health security act 1993 summary

(Sec. Requires a State to establish a State health security program in accordance with this Act to receive Federal health care funding. Authorizes appropriations. Read thesummary of S. 1782from the 113th Congress (2013-2014). Bethesda, MD 20894, Web Policies 1200from the 113th Congress (2013-2014). 5202) Requires each State to establish a complaint review office for each regional alliance established by a State. (Sec. 4031) Amends title XI of the Social Security Act to: (1) provide for termination of the separate Medicare peer review program upon adoption of the National Quality Management Program above under subtitle A of title V of this Act; and (2) repeal provisions on surgical procedure review and second opinions. Concise summaries and expert physician commentary that busy clinicians need to enhance patient care. G.P.O., Supt. The state could either pay bills directly or contract with one fiscal intermediary, which could be an insurance company or a third-party administrator, to do so, as Medicare now does within regions. on this bill on a six-point scale from strongly oppose to strongly support. 7702) Provides for the treatment of long-term care insurance as accident and health insurance. This activity took place on a related bill, H.R. 5433) Amends the Federal criminal code to set penalties for: (1) knowingly and willfully falsifying, concealing, or covering up a material fact, making any false, fictitious, or fraudulent statements or representations, or making or using any false writing or document knowing it to contain any false, fictitious, or fraudulent statement or entry, in any matter involving a health alliance or health plan; and (2) bribery of, and graft by, a health care official. TABLE OF CONTENTS: Title I: Health Care Security Subtitle A: Universal Coverage and Individual Responsibility Subtitle B: Benefits Subtitle C: State Responsibilities Subtitle D: Health Alliances Subtitle E: Health Plans Subtitle F: Federal Responsibilities Subtitle G: Employer Responsibilities Subtitle J (sic): General Definitions; Miscellaneous Provisions Title II: New Benefits Subtitle A: Medicare Outpatient Prescription Drug Benefit Subtitle B: Long-Term Care Title III: Public Health Initiatives Subtitle A: Workforce Priorities Under Federal Payments Subtitle B: Academic Health Centers Subtitle C: Health Research Initiatives Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health Subtitle E: Health Services for Medically Underserved Populations Subtitle F: Mental Health; Substance Abuse Subtitle G: Comprehensive School Health Education; School-Related Health Services Subtitle H: Public Health Service Initiative Subtitle I: Coordination With COBRA Continuation Coverage Title IV: Medicare and Medicaid Subtitle A: Medicare and the Alliance System Subtitle B: Savings in Medicare Program Subtitle C: Medicaid Subtitle D: Increase in SSI Personal Needs Allowance Title V: Quality and Consumer Protection Subtitle A: Quality Management and Improvement Subtitle B: Information Systems, Privacy, and Administrative Simplification Subtitle C: Remedies and Enforcement Subtitle D: Medical Malpractice Subtitle E: Fraud and Abuse Subtitle F: McCarran-Ferguson Reform Title VI: Premium Caps; Premium-Based Financing; and Plan Payments Subtitle A: Premium Caps Subtitle B: Premium-Related Financing Subtitle C: Payments to Regional Alliance Health Plans Title VII: Revenue Provisions Subtitle A: Financing Provisions Subtitle B: Tax Treatment of Employer-Provided Health Care Subtitle C: Employment Status Provisions Subtitle D: Tax Treatment of Funding of Retiree Health Benefits Subtitle E: Coordination with COBRA Continuing Care Provisions Subtitle F: Tax Treatment of Organizations Providing Health Care Services and Related Organizations Subtitle G: Tax Treatment of Long-term Care Insurance and Services Subtitle H: Tax Incentives for Health Services Providers Subtitle I: Miscellaneous Provisions Title VIII: Health and Health-Related Programs of the Federal Government Subtitle A: Military Health Care Reform Subtitle B: Department of Veterans Affairs Subtitle C: Federal Employees Health Benefits Program Subtitle D: Indian Health Service Subtitle E: Amendments to the Employee Retirement Income Security Act of 1974 Subtitle F: Special Fund for WIC Program Title IX: Aggregate Government Payments to Regional Alliances Subtitle A: Aggregate State Payments Subtitle B: Aggregate Federal Alliance Payments Subtitle C: Borrowing Authority to Cover Cash-Flow Shortfalls Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance Subtitle A: Workers Compensation Insurance Subtitle B: Automobile Insurance Subtitle C: Commission on Integration of Health Benefits Subtitle D: Federal Employees' Compensation Act Subtitle E: Davis-Bacon Act and Service Contract Act Subtitle F: Effective Dates Title XI: Transitional Insurance Reform Health Security Act - Title I: Health Care Security - Subtitle A: Universal Courage and Individual Responsibility - Entitles each eligible individual to: (1) the benefit provided under subtitle B through the applicable health plan in which the individual is enrolled; and (2) a health security card to be issued by the alliance or other entity that offers the applicable health plan in which the individual is enrolled. Now what? 1993. And starting in 2019 well be tracking Congresss oversight investigations of the executive branch. Specifies that nothing in this Act affects the eligibility of veterans for Veterans Administration health benefits and services, or of Indians for benefits and services of the Indian Health Service. N Engl J Med 1992;327:1682-1685, 5. Subtitle G: Tax Treatment of Long-term Care Insurance and Services - Treats qualified long-term care services as medical care for purposes of the medical expense deduction. 1200 (110th). Bethesda, MD 20894, Web Policies Now were on Instagram too! (Sec. States that such costs include: (1) costs resulting from reduced staff productivity due to teaching responsibilities; (2) the uncompensated costs of clinical research; and (3) exceptional costs associated with an institutions specialized expertise. Authorizes appropriations. 6006) Directs the chair of the Board to establish an advisory commission on regional variations in health expenditures. 1503) Directs the Board to: (1) interpret the comprehensive benefit package; (2) adjust the delivery of preventive services; (3) take steps to assure that the comprehensive benefit package is available on a uniform national basis; (4) recommend to the President and the Congress appropriate revisions to the package; (5) oversee cost containment requirements; (6) develop and implement eligibility standards; (7) establish a performance based system of quality management; (8) develop and implement standards for a national health information system; (9) establish State requirements and monitor State compliance; (10) establish premium class factors; (11) develop a methodology for the risk-adjustment of premium payments; (12) establish financial requirements for guaranty funds; (13) establish standards for health plan grievance procedures; and (14) report annually to the President and the Congress. 303) Defines a "comprehensive health service organization" (CHSO) as a public or private organization which, in return for a fee for service, furnishes or arranges a full range of health services and out-of-area coverage in the case of urgently needed services to an identified population in a specified service area which enrolls voluntarily in the organization. Read thesummary of H.R. 4033) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate administration of Medicare parts A and B and supersedes certain conflicting requirements to the extent required to achieve such purpose. Read thesummary of S. 491from the 103rd Congress (1993-1994). |author=103rd Congress (1993) The most recent addition to the list of proposals for modifying the health care system is the American Health Security Act of 1993, introduced by President Clinton in September 1993. H.R. Subtitle B: Control Over Fraud and Abuse - Authorizes the Board to exclude providers from participation, impose civil monetary penalties, and seek criminal prosecution for fraud or abuse, based on current Medicaid standards. Prohibits the sale of a long-term care policy in a State without a regulatory program. Bookshelf (Sec. Provides two different formulas. Nov 4, 2022. Subtitle D: Health Alliances - Provides for regional alliances and corporate alliances. The single-payer system would replace private premiums with public premiums. 1322) Requires each regional alliance to offer a choice of health plans, including at least one fee-for-service plan. J Health Hum Serv Adm. 1997 Winter;19(3):341-56. 2105) Sets forth provisions relating to: (1) cost sharing; (2) quality assurance and safeguards; (3) advisory groups; (4) payments to States; and (5) the total Federal budget for State plans and allotments to States. Provides that employers that were corporate alliance employers with respect to a terminated alliance shall become regional alliance employers. 1361) Requires each regional alliance to comply with specified standards relating to the management of finances, maintenance of records, accounting practices, auditing procedures, financial reporting, and employer payments. Furthermore, Clinton's plan failed also because the policy itself was too comprehensive and complicated. 4231) Discontinues certain payment policies under Medicaid. 1200 (107th). (Sec. (Sec. (Sec. A single-payer proposal. 8306) Sets forth provisions regarding health service to non-enrollees and non-Indians. Committe 0 Ratings 0 (Sec. Permits aggrieved individuals to file complaints with the appropriate review office. (Sec. 406) Directs each program to establish DHACs covering distinct geographic areas for purposes of: (1) advising and making recommendations to the State with respect to implementation of the program in that geographic area; (2) receiving and investigating complaints by eligible persons and service providers concerning program administration and taking corrective action; and (3) carrying out district management and planning functions with the program. Requires providers to disclose relevant information about their ownership interest in health facilities and services, based on current Medicaid standards. Prohibits a plan from: (1) restricting or terminating coverage for any reason, including nonpayment of premiums; (2) cancelling coverage for any eligible individual until that individual is enrolled in another plan; (3) excluding an eligible individual because of an existing medical condition; (4) imposing a waiting period before coverage begins; or (5) imposing a rider that excludes the coverage of particular eligible individuals. According to the CBO, if such a system had been in full effect in 1986, it would have resulted in national health expenditures of only $651 billion in 1991, rather than the $752 billion we actually spent. Mariner WK. Sets forth provisions for determining such premium. In contrast, the Congressional Budget Office (CBO) reported on February 2 that central features of the American Health Security Act would increase the likelihood of success in controlling cost increases, as compared with alternative proposals. 1200from the 103rd Congress (1993-1994). Instead of insurance plans that charge individual people and businesses the same amount regardless of income or profits, the public plan would be progressively financed by increases in the top marginal income-tax rates for individuals and corporations, payroll taxes on employers, and a premium equivalent to the Medicare Part B premium to be paid by those over 65 years of age, as well as by closing a variety of tax loopholes. (Sec. Sets forth other requirements for such policies, including requirements related to: (1) premiums; (2) sales practices; (3) continuation, renewal, replacement, conversion, and cancellation of policies; and (4) payment of benefits. In our present profit-oriented insurance market, competition based on price could permit the same kind of adverse selection and cost shifting that characterize the current health care system. 502) Requires each participating State to establish an entity to conduct quality reviews of persons providing covered services under its program which meet Federal standards for the adoption of practice guidelines, identification of outliers, development of remedial programs and monitoring for outliers, and the application of sanctions. Follow @govtrack.us on Instagram for new 60-second summary videos of legislation in Congress. Without constraints, as far too many managed-care plans have demonstrated, health plans driven to control costs will reduce services, either by taking the telephone off the hook to discourage initial visits or by limiting the services available to those who do manage to consult a provider. Provides for increased premiums of 15 percent during Federal operation of a State system to provide reimbursement for the Federal cost of operating the system. (Sec. 1302) Requires a regional alliance to be governed by a Board of Directors consisting of: (1) employers, including self-employed individuals; and (2) members who represent individuals purchasing coverage. If you can, please take a few minutes to help us improve GovTrack for users like you. Removes residence sale, purchase, or lease expenses and meals while traveling from the deduction for moving expenses. 2103) Defines "individuals with disabilities" to mean any individual within one or more of the following four categories: (1) individuals requiring help with the activities of daily living; (2) individuals with severe cognitive or mental impairment; (3) individuals with severe or profound mental retardation; and (4) severely disabled children. (Sec. 1162) Permits a health professional or facility to refuse to provide a benefit if the professional or facility objects on the basis of a religious belief or moral conviction. (Sec. AMERICAN HEALTH SECURITY ACT (H.R. Please join our advisory group to let us know what more we can do. FOIA Although costs may rise, these countries can and do use the lever of public control to recognize problems quickly and then move to address them. The American Health Security Act of 1993 (S. 491), which one of us (Senator Wellstone) introduced into the Senate, proposes such a solution, through a publicly Subtitle E: Fraud and Abuse - Directs the Secretary and the Attorney General to establish a program: (1) to coordinate the functions of the Attorney General, the Secretary, and other organizations with respect to the prevention, detection, and control of health care fraud and abuse; (2) to conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for health care; and (3) to facilitate the enforcement of this and other statutes applicable to health care fraud. 1200 109th Congress (2005-2006) Title IV: Administration - Subtitle A: General Administrative Provisions - Establishes the American Health Security Standards Board to develop policies and procedures for enrollment, benefits, provider participation, national and State funding levels, determination of medical necessity and appropriateness (including the coverage of new technologies and the application of medical practice guidelines), quality assurance, assisting programs with planning for capital expenditures and service delivery, and other functions and to establish uniform reporting standards for health services and programs. Provides for the collection of a monthly long-term health care premium for the elderly (other than the low-income elderly) for deposit into the American Health Security Trust Fund. See the list of 4 Congressional cosponsorsfor the 103rd Congress (1993-1994). (Sec. (Sec. 1200 114th Congress (2015-2016) Requires that, in the case of a for-profit CHSO, the total amount of capitation payments in a period be reduced by operating profit for the period less a reasonable rate of return on equity capital and that such profit be additionally limited to such amounts as the Board determines are attributable to operating efficiencies and not to any reduction of care provided. (Sec. Please sign up for our advisory group to be a part of making GovTrack a better tool for what you do. Almost 30 years after the nation's last brush with comprehensive health care reform, the prospect of fundamental change once again seems almost palpable. Specifies that: (1) nursing facility and home health services (other than post-hospital services) furnished to an individual who is not qualifying are not covered services unless the services are determined to meet specified standards and, with respect to nursing facility services, to be provided in the least restrictive and most appropriate setting; and (2) benefits are not available under this Act with respect to services involving unapproved capital expenditures. 1431) Requires each health plan, with respect to each electing essential community provider located within the plan's service area, to either: (1) enter into a written provider participation agreement; or (2) enter into a written agreement under which the plan will make payment to the provider as specified. Defines a child as being under age 18, or under age 24 in the case of a full-time student. 5207) Sets monetary penalties for a plan which unreasonably denies or delays payment or provision of benefits. 102) Entitles every individual who is a resident of the United States and is a U.S. citizen or national or a lawful resident alien to benefits for health care services under this Act under the appropriate State program. Contemporary Analysis of the Universal Health Care Act. Subtitle B: Payments by States to Providers - Directs that: (1) payment for operating expenses for hospital and nursing facility services under State programs be made directly to each hospital or nursing facility under an annual prospective global budget approved under the program; (2) such budgets take into account discharges by diagnosis-related group, prior expenditures, change in the consumer price index and other price indices, compensation, occupancy levels, past financial and clinical performance, training, technological changes, and incentives to maintain costs without reducing care; (3) capital expenditures be subject to prior approval; (4) a budget of a hospital or nursing facility be subject to prior review by the SHSAC and appropriate DHAC; (5) facility budgets be adjusted to reflect payments made by CHSOs; and (6) the Board promulgate regulations permitting hospitals and nursing facilities to raise funds from private sources to pay for newly constructed facilities, major renovations, and equipment. (Sec. 1373) Provides for premium discounts and reduction in liabilities for low-income families. Current managed-care plans, although they offer some excellent examples of multidisciplinary practice and of the use of data to improve care, have not on the whole saved money. Provides that the funding for such payments will come from transfers from the Federal Hospital Insurance Trust Fund, payments made by regional alliances to the Federal government for academic health centers and graduate medical education, and payments from corporate alliances. Subtitle C: Primary Care and Outcomes Research - Requires the Board to transfer specified Trust Fund revenues to the Agency for Health Care Policy and Research for health outcomes research. Youve cast your vote. Visit us on Instagram, Despite what many people mistakenly say, its not actually called an ATM machine, because the M already stands for machine. Nov 9, 2022, This bill would be good news for the cows which got swept airborne in the movie Twister. 2361) Authorizes the Secretary to make grants for the development and implementation of long-term care information, counseling, and other programs to: (1) States; (2) regional alliances (at the option of States within which such alliances are located; and (3) national organizations representing insurance consumers, long-term care providers, and insurers. We hope that with your input we can make GovTrack more accessible to minority and disadvantaged communities who we may currently struggle to reach. Read thesummary of H.R. 1402) Requires each health plan offered by either a regional or corporate alliance to accept for enrollment every alliance eligible individual, unless the plan has reached its enrollment limit. Sets as national goals that: (1) at least 50 percent of graduate medical residencies be in primary care within five years of this Act's enactment; and (2) there be a certain number, specified by the Board, of midlevel primary care practitioners employed in the health care system as of January 1, 2000. Requires a report from the Secretary to the Congress concerning the operation of the VA health care system within the requirements of this Act. (Sec. 1200 113th Congress (2013-2014) Special supplement: a guide to committee-passed health reform bills. Disclaimer, National Library of Medicine Directs the Board to specify standards for the capital approval process which meet specified requirements. American Health Security Act, S.1782 113th Congress (2013-2014) 1381) Permits each corporate alliance to: (1) offer coverage under either an appropriate self-insured health plan; or (2) negotiate with a State-certified plan to enter into a contract with the plan. Provides for grants to: (1) increase access to mental health and substance abuse services; (2) improve State and local capacity to coordinate and monitor such services; (3) provide incentives to integrate public and private service systems; and (4) supplement any activity under part B (Alcohol and Drug Abuse and Mental Services Block Grant) of title XIX of the Public Health Service Act. Requires reports to the Congress on the demonstration program. Launched in 2004, GovTrack helps everyone learn about and track the activities of the United States Congress. |work=Legislation 105) Makes benefits available under this Act for items and services furnished on or after January 1, 1995. Makes the highest estate and gift tax rates permanent. (Sec. 403) Directs the Board to appoint advisory committees on benefits, cost containment, primary care and the medically underserved, mental health and substance abuse treatment, prescription drugs, and rehabilitation and chronic care management. Authorizes appropriations. The American health care system -- managed care. Allows the State to adopt alternative methodologies to those adopted by the Quality Council, provided that the State can demonstrate that the efficacy of such review and education programs meets Federal standards. (Sec. Participating physicians are entitled to receive payments on the basis of fee-for-service, but states can provide alternative payment methodologies as options as well. The elements of the proposal are fairly simple: fixed annual budgets; free choice of providers, including consumer-oriented managed-care plans; streamlined and publicly accountable administration; universal coverage based on residency instead of employment; comprehensive benefits with an emphasis on primary and preventive care; quality controls based on outcomes data and designed with the involvement of providers and patients; equitable financing; and affordability. Sponsor. Allows such plans to offer supplemental health benefits and cost-sharing policies as consistent with this Act. 10011) Sets forth requirements for participating States. Subtitle D: Medical Malpractice - Prohibits any medical malpractice liability action until the final resolution of the claim under alternative dispute resolution. The President's Report to the (Sec. (Sec. 1341) Set forth provisions concerning the collection of funds by regional alliances from individuals, employers, and others. Sets forth the following categories of providers automatically certified (under provisions of the Public Health Service Act): (1) migrant health centers; (2) community health centers; (3) homeless program providers; (4) public housing providers; (5) family planning clinics; and (6) AIDS providers under the Ryan White Act. (Sec. Hackers/journalists/researchers: See these open data sources. (Sec. (Sec. Subtitle C: Federal Employees Health Benefits Programs - (Secs. An official website of the United States government. (Sec. The American Health Security Act (S 491, HR 1200) was introduced in the U.S. Senate by Paul Wellstone (D-MN) and in the House of Representatives by John Conyers (D-MI) and Jim McDermott (D-WA), along with 54 co-sponsors. Sets forth guidelines for developing such methodology. |publisher=GovTrack.us Follow @govtrack.us on Instagram for new 60-second summary videos of legislation in Congress. Part 4 of the Act sets out reasons why such individual access request may be refused. (Sec. Everyone would be covered under the same health insurance system with the same benefits, and there would be no duplicative insurance outside the system for covered benefits. 5437) Sets penalties for: (1) theft or embezzlement in connection with a health alliance, health plan, or fund connected with such alliance or plan; and (2) misuse of a health security card issued, or unique identifier provided, pursuant to this Act. 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