HR 676 Benefits Include (see Section 102 in Bold)::::
To provide for comprehensive health insurance coverage for all United States residents, and for other purposes.
A BILL
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. Short title; table of contents.
(a) Short title.—This Act may be cited as the “United States National Health Insurance Act (or the Expanded and Improved Medicare for All Act)”.
(b) Table of contents.—The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents
Sec. 2. Definitions and terms.
TITLE I—ELIGIBILITY AND BENEFITS
Sec. 101. Eligibility and registration.
Sec. 102. Benefits and portability.
Sec. 103. Qualification of participating providers.
Sec. 104. Prohibition against duplicating coverage.
TITLE II—FINANCES
Subtitle A—Budgeting and Payments
Sec. 201. Budgeting process.
Sec. 202. Payment of providers and health care clinicians.
Sec. 203. Payment for long-term care.
Sec. 204. Mental health services.
Sec. 205. Payment for prescription medications, medical supplies, and medically necessary assistive equipment.
Sec. 206. Consultation in establishing reimbursement levels.
Subtitle B—Funding
Sec. 211. Overview: funding the USNHI Program.
Sec. 212. Appropriations for existing programs for uninsured and indigent.
TITLE III—ADMINISTRATION
Sec. 301. Public administration; appointment of Director.
Sec. 302. Office of Quality Control.
Sec. 303. Regional and State administration; employment of displaced clerical workers.
Sec. 304. Confidential Electronic Patient Record System.
Sec. 305. National Board of Universal Quality and Access.
TITLE IV—ADDITIONAL PROVISIONS
Sec. 401. Treatment of VA and IHS health programs.
Sec. 402. Public health and prevention.
Sec. 403. Reduction in health disparities.
TITLE V—EFFECTIVE DATE
Sec. 501. Effective date.
SEC. 2. Definitions and terms.
In this Act:
(1) USNHI Program; Program.—The terms “USNHI Program” and “Program” mean the program of benefits provided under this Act and, unless the context otherwise requires, the Secretary with respect to functions relating to carrying out such program.
(2) National Board of Universal Quality and Access.—The term “National Board of Universal Quality and Access” means such Board established under section 305.
(3) Regional office.—The term “regional office” means a regional office established under section 303.
(4) Secretary.—The term “Secretary” means the Secretary of Health and Human Services.
(5) Director.—The term “Director” means, in relation to the Program, the Director appointed under section 301.
TITLE I—Eligibility and Benefits
SEC. 101. Eligibility and registration.
(a) In general.—All individuals residing in the United States (including any territory of the United States) are covered under the USNHI Program entitling them to a universal, best quality standard of care. Each such individual shall receive a card with a unique number in the mail. An individual’s social security number shall not be used for purposes of registration under this section.
(b) Registration.—Individuals and families shall receive a United States National Health Insurance Card in the mail, after filling out a United States National Health Insurance application form at a health care provider. Such application form shall be no more than 2 pages long.
(c) Presumption.—Individuals who present themselves for covered services from a participating provider shall be presumed to be eligible for benefits under this Act, but shall complete an application for benefits in order to receive a United States National Health Insurance Card and have payment made for such benefits.
SEC. 102. Benefits and portability.
(a) In general.—The health insurance benefits under this Act cover all medically necessary services, including at least the following:
(1) Primary care and prevention.
(2) Inpatient care.
(3) Outpatient care.
(4) Emergency care.
(5) Prescription drugs.
(6) Durable medical equipment.
(7) Long term care.
(8) Mental health services.
(9) The full scope of dental services (other than cosmetic dentistry).
(10) Substance abuse treatment services.
(11) Chiropractic services.
(12) Basic vision care and vision correction (other than laser vision correction for cosmetic purposes).
(13) Hearing services, including coverage of hearing aids.
(b) Portability.—Such benefits are available through any licensed health care clinician anywhere in the United States that is legally qualified to provide the benefits.
(c) No cost-sharing.—No deductibles, copayments, coinsurance, or other cost-sharing shall be imposed with respect to covered benefits.
SEC. 103. Qualification of participating providers.
(a) Requirement To be public or non-profit.—
(1) In general.—No institution may be a participating provider unless it is a public or not-for-profit institution.
(2) Conversion of investor-owned providers.—Investor-owned providers of care opting to participate shall be required to convert to not-for-profit status.
(3) Compensation for conversion.—The owners of such investor-owned providers shall be compensated for the actual appraised value of converted facilities used in the delivery of care.
(4) Funding.—There are authorized to be appropriated from the Treasury such sums as are necessary to compensate investor-owned providers as provided for under paragraph (3).
(5) Requirements.—The conversion to a not-for-profit health care system shall take place over a 15-year period, through the sale of U.S. Treasury Bonds. Payment for conversions under paragraph (3) shall not be made for loss of business profits, but may be made only for costs associated with the conversion of real property and equipment.
(b) Quality standards.—
(1) In general.—Health care delivery facilities must meet regional and State quality and licensing guidelines as a condition of participation under such program, including guidelines regarding safe staffing and quality of care.
(2) Licensure requirements.—Participating clinicians must be licensed in their State of practice and meet the quality standards for their area of care. No clinician whose license is under suspension or who is under disciplinary action in any State may be a participating provider.
(c) Participation of health maintenance organizations.—
(1) In general.—Non-profit health maintenance organizations that actually deliver care in their own facilities and employ clinicians on a salaried basis may participate in the program and receive global budgets or capitation payments as specified in section 202.
(2) Exclusion of certain health maintenance organizations.—Other health maintenance organizations, including those which principally contract to pay for services delivered by non-employees, shall be classified as insurance plans. Such organizations shall not be participating providers, and are subject to the regulations promulgated by reason of section 104(a) (relating to prohibition against duplicating coverage).
(d) Freedom of choice.—Patients shall have free choice of participating physicians and other clinicians, hospitals, and inpatient care facilities.
SEC. 104. Prohibition against duplicating coverage.
(a) In general.—It is unlawful for a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act.
(b) Construction.—Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act, such as for cosmetic surgery or other services and items that are not medically necessary.http://www.johnconyers.com/hr676text
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