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evant fields, including hospital executives, hospital

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data base managers, physicians, health services re

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searchers, insurers, other third-party payors, and

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representatives of labor and business.

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(3) REPORT TO CONGRESS.—Not later than 3

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years after the date of the enactment of this Act, the

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(1) IN GENERAL.-Section 1866(a)(1)(F) of the

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Social Security Act (42 U.S.C. 1395cc(a)(1)(F)) is

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“(I) must maintain clinical data in elec

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tronic form on all inpatients, and

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"(II) must transmit, electronically to the

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Secretary or a utilization and quality control peer review organization, a common set of clini

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cal inpatient hospital data (maintained under

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subclause (1)) relating to any individual who

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has received inpatient hospital services for

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section 301(a) of the Health Equity and Access Reform Today Act of 1991,".

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(2) EFFECTIVE DATE.-The amendment made

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by paragraph (1) shall be effective for participation

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agreements as of 8 years after the date of the enact

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ment of this Act.

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(c) DEMONSTRATIONS AND RESEARCH ON MON

11 ITORING AND IMPROVING PATIENT CARE.—The Secretary

12 shall provide grants to qualified entities to demonstrate 13 (and conduct research concerning) the application of com

14 prehensive information systems,

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(1) in continuously monitoring patient care, and 16

(2) in improving patient care. 17 Up to $10,000,000 shall be available each fiscal year (be18 ginning with fiscal year 1994 and ending with fiscal year 19 1998) from the Federal Hospital Insurance Trust Fund 20 for grants under this subsection.

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102D CONGRESS

1ST SESSION

H.R. 3626

To amend the Social Security Act and the Internal Revenue Code of 1986

to provide for improvements in health insurance coverage through employer health insurance reform, for health care cost containment, for improvements in medicare prevention benefits, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

OCTOBER 24, 1991 Mr. ROSTENKOWSKI introduced the following bill; which was referred jointly

to the Committees on Ways and Means and Energy and Commerce

A BILL

To amend the Social Security Act and the Internal Revenue

Code of 1986 to provide for improvements in health insurance coverage through employer health insurance reform, for health care cost containment, for improvements in medicare prevention benefits, and for other purposes.

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Be it enacted by the Senate and House of Representa

2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

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(a) SHORT TITLE.—This Act may be cited as the

5 "Health Insurance Reform and Cost Control Act of

6 1991”.

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1 (b) TABLE OF CONTENTS.—The table of contents of

2 this Act is as follows:

Sec. 1. Short title; table of contents.

TITLE I-INCREASE IN DEDUCTION FOR HEALTH INSURANCE

FOR SELF-EMPLOYED INDIVIDUALS

Sec. 101. Indefinite extension of deduction for health insurance costs of self

employed individuals. Sec. 102. Increase in amount of deduction for years after 1992.

TITLE II—IMPROVEMENTS IN HEALTH INSURANCE FOR SMALL

EMPLOYERS

SUBTITLE A-STANDARDS AND REQUIREMENTS OF SMALL EMPLOYER

HEALTH INSURANCE REFORM

Sec. 201. Standards and requirements of small employer health insurance.

"TITLE XXI-HEALTH INSURANCE STANDARDS

"PART A-SMALL EMPLOYER HEALTH INSURANCE STANDARDS

“Subpart 1-General Standards;

“Sec. 2101. Standards and requirements of small employer health insur

ance.
“Sec. 2102. Establishment of standards.
*Sec. 2103. Definitions.

"Subpart 2-Small Employer Health Insurance Reform

“Sec. 2111. General requirements for health insurance plans issued to

small employers. “Sec. 2112. Requirements related to restrictions on rating practices. “Sec. 2113. Requirements for small employer health insurance benefit

package offerings.

SUBTITLE B–Tax PENALTY ON NONCOMPLYING INSURERS

Sec. 211. Excise tax on premiums received on health insurance policies which

do not meet certain requirements.

SUBTITLE C-STUDIES AND REPORTS

Sec. 221. GAO study and report on rating requirements for small group health

insurance.

TITLE III-IMPROVEMENTS IN PORTABILITY OF PRIVATE

HEALTH INSURANCE

Sec. 301. Excise tax imposed on failure to provide for preexisting condition.
Sec. 302. Prohibition of discrimination based on health status for certain serv-

ices.

"PART B-PROHIBITION OF DISCRIMINATION BASED ON HEALTH STATUS

FOR CERTAIN SERVICES

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“Sec. 2131. In general.
"Sec. 2132. Treatment of preexisting condition exclusions for all services.
“Sec. 2133. Definitions.

TITLE IV-HEALTH CARE COST CONTAINMENT

Sec. 401. Establishment of National Health Care Cost Commission.
Sec. 402. Establishment of optional provider payment rates.

TITLE V-MEDICARE PREVENTION BENEFITS

Sec. 501. Coverage of colorectal screening.
Sec. 502. Coverage of certain immunizations.
Sec. 503. Coverage of well-child care.
Sec. 504, Annual screening mammography.
Sec. 505. Demonstration projects for coverage of other preventive services.
Sec. 506, OTA study of process for review of medicare coverage of preventive

services.

1 TITLE I–INCREASE IN DEDUC2

TION FOR HEALTH INSUR-
ANCE FOR SELF-EMPLOYED
INDIVIDUALS

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5 SEC. 101. INDEFINITE EXTENSION OF DEDUCTION FOR

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HEALTH INSURANCE COSTS OF SELF-EM

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PLOYED INDIVIDUALS.

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Subsection (1) of section 162 of the Internal Revenue

9 Code of 1986 (relating to special rules for health insur

10 ance costs of self-employed individuals) is amended by

11 striking paragraph (6).

12 SEC. 102. INCREASE IN AMOUNT OF DEDUCTION FOR

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(a) GENERAL RULE.-Section 162(1) of the Internal

15 Revenue Code of 1986 is amended

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