Comprehensive and Uniform Remedy for the Health Care System Act of 1989

Summary

Comprehensive and Uniform Remedy for the Health Care System Act of 1989 - Title I: Improving the Health of Mothers and Their Babies - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to establish a program to make grants to States to coordinate Federal and State prenatal care programs. Authorizes appropriations for FY 1990 through 1992. Title II: Removing Barriers to Affordable Health Insurance - Subtitle A: Preemption of State Mandated Benefits - Amends the Employee Retirement Income Security Act of 1974 to declare that such Act supersedes any provision of State law relating to the type or level of benefits that are to be provided under health insurance that constitutes an employee welfare benefit plan, as defined in such Act. Subtitle B: State Uninsurable Pools - Amends the Public Health Service Act to authorize appropriations for FY 1990 and each subsequent fiscal year for allotments to States. Directs the Secretary of Health and Human Services to make an allotment to each State each fiscal year, subject to exception and limitation, in proportion to the State's population. Provides for the amount of payments under the allotments. Requires non-Federal contributions in a specified percentage. Requires the payments to be used by the State to develop and operate qualified uninsurable pools to provide health insurance for medically uninsurable individuals. Allows a State to use any amount paid under these provisions to assist in the underwriting of the costs of the pool. Authorizes the Secretary to provide technical assistance to States. Limits administrative expenditures to ten percent of the amount paid to a State. Allows a State to transfer amounts not exceeding ten percent of amounts provided to the State under other provisions of the Public Health Service Act relating to block grants each fiscal year to carry out these activities. Sets forth application procedures and requirements. Requires an annual report by States to the Secretary. Requires States to establish fiscal control procedures and conduct an annual independent audit. Directs the Secretary to report to the appropriate committees of the Congress by October 1, 1991, on activities of the States under these provisions. Declares that title XVII (Civil Service and Postal Service Programs; Governmental Affairs Generally) of the Omnibus Budget Reconciliation Act of 1981 shall not apply with respect to audits of funds allotted under these provisions. Directs the Secretary to develop model criteria and forms for data collection to enable States to share uniform data regarding the provision of services under these provisions. Directs the Secretary to conduct investigations and to withhold payments from any State that does not use its allotment in accordance with the requirements of these provisions. Declares that programs and activities funded in whole or in part with funds under these provisions are considered to be programs and activities receiving Federal financial assistance for purposes of prohibitions of discrimination, in specified Acts, on the basis of age, handicap, sex, race, color, or national origin. Prohibits discrimination on the basis of sex or religion in any program or activity funded under these provisions. Allows the Secretary, if a State fails to comply, to refer the matter to the Attorney General, exercise the powers and functions provided in the applicable Acts, or take other action as provided by law. Allows the Attorney General to bring a civil action for appropriate relief, including injunctive relief. Provides for criminal penalties for certain false statements in connection with payments under these provisions. Title III: Treatment Practice Guidelines - Amends the Public Health Service Act to direct the Assistant Secretary for Health to establish treatment practice guidelines for health care services provided to patients, including guidelines for appropriate, inappropriate, and permissive evaluation and treatment. Requires the Assistant Secretary, in establishing the guidelines, to consider the setting of the evaluation and treatment, including whether the setting is urban or rural. Prohibits, notwithstanding any other law, the guidelines from being introduced in any Federal or State court action, unless the action arises from a health care service which was given to an individual in accordance with the guidelines, in which case the guidelines may be introduced by a provider who is a party to the action. Declares that the guidelines, if so introduced, shall be the appropriate standard of medical care. Requires the guidelines, where followed, to be used by the Secretary under provisions of the Social Security Act requiring peer review organizations to determine whether payment shall be made for services under title XVIII (Medicare) of that Act. Directs the Assistant Secretary to review the guidelines at least every two years. Directs the Assistant Secretary, if a Federal agency or a private organization requests the establishment or review of guidelines for an area of health care services, to determine if establishment or review is appropriate and, if so, to establish or review the guidelines. Amends the Public Health Service Act to establish the National Advisory Council on Treatment Practice Guidelines (Guideline Council) to advise the Assistant Secretary with respect to the establishment of the guidelines. Authorizes appropriations for FY 1990 through 1992 for health service research, evaluation, and demonstration activities under provisions relating to the National Center for Health Services Research and Health Care Technology Assessment and the National Center for Health Statistics. Requires that a specified sum of amounts appropriated under this authorization for such fiscal years be available for expenses of the Guideline Council. Extends through FY 1992 the requirement that the Secretary, from amounts appropriated under specified provisions: (1) obligate not less than a specified sum for health care technology assessment activities undertaken under specified provisions; and (2) make available not more than a specified sum for grants for a council on health care technology under specified provisions. Authorizes appropriations for FY 1990 through 1992 for health statistical and epidemiological activities undertaken or supported under specified provisions. Title IV: Reducing Health Care Costs Through Prevention and Public Awareness Programs - Subtitle A: Treatment of Work-Based Prevention Efforts - Directs the Secretary of the Treasury to establish a taxpayer awareness program to inform employers that work-based prevention efforts that are effective are considered health benefits for which deductions are allowed under specified provisions of the Internal Revenue Code. Directs the Secretary to use public service and paid commercial advertising, direct mail, and any other appropriate means. Subtitle B: Public Service Announcements on Health Promotion Activities - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to establish and implement a program to provide the public with information concerning health promotion, prenatal care, and health benefits. Includes in the program public service announcements: (1) targeted to pregnant women who are at increased risk of suffering complications during pregnancy or having unhealthy babies; and (2) on the appropriate and effective use of health benefits. Requires an annual report by the Secretary to the appropriate congressional committees. Authorizes appropriations for FY 1990 through 1992. Title V: Improving the Trauma Care System - Subtitle A: General Federal Emergency Medical Services Programs - Amends the Public Health Service Act to create a new title on emergency medical services. Directs the Secretary by contract, to provide for the establishment and operation of a National Clearinghouse on Emergency Medical Services and Trauma Care. Sets forth the duties of the Clearinghouse. Allows the Clearinghouse to charge fees to defray and, starting with FY 1991, to cover its costs of operating. Authorizes appropriations for FY 1990 through 1992 or for the first through the third fiscal year after FY 1990 for which funds are appropriated under these provisions. Directs the Secretary to promulgate regulations that require States that receive grants under provisions added by this Act relating to emergency medical services block grants to provide the Secretary with certain data and information concerning the use of the grants. Authorizes the Secretary to make grants for research and demonstration projects concerning ways to improve the availability and quality of prehospital emergency medical services in rural areas by: (1) developing innovative uses of communications technologies; (2) making continuing education more accessible to emergency medical services personnel; (3) developing and refining training curricula; (4) undertaking outcome studies; and (5) developing innovative financing mechanisms. Authorizes appropriations for FY 1990 through 1992. Requires the Federal Communications Commission, within one year of enactment of this Act, to: (1) complete a study of the availability of radio channels for emergency medical services; (2) establish a plan to ensure that the needs of such services shall be adequately provided for in the allocation of frequencies; and (3) submit a report containing the study and the plan to the appropriate congressional committees. Subtitle B: Emergency Medical Services Block Grant - Amends the Public Health Service Act to authorize appropriations for allotments to States for FY 1990 through 1992. Directs the Secretary, for each such fiscal year, to: (1) allot to each State an amount under a specified formula related to its population and land area; and (2) make payments to each State. Prohibits the Secretary from making payments unless the State identifies any rural area for which there is no: (1) emergency medical services access through a 911 telephone number; (2) basic life-support system; or (3) advanced life-support system. Sets forth application requirements. Requires that amounts paid to a State under the allotments be used for: (1) accident prevention programs; (2) feasibility studies and planning activities for emergency medical services systems; (3) emergency medical services; (4) uncompensated trauma care; and (5) other activities as determined by the Secretary. Allows a State that receives a grant under the allotment to use not more than 25 percent of the grant to pay the expenses of certain uncompensated trauma care that has been provided. Allows a State to use a limited amount to carry out emergency medical services activities under these provisions. Repeals provisions of the Public Health Service Act which allow States to use block grant allotment sums for feasibility studies and planning for emergency medical services systems and the establishment, expansion, and improvement of such systems.

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• Introduced in Senate (text)

  Introduced in Senate · EN

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• Introduced in Senate

  summary · EN · 23 June 1989

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