Title I, SEC. 1202. STATE RESPONSIBILITIES WITH RESPECT TO ALLIANCES. (a) Establishment of Alliances. (1) In general. A participating State shall (A) establish and maintain one or more regional alliances in accordance with this section and subtitle D, and ensure that such alliances meet the requirements of this Act; and (B) designate alliance areas in accordance with subsection (b). (2) Deadline. A State may not be a participating State for a year unless the State has established such alliances by March 1 of the previous year. (b) Alliance Areas. (1) In general. In accordance with this subsection, each State shall designate a geographic area assigned to each regional alliance. Each such area is referred to in this Act as an ``alliance area''. (2) Population required. (A) In general. Each alliance area shall encompass a population large enough to ensure that the alliance has adequate market share to negotiate effectively with health plans providing the comprehensive benefit package to eligible individuals who reside in the area. (B) Treatment of consolidated metropolitan statistical areas. An alliance area that includes a Consolidated Metropolitan Statistical Area within a State is presumed to meet the requirements of subparagraph (A). (3) Single alliance in each area. No geographic area may be assigned to more than one regional alliance. (4) Boundaries. In establishing boundaries for alliance areas, the State may not discriminate on the basis of or otherwise take into account race, ethnicity, language, religion, national origin, socio-economic status, disability, or perceived health status. (5) Treatment of metropolitan areas. The entire portion of a metropolitan statistical area located in a State shall be included in the same alliance area. (6) No portions of State permitted to be outside alliance area. Each portion of the State shall be assigned to a regional alliance under this subsection. (c) State Coordination of Regional Alliances. One or more States may allow or require two or more regional alliances to coordinate their operations, whether such alliances are in the same or different States. Such coordination may include adoption of joint operating rules, contracting with health plans, enforcement activities, and establishment of fee schedules for health providers. (d) Assistance in Collection of Amounts Owed to Alliances. Each State shall assure that the amounts owed to regional alliances in the State are collected and paid to such alliances. (e) Assistance in Eligibility Verifications. (1) In general. Each State shall assure that the determinations of eligibility for cost sharing assistance (and premium discounts and cost sharing reductions for families) are made by regional alliances in the State on the basis of the best information available to the alliances and the State. (2) Provision of information. Each State shall use the information available to the State under section 6103(l)(7)(D)(x) of the Internal Revenue Code of 1986 to assist regional alliances in verifying such eligibility status. (f) Special Requirements for Alliances With Single-Payer System. If the State operates an alliance-specific single-payer system (as described in part 2), the State shall assure that the regional alliance in which the system is operated meets the requirements for such an alliance described in section 1224(b). (g) Payment of Shortfalls for Certain Administrative Errors. Each participating State is financially responsible, under section 9201(c)(2), for administrative errors described in section 9201(e)(2).