(2) SYSTEM SAVINGS AS A SOURCE OF FINANC-
ING.—Funding otherwise required for the Program 
is reduced as a result of— 
(A) vastly reducing paperwork; 
(B) requiring a rational bulk procurement 
of medications under section 205(a); and 
(C) improved access to preventive health 
care. 
(3) ADDITIONAL ANNUAL APPROPRIATIONS TO 
MEDICARE FOR ALL PROGRAM.—Additional sums are 
authorized to be appropriated annually as needed to 
maintain maximum quality, efficiency, and access 
under the Program. 
SEC. 212. APPROPRIATIONS FOR EXISTING PROGRAMS. 
Notwithstanding any other provision of law, there are 
hereby transferred and appropriated to carry out this Act, 
amounts from the Treasury equivalent to the amounts the 
Secretary estimates would have been appropriated and ex-
pended for Federal public health care programs, including 
funds that would have been appropriated under the Medi-
care program under title XVIII of the Social Security Act, 
under the Medicaid program under title XIX of such Act, 
and under the Children’s Health Insurance Program 
under title XXI of such Act. 
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TITLE III—ADMINISTRATION 
SEC. 301. PUBLIC ADMINISTRATION; APPOINTMENT OF DI-
RECTOR. 
(a) IN GENERAL.—Except as otherwise specifically 
provided, this Act shall be administered by the Secretary 
through a Director appointed by the Secretary. 
(b) LONG-TERM CARE.—The Director shall appoint 
a director for long-term care who shall be responsible for 
administration of this Act and ensuring the availability 
and accessibility of high quality long-term care services. 
(c) MENTAL HEALTH.—The Director shall appoint a 
director for mental health who shall be responsible for ad-
ministration of this Act and ensuring the availability and 
accessibility of high quality mental health services. 
SEC. 302. OFFICE OF QUALITY CONTROL. 
The Director shall appoint a director for an Office 
of Quality Control. Such director shall, after consultation 
with state and regional directors, provide annual rec-
ommendations to Congress, the President, the Secretary, 
and other Program officials on how to ensure the highest 
quality health care service delivery. The director of the Of-
fice of Quality Control shall conduct an annual review on 
the adequacy of medically necessary services, and shall 
make recommendations of any proposed changes to the 
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Congress, the President, the Secretary, and other Medi-
care For All Program officials. 
SEC. 303. REGIONAL AND STATE ADMINISTRATION; EM-
PLOYMENT OF DISPLACED CLERICAL WORK-
ERS. 
(a) ESTABLISHMENT OF MEDICARE FOR ALL PRO-
GRAM REGIONAL OFFICES.—The Secretary shall establish 
and maintain Medicare For All regional offices for the 
purpose of distributing funds to providers of care. When-
ever possible, the Secretary should incorporate pre-exist-
ing Medicare infrastructure for this purpose. 
(b) APPOINTMENT OF REGIONAL AND STATE DIREC-
TORS.—In each such regional office there shall be— 
(1) one regional director appointed by the Di-
rector; and 
(2) for each State in the region, a deputy direc-
tor (in this Act referred to as a ‘‘State Director’’) 
appointed by the governor of that State. 
(c) REGIONAL OFFICE DUTIES.—Regional offices of 
the Program shall be responsible for— 
(1) coordinating funding to health care pro-
viders and physicians; and 
(2) coordinating billing and reimbursements 
with physicians and health care providers through a 
State-based reimbursement system. 
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(d) STATE DIRECTOR’S DUTIES.—Each State Direc-
tor shall be responsible for the following duties: 
(1) Providing an annual state health care needs 
assessment report to the National Board of Uni-
versal Quality and Access, and the regional board, 
after a thorough examination of health needs, in 
consultation with public health officials, clinicians, 
patients, and patient advocates. 
(2) Health planning, including oversight of the 
placement of new hospitals, clinics, and other health 
care delivery facilities. 
(3) Health planning, including oversight of the 
purchase and placement of new health equipment to 
ensure timely access to care and to avoid duplica-
tion. 
(4) Submitting global budgets to the regional 
director. 
(5) Recommending changes in provider reim-
bursement or payment for delivery of health services 
in the State. 
(6) Establishing a quality assurance mechanism 
in the State in order to minimize both under utiliza-
tion and over utilization and to assure that all pro-
viders meet high quality standards. 
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(7) Reviewing program disbursements on a 
quarterly basis and recommending needed adjust-
ments in fee schedules needed to achieve budgetary 
targets and assure adequate access to needed care. 
(e) FIRST
PRIORITY
IN
RETRAINING
AND
JOB 
PLACEMENT; 2 YEARS OF SALARY PARITY BENEFITS.— 
The Program shall provide that clerical, administrative, 
and billing personnel in insurance companies, doctors of-
fices, hospitals, nursing facilities, and other facilities 
whose jobs are eliminated due to reduced administration— 
(1) should have first priority in retraining and 
job placement in the new system; and 
(2) shall be eligible to receive two years of 
Medicare For All employment transition benefits 
with each year’s benefit equal to salary earned dur-
ing the last 12 months of employment, but shall not 
exceed $100,000 per year. 
(f) ESTABLISHMENT OF MEDICARE FOR ALL EM-
PLOYMENT TRANSITION FUND.—The Secretary shall es-
tablish a trust fund from which expenditures shall be 
made to recipients of the benefits allocated in subsection 
(e). 
(g) ANNUAL APPROPRIATIONS TO MEDICARE FOR 
ALL EMPLOYMENT TRANSITION FUND.—Sums are au-
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