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106275 1 (1978-06-30)

handle is hein.gao/gaobadyad0001 and id is 1 raw text is: DOCUMEIT RESURIE 06275 - [B18468701 Isplementation of the Health Maintenance Crganizaticn Act of 1973, as Amended. June 30, 1978. 17 pp. Testimony before the Hcuse Committee on Interstate and Foreign Commerce: Health and the Envircnment Subcommittee; by Gregory J. Ahart, Director, Human B.sources Div. Contact: Human Resources Div. Organization Concerned: Department of Health, Education, and Uelfare. Conqressional Relevance: House Committee on Interstate and Foreign Commerce: Health and the lnvircnment Sutcommittee. Authority: Health Maintenance Organizaticn Act of 1S73, as amended (87 Stat. 914). Health Maintenance Crganization Amendments of 1976 (90 Stat. 1945). Putlic Health Service Act. H.R. 13266 (95th Cong.). The Health Maintenance OrqanriatiCn (81O) Lct of 1973 provided for a trial Federal program tc develcE alternatives to traditional forms of health care delivery and financing ty assisting and encouraging the establishment and expansion of UMO's. Through May 31, 1978, the Department of Health, Education, and Welfarf (HEW) bad awarded $151.! million in grant and loan assistance under the act to 215 organizaticns-371.3 million in grants and S80.2 million in loans. Two additional organizations received loan guarantees for $2.2 million. REV considers 131 of the 215 organizations to be active grantees or active loan recipients. As of June 20, 1978, there .ere 63 federally qvilified HMO's. A review cf 14 HMO's indicated that each was generally providing health services in the maner required by the act and that each was generally organized and operated in the manner prescribed. The 14 HOls, however, had not expeided extensive effort to enroll elderly, indigent, or medically hiqh-risk people. Three of the 14 HMO's reviewed have a qood chance of being able to operate withcut Federal financial assistance within 5 years after qualification; 5 HMOs have a fair chance; and 6 have a poor chance. Of the six 080as with a poor chance of operating without Federal assistance, three have received notices of noncompliancn from BoE. Concern remains regarding HEW's ability to issue regulations and guidelines needed to implement the act effectively and uniformly and to organize the HMO program and obtain the rumbers and types of personnel needed. A*lthough the financial assistance Froicsed by H.R. 13266 could benefit HKO's, there are reservations about expanding the loan assistance because BEl has act demonstrated the ability to effectively monitor and administer the loan program already in effect. (HRS)

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