Health Maintenance Organizations Amendments of 1981

Summary

Health Maintenance Organizations Amendments of 1981 - Amends title XIII (Health Maintenance Organizations) of the Public Health Service Act regarding health maintenance organizations (HMOs) requirements to: (1) eliminate community rating-based premiums; (2) eliminate open enrollment; (3) permit individual physicians to contract for basic health services provided they agree not to hold HMO members personally liable for any defaulted payments; (4) permit an HMO to be part of another corporate entity if such entity provides necessary financial assurances; (5) protect the members of an HMO from any hospital fees incurred by such organization; and (6) eliminate certain policymaking board membership requirements. Includes drug and alcohol treatment under "supplemental health benefits" rather than under "basic health services" as currently provided. Eliminates: (1) grants for feasibility surveys and for initial development; (2) grants, loans, and loan guarantees for planning projects and for ambulatory health care and facilities; and (3) priorities for nonmetropolitan areas and medically underserved populations. Extends loan guarantees for initial development and operations for those entities receiving funds as of September 30, 1981. Places aggregate and cumulative ceilings on such loan guarantees. Revises: (1) application requirements, including reconsideration of a denial of federally qualified status; and (2) administration provisions. Authorizes specified appropriations for training and technical assistance (including a national health maintenance organization intern program) for fiscal years 1982-1984. Extends authorizations for the Treasury loan fund to assist those HMOs receiving assistance before October 1, 1981. Permits the Secretary to delegate specified HMO regulatory responsibility to a State. Eliminates: (1) required HMO evaluations by the Comptroller General; and (2) annual congressional reporting requirements imposed on the Secretary. Makes this Act effective as of October 1, 1981.

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Documents

2 official files

• Reported to Senate with amendment(s)

  summary · EN · 15 May 1981

  Open at official source

• Introduced in Senate

  summary · EN · 29 April 1981

  Open at official source

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