Law and Government Legislation regarding 'Health maintenance organizations' in Federal Government

Quality Health Care Coalition Act of 2007 - Exempts health care professionals that are negotiating with a health plan regarding contract terms under which the professionals provide health care items or services for which plan benefits are provided from federal antitrust laws in connection with such negotiations.

Declares that this Act: (1) applies only to health care professionals excluded from the National Labor Relations Act; and (2) does not apply to such negotiations relating to Medicare or Medicaid programs, the State Children's Health Insurance Program (SCHIP), medical and dental care for members of the uniformed services, veterans' medical care, the federal employees health benefits program, or the Indian Health Care Improvement Act.

Medicare Part D Drug Class Protection Act of 2007 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to require that Medicare prescription drug plans using formularies cover all drugs included in six specified therapeutic categories.

Sets forth special requirements for reconsideration of coverage determinations, and appeals for drugs included in such categories.

Establishes reporting requirements for drugs in these categories.

Medicare Advantage Truth in Advertising Act of 2007 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act to restrict cost-sharing under the Medicare Advantage (MA) Program to a level no greater (and permissably less) than the cost-sharing that would otherwise be imposed under the original Medicare fee-for-service program option.

Declares that nothing regarding original Medicare fee-for-service program option benefits shall be construed as prohibiting an MA plan from using a flat copayment or per diem rate, under this Act, in lieu of the cost-sharing imposed under Medicare part A or part B.

Rural Health Services Preservation Act of 2007 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act to require Medicare Advantage organizations to provide for a payment rate for critical access hospital services and rural health clinic services that is: (1) at least the applicable payment rate established under Medicare part A (Hospital Insurance) or part B (Supplementary Medical Insurance) for such services; or (2) 103% of the otherwise applicable payment rate, if the critical access hospital or the rural health clinic determines appropriate.

Medicare Part D Improvement Act of 2007 - Amends part D (Voluntary Prescription Drug Benefit Program) of the Social Security Act to revise requirements for the Medicare prescription drug program with respect to: (1) counting certain expenditures towards out-of-pocket limits; (2) conforming the late enrollment penalty to the Medicare part B penalty structure; (3) allowing more frequent changes in plans; and (4) removing the asset test and eliminating late enrollment penalties for low-income subsidy eligible individuals.

Directs the Secretary of Health and Human Services to study and report to Congress on how to: (1) eliminate the gap in Medicare part D prescription drug coverage created through the application of an initial coverage limit; and (2) finance such elimination.

Amends title XIX (Medicaid) of the Social Security Act (SSA) to permit local public agencies to act as Medicaid enrollment brokers.

Rural Health Services Preservation Act of 2007 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act to require Medicare Advantage organizations to provide for a payment rate for critical access hospital services and rural health clinic services that is: (1) at least the applicable payment rate established under Medicare part A (Hospital Insurance) or part B (Supplementary Medical Insurance) for such services; or (2) 103% of the otherwise applicable payment rate, if the critical access hospital or the rural health clinic determines appropriate.

Universal Health Act of 2007: Repeal of the Late Enrollment Penalty in Medicare Part D - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to repeal the Medicare prescription drug benefit late enrollment penalty.

Relief and Elimination of the Medicare Enrollment Deadline Penalty (REMEDY) Act of 2007 - Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to: (1) postpone the Medicare part D late enrollment penalty until after 2007; and (2) eliminate such penalties for low-income subsidy-eligible individuals for periods after 2007.

Directs the Secretary of Health and Human Services to establish a method for providing rebates of late enrollment penalties paid for months before the enactment of this Act.

Rural Health Services Preservation Act of 2007 - Amends part C (Medicare+Choice) of title XVIII (Medicare) of the Social Security Act to require Medicare Advantage organizations to provide for a payment rate for critical access hospital services and rural health clinic services that is: (1) at least the applicable payment rate established under Medicare part A (Hospital Insurance) or part B (Supplementary Medical Insurance) for such services; or (2) 103% of the otherwise applicable payment rate, if the critical access hospital or the rural health clinic determines appropriate

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Protecting Children's Health in Schools Act of 2007 - Amends title XIX (Medicaid) and XXI (State Children's Health Insurance) (SCHIP) of the Social Security Act (SSA) to establish requirements for providing and receiving reimbursement for school-based health care for children, including children with special needs, and the related administrative and transportation costs covered under Medicaid. Includes health care provided through Medicaid managed care organizations.

Directs the Secretary of Health and Human Services and the Secretary of Education, acting jointly, to develop and implement a uniform methodology for claims under this Act.

Protecting Children's Health in Schools Act of 2007 - Amends titles XIX (Medicaid) and XXI (State Children's Health Insurance) (SCHIP) of the Social Security Act (SSA) to establish requirements for providing and receiving reimbursement for school-based health care for children, including children with special needs, and the related administrative and transportation costs covered under Medicaid. Includes health care provided through Medicaid managed care organizations.

Directs the Secretary of Health and Human Services and the Secretary of Education, acting jointly, to develop and implement a uniform methodology for claims under this Act.

Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act (SSA) to limit to $10, adjusted for inflation, the monthly amount of prescription drug cost-sharing for full-benefit dual eligible individuals (eligible for both part D and Medicaid under SSA title XIX) and other lowest-income individuals.

Amends the Consolidated Omnibus Budget Reconciliation Act of 1985, as added by the Omnibus Budget Reconciliation Act of 1990 and as amended by the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000, to add health insuring organizations operated by public entities established by Ventura and Merced Counties, California, to the number of county-organized health insuring organizations in California authorized to enroll Medicaid beneficiaries under title XIX of the Social Security Act.

Increases from 14% to 16% the maximum percentage of California Medicaid beneficiaries which may be enrolled with such organizations.

Abortion Non-Discrimination Act of 2007 - Amends the Public Health Service Act to include a health care entity's refusal to provide coverage of, or pay for, induced abortions among the bases for which the federal government or any state or local government that receives federal financial assistance may not discriminate against such an entity. Expands the definition of "health care entity" to include a hospital, a provider sponsored organization, a health maintenance organization, a health insurance plan, and any other kind of health care facility, organization, or plan.

(This measure has not been amended since it was introduced. The summary of that version is repeated here.)

Medicare Prescription Drug Price Negotiation Act of 2007 - Amends title XVIII (Medicare) of the Social Security Act to require the Secretary of Health and Human Services to negotiate with pharmaceutical manufacturers the prices that may be charged to prescription drug plan sponsors and Medicare Advantage organizations for covered part D drugs for part D eligible individuals enrolled under a prescription drug plan or under a Medicare Advantage prescription drug (MA-PD) plan.

Amends part D (Voluntary Prescription Drug Benefit Program) of title XVIII (Medicare) of the Social Security Act to authorize the Secretary of Health and Human Services to negotiate with drug manufacturers and pharmacies prices charged to prescription drug plan (PDP) sponsors and Medicare Advantage organizations for covered part D drugs provided under Medicare.

Medicare Prescription Drug Enrollment Extension Act of 2007 - Amends title XVIII (Medicare) of the Social Security Act to extend the annual enrollment periods of the Medicare and Medicare Advantage prescription drug benefit programs.