H.R. 101 (103rd): Action Now Health Care Reform Act of 1993

Jan 05, 1993 (103rd Congress, 1993–1994)
Died (Referred to Committee)
Robert Michel
Representative for Illinois's 18th congressional district
Read Text »
Last Updated
Mar 24, 1993
236 pages
Related Bills
H.R. 5325 (102nd) was a previous version of this bill.

Referred to Committee
Last Action: Jun 04, 1992

H.R. 3600 (Related)
Health Security Act

Reported by Committee
Last Action: Jun 23, 1994


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

Introduced Jan 05, 1993
Referred to Committee Jan 05, 1993
Full Title

To improve access to health insurance and contain health care costs, and for other purposes.


No summaries available.

72 cosponsors (72R) (show)

House Education and the Workforce

Health, Employment, Labor, and Pensions

House Energy and Commerce

House Judiciary

Regulatory Reform, Commercial, and Antitrust Law

House Ways and Means


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

Primary Source

THOMAS.gov (The Library of Congress)

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H.R. stands for House of Representatives bill.

A bill must be passed by both the House and Senate in identical form and then be signed by the president to become law.

The bill’s title was written by its sponsor.

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.

Title I - Improved Access to Affordable Health Care Coverage Subtitle A: Increased Affordability and Availability for Employees Subtitle B: Improved Small Employer Purchasing Power of Affordable Health Insurance Subtitle C: Health Deduction Fairness Subtitle D: Improved Access to Community Health Services Subtitle E: Improved Access to Rural Health Services Title II: Health Care Cost Containment and Quality Enhancement Subtitle A: Medical Malpractice Liability Reform Subtitle B: Administrative Cost Savings Subtitle C: Medical Savings Accounts (Medisave) Subtitle D: Medicaid Program Flexibility Subtitle E: Limitations on Physician Self-Referrals Subtitle F: Removing Restrictions on Managed Care Subtitle G: Medicare Payment Changes Subtitle H: Limitation of Antitrust Recovery for Certain Hospital Joint Ventures Subtitle I: Encouraging Enforcement Activities of Medical Self-Regulatory Entities Action Now Health Care Reform Act of 1993
Title I - Improved Access to Affordable Health Care Coverage
Section 102 -
Preempts inconsistent State laws.
Section 103 -
Requires small employer health insurance carriers to offer a MedAccess basic plan (providing only benefits for essential preventive and medical services and having an actuarial value not over 60 percent of a MedAccess standard plan) and a MedAccess standard plan (providing benefits typical of the small employer market).
Amends the Internal Revenue Code (IRC) to tax the failure of a carrier or plan to comply with related standards.
(1) acceptance of every small employer and full-time employee; or
(2) in States that so provide, allocation of risk.
Section 104 -
Regulates pre-existing condition requirements, premiums, rating practices disclosure, minimum participation requirements, and renewability.
Section 108 -
Mandates development of models for reinsurance or allocation of risk mechanisms. Requires State (or Federal) establishment of at least one mechanism in each State. Amends the IRC to impose a tax in any such Federal reinsurance State.
Section 110 -
Establishes the Office of Private Health Care Coverage and a related advisory committee.
Section 111 -
Authorizes research and demonstration projects on the impact of these provisions on the availability of affordable small employer coverage. Requires: (1) methods for measuring the relative health risks of eligible individuals; and (2) a model for equitably distributing health risks among small employer carriers. Authorizes appropriations.
Section 121 -
Preempts State laws: (1) requiring the offering of health plans providing certain services; and (2) prohibiting employer groups from purchasing health insurance.
Section 131 -
Amends the IRC to increase and make permanent deductions for the health insurance costs of self-employed individuals.
Section 141 -
Amends the Public Health Service Act (PHSA) to provide for grants to: (1) migrant and community health centers and to entities providing health services for the homeless to promote primary health services for underserved individuals; and (2) increase access to outpatient primary services in certain geographic areas. Authorizes appropriations.
Section 171 -
Changes the heading of title XII (Trauma Care) of the PHSA to "Emergency Medical Services" and makes similar changes to references within the title.
Section 172 -
Authorizes grants to States for State offices of emergency medical services.
Section 173 -
Requires projects under existing provisions to include demonstrations on telecommunications between rural medical facilities and other medical facilities with useful expertise or equipment.
Section 174 -
Authorizes appropriations to carry out specified provisions of title XII.
Section 181 -
Mandates grants to States for rural air medical transport systems. Authorizes appropriations.
Section 191 -
Amends title XVIII (Medicare) of the Social Security Act to extend special payments for the inpatient services of small, rural Medicare-dependent hospitals.
Title II - Health Care Cost Containment and Quality Enhancement
Section 211 -
Reforms medical malpractice regarding:
(1) a statute of limitations;
(2) use of alternative dispute resolution systems (ADRs), including for claims against the United States;
(3) settlement offers and conferences;
(4) noneconomic and punitive damages;
(5) periodic payment for future damages;
(6) mandatory offsets for collateral source payments;
(7) contingent attorney's fees;
(8) several and joint liability;
(9) findings of negligence;
(10) practice guidelines sanctioned as affirmative defenses;
(11) the standard of proof regarding certain labor and delivery circumstances;
(12) supersedure of certain State laws; and
(13) establishment and certification of State ADRs.
Section 241 -
Amends title II (Old Age, Survivors, and Disability Insurance) (OASDI) of the Social Security Act to authorize appropriations for sanctioning guidelines as affirmative defenses. Mandates: (1) research and demonstrations on the use of data on malpractice actions; and (2) development of a standard reporting form for State ADRs in transmitting information on disputes resolved.
Section 242 -
Authorizes State professional disciplinary agencies to make agreements with professional societies to allow the societies to: (1) participate in licensing; and (2) review malpractice allegations or other information on the practice patterns of a practitioner.
Section 243 -
Requires each health professional and provider to participate in a risk management program.
Section 244 -
Mandates grants: (1) for basic research on malpractice prevention and compensation and outcomes research; (2) to States to improve licensing and discipline; and (3) for public education on appropriate health care use and realistic expectations, public education on the resources and role of licensing and disciplinary boards, and development of faculty training and curricula regarding quality assurance, risk management, and medical injury protection. Authorizes appropriations.
Section 245 -
Mandates a study on factors preventing or discouraging physicians from volunteering in medically underserved areas.
Section 251 -
Regulates: (1) data elements, uniform claims forms, and uniform electronic transmission of data elements; (2) provider claims submission; and (3) hospital and non-hospital electronic medical data.
Section 262 -
Requires hospitals, in order to participate in Medicare, to maintain and electronically transmit clinical data on patients in a set of electronic comprehensive data elements.
Section 263 -
Provides for electronic transmission of data elements to Federal agencies.
Section 264 -
Prohibits plans from requiring that a provider provide any data element not in the set or transmit any data element in a manner inconsistent with standards.
Section 265 -
Establishes an advisory commission. Authorizes appropriations.
Section 271 -
Provides for a comparative health care value program in each State. Authorizes grants and appropriations.
Section 273 -
Requires each Federal agency concerned with health insurance or care to develop comparative value information.
Section 274 -
Mandates model systems for the gathering and analysis of data on health care cost, quality, and outcome. Authorizes appropriations.
Section 281 -
Provides for standards regarding Medicare and Medicaid identification cards. Establishes a Medicare and Medicaid system to provide information on primary payors. Authorizes appropriations.
Section 282 -
Nullifies any State law requiring that medical or health insurance records be maintained in written rather than electronic form.
Section 283 -
Provides for standards regarding: (1) beneficiary and provider identification numbers; and (2) coordination of benefits.
Section 285 -
Mandates grants to demonstrate the application of comprehensive information systems in continuously monitoring patient care and improving patient care.
Authorizes appropriations from the Federal Hospital Insurance Trust Fund. Authorizes grants for:
(1) communication links between plan and provider information systems;
(2) regional or community-based clinical information systems; and
(3) developing and testing, for physicians and non-hospital entities, the definition of a comprehensive data set and the specification and presentation of individual data elements.
Authorizes appropriations.
Section 291 -
Amends the IRC to exclude from an employee's gross income any amount contributed by the employer to a trust created exclusively to pay an individual's medical expenses (medical savings account). Sets contribution limits. Subjects the employee to taxation as owner of the account.
Section 301 -
Amends Medicaid provisions to modify contracting requirements for coordinated care services.
Section 311 -
Amends Medicare provisions to extend physician self-referral limitations to all payors and certain additional services. Revises exceptions.
Section 314 -
Mandates a study to estimate the changes in aggregate costs that will result from the amendments made by these provisions.
Section 321 -
Preempts managed care restrictions under State law. Mandates a study of managed care benefits and cost effectiveness.
Section 331 -
Amends Medicare provisions to revise the method for determining prospective payment updates to hospitals.
Section 332 -
Lowers the limitation amount and suspends certain annual adjustments regarding clinical diagnostic laboratory tests.
Section 343 -
Limits antitrust recovery to actual damages if certain requirements are met, including the filing and publication of information regarding hospital joint ventures.
Section 345 -
Establishes the Interagency Committee on Competition, Antitrust Policy, and Health Care.
Section 351 -
Prohibits, subject to exception, damages and other recovery under the Clayton Act or similar State laws from a medical self-regulatory entity engaging in standard setting or enforcement activities designed to promote the quality of health care and not conducted for financial gain.

House Republican Conference Summary

The summary below was written by the House Republican Conference, which is the caucus of Republicans in the House of Representatives.

No summary available.

House Democratic Caucus Summary

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