Improved Access to Affordable Health Care Act of 1992

Summary

Improved Access to Affordable Health Care Act of 1992 - Title I: Improvements in Health Insurance for Small Employers - Amends the Social Security Act to add a new title, Title XXI: Standards for Small Employer Health Insurance and Certification of Managed Care Plans. Directs the Secretary of Health and Human Services to request that the National Association of Insurance Commissioner (NAIC) develop standards concerning requirements for health insurance plans for small employers. Requires the Secretary to develop such standards if NAIC fails to do so. Requires such plans to provide for: (1) guaranteed eligibility; (2) guaranteed availability; and (3) guaranteed renewability. Prohibits: (1) an insurer from refusing to renew or terminate a plan, except for nonpayment of premiums, fraud, or failure to maintain minimum participation rates; and (2) for certain services, discrimination based on health status. Sets limits controlling the variation of premium charges permitted among all small employers insured by an insurer. Requires the full disclosure of an insurer's rating practices. Requires a health insurance plan for small employers to offer: (1) both a standard and basic benefit package; and (2) a managed care option, under certain conditions. Provides, under both the standard and basic package, for coverage of: (1) inpatient and outpatient hospital care; (2) inpatient and outpatient physician services; (3) diagnostic tests; and (4) preventive services. Provides, in addition, under the standard plan: (1) for the coverage of certain mental health care; (2) that, except as specified, there will be no limits on the amount, scope, or duration of benefits; and (3) for specified limits on deductibles, copayment, coinsurance, and out-of-pocket expenses. Provides under the basic plan that: (1) premiums, deductibles, copayments, or other cost-sharing may be imposed; and (2) there shall be an out-of-pocket limit. Sets forth study and reporting requirements. Title II: Improvements in Portability of Private Health Insurance - Amends title XXI of the Social Security Act to prohibit group health plans from denying, limiting, or conditioning plan coverage based on the individual's health status and other factors, subject to stated exceptions for preexisting conditions. Title III: Health Care Cost Containment - Establishes a Health Care Cost Commission which shall report annually to the President and the Congress on national health care costs. Authorizes appropriations. Requires the Secretary, under title XXI of the Social Security Act, to establish a process for the certification of managed care plans and of utilization review programs. Sets forth requirements for certification. Amends the Public Health Service Act to authorize additional funding for outcomes research. Title IV: Grants To States for Small Employer Health Insurance Purchasing Programs - Directs the Secretary to make grants to States for small employer health insurance purchasing programs. Authorizes appropriations. Sets forth reporting requirements. Directs the Secretary to study and report to the Congress on the feasibility and desirability of establishing payment rates, based upon Medicare payment rules, for optional use by private health insurers.

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2 official files

• Introduced in House (text)

  Introduced in House · EN

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• Introduced in House

  summary · EN · 30 April 1992

  Open at official source

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