S. 1743 (103rd): Consumer Choice Health Security Act of 1994

Nov 20, 1993 (103rd Congress, 1993–1994)
Died (Referred to Committee)
Don Nickles
Senator from Oklahoma
Read Text »
Last Updated
Nov 20, 1993
197 pages

This bill was introduced on November 20, 1993, in a previous session of Congress, but was not enacted.

Introduced Nov 20, 1993
Referred to Committee Nov 20, 1993
Primary Source

THOMAS.gov (The Library of Congress)

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S. stands for Senate bill.

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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 - Tax and Insurance Provisions Subtitle A: Tax Treatment of Health Care Expenses Subtitle B: Insurance Provisions Subtitle C: Employer Provisions Subtitle D: Federal Preemption Subtitle E: Report Title II: Medicare and Medicaid Reforms Subtitle A: Medicare Subtitle B: Medicaid Title III: Health Care Liability Reform Title IV: Administrative Cost Savings Subtitle A: Standardization of Claims Processing Subtitle B: Electronic Medical Data Standards Subtitle C: Development and Distribution of Comparative Value Information Subtitle D: Preemption of State Quill Pen Laws Title V: Anti-Fraud Subtitle A: Criminal Prosecution of Health Care Fraud Subtitle B: Coordination of Health Care Anti-Fraud and Abuse Activities Title VI: Antitrust Provisions Title VII: Long-Term Care Consumer Choice Health Security Act of 1994
Title I - Tax and Insurance Provisions
Subtitle A - Tax Treatment of Health Care Expenses
Amends the Internal Revenue Code to allow a tax credit for health care expenses based upon percentages of qualified health insurance premiums and adjusted gross income. Provides advance payments of such credit by employers.
Section 102 -
Allows individuals a tax credit for a percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Exempts such accounts from taxation. Establishes an excise tax for excess contributions to medical care savings accounts and makes such accounts subject to the tax on prohibited transactions.
Section 103 -
Terminates the medical expense deduction and the exclusion for employer-provided health insurance.
Subtitle B - Insurance Provisions
Part I - Federally Qualified Health Insurance Plans
Sets forth requirements for federally qualified health insurance plans, including coverage for acute medical care, cost-sharing, premium rating practices, and guaranteed issuance and renewability.
Part II - Certification of Federally Qualified Health Insurance Plans
Requires States to meet standards for regulatory programs for the certification of federally qualified health insurance plans.
Subtitle C - Employer Provisions
Requires employers to: (1) withhold health insurance premiums from employee wages and remit such premiums to the employee's chosen insurer; and (2) notify employees of their right to claim an advance refundable tax credit for such premiums.
Section 122 -
Provides for the conversion and continuation of existing insurance plans to required coverage under this Act.
Section 125 -
Establishes the Benefits Cash Out Commission to propose a procedure under which individuals may cash out Federal health benefits. Provides for congressional consideration of such proposal prior to its implementation.
Section 126 -
Imposes excise taxes on employers and health insurance carriers for noncompliance with this Act.
Subtitle D - Federal Preemption
Preempts specified State laws concerning health insurance.
Subtitle E - Report
Requires the Secretary of Health and Human Services to report to the Congress five years after the enactment of this Act on certain aspects of health insurance coverage.
Title II - Medicare and Medicaid Reforms
Subtitle A - Medicare
Directs the Secretary to report to the Congress on the feasibility of allowing future Medicare beneficiaries to elect to receive certificates with which to purchase private health insurance coverage instead of receiving Medicare benefits.
Section 202 -
Eliminates disproportionate share hospital payments under Medicare.
Section 203 -
Provides for a reduction in the adjustment for indirect medical education costs under Medicare.
Section 204 -
Imposes copayments for laboratory services, certain home health visits, and skilled nursing facility services provided under Medicare.
Section 207 -
Moves payment updates to January for all payment rates under Medicare's hospital insurance program.
Section 208 -
Accelerates the transition to prospective rates for facility costs in hospital outpatient departments.
Subtitle B - Medicaid
Places a cap on Federal payments for acute medical services furnished under a State's Medicaid program.
Section 212 -
Provides for waivers from Medicaid requirements in order to establish acute medical services programs.
Section 213 -
Terminates disproportionate share hospital payments under Medicaid.
Section 214 -
Directs the Secretary to provide grants to States for programs to provide health insurance coverage, acute medical services, preventive care, and disease prevention services to low-income individuals.
Title III - Health Care Liability Reform
Health Care Liability Reform Act of 1994 - Limits payments, damages, and attorney's fees in health care malpractice actions and claims.
Section 304 -
Declares that a manufacturer or seller of a health care product shall not be strictly liable for injury from: (1) a defect in the design of the product; or (2) a failure to warn or instruct regarding a risk posed by the product that was not known or reasonably knowable.
Section 305 -
Limits the amount of noneconomic damages that may be awarded in a health care malpractice claim or a health care product liability claim. Allows several liability for noneconomic loss and for punitive damages.
Section 306 -
Allows punitive damages to be awarded only if the claimant establishes that the harm suffered was the result of conduct manifesting conscious, flagrant indifference to the health of those harmed by the product. Disallows punitive damages against a product approved by the Food and Drug Administration.
Title IV - Administrative Cost Savings
Subtitle A - 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 and in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements.
Section 402 -
Authorizes the Secretary, two years after standards are adopted for classes of services upon determining that a significant number of claims for benefits for such services under health benefit plans are not being submitted in accordance with such standards, to require that all providers of such services submit claims to health benefit plans in accordance with such standards.
Section 403 -
Directs the Secretary to: (1) provide for the ongoing receipt and review of comments and suggestions for changes in the standards adopted and promulgated; (2) establish a schedule for the periodic review of such standards; and (3) revise such standards.
Subtitle B - Electronic Medical Data Standards
Directs the Secretary to promulgate standards for hospitals concerning electronic medical data, including standards for transmission of such data and confidentiality of patient-specific information. Authorizes the Secretary to periodically revise such standards.
Section 412 -
Sets forth requirements with respect to: (1) the sharing of hospital information under Medicare; (2) waiver of such requirements; and (3) application of such requirements to hospitals of the Department of Veterans Affairs.
Section 413 -
Authorizes the head of a Federal agency to require a provider to present and transmit a required data element electronically in accordance with applicable presentation or transmission standards.
Section 414 -
Sets forth limitations on data requirements where standards with respect to data elements are in effect.
Section 415 -
Directs the Secretary to establish an advisory commission on the standards established under this part and operational concerns about the implementation of such standards. Authorizes appropriations.
Subtitle C - Development and Distribution of Comparative Value Information
Directs the Secretary to determine whether each State is developing and implementing a health care value information program that meets specified criteria and a specified schedule.
Authorizes the Secretary to:
(1) make grants to enable each State to plan development and initiate implementation of its health care value information program; and
(2) recover the amount of such a grant by offset against any other amount payable to the State under the Social Security Act under specified circumstances.
Authorizes appropriations.
Section 422 -
Directs the Secretary to take actions necessary to implement a comparable program in a State that fails to develop or implement a health care value information program in accordance with such criteria and schedule. Authorizes the Secretary to charge fees for the information materials provided pursuant to such a program.
Section 423 -
Directs the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to develop health care value information relating to each program that such head administers and covering the same types of data that a State program meeting such criteria would provide.
Subtitle D - Preemption of State Quill Pen Laws
Specifies that, effective January 1, 1996, no effect shall be given to any provision of State law that requires medical or health insurance records (including billing information) to be maintained in written, rather than electronic, form.
Title V - Anti-Fraud
Subtitle A - Criminal Prosecution of Health Care Fraud
Amends the Federal criminal code to impose penalties upon a health care provider that knowingly engages in any scheme or artifice to defraud a person in connection with the provision of health care.
Section 502 -
Authorizes the Attorney General to pay a reward of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution for health care fraud, with exceptions.
Subtitle B - Coordination of Health Care Anti-Fraud and Abuse Activities
Amends the Social Security Act to provide for:
(1) the application of Federal health anti-fraud and abuse sanctions to all fraud and abuse against any health insurance plan; and
(2) treble damages for making or causing to be made false statements or representatives involving Medicare or State health care programs, for illegal remuneration, and for false statements or representatives with respect to the condition or operation of health care institutions.
Directs the Secretary of Health and Human Services, in consultation with State and local health care officials, to:
(1) identify opportunities for the satisfaction of community service obligations that a court may impose upon the conviction of a criminal offense involving Medicare or State health care programs; and
(2) make information concerning such opportunities available to Federal and State law enforcement officers and State and local health care officials.
Title VI - Antitrust Provisions
Exempts from the antitrust laws specified "safe harbor" activities related to the provision of health care services. Sets forth provisions regarding the award of attorney's fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt.
Section 602 -
Lists as safe harbors specified:
(1) activities relating to health care services of combinations of health care providers with market share below a specified threshold;
(2) activities of medical self-regulatory entities relating to standard setting or enforcement activities not conducted for purposes of financial gain;
(3) participation of a health care provider in a written survey of the prices of services, reimbursement levels, or the compensation and benefits of employees and personnel;
(4) activities relating to health care joint ventures for high technology and costly equipment and services;
(5) activities relating to hospital mergers;
(6) joint purchasing arrangements; and
(7) negotiations.
Section 603 -
Directs the Attorney General to publish a notice in the Federal Register soliciting proposals for additional safe harbors and to review and report to the Congress on proposed safe harbors.
Sets forth criteria in establishing safe harbors, including:
(1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and
(2) whether designation as a safe harbor will result in specified desirable outcomes.
Section 604 -
Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates. Sets forth provisions regarding applications for, revocation of, and review of determinations regarding such certificates. Limits the disclosure of information.
Section 605 -
Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures.
Section 606 -
Directs the Attorney General to: (1) review the safe harbors and certificates of review periodically and (2) promulgate such rules, regulations, and guidelines as necessary to carry out provisions of this title.
Title VII - Long-Term Care
Amends the Internal Revenue Code to exclude from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangements to pay long-term care premiums.
Section 702 -
Provides for the nonrecognition of gain or loss on the exchange of any life insurance contract or an endowment or annuity contract for a long-term care insurance contract.
Section 703 -
Provides for the exclusion as a death benefit of any amount paid or advanced to an individual under a life insurance contract because such individual is terminally ill or chronically and has been permanently confined to ill and qualified facility.

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

The House Democratic Caucus does not provide summaries of bills.

So, yes, we display the House Republican Conference’s summaries when available even if we do not have a Democratic summary available. That’s because we feel it is better to give you as much information as possible, even if we cannot provide every viewpoint.

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