Health Maintenance Organization Amendments of 1981

Summary

Health Maintenance Organization Amendments of 1981 - Amends title XIII (Health Maintenance Organizations) of the Public Health Service Act to authorize necessary appropriations for fiscal years 1982-1984 for health maintenance organization (HMOs) grants, contracts, and loan guarantees for planning and initial development and for training and technical assistance. Stipulates that an entity may not receive funds appropriated for: (1) planning purposes unless it received such funds or feasibility study funds in fiscal year 1981; and (2) initial development purposes unless it received such funds, planning funds, or feasibility study funds in fiscal year 1981. Authorizes: (1) appropriations (with an annual limit) for the Treasury loan fund for purposes of such Act; and (2) appropriations through fiscal year 1984 for planning and initial development loan guarantees. Eliminates: (1) open enrollment period; and (2) policymaking body membership requirements. Permits pay rates to be alternatively determined on a per-class basis under the "community rating system" definition. Makes private HMOs that are not nonprofit eligible for initial operation cost loans and loan guarantees. Increases the aggregate and 12-month amounts of such loans and guarantees and extends their availability through fiscal year 1985. Repeals the provision prohibiting cumulative loan guarantees to a private HMO from exceeding fund obligations in any fiscal year. Repeals existing ambulatory facility acquisition and construction loan provisions. Requires an employer: (1) subject to this Act to include in his employee health benefits plan the option of membership in each qualified HMO providing basic health services in an area in which at least 500 employees of such employer reside; and (2) who includes certain insurance carrier-owned HMOs in such plan to include an additional HMO (if one exists) which has residing in its service area at least 25 employees of such employer. Eliminates: (1) loan and grant priorities for nonmetropolitan areas and medically underserved populations; (2) the National Health Maintenance Organization Intern Program; and (3) certificate of need exemptions (for certain State health services) for HMOs or specified health care facilities with an enrollment of at least 50,000 persons.

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1 official file

• Introduced in House

  summary · EN · 11 March 1981

  Open at official source

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