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Bill· HRH.R. 14181 (93rd)referred
United States · United States Congress · 10 April 1974
Arthritis Prevention Treatment, and Rehabilitation Act - Makes it the purpose of this Act to establish: (1) a long-range plan to expand and coordinate the national research, treatment, and control effort against arthritis and related musculoskeletal diseases; (2) centers for arthritis prevention, research, screening, early detection, training, treatment, and rehabilitation programs; and (3) programs to develop new and improved methods of arthritis screening and early detection and to establish a central arthritis screening and early detection data bank. Requires the Director of the National Institutes of Health to establish a National Commission on Arthritis and Related Musculoskeletal Diseases. Specifies the composition, duties, and powers of the Commission. States that the Commission shall formulate a long-range plan to combat arthritis and related musculoskeletal diseases with specific recommendations for the utilization and organization of national resources for that purpose. States that the plan shall include a plan for a coordinated research program encompassing existing and proposed Federal, non-Federal and local programs. Enumerates investigations, studies, and programs to be carried out under such plan. Authorizes to be appropriated $1,000,000 to carry out the above purposes. Establishes within the National Institute on Arthritis, Metabolism, and Digestive Diseases the position of Associate Director for Arthritis and Related Musculoskeletal Diseases. States that the Director of the National Institutes of Health shall establish an Inter-Institute Arthritis and Related Diseases Coordinating Committee to better coordinate research activities relating to arthritis and related musculoskeletal diseases. Provides for the development, establishment, construction, and operation of arthritis research and training centers. Specifies the purposes to be achieved by such research and training programs. Provides for the geographical distribution, operational support, and evaluation of such research and training centers. Authorizes specified appropriations for fiscal years 1975, 1976, and 1977 for the establishment of such centers. Authorizes the Secretary of Health, Education, and Welfare to establish and support arthritis screening, early detection, prevention, and control demonstration programs. Specifies the purpose of such programs. Authorizes specified appropriations for fiscal years 1975, 1976, and 1977 for the establishment and support of such programs. Requires the Secretary to establish the Arthritis Screening and Detection Data Bank as soon as practicable after the enactment of this Act. Provides that not less than $500,000 of the sums appropriated to the National Institutes of Health to carry out the purposes of this Act shall be obligated for basic and clinical orthopedic research conducted or supported by the National Institute on Arthritis, Rheumatism, and Metabolic Diseases.
Bill· HRH.R. 14191 (93rd)referred
United States · United States Congress · 10 April 1974
Health Resources Development and Planning Act - Declares that it is the purpose of this Act to assist private and public health care systems to plan more effectively the provision of resources necessary to meet the health care needs of the Nation, and to facilitate governmental regulation of health care costs. Repeals provisions of the Public Health Service Act, which provides for a National Advisory Council on Comprehensive Health Planning Programs. Directs the chief executive officer of each State to designate geographical regions as health service areas to be served by the Health Systems Agencies. Identifies the geographical characteristics of such health service areas. Directs the Secretary of Health, Education, and Welfare to certify a Health Agency for each health service area and to enter into an agreement obligating the Agency: (1) to prepare and maintain a comprehensive health plan for the health service area; (2) to review the Secretary's grants of Federal financial assistance for health care activities; (3) to review State and local health care activities; (4) to offer technical assistance in furtherance of the health plan; (5) to participate in the statewide Health Coordinating Council; and (6) to comply with subsidiary requirements, including auditing and examination of books. Empowers tthe Secretary to make grants for an agency's operational expenses and to extend to the Agency technical assistance, and to keep it appraised of national health policies and issues. Prescribes the procedures for termination or withdrawal of certification and the organizational requirements to be met by agencies, including that an agency be a nonprofit private corporation that exercises no Federal, State, or local regulatory authority, and is not a provider or insurer of health services or an educational institution. Outlines the composition of the governing body of each agency. Provides that members are relieved of civil or criminal liability under any law for the performance, with the exercise of due care of functions authorized by this Act. States that an agency may receive unconditional contributions from any private source of up to 5 percent of the amount of assistance received from the Secretary, and of up to 25 percent of that amount from any public sources. Requires each agency to annually adopt a comprehensive health plan for its health service area identifying shortages, maldistributions, and surpluses of health personnel, facilities, and services, and the most serious organizational and operational deficiencies of health care providers. States that the plan must set forth long-range goals and annual priorities for the establishment or improvement of health care systems, and recommend actions to alleviate the problems identified by the plan. Provides that an Agency may provide technical assistance, directly or by grant or contract, to implement the recommendations of its comprehensive health plan. Sets limitations on the purpose, amount and duration of such grants. Requires that two or more agencies that serve health service areas that fall in whole or in part within the same State form a Statewide Health Coordinating Council. Directs the Council to draw on the comprehensive health plans of its member Agencies to prepare a Statewide plan, and perform other advisory analytical, and coordinative functions. Directs the Secretary to evaluate the performance of Agencies and Councils on a regular basis and to prescribe standards of performance to facilitate this evaluation. Authorizes the appropriation of such sums as may be necessary for fiscal years 1975, 1976, and 1977 to carry out the provisions of this Act. Makes various technical and conforming amendments. Defines the terms used in this Act.
Bill· HRH.R. 14196 (93rd)referred
United States · United States Congress · 10 April 1974
National Health Action Corps Act - States that the purpose of this Act is to increase the number of trained professional personnel in the allied health field by providing young Americans training and practical work experience in the allied health field. Establishes within the executive branch an independent agency to be known as the Health Action Corps. Provides that the Corps shall be headed by a Board of Directors which shall consist of the Secretary of Health, Education, and Welfare, the Secretary of Housing and Urban Development, the Secretary of Labor, the Secretary of Commerce, and the Director of the Office of Management and Budget, or their respective designees. States that it shall be the duty of the Corps to provide opportunities for young Americans to participate in programs which provide training and practical work experience in the allied health field. Provides that such programs shall include career counseling, exposure to various health-related occupations, and training and work experience in clinical settings. Stipulates that the Corps shall be composed of volunteers selected by the Administrator in accordance with policies and procedures established by the Board. States that the Administrator, in accordance with policies and procedures prescribed by the Board, may provide to any volunteer who has completed his period of enlistment: (1) a scholarship of $3,000 if such volunteer is a full-time student at a junior college, college, or university; or (2) a bonus of $3,000, if such volunteer works for one year in an area which (as determined by the Administrator) has a critical shortage of trained professional personnel in the allied health field. Stipulates that the Board shall establish a National Advisory Committee to advise, consult with, and make recommendations to the Board on matters relating to the following: (1) policies for the recruitment of Corps volunteers; (2) evaluation of the quality of the training provided to the Corps volunteers; (3) the projected future demand for trained professionals in the allied health field; and (4) innovations in the utilization of trained professional personnel in the allied health field.
Bill· HRH.R. 14176 (93rd)referred
United States · United States Congress · 10 April 1974
Repeals, under the Social Security Act, the provisions for the establishment of Professional Standards Review Organizations to review services covered under the medicare and medicaid programs.
Bill· HRH.R. 14122 (93rd)referred
United States · United States Congress · 10 April 1974
Home Health Services Act - Provides, under the Public Health Service Act, for the establishment and initial operation of public and nonprofit private agencies which will provide home health services in areas in which such services are not otherwise available. Authorizes the Secretary of Health, Education, and Welfare to make grants: (1) to meet the initial and expanding costs of such agencies; and (2) for programs for the training of professional and paraprofessional personnel to provide home health services. Authorizes the appropriation of such sums as may be necessary to carry out this Act.
Bill· HRH.R. 14137 (93rd)referred
United States · United States Congress · 10 April 1974
National Huntington's Disease Control Act - States that it is the purpose of this Act to establish a national program for the diagnosis, prevention, and treatment of, and research in, Huntington's disease. Authorizes the Secretary of Health, Education, and Welfare to make grants for projects for the establishment and operation of Huntington's disease screening, treatment, and counseling programs. Authorizes the appropriation of $500,000 for the fiscal year ending June 30, 1975, and for each each of the next two fiscal years for such grants. Authorizes the Secretary to make grants for research in the diagnosis, treatment, and prevention of Huntington's disease. Authorizes the appropriation of $1,500,000 for the fiscal year ending June 30, 1975 and for each of the next two fiscal years for use for such grants. Directs the Secretary to carry out a program to develop information and educational materials relating to Huntington's disease and to disseminate such information and materials to persons providing health care and to the public in general. Authorizes the appropriation of $25,000 for the fiscal year ending June 30, 1975, and for each of the next two fiscal years to carry out this information program. Sets forth the requirements for applications for grants under this Act and the administration of such grants. Directs the Secretary to establish a program within the Public Health Service to provide for voluntary Huntington's disease screening, counseling, and treatment.
Bill· HRH.R. 14164 (93rd)referred
United States · United States Congress · 10 April 1974
Health Policy and Health Resources Development Act - Expresses the findings of Congress with regard to facilitating the development of recommendations for a national health policy and planning for health services, manpower, and facilities. Establishes, under the Public Health Service Act, the National Council for Health Policy, in the Department of Health, Education, and Welfare. Specifies the composition and terms of office of Council members. Enumerates the functions of the Council, including: (1) to develop a national health policy with national goals and priorities; (2) to conduct studies in specified health areas; and (3) to evaluate the implications of developing medical technology for the health care delivery system. Enumerates the priorities of the national health policy. Directs the Council to convene a National Health Conference to assist in performing its functions. Requires the Secretary to announce the initiation of proceedings to designate geographical regions, to be known as health service areas, to be served by health systems agencies. Outlines the characteristics of a health service area and the procedures for reviewing the boundaries of such areas. Describes the term "health systems agency," including the legal, staff and governing body structure requirements. Enumerates the functions of health systems agencies, including to analyze data, to establish a health system plan, and to establish an annual implementation plan. Sets forth the requirements to be met in implementing such plans. Prescribes the procedures and criteria for reviews of proposed health system changes. Provides for the designation of health systems agencies. Directs the Secretary to provide technical assistance to agencies. Details the form and content of such assistance. Empowers the Secretary to make grants to health systems agencies for carrying out their activities. Sets limits on the amounts of such grants. Authorizes to be appropriated $60,000,000 for fiscal year 1975 and $100,000,000 for fiscal year 1976 for such grants. Provides for the making of development grants for area health services development funds. Authorizes appropriations of $100,000,000 for fiscal year 1975 and $125,000,000 for fiscal year 1976 for such purposes. Requires the Secretary to review and approve the annual budget of each health systems agency with which there is in effect a designation agreement. Specifies the extent and subject matter of such reviews. Provides that, to be eligible for specified grants, the Governor of a State shall designate or establish a single State agency for administering the State's health planning functions. Specifies the requirements to be met by State administrative programs for approval. Enumerates the functions to be performed by each State health planning agency. States that a State health planning agency must be advised by a Statewide Health Coordinating Council. Sets forth the criteria for composition and duties of such Councils. Empowers the Secretary to make grants to the States for the development and operation of State Health Planning Agencies. Authorizes appropriations for such purposes.
Bill· HRH.R. 14121 (93rd)referred
United States · United States Congress · 10 April 1974
Home Health Services Act - Provides, under the Public Health Service Act, for the establishment and initial operation of public and nonprofit private agencies which will provide home health services in areas in which such services are not otherwise available. Authorizes the Secretary of Health, Education, and Welfare to make grants: (1) to meet the initial and expanding costs of such agencies; and (2) for programs for the training of professional and paraprofessional personnel to provide home health services. Authorizes the appropriation of such sums as may be necessary to carry out this Act.
Bill· HRH.R. 14143 (93rd)referred
United States · United States Congress · 10 April 1974
Authorizes the additional appropriation of $20,000,000 for the fiscal year ending June 30, 1974, for the Department of Health, Education, and Welfare for research on the cause and treatment of diabetes under the Public Health Service Act.
Bill· HRH.R. 14144 (93rd)referred
United States · United States Congress · 10 April 1974
Authorizes the additional appropriation of $20,000,000 for the fiscal year ending June 30, 1974, for the Department of Health, Education, and Welfare for research on the cause and treatment of diabetes under the Public Health Service Act.
Bill· HRH.R. 14120 (93rd)referred
United States · United States Congress · 10 April 1974
Home Health Services Act - Provides, under the Public Health Service Act, for the establishment and initial operation of public and nonprofit private agencies which will provide home health services in areas in which such services are not otherwise available. Authorizes the Secretary of Health, Education, and Welfare to make grants: (1) to meet the initial and expanding costs of such agencies; and (2) for programs for the training of professional and paraprofessional personnel to provide home health services. Authorizes the appropriation of such sums as may be necessary to carry out this Act.
Bill· HRH.R. 14097 (93rd)referred
United States · United States Congress · 9 April 1974
Comprehensive National Health Insurance Act - Title I: National Health Insurance Program - Provides that this Act shall not interfere with the freedom of every physician and every patient to choose where and how they will give or receive health care. States that the national health insurance program established by this title shall be administered by the Board of the Social Security Administration established by this Act. Provides the following benefits under the National Health Insurance Program: (1) inpatient hospital services with no day or dollar limitation; (2) physicians' services, in home, office, or elsewhere, with no dollar limitation; (3) medical and other health services (as defined under medicare); (4) home health services-100 visits per year; (5) post-hospital extended care services-100 days per year; (6) mental health services-inpatient, 30 full days in a psychiatric hospital or 60 partial days; outpatient services in a comprehensive community care center equivalent to the costs of 30 visits to a private practitioner or outpatient services of a private practitioner equal to half the costs of 30 visits; (7) outpatient prescription drugs and biologicals for specified chronic conditions; (8) preventive care services, including (a) routine dental services for children under age 13; (b) developmental vision care services, routine eye and vision exams, and lenses or eyeglasses for children under age 13; (c) hearing aids and exams for children under age 13; (d) well-child care to age 6; (e) prenatal care; and (f) family planning services. Makes all services, except those listed under preventive care subject to a combined annual per person deductible of $150 except that no family would have to meet more than 2 deductibles. States that all services, except drugs, would be subject to a 25-percent coinsurance. Provides that out-patient drugs would be subject to a separate copayment of $1 per prescription drug. Makes all residents who are not eligible for Medicare eligible for the program through their contributions to the Social Security System, contributions being made by all Americans who have earned or unearned income of any kind, including governmental benefits. Makes each person who is fully or currently insured, as defined under the present social security law, and his dependents eligible. Provides immediate coverage under the plan for the individuals who are not fully or currently insured. Provides that coverage be extended to an employee during the first week during which he worked 25 hours or more, coverage not ending until after there were three consecutive weeks in each of which he did not work 25 hours or more. Provides that people beginning self-employment, or starting to receive unearned income, would be eligible beginning with the first day of the first year in which they have such income. Makes all social security and railroad retirement cash beneficiaries (including widows and widowers under age 65) who are not eligible for coverage under Medicare, eligible for the program. Directs the Social Security Administration to establish for each eligible individual an account against which such individual may charge the cost of obtaining any items and services furnished him under this title, without regard to any deductible or coinsurance requirement which may be applicable. Requires that payment for items and services furnished an eligible individual be made by the Social Security Administration to the providers of services on the basis of charges against such individual's account. States that the Administration shall have full responsibility for the collection of any deductible and coinsurance amounts due from an individual. Provides for a special waiver of or limitation on deductibles and coinsurance for lower income families. Enumerates the conditions of and limitations on payment for the following: (1) requirement of requests and certifications, (2) no payments to Federal providers of services, (3) payment for emergency hospital services, (4) payment for inpatient hospital services prior to notification of noneligibility, (5) payment for posthospital extended care services, (6) payment for home health services, (7) limitation on payment for outpatient drugs and biologicals, (8) limitations on payment for surgery and other specialized services, (9) limitation on payment for practitioner services furnished in nonparticipating hospitals, (10) limitation on payment for certain prosthetic devices, (11) payment for certain outpatient services furnished by nonparticipating hospitals, and (12) collection by hospitals of customary charges for certain outpatient services. Makes provisions for payment to the providers of services and for prospective determination of payment to providers of services. Directs the Administration to award on an annual basis quality management payments to any provider of services under this title whenever either the percentage amount or the dollar amount of increase in such provider's prospective rate for a fiscal year is less than the average annual increase in such rate for the three previous fiscal years for all providers in the same class, such payment to be equal to 50 percent of the difference between such provider's total costs to the program and what its costs to the program would have been had they increased at the class average rate. Lists the agreements a provider of services must file with the Administration in order to qualify to participate and to be eligible for payments under this title. Authorizes the Administration to use public agencies or private organizations to facilitate payment to providers of services. Authorizes the Administation to use carriers, as defined in this Act, for the administration of noninstitutional benefits. Requires that payment for services rendered by a physician be made in accordance with a single fee schedule applicable throughout that area. Provides a method to determine the fee schedule. Allows all physicians to elect whether to participate or not to participate. States that each fee schedule in effect and the names and addresses of all participating physicians shall be made available to the public throughout the State involved, in such manner and at such times as the Administration may consider appropriate, by the Administration or by the appropriate State agency with the approval of the Administration. Establishes, within the Social Security Administration, a National Health Insurance Formulary Committee, a majority of whose members shall be physicians and which shall consist of the Commissioner of Food and Drugs and of four individuals (not otherwise in the employ of the Federal Government) who do not have a direct or indirect financial interest in the compensation of the Formularly established under this Act and who are of recognized professional standing and distinction in the fields of medicine, pharmacology, or pharmacy, to be appointed by the Administration without regard to the statutory provisions governing appointments in the competitive service. Provides that the Chairman of the Committee shall be elected annually from the appointed members, by majority vote of the members of the Committee. Requires the Formulary to compile, publish, and make available a National Health Insurance Formulary, containing an alphabetically arranged listing, by established name, of those drug entities within specified therapeutic categories which the Committee decides are necessary for individuals using such drugs. States that a fee, charge, or billing allowance shall not be payable under this title with respect to any drug entity that is furnished as an incident to a physician's professional service, and is of a kind commonly furnished in physicians' offices and commonly either rendered without charge or included in the physicians' bills. Provides a reasonable allowance for outpatient drugs and biologicals. Makes special provisions for physicians dispensing outpatient drugs and biologicals where the Administration determines that no participating licensed pharmacies exist in a community. Creates on the books of the Treasury of the United States a trust fund to be known as the National Health Insurance Trust Fund and a body to be known as the Board of Trustees of the Trust Fund, composed of the Secretary of the Treasury, the Secretary of Labor, the Chairman of the Board of the Social Security Administration, and the Secretary of Health, Education, and Welfare. Directs the Administration to consult with State agencies and other organizations to develop conditions of participation for providers of services. Provides for the use of State agencies to determine compliance by providers of services with the conditions of participation. States that the determination of whether an individual is entitled to benefits under this title, and the determination of the amount of such benefits, shall be made by the Administration in accordance with regulations prescribed by it. Provides that where overpayments on behalf of individuals occur, proper adjustment shall be made under regulations prescribed by the Administration, by decreasing subsequent payments. Provides for the settlement of claims for benefits on behalf of deceased individuals. Provides criminal penalties for violation of this Act. Creates a National Health Insurance Benefits Advisory Council consisting of 19 persons, not otherwise in the employ of the United States, appointed by the Board without regard to statutory provisions governing appointments in the competitive service. Lists criteria for serving on the Council. Declares that it shall be the function of the Advisory Council to provide advice and recommendations for the consideration of the Administration on matters of general policy with respect to this title. Imposes the following taxes for each taxable year for health insurance purposes: two and one half percent of the amount of an individual's self-employment income (and unearned income); on the income of every individual, one percent of the person's wages; and on every employer, an excise tax equal to three percent of the wages paid by him with respect to employment. Provides special coverage provisions, under the Social Security Act, for purposes of National Health Insurance Taxes. Title II: Changes in Medicare Program - Establishes, under title XVIII of the Social Security Act (Medicare), a voluntary program to provide long-term care benefits for aged and disabled individuals who elect to enroll under such program, financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government and contributions by the States. Lists criteria for eligibility for long-term care service benefits. Provides that the benefits provided to an individual by the program established by this Act shall consist of (1) home health services, (2) homemaker services, (3) nutrition services, (4) long-term institutional care services, (5) day care and foster home services, and (6) community mental health center outpatient services. Enumerates the requirements for a State long-term care agency. Provides for the payment of premiums for benefits received under this Act. Establishes on the books of the Treasury of the United States a trund fund to be known as the Federal Long-Term Care Trust Fund. Creates a body to known as the Board of Trustees, composed of the Secretary of the Treasury, the Secretary of Labor, the Chariman of the Board of the Social Security Administration, and the Secretary of Health, Education, and Welfare. States that the Secretary of the Treasury shall be the Managing Trustee of the Board of Trustees and that the Executive Director of the Social Security Administration shall serve as the Secretary of the Board of Trustees. Provides that the Board of Trustees shall meet not less frequently than once each calendar year. Enumerates the duties of the Board of Trustees. Declares that a community long-term care center shall: (1) provide the items and services listed in this Act to each individual (i) who is eligible for benefits under this part, (ii) who resides in the area served by such center, and (iii) who is certified as requiring such services; (2) evaluate and certify the long-term care needs of an individual for whom such care may be required in order to maintain such individual in an independent living arrangement which is reasonable given such individual's state of health and other circumstances (but not including such individual's economic circumstances); (3) maintain a continuous relationship with (and periodically evaluate not less that annually) each individual who is receiving any of the items and services listed in this Act; (4) provide full opportunity for such individual and his family to participate in the determinations and functions under this Act; (5) provide an organized system for making its existence and location known to all individuals in its service area who are eligible for benefits under this part, and for making known to such individuals the method or methods by which they may most efficiently obtain and use the services which it makes available; and (6) performs such other functions as the Administration may by regulation prescribe in order to have such center most effective carry out the purposes of this Act. Provides a formula for payments to States for the reimbursement of community long-term care centers. Directs the Administration, after consultation with organizations representing the chief executives of the various States, and other interested parties, to develop and make available to community long-term care centers one or more methods of obtaining payment for the benefits covered under this Act on a prospective basis. States that once a community long-term care center elects a particular prospective method, it may not alter its election without the prior approval of the Administration. Provides that whenever the Administration finds that the number of community long-term care centers electing a particular prospective payment method promulgated in accordance with this Act is not sufficient to provide an adequate basis for either the operation or evaluation of that method, the Administration shall withdraw that method and allow the community long-term care centers which have elected such method to select another method within 30 days of notice of such withdrawal. Permits a Governor of a State to certify to the Administration a method of prospective payment other than those promulgated under this Act. States that the determination of whether an individual is entitled to benefits under this Act shall be made by the Administration in accordance with regulations it prescribes. Provides coverage for prescription drugs. Declares that no further deductible or coinsurance requirement shall be imposed under this Act with respect to items or services furnished to or for any individual in any calendar year after the total of the deductibles and coinsurance paid by or on behalf of such individual and the other members of his family in that year equals $1,000. Eliminates the posthospital requirement for home health services under Medicare and the durational limits on inpatient hospital services. Title III: Independent Social Security Administration - Establishes, as an independent agency of the executive branch of the Government, a Social Security Administration to be headed by a Board, consisting of three members appointed by the President, by and with the advice and consent of the Senate. Declares that it shall be the duty of the Administration to administer specified programs of the Social Security Act, and to discharge the duties and responsibilities imposed on the Secretary of Health, Education, and Welfare in connection with the administration of the program established by the Federal Coal Mine Health and Safety Act of 1969. Abolishes the position of Commissioner of Social Security. Title IV: Amendment to Public Health Service Act - Establishes in the Department of Health, Education, and Welfare the Health Resources Development Board which shall be composed of three members to be appointed by the President, by and with the advice and consent of the Senate. Provides for an Executive Director and for the recruitment of qualified persons experienced in the administration or operation of private health insurance and health prepayment plans, or experienced in other fields pertinent to the national health insurance program. Requires the Board to make an annual report to the Committee on Interstate and Foreign Commerce of the United States House of Representatives and to the Committee on Labor and Public Welfare of the United States Senate. Enumerates the functions of the Board including: studies and evaluations, systems development, tests and demonstrations, research, and planning. Establishes a National Health Insurance Resources Advisory Council, consisting of the Chairman of the Board, the Chairman of the Social Security Board, and twenty members, not otherwise in the employ of the United States, appointed by the Secretary on recommendation of the Board, without regard to the statutory provisions governing appointments in the competitive service. Provides criteria for membership on the Council. Enumerates the functions of the Council. Authorizes to be appropriated to carry out this title: $400,000,000 for the fiscal year ending June 30, 1975, and $600,000,000 for the fiscal year ending June 30, 1976. Title V: Miscellaneous Provisions - Provides for the Administration's certfication of supplemental private health insurance policies. Sets standards with respect to supplemental health insurance policies. Leaves existing employer-employee health benefit plans unaffected. Provides regulations for planning by health care providers and the conditions for payment.
Bill· HRH.R. 14070 (93rd)referred
United States · United States Congress · 9 April 1974
Hemophilia Act - Provides that any individual suffering from hemophilia may file a claim for benefits under this Act with the Secretary of Health, Education, and Welfare in such form and containing such information as he may reasonably require. States that benefits under this Act shall be paid to, or on behalf of a claimant, in an amount equal to 100 percent of the actual cost of providing blood, blood products, and services associated with the treatment of hemophilia, less: (1) amounts payable by third parties (including governmental agencies), and (2) amounts determined by the Secretary (in accordance with this Act) to be payable by the individual suffering from hemophilia. Authorizes to be appropriated for the fiscal years beginning July 1, 1973, and ending June 30, 1976, such sums as may be necessary to carry out the purpose of this Act. Directs the Secretary to provide for the establishment of no less than fifteen new centers for the diagnosis and treatment of individuals suffering from hempophilia. Authorizes to be appropriated to carry out the purposes of this section $5,000,000 for the fiscal year ending June 30, 1974, $10,000,000 for the fiscal year ending June 30, 1975, and $15,000,000 for the fiscal year year ending June 30, 1976. Provides that the Secretary shall establish a program within the Public Health Service to provide for diagnosis, treatment, and counseling of individuals suffering from hemophilia. States that such program shall be made available through the facilities of the Public Health Service to any individual requesting diagnosis, treatment, or counseling for hemophilia. Permits the Secretary to make grants to public and nonprofit private entities, and to enter into contracts with public and private entities and individuals to establish blood fractionation centers, for the purpose of fractionating and making available for distribution blood and blood products, in accordance with regulations prescribed by the Secretary to hemophilia treatment and diagnostic centers. Authorizes to be appropriated $5,000,000 for the fiscal year ending June 30, 1974, $10,000,000 for the fiscal year ending June 30, 1975, and $15,000,000 for the fiscal year ending June 30, 1976 for this purpose. Establishes in the National Institutes of Health a National Hemophilia Advisory Board to be composed of twenty members. States that it shall be the function of the Board to: (1) establish guidelines for the diagnosis and treatment of persons suffering from hemophilia; and (2) submit a report to the President for transmittal to the Congress not later than January 31 of each year on the scope of actions conducted under this Act.
Bill· HRH.R. 14062 (93rd)referred
United States · United States Congress · 9 April 1974
National Huntington's Disease Control Act - States that it is the purpose of this Act to establish a national program for the diagnosis, prevention, and treatment of, and research in, Huntington's disease. Authorizes the Secretary of Health, Education, and Welfare to make grants for projects for the establishment and operation of Huntington's disease screening, treatment, and counseling programs. Authorizes the appropriation of $500,000 for the fiscal year ending June 30, 1975, and for each each of the next two fiscal years for such grants. Authorizes the Secretary to make grants for research in the diagnosis, treatment, and prevention of Huntington's disease. Authorizes the appropriation of $1,500,000 for the fiscal year ending June 30, 1975 and for each of the next two fiscal years for use for such grants. Directs the Secretary to carry out a program to develop information and educational materials relating to Huntington's disease and to disseminate such information and materials to persons providing health care and to the public in general. Authorizes the appropriation of $25,000 for the fiscal year ending June 30, 1975, and for each of the next two fiscal years to carry out this information program. Sets forth the requirements for applications for grants under this Act and the administration of such grants. Directs the Secretary to establish a program within the Public Health Service to provide for voluntary Huntington's disease screening, counseling, and treatment.
Bill· HRH.R. 14095 (93rd)referred
United States · United States Congress · 9 April 1974
National Hospital Act - States that the purpose of this Act is to establish a sound and viable national hospital system. Defines the terms used in this Act. Establishes the National Hospital Administration, as an independent establishment of the executive branch of the Government of the United States, which shall have a nine-member Board of Directors. Sets forth the method of, and criteria for, appointment to the Board. Authorizes the Board to conduct an investigation into the hospital care needs of people in the United States and the hospital care needs that are met, or could be met, by existing hospital facilities within the United States. Directs the Board to divide the United States into geographic areas which shall be designated for purposes of this Act as health service areas. Authorizes the Board to enter into an agreement to pay the operating cost of any hospital in a health service area that can provide in one or more categories of care the level of hospital care determined to be necessary by the Board. Enumerates elements to be contained in any such agreement. Directs the Administrator of the National Hospital Administration to survey projected long-term national hospital needs and develop a ten-year program for the construction, modernization, and consolidation of hospitals to meet such projected needs which shall be submitted to the Board for its approval. Directs the Administrator to carry out the program with the approval of the Board. Authorizes the Administrator to enter into such agreements as he deems necessary to carry out the ten-year program. Sets forth the required content of such agreements. Authorizes the Board to establish within the Administration a Hospital Health Service Corps, the function of which shall be to stimulate volunteer work in hospitals. Establishes within the Administration the National Hospital Advisory Council and the National Hospital Services Council. Sets forth the membership composition of each Council and requires the Councils to report to the Board any recommendations for the improvement of hospital facilities and services. Establishes within the Administration an Office of Patient Advocate which shall be headed by the Patient Advocate. Requires the Patient Advocate to investigate any complaint submitted by a patient as to the quality of service received at a participating hospital and to submit his findings and recommendations with respect to each complaint to the Board. Authorizes the appropriation of $50,000,000 per year for each of the three fiscal years beginning on or after the date of enactment of this Act to carry out the purposes of this Act.
Bill· HRH.R. 14096 (93rd)referred
United States · United States Congress · 9 April 1974
Comprehensive National Health Insurance Act - Title I: National Health Insurance Program - Provides that this Act shall not interfere with the freedom of every physician and every patient to choose where and how they will give or receive health care. States that the national health insurance program established by this title shall be administered by the Board of the Social Security Administration established by this Act. Provides the following benefits under the National Health Insurance Program: (1) inpatient hospital services with no day or dollar limitation; (2) physicians' services, in home, office, or elsewhere, with no dollar limitation; (3) medical and other health services (as defined under medicare); (4) home health services-100 visits per year; (5) post-hospital extended care services-100 days per year; (6) mental health services-inpatient, 30 full days in a psychiatric hospital or 60 partial days; outpatient services in a comprehensive community care center equivalent to the costs of 30 visits to a private practitioner or outpatient services of a private practitioner equal to half the costs of 30 visits; (7) outpatient prescription drugs and biologicals for specified chronic conditions; (8) preventive care services, including (a) routine dental services for children under age 13; (b) developmental vision care services, routine eye and vision exams, and lenses or eyeglasses for children under age 13; (c) hearing aids and exams for children under age 13; (d) well-child care to age 6; (e) prenatal care; and (f) family planning services. Makes all services, except those listed under preventive care subject to a combined annual per person deductible of $150 except that no family would have to meet more than 2 deductibles. States that all services, except drugs, would be subject to a 25-percent coinsurance. Provides that out-patient drugs would be subject to a separate copayment of $1 per prescription drug. Makes all residents who are not eligible for Medicare eligible for the program through their contributions to the Social Security System, contributions being made by all Americans who have earned or unearned income of any kind, including governmental benefits. Makes each person who is fully or currently insured, as defined under the present social security law, and his dependents eligible. Provides immediate coverage under the plan for the individuals who are not fully or currently insured. Provides that coverage be extended to an employee during the first week during which he worked 25 hours or more, coverage not ending until after there were three consecutive weeks in each of which he did not work 25 hours or more. Provides that people beginning self-employment, or starting to receive unearned income, would be eligible beginning with the first day of the first year in which they have such income. Makes all social security and railroad retirement cash beneficiaries (including widows and widowers under age 65) who are not eligible for coverage under Medicare, eligible for the program. Directs the Social Security Administration to establish for each eligible individual an account against which such individual may charge the cost of obtaining any items and services furnished him under this title, without regard to any deductible or coinsurance requirement which may be applicable. Requires that payment for items and services furnished an eligible individual be made by the Social Security Administration to the providers of services on the basis of charges against such individual's account. States that the Administration shall have full responsibility for the collection of any deductible and coinsurance amounts due from an individual. Provides for a special waiver of or limitation on deductibles and coinsurance for lower income families. Enumerates the conditions of and limitations on payment for the following: (1) requirement of requests and certifications, (2) no payments to Federal providers of services, (3) payment for emergency hospital services, (4) payment for inpatient hospital services prior to notification of noneligibility, (5) payment for posthospital extended care services, (6) payment for home health services, (7) limitation on payment for outpatient drugs and biologicals, (8) limitations on payment for surgery and other specialized services, (9) limitation on payment for practitioner services furnished in nonparticipating hospitals, (10) limitation on payment for certain prosthetic devices, (11) payment for certain outpatient services furnished by nonparticipating hospitals, and (12) collection by hospitals of customary charges for certain outpatient services. Makes provisions for payment to the providers of services and for prospective determination of payment to providers of services. Directs the Administration to award on an annual basis quality management payments to any provider of services under this title whenever either the percentage amount or the dollar amount of increase in such provider's prospective rate for a fiscal year is less than the average annual increase in such rate for the three previous fiscal years for all providers in the same class, such payment to be equal to 50 percent of the difference between such provider's total costs to the program and what its costs to the program would have been had they increased at the class average rate. Lists the agreements a provider of services must file with the Administration in order to qualify to participate and to be eligible for payments under this title. Authorizes the Administration to use public agencies or private organizations to facilitate payment to providers of services. Authorizes the Administation to use carriers, as defined in this Act, for the administration of noninstitutional benefits. Requires that payment for services rendered by a physician be made in accordance with a single fee schedule applicable throughout that area. Provides a method to determine the fee schedule. Allows all physicians to elect whether to participate or not to participate. States that each fee schedule in effect and the names and addresses of all participating physicians shall be made available to the public throughout the State involved, in such manner and at such times as the Administration may consider appropriate, by the Administration or by the appropriate State agency with the approval of the Administration. Establishes, within the Social Security Administration, a National Health Insurance Formulary Committee, a majority of whose members shall be physicians and which shall consist of the Commissioner of Food and Drugs and of four individuals (not otherwise in the employ of the Federal Government) who do not have a direct or indirect financial interest in the compensation of the Formularly established under this Act and who are of recognized professional standing and distinction in the fields of medicine, pharmacology, or pharmacy, to be appointed by the Administration without regard to the statutory provisions governing appointments in the competitive service. Provides that the Chairman of the Committee shall be elected annually from the appointed members, by majority vote of the members of the Committee. Requires the Formulary to compile, publish, and make available a National Health Insurance Formulary, containing an alphabetically arranged listing, by established name, of those drug entities within specified therapeutic categories which the Committee decides are necessary for individuals using such drugs. States that a fee, charge, or billing allowance shall not be payable under this title with respect to any drug entity that is furnished as an incident to a physician's professional service, and is of a kind commonly furnished in physicians' offices and commonly either rendered without charge or included in the physicians' bills. Provides a reasonable allowance for outpatient drugs and biologicals. Makes special provisions for physicians dispensing outpatient drugs and biologicals where the Administration determines that no participating licensed pharmacies exist in a community. Creates on the books of the Treasury of the United States a trust fund to be known as the National Health Insurance Trust Fund and a body to be known as the Board of Trustees of the Trust Fund, composed of the Secretary of the Treasury, the Secretary of Labor, the Chairman of the Board of the Social Security Administration, and the Secretary of Health, Education, and Welfare. Directs the Administration to consult with State agencies and other organizations to develop conditions of participation for providers of services. Provides for the use of State agencies to determine compliance by providers of services with the conditions of participation. States that the determination of whether an individual is entitled to benefits under this title, and the determination of the amount of such benefits, shall be made by the Administration in accordance with regulations prescribed by it. Provides that where overpayments on behalf of individuals occur, proper adjustment shall be made under regulations prescribed by the Administration, by decreasing subsequent payments. Provides for the settlement of claims for benefits on behalf of deceased individuals. Provides criminal penalties for violation of this Act. Creates a National Health Insurance Benefits Advisory Council consisting of 19 persons, not otherwise in the employ of the United States, appointed by the Board without regard to statutory provisions governing appointments in the competitive service. Lists criteria for serving on the Council. Declares that it shall be the function of the Advisory Council to provide advice and recommendations for the consideration of the Administration on matters of general policy with respect to this title. Imposes the following taxes for each taxable year for health insurance purposes: two and one half percent of the amount of an individual's self-employment income (and unearned income); on the income of every individual, one percent of the person's wages; and on every employer, an excise tax equal to three percent of the wages paid by him with respect to employment. Provides special coverage provisions, under the Social Security Act, for purposes of National Health Insurance Taxes. Title II: Changes in Medicare Program - Establishes, under title XVIII of the Social Security Act (Medicare), a voluntary program to provide long-term care benefits for aged and disabled individuals who elect to enroll under such program, financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government and contributions by the States. Lists criteria for eligibility for long-term care service benefits. Provides that the benefits provided to an individual by the program established by this Act shall consist of (1) home health services, (2) homemaker services, (3) nutrition services, (4) long-term institutional care services, (5) day care and foster home services, and (6) community mental health center outpatient services. Enumerates the requirements for a State long-term care agency. Provides for the payment of premiums for benefits received under this Act. Establishes on the books of the Treasury of the United States a trund fund to be known as the Federal Long-Term Care Trust Fund. Creates a body to known as the Board of Trustees, composed of the Secretary of the Treasury, the Secretary of Labor, the Chariman of the Board of the Social Security Administration, and the Secretary of Health, Education, and Welfare. States that the Secretary of the Treasury shall be the Managing Trustee of the Board of Trustees and that the Executive Director of the Social Security Administration shall serve as the Secretary of the Board of Trustees. Provides that the Board of Trustees shall meet not less frequently than once each calendar year. Enumerates the duties of the Board of Trustees. Declares that a community long-term care center shall: (1) provide the items and services listed in this Act to each individual (i) who is eligible for benefits under this part, (ii) who resides in the area served by such center, and (iii) who is certified as requiring such services; (2) evaluate and certify the long-term care needs of an individual for whom such care may be required in order to maintain such individual in an independent living arrangement which is reasonable given such individual's state of health and other circumstances (but not including such individual's economic circumstances); (3) maintain a continuous relationship with (and periodically evaluate not less that annually) each individual who is receiving any of the items and services listed in this Act; (4) provide full opportunity for such individual and his family to participate in the determinations and functions under this Act; (5) provide an organized system for making its existence and location known to all individuals in its service area who are eligible for benefits under this part, and for making known to such individuals the method or methods by which they may most efficiently obtain and use the services which it makes available; and (6) performs such other functions as the Administration may by regulation prescribe in order to have such center most effective carry out the purposes of this Act. Provides a formula for payments to States for the reimbursement of community long-term care centers. Directs the Administration, after consultation with organizations representing the chief executives of the various States, and other interested parties, to develop and make available to community long-term care centers one or more methods of obtaining payment for the benefits covered under this Act on a prospective basis. States that once a community long-term care center elects a particular prospective method, it may not alter its election without the prior approval of the Administration. Provides that whenever the Administration finds that the number of community long-term care centers electing a particular prospective payment method promulgated in accordance with this Act is not sufficient to provide an adequate basis for either the operation or evaluation of that method, the Administration shall withdraw that method and allow the community long-term care centers which have elected such method to select another method within 30 days of notice of such withdrawal. Permits a Governor of a State to certify to the Administration a method of prospective payment other than those promulgated under this Act. States that the determination of whether an individual is entitled to benefits under this Act shall be made by the Administration in accordance with regulations it prescribes. Provides coverage for prescription drugs. Declares that no further deductible or coinsurance requirement shall be imposed under this Act with respect to items or services furnished to or for any individual in any calendar year after the total of the deductibles and coinsurance paid by or on behalf of such individual and the other members of his family in that year equals $1,000. Eliminates the posthospital requirement for home health services under Medicare and the durational limits on inpatient hospital services. Title III: Independent Social Security Administration - Establishes, as an independent agency of the executive branch of the Government, a Social Security Administration to be headed by a Board, consisting of three members appointed by the President, by and with the advice and consent of the Senate. Declares that it shall be the duty of the Administration to administer specified programs of the Social Security Act, and to discharge the duties and responsibilities imposed on the Secretary of Health, Education, and Welfare in connection with the administration of the program established by the Federal Coal Mine Health and Safety Act of 1969. Abolishes the position of Commissioner of Social Security. Title IV: Amendment to Public Health Service Act - Establishes in the Department of Health, Education, and Welfare the Health Resources Development Board which shall be composed of three members to be appointed by the President, by and with the advice and consent of the Senate. Provides for an Executive Director and for the recruitment of qualified persons experienced in the administration or operation of private health insurance and health prepayment plans, or experienced in other fields pertinent to the national health insurance program. Requires the Board to make an annual report to the Committee on Interstate and Foreign Commerce of the United States House of Representatives and to the Committee on Labor and Public Welfare of the United States Senate. Enumerates the functions of the Board including: studies and evaluations, systems development, tests and demonstrations, research, and planning. Establishes a National Health Insurance Resources Advisory Council, consisting of the Chairman of the Board, the Chairman of the Social Security Board, and twenty members, not otherwise in the employ of the United States, appointed by the Secretary on recommendation of the Board, without regard to the statutory provisions governing appointments in the competitive service. Provides criteria for membership on the Council. Enumerates the functions of the Council. Authorizes to be appropriated to carry out this title: $400,000,000 for the fiscal year ending June 30, 1975, and $600,000,000 for the fiscal year ending June 30, 1976. Title V: Miscellaneous Provisions - Provides for the Administration's certfication of supplemental private health insurance policies. Sets standards with respect to supplemental health insurance policies. Leaves existing employer-employee health benefit plans unaffected. Provides regulations for planning by health care providers and the conditions for payment.
Bill· HRH.R. 14079 (93rd)referred
United States · United States Congress · 9 April 1974
Catastrophic Health Insurance and Medical Assistance Reform Act - Title I: Catastrophic Illness Insurance - Establishes a Catastrophic Health Insurance Program under the Social Security Act. Sets forth the eligibility criteria for individuals. Provides that every individual who: (A) is fully insured or otherwise entitled to monthly insurance benefits under title II of such Act; (B) is the wife, husband, widow, or widower, or dependent child of an individual who is fully insured or otherwise entitled to monthly insurance beneifts; and (C) has appropriately applied therefor, shall be entitled to catastrophic health insurance benefits. Delimits the scope of benefits. Includes therein hospital insurance benefits (hospital, post-hospital, home health, outpatient physical therapy and medical and other health services) and medical insurance benefits (medical and other health services and emergency hospital services). Sets forth the terms and conditions for payment, deductibles and coinsurance. Directs that a payment shall be made from the Federal Catastrophic Health Insurance Trust Fund to an eligible individual equal to the reasonable cost of services covered by this Act which are furnished after the 60th day of inpatient hospital services, reduced by a coinsurance amount equal to one-fourth of the inpatient hospital deductible as determined by title XVIII of the Social Security Act (Medicare). Enumerates such reductions as they apply to other types of hospital insurance benefits. Provides for a general deductible from: (a) the reasonable costs of inpatient hospital services past the 60th day; and (b) inpatient hospital benefits of the higher of the following: (1) $2,000, or (2) $2,000 adjusted by the Consumer Price Index to reflect changes in fees for physician services (in $50 increments). Provides for States' agreements for coverage of annuitants and members of retirement systems and their dependents and survivors in order to extend the benefits of this Act to such individuals. Creates, in the United States Treasury, a "Federal Catastrophic Health Insurance Trust Fund" to provide a reserve for payment of benefits authorized by this Act. Imposes a tax for catastrophic health insurance protection, under the Internal Revenue Code of 1954, on the self-employment income of every individual and other individuals income in the following amounts for the calendar years indicated: (a) 0.30 percent of income for 1975 and 1976; (b) 0.35 percent of income for 1977 through 1981; and (c) 0.40 percent of income for each year thereafter. Imposes, similarly, an excise tax on employers on the amount of wages paid by the employer in the same percentages for the respective years indicated above. Title II: Medical Assistance Plan for Low-Income People - Provides, for low-income individuals and families, assistance toward the costs of necessary hospital, skilled nursing facility, medical, and other health care services. Guarantees free choice by patients of health services from any person, institution, or agency qualified under this Act. Permits individuals the option of obtaining other health insurance protection. Describes the medical assistance plan, what individuals are eligible to receive its health benefits, and the application procedure. Enumerates the scope of benefits under the plan, including: (1) 60 days of inpatient hospital services; (2) skilled nursing facility services; and (3) home health services. Prescribes the co-payment requirements and procedures of persons eligible for benefits. Makes special provisions relating to Medicaid eligibility and the circumstances under which such persons are eligible for health benefits under this title. Authorizes the Secretary to require consolidation of facilities of carriers and intermediaries in geographic regions with minimum size populations of persons covered under this title. Creates the Medical Coverage Trust Fund to consist of gifts and bequests and held by a Board of Trustees. Makes provisions for State contributions to the Fund. Sets forth the definitions of terms used in this title, including the meaning of "income," "health care expenses" and "inpatient hospital services". Prohibits exclusion by employers of specified employees from coverage under group health insurance plans. Title III: Private Basic Health Insurance Certification Program - States that any insurer may provide any health insurance policy to the Secretary for his examination and certification. Sets forth the standards under which the Secretary shall not certify any such insurance policy.
Bill· HRH.R. 14059 (93rd)referred
United States · United States Congress · 9 April 1974
Home Health Services Act - Provides, under the Public Health Service Act, for the establishment and initial operation of public and nonprofit private agencies which will provide home health services in areas in which such services are not otherwise available. Authorizes the Secretary of Health, Education, and Welfare to make grants: (1) to meet the initial and expanding costs of such agencies; and (2) for programs for the training of professional and paraprofessional personnel to provide home health services. Authorizes the appropriation of such sums as may be necessary to carry out this Act.
Bill· HRH.R. 14017 (93rd)referred
United States · United States Congress · 8 April 1974
National Healthcare Act - Title I: Findings and Declaration of Purpose - Declares the purpose of this Act to be to improve the organization, delivery, and financing of health care for all Americans by increasing health personnel, promoting ambulatory care, strengthening health planning, establishing national standards of health care benefits, including coverage for medical catastrophes, encouraging provisions of such benefits through comprehensive health care insurance, and by assisting persons of low income or in poor health to secure that insurance. Title II: Provisions to Increase the Supply and Improve the Distribution of Health Care Personnel - Allows a medical student to borrow the lesser of the sum of the full cost of tuition, fees, and reasonable amounts for room, board, books, supplies, and other related costs, or $5,000. Authorizes $100 million a year for fiscal years 1975, 1976, and 1977 for this purpose. Grants loans to student nurses covering the lesser of the sum of the full cost of tuition, fees, and reasonable amounts for room, board, books, supplies and other related costs, or $3,500. Authorizes $75 million a year for fiscal years 1975, 1976, and 1977 for this purpose. Provides that scholarship grants may, in accordance with regulations of the Secretary of Health, Education, and Welfare, be awarded, according to the needs of the individual, up to the full cost of his tuition, fees, books, equipment and living expenses. Authorizes for this purpose $50 million a year for fiscal years 1975, 1976, and 1977. Allows loans for students in the allied health professions covering the full cost of tuition fees, and reasonable amounts for room, board, books, supplies, and other related costs. Provides that up to half of the loan may be forgiven at the rate of 20 percent a year for service in a public or nonprofit private institution or agency and that up to 100 percent of the loan may be forgiven at the rate of 33 1/3 percent a year for appropriate service in an area designated as having a substantial shortage of allied health professionals. Authorizes $40 million for fiscal year 1975, $60 million for fiscal year 1976, and $75 million for fiscal year 1977 for this purpose. Includes junior colleges, colleges and universities which offer training in health care center administration or curriculums providing the allied health-professionals needed to operate comprehensive ambulatory health care centers within the training grant provisions of the Public Health Service Act. Establishes a new program of special project grants to help education institutions meet the cost of developing curriculums and training programs to develop the skills needed to administer and staff comprehensive ambulatory health care centers. Authorizes $40 million for fiscal year 1975, and $50 million a year for fiscal years 1976 and 1977 for this purpose. Establishes a program of Federal grants to medical personnel in return for service in urban and rural areas of critical need to alleviate the distribution of health care personnel. Authorizes the Secretary of Health, Education, and Welfare to contract with individual health professionals, nurses, or allied health professionals who agree to provide health care services for a period of at least two years in an area designated by the Secretary as having a critical need for those services. Provides that the amount of the grant is that amount which, when added to the recipient's income from providing health care services for each contract year, provides a total income equal to 110 percent of the national annual median income for persons of comparable education and training, or 110 percent of his earnings from providing health care services in the previous year, whichever is greater. Provides that in determining the precise amount of the grant the Secretary may consider such factors as he deems relevant, including: (1) the national median annual income for the applicant's profession; (2) the cost of living in the area of need; (3) the background, training, and education of the applicant; (4) the amount of income the applicant can reasonably expect to receive from service in the area; (5) the number of persons of applicant's profession needed in the area; and (6) where appropriate, cost of equipment, supplies, and facilities. Title III: Provisions to Encourage Comprehensive Ambulatory Health Care Centers - Provides grants to comprehensive ambulatory health care centers. Sets up a special category of grants to comprehensive ambulatory health care centers. Revises the declaration of purpose of title VI of the Public Health Service Act to recognize specifically the concept of a comprehensive ambulatory health care center. Provides that for fiscal years commencing after June 30, 1973 there is authorized an additional $200 million in grant authority to be used for the construction of comprehensive ambulatory health care facilities. Provides this sum through a new allotment category which is separate from existing allotment categories for construction and modernization of hospitals and other medical facilities. Provides that a portion of the funds available for grants hereunder be used to assist nearly-constructed facilities to pay initial start-up and operation expenses during the first three years of operation of such centers. Directs that funds available for the construction and modernization of comprehensive ambulatory health care centers will be allotted to the several States on the same basis as allotments now made for construction of hospitals and other medical facilities. Provides that transfers from allotments for the construction and modernization of comprehensive ambulatory health care facilities to allotments for the construction of other types of facilities are not authorized. Permits carryovers of unused allotments from one fiscal year to the other. Requires that priorities for awarding grants to comprehensive ambulatory health care centers be given to proposed facilities in densely populated areas now lacking such facilities. Provides that, in its evaluation of the health needs of its citizens, the State health planning agency would be required to determine as part of its planning process the number of comprehensive ambulatory health care centers needed in the State and a plan for distribution of such centers. Requires the adoption of a program providing for construction of those comprehensive ambulatory health care centers identified as needed in its State plan, or for modernizing such existing facilities. Adds comprehensive ambulatory health care centers to the list of types of health facilities from which recovery of Federal funds may be made by the Federal Government from facilities which no longer qualify. Adds comprehensive ambulatory health care centers to the list of types of facilities which qualify for Public Health Service Act loans, guarantees, and interest subsidies for construction or modernization of health facilities. Defines comprehensive ambulatory health care centers to encompass only facilities which provide a wide range of preventive, diagnostic and treatment services for ambulatory patients. Title IV: Provisions to Strengthen Health Care Planning - Provides that the President shall make a health report to the Congress no later than July 1 of each year on the status of the nation's health needs and health care system with a program for meeting those needs. Creates a three-man Council of Health Policy Advisers in the Executive Office of the President, its members appointed by the President with the advice and consent of the Senate. Authorizes the Council to hire officers, employees and such experts and consultants as may be needed. Requires the Council to make an annual health report to the President not later than April 1 of each year to be transmitted to the Congress as a supplement to the next Health Report of the President to the Congress. Provides that in its first report to the President the Council shall specifically review and advise the President on health programs. Requires the Council to develop and recommend goals for a national health policy to promote efficiency, eliminate waste and duplication in the utilization of health facilities and resources, and to recommend specific programs to streamline and consolidate health manpower programs. Directs the Council to consult with the National Advisory Health Council, and other advisory councils or committees as well as such representatives of the private sector as it deems advisable and to utilize the services, facilities and information of other public and private organizations to the fullest extent to avoid unnecessary overlapping or duplication of effort. Provides that the Chairman shall be compensated at the rate of Level II and the other members at the rate of Level IV of the Executive Schedule Pay Rates. Authorizes such sums as are needed to enable the Council to function, not to exceed $1 million in any fiscal year. Requires every agency of the Federal Government to include, to the fullest extent possible, in each report on proposals for legislation or other major Federal action significantly affecting health or the health care system, the impact of the proposal on the nation's health care system, adverse effects, alternatives, the relative priority established by the Council of Health Policy Advisers, and any irreversible or irretrievable commitments of resources involved. Provides that in order to qualify for the comprehensive health planning grants a State plan for comprehensive State health planning must, in addition to existing requirements, provide for the project certification procedures established by this Act. Increases the funds authorized for project grants for areawide health planning to $100 million for fiscal year 1975. Directs that to be eligible for the grants the agency must be prepared to function as the "appropriate comprehensive health planning agency" for the area or region. Requires the agency to be prepared to play a strengthened role in coordinating areawide health affairs, including the determination of health needs, capital expenditures programs, cooperative use of facilities, optimum use of available manpower and improved management techniques. Requires the agency to provide for consultation with the areawide health planning council and other groups, for the representation of health care facilities and physicians for enlisting public support, and for educating the public concerning the proper use of facilities and services available. Provides that, in the case of applications for Federal grants, loans, or other financial aid involving more than $100,000 which require certification by the appropriate comprehensive health planning agency, the application may be approved by the Secretary only after he is satisfied that the review provisions of this title have been met. Requires that the agency have reasonable opportunity to review and comment on the application and has certified to its essential need and high priority. Provides that if the "appropriate comprehensive health planning agency" is a metropolitan or other local planning agency, that agency, after reviewing the application, must have communicated its comments to both the applicant and the State agency. Directs the State planning agency to make its own determination that the application fits in with the State's overall needs and priorities as expressed in the State plan. Requires that if two or more States are involved, each State agency must make a separate certification as to the need and priority of the project in its State. Provides that in the case of a project affecting an entire State, the appropriate comprehensive health planning agency is the agency designated in the State plan. Provides that in the case of a project affecting a region, metropolitan area, or other local area, the appropriate comprehensive health planning agency is the areawide comprehensive health planning agency or such other public or nonprofit private agency determined in accordance with regulations to be performing the required health planning functions. Title V: Provisions to Make Comprehensive Health Care Insurance Available to All - Requires that benefits paying for not less than the health care required under the minimum standards must be included in private or State established health care plans as a condition of eligibility for the Federal tax or other public financial assistance accorded under this bill. Permits additional benefits and allows a qualified private health care plan to provide for a covered individual's payment of medical expenses exceeding established deductible and co-payment standards. Permits qualifying health care plans to include various other optional provisions. Assures that the minimum standards of health care required to be provided to needy and uninsurable individuals will be no less than those required for others. Assigns one of three "priority designations" to each of the benefits covered and requires benefits in the several priority categories to be phased-in in accordance with a schedule prescribed in the law. Authorizes the President, under restricted conditions stated in the law, to defer the scheduled time for phase-in benefits under this title. Specifies the initial minimum standard healthcare benefits for individuals covered under qualified private plans and those for individuals covered under qualified public plans. Revises the Internal Revenue Code to restrict the Federal income tax deduction otherwise allowable to an employer for any amount paid or incurred by the employer for medical care of any employee or his dependents. Restricts this deduction to 50 percent of the described expense for the medical care of the employee if the amount is incurred in 1975, 75 percent if the amount is incurred in 1976, and 100 percent thereafter. Provides that if the employer establishes and maintains a qualified employee healthcare plan the restriction will not apply, and 100 percent of the described expense is deductible. Applies such provision to taxable years after December 31, 1974, except that, in the case of any employer plan providing medical care for employees which was established pursuant to a collectively-bargained agreement, the restrictions on the deduction will not apply until the expiration of the agreement, or December 31, 1977, whichever occurs first. Requires that each qualified employee healthcare plan provide at least the minimum standard healthcare benefits described in this Act and be in writing, adopted by the employer, and communicated to his employees. Requires that a coordination of benefits provision be included in a qualified plan to avoid costly duplication of coverage and the plan must permit eligible employees to seek coverage instead from any approved health maintenance organization in cases where specified conditions are satisfied. Allows 100 percent of medical care insurance premiums as an income tax deduction, if such expenses are paid by an individual who is covered by a qualified individual healthcare plan, a qualified employee healthcare plan, or a qualified state healthcare plan. Requires that each qualified individual healthcare plan provide at least the minimum standard healthcare benefits described in this Act. Requires that a qualified individual insurance contract contain provisions which obligate the insurer to renew the policy, and allows covered dependents to continue their coverage under the policy after the death of the insured as if he were still alive. Adds a new title XX to the Social Security Act to provide for the establishment of publicly subsidized health care insurance plans on a State by State basis. Provides that each State will have a health insurance pool, which all private entities in that State (both profit and non-profit) which currently indemnify the cost of health care would be required to underwrite. Directs that one or more private insurance carriers will be designated by the State to administer the State plan on a retention accounting basis. Provides that these State plans will guarantee that minimum standard healthcare benefits are made available to individuals and families who previously were unable to purchase health care insurance, either because of their low income or their extremely poor health. Provides that, in order to encourage a State to establish a plan, Federal appropriations otherwise payable to the State pursuant to titles V and XIX of the Social Security Act are conditioned on the State having in operation a Qualified State Healthcare Plan. Provides that individuals or families who are eligible to receive public cash assistance under a program financed in whole or in part by Federal funds will be enrolled in the State plan automatically, and without cost. Permits those individuals who are financially capable of procuring health insurance, but who are uninsurable because of poor health, to enroll in the State plan at their own expense; however, these individuals may not be charged more than the established rate for other individuals enrolled in that State plan. Provides that enrollment of other individuals and families who had low incomes the previous year (less than $4,000 for single individuals, less than $6,000 for a family of two, and less than $8,000 for a family of three or more) is voluntary. Allows such individuals and families to elect to be enrolled once each year and requires them to make contributions toward the cost of insuring their own health care, depending on the size of their family and the amount of their income. Provides that the premiums to be charged for each policy year under a State plan will be actuarially determined in each State, and for each family size risk category. Directs that if the established premiums are found to be unjustified within a particular State, the Secretary of Health, Education, and Welfare may direct a reduction in the Federal appropriation for that State's premium cost. States that each State has the primary obligation to provide the uncontributed premium cost for its plan; but if the State implements and utilizes controls which are designed to promote the delivery of lower-cost, higher-quality institutional health care services, if it exempts qualified state healthcare plan transactions from State taxation, and if it eliminates discriminatory State tax treatment of health care insurers, then the State will receive Federal appropriations reimbursing it for a percentage of its total uncontributed premium cost. Provides that the base figure may be between 70 and 90 percent, depending on the State's per capita income, but further adjustments to this percentage may be made if institutional rates charged in any particular State for health care services are unjustifiably high in comparison with other States. Gives States the authority to review in advance the rates to be charged by health care institutions for their services, and to refuse to approve these rates for payment under the State plan. Provides that a professional service, otherwise covered by these State plans, shall be reimbursed only if it falls within professionally established utilization guidelines or is found to be necessary health care by a qualified peer review committee. Asserts that no charge for a necessary service shall be reimbursed to the extent that it exceeds the prevailing charge in a locality for similar services. Provides that if the premiums collected and other monies received under the State plan are not sufficient to pay the claims incurred and the other costs of operating the State plan, the private underwriters of the plan shall bear the losses to the extent of 3 percent of the premiums collected for that year. Directs the State to bear the excess losses equal to the base Federal percentage for that State's premium costs. Provides that enrollment is not available to those individuals or families covered under a qualified employee healthcare plan. Provides that applicants for enrollment in the State plan must provide and certify all information required to make an eligibility determination. States that any Federal or State agency may be required to furnish information deemed by the administering carrier to be necessary to verify eligibility. Revises title V of the Social Security Act (Maternal and Child Health and Crippled Children's Services) to avoid unnecessary and costly duplication of federally subsidized health care programs. Excludes payment for items and services now covered under title V of the Social Security Act if they also would be covered under a qualified state healthcare plan. Provides that title V will continue to pay for items and services which are not covered by qualified State healthcare plans. Revises title XVIII of the Social Security Act to remove existing limitations on Medicare Part B enrollment which prevent otherwise eligible State plan enrollees from qualifying for qualified State healthcare plan to pay the premium for supplementary medical insurance benefits under Part B of title XVIII of the Social Security Act for individuals and families who are eligible to enroll in the Part B program and who are also eligible to receive public cash assistance under a federally financed program. Revises title XVIII to allow a State to enter into an agreement with the Secretary of Health, Education, and Welfare pursuant to which all of these indigent State plan enrollees will be enrolled under the program established by Part B of title XVIII. Revises title XIX of the Social Security Act (Grants to States for Medical Assistance Programs) to avoid unnecessary and costly duplication of federally subsidized health care programs. Provides that on July 1, 1975, or upon a State's establishment of a qualified State healthcare plan, whichever occurs first, payment for items and services now covered under title XIX would be excluded if they would be covered under a qualified state healthcare plan. Directs that title XIX will continue to pay for items and services which are not covered by qualified State healthcare plans. Establishes standards for the quality and cost to enrollees for health care service provided by physicians or other medical practitioners and for health care services rendered to State plan enrollees in health care institutions. Provides that these standards shall apply to determine "reasonable cost" under the existing federally subsidized health care programs established by title V, XVIII, and XIX of the Social Security Act. Requires that the premiums and other monies received pursuant to the operation of a qualified State healthcare plan will, to the extent feasible, be invested by the administering carrier in interest-bearing obligations and other income-yielding securities. Exempts this interest or other income from Federal income taxation. Requires insurance carriers to pool their efforts and resources to insure that all individuals and families will receive higher-quality, lower-cost health care benefits. Provides that these carriers will not be subject to Federal or State antitrust legislation solely as a result of their efforts to comply with the provisions of this Act.
Bill· SS. 3305 (93rd)referred
United States · United States Congress · 4 April 1974
National Huntington's Disease Control Act - States that it is the purpose of this Act to establish a national program for the diagnosis, prevention, and treatment of, and research in, Huntington's disease. Authorizes the Secretary of Health, Education, and Welfare to make grants for projects for the establishment and operation of Huntington's disease screening, treatment, and counseling programs. Authorizes the appropriation of $500,00 for the fiscal year ending June 30, 1975, and for each of the next two fiscal years for such grants. Authorizes the Secretary to make grants for research in the diagnosis, treatment, and prevention of Huntington's disease. Authorizes the appropriation of $1,500,000 for the fiscal year ending June 30l 1975 and for each of the next two fiscal years for use for such grants. Directs the Secretary to carry out a program to develop information and educational materials relating to Huntington's disease and to ddisseminate such information and materials to persons providing health care and to the public in general. Authorizes the appropriation of $150,000 for the fiscal year ending June 30, 1085, and for each of the next two fiscal years to carry out this information program. Sets forth the requirements for applications for grants under this Act and the administration of such grants. Directs the Secretary to establish a program within the Public Health Service to provide for voluntary Huntington's disease screening, counseling, and treatment. National Huntington's Disease Control Act - States that it is the purpose of this Act to establish a national program for the diagnosis, prevention, and treatment of, and research in, Huntington's disease. Authorizes the Secretary of Health, Education, and Welfare to make grants for projects for the establishment and operation of Huntington's disease screeening, treatment, and counseling programs. Authorizes the appropriation of $500,000 for the fiscal year ending June 30, 1975, and for each of the next two fiscal years for such grants. Authorizes the Secretary to make grants for research in the diagnosis, treatment, and prevention of Huntington's disease. Authorizes the appropriation of $1,500,000 for the fiscal year ending June 30, 1975 and for each of the next two fiscal years for use for such grants. Directs the Secretary to carry out a program to develop information and educational materials relating to Huntington's disease and to disseminate such information and materials to persons providing health care and to the public in general. Authorizes the appropriation of $150,000 for the fiscal year ednding June 30, 1975, and for each of the next two fiscal years to carry out this information program. Sets forth the requirements for applications for grants under this Act and the administration of such grants. Directs the Secretary to establish a program within the Public Health Service to provide for voluntary Huntington's disease screening, counseling, and treatment.
Bill· HRH.R. 14007 (93rd)referred
United States · United States Congress · 4 April 1974
Medicare Long-Term Care Act - Establishes, under title XVIII of the Social Security Act (Medicare), a voluntary program to provide long-term care benefits for aged and disabled individuals who elect to enroll under such program, financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government and contributions by the States. Lists criteria for eligibility for long-term care service benefits. Provides that the benefits provided to an individual by this Act shall consist of (1) home health services, (2) homemaker services, (3) nutrition services, (4) long-term institutional care services, (5) day care and foster home services, and (6) community mental health center outpatient services. Enumerates the requirements for a State long-term care agency. Provides for the payment of premiums for benefits received under this Act. Establishes on the books of the Treasury of the United States a trust fund to be known as the Federal Long-Term Care Trust Fund. Creates a body to be known as the Board of Trustees, composed of the Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health, Education, and Welfare, all ex officio. States that the Secretary of the Treasury shall be the Managing Trustee of the Board of Trustees and that the Commissioner of Social Security shall serve as the Secretary of the Board of Trustees. Provides that the Board of Trustees shall meet not less frequently than once each calendar year. Enumerates the duties of the Board of Trustees. Declares that a community long-term care center shall: (1) provide the items and services listed in this Act to each individual (i) who is eligible for benefits under this part, (ii) who resides in the area served by such center and (iii) who is certified as requiring such services; (2) evaluate and certify the long-term care needs of an individual for whom such care may be required in order to maintain such individual in an independent living arrangement which is reasonable given such individual's state of health and other circumstances (but not including such individual's economic circumstances); (3) maintain a continuous relationship with (and periodically evaluate not less than annually) each individual who is receiving any of the items and services listed in this Act; (4) provide full opportunity for such individual and his family to participate in the determinations and functions under this Act; (5) provide an organized system for making its existence and location known to all individuals in its service area who are eligible for benefits under this part, and for making known to such individuals the method or methods by which they may most efficiently obtain and use the services which it makes available; and (6) performs such other functions as the Secretary of Health, Education, and Welfare may by regulation prescribe in order to have such center most effectively carry out the purposes of this Act. Provides a formula for payments to States for the reimbursement of community long-term care centers. Directs the Secretary, after consultation with organizations representing the chief executives of the various States, and other interested parties, to develop and make available to community long-term care centers one or more methods of obtaining payment for the benefits covered under this Act on a prospective basis. States that once a community long-term care center elects a particular prospective method, it may not alter its election without the prior approval of the Secretary. Provides that whenever the Secretary finds that the number of community long-term care centers electing a particular prospective payment method promulgated in accordance with this Act is not sufficient to provide an adequate basis for either the operation or evaluation of that method, the Secretary shall withdraw that method and allow the community long-term care centers which have elected such method to select another method withn 30 days of notice of such withdrawal. Permits a Governor of a State to certify to the Secretary a method of prospective payment other than those promulgated under this Act. States that the determination of whether an individual is entitled to benefits under this Act shall be made by the Secretary in accordance with regulations prescribed by him. Provides for increases in supplemental security income benefits.
Bill· HRH.R. 14003 (93rd)referred
United States · United States Congress · 4 April 1974
Repeals, under the Social Security Act, the provisions for the establishment of Professional Standards Review Organizations to review services covered under the medicare and medicaid programs.
Bill· HRH.R. 14008 (93rd)referred
United States · United States Congress · 4 April 1974
National Arthritis Act - States that it is the purpose of this Act to expand the authority of the National Institute of Arthritis, Metabolism, and Digestive Diseases in order to advance a national attack on arthritis. Establishes a National Task Force on Arthritis to formulate a long-range plan to combat arthritis and related musculoskeletal and other related diseases. Provides that the Arthritis Plan shall include recommendations for the utilization and organization of national resources for the campaign against arthritis, and a program for the National Institute of Arthritis, Metabolism, and Digestive Diseases as a major participant in the campaign against arthritis. Specifies the composition of the Task Force membership. Authorizes to be appropriated $500,000 for fiscal years 1974 and 1975 to carry out the purposes of the national arthritis program. Establishes within the Institute the position of Associate Director for Arthritis who shall be responsible for programs regarding arthritis within such Institute. Provides that the Director of the National Institutes of Health shall establish an Inter-Institute Arthritis Coordinating Committee to be composed of representatives who can make policy commitments for each of the Institutes and divisions involved in arthritis-related research. Creates within the Federal Government an Interagency Technical Committee on Arthritis which shall be responsible for promoting the coordination of those aspects of all Federal health programs and activities relating to arthritis to assure the adequacy and technical soundness of such programs and activities and to provide for the full communication and exchange of information necessary to maintain adequate coordination of such programs and activities. States that the Director of the Institute shall establish programs for cooperation with other health agencies in the screening, detection, prevention, and control of arthritis which emphasize the development of new diagnostic and treatment methods for arthritis, and the dissemination of the knowledge about these methods to the health professions. Authorizes to be appropriated to carry out these provisions $5,000,000 for fiscal year 1975; $10,000,000 for fiscal year 1976; and $15,000,000 for fiscal year 1977. Provides that the Director of the Institute shall provide for the development of centers for basic and clinical research into, training in, and demonstration of, advanced diagnostic, prevention, control, and treatment methods for arthritis. Authorizes to be appropriated to carry out these provisions $10,000,000 for fiscal year 1975; $15,000,000 for fiscal year 1976; and $20,000,000 for fiscal year 1977. Requires the Director of the Institute, after the end of each calendar year, to submit to the President and Congress a report including: (1) a proposal for the Institute's activities during the next five years; and (2) a program evaluation section.
Bill· HRH.R. 13995 (93rd)referred
United States · United States Congress · 4 April 1974
Health Policy and Health Resources Development Act - Expresses the findings of Congress with regard to facilitating the development of recommendations for a national health policy and planning for health services, manpower, and facilities. Establishes, under the Public Health Service Act, the National Council for Health Policy, in the Department of Health, Education, and Welfare. Specifies the composition and terms of office of Council members. Enumerates the functions of the Council, including: (1) to develop a national health policy with national goals and priorities; (2) to conduct studies in specified health areas; and (3) to evaluate the implications of developing medical technology for the health care delivery system. Enumerates the priorities of the national health policy. Directs the Council to convene a National Health Conference to assist in performing its functions. Requires the Secretary to announce the initiation of proceedings to designate geographical regions, to be known as health service areas, to be served by health systems agencies. Outlines the characteristics of a health service area and the procedures for reviewing the boundaries of such areas. Describes the term "health systems agency," including the legal, staff and governing body structure requirements. Enumerates the functions of health systems agencies, including to analyze data, to establish a health system plan, and to establish an annual implementation plan. Sets forth the requirements to be met in implementing such plans. Prescribes the procedures and criteria for reviews of proposed health system changes. Provides for the designation of health systems agencies. Directs the Secretary to provide technical assistance to agencies. Details the form and content of such assistance. Empowers the Secretary to make grants to health systems agencies for carrying out their activities. Sets limits on the amounts of such grants. Authorizes to be appropriated $60,000,000 for fiscal year 1975 and $100,000,000 for fiscal year 1976 for such grants. Provides for the making of development grants for area health services development funds. Authorizes appropriations of $100,000,000 for fiscal year 1975 and $125,000,000 for fiscal year 1976 for such purposes. Requires the Secretary to review and approve the annual budget of each health systems agency with which there is in effect a designation agreement. Specifies the extent and subject matter of such reviews. Provides that, to be eligible for specified grants, the Governor of a State shall designate or establish a single State agency for administering the State's health planning functions. Specifies the requirements to be met by State administrative programs for approval. Enumerates the functions to be performed by each State health planning agency. States that a State health planning agency must be advised by a Statewide Health Coordinating Council. Sets forth the criteria for composition and duties of such Councils. Empowers the Secretary to make grants to the States for the development and operation of State Health Planning Agencies. Authorizes appropriations for such purposes.
Bill· HRH.R. 13987 (93rd)referred
United States · United States Congress · 4 April 1974
Health Resources Planning Act - Declares that it is the purpose of this Act to assist private and public health care systems to plan more effectively the provision of resources necessary to meet the health care needs of the nation, and to facilitate governmental regulation of health care costs. Repeals provisions of the Public Health Service Act, which provide for a National Advisory Council on Comprehensive Health Planning Programs. Directs the chief executive officer of each State to designate geographical regions as health service areas to be served by the Health Systems Agencies. Identifies the geographical characteristics of such health service areas. Directs the Secretary of Health, Education, and Welfare to certify a Health Systems Agency for each health service area and to enter into an agreement obligating the Agency: (1) to prepare and maintain a comprehensive health plan for the health service area, (2) to review the Secretary's grants of Federal financial assistance for health care activities, (3) to review State and local health care activities; (4) to offer technical assistance in furtherance of the health plan; (5) to participate in the Statewide Health Coordinating Council; and (6) to comply with subsidiary requirements, including auditing and examination of books. Empowers the Secretary to make grants for an agency's operational expenses and to extend to the agency technical assistance, and to keep it apprised of national health policies and issues. Prescribes the procedures for termination or withdrawal of certification and the organizational requirements to be met by agencies, including that an agency be a nonprofit private corporation that exercises no Federal, State, or local regulatory authority, and is not a provider or insurer of health services or an educational institution. Outlines the composition of the governing body of each agency. Provides that members and employees of the Agency are relieved of civil or criminal liability under any law for the performance, with the exercise of due care of functions authorized by this Act. States that an agency may receive unconditional contributions from any private source of up to 5 percent of the amount of assistance received from the Secretary, and of up to 25 percent of that amount from any public sources. Requires each agency to annually adopt a comprehensive health plan for its health service area identifying shortages, maldistributions, and surpluses of health personnel, facilities, and services, and the most serious organizational and operational deficiencies of health care providers. States that the plan must set forth long-range goals and annual priorities for the establishment or improvement of health care systems, and recommend actions to alleviate the problems identified by the plan. Provides that an agency may provide technical assistance, directly or by grant or contract to implement the recommendations of its comprehensive health plan. Sets limitations on the purpose, amount and duration of such grants. Requires that two or more agencies that serve health service areas that fall in whole or in part, within the same State shall form a Statewide Health Coordinating Council. Directs the Council to draw on the comprehensive health plans of its member agencies to prepare a Statewide plan, and perform other advisory analytical, and coordinative functions. Directs the Secretary to evaluate the performance of agencies and Councils on a regular basis and to prescribe standards of performance to facilitate this evaluation. Authorizes the appropriation of such sums as may be necessary for fiscal years 1975, 1976, and 1977 to carry out the provisions of this Act. Establishes a formula grant program to assist the States to pay their costs of regulating capital expenditures related to health care, and to establish or regulate rates used for the payment or reimbursement for health care services. Provides that the allotment would be in accordance with the populations of the respective States eligible for it, and the costs of regulating the activities selected by the States for regulation. States that the Secretary, after reasonable notice and opportunity for hearing to a State, may terminate assistance for noncompliance. Authorizes the appropriation of such sums as may be necessary for fiscal years 1975, 1976, and 1977, for grants to States for the regulation of health care costs.
Bill· HRH.R. 13971 (93rd)referred
United States · United States Congress · 4 April 1974
National Health Education Policy and Development Act - Sets forth the findings and declarations of Congress. Establishes within the Department of Health, Education, and Welfare a Health Education Administration to be headed by an Administrator appointed by the Secretary of Health, Education, and Welfare. Establishes an Advisory Council for Health Education to advise, consult with, and make recommendations to, the Administrator on matters relating to the administration of this Act. Declares that the Council shall be composed of 12 members: (1) the Assistant Secretary of Health, Education, and Welfare for Health; (2) the Assistant Secretary of Health, Education, and Welfare for Education; and (3) 10 appointed by the Administrator. Directs the Administrator to conduct a study and investigation of, but not limited to the following: (1) the current status of health education in the Nation; (2) the existing and proposed Federal, State, and local health education programs; (3) factors bearing upon a consumer's motivation for preserving his own health and utilizing health care services; (4) areas of greatest potential impact for health education; and (5) particularized cultural needs, including those relating to diseases affecting specific ethnic, economic, and geographic populations. Requires the Administrator to make grants to public or nonprofit private organizations or to enter into contracts with public or private organizations for the purpose of developing and evaluating specific educational and informational mechanisms, aids, and systems. Directs the Administrator to make grants to public or nonprofit private organizations for the purpose of developing multifaceted systems of health care education for a defined geographic region. Provides that no such grant may be made unless an application has been submitted to and approved by the Secretary. Requires the Administrator to submit annual reports to Congress and the Secretary of Health, Education, and Welfare on the status of health education in the United States. Directs the Administrator, not later than 3 years after the date of the enactment of this Act, to submit a report to Congress and the Secretary on his recommendations for a continuing program of health education and for consolidation of the existing health education and consultation programs.
Bill· HRH.R. 13972 (93rd)referred
United States · United States Congress · 4 April 1974
Medicare Long-Term Care Act - Establishes, under title XVIII of the Social Security Act (Medicare), a voluntary program to provide long-term care benefits for aged and disabled individuals who elect to enroll under such program, financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government and contributions by the States. Lists criteria for eligibility for long-term care service benefits. Provides that the benefits provided to an individual by this Act shall consist of (1) home health services, (2) homemaker services, (3) nutrition services, (4) long-term institutional care services, (5) day care and foster home services, and (6) community mental health center outpatient services. Enumerates the requirements for a State long-term care agency. Provides for the payment of premiums for benefits received under this Act. Establishes on the books of the Treasury of the United States a trust fund to be known as the Federal Long-Term Care Trust Fund. Creates a body to be known as the Board of Trustees, composed of the Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health, Education, and Welfare, all ex officio. States that the Secretary of the Treasury shall be the Managing Trustee of the Board of Trustees and that the Commissioner of Social Security shall serve as the Secretary of the Board of Trustees. Provides that the Board of Trustees shall meet not less frequently than once each calendar year. Enumerates the duties of the Board of Trustees. Declares that a community long-term care center shall: (1) provide the items and services listed in this Act to each individual (i) who is eligible for benefits under this part, (ii) who resides in the area served by such center and (iii) who is certified as requiring such services; (2) evaluate and certify the long-term care needs of an individual for whom such care may be required in order to maintain such individual in an independent living arrangement which is reasonable given such individual's state of health and other circumstances (but not including such individual's economic circumstances); (3) maintain a continuous relationship with (and periodically evaluate not less than annually) each individual who is receiving any of the items and services listed in this Act; (4) provide full opportunity for such individual and his family to participate in the determinations and functions under this Act; (5) provide an organized system for making its existence and location known to all individuals in its service area who are eligible for benefits under this part, and for making known to such individuals the method or methods by which they may most efficiently obtain and use the services which it makes available; and (6) performs such other functions as the Secretary of Health, Education, and Welfare may by regulation prescribe in order to have such center most effectively carry out the purposes of this Act. Provides a formula for payments to States for the reimbursement of community long-term care centers. Directs the Secretary, after consultation with organizations representing the chief executives of the various States, and other interested parties, to develop and make available to community long-term care centers one or more methods of obtaining payment for the benefits covered under this Act on a prospective basis. States that once a community long-term care center elects a particular prospective method, it may not alter its election without the prior approval of the Secretary. Provides that whenever the Secretary finds that the number of community long-term care centers electing a particular prospective payment method promulgated in accordance with this Act is not sufficient to provide an adequate basis for either the operation or evaluation of that method, the Secretary shall withdraw that method and allow the community long-term care centers which have elected such method to select another method withn 30 days of notice of such withdrawal. Permits a Governor of a State to certify to the Secretary a method of prospective payment other than those promulgated under this Act. States that the determination of whether an individual is entitled to benefits under this Act shall be made by the Secretary in accordance with regulations prescribed by him. Provides for increases in supplemental security income benefits.
Bill· HRH.R. 13968 (93rd)referred
United States · United States Congress · 4 April 1974
Comprehensive Health Insurance Act - Title I: National Health Care Benefits Program. States that the purpose of this title is to provide adequate protection against costs by requiring all employers to offer health care plans to their employees; and to assist the States in making similar plans available to individuals in need of such protection. Requires, under the Social Security Act, that every employer provide to each of his employees under the age of 65 a reasonable opportunity, as determined under regulations prescribed by the Secretary of Health, Education, and Welfare, to obtain coverage for himself and the members of his family under the age 65 at the option of the employee: (1) an employee health care insurance plan approved under this title or an assisted health care insurance plan obtained by the employer, (2) a group practice prepaid health care plan approved under this title, or (3) an individual practice prepaid health care plan approved under this title. States that the employer shall provide an amount equal to at least 75 percent of the cost of that coverage. Prohibits discrimination against an indiviudal with respect to the opportunity for employment, or the compensation, terms, condition, or privileges of employment, because of the individual's health status or the health status of his dependents, except when directly related to the capacity of the individual to perform his duties as an employee. Directs the Secretary to make grants for health care programs to States which have submitted approved plans for the provision of health care benefits to individuals under the age of 65 who are otherwise unable to obtain such benefits. Authorizes appropriations for each fiscal year of sums necessary to carry out this purpose. Directs the Secretary to establish a Federal health care benefits program under which an individual who has attained the age of 65 and is entitled to monthly insurance benefits under Title II of this Act (Old-Age, Survivor's, and Disability Insurance Benefits) shall be entitled to Federal health care benefits under Title XVIII (Medicare). States that the benefits provided under the program shall be at the option of the individual: (1) to obtain coverage under the Federal health care insurance plan, or (2) to have the Secretary pay to any prepaid health care plan approved under this title under which the individual has obtained coverage at a rate which the Secretary determines is reasonable, on behalf of the individual, an amount equal to the cost to the Government of providing coverage under a Federal health care insurance plan, as determined under regulations prescribed by the Secretary. Provides that the Federal health care insurance plan shall impose, with respect to all items and services other than outpatient drugs and biologicals, and other blood and blood product, a per individual deductible equal to a specified percentage of the income base. States that the Federal health care insurance plan shall provide: (1) that an account will be established against which a covered individual may charge the cost of obtaining items and services covered under the plan, without regard to the deductible and coinsurance requirements applicable under the plan; (2) that payment for items and services covered under the plan, other than emergency services, will be made only on the basis of charges against that account; and (3) that payment will be made on the basis of charges against the account for items and services covered under the plan at the applicable reimbursement rates. Authorizes the Secretary to enter into contracts with carriers for the administration of benefits under the Federal health care insurance program. Establishes a Federal Helath Care Benefits Trust Fund. States that the Trust Fund shall consist of such gifts and bequests as may be made together with such amounts as may be deposited in, or appropriated to, such Fund under the provisions of this Act. Sets forth criteria for determining the amount to be aporopriated to the Trust Fund for each fiscal year. Establishes a Board of Trustees to be composed of the Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health, Education, and Welfare. States that the duties of the Board of Trustees shall be to: (1) hold the Trust Fund; (2) report to the Congress not later than the first day of April of each year on the operation and status of the Trust Fund during the preceding fiscal year and on its expected operation and status during the current fiscal year and the next two fiscal years; (3) report immediately to the Congress whenever the Board is of the opinion that the amount of the Trust Fund is unduly small; and (4) review the general policies followed in managing the Trust Fund, and recommend changes in such policies, including necessary changes in the provisions of law which govern the way in which the Trust Fund is to be managed. Requires that employee health care insurance plans provide for the following services for each covered individual: (1) inpatient hospital services; (2) physicians' services; (3) medical and other health services; (4) home health services; (5) post-hospital extended care services; (6) outpatient drugs and biologicals; (7) routine dental services for individuals under the age of 13; (8) developmental vision care services, as defined in regulations prescribed by the Secretary routine eye and vision examinations, and eyeglasses, for individuals under the age of 13; and (9) hearing aids and examinations therefor, for individuals under the age of 13. Sets forth limits for employee health care insurance plans, including the following: (1) post-hospital extended care services shall be limited to 100 days per calendar year; (2) home health services must be limited to 100 visits per calendar year; and (3) inpatient hospital services for the treatment of mental illness shall be limited to 30 days per calendar year, with each day of partial hospitalization, as defined in regulations prescribed by the Secretary, counting as one-half day of inpatient services. Enumerates the requirements for meeting the provisions of this Act. States that a group practice pre-paid health care plan must: (1) provide physicians' services (other than infrequently used services, as determined under regulations prescribed by the Secretary) through physicians who are employees or partners of the organization, or through arrangements with one or more groups of physicians engaged in the coordinated practice of their profession for the organization; and (2) meet such requirements concerning its organizational structure and financial arrangements as the Secretary may, by regulation, prescribe. Provides that the Secretary may, by regulation, make such modifications in the requirements imposed by this section as he determines are appropriate with respect to group practice prepaid health care plans offered to employees whose place of employment is outside the United States. Sets forth requirements for approval of individual practice prepaid health care plans, approval of special employee health care programs, and requirements for certification of providers. States that any State dissatisfied with a determination of the Secretary with respect to whether the State is meeting the provisions of this Act may file a petition for review of such determination with the United States court of appeals to the circuit in which such state is located. Stipulates that the court shall have jurisdiction to affirm the action of the Secretary, or to set it aside, in whole or in part. Sets forth judicial remedies and criminal sanctions for noncompliance. Title II: Reduction in Services Provided Under Medical Assistance Programs - Sets forth technical and conforming amendments to the Medical Program. Title III: Sets forth technical and conforming amendments to the Professional Standards Review Program, and the Capital Expenditures Review Program. Title IV - General Provisions: States that if a provision of this Act is held invalid, all other provisions so enacted shall remain in effect.
Bill· HRH.R. 13940 (93rd)referred
United States · United States Congress · 3 April 1974
Comprehensive National Health Insurance Act - Title I: National Health Insurance Program - Provides that this Act shall not interfere with the freedom of every physician and every patient to choose where and how they will give or receive health care. States that the national health insurance program established by this title shall be administered by the Board of the Social Security Administration established by this Act. Provides the following benefits under the National Health Insurance Program: (1) inpatient hospital services with no day or dollar limitation; (2) physicians' services, in home, office, or elsewhere, with no dollar limitation; (3) medical and other health services (as defined under medicare); (4) home health services-100 visits per year; (5) post-hospital extended care services-100 days per year; (6) mental health services-inpatient, 30 full days in a psychiatric hospital or 60 partial days; outpatient services in a comprehensive community care center equivalent to the costs of 30 visits to a private practitioner or outpatient services of a private practitioner equal to half the costs of 30 visits; (7) outpatient prescription drugs and biologicals for specified chronic conditions; (8) preventive care services, including (a) routine dental services for children under age 13; (b) developmental vision care services, routine eye and vision exams, and lenses or eyeglasses for children under age 13; (c) hearing aids and exams for children under age 13; (d) well-child care to age 6; (e) prenatal care; and (f) family planning services. Makes all services, except those listed under preventive care subject to a combined annual per person deductible of $150 except that no family would have to meet more than 2 deductibles. States that all services, except drugs, would be subject to a 25-percent coinsurance. Provides that out-patient drugs would be subject to a separate copayment of $1 per prescription drug. Makes all residents who are not eligible for Medicare eligible for the program through their contributions to the Social Security System, contributions being made by all Americans who have earned or unearned income of any kind, including governmental benefits. Makes each person who is fully or currently insured, as defined under the present social security law, and his dependents eligible. Provides immediate coverage under the plan for the individuals who are not fully or currently insured. Provides that coverage be extended to an employee during the first week during which he worked 25 hours or more, coverage not ending until after there were three consecutive weeks in each of which he did not work 25 hours or more. Provides that people beginning self-employment, or starting to receive unearned income, would be eligible beginning with the first day of the first year in which they have such income. Makes all social security and railroad retirement cash beneficiaries (including widows and widowers under age 65) who are not eligible for coverage under Medicare, eligible for the program. Directs the Social Security Administration to establish for each eligible individual an account against which such individual may charge the cost of obtaining any items and services furnished him under this title, without regard to any deductible or coinsurance requirement which may be applicable. Requires that payment for items and services furnished an eligible individual be made by the Social Security Administration to the providers of services on the basis of charges against such individual's account. States that the Administration shall have full responsibility for the collection of any deductible and coinsurance amounts due from an individual. Provides for a special waiver of or limitation on deductibles and coinsurance for lower income families. Enumerates the conditions of and limitations on payment for the following: (1) requirement of requests and certifications, (2) no payments to Federal providers of services, (3) payment for emergency hospital services, (4) payment for inpatient hospital services prior to notification of noneligibility, (5) payment for posthospital extended care services, (6) payment for home health services, (7) limitation on payment for outpatient drugs and biologicals, (8) limitations on payment for surgery and other specialized services, (9) limitation on payment for practitioner services furnished in nonparticipating hospitals, (10) limitation on payment for certain prosthetic devices, (11) payment for certain outpatient services furnished by nonparticipating hospitals, and (12) collection by hospitals of customary charges for certain outpatient services. Makes provisions for payment to the providers of services and for prospective determination of payment to providers of services. Directs the Administration to award on an annual basis quality management payments to any provider of services under this title whenever either the percentage amount or the dollar amount of increase in such provider's prospective rate for a fiscal year is less than the average annual increase in such rate for the three previous fiscal years for all providers in the same class, such payment to be equal to 50 percent of the difference between such provider's total costs to the program and what its costs to the program would have been had they increased at the class average rate. Lists the agreements a provider of services must file with the Administration in order to qualify to participate and to be eligible for payments under this title. Authorizes the Administration to use public agencies or private organizations to facilitate payment to providers of services. Authorizes the Administation to use carriers, as defined in this Act, for the administration of noninstitutional benefits. Requires that payment for services rendered by a physician be made in accordance with a single fee schedule applicable throughout that area. Provides a method to determine the fee schedule. Allows all physicians to elect whether to participate or not to participate. States that each fee schedule in effect and the names and addresses of all participating physicians shall be made available to the public throughout the State involved, in such manner and at such times as the Administration may consider appropriate, by the Administration or by the appropriate State agency with the approval of the Administration. Establishes, within the Social Security Administration, a National Health Insurance Formulary Committee, a majority of whose members shall be physicians and which shall consist of the Commissioner of Food and Drugs and of four individuals (not otherwise in the employ of the Federal Government) who do not have a direct or indirect financial interest in the compensation of the Formularly established under this Act and who are of recognized professional standing and distinction in the fields of medicine, pharmacology, or pharmacy, to be appointed by the Administration without regard to the statutory provisions governing appointments in the competitive service. Provides that the Chairman of the Committee shall be elected annually from the appointed members, by majority vote of the members of the Committee. Requires the Formulary to compile, publish, and make available a National Health Insurance Formulary, containing an alphabetically arranged listing, by established name, of those drug entities within specified therapeutic categories which the Committee decides are necessary for individuals using such drugs. States that a fee, charge, or billing allowance shall not be payable under this title with respect to any drug entity that is furnished as an incident to a physician's professional service, and is of a kind commonly furnished in physicians' offices and commonly either rendered without charge or included in the physicians' bills. Provides a reasonable allowance for outpatient drugs and biologicals. Makes special provisions for physicians dispensing outpatient drugs and biologicals where the Administration determines that no participating licensed pharmacies exist in a community. Creates on the books of the Treasury of the United States a trust fund to be known as the National Health Insurance Trust Fund and a body to be known as the Board of Trustees of the Trust Fund, composed of the Secretary of the Treasury, the Secretary of Labor, the Chairman of the Board of the Social Security Administration, and the Secretary of Health, Education, and Welfare. Directs the Administration to consult with State agencies and other organizations to develop conditions of participation for providers of services. Provides for the use of State agencies to determine compliance by providers of services with the conditions of participation. States that the determination of whether an individual is entitled to benefits under this title, and the determination of the amount of such benefits, shall be made by the Administration in accordance with regulations prescribed by it. Provides that where overpayments on behalf of individuals occur, proper adjustment shall be made under regulations prescribed by the Administration, by decreasing subsequent payments. Provides for the settlement of claims for benefits on behalf of deceased individuals. Provides criminal penalties for violation of this Act. Creates a National Health Insurance Benefits Advisory Council consisting of 19 persons, not otherwise in the employ of the United States, appointed by the Board without regard to statutory provisions governing appointments in the competitive service. Lists criteria for serving on the Council. Declares that it shall be the function of the Advisory Council to provide advice and recommendations for the consideration of the Administration on matters of general policy with respect to this title. Imposes the following taxes for each taxable year for health insurance purposes: two and one half percent of the amount of an individual's self-employment income (and unearned income); on the income of every individual, one percent of the person's wages; and on every employer, an excise tax equal to three percent of the wages paid by him with respect to employment. Provides special coverage provisions, under the Social Security Act, for purposes of National Health Insurance Taxes. Title II: Changes in Medicare Program - Establishes, under title XVIII of the Social Security Act (Medicare), a voluntary program to provide long-term care benefits for aged and disabled individuals who elect to enroll under such program, financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government and contributions by the States. Lists criteria for eligibility for long-term care service benefits. Provides that the benefits provided to an individual by the program established by this Act shall consist of (1) home health services, (2) homemaker services, (3) nutrition services, (4) long-term institutional care services, (5) day care and foster home services, and (6) community mental health center outpatient services. Enumerates the requirements for a State long-term care agency. Provides for the payment of premiums for benefits received under this Act. Establishes on the books of the Treasury of the United States a trund fund to be known as the Federal Long-Term Care Trust Fund. Creates a body to known as the Board of Trustees, composed of the Secretary of the Treasury, the Secretary of Labor, the Chariman of the Board of the Social Security Administration, and the Secretary of Health, Education, and Welfare. States that the Secretary of the Treasury shall be the Managing Trustee of the Board of Trustees and that the Executive Director of the Social Security Administration shall serve as the Secretary of the Board of Trustees. Provides that the Board of Trustees shall meet not less frequently than once each calendar year. Enumerates the duties of the Board of Trustees. Declares that a community long-term care center shall: (1) provide the items and services listed in this Act to each individual (i) who is eligible for benefits under this part, (ii) who resides in the area served by such center, and (iii) who is certified as requiring such services; (2) evaluate and certify the long-term care needs of an individual for whom such care may be required in order to maintain such individual in an independent living arrangement which is reasonable given such individual's state of health and other circumstances (but not including such individual's economic circumstances); (3) maintain a continuous relationship with (and periodically evaluate not less that annually) each individual who is receiving any of the items and services listed in this Act; (4) provide full opportunity for such individual and his family to participate in the determinations and functions under this Act; (5) provide an organized system for making its existence and location known to all individuals in its service area who are eligible for benefits under this part, and for making known to such individuals the method or methods by which they may most efficiently obtain and use the services which it makes available; and (6) performs such other functions as the Administration may by regulation prescribe in order to have such center most effective carry out the purposes of this Act. Provides a formula for payments to States for the reimbursement of community long-term care centers. Directs the Administration, after consultation with organizations representing the chief executives of the various States, and other interested parties, to develop and make available to community long-term care centers one or more methods of obtaining payment for the benefits covered under this Act on a prospective basis. States that once a community long-term care center elects a particular prospective method, it may not alter its election without the prior approval of the Administration. Provides that whenever the Administration finds that the number of community long-term care centers electing a particular prospective payment method promulgated in accordance with this Act is not sufficient to provide an adequate basis for either the operation or evaluation of that method, the Administration shall withdraw that method and allow the community long-term care centers which have elected such method to select another method within 30 days of notice of such withdrawal. Permits a Governor of a State to certify to the Administration a method of prospective payment other than those promulgated under this Act. States that the determination of whether an individual is entitled to benefits under this Act shall be made by the Administration in accordance with regulations it prescribes. Provides coverage for prescription drugs. Declares that no further deductible or coinsurance requirement shall be imposed under this Act with respect to items or services furnished to or for any individual in any calendar year after the total of the deductibles and coinsurance paid by or on behalf of such individual and the other members of his family in that year equals $1,000. Eliminates the posthospital requirement for home health services under Medicare and the durational limits on inpatient hospital services. Title III: Independent Social Security Administration - Establishes, as an independent agency of the executive branch of the Government, a Social Security Administration to be headed by a Board, consisting of three members appointed by the President, by and with the advice and consent of the Senate. Declares that it shall be the duty of the Administration to administer specified programs of the Social Security Act, and to discharge the duties and responsibilities imposed on the Secretary of Health, Education, and Welfare in connection with the administration of the program established by the Federal Coal Mine Health and Safety Act of 1969. Abolishes the position of Commissioner of Social Security. Title IV: Amendment to Public Health Service Act - Establishes in the Department of Health, Education, and Welfare the Health Resources Development Board which shall be composed of three members to be appointed by the President, by and with the advice and consent of the Senate. Provides for an Executive Director and for the recruitment of qualified persons experienced in the administration or operation of private health insurance and health prepayment plans, or experienced in other fields pertinent to the national health insurance program. Requires the Board to make an annual report to the Committee on Interstate and Foreign Commerce of the United States House of Representatives and to the Committee on Labor and Public Welfare of the United States Senate. Enumerates the functions of the Board including: studies and evaluations, systems development, tests and demonstrations, research, and planning. Establishes a National Health Insurance Resources Advisory Council, consisting of the Chairman of the Board, the Chairman of the Social Security Board, and twenty members, not otherwise in the employ of the United States, appointed by the Secretary on recommendation of the Board, without regard to the statutory provisions governing appointments in the competitive service. Provides criteria for membership on the Council. Enumerates the functions of the Council. Authorizes to be appropriated to carry out this title: $400,000,000 for the fiscal year ending June 30, 1975, and $600,000,000 for the fiscal year ending June 30, 1976. Title V: Miscellaneous Provisions - Provides for the Administration's certfication of supplemental private health insurance policies. Sets standards with respect to supplemental health insurance policies. Leaves existing employer-employee health benefit plans unaffected. Provides regulations for planning by health care providers and the conditions for payment.
Bill· SS. 3290 (93rd)referred
United States · United States Congress · 2 April 1974
Public Health and National Health Service Corps Scholarship Training Program Amendments - Extends the Public Health and National Health Service Corps Scholarship Training Program to obtain health related specialists not only for the National Health Service Corps but for such other uniformed or civilian Federal health service as the Secretary of Health, Education and Welfare may determine is appropriate. Adds to the criteria for participation in the Program by broadening eligibility to include those selected for civilian service in the National Health Service Corps or in such other uniformed or civilian Federal health service as the Secretary may determine is appropriate and eliminates as criteria for participation in the Program the requirement that each applicant must be eligible for, or hold, an appointment as a commissioned officer in the Regular or Reserve Corps of the Service. Eliminates, as a requirement for participation in the Program, written agreement to serve in the Commissioned Corps of the Service while revising the written agreement requirement to include such other uniformed or civilian Federal health service as the Secretary may determine is appropriate. Alters the active duty obligations of participants in the Program by eliminating the alternative of serving as a commissioned officer in the Service and adding the alternative of serving in such other uniformed or civilian Federal health service as the Secretary may determine is appropriate. Eliminates the requirement that at least one-half of the active duty obligation must be spent providing health care and services in specific areas. Provides that periods of internship or residency shall not be creditable in satisfying an active duty service obligation unless the internship or residency is served in a Federal health facility, thus eliminating the restriction that internship or residency are only creditable when served in a facility of the Public Health Service or other facility of the National Health Service Corps. Eliminates the authorization to appropriate $3,000,000 for the fiscal year ending June 30, 1974, and authorizes the appropriation of such sums as may be necessary to carry out the program. Provides that this Act shall be effective with respect to appropriations for fiscal years ending after June 30, 1974.
Bill· SS. 3286 (93rd)referred
United States · United States Congress · 2 April 1974
Comprehensive National Health Insurance Act - Title I: National Health Insurance Program - National Health Insurance Program - Provides that this Act shall not interfere with the freedom of every physician and every patient to choose where and how they will give or receive health care. States that the national health insurance program established by this title shall be administered by the Board of the Social Security Administration established by this Act. Provides the following benefits under the National Health Insurance Program: (1) inpatient hospital services with no day or dollar limitation; (2) physicians' services, in home, office, or elsewhere, with no dollar limitation; (3) medical and other health services (as defined under medicare); (4) home health services-100 visits per year; (5) post-hospital extended care services-100 days per year; (6) mental health services-inpatient, 30 full days in a psychiatric hospital or 60 partial days; outpatient services in a comprehensive community care center equivalent to the costs of 30 visits to a private practitioner or outpatient services of a private practitioner equal to half the costs of 30 visits; (7) outpatient prescription drugs and biologicals for specified chronic conditions; (8) preventive care services, including (a) routine dental services for children under age 13; (b) developmental vision care services, routine eye and vision exams, and lenses or eyeglasses for children under age 13; (c) hearing aids and exams for children under age 13; (d) well-child care to age 6; (e) prenatal care; and (f) family planning services. Makes services, except those listed under preventive care, subject to a combined annual per person deductible of $150 except that no family would have to meet more than 2 deductibles. States that all services, except drugs, would be subject to a 25-percent coinsurance. Provides that patient drugs would be subject to a separate copayment of $1 per prescription drug. Makes all residents who are not eligible for Medicare eligible for the program through their contributions to the Social Security System, contributions being made by all Americans who have earned or unearned income of any kind, including governmental benefits. Makes each person who is fully or currently insured, as defined under the present social security law, and his dependents eligible. Provides immediate coverage under the plan for the individuals who are not fully or currently insured. Provides that coverage be extended to an employee during the first week during which he worked 25 hours or more, coverage not ending until after there were three consecutive weeks in each of which he did not work 25 hours or more. Provides that people beginning self-employment, or starting to receive unearned income, would be eligible beginning with the first day of the first year in which they have such income. Makes all social security and railroad retirement cash beneficiaries (including widows and widowers under age 65) who are not eligible for coverage under Medicare, eligible for the program. Directs the Social Security Administration to establish for each eligible individual an account against which such individual may charge the cost of obtaining any items and services furnished him under this title, without regard to any deductible or coinsurance requirement which may be applicable. Requires that payment for items and services furnished an eligible individual be made by the Social Security Administration to the providers of services on the basis of charges against such individual's account. States that the Administration shall have full responsibility for the collection of any deductible and coinsurance amounts due from an individual. Provides for a special waiver of or limitation on deductibles and coinsurance for lower income families. Enumerates the conditions of and limitations on payment for the following: (1) requirement of requests and certifications, (2) no payments to Federal providers of services, (3) payment for emergency hospital services, (4) payment for inpatient hospital services prior to notification of noneligibility, (5) payment for posthospital extended care services, (6) payment for home health services, (7) limitation on payment for outpatient drugs and biologicals, (8) limitations on payment for surgery and other specialized services, (9) limitation on payment for practitioner services furnished in nonparticipating hospitals, (10) limitation on payment for certain prosthetic devices, (11) payment for certain outpatient services furnished by nonparticipating hospitals, and (12) collection by hospitals of customary charges for certain outpatient services. Makes provisions for payment to the providers of services and for prospective determination of payment to providers of services. Directs the Administration to award on an annual basis quality management payments to any provider of services under this title whenever either the percentage amount or the dollar amount of increase in such provider's prospective rate for a fiscal year is less than the average annual increase in such rate for the three previous fiscal years for all providers in the same class, such payment to be equal to 50 percent of the difference between such provider's total costs to the program and what its costs to the program would have been had they increased at the class average rate. Lists the agreements a provider of services must file with the Administration in order to qualify to participate and to be eligible for payments under this title. Authorizes the Administration to use public agencies or private organizations to facilitate payment to providers of services. Authorizes the Administation to use carriers, as defined in this Act, for the administration of noninstitutional benefits. Requires that payment for services rendered by a physician be made in accordance with a single fee schedule applicable throughout that area. Provides a method to determine the fee schedule. Allows all physicians to elect whether to participate or not to participate. States that each fee schedule in effect and the names and addresses of all participating physicians shall be made available to the public throughout the State involved, in such manner and at such times as the Administration may consider appropriate, by the Administration or by the appropriate State agency with the approval of the Administration. Establishes, within the Social Security Administration, a National Health Insurance Formulary Committee, a majority of whose members shall be physicians and which shall consist of the Commissioner of Food and Drugs and of four individuals (not otherwise in the employ of the Federal Government) who do not have a direct or indirect financial interest in the compensation of the Formularly established under this Act and who are of recognized professional standing and distinction in the fields of medicine, pharmacology, or pharmacy, to be appointed by the Administration without regard to the statutory provisions governing appointments in the competitive service. Provides that the Chairman of the Committee shall be elected annually from the appointed members, by majority vote of the members of the Committee. Requires the Formulary to compile, publish, and make available a National Health Insurance Formulary, containing an alphabetically arranged listing, by established name, of those drug entities within specified therapeutic categories which the Committee decides are necessary for individuals using such drugs. States that a fee, charge, or billing allowance shall not be payable under this title with respect to any drug entity that is furnished as an incident to a physician's professional service, and is of a kind commonly furnished in physicians' offices and commonly either rendered without charge or included in the physicians' bills. Provides a reasonable allowance for outpatient drugs and biologicals. Makes special provisions for physicians dispensing outpatient drugs and biologicals where the Administration determines that no participating licensed pharmacies exist in a community. Creates on the books of the Treasury of the United States a trust fund to be known as the National Health Insurance Trust Fund and a body to be known as the Board of Trustees of the Trust Fund, composed of the Secretary of the Treasury, the Secretary of Labor, the Chairman of the Board of the Social Security Administration, and the Secretary of Health, Education, and Welfare Directs the Administration to consult with State agencies and other organizations to develop conditions of participation for providers of services. Provides for the use of State agencies to determine compliance by providers of services with the conditions of participation. States that the determination of whether an individual is entitled to benefits under this title, and the determination of the amount of such benefits, shall be made by the Administration in accordance with regulations prescribed by it. Provides that where overpayments on behalf of individuals occur, proper adjustment shall be made under regulations prescribed by the Administration, by decreasing subsequent payments. Provides for the settlement of claims for benefits on behalf of deceased individuals. Provides criminal penalties for violation of this Act. Creates a National Health Insurance Benefits Advisory Council consisting of 19 persons, not otherwise in the employ of the United States, appointed by the Board without regard to statutory provisions governing appointments in the competitive service. Lists criteria for serving on the Council. Declares that it shall be the function of the Advisory Council to provide advice and recommendations for the consideration of the Administration on matters of general policy with respect to this title. Imposes the following taxes for each taxable year for health insurance purposes: two and one half percent of the amount of an individual's self-employment income (and unearned income); on the income of every individual, one percent of the person's wages; and on every employer, an excise tax equal to three percent of the wages paid by him with respect to employment. Provides special coverage provisions, under the Social Security Act, for purposes of National Health Insurance Taxes. Title II: Changes in Medicare Program - Establishes, under title XVIII of the Social Security Act (Medicare), a voluntary program to provide long-term care benefits for aged and disabled individuals who elect to enroll under such program, financed from permium payments by enrollees together with contributions from funds appropriated by the Federal Government and contributions by the States. Lists criteria for eligibility for long-term care service benefits. Provides that the benefits provided to an individual by the program established by this Act shall consist of (1) home health services, (2) homemaker services, (3) nutrition services, (4) long-term institutional care services, (5) day care and foster home services, and (6) community mental health center outpatient services. Enumerates the requirements for a State long-term care agency. Provides for the payment of premiums for benefits received under this Act. Establishes on the books of the Treasury of the United States a trund fund to be known as the Federal Long-Term Care Trust Fund. Creates a body to known as the Board of Trustees, composed of the Secretary of the Treasury, the Secretary of Labor, the Chariman of the Board of the Social Security Administration, and the Secretary of Health, Education, and Welfare. States that the Secretary of the Treasury shall be the Managing Trustee of the Board of Trustees and that the Executive Director of the Social Security Administration shall serve as the Secretary of the Board of Trustees. Provides that the Board of Trustees shall meet not less frequently than once each calendar year. Enumerates the duties of the Board of Trustees. Declares that a community long-term care center shall: (1) provide the items and services listed in this Act to each individual (i) who is eligible for benefits under this part, (ii) who resides in the area served by such center, and (iii) who is certified as requiring such services; (2) evaluate and certify the long-term care needs of an individual for whom such care may be required in order to maintain such individual in an independent living arrangement which is reasonable given such individual's state of health and other circumstances (but not including such individual's economic circumstances); (3) maintain a continuous relationship with (and periodically evaluate not less that annually) each individual who is receiving any of the items and services listed in this Act; (4) provide full opportunity for such individual and his family to participate in the determinations and functions under this Act; (5) provide an organized system for making its existence and location known to all individuals in its service area who are eligible for benefits under this part, and for making known to such individuals the method or methods by which they may most efficiently obtain and use the services which it makes available; and (6) performs such other functions as the Administration may by regulation prescribe in order to have such center most effective carry out the purposes of this Act. Provides a formula for payments to States for the reimbursement of community long-term care centers. Directs the Administration, after consultation with organizations representing the chief executives of the various States, and other interested parties, to develop and make available to community long-term care centers one or more methods of obtaining payment for the benefits covered under this Act on a prospective basis. States that once a community long-term care center elects a particular prospective method, it may not alter its election without the prior approval of the Administration. Provides that whenever the Administration finds that the number of community long-term care centers electing a particular prospective payment method promulgated in accordance with this Act is not sufficient to provide an adequate basis for either the operation or evaluation of that method, the Administration shall withdraw that method and allow the community long-term care centers which have elected such method to select another method within 30 days of notice of such withdrawal. Permits a Governor of a State to certify to the Administration a method of prospective payment other than those promulgated under this Act. States that the determination of whether an individual is entitled to benefits under this Act shall be made by the Administration in accordance with regulations it prescribes. Provides coverage for prescription drugs. Declares that no further deductible or coinsurance requirement shall be imposed under this Act with respect to items or services furnished to or for any individual in any calendar year after the total of the deductibles and coinsurance paid by or on behalf of such individual and the other members of his family in that year equals $1,000. Eliminates the posthospital requirement for home health services under Medicare and the durational limits on inpatient hospital services. Title III: Independent Social Security Administration - Establishes, as an independent agency of the executive branch of the Government, a Social Security Administration to be headed by a Board, consisting of three members appointed by the President, by and with the advice and consent of the Senate. Declares that it shall be the duty of the Administration to administer specified programs of the Social Security Act, and to discharge the duties and responsibilities imposed on the Secretary of Health, Education, and Welfare in connection with the administration of the program established by the Federal Coal Mine Health and Safety Act of 1969. Abolishes the position of Commissioner of Social Security. Title IV: Amendment to Public Health Service Act - Establishes in the Department of Health, Education, and Welfare the Health Resources Development Board which shall be composed of three members to be appointed by the President, by and with the advice and consent of the Senate. Provides for an Executive Director and for the recruitment of qualified persons experienced in the administration or operation of private health insurance and health prepayment plans, or experienced in other fields pertinent to the national health insurance program. Requires the Board to make an annual report to the Committee on Interstate and Foreign Commerce of the United States House of Representatives and to the Committee on Labor and Public Welfare of the United States Senate. Enumerates the functions of the Board including: studies and evaluations, system development, tests and demonstrations, research, and planning. Establishes a National Health Insurance Resources Advisory Council, consisting of the Chairman of the Board, the Chairman of the Social Security Board, and twenty members, not otherwise in the employ of the United States, appointed by the Secretary on recommendation of the Board, without regard to the statutory provisions governing appointments in the competitive service. Provides criteria for membership on the Council. Enumerates the functions of the Council. Authorizes to be appropriated to carry out this title: $400,000,000 for the fiscal year ending June 30, 1975; and $600,000,000 for the fiscal year ending June 30, 1976. Title V: Miscellaneous Provisions - Provides for the Administration's certfication of Supplemental Private Health Insurance Policies. Sets standards with respect to supplemental health insurance policies. Leaves existing employer-employee health benefit plans unaffected. Provides regulations for planning by health care providers and the conditions for payment.
Bill· HRH.R. 13870 (93rd)referred
United States · United States Congress · 2 April 1974
Comprehensive National Health Insurance Act - Title I: National Health Insurance Program - Provides that this Act shall not interfere with the freedom of every physician and every patient to choose where and how they will give or receive health care. States that the national health insurance program established by this title shall be administered by the Board of the Social Security Administration established by this Act. Provides the following benefits under the National Health Insurance Program: (1) inpatient hospital services with no day or dollar limitation; (2) physicians' services, in home, office, or elsewhere, with no dollar limitation; (3) medical and other health services (as defined under medicare); (4) home health services-100 visits per year; (5) post-hospital extended care services-100 days per year; (6) mental health services-inpatient, 30 full days in a psychiatric hospital or 60 partial days; outpatient services in a comprehensive community care center equivalent to the costs of 30 visits to a private practitioner or outpatient services of a private practitioner equal to half the costs of 30 visits; (7) outpatient prescription drugs and biologicals for specified chronic conditions; (8) preventive care services, including (a) routine dental services for children under age 13; (b) developmental vision care services, routine eye and vision exams, and lenses or eyeglasses for children under age 13; (c) hearing aids and exams for children under age 13; (d) well-child care to age 6; (e) prenatal care; and (f) family planning services. Makes all services, except those listed under preventive care subject to a combined annual per person deductible of $150 except that no family would have to meet more than 2 deductibles. States that all services, except drugs, would be subject to a 25-percent coinsurance. Provides that out-patient drugs would be subject to a separate copayment of $1 per prescription drug. Makes all residents who are not eligible for Medicare eligible for the program through their contributions to the Social Security System, contributions being made by all Americans who have earned or unearned income of any kind, including governmental benefits. Makes each person who is fully or currently insured, as defined under the present social security law, and his dependents eligible. Provides immediate coverage under the plan for the individuals who are not fully or currently insured. Provides that coverage be extended to an employee during the first week during which he worked 25 hours or more, coverage not ending until after there were three consecutive weeks in each of which he did not work 25 hours or more. Provides that people beginning self-employment, or starting to receive unearned income, would be eligible beginning with the first day of the first year in which they have such income. Makes all social security and railroad retirement cash beneficiaries (including widows and widowers under age 65) who are not eligible for coverage under Medicare, eligible for the program. Directs the Social Security Administration to establish for each eligible individual an account against which such individual may charge the cost of obtaining any items and services furnished him under this title, without regard to any deductible or coinsurance requirement which may be applicable. Requires that payment for items and services furnished an eligible individual be made by the Social Security Administration to the providers of services on the basis of charges against such individual's account. States that the Administration shall have full responsibility for the collection of any deductible and coinsurance amounts due from an individual. Provides for a special waiver of or limitation on deductibles and coinsurance for lower income families. Enumerates the conditions of and limitations on payment for the following: (1) requirement of requests and certifications, (2) no payments to Federal providers of services, (3) payment for emergency hospital services, (4) payment for inpatient hospital services prior to notification of noneligibility, (5) payment for posthospital extended care services, (6) payment for home health services, (7) limitation on payment for outpatient drugs and biologicals, (8) limitations on payment for surgery and other specialized services, (9) limitation on payment for practitioner services furnished in nonparticipating hospitals, (10) limitation on payment for certain prosthetic devices, (11) payment for certain outpatient services furnished by nonparticipating hospitals, and (12) collection by hospitals of customary charges for certain outpatient services. Makes provisions for payment to the providers of services and for prospective determination of payment to providers of services. Directs the Administration to award on an annual basis quality management payments to any provider of services under this title whenever either the percentage amount or the dollar amount of increase in such provider's prospective rate for a fiscal year is less than the average annual increase in such rate for the three previous fiscal years for all providers in the same class, such payment to be equal to 50 percent of the difference between such provider's total costs to the program and what its costs to the program would have been had they increased at the class average rate. Lists the agreements a provider of services must file with the Administration in order to qualify to participate and to be eligible for payments under this title. Authorizes the Administration to use public agencies or private organizations to facilitate payment to providers of services. Authorizes the Administation to use carriers, as defined in this Act, for the administration of noninstitutional benefits. Requires that payment for services rendered by a physician be made in accordance with a single fee schedule applicable throughout that area. Provides a method to determine the fee schedule. Allows all physicians to elect whether to participate or not to participate. States that each fee schedule in effect and the names and addresses of all participating physicians shall be made available to the public throughout the State involved, in such manner and at such times as the Administration may consider appropriate, by the Administration or by the appropriate State agency with the approval of the Administration. Establishes, within the Social Security Administration, a National Health Insurance Formulary Committee, a majority of whose members shall be physicians and which shall consist of the Commissioner of Food and Drugs and of four individuals (not otherwise in the employ of the Federal Government) who do not have a direct or indirect financial interest in the compensation of the Formularly established under this Act and who are of recognized professional standing and distinction in the fields of medicine, pharmacology, or pharmacy, to be appointed by the Administration without regard to the statutory provisions governing appointments in the competitive service. Provides that the Chairman of the Committee shall be elected annually from the appointed members, by majority vote of the members of the Committee. Requires the Formulary to compile, publish, and make available a National Health Insurance Formulary, containing an alphabetically arranged listing, by established name, of those drug entities within specified therapeutic categories which the Committee decides are necessary for individuals using such drugs. States that a fee, charge, or billing allowance shall not be payable under this title with respect to any drug entity that is furnished as an incident to a physician's professional service, and is of a kind commonly furnished in physicians' offices and commonly either rendered without charge or included in the physicians' bills. Provides a reasonable allowance for outpatient drugs and biologicals. Makes special provisions for physicians dispensing outpatient drugs and biologicals where the Administration determines that no participating licensed pharmacies exist in a community. Creates on the books of the Treasury of the United States a trust fund to be known as the National Health Insurance Trust Fund and a body to be known as the Board of Trustees of the Trust Fund, composed of the Secretary of the Treasury, the Secretary of Labor, the Chairman of the Board of the Social Security Administration, and the Secretary of Health, Education, and Welfare. Directs the Administration to consult with State agencies and other organizations to develop conditions of participation for providers of services. Provides for the use of State agencies to determine compliance by providers of services with the conditions of participation. States that the determination of whether an individual is entitled to benefits under this title, and the determination of the amount of such benefits, shall be made by the Administration in accordance with regulations prescribed by it. Provides that where overpayments on behalf of individuals occur, proper adjustment shall be made under regulations prescribed by the Administration, by decreasing subsequent payments. Provides for the settlement of claims for benefits on behalf of deceased individuals. Provides criminal penalties for violation of this Act. Creates a National Health Insurance Benefits Advisory Council consisting of 19 persons, not otherwise in the employ of the United States, appointed by the Board without regard to statutory provisions governing appointments in the competitive service. Lists criteria for serving on the Council. Declares that it shall be the function of the Advisory Council to provide advice and recommendations for the consideration of the Administration on matters of general policy with respect to this title. Imposes the following taxes for each taxable year for health insurance purposes: two and one half percent of the amount of an individual's self-employment income (and unearned income); on the income of every individual, one percent of the person's wages; and on every employer, an excise tax equal to three percent of the wages paid by him with respect to employment. Provides special coverage provisions, under the Social Security Act, for purposes of National Health Insurance Taxes. Title II: Changes in Medicare Program - Establishes, under title XVIII of the Social Security Act (Medicare), a voluntary program to provide long-term care benefits for aged and disabled individuals who elect to enroll under such program, financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government and contributions by the States. Lists criteria for eligibility for long-term care service benefits. Provides that the benefits provided to an individual by the program established by this Act shall consist of (1) home health services, (2) homemaker services, (3) nutrition services, (4) long-term institutional care services, (5) day care and foster home services, and (6) community mental health center outpatient services. Enumerates the requirements for a State long-term care agency. Provides for the payment of premiums for benefits received under this Act. Establishes on the books of the Treasury of the United States a trund fund to be known as the Federal Long-Term Care Trust Fund. Creates a body to known as the Board of Trustees, composed of the Secretary of the Treasury, the Secretary of Labor, the Chariman of the Board of the Social Security Administration, and the Secretary of Health, Education, and Welfare. States that the Secretary of the Treasury shall be the Managing Trustee of the Board of Trustees and that the Executive Director of the Social Security Administration shall serve as the Secretary of the Board of Trustees. Provides that the Board of Trustees shall meet not less frequently than once each calendar year. Enumerates the duties of the Board of Trustees. Declares that a community long-term care center shall: (1) provide the items and services listed in this Act to each individual (i) who is eligible for benefits under this part, (ii) who resides in the area served by such center, and (iii) who is certified as requiring such services; (2) evaluate and certify the long-term care needs of an individual for whom such care may be required in order to maintain such individual in an independent living arrangement which is reasonable given such individual's state of health and other circumstances (but not including such individual's economic circumstances); (3) maintain a continuous relationship with (and periodically evaluate not less that annually) each individual who is receiving any of the items and services listed in this Act; (4) provide full opportunity for such individual and his family to participate in the determinations and functions under this Act; (5) provide an organized system for making its existence and location known to all individuals in its service area who are eligible for benefits under this part, and for making known to such individuals the method or methods by which they may most efficiently obtain and use the services which it makes available; and (6) performs such other functions as the Administration may by regulation prescribe in order to have such center most effective carry out the purposes of this Act. Provides a formula for payments to States for the reimbursement of community long-term care centers. Directs the Administration, after consultation with organizations representing the chief executives of the various States, and other interested parties, to develop and make available to community long-term care centers one or more methods of obtaining payment for the benefits covered under this Act on a prospective basis. States that once a community long-term care center elects a particular prospective method, it may not alter its election without the prior approval of the Administration. Provides that whenever the Administration finds that the number of community long-term care centers electing a particular prospective payment method promulgated in accordance with this Act is not sufficient to provide an adequate basis for either the operation or evaluation of that method, the Administration shall withdraw that method and allow the community long-term care centers which have elected such method to select another method within 30 days of notice of such withdrawal. Permits a Governor of a State to certify to the Administration a method of prospective payment other than those promulgated under this Act. States that the determination of whether an individual is entitled to benefits under this Act shall be made by the Administration in accordance with regulations it prescribes. Provides coverage for prescription drugs. Declares that no further deductible or coinsurance requirement shall be imposed under this Act with respect to items or services furnished to or for any individual in any calendar year after the total of the deductibles and coinsurance paid by or on behalf of such individual and the other members of his family in that year equals $1,000. Eliminates the posthospital requirement for home health services under Medicare and the durational limits on inpatient hospital services. Title III: Independent Social Security Administration - Establishes, as an independent agency of the executive branch of the Government, a Social Security Administration to be headed by a Board, consisting of three members appointed by the President, by and with the advice and consent of the Senate. Declares that it shall be the duty of the Administration to administer specified programs of the Social Security Act, and to discharge the duties and responsibilities imposed on the Secretary of Health, Education, and Welfare in connection with the administration of the program established by the Federal Coal Mine Health and Safety Act of 1969. Abolishes the position of Commissioner of Social Security. Title IV: Amendment to Public Health Service Act - Establishes in the Department of Health, Education, and Welfare the Health Resources Development Board which shall be composed of three members to be appointed by the President, by and with the advice and consent of the Senate. Provides for an Executive Director and for the recruitment of qualified persons experienced in the administration or operation of private health insurance and health prepayment plans, or experienced in other fields pertinent to the national health insurance program. Requires the Board to make an annual report to the Committee on Interstate and Foreign Commerce of the United States House of Representatives and to the Committee on Labor and Public Welfare of the United States Senate. Enumerates the functions of the Board including: studies and evaluations, systems development, tests and demonstrations, research, and planning. Establishes a National Health Insurance Resources Advisory Council, consisting of the Chairman of the Board, the Chairman of the Social Security Board, and twenty members, not otherwise in the employ of the United States, appointed by the Secretary on recommendation of the Board, without regard to the statutory provisions governing appointments in the competitive service. Provides criteria for membership on the Council. Enumerates the functions of the Council. Authorizes to be appropriated to carry out this title: $400,000,000 for the fiscal year ending June 30, 1975, and $600,000,000 for the fiscal year ending June 30, 1976. Title V: Miscellaneous Provisions - Provides for the Administration's certfication of supplemental private health insurance policies. Sets standards with respect to supplemental health insurance policies. Leaves existing employer-employee health benefit plans unaffected. Provides regulations for planning by health care providers and the conditions for payment.
Bill· SS. 3280 (93rd)passed
United States · United States Congress · 1 April 1974
Health Services Act - Title I: Community Health Centers, Migrant Health Centers, and Community Mental Health Centers - Sets forth congressional findings regarding the need for the provision of high quality essential health services and comprehensive mental health services in all American communities. States that the essential health services which shall be provided by a community health center are: (1) physician services (including consultant and referral services by a physician) and, where feasible, services of physicians' assistants and nurse clinicians; (2) emergency medical services; (3) diagnostic laboratory and radiologic services; (4) preventive health services; (5) transportation services necessary to overcome special difficulty of access to services provided by the community health center; and (6) services which promote and facilitate optimal use of available health services. Specifies that a community health center shall provide services in the following manner: (1) directly through its own professional staff and supporting resources; and (2) indirectly under agreements with providers designed to assure to the patient maximum accessibility to efficient, economical, and high-quality services. Authorizes the Secretary of Health, Education, and Welfare to make planning grants to any public or private nonprofit agency, organization, or institution which has demonstrated the capacity to prepare a satisfactory plan for providing essential health services through a community health center. Provides that the Secretary may make development grants to any public or private nonprofit agency, organization, or institution which has a plan satisfactory to the Secretary for providing essential health services through a community health center. States that grants for development shall be made to assist in meeting the costs of: (1) development of essential and supplemental health services, including the addition of new services to those already offered, to the extent that such costs are not ordinary costs of operation, as defined in regulations of the Secretary; (2) development of the resources and techniques to achieve compliance with specified conditions; and (3) acquisition and construction of new facilities, expansion and remodeling of existing facilities, leasing of facilities, and initial equipment of facilities acquired, constructed, expanded, remodeled, or leased with financial assistance provided for grants under this Act. Authorizes the Secretary to make operating grants to any: (1) community health center; or (2) public or private nonprofit agency, organization, or institution which is providing services or meets the definition of a community health center except that it is not providing all of the essential health services described in this Act. Sets forth conditions to be met for approval of grant applications. Directs the Secretary to appoint and organize a National Advisory Council on Community Health Centers which shall advise, consult with, and make recommendations to the Secretary on matters concerning the organization, operation, and funding of community health centers and other grantees. Authorizes appropriations of $500,000 for each fiscal year 1975-1979 for planning grants. Authorizes appropriations of $30,000,000 for each fiscal year 1975-1979 for development grants. Authorizes necessary appropriations for the fiscal year ending June 30, 1975, and for each of the succeeding four fiscal years to make operating grants. Directs the Secretary to make available planning, development, and operating grants for the establishment and maintenance of migrant health centers. Sets forth conditions for the approval of migrant health center grants. Directs the Secretary to appoint and organize a National Advisory Council on Migrant Health Centers which shall advise, consult with, and make recommendations to the Secretary on matters concerning the organization, operation, and funding of migrant health centers and other grantees under this part. Authorizes appropriations for migrant health center grants for the fiscal years 1975, 1976, 1977, 1978, and 1979. Directs the Secretary to make available planning, development, and operating grants for the establishment and maintenance of community mental health centers. Sets forth conditions for the approval of mental health center grants. Authorizes the Secretary to provide all necessary technical and other nonfinancial assistance (including fiscal and program management and training in fiscal and program management) to any public or private, nonprofit agency, organization, or institution which is eligible to receive grants under this Act to assist such agency, organization, or institution in developing plans for and in becoming a community health center. Authorizes appropriations for community mental health center grants for the fiscal years 1975, 1976, 1977, 1978, and 1979. Title II: Health Revenue Sharing - Authorizes appropriations of $90,000,000 for the fiscal year ending June 30, 1975, and for each of the four succeeding fiscal years for grants to States for comprehensive public health resources.
Bill· HRH.R. 13859 (93rd)referred
United States · United States Congress · 1 April 1974
Redefines "spell of illness" under the medicare provisions of the Social Security Act.
Bill· HRH.R. 13819 (93rd)referred
United States · United States Congress · 28 March 1974
Repeals, under the Social Security Act, the provisions for the establishment of Professional Standards Review Organizations to review services covered under the medicare and medicaid programs.
Bill· HRH.R. 13811 (93rd)referred
United States · United States Congress · 28 March 1974
Health Security Act - Title I: Health Security Benefits - Provides that every resident of the U.S. (and every non-resident citizen when in the U.S.) will be eligible for covered services. Permits reciprocal and "buy-in" agreements for groups of non-resident aliens, and in some cases benefits to U.S. residents when visiting in other countries. Entitles every eligible person to have payments made by the Health Security Board for covered services provided within the United States by a participating provider. Provides that all necessary professional services of physicians, wherever furnished are covered, including preventive care, with two important restrictions: (1) specialist services are covered only when performed by a qualified specialist except in emergency situations, and generally only on referral from a primary physician; and (2) psychiatric services to an ambulatory patient are covered only for active preventive, diagnostic, therapeutic or rehabilitative service with respect to mental illness. Provides that comprehensive dental services (exclusive of most orthodontic services) are covered for children under age 15, with the covered age group increasing by two years each year until all those under age 25 are covered. Provides that: (1) inpatient and outpatient hospital services and services of a home health agency are covered without arbitrary limitation; (2) pathology and radiology services are specifically included as parts of institutional services; and (3) custodial care is specifically excluded in specified institutional settings. Limits payment for skilled nursing home care to 120 days per spell of illness, except that this limit may be increased when the nursing home is owned or managed by a hospital and payment for care is made through the hospital's budget. Limits the psychiatric hospital benefit to 45 consecutive days of active treatment during a spell of illness. Provides coverage for two categories of drug use: prescribed medicines administered to inpatients or outpatients within participating hospitals; or to enrollees of comprehensive health service organizations, and drugs necessary for the treatment of specified chronic illnesses or conditions requiring long or expensive therapy. Requires the Board and the Secretary of Health, Education, and Welfare to establish two lists of approved drugs, taking into account the safety, efficacy and cost of each drug. Provides a broad list of approved medicines available for use in institutions and by comprehensive health service organizations and a more restricted list which is available for use outside such organized settings. Provides that the appliances benefit is similar in concept and operation to the drug benefit, subject to a limitation on aggregate cost. Asserts that the professional services of optometrists and podiatrists are covered, subject to regulations, as are diagnostic or therapeutic services furnished by independent pathology laboratories and radiology services. States that health services furnished or paid for under a workmen's compensation law are not covered. Provides that the services of a professional practitioner are not covered if they are furnished in a hospital which is not a participating provider. Requires that participating providers meet standards established in this title or by the Board. Requires that such providers must agree to provide services without discrimination, to make no unauthorized charge to the patient for any covered service, and to furnish data necessary for utilization review by professional peers, statistical studies by the Board, and verification of information for payments. Makes professional practitioners, licensed when the program begins, eligible to practice in the State where they are licensed and requires that all newly licensed applicants for participation meet national standards established by the Board in addition to those required by his State. Establishes conditions of participation for general hospitals similar to those required under Medicare. States that the two requirements not found in the Medicare program are: (1) that the hospital must not discriminate in granting staff privileges on any grounds unrelated to professional qualifications; and (2) that it establish a pharmacy and drug therapeutics committee for supervision of hospital drug therapy. Provides that psychiatric hospitals will be eligible to participate only if the Board finds that the hospital (or a distinct part of the hospital) is engaged in furnishing active diagnostic, therapeutic and rehabilitative services to mentally ill patients. Establishes conditions of participation for skilled nursing homes similar to those established for extended care facilities under Medicare. Makes provisions for the participation of home health service agencies. Describes as eligible a health maintenance organization which undertakes to provide an enrolled population either with complete health care or with complete health security services (other than institutional services, mental health or dental services) for the maintenance of the health and care of ambulatory patients. Permits a foundation sponsored by a county or other local medical society to participate as a provider of services. Authorizes the Board to deal separately with the primary care portion of a system of comprehensive health care where it is necessary to rely on arrangements with other providers. Permits the Board to contract directly with public or other nonprofit mental health centers and mental health day care services. Specifies the broad and general conditions under which independent pathology laboratories, independent radiological services, and providers of drugs, devices, appliances, equipment, or ambulance services may qualify as providers under Health Security. Requires that a participating skilled nursing home have in effect an agreement with at least one participating hospital for the transfer of patients and medical and other information as medically appropriate. Prohibits in malpractice judgments any damages to be awarded to the injured party for the cost of remedial services which he is entitled to receive under this Act. Excludes the institutions of the Department of Defense and the Veterans Administration, and institutions of the Department of Health, Education, and Welfare serving merchant seamen or Indians or Alaskan natives, from serving as participating providers, as well as any employee of these institutions when he is acting as an employee. Provides reimbursement for any services furnished by these institutions or agencies to eligible persons who are not a part of their normal clientele. Permits a physician, dentist, optometrist, or podiatrist, licensed in one State and meeting the national standards, to furnish Health Security benefits in any other State, the scope of his permissible practice being governed by the law of the State in which he is practicing. Grants a similar authority to other health professional and nonprofessional personnel. Establishes the Health Security Trust Fund, to receive the net assets of existing (Medicare) funds taken over by the Health Security program, the yield of the Health Security taxes, and the Government's contribution from general revenues amounting to 100 percent of the yield from these taxes. Provides that three separate accounts shall be established in the Health Security Trust Fund: a Health Service Account, a Health Resources Development Account, and an Administration Account. Provides that in each of the first two years of the program operation, 2 percent of the Trust Fund shall be set aside for the Health Resources Development Fund; and the allocation shall increase by 1 percent at two-year intervals to 5 percent within the next 6 years. Provides for allocation of the Health Services account among the regions of the country. Provides that the allocation to each region shall be based on the aggregate sum expended during the most recent 12-month period for covered services (with appropriate modification for estimated changes in the consumer price index, the expected number of eligible beneficiaries, and estimated changes in the number of participating providers). Provides that the Board will divide the allocation to each region into funds available to pay: institutional services; physician services; dental services; furnishing of drugs; furnishing of devices, applications, and equipment; and miscellaneous services. Provides that payments for covered services provided to eligible persons by participating providers will be made from the Health Service Account in the Trust Fund. Describes the method to be used in applying, as between practitioners electing the various methods of payment fee for service, the monies available in each health service area for payment to each category of professional providers. Authorizes the Board to experiment with other methods of reimbursement so long as the experimental method does not increase the cost of service or lead to overutilization or underutilization of services. Provides that skilled nursing homes and home health agencies will be paid in the same manner as a general hospital (on an approved annual budget basis). Provides that a health maintenance organization will be paid for covered services, on the basis of a fixed capitation rate multiplied by the number of eligible enrollees. Contains a series of provisions for developing a continuous process of health service planning and for assisting in the recruitment, education, and training of health personnel. Authorizes special improvement grants: (1) to any public or other nonprofit health agency or institution to establish improved coordination and linkages with other providers of services, and (2) to organizations providing comprehensive ambulatory care to improve their utilization review, budget, statistical, or records and information retrieval systems, to acquire equipment needed for those purposes, or to acquire equipment useful for mass screening or for other diagnostic or therapeutic purposes. Sets forth the responsibilities and duties of the Secretary of HEW and the Board with regard to this title. Creates an administrative structure within the Department of Health, Education, and Welfare with exclusive responsibility for administration of the Health Security program. Establishes a five-member full-time Health Security Board serving under the Secretary of Health, Education, and Welfare. Provides that the members shall be appointed by the President with the advice and consent of the Senate, for five-year overlapping terms. Creates the position of an Executive Director, appointed by the Board with the approval of the Secretary. Provides that the Executive Director shall serve as secretary to the Board and shall perform such duties in the administration of the program as the Board assigns to him. Provides that the program will be administered through the regional offices of the Department of Health, Education, and Welfare. Requires the establishment of sub-regional (service area) offices. Establishes a National Health Security Advisory Council, with the Chairman of the Board serving as the Council's Chairman and 20 additional members not in the employ of the Federal Government. Authorizes the Advisory Council to appoint professional or technical committees to assist in its functions. Provides that the Advisory Council will advise the Board on matters of general policy in the administration of the program, the formulation of regulations and the allocation of funds for services. Charges the Board with responsibility for informing the public and providers about the administration and operation of the Health Security program. Requires the Board to make a continuing study and evaluation of the program, including adequacy, quality and costs of services. Authorizes the Board directly or by contract to make detailed statistical and other studies on a national, regional, or local basis of any aspect of the title; to develop and test incentive systems for improving quality of care, methods of peer review of drug utilization and of other service performances; to develop and test systems of information retrieval, budget programs, instrumentation for multiphasic screening or patient services, reimbursement systems for drugs; and to make such other studies which it considers would improve the quality of services of administration of the program. Grants authority to the Board, in accordance with regulations, to make determinations of who are participating providers of services, determinations of eligibility, of whether services are covered, and the amount to be paid to providers. Allows a provider of services who is dissatisfied with a final Board determination to obtain a hearing before a Board panel, and judicial review of a final decision. Authorizes the Board, with the advice and assistance of the Commission on the Quality of Health Care, to issue and review regulations assuring the quality of care furnished under this Act. Requires continuing professional education by physicians, dentists, optometrists, and podiatrists. Provides for the appointment of a Deputy Secretary of HEW and an Under Secretary for Health and Science. States that no provision of this Act shall alter any contractual obligation of an employer to provide health services to his employees and their dependents. Title II: Health Security Taxes - Converts the existing Medicare hospital insurance payroll taxes into Health Security taxes, and raises the rates to 1 percent on employees and 3.5 percent on employers. Raises the wage base for the employee tax from the present $7,800 to $15,000 or, if higher 125 percent of the contribution and benefit base. Broadens the definitions of covered employment to include foreign agricultural workers, employees of the U.S. and its instrumentalities (other than members of the armed forces and the President, Vice-President, and Members of Congress), employees of charitable and similar organizations, railroad employees, and (for the employee tax only) employees of States and their political subdivisions and instrumentalities. Excludes from the gross income of employees, for income tax purposes, payment by their employers of part or all of the Health Security taxes on the employees. Spells out the precise effective dates of the new payroll tax provisions. Converts the existing Medicare self-employment tax into a Health Security self-employment tax, and raises the rate to 2.5 percent, and raises the maximum taxable self-employment income from $7,800 to $15,000. Adds a new 1 percent Health Security tax on unearned income (unless such income is less than $400 a year), subject to the same maximum on taxable income as is applicable to the employee and self-employment taxes. Title III: Commission on the Quality of Health Care - Establishes in the Department of HEW a Commission on the Quality of Health Care, with the primary responsibility of: (1) initiating and continuing development of methods of assessing the quality of health care furnished under the Health Security Act, and (2) submitting to the Secretary and the Health Security Board its findings and recommendations. Stipulates that in carrying out its duties the Commissioner shall emphasize, and give first consideration to, care furnished for those illnesses and conditions which have relatively high incidence in the population and which are relatively amenable to medical or other care. Title IV: Repeal or Amendment of Other Acts - Makes various conforming amendments to the medicare, medicaid, vocational rehabilitation, and Federal employees health benefits statutes to bring it into conformity with this Act. Requires that, after the effective date of benefits, no State shall be required to furnish any service covered under Health Security as a part of its State plan for participation under Medicaid, and that the Federal government will have no responsibility to reimburse any State for the cost of providing a service which is covered under Health Security. Provides that funds available under the Vocational Rehabilitation Act or the Maternal and Child Health title of the Social Security Act shall not be used to pay for personal health services after the effective date of benefits, except (to the extent prescribed in regulations by the Secretary of HEW) to pay for services which are more extensive than those covered under Health Security. Title V: Studies Related to Health Security - Authorizes the Secretary of Health, Education, and Welfare in consultation with the Secretary of State and the Secretary of Treasury to study the coverage of health services for U.S. residents in other countries. Directs the Secretary of HEW to study the feasibility and desirability of coordinating the Federal health benefit programs for merchant seamen, and Indians and Alaskan natives, and veterans and members of the Armed Forces, with the Health Security Benefit Program.
Bill· HRH.R. 13782 (93rd)referred
United States · United States Congress · 27 March 1974
Repeals, under the Social Security Act, the provisions for the establishment of Professional Standards Review Organizations to review services covered under the medicare and medicaid programs.
Bill· HRH.R. 13769 (93rd)referred
United States · United States Congress · 27 March 1974
Comprehensive Medicare Reform Act - Title I: Revision of Medicare Entitlement and Benefits - Repeals Parts A (Hospital Insurance Benefits for the Aged) and Part B (Supplementary Medical Insurance Benefits for the Aged) of Title XVIII (Health Insurance for the Aged) of the Social Security Act and enacts in lieu of those parts the provisions of this title. Lowers the age for participation in the Insurance Plan (Medicare) provided under title XVIII for specified classes of individuals. Makes the following classes of persons entitled to benefits under such title: (1) specified individuals receiving disability payments, and (2) specified individuals with chronic renal disease. Specifies covered institutional services including, but not limited to: (1) inpatient and outpatient hospital services; (2) skilled-nursing home services; (3) intermediate-care facility services; and (4) home health services. Lists the following covered services: (1) physicians' services (including psychiatric services if provided by a health maintenance organization); (2) dental services; (3) drugs; (4) devices, appliances, and equipment (if the item is prescribed or certified as medically necessary by an appropriate professional practitioner and if it appears on a current list of items established by the Secretary of Health, Education, and Welfare); and (5) other professional and supporting services, including, but not limited to (a) the professional services of optometrists, (b) the professional services of podiatrists, and (c) the diagnostic services of independent pathology laboratories, and diagnostic and therapeutic radiology furnished by independent radiology services. Excludes services and items from coverage under this title, including but not limited to: (1) services furnished outside the United States, with an exception for specified hospital services and related professional services; (2) the furnishing of personal comfort items; (3) purely custodial care; (4) cosmetic services; and (5) services for which the individual has no legal obligation to pay. Provides for the reduction in the amounts otherwise payable under this title from the Medicare Trust Fund with respect to a covered service based upon the applicable amount of coinsurance held by individuals entitled to benefits under this title. Provides for exceptions to the above reductions in the cases of low-income persons, members of low-income families, and specified cases of payment of catastrophic expense benefits. Sets forth a schedule for the degree of payment reduction by type of service to be effectuated by the individual's coinsurance amount. Sets forth an initial table for the determination of income classes for individuals and members of families under this title. Provides for the periodic revision of income classes established under this title. Provides for the periodic revision of the catastrophic expense benefit expenditure limitations sets under this title. Provides that payment of covered services provided to an individual by an institutional provider shall be made only to that provider. States that the amount payable to that provider with respect to such services shall be the reasonable cost of the services to the provider governed by the provisions of this title less the amount of any payment of coinsurance. Provides that payment for covered services that were furnished to an individual by a noninstitutional provider shall be made only to: (1) the participating provider who furnished the services, or (2) in the case of emergency services furnished by a nonparticipating provider, either (a) to the individual on the basis of an itemized bill, or (b) to the provider on the basis of an assignment from the individual. Authorizes the Secretary to enter into contracts with carriers under which the carrier, on behalf of the Secretary (and subject to review by the Secretary), will perform administrative functions, including the administration of benefits under this Act. Provides that no contract shall be entered into with a carrier unless the Secretary finds that the carrier will perform its obligations under the contract efficiently and effectively and will meet such requirements as to financial responsibility, legal authority, and other matters as he finds pertinent. Creates the Medicare Trust Fund which shall consist of the assets and liabilities of the Federal Hospital Insurance Fund and the Federal Supplementary Medical Insurance Trust Fund. Authorizes to be appropriated to the Trust Fund a Government contribution in an amount, as estimated by the Board of Trustees, which when added to other income and assets of the Trust Fund will make the Trust Fund sufficient for the prompt payment of all amounts required or authorized by law to be paid therefrom. Authorizes the Board to borrow funds from the Treasury, pending the approval by Congress of the Government contribution, if the Board determines that the amount of the Trust Fund is insufficient to make all required payments in the next three calendar months. Creates an Institutional Provider Reimbursement Review Board to hear disputes presented by any institutional provider of services which has filed a required cost report (for purposes of reimbursement) within the time specified in regulations if: (1) the provider is dissatisfied with a final determination of the organization serving as its fiscal intermediary as to the amount of total program reimbursement due the provider for the items and services furnished to individuals for which payment may be made under this title for the period covered by the report; (2) the amount in controversy is $10,000 or more; and (3) the provider files a request for a hearing within 180 days after notice of the intermediary's final determination. Title II: Health Insurance Taxes - Defines the term "employment" for purposes of the health insurance tax provisions of the Internal Revenue Code of 1954. Provides for the exclusion of employer payment of employee taxes from employees' gross income as determined under such provisions of such Code. Title III: Studies Related to Long-Term Care - Authorizes the Secretary of Health, Education, and Welfare, the Secretary of Housing and Urban Development, and the Secretary of Labor to conduct a joint study on the subject of health related and other long-term institutional care. Authorizes additional studies by the Secretary of Health, Education, and Welfare and the Secretary of Housing and Urban Development concerning the provision of social services to enable elderly persons to live in their own homes. Requires the Secretaries to submit reports to the President and the Congress not later than two years after the date of enactment of this Act.
Bill· HRH.R. 13779 (93rd)referred
United States · United States Congress · 27 March 1974
Authorizes an appropriation of $35,000,000 for fiscal year 1975 for the expenses of the National Institute of Neurological Diseases and Stroke in carrying out title IV of the Public Health Service Act with respect to dystonia.
Bill· HRH.R. 13792 (93rd)referred
United States · United States Congress · 27 March 1974
Authorizes the Administrator of the Environmental Protection Agency to promote to Assistant Surgeon General commissioned officers of the Public Health Service assigned to the Agency.
Bill· HRH.R. 13784 (93rd)referred
United States · United States Congress · 27 March 1974
Comprehensive Medicare Reform Act - Title I: Revision of Medicare Entitlement and Benefits - Repeals Parts A (Hospital Insurance Benefits for the Aged) and Part B (Supplementary Medical Insurance Benefits for the Aged) of Title XVIII (Health Insurance for the Aged) of the Social Security Act and enacts in lieu of those parts the provisions of this title. Lowers the age for participation in the Insurance Plan (Medicare) provided under title XVIII for specified classes of individuals. Makes the following classes of persons entitled to benefits under such title: (1) specified individuals receiving disability payments, and (2) specified individuals with chronic renal disease. Specifies covered institutional services including, but not limited to: (1) inpatient and outpatient hospital services; (2) skilled-nursing home services; (3) intermediate-care facility services; and (4) home health services. Lists the following covered services: (1) physicians' services (including psychiatric services if provided by a health maintenance organization); (2) dental services; (3) drugs; (4) devices, appliances, and equipment (if the item is prescribed or certified as medically necessary by an appropriate professional practitioner and if it appears on a current list of items established by the Secretary of Health, Education, and Welfare); and (5) other professional and supporting services, including, but not limited to (a) the professional services of optometrists, (b) the professional services of podiatrists, and (c) the diagnostic services of independent pathology laboratories, and diagnostic and therapeutic radiology furnished by independent radiology services. Excludes services and items from coverage under this title, including but not limited to: (1) services furnished outside the United States, with an exception for specified hospital services and related professional services; (2) the furnishing of personal comfort items; (3) purely custodial care; (4) cosmetic services; and (5) services for which the individual has no legal obligation to pay. Provides for the reduction in the amounts otherwise payable under this title from the Medicare Trust Fund with respect to a covered service based upon the applicable amount of coinsurance held by individuals entitled to benefits under this title. Provides for exceptions to the above reductions in the cases of low-income persons, members of low-income families, and specified cases of payment of catastrophic expense benefits. Sets forth a schedule for the degree of payment reduction by type of service to be effectuated by the individual's coinsurance amount. Sets forth an initial table for the determination of income classes for individuals and members of families under this title. Provides for the periodic revision of income classes established under this title. Provides for the periodic revision of the catastrophic expense benefit expenditure limitations sets under this title. Provides that payment of covered services provided to an individual by an institutional provider shall be made only to that provider. States that the amount payable to that provider with respect to such services shall be the reasonable cost of the services to the provider governed by the provisions of this title less the amount of any payment of coinsurance. Provides that payment for covered services that were furnished to an individual by a noninstitutional provider shall be made only to: (1) the participating provider who furnished the services, or (2) in the case of emergency services furnished by a nonparticipating provider, either (a) to the individual on the basis of an itemized bill, or (b) to the provider on the basis of an assignment from the individual. Authorizes the Secretary to enter into contracts with carriers under which the carrier, on behalf of the Secretary (and subject to review by the Secretary), will perform administrative functions, including the administration of benefits under this Act. Provides that no contract shall be entered into with a carrier unless the Secretary finds that the carrier will perform its obligations under the contract efficiently and effectively and will meet such requirements as to financial responsibility, legal authority, and other matters as he finds pertinent. Creates the Medicare Trust Fund which shall consist of the assets and liabilities of the Federal Hospital Insurance Fund and the Federal Supplementary Medical Insurance Trust Fund. Authorizes to be appropriated to the Trust Fund a Government contribution in an amount, as estimated by the Board of Trustees, which when added to other income and assets of the Trust Fund will make the Trust Fund sufficient for the prompt payment of all amounts required or authorized by law to be paid therefrom. Authorizes the Board to borrow funds from the Treasury, pending the approval by Congress of the Government contribution, if the Board determines that the amount of the Trust Fund is insufficient to make all required payments in the next three calendar months. Creates an Institutional Provider Reimbursement Review Board to hear disputes presented by any institutional provider of services which has filed a required cost report (for purposes of reimbursement) within the time specified in regulations if: (1) the provider is dissatisfied with a final determination of the organization serving as its fiscal intermediary as to the amount of total program reimbursement due the provider for the items and services furnished to individuals for which payment may be made under this title for the period covered by the report; (2) the amount in controversy is $10,000 or more; and (3) the provider files a request for a hearing within 180 days after notice of the intermediary's final determination. Title II: Health Insurance Taxes - Defines the term "employment" for purposes of the health insurance tax provisions of the Internal Revenue Code of 1954. Provides for the exclusion of employer payment of employee taxes from employees' gross income as determined under such provisions of such Code. Title III: Studies Related to Long-Term Care - Authorizes the Secretary of Health, Education, and Welfare, the Secretary of Housing and Urban Development, and the Secretary of Labor to conduct a joint study on the subject of health related and other long-term institutional care. Authorizes additional studies by the Secretary of Health, Education, and Welfare and the Secretary of Housing and Urban Development concerning the provision of social services to enable elderly persons to live in their own homes. Requires the Secretaries to submit reports to the President and the Congress not later than two years after the date of enactment of this Act.
Bill· HRH.R. 13780 (93rd)referred
United States · United States Congress · 27 March 1974
Makes a supplemental appropriation for fiscal year 1974 of $25,000,000 for the expenses of the National Institute of Neurological Diseases and Stroke in carrying out title IV of the Public Health Service Act with respect to dystonia.
Resolution· HRESH.Res. 1016 (93rd)passed
United States · United States Congress · 27 March 1974
States that upon the adoption of this resolution it shall be in order to move that the House resolve itself into the Committee of the Whole House on the State of the Union for the consideration of the bill (H.R. 11989) to enhance the public health and safety by reducing the human and material losses resulting from fires through better fire prevention and control, and for other purposes. Provides that after general debate, which shall be confined to the bill and shall continue not to exceed one hour, to be equally divided and controlled by the chairman and ranking minority member of the Committee on Science and Astronautics, the bill shall be read for amendment under the five-minute rule by titles instead of by sections. Stipulates that, at the conclusion of the consideration of the bill for amendment, the Committee shall rise and report the bill to the House with such amendments as may have been adopted, and the previous question shall be considered as ordered on the bill and amendments thereto to final passage without intervening motion except one motion to recommit.
Bill· HRH.R. 13750 (93rd)referred
United States · United States Congress · 26 March 1974
Establishes, within the Department of Health, Education, and Welfare, an Office of Population Affairs, to be directed by the Assistant Secretary for Population Affairs, appointed by the President. Enumerates the functions of the Assistant Secretary for Population Affairs. Establishes, within the Department of Health, Education, and Welfare, an Administration on Reproductive Research and Family Planning, under the direct supervision of the Assistant Secretary for Population Affairs. Provides that the Administration shall have a Director and a Deputy Director and such advisers of the Administration as the Director, with the approval of the Secretary of Health, Education, and Welfare, may determine. Establishes, with the Administration, a National Center for Family Planning Services, which shall establish identifiable units to carry out, at a minimum, the following functions: public information, program planning and evaluation, manpower development and training, supervision of field services, and grants management. Establishes, within the Administration, a National Institute for Research on Human Reproduction and Population Change, which shall establish identifiable units to carry out, at a minimum, the following functions: reproductive physiology research, contraceptive development and evaluation, operational research, social science research, public information, manpower development and training, and grants management. Establishes a National Family Planning Service Advisory Council to advise, consult with, and make recommendations to the Director, at meetings held no less than two times each year, on matters relating to the activities of the National Center for Research on Human Reproduction and Population Change. States that the Council shall be composed of the Director of the Administration, who shall serve as Chairman, and at least eighteen members appointed by the President without regard to civil service laws. Establishes a National Population Sciences Advisory Council to advise, consult with, and make recommendations to the Director, at meetings held no less than two times each year, on matters relating to the activities of the National Institute for Research on Human Reproduction and Population Change. States that the Council shall be composed of the Director of the Administration, who shall serve as Chairman, and at least eighteen members appointed by the President without regard to civil service laws. Enumerates the functions of the Administration on Reproductive Research and Family Planning. Provides that the Director of the Administration shall, by regulation, provide for proper scientific review of all research grants and programs over which he has authority by establishing and utilizing, to be extent possible, appropriate peer review committees established with the approval of the National Population Sciences Advisory Council and composed principally of non-Federal scientists and other experts as may be required, to provide initial and continuing evaluations and reviews of the planning, administration, and progress of research grants and programs of the Institute. States that beginning on or before January 1 at the termination of the current five-year plan, the Secretary shall make a report to the Congress setting forth a plan, to be carried out over a period of five years, for continuation and, if necessary, expansion of family planning services to all persons desiring such services, for research programs, for training of necessary manpower, and for carrying out the other purposes of this Act. Authorizes specific appropriations to carry out the purposes of and programs under this Act.
Bill· HRH.R. 13721 (93rd)referred
United States · United States Congress · 26 March 1974
National Health Education Policy and Development Act - Sets forth the findings and declarations of Congress. Establishes within the Department of Health, Education, and Welfare a Health Education Administration to be headed by an Administrator appointed by the Secretary of Health, Education, and Welfare. Establishes an Advisory Council for Health Education to advise, consult with, and make recommendations to, the Administrator on matters relating to the administration of this Act. Declares that the Council shall be composed of 12 members: (1) the Assistant Secretary of Health, Education, and Welfare for Health; (2) the Assistant Secretary of Health, Education, and Welfare for Education; and (3) 10 appointed by the Administrator. Directs the Administrator to conduct a study and investigation of, but not limited to the following: (1) the current status of health education in the Nation; (2) the existing and proposed Federal, State, and local health education programs; (3) factors bearing upon a consumer's motivation for preserving his own health and utilizing health care services; (4) areas of greatest potential impact for health education; and (5) particularized cultural needs, including those relating to diseases affecting specific ethnic, economic, and geographic populations. Requires the Administrator to make grants to public or nonprofit private organizations or to enter into contracts with public or private organizations for the purpose of developing and evaluating specific educational and informational mechanisms, aids, and systems. Directs the Administrator to make grants to public or nonprofit private organizations for the purpose of developing multifaceted systems of health care education for a defined geographic region. Provides that no such grant may be made unless an application has been submitted to and approved by the Secretary. Requires the Administrator to submit annual reports to Congress and the Secretary of Health, Education, and Welfare on the status of health education in the United States. Directs the Administrator, not later than 3 years after the date of the enactment of this Act, to submit a report to Congress and the Secretary on his recommendations for a continuing program of health education and for consolidation of the existing health education and consultation programs.
Bill· HRH.R. 13736 (93rd)referred
United States · United States Congress · 26 March 1974
National Huntington's Disease Control Act - States that it is the purpose of this Act to establish a national program for the diagnosis, prevention, and treatment of, and research in, Huntington's disease. Authorizes the Secretary of Health, Education, and Welfare to make grants for projects for the establishment and operation of Huntington's disease screening, treatment, and counseling programs. Authorizes the appropriation of $500,000 for the fiscal year ending June 30, 1975, and for each each of the next two fiscal years for such grants. Authorizes the Secretary to make grants for research in the diagnosis, treatment, and prevention of Huntington's disease. Authorizes the appropriation of $1,500,000 for the fiscal year ending June 30, 1975 and for each of the next two fiscal years for use for such grants. Directs the Secretary to carry out a program to develop information and educational materials relating to Huntington's disease and to disseminate such information and materials to persons providing health care and to the public in general. Authorizes the appropriation of $25,000 for the fiscal year ending June 30, 1975, and for each of the next two fiscal years to carry out this information program. Sets forth the requirements for applications for grants under this Act and the administration of such grants. Directs the Secretary to establish a program within the Public Health Service to provide for voluntary Huntington's disease screening, counseling, and treatment.
Bill· HRH.R. 13720 (93rd)referred
United States · United States Congress · 26 March 1974
Medicare Long-Term Care Act - Establishes, under title XVIII of the Social Security Act (Medicare), a voluntary program to provide long-term care benefits for aged and disabled individuals who elect to enroll under such program, financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government and contributions by the States. Lists criteria for eligibility for long-term care service benefits. Provides that the benefits provided to an individual by this Act shall consist of (1) home health services, (2) homemaker services, (3) nutrition services, (4) long-term institutional care services, (5) day care and foster home services, and (6) community mental health center outpatient services. Enumerates the requirements for a State long-term care agency. Provides for the payment of premiums for benefits received under this Act. Establishes on the books of the Treasury of the United States a trust fund to be known as the Federal Long-Term Care Trust Fund. Creates a body to be known as the Board of Trustees, composed of the Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health, Education, and Welfare, all ex officio. States that the Secretary of the Treasury shall be the Managing Trustee of the Board of Trustees and that the Commissioner of Social Security shall serve as the Secretary of the Board of Trustees. Provides that the Board of Trustees shall meet not less frequently than once each calendar year. Enumerates the duties of the Board of Trustees. Declares that a community long-term care center shall: (1) provide the items and services listed in this Act to each individual (i) who is eligible for benefits under this part, (ii) who resides in the area served by such center and (iii) who is certified as requiring such services; (2) evaluate and certify the long-term care needs of an individual for whom such care may be required in order to maintain such individual in an independent living arrangement which is reasonable given such individual's state of health and other circumstances (but not including such individual's economic circumstances); (3) maintain a continuous relationship with (and periodically evaluate not less than annually) each individual who is receiving any of the items and services listed in this Act; (4) provide full opportunity for such individual and his family to participate in the determinations and functions under this Act; (5) provide an organized system for making its existence and location known to all individuals in its service area who are eligible for benefits under this part, and for making known to such individuals the method or methods by which they may most efficiently obtain and use the services which it makes available; and (6) performs such other functions as the Secretary of Health, Education, and Welfare may by regulation prescribe in order to have such center most effectively carry out the purposes of this Act. Provides a formula for payments to States for the reimbursement of community long-term care centers. Directs the Secretary, after consultation with organizations representing the chief executives of the various States, and other interested parties, to develop and make available to community long-term care centers one or more methods of obtaining payment for the benefits covered under this Act on a prospective basis. States that once a community long-term care center elects a particular prospective method, it may not alter its election without the prior approval of the Secretary. Provides that whenever the Secretary finds that the number of community long-term care centers electing a particular prospective payment method promulgated in accordance with this Act is not sufficient to provide an adequate basis for either the operation or evaluation of that method, the Secretary shall withdraw that method and allow the community long-term care centers which have elected such method to select another method withn 30 days of notice of such withdrawal. Permits a Governor of a State to certify to the Secretary a method of prospective payment other than those promulgated under this Act. States that the determination of whether an individual is entitled to benefits under this Act shall be made by the Secretary in accordance with regulations prescribed by him. Provides for increases in supplemental security income benefits.
Bill· HRH.R. 13702 (93rd)referred
United States · United States Congress · 25 March 1974
Stipulates that no department, agency, or instrumentality of the United States may make a grant, contract, or loan for any hospital or other health care facility unless such facility agrees to prohibit the performance of psychosurgery on its premises or for any prison or other correctional facility unless such facility agrees to prohibit the performance of psychosurgery on any of its inmates. Makes it unlawful for: (1) any person to perform psychosurgery in any federally connected health care facility, and (2) any federally connected health care facility to permit any person to perform psychosurgery in violation of this Act. Prescribes civil penalties for violation of this Act. Establishes a nine-member Psychosurgery Commission, and authorizes it to initiate civil actions in U.S. district courts to restrain violations of this Act. Provides for an annual report by the Commission on its activities under this Act.
Bill· HRH.R. 13695 (93rd)referred
United States · United States Congress · 25 March 1974
Establishes a voluntary insurance program to provide pharmaceutical services benefits in accordance with the provisions of title XVIII of the Social Security Act (Medicare) for aged and disabled individuals who elect to enroll under such program, to be financed from premium payments by enrollees together with contributions from funds appropriated by the Federal Government. Declares that the benefits provided to an individual by the insurance program established by this Act shall consist of entitlement to have payment made on his behalf for (1) pharmaceutical services in the form of prescription drugs furnished by a provider of pharmaceutical services pursuant to a prescriber's prescription; and (2) such other drugs and pharmaceutical services as are specified in regulations promulgated by the Secretary of Health, Education, and Welfare and furnished by a provider of pharmaceutical services. States that there shall be paid from the Federal Pharmaceutical Services Insurance Trust Fund, in the case of each individual who is covered under the insurance program established by this Act and incurs expenses for pharmaceutical services, including prescription drugs or other drugs with respect to which benefits are payable under this part, amounts equal to the reasonable drug charge for such pharmaceutical services, reduced by an amount equal to the mandatory pharmaceutical services copayment, to the provider of such services. Sets forth the procedure for the payment of claims of providers of pharmaceutical services. Establishes criteria for eligibility to enroll in the insurance program established by this Act. Provides that the montlhy premium of each individual enrolled under this Act for each month of eligibility shall be $5. Declares that the Secretary of the Treasury shall from time to time transfer from the Federal Old-Age Survivors Insurance Trust Fund or the Federal Disability Insurance Trust Fund, the Railroad Retirement Account, and the Civil Service Retirement and Disability Fund to the Federal Pharmaceutical Services Insurance Trust Fund the aggregate amount deducted for the payment of premiums. Establishes on the books of the Treasury of the United States a trust fund to be known as the Federal Pharmaceutical Services Insurance Trust Fund. Establishes the Board of Trustees of the Pharmaceutical Services Trust Fund composed of the Secretary of the Treasury, the Secretary of Labor, and the Secretary of Health, Education, and Welfare. Enumerates the duties of the Board of Trustees. Authorizes the Secretary of Health, Education, and Welfare to enter into contracts with organizations for the purpose of administering the provisions of this Act. Provides that such contracts may be entered into without regard to advertising a sufficient time previously for proposals or without regard to any provision of law requiring competitive bidding. Establishes the National Pharmacy Advisory Committee which shall consist of ten practicing retail pharmacists, not otherwise in the employ of the United States, appointed by the Secretary without regard to provisions governing appointments in the competitive service. States that it shall be the function of the Advisory Committee to advise the Secretary on matters of general policy in the administration of the program provided under this Act for furnishing pharmaceutical services to eligible individuals. Declares that it shall be the further function of the Advisory Committee, and its duty and responsibility, to establish and maintain a utilization review plan applicable to pharmaceutical services furnished individuals entitled to insurance benefits under this Act which provides: (1) for review, on a sample or other appropriate basis, of the number, variety, and frequency of pharmaceutical services furnished by any provider or obtained by any individual entitled to benefits for the purpose of promoting the most efficient use of available financial and professional resources; (2) for such review to include a review of the manner, frequency, and variety of providing pharmaceutical services to be made by committees of pharmacists regularly engaged in the rendering of pharmaceutical services, such committees to be established in such places and at such times as shall be necessary as determined by the Secretary upon the recommendation of the Advisory Committee; (3) that no review authorized by this section shall relate to or cover medical, hospital, or any other benefits or services provided under this title; and (4) for prompt notification to the Secretary, the provider or providers of pharmaceutical services involved or affected, and the individual entitled to benefits and his attending physician, of any finding that such services were not professionally appropriate or necessary under recognized standards of pharmaceutical service. Authorizes to be appropriated such sums necessary to carry out the purposes of this Act.
Bill· HRH.R. 13678 (93rd)passed
United States · United States Congress · 21 March 1974
Extends the coverage of the National Labor Relations Act to employees of nonprofit hospitals. Defines the term "health care institution" for purposes of this Act. Sets forth collective bargaining notice, mediation, and agreement procedures to government employees of a health care institution.