PlainBillCongress, translated.Legislation. Context. Public interest.Congressional Research Service
Version 00 · Introduced in House · Jun 30, 1994
TABLE OF CONTENTS: Title I: Grants to Encourage Establishment of Community Rural Health Networks Title II: Incentives For Health Professionals to Practice in Rural Areas Subtitle A: National Health Service Corps Program Subtitle B: Incentives Under Other Programs Title III: Assistance for Institutional Providers Subtitle A: Emergency Medical Systems Subtitle B: Assistance to Rural Providers Under Medicare Subtitle D: Demonstration Projects to Encourage Primary Care and Rural-Based Graduate Medical Education Title IV: Hospital Antitrust Fairness Rural Health Care Improvement Act of 1994 - Title I: Grant to Encourage Establishment of Community Rural Health Networks - Directs the Secretary of Health and Human Services to make grants to an eligible State for the development of plans to increase access to health care services for residents of areas in the State designated as chronically underserved areas. Provides for technical assistance for entities establishing or enhancing a community rural health network in an underserved rural area. Provides financial assistance to entities to provide for the development and implementation of community rural health networks. Authorizes appropriations. Title II: Incentives for Health Professionals to Practice in Rural Areas - Subtitle A: National Health Service Corps Program - Amends the Internal Revenue Code to exclude National Health Service Corps Loan Repayments from gross income. (Sec. 202) Amends the Public Health Service Act to take into consideration, when designating an area as a health professional shortage area, the number of individuals in the area paying through Medicare or Medicaid, the number of individuals who are uninsured, and the number of physicians who will accept additional Medicare and Medicaid patients. (Sec. 203) Increases the authorization of appropriations for the National Health Service Corps Scholarship and Loan Repayment Programs. Subtitle B: Incentives Under Other Programs - Amends title XVIII (Medicare) of the Social Security Act and the Higher Education Act of 1965 to provide incentives under those Acts to physicians informer shortage areas and to primary care physicians, in addition to those provided in Subtitle A. Directs the Secretary to develop and publish a model law for adoption by States to increase the access of individuals residing in underserved rural areas to health care services by expanding the services which non-physician health care professionals may provide in such areas. Title III: Assistance for Institutional Providers - Subtitle A: Community and Migrant Health Centers - Extends and increases the authorizations of appropriations for migrant health centers and community health centers. Subtitle A: Emergency Medical Systems - Revises title XII (Trauma Care) of the Public Health Service Act. Renames such title Emergency Health Services. Directs the Secretary to establish the Office of Emergency Medical Services to: conduct and support research and demonstration projects; (2) foster development of appropriate modern systems of services; (3) assist States; and (4) coordinate and sponsor related activities. Requires that activities meet the unique needs of underserved innercity and rural areas. Authorizes grants to States in order to improve the availability and quality of emergency medical services through the operation of State offices of emergency medical services. Authorizes appropriations for emergency medical services and trauma care. (Sec. 312) Directs the Secretary to make grants to assist States in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments for injuries resulting from such emergencies. Authorizes appropriations. Subtitle B: Assistance to Rural Providers Under Medicare - Amends title XVIII (Medicare) of the Social Security Act to: (1) increase by two the number of States eligible to participate in the essential access community hospital program; and (2) make other revisions concerning such program, including permitting the participation of hospitals in urban areas and the participation of hospitals in States adjoining participating States. Extends, by three years, the deadline for the development of prospective payment systems for both inpatient and outpatient rural primary care hospital services. (Sec. 331) Defines a rural emergency access care hospital and rural emergency access care hospital services for purposes of title XVIII. Provides for the coverage of such services under part B (Supplementary Medical Insurance) of title XVIII. Subtitle D: Demonstration Projects to Encourage Primary Care and Rural-Based Graduate Medical Education - Directs the Secretary to establish and conduct a demonstration project to increase the number and percentage of medical students entering nonprimary care practice. Authorizes appropriations. Title IV: Hospital Antitrust Fairness - Exempts the merger or attempted merger of hospitals from the application of the antitrust laws; if specified conditions are met, including that: (1)a hospital be located outside of a city or in a city of less than 150,000; and (2) consumer costs would not increase and access would not be reduced if there was a merger.
People & committees
Rep. Bereuter, Doug [R-NE-1] · R–NE
Legislative record
A procedural vote is different from passage. Passage in one chamber does not establish enactment. Explore the glossary.
See H.R.3600.
Referred to the Subcommittee on Economic and Commercial Law.
Referred to the Subcommittee on Health and the Environment.
Referred to the Subcommittee on Postsecondary Education and Training.
Referred to the Subcommittee on Health.
Referred to the House Committee on Ways and Means.
Referred to the House Committee on Judiciary.
Referred to the House Committee on Energy and Commerce.
Referred to the House Committee on Education and Labor.
Introduced in House
Introduced in House
Primary sources
Text links open the official source. We currently store references to these documents.
No related bills are listed in this snapshot. This does not establish whether the proposal has appeared in earlier Congresses.
Source last updated: Jun 3, 2026. Consult Congress.gov for the current record.
AI Conversation Starters
Choose a perspective, copy a prompt, and paste it into your preferred AI. Each prompt includes the bill version and available official source links, and asks for counterarguments as well as supporting evidence.
Analyze H.R.4690 as objectively as possible. Explain its main provisions, who would be affected, possible benefits and harms, implementation, exceptions, and uncertainties. Present the strongest arguments for and against it, and identify evidence needed to assess its public impact.
Examine H.R.4690 through a progressive lens, focusing on fairness, access, economic inequality, and effects on vulnerable communities. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and distinguish stated goals from demonstrated outcomes.
Examine H.R.4690 through a conservative lens, focusing on fiscal responsibility, institutional stability, federalism, and the scope of government. Explain potential benefits, costs, and unintended consequences. Consider the strongest counterarguments and any provisions that challenge this perspective.
Examine H.R.4690 through a civil-liberties and limited-government lens. Consider individual rights, privacy, voluntary choice, accountability, and government power. Explain tradeoffs, possible safeguards, and the strongest counterarguments without assuming the proposal is beneficial or harmful.