H.R.94 - National Health Insurance Act94th Congress (1975-1976)
|Sponsor:||Rep. Dingell, John D. [D-MI-16] (Introduced 01/14/1975)|
|Committees:||House - Interstate and Foreign Commerce|
|Latest Action:||House - 01/14/1975 Referred to House Committee on Interstate and Foreign Commerce. (All Actions)|
This bill has the status Introduced
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Summary: H.R.94 — 94th Congress (1975-1976)All Information (Except Text)
Introduced in House (01/14/1975)
National Health Insurance Act - Title I: Benefits and Eligibility - Establishes a program of personal health services including medical, dental, podiatric home-nursing, hospital, and auxiliary services for eligible individuals. Sets forth the eligibility requirements for such benefits generally so that all employed or self-employed individuals and individuals entitled to old age and survivors benefits under the Social Security Act are covered. Permits benefits to be provided for "noninsured" needy and other uncovered individuals when reimbursements are made by public agencies. Provides that medical services consist of: (1) general medical services such as can be rendered by a physician engaged in the general or family practice of medicine, including preventive, diagnostic, and therapeutic care and periodic medical examinations; and (2) specialist services rendered by a physician who is a specialist in the class of services rendered.
Provides that such services may be rendered at the office, home, hospital, or elsewhere, as necessary. Provides that medical, hospital, and other personal health services shall be made available as soon as practicable. Allows eligible individuals for personal health services freedom to select the physician or other person of his choice to render such services.
Title II: Participation of Physicians, Dentists, Nurses, Hospitals, and Others - Provides that any individual who is a physician, dentist, or podiatrist legally authorized in a State to render any services included as general medical, dental, or podiatric services in that State as benefits under this Act.
Directs that any such individual who is found to possess skill and experience of a degree and kind sufficient to meet standards established for a class of specialist services shall be deemed qualified to receive compensation for specialist services of such class benefits under this Act. Authorizes the National Health Insurance Board, after consultation with the Advisory Council, to establish standards as to the special skills and experience required to qualify an individual to render each such class of specialist services as benefits under this Act, and to receive compensation for such specialist services.
Sets forth requirements for participation in the program and the method and amount of payments for services.
Title III: Local Administration - Provides for the administration of personal health service benefits through local area committees under plans prepared by the State. Sets forth requirements for State plans. Provides that in order that personal health service benefits may be made available promptly and in a manner best adapted to local practices, conditions, and needs, responsibility for administration of the benefits provided under this Act in the several local health-service areas shall be decentralized as fully as practicable to local administrative committees or local administrative officers, acting with the advice and assistance, as provided in this title, of local professional committees and, in the case of local administrative officers, the advice and assistance of local area committees. Provides that health-service areas of a State shall be those so designated in the State plan of operations.
Establishes a local area committee in each health service area to perform the functions of this Act and to formulate the administration of policies for this Act.
Title IV: State Administration - Provides that it is the intent of Congress that the benefits provided under this Act be administered wherever possible by the several States, in accordance with plans of operations submitted and approved as provided in this title, and in each State insofar as feasible by the same State agency which administers, or supervises the administration of, the State's general public health and maternal and child health programs. Provides that the Board shall approve any State plan and any modification thereof submitted by the State which it finds complies with various provisions pertaining to State plans of operation. Declares that no change in a State plan shall be required within one year after initial approval thereof, or within one year after any change in the regulations or standards prescribed pursuant to this Act except with the consent with the consent of the State or in accordance with further action by Congress.
Title V: National Health Insurance Board: National Advisory Medical Policy Council; General Administrative Provisions - Establishes in the Department of Health, Education, and Welfare a National Health Insurance Board, to be composed of five members, three of whom shall be appointed by the President by and with the advice and consent of the Senate, and the other two of whom shall be the Surgeon General of the Public Health Service and the Commissioner of Social Security, to assist in carrying out the provisions of this Act.
Provides that during his term of membership on the Board, no appointed member shall engage in any other business, vocation, or employment. Establishes a National Advisory Medical Policy Council to consist of the Chairman of the Board, who shall serve as Chairman of the Advisory Council ex officio, and sixteen members appointed by the Secretary of Health, Education, and Welfare. Provides that at least eight of the sixteen appointed members shall be individuals who are familiar with the need for personal health services in urban or rural areas and who are representative of the interests of individuals eligible for benefits under this Act, and at least six of the members shall be individuals who are outstanding in the medical or other professions concerned with the provision of services provided as benefits under this Act and who are representative of the individuals, organizations, and other persons by whom personal health services will be provided.
Title VI: Eligibility Determinations, Complaints, Hearings, and Judicial Review - Provides that the Secretary of Health, Education, and Welfare, through such units of the Department of Health, Education, and Welfare as he may determine, shall upon his own initiative or upon application of any individual make determinations as to the eligibility of individuals for benefits under this Act. Provides that whenever requested by any individual determined by the Secretary not to be eligible for benefits for any period, or by a dependent of any such individual, the Secretary shall give such individual or such dependent reasonable notice and opportunity for a hearing with respect to such determination and on the basis of the evidence adduced at the hearings shall affirm, modify, or reverse his determination. Provides for judicial review of adverse decisions by the Secretary.
Title VII: Application of Act To Individuals Covered Under Medicare Program - Provides that any individual who is entitled to hospital insurance benefits under title XVIII (Medicare) of the Social Security Act, or to supplementary medical insurance benefits under the insurance program of the Social Security Act, during any benefit year or part thereof in which he is otherwise eligible for benefits under this Act which may be made available to him as benefits under this Act shall be limited to those services for which he is ineligible under title XVIII of the Social Security Act. Requires the Secretary of HEW to study and report not later than one year after the enactment of this Act the interrelationship of the national health insurance program under this Act and under title XVIII of the Social Security Act.
Title VIII: Fiscal Provisions - Creates on the books of the Treasury of the United States a separate account to be known as the "Personal Health Services Account".
Provides that funds in the account not required for current withdrawals shall be invested by the Secretary of the Treasury in the types of obligations which may be acquired, under section 201 of the Social Security Act, by the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund. Makes funds in the account available for all expenditures necessary or appropriate to carry out this Act.
Title IX: Miscellaneous Provisions - Defines such terms as "wages", "employment", "benefit year", "quarter", and "person", as used in this Act.