(C) reimbursement levels for providers con-
sistent with subtitle B; and 
(D) a health professional education budget, 
including amounts for the continued funding of 
resident physician training programs. 
(2) REGIONAL
ALLOCATION.—After Congress 
appropriates amounts for the annual budget for the 
Medicare For All Program, the Director shall pro-
vide the regional offices with an annual funding al-
lotment to cover the costs of each region’s expendi-
tures. Such allotment shall cover global budgets, re-
imbursements to clinicians, health professional edu-
cation, and capital expenditures. Regional offices 
may receive additional funds from the national pro-
gram at the discretion of the Director. 
(b) OPERATING BUDGET.—The operating budget 
shall be used for— 
(1) payment for services rendered by physicians 
and other clinicians; 
(2) global budgets for institutional providers; 
(3) capitation payments for capitated groups; 
and 
(4) administration of the Program. 
(c) CAPITAL EXPENDITURES BUDGET.—The capital 
expenditures budget shall be used for funds needed for— 
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(1) the construction or renovation of health fa-
cilities; and 
(2) for major equipment purchases. 
(d) PROHIBITION AGAINST CO-MINGLING OPER-
ATIONS AND CAPITAL IMPROVEMENT FUNDS.—It is pro-
hibited to use funds under this Act that are earmarked— 
(1) for operations for capital expenditures; or 
(2) for capital expenditures for operations. 
SEC. 202. PAYMENT OF PROVIDERS AND HEALTH CARE CLI-
NICIANS. 
(a) ESTABLISHING GLOBAL BUDGETS; MONTHLY 
LUMP SUM.— 
(1) IN GENERAL.—The Medicare For All Pro-
gram, through its regional offices, shall pay each in-
stitutional provider of care, including hospitals, 
nursing homes, community or migrant health cen-
ters, home care agencies, or other institutional pro-
viders or pre-paid group practices, a monthly lump 
sum to cover all operating expenses under a global 
budget. 
(2) ESTABLISHMENT OF GLOBAL BUDGETS.— 
The global budget of a provider shall be set through 
negotiations between providers, State directors, and 
regional directors, but are subject to the approval of 
the Director. The budget shall be negotiated annu-
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ally, based on past expenditures, projected changes 
in levels of services, wages and input, costs, a pro-
vider’s maximum capacity to provide care, and pro-
posed new and innovative programs. 
(b) THREE PAYMENT OPTIONS FOR PHYSICIANS AND 
CERTAIN OTHER HEALTH PROFESSIONALS.— 
(1) IN GENERAL.—The Program shall pay phy-
sicians, dentists, doctors of osteopathy, pharmacists, 
psychologists, chiropractors, doctors of optometry, 
nurse practitioners, nurse midwives, physicians’ as-
sistants, and other advanced practice clinicians as li-
censed and regulated by the States by the following 
payment methods: 
(A) Fee for service payment under para-
graph (2). 
(B) Salaried positions in institutions re-
ceiving global budgets under paragraph (3). 
(C) Salaried positions within group prac-
tices or non-profit health maintenance organiza-
tions receiving capitation payments under para-
graph (4). 
(2) FEE FOR SERVICE.— 
(A) IN GENERAL.—The Program shall ne-
gotiate a simplified fee schedule that is fair and 
optimal with representatives of physicians and 
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other clinicians, after close consultation with 
the National Board of Universal Quality and 
Access and regional and State directors. Ini-
tially, the current prevailing fees or reimburse-
ment would be the basis for the fee negotiation 
for all professional services covered under this 
Act. 
(B) 
CONSIDERATIONS.—In 
establishing 
such schedule, the Director shall take into con-
sideration the following: 
(i) The need for a uniform national 
standard. 
(ii) The goal of ensuring that physi-
cians, clinicians, pharmacists, and other 
medical professionals be compensated at a 
rate which reflects their expertise and the 
value of their services, regardless of geo-
graphic region and past fee schedules. 
(C) STATE PHYSICIAN PRACTICE REVIEW 
BOARDS.—The State director for each State, in 
consultation with representatives of the physi-
cian community of that State, shall establish 
and appoint a physician practice review board 
to assure quality, cost effectiveness, and fair re-
imbursements for physician delivered services. 
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(D) FINAL
GUIDELINES.—The Director 
shall be responsible for promulgating final 
guidelines to all providers. 
(E) BILLING.—Under this Act physicians 
shall submit bills to the regional director on a 
simple form, or via computer. Interest shall be 
paid to providers who are not reimbursed within 
30 days of submission. 
(F) 
NO
BALANCE
BILLING.—Licensed 
health care clinicians who accept any payment 
from the Medicare For All Program may not 
bill any patient for any covered service. 
(G) UNIFORM
COMPUTER
ELECTRONIC 
BILLING SYSTEM.—The Director shall create a 
uniform computerized electronic billing system, 
including those areas of the United States 
where electronic billing is not yet established. 
(3) SALARIES WITHIN INSTITUTIONS RECEIVING 
GLOBAL BUDGETS.— 
(A) IN GENERAL.—In the case of an insti-
tution, such as a hospital, health center, group 
practice, community and migrant health center, 
or a home care agency that elects to be paid a 
monthly global budget for the delivery of health 
care as well as for education and prevention 
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