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Bill· HRH.R. 7864 (94th)referred
United States · United States Congress · 12 June 1975
Revises the limitations applicable to home health services under the Medicare (Title XVIII) supplementary medical insurance program of the Social Security Act. Redefines home health services for purposes of such program to include the services of a homemaker or chore service worker.
Bill· HRH.R. 7852 (94th)referred
United States · United States Congress · 12 June 1975
Indian Health Care Improvement Act - States that the Congress declares that it is the policy of this Nation, in fulfillment of its special responsibilities and legal obligation to the American Indian people, to meet the national goal of providing the highest possible health status to Indians and to provide existing Indian health services with all resources necessary to effect that policy. Defines the terms used in this Act. Title I: Indian Health Manpower - Authorizes the Secretary of Health, Education, and Welfare acting through the Indian Health Service, to make grants to public or nonprofit private health or educational entities or Indian tribes or tribal organizations to assist such entities in meeting the costs of: (1) identifying Indians with a potential for education or training in the health professions and encouraging and assisting them; (2) publicizing existing sources of financial aid available to Indians enrolled in any medical or health-related school referred to in this Act or who are undertaking training necessary to qualify them to enroll in any such school; or (3) establishing other programs which the Secretary determines will enhance and facilitate the enrollment of Indians, and the subsequent pursuit and completion by them of courses of study, in any school referred to in this Act. Authorizes to be appropraited specified sums for each of the seven fiscal years commencing with that of 1977 for payment of such grants. Directs the Secretary, acting through the Service, to make scholarship grants for up to two years to Indians who: (1) have successfully completed their high school education or high school equivalency; and (2) have demonstrated the capability to successfully complete courses of study in schools of medicine, osteopathy, dentistry, veterinary medicine, optometry, podiatry, pharmacy, public health, nursing, or allied health professions. Authorizes appropriations for scholarship grants of $2,000,000 for fiscal year 1977; $2,500,000 for fiscal year 1978; and similar sums through fiscal year 1983. Directs the Secretary, acting through the Service, to make scholarship grants to individuals who are enrolled in schools of medicine, osteopathy, denistry, veterinary medicine, optometry, podiatry, pharmacy, public health, nursing, or allied health professions, and who agree to provide their professional services to Indians after the completion of their professional training. Authorizes appropriations for such grants of specified sums for the fiscal years 1977 through 1983, and of such sums as are necessary for the succeeding fiscal years, to continue to make scholarship grants under this Act to individuals who have received such grants prior to the end of the fifth fiscal year and who are eligible for such grants during each such succeeding fiscal year. Directs the Secretary, acting through the Service, to make grants to individuals, nonprofit entities, appropriate public or private agencies, educational institutions, or Indian tribes and tribal organizations to enable the recipients of such grants to establish and carry out programs to train individuals so as to enable them to provide their services to Indians. Authorizes to be appropriated specified sums to carry out such provisions for the fiscal years 1977 through 1983. States that the Secretary may provide allowances to health professionals employed in the Service to enable them for a period of time each year prescribed by regulation of the Secretary to take leave of their duty stations for professional consultation and refresher training courses. Title II: Health Services - Authorizes the Secretary to expend specific amounts of funds over a five-fiscal year period for the following health services: (1) patient care; (2) field health, excluding dental care; (3) dental care; (4) mental health; (5) provision of health care personnel in primary and secondary Bureau of Indian Affairs schools; and (6) maintenance and repair. Title III: Health Facilities - Authorizes the Secretary to expend $528,637,000 over a seven-fiscal year period in order to eliminate inadequate, outdated, and otherwise unsatisfactory service in hospitals, health centers, health stations, staff housing, and other service facilities. Authorizes the Secretary to expend $378,000,000 within a five-fiscal year period following the enactment of this Act, to supply unmet needs for safe water and sanitary waste disposal facilities in existing and new Indian homes and communities. Title IV: Access to Health Services - Provides that the Secretary may enter into agreements with the appropriate State agency for the purpose of reimbursing such agency for health care and services provided in Service facilities to Indians who are beneficiaries of the Medicaid provisions of the Social Security Act. Title V: Health Services for the Urban Indians - Directs the Secretary, acting through the Service, to enter into contracts with urban Indian organizations to assist such organizations to establish and administer, in the urban centers in which such organizations are situated, programs which meet the requirements set forth in this Act of making health services more accessible to the urban Indian population. Authorizes to be appropriated for the purpose of this title $5,000,000 for fiscal year 1977; $10,000,000,000 for fiscal year 1978; and $15,000,000 for fiscal year 1979. Title VI: Miscellaneous - Requires the Secretary to report annually to the President and the Congress on progress made in effecting the purposes of this Act. Authorizes appropriations to the Secretary of $150,000 to support a one-year study by the National Indian Health Board of mental health problems, including alcoholism and related problems, among Indians.
Bill· HRH.R. 7855 (94th)referred
United States · United States Congress · 12 June 1975
Repeals, under the Social Security Act, the provisions for the establishment of Professional Standards Review Organizations to review services covered under the medicare and medicaid programs.
Bill· HRH.R. 7848 (94th)referred
United States · United States Congress · 12 June 1975
Makes the patient payment provisions presently applicable to members of the uniformed services on active duty and their dependents applicable to all persons eligible for contract health care, including former members. (Amends 10 U.S.C. 1086 (b))
Bill· HRH.R. 7847 (94th)referred
United States · United States Congress · 12 June 1975
Health Maintenance Organization Amendments - Makes the offering of supplemental health services, as defined by the Health Maintenance Organization Act of 1973, optional by health maintenance organizations. Eliminates the requirement imposed by such Act that health maintenance organizations offer annual open enrollment for individual membership. Redesignates medical treatment and referral services for drug or alcohol abuse or addiction and home health services as supplemental health services for purposes of such Act. Enables private entities to obtain federally guaranteed loans for the planning, initial development, and operation of a health maintenance organization to serve populations in addition to medically underserved populations. Includes State and local governmental employers as among those employers which must offer employees the option of membership in a health maintenance organization. Sets forth new procedures, penalties, and other requirements, to be applied by the Secretary of Health, Education, and Welfare where health maintenance organizations are alleged to be in noncompliance with such Act. Extends the authorization of appropriations for programs under such Act an additional two years.
Bill· HRH.R. 7807 (94th)referred
United States · United States Congress · 11 June 1975
Provides for inclusion of the services of licensed (registered) nurses under the medicare and medicaid, titles XVIII and XIX of the Social Security Act.
Bill· HJRESH.J.Res. 504 (94th)referred
United States · United States Congress · 11 June 1975
Authorizes the President to proclaim September 8 of each year as "National Cancer Day".
Bill· SS. 1905 (94th)referred
United States · United States Congress · 10 June 1975
Health Planning and Resource Development Act Amendments - Authorizes the Secretary of Health, Education, and Welfare to grant waivers from the health service area population requirements of the Public Health Service Act in unusual circumstances, if requested by the Governor of the State in which such area is located.
Bill· SS. 1906 (94th)referred
United States · United States Congress · 10 June 1975
Requires the continued application of the minimum nursing salary cost differential of 8 1/2 percent which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the Medicare program of the Social Security Act.
Bill· HRH.R. 7762 (94th)referred
United States · United States Congress · 10 June 1975
Provides for inclusion of the services of licensed (registered) nurses under the medicare and medicaid, titles XVIII and XIX of the Social Security Act.
Bill· HRH.R. 7741 (94th)referred
United States · United States Congress · 9 June 1975
Health Security Act - Title I: Health Security Benefits - Provides that every resident of the U.S. (and every non-resident citizen when in the U.S.) will be eligible for covered services. Permits reciprocal and "buy-in" agreements for groups or non-resident aliens, and in some cases benefits to U.S. residents when visiting in other countries. Entitles every eligible person to have payments made by the Health Security Board for covered services provided within the United States by a participating provider. Provides that all necessary professional services of physicians, wherever furnished are covered, including preventive care, with two restrictions: (1) specialist services are covered only when performed by a qualified specialist except in emergency situations, and generally only on referral from a primary physician; and (2) psychiatric services to an ambulatory patient are covered only for active preventive, diagnostic, therapeutic or rehabilitative service with respect to mental illness. Provides that comprehensive dental services (exclusive of most orthodontic services) are covered for children under age 15, with the covered age group increasing by two years each year until all those under age 25 are covered. Provides that: (1) inpatient and outpatient hospital services and services of a home health agency are covered without arbitrary limitation; and (2) pathology and radiology services are specifically included as parts of institutional services. Limits payment for skilled nursing home care to 120 days per spell of illness, except that this limit may be increased when the nursing home is owned or managed by a hospital and payment for care is made through the hospital budget. Limits the psychiatric hospital benefit to 45 consecutive days of active treatment during a spell of illness. Provides coverage for two categories of drug use: prescribed medicines administered to inpatients or outpatients within participating hospitals; or to enrollees of comprehensive health service organizations, and drugs necessary for the treatment of specified chronic illnesses or conditions requiring long or expensive therapy. Requires the Board and the Secretary of Health, Education, and Welfare to establish two lists of approved drugs, taking into account the safety, efficacy and cost of each drug. Provides a broad list of approved medicines available for use in institutions and by comprehensive health service organizations and a more restricted list which is available for use outside such organized settings. Provides that the appliances benefit is similar in concept and operation to the drug benefit, subject to a limitation on aggregate cost. Asserts that the professional services of optometrists and podiatrists are covered, subject to regulations, as are diagnostic or therapeutic services furnished by independent pathology laboratories and radiology services. States that health services furnished or paid for under a workmen's compensation law are not covered. Provides that the services of a professional practitioner are not covered if they are furnished in a hospital which is not a participating provider. Requires that participating providers meet standards established in this title or by the Board. Requires that such providers must agree to provide services without discrimination, to make no unauthorized charge to the patient for any covered service, and to furnish data necessary for utilization review by professional peers, statistical studies by the Board, and verification of information for payments. Makes professional practitioners licensed when the program begins eligible to practice in the State where they are licensed and requires that all newly licensed applicants for participation meet national standards established by the Board in addition to those required by his State. Establishes conditions of participation for general hospitals similar to those required by Medicare. States that the two requirements not found in the Medicare program are: (1) that the hospital must not discriminate in granting staff privileges on any grounds unrelated to professional qualifications, and (2) that it establish a pharmacy and drug therapeutics committee for supervision of hospital drug therapy. Provides that psychiatric hospitals will be eligible to participate only if the Board finds that the hospital (or a distinct part of the hospital) is engaged in furnishing active diagnostic, therapeutic and rehabilitative services to mentally ill patients. Establishes conditions of participation for skilled nursing homes similar to those established for extended care facilities under Medicare. Makes provisions for the participation of home health service agencies. Describes as eligible a health maintenance organization which undertakes to provide an enrolled population either with complete health care or, at least, with complete health security services (other than institutional services, mental health or dental services) for the maintenance of health and the care of ambulatory patients. Permits a foundation sponsored by a county or other local medical society to participate as a provider of services. Permits the participation of community health centers or the like which, though furnishing services as comprehensive as are required by this Act, do not serve an enrolled or otherwise predetermined population and may not meet other requirements of this Act. Authorizes the Board to deal separately with the primary care portion of a system of comprehensive health care where it is necessary to rely on arrangements with other providers. Permits the Board to contract directly with public or other nonprofit mental health centers and mental health day care services. Specifies the conditions under which independent pathology laboratories, independent radiological services, and providers of drugs, devices, appliances, equipment, or ambulance services may qualify as providers under Health Security. Requires that a participating skilled nursing home have in effect an agreement with at least one participating hospital for the transfer of patients and medical and other information as medically appropriate. Prohibits in malpractice judgments any damages to be awarded to the injured party for the cost of remedial services which he is entitled to receive under this Act. Excludes the institutions of the Department of Defense and the Veterans Administration, and institutions of the Department of Health, Education, and Welfare serving merchant seamen or Indians or Alaskan natives, from serving as participating providers, as well as any employee of these institutions when he is acting as an employee. Provides reimbursement for any services furnished by these institutions or agencies to eligible persons who are not a part of their normal clientele. Permits a physician, dentist, optometrist, or podiatrist, licensed in one State and meeting the national standards, to furnish Health Security benefits in any other State, the scope of his permissible practice being governed by the law of the State in which he is practicing. Grants a similar authority to other health professional and nonprofessional personnel. Establishes the Health Security Trust Fund, to receive the net assets of existing (Medicare) funds taken over by the Health Security program, the yield of the Health Security taxes, and the Government's contribution from general revenues amounting to 100 percent of the yield from these taxes. Provides that three separate accounts shall be established in the Health Security Trust Fund: a Health Service Account, a Health Resources Development Account, and an Administration Account. Provides that in each of the first two years of program operation, 2 percent of the Trust Fund shall be set aside for the Health Resources Development Fund; and the allocation shall increase by 1 percent at two-year intervals to 5 percent within the next 6 years. Provides for allocation of the Health Services account among the regions of the country. Provides that the allocation to each region shall be based on the aggregate sum expended during the most recent 12-month period for covered services (with appropriate modification for estimated changes in the consumer price index, the expected number of eligible beneficiaries, and estimated changes in the number of participating providers). Provides that the Board shall divide the allocation to each region into funds available to pay: institutional services; physician services; dental services; furnishing of drugs; furnishing of devices, appliances, equipment; and miscellaneous services. Provides that payments for covered services provided to eligible persons by participating providers will be made from the Health Service Account in the Trust Fund. Describes the method to be used in applying, as between practitioners electing the various methods of payment (fee-for-service and capitation), the monies available in each health service area for payment to each category of professional providers. Authorizes the Board to experiment with other methods of reimbursement so long as the experimental method does not increase the cost of service or lead to overutilization or underutilization of services. Provides that skilled nursing homes and home health agencies will be paid in the same manner as a general hospital (on an approved annual budget basis). Provides that a health organization will be paid for covered services, on the basis of a fixed capitation rate multiplied by the number of eligible enrollees. Contains a series of provisions for developing a continuous process of health service planning and for assisting in the recruitment, education, and training of health personnel. Authorizes special improvement grants: (1) to any public or other nonprofit health agency or institution to establish improved coordination and linkages with other providers of services, and (2) to organizations providing comprehensive ambulatory care, to improve their utilization review, budget, statistical, or records and information retrieval systems, to acquire equipment needed for those purposes, or to acquire equipment useful for mass screening or for other diagnostic or therapeutic purposes. Sets forth the responsibilities and duties of the Secretary of HEW and the Board with regard to this title. Creates an administrative structure within the Department of Health, Education, and Welfare with exclusive responsibility for the administration of the Health Security program. Establishes a five-member, full-time Health Security Board serving under the Secretary of Health, Education, and Welfare. Provides that the members shall be appointed by the President with the advice and consent of the Senate, for five-year overlapping terms. Creates the position of an Executive Director, appointed by the Board with the approval of the Secretary. Provides that the Executive Director will serve as secretary to the Board and shall perform such duties in the administration of the program as the Board may assign. Provides that the program will be administered through the regional offices of the Department of Health, Education, and Welfare. Requires the establishment of sub-regional (service area) offices. Establishes a National Health Security Advisory Council, with the Chairman of the Board serving as the Council's Chairman and 20 additional members not in the employ of the Federal Government. Authorizes the Advisory Council to appoint professional or technical committees to assist in its functions. Provides that the Advisory Council will advise the Board on matters of general policy in the administration of the program, the formulation of regulations and the allocation of funds for services. Charges the Board with responsibility for informing the public and providers about the administration and operation of the Health Security program. Requires the Board to make a continuing study and evaluation of the program, including adequacy, quality and costs of services. Authorizes the Board directly or by contract to make detailed statistical and other studies on a national, regional, or local basis of any aspect of the title; to develop and test incentive systems for improving quality of care, methods of peer review of drug utilization and of other service performances; to develop and test systems of information retrieval, budget programs, instrumentation for multiphasic screening or patient services, and reimbursement systems for drugs; and to make such other other studies which it considers would improve the quality of services of the administration of the program. Grants authority to the Board, in accordance with regulations, to make determinations of who are participating providers of services, determinations of eligibility, of whether services are covered, and the amount to be paid to providers. Allows a provider of services who is dissatisfied with a final Board determination to obtain a hearing before a Board panel, and judicial review of a final decision. Authorizes the Board, with the advice and assistance of the Commission on the Quality of Health Care, to issue and review regulations assuring the quality of care furnished under this Act. Requires continuing professional education by physicians, dentists, optometrists, and podiatrists. Provides for the appointment of a Deputy Secretary of HEW and an Under Secretary for Health and Science. States that no provision of this Act shall alter any contractual obligation of an employer to provide health services to his employees and their dependents. Title II: Health Security Taxes - Converts the existing Medicare hospital insurance payroll taxes into Health Security taxes, and raises the rates to 1 percent on employees and 3.5 percent on employers. Raises the wage base for the employee tax from the present $7,800 to $15,000; or, if higher, 125 percent of the contribution and benefit base. Broadens the definitions of covered employment to include foreign agricultural workers, employees of the U.S. and its instrumentalities (other than members of the armed forces and the President, Vice-President, and Members of Congress), employees of charitable and similar organizations, railroad employees, and (for the employee tax only) employees of States and their political subdivisions and instrumentalities. Excludes from the gross income of employees, for income tax purposes, payment by their employers of part or all of the Health Security taxes on the employees. Spells out the precise effective dates of the new payroll tax provisions. Converts the existing Medicare self-employment tax into a Health Security self-employment tax, raising the rate to 2.5 percent, and raises the maximum taxable self-employment income from $7,800 to $15,000. Adds a new 1 percent Health Security tax on unearned income (unless such income is less than $400 a year), subject to the same maximum on taxable income as is applicable to the employee and self-employment taxes. Title III: Commission on the Quality of Health Care - Establishes in the Department of HEW a Commission on the Quality of Health Care, with the primary responsibility of: (1) initiating and continuing development of methods of assessing the quality of health care furnished under the Health Security Act, and (2) submitting to the Secretary and the Health Security Board its findings and recommendations. Stipulates that in carrying out its duties the Commissioner shall emphasize, and give first consideration to, care furnished for those illnesses and conditions which have relatively high incidence in the population and which are relatively amenable to medical or other care. Title IV: Repeal or Amendment of Other Acts - Requires that after the effective date of benefits, no State shall be required to furnish any service covered under Health Security as a part of its State plan for participation under Medicaid. Title V: Studies Related to Health Security - Authorizes the Secretary of Health, Education, and Welfare in consultation with the Secretary of State and the Secretary of Treasury to study the coverage of health services for U.S. residents in other countries. Directs the Secretary of HEW to study the feasibility and desirability of coordinating the Federal health benefit programs for merchant seamen and Indians and Alaskan natives and also veterans and members of the Armed Forces, with the Health Security Benefit Program.
Bill· HRH.R. 7737 (94th)referred
United States · United States Congress · 9 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7742 (94th)referred
United States · United States Congress · 9 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7738 (94th)referred
United States · United States Congress · 9 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7713 (94th)referred
United States · United States Congress · 9 June 1975
Comprehensive Health Care Insurance Act - States that the purpose of this Act is to establish a national health care insurance program that will provide comprehensive benefits, including institutional, medical, dental, and other health care, protecting against ordinary and catastrophic expenses of illnesses for all individuals. Requires every employer to offer each of his employees and their families qualified health care insurance. States that such coverage shall be optional with the employee. Provides that when an employee elects to obtain such coverage, the employer shall contribute to the cost of such coverage for the benefit of the employee and his family at least 65 percent of the premium; the employee shall contribute the balance. Permits the Attorney General to bring suit to compel an employer to comply with the provisions of this Act. Stipulates that employers experiencing substantial increases in payroll costs due to the provisions of this Act will be entitled to a cash payment by the Secretary of Health, Education, and Welfare or a credit against income tax. Authorizes appropriations of such sums as are necessary for the Secretary to make such payments. Provides that premiums for employee groups of one to 100 persons and self-employed persons shall not exceed 125 percent of the estimated average in the State of annual premium for employee groups of more than 100 persons. Establishes a program of Federal participation, through a system of certificates of entitlement issued by the Secretary and credits against income tax, in the premium for qualified health care insurance providing comprehensive hospital, medical, dental, and other health care services for non-employed and self-employed individuals and families. States that the amount of Federal participation shall be related to income of the individual or family, the Government to pay the full premium for those whose annual incomes are insufficient to create income tax liability, and to pay a gradually smaller proportion of the premium for others in relation to increasing amounts of income tax liability. Provides that if an individual or family incurs no income tax liability for a base year, such individual or family shall be eligible for a certificate of entitlement or a credit against income tax for 100 percent of the premium for qualified health care insurance. Stipulates that the premium rate to be charged for a qualified health care insurance policy offered under this part for any year shall in no case exceed 125 percent of the estimated average of premiums paid in the State for qualified health care insurance for groups of employees with more than 100 members. Excludes from qualified health care insurance coverage payment for stipulated items, including: (1) personal comfort items; (2) eyeglasses, hearing aids, or orthopedic shoes; and (3) private room inpatient hospital accomodations. Limits the aggregate amount of expenditures for castastrophic illness expenses. Sets forth requirements which must be met by qualified health care insurance plans. Defines terms used in this Act. Establishes the Federal Health Insurance Redemption Fund. Authorizes appropriations to the fund of amounts equal to the aggregate amount of premiums paid under this Act. Requires carriers offering qualified health care insurance policies to participate in an assigned-risk pool which may be established in such State by the State insurance department or by such agency as may be authorized by the State. Establishes a Health Insurance Advisory Board to: (1) prescribe such regulations as may be necessary to carry out the purposes and provisions of this Act; (2) establish minimum Federal standards for the use of State insurance departments in determining whether an insurance company and plan are qualified under this Act; (3) in consultation with carriers, providers of services, and consumers, plan, review, and develop, where necessary programs whose purposes are to provide for maintaining the quality of medical care; and (4) review the effectiveness of the program established in this Act. Stipulates that individuals collecting unemployment compensation are eligible for coverage under this Act, unless covered through an employed member of his family. Permits an income tax credit for premiums paid for qualified insurance plans under this Act.
Bill· HRH.R. 7714 (94th)referred
United States · United States Congress · 9 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7708 (94th)referred
United States · United States Congress · 9 June 1975
Provides that eligibility of home- dialysis treatments or kidney transplants for payment under the Medicare program of the Social Security Act shall begin with the first month of treatment or preparation therefor and last up to 12 months after termination of a regular course of dialysis (or up to 36 months after receipt of the last kidney transplant).
Bill· HJRESH.J.Res. 494 (94th)referred
United States · United States Congress · 9 June 1975
Authorizes the President to proclaim September 8 of each year as "National Cancer Day".
Bill· HRH.R. 7694 (94th)referred
United States · United States Congress · 6 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7661 (94th)referred
United States · United States Congress · 5 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7657 (94th)referred
United States · United States Congress · 5 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7658 (94th)referred
United States · United States Congress · 5 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7671 (94th)referred
United States · United States Congress · 5 June 1975
Provides payment under the supplementary medical insurance program (Medicare) of the Social Security Act for additional optometrists' services and for eyeglasses.
Bill· HRH.R. 7660 (94th)referred
United States · United States Congress · 5 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7659 (94th)referred
United States · United States Congress · 5 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7638 (94th)referred
United States · United States Congress · 5 June 1975
Establishes a minimum amount of $2 per day which a patient participating in the Medicaid program of the Social Security Act in a nursing home has a right to keep (from medicaid benefits) for incidental expenses. Prohibits any requirement that such a patient turn over any part of such amount to the State as a condition of his or her medicaid coverage.
Bill· HRH.R. 7644 (94th)referred
United States · United States Congress · 5 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7643 (94th)referred
United States · United States Congress · 5 June 1975
Provides for inclusion of the services of licensed (registered) nurses under the medicare and medicaid, titles XVIII and XIX of the Social Security Act.
Bill· HRH.R. 7621 (94th)referred
United States · United States Congress · 4 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7618 (94th)referred
United States · United States Congress · 4 June 1975
Provides that eligibility of home- dialysis treatments or kidney transplants for payment under the Medicare program of the Social Security Act shall begin with the first month of treatment or preparation therefor and last up to 12 months after termination of a regular course of dialysis (or up to 36 months after receipt of the last kidney transplant).
Bill· HRH.R. 7604 (94th)referred
United States · United States Congress · 4 June 1975
Prohibits carriers of Federal employee insurance from reducing or excluding health benefits without such proposed changes being published in the Federal Register and without hearings by the Civil Service Commission on such proposed changes.
Bill· HRH.R. 7595 (94th)referred
United States · United States Congress · 4 June 1975
Social Security Reform Amendments - Repeals the earnings limitation under title II (Old-Age, Survivors, and Disability Insurance) of the Social Security Act. Provides benefits under such title to husbands, widowers, and fathers on the same basis as wives, widows, and mothers who presently receive benefits. Eliminates the five-month waiting period for disability benefits. Continues the benefit entitled under such title through the month of the beneficiary's death. Permits individuals 65 years of age or older to elect an exemption from Social Security coverage and payment of Social Security taxes. Eliminates marriage or remarriage of a beneficiary as a factor in terminating or reducing the amount of benefits available. Authorizes direct payments to physicians and other providers at their option under the supplementary medical insurance program of title XVIII (Medicare) of the Social Security Act.
Bill· HRH.R. 7564 (94th)referred
United States · United States Congress · 3 June 1975
Authorizes the President to award an annual $50,000 prize for the individual who has conducted the research project which has made the most outstanding contribution to the world's understanding of the causes and cures of cancer. Provides that such prizes shall be known as the President's Cancer Research Prize. Requires the Director of the National Cancer Institute to review projects in cancer research throughout the world in order to make recommendations to facilitate the provisions of this Act.
Bill· HRH.R. 7562 (94th)referred
United States · United States Congress · 3 June 1975
Title I: Revision of National Heart and Lung Institute Programs - Authorizes research and training in the use of blood products and the management of blood resources under the National Heart and Lung Institute programs. Authorizes the use of funds under such programs for the prevention and control of blood diseases. Title II: National Research Service Awards - Makes such awards available under Federal programs and extends the authorize for them through fiscal year 1977. Title III: Disclosure of Research Information - Provides that, subject to specified exceptions, the Secretary of Health, Education, and Welfare may not disclose any information contained in a research protocol, research hypothesis, or research design obtained by him in connection with an application or proposal for a grant, fellowship, or contract under the Public Health Service Act.
Bill· HRH.R. 7508 (94th)referred
United States · United States Congress · 2 June 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7515 (94th)referred
United States · United States Congress · 2 June 1975
Medical Malpractice Claims Settlement Assistance Act - Sets forth the findings of Congress that the achievement of equal access to quality health care at a reasonable cost is jeopardized by the uncertain future availability and cost of medical malpractice insurance. Title I: Federal Authority - Authorizes the Secretary of Health, Education, and Welfare to make available to insurance companies and other insurers reinsurance against medical malpractice claims by any of their insureds which exceed $200,000 within a qualified State. Defines "qualified States" as a State which meets requirements set forth in this Act. Permits the Secretary to use existing facilities and services in carrying out his responsibilities under this Act. Entitles the Secretary to recover from any insurer the amount of any unpaid premiums lawfully payable by such insurer to the Secretary. Requires, as a condition to the receipt of reinsurance, that each insurer file specified information with the Secretary. Directs the Secretary to conduct comprehensive studies of medical malpractice claims and litigation, in order to determine methods of minimizing the costs of such a system. Title II: State Programs - Requires States to establish a program for the arbitration of medical malpractice claims. Provides that any civil action arising from a claim for damages on account of alleged medical malpractice on the part of any health professional or health care insitution may be instituted in a court of the State only after there has been an arbitration of the claim which forms the basis for such action. Sets forth procedures governing the initiation of arbitration, the appointment of an arbitration panel, hearing procedures, the decision of the arbitration panel, proceedings subsequent to the decision of the arbitration panel, the admissibility of the arbitration panel decision as evidence at trial, and the reporting of arbitration decisions. Requires States to establish and appropriately enforce a schedule of maximum contingent fee rates which may be charged or accepted by attorneys for services performed in connection with claims for damages on account of alleged medical malpractice. Provides that in order for any State to be eligible for Medicaid payments under title XIX of the Social Security, such State must have in effect a patient grievance mechanism applicable to all health care entities within the State. States that in order to qualify for malpractice reinsurance under this Act, such patient grievance mechanism must (1) receive, investigate, and evaluate grievances of patients respecting medical injuries occurring in noninstitutional settings, and (2) assist in the equitable settlement of any claims arising out of such grievances. Requires such mechanism to make quarterly reports to the Secretary on the grievances received by the mechanism, the disposition of such grievances, and the medical malpractice claims arising out of such grievances.
Bill· HRH.R. 7480 (94th)referred
United States · United States Congress · 22 May 1975
Extends appropriations authorizations for emergency medical services systems under the Public Health Service Act.
Bill· HRH.R. 7453 (94th)referred
United States · United States Congress · 22 May 1975
Health Security Act - Title I: Health Security Benefits - Provides that every resident of the U.S. (and every non-resident citizen when in the U.S.) will be eligible for covered services. Permits reciprocal and "buy-in" agreements for groups or non-resident aliens, and in some cases benefits to U.S. residents when visiting in other countries. Entitles every eligible person to have payments made by the Health Security Board for covered services provided within the United States by a participating provider. Provides that all necessary professional services of physicians, wherever furnished are covered, including preventive care, with two restrictions: (1) specialist services are covered only when performed by a qualified specialist except in emergency situations, and generally only on referral from a primary physician; and (2) psychiatric services to an ambulatory patient are covered only for active preventive, diagnostic, therapeutic or rehabilitative service with respect to mental illness. Provides that comprehensive dental services (exclusive of most orthodontic services) are covered for children under age 15, with the covered age group increasing by two years each year until all those under age 25 are covered. Provides that: (1) inpatient and outpatient hospital services and services of a home health agency are covered without arbitrary limitation; and (2) pathology and radiology services are specifically included as parts of institutional services. Limits payment for skilled nursing home care to 120 days per spell of illness, except that this limit may be increased when the nursing home is owned or managed by a hospital and payment for care is made through the hospital budget. Limits the psychiatric hospital benefit to 45 consecutive days of active treatment during a spell of illness. Provides coverage for two categories of drug use: prescribed medicines administered to inpatients or outpatients within participating hospitals; or to enrollees of comprehensive health service organizations, and drugs necessary for the treatment of specified chronic illnesses or conditions requiring long or expensive therapy. Requires the Board and the Secretary of Health, Education, and Welfare to establish two lists of approved drugs, taking into account the safety, efficacy and cost of each drug. Provides a broad list of approved medicines available for use in institutions and by comprehensive health service organizations and a more restricted list which is available for use outside such organized settings. Provides that the appliances benefit is similar in concept and operation to the drug benefit, subject to a limitation on aggregate cost. Asserts that the professional services of optometrists and podiatrists are covered, subject to regulations, as are diagnostic or therapeutic services furnished by independent pathology laboratories and radiology services. States that health services furnished or paid for under a workmen's compensation law are not covered. Provides that the services of a professional practitioner are not covered if they are furnished in a hospital which is not a participating provider. Requires that participating providers meet standards established in this title or by the Board. Requires that such providers must agree to provide services without discrimination, to make no unauthorized charge to the patient for any covered service, and to furnish data necessary for utilization review by professional peers, statistical studies by the Board, and verification of information for payments. Makes professional practitioners licensed when the program begins eligible to practice in the State where they are licensed and requires that all newly licensed applicants for participation meet national standards established by the Board in addition to those required by his State. Establishes conditions of participation for general hospitals similar to those required by Medicare. States that the two requirements not found in the Medicare program are: (1) that the hospital must not discriminate in granting staff privileges on any grounds unrelated to professional qualifications, and (2) that it establish a pharmacy and drug therapeutics committee for supervision of hospital drug therapy. Provides that psychiatric hospitals will be eligible to participate only if the Board finds that the hospital (or a distinct part of the hospital) is engaged in furnishing active diagnostic, therapeutic and rehabilitative services to mentally ill patients. Establishes conditions of participation for skilled nursing homes similar to those established for extended care facilities under Medicare. Makes provisions for the participation of home health service agencies. Describes as eligible a health maintenance organization which undertakes to provide an enrolled population either with complete health care or, at least, with complete health security services (other than institutional services, mental health or dental services) for the maintenance of health and the care of ambulatory patients. Permits a foundation sponsored by a county or other local medical society to participate as a provider of services. Permits the participation of community health centers or the like which, though furnishing services as comprehensive as are required by this Act, do not serve an enrolled or otherwise predetermined population and may not meet other requirements of this Act. Authorizes the Board to deal separately with the primary care portion of a system of comprehensive health care where it is necessary to rely on arrangements with other providers. Permits the Board to contract directly with public or other nonprofit mental health centers and mental health day care services. Specifies the conditions under which independent pathology laboratories, independent radiological services, and providers of drugs, devices, appliances, equipment, or ambulance services may qualify as providers under Health Security. Requires that a participating skilled nursing home have in effect an agreement with at least one participating hospital for the transfer of patients and medical and other information as medically appropriate. Prohibits in malpractice judgments any damages to be awarded to the injured party for the cost of remedial services which he is entitled to receive under this Act. Excludes the institutions of the Department of Defense and the Veterans Administration, and institutions of the Department of Health, Education, and Welfare serving merchant seamen or Indians or Alaskan natives, from serving as participating providers, as well as any employee of these institutions when he is acting as an employee. Provides reimbursement for any services furnished by these institutions or agencies to eligible persons who are not a part of their normal clientele. Permits a physician, dentist, optometrist, or podiatrist, licensed in one State and meeting the national standards, to furnish Health Security benefits in any other State, the scope of his permissible practice being governed by the law of the State in which he is practicing. Grants a similar authority to other health professional and nonprofessional personnel. Establishes the Health Security Trust Fund, to receive the net assets of existing (Medicare) funds taken over by the Health Security program, the yield of the Health Security taxes, and the Government's contribution from general revenues amounting to 100 percent of the yield from these taxes. Provides that three separate accounts shall be established in the Health Security Trust Fund: a Health Service Account, a Health Resources Development Account, and an Administration Account. Provides that in each of the first two years of program operation, 2 percent of the Trust Fund shall be set aside for the Health Resources Development Fund; and the allocation shall increase by 1 percent at two-year intervals to 5 percent within the next 6 years. Provides for allocation of the Health Services account among the regions of the country. Provides that the allocation to each region shall be based on the aggregate sum expended during the most recent 12-month period for covered services (with appropriate modification for estimated changes in the consumer price index, the expected number of eligible beneficiaries, and estimated changes in the number of participating providers). Provides that the Board shall divide the allocation to each region into funds available to pay: institutional services; physician services; dental services; furnishing of drugs; furnishing of devices, appliances, equipment; and miscellaneous services. Provides that payments for covered services provided to eligible persons by participating providers will be made from the Health Service Account in the Trust Fund. Describes the method to be used in applying, as between practitioners electing the various methods of payment (fee-for-service and capitation), the monies available in each health service area for payment to each category of professional providers. Authorizes the Board to experiment with other methods of reimbursement so long as the experimental method does not increase the cost of service or lead to overutilization or underutilization of services. Provides that skilled nursing homes and home health agencies will be paid in the same manner as a general hospital (on an approved annual budget basis). Provides that a health organization will be paid for covered services, on the basis of a fixed capitation rate multiplied by the number of eligible enrollees. Contains a series of provisions for developing a continuous process of health service planning and for assisting in the recruitment, education, and training of health personnel. Authorizes special improvement grants: (1) to any public or other nonprofit health agency or institution to establish improved coordination and linkages with other providers of services, and (2) to organizations providing comprehensive ambulatory care, to improve their utilization review, budget, statistical, or records and information retrieval systems, to acquire equipment needed for those purposes, or to acquire equipment useful for mass screening or for other diagnostic or therapeutic purposes. Sets forth the responsibilities and duties of the Secretary of HEW and the Board with regard to this title. Creates an administrative structure within the Department of Health, Education, and Welfare with exclusive responsibility for the administration of the Health Security program. Establishes a five-member, full-time Health Security Board serving under the Secretary of Health, Education, and Welfare. Provides that the members shall be appointed by the President with the advice and consent of the Senate, for five-year overlapping terms. Creates the position of an Executive Director, appointed by the Board with the approval of the Secretary. Provides that the Executive Director will serve as secretary to the Board and shall perform such duties in the administration of the program as the Board may assign. Provides that the program will be administered through the regional offices of the Department of Health, Education, and Welfare. Requires the establishment of sub-regional (service area) offices. Establishes a National Health Security Advisory Council, with the Chairman of the Board serving as the Council's Chairman and 20 additional members not in the employ of the Federal Government. Authorizes the Advisory Council to appoint professional or technical committees to assist in its functions. Provides that the Advisory Council will advise the Board on matters of general policy in the administration of the program, the formulation of regulations and the allocation of funds for services. Charges the Board with responsibility for informing the public and providers about the administration and operation of the Health Security program. Requires the Board to make a continuing study and evaluation of the program, including adequacy, quality and costs of services. Authorizes the Board directly or by contract to make detailed statistical and other studies on a national, regional, or local basis of any aspect of the title; to develop and test incentive systems for improving quality of care, methods of peer review of drug utilization and of other service performances; to develop and test systems of information retrieval, budget programs, instrumentation for multiphasic screening or patient services, and reimbursement systems for drugs; and to make such other other studies which it considers would improve the quality of services of the administration of the program. Grants authority to the Board, in accordance with regulations, to make determinations of who are participating providers of services, determinations of eligibility, of whether services are covered, and the amount to be paid to providers. Allows a provider of services who is dissatisfied with a final Board determination to obtain a hearing before a Board panel, and judicial review of a final decision. Authorizes the Board, with the advice and assistance of the Commission on the Quality of Health Care, to issue and review regulations assuring the quality of care furnished under this Act. Requires continuing professional education by physicians, dentists, optometrists, and podiatrists. Provides for the appointment of a Deputy Secretary of HEW and an Under Secretary for Health and Science. States that no provision of this Act shall alter any contractual obligation of an employer to provide health services to his employees and their dependents. Title II: Health Security Taxes - Converts the existing Medicare hospital insurance payroll taxes into Health Security taxes, and raises the rates to 1 percent on employees and 3.5 percent on employers. Raises the wage base for the employee tax from the present $7,800 to $15,000; or, if higher, 125 percent of the contribution and benefit base. Broadens the definitions of covered employment to include foreign agricultural workers, employees of the U.S. and its instrumentalities (other than members of the armed forces and the President, Vice-President, and Members of Congress), employees of charitable and similar organizations, railroad employees, and (for the employee tax only) employees of States and their political subdivisions and instrumentalities. Excludes from the gross income of employees, for income tax purposes, payment by their employers of part or all of the Health Security taxes on the employees. Spells out the precise effective dates of the new payroll tax provisions. Converts the existing Medicare self-employment tax into a Health Security self-employment tax, raising the rate to 2.5 percent, and raises the maximum taxable self-employment income from $7,800 to $15,000. Adds a new 1 percent Health Security tax on unearned income (unless such income is less than $400 a year), subject to the same maximum on taxable income as is applicable to the employee and self-employment taxes. Title III: Commission on the Quality of Health Care - Establishes in the Department of HEW a Commission on the Quality of Health Care, with the primary responsibility of: (1) initiating and continuing development of methods of assessing the quality of health care furnished under the Health Security Act, and (2) submitting to the Secretary and the Health Security Board its findings and recommendations. Stipulates that in carrying out its duties the Commissioner shall emphasize, and give first consideration to, care furnished for those illnesses and conditions which have relatively high incidence in the population and which are relatively amenable to medical or other care. Title IV: Repeal or Amendment of Other Acts - Requires that after the effective date of benefits, no State shall be required to furnish any service covered under Health Security as a part of its State plan for participation under Medicaid. Title V: Studies Related to Health Security - Authorizes the Secretary of Health, Education, and Welfare in consultation with the Secretary of State and the Secretary of Treasury to study the coverage of health services for U.S. residents in other countries. Directs the Secretary of HEW to study the feasibility and desirability of coordinating the Federal health benefit programs for merchant seamen and Indians and Alaskan natives and also veterans and members of the Armed Forces, with the Health Security Benefit Program.
Bill· HRH.R. 7421 (94th)referred
United States · United States Congress · 22 May 1975
Health Security Act - Title I: Health Security Benefits - Provides that every resident of the U.S. (and every non-resident citizen when in the U.S.) will be eligible for covered services. Permits reciprocal and "buy-in" agreements for groups or non-resident aliens, and in some cases benefits to U.S. residents when visiting in other countries. Entitles every eligible person to have payments made by the Health Security Board for covered services provided within the United States by a participating provider. Provides that all necessary professional services of physicians, wherever furnished are covered, including preventive care, with two restrictions: (1) specialist services are covered only when performed by a qualified specialist except in emergency situations, and generally only on referral from a primary physician; and (2) psychiatric services to an ambulatory patient are covered only for active preventive, diagnostic, therapeutic or rehabilitative service with respect to mental illness. Provides that comprehensive dental services (exclusive of most orthodontic services) are covered for children under age 15, with the covered age group increasing by two years each year until all those under age 25 are covered. Provides that: (1) inpatient and outpatient hospital services and services of a home health agency are covered without arbitrary limitation; and (2) pathology and radiology services are specifically included as parts of institutional services. Limits payment for skilled nursing home care to 120 days per spell of illness, except that this limit may be increased when the nursing home is owned or managed by a hospital and payment for care is made through the hospital budget. Limits the psychiatric hospital benefit to 45 consecutive days of active treatment during a spell of illness. Provides coverage for two categories of drug use: prescribed medicines administered to inpatients or outpatients within participating hospitals; or to enrollees of comprehensive health service organizations, and drugs necessary for the treatment of specified chronic illnesses or conditions requiring long or expensive therapy. Requires the Board and the Secretary of Health, Education, and Welfare to establish two lists of approved drugs, taking into account the safety, efficacy and cost of each drug. Provides a broad list of approved medicines available for use in institutions and by comprehensive health service organizations and a more restricted list which is available for use outside such organized settings. Provides that the appliances benefit is similar in concept and operation to the drug benefit, subject to a limitation on aggregate cost. Asserts that the professional services of optometrists and podiatrists are covered, subject to regulations, as are diagnostic or therapeutic services furnished by independent pathology laboratories and radiology services. States that health services furnished or paid for under a workmen's compensation law are not covered. Provides that the services of a professional practitioner are not covered if they are furnished in a hospital which is not a participating provider. Requires that participating providers meet standards established in this title or by the Board. Requires that such providers must agree to provide services without discrimination, to make no unauthorized charge to the patient for any covered service, and to furnish data necessary for utilization review by professional peers, statistical studies by the Board, and verification of information for payments. Makes professional practitioners licensed when the program begins eligible to practice in the State where they are licensed and requires that all newly licensed applicants for participation meet national standards established by the Board in addition to those required by his State. Establishes conditions of participation for general hospitals similar to those required by Medicare. States that the two requirements not found in the Medicare program are: (1) that the hospital must not discriminate in granting staff privileges on any grounds unrelated to professional qualifications, and (2) that it establish a pharmacy and drug therapeutics committee for supervision of hospital drug therapy. Provides that psychiatric hospitals will be eligible to participate only if the Board finds that the hospital (or a distinct part of the hospital) is engaged in furnishing active diagnostic, therapeutic and rehabilitative services to mentally ill patients. Establishes conditions of participation for skilled nursing homes similar to those established for extended care facilities under Medicare. Makes provisions for the participation of home health service agencies. Describes as eligible a health maintenance organization which undertakes to provide an enrolled population either with complete health care or, at least, with complete health security services (other than institutional services, mental health or dental services) for the maintenance of health and the care of ambulatory patients. Permits a foundation sponsored by a county or other local medical society to participate as a provider of services. Permits the participation of community health centers or the like which, though furnishing services as comprehensive as are required by this Act, do not serve an enrolled or otherwise predetermined population and may not meet other requirements of this Act. Authorizes the Board to deal separately with the primary care portion of a system of comprehensive health care where it is necessary to rely on arrangements with other providers. Permits the Board to contract directly with public or other nonprofit mental health centers and mental health day care services. Specifies the conditions under which independent pathology laboratories, independent radiological services, and providers of drugs, devices, appliances, equipment, or ambulance services may qualify as providers under Health Security. Requires that a participating skilled nursing home have in effect an agreement with at least one participating hospital for the transfer of patients and medical and other information as medically appropriate. Prohibits in malpractice judgments any damages to be awarded to the injured party for the cost of remedial services which he is entitled to receive under this Act. Excludes the institutions of the Department of Defense and the Veterans Administration, and institutions of the Department of Health, Education, and Welfare serving merchant seamen or Indians or Alaskan natives, from serving as participating providers, as well as any employee of these institutions when he is acting as an employee. Provides reimbursement for any services furnished by these institutions or agencies to eligible persons who are not a part of their normal clientele. Permits a physician, dentist, optometrist, or podiatrist, licensed in one State and meeting the national standards, to furnish Health Security benefits in any other State, the scope of his permissible practice being governed by the law of the State in which he is practicing. Grants a similar authority to other health professional and nonprofessional personnel. Establishes the Health Security Trust Fund, to receive the net assets of existing (Medicare) funds taken over by the Health Security program, the yield of the Health Security taxes, and the Government's contribution from general revenues amounting to 100 percent of the yield from these taxes. Provides that three separate accounts shall be established in the Health Security Trust Fund: a Health Service Account, a Health Resources Development Account, and an Administration Account. Provides that in each of the first two years of program operation, 2 percent of the Trust Fund shall be set aside for the Health Resources Development Fund; and the allocation shall increase by 1 percent at two-year intervals to 5 percent within the next 6 years. Provides for allocation of the Health Services account among the regions of the country. Provides that the allocation to each region shall be based on the aggregate sum expended during the most recent 12-month period for covered services (with appropriate modification for estimated changes in the consumer price index, the expected number of eligible beneficiaries, and estimated changes in the number of participating providers). Provides that the Board shall divide the allocation to each region into funds available to pay: institutional services; physician services; dental services; furnishing of drugs; furnishing of devices, appliances, equipment; and miscellaneous services. Provides that payments for covered services provided to eligible persons by participating providers will be made from the Health Service Account in the Trust Fund. Describes the method to be used in applying, as between practitioners electing the various methods of payment (fee-for-service and capitation), the monies available in each health service area for payment to each category of professional providers. Authorizes the Board to experiment with other methods of reimbursement so long as the experimental method does not increase the cost of service or lead to overutilization or underutilization of services. Provides that skilled nursing homes and home health agencies will be paid in the same manner as a general hospital (on an approved annual budget basis). Provides that a health organization will be paid for covered services, on the basis of a fixed capitation rate multiplied by the number of eligible enrollees. Contains a series of provisions for developing a continuous process of health service planning and for assisting in the recruitment, education, and training of health personnel. Authorizes special improvement grants: (1) to any public or other nonprofit health agency or institution to establish improved coordination and linkages with other providers of services, and (2) to organizations providing comprehensive ambulatory care, to improve their utilization review, budget, statistical, or records and information retrieval systems, to acquire equipment needed for those purposes, or to acquire equipment useful for mass screening or for other diagnostic or therapeutic purposes. Sets forth the responsibilities and duties of the Secretary of HEW and the Board with regard to this title. Creates an administrative structure within the Department of Health, Education, and Welfare with exclusive responsibility for the administration of the Health Security program. Establishes a five-member, full-time Health Security Board serving under the Secretary of Health, Education, and Welfare. Provides that the members shall be appointed by the President with the advice and consent of the Senate, for five-year overlapping terms. Creates the position of an Executive Director, appointed by the Board with the approval of the Secretary. Provides that the Executive Director will serve as secretary to the Board and shall perform such duties in the administration of the program as the Board may assign. Provides that the program will be administered through the regional offices of the Department of Health, Education, and Welfare. Requires the establishment of sub-regional (service area) offices. Establishes a National Health Security Advisory Council, with the Chairman of the Board serving as the Council's Chairman and 20 additional members not in the employ of the Federal Government. Authorizes the Advisory Council to appoint professional or technical committees to assist in its functions. Provides that the Advisory Council will advise the Board on matters of general policy in the administration of the program, the formulation of regulations and the allocation of funds for services. Charges the Board with responsibility for informing the public and providers about the administration and operation of the Health Security program. Requires the Board to make a continuing study and evaluation of the program, including adequacy, quality and costs of services. Authorizes the Board directly or by contract to make detailed statistical and other studies on a national, regional, or local basis of any aspect of the title; to develop and test incentive systems for improving quality of care, methods of peer review of drug utilization and of other service performances; to develop and test systems of information retrieval, budget programs, instrumentation for multiphasic screening or patient services, and reimbursement systems for drugs; and to make such other other studies which it considers would improve the quality of services of the administration of the program. Grants authority to the Board, in accordance with regulations, to make determinations of who are participating providers of services, determinations of eligibility, of whether services are covered, and the amount to be paid to providers. Allows a provider of services who is dissatisfied with a final Board determination to obtain a hearing before a Board panel, and judicial review of a final decision. Authorizes the Board, with the advice and assistance of the Commission on the Quality of Health Care, to issue and review regulations assuring the quality of care furnished under this Act. Requires continuing professional education by physicians, dentists, optometrists, and podiatrists. Provides for the appointment of a Deputy Secretary of HEW and an Under Secretary for Health and Science. States that no provision of this Act shall alter any contractual obligation of an employer to provide health services to his employees and their dependents. Title II: Health Security Taxes - Converts the existing Medicare hospital insurance payroll taxes into Health Security taxes, and raises the rates to 1 percent on employees and 3.5 percent on employers. Raises the wage base for the employee tax from the present $7,800 to $15,000; or, if higher, 125 percent of the contribution and benefit base. Broadens the definitions of covered employment to include foreign agricultural workers, employees of the U.S. and its instrumentalities (other than members of the armed forces and the President, Vice-President, and Members of Congress), employees of charitable and similar organizations, railroad employees, and (for the employee tax only) employees of States and their political subdivisions and instrumentalities. Excludes from the gross income of employees, for income tax purposes, payment by their employers of part or all of the Health Security taxes on the employees. Spells out the precise effective dates of the new payroll tax provisions. Converts the existing Medicare self-employment tax into a Health Security self-employment tax, raising the rate to 2.5 percent, and raises the maximum taxable self-employment income from $7,800 to $15,000. Adds a new 1 percent Health Security tax on unearned income (unless such income is less than $400 a year), subject to the same maximum on taxable income as is applicable to the employee and self-employment taxes. Title III: Commission on the Quality of Health Care - Establishes in the Department of HEW a Commission on the Quality of Health Care, with the primary responsibility of: (1) initiating and continuing development of methods of assessing the quality of health care furnished under the Health Security Act, and (2) submitting to the Secretary and the Health Security Board its findings and recommendations. Stipulates that in carrying out its duties the Commissioner shall emphasize, and give first consideration to, care furnished for those illnesses and conditions which have relatively high incidence in the population and which are relatively amenable to medical or other care. Title IV: Repeal or Amendment of Other Acts - Requires that after the effective date of benefits, no State shall be required to furnish any service covered under Health Security as a part of its State plan for participation under Medicaid. Title V: Studies Related to Health Security - Authorizes the Secretary of Health, Education, and Welfare in consultation with the Secretary of State and the Secretary of Treasury to study the coverage of health services for U.S. residents in other countries. Directs the Secretary of HEW to study the feasibility and desirability of coordinating the Federal health benefit programs for merchant seamen and Indians and Alaskan natives and also veterans and members of the Armed Forces, with the Health Security Benefit Program.
Bill· HRH.R. 7430 (94th)referred
United States · United States Congress · 22 May 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7439 (94th)referred
United States · United States Congress · 22 May 1975
Title I: Survey And Certification, Ratesetting And Audit, And General Regulation Of Long-Term Care Facilities Under Medicaid Programs - Requires that a State plan for medical assistance must provide that no skilled nursing facility may receive payments under such plan unless and until it is approved to receive payments under title XVIII (Medicare) of the Social Security Act. Provides that such State plan require that the State agency have the power to terminate reimbursement to a skilled nursing or intermediate care facility which violates its provider agreement. Requires such State plan to include that the inspection and medical review shall serve as the basis for determining the overpayment to such facility, and the amount such agency must refund. Requires such State plan to provide that any skilled nursing facility receiving payments under the plan be required to maintain with the State agency a bond to anticipate any and all claims for overpayment. Title II: Medical, Psychological, And Social Assessment Of Patients In Need Of Long-Term Care Under Medicare And Medicaid Programs - Requires that for payment of services furnished and individual under the Medicare and Medicaid programs that a physicain's certification be based on such patient assessment criteria as the Secretary of Health, Education, and Welfare may require. Provides that a State plan msut include a regular program of medical review utilizing such criteria as required by the Secretary of meeting their health care needs through alternative institutional or noninstitutional services.
Bill· HRH.R. 7431 (94th)referred
United States · United States Congress · 22 May 1975
Requires under the Social Security Act the continued application of the 8 1/2 percent nursing salary cost differential which is presently allowed in determining the reasonable cost of inpatient nursing care for purposes of reimbursement to providers under the medicare program.
Bill· HRH.R. 7393 (94th)referred
United States · United States Congress · 21 May 1975
Title I: Survey And Certification, Ratesetting And Audit, And General Regulation Of Long-Term Care Facilities Under Medicaid Programs - Requires that a State plan for medical assistance must provide that no skilled nursing facility may receive payments under such plan unless and until it is approved to receive payments under title XVIII (Medicare) of the Social Security Act. Provides that such State plan require that the State agency have the power to terminate reimbursement to a skilled nursing or intermediate care facility which violates its provider agreement. Requires such State plan to include that the inspection and medical review shall serve as the basis for determining the overpayment to such facility, and the amount such agency must refund. Requires such State plan to provide that any skilled nursing facility receiving payments under the plan be required to maintain with the State agency a bond to anticipate any and all claims for overpayment. Title II: Medical, Psychological, And Social Assessment Of Patients In Need Of Long-Term Care Under Medicare And Medicaid Programs - Requires that for payment of services furnished and individual under the Medicare and Medicaid programs that a physicain's certification be based on such patient assessment criteria as the Secretary of Health, Education, and Welfare may require. Provides that a State plan msut include a regular program of medical review utilizing such criteria as required by the Secretary of meeting their health care needs through alternative institutional or noninstitutional services.
Bill· HRH.R. 7377 (94th)referred
United States · United States Congress · 21 May 1975
Authorizes the Secretary of Health, Education, and Welfare to make grants under the Public Health Service Act to colleges and universities to assist them in the establishment and operation of programs for the training of physicians' assistants. Authorizes appropriations of $10,000,000 annually commencing with fiscal year 1974 to carry out the provisions of this Act.
Bill· HRH.R. 7373 (94th)referred
United States · United States Congress · 21 May 1975
Authorizes the Secretary of Health, Education, and Welfare to make grants to schools of medicine to train veterans, with appropriate experience as paramedical personnel, to serve as medical assistants in long-term health care facilities. Authorizes appropriations of $2,500,000 for fiscal year 1974 and $5,000,000 for each of the next three fiscal years to carry out the provisions of this Act.
Bill· HRH.R. 7369 (94th)referred
United States · United States Congress · 21 May 1975
Authorizes the Secretary of Health, Education, and Welfare to make grants to assist schools of medicine in the establishment and operation, within such schools, of conintuing education programs in geriatrics for physicians.
Bill· HRH.R. 7392 (94th)referred
United States · United States Congress · 21 May 1975
Title I: Survey And Certification, Ratesetting And Audit, And General Regulation Of Long-Term Care Facilities Under Medicaid Programs - Requires that a State plan for medical assistance must provide that no skilled nursing facility may receive payments under such plan unless and until it is approved to receive payments under title XVIII (Medicare) of the Social Security Act. Provides that such State plan require that the State agency have the power to terminate reimbursement to a skilled nursing or intermediate care facility which violates its provider agreement. Requires such State plan to include that the inspection and medical review shall serve as the basis for determining the overpayment to such facility, and the amount such agency must refund. Requires such State plan to provide that any skilled nursing facility receiving payments under the plan be required to maintain with the State agency a bond to anticipate any and all claims for overpayment. Title II: Medical, Psychological, And Social Assessment Of Patients In Need Of Long-Term Care Under Medicare And Medicaid Programs - Requires that for payment of services furnished and individual under the Medicare and Medicaid programs that a physicain's certification be based on such patient assessment criteria as the Secretary of Health, Education, and Welfare may require. Provides that a State plan msut include a regular program of medical review utilizing such criteria as required by the Secretary of meeting their health care needs through alternative institutional or noninstitutional services.
Bill· HRH.R. 7365 (94th)referred
United States · United States Congress · 21 May 1975
Authorizes the Secretary of Health, Education and Welfare to make grants to assist schools of medicine in the establishment and operation, within such schools, of departments of geriatrics. Stipulates that such grants shall not be made to more than six schools of medicine and the amount of such grants to any school of medicine for any year shall not exceed $500,000. Authorizes to be appropriated for each fiscal year such sums as may be necessary to carry out the provisions of this section.
Bill· HRH.R. 7361 (94th)referred
United States · United States Congress · 21 May 1975
Nursing Home Personnel In-Service Training Act - Authorizes the Secretary of Health, Education, and Welfare to make grants, not to exceed $100,000 per grant, to assist public or nonprofit private schools of nursing to meet the costs of developing short-term in-service training programs for nurses aids and orderlies for nursing homes. Provides that such programs shall emphasize the special problems of geriatric patients. Authorizes to be appropriated $1,000,000 for fiscal year 1975, and $1,000,000 for fiscal year 1976, to carry out the purposes of this Act.
Bill· HRH.R. 7357 (94th)referred
United States · United States Congress · 21 May 1975
National Home Health Care Act - Broadens the coverage of home health services under the supplementary medical insurance (Medicare) program of of the Social Security Act and removes the 100-visit limitation presently applicable to the home health service program. Extends the coverage of posthospital home health services to include payment for items and services which the indiviudal could otherwise obtain in a skilled nursing facility. Requires the inclusion of home health services in a State's medicaid program under the Social Security Act and permits the payment of rent under such program for elderly persons who would otherwise require nursing home care. Provides expanded Federal funding for congregate housing for the displaced and the elderly by increasing the amount available for such housing under the low income housing program. Establishes, in the Department of Health, Education, and Welfare, a home health patient ombudsman, who shall be appointed and provided with adequate staff and facilities by the Secretary. Makes it the duty and responsibility of the ombudsman to monitor specified programs under the Social Security and the various medical assistance programs under the State plans approved pursuant to such Act, and to maintain such oversight of those programs and their operation and administration as may be necessary to: (1) assure that home health patients under such programs are receiving the care to which they are entitled, (2) provide safeguards against over-charging for home health services, (3) identify abuses against home health patients, (4) receive, handle, and expedite complaints by home health patients, (5) recommend to the Secretary any changes in the regulations affecting home health services which may appear necessary or desirable, and (6) take appropriate action (including the transmission of findings to the Attorney General) with respect to abuses and violations of law affecting the provision or receipt of home health services under such programs. Makes the children over 18 of parents receiving nursing and home health care assistance under the medicaid program liable for a specified portion of the expenses of such assistance, depending upon the income of such child. Permits the waiver of such obligation in any case where the State agency determines, in accordance with regulations prescribed by the Secretary, that the imposition of such obligation or the making of such collection would impose undue hardship. Provides that any amount collected from or otherwise paid by any person in satisfaction of any obligation imposed by this section shall constitute a medical expense paid or incurred by such person for purposes of deductions under the Internal Revenue Code ot 1954.