Summary: H.R.16 — 99th Congress (1985-1986)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 (01/03/1985)

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

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. Authorizes the Board to limit health services 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, or hospital.

Sets forth eligibility requirements. States that the United States shall be subrogated to all rights of an individual who receives benefits under this Act with respect to any workmen's compensation injury or disability.

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 individuals.

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

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

Authorizes patient limits. Allows health care providers entering into an agreement under this title to accept or reject patients.

Title III: Local Administration - Imposes administrative responsibility 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.

Requires the establishment of: (1) local policy committees; and (2) local health services provider committees to assist such local administrative committees and executive officers.

Title IV: State Administration - Expresses the intent of the Congress that the benefits provided under the Act be administered whenever possible by the States. Sets forth administrative requirements.

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.

Title VI: Eligibility Determinations, Complaints, Hearings, and Judicial Review - Requires the Secretary of Health and Human Services to determine benefit eligibility.

Establishes procedures for complaint investigation and adjudication.

Title VII: Application of Act to Individuals Covered Under Medicare Program - States 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 a separate account to be known as the "Personal Health Services Account." Appropriates funds for such account in amounts pursuant to the formula specified in the Act for FY 1986 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 FY 1986 and $15,000,000 for FY 1987 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, 1986.