Health Care Freedom Legislations

Here are six pieces of legislation, four to Nullify Obama Care, a Single Payer Non-Profit Health Care bill to replace if if we want, and one that just bans the forced micro-chiping of humans.  Health Care can be focuses on prevention. Insurance can be  voluntary and far cheaper than for profit health insurance. Other bills to open realistic improvement to health care that do not rely on Big Pharma can work, but Obama Cares bailout of Insurance Companies is a royal failure as people are seeing their costs go up, quality of care go down, and further dependency on the broken "sick care" system that profits more and more the sicker you get. We need a completely new perspective on health care, it starts with prevention and ideally, a voluntary non-profit health care plan called a single payer system would be far better than Obama Care.

This initiatives below are very important to me because Obama Care is too costly and mandatory payments for insurance companies that then bail out Pharmaceutical companies does not stop sickness, it only creates more disease and death. More people die from Big Pharma every year as they push drugs down peoples throats. Psychiatry and Pharma are sick systems of self induced chemical suicide. Remember, an ounce of prevention is worth a pound of "cure." The FDA is a big corrupt institution. The solution we need is to first nullify Obama Care. Second stop subsidizing Big Pharma and GMO foods, and third legalize alternative medicine. If Obama cared about our health, he wouldn't have bailed out Monsanto and signed laws to protect them from lawsuits against their killer foods. If you want to stay healthy, eat organic foods you grow yourself, drink good water, get plenty of sunshine, exercise and stay away from GMOs. We need to stop the eugenics created by Chemtrails, Fluoride, GMO's, Petroleum Dependency, Nuclear Dependency and use of toxic chemicals in our lives.

This following initiatives can be filed in any city county or state with ballot initiative rights to nullify federal actions "we the people" deem unconstitutional. A group the Tenth Amendment Center is proposing this bill for legislative vote, as you know Activism Truth proposes that legislative votes are weaker that direct citizen initiative however, lobbying groups are great resources for the Activism Truth movement to find legislation for the people to put on the ballot using our critical mass organization method. Please join the network of activist minded people who agree to either sign petitions or circulate them so that we can reach a critical mass of voters that can achieve ballot access, allowing citizens to vote on the issue at the ballot directly. Join at http://www.ActivismTruth.com by linking up with any or all of our contact methods including Facebook, Twitter, Youtube, our Thrive forum and direct Email. Please subscribe to this blog or any other social media tools we utilize to distribute information about the "Activism Truth" movement. Thank you for reading. This information can help save the world. If you don't understand how important this is, please investigate more or contact us directly with any questions you have. It's most crucial you realize what the concept of "permanent ballot access" entails, and how your participation of being aware of the solutions and making a pledge to get involved is the only way the citizens of the United States of America or any other nation in the world can achieve true checks and balances on corruption in government. Either the government is self regulating, and we have all seen how that has turned out for us, or "we the people" create a strong enough "citizenry" with solidarity for transpartisan reform to improve our government institutions, and we participate in creating the government with the best direct methods possible with the ballot access process.

The long term plan is to create a Quorum of experts and public debate to bring ideas forward to find ways to improve the bill for the desired results that the bills are designed to create. This way, people can benefit from the concepts of the bill, without having a weak bill that would have unintended consequences. Here is the bills for the Nullifying Obama Care and the one to ban forced micro-chipping.

This first bill was designed for the State of Georgia but it can be formatted for any state. 

Senate Bill 235
By: Senators Pearson of the 51st, Rogers of the 21st, Smith of the 52nd and Tolleson of the
20th
AS PASSED SENATE
A BILL TO BE ENTITLED
AN ACT
1 To provide for a short title; to amend Article 2 of Chapter 5 of Title 16 of the Official Code
2 of Georgia Annotated, relating to assault and battery, so as to prohibit requiring a person to
3 be implanted with a microchip; to provide for definitions; to provide for penalties; to provide
4 for regulation by the Georgia Composite Medical Board; to provide for related matters; to
5 provide for an effective date; to repeal conflicting laws; and for other purposes.
6 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:
7 SECTION 1.
8 This Act shall be known as the "Microchip Consent Act of 2010."
9 SECTION 2.
10 Article 2 of Chapter 5 of Title 16 of the Official Code of Georgia Annotated, relating to
11 assault and battery, is amended by adding a new Code section to read as follows:
12 " 16-5-23.2.
13 (a) As used in this Code section, the term:
14 (1) 'Implant' includes any means intended to introduce a microchip internally, beneath
15 the skin, or applied to the skin of a person.
16 (2) 'Microchip' means any microdevice, sensor, transmitter, mechanism, electronically
17 readable marking, or nanotechnology that is passively or actively capable of transmitting
18 or receiving information. Such term shall not include pacemakers.
19 (3) 'Person' means any individual, irrespective of age, legal status, or legal capacity.
20 (4) 'Require' includes physical violence; threat; intimidation; retaliation; the conditioning
21 of any private or public benefit or care on consent to implantation, including
22 employment, promotion, or other benefit; or any means that causes a person to acquiesce
23 to implantation when he or she otherwise would not.
24 (b) No person shall be required to be implanted with a microchip.
10 LC 29 4070S (SCS)
S. B. 235
- 2 -
25 (c) Any person who implants a microchip in violation of this Code section shall be guilty
26 of a misdemeanor.
27 (d) Any person required to have a microchip implanted in violation of this Code section
28 may file a civil action for damages.
29 (e) The voluntary implantation of any microchip may only be performed by a physician
30 and shall be regulated under the authority of the Georgia Composite Medical Board."
31 SECTION 3.
32 This Act shall become effective on July 1, 2010.
33 SECTION 4.
34 All laws and parts of laws in conflict with this Act are repealed.

There are 4 parts to the next part of this document.
1. Health Care Nullification V1 and V2
2. Health Care Freedom Act
3. Model Legislation to Ban State Run Health Exchanges
4. Reject Medicaid Expansion

HEALTH CARE NULLIFICATION ACT, V1
An Act to render null and void certain unconstitutional laws enacted by the Congress of the United States, taking control over the health insurance industry and mandating that individuals purchase health insurance under threat of penalty.
SECTION 1. The legislature of the State of ____________ finds that:
1. The People of the several states comprising the United States of America created the federal government to be their agent for certain enumerated purposes, and nothing more.
2. The Tenth Amendment to the United States Constitution defines the total scope of federal power as being that which has been delegated by the people of the several states to the federal government, and all power not delegated to the federal government in the Constitution of the United States is reserved to the states respectively, or to the people themselves.
3. The assumption of power that the federal government has made by enacting the “Patient Protection and Affordable Care Act” interferes with the right of the People of the State of _____________ to regulate health care as they see fit, and makes a mockery of James Madison’s assurance in Federalist #45 that the “powers delegated” to the Federal Government are “few and defined”, while those of the States are “numerous and indefinite.”
SECTION 2. NEW LAW
A new section of law to be codified in the [STATE] Statutes as Section [NUMBER] of Title [NUMBER], unless there is created a duplication in numbering, reads as follows:
A. The Legislature of the State of _______________ declares that the federal law known as the “Patient Protection and Affordable Care Act,” signed by President Barack Obama on March 23, 2010, is not authorized by the Constitution of the United States and violates its true meaning and intent as given by the Founders and Ratifiers, and is hereby declared to be invalid in this state, shall not be recognized by this state, is specifically rejected by this state, and shall be considered null and void and of no effect in this state.
B. It shall be the duty of the legislature of this State to adopt and enact any and all measures as may be necessary to prevent the enforcement of the “Patient Protection and Affordable Care Act” within the limits of this State.
SECTION 3. This act takes effect upon approval by the Governor.

Here is a bill proposed for the State of Arizona, it can easily be changed for other states, counties and cities to be enacted by citizen initiative. The group that created this is Arizonans for Health Care Freedom.

HEALTH CARE NULLIFICATION ACT, V2 – w/PENALTIES
An Act to render null and void certain unconstitutional laws enacted by the Congress of the United States, taking control over the health insurance industry and mandating that individuals purchase health insurance under threat of penalty.
SECTION 1. The legislature of the State of ____________ finds that:
1. The People of the several states comprising the United States of America created the federal government to be their agent for certain enumerated purposes, and nothing more.
2. The Tenth Amendment to the United States Constitution defines the total scope of federal power as being that which has been delegated by the people of the several states to the federal government, and all power not delegated to the federal government in the Constitution of the United States is reserved to the states respectively, or to the people themselves.
3. The assumption of power that the federal government has made by enacting the “Patient Protection and Affordable Care Act” interferes with the right of the People of the State of _____________ to regulate health care as they see fit, and makes a mockery of James Madison’s assurance in Federalist #45 that the “powers delegated” to the Federal Government are “few and defined”, while those of the States are “numerous and indefinite.”
SECTION 2. NEW LAW
A new section of law to be codified in the [STATE] Statutes as Section [NUMBER] of Title [NUMBER], unless there is created a duplication in numbering, reads as follows:
A. The Legislature of the State of _______________ declares that the federal law known as the “Patient Protection and Affordable Care Act,” signed by President Barack Obama on March 23, 2010, is not authorized by the Constitution of the United States and violates its true meaning and intent as given by the Founders and Ratifiers, and is hereby declared to be invalid in this state, shall not be recognized by this state, is specifically rejected by this state, and shall be considered null and void and of no effect in this state.
B. It shall be the duty of the legislature of this State to adopt and enact any and all measures as may be necessary to prevent the enforcement of the “Patient Protection and Affordable Care Act” within the limits of this State.
C. Any official, agent, or employee of the United States government or any employee of a corporation providing services to the United States government that enforces or attempts to enforce an act, order, law, statute, rule or regulation of the government of the United States in violation of this act shall be guilty of a felony and upon conviction must be punished by a fine not exceeding five thousand dollars ($5,000.00), or a term of imprisonment not exceeding five (5) years, or both.
D. Any public officer or employee of the State of ____________ that enforces or attempts to enforce an act, order, law, statute, rule or regulation of the government of the United States in violation of this act shall be guilty of a misdemeanor punishable by imprisonment in the county jail not exceeding two (2) years or by a fine not exceeding One Thousand Dollars ($1,000.00) or both such fine and imprisonment.
E. Any aggrieved party shall also have a private action against any person violating the provisions of subsections (C) or (D).
SECTION 3. This act takes effect upon approval by the Governor Citizens by popular vote at the ballot.

PROPOSITION 106

OFFICIAL TITLE

HOUSE CONCURRENT RESOLUTION 2014

A CONCURRENT RESOLUTION

PROPOSING AN AMENDMENT TO THE CONSTITUTION OF ARIZONA; AMENDING ARTICLE XXVII, BY ADDING SECTION 2, CONSTITUTION OF ARIZONA; RELATING TO HEALTH CARE SERVICES.

TEXT OF PROPOSED AMENDMENT

Be it resolved by the House of Representatives of the State of Arizona, the Senate concurring:

1. Article XXVII, Constitution of Arizona, is proposed to be amended by adding section 2 as follows if approved by the voters and on proclamation of the Governor:

2. Health care; definitions

SECTION 2. A. TO PRESERVE THE FREEDOM OF ARIZONANS TO PROVIDE FOR THEIR HEALTH CARE:

1. A LAW OR RULE SHALL NOT COMPEL, DIRECTLY OR INDIRECTLY, ANY PERSON, EMPLOYER OR HEALTH CARE PROVIDER TO PARTICIPATE IN ANY HEALTH CARE SYSTEM.

2. A PERSON OR EMPLOYER MAY PAY DIRECTLY FOR LAWFUL HEALTH CARE SERVICES AND SHALL NOT BE REQUIRED TO PAY PENALTIES OR FINES FOR PAYING DIRECTLY FOR LAWFUL HEALTH CARE SERVICES. A HEALTH CARE PROVIDER MAY ACCEPT DIRECT PAYMENT FOR LAWFUL HEALTH CARE SERVICES AND SHALL NOT BE REQUIRED TO PAY PENALTIES OR FINES FOR ACCEPTING DIRECT PAYMENT FROM A PERSON OR EMPLOYER FOR LAWFUL HEALTH CARE SERVICES.

B. SUBJECT TO REASONABLE AND NECESSARY RULES THAT DO NOT SUBSTANTIALLY LIMIT A PERSON'S OPTIONS, THE PURCHASE OR SALE OF HEALTH INSURANCE IN PRIVATE HEALTH CARE SYSTEMS SHALL NOT BE PROHIBITED BY LAW OR RULE.

C. THIS SECTION DOES NOT:

1. AFFECT WHICH HEALTH CARE SERVICES A HEALTH CARE PROVIDER OR HOSPITAL IS REQUIRED TO PERFORM OR PROVIDE.

2. AFFECT WHICH HEALTH CARE SERVICES ARE PERMITTED BY LAW.

3. PROHIBIT CARE PROVIDED PURSUANT TO ARTICLE XVIII, SECTION 8 OF THIS CONSTITUTION OR ANY STATUTES ENACTED BY THE LEGISLATURE RELATING TO WORKER'S COMPENSATION.

4. AFFECT LAWS OR RULES IN EFFECT AS OF JANUARY 1, 2009.

5. AFFECT THE TERMS OR CONDITIONS OF ANY HEALTH CARE SYSTEM TO THE EXTENT THAT THOSE TERMS AND CONDITIONS DO NOT HAVE THE EFFECT OF PUNISHING A PERSON OR EMPLOYER FOR PAYING DIRECTLY FOR LAWFUL HEALTH CARE SERVICES OR A HEALTH CARE PROVIDER OR HOSPITAL FOR ACCEPTING DIRECT PAYMENT FROM A PERSON OR EMPLOYER FOR LAWFUL HEALTH CARE SERVICES.

D. FOR THE PURPOSES OF THIS SECTION:

1. "COMPEL" INCLUDES PENALTIES OR FINES.

2. "DIRECT PAYMENT OR PAY DIRECTLY" MEANS PAYMENT FOR LAWFUL HEALTH CARE SERVICES WITHOUT A PUBLIC OR PRIVATE THIRD PARTY, NOT INCLUDING AN EMPLOYER, PAYING FOR ANY PORTION OF THE SERVICE.

3. "HEALTH CARE SYSTEM" MEANS ANY PUBLIC OR PRIVATE ENTITY WHOSE FUNCTION OR PURPOSE IS THE MANAGEMENT OF, PROCESSING OF, ENROLLMENT OF INDIVIDUALS FOR OR PAYMENT FOR, IN FULL OR IN PART, HEALTH CARE SERVICES OR HEALTH CARE DATA OR HEALTH CARE INFORMATION FOR ITS PARTICIPANTS.

4. "LAWFUL HEALTH CARE SERVICES" MEANS ANY HEALTH-RELATED SERVICE OR TREATMENT TO THE EXTENT THAT THE SERVICE OR TREATMENT IS PERMITTED OR NOT PROHIBITED BY LAW OR REGULATION THAT MAY BE PROVIDED BY PERSONS OR BUSINESSES OTHERWISE PERMITTED TO OFFER SUCH SERVICES.

5. "PENALTIES OR FINES" MEANS ANY CIVIL OR CRIMINAL PENALTY OR FINE, TAX, SALARY OR WAGE WITHHOLDING OR SURCHARGE OR ANY NAMED FEE WITH A SIMILAR EFFECT ESTABLISHED BY LAW OR RULE BY A GOVERNMENT ESTABLISHED, CREATED OR CONTROLLED AGENCY THAT IS USED TO PUNISH OR DISCOURAGE THE EXERCISE OF RIGHTS PROTECTED UNDER THIS SECTION.

2. The article heading of article XXVII, Constitution of Arizona, is proposed to be changed as follows if approved by the voters and on proclamation of the Governor: The article heading of article XXVII, Constitution of Arizona, is changed from "REGULATION OF PUBLIC HEALTH, SAFETY AND WELFARE" to "REGULATION OF HEALTH, SAFETY AND WELFARE".

3. The Secretary of State shall submit this proposition to the voters at the next general election as provided by article XXI, Constitution of Arizona.

ANALYSIS BY LEGISLATIVE COUNCIL

Proposition 106 would amend the Arizona Constitution to:

1. Prohibit any law or rule from compelling any person, employer or health care provider to participate in any health care system.

2. Allow a person or employer to pay directly for lawful health care services without being penalized or fined.

3. Allow a health care provider to accept direct payment for lawful health care services without being penalized or fined.

4. Provide that the purchase or sale of health insurance in private health care systems shall not be prohibited by law or rule, subject to reasonable and necessary rules that do not substantially limit a person's options.

Proposition 106 would not:

1. Affect which health care services a health care provider or hospital is required to perform or provide.

2. Affect which health care services are permitted by law.

3. Prohibit care provided by law relating to worker's compensation.

4. Affect laws or rules in effect as of January 1, 2009.

5. Affect the terms or conditions of any health care system unless those terms and conditions have the effect of punishing a person or employer for paying directly for lawful health care services or punishing a health care provider or hospital for accepting direct payment from a person or employer for lawful health care services.

Model Legislation to Ban State Run Health Exchanges

This bill clarifies the implementation of certain provisions of the Patient Protection and Affordable Care Act. This bill prohibits the state of (STATE) from planning, creating, or participating in a state health care exchange.
AN ACT relative to federal health care reform and health care exchanges.
SECTION 1 Prohibition on State-Based Health Exchange.
A. No (STATE) state agency, department, or political subdivision shall plan, create, participate in or enable a state-based exchange for health insurance under the Act, or contract with any private entity to do so.
SECTION 2, EFFECTIVE DATE
This act takes effect upon approval by the Governor.

Model Legislation: Reject Medicaid Expansion

This bill clarifies the implementation of certain provisions of the Patient Protection and Affordable Care Act. This bill prohibits the state of (STATE) from facilitating in any way the expansion of the Medicaid program under the Act.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF (STATE):
SECTION 1. (STATE) Code Annotated, Title (NUMBER), Chapter (NUMBER)), is amended by adding the following as a new part:
(NEW CODE NUMBER).
Notwithstanding any provision of law to the contrary, the state shall not establish, facilitate, implement or participate in the expansion of the Medicaid program pursuant to the Patient Protection and Affordable Care Act, Public Law 111-148, as amended.
SECTION 2. This act shall take effect upon becoming a law, the public welfare requiring it.

Finally, a Single Payer Bill that can be amended for state initiatives, it may be amended. A voluntary Single Payer bill is the best option, so people are not forced into paying for healthcare but they can have better options than more expensive for profit insurance schemes and dominate the insurance industry in the USA today. 

THE GENERAL ASSEMBLY OF PENNSYLVANIA
	SENATE BILL
No. 400 Session of 2011
	INTRODUCED BY FERLO, TARTAGLIONE, FONTANA, SCHWANK, WASHINGTON, HUGHES, KITCHEN AND FARNESE, OCTOBER 12, 2011
	REFERRED TO BANKING AND INSURANCE, OCTOBER 12, 2011
	AN ACT
1	Providing for a Statewide comprehensive health care system;
2	establishing the Pennsylvania Health Care Plan and providing
3	for eligibility, services, coverages, subrogation,
4	participating providers, cost containment, reduction of
5	errors, tort remedies, administrative remedies and
6	procedures, attorney fees, quality assurance,
7	nonparticipating providers, transitional support and
8	training; and establishing the Pennsylvania Health Care
9	Agency, the Employer Health Services Levy, the Individual
10	Wellness Tax, the Pennsylvania Health Care Trust Fund and the
11	Pennsylvania Health Care Board and providing for their powers
12	and duties.
13	TABLE OF CONTENTS
14	Chapter 1.  Preliminary Provisions
15	Section 101.  Short title.
16	Section 102.  Definitions.
17	Chapter 3.  Administration and Oversight of the Pennsylvania
18	Health Care Plan
19	Subchapter A.  Pennsylvania Health Care Board
20	Section 301.  Organization.
21	Section 302.  Duties of board.
22	Subchapter B.  Pennsylvania Health Care Agency
23	Section 321.  Pennsylvania Health Care Agency.
1
2	Subchapter C.  (Reserved).
3	Subchapter D.  (Reserved).
4	Subchapter E.  (Reserved).
5	Subchapter F.  Immunity
6	Section 371.  Immunity.
7	Chapter 5.  Pennsylvania Health Care Plan
8	Section 501.  General provisions.
9	Section 502.  Universal health care access eligibility.
10	Section 503.  Covered services.
11	Section 504.  Excess and collective bargaining agreement health
12	insurance coverage.
13	Section 505.  Duplicate coverage.
14	Section 506.  Subrogation.
15	Section 507.  Eligible participating providers and availability
16	of services.
17	Section 508.  Rational cost containment.
18	Chapter 9.  Pennsylvania Health Care Trust Fund
19	Section 901.  Pennsylvania Health Care Trust Fund.
20	Section 902.  Limitation on administrative expense.
21	Section 903.  Funding sources.
22	Chapter 11.  Transitional Support and Training for Displaced
23	Workers
24	Section 1101.  Transitional support and training for displaced
25	workers.
26	Chapter 13.  Volunteer Emergency Responder Network
27	Section 1301.  Preservation of volunteer emergency responder
28	network.
29	Section 1302.  Eligibility certification.
30	Section 1303.  Eligibility criteria.
20110SB0400PN1652 - 2 -
1	Section 1304.  Amount of tax credit.
2	Section 1305.  Reimbursement of Department of Revenue.
3	Chapter 45.  Miscellaneous Provisions
4	Section 4501.  Effective date.
5	The General Assembly of the Commonwealth of Pennsylvania
6	hereby enacts as follows:
7	CHAPTER 1
8	PRELIMINARY PROVISIONS
9	Section 101.  Short title.
10	This act shall be known and may be cited as the Family and
11	Business Healthcare Security Act.
12	Section 102.  Definitions.
13	The following words and phrases when used in this act shall
14	have the meanings given to them in this section unless the
15	context clearly indicates otherwise:
16	"Agency."  The Pennsylvania Health Care Agency established
17	under this act.
18	"Board."  The Pennsylvania Health Care Board established
19	under this act.
20	"Certificate of need."  A notice of approval issued by the
21	Department of Health under the provisions of the act of July 19,
22	1979 (P.L.130, No.48), known as the Health Care
23	Facilities Act, including those notices of approval issued as an
24	amendment to an existing certificate of need.
25	"Chair."  The Chair of the Pennsylvania Health Care Board.
26	"Department."  The Department of Health of the Commonwealth.
27	"Executive director."  The Executive Director of the
28	Pennsylvania Health Care Agency.
29	"Fund."  The Pennsylvania Health Care Trust Fund established
30	under this act.
20110SB0400PN1652 - 3 -
1	"Individual Fair Share Health and Wellness Tax."  The
2	Individual Fair Share Health and Wellness Tax established under
3	this act.
4	"Ombudsman."  The Pennsylvania Health Care Ombudsman
5	established under this act.
6	"Plan."  The Pennsylvania Health Care Plan established under
7	this act.
8	"Tax."  The Employer Fair Share Health and Wellness Tax
9	established under this act.
10	CHAPTER 3
11	ADMINISTRATION AND OVERSIGHT OF THE
12	PENNSYLVANIA HEALTH CARE PLAN
13	SUBCHAPTER A
14	PENNSYLVANIA HEALTH CARE BOARD
15	Section 301.  Organization.
16	(a)  Composition.--The Pennsylvania Health Care Board shall
17	be composed of 12 voting members. The chair shall preside over
18	the board and shall set the agenda but may vote only in the
19	event of a tie vote.
20	(b)  Appointments.--
21	(1)  The board shall consist of 12 members to be
22	appointed by the Governor by and with the advice and consent
23	of a majority of all the members of the Senate from
24	individuals representative of each of the following
25	constituencies and reflective of the diversity of this
26	Commonwealth:
27	(i)  Three patients or caregivers of patients who
28	experience the health care system daily. These members
29	must be geographically diverse, knowledgeable about
30	health issues and represent the following categories:
20110SB0400PN1652 - 4 -
1	(A)  A caregiver of a child with a chronic
2	illness or developmental disability.
3	(B)  An adult with a chronic illness or physical
4	disability.
5	(C)  An adult with mental illness requiring
6	medications.
7	(ii)  A physician.
8	(iii)  A hospital representative.
9	(iv)  A long-term care representative.
10	(v)  A health care attorney.
11	(vi)  Health care informatics.
12	(vii)  A small business representative.
13	(viii)  A large business representative.
14	(ix)  An organized labor representative from the
15	health sector.
16	(x)  Public health.
17	(2)  Appointed board members shall take the oath of
18	office prior to serving on the board and may be removed only
19	for cause under subsection (j).
20	(b.1)  Quality of care panels.--
21	(1)  In addition to the board, there shall be four
22	quality of care panels as follows:
23	(i)  A health professional quality panel.
24	(ii)  A health institution quality panel.
25	(iii)  A health supplier quality panel.
26	(iv)  The health care ombudsman panel.
27	(2)  The quality of care panels shall meet regularly as
28	needed to create policies and recommendations to deliver
29	cost-effective, evidence-based, quality health care to the
30	residents of this Commonwealth.
20110SB0400PN1652 - 5 -
1	(3)  The quality of care panels shall hire staff who will
2	work daily on quality of care recommendations with agency
3	staff. The quality of care recommendations shall be presented
4	in a formal report at every board meeting.
5	(4)  The chair shall inform the board on progress or
6	explaining the lack of progress in implementing key
7	recommendations of the quality of care panels.
8	(c)  Chairman.--The Governor shall designate one of the board
9	members as chairman, who shall serve in that position at the
10	pleasure of the Governor. The chairman shall, when present,
11	preside at all meetings, and in his absence a member designated
12	by the chairman shall preside.
13	(d)  Midterm vacancies.--Midterm vacancies shall be filled by
14	a representative from the same constituent group required under
15	subsection (b) and the individual appointed to fill a vacancy
16	occurring prior to the expiration of the term for which a member
17	is appointed shall hold office for the remainder of the
18	predecessor's term.
19	(e)  Compensation, benefits and expenses.--The chair shall
20	receive an annual salary, benefits and expense reimbursement
21	established by the board, to be paid from the fund, but the
22	salary may not exceed the salary of the Governor. The initial
23	board shall establish its own compensation per diem and, for
24	travel, reimbursement of expenses incurred on behalf of the
25	board and other necessary expenses. No increase or decrease in
26	salary or benefits adopted by the board for the chair or members
27	shall become effective within the same three-year term, except
28	for the first three initial years of the plan when readjustments
29	may be made.
30	(f)  Meetings.--
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1	(1)  The chair shall set the time, place and date for the
2	initial and subsequent meetings of the board and shall
3	preside over its meetings. The initial meeting shall be set
4	not sooner than 50 nor later than 100 days after the
5	appointment of the chair. Subsequent meetings shall occur as
6	determined by the board but not less than six times annually.
7	(2)  All meetings of the board are open to the public
8	unless questions of patient confidentiality arise. The board
9	may conduct closed executive session for issues relating to
10	confidential patient information, to evaluation of the chair
11	or to personnel matters.
12	(3)  The board shall publish its rulings in the
13	Pennsylvania Bulletin with an opportunity for public comment
14	as determined by State law.
15	(4)  The minutes of the board, except for executive
16	session deliberations, shall be public information. The media
17	shall be allowed access to all final public reports to ensure
18	full disclosure of decisions that impact the public.
19	(g)  Quorum.--Two-thirds of the appointed members of the
20	board shall constitute a quorum for the conducting of business
21	at meetings of the board. Decisions at ordinary meetings of the
22	board shall be reached by majority vote of those actually
23	present or, in the event of an emergency meeting, those also
24	present by electronic or telephonic means. Where there is a tie
25	vote, the chair shall vote to break the tie. Except as otherwise
26	provided in this act, absentee or proxy voting shall not be
27	allowed.
28	(h)  Ethics.--The executive director, the chair and other
29	board members and their immediate families are prohibited from
30	having any pecuniary interest in any business with a contract or
20110SB0400PN1652 - 7 -
1	in negotiation for a contract with the agency. The board shall
2	also adopt rules of ethics and definitions of irreconcilable
3	conflicts of interest that will determine under what
4	circumstances members must recuse themselves from voting.
5	(i)  Prohibitions.--
6	(1)  No member of the board may receive any additional
7	salary or benefits by virtue of serving on the board.
8	(2)  No member of the board may hold any other salaried
9	Commonwealth public position, either elected or appointed,
10	during the member's tenure on the board, including, but not
11	limited to, the position of State legislator or member of the
12	United States Congress.
13	(3)  The executive director, chair and board members may
14	not be a State legislator or member of the United States
15	Congress.
16	(j)  Dismissal.--Board members shall attend all meetings and
17	be prepared to discuss and vote on information presented. Board
18	members may be dismissed and positions refilled for any of the
19	following reasons:
20	(1)  Failure to attend 75% of the meetings in one year.
21	(2)  Inability to represent their constituency group.
22	(3)  Clear conflict of interest.
23	(4)  Fraud or criminal activity either present or in the
24	past.
25	Section 302.  Duties of board.
26	(a)  General duties.--The board is responsible for directing
27	the agency in the performance of all duties, the exercise of all
28	powers, and the assumption and discharge of all functions vested
29	in the agency. The board shall adopt and publish its rules and
30	procedures in the Pennsylvania Bulletin no later than 180 days
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1	after the first meeting of the board.
2	(b)  Specific duties.--The duties and functions of the board
3	include, but are not limited to, the following:
4	(1)  Implementing statutory eligibility standards for
5	benefits.
6	(2)  Annually adopting a benefits package for
7	participants of the plan.
8	(3)  Acting directly or through one or more contractors
9	as the single payer administrator for all claims for health
10	care services made under the plan.
11	(4)  At least annually, reviewing the appropriateness and
12	sufficiency of reimbursements and considering whether a
13	charge is fair and reasonable for its geographic region or
14	location.
15	(5)  Providing for timely payments to participating
16	providers through a structure that is well organized and that
17	eliminates unnecessary administrative costs.
18	(6)  Implementing standardized claims and reporting
19	methods for use by the plan.
20	(7)  Developing a system of centralized electronic claims
21	and payments accounting.
22	(8)  Establishing an enrollment system that will ensure
23	that those who travel frequently and cannot read or speak
24	English are aware of their right to health care and are
25	formally enrolled in the plan.
26	(9)  Reporting annually to the General Assembly and to
27	the Governor, on or before the first day of October, on the
28	performance of the plan, the fiscal condition of the plan,
29	recommendations for statutory changes, the receipt of
30	payments from the Federal Government, whether current year
20110SB0400PN1652 - 9 -
1	goals and priorities were met, future goals and priorities,
2	and major new technology or prescription drugs that may
3	affect the cost of the health care services provided by the
4	plan.
5	(10)  Administering the revenues of the fund.
6	(11)  Obtaining appropriate liability and other forms of
7	insurance to provide coverage for the plan, the board, the
8	agency and their employees and agents.
9	(12)  Establishing, appointing and funding appropriate
10	staff, office space, equipment, training and administrative
11	support for the agency throughout this Commonwealth, all to
12	be paid from the fund.
13	(13)  Administering aspects of the agency by taking
14	actions that include, but are not limited to, the following:
15	(i)  Establishing standards and criteria for the
16	allocation of operating funds.
17	(ii)  Meeting regularly to review the performance of
18	the agency and to adopt and revise its policies.
19	(iii)  Establishing goals for the health care system
20	established pursuant to the plan in measurable terms.
21	(iv)  Establishing Statewide health care databases to
22	support health care services planning.
23	(v)  Implementing policies and developing mechanisms
24	and incentives to assure culturally and linguistically
25	sensitive care.
26	(vi)  Establishing rules and procedures for
27	implementation and staffing of a no-fault compensation
28	system for iatrogenic injuries or complications of care
29	whereby a patient's condition is made worse or an
30	opportunity for cure or improvement is lost due to the
20110SB0400PN1652 - 10 -
1	health care or medications provided or appropriate care
2	not provided by participating providers under the plan.
3	(vii)  Establishing standards and criteria for the
4	determination of appropriate transitional support and
5	training for residents of this Commonwealth who are
6	displaced from work during the first two years of the
7	implementation of the plan.
8	(viii)  Evaluating the state of the art in proven
9	technical innovations, medications and procedures and
10	adopting policies to expedite the rapid introduction
11	thereof in this Commonwealth.
12	(ix)  Establishing methods for the recovery of costs
13	for health care services provided pursuant to the plan to
14	a beneficiary who is also covered under the terms of a
15	policy of insurance, a health benefit plan or other
16	collateral source available to the participant under
17	which the participant has a right of action for
18	compensation. Receipt of health care services pursuant to
19	the plan shall be deemed an assignment by the participant
20	of any right to payment for services from any such
21	policy, plan or other source. The other source of health
22	care benefits shall pay to the trust all amounts it is
23	obligated to pay to, or on behalf of, the participant for
24	covered health care services. The board may commence any
25	action necessary to recover the amounts due.
26	(14)  Establishing the Health Professional Quality Panel,
27	Health Institution Quality Panel and Health Supplier Quality
28	Panel, which panels shall be comprised of persons who
29	represent a cross section of the medical and provider
30	community as follows:
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1	(i)  Appointments shall be nominated by the trade
2	organizations and in the event of multiple nominations,
3	made by the board. Each quality panel shall submit
4	recommendations for continual improvement in cost-
5	effective, quality health car.
6	(ii)  The Health Professional Quality Panel shall
7	consist of one representative of the following
8	constituencies:
9	(A)  Primary care physicians.
10	(B)  Specialty care physicians.
11	(C)  Clinical psychologists.
12	(D)  Nurses.
13	(E)  Social workers.
14	(F)  Midwives.
15	(G)  Nutritionists.
16	(H)  Pharmacists.
17	(I)  Optometrists.
18	(J)  Podiatrists.
19	(K)  Hearing specialists.
20	(L)  Physical or occupational therapists.
21	(M)  Dentists.
22	(N)  Chiropractors.
23	(O)  Health educators.
24	(P)  Acupuncturists.
25	(iii)  The Health Institution Quality Panel shall
26	consist of one representative of the following
27	constituencies:
28	(A)  Academic medical centers.
29	(B)  Community hospitals.
30	(C)  Rehabilitation centers.
20110SB0400PN1652 - 12 -
1	(D)  Trauma systems.
2	(E)  Convenient care centers.
3	(F)  Hospice program.
4	(G)  Substance abuse centers.
5	(H)  Home health care services.
6	(I)  Long-term care facilities.
7	(iv)  The Health Supplier Quality Panel shall consist
8	of one representative of the following constituencies:
9	(A)  Medical imaging.
10	(B)  Laboratory.
11	(C)  Durable medical equipment suppliers.
12	(D)  Pharmaceutical.
13	(E)  Medical suppliers other than durable medical
14	equipment suppliers.
15	(v)  The members of the quality panels shall be paid
16	a per diem rate, established by the board, for attendance
17	at meetings and further be reimbursed for actual and
18	necessary expenses incurred in the performance of their
19	duties, which shall include:
20	(A)  Making recommendations to the agency on the
21	establishment of policy on medical issues,
22	population-based public health issues, research
23	priorities, scope of services, expansion of access to
24	health care services and evaluation of the
25	performance of the plan in order to provide high
26	quality care for Pennsylvania residents.
27	(B)  Investigating proposals for innovative
28	approaches to the promotion of health, the prevention
29	of disease and injury, patient education, research
30	and health care delivery.
20110SB0400PN1652 - 13 -
1	(C)  Advising the agency on the establishment of
2	standards and criteria to evaluate requests from
3	health care facilities for capital improvements.
4	(D)  Evaluating and advising the board on
5	requests from providers or their representatives for
6	adjustments to reimbursements reflective of their
7	education and responsibilities.
8	(E)  Coordinating resources in order to minimize
9	duplication among providers, institutions and
10	suppliers.
11	(F)  Evaluating or conducting research in order
12	to recommend products or services.
13	(G)  Presenting key recommendations in a report
14	to the board on improving quality of care.
15	(15)  Establishing an Office of the Health Care
16	Ombudsman. Acting directly or through one or more
17	contractors, the ombudsman and staff shall expeditiously
18	resolve issues related to the implementation of the plan
19	within 24 hours. The office shall receive questions,
20	complaints or problems from the public and work with agency
21	staff in order to quickly find a permanent or temporary
22	resolution. The staff of the ombudsman shall be hired from
23	the funds deposited in the Pennsylvania Health Care Trust
24	Fund. The ombudsman shall prepare a report for every board
25	meeting summarizing the major issues and recommendations for
26	resolution by the board.
27	(16)  Establishing a secure and centralized electronic
28	health record system wherein a beneficiary's entire health
29	record can be readily and reliably accessed by authorized
30	persons with the objective of eliminating the errors and
20110SB0400PN1652 - 14 -
1	expense associated with paper records and diagnostic films.
2	The system shall ensure the privacy of all health records it
3	contains.
4	(17)  Establishing, from the revenues received, a reserve
5	fund sufficient to provide a continuation of services during
6	periods of reduced or insufficient revenue due to economic
7	conditions or unforeseen emergency major health care needs.
8	SUBCHAPTER B
9	PENNSYLVANIA HEALTH CARE AGENCY
10	Section 321.  Pennsylvania Health Care Agency.
11	(a)  Establishment.--The Pennsylvania Health Care Agency is
12	established. The agency shall administer the plan and is the
13	sole agency authorized to accept applicable grants-in-aid from
14	the Federal Government and State government. It shall use such
15	funds in order to secure full compliance with provisions of
16	Federal and State law and to carry out the purposes established
17	under this act. All grants-in-aid accepted by the agency shall
18	be deposited into the Pennsylvania Health Care Trust Fund
19	established under this act, together with other revenues raised
20	within this Commonwealth to fund the plan.
21	(b)  Appointment of executive director.--The executive
22	director of the agency shall be appointed by the board and shall
23	be the chief administrator of the plan. The executive director
24	shall implement the plan and serve at the pleasure of the board.
25	The salary of the executive director shall not exceed the
26	statutory salary of the Governor.
27	(c)  Personnel and employees.--The board shall employ and fix
28	the compensation of agency personnel as needed by the agency to
29	properly discharge the agency's duties. The employment of
30	personnel by the board is subject to the civil service laws of
20110SB0400PN1652 - 15 -
1	this Commonwealth. The executive director shall oversee the
2	operation of the agency and the agency's performance of any
3	duties assigned by the board.
4	SUBCHAPTER C
5	(Reserved)
6	SUBCHAPTER D
7	(Reserved)
8	SUBCHAPTER E
9	(Reserved)
10	SUBCHAPTER F
11	IMMUNITY
12	Section 371.  Immunity.
13	In the absence of fraud or bad faith, the health quality
14	panels, the board and agency and their respective members and
15	employees shall incur no liability in relation to the
16	performance of their duties and responsibilities under this act.
17	The Commonwealth shall incur no liability in relation to the
18	implementation and operation of the plan.
19	CHAPTER 5
20	PENNSYLVANIA HEALTH CARE PLAN
21	Section 501.  General provisions.
22	(a)  Establishment of plan.--There is hereby established the
23	Pennsylvania Health Care Plan that shall be administered by the
24	independent Pennsylvania Health Care Agency under the direction
25	of the Pennsylvania Health Care Board.
26	(b)  Coverage.--The plan shall provide health care coverage
27	for all citizens of this Commonwealth. The agency shall work
28	simultaneously to control health care costs, achieve measurable
29	improvement in health care outcomes, promote a culture of health
30	awareness and develop an integrated health care database to
20110SB0400PN1652 - 16 -
1	support health care planning and quality assurance.
2	(c)  Reforms.--The board shall implement the reforms adopted
3	by the General Assembly hereby within one year of the effective
4	date of the plan.
5	Section 502.  Universal health care access eligibility.
6	(a)  Eligibility.--All Pennsylvania residents, including
7	aliens or immigrants lawfully given admission to the United
8	States under the Immigration and Nationality Act (66 Stat. 163,
9	8 U.S.C. § 1101 et seq.), homeless persons and migrant
10	agricultural workers and their accompanying families who reside
11	in this Commonwealth and are required to pay personal income tax
12	to the Commonwealth are eligible beneficiaries under the plan.
13	Health benefits shall be covered for the period when the
14	individual resided in Pennsylvania for tax purposes. When in
15	doubt, the definition of residency status shall follow the
16	definitions used by the Department of Revenue for paying
17	personal income taxes. The board shall establish standards and a
18	simple procedure to demonstrate proof of eligibility. Out-of-
19	State students who are not independent of their parents or
20	guardian attending school in this Commonwealth must obtain
21	health insurance. Part-year residents must obtain health
22	insurance for the period of time that they are not in State.
23	(b)  Enrollment.--Enrollment in the plan shall be established
24	by the board and beneficiaries shall be provided with access
25	cards with appropriate proof of identity technology and privacy
26	protection.
27	(c)  Outreach to eligible residents.--Pennsylvania residents
28	who are unable to pay their taxes because of physical or mental
29	disabilities may obtain assistance through county assistance
30	offices and other agencies identified by the board.
20110SB0400PN1652 - 17 -
1	(d)  Waivers.--If waivers are not obtained from the medical
2	assistance and/or Medicare programs operated under Title XVIII
3	or XIX of the Social Security Act (49 Stat. 620, 42 U.S.C. § 301
4	et seq.), the medical assistance and Medicare nonwaived programs
5	shall act as the primary insurers for those eligible for such
6	coverage, and the plan shall serve as the secondary or
7	supplemental plan of health coverage. Until such time as waivers
8	are obtained, the plan will not pay for services for persons
9	otherwise eligible for the same benefits under Medicare or
10	Medicaid. The plan shall also be secondary to benefits provided
11	to military veterans except where reasonable and timely access,
12	as defined by the board, is denied or unavailable through the
13	United States Veterans' Administration, in which instance the
14	plan will be primary and will seek reasonable reimbursement from
15	the United States Veterans' Administration for the services
16	provided to veterans.
17	(e)  Priority of plans.--A plan of employee health coverage
18	provided by an out-of-State employer to a Pennsylvania resident
19	working outside of this Commonwealth shall serve as the
20	employee's primary plan of health coverage, and the plan shall
21	serve as the employee's secondary plan of health coverage.
22	(f)  Reimbursement.--The plan shall reimburse providers
23	practicing outside of this Commonwealth at plan rates, or the
24	reasonable prevailing rate of the locale where the service is
25	provided, not to exceed 115% of the amount physicians in this
26	Commonwealth would have been paid for health care services
27	rendered to a beneficiary while the beneficiary is out of this
28	Commonwealth. Services provided to a beneficiary out of this
29	Commonwealth by other than a participating provider shall be
30	reimbursed to the beneficiary or to the provider at a fair and
20110SB0400PN1652 - 18 -
1	reasonable rate for that location. The plan may suggest
2	Pennsylvania providers for those who consistently use out-of-
3	State providers.
4	(g)  Presumption of eligibility.--Any individual who arrives
5	at a health care facility unconscious or otherwise unable due to
6	their mental or physical condition to document eligibility for
7	coverage shall be presumed to be eligible, and emergency care
8	shall be provided without delay occasioned over issues of
9	ability to pay.
10	(h)  Rules.--The board shall adopt rules assuring that any
11	participating provider who renders humanitarian emergency care,
12	urgent care or prevention or treatment for a communicable
13	disease or prenatal and delivery care within this Commonwealth
14	to a not actually eligible recipient shall nevertheless be
15	reimbursed for such care from the plan subject to such rules as
16	will reasonably limit the frequency of such events to protect
17	the fiscal integrity of the plan. It shall be the agency's
18	responsibility to secure reimbursement for the costs paid for
19	such care from any appropriate third party funding source, or
20	from the individual to whom the services were rendered.
21	Section 503.  Covered services.
22	(a)  Benefits package.--The board shall establish a single
23	health benefits package within the plan that shall include, but
24	not be limited to, all of the following:
25	(1)  All medically necessary inpatient and outpatient
26	care and treatment, both primary and secondary.
27	(2)  Emergency services.
28	(3)  Emergency and other medically necessary transport to
29	covered health services.
30	(4)  Rehabilitation services, including speech,
20110SB0400PN1652 - 19 -
1	occupational, physical and massage therapy.
2	(5)  Inpatient and outpatient mental health services and
3	substance abuse treatment.
4	(6)  Hospice care.
5	(7)  Prescription drugs and prescribed medical nutrition.
6	(8)  Vision care, aids and equipment.
7	(9)  Hearing care, hearing aids and equipment.
8	(10)  Diagnostic medical tests, including laboratory
9	tests and imaging procedures.
10	(11)  Medical supplies and prescribed medical equipment.
11	(12)  Immunizations, preventive care, health maintenance
12	care and screening.
13	(13)  Dental care.
14	(14)  Home health care services.
15	(15)  Chiropractic and massage therapy.
16	(16)  Complementary and alternative modalities that have
17	been shown by the National Institute of Health's Division of
18	Complementary and Alternative Medicine to be safe and
19	effective for possible inclusion as covered benefits.
20	(17)  Long-term care for those unable to care for
21	themselves independently and including assisted and skilled
22	care.
23	(b)  Exclusions for preexisting conditions.--The plan shall
24	not exclude or limit coverage due to preexisting conditions.
25	(c)  Copayments, deductibles, etc.--Beneficiaries of the plan
26	are not subject to copayments, deductibles, point-of-service
27	charges or any other fee or charge for a service within the
28	package and shall not be directly billed nor balance billed by
29	participating providers for covered benefits provided to the
30	beneficiary. Where a beneficiary has directly paid for
20110SB0400PN1652 - 20 -
1	nonemergency services of a nonparticipating provider, the
2	beneficiary may submit a claim for reimbursement from the plan
3	for the amount the plan would have paid a participating provider
4	for the same service. Where emergency services are rendered by a
5	nonparticipating provider, the beneficiary shall receive
6	reimbursement of the full amount paid to such nonparticipating
7	provider not to exceed 115% of the amount the plan would have
8	paid a participating provider for the same service.
9	(d)  Exclusions of coverage.--
10	(1)  The board shall remove or exclude procedures and
11	treatments, equipment and prescription drugs from the plan
12	benefit package that the Food and Drug Administration or a
13	health quality panel finds unsafe or that add no therapeutic
14	value.
15	(2)  The board shall exclude coverage for any surgical,
16	orthodontic or other procedure or drug that the board
17	determines was or will be provided primarily for cosmetic
18	purposes unless required to correct a congenital defect, to
19	restore or correct disfigurements resulting from injury or
20	disease or that is certified to be medically necessary by a
21	qualified, licensed provider.
22	(e)  Choice by beneficiary.--Beneficiaries shall normally be
23	granted free choice of the participating providers, including
24	specialists, without preapprovals or referrals. However, the
25	board shall adopt procedures to restrict such free choice for
26	those individuals who engage in patterns of wasteful or abusive
27	self-referrals to specialists. Specialists who provide primary
28	care to a self-referred beneficiary will be reimbursed at the
29	board-approved primary care rate established for the service in
30	that community.
20110SB0400PN1652 - 21 -
1	(f)  Practice patterns.--Practice patterns of participating
2	providers shall be monitored. Outliers in terms of
3	overutilization or underutilization shall be reviewed by a panel
4	of peers and, if necessary, constructive feedback given. The
5	board may set outlier policies after reviewing practice patterns
6	and recommendations from the health quality panels.
7	(g)  Service.--No participating provider shall be compelled
8	to offer any particular service so long as the refusal is
9	consistent with the provider's practice.
10	(h)  Discrimination.--The plan and participating providers
11	shall not discriminate on the basis of race, ethnicity, national
12	origin, gender, age, religion, sexual orientation, health
13	status, mental or physical disability, employment status,
14	veteran status or occupation.
15	Section 504.  Excess and collective bargaining agreement health
16	insurance coverage.
17	Subject to the regulations of the Insurance Commissioner and
18	all applicable laws, private health insurers shall be authorized
19	to offer coverage supplemental to the package approved and
20	provided automatically under this act.
21	Section 505.  Duplicate coverage.
22	The agency is subrogated to and shall be deemed an assignee
23	of all rights of a beneficiary who has received duplicate health
24	care benefits, or who has a right to such benefits, under any
25	other policy or contract of health care or under any government
26	program.
27	Section 506.  Subrogation.
28	The agency shall have no right of subrogation against a
29	beneficiary's third-party claims for harm or losses not covered
30	under this act. Nor shall any beneficiary under this act have a
20110SB0400PN1652 - 22 -
1	claim against a third-party tortfeasor for the services provided
2	or available to the beneficiary under this act. In all personal
3	injury actions accruing and prosecuted by a beneficiary on or
4	after January 1, 2008, the presiding judge shall advise any jury
5	that all health care expenses have been or will be paid under
6	the plan, and, therefore, no claim for past or future health
7	care benefits is pending before the court.
8	Section 507.  Eligible participating providers and availability
9	of services.
10	(a)  General rule.--All licensed health care providers and
11	facilities are eligible to become a participating provider in
12	the plan in which instance they shall enjoy the rights and have
13	the duties as set forth in the plan as stated in this section or
14	as adopted by the board from time to time. Nonparticipating
15	providers shall not enjoy the rights nor bear the duties of
16	participating providers.
17	(b)  Required notice.--In advance of initially providing
18	services to a beneficiary, nonparticipating providers shall
19	advise the beneficiary at the time the appointment is made that
20	the person or entity is a nonparticipating provider and that the
21	recipient of the service will be initially personally
22	responsible for the entire cost of the service and ultimately
23	responsible for the cost in excess of the reimbursement approved
24	by the board for participating providers. A sign at the point of
25	entry or reminder by the office staff disclosing whether the
26	provider accepts or does not accept the plan card and who covers
27	the cost of care shall be deemed sufficient notice. Failure to
28	make such financial disclosure will be deemed a fraud on the
29	beneficiary and entitle the beneficiary to a refund from the
30	provider equal to 200% of the amount paid to the
20110SB0400PN1652 - 23 -
1	nonparticipating provider in excess of the board-approved
2	reimbursement for the services rendered, plus all reasonable
3	fees for collection. The burden of proof that such disclosure
4	was made shall be on the nonparticipating provider.
5	(c)  Plan by board.--The board shall assess the number of
6	primary and specialty providers needed to supply adequate health
7	care services in this Commonwealth generally and in all
8	geographic areas and shall develop a plan to meet that need. The
9	board shall develop financial incentives for participating
10	providers in order to maintain and increase access to health
11	care services in underserved areas of this Commonwealth.
12	(d)  Reimbursements.--Reimbursements shall be determined by
13	the board in such a fashion as to assure that a participating
14	provider receives compensation for services that fairly and
15	fully reflect the skill, training, operating overhead included
16	in the costs of providing the service, capital costs of
17	facilities and equipment, cost of consumables and the expense of
18	safely discarding medical waste, plus a reasonable profit
19	sufficient to encourage talented individuals to enter the field
20	and for investors to make capital available for the construction
21	of state-of-the-art health care facilities in this Commonwealth.
22	The plan shall review fee schedules and may offer alternative
23	reimbursement mechanisms, including capitation, salary and
24	bonuses.
25	(e)  Adjustments to reimbursements.--Participating providers
26	shall have the right alone or collectively to petition the board
27	for adjustments to reimbursements believed to be too low. Such
28	petitions shall be initially evaluated by the administrator of
29	provider services, with input from the Health Professional
30	Quality Panel, who shall submit a report to the chair within 30
20110SB0400PN1652 - 24 -
1	days. The chair shall then submit a recommendation to the board
2	for action at the next scheduled board meeting. Participating
3	providers who remain dissatisfied after the board has ruled may
4	appeal the board's determination to Commonwealth Court, which
5	shall review the action of the board on an abuse of discretion
6	standard.
7	(f)  Evaluation of access to care.--The board annually shall
8	evaluate access to trauma care, diagnostic imaging technology,
9	emergency transport and other vital urgent care requirements and
10	shall establish measures to assure beneficiaries have equitable
11	and ready access to such resources regardless of where in this
12	Commonwealth they may be.
13	(g)  Health care delivery models.--The board, with the
14	assistance of the health quality panels, shall review best
15	community practices in delivering high quality care. Those
16	wellness practices that can be adopted will be funded with an
17	increasing emphasis on prevention and community-based care in
18	order to reduce the need for hospitalization and nursing home
19	care in the future.
20	(h)  Performance reports.--The board, with the assistance of
21	the Health Advisory Panel, shall define performance criteria and
22	goals for the plan and shall make a written report to the
23	General Assembly at least annually on the plan's performance.
24	All such reports, including the survey results obtained, shall
25	be made publicly available with the goal of total transparency
26	and open self-analysis as a defining quality of the agency. The
27	board shall establish a system to monitor the quality of health
28	care and patient and provider satisfaction and to adopt a system
29	to devise improvements and efficiencies to the provision of
30	health care services.
20110SB0400PN1652 - 25 -
1	(i)  Data reporting.--All participating providers shall, in a
2	prompt and timely manner, provide existing and ongoing data to
3	the agency upon its request.
4	(j)  Coordination of services.--The agency shall coordinate
5	the provision of health care services with any other
6	Commonwealth and local agencies that provide health care
7	services directly to their charges or residents.
8	Section 508.  Rational cost containment.
9	(a)  Approval of expenditures.--As part of its cost
10	containment mission and based on the certificate of need, the
11	board, with the assistance of the Health Institution Quality
12	Panel, shall screen and approve or disapprove private or public
13	expenditures for new health care facilities and other capital
14	investments that may lead to redundant and inefficient health
15	care provider capacity. Procedures shall be adopted for this
16	purpose with an emphasis upon efficiency, quality of delivery
17	and a fair and open consideration of all applications.
18	(b)  Capital investments.--Based on the certificate of need
19	all capital investments valued at $1,000,000 or greater,
20	including the costs of studies, surveys, design plans and
21	working drawing specifications, and other activities essential
22	to planning and execution of capital investment and all capital
23	investments that change the bed capacity of a health care
24	facility by more than 10% over a 24-month period or that add a
25	new service or license category shall require the approval of
26	the board. When a facility, an individual acting on behalf of a
27	facility or any other purchaser obtains by lease or comparable
28	arrangement any facility or part of a facility, or any equipment
29	for a facility, the market value of which would have been a
30	capital expenditure, the lease or arrangement shall be
20110SB0400PN1652 - 26 -
1	considered a capital expenditure for purposes of this section.
2	(c)  Study.--Those intending to make capital investments or
3	acquisitions shall prepare a business case for making each
4	investment and acquisition. It shall include the full-life-cycle
5	costs of the investment or acquisition, an environment impact
6	report that meets existing State standards and a demonstration
7	of how the investment or acquisition meets the health care needs
8	of the population it is intended to serve. Acquisitions may
9	include, but not be limited to, acquisitions of land,
10	operational property or administrative office space.
11	(d)  Deemed approval.--Capital investment programs submitted
12	for approval shall be deemed approved by the board within 60
13	days from the date the submissions are received by the chair. A
14	60-day extension may apply if the board requires additional
15	information.
16	(e)  Recommendations.--Recommendations of the Pennsylvania
17	Heath Cost Containment Council and such other public and private
18	authoritative bodies as shall be identified from time to time by
19	the board shall be received by the chair and submitted to the
20	board with the chair's recommendation regarding implementation
21	of the recommended reforms. The board shall receive input from
22	all interested parties and then shall vote upon all such
23	recommendations within 60 days. Where procedural or protocol
24	reforms are adopted, participating providers will be required to
25	implement such designated best practices within the next 60
26	days.
27	(f)  Appeal.--A decision of the board may be appealed through
28	a uniform dispute resolution process that has been established
29	by unanimous approval of the board.
30	(g)  Required investments.--The board, with the
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1	recommendations of the Health Institution Quality Panel, may
2	adopt programs to assist participating providers in making
3	capital investments responsive to best practice recommendations.
4	(h)  Decertification.--Participating providers refusing to
5	adopt recommended reforms shall, after a reasonable opportunity
6	to be heard, be subject to such sanctions as the board shall
7	deem appropriate and necessary up to and including a
8	recommendation by the board to the Bureau of Professional and
9	Occupational Affairs or the Department of Health for the
10	suspension or permanent decertification of the participating
11	provider.
12	CHAPTER 9
13	PENNSYLVANIA HEALTH CARE TRUST FUND
14	Section 901.  Pennsylvania Health Care Trust Fund.
15	(a)  Establishment.--The Pennsylvania Health Care Trust Fund
16	is hereby established within the State Treasury. All moneys
17	collected and received by the plan shall be transmitted to the
18	State Treasurer for deposit into the fund, to be used
19	exclusively to finance the plan.
20	(b)  State Treasurer.--The State Treasurer may invest the
21	principal and interest earned by the fund in any manner
22	authorized under law for the investment of Commonwealth moneys.
23	Any revenue or interest earned from the investments shall be
24	credited to the fund.
25	Section 902.  Limitation on administrative expense.
26	The system budget referred to in this chapter shall comprise
27	the cost of the agency, services and benefits provided,
28	administration, data gathering, planning and other activities
29	and revenues deposited with the system account of the fund. The
30	board shall limit ongoing administrative costs, excluding start-
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1	up costs, to 5% of the agency budget and shall annually evaluate
2	methods to reduce administrative costs and publicly report the
3	results of that evaluation.
4	Section 903.  Funding sources.
5	Funding of the plan shall be obtained from the following
6	dedicated sources:
7	(1)  Funds obtained from existing or future Federal
8	health care programs.
9	(2)  Funds from dedicated sources specified by the
10	General Assembly.
11	(3)  Receipts from the tax of 10% of gross payroll,
12	including self-employment profits. One percent of the tax
13	shall become effective the date that shall be the first day
14	of a calendar month no less than 32 days after the effective
15	date of this act, and the tax shall become fully effective 60
16	days before the plan takes effect. Employers who are part of
17	a collective bargaining agreement whereby the health care
18	benefits are no less generous than those provided under the
19	plan shall be excused from paying 90% of the tax.
20	(4)  Receipts from the Individual Fair Share Health and
21	Wellness Tax of 3% on income as defined in sections 301 and
22	303 of the act of March 4, 1971 (P.L.6, No.2), known as the
23	Tax Reform Code of 1971. One-half of one percent of the
24	Individual Fair Share Health and Wellness Tax shall become
25	effective the date that shall be the first day of a calendar
26	month no less than 32 days after the effective date of this
27	act, and the Individual Fair Share Health and Wellness tax
28	shall become fully effective 60 days before the plan takes
29	effect.
30	CHAPTER 11
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1	TRANSITIONAL SUPPORT AND TRAINING FOR DISPLACED WORKERS
2	Section 1101.  Transitional support and training for displaced
3	workers.
4	(a)  Determination of eligibility.--The plan shall determine
5	which citizens of this Commonwealth employed by a health care
6	insurer, health insuring corporation or other health care-
7	related business have lost their employment as a result of the
8	implementation and operation of the plan, including the amount
9	of monthly wages that the individual has lost due to the plan's
10	implementation. The plan shall attempt to position these
11	displaced workers in comparable positions of employment or
12	assist in the retraining and placement of such displaced
13	employees elsewhere.
14	(b)  Compensation.--The plan shall forward the information on
15	the amount of monthly wages lost by Commonwealth residents due
16	to the implementation of the plan to the board. Compensation
17	shall be up to $5,000 each month but may not exceed the monthly
18	wages of the individual when he was displaced. Compensation will
19	cease upon reemployment or after two years, whichever comes
20	first. A displaced worker shall be eligible to receive
21	compensation, training assistance, or both, from the fund.
22	Training assistance may not exceed $20,000.
23	(c)  Coordination of services.--The plan shall fully
24	coordinate activity with public and private services also
25	available or actually participating in the assistance to the
26	affected individuals.
27	(d)  Appeals.--Persons dissatisfied with the level of
28	assistance they are receiving may appeal to the office of the
29	executive director whose determination shall be final and not
30	subject to appeal.
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1	CHAPTER 13
2	VOLUNTEER EMERGENCY RESPONDER NETWORK
3	Section 1301.  Preservation of volunteer emergency responder
4	network.
5	Because this Commonwealth is dependent upon the volunteered
6	services of firefighters, emergency medical technicians and
7	search and rescue workers, the board is further charged with
8	administering a Commonwealth income tax credit program for such
9	volunteers.
10	Section 1302.  Eligibility certification.
11	Annually, in January, administrators of volunteer
12	firefighting and rescue departments, emergency medical
13	technicians and paramedics stations and similar volunteer
14	emergency entities shall certify the identity of Commonwealth
15	residents providing active services during the prior calendar
16	year.
17	Section 1303.  Eligibility criteria.
18	Active status shall require a minimum of 200 hours of service
19	during the preceding year and response to no less than 50% of
20	the emergency calls during at least three of the four calendar
21	quarters.
22	Section 1304.  Amount of tax credit.
23	Each volunteer certified as active shall be granted a credit
24	equal to $1,000 toward the volunteer's State income tax
25	obligation under Article III of the act of March 4, 1971 (P.L.6,
26	No.2), known as the Tax Reform Code of 1971. Any eligible
27	volunteer who does not incur $1,000 in annual State income tax
28	liability shall nevertheless be eligible for a refund equal to
29	the amount the credit exceeds that volunteer's tax obligation.
30	Section 1305.  Reimbursement.
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1	The State Treasury shall be reimbursed the value of such
2	volunteer credits from the fund.
3	CHAPTER 45
4	MISCELLANEOUS PROVISIONS
5	Section 4501.  Effective date.
6	This act shall take effect immediately.
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