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451 records in US in 1997
United States · United States Congress · 5 March 1997
Human Cloning Research Prohibition Act - Prohibits the expenditure of Federal funds to conduct or support any research on the cloning of humans.
United States · United States Congress · 5 March 1997
Drug-Free Communities Act of 1997 - Amends the National Narcotics Leadership Act of 1988 to direct Director of the Office of National Drug Control Policy to establish a program to support communities in the development and implementation of comprehensive, long-term plans and programs to prevent and treat substance abuse among youth (referred hereafter as the Program). Requires that the Program shall include grant making and tracking, technical assistance and training, data collection and dissemination on state-of-the-art practices which have proven effective in reducing substance abuse, and general administration. Authorizes appropriations. Sets forth specified criteria a coalition shall meet to be eligible to receive a grant. Prescribes limitations concerning: (1) grant amounts; (2) coalition awards; and (3) rural coalition grants. Requires the Administrator of the Program to: (1) have access for the purpose of audit and examination to any books, documents, and records that are pertinent to any grant or grant renewal request and may periodically request information from a grantee to ensure that the criteria set forth are being met; (2) issue rules and regulations regarding the application process, grant renewal, and suspension or withholding of any renewal grant awards; and (3) make every effort, consistent with existing law, to minimize reporting requirements by a grantee and to expedite any grant renewal requests. Authorizes the Administrator to: (1) collect data from national substance abuse organizations working with coalitions, community anti-drug coalitions, departments or agencies of Federal, State and local or tribal governments and any other entity or organization whose activities relate to the purposes of the Program, and evaluate the utility of specific initiatives, engage in research and development activities related to the Program, and disseminate such information to eligible coalitions, any other substance abuse organization, or the public; and (2) offer technical assistance and training, enter into contracts and cooperative agreements, coordinate programs with any grantee or other organization, and train any representatives designated by a grantee in coalition building, task force development, mediation and facilitation, direct service, assessment and evaluation or any other activity related to the purposes of the Program. Establishes the Advisory Commission on Drug-Free Communities (Advisory Commission) to advise, consult with, and make recommendations to the Administrator concerning matters related to the activities carried out under the Program. Sets forth the duties of the Advisory Commission. Requires that if the Administrator rejects recommendations of the Advisory Commission, the Administrator shall notify the Advisory Commission and the Director in writing of the reasons for so doing not later than 15 days after receiving such recommendations. Terminates the Advisory Commission five years after enactment of this Act.
United States · United States Congress · 5 March 1997
Ovarian Cancer Research and Information Amendments of 1997 - Amends the Public Health Service Act to authorize appropriations for research on ovarian cancer. Specifies material to be included in ovarian cancer information and education programs.
United States · United States Congress · 5 March 1997
Human Cloning Prohibition Act - Makes it unlawful for any person to use a human somatic cell for the process of producing a human clone. Sets forth a civil money penalty.
United States · United States Congress · 5 March 1997
Biomedical Research Commitment Resolution of 1997 - Expresses the sense of the House of Representatives that appropriations for the National Institutes of Health should be increased by 100 percent over the next five fiscal years.
United States · United States Congress · 4 March 1997
Amends title XVIII (Medicare) of the Social Security Act to remove the requirement for an X-ray as a condition of coverage of chiropractic services under the Medicare program.
United States · United States Congress · 4 March 1997
Women's Health Office Act of 1997 - Amends the Public Health Service Act, the Social Security Act, and the Federal Food, Drug, and Cosmetic Act to establish an Office of (or on) Women's Health and a related coordinating committee in the Office of the Secretary of Health and Human Services, the Centers for Disease Control and Prevention, the Agency for Health Care Policy and Research, the Health Care Resources and Services Administration, and the Office of the Commissioner of the Food and Drug Administration. Authorizes the Secretary of Health and Human Services to make grants to, and enter into cooperative agreements, contracts, and interagency agreements with public and nonprofit private entities, agencies, and organizations. Requires that the Office on Women's Health in the Office of the Secretary of Health and Human Services shall directly or through contracts with public and private entities, agencies, and organization, provide for evaluations of projects carried out with financial assistance provided under the grants and for the dissemination of information developed as a result of such projects. Transfers to such Office all functions exercised by the Office on Women's Health of the Public Health Service prior to the enactment of this Act, including all personnel and compensation authority, all delegation and assignment authority, and all remaining appropriations. Authorizes appropriations of such sums as may be necessary for FY 1998 through 2001.
United States · United States Congress · 4 March 1997
Amends title XIX (Medicaid) of the Social Security Act to extend Medicaid eligibility for a pediatric vaccine to all children who are not insured with respect to that vaccine.
United States · United States Congress · 3 March 1997
TABLE OF CONTENTS: Title I: Promoting Competition, Quality, and Beneficiary Choice in Medicare Title II: Increasing Medicare Coverage Options Subtitle A: Risk Plan Improvements Subtitle B: Maintaining Fee-for-Service Program Title III: Promotion of Programs of All-Inclusive Care for the Elderly (PACE) and of Social Health Maintenance Organizations (SHMOS) Title IV: Other Medicare Changes Title V: Prospective Payment for Home Health Services Title VI: Prospective Payment System for Nursing Facilities Title VII: Telemedicine Medicare Modernization and Patient Protection Act of 1997 - Title I: Promoting Competition, Quality, and Beneficiary Choice in Medicare - Directs the Secretary of Health and Human Services to establish the Office of Plan Improvement and Competition within the Health Care Financing Administration to: (1) collect and distribute certain data, including research on improvement in health care quality and best-practice information; (2) monitor and supervise Medicare supplemental health insurance (Medigap) policy advertising; and (3) publish and distribute certain quality and comparative reports. (Sec. 102) Directs the Secretary to conduct demonstration projects in applicable areas for the purpose of establishing competitive pricing for eligible organizations with risk-sharing contracts. (Sec. 103) Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) guarantee the issue of Medigap policies regardless of preexisting health conditions to certain eligible individuals who seek to enroll under the policy within a certain period of time after their current organization enrollment or policy coverage is terminated; (2) prohibit exclusion from coverage due to pre-existing health conditions during the initial open enrollment period; (3) revise non-discrimination requirements for initial enrollment periods; and (4) extend the six-month initial enrollment period to nonelderly Medicare beneficiaries. Title II: Increasing Medicare Coverage Options - Subtitle A: Risk Plan Improvements - Amends SSA title XVIII (Medicare) with respect to Medicare managed care arrangements. Revises the formulae for determining the annual reimbursement rates for health maintenance organizations (HMOs) and competitive medical plans. Requires the Health Care Financing Administration (HCFA), beginning FY 1998, to pay no less than 80 percent of the national average for payments to all plans in 1997, with annual payment increases according to a specified formula. (Sec. 201) Provides for additional enrollee protections involving provision of emergency services and renal dialysis. Directs the Secretary to conduct a study for a report to the Congress on increased portability of items and services under organization plans. Provides for intermediate sanctions against plans for program violations, short of termination. Requires an HMO to meet quality standards the Secretary establishes in consultation with private quality accreditation entities. Requires coordinated enrollment and disenrollment periods. Requires an HMO's service area to include an entire metropolitan area if it includes any part of such area. Authorizes certain additional (outlier) payments for 50 percent of imputed reasonable costs in certain circumstances. Directs the Secretary to develop a model of the agreement that an eligible organization must enter into with an entity providing peer review services. Requires the Comptroller General to study and report to the Congress on the costs incurred by eligible organizations in complying with the requirement that any agreement it makes with an entity providing peer review services be in writing. Eliminates organization "gag clauses" on health care providers which have prohibited them from openly communicating within the scope of their license with any of their patients. (Sec. 202) Provides for quality report cards on eligible organizations and comparative reports on their plans in order to assist Medicare beneficiaries' decisionmaking regarding health care and treatment. (Sec. 203) Preempts certain State laws mandating benefits and restricting managed care. (Sec. 204) Amends SSA title XVIII to require eligible organizations to: (1) designate an independent ombudsman to assist members enrolled with such organization in exercising their right to file grievances and appeals; and (2) provide to enrollees a clear and understandable statement regarding such right. Directs the Secretary to promulgate regulations intended to expedite determinations and appeals regarding covered items and services for individuals entitled to them under Medicare parts A and B. (Sec. 205) Requires the Secretary to coordinate an annual enrollment fair in each Medicare payment area in order for eligible organizations to inform eligible individuals about their plans. Requires such organizations to participate in such fairs in each Medicare payment area in which the organization offers a plan. Subtitle B: Maintaining Fee-for-Service Program - Requires adjustment in applicable payment rates or payments for items and services in each excess spending sector of Medicare services for a fiscal year if the fee-for-service expenditures for all sectors for the fiscal year will exceed the sum of their allotments ("failsafe budget mechanism"). Specifies the sectors of Medicare services, as well as the formula for determining each sector's fiscal year allotment. (Sec. 212) Provides for maintenance of the part B Medicare premium at the current percentage of part B program costs. Title III: Promotion of Programs of All-Inclusive Care for the Elderly (PACE) and of Social Health Maintenance Organizations (SHMOS) - Directs the Secretary to establish PACE (Program of All-Inclusive Care for the Elderly) provider status for public and nonprofit community-based organizations to enable them to provide comprehensive health care services of proper quality on a cost-effective, capitated basis to at-risk frail elderly patients under the Medicare or Medicaid programs or under any other applicable SSA program. (Sec. 302) Requires the terms and conditions of PACE provider status to include those of the On Lok waiver under the Social Security Amendments of 1983, and those under the PACE Protocol, as published by On Lok, Inc. (Sec. 303) Applies Medicaid spousal impoverishment rules to individuals receiving services from any organization that is a PACE provider under this Act. (Sec. 304) Declares that there shall be no limitations on how many Social Health Maintenance Organizations (SHMOS) demonstration projects the Secretary may approve, how many individuals may participate in any such project, or on the period of applicable waivers. Title IV: Other Medicare Changes - Amends SSA title XVIII to: (1) provide for a competitive acquisition process for awarding contracts for specified items and services under Medicare part B (Supplementary Medical Services), including durable medical equipment and related supplies; (2) provide for new procedures for inherent reasonableness determinations; (3) revise requirements for the promotion of advance directives, especially in individual medical charts; (4) extend the benefit period for hospice care to an unlimited number of 60-day periods, and allow contracting with independent physicians and physician groups for such services; and (5) specify the entitlement structure for up to 32 hours of respite services per year. (Sec. 404) Amends the Federal criminal code to establish criminal penalties for Medicare fraud, including forfeiture of real or personal property derived from such fraud. Directs the Secretary to study and report to the Congress on the feasibility and desirability of establishing a standardized Medicare claims administration process, implementing other measures to improve recordkeeping, and taking other appropriate steps to reduce waste, fraud, and abuse in making Medicare payments. Directs the Vice President's Commission on Reinventing Government to report to the Congress on the effectiveness of current Federal Government efforts to combat waste, fraud, and abuse in the Medicare program and on whether they would be enhanced by establishment of a coordinated, all-payer, multijurisdiction antifraud program. (Sec. 406) Directs the Secretary to study and report to the Congress on providing pharmacy services to Medicare beneficiaries. Title V: Prospective Payment for Home Health Service - Amends SSA title XVIII to direct the Secretary to: (1) require reimbursement for specified home health services under a prospective payment system (PPS), with a specified national per visit payment rate for each type of service, and per patient and per episode limits; and (2) implement a medical review process for such PPS providing an assessment of the pattern of home health service care furnished to individuals to ensure such services are appropriate. Directs the Medicare Prospective Payment Review Commission to report annually to the Congress on the effectiveness of the payment methodology. Directs the Secretary to: (1) develop a method of payments for home health services in accordance with an episodic PPS; (2) initiate development of a data base upon which a fair and accurate case mix adjustor can be developed and implemented. Grants home health agencies receiving prospective payments the right to obtain a hearing by the Provider Reimbursement Review Board with respect to such payment. (Sec. 502) Amends SSA title XI to provide for: (1) utilization and quality control peer review organization (PRO) review of the level of care and quality of services provided to individuals receiving home health services; and (2) hearing and judicial review rights for affected parties with respect to PRO determinations concerning home health services with which they are dissatisfied. Amends SSA title XVIII to eliminate certain fiscal intermediary responsibilities with regard to denied claims for home health services. Title VI: Prospective Payment System for Nursing Facilities - Establishes a PPS for nursing facilities reflecting specified payment objectives (and specifically exempting skilled nursing facilities under Medicare). Directs the Secretary to: (1) establish a resident classification system modelled after the updated RUG-II system, grouping residents into classes according to similarity of assessed condition and required services; and (2) determine payment rates for nursing facilities using specified cost- service groupings, adjusted at mid-year. (Sec. 607) Requires nursing facilities, in order to be eligible to receive payments under such system, to perform a resident assessment within 14 days after admission of the resident and at such other times as required. (Sec. 608) Establishes per diem reimbursement systems with respect to: (1) enrolled residents; (2) facility administrative and general costs, subject to geographic ceilings the Secretary shall formulate; and (3) property costs. (Sec. 610) Requires the Secretary to: (1) pay for ancillary services on a prospective fee-for-service basis; but (2) reimburse for selected ancillary services on a retrospective basis as pass-through costs. (Sec. 614) Provides payment rate exceptions for new and low volume nursing facilities. (Sec. 615) Establishes a process for appealing decisions by the Secretary regarding payments in the amount of $10,000 or more. Title VII: Telemedicine - Amends the Communications Act of 1934 to direct the Federal Communications Commission to adopt rules requiring telecommunications carriers to provide access (including requisite infrastructure and bandwidth) to the Internet or other interactive computer service necessary for the provision of health care services in rural areas at certain rates. (Sec. 702) Establishes the Commission on Telemedicine to study, develop recommendations, and report to the President and the Congress on all matters relating to which telemedicine services should be covered under Medicare. Authorizes funds to the Commission.
United States · United States Congress · 3 March 1997
TABLE OF CONTENTS: Title I: Medicare Reimbursement for Telehealth Services Title II: Telehealth Licensure Title III: Periodic Reports to Congress from the Joint Working Group on Telehealth Title IV: Development of Telehealth Networks Comprehensive Telehealth Act of 1997 - Title I: Medicare Reimbursement for Telehealth Services - Directs the Secretary of Health and Human Services to make payments from the Federal Supplementary Medical Insurance Trust Fund under part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act (SSA) in accordance with a specified payment methodology for professional consultation via telecommunications systems with an individual or entity furnishing a service for which payment may be made to a Medicare beneficiary residing in a rural or an underserved area, notwithstanding that the individual health care provider providing the professional consultation is not at the same location as the individual furnishing the service to that beneficiary. (Sec. 101) Directs the Secretary to report to the Congress: (1) a detailed analysis of how telemedicine and telehealth (T&T) systems are expanding access to health care services, clinical efficacy and cost-effectiveness of T&T applications, quality of T&T services delivered, and the reasonable cost of telecommunications charges incurred in practicing T&T in rural, frontier, and underserved areas; and (2) an examination of the possibility (including the potential costs to the Medicare program) of making similar payments for such services to Medicare beneficiaries who do not reside in a rural or an underserved area, are homebound or nursing homebound, and for whom being transferred for health care services imposes a serious hardship. Title II: Telehealth Licensure - Directs the Secretary to report to the appropriate congressional committees on: (1) providers licensed to provide telehealth services across State lines, including the number and types of providers licensed to provide them in more than three States; (2) any reciprocal or other licensure agreements between or among various States; (3) any efforts to develop uniform national sets of licensure standards for interstate telehealth services; (4) a projection of future interstate telehealth consultations; (5) State efforts to increase or reduce licensure as a burden to interstate telehealth practice; and (6) any State licensure requirements that appear to constitute unnecessary barriers to interstate telehealth services. (Sec. 202) Directs the Secretary to report annually to the appropriate congressional committees on relevant developments concerning such matters. Provides that, if States are not making progress in facilitating interstate telehealth services by eliminating unnecessary requirements, adopting reciprocal licensing arrangements, implementing uniform licensure requirements, or other means, the Secretary must include in the report recommendations on the Federal actions required to reduce licensure as a barrier to the interstate provision of telehealth services. Title III: Periodic Reports to Congress from the Joint Working Group on Telehealth - Redesignates the Joint Working Group on Telemedicine as the Joint Working Group on Telehealth, with the chairperson designated by the Director of the Office of Rural Health Policy. Makes it the mission of the Joint Working Group on Telehealth to: (1) identify, monitor, coordinate, and analyze Federal telehealth projects, data sets, and programs; and (2) make further recommendations for coordination of Federal and State efforts to increase access to health services, education, and information in rural and underserved areas. Requires the Joint Working Group to report annually to the Congress on mission status and the state of the telehealth field generally. (Sec. 301) Authorizes appropriations. Title IV: Development of Telehealth Networks - Directs the Secretary, acting through the Director of the Office of Rural Health Policy, to provide specified financial assistance to eligible providers to expand access to health care services for individuals in rural and frontier areas through the use of telehealth. Authorizes appropriations.
United States · United States Congress · 27 February 1997
Health Insurance Bill of Rights Act of 1997 - Amends the Public Health Service Act to require a health insurance issuer under provisions of this Act to comply with certain notice requirements of the Employee Retirement Income Security Act of 1974 (ERISA). Requires an issuer, if coverage provides any emergency services benefits, to cover emergency services without authorization, participating provider, or (subject to exception) other restrictions. Requires an issuer, if the issuer requires or provides for an enrollee to designate a participating primary care provider, to permit a female enrollee to designate an obstetrics and gynecology specialist as the enrollee's primary care provider. Prohibits an issuer, if an enrollee has not designated such a specialist as a primary care provider, from requiring prior authorization for coverage of routine gynecological care and pregnancy-related services provided by such a specialist. Requires an issuer to refer to a specialist an enrollee who requires treatment by a specialist. Provides, in certain circumstances, for: (1) a specialist to provide and coordinate an enrollee's primary and specialty care; and (2) standing referrals. Requires an issuer, if a contract between the issuer and a provider is terminated, to permit an enrollee undergoing a course of treatment to continue with the provider during a transitional period. Requires an issuer to permit each enrollee to receive: (1) primary care from any available participating primary care provider; and (2) subject to limitation, specialty care from any available qualified participating provider. Prohibits issuer discrimination against an enrollee on the basis of the enrollee's participation in a clinical study or investigation approved and funded by specified Federal agencies. Regulates coverage of prescription drugs when an issuer uses a formulary. Requires issuers to: (1) maintain a quality assurance and improvement program; (2) collect uniform quality data; (3) have a written process for the selection of participating professionals; (4) maintain a drug utilization program; (5) conduct utilization review; (6) disclose specified information to enrollees and prospective enrollees; (7) ensure compliance with confidentiality laws; and (8) maintain a complaints and appeals system. Authorizes appropriations for grants to States to establish and maintain a Health Insurance Ombudsman. Prohibits agreements between issuers and providers from: (1) restricting the provider from engaging in medical communications with a patient; or (2) transferring to the provider any liability relating to actions or omissions of the issuer or agent. Imposes requirements on physician incentive plans. Prohibits an issuer from limiting the manner in which covered services are delivered. Requires each health issuer to comply with patient protection requirements of this Act regarding group and individual health insurance coverage it offers. Allows a State to establish requirements at least as stringent on issuers as the requirements of this Act. Amends the ERISA to require a group health plan and an issuer to comply with the requirements of this Act. Directs the Secretary of Labor, for group health plans that provide benefits other than through health insurance coverage, to establish a Federal Group Health Plan Ombudsman. Allows a State to establish requirements at least as stringent on issuers as the requirements of this Act.
United States · United States Congress · 27 February 1997
Amends title XVIII (Medicare) of the Social Security Act to reinstate, for five years starting in FY 1998, the Medicare-dependent, small, rural hospital program as it was contained in the Omnibus Budget Reconciliation Act of 1993, including target amount provisions, which are updated to account for the applicable percentage increases which would have occurred if the program had been in effect since it expired in FY 1995.
United States · United States Congress · 27 February 1997
Prohibits the use of Federal funds for research regarding the cloning of a human individual.
United States · United States Congress · 27 February 1997
Primary Care Health Practitioner Incentive Act of 1997 - Amends title XVIII (Medicare) of the Social Security Act, with respect to payments for medical and other health services, to cover services which would be physicians' services if furnished by a physician but: (1) which are performed by a clinical nurse specialist; and (2) which the clinical nurse specialist is legally authorized to perform by the State. Eliminates the requirement, with respect to such services performed by a nurse practitioner, that they be performed in a skilled nursing facility or other specified nursing facility. Covers, in addition, other services and supplies incidental to such services. Revises the formula for payment from the Federal Supplementary Medical Insurance Trust Fund for such services (thereby increasing such payment). Repeals the rural area restriction on services performed by nurse practitioners or clinical nurse specialists for which direct payment may be made. Requires a ten percent bonus payment from the Fund for services of a nurse practitioner or clinical nurse specialist furnished in a health professional shortage area.
United States · United States Congress · 27 February 1997
Medicare Cancer Clinical Trial Coverage Act of 1997 - Directs the Secretary of Health and Human Services to establish a demonstration project which provides for payment under title XVIII (Medicare) of the Social Security Act of routine patient care costs for Medicare beneficiaries with cancer who are enrolled in an approved clinical trial program, while still applying the beneficiary cost sharing provisions of such program to project participants. Directs the Secretary to study and report to the Congress on the impact on Medicare of covering such costs as well as the cost of extending routine patient care coverage to Medicare beneficiaries with a diagnosis other than cancer.
United States · United States Congress · 27 February 1997
Amends title XI of the Social Security Act (SSA) to repeal the criminal penalty added by the Health Insurance Portability and Accountability Act of 1996 for the fraudulent disposition of assets in order to obtain Medicaid benefits under SSA title XIX.
United States · United States Congress · 27 February 1997
Physician Assistant Incentive Act of 1997 - Amends title XVIII (Medicare) of the Social Security Act to repeal restrictions on the setting of services provided by physician assistants for which payment may be made. Permits the specified payment for physician assistant services, and services and supplies furnished as an incident to physician assistant services, on an assignment-related basis only. Requires a bonus Medicare payment to physician assistants employed in specified health professional shortage areas. Revises the definition of an employment relationship for physician assistants to include any independent contractor arrangement. Subjects the determination of employer status to State law.
United States · United States Congress · 27 February 1997
Domestic Violence Identification and Referral Act of 1997 - Amends the Public Health Service Act to give preference, in making grants or contracts under provisions relating to health professions education and provisions relating to nurse education, to certain health professions entities that train students in the identification, examination, treatment, and referral of victims of domestic violence.
United States · United States Congress · 27 February 1997
Primary Care Health Practitioner Incentive Act of 1997 - Amends title XVIII (Medicare) of the Social Security Act, with respect to payments for medical and other health services, to cover services which would be physicians' services if furnished by a physician but: (1) which are performed by a clinical nurse specialist; and (2) which the clinical nurse specialist is legally authorized to perform by the State. Eliminates the requirement, with respect to such services performed by a nurse practitioner, that they be performed in a skilled nursing facility or other specified nursing facility. Covers, in addition, other services and supplies incidental to such services. Revises the formula for payment from the Federal Supplementary Medical Insurance Trust Fund for such services (thereby increasing such payment). Repeals the rural area restriction on services performed by nurse practitioners or clinical nurse specialists for which direct payment may be made. Requires a ten percent bonus payment from the Fund for services of a nurse practitioner or clinical nurse specialist furnished in a health professional shortage area.
United States · United States Congress · 27 February 1997
Physician Assistant Incentive Act of 1997 - Amends title XVIII (Medicare) of the Social Security Act to repeal restrictions on the setting of services provided by physician assistants for which payment may be made. Permits the specified payment for physician assistant services, and services and supplies furnished as an incident to physician assistant services, on an assignment-related basis only. Requires a bonus Medicare payment to physician assistants employed in specified health professional shortage areas. Revises the definition of an employment relationship for physician assistants to include any independent contractor arrangement. Subjects the determination of employer status to State law.
United States · United States Congress · 27 February 1997
Integrity in Medical Funding Act of 1997 - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to prohibit Federal payment for assisted suicide or euthanasia. Preempts State and Federal limits on malpractice awards in health care liability actions that arise from the provision of any medical item or service for the purpose of causing the death of any individual, or from the failure to provide any medical item or service to an individual against the direction of the individual or the individual's agent or surrogate for the purpose of causing the individual's death.
United States · United States Congress · 27 February 1997
Medical Education Trust Fund Act of 1997 - Amends the Social Security Act (SSA) to add a new title XXI (Medical Education Trust Fund) establishing in the Treasury the Medical Education Trust Fund, consisting of various specified accounts. Requires the Secretary of Health and Human Services to make annual payments from the Fund to eligible medical schools and teaching hospitals applying for assistance to: (1) maintain and develop quality educational programs in an increasingly competitive health care system; and (2) meet the indirect and direct costs of graduate medical education. Outlines requirements for Fund investments and determination of payments. Amends SSA titles XVIII (Medicare) and XIX (Medicaid) to provide for annual transfers to the Fund. Makes specified appropriations to the Fund. Amends the Internal Revenue Code to impose a tax equal to 1.5 percent of premiums received under accident or health insurance policies (including applicable self-insured plans), and equal to 1.5 percent of the amount received for certain health-related administrative services, payable by the policy issuer and the service provider, respectively. Makes specified appropriations and transfers of such amounts collected to the Fund for allocation among the various specified accounts. Establishes the Medical Education Advisory Commission to study and report on Fund operations and other specified matters, including recommendations for demonstration projects. Authorizes appropriations. Directs the Secretary to prescribe guidelines for the establishment and operation of such demonstration projects.
United States · United States Congress · 26 February 1997
TABLE OF CONTENTS: Title I: Hemophilia Relief Fund Title II: Treatment of Certain Private Settlement Payments in Hemophilia-Clotting-Factor Suit under the Medicaid and SSI Programs Ricky Ray Hemophilia Relief Fund Act of 1997 - Title I: Hemophilia Relief Fund - Establishes in the Treasury the Ricky Ray Hemophilia Relief Fund. Authorizes appropriations. (Sec. 103) Specifies that any individual who has a human immunodeficiency virus (HIV) infection shall receive $125,000 from amounts available in the Fund if the individual meets one of the following conditions: (1) has a blood-clotting disorder and was treated with blood-clotting agents between July 1, 1982, and December 31, 1987; (2) is the lawful spouse of such individual or the former lawful spouse and was the lawful spouse of the individual at any time after a date within such period on which the individual was treated; or (3) acquired the HIV infection through perinatal transmission from a parent who is such an individual. Requires that the following conditions be met with respect to such individual: (1) the individual submit to the Secretary of Health and Human Services written medical documentation that the individual has an HIV infection; (2) a petition for payment be filed with the Secretary by or on behalf of such individual; and (3) that the Secretary determine that the claim meets the requirements of this Act. (Sec. 105) Specifies that any right under this Act shall not be assignable or transferable. Sets limits regarding the number of claims per victim. (Sec. 106) Prohibits the Secretary from making any payment with respect to any petition filed under this Act unless the petition is filed within three years after the enactment of this Act. Title II: Treatment of Certain Private Settlement Payments in Hemophilia-Clotting-Factor Suit under the Medicaid and SSI Programs - Prohibits a settlement payment from being considered income or resources in determining a class member's eligibility for, or the amount of: (1) medical assistance under the Medicaid program; or (2) benefits under the Supplemental Security Income program. Defines the terms: (1) "class member"; and (2) "settlement payment.
United States · United States Congress · 26 February 1997
Medicare Payment Equity Act of 1997 - Amends title XVIII (Medicare) of the Social Security Act to revise the formulae for payments to health maintenance organizations and competitive medical plans. Provides for a metropolitan based system under which: (1) all portions of each metropolitan statistical area in a State are treated as a single Medicare payment area; and (2) all areas in that State that do not fall within a metropolitan statistical area are treated as a single Medicare payment area. Requires the Secretary of Health and Human Services to determine the annual per capita rate of payment for each Medicare payment area by adjusting the adjusted capitation rate for: (1) individuals who are enrolled with an eligible organization which has entered into a risk-sharing contract and who are enrolled under Medicare part B (Supplementary Medical Insurance) only; and (2) such risk factors as age, disability status, gender, institutional status, and such other factors as the Secretary determines to be appropriate so as to ensure actuarial equivalence. Requires the Secretary to establish a separate rate of payment to an eligible organization with respect to any individual determined to have end-stage renal disease and enrolled with the organization. Prescribes a general formula for the adjusted capitation rate of a Medicare payment area based on an area-specific adjusted capitation rate and an input-price-adjusted national adjusted capitation rate. Specifies area-specific and national percentages for contract years 1998 through 2001 and after. Requires the Secretary, upon written request of the Chief Executive Officer of a State for a contract year, to adjust the system under which Medicare payment areas in the State are otherwise determined to a system which: (1) has a single Statewide Medicare payment area; (2) is a metropolitan based system; or (3) consolidates into a single Medicare payment area noncontiguous counties (or equivalent areas) within the State. Directs the Secretary to: (1) conduct demonstration projects in certain Medicare payment areas for the purpose of establishing competitive pricing for eligible organizations with risk-sharing contracts; and (2) report to the Congress regarding such demonstration projects.
United States · United States Congress · 26 February 1997
Eating Disorders Information and Education Act of 1997 - Amends the Public Health Service Act to provide for a program of information and public education concerning the prevention and treatment of eating disorders. Authorizes appropriations.
United States · United States Congress · 25 February 1997
Health Insurance Bill of Rights Act of 1997 - Amends the Public Health Service Act to require a health insurance issuer under provisions of this Act to comply with certain notice requirements of the Employee Retirement Income Security Act of 1974 (ERISA). Requires an issuer, if coverage provides any emergency services benefits, to cover emergency services without authorization, participating provider, or (subject to exception) other restrictions. Requires an issuer, if the issuer requires or provides for an enrollee to designate a participating primary care provider, to permit a female enrollee to designate an obstetrics and gynecology specialist as the enrollee's primary care provider. Prohibits an issuer, if an enrollee has not designated such a specialist as a primary care provider, from requiring prior authorization for coverage of routine gynecological care and pregnancy-related services provided by such a specialist. Requires an issuer to refer to a specialist an enrollee who requires treatment by a specialist. Provides, in certain circumstances, for: (1) a specialist to provide and coordinate an enrollee's primary and specialty care; and (2) standing referrals. Requires an issuer, if a contract between the issuer and a provider is terminated, to permit an enrollee undergoing a course of treatment to continue with the provider during a transitional period. Requires an issuer to permit each enrollee to receive: (1) primary care from any available participating primary care provider; and (2) subject to limitation, specialty care from any available qualified participating provider. Prohibits issuer discrimination against an enrollee on the basis of the enrollee's participation in a clinical study or investigation approved and funded by specified Federal agencies. Regulates coverage of prescription drugs when an issuer uses a formulary. Requires issuers to: (1) maintain a quality assurance and improvement program; (2) collect uniform quality data; (3) have a written process for the selection of participating professionals; (4) maintain a drug utilization program; (5) conduct utilization review; (6) disclose specified information to enrollees and prospective enrollees; (7) ensure compliance with confidentiality laws; and (8) maintain a complaints and appeals system. Authorizes appropriations for grants to States to establish and maintain a Health Insurance Ombudsman. Prohibits agreements between issuers and providers from: (1) restricting the provider from engaging in medical communications with a patient (allowing the issuer to advise of the coverage's limitations on particular services based on the religious or moral convictions of the issuer); or (2) transferring to the provider any liability relating to actions or omissions of the issuer or agent. Imposes requirements on physician incentive plans. Prohibits an issuer from limiting the manner in which covered services are delivered. Requires each health issuer to comply with patient protection requirements of this Act regarding group and individual health insurance coverage it offers. Allows a State to establish requirements at least as stringent on issuers as the requirements of this Act. Amends ERISA to require a group health plan and an issuer to comply with the requirements of this Act. Directs the Secretary of Labor, for group health plans that provide benefits other than through health insurance coverage, to establish a Federal Group Health Plan Ombudsman. Allows a State to establish requirements at least as stringent on issuers as the requirements of this Act.
United States · United States Congress · 25 February 1997
Women's Cardiovascular Diseases Research and Prevention Act - Amends the Public Health Service Act to mandate expansion, intensification, and coordination of research and related activities of the National Heart, Lung, and Blood Institute with regard to cardiovascular diseases in women. Authorizes appropriations.
United States · United States Congress · 25 February 1997
Access to Emergency Medical Services Act of 1997 - Amends the Internal Revenue Code, the Employee Retirement Income Security Act of 1974, and the Public Health Service Act to require any group health plan which provides emergency health services to cover emergency services furnished to a plan participant: (1) without need for any prior authorization; (2) subject to stated exceptions, whether or not the physician or provider is plan participant; and (3) subject to stated exceptions, without regard to any other term or condition of the plan. Defines "emergency medical services" and related terms. Amends titles XVIII (Medicare) and XIX (Medicaid) to provide for the provision of the same benefits to Medicare and Medicaid plan participants. Provides for the establishment of guidelines by the appropriate Secretaries in order carry out the provisions of this Act. Directs the Secretaries to jointly establish an advisory panel to assist in the development of such guidelines.
United States · United States Congress · 25 February 1997
Health Insurance Bill of Rights Act of 1997 - Amends the Public Health Service Act to require a health insurance issuer under provisions of this Act to comply with certain notice requirements of the Employee Retirement Income Security Act of 1974 (ERISA). Requires an issuer, if coverage provides any emergency services benefits, to cover emergency services without authorization, participating provider, or (subject to exception) other restrictions. Requires an issuer, if the issuer requires or provides for an enrollee to designate a participating primary care provider, to permit a female enrollee to designate an obstetrics and gynecology specialist as the enrollee's primary care provider. Prohibits an issuer, if an enrollee has not designated such a specialist as a primary care provider, from requiring prior authorization for coverage of routine gynecological care and pregnancy-related services provided by such a specialist. Requires an issuer to refer to a specialist an enrollee who requires treatment by a specialist. Provides, in certain circumstances, for: (1) a specialist to provide and coordinate an enrollee's primary and specialty care; and (2) standing referrals. Requires an issuer, if a contract between the issuer and a provider is terminated, to permit an enrollee undergoing a course of treatment to continue with the provider during a transitional period. Requires an issuer to permit each enrollee to receive: (1) primary care from any available participating primary care provider; and (2) subject to limitation, specialty care from any available qualified participating provider. Prohibits issuer discrimination against an enrollee on the basis of the enrollee's participation in a clinical study or investigation approved and funded by specified Federal agencies. Regulates coverage of prescription drugs when an issuer uses a formulary. Requires issuers to: (1) maintain a quality assurance and improvement program; (2) collect uniform quality data; (3) have a written process for the selection of participating professionals; (4) maintain a drug utilization program; (5) conduct utilization review; (6) disclose specified information to enrollees and prospective enrollees; (7) ensure compliance with confidentiality laws; and (8) maintain a complaints and appeals system. Authorizes appropriations for grants to States to establish and maintain a Health Insurance Ombudsman. Prohibits agreements between issuers and providers from: (1) restricting the provider from engaging in medical communications with a patient (allowing the issuer to advise of the coverage's limitations on particular services based on the religious or moral convictions of the issuer); or (2) transferring to the provider any liability relating to actions or omissions of the issuer or agent. Imposes requirements on physician incentive plans. Prohibits an issuer from limiting the manner in which covered services are delivered. Requires each health issuer to comply with patient protection requirements of this Act regarding group and individual health insurance coverage it offers. Allows a State to establish requirements at least as stringent on issuers as the requirements of this Act.
United States · United States Congress · 25 February 1997
Nuclear Disarmament and Economic Conversion Act - Requires the U.S. Government to: (1) disable and dismantle all its nuclear weapons and refrain from replacing them at any time with weapons of mass destruction; (2) undertake vigorous good faith efforts to eliminate war, armed conflict, and all military operations; (3) actively promote policies to induce all other countries to join in these commitments for peace on earth; and (4) redirect resources that are currently being used for nuclear weapons programs to constructive, ecologically beneficial peacetime activities and to address human needs such as housing, health care, education, agriculture, and environmental protection. Makes this Act effective when the President certifies to the Congress that all foreign countries possessing nuclear weapons have established legal requirements comparable to those set forth in this Act.
United States · United States Congress · 25 February 1997
Access to Emergency Medical Services Act of 1997 - Amends the Internal Revenue Code, the Employee Retirement Income Security Act of 1974, and the Public Health Service Act to require any group health plan which provides emergency health services to cover emergency services furnished to a plan participant: (1) without need for any prior authorization; (2) subject to stated exceptions, whether or not the physician or provider is plan participant; and (3) subject to stated exceptions, without regard to any other term or condition of the plan. Defines "emergency medical services" and related terms. Amends titles XVIII (Medicare) and XIX (Medicaid) to provide for the provision of the same benefits to Medicare and Medicaid plan participants. Provides for the establishment of guidelines by the appropriate Secretaries in order carry out the provisions of this Act. Directs the Secretaries to jointly establish an advisory panel to assist in the development of such guidelines.
United States · United States Congress · 25 February 1997
Menopause Outreach, Research, and Education Act of 1997 - Amends the Public Health Service Act to require the Director of the National Institute on Aging to provide for the expansion of at least five centers for research on: (1) menopause; and (2) conditions arising from the diminishing or cessation of the functioning of the ovaries, whether occurring naturally or otherwise. Outlines research activities to be performed at each center. Requires the Director to establish a program to develop protocols for the prevention and treatment of menopausal health conditions and other conditions regarding women's midlife health. Requires the Director to provide for an equitable geographical distribution of such centers. Requires each center to be supported for at least five years, with possible renewal after review and recommendation by an appropriate technical and scientific peer review group established by the Director.
United States · United States Congress · 25 February 1997
Fairness in Medicaid Funding Act of 1997 - Amends title XIX (Medicaid) of the Social Security Act to revise the State percentage factor and related factors in the Federal medical assistance percentage used under the Medicaid program. Bases payments to the States for administration costs on the Federal medical assistance percentage.
United States · United States Congress · 24 February 1997
TABLE OF CONTENTS: Title I: Office for Consumer Information, Counseling and Assistance with Health Care Title II: Utilization Management Title III: Health Plan Standards Title IV: Miscellaneous Provisions Patient Protection Act of 1997 - Title I: Office for Consumer Information, Counseling and Assistance with Health Care - Mandates grants to States for establishment and operation of an Office for Consumer Information, Counseling and Assistance in each State to be concerned with consumer health insurance rights. Authorizes appropriations. Title II: Utilization Management - Requires a health plan to have a utilization review program meeting the requirements of this title and certified by the State. (Sec. 203) Requires Federal standards for the establishment, operation, certification, and recertification of review programs. Allows States to certify a plan as meeting Federal standards if the plan meets standards for accreditation as applied by a nationally recognized, independent, non-profit accreditation entity. Sets forth review program requirements and related plan requirements. Prohibits preauthorization requirements if an enrollee arrived at the emergency department with symptoms reasonably suggesting an emergency based on the judgment of a prudent layperson. Title III: Health Plan Standards - Mandates Federal standards for health plan certification and recertification. Requires a State to provide for plan certification if the State-designated certifying authority finds the plan meets this Act's requirements. Allows a plan sponsor to offer a plan only if the plan is State-certified. (Sec. 302) Requires plan minimum solvency standards. (Sec. 303) Mandates disclosure to prospective covered individuals of certain plan terms and conditions in an easily understandable, truthful, linguistically appropriate, and objective manner. (Sec. 304) Requires plans to demonstrate a sufficient number, distribution, and variety of providers to ensure that services will be available and accessible in a timely manner, including access to specialized treatment. Requires plans to reasonable efforts to address issues of cultural competence and appropriateness with respect to providers. Prohibits care coordination and cost control processes from imposing an undue enrollee burden. Makes these requirements applicable in all areas, including rural areas. Allows a plan to arrange for providing out-of-network services if the plan fails to meet such requirements. (Sec. 305) Requires plans to credential the health providers furnishing services under the plan. Requires credentialing decisions to be made on objective standards with input from health providers credentialed under the plan. (Sec. 306) Mandates a timely and organized system for resolving complaints and formal grievances filed by covered individuals. Mandates disclosure of credentialing information to the provider involved and provides for submission of corrections. Declares that a provider is not entitled to be selected or retained by a plan whether or not the provider meets credentialing standards. Regulates the use of economic considerations in the selection process. Provides for procedures relating to the suspension, termination, and review of the plan contract with a provider. Prohibits plans from: (1) restricting or inhibiting communication between providers and patients or penalizing a provider making public the failure of the plan to comply with the requirements; and (2) requiring a provider to sign any type of hold-harmless agreement as requirement for participation in the plan. (Sec. 307) Mandates confidentiality of specified enrollee patient information and records. (Sec. 308) Prohibits plan discrimination: (1) on the basis of race and other factors, including culture, socio-economic status, disability, health status (including genetic information), or anticipated utilization of health services; and (2) in the selection of provider members on the basis of race or other factors, including the anticipated utilization of health services of the provider's patients. (Sec. 309) Prohibits plan marketing or other practices intended to discourage or limit the plan on the basis of risk factors. Title IV: Miscellaneous Provisions - Requires States to prohibit the offering or issuance of any health plan if it does not meet certain requirements of this Act and any other requirements determined appropriate by the Secretary of Health and Human Services. Authorizes the Secretary of Labor to terminate or disqualify a self-insured plan not meeting those standards.
United States · United States Congress · 13 February 1997
Amends the National Housing Act to authorize the Department of Housing and Urban Development to make partial guaranteed mortgage loan payments for health care facilities.
United States · United States Congress · 13 February 1997
National Bipartisan Commission on the Future of Medicare Act of 1997 - Establishes the National Bipartisan Commission on the Future of Medicare to: (1) review and analyze the long-term financial condition of the Medicare program under title XVIII of the Social Security Act; (2) identify problems that threaten the financial integrity of the Medicare trust funds and make appropriate recommendations to restore such integrity through 2030; (3) analyze potential solutions to the problems identified that will ensure both the financial integrity of Medicare and the provision of appropriate benefits; and (4) make recommendations for establishing the appropriate financial structure of the Medicare program and for establishing the appropriate balance of benefits covered and beneficiary contributions to the Medicare program. Requires a report to the President and the Congress. Authorizes appropriations.
United States · United States Congress · 13 February 1997
Amends title XVIII (Medicare) of the Social Security Act to require Medicare national accrediting organizations to have governing boards with public representation and meetings open to the public.
United States · United States Congress · 13 February 1997
Shackleford Banks Wild Horses Protection Act - Directs the Secretary of the Interior to: (1) allow a herd of free roaming horses in the Cape Lookout National Seashore, North Carolina; and (2) enter into an agreement with the Foundation for Shackleford Horses (a nonprofit corporation established under North Carolina laws) to provide for cost-effective management of such horses and adoption by the Foundation of those horses that the Secretary removes from the Seashore. Requires the Secretary to accommodate the historic population level of the free roaming horse herd (between 100 and 110 horses) in the Seashore. Prohibits the Secretary from removing or assisting in or permitting the removal of any free roaming horses from Federal lands within the Seashore unless: (1) the number of such horses exceeds 110; (2) there is an emergency or a need to protect public health and safety; or (3) there is concern for the persistence and viability of the horse population. Requires the Secretary to annually monitor, assess, and make available to the public findings regarding the population structure and health of such horses.
United States · United States Congress · 13 February 1997
Women's Preventive Health Care Act of 1997 - Amends the Public Health Service Act and the Employee Retirement Income Security Act of 1974 to require a group health plan, and a health insurance issuer offering group coverage, to include coverage for screening pap smears and low-dose screening mammography. Prohibits cost sharing or other limitations higher than those applied to similar services. Regulates coverage frequency. Prohibits related enrollment or coverage discrimination, monetary incentives to women, and penalties against or incentives to providers. Allows State laws providing greater protection to women. Amends the Public Health Service Act to apply these requirements to health insurance issuers in the individual market.
United States · United States Congress · 13 February 1997
Access to Medical Treatment Act - Permits any individual to be treated by a health care practitioner with any medical treatment that the individual desires (including a treatment that is not approved, certified, or licensed by the Secretary of Health and Human Services) if: (1) the practitioner agrees to treat the individual; and (2) the administration of such treatment does not violate licensing laws. Authorizes health care practitioners to provide any method of treatment to such an individual if certain requirements are met. Requires a practitioner to report: (1) administering such treatment and discovering it to be a danger to an individual; and (2) the positive effects of an unconventional medical treatment for a life-threatening medical condition.
United States · United States Congress · 13 February 1997
Public Health and Safety Act of 1997 - Amends the Federal criminal code to prohibit the manufacture, import, export, sale, purchase, transfer, receipt, ownership, possession, transport, or use (transaction) of a handgun or handgun ammunition. Makes exceptions with respect to the military, law enforcement agencies, registered security guard services, and licensed handgun clubs and members of such clubs. Authorizes the Secretary of the Treasury to approve such a transaction by licensed manufacturers, importers, and dealers as necessary to meet the lawful requirements of such persons and entities covered by the exceptions. Specifies handgun club licensing requirements. Requires: (1) the Secretary to revoke the license of any such club that does not continue to meet such requirements; and (2) such club to pay to the Secretary an annual license fee of $25. Specifies security guard service registration requirements. Requires: (1) the Secretary to revoke such registration if the service does not continue to meet such requirements; and (2) such service to pay to the Secretary an annual registration fee of $50. Sets forth provisions with respect to: (1) recordkeeping (by licensed manufacturers, importers, dealers, handgun clubs or their members and by registered security guard services that transfer handguns or handgun ammunition); (2) reports of loss or theft; and (3) transfers to handgun clubs. Authorizes the voluntary delivery to any designated Federal, State, or local law enforcement agency of a handgun owned or possessed by a person. Directs the Secretary to: (1) arrange with each such agency to receive handguns for the transfer, destruction, or other disposition of such handguns; and (2) pay to such person $25 or the fair market value of the gun. Authorizes appropriations. Sets penalties for violations of this Act. Specifies that a person who voluntarily delivers a handgun under this Act after 180 days after enactment shall not be subject to criminal prosecution for possession of the handgun, but shall pay to the Secretary a civil penalty in an amount not to exceed $500. Establishes penalties for: (1) failure to report the loss or theft of a handgun; (2) negligent and intentional deliveries to an unauthorized place; (3) false statements or representations; and (4) failure to keep, or permit inspection of, records. Provides for the forfeiture of any handgun or handgun ammunition involved or used in a violation of this Act or of any other criminal law of the United States.
United States · United States Congress · 13 February 1997
Prohibits, if a State has a law prohibiting the sale of cigarettes and smokeless tobacco products to individuals under the age of 18 or 19, the Food and Drug Administration from taking enforcement action against a cigarette and smokeless tobacco products retailer for the sale of such items in that State if the sale is a face-to-face transaction conducted in accordance with State law.
United States · United States Congress · 13 February 1997
LAM Disease Research Act of 1997 - Amends the Public Health Service Act to require that the National Heart, Blood Vessel, Lung, and Blood Diseases and Blood Resources Program conduct or support research on lymphangioleiomyomatosis (LAM). Authorizes appropriations.
United States · United States Congress · 12 February 1997
Prohibits parking fees from being charged at a Department of Veterans Affairs medical facility which is operated jointly with the Department of Defense pursuant to a contract or agreement for the sharing of health care resources.
United States · United States Congress · 12 February 1997
Assisted Suicide Funding Restriction Act of 1997 - Prohibits the use of appropriated funds to provide, procure, furnish, fund, or support, or to compel any individual, institution, or government entity to provide, procure, furnish, fund, or support, any item, good, benefit, program, or service, the purpose of which is to cause, or to assist in causing, the suicide, euthanasia, or mercy killing of any individual. Amends titles XVIII (Medicare), XIX (Medicaid), and XX (Block Grants to States for Social Services) of the Social Security Act to prohibit payment (or use of block grant funds) for any item or service furnished to cause the death of any individual. Provides for the treatment of advance directives. Amends the Indian Health Care Improvement Act to prohibit the use of appropriated funds to cause the death of any individual. Amends Federal law relating to members and certain former members of the uniformed services and to dependents of members to prohibit furnishing (or including coverage under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) for) any item or service to cause the death of any individual. Amends Federal law relating to contracting for government employees' health benefit plans to prohibit including coverage for any item or service to cause the death of any individual. Amends Federal law relating to health care for Peace Corps volunteers to prohibit providing any item or service to cause the death of any individual. Amends Federal criminal code provisions relating to medical and other services to the Federal penal and correctional institutions to prohibit furnishing any item or service to cause the death of any individual. Amends the District of Columbia Self-Government and Governmental Reorganization Act to prohibit the use of funds appropriated under specified provisions of that Act for any item or service to cause the death of any individual.
United States · United States Congress · 12 February 1997
Waives, with respect to facilities of HealthCare USA, Inc. and Ultramedix Health Care Systems Inc., operating in Florida, for contract periods beginning on July 1, 1996, and ending on June 30, 1999, the (75-25) requirement under the Social Security Act that Medicare and Medicaid beneficiaries under titles XVIII and XIX of that Act constitute less than 75 percent of the membership of a participating health maintenance organization.
United States · United States Congress · 12 February 1997
Medicare Preventive Benefit Improvement Act of 1997 - Amends title XVIII (Medicare) of the Social Security Act to provide for expanded coverage of preventive benefits under part B (Supplementary Medical Insurance) of the Medicare program. Makes all women over age 49 eligible for annual screening mammography benefit coverage. Waives the deductible co-payment on such benefit. Makes women of childbearing age (if they have not had a negative result in such a test in each of the preceding three years), or at high risk of developing cervical cancer, eligible for yearly pap smears, by suspending in their cases a specified three-year frequency limitation on benefit coverage for screening pap smears. Makes such women eligible also for yearly screening pelvic exams, including a clinical breast exam. Makes other women eligible for triennial screening pelvic exams. Waives the deductible co-payment for such exams. Adds coverage of screening procedures, with specified payment and frequency limitations, for early detection of colorectal cancer, including fecal occult blood test, flexible sigmoidoscopy, and colonoscopy for high risk individuals, as well as a barium enema. Directs the Secretary of Health and Human Services to review the standards of medical practice with regard to colorectal cancer screening tests and, on the basis of such review if determined appropriate, issue and publish a determination that one or more colorectal cancer screening tests will no longer be covered under Medicare. Adds biennial coverage of certain prostate cancer screening procedures for men over 50 years of age, including a digital rectal examination and a prostate-specific antigen (PSA) blood test. Adds coverage of the following diabetes screening benefits: (1) diabetes outpatient self-management training services; and (2) blood-testing strips (with payment based on inexpensive, routinely purchased durable medical equipment). Directs the Secretary to: (1) establish outcome measures to evaluate improvement of the health of Medicare beneficiaries with diabetes mellitus; and (2) submit recommendations to the Congress regarding modifications to the Medicare coverage of services for such beneficiaries.
United States · United States Congress · 12 February 1997
TABLE OF CONTENTS: Title I: Essential Access Community Hospital Program Title II: Capital Financing Assistance for Safety Net Providers Subtitle A: Amendments of Internal Revenue Code of 1986 Subtitle B: Capital Financing Assistance for Safety Net Providers Title III: Capital Allocation Plans Essential Health Facilities Investment Act of 1997 - Title I: Essential Access Community Hospital Program - Amends part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act (SSA) to: (1) revise the Essential Access Community Hospital Program (EACH), extending EACH to all States and authorizing increased appropriations for EACH grants; and (2) establish a program of assistance (PA) for activities related to the formation of State and local community health networks. (Sec. 103) Requires the Secretary of Health and Human Services to report on EACH and PA effectiveness in increasing medically underserved population health care. Title II: Capital Financing Assistance for Safety Net Providers - Subtitle A: Amendments of Internal Revenue Code of 1986 - Amends the Internal Revenue Code (IRC) to impose a tax on the hospital gross receipts of any person for the taxable year. Subtitle B: Capital Financing Assistance for Safety Net Providers - Amends SSA to establish a program to provide capital financing assistance in the form of loan guarantees, interest rate subsidies, matching loans, and direct grants to eligible hospitals and facilities. Creates in the Treasury the related Capital Financing Trust Fund. (Sec. 212) Provides for adjustment of Medicare hospital payments to take into account any capital financing assistance received by the hospital. (Sec. 213) Amends the IRC to grant tax-exempt status to State and local bonds guaranteed by the Fund. Title III: Capital Allocation Plans - Amends SSA title XVIII to mandate that each State establish a plan for Federal approval of capital expenditures for certain non-rural health care services in the State in order to receive Medicare reimbursement for capital-related expenses.
United States · United States Congress · 12 February 1997
Patient Freedom of Choice Act of 1997 - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act (SSA) to require hospitals participating in the Medicare or Medicaid programs to: (1) give notice of availability of providers as part of the discharge planning process; and (2) maintain and disclose information on certain referrals. Provides for additional enforcement of such requirement through civil money penalties. Amends SSA title XI to provide for disclosure of certain information on hospital financial interest and referral patterns to the Secretary of Health and Human Services, who shall in turn make such information public.
United States · United States Congress · 12 February 1997
Waives, with respect to HealthCare USA, Inc. and Ultramedix Health Care Systems Inc., operating in Florida, for contract periods beginning on or after July 1, 1996, and ending on or before June 30, 2000, the (75-25) requirement under the Social Security Act that Medicare and Medicaid beneficiaries under titles XVIII and XIX of that Act constitute less than 75 percent of the membership of a participating health maintenance organization.