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201 records in US in 1989
United States · United States Congress · 27 June 1989
Amends the Internal Revenue Code to allow married individuals filing separate returns to pay supplemental medicare premiums which in the aggregate are not less than the aggregate limitation on annual premiums which would otherwise apply.
United States · United States Congress · 23 June 1989
Comprehensive and Uniform Remedy for the Health Care System Act of 1989 - Title I: Improving the Health of Mothers and Their Babies - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to establish a program to make grants to States to coordinate Federal and State prenatal care programs. Authorizes appropriations for FY 1990 through 1992. Title II: Removing Barriers to Affordable Health Insurance - Subtitle A: Preemption of State Mandated Benefits - Amends the Employee Retirement Income Security Act of 1974 to declare that such Act supersedes any provision of State law relating to the type or level of benefits that are to be provided under health insurance that constitutes an employee welfare benefit plan, as defined in such Act. Subtitle B: State Uninsurable Pools - Amends the Public Health Service Act to authorize appropriations for FY 1990 and each subsequent fiscal year for allotments to States. Directs the Secretary of Health and Human Services to make an allotment to each State each fiscal year, subject to exception and limitation, in proportion to the State's population. Provides for the amount of payments under the allotments. Requires non-Federal contributions in a specified percentage. Requires the payments to be used by the State to develop and operate qualified uninsurable pools to provide health insurance for medically uninsurable individuals. Allows a State to use any amount paid under these provisions to assist in the underwriting of the costs of the pool. Authorizes the Secretary to provide technical assistance to States. Limits administrative expenditures to ten percent of the amount paid to a State. Allows a State to transfer amounts not exceeding ten percent of amounts provided to the State under other provisions of the Public Health Service Act relating to block grants each fiscal year to carry out these activities. Sets forth application procedures and requirements. Requires an annual report by States to the Secretary. Requires States to establish fiscal control procedures and conduct an annual independent audit. Directs the Secretary to report to the appropriate committees of the Congress by October 1, 1991, on activities of the States under these provisions. Declares that title XVII (Civil Service and Postal Service Programs; Governmental Affairs Generally) of the Omnibus Budget Reconciliation Act of 1981 shall not apply with respect to audits of funds allotted under these provisions. Directs the Secretary to develop model criteria and forms for data collection to enable States to share uniform data regarding the provision of services under these provisions. Directs the Secretary to conduct investigations and to withhold payments from any State that does not use its allotment in accordance with the requirements of these provisions. Declares that programs and activities funded in whole or in part with funds under these provisions are considered to be programs and activities receiving Federal financial assistance for purposes of prohibitions of discrimination, in specified Acts, on the basis of age, handicap, sex, race, color, or national origin. Prohibits discrimination on the basis of sex or religion in any program or activity funded under these provisions. Allows the Secretary, if a State fails to comply, to refer the matter to the Attorney General, exercise the powers and functions provided in the applicable Acts, or take other action as provided by law. Allows the Attorney General to bring a civil action for appropriate relief, including injunctive relief. Provides for criminal penalties for certain false statements in connection with payments under these provisions. Title III: Treatment Practice Guidelines - Amends the Public Health Service Act to direct the Assistant Secretary for Health to establish treatment practice guidelines for health care services provided to patients, including guidelines for appropriate, inappropriate, and permissive evaluation and treatment. Requires the Assistant Secretary, in establishing the guidelines, to consider the setting of the evaluation and treatment, including whether the setting is urban or rural. Prohibits, notwithstanding any other law, the guidelines from being introduced in any Federal or State court action, unless the action arises from a health care service which was given to an individual in accordance with the guidelines, in which case the guidelines may be introduced by a provider who is a party to the action. Declares that the guidelines, if so introduced, shall be the appropriate standard of medical care. Requires the guidelines, where followed, to be used by the Secretary under provisions of the Social Security Act requiring peer review organizations to determine whether payment shall be made for services under title XVIII (Medicare) of that Act. Directs the Assistant Secretary to review the guidelines at least every two years. Directs the Assistant Secretary, if a Federal agency or a private organization requests the establishment or review of guidelines for an area of health care services, to determine if establishment or review is appropriate and, if so, to establish or review the guidelines. Amends the Public Health Service Act to establish the National Advisory Council on Treatment Practice Guidelines (Guideline Council) to advise the Assistant Secretary with respect to the establishment of the guidelines. Authorizes appropriations for FY 1990 through 1992 for health service research, evaluation, and demonstration activities under provisions relating to the National Center for Health Services Research and Health Care Technology Assessment and the National Center for Health Statistics. Requires that a specified sum of amounts appropriated under this authorization for such fiscal years be available for expenses of the Guideline Council. Extends through FY 1992 the requirement that the Secretary, from amounts appropriated under specified provisions: (1) obligate not less than a specified sum for health care technology assessment activities undertaken under specified provisions; and (2) make available not more than a specified sum for grants for a council on health care technology under specified provisions. Authorizes appropriations for FY 1990 through 1992 for health statistical and epidemiological activities undertaken or supported under specified provisions. Title IV: Reducing Health Care Costs Through Prevention and Public Awareness Programs - Subtitle A: Treatment of Work-Based Prevention Efforts - Directs the Secretary of the Treasury to establish a taxpayer awareness program to inform employers that work-based prevention efforts that are effective are considered health benefits for which deductions are allowed under specified provisions of the Internal Revenue Code. Directs the Secretary to use public service and paid commercial advertising, direct mail, and any other appropriate means. Subtitle B: Public Service Announcements on Health Promotion Activities - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to establish and implement a program to provide the public with information concerning health promotion, prenatal care, and health benefits. Includes in the program public service announcements: (1) targeted to pregnant women who are at increased risk of suffering complications during pregnancy or having unhealthy babies; and (2) on the appropriate and effective use of health benefits. Requires an annual report by the Secretary to the appropriate congressional committees. Authorizes appropriations for FY 1990 through 1992. Title V: Improving the Trauma Care System - Subtitle A: General Federal Emergency Medical Services Programs - Amends the Public Health Service Act to create a new title on emergency medical services. Directs the Secretary by contract, to provide for the establishment and operation of a National Clearinghouse on Emergency Medical Services and Trauma Care. Sets forth the duties of the Clearinghouse. Allows the Clearinghouse to charge fees to defray and, starting with FY 1991, to cover its costs of operating. Authorizes appropriations for FY 1990 through 1992 or for the first through the third fiscal year after FY 1990 for which funds are appropriated under these provisions. Directs the Secretary to promulgate regulations that require States that receive grants under provisions added by this Act relating to emergency medical services block grants to provide the Secretary with certain data and information concerning the use of the grants. Authorizes the Secretary to make grants for research and demonstration projects concerning ways to improve the availability and quality of prehospital emergency medical services in rural areas by: (1) developing innovative uses of communications technologies; (2) making continuing education more accessible to emergency medical services personnel; (3) developing and refining training curricula; (4) undertaking outcome studies; and (5) developing innovative financing mechanisms. Authorizes appropriations for FY 1990 through 1992. Requires the Federal Communications Commission, within one year of enactment of this Act, to: (1) complete a study of the availability of radio channels for emergency medical services; (2) establish a plan to ensure that the needs of such services shall be adequately provided for in the allocation of frequencies; and (3) submit a report containing the study and the plan to the appropriate congressional committees. Subtitle B: Emergency Medical Services Block Grant - Amends the Public Health Service Act to authorize appropriations for allotments to States for FY 1990 through 1992. Directs the Secretary, for each such fiscal year, to: (1) allot to each State an amount under a specified formula related to its population and land area; and (2) make payments to each State. Prohibits the Secretary from making payments unless the State identifies any rural area for which there is no: (1) emergency medical services access through a 911 telephone number; (2) basic life-support system; or (3) advanced life-support system. Sets forth application requirements. Requires that amounts paid to a State under the allotments be used for: (1) accident prevention programs; (2) feasibility studies and planning activities for emergency medical services systems; (3) emergency medical services; (4) uncompensated trauma care; and (5) other activities as determined by the Secretary. Allows a State that receives a grant under the allotment to use not more than 25 percent of the grant to pay the expenses of certain uncompensated trauma care that has been provided. Allows a State to use a limited amount to carry out emergency medical services activities under these provisions. Repeals provisions of the Public Health Service Act which allow States to use block grant allotment sums for feasibility studies and planning for emergency medical services systems and the establishment, expansion, and improvement of such systems.
United States · United States Congress · 23 June 1989
Designates the decade beginning January 1, 1990, as the Decade of the Brain.
United States · United States Congress · 23 June 1989
Designates September 1989 as National Minority Health Awareness Month. Directs the Secretary of Health and Human Services to: (1) make publicly available information on minority health problems and minority health professionals' careers and contributions; and (2) present public service announcements on health promotion and disease prevention among minority Americans.
United States · United States Congress · 22 June 1989
Alzheimer's Disease Research and Training Act of 1989 - Authorizes appropriations, in addition to amounts otherwise authorized for FY 1990, to conduct biomedical research relating to Alzheimer's disease in order to increase, by at least 50 percent, the number of approved investigator-initiated grant proposals funded in accordance with the recommendations of the Advisory Panel on Alzheimer's Disease. Directs the Secretary of Health and Human Services, from amounts appropriated under this authorization, to provide specified minimum amounts: (1) to the Alzheimer's Disease Research Centers (ADRCs) for specified activities and facilities; (2) to the National Institute on Aging (NIA); and (3) for the purpose of expanding construction on the ADRC. Requires that at least 70 percent of the funds appropriated be administered by the National Institute on Aging and at least 15 percent by the National Institute of Mental Health (NIMH) and the National Institute of Neurological Disorders and Stroke. Requires research activities conducted with the funds to be coordinated by the Alzheimer's Disease Coordinating Committee of the National Institutes of Health and the Council on Alzheimer's Disease. Authorizes appropriations for each fiscal year to be used by the Secretary to conduct research and prepare evaluations on Alzheimer's disease services, psychosocial issues, and behavioral management methods. Requires that, of the amounts appropriated, specified sums be made available to establish not more than ten Health Services Research Centers on Alzheimer's Disease to work in conjunction with the ADRC. Authorizes appropriations for FY 1990 to carry out the Alzheimer's Disease and Related Dementias Service Research Act, to be used by the NIA, the NIMH, the National Center for Health Services Research and Health Care Technology Assessment, and the Health Care Financing Administration. Authorizes appropriations for FY 1990 through 1992 to establish Centers for Health Services Research on Alzheimer's Disease and Related Dementias. Requires research that receives assistance to be coordinated through the ADRCs in existence on the date of enactment of this Act. Specifies the types of research to be conducted. Authorizes appropriations for FY 1990 to be used by the Secretary for training professionals, paraprofessionals, and support personnel responsible for the care of, or working with, patients with Alzheimer's disease and related dementias.
United States · United States Congress · 22 June 1989
Drug Abuse Treatment Policy Act of 1989 - Prohibits the expenditure of any Federal funds or the provision of advice by any Federal officer or employee with respect to any program of distributing needles for the injection of any illegal drug or distributing bleach for cleansing needles for such injection. Prohibits any narcotic treatment program from providing any narcotic to treat any individual for dependence on heroin or any similar drug unless the program provides a comprehensive range of rehabilitative services, including counseling. Allows an exception for certain short-term detoxification programs. Prohibits the Secretary of Health and Human Services and the Attorney General from authorizing a program for narcotic addiction treatment involving the provision of methadone under the terms and conditions proposed on a specified date, as published in the Federal Register.
United States · United States Congress · 22 June 1989
Amends part B (Peer Review) of title XI of the Social Security Act to require peer review organizations to give providers whose services are denied coverage under title XVIII (Medicare) of the Act an opportunity for reconsideration of the determination before patients and organizations responsible for paying claims are notified of such determination. Permits a physician to have such reconsideration conducted by a physician who specializes in his or her own field.
United States · United States Congress · 22 June 1989
Comprehensive Community Substance Abuse Prevention Act of 1989 - Amends the Public Health Service Act to direct the Secretary of Health and Human Services, through the Director of the Office for Substance Abuse Prevention, to make grants to eligible coalitions to: (1) plan and implement comprehensive long-term strategies for substance abuse prevention; (2) assess existing programs and activities to determine community resources, gaps, and barriers; (3) identify and solicit funding sources to enable the programs and activities to become self-sustaining; (4) develop a consensus regarding community priorities concerning substance abuse; (5) develop a plan to implement the priorities; and (6) coordinate substance abuse services and treatment programs, including those in schools and communities. Requires the coalitions to emphasize: (1) voluntary participation in the community; and (2) the involvement of community organizations and members. Sets forth application requirements. Mandates certain priorities in awarding grants. Authorizes appropriations for FY 1990 through 1992. Directs the Secretary, through the Director of the Office, to establish a National Substance Abuse Prevention Training Program. Requires the Director of the Program to: (1) develop a substance abuse prevention training curriculum for community groups; (2) provide technical assistance and support for community training on prevention and for advanced prevention and intervention training for community, State, and local staff; (3) develop specific training modules for problem areas and for professional groups that work with children and adolescents; (4) provide outreach to communities with substantial minority populations; (5) disseminate successful curricula and training practices in communities; and (6) evaluate training. Authorizes appropriations for FY 1990 through 1992. Directs the Secretary, through the Director of the Office, to make grants to: (1) provide substance abuse prevention training; (2) coordinate with other community resources and training; and (3) provide specialized training programs for professional groups that work with children and adolescents or that are targeted to specific population groups. Authorizes appropriations for FY 1990 through 1992. Amends the Public Health Service Act to increase the amount that the Secretary is required to make available for specified functions of the Office for Substance Abuse Prevention.
United States · United States Congress · 22 June 1989
Designates the week of October 22 through October 28, 1989, as National Save Your Back Week.
United States · United States Congress · 21 June 1989
Repeals provisions of the Medicare Catastrophic Coverage Act of 1988 expanding coverage under part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act and imposing a supplemental premium on Medicare beneficiaries. Adjusts the Medicare part B premium to such reduction of coverage. Requires the Congress to consult with elderly individuals and organizations representing such individuals before passing long-term health care legislation.
United States · United States Congress · 21 June 1989
Designates October 22 through October 28, 1989, and October 21 through October 27, 1990, as National Adult Immunization Awareness Week.
United States · United States Congress · 20 June 1989
Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to delay from January 1, 1990, to January 1, 1991, the requirement that before a nursing facility uses a nurse aide for over four months such aide must complete a State-approved training and/or competency evaluation program.
United States · United States Congress · 20 June 1989
Prohibits the Secretary of Health and Human Services from denying Medicaid (title XIX of the Social Security Act) coverage of daytime habilitation services for persons with mental retardation or related conditions pursuant to a State plan amendment approved before June 2, 1989, until the Secretary promulgates final regulations delineating the types of daytime habilitation services that may be covered and any specific requirements regarding such coverage. Permits States that have such an amendment to transfer coverage of such services to coverage under a Medicaid home and community-based waiver program.
United States · United States Congress · 19 June 1989
Maternal and Child Health Act of 1989 - Amends title XIX (Medicaid) of the Social Security Act to require States to provide Medicaid coverage to pregnant women and children under age six whose family income is below 185 percent of the Federal poverty level. Authorizes States to provide Medicaid coverage to children under age 19 whose family income is below the Federal poverty level. Directs the Secretary of Health and Human Services to conduct three-year demonstration projects to study the effect on access to health care, private insurance coverage, and health care costs of extending Medicaid coverage in three States to medically uninsurable children and extending such coverage in one State to children under age six whose family income is below 185 percent of the Federal poverty level and children under age 20 whose family income is below the Federal poverty level. Permits such States to provide coverage by buying into the health insurance offered by certain employers. Imposes premiums on project beneficiaries whose family income exceeds the Federal poverty level. Caps project expenditures. Sets forth reporting requirements. Requires States to make Medicaid ambulatory prenatal care available to pregnant women during a presumptive eligibility period. Eliminates the requirement that pregnant women apply for Medicaid coverage within 14 days of the commencement of presumptive eligibility. Requires States to continue the Medicaid coverage of a woman and her infant for 60 days after delivery regardless of fluctuations in her income during such period. Prohibits the redetermination of the Medicaid eligibility of a child under age six who has been deemed eligible less than six months previously, unless such eligibility is due to his or her receipt of aid under part A (Aid to Families with Dependent Children) (AFDC) or E (Foster Care and Adoption Assistance) of title IV of the Act or under title XVI (Supplemental Security Income) (SSI) of the Act. Preserves the Medicaid eligibility of a child under age six who loses such aid until it is determined that he or she is not eligible for Medicaid on some other basis. Amends the Child Support Enforcement Amendments of 1984 to make permanent the four-month continuation of Medicaid eligibility for children who lose AFDC eligibility due to increased collection of child support payments. Requires that Medicaid coverage of inpatient hospital services provided to children under age 18 at hospitals serving a disproportionate share of low-income patients: (1) make an outlier adjustment in payment amounts for exceptionally long or costly cases if such payments are made on a prospective basis; (2) not impose durational limitations on such services; and (3) not set dollar limits on the delivery of services to individuals who enter the hospital prior to their first birthday. Directs States to pay for the care of a child under age 19 in an out-of-State hospital at the receiving State's rate, unless the involved States have an alternative payment agreement. Requires States to provide Medicaid coverage of services furnished by certified pediatric or family nurse practitioners. Permits States to cover home and community-based services for children under age 18 who have acquired immune deficiency syndrome (AIDS) or are medically dependent on a ventilator for life support. Allows States to cover home visitor services furnished by registered nurses to infants, during the first six months of life, who require treatment with life sustaining medication or equipment or technically-assisted feeding. Prohibits the Secretary from limiting to fewer than 500 (currently, 200) the number of individuals in a State who may receive home and community-based services under a waiver of certain Medicaid requirements. Amends title V (Maternal and Child Health Services) of the Act to increase authorized appropriations for such program for FY 1990. Requires the Secretary to set-aside 15 percent of appropriated amounts for special Federal projects which include: (1) projects promoting the use of outpatient and community-based services for children with special health care needs; and (2) demonstration projects utilizing alternative approaches to providing health insurance coverage to children under age 19 who are not covered by other public or private programs. Directs States to use at least 30 percent of their title V allotments on services for children with special health care needs, and at least five percent of such allotments for projects in sickle-cell anemia and genetic disorders screening, the development of community-based service networks and case management services for children with special health care needs, and programs providing primary health care services to children. Requires each State to: (1) conduct a statewide maternal and child health care needs assessment; (2) establish a State maternal child health advisory board to participate in the planning and development of services; (3) develop a system of family centered community-based coordinated care for children with special care needs in collaboration with other programs; (4) develop and maintain a consolidated data base containing information about providers available to meet the needs of chronically ill children and establish a toll-free number for parents to access such information; (5) include in the annual title V report information on the extent to which needs have been met with respect to specific services and the amount of funds allotted for family centered community-based coordinated care; and (6) maintain its title V funding at at least 1989 levels. Amends part A (General Provisions) of title XI of the Act to direct the Secretary to publish an annual report on the health status of U.S. children. Requires the Secretary to make available to States, by January 1, 1991, a model uniform Medicaid application for individuals who are neither institutionalized nor receiving AFDC cash assistance. Directs the Secretary to: (1) develop definitions of medically high risk pregnancy and children at a high risk of medical problems; (2) develop alternative definitions of medically uninsurable children; (3) develop a model health benefit package for pregnant women and children through age 18; and (4) study different methodologies to improve the coordination between various public health programs. Sets forth reporting requirements. Amends the Medicaid program to set forth the required components of Medicaid early and periodic screening, diagnostic, and treatment services. Requires Medicaid coverage of the measures which need to be taken to correct or ameliorate defects or conditions discovered by the screening services. Directs the Secretary to conduct demonstration projects and establish annual participation goals for each State to increase participation in Medicaid early and periodic screening and diagnostic services. Requires the Secretary to report to the Congress by the close of 1990 on the requirements of such services relative to mental illness. Requires States to provide Medicaid coverage to all children under age 18 who are SSI recipients. Requires that Medicaid payment rates for obstetric and pediatric services be set at levels which are sufficient to induce enough providers of such services to participate in the Medicaid program so that such services are available to beneficiaries to at least the same extent that they are available to the general population. Directs States to furnish providers of such services with assistance in complying with Medicaid billing and recordkeeping requirements, which includes: (1) training; (2) a toll-free number for resolving administrative problems; and (3) a State ombudsman for resolving their complaints. Requires the Secretary to report to the Congress by January 1, 1990, on the adequacy and timeliness of Medicaid payments to providers of obstetric and pediatric services. Amends part E (Foster Care and Adoption Assistance) of title IV of the Social Security Act to require that a preplacement health care record for a child be provided to such child's foster care provider and be completed before he or she is placed in foster care or within 30 days after an emergency foster care placement. Requires the maintenance of a health care plan and record for such child while he or she is in foster care, and notification of the provider concerning such child's eligibility for Medicaid early and periodic screening, diagnosis, and treatment services. Amends part A (General Provisions) of title XI of the Act to reduce the lag time between the Secretary's calculation of the Federal matching rate under the AFDC, Medicaid, and Foster Care and Adoption Assistance programs and its implementation.
United States · United States Congress · 16 June 1989
Community Health Clinic Improvement Act of 1989 - Amends title XVIII (Medicare) of the Social Security Act to provide Medicare cost-based reimbursement to all community health clinics which meet the requirements for receiving a grant under the Public Health Service Act. Amends title XIX (Medicaid) of the Act to require States to cover the reasonable costs for services provided by such community health clinics.
United States · United States Congress · 15 June 1989
End Stage Renal Disease Patient Protection and Quality Assurance Act of 1989 - Amends title XVIII (Medicare) of the Social Security Act to require providers of end stage renal disease services to protect and promote listed patient rights regarding the quality of patient care and the provision of information about the renal disease facility. Requires providers to have a registered professional nurse experienced in dialytic therapy available during dialysis treatment to direct any technicians providing such treatment. Makes States responsible for certifying the compliance of end stage renal disease facilities with Medicare requirements on the basis of surveys conducted by a multidisciplinary team of professionals. Requires that an unannounced standard survey be conducted with respect to each facility at at least 15 month intervals (though the Statewide average interval may not exceed one year) and within two months of any change of ownership, administration, or management of the facility. Subjects facilities which perform poorly on such surveys to an extended survey, though any other facility may, at the Secretary of Health and Human Services, or the State's discretion, be subject to an extended survey. Authorizes the Secretary to perform a special survey when there is reason to question a facility's compliance with Medicare requirements. Requires the disclosure of survey results. Requires a renal disease network administrative organization with which a patient files a grievance against a facility to disclose the findings and consequences of its investigation into such grievance to the facility administrator and the complainant. Authorizes States to award annual "excellence in quality" designations to facilities that have achieved outstanding quality in various categories of care. Directs the Secretary to establish a board of experts and at least one patient to advise the Secretary in establishing end stage renal disease service quality standards, survey protocols, minimum surveyor qualifications, and uniform instructional guidelines for surveyors and providers outlining the methodology by which facilities will be judged under surveys. Sets forth reporting requirements. Subjects end stage renal disease facilities to the same enforcement process as skilled nursing facilities are subject to when found out of compliance with Medicare requirements. Adjusts the duties of renal disease network administrative organizations so that while such organizations are no longer responsible for conducting on-site reviews of facilities and providers they are assigned new duties which include: (1) giving special attention to the correction of minority underrepresentation in transplantation and self-care options; (2) verifying each facility's implementation of a grievance mechanism as required by this Act and informing all patients of its own patient grievance mechanism; (3) developing and implementing specified informational services for patients and facilities; and (4) participating in special studies designed by the United States Renal Data System to help develop and evaluate indices of quality care or for other purposes relevant to the maintenance of such system.
United States · United States Congress · 15 June 1989
Drug Utilization Review Act of 1989 - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to require the establishment of a Drug Utilization Review System (System) providing participating pharmacies, pharmacists, and dispensing physicians with prompt 24-hour electronic access to a medication profile for each Medicare beneficiary for whom they prescribe a covered outpatient drug. Requires that such system identify potential adverse drug reactions that may result from: (1) the interaction of the prescribed drug with other drugs being used by the beneficiary and with a known allergy, physical condition or illness presented by the beneficiary; and (2) misuse of the prescribed drug. Requires that participating pharmacies, pharmacists and dispensing physicians having access to the System agree that: (1) no beneficiary will be required to disclose medication profile information as a condition of receiving benefits; (2) the beneficiary's medication profile will not be accessed without the beneficiary's specific and voluntary authorization; (3) data acquired will not be disclosed to anyone other than the beneficiary, except when consultations between those involved in the beneficiary's health care are medically necessary; and (4) each beneficiary shall receive written notice of such requirements. Penalizes, by fine and/or imprisonment, those guilty of the unauthorized disclosure of medication profile information. Authorizes appropriations. Directs the Secretary of Health and Human Services to conduct a study and report to the Congress by October 1, 1992, on the efficacy of expanding the System to include all Medicare-eligible outpatients who are inpatients and information on over-the-counter drugs and biologicals.
United States · United States Congress · 15 June 1989
Amends title XVIII (Medicare) of the Social Security Act to provide direct coverage under part B (Supplementary Medical Insurance) of the Medicare program of the services of a nurse practitioner working in collaboration with a physician. Makes Medicare payments for such services to the nurse practitioner's employer. Requires Medicare carriers to permit routine part B payments for up to 1.5 monthly visits per resident of a nursing facility by a member of a team which includes a physician and physician assistant and/or nurse practitioner. Directs the Secretary of Health and Human Services to establish at least one demonstration project applying such limitation on visits on an average basis over the aggregate total of nursing facility residents served by team members.
United States · United States Congress · 14 June 1989
Medicare Catastrophic Coverage Improvement Act of 1989 - Repeals provisions of the Medicare Catastrophic Coverage Act of 1988 (the Act): (1) establishing a Supplemental Medicare Premium; (2) providing Medicare (title XVIII of the Social Security Act) coverage of prescription drugs and insulin, home intravenous drug therapy services, screening mammographies, and in-home care for chronically dependent individuals; and (3) requiring Medicaid (title XIX of the Social Security Act) coverage of pregnant women and infants, and Medicare cost-sharing amounts incurred by individuals whose family income is below the Federal poverty level. Expresses the sense of the Congress that such Medicaid coverage should be restored within the framework of the budget resolution for FY 1990. Directs the Secretary of Health and Human services to conduct a study and report to the Congress, by January 1, 1990, on the possibility of reinstating repealed Medicare benefits. Amends part A (Hospital Insurance) of the Medicare program to eliminate provisions waiving the imposition of an additional deductible on persons hospitalized in December of one year and rehospitalized in January of the following year or hospitalized in 1990 for a spell of illness which began prior to 1989. Amends part B (Supplementary Medical Insurance) of the Medicare program to cover all of the reasonable out-of-pocket part A and B expenses a part B enrollee incurs in excess of $2,500 in 1990, adjusting such ceiling annually thereafter so as to maintain the percentage of enrollees exceeding such cap at the 1990 percentage. Delays, from January 1, 1990, to October 1, 1990, the coverage of nursing care and home health aide services as home health services. Includes in the computation of the part B premium an amount equal to the Secretary's estimate of a part B enrollee's share of the benefits and administrative costs which result from catastrophic care coverage and the beneficiary expense ceiling. Delays, from April 1, 1989, to April 1, 1990, the date by which the Director of the Office of Personnel Management must report to the Congress regarding: (1) changes to the Federal Employees Health Benefits (FEHB) program that may be required to incorporate FEHB plans designed for Medicare-eligible individuals and to improve the efficiency and effectiveness of the program; and (2) the feasibility of adopting National Association of Insurance Commissioners Model Standards for Medicare supplemental policies when providing Medicare supplemental plans as a type of FEHB plan.
United States · United States Congress · 14 June 1989
Title I: Repeal of Certain Provisions in Medicare Catastrophic Coverage Act of 1988 - Medicare Catastrophic Coverage Improvement Act of 1989 - Repeals provisions of the Medicare Catastrophic Coverage Act of 1988 (the Act) establishing a Supplemental Medicare Premium and providing Medicare coverage (title XVIII of the Social Security Act) of prescription drugs and insulin, home intravenous drug therapy services, screening mammographies, and in-home care for chronically dependent individuals. Amends the Medicare program to increase the limit on Medicare part B (Supplementary Medical Insurance) out-of-pocket expenses incurred by beneficiaries for 1990. Gears future adjustments of such limit to changes in expenses of the Medicare trust funds. Modifies the Act's premium financing mechanisms. Amends title XIX (Medicaid) of the Social Security Act to require States to establish a family income eligibility level for Medicaid coverage of Medicare cost-sharing amounts which is equal to at least 85 percent of the Federal poverty level and no more than 90 percent of such level in 1990, 95 percent of such level in 1991, and 100 percent of such level thereafter. Requires Medicaid coverage of prescription drugs for individuals who are at least 65 years old and whose income does not exceed 125 percent of the Federal poverty level. Directs the Boards of Trustees of the Medicare trust funds to include in their reports to the Congress in April 1990 an analysis, performed by the Secretary of the Treasury, of options to strengthen the long-term solvency of such trust funds. Title II: Tax Provisions Related to Long-Term Care Insurance - Amends the Internal Revenue Code to treat certain long-term care insurance which offers coverage to each covered person for at least one year for diagnostic, preventive, therapeutic, rehabilitation, maintenance, or personal care services provided in a setting other than the acute care unit of a hospital as accident or health insurance when taxing issuers of such insurance (hereafter referred to as qualified long-term care insurance). Provides that for the purpose of determining whether a tax exclusion applies to an employee's receipt of benefits from qualified long-term care insurance such benefits shall be considered to be for personal injury or sickness, and medical care. Excludes from taxation: (1) the portion of distributions from individual retirement plans which is used during the year to pay the premiums for qualified long-term care coverage of individuals who are age 59 1/2 or older on the date of distribution; and (2) amounts received, when an individual who has attained age 65 surrenders, cancels, or exchanges a life insurance contract, and used during such year to pay the premiums for qualified long-term care insurance.
United States · United States Congress · 14 June 1989
Federal Health Insurance Equity Act of 1989 - Directs the Secretary of Health and Human Services to establish by rule national minimum standards regarding the provision of health insurance to persons with pre-existing conditions. Describes elements required to be included. Requires that, within 24 months of establishment of the standards and notwithstanding other laws: (1) each sponsor of a health benefit plan comply with the standards; and (2) each State adopt the standards and assume responsibility for enforcing them through assessment of penalties. Requires States to notify the Secretary when they have done so and the Secretary to certify that they have adopted the standards and assumed such responsibility. Prohibits the Secretary, in the case of a State that must enact legislation in order to adopt and assume responsibility for enforcing the standards, from refusing to certify a State before the close of the first regular session of the State legislature that begins after establishment of the standards. Directs the Secretary to withdraw a State's certification for stated reasons. Provides, with regard to a sponsor who does not comply with the standards, for civil monetary penalties, subject to exception, and for liability to individuals for damages.
United States · United States Congress · 14 June 1989
Maternal and Child Health Block Grant Amendments of 1989 - Amends title V (Maternal and Child Health Services) of the Social Security Act to increase authorized appropriations under such title. Adds the promotion and provision of family-centered, community-based, coordinated care for children with special health care needs to the purposes to which title V block grants to States shall be devoted. Increases amounts set aside from the block grant program to enable the Secretary of Health and Human Services to develop and expand: (1) maternal and infant health home visiting programs; (2) integrated maternal and child health service delivery systems; (3) maternal and child health centers; and (4) maternal and child health projects serving rural populations. Authorizes States to use block grant funds to pay the salaries of National Health Service Corps personnel. Prohibits States from using more than ten percent of block grant funds for administering such funds. Requires States to use at least: (1) 30 percent of block grant funds for preventive and primary care for pregnant women, mothers, and infants; (2) 30 percent of such funds for preventive and primary care for children; and (3) 30 percent of such funds on children with special health care needs. Permits a waiver of such requirement if a State demonstrates an extraordinary unmet need for one of the activities. Requires State agencies administering a State's title V program to assist individuals who are eligible for assistance under title XIX (Medicaid) of the Social Security Act in applying for Medicaid benefits. Requires title V providers to provide Medicaid services. Imposes maternal and child health reporting requirements on States and the Secretary of Health and Human Services. Provides States with Federal, technical assistance in developing consistent and accurate maternal and child health data collection mechanisms. Directs the Secretary to develop: (1) a model application form for use in applying, simultaneously, for assistance for a pregnant woman or a child under age six under specified maternal and child assistance programs; and (2) a national system for linking an infant's birth record, such infant's death record, and information on Medicaid claims submitted with respect to such infant or his or her birth.
United States · United States Congress · 14 June 1989
Medicare Physician Payment Reform Amendments of 1989 - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to phase-in, from 1990 to 1993, Medicare payment for physician services pursuant to a fee schedule which is based upon the relative value of the resources devoted to each physician service. Directs the Secretary of Health and Human Services to adjust fee schedule amounts to take into account geographical variations in resource values and to make the transition to such payment methodology budget neutral. Prohibits the Secretary, after 1990, from making variations in the relative value of a physician service turn on whether the physician is a specialist or such service is his or her specialty. Requires that, after 1991, classification and coding of physician services: (1) be uniform for the same physician service in all fee schedule areas; (2) include pre-operative and post-operative physician services with related surgical procedures; and (3) differentiate evaluation and management services (primary case) on the basis of the time spent in providing different primary care services. Directs the Secretary to report to the Congress, by July 1, 1991, on whether geographical variations in fee schedules should be based on variations in resource values among States or between urban and rural areas. Factors malpractice expenses into the relative value of a physician service. Phases-in, from 1991 to 1993, the limitation of a nonparticipating physician's actual charge for a service to 120 percent of the fee schedule amount for such service.
United States · United States Congress · 13 June 1989
Health Care Research and Policy Act of 1989 - Title I: Agency for Health Care Research and Policy - Amends the Public Health Service Act to create a new title to establish, within the Public Health Service, the Agency for Health Care Research and Policy (Agency) to enhance the quality, appropriateness, and effectiveness of health care services, and access to such services, through improvements in clinical practice and in the organization, financing, and delivery of health care services. Requires that the agency be headed by an Administrator for Health Care Research and Policy, to be appointed by the President, by and with the advice and consent of the Senate. Directs the Secretary of Health and Human Services, through the Administrator, to carry out the new title. Sets forth the general authorities and duties of the Administrator, including conducting and supporting research, demonstration projects, evaluations, training, and the dissemination of information. Prohibits the Administrator from restricting the publication of data or results from projects conducted or supported under the new title, but prohibits disclosure of identifying data without consent. Directs the Administrator and the Director of the National Library of Medicine (the Library) to enter into an agreement for indexing, abstracting, translating, publishing, and other services leading to a more effective and timely dissemination of information on research, demonstration projects, and evaluations. Directs the Administrator to promote the development and application of appropriate health care technology assessments. Establishes at the Library a clearinghouse for information on health care technologies and health care technology assessment. Directs the Administrator and the Director of the Library to enter into an agreement providing for the clearinghouse. Directs the Administrator to make recommendations to the Secretary and to the Administrator of the Health Care Financing Administration with respect to whether specific health care technologies should be reimbursable under federally financed health programs. Establishes within the Agency the Office of the Forum for Quality and Effectiveness in Health Care, to be headed by a director to be appointed by the Administrator. Directs the Administrator, through the Director, to establish the Forum for Quality and Effectiveness in Health Care to develop, review, and update: (1) clinically relevant diagnosis and treatment guidelines for physicians and health care practitioners; and (2) standards of quality, performance measures, and medical review criteria. Authorizes the Director, in establishing and carrying out the Forum, to enter into contracts with public or nonprofit private entities. Requires the Director to convene panels of qualified experts, practicing physicians, and health care consumers to carry out the development, review, and updating. Authorizes the Director to convene panels of the same composition to develop the standards and criteria and to provide advice to the Administrator. Title II: Outcomes of Health Care Services and Procedures - Amends part A (General Provisions) of title XI of the Social Security Act to direct the Secretary of Health and Human Services, through the Administrator for Health Care Research and Policy, to conduct and support research with respect to the outcomes of health care services and procedures to identify how diseases and disorders can most effectively and appropriately be diagnosed and treated. Directs the Administrator to establish priorities with respect to the diseases and disorders for which outcome evaluations are to be conducted. Directs the Administrator to conduct and support: (1) research on improvement of the methodologies and criteria utilized in the outcomes research; and (2) evaluations of methodologies that utilize large data bases, including claims data and clinical data, in conducting outcomes research. Directs the Administrator to: (1) develop and promote uniform standards and formats for information on outcomes; (2) provide for dissemination of research findings and education of providers; and (3) conduct and support evaluations of outcome research activities. Authorizes the Administrator to conduct or support research on improving methods of disseminating information on the effectiveness and appropriateness of health care services and procedures. Declares that the authorities and duties of the Administrator under specified portions of the new title of the Public Health Service Act added by this Act apply with respect to activities carried out under these provisions (relating to outcomes research) as such authorities and duties apply under the new title. Authorizes appropriations for the outcomes research for FY 1990 through 1992. Authorizes, in addition to appropriations, transfers from the Federal Supplementary Medical Insurance Trust Fund in specified amounts for FY 1990 through 1992. Title III: Additional Authorities and Duties with Respect to Agency for Health Care Research and Policy - Amends the Public Health Service Act to establish the National Advisory Council for Health Care Research, Evaluation, and Policy to advise the Secretary and the Administrator with respect to activities of the Agency for Health Care Research and Policy (Agency). Declares that the Council shall, notwithstanding the Federal Advisory Committee Act, continue in existence until otherwise provided by law. Requires that technical and scientific peer review be conducted on each application for a grant, cooperative agreement, or contract under the new title of the Public Health Service Act added by this Act. Prohibits application approval by the Administrator unless the application has been recommended for approval by a peer review group. Allows adjusted peer review procedures for applications involving a direct cost under a specified amount. Directs the Administrator to establish such technical and scientific peer review groups as may be necessary. Requires that they continue in existence, notwithstanding the Federal Advisory Committee Act, until otherwise provided by law. Requires that the reviews of applications be conducted by different peer review groups than those that conduct review of applications involving dissemination activities or the development of research agendas. Directs the Administrator to: (1) establish guidelines for uniform methods of developing and collecting data under the title added by this Act; (2) assure that statistics developed under that title are of high quality, timely, comprehensive, specific, standardized, and adequately analyzed and indexed; and (3) disseminate the statistics as widely as possible. Authorizes the Administrator to provide supplies and services in lieu of funds. Declares that contracts may be entered into without regard to specified provisions of Federal law relating to advances and to advertising for Government contracts. Authorizes the Administrator to appoint a deputy administrator for the Agency. Sets forth other administrative authorities. Authorizes the Administrator to make grants, cooperative agreements, and contracts to carry out the title added by this Act. Authorizes the Administrator to secure the services of experts and consultants, subject to specified Federal law. Exempts not more than 50 experts or consultants from limitations, set forth in the same Federal provisions, relating to duration of service. Allows payment of travel expenses for the exempted experts or consultants if certain requirements are met. Authorizes appropriations for FY 1990 through 1992 to carry out the title added by this Act. Requires, in addition, that a portion of amounts available under specified existing provisions of the Public Health Service Act relating to evaluations of programs be made available for evaluations under the title added by this Act. Title IV: General Provisions - Removes from the Public Health Service Act provisions establishing the National Center for Health Services Research and provisions providing for grants for a council on health care technology. Applies existing provisions enumerating certain authorities of the Secretary of Health and Human Services to provisions establishing the National Center for Health Statistics. Requires the Director of the National Center for Health Statistics to establish peer review groups to evaluate applications for grants and contracts. (Current law directs the Secretary, through the Director, to establish such groups.)
United States · United States Congress · 13 June 1989
Amends the Social Security Act to establish a title XXI titled "Health Care Coverage for the Elderly." Prohibits such title from being construed as authorizing Federal officers or employees to supervise or control the provision of medical or health services. Establishes an Elderly Health Financing Authority (Authority) to be governed by a Board responsible for the operation of the title XXI program. Sets forth the duties of such Board, which shall include: (1) making recommendations to the Congress on the adequate level of health care benefits under title XXI; (2) annually proposing to the Congress any changes necessary to maintain the fiscal integrity of the program; (3) qualifying and reviewing the qualifications of private health care benefit plans for participation in such program; and (4) distributing annual health care vouchers to eligible individuals for the purchase of qualified private health care benefit plans. Increases the age of eligibility for title XXI benefits from 65 to 67 over the nine-year period following enactment of this Act. Requires the Administrator of the Board to provide beneficiaries with an annual health care voucher for the purchase of a qualified private health care benefit plan. Prohibits the assignment of vouchers. Prohibits a beneficiary from transferring a voucher from one qualified plan to another except upon substantiation of a complaint by the beneficiary that the insurance carrier has breached its agreement with the beneficiary. Authorizes the Board, upon substantiation of such a complaint, to: (1) require the insurance carrier to reimburse the beneficiary for such breach; (2) fine the carrier up to $2,000 for each breach; and (3) remove the carrier and such carrier's plan as a qualified private health benefit plan for repeated incidences amounting to substantial nonperformance of responsibilities. Provides that when a beneficiary fails to enter into an agreement with a carrier the agreement for the preceding year shall be extended through the present voucher year. Requires that the vouchers be of such form that the beneficiary and carrier can enter into an agreement for private health care benefit coverage under title XXI upon the voucher document itself. Sets forth beneficiary cost-sharing requirements which differ among individuals on the basis of their income and marital status. Sets the required coinsurance at 20 percent, but limits annual coinsurance payments to $2,000 for individuals and $3,000 for couples. Directs the Administrator to establish a certification procedure for private health care benefit plans. Provides for the annual recertification of such plans. Lists the medically necessary services which certified plans must provide without limitation or liability beyond specified cost sharing requirements. Directs the Administrator to establish a procedure for the review of proposed health insurance policy marketing materials to determine whether they are false and misleading. Defines a "health individual retirement account" as an irrevocable trust (including certain custodial accounts) created for the sole purpose of paying one individual's health care expenses upon his or her eligibility for coverage under titles XVIII (Medicare), XIX (Medicaid), or XXI of the Act. Amends the Internal Revenue Code to allow contributors to a health individual retirement account to deduct such contributions, provided previous contributions for the year do not exceed $500, adjusted annually for inflation. Limits eligible contributors to the individual who has the account and such individual's spouse, parents, children, and guardians. Excludes account distributions which are used to pay a beneficiary's health care expenses from such beneficiary's gross income. Exempts such accounts from income taxation. Taxes account amounts improperly used. Imposes an additional income tax on individuals to assure the adequacy of title XXI funding. Requires that the rate of such tax be adjusted by the Secretary of the Treasury on the basis of the Authority's recommendation. Makes such tax inapplicable to: (1) individuals whose income does not exceed the per capita income of the lowest fifth percentile of taxpayers or who are eligible for title XXI benefits; and (2) an individual's income in excess of $100,000, adjusted annually for inflation. Repeals Chapter 2 (Tax on Self-Employment Income) of the Internal Revenue Code. Repeals social security taxes imposed on the wages of employees. Sets the 1990 rate of Hospital Insurance taxes imposed on employers at 2.21 percent and at a percentage to be determined by the Authority thereafter.
United States · United States Congress · 13 June 1989
Amends the Medicare Catastrophic Coverage Act of 1988 to direct the Advisory Committee on Medicare Home Health Claims to evaluate and report to the Congress and the Administrator of the Health Care Financing Administration, by September 1, 1990, on the implementation of revised home health coverage policies, and on changes in the process for denying claims for home health services, under title XVIII (Medicare) of the Social Security Act. Terminates the Commission 30 days after its issuance of such report. Requires the Administrator to: (1) give the public an opportunity to comment on the Committee's earlier report on, and recommendations for, changing the home health services claims denial process; and (2) evaluate such recommendations and report to the Congress by October 31, 1989, on their implementation.
United States · United States Congress · 13 June 1989
Declares that it is the sense of the House of Representatives that: (1) recognition and further attention should be given to the professional and personal needs of long-term care aides; (2) expanded access to health and pension benefits should be provided to such aides; (3) long-term care policy makers should recognize that problems of female household heads and minority workers affect most nursing care aides; (4) more data is needed on home health and nursing home aides; (5) expanded recruitment of specified groups should be considered to abate the long-term care aide shortage; and (6) changes should be made in nursing aide positions to ensure integration into management structures and to enhance attraction to careers in long-term care.
United States · United States Congress · 13 June 1989
Expresses the sense of the House of Representatives that the Committees on Energy and Commerce and Ways and Means should review the Medicare Catastrophic Coverage Act of 1988 and hold hearings in the process of such review.
United States · United States Congress · 8 June 1989
Amends title XVIII (Medicare) of the Social Security Act and the Internal Revenue Code to limit application of the benefits and premiums of the Medicare Catastrophic Coverage Act of 1988 to those voluntarily enrolled in part B (Supplementary Medical Insurance) of the Medicare program.
United States · United States Congress · 8 June 1989
Designates November 16, 1989, as Interstitial Cystitis Awareness Day.
United States · United States Congress · 7 June 1989
Designates October 22 through October 28, 1989, and the last full week of October in following years as National Adult Immunization Awareness Week.
United States · United States Congress · 6 June 1989
Amends the Public Health Service Act to authorize appropriations for FY 1990 through 1992 for adolescent family life demonstration projects.
United States · United States Congress · 6 June 1989
Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to set forth factors which must be considered in determining whether a charge for an intraocular lens insertion is reasonable and related to the cost of acquiring the class of lens involved. Directs the Secretary to issue final regulations, within six months after this Act's enactment, regarding charges for intraocular lens insertions.
United States · United States Congress · 1 June 1989
Amends the Medicare Catastrophic Coverage Act of 1988 to direct the Advisory Committee on Medicare Home Health Claims to evaluate and report to the Congress and the Administrator of the Health Care Financing Administration, by October 1, 1990, on the implementation of revised home health coverage policies, and on changes in the process for denying claims for home health services, under title XVIII (Medicare) of the Social Security Act. Requires the Secretary of Health and Human Services to: (1) give the public an opportunity to comment on the Committee's earlier report on, and recommendations for, changing the home health services claims denial process; and (2) evaluate such recommendations and report to the Congress and the Administrator by the close of 1989 on their implementation. Terminates the Commission on October 1, 1990.
United States · United States Congress · 1 June 1989
Classification of Transitional Devices Amendments Act of 1989 - Amends the Federal Food, Drug, and Cosmetic Act to direct the Secretary of Health and Human Services to publish a notice in the Federal Register stating whether each transitional medical device for which a reclassification petition was not pending on January 1, 1989, shall remain in class III (devices requiring premarket approval) or be reclassified into class I (devices requiring general controls) or class II (devices requiring performance standards). Requires the manufacturers of devices that are to be classified in class I or II to submit to the Secretary any adverse safety and effectiveness information not previously reported. Requires the Secretary, within one year after enactment of this Act, to promulgate a regulation classifying each such device as class I or II, or providing that each such device shall remain in class III. Authorizes the Secretary to extend the one year period for classification for any such device for a period not to exceed one year. Prohibits the Secretary from retaining any daily wear nonhydrophilic plastic contact lens in class III unless such lens: (1) is used in supporting human life or preventing impairment of human health; or (2) presents an unreasonable risk of illness or injury.
United States · United States Congress · 1 June 1989
Designates the week beginning June 11, 1989, as National Scleroderma Awareness Week.
United States · United States Congress · 31 May 1989
Medicaid Community and Facility Habilitation Services Amendments of 1989 - Title I: Community Habilitation and Supportive Services - Amends title XIX (Medicaid) of the Social Security Act to authorize States to cover community habilitation and supportive services for individuals with mental retardation or related conditions without regard to whether or not such individuals have been discharged from a nursing or habilitation facility. Defines community habilitation and supportive services as services which assist individuals in developing and maintaining the skills necessary to function successfully in a home or community-based setting. Requires that community habilitation and supportive services be provided to each client in accordance with an individual service plan prepared and periodically reviewed and revised by an interdisciplinary team on the basis of a comprehensive functional assessment of a client's needs conducted before his or her receipt of services and at least annually thereafter. Requires that such services meet minimum requirements, to be developed by the Secretary of Health and Human Services, regarding client rights and service quality. Makes the requirements imposed on habilitation facilities (under title II of this Act) regarding patient's rights and facility safety and sanitation applicable to residential settings in which community habilitation and supportive services are provided. Requires that residential settings: (1) disclose persons having an ownership or control interest in the setting; and (2) exclude a person from such interest if he or she has been excluded from the Medicaid program or had an interest in a residential setting repeatedly found to have provided substandard care. Requires a habilitation facility which converts to a residential setting to continue to provide continuous active treatment to residents who required such treatment at the time of conversion. Requires a residential setting to document a client's receipt of medical services. Makes the: (1) Secretary responsible for certifying that State providers of community habilitation and supportive services and residential settings in which such services are provided comply with Medicaid requirements; and (2) States responsible for certifying that other providers of and residential settings for such services comply with Medicaid requirements. Requires each State to: (1) conduct periodic educational programs for the staff and clients in residential settings for community habilitation and supportive services regarding requirements imposed on such setting; and (2) provide, through the State agency responsible for the certification of such providers and residential settings, for the receipt, review, and investigation of allegations of client neglect and abuse and of misappropriation of client property by providers. Requires that such providers and settings be certified annually. Bases residential setting certification on an annual, unannounced survey. Directs the Secretary to: (1) develop a protocol for conducting surveys; and (2) conduct sample surveys of residential settings, within two months of State surveys, to test the adequacy of State surveys. Authorizes the Secretary to conduct a special survey of a setting or a review of the provider when there is reason to question its compliance with this Act. Prohibits the use of surveyors who have an interest in the provider or setting being surveyed or have not completed a training and testing program approved by the Secretary. Requires States and the Secretary to investigate complaints against providers or settings concerning violations of this Act's requirements. Requires that: (1) certain information regarding providers and settings and their compliance with this Act's requirements be made available to the public; and (2) the State agency responsible for the protection and advocacy system for the developmentally disabled and the guardians of clients be notified of a provider's or setting's noncompliance with this Act's requirements. Gives State Medicaid fraud and abuse control units access to provider or setting survey and certification information. Requires that when the Secretary or State determines that a provider's or setting's deficiencies immediately jeopardize client health and safety, immediate action be taken to remove the jeopardy and correct the deficiencies or the provider's or setting's participation in Medicaid be terminated. Directs the Secretary and States to apply certain other remedies where the health and safety of clients are not immediately jeopardized. Requires the imposition of civil money penalties against providers and settings which are, or are found to have been, out of compliance with any of this Act's requirements. Sets forth the Secretary's responsibilities relating to community habilitation and supportive service requirements. Eliminates the restriction of the Medicaid waiver for community habilitation services to individuals who have been discharged from a skilled nursing or intermediate care facility. Directs the Secretary to report to the Congress annually on the extent to which providers and residential settings are complying with this Act's requirements and the number and type of enforcement actions taken by the Secretary and the States. Title II: Quality Assurance for Habilitation Facility Services - Defines a "habilitation facility" as an institution primarily engaged in providing health or habilitation services to individuals with mental retardation or related conditions and not primarily for the care and treatment of mental diseases. Sets forth requirements for habilitation facilities, including requirements that such facilities: (1) promote maintenance or enhancement of the quality of life, independence, productivity, and integration into the community of each client; (2) provide continuous active treatment which is coordinated and monitored by a qualified mental retardation professional; (3) provide such treatment in accordance with an individual program plan prepared and periodically reviewed and revised by an interdisciplinary team of professionals on the basis of an assessment of a client's developmental and behavioral management needs conducted upon the client's admission and at least annually thereafter; (4) not admit any new client with mental retardation or a related condition on or after January 1, 1991, unless the State mental retardation or developmental disability authority has determined on the basis of an evaluation performed independently of the facility that the individual requires habilitation facility services; (5) provide physician services 24 hours a day, annual physical examinations, licensed nursing services, comprehensive dental diagnostic and treatment services, routine and emergency drugs and biologicals, professional program services to implement each client's active treatment plan, and meal services; (6) require a physician's supervision of each patient's care, have a physician available to furnish emergency medical care, and maintain clinical records on all clients; (7) protect specified client rights, including the right to appeal a transfer or discharge and receive post-discharge preparation and planning services; (8) provide applicants and residents with information regarding the Medicaid program and not require applicants to waive their rights to such benefits or have a third party guarantee payment to the facility as a condition of their admission; (9) protect a client's personal funds upon the client's authorization and teach clients to manage their funds to the extent of their capabilities; (10) adopt certain measures to preserve facility safety and sanitation; and (11) meet such other conditions which the Secretary of Health and Human Services deems necessary for client health and safety. Sets forth the Secretary's responsibilities relating to habilitation facility requirements. Makes the Secretary responsible for certifying that State habilitation facilities comply, and States responsible for certifying that other habilitation facilities comply, with Medicaid habilitation facility requirements. Requires each State to: (1) conduct periodic educational programs for habilitation facility staff and clients regarding the requirements imposed on such facilities; and (2) provide, through the State agency responsible for the certification of habilitation facilities, for the receipt, review, and investigation of allegations of client neglect and abuse and of misappropriation of client property by facility staff. Bases habilitation facility certification on an annual, unannounced survey. Directs the Secretary to: (1) develop and test a protocol for conducting surveys; (2) establish minimum qualifications for surveyors and train them in survey and certification techniques; and (3) conduct sample surveys of habilitation facilities, within two months of State surveys, to test the adequacy of State surveys, and reduce Federal payments for State Medicaid administrative costs if such State surveys prove inadequate. Authorizes the Secretary to conduct a special survey of a facility when there is reason to question its compliance with this Act. Requires States and the Secretary to investigate complaints against a facility and monitor the compliance of a facility with this Act's requirements if the facility was previously found out of compliance or the State or Secretary has reason to question its compliance. Requires that: (1) certain information regarding habilitation facilities and their compliance with this Act's requirements be made available to the public; (2) the State agency responsible for the protection and advocacy system for the developmentally disabled and the guardians of facility clients be notified of a facility's noncompliance with this Act's requirements; and (3) survey results be posted in a place that is readily accessible to clients. Gives State Medicaid fraud and abuse control units access to facility survey and certification information. Requires that when the Secretary or a State determines that a habilitation facility's deficiencies immediately jeopardize residents' health and safety, immediate action be taken to remove the jeopardy and correct the deficiencies or such facility's participation in Medicaid be terminated. Directs the Secretary and States to apply certain other remedies where the health and safety of facility residents are not immediately jeopardized. Authorizes the imposition of civil money penalties against facilities found to be in compliance with this Act's requirements but to have been out of compliance previously. Provides that if a facility is out of compliance with any of this Act's requirements three months after having been found out of compliance with such requirements or on three consecutive annual surveys, Medicaid payments for newly admitted residents shall be denied, civil monetary penalties assessed and collected, and, in the latter case, on-site monitoring of the facility's compliance shall be established. Provides that when a facility is found to have deficiencies relating to the facility's physical plant that do not immediately jeopardize the health or safety of its clients, the State may submit to the Secretary a written plan for permanently reducing the number of certified beds in such facility within 36 months of such finding and providing services, including community habilitation and supportive services, to clients who thereby cease to receive facility services. Requires that Medicaid-eligible clients be given the option of retaining facility services. Requires the Secretary to report to the Congress annually on the extent to which habilitation facilities are complying with this Act's requirements and the number and type of enforcement actions taken by States and the Secretary. Title III: Appropriate Placement for Individuals with Mental Retardation or Related Condition - Requires that State mental retardation or developmental disability authorities conduct preadmission and annual reviews of habilitation facility applicants and residents with mental retardation or related conditions to determine whether they require facility services or community habilitation and supportive services. Directs that such preadmission and annual reviews be conducted in accordance with criteria to be developed by the Secretary by July 1, 1990. Requires States to provide community habilitation and supportive services for facility clients who need such services but no longer need habilitation facility services. Requires States to establish an appeals procedure for individuals adversely affected by such preadmission and annual reviews. Eliminates existing utilization review and penalty provisions directed at the provision of services in an intermediate care facility for the mentally retarded. Title IV: Payment for Community Habilitation Services and Habilitation Facility Services - Covers the reasonable and adequate costs of community habilitation and supportive services and habilitation facility services. Prohibits Medicaid reimbursement of providers or facilities for civil monetary penalties imposed pursuant to this Act. Title V: Employee Protections and Miscellaneous - Provides employment protections for employees affected by habilitation facility closures or capacity reductions occurring after this Act's enactment. Authorizes States to assign specific management functions relating to the provision of Medicaid services to individuals with mental retardation or related conditions to State agencies responsible for developmentally disabled individuals.
United States · United States Congress · 31 May 1989
Designates the week beginning July 23, 1989, as Lyme Disease Awareness Week.
United States · United States Congress · 31 May 1989
Smith-Wyden Rural Health Care Improvement Act of 1989 - Title I: Tax Provisions - Amends the Internal Revenue Code to allow a tax credit for family practice physicians, nurse practitioners, and certified physicians' assistants who serve in rural and medically underserved areas. Allows such individuals a tax deduction for education loan interest. Title II: Provisions Relating to Rural Health Care - Amends title XVIII (Medicare) of the Social Security Act to provide coverage for clinical social workers in rural health clinics. Directs the Secretary of Health and Human Services to make additional payments for Medicare-dependent, small, rural hospitals from October 1, 1989, and on or before September 30, 1994. Directs the Secretary to provide for an additional payment after October 1, 1994, for each critical access facility designated by the Medicare Geographical Classification/Critical Access Facility Review Board. Establishes such Board to: (1) designate certain hospitals as critical access facilities; (2) hear appeals from rural hospitals which the Secretary determines do not qualify for treatment as being located in an adjacent urban metropolitan statistical area; and (3) conduct hearings with respect to the refusal of the Secretary to consider a hospital a sole community hospital. Requires the Board to report to the Congress on its activities. Amends the Public Health Service Act to authorize appropriations for FY 1992 for area health education centers.
United States · United States Congress · 31 May 1989
National Commission on Medicare Reform Act of 1989 - Establishes the National Commission on Medicare Reform, which shall conduct a comprehensive review of the Medicare program (title XVIII of the Social Security Act) and make recommendations to the Congress and President, within one year and 30 days after this Act's enactment, on methods for limiting the growth of Medicare spending while preserving the quality of patient care under the program.
United States · United States Congress · 31 May 1989
Designates the month of October 1989 as National Spina Bifida Month.
United States · United States Congress · 25 May 1989
U.S. Health Service Act - Title I: Establishment and Operation of the United States Health Service - Part A: Initial Organization - Establishes, as an independent entity within the executive branch, the United States Health Service (Service). Vests authority of the Service in the appropriate National Health Board and area health boards. Grants the Service the power of eminent domain. Directs the President to: (1) appoint 21 individuals to serve as members of the Interim National Health Board of the Service; and (2) designate two nominees as chairperson and vice chairperson of the Interim National Board. Declares that the members of the Interim National Board shall serve until the National Health Board holds its initial meeting in accordance with certain provisions of this Act. Sets forth the duties of the Interim National Board. Authorizes appropriations. Part B: Organization of Area Health Boards - Requires the Interim National Board to establish health care delivery regions throughout the United States which meet specified requirements. Sets forth procedures regarding election and appointment of members and certain officers of: (1) interim national, interim regional, and interim district health boards; and (2) initial and subsequent national, regional, district, and community health boards. Requires the National Health Board (National Board) to modify the boundaries of each health care delivery region after each census and at such other times as it deems necessary, provided such modification is approved in a referendum of registered users residing in an area whose regional identification would be changed by such modification. Requires each regional board, in certain circumstances, to review the appropriateness of district and community boundaries. Allows regional boards to modify such boundaries in certain circumstances, provided modification is approved in a referendum. Part C: General Provisions Regarding Health Boards - Sets forth the membership and terms of office of health boards. Provides for recall of board members for specified reasons and for filling vacancies on health boards. Provides for the manner of conducting meetings of health boards and for the compensation of members of the National Board and compensation of and payment of expenses for members of other health boards. Sets forth procedures for the establishment by the National Board of guidelines and standards required by or in furtherance of the objectives of this Act. Requires each regional board to provide orientation, education, and technical assistance to district and community boards. Requires the appropriate national board to provide such assistance to regional boards. Title II: Delivery of Health Care and Supplemental Services - Part A: Patients' Rights in Health Care Delivery - Requires the Service to ensure that every user is given the right to receive high quality care and supplemental services without charge and without discrimination. Sets forth a list of other basic health rights. Amends the Fair Labor Standards Act of 1973 to entitle certain employees to health leave compensation, subject to specified exceptions which exist in current law as exceptions to minimum wage and maximum hours provisions. Part B: Eligibility for, Nature of, and Scope of Services Provided by the Service - Declares all individuals, while within the United States, to be eligible to receive health care and supplemental services under this Act. Excludes personal comfort or cosmetic services unless they are necessary for health-related reasons. Requires the Service to provide in the United States specified services in or through facilities established by the Service. Prohibits the Service from providing such services in a region, district, or community other than under the auspices of a regional, district, or community board established in accordance with this Act. Requires the Service to provide specified supplemental services in or through health care facilities established by the Service. Provides for reimbursement by the Service of the cost of emergency health care services under certain circumstances. Part C: Health Care Facilities and Delivery of Health Care Services - Requires each community board to establish and maintain such health care facilities as are necessary for efficient and effective delivery or comprehensive primary health care services, specialized health care services, special services, and community-oriented health measures which are provided, as much as possible, through a single comprehensive health center. Requires each district board to establish and maintain in its district a general hospital, such other health care facilities as are necessary, and such health care services of a specialized nature as may be provided most effectively and efficiently at the district level. Requires each regional board to establish and maintain: (1) a regional medical facility for highly specialized health care services; (2) health care and supplemental services for individuals whose needs cannot be met by community or district boards; and (3) such other facilities as are necessary. Requires each area health board to: (1) hire health workers; (2) purchase or lease necessary premises; and (3) seek to minimize fragmentation and duplication in delivery of health care. Requires each regional board to provide for affiliation and coordination within its region and with adjacent regions. Requires the National Board to establish guidelines for distribution and coordination of the delivery of health care services and plan and transition to the new facilities for affected workers. Requires regional boards, if a community or district board fails to provide health services, to provide the services. Requires each health board to establish policies and organizational plans consistent with provisions of this Act. Requires such boards, in establishing, implementing, and modifying such policies and plans, to seek participation of affected workers and users. Provides for a health board, if it determines that it cannot itself effectively manage the operation of all facilities, to establish a health care facility board or boards. Specifies elements to be provided for in the policies and organizational plans established by health boards. Prohibits a health board, on and after three years after the effective date of health services, from permitting its health care facilities to be used for the private delivery of health services. Prohibits individuals employed by a health board from engaging in the private delivery of health services. Requires each health board to ensure that health facilities it operates which provide outpatient services are open during hours which permit all users to make use of such services. Sets forth requirements for facilities providing inpatient services for 30 continuous days or longer. Requires each health board to provide that, at least once each year, the inpatients of facilities providing inpatient services for 30 continuous days or longer shall elect, from among themselves and representatives of certain user associations, a review committee of not less than three members. Provides for recall and proxies with respect to such committees. Requires various health boards to conduct regular inspections of specified facilities. Requires area health boards to provide: (1) contraception information and materials; (2) evaluation and treatment for venereal diseases and diseases of the reproductive organs; (3) information and counseling regarding pregnancy, child bearing, and possible genetically induced anomalies; (4) pregnancy testing; (5) prenatal services; (6) abortion services; and (7) counseling by women for specified services and counseling by men for specified services. Requires all such services to be delivered without coercion or harassment, with confidentiality, and without prior approval of individuals other than the individual receiving the services. Requires that individuals be permitted to be accompanied by a person of their choice during the provision of such services, subject to exception. Sets forth restrictions and requirements for informed consent regarding: (1) treatments or procedures which could affect an individual's reproductive capacity; and (2) mastectomy or other breast cancer treatment. Requires that women giving birth have the right to choose from a complete range of childbirth options. Title III: Health Labor Force - Part A: Job Categories and Certification - Declares that, notwithstanding State laws to the contrary, the Service shall be the sole judge of the qualifications of its employees. Requires each area health board to insure that work is performed by certified health workers. Mandates health boards to provide for periodic review and assessment of competency. States that area health boards shall provide opportunities for assessment and certification of skills required for advancement. Requires the National Board to establish guidelines for classification, certification, and employment of health workers. Requires that such guidelines: (1) permit alternative approaches to healing, when such approaches have not been shown to be injurious to health; (2) have both flexibility and uniformity to meet stated objectives; and (3) require that each health worker employed by a community board work part of the time in a facility operated by a district or regional board and each health worker employed by a district or regional board work part of the time in a health care facility operated by a community board. Mandates that the National Board periodically evaluate job categories and certification practices established by area health boards and assist regional boards in applying certain guidelines. States that each regional board, for job categories requiring advanced specialty training, shall establish certification standards which contain certain specifications made by the National Board. Requires recognition of training, experience, and performance undertaken or demonstrated before the establishment of health team schools under part B of this title. Requires each board to periodically review, supplement, modify, or eliminate such standards. Part B: Education of Health Workers - Requires each regional board, in consultation with community and district boards, to establish a health team school (school) to provide initial and continuing basic education in health care delivery and initial and continuing advanced education in health care specialties and health science specialty fields. Allows for collaboration between adjacent regions conducting joint educational programs. Requires that the schools be funded exclusively by the Service, prohibits them from charging or accepting tuition or fees, and requires them to provide each student with an allowance for living expenses, educational supplies, and any child care. Sets forth the principles under which the schools are required to be operated and maintained. Requires the National Board to establish guidelines for the application of such principles and for the phased integration of existing health worker education programs into the schools. Requires each regional board to establish and implement for the school: (1) admissions policies with certain required elements; (2) curriculum policies with stated elements; (3) faculty hiring procedures which will create a faculty which approximates the population of the region by race, sex, and language; and (4) a governance plan for the management of its school which gives significant decision making powers to staff and students. Prohibits enrolling any individual unless the individual agrees to perform health care services as an employee of the Service, in a job category for which training is being provided, for a period of time equal to the period of enrollment, but not less than two years, and subject to other terms and conditions. Entitles the Service, if an individual fails to start or fails to complete such service, to recover damages. Cancels payment of damages upon the death of the individual. Allows waiver or suspension of the obligation of service or payment if compliance is impossible or would involve extreme hardship and if enforcement would be unconscionable. Limits discharge of such obligation under bankruptcy. Mandates that each area board periodically assess the ratio of the health workers employed by the board in each job category to the number of residents in the area. Gives priority in hiring individuals obligated to perform service to health worker shortage areas and, as a second level of priority, to the regional, district, or community board for the region, district, or community in which the program was completed. States that the National Board shall establish a program to match the preferences graduates have for locations with the needs and preferences of various boards. Requires the National Board to make payments of principal and interest on certain loans incurred by individuals for an educational program in health care delivery, health care specialties, or health science fields which is outstanding on the day that individual begins to work for the Service. Establishes a schedule for such payments. Part C: Employment and Labor-Management Relations Within the Service - Requires health boards to employ, classify, and fix the salaries and benefits of all employees of the Service. Mandates that the appropriate National Board provide for: (1) employment and promotion in the Service in the same manner as under the Federal civil service system; (2) opportunities for advancement; (3) use of work time for continuing education without loss of pay or other rights; and (4) hearings on adverse actions. States that health boards shall give hiring preference to individuals employed as health workers before enactment of this Act. Requires the National Board to ensure that all such individuals desiring employment in the Service find appropriate employment in the Service. Declares employees of the Service eligible for promotion or transfer to any position in the Service for which they are qualified. Mandates that each regional board establish and maintain a job placement service. Places restrictions on hiring relating to the: (1) ratio of health workers to residents; and (2) existence of a health worker shortage area in the same region. Declares that employees of the Service are covered by specified Federal laws relating to adverse actions, compensation for work injuries, civil service retirement, and withholding of pay for the Civil Service Retirement and Disability Fund, subject to exceptions relating to collective bargaining agreements and conditioned on approval by the Office of Personnel Management. Declares sick and annual leave and compensatory time of employees of the Service, whether accrued prior to or after the commencement of operations of the Service, to be obligations of the Service. Requires compensation, benefits, and other terms and conditions of employment to be the same on the effective date of health services as for Federal Government employees until changed by the Service. Makes specified provisions of Federal law relating to unemployment compensation and life insurance apply to employees of the Service unless modified. Prohibits changes in fringe benefits which result in a program which is less favorable to employees of the Service than fringe benefits for employees of the Federal Government on the effective date of health services. Declares that the provisions of the National Labor Relations Act shall apply to the Service and its employees, subject to specified exceptions. Declares that provisions of Federal law relating to participation in a strike shall not apply to employees of the Service. Authorizes provisions in collective bargaining agreements between the Service and its employees regarding procedures for the resolution of grievances and adverse actions, including binding third-party arbitration. Amends the Labor-Management Reporting and Disclosure Act of 1959 to include the Service in the definition of the term "employer" under that Act. Provides that the remedies provided by stated Federal laws regarding jurisdiction and tort claims shall be exclusive of any other civil action or proceeding. Directs the Attorney General to defend any such action or proceeding. Provides, in certain circumstances, for removal and remanding of cases between State and Federal courts and for suspensions of specified limitations of time. Authorizes the Attorney General to compromise or settle such cases as provided in specified Federal law. Declares that assault or battery arising out of negligence in various health care functions is not an exception under specified Federal law to tort claims and jurisdiction provisions of Federal law. Authorizes the National Board to hold harmless or provide liability insurance for any employee of the Service under certain circumstances. Title IV: Other Functions of Health Boards - Part A: Advocacy, Grievance Procedures, and Trusteeships - Requires each area health board to establish a program of health advocacy with specified elements. Requires the National Board to establish a health rights legal services program, for users and health workers, providing specified elements. Requires each appropriate regional board to provide that any user, health worker, user association, or specified health board may commence grievance proceedings before specified health boards with respect to alleged violations of this Act. Provides for review of adverse decisions. Prohibits commencement or continuation of such review when suit is filed. Provides procedures for handling such grievances. Authorizes, in certain circumstances, the entity before which a grievance proceeding is commenced or reviewed to: (1) set aside an election of a community board and require a new election; and (2) if not involving a community board, require that a new election be conducted or a new appointment be made. Requires such entity to transfer such functions as necessary to the appropriate higher health board until a new election is conducted or a new appointment is made. Authorizes a health board which receives functions under such a transfer to appoint a trustee or trustee committee to carry out transferred functions. Part B: Occupational Safety and Health Programs - Requires the National Board to oversee occupational safety and health programs conducted at the regional level and to participate in the establishment and administration of occupational safety and health standards under the Occupational Safety and Health Act of 1970, with the advice and comments of regional occupational safety and health action councils established under this Act. Amends the Occupational Safety and Health Act of 1970 to substitute references to the National Health Board for references to the Secretary of Health and Human Services throughout such Act, with one specified exception. Adds references to the National Health Board to existing provisions in such Act regarding promulgation, modification, and revocation of safety and health standards. Ends responsibility of the Secretary of Health and Human Services for prescribing rules and regulations to carry out such Secretary's responsibilities under that Act. Adds a reference to consultation with the National Board to existing provisions relating to: (1) exemptions from required provisions on account of national defense; (2) conditions for approval of State safety and health plans; and (3) access to safety and health records and reports required of Federal agencies. Ends the authorization under a specified provision of such Act for the Secretary of Health and Human Services to prescribe regulations requiring employers to measure, record, and make reports on employees' exposure to certain substances or agents. Requires the National Board to establish guidelines for: (1) its participation in the establishment and administration of safety and health standards; (2) the election of community occupational safety and health action councils; (3) the establishment of regional occupational safety and health programs; (4) the establishment and operation of work place health facilities; and (5) the provision of assistance by various health boards to various safety and health councils, and to work place safety and health committees. Requires each community board to provide for the operation of a community occupational safety and health action council (COSHAC). Gives a formula for election of the members of COSHACs. Specifies the duties of each COSHAC. Requires each regional board to establish an occupational health and safety program for its region with specified elements, including staffing and supporting the operation of the regional occupational safety and health action council (ROSHAC). Specifies the responsibilities of each ROSHAC. Requires the employer in each work place to establish and maintain a health facility in or near the work place to meet occupational and emergency health care needs of employees, to be operated either by the community board or by the employer, and the cost, in either case, to be borne by the employer. Grants employees in each work place having 25 or more employees the right to establish work place occupational safety and health committees. Grants the members of such committees rights to engage in certain activities relating to inspections without loss of pay or other job rights. Authorizes employees to monitor conditions and to remove themselves from the site of any hazard without loss of pay or other job rights. Requires employers to minimize hazards and furnish employees with or reimburse employees for needed equipment or clothing. Specifies rights of employees regarding: (1) inspection of medical records maintained by their employers; (2) provision to employees of copies of all reports, studies, and data concerning health and safety in that work place; and (3) the seeking, through collective bargaining, of standards more restrictive than those established under the Occupational Safety and Health Act of 1970. Part C: Health and Health Care Delivery Research - Requires the Service to conduct a program of research concerning health and health care delivery. Transfers the National Institutes of Health from the Department of Health and Human Services to the National Health Board. States that the National Board shall establish five new national institutes: Epidemiology, Evaluative Clinical Research, Health Care Services, Pharmacy and Medical Supply, and Sociology of Health and Health Care. Specifies the duties of each such institute. Part D: Health Planning, Distribution of Drugs and Other Medical Supplies, and Miscellaneous Functions - Requires each area board to collect data on supply and demand regarding health workers and health care delivery. Requires each regional board to coordinate the planning and administration of health care delivery, health worker education, and health research in its region. Requires the National Board to formulate one-year and five-year national plans and budgets. Requires the National Board, after consultation with regional boards, to publish, and regularly update, a National Pharmacy and Medical Supply Formulary. Specifies the contents of the Formulary. Requires each regional board to establish a program for the purchase and distribution of drugs and other medical supplies. Authorizes the National Board to establish and operate drug and medical supply manufacturing facilities in certain circumstances. Requires the National Board to publish an annual report and a comprehensive dictionary of terms used in health care records and services maintained or provided by the Service. Title V: Financing of the Service - Part A: Health Service Taxes - Amends the Internal Revenue Code to add a new part imposing on individuals and corporations an additional tax of specified percentages of the normal tax and surtax imposed by a specified section of such code. Ends the income tax exclusion from gross income of amounts paid by third parties for medical care. Excludes from gross income employer contributions to accident or health plans to the extent that such contributions do not provide for health care available to such employees under the Health Service Act. Prohibits income tax deductions for: (1) health care expenses as a trade or business expense; and (2) contributions to certain medical and hospital facilities. Repeals provisions of the Internal Revenue Code relating to: (1) medical and dental expenses; (2) hospital insurance tax imposed on employment and self-employment income; and (3) receipts for railroad employees. Declares that no contractual or other nonstatutory obligation of any employer to pay or provide for health care for present or former employees and their dependents and survivors shall apply on or after the effective date of health services under this Act to the extent such individuals are eligible to receive such services under this Act. Prohibits Federal, State, or private worker compensation programs from paying for or providing any health care on or after the effective date of health services under this Act to the extent such care is available under this Act. Part B: Health Service Trust Fund - Creates in the Treasury the Health Service Trust Fund (Trust Fund). Appropriates to the Trust Fund amounts equal to 100 percent of the expected net receipts from specified provisions of the Internal Revenue Code. Appropriates to the Trust Fund a Government contribution equal to 40 percent of the amount appropriated under such 100 percent provision. Transfers to the Trust Fund all assets and liabilities of the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund. Creates the Board of Trustees of the Trust Fund. Requires the investment of specified portions of the Trust Fund. Extends the purposes for which obligations of the United States may be issued under the Second Liberty Bond Act, to authorize the issuance at par of public debt obligations for purchase by the Trust Fund. Part C: Preparation of Plans and Budgets - Requires the National Board to annually fix the maximum amount of funds which may be expended from the Trust Fund during the fiscal year. Specifies criteria to be considered in determining such amount's maximum value. Authorizes the National Board to refix such maximum amount in certain circumstances. Authorizes the National Board to exceed such maximum amount as necessary because of epidemic, disaster, or other occurrence which was not and could not have been planned for. Authorizes the National Board to allocate, in addition to such maximum amount, funds borrowed under specified provisions of this Act. Requires each community, district, and regional board to annually submit fiscal year and five-year plans and budgets to the next higher level health board. Requires plans and budgets to be prepared in consultation with appropriate users, health workers, and health boards. Part D: Allocation and Distribution of Funds - Requires the National Board to annually transmit to regional boards a national health budget dividing the total funds available into funds for ordinary operating expenses, preventive health measures, capital expenses, research expenses, and special operating expenses. Requires funds for ordinary operating expenses, preventive health measures, and research expenses to be allocated to the regional boards on the basis of population. Requires funds for capital expenses to be allocated according to stated criteria. Declares the budget submitted to the regional boards by the National Board to be adopted upon the approval by a majority of the regional boards. Sets forth requirements, similar to those for the national health budget, for preparation and adoption of regional and district budgets. Defines "special operating expenses" to mean operating expenses associated with: (1) care and treatment for users 65 years of age and older; (2) care and treatment of persons confined to full-time residential institutions, including nursing homes and facilities for the treatment of mental illness; (3) the special health care needs of low-income users; (4) the special health care needs of rural users; (5) special health care needs arising from environmental or occupational health conditions; (6) special health care needs arising from unexpected occurrences, including epidemics and natural disasters; and (7) the conduct of environmental health inspection and monitoring services. Sets forth rules for allocation of special operating expenses. Requires funds allocated under the national health budget to be distributed by the National Board from the Trust Fund. Prohibits health boards from requesting or receiving funds from any other source. Sets forth rules regarding: (1) distribution of funds in the absence of an adopted budget; (2) maintenance of separate accounts by area boards; (3) payment of area health boards; and (4) allocation of supplementary funds required by events occurring or information acquired after initial allocations. Authorizes area boards to retain unused funds for two years following receipt. Requires any funds unexpended after such time to be returned to the Trust Fund. Mandates annual financial statements by area health boards. Grants the National Board and the Comptroller General of the United States, for the purpose of audits, access to any books, documents, papers, and records related to the operation of the Service. Part E: General Provisions - Authorizes the National Board to borrow money and to issue and sell obligations as necessary for this Act, but only in amounts specified in appropriations Acts. Limits the aggregate amount of such obligations outstanding at any one time. Authorizes the National Board to pledge the assets of the Trust Fund and pledge its revenues and receipts for various purposes related to such obligations. Authorizes the National Board to enter into a variety of covenants as necessary or desirable to enhance the marketability of such obligations. Declares that such obligations: (1) shall be negotiable or nonnegotiable, bearer or registered; (2) shall contain a recital that they are issued under a specified provision of this Act; (3) shall be lawful investments; (4) shall be exempt from State taxes; and (5) shall not, subject to exception, be obligations of the U.S. Government. Requires the National Board to advise the Secretary of the Treasury of the proposed sale of obligations. Authorizes such Secretary to elect to purchase the obligations. Authorizes the National Board, if the Secretary elects not to buy such obligations, to issue and sell them to a party or parties other than the Secretary, upon notice to the Secretary and consultation regarding various terms and conditions. Empowers the National Board to require the Secretary of the Treasury to purchase obligations of the Service. Prohibits any required purchase which would result in a holding by the Secretary in excess of a specified amount. Makes obligations issued by the Service obligations of the U.S. Government under certain circumstances. Authorizes the Secretary of the Treasury, for the purpose of any purchase of the obligations of the Service, to use as a public debt transaction the proceeds from the sale of any securities issued under the Second Liberty Bond Act. Extends the purposes of such Act to include any purchases of the obligations of the Service under this part. Title VI: Miscellaneous Provisions - Repeals, on the effective date of health services, the Public Health Service Act, except for specified provisions relating to: (1) its short title and definitions; (2) licensing, quarantine, and inspections authority; and (3) safety of public water systems. Delays, until four years after the effective date of health services, repeal of portions of the Public Health Service Act regarding provision of assistance to educational institutions and their students, in areas which have not established health team schools under part A of title III of this Act. Repeals specified provisions of the Social Security Act relating to maternal and child health, Medicare, Medicaid, professional standards review, entitlement to hospital insurance benefits, uniform health reporting systems, limitation on Federal participation for capital expenditures, the program for determining qualification for certain health care personnel, disclosure of ownership and related information, disclosure of certain convictions, and payments to States for health care and supplemental services. Repeals specified provisions of Federal law relating to health insurance for Federal employees, medical benefits and programs relating to veterans, and the civilian health and medical program of the uniformed services. Repeals the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970, the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act Amendments of 1974, and a specified provision of the Comprehensive Drug Abuse Prevention and Control Act of 1970 relating to medical treatment of narcotic addiction. Repeals Federal law relating to hospitals, community hospitals, and other health facilities for Indians. Repeals the District of Columbia Medical Facilities Construction Act of 1968 and the District of Columbia Medical and Dental Manpower Act of 1970. Repeals specified provisions of the National Housing Act relating to mortgage insurance for nursing homes, hospitals, and group practice facilities. Repeals the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963, the Family Planning Services and Population Research Act of 1970, the National Arthritis Act of 1974, and the National Diabetes Mellitus Research and Education Act. Repeals specified provisions of the Lead-Based Paint Poisoning Prevention Act relating to grant, demonstration, and research programs for lead-based paint poisoning prevention. Repeals the Act of March 2, 1897, relating to tea importation. Repeals specified provisions of the Occupational Safety and Health Act of 1970 relating to the National Institute for Occupational Safety and Health. Requires the President to prepare and submit to the Congress legislation to repeal or amend provisions of laws which are inconsistent with this Act, including the transfers of authority of the Secretary of Health and Human Services, under specified provisions of Federal law, to the Service. Sets forth various requirements regarding review and reporting to the President and the Congress concerning how the Service is carrying out the purposes of the various programs authorized to be conducted by provisions repealed by this Act. Transfers to the Health Service Trust Fund amounts appropriated to carry out the purposes of any law repealed by this Act. Provides transition rules regarding contracts entered into or rights or obligations arising before the effective date of such repeals. Amends the Budget and Accounting Act, 1921 to require that each budget submitted by the President set forth items relating to the Health Service Trust Fund separately from other operations of the Government. Declares that, if any provisions of this Act are declared invalid, the remainder of the Act shall not be affected.
United States · United States Congress · 25 May 1989
Preventive Health Measures Act of 1989 - Title I: Preventive Health Amendments to Public Health Service Act - Amends the Public Health Service Act to authorize appropriations from FY 1990 through 1992 for the provision of grants for preventive health services other than immunizations. Includes programs for the deterrence of smoking and substance abuse by children and adolescents among the preventive health service programs receiving grants. Authorizes appropriations from FY 1990 through 1992 for the Preventive Health and Health Services Block Grant program. Authorizes States to use grant amounts on demonstration projects for the inclusion of preventive health courses in the curriculum of schools that train health professionals. Title II: Preventive Health Amendment to Maternal and Child Health Services Block Grant - Amends title V (Maternal and Child Health Services) of the Social Security Act to increase authorized appropriations under such title from FY 1990 through 1992. Title III: Preventive Health Amendments for the Elderly under Medicare and under Internal Revenue Code - Subtitle A: Medicare Coverage of Additional Preventive Services - Amends title XVIII (Medicare) of the Social Security Act to cover a beneficiary's annual routine eye and hearing examination and a diabetic beneficiary's annual podiatric foot examination. Subtitle B: Medicare Coverage of Adult Day Care Services - Amends part B (Supplementary Medical Insurance) of the Medicare program to cover 125 days of adult day care per year provided to a clinically impaired individual who, but for the provision of such care, would require the level of care provided in a hospital or nursing facility. Requires that covered adult day care programs provide such care pursuant to a written plan of care which is established and periodically reviewed by the program's multidisciplinary team of personnel which includes at least: (1) a physician; (2) a registered professional nurse and a social worker; (3) a consultant with physical or occupational therapy or speech-language pathology skills; and (4) as needed, a dietitian. Sets forth additional program requirements. Imposes a coinsurance amount of five dollars per day of adult day care on beneficiaries, but no deductible. Provides for State participation in establishing adult day care program requirements and certifying the compliance of such programs with those requirements. Subtitle C: Medicare Coverage of Increased Home Care - Includes periodic chore services performed in the home of an aged, blind, or disabled adult when such individual is not able to perform such services and respite care services provided for no more than 52 days per year by persons who have successfully completed a homemaker/home health aide training program as covered home health care. Covers home health services provided in adult day care centers. Subtitle D: Income Tax Credit for Maintaining Households Which Include Dependents Who Have Attained Age 65 - Amends the Internal Revenue Code to provide a $250 tax credit to individuals who maintain households which include dependents who have attained age 65. Title IV: Further Preventive Health Amendments to Internal Revenue Code - Allows a tax credit of ten percent of the expenses a taxpayer incurs for a weight reduction or exercise program or a program to stop smoking. Increases excise taxes on cigarettes. Establishes the Health Maintenance Trust Fund into which certain cigarette tax revenues shall be deposited for use in: (1) implementing the amendments made by title I of this Act; (2) covering the decrease in Treasury revenues resulting from this Act's health maintenance expense credit; and (3) implementing programs discouraging cigarette smoking as well as disease prevention and health promotion programs unrelated to smoking.
United States · United States Congress · 25 May 1989
Amends title XIX (Medicaid) of the Social Security Act to authorize the Secretary of Health and Human Services to waive the application of certain Medicaid requirements in up to ten States which choose to provide long-term care pursuant to joint, State-sponsored public and private financing arrangements. Sets durational and fiscal limitations on such programs. Directs the Secretary to report to the Congress, by January 1, 1999, on the effectiveness of such programs.
United States · United States Congress · 24 May 1989
Amends the Public Health Service Act to authorize appropriations for FY 1990 through 1992 for adolescent family life demonstration projects.
United States · United States Congress · 24 May 1989
Medicare Financing and Benefit Review Commission Act - Establishes the Medicare Financing and Benefit Review Commission to study the benefit structure and financial problems of the Medicare program (title XVIII of the Social Security Act) and make recommendations to the President and the Congress, within 270 days after the commencement of such study, for changes which would ensure the adequacy and solvency of such program. Authorizes appropriations for the Commission. Terminates the Commission 30 days after transmittal of its report to the President and the Congress.
United States · United States Congress · 24 May 1989
New Drug and Device Application Fee Amendments of 1989 - Amends the Federal Food, Drug, and Cosmetic Act to direct the Secretary of Health and Human Services to establish fees to cover the costs of review for: (1) food additives; (2) new drugs; (3) antibiotic drugs; (4) medical devices; (5) new animal drugs; and (6) biologic products licensing.
United States · United States Congress · 18 May 1989
Title V Infant Mortality Reduction Act of 1989 - Amends title V (Maternal and Child Health Services) of the Social Security Act to increase authorized appropriations for such program. Requires States, as a condition of receiving additional funds, to conduct a statewide needs assessment of maternity and infant care, including prenatal care and prevention of low birthweight and infant mortality, and to develop a plan to meet those needs. Changes State reporting requirements to monitor plan implementation results.
United States · United States Congress · 18 May 1989
Rural Health Clinic Improvement Act of 1989 - Amends title VII (Administration) of the Social Security Act to direct the Office of Rural Health Policy to provide technical assistance to entities seeking certification as rural health clinics and distribute brochures describing the services provided at rural health clinics. Amends title XVIII (Medicare) of the Act to include the services of nurse midwives within covered rural health clinic services. Requires a rural health clinic to: (1) have a nurse practitioner, physician assistant, or certified nurse midwife available to furnish patient care services at least 50 percent of the time the clinic operates; and (2) meet certain requirements for funding as a health center under the Public Health Service Act. Expands the area within which rural health clinics may operate. Amends title XIX (Medicaid) of the Act to modify the method of determining which costs are reasonable and related to Medicaid rural health clinic services when calculating Medicaid payments to such clinics. Deems clinics which are certified as meeting certain requirements for funding as health centers under the Public Health Service Act to be certified as Medicaid rural health clinics.
United States · United States Congress · 18 May 1989
Federal Employees Health Care Freedom-of-Choice Act of 1989 - Amends provisions of law relating to Federal employee health benefits to authorize direct payment or reimbursement for services performed by licensed health practitioners in the State where they practice.