National Voluntary Health Insurance Act of 1979

National Voluntary Health Insurance Act of 1979 - Creates a National Voluntary Health Insurance Agency to operate a National Voluntary Health Insurance Plan with funds supplied by voluntary subscriptions and matching United States Treasury funds, to pay reasonable costs of all medically necessary and appropriate medical and hospital services for all enrollees.

Stipulates that the Agency shall issue no rules or regulations, but shall be governed solely by this Act and its amendments.

Authorizes appropriations of $50,000,000 for the first calendar year after this Act becomes effective for the Agency to carry out its duties.

Eliminates hospital and medical service insurance benefits or payments provided by other Government agencies, including Medicare, Medicaid, the Civilian Health and Medical Plan of the Uniformed Services (CHAMPUS).

Extends coverage to: (1) medical services, wherever furnished, including psychiatric medicine, surgery, obstetrics, radiological and electrical procedures, pathology tests, transfusions, medication and immunization, injections and anesthesia, and osteopathic services; (2) reconstructive oral surgery; (3) podiatric surgery; (4) laboratory services; and (5) inpatient or outpatient hospital service, supplies, medication, transfusions, and food provided by approved hospitals, including general or special category hospitals, outpatient clinics, emergency wards, convalescent hospitals, nursing homes, and acute alcohol or drug toxification treatment centers.

Excludes from coverage: (1) cosmetic surgery not approved under this Act; (2) certain services which are not medically necessary; (3) services for the benefit of a second party other than enrollee; (4) certain employer responsibilities, such as a workmen's compensation insurer; (5) services which are already covered by another plan; (6) unapproved hospital or laboratory services; and (7) certain other medical advice and services.

Sets the amount of premium payments at $25 per month for each adult and one-half of such amount for each child. Entitles subscribers with a total earned and unearned family income of less than $12,000 per year to have their premiums calculated at 2.5 percent of such income for each adult and one-half of such amount for each child. Provides for the payment of premiums by employers and for the reinstatement of coverage on account of unpaid premiums.

Directs the Agency to establish a trust fund for the deposit of all premiums and at least an equal amount of money appropriated from the United States Treasury. Directs Congress to deposit in such fund the amount of $5,000,000,000 by the effective date of the Plan, but provides that the total amount of general funds appropriated to the fund shall not exceed the total amount of subscribers' premiums after the Plan's fifth year of operation.

Reserves 35 percent of the total amount of subscribers' premiums for the payment of medical and laboratory service benefits; 62 percent of such premiums for hospital service benefits; and three percent for administrative costs.

Entitles an enrollee in the Plan to reimbursement in the lesser amount of either the scheduled fee payable by the Plan to a participating provider or the actual fee paid by the enrollee to any qualified nonparticipating provider.

Entitles every nonexcluded and licensed medical doctor, doctor of osteopathic or podiatric medicine, and doctor of dental surgery to be listed by the Plan as a participating provider by making appropriate application. Allows such providers to require an enrollee to pay a reasonable charge in addition to the fee payable by the Plan. Provides for the approval and participation in the Plan of laboratories and hospitals.

Directs the Agency to: (1) set a fee for 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; and (2) provide each approved hospital with a schedule or per diem rate and charges that will be paid by the Plan to such hospital for each specified and covered service which is ordered on behalf of an enrollee by an attending doctor. Requires such hospital charges to be based on each hospital's certified annual financial and operating cost statement. Specifies certain additional requirements with respect to hospital charges.

Species information to be included in all claimed by participating providers. Sets forth requirements with respect to the auditing, payment, and assessment of claims, and utilization of plan benefits.

Authorizes the Agency to temporarily or permanently exclude any enrollee or provider of services found to have made any false claim for payment for services.

Requires the Congress, at the time this Act becomes operational, to amend the rates of Social Security taxes relative to the reduction in Social Security health insurance expenditures effected by this Act.

Requires the arbitration of claims for damages resulting from alleged malpractice in the provision of any service that is a benefit of the plan.

Stipulates that the resources of the Agency and Plan shall not be used in any way directly to regulate the quality or availability of, or to establish or operate, medical and hospital services.

Details the estimated cost of the Plan for fiscal year 1980.