order to minimize both under-utilization and over-utilization of health care items and services covered under the Medicare for All Program and to ensure that all participating providers described in section 301(a) meet the quality and other standards established pursuant to this Act. 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 and in providing assistance to individuals entitled to benefits under the Medicare for All Program. (b) Duties (1) In general The Beneficiary Ombudsman shall— (A) receive complaints, grievances, and requests for information submitted by individuals entitled to benefits under the Medicare for All Program with respect to any aspect of such Program; (B) provide assistance with respect to complaints, grievances, and requests referred to in subparagraph (A), including— (i) 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 (ii) assistance to such individuals in presenting information relating to cost-sharing