Health Equity and Access Improvement Act of 1992

TABLE OF CONTENTS:

Title I: Tax Incentives for Health Care Access

Title II: Health Care Reform Provisions

Subtitle A: Model Health Care Insurance Benefits Plan

Subtitle B: Managed Care

Subtitle C: Small Employer Purchasing Groups

Subtitle D: Insurance Market Reform

Subtitle E: Uniform Standards for Reporting Services and

Processing Claims

Title III: Medical Liability Reform

Subtitle A: Definitions and Findings

Subtitle B: Expedited Medical Malpractice Settlements

Subtitle C: Alternative Dispute Resolution Procedures

Subtitle D: Uniform Standards for Medical Malpractice

Cases

Subtitle E: Uniform Disciplinary Reforms

Subtitle F: Medical Products

Subtitle G: Community Health Centers

Subtitle H: Miscellaneous Provisions

Title IV: Public Health Provisions

Subtitle A: New Basic Health Care Program

Subtitle B: Medicaid Provisions

Title V: Medically Underserved Areas

Subtitle A: Public Health Service Act Provisions

Subtitle B: Provision Relating to Social Security

Title VI: Incentives to Encourage Preventive Services

Title VII: Tax Treatment of Long-Term Care Insurance And

Plans

Subtitle A: Treatment of Long-Term Care Insurance

Subtitle B: Employer Funding of Medical Benefits

Subtitle C: Reverse Mortgage Insurance for Older

Americans

Subtitle D: Income Tax Credits

Subtitle E: Treatment of Accelerated Death Benefits

Subtitle F: Federal National Long-Term Care

Reinsurance Corporation

Title VIII: Improvements in Portability of Private Health

Insurance

Health Equity and Access Improvement Act of 1992 - Title I: Tax Incentives for Health Care Access - (Sec. 101) Amends the Internal Revenue Code regarding: (1) health expense credits; (2) health premium deductions; (3) small employer health credits; (4) health premium deductions for self-employed individuals; and (5) credits for primary health service providers in rural health professional shortage areas.

(Sec. 105) Excludes from gross income payments made for a taxpayer by the National Health Service Corps Loan Repayment Program. Permits a rural health professional shortage area physician to expense certain property. Allows deductions for rural medical professionals' student loan interest.

Title II: Health Care Reform Provisions - (Sec. 201) Mandates: (1) a model health care insurance benefits plan with standards that carriers should meet; and (2) standards that managed care plan insurers should meet. Establishes the Managed Care Advisory Committee. Preempts State law provisions as applied to managed care plans meeting the recommended standards.

(Sec. 221) Provides for contracts between small employer purchasing groups and carriers.

Title III: Medical Liability Reform - (Sec. 311) Regulates settlement offers in medical malpractice cases.

(Sec. 321) Establishes an Alternative Dispute Resolution Board of Advisers to make recommendations concerning establishing a model voluntary medical malpractice dispute resolution program.

(Sec. 332) Caps future losses, noneconomic damages, and attorneys' fees. Prohibits joint liability in civil actions for noneconomic damages. Establishes a medical malpractice statute of limitations.

(Sec. 342) Imposes requirements on States regarding: (1) allocation of medical licensing fees; (2) disciplinary board membership; (3) risk management programs; and (4) health care disciplinary trust funds.

(Sec. 351) Protects a drug or device producer from punitive damages if the drug or device was subject to approval or premarket approval.

(Sec. 361) Amends the Public Health Service Act to mandate a grant to an entity representing recipients of assistance at migrant and community health centers to develop a business plan and establish a nationwide risk retention group. Authorizes appropriations.

Title IV: Public Health Provisions - (Sec. 401) Amends the Social Security Act to create the BasiCare program. Authorizes appropriations for basic health care benefits for low-income uninsured individuals ineligible for coverage under title XIX (Medicaid) of the Social Security Act.

(Sec. 412) Establishes the Federal Medical Waiver Demonstration Board, permitting it to waive provisions of: (1) the Public Health Service Act; (2) title XVIII (Medicare) of the Social Security Act; (3) Medicaid and BasiCare; (4) veterans' health care programs; and (5) the Employee Retirement Income Security Act of 1974.

Title V: Medically Underserved Areas - (Sec. 501) Amends the Public Health Service Act to authorize appropriations for the National Health Service Corps Scholarship Program and the National Health Service Corps Loan Repayment Program.

(Sec. 502) Mandates allotments to States for grants for community based primary health care entities providing services to pregnant women and children.

(Sec. 503) Mandates grants to federally-qualified health centers (FQHCs) and other entities for services for medically underserved populations or in high impact areas not currently served by a FQHC. Authorizes appropriations.

(Sec. 504) Authorizes grants for a plan for mental health outreach programs in rural areas. Authorizes appropriations.

(Sec. 505) Mandates priority, in awarding grants regarding the research, teaching, and training activities of health personnel educational entities, to entities that demonstrate a commitment to serving medically underserved communities.

Mandates grants for: (1) expanded training for individuals desiring to serve medically underserved communities; and (2) coordination among health professions programs, particularly in medically underserved rural areas. Authorizes appropriations.

(Sec. 506) Authorizes grants: (1) to rural communities for stipends to physicians, nurses, or other health professional trainees; (2) for networks among rural and urban providers to preserve and share health care resources and enhance rural care; and (3) for cooperatives in rural areas to establish a case management and reimbursement system. Authorizes appropriations.

(Sec. 511) Amends: (1) the Omnibus Budget Reconciliation Act of 1987 to authorize appropriations for the Rural Health Care Transition Grant Program; and (2) Medicare to authorize appropriations for the Essential Access Community Hospital Program.

Title VI: Incentives to Encourage Preventive Services - (Sec. 601) Amends the Internal Revenue Code (IRC) to provide credits for preventive services.

(Sec. 602) Amends the Public Health Service Act to authorize appropriations for immunization grants.

Title VII: Tax Treatment of Long-Term Care Insurance and Plans - (Sec. 701) Amends the IRC to provide for the treatment of long-term care insurance regarding: (1) taxation of life insurance companies; (2) taxation of fringe benefits; (3) amounts withdrawn from individual retirement accounts or qualified pension plans for purchasing insurance; and (4) the exchange of life policies for long-term policies.

(Sec. 711) Revises provisions governing medical benefits for retired employees. Allows deductions for employer contributions to health benefits accounts. Defines funded reserve accounts and vesting requirements to qualify for such a deduction.

(Sec. 712) Establishes a penalty on early distributions of medical benefits and an excise tax on allocated assets not used to provide retiree health benefits.

(Sec. 721) Amends the National Housing Act to modify limits on the insurance benefits under an existing program concerning home equity conversion mortgages for elderly homeowners.

(Sec. 731) Allows tax credits for: (1) households including a parent, grandparent, dependent, or spouse who requires custodial care; and (2) long-term care expenses of certain independent persons.

(Sec. 741) Provides for: (1) the treatment of amounts paid to an individual who is terminally ill or permanently confined to a nursing home as death benefits; (2) accelerated death benefit riders on life insurance contracts; and (3) incorporation of the Federal National Long-Term Care Reinsurance Corporation.

Title VIII: Improvements in Portability of Private Health Insurance - (Sec. 801) Imposes an excise tax on group health plans for failure to provide coverage for a preexisting condition.