Summary: H.R.5812 — 102nd Congress (1991-1992)All Information (Except Text)

There is one summary for H.R.5812. Bill summaries are authored by CRS.

Shown Here:
Introduced in House (08/11/1992)

Health Insurance Purchasing Cooperatives Act - Mandates grants to States for the administrative costs of planning and implementing coordinated buying programs through which small employers may purchase employee health insurance. Requires that the programs be the sole mechanism for small employers to purchase such insurance.

Requires that a State program provide each small employer in the State access to health insurance for its employees and their dependents through one or more Health Insurance Purchasing Cooperatives, each covering a defined geographic district. Sets forth Cooperative duties, including issuing contracts and administering all aspects of coverage for all small employers within the district. Waives Federal and State antitrust laws.

Authorizes appropriations.

Establishes the National Health Board. Requires the Board to establish Coordinated Buying Program Precepts setting forth certain criteria, including regarding a uniform data system, collection of outcomes data, and determining minimum benefit requirements. Authorizes appropriations.

Requires the Board to establish minimum benefit requirements for plans offered through Cooperatives, including inpatient and outpatient hospital care and physician services, diagnostic tests, prenatal and well-baby care, preventive and early intervention services, and certain inpatient and outpatient mental disorder services. Allows managed care and different levels of payments for different providers.

Requires the Board to establish minimum benefit requirements for two additional health benefit plans providing more extensive or more innovative benefits.

Amends provisions of the Public Health Service Act relating to health maintenance organizations (HMOs) to exempt from those provisions HMOs that provide services meeting the requirements under this Act.

Establishes the National Health Insurance Data System, consisting of: (1) a National Data Base for Health Insurance and Health Outcomes Information; (2) no more than five Regional Health Insurance Data Centers; and (3) an electronic health insurance and outcomes data processing mechanism.

Requires the Board to: (1) establish uniform billing and claims forms and mandatory reporting requirements; and (2) require carriers to issue to each participant an electronic processing card containing certain information on financial, administrative, and health outcomes matters.

Authorizes appropriations.

Amends the Internal Revenue Code to allow a deduction to self-employed individuals of 100 percent of the amount paid for health insurance purchased through a Cooperative. Retains current provisions allowing a deduction of 25 percent of the amount paid for health insurance not purchased through a Cooperative. Removes provisions ending, on a specified date, deductibility of health insurance payments by self-employed individuals.