Health Care Improved Access Act of 1985

Summary

Health Care Improved Access Act of 1985 - Title I: Continuation of Health Insurance for Individuals Losing Employment-Related Coverage - Amends the Public Health Service Act to require employers with 25 or more employees to offer an option of continuation coverage to beneficiaries who would lose coverage under the health benefits plan because of: (1) the termination, or reduction of hours, of the covered employee; (2) the death of the covered employee; (3) the divorce or separation of the covered employee from his spouse; or (4) the covered employee's eligibility for Medicare benefits. States the terms of continuation coverage. Specifies certain notice requirements for the health benefits plan, the employer, and the employee. Requires the group health plan to provide for an open enrollment period for each married employee who is, or would be, covered under the plan whose spouse loses or will lose coverage under a health benefits plan due to the spouse's separation from employment. Requires such open enrollment period to: (1) be a period of at least 60 days; and (2) begin not earlier than 30 days before the spouse's separation from employment. States the terms of the enrollment option. Imposes civil penalties on any states notice and hearing rights for employers who do not comply with the requirements of this Act. Permits private actions for damages resulting from the employer's failure to comply with such requirements. Title II: Incentives for the Establishment of Statewide Insurance Pools - Requires the employer who offers a health benefits plan, or the entity through which the benefits are offered, to be a member of a qualified pooling association. Title III: Prohibiting Refusal of Examination or Appropriate Care to Stabilize Patients in Medical Emergencies - Requires hospitals with an emergency department to provide individuals seeking treatment with an appropriate medical screening examination to determine whether an emergency medical condition exists. States that where an emergency medical condition exists, or the individual is in active labor, the hospital must provide: (1) such treatment as may be required to stabilize the medical condition or to provide for treatment of the labor; or (2) for the transfer of the patient to another medical facility. Provides certain guidelines for the transfer of patients with emergency medical conditions to other medical facilities. Provides that the failure to meet the requirements of this Act subjects the hospital to: (1) termination of its Medicare provider agreement under title XVIII of the Social Security Act; (2) civil monetary penalties of up to $25,000 per violation; and (3) appropriate civil actions. Imposes criminal penalties upon responsible physicians under specified circumstances. Title IV: Demonstration Projects on Improving Access to Health Insurance for Small Employers and Self-Employed Individuals - Directs the Secretary of Health and Human Services to provide for the conduct of studies and demonstration projects on ways to reduce the costs for small employers and self-employed individuals in obtaining health insurance. Directs the Secretary to report to the Congress on the results of the studies and demonstration projects by January 1, 1988. Authorizes appropriations.

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1 official file

• Introduced in Senate

  summary · EN · 9 September 1985

  Open at official source

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