Comprehensive American Health Care Act

Comprehensive American Health Care Act - Title I: Health Care Access for Uninsured and Medically Underserved Individuals - Subtitle A: Tax Credits for Low and Moderate Income Individuals - Amends provisions of the Internal Revenue Code relating to refundable credits to allow a credit for a portion of the qualified health insurance expenses paid by an individual who is not covered by a health plan maintained by an employer of the individual or the individual's spouse. Provides for coordination with advance payments of credits, special rules relating to Medicare-eligible individuals and subsidized expenses, and coordination with the minimum tax.

Directs the Secretary of the Treasury to enter into an agreement with each State for advance payments of the credit to individuals in the form of certificates usable for the purchase of health insurance. Limits eligibility for advance payments to individuals whose family income is not over a certain ratio to the poverty line and who meet other requirements.

Directs the Secretary to establish a program to inform the public of the availability of the health insurance credit.

Sets forth special rules regarding self-employed individuals. Excludes expenses paid as a credit from treatment as expenses paid for medical care under provisions relating to itemized deductions.

Subtitle B: Rural Health Initiatives - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services and the Prospective Payment Assessment Commission to each submit to the Congress a report recommending a methodology for the elimination of the system of determining separate average standardized amounts for hospitals in large urban, other urban, or rural areas.

Amends National Health Service Corps Scholarship Program and Loan Repayment Program provisions of the Public Health Service Act to set forth additional priorities in the approval of applications and the acceptance of contracts.

Amends the Internal Revenue Code to exclude National Health Service Corps Loan Repayment Program payments from gross income.

Directs the Secretary of Health and Human Services, notwithstanding any other provision of law, from amounts retained under specified provisions of the Social Security Act, to provide for a demonstration project evaluating the availability, accessibility, and use of prenatal care services by pregnant women residing in rural areas.

Amends the Public Health Service Act to increase the authorization of appropriations for area health education centers.

Directs the Secretary of Health and Human Services, from amounts made available under existing block grant authorizations, to make grants to county health departments to provide preventive health services.

Directs the Secretary to review the requirements in regulations with respect to rural hospitals developed under specified provisions of the Social Security Act, including standards related to staffing requirements, to determine which requirements could be made less administratively and economically burdensome.

Subtitle C: Reauthorization of Federal Vaccine and Immunization Program - Authorizes appropriations for certain preventive health service programs relating to immunizations. Removes provisions relating to preventive health service programs for tuberculosis.

Directs the Secretary, through the Director of the Centers for Disease Control, to maintain a supply of vaccines sufficient to provide vaccinations throughout a six-month period. Authorizes appropriations.

Authorizes appropriations for the National Vaccine Program.

Title II: Health Care Cost Control - Subtitle A: Medical Malpractice Reform - Applies this subtitle to any civil action against any individual based on professional medical malpractice, in any State or Federal court, for damages for physical injury, or physical or mental pain or suffering, or economic loss.

Requires a court, subject to exception and limitation, to award costs and attorneys' fees to the prevailing party.

Prohibits joint and several liability in actions under this subtitle, except in cases of concerted action. Allows persons to be found liable only for their pro rata share of fault.

Requires each attorney in cases under this subtitle to advise the party they represent of the existence of alternative dispute resolution options, including extrajudicial proceedings. Requires the court, if all parties agree to alternative proceedings, to issue an order governing the conduct of the proceedings. Makes such issuance a waiver, by each party subject to the order, of the right to proceed further in court.

Subtitle B: Preventive Health Practices Promotion - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services to develop: (1) a summary of recommended preventive health care practices for elderly individuals entitled to Medicare benefits; and (2) a one-page form that may be used by elderly individuals to record information such as a personal and family medical history that may be useful to physicians. Requires distribution of: (1) the summary and form when an individual first becomes eligible for benefits under specified provisions; and (2) the summary in conjunction with general mailings to individuals eligible for Medicare benefits.

Title III: Long-Term Care and Senior Health Promotion - Subtitle A: Long-Term Care Insurance Promotion - Amends the Internal Revenue Code to require that: (1) a long-term care insurance contract be treated as a health insurance contract; (2) amounts received under such a contract be treated as received for personal injuries or sickness; and (3) any employer plan providing qualified long-term care services be treated as an accident or health plan. Adds long-term care services to the definition of medical care in provisions relating to itemized deductions.

Prohibits, subject to exception, employer payments for long-term care insurance from being treated as deferred compensation. Prohibits treating amounts paid or incurred for any long-term care insurance contract as deferred compensation in connection with cafeteria plans.

Allows a tax credit for a portion of the qualified long-term care premiums paid. Provides for coordination with regard to advance payments of credit and with regard to minimum tax. Directs the Secretary of the Treasury to enter into an agreement with each State for advance payments of the credit to individuals in the form of certificates usable for the purchase of long-term care insurance. Limits eligibility for advance payments to individuals whose income is not over a certain ratio to the poverty line and who meet other requirements.

Directs the Secretary to establish a program to inform the public of the availability of the credit.

Excludes early distributions from qualified retirement plans used to pay for long-term care insurance contracts from the ten percent tax imposed on other early distributions.

Prohibits the recognition of gain or loss on the exchange of a contract of life insurance or an endowment or annuity contract for a long-term care insurance contract.

Subtitle B: Medicare Benefit Improvements - Amends title XVIII (Medicare) of the Social Security Act to add references to screening mammography to provisions defining the term "medical and other health services." Provides for payments, standards, and frequencies regarding screening mammographies.

Adds in-home respite care for chronically dependent individuals to the list of benefits of part B (Supplementary Medical Insurance) of the Medicare program.

Describes the circumstances under which nursing care and home health aide services will be considered to be provided or needed on an intermittent basis. Allows Medicare part B payments to be made for such services.

Allows Medicare hospice benefits for an additional extension period.

Increases the Medicare part B monthly premium. Excludes from the determination of the monthly actuarial rate those costs relating to the amendments made by the Medicare Benefit Improvements Act of 1990. Excludes such premium increases from the computation of the aggregate premiums and premiums per enrollee under provisions authorizing appropriations to cover Government contributions and the contingency reserve.

Subtitle C: Senior Health Insurance Consumer Protection - Directs the Secretary of Health and Human Services to establish a procedure for certification by the Secretary of health insurance policies for the elderly as meeting minimum standards set forth in this subtitle. Provides for printing of an emblem on policies which meet the standards.