H.R. 237 (103rd): Rural Health Care Access Improvement Act of 1993

Introduced:
Jan 05, 1993 (103rd Congress, 1993–1994)
Sponsor:
Rep. Larry LaRocco [D-ID1]
Status:
Died (Referred to Committee)

The bill’s title was written by the bill’s sponsor. H.R. stands for House of Representatives bill.

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Status

This bill was introduced on January 5, 1993, in a previous session of Congress, but was not enacted.

Progress
Introduced Jan 05, 1993
Cosponsors
none
Committees

House Energy and Commerce

House Judiciary

House Ways and Means

The committee chair determines whether a bill will move past the committee stage.

Full Title

To increase access to health care services for individuals in rural areas, and for other purposes.

Summary

No summaries available.

Text

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Last updated Jan 05, 1993.
60 pages

Primary Source

View on THOMAS (The Library of Congress)

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GovTrack’s Bill Summary

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Library of Congress Summary

The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress.

1/5/1993--Introduced.
TABLE OF CONTENTS:
Title I - Provisions Relating to Physicians' Services Subtitle A: Incentives Under Medicare Subtitle B: Increasing Number of Physicians Practicing in Rural Areas Subtitle C: Expansion of Exceptions to Limitations on Physician Self-Referrals Title II: Provisons Relating to Hospitals Title III: Miscellaneous Provisions Subtitle A: Administrative Simplification Subtitle B: Other Provisions Rural Health Care Access Improvement Act of 1993
Title I - Provisions Relating to Physicians' Services
Subtitle A - Incentives Under Medicare
Section 101 -
Amends title XVIII (Medicare) of the Social Security Act (SSA) to modify requirements regarding payments to new physicians and other new health care practitioners for rural area services.
Section 102 -
Prohibits the Secretary of Health and Human Services from failing to make Medicare payments on the basis of an individual's failure to complete a questionaire concerning a primary plan.
Section 103 -
Regulates the use of extrapolation by carriers administering Medicare benefits.
Section 104 -
Prohibits certain fees by carriers and the Secretary.
Section 105 -
Requires consideration, in applying standards and criteria for carrier contracts, of evaluations by medical societies representing physicians served by the carrier.
Section 106 -
Provides for appeals of carrier actions.
Section 107 -
Directs carriers to provide for review (of denial of payments for physicians' services) by a physician in the same medical specialty.
Section 108 -
Amends SSA titles XVIII and XIX (Medicaid) to modify the circumstances in which payments may be made to a physician for services provided by another physician.
Section 109 -
Amends SSA title XI to exclude surgical procedures performed in a rural area from utilization and quality control review requirements.
Subtitle B - Increasing Number of Physicians Practicing in Rural Areas
Section 111 -
Amends the Internal Revenue Code (IRC) to allow a personal interest deduction for qualified medical education loan interest which accrues while the physician is providing primary care to medically underserved rural area residents.
Section 112 -
Amends the Public Health Service Act (PHSA) to add the ratio of medically underserved individuals in a health professional shortage area to the aggregate population of all such areas to the exclusive factors considered in determining the greatest shortages in the assignment of National Health Service Corps members.
Subtitle C - Expansion of Exceptions to Limitations on Physician Self-Referrals
Section 121 -
Amends SSA title XVIII to revise the exceptions to prohibitions on physician self-referrals.
Section 122 -
Mandates a study and report to the Congress on the changes in aggregate costs, under Medicare and other health plans, resulting from this subtitle.
Title II - Provisions Relating to Hospitals
Section 201 -
Amends SSA title XVIII to require rural hospital prospective payment system amounts for capital-related costs of inpatient services to be based on either reasonable costs or the payment methodology used for other hospitals, as elected by the hospital.
Section 202 -
Amends the Omnibus Budget Reconciliation Act (OMBRA) of 1989 to extend referral centers. Removes Medicare provisions relating to exceptions and adjustments in certain payments for regional and national referral centers. Provides that the disproportionate share adjustment percentage be determined, in certain circumstances, as though such provisions had not been removed.
Section 203 -
Shields from certain antitrust laws specified actions of hospitals meeting described requirements.
Title III - Miscellaneous Provisions
Subtitle A - Administrative Simplification
Section 301 -
Requires health benefit plans to: (1) issue health claims cards; (2) provide information to appropriate health claims clearinghouses on individual eligibility for benefits; and (3) accept clearinghouse determinations on clean claims.
Section 302 -
Requires health service providers to submit claims only to the appropriate clearinghouse in a manner consistent with this Act. Imposes civil penalties for violation of such requirements. Requires each hospital, as a Medicare participation agreement requirement, to report information in a manner consistent with OMBRA of 1987.
Section 303 -
Requires: (1) designation of certain clearinghouse areas; and (2) a separate contract in each area with an organization to perform clearinghouse functions.
Section 304 -
Mandates standards for: (1) uniform health claims cards; and (2) information required for claims acceptance and payment. Requires the Secretary to develop computer software for provider inquiries, responses, and electronic claims submission and for uniform hospital reporting.
Section 305 -
Amends IRC to impose a tax on the failure of any group health plan to meet certain requirements of this title.
Subtitle B - Other Provisions
Section 311 -
Amends PHSA to require certain demonstration projects in rural areas invovling trauma care to include specified elements.
Section 312 -
Authorizes the use of certain funds for grants to nursing schools for the establishment of clinics to provide primary care services in medically underserved rural areas and related training. Requires a study on reducing the burden of federally conducted or sponsored health care services information collection requests.

House Republican Conference Summary

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No summary available.

House Democratic Caucus Summary

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The bill contains the following citations to other parts of U.S. law:

United States Code

The United States Code is the compilation of permanent laws enacted by Congress. Temporary and other non-permanent laws do not appear in the United States Code. (About half of the United States Code is the law itself, called positive law. The other half is merely a compilation of the laws but has no legal significance.)