Health Maintenance Organization Act

Health Maintenance Organization Act - Defines health maintenance organization as a public or private entity organized to provide basic and supplemental health services to its members. States that each member of such organization is to be provided basic health services for a basic health services payment which: (1) is to be paid on a regular basis without regard to the dates such services are provided; (2) is fixed without regard to the frequency, extent, or kind of health service furnished; and (3) is established under a community rating system.

Authorizes the Secretary of Health, Education, and Welfare to make grants to, and enter into contracts with, public or nonprofit private entities for projects for surveys or other activities to determine the feasibility of developing or expanding health maintenance organizations which will serve residents of medically underserved areas.

Provides that no grant may be made under this Act unless an application therefor has been submitted to, and approved by, the Secretary. States that such application shall be in such form, and submitted in such manner, as the Secretary shall by regulation provide.

States that, in considering applications for feasibility grants and contract proposals under this Act, the Secretary shall give priority to applications and contract proposals for projects and health maintenance organizations which will serve residents of medically underserved areas.

Provides that, if a feasibility project has been assisted with a grant or contract under this Act, the Secretary may not make any other grant or enter into any other contract for such project. Stipulates that any project under this Act must be completed within twelve months from the date the grant is made or the contract entered into.

Provides that the amount to be paid by the United States for a feasibility grant made, or contract entered into, under this Act shall be determined by the Secretary except that the amount to be paid by the United States for any single grant or contract shall not exceed $50,000 or 90 percent of the project cost.

Authorizes the Secretary to make grants to and enter into contracts with public or nonprofit private entities, and to make loans to public entities, for planning projects for the establishment of health maintenance organizations or for significant expansion of the membership of, or area served by, health maintenance organizations. Allows the Secretary to guarantee to non-Federal lenders payment of the principal of and the interest on loans made to any private entity for such a planning project.

States that, in considering applications for grants and contract proposals for planning projects under this section, the Secretary shall give priority to applications and contract proposals for projects for health maintenance organizations which will serve residents of medically underserved areas.

Provides that the Federal share of such planning project grants or contracts shall not exceed $125,000 or 90 percent of the cost of such project.

Specifies the amounts to be paid by the United States for any initial development projects for a health maintenance organization under any grant or contract, or both.

Provides that the United States shall be entitled to recover from an applicant for a loan guarantee under this title the amount of any payment made pursuant to such guarantee, unless the Secretary for good cause waives such right of recovery. States that guarantees of loans under this Act shall be subject to such terms and conditions as the Secretary determines to be necessary to assure that the purposes of this Act will be carried out.

Authorizes the Secretary, with due regard to the financial interests of the United States, to sell loans made by him under this title.

Establishes within the Treasury a loan guarantee fund which shall be available to the Secretary without fiscal year limitation, in such amounts as may be specified from time to time in appropriation Acts, to enable him to discharge his responsibilities under loan guaranties issued by him under this Act.

States that no funds appropriated under any provision of this Act other than this title may be used: (1) for grants or contracts for surveys or other activities to determine the feasibility of developing or expanding health maintenance organizations or other entities which provide, directly or indirectly, health care to a defined population on a prepaid basis; (2) for grants, loans, or contracts, or for payments under loans guarantees, for planning projects for the establishment or expansion of such organizattions or entities; (3) for grants, loans, or contracts, or for payments under loan guarantees, for projects for the initial development or expansion of such organizations or entities, or (4) for loans or for payments under loan guarantees, to assist in meeting the costs of the initial operation after establishment or expansion of such organizations or entities.

Directs the Comptroller General to evaluate the operations of at least fifty of the health maintenance organizations for which assistance was provided under this Act.

Requires the Comptroller General to report to the Congress the results of the evaluation not later than ninety days after at least fifty of such health maintenance organizations have been operation for at least thirty-six months.

Requires the Secretary to make an annual report to the Congress on the program of assistance under this Act.