Comprehensive American Health Care Act

TABLE OF CONTENTS:

Title I: Health Care Access for Uninsured and Medically

Underserved Individuals

Subtitle A: Tax Credits for Low and Moderate Income

Individuals

Subtitle B: Rural Health Initiatives

Subtitle C: Certified Model Health Care Insurance

Benefits Plans

Title II: Health Care Cost Control

Subtitle A: Medical Malpractice Reform

Subtitle B: Standardization of Claims Processing

Subtitle C: Electronic Medical Data Standards

Subtitle D: Preventive Health Practices Promotion

Title III: Long-Term Care and Senior Health Promotion

Subtitle A: Long-Term Care Insurance Promotion

Subtitle B: Medicare Benefit Improvements

Subtitle C: Senior Health Insurance Consumer Protection

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.

(Sec. 101) Directs the Secretary of: (1) 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; and (2) Health and Human Services (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: (1) title XVIII (Medicare) of the Social Security Act to direct the Secretary 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; (2) 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; and (3) the Internal Revenue Code to exclude National Health Service Corps Loan Repayment Program payments from gross income.

(Sec. 114) Directs the Secretary to provide for a demonstration project evaluating the availability, accessibility, and use of prenatal care services by pregnant women residing in rural areas.

(Sec. 115) Amends the Public Health Service Act to direct the Secretary to make grants to county health departments to provide preventive health services.

(Sec. 116) Requires the Secretary to: (1) 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; and (2) conduct a study to determine factors preventing or discouraging physicians from volunteering to provide health care services in underserved areas.

Subtitle C: Certified Model Health Care Insurance Benefits Plans - Directs the Secretary to develop model health care insurance benefits plans.

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.

(Sec. 202) Requires a court to award costs and attorney's fees to the prevailing party.

(Sec. 203) Prohibits joint and several liability in actions under this subtitle, except in cases of concerted action. Allows a person to be found liable only for their pro rata share of fault.

(Sec. 204) 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: Standardization of Claims Processing - Directs the Secretary to adopt standards relating to: (1) data elements for use in paper and electronic claims processing under health benefit plans, as well as for use in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. Provides for periodic review and revision of standards.

Subtitle C: Electronic Medical Data Standards - Directs the Secretary to: (1) promulgate standards for hospitals concerning electronic medical data; and (2) establish an advisory commission.

Subtitle D: Preventive Health Practices Promotion - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary to develop a summary of recommended preventive health care practices for elderly individuals entitled to Medicare benefits. Requires distribution of the summary when an individual first becomes eligible for benefits under specified provisions and 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.

(Sec. 303) Prohibits 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.

(Sec. 304) 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. Directs the Secretary to establish a program to inform the public of the availability of the credit.

(Sec. 305) 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 in-home respite care for chronically dependent individuals to the list of benefits under part B (Supplementary Medical Insurance) of the Medicare program.

(Sec. 312) Adds home intravenous drug therapy services to the list of entitlement services under Medicare and authorizes payments of certain amounts for the services from the Federal Supplementary Medical Insurance Trust Fund. Excludes the services from provisions requiring a deductible payment. Authorizes the Secretary to enter into contracts with agencies or organizations to facilitate payment to providers of the services on a regional basis.

(Sec. 313) 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.

Subtitle C: Senior Health Insurance Consumer Protection - Directs the Secretary to: (1) establish a procedure for certification by the Secretary of insurance policies for the elderly as meeting minimum standards set forth in this subtitle; and (2) conduct a study and report to the Congress on health insurance policies for the elderly.