Summary: H.R.16 — 97th Congress (1981-1982)All Information (Except Text)

There is one summary for H.R.16. Bill summaries are authored by CRS.

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Introduced in House (01/05/1981)

National Health Insurance Act - Title I: Benefits and Eligibility - Makes personal health services available to eligible individuals. Includes medical, dental, podiatric, home-nursing, hospital and auxiliary services within such personal health services.

Directs the National Health Insurance Board to survey the resources and needs of each State and develop in each State a program to assure the maximum participation and use of health personnel and facilities in the provision of benefits. Authorizes the Board to limit health services which may be provided when personnel, facilities, or funds are inadequate to insure the provision of all services.

Allows every individual eligible for personal health services available under this Act to freely select the physician, dentist, podiatrist, nurse, medical group, hospital, or other person of his choice.

Sets forth eligibility requirements. Directs that the United States shall be subrogated to all rights of an individual who receives benefits under this Act with respect to any injury, disease, or disability, for which such person is entitled to workmen's compensation.

States that Federal grants to States under title XIX (Medicaid), and part A of title IV (Aid to Families with Dependent Children) of the Social Security Act shall be available to the States for provision of personal health services for noninsured needy individuals.

Title II: Participation of Physicians, Dentists, Nurses, Hospitals, and Others - States that any physician, dentist, or podiatrist legally authorized in a State to render medical, dental, or podiatric services shall be qualified to render such services as benefits under this Act. Authorizes the State to enter into agreements with any qualified organization for the provision of personal health services under this Act.

Sets forth methods for payment of services. Directs that rates for such payments be adapted to relevant regional, State, or local conditions.

Authorizes the establishment of maximum limits upon the number of eligible individuals with respect to whom any person may undertake to render services in any local health-service area. Allows every physician, dentist, nurse, hospital, or other person entering into an agreement under this title to accept or reject as a patient any individual requesting his services.

Title III: Local Administration - Imposes responsibility for administration of the benefits provided under this Act on the several local health-service areas. Specifies that the local administrative agency for each local health-service area may be either a local administrative committee or a local administrative officer. Directs the committee or officer to: (1) arrange for the furnishing of personal health-service benefits and publish lists of such providers; (2) disseminate information concerning rights and privileges under the Act; and (3) receive and adjust complaints concerning the administration of benefits.

Requires the establishment of a local area committee in each health-service area to formulate policies for the administration of benefits.

Requires the establishment of local committees representative of health services providers in each health service area to assist the local administrative committee and its executive officer.

Title IV: State Administration - Expresses the intent of Congress that the benefits provided under the Act be administered whenever possible by the States. Sets forth requirements which must be met by any State which assumes responsibility for the administration of such benefits.

Title V: National Health Insurance Board; National Advisory Medical Policy Council; General Administrative Provisions - Establishes a National Health Insurance Board in the Department of Health and Human Services.

Establishes a National Advisory Medical Policy Council to make recommendations as to the most effective methods of providing health services.

Title VI: Eligibility Determinations, Complaints, Hearings, and Judicial Review - Requires the Secretary of Health and Human Services to make determinations as to the eligibility of individuals for benefits under this Act. Establishes procedures for complaint investigation and adjudication.

Title VII: Application of Act to Individuals Covered Under Medicare Program - Specifies that in the case of any individual who is entitled to hospital insurance benefits under Medicare, the personal health services which may be made available as benefits under this Act shall be limited to those services for which such individual is ineligible under the Medicare program.

Directs the Secretary to carry out a study of the interrelationship of the program of national health insurance under this Act and the program of health insurance for the aged under title XVIII (Medicare) of the Social Security Act.

Title VIII: Fiscal Provisions - Creates in the Treasury of the United States a separate account to be known as the "Personal Health Services Account." Makes funds in the account available for all expenditures necessary to carry out this Act. Appropriates funds for such account in amounts pursuant to the formula specified in the Act for fiscal year 1982 and each year thereafter.

Authorizes the Board to make grants to public or nonprofit institutions or agencies engaging in undergraduate or postgraduate professional, technical or administrative education or training in the field of personal health services. Makes available for such grants $10,000,000 for fiscal year 1982 and $15,000,000 for fiscal year 1983 and for each fiscal year thereafter an amount not to exceed one-half of one percent of the amount expended for benefits under this Act in the preceding calendar year.

Title IX: Miscellaneous Provisions - Defines terms used in this Act. States that personal health services shall become available no sooner than October 1, 1981.