Health Maintenance Organization Act of 1973

Health Maintenance Organization Act of 1973

Long title	An Act to amend the Public Health Service Act to provide assistance and encouragement for the establishment and expansion of health maintenance organizations, and for other purposes.
Nicknames	Commission on Quality Health Care Act
Enacted by	the 93rd United States Congress
Effective	December 29, 1973
Citations
Public law	93-222
Statutes at Large	87 Stat. 914
Codification
Acts amended	Public Health Service Act of 1944
Titles amended	42 U.S.C.: Public Health and Social Welfare
U.S.C. sections created	42 U.S.C. ch. 6A § 300e et seq.
Legislative history
Introduced in the Senate as S. 14 by Edward M. Kennedy (D-MA) on January 4, 1973 Committee consideration by Senate Labor and Public Welfare, House Interstate and Foreign Commerce Passed the Senate on May 15, 1973 (69-25) Passed the House on September 12, 1973 (369-40, in lieu of H.R. 7974) Reported by the joint conference committee on December 12, 1973; agreed to by the House on December 18, 1973 (agreed) and by the Senate on December 19, 1973 (83-1) Signed into law by President Richard M. Nixon on December 29, 1973
Major amendments
Health Maintenance Organization Amendments of 1976, P.L. 94-460, 90 Stat. 1945 Health Maintenance Organization Amendments of 1978, P.L. 95-559, 92 Stat. 2131 Omnibus Budget Reconciliation Act of 1981, P.L. 97-35, 95 Stat. 357 Health Maintenance Organization Amendments of 1988, P.L. 100-517, 102 Stat. 2578 Health Insurance Portability and Accountability Act (HIPAA), P.L. 104-191, 110 Stat. 1936

The Health Maintenance Organization Act of 1973 (Pub. L. 93-222 codified as 42 U.S.C. §300e) is a United States statute enacted on December 29, 1973. The Health Maintenance Organization Act, informally known as the federal HMO Act, is a federal law that provides for a trial federal program to promote and encourage the development of HMOs. The federal HMO Act amended the Public Health Service Act, which Congress passed in 1944. The principal sponsor of the federal HMO Act was Sen. Edward M. Kennedy (MA).

President Richard Nixon signed bill S.14 into law on December 29, 1973.

It included a mandated Dual Choice under Section 1310 of the Act.

Health Maintenance Organization (HMO) is a term first conceived of by Dr. Paul M. Ellwood, Jr. The concept for the HMO Act began with discussions Ellwood and his Interstudy group members had with Nixon administration advisors who were looking for a way to curb medical inflation. Ellwood's work led to the eventual HMO Act of 1973.

It provided grants and loans to provide, start, or expand a Health Maintenance Organization (HMO); removed certain state restrictions for federally qualified HMOs; and required employers with 25 or more employees to offer federally certified HMO options IF they offered traditional health insurance to employees. It did not require employers to offer health insurance. The Act solidified the term HMO and gave HMOs greater access to the employer-based market. The Dual Choice provision expired in 1995.

To become a certified as a federal qualified HMO, the HMO must meet the following requirements:

A Health Maintenance Organization (HMO) is a managed care plan that incorporates financing and delivery of an inclusive set of health care services to individuals enrolled in a network.

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