Rural Health Delivery System Development Act of 1994

TABLE OF CONTENTS:

Title I: Grants to Encourage Establishment of Community Rural

Health Networks

Title II: Incentives for Health Professionals to Practice in

Rural Areas

Subtitle A: National Health Service Corps Program

Subtitle B: Incentives Under Other Programs

Title III: Assistance for Institutional Providers

Subtitle A: Community and Migrant Health Centers

Subtitle B: Emergency Medical Systems

Subtitle C: Assistance to Rural Providers Under Medicare

Subtitle D: Demonstration Projects to Encourage Primary

Care and Rural-Based Graduate Medical Education

Title IV: United States-Mexico Border Health Commission

Title V: Hospital Antitrust Fairness

Title VI: Financing

Rural Health Delivery System Development Act of 1994 - Title I: Grant to Encourage Establishment of Community Rural Health Networks - Directs the Secretary of Health and Human Services to make grants to an eligible State for the development of plans to increase access to health care services for residents of areas in the State designated as chronically underserved areas. Provides for technical assistance for entities establishing or enhancing a community rural health network in an underserved rural area. Provides financial assistance to entities to provide for the development and implementation of community rural health networks. Authorizes appropriations.

Title II: Incentives for Health Professionals to Practice in Rural Areas - Subtitle A: National Health Service Corps Program - Amends the Internal Revenue Code to exclude National Health Service Corps Loan Repayments from gross income.

(Sec. 202) Amends the Public Health Service Act to take into consideration, when designating an area as a health professional shortage area, the number of individuals in the area paying through Medicare or Medicaid, the number of individuals who are uninsured, and the number of physicians who will accept additional Medicare and Medicaid patients.

(Sec. 203) Increases the authorization of appropriations for the National Health Service Corps Scholarship and Loan Repayment Programs.

Subtitle B: Incentives Under Other Programs - Amends title XVIII (Medicare) of the Social Security Act and the Higher Education Act of 1965 to provide incentives under those Acts to physicians informer shortage areas and to primary care physicians, in addition to those provided in Subtitle A. Directs the Secretary to develop and publish a model law for adoption by States to increase the access of individuals residing in underserved rural areas to health care services by expanding the services which non-physician health care professionals may provide in such areas.

Title III: Assistance for Institutional Providers - Subtitle A: Community and Migrant Health Centers - Extends and increases the authorizations of appropriations for migrant health centers and community health centers.

Subtitle B: Emergency Medical Systems - Revises title XII (Trauma Care) of the Public Health Service Act. Renames such title Emergency Health Services. Directs the Secretary to establish the Office of Emergency Medical Services to: conduct and support research and demonstration projects; (2) foster development of appropriate modern systems of services; (3) assist States; and (4) coordinate and sponsor related activities. Requires that activities meet the unique needs of underserved innercity and rural areas. Authorizes grants to States in order to improve the availability and quality of emergency medical services through the operation of State offices of emergency medical services. Authorizes appropriations for emergency medical services and trauma care.

(Sec. 312) Directs the Secretary to make grants to assist States in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments for injuries resulting from such emergencies. Authorizes appropriations.

Subtitle C: Assistance to Rural Providers Under Medicare - Amends title XVIII (Medicare) of the Social Security Act to: (1) increase by two the number of States eligible to participate in the essential access community hospital program; and (2) make other revisions concerning such program, including permitting the participation of hospitals in urban areas and the participation of hospitals in States adjoining participating States. Extends, by three years, the deadline for the development of prospective payment systems for both inpatient and outpatient rural primary care hospital services.

(Sec. 331) Defines a rural emergency access care hospital and rural emergency access care hospital services for purposes of title XVIII. Provides for the coverage of such services under part B (Supplementary Medical Insurance) of title XVIII.

Subtitle D: Demonstration Projects to Encourage Primary Care and Rural-Based Graduate Medical Education - Directs the Secretary to establish and conduct a demonstration project to increase the number and percentage of medical students entering nonprimary care practice. Authorizes appropriations.

Title IV: United States - Mexico Border Health Commission - Authorizes the President to conclude an agreement with Mexico to establish a binational commission known as the United-States-Mexico Border Health Commission which shall: (1) conduct a needs assessment in the United States-Mexico border area to identify, evaluate, prevent, and resolve health problems that affect the general population of the area; (2) implement actions recommended by the assessment; and (3) formulate recommendations concerning payment for such health care.

Title V: Hospital Antitrust Fairness - Exempts the merger or attempted merger of hospitals from the application of the antitrust laws; if specified conditions are met, including that: (1)a hospital be located outside of a city or in a city of less than 150,000; and (2) consumer costs would not increase and access would not be reduced if there was a merger.

Title VI: Financing - Amends the Internal Revenue Code to impose a tax based on the Medicare part B premium for individuals with a modified adjusted gross income exceeding $100,000 or $125,000 in the case of a joint return.