The world's political record
Person
![Official portrait of Del. de Lugo, Ron [D-VI-At Large]](https://www.congress.gov/img/member/d000209_200.jpg)
United States · Official source
3,606 records where Del. de Lugo, Ron [D-VI-At Large] is listed as a sponsor, author, or other actor. Search with topics and years
United States · United States Congress · 13 April 1994
Designates the United States post office located in the Tutu Park Mall in Saint Thomas, Virgin Islands, as the Earle B. Ottley United States Post Office.
United States · United States Congress · 13 April 1994
Elderly Housing Tax Relief Act - Amends the Internal Revenue Code to provide a tax credit for an individual who maintains a household which includes a qualified elderly relative.
United States · United States Congress · 13 April 1994
Designates November 1994 as National American Lacemaker Month.
United States · United States Congress · 12 April 1994
Requests the President to designate the month beginning on April 1, 1994, as National Savings Month.
United States · United States Congress · 24 March 1994
Designates July 23 as General Bernardo de Galvez Day.
United States · United States Congress · 24 March 1994
A Child is Waiting Resolution - Expresses the sense of the Congress that: (1) any health care reform legislation include guaranteed full funding for the special supplemental food program for women, infants, and children (WIC); and (2) specified amounts should be made available to move toward such full funding goal.
United States · United States Congress · 23 March 1994
Governors Island Reinforcement Act of 1994 - Sets forth trade, assistance, and air transport sanctions against Haiti, and against other nations not cooperating with U.S. or international sanctions. Terminates such sanctions upon the reinstatement of the democratically elected President of Haiti and the military's meeting its obligation under the Governors Island Agreement. States congressional support for: (1) the return of human rights observers to Haiti; (2) the creation of a multinational border patrol between Haiti and the Dominican Republic; and (3) socioeconomic and peacekeeping assistance to Haiti. Directs the President to terminate the bilateral migrant interdiction agreement with Haiti. Provides for the nonrefoulement of Haitians by the United States. Grants temporary protected status under the Immigration and Nationality Act to qualifying Haitians. Excludes from U.S. admission, and blocks U.S. assets of, certain Haitians connected with the military or related activities.
United States · United States Congress · 18 March 1994
Designates April 24 through 30, 1994, as National Crime Victims' Rights Week.
United States · United States Congress · 17 March 1994
Amends the Federal criminal code to provide for criminal and civil forfeiture for mail and wire fraud. Makes specified procedures relating to forfeitures under the Controlled Substances Act applicable to forfeitures under this Act. Requires the court to order the forfeiture of any other property of the defendant up to the value of the property subject to forfeiture under this Act if, as a result of conduct of the defendant, the forfeited property cannot be located upon the exercise of due diligence or has been transferred or sold to, or deposited with, a third party, placed beyond the court's jurisdiction, substantially diminished in value, or commingled with other property which cannot be divided without difficulty. Directs that any such forfeited property be seized by the Attorney General or U.S. Postal Service upon process issued pursuant to the Supplemental Rules for Certain Admiralty and Maritime Claims by a U.S. district court having jurisdiction over the property, with exceptions for innocent owners or lienholders. Authorizes the Attorney General or Postal Service to seize such property without such process under specified circumstances. Directs the: (1) Attorney General, after providing for the rights of any innocent persons and deducting costs incurred by the United States in conducting the seizure, forfeiture, and identification of victims, to deposit the property forfeited or the proceeds from its sale in the Department of Justice Assets Forfeiture Fund; and (2) the Postal Service to deposit property forfeited or the proceeds into the Postal Service Fund. Sets forth provisions regarding: (1) restraint or staying of the sale or disposition of property pending appeal; and (2) rules for the disposition of such property and proceeds. Requires the deposit into the Postal Service Fund of amounts from any forfeiture conducted by the Postal Service and from any forfeiture resulting from an investigation conducted by the Postal Service. Allows the Postal Service to share such amounts with any Federal or State agency whose efforts in investigating or litigating the forfeiture contributed to the receipt of such funds.
United States · United States Congress · 17 March 1994
Authorizes the Postmaster General, whenever there is reason to believe that any person may be in possession, custody, or control of any documentary material or may have information relevant to an investigation of a matter arising under Federal postal law, to issue in writing and cause to be served upon such person before the commencement of a civil or criminal proceeding thereon, a civil investigative demand requiring such person to: (1) produce such documentary material for inspection and copying or reproduction; (2) answer in writing written interrogatories; (3) give oral testimony concerning such material or information; or (4) furnish any combination of such material, answers, or testimony. Requires the Postmaster General to designate an agent to serve as custodian of documentary material, answers to interrogatories, and transcripts of oral testimony received, and such other necessary additional agents to serve as deputies to the custodian. Authorizes the custodian to deliver to the Federal Trade Commission, upon written request, copies of such material, answers, or transcripts for use in connection with an investigation or proceeding under the Commission's jurisdiction to be used only in such manner and subject to such conditions as apply to the Postal Service. Authorizes the Postal Service to file in the district court of the United States for any judicial district in which a person resides, is found, or transacts business and serve upon such person a petition for an order of such court for the enforcement of this Act if the person fails to comply with the civil investigative demand or whenever satisfactory copying or reproduction of any material cannot be done and the person refuses to surrender such material. Exempts any documentary material, answers to written interrogatories, or transcripts of oral testimony provided pursuant to any demand issued under this Act from disclosure under the Freedom of Information Act. Amends the Federal criminal code to impose a fine and up to five years' imprisonment upon anyone who intentionally obstructs any civil investigative demand made under the Antitrust Civil Process Act or provisions of this Act. Revises prescribed civil penalties imposed for violation of specified postal law relating to false representations and lotteries. Requires such penalties to be paid into the Postal Service Fund (currently, the Treasury). Revises provisions in the Federal criminal code relating to injunctions against fraud to allow the Attorney General to obtain temporary and preliminary injunctive relief upon a showing of probable cause to believe that a violation is occurring or is about to occur. Grants permanent relief when a violation is established by a preponderance of the evidence. Deems a violation to be occurring or about to occur for as long as victims of any such violation have not been redressed and the statute of limitations for such violation has not expired.
United States · United States Congress · 17 March 1994
Amends the Federal Home Loan Bank Act to direct the Federal Housing Finance Board to appoint additional elective directors for Guam and the Virgin Islands to represent bank members located in those Islands until directors representing their interests are elected.
United States · United States Congress · 17 March 1994
Amends the Federal criminal code to extend the mail fraud statute to include mail sent by private or commercial interstate carriers.
United States · United States Congress · 15 March 1994
Urban Recreation and At-Risk Youth Act of 1994 - Amends the Urban Park and Recreation Recovery Act of 1978 to authorize the Secretary of the Interior to provide, through the urban park and recreation recovery program, at-risk youth recreation grants in neighborhoods and communities with a high prevalence of crime, particularly violent crime or crime committed by youth, for purposes including the provision of lighting, emergency phones, or other capital improvements for the security of urban parks. Directs the Secretary to give grant priority to local government programs meeting specified criteria, including: (1) targeting youth at the greatest risk of becoming involved in violence and crime; (2) teaching important values and life skills; (3) offering education and counseling in addition to recreation opportunities; and (4) showing the greatest potential of being continued with non-Federal funds or serving as models. Requires local governments, to be eligible for such grants, to include strategies to reduce crime and juvenile delinquency in their five-year action programs for park and recreation recovery. Requires no more than 25 percent of Federal grant funds made available under such Act to be used for program support. Repeals provisions limiting the duration of the urban park and recreation recovery program to five years.
United States · United States Congress · 10 March 1994
Designates May 11, 1994, as Vietnam Human Rights Day in support of efforts by the Non-Violent Movement for Human Rights in Vietnam.
United States · United States Congress · 10 March 1994
Designates May 29 through June 4, 1994, as Pediatric and Adolescent AIDS Awareness Week.
United States · United States Congress · 10 March 1994
Designates the month of April 1994 as Alcohol Awareness Month.
United States · United States Congress · 9 March 1994
Designates July 27 of each year as National Korean War Veterans Armistice Day.
United States · United States Congress · 3 March 1994
TABLE OF CONTENTS: Title I: Establishment of a State-Based American Health Security Program; Universal Entitlement; Enrollment Title II: Comprehensive Benefits, Including Preventive Benefits and Benefits for Long Term Care Title III: Provider Participation Title IV: Administration Subtitle A: General Administrative Provisions Subtitle B: Control Over Fraud and Abuse Title V: Quality Assessment Title VI: National Health Security Budget; Payments; Cost Containment Measures Subtitle A: Budgeting and Payments to States Subtitle B: Payments by States to Providers Subtitle C: Mandatory Assignment and Administrative Provisions Title VII: Promotion of Primary Health Care; Development of Health Service Capacity; Programs to Assist the Medically Underserved Subtitle A: Promotion and Expansion of Primary Care Professional Training Subtitle B: Direct Health Care Delivery Subtitle C: Primary Care and Outcomes Research Subtitle D: School-Related Health Services Title VIII: Financing Provisions; American Health Security Trust Fund Subtitle A: American Health Security Trust Fund Subtitle B: Taxes Based on Income and Wages Subtitle C: Increase in Excise Taxes on Tobacco Products Subtitle D: Increase in Taxes on Firearms and Ammunition Title IX: Conforming Amendments to the Employee Retirement Income Security Act of 1974 American Health Security Act of 1994 - Title I: Establishment of a State-Based American Health Security Program; Universal Entitlement; Enrollment - Establishes in the United States an American Health Security Program (AHSP) to be administered by the States (including the District of Columbia and, if they so choose, U.S. territories) in accordance with Federal standards established under this Act. Requires a State to establish a State health security program (program) in accordance with this Act to receive Federal health care funding. (Sec. 102) Entitles every individual who is a resident of the United States and is a U.S. citizen or national or a lawful resident alien to benefits for health care services under this Act under the appropriate State program. Sets forth provisions regarding the treatment of nonimmigrants and other individuals. (Sec. 103) Requires each State program to: (1) provide a mechanism for the enrollment of individuals entitled or eligible for benefits (which includes a process for the automatic enrollment of individuals at the time of birth, immigration, or other acquisition of lawful resident status in the United States and provides for the enrollment of all individuals who are eligible to be enrolled as of January 1, 1995); and (2) issue a health security card to enrolled individuals. (Sec. 104) Makes benefits portable when enrollees move or travel between States. Prohibits imposition of a minimum residence or waiting period in excess of three months for program benefit eligibility. Allows reciprocal arrangements between programs in adjacent States for coverage for enrollees residing in the border region. (Sec. 105) Makes benefits available under this Act for items and services furnished on or after January 1, 1996. (Sec. 106) Supersedes Medicare, Medicaid, the Federal Employee Health Benefits Program, and CHAMPUS, which must pay for completion of services they covered before January 1, 1996. Specifies that nothing in this Act affects the eligibility of veterans for Veterans Administration health benefits and services, or of Indians for benefits and services of the Indian Health Service. Title II: Comprehensive Benefits, Including Preventive Benefits and Benefits for Long Term Care - Entitles all eligible individuals to have payment made (if medically necessary and appropriate for the maintenance of health or for the diagnosis, treatment, or rehabilitation of a health condition) for inpatient and outpatient hospital services, professional services of State-authorized practitioners, community-based primary health services, preventive services, long-term and chronic care services, prescription drugs, biologicals, insulin, and medical foods, dental services, mental health services, substance abuse treatment services, diagnostic tests, and other specified items and services, including outpatient therapy, durable medical equipment, home dialysis, ambulance, prosthetic devices, and other items and services specified by the American Health Security Standards Board (Board) (established by title IV of this Act). Specifies that: (1) no deductibles, coinsurance, or copayments may be charged for acute care benefits; (2) no provider may charge a patient for covered services; (3) no private insurance may duplicate program benefits; and (4) States and employers may provide additional benefits at their own expense. (Sec. 203) Covers home and community-based long-term care services for persons unable to perform at least two of five listed activities of daily living without assistance. Limits the cost of such services to 65 percent (or an alternative percentage determined by the Board) of the cost of nursing home care for an individual in the same area in which the services were provided. (Sec. 204) Makes mental health, substance abuse, nursing facility, and home health services subject to utilization review. Directs the Board to make national determinations on coverage of experimental services, with professional and public input. Specifies that where the Board has recognized practice guidelines, coverage is limited to services provided according to the guidelines or any established exception process. Allows the Board to limit quantities of eyeglasses, contact lenses, hearing aids, and durable medical equipment that will be covered. Excludes from coverage cosmetic procedures, personal comfort items, and services furnished in non-participating facilities. (Sec. 205) Specifies that: (1) States may require providers to certify that covered services were provided according to program requirements; (2) quality review programs must meet Federal standards; and (3) States may require plans of care for coverage of certain services. Title III: Provider Participation - Requires providers, to receive payment, to agree: (1) not to discriminate based on race, national origin, income, religion, age, sex or sexual orientation, disability, handicapping condition, or (subject to the professional qualifications of the provider) illness; (2) not to charge patients for covered services; (3) to furnish necessary information to the Board or program; (4) not to employ other providers whose participation has been terminated for cause; and (5) to submit bills within a specified time frame. (Sec. 302) Considers a health care provider to be qualified if it is licensed or certified and meets State law requirements, applicable Federal requirements, and additional standards that the Board may specify. Requires: (1) the Board to establish, evaluate, and update national minimum standards to assure the quality of services provided and to monitor efforts by programs to assure such quality; (2) a reasonable transition period for any new standards; and (3) the Board to provide for an exchange of information among programs with respect to quality assurance and cost containment. (Sec. 303) Defines a "comprehensive health service organization" (CHSO) as a public or private organization which, in return for a capitated payment amount, furnishes or arranges a full range of health services and out-of-area coverage in the case of urgently needed services to an identified population in a specified service area which enrolls voluntarily in the organization. Sets forth various CHSO requirements regarding enrollment, withdrawal for cause, accessibility of services, continuity of care, consumer and provider representation on the board of directors, a patient grievance program, medical standards committees, premiums, utilization and bonus information, provision of services to enrollees at institutions operating under global budgets, marketing of services, and provision of emergency services to nonenrollees. (Sec. 304) Extends current Medicare prohibitions on physician self-referrals for clinical laboratory services to other services and applies such prohibitions to AHSP. Title IV: Administration - Subtitle A: General Administrative Provisions - Establishes the American Health Security Standards Board to develop policies and procedures for enrollment, benefits, provider participation, national and State funding levels, assisting programs with planning for capital expenditures and service delivery, and other functions and to establish uniform reporting standards for health services and programs. Authorizes the Board to make statistical and other studies, test alternative payment methods, and develop and test information and budget systems. Provides for the appointment of an Executive Director of the Board and an Inspector General. (Sec. 402) Directs the Board to provide for an American Health Security Advisory Council to advise the Board on matters of general policy, in the formulation of regulations, and in the performance of the Board's duties and to study the operation of, and utilization of health services under, this Act. (Sec. 403) Directs the Board to appoint advisory committees on benefits, cost containment, primary care and the medically underserved, mental health and substance abuse treatment, and prescription drugs. Authorizes the Board to appoint other temporary advisory committees. (Sec. 404) Establishes an American Health Security Quality Council which shall be responsible for quality review activities (under title V). Directs the Quality Council to report to the Board annually on activities and findings from outcomes research and development of practice guidelines that may affect the Board's determination of coverage of services. (Sec. 405) Requires: (1) each State to submit to the Board a plan for a program for providing health care services to residents of the State (but allows neighboring States to join in regional plans); (2) the Board to provide incentives for States to develop regional planning mechanisms to promote the rational distribution of, adequate access to, and efficient use of, tertiary care facilities, equipment, and services; (3) State programs to meet Federal standards, including single-agency administration, a State health security budget, provider payment and quality review methodologies consistent with Federal standards, freedom to choose providers, a consumer ombudsman, an annual report, and a fraud and abuse prevention and control unit; and (4) the Governor of each State to provide for appointment of a State Health Security Advisory Council to advise and make recommendations to the Governor and State regarding program implementation. Allows: (1) programs not meeting Federal requirements, after notice, to be placed in receivership under the Board's jurisdiction; and (2) States to use fiscal agents, after competitive bidding, to process claims. (Sec. 406) Requires the Secretary of Health and Human Services (Secretary) to direct all activities of the Department of Health and Human Services toward contributions to health of the people in a manner complementary to this Act. Subtitle B: Control Over Fraud and Abuse - Authorizes the Board to exclude providers from participation, impose civil monetary penalties, and seek criminal prosecution for fraud or abuse, based on current Medicaid standards. Requires providers to disclose relevant information about their ownership interest in health facilities and services, based on current Medicaid standards. (Sec. 412) Requires the Board: (1) through the Inspector General, to establish a national health care fraud and abuse data base, including the identity of any provider who has been convicted, had a license revoked, has been excluded or suspended from participation, or has been subjected to a civil penalty with respect to a State program, Medicare, Medicaid, or any other federally funded health program; and (2) to establish rules to protect the confidentiality of information in the data base. Requires States to provide relevant information for this purpose and to periodically inquire of the data base to determine provider qualifications to participate in programs. Sets penalties for submitting false information. (Sec. 413) Requires each program to establish and maintain a health care fraud and abuse unit. (Sec. 414) Directs the Board to provide for the assignment of a unique identifier to each participating provider and to each individual eligible for services, which shall be used for claims and payment. Title V: Quality Assessment - Directs the Quality Council to: (1) collect data from outcomes research on an ongoing basis and develop practice guidelines on the basis of such data and existing clinical knowledge; (2) adopt methodologies for profiling the patterns of practice of health care professionals and for identifying outliers (i.e., health care providers whose patterns of practice suggest quality deficiencies); (3) develop standards for the development of centers of excellence for designated procedures and for education of and sanctions for outliers; and (4) disseminate all quality guidelines and standards to the States for implementation. (Sec. 502) Requires each participating State to establish an entity to conduct quality reviews of persons providing covered services under its program which meet Federal standards for the adoption of practice guidelines, identification of outliers, development of remedial programs and monitoring for outliers, and the application of sanctions. Allows the State to adopt alternative methodologies to those adopted by the Quality Council provided that the State can demonstrate that the efficacy of such review and education programs meets Federal standards. Mandates that the quality review entity be administratively independent of the individual or board that administers the program and not provide any financial incentive to reviewers to favor one pattern of practice over another. (Sec. 503) Expresses the intent to replace random utilization controls with a systematic review of patterns of practice that compromise the quality of care by January 1, 1998. Supersedes all existing Federal utilization review programs, including random case-by-case reviews and programs requiring pre-certification of medical procedures on a case-by-case basis, with exceptions. Specifies that nothing in this section shall preclude case management of catastrophic, mental health, or substance abuse cases where necessary to achieve appropriate, cost-effective, and beneficial comprehensive medical care. (Sec. 504) Requires: (1) each State program to develop and use a uniform electronic data base which uses software designated by the Board and which assures confidentiality for all patient records to enable systematic quality review and outcomes analysis; and (2) the Board to designate such software and establish standards designed to protect the privacy of patients. Limits access by government agencies to patient records. Title VI: Health Security Budget; Payments; Cost Containment Measures - Subtitle A: Budgeting and Payments to States - Directs the Board to establish a national health security budget which specifies the total expenditures to be made by the Federal Government and the States for covered health care services, and allocates those expenditures among the States. Prohibits such budget from exceeding the budget for the preceding year increased by the percentage increase in gross domestic product. Divides the budget into quality assessment, professional education, administrative, and operating components. (Sec. 602) Provides for the allocation of funds in the budget by the Board to the States, based on the national average per capita costs of covered services adjusted for differences among the States in costs and the health status of populations. Permits the use of statistical models to estimate State capitation amounts. Sets forth State adjustment factors to reflect differences in relative needs for funds and directs that such factors be applied in a budget-neutral manner resulting in no change in total Federal expenditures from the national per capita average. (Sec. 603) Requires each program to submit to the Board a proposed and final annual budget broken into quality assessment, professional training, administrative, and operating components, with the operating component broken into facility-based services, individual practitioner payments, payments to CHSOs, and payments for other items and services. Sets forth provisions regarding proposed and final budget deadlines, adjustments in allocations, and expenditure limits. Permits programs to provide for a process for the approval of capital expenditures based on information derived from regional planning agencies. (Sec. 604) Provides for programs to receive Federal funds equal to a weighted average of 86 percent of their population-based share of the budget, which the Board may adjust between 81 and 91 percent based on State economic conditions. (Sec. 605) Requires each program to establish a separate budget account for health professional education expenditures and to distribute funds consistent with the achievement of specified national and program goals, including the receipt by the Board of reports to monitor compliance, and taking into account the potentially higher costs of placing health professional students in clinical education programs in health professional shortage areas. Subtitle B: Payments by States to Providers - Directs that: (1) payment for operating expenses for institutional and facility-based care under State programs be made directly to each institution or facility under an annual prospective global budget approved under the program; (2) such budgets take into account discharges by diagnosis-related group, prior expenditures, the extent to which debt service for capital expenditures has been included in the proposed operating budget, change in the consumer price index and other price indices, compensation, occupancy levels, past financial and clinical performance, training, technological changes, and incentives to maintain costs without reducing care; and (3) facility budgets be adjusted to reflect payments made by CHSOs. Allows programs to permit institutions and facilities to raise funds from private sources to pay for newly constructed facilities, major renovations, and equipment. (Sec. 612) Requires: (1) State programs to pay individual practitioners on a fee-for-service basis, as negotiated between States and practitioner representatives; (2) the Board to establish models for such payment and for global fee payment methodologies to encourage payment for combinations of services; and (3) practitioners to bill State programs within 30 days of providing services. Permits States to require electronic billing. (Sec. 613) Authorizes programs to pay CHSOs based on annual budgets or risk-adjusted capitation payments, reduced by the costs of covered services not provided by the CHSO. (Sec. 614) Directs that programs pay for community-based primary health services based on global budgets, basic primary care capitation amounts for enrollees, or fee-for-service, taking into account costs of serving non-covered patients, providing case management, transportation, and translation, and providing health professional education programs. (Sec. 615) Requires: (1) the Board to establish a list of approved prescription drugs based on the recommendations of the Advisory Committee on Prescription Drugs and to negotiate maximum prices with manufacturers; and (2) each program to pay for such drugs based on such maximum prices and to pay separate dispensing fees to pharmacies. (Sec. 616) Directs the Board to establish a list of approved durable medical equipment and therapeutic devices and equipment and programs to pay for such items based on maximum prices determined by the Board. (Sec. 617) Requires State programs to pay for other items and services based on methodologies to be adopted by the Board, consistent with the State health security budget. (Sec. 618) Directs the Board to establish model payment methodologies and other incentives to promote the provision of services in medically underserved areas. Permits programs to adjust payments amounts within their budgets to encourage provision of appropriate services in underserved areas. (Sec. 619) Authorizes programs to utilize alternative payment methodologies, provided that such methodologies do not affect the entitlement of individuals to coverage, the weighting of fee schedules to encourage an increase in the number of primary care providers, the ability of individuals to choose among qualified providers, the benefits covered under the Program, or compliance with the State health security budget. Requires States to report on the operation and effectiveness of alternative methodologies to enable the Board to evaluate the appropriateness of applying such methodologies to other States. Subtitle C: Mandatory Assignment and Administrative Provisions - Specifies that participating providers: (1) must accept payment from a program as full payment for covered services; and (2) may not impose additional charges on patients. Permits the Board to exclude from participation and subject to civil penalties violators of such provision. (Sec. 632) Requires programs to establish: (1) procedures for reimbursing providers within 60 days of bill submission; and (2) an appeals process to handle grievances pertaining to provider payments. Title VII: Promotion of Primary Health Care; Development of Health Service Capacity; Programs to Assist the Medically Underserved - Subtitle A: Promotion and Expansion of Primary Care Professional Training - Makes the Board responsible for: (1) coordinating health professional education policies and goals to achieve national goals; (2) overseeing program health professional education expenditures; (3) developing and maintaining a system to monitor the number and specialties of individuals through their health professional education, any postgraduate training, and professional practice; and (4) developing, coordinating, and promoting other policies that expand the number of primary care practitioners. Sets as national goals that: (1) at least 50 percent of graduate medical residencies be in primary care within five years of this Act's enactment; and (2) there be a certain number, specified by the Board, of midlevel primary care practitioners employed in the health care system as of January 1, 2000. Directs the Board to: (1) establish a method of applying such goals to program goals for each medical residency program or consortium of programs and reducing payments for residency programs failing to meet their goals; (2) advise the Public Health Service on allocations of funding under specified programs to increase the supply of midlevel primary care practitioners; and (3) commission a study of the potential benefits and disadvantages of expanding the scope of practice authorized under State laws for any class of midlevel primary care practitioners. (Sec. 702) Requires the Board to establish an Advisory Committee on Health Professional Education to advise the Board concerning graduate medical education policies under this title. (Sec. 703) Directs the Board to transfer specified revenues from the American Health Security Trust Fund (Trust Fund) for specified existing programs supporting health professional education and nursing education and for the National Health Service Corps. Subtitle B: Direct Health Care Delivery - Requires the Board to transfer specified Trust Fund revenues to the Public Health Service for: (1) maternal and child health block grants, preventive health block grants, grants to States for community mental health services and prevention and treatment of substance abuse, and grants for HIV health care services; and (2) grants to nonprofit community health centers and similar facilities. (Sec. 713) Directs the Board to make grants to primary care centers (i.e., nonprofit community health centers, migrant health centers, and other federally qualified health centers) to serve medically underserved populations in urban and rural areas. Specifies that grant funds may be used to plan, develop, and deliver primary care in such areas. Subtitle C: Primary Care and Outcomes Research - Requires the Board to transfer specified Trust Fund revenues to the Agency for Health Care Policy and Research for health outcomes research. (Sec. 722) Amends the Public Health Service Act to establish within the Office of the Director of the National Institutes of Health (NIH) an Office of Primary Care and Prevention Research to be headed by a Director who shall identify and coordinate research activities relating to primary care and prevention, including care provided by multidisciplinary teams. Authorizes appropriations. Requires the Director of NIH to establish a national data system and clearinghouse on primary care and prevention research. Subtitle D: School-Related Health Services - Authorizes appropriations through FY 2001 for this subtitle. (Sec. 734) Directs the Secretary to make grants to State health agencies or to local community partnerships to develop and operate school health service sites. Requires preference in making grants to be given to those communities showing the most substantial level of need. Title VIII: Financing Provisions; American Health Security Trust Fund - Subtitle A: American Health Security Trust Fund - Amends the Internal Revenue Code to create the American Health Security Trust Fund. Appropriates to the trust fund the increase in tax liabilities attributable to the application of amendments made by this title and receipts from the following programs: Medicare, Medicaid, Federal employees' health benefits program, and the CHAMPUS program, Maternal and Child Health program (under title V of the Social Security Act), vocational rehabilitation programs, drug abuse and mental health services programs under the Public Health Service Act, programs providing general hospital or medical assistance, and certain other Federal programs. Transfers to such trust fund amounts in the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund. Subtitle B: Taxes Based on Income and Wages - Creates a health care excise tax on every employer with respect to each employee equal to the following percentages of wages paid: (1) four percent for each small employer; and (2) 8.4 percent for other employers. Defines a small employer as one who: (1) employs less than 75 full-time employees; and (2) pays less than $24,000 in average annual wages. Imposes the tax on the self-employed, railroad employers, and railroad employee representatives. Imposes an individual health care income tax equal to 2.1 percent of taxable income. Prohibits credits against the tax and any effect on the minimum tax in relation to the individual health care income tax. Subtitle C: Increase in Excise Taxes on Tobacco Products - Increases the excise taxes on tobacco products. Subtitle D: Increase in Taxes on Firearms and Ammunition - Imposes a tax upon the sale by the manufacturer or importer of any pistol, revolver, firearm, shell, or cartridge equal to 50 percent of its price. Title IX: Conforming Amendments to the Employee Retirement Income Security Act of 1974 - Makes ERISA inapplicable to health coverage arrangements under State health security programs. Exempts State health security programs from ERISA preemption. Prohibits employee benefits duplicating State health security program benefits. Repeals continuation coverage requirements under ERISA.
United States · United States Congress · 3 March 1994
TABLE OF CONTENTS: Title I: Research and Related Programs Title II: Construction Grants Title III: Standards and Enforcement Title IV: Permits and Licenses Title V: General Provisions Title VI: State Water Pollution Control Revolving Funds Title VII: Miscellaneous Provisions Water Quality Act of 1994 - Title I: Research and Related Programs - Amends the Federal Water Pollution Control Act (the Clean Water Act or CWA) to add national goal and policy provisions with respect to water quality programs. Title II: Construction Grants - Removes limitations on the use of grants for the construction of publicly owned treatment works and authorizes the use of such grants for purposes for which grants may be made under nonpoint source management and groundwater quality programs. (Sec. 201) Requires grant applicants to demonstrate, along with other existing requirements, that water use efficiency options have been studied and evaluated and, if cost-effective implemented. (Sec. 202) Prohibits the approval of a grant for a treatment works unless the applicant has adopted a system of charges that will recover the costs of operation and maintenance (O&M) of treatment works within the jurisdiction. (Current provisions require the applicant to insure adequate construction and O&M.) (Sec. 205) Requires value engineering reviews to be conducted for any treatment works construction projected in excess of $25 million (currently, $10 million). (Sec. 206) Directs the Administrator of the Environmental Protection Agency to make grants under title II of the CWA for the construction of treatment works to specified cities and counties. Title III: Standards and Enforcement - Revises provisions concerning the use of innovative technology to comply with effluent reduction requirements to authorize the Administrator, if a facility achieves reductions with an innovative system that has the potential for reducing the release of pollutants to other media, to extend the date of compliance for such facility for up to three (currently, two) years if the system has industry-wide application potential. (Sec. 302) Directs States to develop antidegradation policies. Requires the Administrator to publish guidance for States to assist in the designation and protection of outstanding national resource waters. (Sec. 303) Authorizes the Administrator to issue regulations to prohibit or restrict the use of mixing zones with respect to chemicals which are persistent, acutely toxic, or bioaccumulative and pose a sufficient health or environmental risk. (Sec. 304) Requires the Administrator to publish guidance for the States on development and adoption of water quality standards applicable to arid areas. (Sec.305) Directs the Administrator to publish regulations providing guidance for effluent limitations for discharges into the ground or groundwater that are subject to permit requirements for groundwater discharges. (Sec. 307) Requires the Administrator to allow States to use a specified amount of funds to carry out citizen water quality monitoring programs. (Sec. 308) Directs the Administrator, in publishing any revised list of toxic pollutants subject to effluent limitations, to take into account the bioaccumulation potential of, and magnitude and risk of exposure to, a pollutant. Requires effluent standards to take such factors into account as well. Authorizes any person to petition the Administrator to limit or prohibit discharges of toxic pollutants or classes of such pollutants which contribute to water quality impairment. Provides that if the Administrator issues chemical-specific numeric water quality criteria for toxic pollutants and a State has not adopted water quality standards for navigable waters within three years of the issuance of such criteria, the criteria shall be: (1) treated as adopted by the State as a water quality standard for purposes of Federal and State law; and (2) applied consistent with designated uses if the State has designated uses for such waters. Requires the Administrator to develop additional criteria for water quality with respect to pollutants entering navigable waters with an emphasis on pollutants entering such waters from nonpoint sources. Authorizes the Administrator to develop and issue guidance that States may use in: (1) issuing fish consumption advisories and scientific protocols for testing contamination levels of fish; (2) developing a monitoring program for contaminants in fish and shellfish; and (3) monitoring water quality at beaches and issuing health advisories with respect to beaches. Directs the National Academy of Sciences to study and report to the Congress on the current scientific knowledge of chemicals which are present in U.S. waters and for which there is evidence that exposure to such chemicals may result in endocrine, immune, or nervous system or developmental health effects in human, fish, or wildlife. (Sec. 309) Revises Federal enforcement and penalty provisions. (Sec.310) Revises provisions regarding water pollution control at Federal facilities to waive the sovereign immunity of the United States with respect to any requirement, administrative authority, or sanctions that may be imposed for violations. Provides that Federal employees may be subject to criminal sanctions but exempts Federal agencies from such sanctions. Authorizes the Administrator to commence administrative enforcement actions against Federal agencies under this Act. Includes Federal agencies in the definition of "person." (Sec. 311) Includes within the required elements of nonpoint source management programs: (1) a description of monitoring and assessment of program effectiveness; (2) a description of program measures that will apply to land owners and a description of land owners, activities, or areas exempt from such measures; (3) an identification of activities for which land owners will be required to implement site-specific management plans; (4) an identification of methods to inform landowners of sources of assistance for developing such plans; (5) designation of watersheds or other areas for which best management practices will be undertaken; (6) a schedule for addressing nonpoint sources of pollution; and (7) an identification of activities on Federal lands that are inconsistent with such programs. Requires the Administrator to prepare nonpoint source management plans for States that fail to do so or whose plans are not approved. Extends the authorization of appropriations for grants for assessment reports, nonpoint source management programs, and groundwater protection programs through FY 2000. Directs the Administrator to publish guidance to identify best management practices and measures which may be undertaken under such management programs. (Sec. 313) Requires the Administrator to establish a schedule under which major nonmunicipal dischargers of pollutants and significant industrial users are required to submit pollution prevention or reduction plans. Directs the Administrator to report to the Congress on innovative and alternative technologies which are available for preventing and reducing pollution of navigable waters. Requires each publicly owned treatment works that is required to develop a pretreatment program and each federally owned treatment works to develop toxic reduction action plans. Directs the Administrator to publish guidance on such plans and on providing technical assistance to small communities to assist them in reducing the introduction of toxic pollutants and hazardous wastes into treatment works. Makes such plans a precondition for issuance or renewal of a national pollutant discharge elimination system permit for a treatment works that is required to have a pretreatment program. (Sec. 314) Authorizes States to submit watershed management programs to the Administrator for approval. Permits States implementing approved watershed management programs to transfer funds for various water pollution control programs between programs (thus, allowing States to use funds for one program for another program). Authorizes the Administrator, in any year in which a State is implementing such a program, to extend the terms of permits for discharges into watersheds or point source discharges into State waters, subject to certain conditions. Title IV: Permits and Licenses - Revises stormwater discharge permitting provisions. (Sec. 402) Makes stormwater discharges that are composed entirely of stormwater subject to requirements for nonpoint source management programs. Adds to the list of discharges for which permits are required: (1) a discharge associated with any industrial activity that is subject to regulation by a State or local stormwater program and is from a construction activity which disturbs fewer than five acres of total land area and is not part of a larger common plan of development or sale; and (2) a discharge from a municipal separate storm sewer system serving an urbanized area with a population between 50,000 and 100,000. Establishes additional requirements for permits for municipal separate storm sewer systems, including that they: (1) require reasonable progress toward attainment of water quality standards as expeditiously as possible, but by no later than December 31, 2009; and (2) have additional requirements for the control of discharges to attain or maintain such standards if they are renewed after this Act's enactment. Authorizes the issuance of general or group permits for any discharges, other than those from municipal separate storm sewer systems, if the discharges are similar in nature and application of similar management measures will reduce pollution occurring from such discharges. Prohibits the Administrator from requiring, as a permit condition, compliance with a numeric effluent limitation or an applicable water quality standard before December 31, 2009, except to implement management measures under regulations for municipal separate storm sewer systems. Sets forth requirements for regulations for permits for urbanized and municipal separate storm water discharges. (Sec. 403) Subjects existing permits for discharges from municipal combined sewer systems resulting from wet weather overflows to this Act's requirements. Directs the Administrator to issue regulations to require permits for such discharges that provide for: (1) technology-based controls for such overflows and set forth a compliance schedule for a long-term control plan; and (2) reasonable progress toward attainment of water quality standards by no later than December 31, 2009. Prohibits such permits from requiring compliance with a numeric effluent limitation or water quality standard before such date. (Sec. 404) Treats a discharge of a pollutant into groundwater as a discharge into navigable waters if: (1) there is a reasonably foreseeable and demonstrable direct hydrologic connection between the ground and surface waters in the proximity of the discharge; (2) a greater than de minimis quantity of the pollutant is able to reach surface waters; and (3) no other Federal law directly addresses the activity resulting in the discharge. Bars penalties for such a discharge unless the person should have known that there is a direct hydrologic connection between the ground and surface waters in the proximity of the discharge. (Sec. 405) Requires the Administrator to issue guidance on the beneficial use of sewage sludge. Title V: General Provisions - Requires a CWA cost and needs estimate to be submitted quadrennially (currently, biennially) to the Congress. (Sec. 504) Reauthorizes the CWA through FY 2000. (Sec. 505) Requires the Administrator to make grants to Indian tribes to pay the full cost of sewage treatment and nonpoint source management projects. Increases amounts to be reserved for Indian tribes for such projects. Permits State water pollution control revolving funds (SRFs) to be used for assistance to Indian tribes. Title VI: State Water Pollution Control Revolving Funds - Authorizes SRFs to be used for water use efficiency measures whose principal purpose is improving or protecting water quality. (Sec. 602) Requires the Administrator to establish simplified procedures for small communities to obtain assistance from SRFs. (Sec.603) Provides for an extended repayment period for loans made from SRFs for service areas in which the average annual residential sewage treatment charge, after completion of a project, will be greater than 1.25 percent of the median family income for such area. Authorizes negative interest rates for such loans. Permits SRFs to be used to provide technical and planning assistance to small communities. (Sec. 605) Extends the authorization of appropriations for the SRF program through FY 2000. Title VII: Miscellaneous Provisions - Authorizes the Administrator to provide financial assistance to States for planning, design, and construction of international wastewater treatment works in the vicinity of the U.S.-Mexican border. Authorizes appropriations. (Sec. 702) Authorizes the Administrator to make grants to States along such border to provide assistance for planning, design, and construction of treatment works to provide wastewater service to colonias. Makes funds appropriated before this Act's enactment available for such purposes. (Sec. 703) Requires the Administrator to study and report to the Congress on pollutants to navigable waters which originate from mobile sources and impair or threaten water quality and to submit recommendations for reducing pollution from such sources.
United States · United States Congress · 3 March 1994
Honors James Norman Hall for his outstanding contributions to the United States, France, Tahiti, and the South Pacific. Requests the President to provide for the presentation of a copy of this concurrent resolution to the President of Tahiti Nui (French Polynesia) to be publicly displayed at the James Norman Hall Museum in Tahiti.
United States · United States Congress · 23 February 1994
1995 Special Olympics World Games Commemorative Coin Act - Directs the Secretary of the Treasury to issue one-dollar silver coins emblematic of the 1995 Special Olympics World Games. Mandates that the surcharges collected from the sale of such coins be paid to the 1995 Special Olympics World Games Organizing Committee, Inc.
United States · United States Congress · 23 February 1994
Designates June 4, 1994, as National Trails Day.
United States · United States Congress · 22 February 1994
Designates January 16, 1995, as National Good Teen Day.
United States · United States Congress · 10 February 1994
Head Start Act Amendments of 1994 - Amends the Head Start Act to reauthorize and revise Head Start programs. (Sec. 2) Requires the Secretary of Health and Human Services (HHS) to establish quality standards for Head Start agencies and programs, including standards for performance in providing required health, education, parental involvement, social, and other services, for administrative and financial management, and for facilities' condition and location. Provides for monitoring and for corrective actions or terminations if minimum standards are not met. (Sec. 3) Eliminates a provision freezing regulations. Provides that terminations, reductions, or suspensions of financial assistance upheld in administrative hearings shall not be stayed pending any judicial appeal. (Sec. 4) Revises classroom teacher qualifications and waiver requirements. Directs the Secretary to: (1) provide technical assistance and training to enable Head Start agencies to establish positions for mentor teachers; and (2) review and revise standards for family service workers, and promote model curricula and credentials for such workers. Authorizes the Secretary to establish a program of Head Start Fellowships for staff in local Head Start programs and other individuals working in the field of child development and Directs the Secretary to develop model staffing pattern plans to guide local Head Start agencies and programs. (Sec. 5) Sets forth goals and priorities for training and technical assistance. (Sec. 6) Allocates funds for program expansion. (Sec. 7) Authorizes the Secretary to allow certain amounts to be allocated to quality improvement activities (in addition to the required 25 percent portion of appropriations). Sets forth goals and authorized activities for which quality improvement funds are to be used. (Sec. 8) Requires each Head Start agency to coordinate with schools and promote parental involvement to facilitate children's transition from program to school. Directs the Secretaries of HHS and of Education to assess results of demonstration projects under the Head Start Transition Project Act and provide technical assistance to communities to implement promising practices from those demonstrations. Extends the set-aside for the Head Start Transition Project Act. (Sec. 9) Directs the Secretary to carry on a continuing program of research, demonstrations, and evaluations of Head Start programs, and to report on such activities. (Sec. 10) Establishes programs for families with infants and toddlers. Directs the Secretary to make grants for: (1) programs providing family-centered services for low-income families with very young children, designed to promote child development, parental role fulfillment, and movement toward self-sufficiency; and (2) evaluation of, and training and technical assistance for, projects under the Comprehensive Child Development Centers Act of 1988. (Repeals the latter Act because its functions are being consolidated under the Head Start Act.) (Sec. 11) Revises parental involvement considerations with respect to designation of new Head Start agencies well as functions of such agencies. Requires agencies to offer family literacy services and parenting skills training to parents of participating children. Allows agencies also to opt to offer such parents parental social self-sufficiency training, substance abuse counseling, or other partnership in education activities. Requires a family needs assessment, including consultation with the parents, for each participating family. (Sec. 12) Authorizes appropriations. (Sec. 13) Revises the poverty line definition. Updates hold-harmless provisions for Indian and Migrant programs. Specifies that each Head Start program may use Head Start funds for full-day and full-year services and shall be permitted to provide more than one year of services to eligible children in the State.
United States · United States Congress · 9 February 1994
Vieques Lands Transfer Act of 1994 - Directs the Secretary of Defense to transfer all Federal interest in certain lands located in the western region of the municipality of Vieques, Puerto Rico, to such municipality to be used for public purposes (subject to a reversion if such lands cease to be so operated). Makes such lands eligible for transfer after the municipality submits a detailed plan for the public purposes for which the lands may be used to specified congressional committees.
United States · United States Congress · 9 February 1994
Amends the Revised Organic Act of the Virgin Islands to authorize the legislature of the Virgin Islands to create units of local government in the Virgin Islands.
United States · United States Congress · 9 February 1994
Amends Federal civil service law to entitle certain honorably discharged veterans who served on active duty to additional points on examinations for entrance into the competitive service.
United States · United States Congress · 8 February 1994
World War II Peace Accords Commemorative Coin Act - Expresses the sense of the Congress that: (1) the 50th anniversary of the signing of the World War II peace accords on the U.S.S. Missouri should not go unrecognized at the national level; and (2) the United States should recognize such anniversary by minting and issuing a commemorative coin. Sets forth specifications for half dollar clad coins. Mandates that the surcharges received from the sale of such coins be paid by the Secretary of the Treasury to the Admiral Nimitz Foundation for the purpose of preserving the Pacific War heritage of the United States.
United States · United States Congress · 3 February 1994
Designates March 20, 1994, as National Agriculture Day.
United States · United States Congress · 2 February 1994
Designates May 30 through June 6, 1994, as a Time for the National Observance of the Fiftieth Anniversary of World War II.
United States · United States Congress · 1 February 1994
Designates March 25, 1994, as Greek Independence Day: A National Day of Celebration of Greek and American Democracy.
United States · United States Congress · 1 February 1994
Designates the week beginning October 2, 1994, as Chemical Dependency Nurses Week.
United States · United States Congress · 1 February 1994
Designates October 1994 as National Breast Cancer Awareness Month.
United States · United States Congress · 26 January 1994
Directs the Secretary of Health and Human Services to award a grant to the Louisiana Department of Health and Hospitals to establish and construct the National Center for Sickle Cell Disease Research at Southern University in Baton Rouge, Louisiana, and for related facilities and equipment at such Center. Authorizes appropriations.
United States · United States Congress · 25 January 1994
Designates April 28, 1994, as Exercise Tiger Day.
United States · United States Congress · 25 January 1994
Designates 1994 as a year to honor the memory and leadership qualities of the Honorable Thomas P. "Tip" O'Neill, Jr., the late Speaker of the House of Representatives.
United States · United States Congress · 22 November 1993
Commercial Mortgage Capital Availability Act of 1993 - Sets forth a regulatory scheme under which qualified insured depository institutions meeting prescribed reserve and capital requirements may execute mortgage loan transfers with a recourse arrangement. Amends the Securities Exchange Act of 1934 to modify the definition of "mortgage related security" to include notes directly secured by a first lien on real estate with commercial structures located upon it (thus bringing such securities within the purview of the Act). Directs the Secretary of Labor to exempt commercial mortgage related securities transactions from: (1) certain restrictions of the Employee Retirement Income Security Act of 1974; and (2) certain taxes imposed under the Internal Revenue Code. Mandates that securities relying on the provisions of this Act comply with all Federal securities laws relating to disclosure to investors, registrations, reporting and anti-fraud provisions. Requires insured depository institutions to maintain the minimum adequate capital prescribed by regulatory banking agencies when executing mortgage backed securities transactions.
United States · United States Congress · 22 November 1993
George C. Marshall Commemorative Coin Act of 1993 - Directs the Secretary of the Treasury to: (1) mint and issue one-dollar silver coins in commemoration of the end of World War II and General George C. Marshall's participation in service during such War; and (2) pay surcharges received from coin sales to the Friends of George C. Marshall to be used solely for the construction of the George C. Marshall Memorial and Visitor Center in Uniontown, Pennsylvania.
United States · United States Congress · 22 November 1993
Haitian Refugee Fairness Act - Expresses the sense of the Congress with respect to U.S. obligations in support of the international law requirement of nonrefoulement. Prohibits the U.S. Government from returning or causing to be returned to Haiti any Haitian national (with specified exceptions for certain felons and persons who participated in persecutions) outside U.S. territorial waters, or inside territorial waters of another country, unless the Government has first determined the individual not to be a refugee. (Sec. 3) Provides: (1) temporary protected status for qualifying Haitians; and (2) reimbursement for related State and local costs. (Sec. 5) Obligates specified funds for: (1) the Community Relations Service; and (2) primary and secondary resettlement services for paroled Cubans and Haitians. (Sec. 6) Amends the Immigration and Nationality Act to authorize appropriations for a Cuban/Haitian Entrant Emergency Fund to be established in the Treasury. Requires the Attorney General to provide an annual estimation of Cuban and Haitian parolees.
United States · United States Congress · 22 November 1993
Designates 1994 through 1999 as the Years of the Girl Child.
United States · United States Congress · 20 November 1993
TABLE OF CONTENTS: Title I: Health Care Security Subtitle A: Universal Coverage and Individual Responsibility Subtitle B: Benefits Subtitle C: State Responsibilities Subtitle D: Health Alliances Subtitle E: Health Plans Subtitle F: Federal Responsibilities Subtitle G: Employer Responsibilities Subtitle J (sic): General Definitions; Miscellaneous Provisions Title II: New Benefits Subtitle A: Medicare Outpatient Prescription Drug Benefit Subtitle B: Long-Term Care Title III: Public Health Initiatives Subtitle A: Workforce Priorities Under Federal Payments Subtitle B: Academic Health Centers Subtitle C: Health Research Initiatives Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health Subtitle E: Health Services for Medically Underserved Populations Subtitle F: Mental Health; Substance Abuse Subtitle G: Comprehensive School Health Education; School-Related Health Services Subtitle H: Public Health Service Initiative Subtitle I: Coordination With COBRA Continuation Coverage Title IV: Medicare and Medicaid Subtitle A: Medicare and the Alliance System Subtitle B: Savings in Medicare Program Subtitle C: Medicaid Subtitle D: Increase in SSI Personal Needs Allowance Title V: Quality and Consumer Protection Subtitle A: Quality Management and Improvement Subtitle B: Information Systems, Privacy, and Administrative Simplification Subtitle C: Remedies and Enforcement Subtitle D: Medical Malpractice Subtitle E: Fraud and Abuse Subtitle F: McCarran-Ferguson Reform Title VI: Premium Caps; Premium-Based Financing; and Plan Payments Subtitle A: Premium Caps Subtitle B: Premium-Related Financing Subtitle C: Payments to Regional Alliance Health Plans Title VII: Revenue Provisions Subtitle A: Financing Provisions Subtitle B: Tax Treatment of Employer-Provided Health Care Subtitle C: Employment Status Provisions Subtitle D: Tax Treatment of Funding of Retiree Health Benefits Subtitle E: Coordination with COBRA Continuing Care Provisions Subtitle F: Tax Treatment of Organizations Providing Health Care Services and Related Organizations Subtitle G: Tax Treatment of Long-term Care Insurance and Services Subtitle H: Tax Incentives for Health Services Providers Subtitle I: Miscellaneous Provisions Title VIII: Health and Health-Related Programs of the Federal Government Subtitle A: Military Health Care Reform Subtitle B: Department of Veterans Affairs Subtitle C: Federal Employees Health Benefits Program Subtitle D: Indian Health Service Subtitle E: Amendments to the Employee Retirement Income Security Act of 1974 Subtitle F: Special Fund for WIC Program Title IX: Aggregate Government Payments to Regional Alliances Subtitle A: Aggregate State Payments Subtitle B: Aggregate Federal Alliance Payments Subtitle C: Borrowing Authority to Cover Cash-Flow Shortfalls Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance Subtitle A: Workers Compensation Insurance Subtitle B: Automobile Insurance Subtitle C: Commission on Integration of Health Benefits Subtitle D: Federal Employees' Compensation Act Subtitle E: Davis-Bacon Act and Service Contract Act Subtitle F: Effective Dates Title XI: Transitional Insurance Reform Health Security Act - Title I: Health Care Security - Subtitle A: Universal Courage and Individual Responsibility - Entitles each eligible individual to: (1) the benefit provided under subtitle B through the applicable health plan in which the individual is enrolled; and (2) a health security card to be issued by the alliance or other entity that offers the applicable health plan in which the individual is enrolled. Defines an eligible individual as an individual who resides in the United States and is: (1) a citizen or national of the United States; (2) an alien permanently residing in the U.S. under color of law; or (3) a long-term nonimmigrant. Entitles a Medicare-eligible individual to benefits under Medicare instead of the above provisions of this Act. (Sec. 1002) Requires each eligible individual to enroll in an applicable health plan and pay any required premium. Prohibits disenrollment of an eligible individual until the individual is either enrolled in another plan or in Medicare. (Sec. 1003) States that nothing in this Act shall be construed as prohibiting: (1) an individual from purchasing any health services; (2) an individual from purchasing supplemental insurance; (3) an individual who is not an eligible individual from purchasing health insurance; or (4) employers from providing additional coverage. (Sec. 1004) States that a regional alliance health plan is the applicable plan for a family, unless a family member is eligible for a corporate alliance health plan. Allows military personnel, veterans, and Indians to enroll either with an alliance or with a military, veteran, or Indian plan respectively. (Sec. 1005) Prohibits an undocumented alien from enrolling in a health plan under this Act. (Sec. 1011) Defines a family as an eligible individual's eligible spouse and children. Defines couple as meaning an individual and the individual's spouse. Defines a child as being under age 18, or under age 24 in the case of a full-time student. Subtitle B: Benefits - Includes the following terms and services in the comprehensive benefit package: (1) hospital services; (2) services of health professionals; (3) emergency and ambulatory medical and surgical services; (4) clinical preventive services; (5) mental illness and substance abuse services; (6) family planning services and services for pregnant women; (7) hospice care; (8) home health care; (9) extended care services; (10) ambulance services; (11) outpatient laboratory, radiology, and diagnostic services; (12) outpatient prescription drugs and biologicals; (13) outpatient rehabilitation services; (14) durable medical equipment and prosthetic and orthotic devices; (15) vision care; (16) dental care; (17) health education classes; and (18) investigational treatments. Describes such items and services. (Sec. 1131) Requires each health plan to offer to its enrollees only one of the following cost sharing schedules: (1) lower cost sharing; (2) higher cost sharing; or (3) combination cost sharing. Provides that the annual maximum out-of-pocket expenses for an individual in any of the plans shall be $1500 and for a family the annual maximum shall be $3000. (Sec. 1135) Sets forth a table of copayments and coinsurance. (Sec. 1141) Excludes the following items and services: (1) an item or service that is not medically necessary or appropriate; (2) an item or service that the National Health Board may determine is not medically necessary or appropriate; (3) custodial care, except hospice care; (4) surgery performed solely for cosmetic purposes, unless required to correct a congenital anomaly or performed to correct a part of the body injured by either disease or accident; (5) hearing aids; (6) eyeglasses and contact lenses for individuals at least 18 years of age; (7) in vitro fertilization; (8) sex change surgery and related services; (9) private duty nursing; (10) personal comfort items, except in the case of hospice care; and (11) any dental procedures involving orthodontic care, inlays, gold or platinum fillings, bridges, crowns, pin/post retention, dental implants, surgical periodontal procedures, or the preparation of the mouth for the fitting or continued use of dentures, except as specified. (Sec. 1151) Gives the National Health Board the authority to promulgate such regulations or establish such guidelines as necessary to assure uniformity in the application of the comprehensive benefit package across all health plans. Permits the Board to expand the benefit package. (Sec. 1162) Permits a health professional or facility to refuse to provide a benefit if the professional or facility objects on the basis of a religious belief or moral conviction. Subtitle C: State Responsibilities - Requires a State, in order to be approved as a participating State, to submit a document describing the State's health care system. (Sec. 1201) Requires a participating State to: (1) establish one or more regional alliances; (2) establish and publish the criteria used in the certification of its health plan; (3) meet minimum financial solvency requirements for health plans established by the National Health Board; (4) designate an agency or official to coordinate State responsibilities under this Act; (5) conform State laws to meet the requirements of title X of this Act with respect to workers' compensation and automobile insurance; and (6) carry out all the responsibilities of a participating State specified in this Act. (Sec. 1221) Permits a State, with the Board's approval, to operate a single-payer system if specified requirements are met. Subtitle D: Health Alliances - Provides for regional alliances and corporate alliances. (Sec. 1302) Requires a regional alliance to be governed by a Board of Directors consisting of: (1) employers, including self-employed individuals; and (2) members who represent individuals purchasing coverage. Requires each regional alliance to establish a provider advisory board consisting of health care providers and professionals. (Sec. 1311) Includes in a corporate alliance an eligible sponsor who is either a large employer (more than 5,000 full-time employees) or a multiemployer plan (a plan with more than 5000 active participants). Excludes: (1) an employer whose primary business is employee leasing; (2) the Federal Government (other than the U.S. Postal Service); and (3) a State or local government. Excludes from corporate alliance eligibility the following classes of individuals: (1) AFDC recipients; (2) SSI recipients; (3) military personnel and families, veterans, and Indians who elect to enroll in specified plans specifically designed for them; and (4) seasonal or temporary employees. (Sec. 1321) Directs each regional alliance to enter into a contract with any State-certified health plan to contract with the alliance for the enrollment under the plan of eligible individuals. (Sec. 1322) Requires each regional alliance to offer a choice of health plans, including at least one fee-for-service plan. (Sec. 1326) Requires each regional alliance to establish and maintain an office of an ombudsman to assist consumers in dealing with problems that arise with health plans and the alliance. (Sec. 1329) Permits a regional alliance to adjust payments to plans or use other financial incentives to encourage health plans to expand into areas that have inadequate health services. (Sec. 1341) Set forth provisions concerning the collection of funds by regional alliances from individuals, employers, and others. (Sec. 1351) Requires each regional alliance to compute a blended plan per capita payment amount for each regional alliance health plan for enrollment in the alliance. (Sec. 1353) Requires each regional alliance to make payments to the Federal Government for academic health centers and graduate medical education. (Sec. 1361) Requires each regional alliance to comply with specified standards relating to the management of finances, maintenance of records, accounting practices, auditing procedures, financial reporting, and employer payments. (Sec. 1371) Provides for a reduction in cost sharing for low-income families. (Sec. 1373) Provides for premium discounts and reduction in liabilities for low-income families. (Sec. 1381) Permits each corporate alliance to: (1) offer coverage under either an appropriate self-insured health plan; or (2) negotiate with a State-certified plan to enter into a contract with the plan. (Sec. 1382) Requires each corporate alliance to provide a choice of health plans, including at least one fee-for-service plan and two health plans that are not fee-for-service plans. (Sec. 1385) Requires each corporate alliance to make an additional contribution towards the enrollment in health plans of the alliance by certain low-wage families. (Sec. 1386) Sets forth provisions relating to corporate alliances concerning: (1) consumer information and marketing; (2) plan and information requirements; (3) management of funds; (4) cost control; (5) payments by corporate alliance employers to corporate alliances; (6) ERISA; (7) disclosure and reserve requirements; (8) trusteeship of insolvent corporate alliance health plans; (9) imposition and collection of periodic assessments on self-insured corporate alliance plans; and (10) payments to the Federal Government by multiemployer corporate alliances for academic health centers and gradual medical education. Subtitle E: Health Plans - Requires a health plan to: (1) be either a self-insured plan (meaning a group health plan as defined by a the Employee Retirement Income Security Act of 1974) or a State-certified plan (meaning a plan certified by a State or the National Health Board); and (2) meet the applicable regulatory requirements. (Sec. 1402) Requires each health plan offered by either a regional or corporate alliance to accept for enrollment every alliance eligible individual, unless the plan has reached its enrollment limit. Prohibits the limit from being imposed on the basis of any personal characteristics of enrollees such as health status, need for health care, age, occupation, or affiliation with any person or entity. Prohibits a plan from: (1) restricting or terminating coverage for any reason, including nonpayment of premiums; (2) cancelling coverage for any eligible individual until that individual is enrolled in another plan; (3) excluding an eligible individual because of an existing medical condition; (4) imposing a waiting period before coverage begins; or (5) imposing a rider that excludes the coverage of particular eligible individuals. Prohibits discrimination by a health plan on the basis of race, national origin, sex, language, socio-economic status, age, disability, health status, or anticipated need for health services. (Sec. 1405) Requires each plan to have a grievance procedure. (Sec. 1421) Permits an entity to offer a supplemental insurance policy if the policy and the entity meet specified requirements. (Sec. 1431) Requires each health plan, with respect to each electing essential community provider located within the plan's service area, to either: (1) enter into a written provider participation agreement; or (2) enter into a written agreement under which the plan will make payment to the provider as specified. Provides a special rule for providers of school health services. Makes the provisions of the proceeding sentence applicable only to health plans offered by a health alliance during the five year period beginning with the first year in which any health plan is offered by the alliance. Directs the Secretary of Health and Human Services to study essential community providers and to make recommendations concerning such providers to the Congress. Provides that such recommendations shall apply unless a joint resolution of disapproval is enacted by the Congress. (Sec. 1441) Requires each health plan to meet specified requirements of title X of this Act with respect to workers' compensation and automobile medical liability services. Subtitle F: Federal Responsibilities - Establishes the National Health Board in the Executive Branch. Directs the President to appoint the Board's seven members. (Sec. 1503) Directs the Board to: (1) interpret the comprehensive benefit package; (2) adjust the delivery of preventive services; (3) take steps to assure that the comprehensive benefit package is available on a uniform national basis; (4) recommend to the President and the Congress appropriate revisions to the package; (5) oversee cost containment requirements; (6) develop and implement eligibility standards; (7) establish a performance based system of quality management; (8) develop and implement standards for a national health information system; (9) establish State requirements and monitor State compliance; (10) establish premium class factors; (11) develop a methodology for the risk-adjustment of premium payments; (12) establish financial requirements for guaranty funds; (13) establish standards for health plan grievance procedures; and (14) report annually to the President and the Congress. (Sec. 1506) Authorizes appropriations for the Board. (Sec. 1511) Requires the Board to approve a State health care system if the system meets the applicable requirements of this Act. Prohibits approval of a State health care system prior to 1996. (Sec. 1512) Provides for sanctions for States failing to meet conditions for compliance. (Sec. 1515) Provides for planning grants to States for implementation assistance. (Sec. 1521) Provides for the Federal assumption of responsibilities in the absence of a State system. Provides for increased premiums of 15 percent during Federal operation of a State system to provide reimbursement for the Federal cost of operating the system. (Sec. 1541) Directs the Board to develop a risk adjustment and reinsurance methodology. Sets forth guidelines for developing such methodology. (Sec. 1543) Directs the Board to establish an advisory committee to provide technical advice and recommendations regarding the risk adjustment and reinsurance methodology. (Sec. 1551) Directs the Board to establish minimum capital requirements for regional alliance health plans under which at least $500,000 of capital must be maintained for each plan in the area. Permits the Board to require additional capital. (Sec. 1552) Requires the Board to establish standards for guaranty funds established by the States. (Sec. 1571) Sets forth the responsibilities of the Secretary of Health and Human Services. Directs the Secretary to administer and implement all provisions of this Act, except those duties delegated to the Board, any other executive agency, or to any State. (Sec. 1572) Directs the Secretary to appoint an Advisory Council on Breakthrough Drugs that will examine the reasonableness of launch prices of new breakthrough drugs. (Sec. 1581) Provides for the certification of essential community providers. Sets forth the following categories of providers automatically certified (under provisions of the Public Health Service Act): (1) migrant health centers; (2) community health centers; (3) homeless program providers; (4) public housing providers; (5) family planning clinics; and (6) AIDS providers under the Ryan White Act. Includes as automatically certified (under other Acts) following: (1) Indian health programs under the Indian Health Act; and (2) maternal and child health providers and a federally qualified health center or rural health clinic under the Social Security Act. Includes as automatically certified (under provisions of this Act) the following: (1) providers of school health services; and (2) a qualified community practice network. Provides for the setting of standards for additional health providers. (Sec. 1591) Sets forth the responsibilities of the Secretary of Labor. Includes among those responsibilities the following: (1) enforcement requirements applicable to employers; (2) elections to become corporate alliances; (3) temporary assumption of insolvent self-insured corporate alliance health plans; (4) establishment and administration of the Corporate Alliance Health Plan Insolvency Fund; and (5) administering title I of ERISA as it relates to group health plans maintained by corporate alliances. Subtitle G: Employer Responsibilities - Requires employers to provide for the payments required under title VI of this Act. Sets forth other employer responsibilities including: (1) information reporting requirements; (2) requirements relating to new employees; (3) recordkeeping requirements; and (4) antidiscrimination requirements. (Sec. 1606) Prohibits self-funding of cost sharing benefits by regional alliance employers. (Sec. 1607) Requires an employer to make equal employer premium payments to all qualifying employees, if a voluntary premium payment is made. Places a limit on such voluntary employer premium payments. (Sec. 1608) Sets forth an employer's obligation to a qualifying retired beneficiary where the employer, as of October 1, 1993, was providing a threshold payment. (Sec. 1609) Authorizes the Secretary of Labor to impose a civil penalty of up to $10,000 for each violation of this subtitle with respect to each individual. Subtitle J (sic): General Definitions; Miscellaneous Provisions - Sets forth the definitions and rules used in this Act. Subtitle B: Miscellaneous Provisions (sic) - (Sec. 1911) Grants the National Health Board, the Secretary of Health and Human Services, and the Secretary of Labor authority to issue regulations as necessary to permit the timely implementation of this Act. Title II: New Benefits - Subtitle A: Medicare Outpatient Prescription Drug Benefit - (Secs. 2001 through 2005) Amends title XVIII of the Social Security Act to provide for: (1) Medicare coverage of covered outpatient prescription drugs and biologicals as well as home infusion drug therapy services; (2) payment rules and related requirements, such as those pertaining to deductibles, for covered outpatient prescription drugs; (3) manufacturer rebates to the Secretary under Medicare part B for covered outpatient prescription drugs; and (4) determination of the Medicare part B premium attributable to covered outpatient prescription drugs. Subtitle B: Long-Term Care - Establishes requirements for State plans for home and community-based services to individuals with disabilities. Includes among those requirements the following: (1) a prohibition of limiting eligibility of individuals with disabilities based on income, age, geography, severity of disability, residential setting, or other grounds specified by the Secretary; (2) a requirement to serve low-income individuals; (3) a requirement to specify how Federal and State funds will be managed; (4) quality assurance requirements; and (5) reporting requirements. Requires a State to consult with individuals and groups of individuals with disabilities when developing the plan in order to have the plan approved. (Sec. 2103) Defines "individuals with disabilities" to mean any individual within one or more of the following four categories: (1) individuals requiring help with the activities of daily living; (2) individuals with severe cognitive or mental impairment; (3) individuals with severe or profound mental retardation; and (4) severely disabled children. (Sec. 2104) Requires a State plan to specify the services available. Requires each individualized plan to be developed in close consultation with the individual and the individual's family. Prohibits a State plan from covering: (1) room and board; (2) services furnished in a hospital, nursing facility, intermediate care facility for the mentally retarded, or other specified institutional setting; or (3) items or services to the extent coverage is provided for an individual under a health plan or Medicare. (Sec. 2105) Sets forth provisions relating to: (1) cost sharing; (2) quality assurance and safeguards; (3) advisory groups; (4) payments to States; and (5) the total Federal budget for State plans and allotments to States. (Sec. 2301) directs the Secretary, with the advice and assistance of the National Long-Term Care Insurance Advisory Council to promulgate regulations as necessary to implement provisions concerning private long-term care insurance. Directs the Secretary to make appointments to such Council. Authorizes appropriations for such Council. (Sec. 2321) Directs the Secretary, after considering the Council's recommendations to promulgate regulations designed to: (1) standardize formats and terminology used in long-term care policies; (2) require insurers to provide information to customers on the range of public and private long-term care coverage available; and (3) establish other requirements promoting consumer understanding of benefits. (Sec. 2322) Directs the Secretary to promulgate regulations establishing requirements with respect to the terms of and benefits under long-term care policies, which shall include the following requirements that the policy may not: (1) limit coverage based on a preexisting condition, subject to an exception for a six month period; (2) condition eligibility for benefits based on the need or receipt of any other service; (3) condition eligibility for any benefit on any particular diagnosis; (4) condition eligibility for benefits by providers on compliance with requirements not required by State or Federal law; and (5) condition coverage of any service by a provider on the provision of such service at a higher level of care than required by the insured individual. Prohibits discrimination by diagnosis in the treatment of: (1) Alzheimer's disease; (2) any organic or inorganic mental illness; (3) mental retardation or any other cognitive or mental impairment; or (4) HIV infection or AIDS. Sets forth other requirements for such policies, including requirements related to: (1) premiums; (2) sales practices; (3) continuation, renewal, replacement, conversion, and cancellation of policies; and (4) payment of benefits. (Sec. 2342) Provides for grants to States to enforce the Federal standards concerning long-term care policies. Sets forth requirements for receiving such grants. Authorizes appropriations. Prohibits the sale of a long-term care policy in a State without a regulatory program. (Sec. 2361) Authorizes the Secretary to make grants for the development and implementation of long-term care information, counseling, and other programs to: (1) States; (2) regional alliances (at the option of States within which such alliances are located; and (3) national organizations representing insurance consumers, long-term care providers, and insurers. Authorizes appropriations for such grants. (Sec. 2601) Authorizes the Secretary to conduct a demonstration program to test the effectiveness of various approaches to financing and providing integrated acute and long-term care services for the chronically ill and disabled. Sets forth the services and benefits to be provided, including: (1) all benefits of the comprehensive benefit package provided under title I of this Act; (2) transitional benefits, including assessment and home care; (3) long-term care benefits, including adult day care, home-delivered meals, and nursing facility services in specialized care units; and (4) habilitation services. Permits any of the following to be eligible for such services under criteria to be established by the Secretary: (1) individuals with disabilities under a State program; (2) individuals entitled to benefits under the Medicare program; and (3) individuals entitled to Medicaid and who are also either entitled to Medicare or Supplemental Security Income benefits. Requires reports to the Congress on the demonstration program. Title III: Public Health Initiatives - Subtitle A: Workforce Priorities Under Federal Payments - Establishes within the Department of Health and Human Services the National Council on Graduate Medical Education. Directs the National Council to designate for each academic year the number of individuals nationwide who are authorized to be enrolled in each specified approval physician training program for each medical specialty. Sets forth provisions specifying: (1) Federal formula payments to approved physician training programs; (2) application for payments; and (3) amount of payments. (Sec. 3061) Directs the Secretary to carry out a program with respect to graduate nurse training programs that is equivalent to the program for approved physician training programs. Establishes a National Council on Graduate Nurse Education. (Sec. 3071) Authorizes appropriations for the following programs: (1) primary care physician and physician assistant training; (2) training of underrepresented minorities and disadvantaged persons; and (3) nurse training. (Sec. 3072) Authorizes appropriations for the following programs: (1) a program of skill upgrading and occupational retraining for health care workers; (2) a demonstration program to assist workers in health care institutions in obtaining advanced career positions; (3) a program to develop and operate health-worker job banks in local employment services agencies, subject to certain conditions; (4) a program to provide joint labor-management decision-making in the health care sector on workplace matters related to the restructuring of the health care delivery system of this Act; and (5) a program to facilitate the comprehensive workforce adjustment initiative. (Sec. 3073) Directs the Secretary of Health and Human Services and the Secretary of Labor to jointly establish the National Institute for Health Care Workforce Development. States that the Director of the Institute shall make recommendations to the Secretaries regarding: (1) the supply of health care workers; (2) the impact of this Act; and (3) the development and implementation of high-performance, high-quality health care delivery systems. Directs the Secretaries to establish an advisory board to assist in the development of such recommendations. Subtitle B: Academic Health Centers - Directs the Secretary to make payments to a qualified academic health center or qualified teaching hospital in order to assist such eligible institutions with costs that are not routinely incurred by other entities in providing health services, but are incurred by such institutions by virtue of the academic nature of such institutions. States that such costs include: (1) costs resulting from reduced staff productivity due to teaching responsibilities; (2) the uncompensated costs of clinical research; and (3) exceptional costs associated with an institutions specialized expertise. Provides that the funding for such payments will come from transfers from the Federal Hospital Insurance Trust Fund, payments made by regional alliances to the Federal government for academic health centers and graduate medical education, and payments from corporate alliances. (Sec. 3131) Provides for the access of regional and corporate alliance patients to academic health centers. Subtitle C: Health Research Initiatives - Amends the Public Health Service Act to ensure that the National Institutes of Health conducts and supports biomedical and behavioral research on promoting health and preventing diseases, disorders, and other health conditions. Provides for health services research. Authorizes appropriations for such research. Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health - Authorizes appropriations for the core functions of public health programs and national initiatives regarding health promotion and disease prevention. (Sec. 3312) Authorizes the Secretary to make grants to States to carry out one or more of the following core functions: (1) data collection; (2) activities to protect the environment and to assure the safety of housing, workplaces, and food and water; (3) investigation and control of adverse health conditions; (4) public information and education programs to reduce risks to health such as use of tobacco, alcohol, and drugs, sexual activities that increase the risk of HIV transmission and other sexually transmitted diseases, poor diet, physical inactivity, and low childhood immunization levels; (5) accountability and quality assurance activities; (6) provision of public health laboratory services to complement private clinical laboratory services that screen for diseases and conditions; (7) training and education to assure provision of care by all health professionals; and (8) leadership policy development and administrative activities. (Sec. 3331) Authorizes the Secretary to make grants to agencies of State or local government, private nonprofit organizations, and coalitions that link two or more of these groups for the purpose of carrying out projects to develop and implement innovative community-based strategies to provide for health promotion and disease prevention activities for which there is a significant need. Subtitle E: Health Services for Medically Underserved Populations - Directs the Secretary to make grants to migrant health centers and community health centers, which shall be in addition to other funds available to such centers. Authorizes appropriations. (Sec. 3412) Authorizes appropriations for: (1) grants and contracts for the development of qualified community health plans and practice networks; and (2) loans and guaranteeing the principal and interest to Federal and non-Federal lenders on behalf of public and private entities for the capital costs of developing qualified community health plans and practice networks. (Sec. 3461) Authorizes the Secretary to make grants and enter into contracts with qualified community health groups to provide enabling services such as transportation, community and patient outreach, patient education, and translation services in order to increase the capacity of individuals to utilize the items and services under title I of this Act. Authorizes appropriations. (Sec. 3471) Authorizes appropriations for: (1) the National Health Service Corps; and (2) such amounts as are necessary to ensure that at least 20 percent of participants in the Scholarship Program or the Loan Repayment Program of the Corps are nurses. (Sec. 3481) Entitles a hospital with a low-income utilization rate in a base year of at least 25 percent to a payment as specified. Requires 75 percent of the total available to be allocated to hospitals for low-income assistance. Requires 25 percent of the total available to be allocated to hospitals for assistance in furnishing inpatient hospital services that are not covered services under title I of this Act. Subtitle F: Mental Health; Substance Abuse - Authorizes appropriations to carry out this part. Provides for grants to: (1) increase access to mental health and substance abuse services; (2) improve State and local capacity to coordinate and monitor such services; (3) provide incentives to integrate public and private service systems; and (4) supplement any activity under part B (Alcohol and Drug Abuse and Mental Services Block Grant) of title XIX of the Public Health Service Act. (Sec. 3503) Authorizes the Secretary to make loans for the capital costs incurred in the development of non-acute, residential treatment centers and community-based ambulatory clinics. (Sec. 3521) Requires the establishment of a pilot program demonstrating the integration of the mental illness and substance abuse services of the States with the services included under title I of this Act. Subtitle G: Comprehensive School Health Education; School-Related Health Services - Authorizes appropriations for the programs of this subtitle. States that the purposes of the programs shall be to: (1) support, in kindergarten through grade 12, the provision of comprehensive health educator programs; (2) establish a national framework within which States can create comprehensive school health education programs that target the health risk behaviors of youth, including tobacco use, alcohol and drug abuse, sexual behaviors resulting in infections, injury prevention, dietary patterns, and sedentary lifestyles; (3) pay the initial costs of planning and establishing such programs; (4) support related Federal demonstrations and training; (5) motivate youth to stay in school, avoid teen pregnancy, and strive for success; (6) improve the knowledge of health education among youth; and (7) further the National Education Goals set forth in title I of the Goals 2000: Educate America Act. Defines "comprehensive school health education program." Requires such programs to be sensitive to cultural and ethnic issues, promote involvement by families, and promote personal responsibility. Sets forth requirements for applying for grants and selection of grantees. Subtitle H: Public Health Service Initiative - Establishes a Public Health Service Initiative consisting of specified amounts authorized to be appropriated for the Initiative. States that: (1) the Initiative includes the programs of subtitles C through G of this title and the programs of subtitle D of title VIII; and (2) amounts appropriated to carry out the Initiative, including subtitles A through F of this title, are available to carry out specific programs for which the amounts are appropriated. Subtitle I: Coordination with COBRA Continuation Coverage - Amends title XXII (Requirements for Certain Group Health Plans for Certain State and Local Employees) of the Public Health Service Act to provide for coordination with COBRA continuation coverage. Repeals such title XXII upon implementation of this Act. Title IV: Medicare and Medicaid - Subtitle A: Medicare and the Alliance System - Amends title XVIII of the Social Security Act to provide for optional State integration of Medicare beneficiaries into regional alliance plans. (Sec. 4002) Allows individuals to elect to remain in certain plans. (Sec. 4003) Provides for payments to regional alliances on behalf of certain Medicare-eligible individuals. (Sec. 4004) Extends protections for working aged and disabled individuals to group health plans of all employers. Repeals the limitation on the period of protection for individuals with end stage renal disease. Prohibits Medicare payment for items and services provided under any health plan under this Act. Simplifies Medicare benefit coordination in cases where the individual is also eligible for benefits under this Act's health plans. (Sec. 4011) Makes various changes concerning eligible organization and Medicare supplemental policy enrollment and comparative informational materials, eligible organization outlier payments, and participating provider point-of-service networks. (Sec. 4022) Provides for expanded Medicare coverage for physician assistant, nurse practitioner, and clinical nurse specialist services. (Sec. 4031) Amends title XI of the Social Security Act to: (1) provide for termination of the separate Medicare peer review program upon adoption of the National Quality Management Program above under subtitle A of title V of this Act; and (2) repeal provisions on surgical procedure review and second opinions. (Sec. 4032) Amends title XVIII of the Social Security Act to provide for mandatory assignment for all Medicare part B services. (Sec. 4033) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate administration of Medicare parts A and B and supersedes certain conflicting requirements to the extent required to achieve such purpose. (Sec. 4035) Prohibits the Secretary from implementing any change in procedures for billing and processing Medicare claims within six months of implementing any previous change. Adds advanced notification to providers as a requirement for carriers and fiscal intermediaries under Medicare. (Sec. 4041) Amends title XI of the Social Security Act to: (1) provide for civil monetary penalties for kickback violations under Medicare and State health care programs (the programs); (2) make other penalty-related changes, including increases in criminal and civil monetary penalties, a new criminal penalty exception for certain providers, additional civil monetary penalty offenses related to alliance systems, and requirements for the deposit of penalties collected into the All-Payer Account established above under title V of this Act; (3) revise exclusion provisions, with changes establishing a minimum period of exclusion for certain individuals and entities subject to permissive exclusion from the programs, and providing for program exclusions based on actions under alliance systems; and (4) modify sanction provisions, with changes removing certain conditions for imposing sanctions and setting specified civil money penalties for use in lieu of authorized sanctions. (Sec. 4042) Amends title XVIII of the Social Security Act to revise the limitations on physician self-referrals. (Sec. 4051) Provides for the termination of payments under Medicare for medical education costs and directs the Secretary to make specified transfers from certain Medicare trust funds to the new accounts established above for funding physician training programs and academic health centers. (Sec. 4061) Amends title XVIII of the Social Security Act to provide for the treatment of: (1) uniformed services and VA health plans as eligible organizations under Medicare; and (2) health care facilities of the Department of Veterans Affairs as providers under Medicare. Subtitle B: Savings in Medicare Program - Amends title XVIII of the Social Security Act to provide for: (1) reductions in the update for inpatient hospital services and the adjustment for indirect medical education costs, in payments for capital-related costs for inpatient hospital services; (2) revisions to payment adjustments for disproportionate share hospitals in States participating under this Act; and (3) an extension of the freeze on updates to routine service costs of skilled nursing facilities. (Sec. 4111) Amends title XVIII of the Social Security Act to provide for: (1) establishment of cumulative expenditure goals for physician services; (2) use of real gross domestic product for volume adjustments; (3) repeal of restrictions on the maximum reduction permitted in default update; (4) reduction in the conversion factor for the physician fee schedule for 1995; (5) place limitations on payment for physicians' services furnished by high-cost hospital medical staffs; (6) requirements for physicians to identify the hospital at which the service was furnished; (7) an increase in practice expense relative value units for certain services while assuring budget neutrality; (8) a study and report to the Congress by the Secretary on a resource-based system for determining practice expense relative value units for each physician's service; (9) an increase in work relative value units for office visits while assuring budget neutrality; (10) a reduction in relative values for office consultations; (11) adjustment of outlier intensity of relative values; (12) changes in underserved area bonus payments; (13) elimination of formula-driven payments for certain outpatient hospital services; (14) copayments for laboratory services; and (15) competitive acquisition procedures for Medicare part B items and services (including clinical diagnostic laboratory tests). (Sec. 4131) Makes changes with respect to: (1) Medicare as secondary payer; (2) payments for health maintenance organizations and competitive medical plans with risk-sharing contracts; and (3) routine cost limits and copayments for, respectively, home health services and visits. (Sec 4135) Directs the Secretary to use a competitive process to contract with centers of excellence for cataract surgery, coronary artery by-pass surgery, and such other services as the Secretary determines to be appropriate. (Sec. 4141) Amends title XVIII of the Social Security Act to revise Medicare part B premium provisions. (Sec. 4151) Requires the Secretary to submit a report to the Congress on the growth in spending under Medicare for FY 2000 through 2003. Subtitle C: Medicaid - Amends title XIX (Medicaid) of the Social Security Act to provide that if a State Medicaid plan provides for payment to regional alliances of the amounts required above it is not required to provide payment for items and services covered under the comprehensive benefit package for alliance eligible individuals and will receive no Federal financial assistance with respect to such items and services. (Sec. 4211) Provides for: (1) spenddown eligibility and increased income and resource disregard for nursing facility residents; and (2) informing such residents about the availability of assistance for home and community-based services. (Sec. 4221) Provides for: (1) treatment of items and services not covered under the comprehensive benefit package; and (2) establishment of a program under Medicare of noncovered items and services for poor children. (Sec. 4231) Discontinues certain payment policies under Medicaid. (Sec. 4241) Limits the frequency of changes in a State's billing and claims processing system, and provides for advance notification to providers of any major billing change. (Sec. 4251) Establishes the Medicaid Commission to study, report, and make recommendations with respect to options involving block grant use, integration of long-term care services, and consolidation of institutional and home- and community-based long-term care in relation to the Medicaid program. Authorizes appropriations. Subtitle D: Increase in SSI Personal Needs Allowance - Amends title XVI (Supplemental Security Income) (SSI) to provide for an increase in the SSI personal needs allowance. Title V: Quality and Consumer Protection - Subtitle A: Quality Management and Improvement - Requires the National Health Board to establish and oversee a performance-based program of quality management and improvement designed to enhance the quality, appropriateness, and effectiveness of heath care services and access to such services which will be called the National Quality Management Program. (Sec. 5002) Establishes the National Quality Management Council which shall: (1) administer the National Quality Management Program; (2) perform any other duty specified in this subtitle; and (3) advise the National Health Board with respect to its duties under this subtitle. Requires the Council to develop a set of national measures of quality performance to be used in the assessment of and the provision of access to health care services. Requires the Council, in addition, to: (1) recommend to the Board establishing goals for performance by health plans and health care providers on a subset of national measures of quality performance; (2) direct the Administrator for Health Care Policy and Research to develop, review, and disseminate practice guidelines to determine how diseases can most effectively be prevented, diagnosed, treated, and managed; and (3) direct the Administrator for Health Care Policy and Research to support research related to a five year priority list of performance measures. (Sec. 5008) Directs the National Health Board to: (1) establish and oversee regional professional foundations to perform such duties as develop lifetime learning programs for health professionals and conduct research on health care quality; and (2) establish the National Quality Consortium to perform such duties as establishing continuing education for health professionals and provide advice on research priorities. (Sec. 5012) Requires each regional alliance and each corporate alliance to: (1) disseminate specified information to consumers; and (2) ensure that performance and quality standards are continually improved. Subtitle B: Information Systems, Privacy, and Administrative Simplification - Directs the National Health Board to develop and implement a health information system, in consultation with Federal agencies, States, employers, health plans, and others, by which the Board shall collect, report, and regulate the collection and dissemination of health care information which shall be used for: (1) health care planning by Federal, State, and local government; (2) establishing and monitoring payments for health services; (3) assessing and improving the quality of health care; (4) managing and containing costs at the alliance and plan levels; and (5) other specified purposes. Requires the establishment of an electronic data network to collect, compile, and transmit information. (Sec. 5120) Sets forth provisions providing for health information privacy standards. (Sec. 5130) Directs the National Health Board to develop the following standard health care benefit forms: (1) an enrollment and disenrollment form; (2) a clinical encounter record; and (3) a claim form. (Sec. 5140) Establishes the National Privacy and Health Data Advisory Council in order to advise the National Health Board with respect to its duties under this subtitle. (Sec. 5141) Sets forth monetary penalties for violating health information system standards. Subtitle C: Remedies and Enforcement - Sets forth provisions with respect to the review of benefit determinations for enrolled individuals, including provisions: (1) regulating the time limits for notice of disposition of a claim; (2) governing a plan's duty to review claim denials; (3) concerning urgent requests for preauthorization; and (4) concerning other time limits with respect to time limits and notice. (Sec. 5202) Requires each State to establish a complaint review office for each regional alliance established by a State. Permits aggrieved individuals to file complaints with the appropriate review office. (Sec. 5205) Provides for a Federal Health Plan Review Board to review the decisions of complaint review office hearing officers. (Sec. 5207) Sets monetary penalties for a plan which unreasonably denies or delays payment or provision of benefits. (Sec. 5211) Directs each State to establish and maintain an Early Resolution Program in each complaint review office. Requires a program to include: (1) forums for mediation disputes; and (2) other forums of alternative dispute resolution as may be prescribed. Establishes guidelines for the eligibility of cases for submission to the Early Resolution Program. States that conclusions of the mediation proceedings shall be treated as nonbinding and shall not affect any rights to review. (Sec. 5231) Sets forth additional remedies and enforcement provisions. Subtitle D: Medical Malpractice - Prohibits any medical malpractice liability action until the final resolution of the claim under alternative dispute resolution. Requires each regional alliance health plan and corporate alliance health plan to adopt at least one specified method of alternative dispute resolution. Prohibits an individual from bringing a medical malpractice liability action unless the individual submits an affidavit that includes a report by a qualified specialist that states that there is a meritorious cause for filing the action. (Sec. 5311) Directs the Secretary to establish: (1) a project to demonstrate whether substituting liability for medical malpractice on the part of the health plan in which a physician participates for the personal liability of the physician will result in improvements in the quality of care, reductions in defense medical practices, and better risk management; (2) a pilot program under which the Secretary provides funds to one or more eligible States to determine the effect of applying practice guidelines in the resolution of medical malpractice liability actions. Subtitle E: Fraud and Abuse - Directs the Secretary and the Attorney General to establish a program: (1) to coordinate the functions of the Attorney General, the Secretary, and other organizations with respect to the prevention, detection, and control of health care fraud and abuse; (2) to conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for health care; and (3) to facilitate the enforcement of this and other statutes applicable to health care fraud. (Sec. 5402) Creates, in the Treasury, the All-Payer Health Care Fraud and Abuse Control Account which shall consist of: (1) gifts and bequests; (2) administrative penalties and assessments and portions of civil monetary penalties imposed under provisions of the Social Security Act; (3) all criminal fines imposed in cases involving a Federal health care offense; (4) penalties imposed under the False Claims Act involving claims related to the provision of health care items and services; and (5) amounts resulting from the forfeiture of property by reason of Federal health care offense. States that amounts in the fund may be used to cover costs incurred in operating the Program. (Sec. 5411) Excludes from participation in any health plan any individual or entity excluded from participation in a public program under provisions of the Social Security Act. (Sec. 5413) Sets forth physician self-referral limitations. (Sec. 5431) Amends the Federal criminal code to set penalties for knowingly executing a scheme or artifice to: (1) defraud any health alliance, health plan, or other person (alliance) in connection with the delivery of, or payment for, health care benefits, items, or services (benefits); and (2) obtain, by false or fraudulent means, money or property owned by, or under the custody of control of, any such alliance in connection with the delivery of, or payment for, health care benefits. (Sec. 5432) Amends: (1) the Federal criminal code to require the court, in imposing sentence on a person convicted of a Federal health care offense that poses a serious threat to the health of any person or has a significant detrimental impact on the health care system, to order such person to forfeit property used in the commission of the offense or that constitutes, or is derived from, proceeds traceable to the commission of the offense which is of a value proportionate to the seriousness of the offense; and (2) the Federal judicial code to require that all proceeds of forfeiture relating to Federal health care offenses be deposited into the Department of Justice Assets Forfeiture Fund. (Sec. 5433) Amends the Federal criminal code to set penalties for: (1) knowingly and willfully falsifying, concealing, or covering up a material fact, making any false, fictitious, or fraudulent statements or representations, or making or using any false writing or document knowing it to contain any false, fictitious, or fraudulent statement or entry, in any matter involving a health alliance or health plan; and (2) bribery of, and graft by, a health care official. (Sec. 5435) Authorizes: (1) the Attorney General to commence a civil action in Federal court to enjoin a Federal health care offense; and (2) a person privy to certain grand jury information concerning a health law violation to disclose that information to an attorney for the Government to use in any civil proceeding related to a Federal health care offense. (Sec. 5437) Sets penalties for: (1) theft or embezzlement in connection with a health alliance, health plan, or fund connected with such alliance or plan; and (2) misuse of a health security card issued, or unique identifier provided, pursuant to this Act. (Sec. 5441) Makes provisions of the Civil False Claims Act applicable to the use of false records or statements made to a health plan. Includes within the definition of "claim" for purposes of such Act any request or demand for money or property which is made or presented to a health plan. Subtitle F: McCarran-Ferguson Reform - Amends the McCarran-Ferguson Act to repeal the exemption under specified antitrust laws for the business of insurance to the extent that such business relates to the provision of health benefits. Title VI: Premium Caps; Premium-Based Financing; and Plan Payments - Subtitle A: Premium Caps - Sets forth provisions which provide for the computation of factors that limit the growth of premiums for the comprehensive benefit package in regional alliance health plans, including the computation of a: (1) regional alliance inflation factor; and (2) general health care inflation factor. (Sec. 6002) Directs the Board to determine: (1) a national per capita baseline premium target; (2) the national average per capita current coverage health expenditures; and (3) current health care expenditures. (Sec. 6003) Directs the Board to determine a regional alliance per capita premium. (Sec. 6004) Requires a regional alliance to annually obtain premium bids from each plan seeking to participate as a regional alliance health plan with respect to the alliance. (Sec. 6005) Permits any participating State to assume responsibility for containment of health care expenditures in the State consistent with this Act. (Sec. 6006) Directs the chair of the Board to establish an advisory commission on regional variations in health expenditures. Requires the commission to examine methods of eliminating variation in regional alliance per capita premium targets due to variation in practice patterns, not due to other factors. Requires the Board to submit its recommendations to the Congress. Requires such recommendations to apply unless a joint resolution of disapproval is passed. (Sec. 6011) Subjects each noncomplying regional alliance health plan for a year to a reduction in plan payment as specified, in order to assure that payments to regional alliance health plans by a regional alliance are consistent. Defines a noncomplying plan to include a plan in which the final accepted bid exceeds the maximum complying bid for the per capita target premium. Defines "maximum complying bid." (Sec. 6021) Directs the Board to develop a methodology for calculating an annual per capita expenditure equivalent for amounts paid for coverage for the comprehensive benefit package within a corporate alliance. (Sec. 6022) Terminates a corporate alliance with two excess years in a three year period. Provides that employers that were corporate alliance employers with respect to a terminated alliance shall become regional alliance employers. Defines an excess year as one in which the rate of increase for the corporate alliance exceeds the national corporate inflation factor. Defines rate of increase and national corporate inflation factor. (Sec. 6031) Sets forth special rules for a single-payer State. (Sec. 6041) Directs the Secretary to establish a program to monitor prices and expenditures in the U.S. health care system. Subtitle B: Premium-Related Financings - Makes each family enrolled in a regional health alliance plan or in a corporate alliance health plan in a class of family enrollment responsible for payment of the family share of premium payable for enrollment. Provides for income related discounts and specified credits. (Sec. 6102) Establishes the formula for determining the premiums. (Sec. 6111) Provides for the repayment of credit by certain families. (Sec. 6114) Provides for the special treatment of certain retirees and qualified spouses and children. (Sec. 6121) Requires each regional alliance employer to pay a monthly premium to the regional alliance for a qualifying employee. Sets forth provisions for determining such premium. Varies the premium depending upon such factors as the employer's size and average wages paid. (Sec. 6126) Sets forth provisions applicable to self-employed individuals. (Sec. 6131) Sets forth provisions for determining the corporate employer premium. Subtitle C: Payments to Regional Alliance Health Plans - Sets forth provisions to determine the computation of: (1) the blended plan per capita payment amount; and (2) the plan bid, AFDC, and SSI proportions. Title VII: Revenue Provisions - Subtitle A: Financing Provisions - Amends the Internal Revenue Code to increase the excise taxes on cigarettes and other tobacco products. (Sec. 7113) Imposes an excise tax on the manufacture or importation of roll-your-own tobacco. (Sec. 7121) Imposes an assessment on each corporate alliance employer and a temporary assessment on employers with retiree health benefit costs. Requires such assessments to be paid in the same manner as employment taxes. (Sec. 7131) Provides for the recapture of certain health care subsidies received by high-income individuals. Transfers such amounts to the Supplemental Medical Insurance Trust Fund. (Sec. 7141) Requires certain shareholders of S corporations and limited partners who materially participate in corporate activities to include their share of income or loss from such corporation when determining net earnings from self-employment. (Sec. 7142) Provides for extending Medicare coverage and applying the hospital insurance tax to all State and local government employees. Subtitle B: Tax Treatment of Employer-Provided Health Care - Provides exceptions to the exclusion of employer-provided contributions to an accident or health plan from the gross income of an employee. (Sec. 7202) Prohibits the provision of health benefit under cafeteria plans. (Sec. 7203) Makes permanent the deduction for health insurance costs of self-employed individuals. Increases such deduction to 100 percent of the basic coverage purchased from a health alliance with limitations. Subtitle C: Employment Status Provisions - Requires the Secretary of the Treasury to prescribe regulations defining an employee for employment tax purposes. (Sec. 7302) Increases the penalty for failure to file correct returns involving payments for services. (Sec. 7303) Sets forth rules to limit retroactive employment tax reclassifications. Subtitle D: Tax Treatment of Funding of Retiree Health Benefits - Requires additional reserves for post-retirement medical and life insurance benefits to cover not less than ten years of the working lives of covered employees and to be maintained as separate accounts. (Sec. 7402) Terminates the authority of pension plans to maintain health benefits accounts. Subtitle E: Coordination with COBRA Continuing Care Provisions - Repeals provisions concerning continuation coverage requirements of group health plans upon implementation of this Act. Subtitle F: Tax Treatment of Organizations Providing Health Care Services and Related Organizations - Provides for the tax treatment of charitable organizations providing health care services, insurance provided by health maintenance organizations, and certain private foundations. (Sec. 7602) Sets forth transitional rules for taxing certain organizations providing health insurance and other prepaid health care services as insurance companies other than life insurance companies. (Sec. 7603) Exempts regional alliances from income tax. Subtitle G: Tax Treatment of Long-term Care Insurance and Services - Treats qualified long-term care services as medical care for purposes of the medical expense deduction. (Sec. 7702) Provides for the treatment of long-term care insurance as accident and health insurance. (Sec. 7703) Allows accelerated death benefits under life insurance contracts to be paid to terminally ill individuals. Subtitle H: Tax Incentives for Health Service Providers - Allows a tax credit for certain qualified individuals who provide primary health services full time in a health professional shortage area. (Sec. 7802) Increases the allowable depreciation deduction for expensing certain medical equipment. Subtitle I: Miscellaneous Provisions - Allows a tax credit for the cost of personal assistance services required by an employed individual who for medical reasons is unable to engage in substantial gainful activity. (Sec. 7902) Denies tax-exempt status for private activity bonds of regional alliances, corporate alliances, or guaranty funds established under this Act. Title VIII: Health and Health-Related Programs of the Federal Government - Subtitle A: Military Health Care Reform - Directs the Secretary of Defense to establish one or more uniformed services health plans in order to provide health care services to members of the armed forces on active duty for 30 or more days as well as their covered beneficiaries. Requires conformity of such plans with health plan requirements set forth in this Act. (Sec. 8001b) Allows any such plan to rely upon the use of military health care facilities, supplemented by civilian health care providers or health plans under agreements entered into by the Secretary. Requires at least the items and services in the comprehensive benefit package under this Act to be included in each such plan. Preempts any conflicting State health plan requirements. Provides for plan enrollment, effect of failure to enroll, and choosing between a uniformed services health plan and other available plans. Prohibits the imposition of plan charges to an active-duty member other than subsistence charges, but allows the Secretary to impose limited charges for covered beneficiaries. Establishes in the Department of Defense a financial account for payments received in connection with a uniformed services health plan, allowing such funds to be used only for purposes directly related to the delivery and financing of health care services under this Subtitle. Subtitle B: Department of Veterans Affairs - Allows each veteran who is an eligible individual under this Act and individuals currently enrolled in a health plan under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to be enrolled with a Department of Veterans Affairs (VA) health plan. Requires conformity of such plans with health plan requirements set forth in this Act, with all the items and services of the comprehensive benefit package under this Act included. Allows such plans to offer supplemental health benefits and cost-sharing policies as consistent with this Act. Provides a limitation with regard to veterans enrolled with health plans outside the VA. Prohibits the imposition of any plan enrollment charges upon service-connected disabled veterans, veterans receiving disability compensation from the VA, former prisoners of war, and veterans unable to defray the costs of such care. Allows the Secretary of Veterans Affairs to establish plan charges for other veterans. Deems a VA facility to be a Medicare provider for purposes of any program administered by the Secretary of Health and Human Services. Allows for the recovery of certain care and services provided under a VA plan in the case of an individual who has coverage under another plan. Establishes in the Treasury the Department of Veterans Affairs Health Plan Fund to be used for VA health plan payments and services. Preserves existing benefits for VA facilities not operating within a health plan certified under this Act. (Sec. 8102) Directs the Secretary of Veterans Affairs to organize health plans and operate VA facilities as, or within, health plans under this Act. Preempts existing State health plan standards or requirements. Authorizes the Secretary to contract for the provision of services by a VA health plan when cost-effective, or to share resources with other health care plans, providers, or organizations. Authorizes appropriations to the VA for FY 1995 through 1997 for VA health plans under this Subtitle, subject to availability of appropriations. Requires a report from the Secretary to the Congress concerning the operation of the VA health care system within the requirements of this Act. Authorizes the Secretary to accept and use grants for health care services provided to special populations if used by the VA while operating under a VA health plan. Subtitle C: Federal Employees Health Benefits Programs - (Secs. 8202 through 8204) Provides for termination of the Federal Employees Health Benefits Program (FEHB) and treatment of Federal employees, annuitants, and other individuals (including those residing abroad) who would otherwise have been eligible for FEHBP under this Act's health plans. Subtitle D: Indian Health Service - Makes qualifying Indians eligible to enroll in a comprehensive benefits health program of the Indian Health Service. (Sec. 8303) Authorizes appropriations for supplemental Indian health care benefits. (Sec. 8305) Exempts tribal governments and organizations from making employer payments. (Sec. 8306) Sets forth provisions regarding health service to non-enrollees and non-Indians. (Sec. 8311) Requires each health program of the Indian Health Service to establish a comprehensive benefit package fund. (Sec. 8313) Authorizes appropriations for the Indian Health Service programs. Subtitle E: Amendments to the Employee Retirement Income Security Act of 1974 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to revise and limit the coverage of group health plans under ERISA. Makes certain ERISA provisions inapplicable with respect to State-certified health plans. Provides for an exception from ERISA civil action provisions where review is otherwise available under the Health Security Act (this Act, HSA). (Sec. 8402) Establishes ERISA requirements for expeditious reporting and disclosure applicable to group health plans, through special rules consistent with ERISA and HSA purposes. Excludes plans maintained by regional alliances from treatment as multiple employer welfare arrangements. (Sec. 8403) Revises certain ERISA provisions relating to continuation coverage under group health plans. Repeals such provisions upon implementation of HSA. (Sec. 8404) Makes ERISA standards for group health plans regarding: (1) cases of adoption applicable except to the extent otherwise provided in regulations of the National Health Board under HSA; and (2) coverage of pediatric vaccines inapplicable to a group health plan upon its becoming a corporate alliance health plan under HSA. (Sec. 8405) Requires group health plans under ERISA to comply with HSA requirements relating to health plan claims procedure. Subtitle F: Special Fund for WIC Program - Authorizes appropriations through FY 2000 for the special supplemental food program for women, infants, and children under the Child Nutrition Act of 1966. Title IX: Aggregate Government Payments - Subtitle A: Aggregate State Payments - Sets forth provisions which have formulas for determining each participating State's payment to regional alliances within the State. Provides two different formulas. Establishes one payment formula for non-cash assistance recipients. Establishes another formula relating to cash assistance recipients. Defines a non-cash assistance adult as an individual who is: (1) over 21 years; (2) a U.S. citizen or lawful alien; and (3) is not an AFDC or SSI recipient or a Medicare-eligible individual. (Sec. 9022) Directs the National Health Board to review appropriateness of such payments. Subtitle B: Aggregate Federal Alliance Payments - Sets forth the formula for determining Federal payments to regional alliances for cash assistance recipients. (Sec. 9102) States that this section constitutes budget authority in advance of appropriation Acts and obligates the Federal Government to provide for the payment to regional alliances of a capped Federal alliance payment amount. Defines "capped Federal alliance payment amount." Subtitle C: Borrowing Authority to Cover Cash-flow Shortfalls - Authorizes the Secretary to make available loans to regional alliances to cover any period of temporary cash-flow shortfall attributable to: (1) any estimation discrepancy; (2) a period of temporary cash-flow shortfall attributable to an administrative error; or (3) a period of temporary cash-flow shortfall relating to the relative timing during the year in which amounts are received and payments are required. Sets forth loan terms and conditions. Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance - Subtitle A: Workers Compensation Insurance - Requires each health plan that provides services to enrollees through participating providers to make arrangements to provide workers compensation to such enrollees. (Sec. 10002) Requires each workers' compensation carrier that is liable for payment for workers' compensation services furnished by or through a health plan, regardless of whether or not the services are included in the comprehensive benefit package, to make payment for such services. (Sec. 10011) Sets forth requirements for participating States. (Sec. 10031) Authorizes demonstration projects in one or more States with respect to the treatment of work-related injuries and illnesses. Subtitle B: Automobile Insurance - Requires an individual entitled to automobile insurance medical benefits and enrolled in a health plan to receive automobile insurance medical services through the provision of such services by the health plan. (Sec. 10102) Requires each automobile insurance carrier that is liable for payment for automobile insurance medical services furnished by or through a health plan, regardless of whether or not the services are included in the comprehensive benefit package, to make payment for such services. (Sec. 10111) Requires each participating State to develop a fee schedule applicable to payment for automobile insurance medical services for which a fee is not included in the applicable fee schedule. Subtitle C: Commission on Integration of Health Benefits - Establishes the Commission on Integration of Health Benefits which shall study and report on the feasibility and appropriateness of transferring financial responsibility for all medical benefits, including those currently covered by workers compensation and automobile insurance, to health plans. Authorizes appropriations. Subtitle D: Federal Employees' Compensation Act - Requires the Federal Employees' Compensation Act to be interpreted and administered consistent with the provisions of subtitle A. Subtitle E: Davis-Bacon Act and Service Contract Act - Amends the Davis-Bacon Act and the Service Contract Act of 1965 to require Health Security Act benefits. Subtitle F: Effective Dates - Sets forth effective date provisions. Title XI: Transitional Insurance Reform - Sets forth transitional provisions concerning: (1) enforcement; (2) preservation of current coverage; (3) restrictions on premium increases during transition; (4) portability requirements; (5) restrictions limiting benefit reductions; and (6) the establishment of the National Transitional Health Insurance Risk Pool.
United States · United States Congress · 19 November 1993
Designates 1994 as The Year of Gospel Music.
United States · United States Congress · 17 November 1993
Prohibits the shipment in interstate or foreign commerce of steel jaw leghold traps and of articles of fur derived from animals trapped in such traps. Prescribes criminal penalties for violations of this Act. Directs the Secretary of the Interior to reward nongovernment informers for information leading to a conviction under this Act. Empowers enforcement officials to detain, search, and seize suspected merchandise or documents and to make arrests with and without warrants. Subjects seized merchandise to forfeiture.
United States · United States Congress · 10 November 1993
Amends the Immigration Reform and Control Act of 1986 to extend: (1) the period of availability of State legalization impact-assistance grants; and (2) the period of State authority to use funds for educational and naturalization services. Makes specified other funds available to States for services provided to eligible legalized aliens.
United States · United States Congress · 10 November 1993
United States Military Academy Bicentennial Commemorative Coin Act of 1993 - Directs the Secretary of the Treasury to issue five-dollar gold coins, one-dollar silver coins, and half dollar clad coins emblematic of the U.S. Military Academy. Mandates that surcharges collected from coin sales be paid to the Association of Graduates, U.S. Military Academy, to assist its efforts to provide direct support to the Corps of Cadets, U.S. Military Academy.
United States · United States Congress · 10 November 1993
Designates March 20 through 26, 1994, as Small Family Farm Week.
United States · United States Congress · 9 November 1993
Designates June 17, 1994, as African-American Men Positive Role Model Day.
United States · United States Congress · 9 November 1993
Designates May 6, 1994, as African-American Women Positive Role Model Day.
United States · United States Congress · 8 November 1993
Expresses the sense of the Congress that the United States should: (1) seek an international agreement to ban the deliberate ocean dumping of low-level radioactive waste and encourage a periodic international scientific review of the environmental impacts of such dumping; and (2) urge all nations to comply with existing and future international agreements prohibiting the deliberate ocean dumping of low- and high-level radioactive waste.
United States · United States Congress · 3 November 1993
Establishes within the Department of the Interior the Presidio Corporation to manage the leasing, maintenance, rehabilitation, repair, and improvement of the following properties within the Presidio in California leaseholds to which shall be transferred under this Act to the Corporation by the Secretary of the Interior: (1) the Letterman-LAIR complex; (2) Fort Scott; (3) Main Post; (4) Cavalry Stables; (5) Presidio Hill; (6) Wherry Housing; (7) East Housing; (8) the structures at Crissy Field; and (9) such other buildings within the Presidio as the Secretary determines appropriate. Requires the Corporation to establish competitive bidding procedures for issuance of leases and contracts under this Act. Reverts all interests and assets of the Corporation to the United States in the event the Corporation fails or defaults. Authorizes appropriations.