legislation: 93-hr-16532
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| 93-hr-16532 | 93 | hr | 16532 | National Voluntary Medical and Hospital Services Act | Health | 1974-08-21 | 1974-08-21 | Referred to House Committee on Ways and Means. | House | Rep. Ketchum, William M. [R-CA-36] | CA | R | K000153 | 1 | National Voluntary Medical and Hospital Services Act - Creates the National Voluntary Medical and Hospital Services Insurance Agency to operate a National Voluntary Medical and Hospital Services Insurance Plan with funds supplied by voluntary subscriptions and matching United States Treasury funds, to pay all reasonable costs of all medically necessary and appropriate medical and hospital services for all voluntary enrollees. Provides that this Act shall become operative within two years of its enactment, and that Congress shall appropriate $50,000,000 for the first calendar year after this Act becomes effective. Provides that payment shall be made by the plan to or on behalf of every enrollee for all legal, appropriate, and professionally recognized and medically necessary service provided as a personal professional service by or under the direct supervision of a licensed medical doctor, whenever performed. Specifies services excluded from benefits of the plan. Provides for premium payments in the amount of fifteen dollars per month for each adult and one-half of the amount for each child. Provides that subscribers with a total earned and unearned family income of less than $9,969 per year shall be entitled to have their premiums calculated at 1.8 percent of such income for each adult enrollee, and at half that amount for each child enrollee. Provides that not more than 3 percent of all premiums received shall be used for the payment of costs of the plan other than benefits. States that the Agency shall affix a fee to every professionally recognized diagnostic and therapeutic medical service procedure or treatment and laboratory pathological test and procedure that is proportionate to the customary and reasonable fee for such service in each general area of the United States. Enumerates, with respect to claims for the benefits of this plan, the form of, items of information to be contained in, and procedures for auditing, assessment, and payment of, such claims. States that the Agency shall have the right to temporarily or permanently exclude any enrollee or provider of services found to have made any false claim for payment for services. Provides for the arbitration of claims for damages resulting from the alleged malpractice in the provision of any service that is a benefit of the plan. | 2025-09-03T12:49:49Z |