American Health Care Access Improvements Act of 1992

American Health Care Access Improvements Act of 1992 - Title I: Health Care Access Improvements - Subtitle A: Health Insurance Deduction Fairness - Amends the Internal Revenue Code to make permanent and increase from 25 to 100 percent the health insurance tax deduction for the self-employed.

Subtitle B: Extension of Special Treatment Rules for Medicare-Dependent, Small Rural Hospitals - Amends title XVIII (Medicare) of the Social Security Act to extend for one year special treatment rules for Medicare-dependent small rural hospitals.

Subtitle C: Benefits and Services Requirements for Exemption From Tax for Hospitals - Amends the Internal Revenue Code to set forth requirements for hospitals to maintain tax-exempt status, including: (1) the provision of certain emergency medical care; (2) the acceptance of Medicaid and Medicare patients; and (3) the provision of community health centers and clinics in medically underserved areas.

Title II: Insurance Availability - Requires eligible uninsured individuals to register with the Secretary of Health and Human Services for enrollment in a qualified Federal health plan. Provides for the collection of premiums through the income tax system. Authorizes appropriations.

Title III: Health Care Cost Containment - Subtitle A: Paperwork and Administrative Expense Reduction - Requires the Director of the Office of Management and Budget to: (1) identify, inventory, and assess the Federal paperwork burden associated with health care services; and (2) establish a goal for reducing such burden in each of the fiscal years 1993 through 1998 by at least five percent of the preceding fiscal year's paperwork burden.

Provides a bonus for providers who initiate the use of electronic claims under the Medicare program.

Subtitle B: Medical Malpractice Liability Reform - Directs the Secretary of Health and Human Services to make grants to States for the implementation and evaluation of alternative dispute resolution (ADR) systems. Sets forth eligibility requirements for States seeking such grants. Directs the Secretary to award not less than ten such grants each fiscal year, with exceptions.

Requires the Secretary to: (1) designate each State receiving such a grant as a model ADR State (making such State eligible for a two-year extension); and (2) disseminate information on the ADR systems implemented by such States to other States, health care professionals and providers, and other interested parties.

Directs the Secretary to: (1) develop and promulgate standards and regulations necessary to carry out the grant program, including qualification standards that States must meet to receive grants and regulations establishing State data gathering requirements; (2) take into account, in developing qualification standards, specified factors such as the effectiveness of such systems in supporting access to health care, encouraging improvements in the quality of care, resolving claims promptly, and providing predictable outcomes; (3) provide States with technical assistance; and (4) report to the Congress, within four years of the first grant, describing and evaluating the ADR systems implemented.

Specifies that, with respect to any health care liability action brought in a Federal or State court and any medical malpractice claim or medical product liability claim subject to an ADR system: (1) no person may be required to pay more than $100,000 in a single payment in damages (whether for economic or non-economic losses) for expenses to be incurred in the future, but shall be permitted to make periodic payments (as determined by the court); (2) the total amount of damages that may be awarded to an individual and the family members of such individual for non-economic losses may not exceed $250,000; (3) the total amount of damages received by an individual shall be reduced by any other payment that has been or will be made to the individual to compensate such individual for the injury that was the subject of the action or claim; (4) a claimant's attorney's fees may not exceed 25 percent of the first $150,000 of any award or settlement, or 15 percent of any additional amounts, paid to the claimant; (5) the total amount of punitive damages that may be assessed may not exceed twice the total amount of the damages awarded to compensate the claimant for losses resulting from the injury; and (6) the liability of each defendant for non-economic losses shall be several only and not joint, and each defendant shall be liable only for the amount of non-economic losses allocated to the defendant in direct proportion to the defendant's percentage of responsibility. Establishes a two-year statute of limitations for medical malpractice and product liability claims, beginning on the earlier of the date on which the injury that is the subject of the action was discovered or the date it should reasonably have been discovered.

Specifies that, in the case of a medical malpractice or product liability claim relating to services provided during labor or the delivery of a baby, if the claimant was not previously treated for the pregnancy by the defendant health care professional or provider a court may not find that the defendant committed malpractice and assess damages against the defendant unless the malpractice is proven by clear and convincing evidence.

Bars a defendant from being found to have committed malpractice unless the defendant's conduct at the time of providing the health care services was not reasonable, except where the claimant asserts that the defendant is liable under a strict liability theory.

Bars the award of punitive damages with respect to any medical product liability claim alleged against a medical product producer if the drug or device that is the subject of the claim: (1) was subject to approval or premarket approval under the Federal Food, Drug, and Cosmetic Act by the Food and Drug Administration (FDA) with respect to the safety or performance of the drug or device or the adequacy of the packaging or labeling; (2) was approved by FDA; or (3) is generally recognized as safe and effective pursuant to conditions established by FDA and applicable regulations. Makes an exception in the case of withheld information, misrepresentation, or illegal payment to an FDA official for purposes of securing approval of the drug or device.

Provides for a separate proceeding to determine punitive damages. Sets forth provisions with respect to: (1) the admissibility of evidence; and (2) criteria for determining the amount of punitive damages.

Provides that the U.S. district courts shall not have jurisdiction over health care liability actions based on Federal questions or based on specified provisions concerning commerce and antitrust regulations.

Specifies that this title preempts State law only to the extent that State law: (1) permits the recovery by a claimant or the assessment against a defendant of a greater amount of damages; (2) permits the awarding of a greater amount of attorney's fees; (3) establishes a longer period during which medical malpractice or product liability claims may be initiated; or (4) establishes a less strict standard of proof for determining whether a defendant has committed malpractice.

Amends the Public Health Service Act to direct the Secretary to encourage the establishment of a nationwide risk retention group (RRG) for community and migrant health centers receiving assistance under such Act.

Defines an RRG for purposes of this title as an entity defined in the Liability Risk Retention Act of 1986 that: (1) provides professional liability insurance and other types of profitable insurance approved for issuance by the Secretary to community and migrant health centers; (2) provides insurance that applies to all claims filed against a community or migrant health center after the entity initiates insurance coverage and to claims arising from acts that occurred prior to the initiation of coverage if the claims are not covered by other insurance; and (3) meets such other requirements as the Secretary may establish.

Subtitle C: Medical Savings Accounts - Amends the Internal Revenue Code to allow individuals a tax deduction for contributions made to a medical care savings account established for the benefit of an eligible individual. Defines an eligible individual as: (1) one who is not covered by an employer-provided group health plan; or (2) one who is covered by such a plan which is a qualified catastrophic coverage health plan and is not covered by any other health plan. Allows penalty-free withdrawals from such accounts to the extent that amounts in such accounts exceed $15,000.

Allows such deduction in arriving at adjusted gross income.

Establishes an excise tax for excess contributions to medical care savings accounts and makes such accounts subject to the tax on prohibited transactions.

Allows the transfer of unused amounts in flexible spending accounts of cafeteria plans to medical savings accounts.

Subtitle D: Estimates of Expenses Prior to Treatment - Requires providers of health care items or services to disclose to individuals prior to their treatment the price to be charged for such items or services, except in cases of emergencies.

Subtitle E: Limitation on Exclusion for Employer Provided Health Coverage - Limits the amount excludable from the gross income of an employee for employer-provided health care coverage. Subjects such amount to an inflation adjustment.