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mittee, and monitor and review the quality of all
health services (including drugs, education, and pre-
ventive services).
(6) PREMIUMS.—Premiums or other charges by
a CHSO for any services not paid for under this Act
must be reasonable.
(7) UTILIZATION AND BONUS INFORMATION.—
Each CHSO must—
(A) comply with the requirements of sec-
tion 1876(i)(8) of the Social Security Act (re-
lating to prohibiting physician incentive plans
that provide specific inducements to reduce or
limit medically necessary services), and
(B) make available to its membership utili-
zation information and data regarding financial
performance, including bonus or incentive pay-
ment arrangements to practitioners.
(8) PROVISION OF SERVICES TO ENROLLEES AT
INSTITUTIONS
OPERATING
UNDER
GLOBAL
BUDG-
ETS.—The organization shall arrange to reimburse
for hospital services and other facility-based services
(as identified by the Board) for services provided to
members of the organization in accordance with the
global operating budget of the hospital or facility ap-
proved under section 611.
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(9) BROAD
MARKETING.—Each CHSO must
provide for the marketing of its services (including
dissemination of marketing materials) to potential
enrollees in a manner that is designed to enroll indi-
viduals representative of the different population
groups and geographic areas included within its
service area and meets such requirements as the
Board or a State health security program may
specify.
(10) 
ADDITIONAL
REQUIREMENTS.—Each
CHSO must meet—
(A) such requirements relating to mini-
mum enrollment,
(B) such requirements relating to financial
solvency,
(C) such requirements relating to quality
and availability of care, and
(D) such other requirements,
as the Board or a State health security program
may specify.
(d) PROVISION
OF
EMERGENCY
SERVICES
TO
NONENROLLEES.—A CHSO may furnish emergency serv-
ices to persons who are not enrolled in the organization.
Payment for such services, if they are covered services to
eligible persons, shall be made to the organization unless
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the organization requests that it be made to the individual
provider who furnished the services.
SEC. 304. LIMITATION ON CERTAIN PHYSICIAN REFERRALS.
(a) APPLICATION TO AMERICAN HEALTH SECURITY
PROGRAM.—Section 1877 of the Social Security Act, as
amended by subsections (b) and (c), shall apply under this
Act in the same manner as it applies under title XVIII
of the Social Security Act; except that in applying such
section under this Act any references in such section to
the Secretary or title XVIII of the Social Security Act are
deemed references to the Board and the American Health
Security Program under this Act, respectively.
(b) EXPANSION OF PROHIBITION TO CERTAIN DES-
IGNATED SERVICES.—Section 1877 of the Social Security
Act (42 U.S.C. 1395nn) is amended—
(1) by striking ‘‘clinical laboratory services’’
and ‘‘CLINICAL LABORATORY SERVICES’’ and insert-
ing ‘‘designated health services’’ and ‘‘DESIGNATED
HEALTH SERVICES’’, respectively, each place either
appears 
in 
subsections 
(a)(1), 
(b)(2)(A)(ii)(I),
(b)(4), (d)(1), (d)(2), and (d)(3);
(2) by adding at the end of such section the fol-
lowing new subsection:
‘‘(i) DESIGNATED HEALTH SERVICES DEFINED.—In
this section, the term ‘designated health services’ means—
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‘‘(1) clinical laboratory services;
‘‘(2) physical therapy services;
‘‘(3) radiology services, including magnetic reso-
nance imaging, computerized axial tomography
scans, and ultrasound services;
‘‘(4) radiation therapy services;
‘‘(5) the furnishing of durable medical equip-
ment;
‘‘(6) the furnishing of parenteral and enteral
nutrition equipment and supplies;
‘‘(7) the furnishing of outpatient prescription
drugs;
‘‘(8) ambulance services;
‘‘(9) home infusion therapy services;
‘‘(10) occupational therapy services; and
‘‘(11) inpatient and outpatient hospital services
(including services furnished at a psychiatric or re-
habilitation hospital).’’;
(3) in subsection (d)(2), by striking ‘‘labora-
tory’’ and by inserting ‘‘entity’’;
(4) in subsection (g)(1), by striking ‘‘clinical
laboratory service’’ and by inserting ‘‘designated
health service’’; and
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(5) in subsection (h)(7)(B), by striking ‘‘clinical
laboratory service’’ and by inserting ‘‘designated
health service’’.
(c) CONFORMING AMENDMENTS.—Such section is
further amended—
(1) in subsection (a)(1)(A), by striking ‘‘for
which payment otherwise may be made under this
title’’ and by inserting ‘‘for which a charge is
imposed’’;
(2) in subsection (a)(1)(B), by striking ‘‘under
this title’’;
(3) by amending paragraph (1) of subsection
(g) to read as follows:
‘‘(1) DENIAL OF PAYMENT.—No payment may
be made under a State health security program for
a designated health service for which a claim is pre-
sented in violation of subsection (a)(1)(B). No indi-
vidual, third party payor, or other entity is liable for
payment for designated health services for which a
claim is presented in violation of such subsection.’’;
and
(4) In subsection (g)(3), by striking ‘‘for which
payment may not be made under paragraph (1)’’
and by inserting ‘‘for which such a claim may not
be presented under subsection (a)(1)’’.
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TITLE IV—ADMINISTRATION
Subtitle A—General Administrative
Provisions
SEC. 
401. 
AMERICAN 
HEALTH 
SECURITY 
STANDARDS
BOARD.
(a) ESTABLISHMENT.—There is hereby established
an American Health Security Standards Board.
(b) APPOINTMENT AND TERMS OF MEMBERS.—
(1) IN
GENERAL.—The Board shall be com-
posed of—
(A) the Secretary of Health and Human
Services, and
(B) 6 other individuals (described in para-
graph (2)) appointed by the President with the
advice and consent of the Senate.
The President shall first nominate individuals under
subparagraph (B) on a timely basis so as to provide
for the operation of the Board by not later than
January 1, 1994.
(2) SELECTION
OF
APPOINTED
MEMBERS.—
With respect to the individuals appointed under
paragraph (1)(B):
(A) They shall be chosen on the basis of
backgrounds in health policy, health economics,
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SEC. 403. PROFESSIONAL, TECHNICAL, AND TEMPORARY
ADVISORY COMMITTEES.
(a) IN GENERAL.—The Board shall appoint the
standing advisory committees specified in subsections (b)
through (f), and such other standing professional and
technical committees in order to advise it in carrying out
its duties under this Act.
(b) ADVISORY COMMITTEE ON BENEFITS.—
(1) IN GENERAL.—The Board shall appoint a
standing Advisory Committee on Benefits to advise
it with respect to the several classes of covered
services under this Act.
(2) MEMBERSHIP.—The membership of the
committee shall include individuals (in such number
as the Board may determine) drawn from the health
professions, from consumers of health services, from
providers of health services (including non-medical
licensed and non-licensed providers), or from other
sources, whom the Board deems best qualified to ad-
vise it with respect to the professional and technical
aspects of the furnishing and utilization of, and the
evaluation of, a class of covered services designated
by the Board, and with respect to the relationship
of that class of services to other covered services. In
appointing such individuals, the Board shall assure