United States · United States Congress · 9 February 1994
Amends rule XI of the Rules of the House of Representatives to require each committee report on each authorization or revenue bill or joint resolution of a public character to contain a detailed analytical statement prepared by the Director of the Congressional Budget Office of the estimated impact of that bill or joint resolution on public and private sector employment over a five-fiscal year period.
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
Prohibits the U.S. Postal Service or the Attorney General from fining or otherwise penalizing any person who transmits by private express or other unlawful means, delivers to any agent thereof, or deposits at any appointed place any letter or packet. Amends the Federal criminal code to conform with this Act. Prohibits the U.S. Postal Service from authorizing any officer or employee to make searches of mail matter transported in violation of law in any store or office of a customer of a common carrier or transportation company.
United States · United States Congress · 3 February 1994
Budget Accountability Act of 1994 - Provides for the termination of Federal programs that are not reauthorized by the Congress. Amends the Rules of the House of Representatives to prohibit the consideration of legislation that does not contain an authorization period for the use of appropriated amounts. Prohibits the imposition of any tax unless a later date for such tax to terminate is specified by law. Amends the Rules of the House of Representatives to prohibit the consideration of such legislation. Expresses the sense of the Congress that: (1) the House rule concerning the reporting requirements in general appropriations bills should be vigorously applied; (2) laws that affect the Federal revenue should be periodically reviewed by the appropriate congressional committees to determine, based on the health of the economy, whether such laws should continue in effect; and (3) reducing the debt of the Federal Government is critical to the long-term health of the economy.
United States · United States Congress · 2 February 1994
Prohibits the Department of Transportation or any other Federal department, agency, or instrumentality from requiring any State or political subdivision to convert highway signs to metric units.
United States · United States Congress · 2 February 1994
Small Business Empowerment Act - Amends the Internal Revenue Code to allow an individual retirement account to be pledged as security for a qualified business loan.
United States · United States Congress · 26 January 1994
Capital Formation and Jobs Creation Act of 1994 - Amends the Internal Revenue Code to allow a 50 percent income tax deduction for the net capital gain of both corporate and noncorporate taxpayers. Requires indexing, based on the gross national product deflator, of the adjusted basis of certain assets (corporate stock and tangible property that is a capital asset or property used in a trade or business) that have been held for more than one year at the time of sale or other transfer, solely for the purpose of determining gain or loss. Allows an itemized deduction for losses arising from the sale or exchange of a principal residence.
United States · United States Congress · 25 January 1994
Directs the Secretary of Health and Human Services to study and report to the Congress on the feasibility of using biometric devices to verify the identity of applicants and recipients of Aid to Families with Dependent Children under part A of title IV of the Social Security Act.
United States · United States Congress · 25 January 1994
Education Bureaucracy Reduction Act - Directs the Secretary of Education, for FY 1995 and 1996, to reduce personnel costs of the Department of Education by ten percent. Requires savings from such reduction to be used as follows: (1) 90 percent transferred to local educational agencies according to State distribution formulas; and (2) ten percent to reduce the Federal budget deficit.
United States · United States Congress · 22 November 1993
TABLE OF CONTENTS: Title I: Tax and Insurance Provisions Subtitle A: Tax Treatment of Health Care Expenses Subtitle B: Insurance Provisions Subtitle C: Employer Provisions Subtitle D: State Plan Requirements Subtitle E: Federal Preemption Title II: Medicare and Medicaid Reforms Subtitle A: Medicare Subtitle B: Medicaid Title III: Health Care Liability Reform Title IV: Administrative Cost Savings Subtitle A: Standardization of Claims Processing Subtitle B: Electronic Medical Data Standards Subtitle C: Development and Distribution of Comparative Value Information Subtitle D: Preemption of State Quill Pen Laws Title V: Anti-Fraud Subtitle A: Criminal Prosecution of Health Care Fraud Subtitle B: Coordination of Health Care Anti-Fraud and Abuse Activities Title VI: Antitrust Provisions Title VII: Long-Term Care Title VIII: Welfare Restrictions for Aliens Title IX: Increase in Assistance to Community and Migrant Health Centers from Residual Savings Consumer Choice Health Security Act of 1993 - Title I: Tax and Insurance Provisions - Subtitle A: Tax Treatment of Health Care Expenses - Amends the Internal Revenue Code to allow a tax credit for health care expenses based upon percentages of qualified health insurance premiums and adjusted gross income. Provides for employers to make advance payments of such credit. (Sec. 102) Allows individuals a tax credit for a percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Exempts such accounts from taxation. Establishes an excise tax for excess contributions to medical care savings accounts and makes such accounts subject to the tax on prohibited transactions. (Sec. 103) Disallows the use of a personal exemption for an uninsured individual. Terminates the medical expense deduction, the deduction for health insurance costs of self-employed individuals, and the exclusion for employer-provided health insurance. Subtitle B: Insurance Provisions - Part I: Federally Qualified Health Insurance Plans - Sets forth requirements for federally qualified health insurance plans, including coverage for acute medical care, cost-sharing, premium rating practices, and guaranteed issuance and renewability. Part II: Certification of Federally Qualified Health Insurance Plans - Requires States to meet standards for regulatory programs for the certification of federally qualified health insurance plans. Subtitle C: Employer Provisions - Requires employers to: (1) withhold health insurance premiums from employee wages and remit such premiums to the employee's chosen insurer; and (2) notify each employee of their right to claim an advance refundable tax credit for such premiums. (Sec. 122) Provides for the conversion and continuation of existing insurance plans to required coverage under this Act. (Sec. 125) Establishes the Benefits Cash Out Commission to propose a procedure under which individuals may cash out Federal health benefits. Provides for congressional consideration of such proposal prior to its implementation. (Sec. 126) Imposes excise taxes on employers and health insurance carriers for noncompliance with this Act. Subtitle D: State Plan Requirements - Sets forth requirements for States to meet in order to receive Federal funds for health care programs. Subtitle E: Federal Preemption - Preempts specified State laws concerning health insurance. Title II: Medicare and Medicaid Reforms - Subtitle A: Medicare - Directs the Secretary to report to the Congress on the feasibility of allowing future Medicare beneficiaries to elect to receive certificates with which to purchase private health insurance coverage instead of receiving Medicare benefits. (Sec. 202) Eliminates disproportionate share hospital payments under Medicare. (Sec. 203) Provides for a reduction in the adjustment for indirect medical education costs under Medicare. (Sec. 204) Imposes copayments for skilled nursing facility services provided under Medicare. (Sec. 205) Moves payment updates to January for all payment rates under Medicare's hospital insurance program. (Sec. 206) Accelerates the transition to prospective rates for facility costs in hospital outpatient departments. Subtitle B: Medicaid - Places a cap on Federal payments for acute medical services furnished under a State's Medicaid program. (Sec. 212) Provides for waivers from Medicaid requirements in order to establish acute medical services programs. (Sec. 213) Terminates disproportionate share hospital payments under Medicaid. (Sec. 214) Directs the Secretary to provide grants to States for programs to provide health insurance coverage, acute medical services, preventive care, and disease prevention services to low-income individuals. Title III: Health Care Liability Reform - Health Care Liability Reform Act of 1993 - Limits payments, damages, and attorney's fees in health care malpractice actions and claims. (Sec. 304) Declares that a manufacturer or seller of a health care product shall not be strictly liable for injury from: (1) a defect in the design of the product; or (2) a failure to warn or instruct regarding a risk posed by the product that was not known or reasonably knowable. (Sec. 305) Limits the amount of noneconomic damages that may be awarded in a health care malpractice claim or a health care product liability claim. Allows several liability for noneconomic loss and for punitive damages. (Sec. 306) Allows punitive damages to be awarded only if the claimant establishes that the harm suffered was the result of conduct manifesting conscious, flagrant indifference to the health of those harmed by the product. Disallows punitive damges against a product approved by the Food and Drug Administration. Title IV: Administrative Cost Savings - Subtitle A: Standardization of Claims Processing - Directs the Secretary to adopt standards relating to: (1) data elements for use in paper and electronic claims processing under health benefit plans and in utilization review and mangement of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. (Sec. 402) Authorizes the Secretary, two years after standards are adopted for classes of services upon determining that a significant number of claims for benefits for such services under health benefit plans are not being submitted in accordance with such standards, to require that all providers of such services submit claims to health benefit plans in accordance with such standards. (Sec. 403) Directs the Secretary to: (1) provide for the ongoing receipt and review of comments and suggestions for changes in the standards adopted and promulgated; (2) establish a schedule for the periodic review of such standards; and (3) revise such standards. Subtitle B: Electronic Medical Data Standards - Directs the Secretary to promulgate standards for hospitals concerning electronic medical data, including standards for transmission of such data and confidentiality of patient-specific information. Authorizes the Secretary to periodically revise such standards. (Sec. 412) Sets forth requirements with respect to: (1) the sharing of hospital information under Medicare; (2) waiver of such requirements; and (3) application of such requirements to hospitals of the Department of Veterans Affairs. (Sec. 413) Authorizes the head of a Federal agency to require a provider to present and transmit a required data element electronically in accordance with applicable presentation or transmission standard. (Sec. 414) Sets forth limitations on data requirements where standards with respect to data elements are in effect. (Sec. 415) Directs the Secretary to establish an advisory commission on the standards established under this part and operational concerns about the implementation of such standards. Authorizes appropriations. Subtitle C: Development and Distribution of Comparative Value Information - Directs the Secretary to determine whether each State is developing and implementing a health care value information program that meets specified criteria and a specified schedule. Authorizes the Secretary to: (1) make grants to enable each State to plan development and initiate implementation of its health care value information program; and (2) recover the amount of such a grant by offset against any other amount payable to the State under the Social Security Act under specified circumstances. Authorizes appropriations. (Sec. 422) Directs the Secretary to take actions necessary to implement a comparable program in a State that fails to develop or implement a health care value information program in accordance with such criteria and schedule. Authorizes the Secretary to charge fees for the information materials provided pursuant to such a program. (Sec. 423) Directs the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to develop health care value information relating to each program that such head administers and covering the same types of data that a State program meeting such criteria would provide. Subtitle D: Preemption of State Quill Pen Laws - Specifies that, effective January 1, 1996, no effect shall be given to any provision of State law that requires medical or health insurance records (including billing information) to be maintained in written, rather than electronic, form. Title V: Anti-Fraud - Subtitle A: Criminal Prosecution of Health Care Fraud - Amends the Federal criminal code to impose penalties upon a health care provider that knowingly engages in any scheme or artifice to defraud a person in connection with the provision of health care. (Sec. 502) Authorizes the Attorney General to pay a reward of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution for health care fraud, with exceptions. Subtitle B: Coordination of Health Care Anti-Fraud and Abuse Activities - Amends the Social Security Act to provide for: (1) the application of Federal health anti-fraud and abuse sanctions to all fraud and abuse against any health insurance plan; and (2) treble damages for making or causing to be made false statements or representations involving Medicare or State health care programs, for illegal remuneration, and for false statements or representations with respect to the condition or operation of health care institutions. Directs the Secretary of Health and Human Services, in consultation with State and local health care officials, to: (1) identify opportunities for the satisfaction of community service obligations that a court may impose upon the conviction of a criminal offense involving Medicare or State health care programs; and (2) make information concerning such opportunities available to Federal and State law enforcement officers and State and local health care officials. Title VI: Antitrust Provisions - Exempts from the antitrust laws specified "safe harbor" activities related to the provision of health care services. Sets forth provision regarding the award of attorney fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt. (Sec. 602) Lists as safe harbors specified: (1) activities relating to health care services of combinations of health care providers with market share below a specified threshold; (2) activities of medical self-regulatory entities relating to standard setting or enforcement activities not conducted for purposes of financial gain; (3) participation of a health care provider in a written survey of the prices of services, reimbursement levels, or the compensation and benefits of employees and personnel; (4) activities relating to health care joint ventures for high technology and costly equipment and services; (5) activities relating to hospital mergers; (6) joint purchasing arrangements; and (7) negotiations. (Sec. 603) Directs the Attorney General to publish a notice in the Federal Register soliciting proposals for additional safe harbors and to review and report to the Congress on proposed safe harbors. Sets forth criteria in establishing safe harbors, including: (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. (Sec. 604) Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates. Sets forth provisions regarding applications for, revocation of, and review of determinations regarding such certificates. Limits the disclosure of information. (Sec. 605) Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. (Sec. 606) Directs the Attorney General to: (1) review the safe harbors and certificates of review periodically; and (2) promulgate such rules, regulations, and guidelines as necessary to carry out provisions of this title. Title VII: Long-Term Care - Amends the Internal Revenue Code to exclude from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangements to pay long-term care premiums. (Sec. 702) Provides for the nonrecognition of gain or loss on the exchange of any life insurance contract or an endowment or annuity contract for a long-term care insurance contract. (Sec. 703) Provides for the exclusion as a death benefit of any amount paid or advanced to an individual under a life insurance contract because such individual is terminally ill, or chronically ill and has been permanently confined to a qualified facility. Title VIII: Welfare Restrictions for Aliens - Makes aliens ineligible for programs of public welfare assistance, other than medical assistance with respect to emergency services. (Sec. 802) Amends the Social Security Act to require State agencies to provide the Immigration and Naturalization Service with identifying information on individuals unlawfully in the United States whose children are citizens for purposes of the Aid to Families with Dependent Children program. Title IX: Increase in Assistance to Community and Migrant Health Centers from Residual Savings - Directs the Secretary of Health and Human Services to provide for a program of grants to migrant and community health centers to promote primary health care services for underserved individuals. Authorizes appropriations with limitations. Requires a report to the Congress on such program.
United States · United States Congress · 22 November 1993
TABLE OF CONTENTS: Title I: Family Tax Credit Title II: Reducing the Cost of Capital by Reducing Capital Gains Tax Rates and Indexing the Basis of Certain Assets Title III: Neutral Cost Recovery Title IV: Increasing National Savings Through Individual Retirement Plus Accounts, Indexing for Inflation the Income Thresholds for Taxing Social Security Benefits, etc. Title V: Cap on Federal Spending and Establishment of Commission to Reduce Federal Spending Title VI: Elimination of Social Security Earnings Test Family, Investment, Retirement, Savings, and Tax Fairness Act of 1993 - Title I: Family Tax Credit - Amends the Internal Revenue Code to allow individuals a tax credit of $500 multiplied by the number of qualifying children who have not attained age 18. Places limitations on such credit and adjusts it for inflation. Title II: Reducing the Cost of Capital by Reducing Capital Gains Tax Rates and Indexing the Basis of Certain Assets - Reduces the individual and corporate capital gains rate from 34 percent to 15 percent. Reduces such tax to 7.5 percent for low- and middle-income taxpayers. Provides for the phaseout of personal exemptions and the overall limitation on itemized deductions to take into account adjusted gross income which has been reduced by net capital gain. Requires indexing, based on the gross national product deflator, of the adjusted basis of certain assets (corporate stock and tangible property that is a capital asset of property used in a trade or business) that have been held for more than one year at the time of sale or other transfer, solely for the purpose of determining gain or loss. Provides for indexing the limitation on capital losses of noncorporate taxpayers. Title III: Neutral Cost Recovery - Allows the depreciation deduction to be computed based on a neutral recovery basis for property placed in service after December 31, 1993. Disallows the interest deduction for such property to ensure that equity financing receives the same treatment as debt financing. Provides special depreciation rules applicable under the adjusted current earnings provisions of the minimum tax for 1994. Title IV: Increasing National Savings Through Individual Retirement Plus Accounts, Indexing for Inflation the Income Thresholds for Taxing Social Security Benefits, etc. - Allows individuals to establish individual retirement plus accounts with tax treatment similar to that for individual retirement plans. Makes contributions to such account nondeductible. Provides for qualified distributions from such accounts. Other than for general retirement purposes, including special purpose distributions made for the purchase of a first home and for medical or educational purposes. Prohibits special purpose distributions from being made during the first five years of the account. Provides an inflation adjustment after 1996 for income thresholds in determining the taxation of social security benefits. Excludes income from individual retirement plans when determining modified adjusted gross income. Provides an inflation adjustment after 1996 for the maximum amount allowable as a deduction for retirement savings. Title V: Cap on Federal Spending and Establishment of Commission to Reduce Federal Spending - Establishes the Commission on Reduction of Federal Spending to: (1) recommend specific reductions in Federal activities to assure that spending does not grow at a rate in excess of two percent per year through FY 1998; and (2) report a bill to the Congress with changes necessary to achieve such reductions. Establishes an advisory council to assist the Commission. Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to set forth sequestration procedures when the increase in annual Federal spending exceeds the amount resulting from an annual rate of inflation of two percent. Title VI: Elimination of Social Security Earnings Test - Amends title II (Old Age, Survivors and Disability Insurance) of the Social Security Act to remove the limitation on the amount of outside income which beneficiaries who have attained retirement age may earn without incurring a reduction in benefits.
United States · United States Congress · 22 November 1993
Truth in Voting Act of 1993 - Amends the Congressional Budget Act of 1974 to provide for downward adjustments in Appropriations Committees allocations and suballocations when bills are passed that reduce appropriations and require rescissions. Requires the Congressional Budget Office to provide scorecards for such measures. Amends rule XI of the Rules of the House of Representatives to prohibit proxy voting by any committee or subcommittee member. Establishes conditions under which meetings of the standing committees and subcommittees may be closed to the public. Requires proceedings of open committee hearings or meetings to be open to television or radio broadcast and still photography. Applies the Freedom of Information Act to the Congress as such Act applies to executive agencies. Prohibits the Committee on Rules from reporting any rule for the consideration of a measure commonly known as a "king of the hill" rule. Repeals rule XLIX (statutory limit on the public debt). Amends rule XXVIII to prohibit conference committee reports from funding any program or activity at a level higher than that contained in the bill or resolution as passed by the House or Senate or from funding any program not contained in such versions. Requires the President's annual budget to include estimated expenditures and proposed appropriations for each function and subfunction in the current fiscal year and the fiscal year for which the budget is submitted. Amends the Congressional Budget Act of 1974 to make the starting point for any deliberations on the budget in committee the estimated level of outlays for the current period in each function and subfunction. Requires the budget to include comparisons of current fiscal year and proposed subsequent fiscal year spending. Requires the Comptroller General to prepare an economic and employment impact statement to accompany each bill, resolution, or conference report reported by a committee or considered on the floor. Makes it out of order to consider any legislation that is not accompanied by such statement unless the point of order is waived by a two-thirds vote. Requires regulations and proposed regulations promulgated by Federal agencies to be accompanied by such statements as well.
United States · United States Congress · 22 November 1993
Requires the United States to withdraw from the North American Agreement on Environmental Cooperation and the North American Agreement on Labor Cooperation (North American Free Trade Agreement supplemental agreements). Requires the President to provide notice of such withdrawal to Canada and Mexico. Repeals provisions of the North American Free Trade Agreement Implementation Act relating to implementation of such agreements.
United States · United States Congress · 19 November 1993
TABLE OF CONTENTS: Title I: 100 Percent Cross-Guarantees Subtitle A: Definitions Subtitle B: Cross-Guarantee Process Subtitle C: Powers and Duties of the CGRC Subtitle D: Miscellaneous Provisions Subtitle E: Transition to 100 Percent Cross-Guarantee Process Title II: Amendments to Other Banking Laws Title III: Amendments to Title 11, United States Code Subtitle A: Amendments to chapter 1 of Title 11 Subtitle B: Amendments to chapter 3 of Title 11 Subtitle C: Amendments to chapter 5 of Title 11 Subtitle D: Amendments to chapter 11 of Title 11 Title IV: Amendment to Title 28, United States Code Deposit Insurance Reform, Regulatory Modernization, and Taxpayer Protection Act of 1993 - Title I: 100 Percent Cross-Guarantees - Subtitle A: Definitions - Sets forth definitions relating to depository institutions, non-depository guarantors, affiliates, financial terms, and funds. Subtitle B: Cross-Guarantee Process - Sets forth a cross-guarantee mechanism whose purpose is to: (1) protect the full amount of deposits by prohibiting depository institutions from operating without a cross-guarantee contract issued by syndicates of guarantors; (2) charge risk-sensitive premiums for the guarantees provided; (3) establish a self-regulating system with stop-loss mechanisms; and (4) regulate the cross-guarantee marketplace only to the extent of maintaining its soundness and viability (but not the solvency of any individual depository institution regardless of its size). (Sec. 113) Includes a stop-loss limit for losses of a guaranteed party as a direct guarantor of other guaranteed parties. Requires the cross-guarantor's contract obligations to be independent of the obligations of any other party under the contract. Prohibits direct guarantors under any cross-guarantee or stop-loss contract from obtaining collateral for cross-guarantee obligations. Sets forth the requirements for: (1) cross-guarantee contracts; (2) stop-loss contracts; (3) direct guarantors; and (4) cross-guarantee and stop-loss syndicates. (Sec. 119) Declares that any action arising under a cross-guarantee or stop-loss contract shall be deemed to arise under Federal law. Confers original jurisdiction upon the Federal courts for any action arising under such contracts. Subtitle C: Powers and Duties of the CGRC - Establishes the Cross Guarant Regulation Corporation (CGRC) to enforce, regulate, and approve the cross-guarantee process. Outlines the CGRC approval process for cross-guarantee and stop-loss contracts. (Sec. 124) Requires the CGRC to establish and maintain a central electronic repository for: cross-guarantee, stop-loss, and group cross-guarantee syndicate contracts. Mandates that the repository files be directly accessible to any direct guarantor, guaranteed party, syndicate agent, and other eligible persons. Prohibits closed loop situations (i.e., a group of institutions guarantee each other without sharing such risk with outside guarantors) unless at least one cross-guarantee or stop-loss contract is a contract in each closed loop that exists in the system. Cites conditions under which the FDIC must appoint itself conservator or receiver for a depository institution guaranteed under a cross-guarantee contract. (Sec. 126) Confers upon the Secretary of Treasury oversight powers over the CRGC. (Sec. 128) Establishes a CGRC- administered cross-guarantee backup fund to pay for any loss incurred by a depositor in connection with an insured deposit at a depository institution. States that deposits in any guaranteed depository institution shall be insured against loss to the same extent as deposits are insured against loss by the CGRC if the CGRC cannot recover adequate funds to pay for any loss due to the appointment of a receiver under this Act. Subtitle D: Miscellaneous Provisions - Requires the CGRC to ensure that all deposit-taking institutions, with specified exceptions, comply with all Federal and State licensing and regulation laws. (Sec. 133) Declares that no collateral is required for lending by any Federal Reserve Bank to a guaranteed company. Requires the Board of Governors of the Federal Reserve System to submit annual status reports to certain congressional committees regarding losses incurred as a result of lending within the cross-guarantee system. (Sec. 134) Permits a cross-guarantee company or banking office to advertise that deposits and certain other liabilities under an CGRC-approved cross-guarantee contract are fully guaranteed against loss. Subtitle E: Transition to 100 Percent Cross-Guarantee Process - Sets forth a conversion schedule to implement an eight-year transition period for the cross-guarantee system, effectuated when a specified minimum number of CGRC-approved cross-guarantee contracts and total assets are approved. Requires the CGRC immediately to appoint a conservator or receiver for any depository institution which has not complied with such schedule. (Sec. 144) Prescribes guidelines for severance pay and related benefits for former State and Federal banking agency employees. (Sec. 146) Abolishes: (1) the Federal Financial Institutions Examination Council; and (2) the Federal Deposit Insurance Corporation. Title II: Amendments to Other Banking Laws - Amends Federal banking laws to conform with the provisions of this Act, including amendments relating to: (1) national banks; (2) Federal Reserve System member banks; (3) savings associations; (4) savings and loan holding companies; (5) the FDIC; and (6) other Federal banking laws. Title III: Amendments to Title 11, United States Code - Amends Federal bankruptcy law to conform with this Act. Title IV: Amendment to Title 28, United States Code - Amends the Federal judiciary code to conform its venue provisions with this Act.
United States · United States Congress · 19 November 1993
Independent Counsel Accountability and Reform Act of 1993 - Amends the Federal judicial code to reauthorize the independent counsel statute (the Act). Makes the Act applicable to Members of Congress. Revises the Act to: (1) require specific information from a credible source sufficient to constitute grounds to investigate whether a person covered by the Act has violated specified Federal criminal laws; and (2) permit the Attorney General to issue subpoenas. Requires the division of the court that appoints an independent counsel to: (1) define with specificity the independent counsel's prosecutorial jurisdiction; (2) assure that the independent counsel has adequate authority to fully investigate and prosecute the alleged violations of criminal law with respect to which the Attorney General has requested the appointment and matters directly related to such criminal violations; and (3) strongly consider appointing independent counsel prosecutors from State or local governments. Revises provisions regarding compensation of staff of an independent counsel. Directs the independent counsel, to the greatest extent possible, to use personnel of the Department of Justice (DOJ) on a reimbursable basis in lieu of appointing employees. Directs (currently, authorizes) the division to award reimbursement for attorney's fees upon the request of an individual who is the subject of an investigation conducted by an independent counsel if no indictment is brought against such individual pursuant to that investigation (as under current law), if such individual is acquitted of all charges, if no conviction is obtained against such individual, or if the conviction of such individual is overturned on appeal. Establishes or revises provisions regarding: (1) treatment of classified information by, per diem expenses of, administrative support for, compliance with DOJ policies by, limitations on expenditures of, periodic reports on activities of, and the removal, termination, and periodic reappointment of, an independent counsel; and (2) job protections for individuals under investigation. Directs the Comptroller General of the United States to report to the Congress with recommendations of ways to improve controls on costs of offices of independent counsel.
United States · United States Congress · 10 November 1993
Health Care Antitrust Improvements Act of 1993 - Exempts from the antitrust laws specified "safe harbor" activities listed in, or designated by the Attorney General pursuant to, this Act. Sets forth provisions regarding the award of attorney's fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt. Lists as safe harbors specified: (1) activities relating to health care services of combinations of health care providers with market share below a specified threshold; (2) activities of medical self-regulatory entities relating to standard setting or enforcement activities not conducted for purposes of financial gain; (3) participation of a health care provider in a written survey of the prices of services, reimbursement levels, or the compensation and benefits of employees and personnel; (4) activities relating to health care joint ventures for high technology and costly equipment and services; (5) activities relating to hospital mergers; (6) joint purchasing arrangements; and (7) negotiations. Directs the Attorney General to publish a notice in the Federal Register soliciting proposals for additional safe harbors. Sets forth criteria in establishing safe harbors, including: (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates. Sets forth procedures regarding applications for, revocation of, and review of determinations regarding, such certificates. Limits the disclosure of information. Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. Directs the Attorney General to periodically review the safe harbors and certificates of review. Establishes within the Department of Health and Human Services an Office of Health Care Competition Policy.
United States · United States Congress · 10 November 1993
TABLE OF CONTENTS: Title I: AFDC Transition and Work Program Title II: Paternity Establishment Title III: Expansion of Statutory Flexibility of States Title IV: Expansion of State and Local Flexibility Title V: Child Support Enforcement Title VI: Welfare Restrictions for Aliens Title VII: Controlling Welfare Costs Title VIII: Consolidated Block Grant to States for Food Assistance Title IX: Miscellaneous Responsibility and Empowerment Support Program Providing Employment, Child Care, and Training Act - Title I: AFDC Transition and Work Program - Amends part F (Job Opportunities and Basic Skills Training Program) (JOBS) of title IV of the Social Security Act (SSA) to give the JOBS program the new purpose of assuring that needy families with children obtain not only the education and training needed to prepare them for a life without welfare, but the work experience as well. (Sec. 101) Requires State JOBS programs to include a transition component and a work supplementation component that: (1) are each allowed to include any State work experience program approved by the Secretary; and (2) with respect to the first component, must include the State's job search program, and, with respect to the second component, may include the State's work supplementation or community work experience program. Amends part A (Aid to Families with Dependent Children) (AFDC) of SSA title IV to revise State AFDC plan participation requirements to incorporate participation in the two JOBS program components above under specified guidelines as a requirement for qualified individuals to receive AFDC. Imposes sanctions for a qualified individual's failure to participate in the JOBS program as required under such guidelines, which include a reduction in AFDC benefits and eventual benefit termination for repeated failures. Revises the exemptions from JOBS program participation requirements. Extends to all States the option to limit AFDC-UP. Increases State JOBS program and work program participation rates with regard to, respectively, AFDC-eligible individuals and unemployed parents. Provides for additional payments to States for JOBS programs. (Sec. 102) Amends community work experience and work supplementation program provisions. Title II: Paternity Establishment - Amends SSA title IV part A to: (1) provide for denial or reduction of AFDC for children whose paternity is not established; and (2) require unmarried individuals under 19 who are eligible for AFDC and are pregnant or with dependent children under their care to reside at home in order to receive AFDC. (Sec. 203) Amends SSA title IV part D (Child Support and Establishment of Paternity) to require earlier specified paternity establishment efforts by States. Expresses the encouragement of the Congress for States to develop procedures in public hospitals and clinics to facilitate the acknowledgment of paternity. (Sec. 204) Increases the paternity establishment percentage. Title III: Expansion of Statutory Flexibility of States - Amends SSA title IV part A to give States the option to: (1) convert AFDC into a block grant program; (2) exempt themselves from otherwise mandatory denial of AFDC where either parent is a minor; (3) treat families moving interstate who apply for AFDC in their new State of residence (where they have resided for less than on year) under the AFDC rules of their former State of residence; (4) reduce AFDC for parents under 21 who have dropped out of school and dependent children who, without good cause, do not maintain minimum school attendance; (5) exempt themselves from otherwise mandatory denial of AFDC for additional children; (6) modify certain AFDC income disregard rules; (7) provide for a married couple transitional benefit in cases where an AFDC recipient marries an individual who is not a parent of the recipient's child, and the resulting family would become ineligible for AFDC by reason of the marriage; (8) disregard certain savings and income of a family on AFDC designated for education, training, employability, home purchase, or residence change in determining eligibility for AFDC; and (9) condition the receipt of AFDC on the recipient's attendance at parenting and money management classes and prior approval of any action requiring a change in the educational institution attended by the recipient's dependent child. Title IV: Expansion of State and Local Flexibility -Establishes an Interagency Waiver Request Board in order to provide a focal point within the Federal Government for the development and coordination of waiver requests to improve opportunities for low-income individuals and families. (Sec. 402) Prescribes contents of applications to implement Federal assistance plans, as well as the review, approval, implementation, and evaluation processes. (Sec. 405) Requires any entity applying for plan approval to establish a Public Private Partnership Committee to advise it on plan development and implementation. Title V: Child Support Enforcement - Provides for a national system for employee reporting of any child support owed, the obligee involved, and other specified related information on W-4 forms for employer withholding and distribution of support owed, and reporting of related information to the State involved for availability to other States through the Interstate Locate Network established under this title. (Sec. 502) Makes various changes with regard to State child support order registries, the Parent Locater Service, regulations for sharing child support information, withholding orders, and noncustodial parents with child support arrearages who are receiving certain public welfare assistance. Title VI: Welfare Restrictions for Aliens - Makes aliens (except refugees, permanent residents, and certain current residents) ineligible for various specified types of public welfare assistance, including non-emergency related assistance under Medicaid, food stamps, and job training assistance. (Sec. 602) Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act (SSA) to require State AFDC agencies to provide information on illegal aliens to the Immigration and Naturalization Service. Title VII: Controlling Welfare Costs - Amends the Congressional Budget Act of 1974, the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act), and other Federal law to establish various specified measures for controlling welfare costs, including Federal spending caps. Title VIII: Consolidated Block Grant to States for Food Assistance - Repeals the Food Stamp Act of 1977, National School Lunch Act, Commodity Distribution Reform Act and WIC Amendments of 1987, and other specified Federal laws and replaces them with a: (1) State food assistance block grant program to provide food assistance to economically disadvantaged individuals and families (eligible populations); and (2) new food coupon program. Authorizes appropriations. (Sec. 803) Grants the Secretary of Agriculture and the Commodity Credit Corporation the authority to sell surplus commodities and foodstuffs to the States to provide food assistance to eligible populations. Title IX: Miscellaneous - Amends SSA title IV part A to require AFDC applicants and recipients to undergo any necessary substance abuse treatment as a condition of receiving AFDC. (Sec. 902) Amends SSA title XVI (Supplemental Security Income) (SSI) to: (1) make ineligible for SSI benefits individuals receiving SSI on the basis of a disability resulting from illegal drug addiction who continue to use illegal drugs or refuse to be tested for them; and (2) make representative payee changes. (Sec. 903) Directs the Secretary of Health and Human Services to: (1) conduct research projects to evaluate the impact of education and training programs on the ability of individuals to end participation in the AFDC program; (2) conduct demonstration projects and report to the Congress on whether providing benefits based on need through the use of electronic cards and automatic teller machines would reduce administrative costs and fraud; and (3) establish a commission to determine the cost and feasibility of creating an interstate system to compare the social security numbers of all AFDC recipients in order to identify those recipients receiving AFDC from multiple States. (Sec. 904) Amends SSA to require State AFDC applicants to participate in job search activities while the application is pending, unless a State by law exempts itself from this requirement. (Sec. 906) Public Housing Rent Reform and Empowerment Act - Amends the United States Housing Act of 1937 with regard to the determination of income and rent charges. Authorizes the Secretary of Housing and Urban Development to allow, upon request, under certain circumstances, a public housing agency or resident management corporation to carry out a demonstration program to determine the feasibility and desirability of providing such entities with the authority to establish policies for agency-administered public housing projects, without regard to the public housing requirements of the United States Housing Act of 1937. (Sec. 907) Amends SSA title IV part A to deny AFDC for certain children who have not received appropriate medical examinations and immunizations. Amends the Child Care and Development Block Grant Act with regard to childhood immunizations. Requires the Surgeon General to issue and periodically revise recommendations for the immunization of children under age six.
United States · United States Congress · 4 November 1993
Declares that none of the following entities established under national health care reform enacted by the Congress should be permitted to form a political action committee or to make a contribution to Federal candidates: (1) any entity established to oversee or set Federal standards regarding national health care benefits, costs, or quality standards; (2) any entity established by States to purchase coverage for employees and dependents of companies with fewer than 5,000 employees and for the families of most part-time workers, self-employed, unemployed, and nonworkers; and (3) any entity established by corporations with more than 5,000 employees, Taft-Hartley plans, and rural electric and telephone cooperatives to purchase coverage.
United States · United States Congress · 1 November 1993
Federal Mandate Reduction, Reform, and Budget Act of 1993 - Amends the Congressional Budget Act of 1974 to set forth reporting requirements for the Office of Management and Budget and the Congressional Budget Office (CBO) with respect to reducing the direct costs to States and local governments of complying with Federal mandates. Requires concurrent resolutions on the budget to provide for such reductions until such costs do not exceed three percent of the estimated gross national product for the same fiscal year as the costs will be incurred. Requires CBO to prepare an analysis of mandated costs for States and local governments for each public bill or resolution reported in the Congress (except those from Appropriations Committees). Requires a similar analysis in the President's annual budget submissions. Requires initial regulatory flexibility analyses for proposed rules that establish or implement new Federal mandates to contain a description of the nature and amount of monetary costs to be incurred by State and local governments. Requires Federal agencies to prepare a cost estimate and cost benefit analysis of such mandates that would cost State and local governments at least $10 million for a fiscal year.
United States · United States Congress · 28 October 1993
TABLE OF CONTENTS: Title I: Medical Savings Accounts Title II: Development and Distribution of Comparative Value Information Health Care Savings Plan Act of 1993 - Title I: Medical Savings Account - Amends the Internal Revenue Code to allow individuals a tax deduction for contributions made to a medical care savings account established for the benefit of an eligible individual. Defines an eligible individual as: (1) one who is not covered by an employer-provided group health plan; or (2) one who is covered by such a plan which is a qualified catastrophic coverage health plan and is not covered by any other health plan. Allows penalty-free withdrawals from such accounts to the extent that amounts in such accounts exceed $15,000. Allows such deduction in arriving at adjusted gross income. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to medical care savings accounts and makes such accounts subject to the tax on prohibited transactions. Allows the transfer of unused amounts in flexible spending accounts of cafeteria plans to medical savings accounts. Allows the full deduction for medical and dental expenses for amounts paid for qualified catastrophic coverage health plans. Title II: Development and Distribution of Comparative Value Information - Requires each State to develop and implement information programs regarding comparative health values for purchasers of health care. Makes grants available for the development of such programs. Requires Federal implementation of a program for any State that does not develop or continue to implement such a program. Requires the dissemination of comparative value information relative to Federal programs of health insurance and health care services. Requires the development of model systems to facilitate the gathering and analyzing of data on health care cost, quality, and outcome with respect to health insurance plans and hospitals. Authorizes appropriations.
United States · United States Congress · 28 October 1993
Expresses the sense of the House of Representatives that: (1) a presidential commission should be established to investigate whether there has been any measurable depletion of stratospheric ozone beyond the seasonal variations caused by natural phenomena; (2) such commission should investigate whether it has been proven that the use of man-made chlorofluorocarbons damages stratospheric ozone and whether the phaseout of chlorofluorocarbons will have any effect on ozone levels in the stratosphere; and (3) the membership of the commission should be equally apportioned between representatives from the scientific community whose published research shows that chlorofluorocarbons have a negligible effect on ozone depletion and representatives whose research makes contrary claims.
United States · United States Congress · 27 October 1993
Safe Drinking Water Act Amendments of 1993 - Amends the Safe Drinking Water Act to require the Administrator of the Environmental Protection Agency, in the case of specified contaminants listed in the Federal Register for which national primary drinking water regulations have not been promulgated, to: (1) publish maximum contaminant level goals and promulgate such regulations for those contaminants that occur in drinking water and are of public health concern; and (2) eliminate monitoring, compliance, and enforcement requirements for those contaminants that do not occur in drinking water at levels of public health concern. (Current law requires the promulgation of such goals and regulations for specified numbers of such contaminants by certain dates.) Directs the Administrator to promulgate such goals and regulations for new contaminants every five years. Requires the Administrator to establish in each national primary drinking water regulation best technology treatment techniques for public water systems serving fewer than 1,000, between 1,000 and 10,000, and more than 10,000 people, respectively. Directs the Administrator to promulgate national primary drinking water regulations for radionuclides, disinfection and corrosion byproducts, and sulfate. Revises provisions concerning variances from national drinking water regulations to permit the issuance of a variance by a State only if the water system cannot afford to install the best available technology to meet the maximum contaminant level and it is not feasible for the system to connect with another source of water that will meet the standards. Requires variances to be reviewed by the State at least every three years. Repeals provisions that authorize States to exempt public water systems from requirements respecting maximum contaminant levels or treatment techniques. Prohibits treated drinking water from being removed from a public water system or routed through any device or pipes outside the system and returned to the system. Includes such action in the definition of "tampering," a violation for which criminal penalties are imposed. Makes such prohibition inapplicable to pipes and devices totally within the control of one or more public water systems or to connections between water mains. Requires (currently, authorizes) the Administrator to conduct research relating to diseases and other impairments resulting from contaminants in drinking water or to the provision of a safe supply of drinking water. Authorizes appropriations. Extends the authorization of appropriations for grants for State public water system supervision programs. Requires the Administrator to promulgate revised regulations every five years that list up to 30 unregulated contaminants to be monitored by public water systems. Directs the Administrator to assemble a national drinking water occurrence data base to include information on the occurrence of regulated and unregulated contaminants.
United States · United States Congress · 27 October 1993
Amends the Federal Water Pollution Control Act to require the Administrator of the Environmental Protection Agency or a State, in issuing permits for discharges from municipal storm sewers, to consider the ability of the applicant to pay to meet permit requirements and the environmental impact of the issuance of the permit at the site of the discharge.
United States · United States Congress · 27 October 1993
Declares that the generally applicable Federal employment and civil rights laws should apply to the Congress. Requires the appropriate committees of the House of Representatives to report legislation providing for coverage of the Congress by the following laws, together with any related or similar laws: (1) the Social Security Act; (2) the National Labor Relations Act; (3) the Fair Labor Standards Act of 1938; (4) the Civil Rights Act of 1964; (5) the Age Discrimination in Employment Act of 1967; (6) the Occupational Safety and Health Act of 1970; (7) title IX of the Education Amendments of 1972; (8) the Rehabilitation Act of 1973; (9) the Age Discrimination Act of 1975; (10) the Ethics in Government Act of 1978; (11) the Americans with Disabilities Act of 1990; (12) the Freedom of Information Act; and (13) the Privacy Act of 1974.
United States · United States Congress · 26 October 1993
Crime Victims' Restitution Act of 1993- Amends the Federal criminal code to require (current law authorizes) the court to order restitution of the victim when a convicted defendant is being sentenced for specified offenses. Authorizes a court to order restitution of any person who, as shown by a preponderance of the evidence, was harmed physically, emotionally, or pecuniarily by unlawful conduct of the defendant during the offense or during the course of a scheme, conspiracy, or pattern of unlawful activity related to the offense. Directs the court: (1) to order restitution in the full amount of the victim's losses without consideration of the economic circumstances of the offender or the fact that a victim is entitled to receive compensation from insurance or any other source; and (2) upon determination of the amount owed to each victim, to specify in the restitution order the manner of, and schedule for, restitution in consideration of the financial resources and other assets, projected earnings and other income, and financial obligations of the offender. Specifies that: (1) a restoration order may direct the offender to make a single, lump-sum payment, partial payments at specified intervals, or such in-kind payments as may be agreeable to the victim and the offender; and (2) such in-kind payments may be in the form of the return or replacement of property, or services rendered to the victim or another person or organization. Provides that when the court finds that more than one: (1) offender has contributed to the loss of a victim, the court may make each offender liable for payment of the full amount or may apportion liability among the offenders to reflect the level of contribution and economic circumstances of each offender; and (2) victim has sustained a loss requiring restitution by an offender, the court shall order full restitution of each victim but provide for different payment schedules to reflect the economic circumstances of each victim. Sets forth provisions regarding: (1) compensation with respect to losses from insurance or other sources; (2) set-offs against amounts later recovered as compensatory damages by the victim in Federal and State civil proceedings; and (3) payment by the offender to the clerk of the court for accounting and payment in accordance with this Act. Specifies that a restitution order shall constitute a lien against all property of the offender. Makes compliance with a restitution order a condition of any probation, parole, or other form of release of an offender. Specifies actions the court may take, including revocation of probation or supervised release, if a defendant fails to comply. Provides for enforcement of restitution orders. Authorizes: (1) a victim or the offender to petition the court to modify a restitution order in view of a change in the economic circumstances of the offender; and (2) the court to refer any issue arising in connection with a proposed restitution order to a magistrate or special master for proposed findings of fact and recommendations as to disposition, subject to a de novo determination of the issue by the court.
United States · United States Congress · 26 October 1993
Federal Deposit Insurance Reform Act - Amends the Federal Deposit Insurance Act and the Federal Credit Union Act to mandate a lifetime maximum amount of insurance of $100,000 on insured deposits.
United States · United States Congress · 21 October 1993
Medisave Patient Empowerment Act of 1993 - Amends the Internal Revenue Code to allow to individuals a tax deduction for contributions made to a Medisave account established for the benefit of an eligible individual. Limits the amount of allowable contributions. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to such accounts.
United States · United States Congress · 20 October 1993
Expresses the sense of the House of Representatives that the Department of Justice should repudiate its reinterpretation of Federal child pornography laws, defend the conviction won in lower courts in Knox v. United States, and vigorously prosecute sexual exploitation of children.
United States · United States Congress · 12 October 1993
Amends the Internal Revenue Code to make Internal Revenue Service employees personally liable for a portion of litigation costs resulting from arbitrary, capricious, or malicious acts. Increases (from $100,000 to $1 million) the limitation on recovery of civil damages for certain unauthorized collection actions. Places the burden of proof upon the Secretary of the Treasury with respect to the issue of whether any person has been guilty of fraud with intent to evade tax.
United States · United States Congress · 12 October 1993
Cable Consumer Protection and Competition Act of 1993 - Repeals the Cable Television Consumer Protection and Competition Act of 1992 except for provisions relating to retransmission consent for cable systems. Applies all other sections of the Communications Act of 1934 amended by such Act as if such Act had not been enacted. Makes any regulations prescribed by the Federal Communications Commission to implement such Act ineffective after enactment of this Act.
United States · United States Congress · 7 October 1993
Amends the Internal Revenue Code to repeal the retroactive application of income, estate, and gift tax rate increases. Requires a reduction in administrative expenses of Federal departments and agencies for FY 1994 through 1996.
United States · United States Congress · 6 October 1993
Provides that any comprehensive health care reform legislation should be considered on the floor of the House of Representatives under an open rule that authorizes any Representative to offer one or more amendments.
United States · United States Congress · 29 September 1993
Individual Investment Account Act of 1993 - Amends the Internal Revenue Code to allow a deduction for amounts contributed to individual investment accounts. Allows tax-free distributions, limited to $15,000 for all taxable years, from such accounts for use in the purchase of a principal residence by a first-time homebuyer. Makes such accounts tax-exempt unless the individual engages in prohibited transactions. Adjusts dollar limitations under this Act for inflation. Allows such deduction in determining adjusted gross income. Excludes from gross income gain from the sale or exchange of property if, during the five-year period ending on the date of the sale or exchange, such property has been owned and used by the taxpayer as a principal residence for periods aggregating three years or more. Limits such exclusion to the amount paid to an individual investment account during the one-year period beginning on the date of the sale or exchange. Provides for adjusting the basis of a residence acquired through the use of an individual investment account.
United States · United States Congress · 28 September 1993
Amends the Clean Air Act to remove a requirement that vehicle inspection and maintenance programs for Serious ozone nonattainment areas be operated on a centralized basis.
United States · United States Congress · 28 September 1993
Amends the Congressional Budget Act of 1974 to provide for downward adjustments in Appropriations Committees' allocations and suballocations when bills are passed that reduce appropriations and require rescissions. Requires the Congressional Budget Office to provide scorecards for such measures.
United States · United States Congress · 27 September 1993
Foreign Tourist Protection Act of 1993 - Amends the Federal criminal code to provide the death penalty for the first degree murder of a person who is not a U.S. national, is legally in the United States, and does not have the right to permanently reside in the United States. Prohibits imposition of a death sentence on persons under age 18 at the time of the offense or who are mentally retarded. Sets forth mitigating factors (such as mental capacity, duress, minor participation in the offense, and no significant criminal history) and aggravating factors (such as involvement of a firearm or previous conviction of a violent felony involving a firearm, previous conviction for other serious offenses, substantial planning and premeditation, and vulnerability of the victim). Sets forth provisions regarding: (1) procedures for a special hearing to determine whether a death sentence is justified; (2) the return of findings; (3) special precaution to assure against discrimination (based on the race, color, religion, national origin, or sex of the defendant or any victim); and (4) imposition, review, and implementation of a death sentence. Prohibits: (1) the execution of persons lacking the mental capacity to understand the death penalty and why it was imposed or of a pregnant woman; and (2) requiring any employee of a State department of corrections, the Federal Bureau of Prisons, the U.S. Marshals Service, or any contractor providing services to such department, bureau, or service to attend or participate in any execution contrary to such employee's moral or religious convictions. Sets forth provisions regarding: (1) the use of State facilities; (2) appointment of counsel; (3) standards for competence of counsel; (4) collateral attacks on judgments imposing a death sentence; and (5) stays of execution.
United States · United States Congress · 15 September 1993
TABLE OF CONTENTS: Title I: Improved Access to Affordable Health Care Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families Subtitle B: Reform of Health Insurance Marketplace for Small Business Subtitle C: Preemption Subtitle D: Health Deduction Fairness Subtitle E: Improved Access to Community Health Services Subtitle F: Improved Access to Rural Health Services Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program Title II: Health Care Cost Containment and Quality Enhancement Subtitle A: Medical Malpractice Liability Reform Subtitle B: Administrative Cost Savings Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Accounts Subtitle D: Anti-Fraud Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals Subtitle F: Removing Anti-Trust Impediments Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities Subtitle H: Prefunding Government Health Benefits for Certain Annuitants Subtitle I: Miscellaneous Provisions Title III: Long-Term Care Subtitle A: Tax Treatment of Long-Term Care Insurance Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance Subtitle C: Studies Subtitle D: Volunteer Service Credit Demonstration Projects Affordable Health Care Now Act of 1993 - Title I: Improved Access to Affordable Health Care - Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families - Part 1: Required Coverage Options for Eligible Employees, Spouses, and Dependents - Requires each employer to make available to each eligible employee a group health plan under which: (1) coverage of each eligible individual with respect to such employee may be elected on an annual basis; (2) coverage is provided for at least the required coverage specified; and (3) employees may elect to have premiums collected through payroll deduction. Does not require employer contributions to the cost of coverage under such a plan. Provides for the exclusion of: (1) employers who have been employers for less than two years or who have no more than two eligible employees or no more than two eligible employees not covered under any group health plan; and (2) family members under specified circumstances. Specifies that a group health plan shall not be treated as failing to meet the requirements of this Act solely because a period of service by an eligible employee of not more than 60 days is required for coverage. Specifies that the required coverage is standard coverage, except that in the case of a small employer that has not contributed during the previous plan year to the cost of coverage for any eligible employee under any group health plan, the required coverage for the plan year is coverage under a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan. Provides for a five-year transition for existing group health plans. (Sec. 1002) Sets forth provisions regarding: (1) compliance with applicable requirements through multiple employer health arrangements; and (2) coverage options under a State medical health allowance program. Part 2: Preexisting Conditions and Continuity of Coverage; Renewability - Prohibits a group health plan from imposing (and an insurer from requiring an employer from imposing through a waiting period for coverage under a plan or similar requirement) a limitation or exclusion of benefits relating to treatment of a preexisting condition if: (1) the condition relates to a condition that was not diagnosed or treated within three months before the date of coverage under the plan; or (2) the limitation or exclusion extends over more than six month after the date of coverage, applies to an individual who, as of the date of birth, was covered under the plan, or relates to pregnancy. Specifies that, in the case of an individual who is eligible for coverage under a plan but for a waiting period imposed by the employer, the individual shall be treated as having been covered under the plan as of the earliest date of the beginning of the waiting period. (Sec. 1012) Requires each group health plan to waive any period applicable to a preexisting condition for similar benefits with respect to an individual to the extent that the individual, prior to enrollment in such plan, was covered for the condition under any other health plan. (Sec. 1013) Prohibits: (1) a multiemployer plan and an exempted multiple employer health plan from canceling or denying renewal of coverage under such a plan for an employer other than for nonpayment of contributions, fraud or other misrepresentation, noncompliance with plan provisions, or misuse of a provider network provision, or because the plan is ceasing to provide any coverage in a geographic area; (2) an insurer from canceling a health insurance plan or denying renewal of coverage other than as prescribed above; and (3) an insurer who terminates the offering of health insurance plans in an area from offering such a plan to any employer in the area until five years after the date of the termination. Part 3: Enforcement; Effective Dates; Definitions - Makes provisions of the Employee Retirement Income Security Act of 1974 applicable with respect to enforcement of this Act (by the Department of Labor). Amends the Internal Revenue Code (Code) to impose a tax ($100 per day for each individual involved, subject to specified limitations) on the failure of an insurer to comply with the requirements under part 2 unless the Secretary of Health and Human Services (Secretary) determines that the State has in effect a regulatory enforcement mechanism that provides adequate sanctions. Subtitle B: Reform of Health Insurance Marketplace for Small Business - Requires each insurer that makes available a health insurance plan to a small employer in a State to make available to each small employer in the State a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan, with exceptions for health maintenance organizations (HMOs) and if a State provides for guaranteed availability (rather than guaranteed issue). Requires each insurer that offers a MedAccess plan to a small employer in a State to accept: (1) every small employer in the State that applies for coverage; and (2) every eligible individual who applies for enrollment on a timely basis. Sets forth provision regarding: (1) special rules for HMOs; (2) timely enrollment requirements; and (3) enrollment of spouses and dependents. Makes such requirements inapplicable in a State that has provided (in accordance with specified standards) a mechanism under which each insurer offering a health insurance plan to a small employer in the State must participate in a program for assigning high-risk small employer groups (or individuals within such a group) among some or all such insurers, if the insurers comply. (Sec. 1102) Defines "MedAccess plan" as a health insurance plan that: (1) is designed to provide standard coverage with substantial cost-sharing, only catastrophic coverage, or medisave coverage; (2) includes only essential and medically necessary services; (3) meets applicable requirements relating to guaranteed issue; and (4) meets specifies consumer protection standards. Defines "MedAccess standard plan," "MedAccess catastrophic plan," and "MedAccess medisave plan" to mean a MedAccess plan that provides for at least standard coverage, for only catastrophic coverage, or medisave coverage, respectively. Requests the National Association of Insurance Commissioners (NAIC) to submit to the Secretary a set of rules which NAIC determines is sufficient for determining, in the case of any health insurance plan and for purposes of this subtitle, the actuarial value of the coverage offered by the plan. Directs the Secretary to certify such set of rules for use under this subtitle if they meet such requirements or establish such a set of rules. Specifies that a health insurance plan is considered to provide: (1) standard coverage if the benefits are determined, in accordance with certified rules of actuarial equivalence, to have a value that is within five percentage points of an established target actuarial value for standard coverage; (2) catastrophic coverage if benefits are available under the plan for a year only to the extent that expenses for covered services in a year exceed a deductible amount that is consistent with a specified requirement for a catastrophic health plan under the Code, and are determined, in accordance with certified actuarial equivalence rules, to have a value that is within five percentage points of an established target actuarial value for catastrophic coverage; and (3) medisave coverage if such plan consists of a catastrophic health plan within the meaning of the Code and a medical savings account. Requests NAIC to submit to the Secretary target actuarial values for standard and catastrophic coverage. Permits NAIC to submit periodic revisions of, and permits the Secretary to revise, the set of rules of actuarial equivalence and target actuarial values where necessary to take into account changes in the relevant types of health benefits provisions, in deductible levels for catastrophic coverage, or in relevant demographic conditions. (Sec. 1103) Directs the Secretary to request NAIC to develop model regulations that specify standards with respect to requirements: (1) that insurers make available MedAccess plans; (2) of guaranteed availability of MedAccess plans to small employers; (3) relating to limits on premiums and certain consumer protections; and (4) relating to limitation of annual premium increases. Requires the Secretary to review such standards and, if NAIC fails to specify standards meeting such requirements, to promulgate standards. Sets forth provisions regarding: (1) the application of MedAccess standards and consumer protection standards by the States; and (2) the Federal role. (Sec. 1104) Sets forth provisions: (1) regarding limits on premiums and annual premium increases; and (2) requiring an insurer, at the time of offering a health insurance plan to a small employer, to fully disclose rating practices for health insurance plans, including rating practices for different populations and benefit designs. (Sec. 1106) Directs the Secretary to: (1) request NAIC to develop models for reinsurance or allocation of risk mechanisms for health insurance plans made available to small employers for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models or specify models. Sets forth provisions regarding implementation of reinsurance or allocation of risk mechanisms by the States and the Federal role. Amends the Code to provide for the imposition of a tax on any health insurance plan which covers any employee in a Federal reinsurance State. (Sec. 1108) Directs the Secretary to establish an Office of Private Health Care Coverage. Requires the Office Director to submit to the Congress annual reports evaluating health care coverage reform. (Sec. 1109) Authorizes the Director to conduct: (1) research on the impact of this subtitle on the availability of affordable health coverage for employees and dependents in the small employers group health care coverage market and other specified topics; and (2) demonstration projects relating to such topics. Requires the Director to develop: (1) methods for measuring the relative health risks of eligible individuals in terms of the expected costs of providing benefits under health insurance plans and, in particular, MedAccess plans; and (2) a model for equitably distributing health risks among insurers in the small employer health care coverage market. Authorizes appropriations. Subtitle C: Preemption - Part 1: Scope of State Regulation - Prohibits: (1) State benefit mandates for group health plans; and (2) State or local law prohibitions against two or more employers obtaining coverage under an insured multiple employer health plan. (Sec. 1203) Preempts State restrictions concerning: (1) reimbursement rates or selective contracting; (2) differential financial incentives; and (3) utilization review methods. Directs the Comptroller General to conduct a study of the benefits and cost effectiveness of the use of managed care in the delivery of health services. Part 2: Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to allow a limited exemption under preemption rules for multiple employer plans providing health benefits subject to certain Federal standards. (Sec. 1212) Relieves exempted multiple employer plans providing medical care benefits of certain restrictions on preemption of State law. Treats such plans as employee welfare benefit plans. Allows commencement of new arrangements only if such exemption is in effect or an application is pending and the Secretary of Labor determines that provisional protection is appropriate. Sets forth exemption procedures, eligibility requirements, and additional requirements applicable to exempted arrangements. Requires certain disclosures to participating employers, maintenance of reserves, and corrective actions. Provides for expiration, suspension, and revocation of exemptions, and for review of actions by the Secretary. (Sec. 1213) Revises provisions relating to scope of preemption rules, and to treatment of single employer arrangements and of certain collectively bargained arrangements. (Sec. 1215) Establishes special rules for employee leasing healthcare arrangements. Treats such arrangements as multiple employer welfare arrangements except when they are multiple employer health plans. (Sec. 1216) Sets forth enforcement provisions relating to multiple employer welfare arrangements and employee leasing health care arrangements. (Sec. 1217) Sets forth filing requirements for multiple employer welfare arrangements. (Sec. 1218) Provides for cooperation between Federal and State authorities in enforcing ERISA requirements for multiple employer welfare arrangements with the limited exemption. Part 3: Encouragement of Multiple Employer Arrangements Providing Basic Health Benefits - Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax exempt trust status for multiple employer health plans and insured multiple employer health plans if they meet certain requirements under ERISA and this Act. Part 4: Simplifying Filing of Reports for Employers Covered under Insured Multiple Employer Health Plans - Amends ERISA to direct the Secretary of Labor to prescribe an alternative method providing for a single annual report with respect to all employers who are covered under the same insured multiple employer health plan. Part 5: Compliance with Coverage Option Requirements - Provides for compliance with applicable coverage requirements through multiemployer plans and other multiple employer health arrangements. Subtitle D: Health Deduction Fairness - Amends the Internal Revenue Code to provide: (1) for a permanent extension and increase in the health insurance tax deduction for self-employed individuals; and (2) that the deduction for certain health insurance costs be determined without regard to an adjusted gross income threshold. Disallows the deduction to individuals eligible for employer-subsidized coverage. Allows the deduction whether or not the individual itemizes other deductions. Subtitle E: Improved Access to Community Health Services - Part 1: Increased Authorization for Community and Migrant Health Centers - Directs the Secretary to provide for grants to migrant and community health centers to promote primary health care services for underserved individuals. Allows grants to be used to promote the provision of off-site services, to improve birth outcomes in areas with high infant mortality and morbidity, to establish primary care clinics in areas in need, and for recruitment and training costs of necessary providers and operating costs for unreimbursed services. Authorizes appropriations. Directs the Secretary to conduct a study of the impact of such grants on access to health care, birth outcomes, and the use of emergency room services. Part 2: Grants for Projects for Coordinating Delivery of Services - Amends the Public Health Service Act to authorize the Secretary to make grants to public and nonprofit private entities: (1) to carry out demonstration projects to increase access to outpatient primary health services in specified geographic areas (i.e., areas that are rational areas for the delivery of health services, have a population of not more than 500,000 individuals, and have been designated by the Secretary as areas with a shortage of personal health services or that have a significant number of individuals with low incomes or insufficient health care insurance through coordinating the delivery of such services under Federal, State, local, and private programs; and (2) for developing plans to carry out such projects. Authorizes appropriations. Subtitle F: Improved Access to Rural Health Services - Part 1: Establishment of Rural Emergency Access Care Hospitals Under Medicare - Amends title XVIII (Medicare) of the Social Security Act (SSA) to provide for: (1) establishment of rural emergency access care hospitals under Medicare; and (2) coverage of and payment for rural emergency access care hospital services under Medicare part B (Supplementary Medical Insurance). Part 2: Rural Medical Emergencies Air Transport - Amends the Public Health Service Act to direct the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments. Sets forth provisions regarding: (1) application and State plan requirements; (2) considerations in awarding grants; (3) State administration and use of grants; (4) the number of grants; and (5) reporting requirements. Authorizes appropriations. Part 3: Emergency Medical Services Amendments - Amends the Public Health Service Act to direct the Secretary to: (1) establish an Office of Emergency Medical Services, headed by a Director; (2) engage in specified emergency medical services activities, including disseminating information obtained in carrying out specified activities to public and private entities, providing technical assistance to State and local agencies, coordinating Department of Health and Human Services (DHHS) activities with those of other Federal agencies; and (3) ensure that such activities are carried out consistent with certain requirements regarding maintaining an adequate number of health professionals with expertise in the provision of services, developing, periodically reviewing, and revising as appropriate guidelines for the provision of such services, appropriately using available technologies, and serving the unique needs of underserved inner-city and rural areas. (Sec. 1522) Authorizes the Secretary to make grants to States for the purpose of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services, subject to specified matching fund, budgetary, and other requirements. (Sec. 1523) Provides for demonstration projects to establish telecommunications between rural medical facilities and medical facilities with expertise or equipment. Directs the Secretary to ensure that the telecommunications technologies demonstrated include interactive video telecommunications, static video imaging transmitted through the telephone system, and facsimiles transmitted through such system. (Sec. 1524) Authorizes appropriations for: (1) emergency medical services (including for State offices of Emergency Medical Services and for telecommunications demonstrations); and (2) trauma care and certain other activities. Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program - Amends SSA title XIX (Medicaid) to provide for the establishment of State health allowance programs under which the State makes payments to a group health plan which provides coverage to an eligible individual as an allowance towards the costs of providing the individual with benefits under the plan. Subtitle H: Medicaid Program Flexibility - Amends SSA title XIX Medicaid) to modify: (1) Federal requirements to allow States more flexibility in contracting for coordinated care services under Medicaid; and (2) provisions regarding the extension of certain waivers. Title II: Health Care Cost Containment and Quality Enhancement - Subtitle A: Medical Malpractice Liability Reform - Part 1: General Provisions - Makes this subtitle applicable with respect to any medical malpractice liability claim and to any medical malpractice liability action brought in State or Federal court, except a claim or action for damages arising from a vaccine-related injury or death to the extent that title XXI of the Public Health Service Act applies. Sets forth provisions regarding: (1) preemption of State law; (2) effect on sovereign immunity and choice of law or venue; (3) jurisdiction; and (4) effective dates. Part 2: Medical Malpractice and Product Liability Reform - Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified alternative dispute resolution (ADR) system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States under chapter 171 of the Federal judicial code (U.S. Court of Federal Claims). Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 2012) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action. Sets limits on punitive damages and on periodic payments for future losses. (Sec. 2013) Set forth provisions regarding: (1) limits on attorney fees and other costs; (2) joint and several liability (generally, liability may be found only for those damages directly attributable to the person's proportionate share of fault or responsibility for the injury); (3) a statute of limitations of seven years; and (4) a uniform standard for determining negligence (the defendant's conduct at the time of providing the health care services was not reasonable). (Sec. 2017) Specifies that in the case of a medical malpractice liability claim relating to services provided during labor or the delivery of a baby, if the health care professional did not previously treat the injured individual for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. Part 3: Requirements for State Alternative Dispute Resolution Systems - Lists requirements for State ADR systems, including that such a system: (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 2032) Directs the Secretary, by October 1 of each year, to certify State ADR systems that meet such requirements. Directs the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 2033) Directs the Secretary, within five years, to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system, including: (1) information on the effect of the ADR systems on health care costs, access to health care, and quality of care provided within the State; and (2) to the extent that such report does not provide information on no-fault systems operated by States as ADR systems, an analysis of the feasibility and desirability of establishing a system for resolving medical malpractice liability claims on a no-fault basis. Part 4: Other Provisions Relating to Medical Malpractice Liability - Authorizes a State agency responsible for disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies to permit their participation in the licensing of such practitioner and to review any health care malpractice action, claims, or allegation, or other information concerning the practice patterns of any such practitioner. Sets forth agreement requirements. (Sec. 2042) Directs the Secretary to study incentives adopted by State and local governments, insurers, medical societies, and other entities to encourage physicians to volunteer to provide health care services in medically underserved areas. (Sec. 2043) Directs each State to require: (1) each health care professional and health care provider to participate in a risk management program to prevent, and provide early warning of, practices which may result in injuries to patients or endanger patient safety; and (2) each provider of health care professional and provider liability insurance in the State to establish risk management programs or sanction programs of risk management for health care professionals and providers provided by other entities, and require each such professional or provider, as a condition of maintaining insurance, to participate in one such program at least once in each three-year period. (Sec. 2044) Directs the Secretary to make grants: (1) for basic research in the prevention of, and compensation for, injuries resulting from health care professional or provider malpractice and for research of the outcomes of health care procedures; (2) to the States to assist in improving their ability to license and discipline health care professionals; and (3) to States and local governments, private nonprofit organizations, and health professional schools for educating the general public about the appropriate use of health care, realistic expectations of medical intervention, and the resources and role of health care professional licensing and disciplinary boards in investigating claims of incompetence or health care malpractice, and for developing programs of faculty training and curricula for educating health care professionals in quality assurance, risk management, and medical injury prevention. Authorizes appropriations. Subtitle B: Administrative Cost Savings - Part 1: Standardization of Claims Processing - Directs the Secretary to adopt standards relating to: (1) data elements for use in paper and electronic claims processing under health benefit plans and in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. (Sec. 2102) Authorizes the Secretary, two years after standards are adopted for classes of services upon determining that a significant number of claims for benefits for such services under health benefit plans are not being submitted in accordance with such standards, to require that all providers of such services submit claims to health benefit plans in accordance with such standards. (Sec. 2103) Directs the Secretary to: (1) provide for the ongoing receipt and review of comments and suggestions for changes in the standards adopted and promulgated; (2) establish a schedule for the periodic review of such standards; and (3) revise such standards. Part 2: Electronic Medical Data Standards - Directs the Secretary to promulgate standards for hospitals concerning electronic medical data, including standards for transmission of such data and confidentiality of patient-specific information. Authorizes the Secretary to periodically revise such standards. (Sec. 2112) Sets forth requirements with respect to: (1) the sharing of hospital information under Medicare; (2) waiver of such requirements; and (3) application of such requirements to hospitals of the Department of Veterans Affairs. (Sec. 2113) Authorizes the head of a Federal agency to require a provider to present and transmit a required data element electronically in accordance with applicable presentation or transmission standard. (Sec. 2114) Sets forth limitations on data requirements where standards with respect to data elements are in effect. (Sec. 2115) Directs the Secretary to establish an advisory commission on the standards established under this part and operational concerns about the implementation of such standards. Authorizes appropriations. Part 3: Development and Distribution of Comparative Value Information - Directs the Secretary to determine whether each State is developing and implementing a health care value information program that meets specified criteria and a specified schedule. Authorizes the Secretary to: (1) make grants to enable each State to plan development and initiate implementation of its health care value information program; and (2) recover the amount of such a grant by offset against any other amount payable to the State under the Social Security Act under specified circumstances. Authorizes appropriations. (Sec. 2122) Directs the Secretary to take actions necessary to implement a comparable program in a State that fails to develop or implement a health care value information program in accordance with such criteria and schedule. Authorizes the Secretary to charge fees for the information materials provided pursuant to such a program. (Sec. 2123) Directs the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to develop health care value information relating to each program that such head administers and covering the same types of data that a State program meeting such criteria would provide. (Sec. 2124) Directs the Secretary to: (1) develop model systems to facilitate the gathering of data on health care cost, quality, and outcome and the analysis of such data in a manner that will permit the valid comparison of such data among providers and among health plans; (2) support experimentation with different approaches to achieve such objectives in the most cost effective manner; and (3) evaluate the various methods to determine their relative success. Authorizes the Secretary to establish standards for the collective and reporting of data on health care cost, quality, and outcomes. Authorizes appropriations. Part 4: Additional Standards and Requirements; Research and Demonstrations - Directs the Secretary to: (1) adopt standards relating to the design and use of magnetized Medicare identification cards to assist health care providers in determining whether individuals are eligible for benefits for provided services under the Medicare program and in billing the Medicare program for covered services; (2) take steps to encourage and assist States in the design and use of magnetized Medicaid identification cards under their Medicaid plans; and (3) establish a Medicare and Medicaid information system to provide information on group health and other health benefit plans that are primary payors to the Medicare and Medicaid programs. Authorizes appropriations. (Sec. 2132) Specifies that, effective January 1, 1994, no effect shall be given to any provision of State law that requires medical or health insurance records (including billing information) to be maintained in written, rather than electronic, form. (Sec. 2133) Requires, effective January 1, 1995, each health benefit plan: (1) to use a beneficiary's social security number as the personal identifier for claims processing and related purposes (authorizes the Secretary to impose a civil money penalty on any plan that fails to do so); and (2) to use the unique identifier under title XVIII of the Social Security Act (Medicare) for a provider that furnishes health care items or services to a beneficiary under the plan as the identifier of that provider for claims processing and related purposes. (Sec. 2134) Directs the Secretary to: (1) determine, where benefits are payable under two or more health benefit plans, whether problems relating to the rules for determining the liability of plans or the availability of information among plans causes significant administrative costs; and (2) promulgate standards, if the implementation of standards would significantly reduce such administrative costs. Authorizes the Secretary to impose a civil money penalty on plans that fail to comply with such standards. (Sec. 2135) Directs the Secretary to provide grants to qualified entities for research on the application of comprehensive information systems in continuously monitoring and improving patient care. Authorizes the Secretary to make grants to: (1) two to five community organizations or coalitions of health care providers, health benefit plans, and purchasers to establish and document the efficacy of communication links between the information systems of health benefit plans and of health care providers; (2) two to five public or private nonprofit entities for the development of regional or community-based clinical information systems; and (3) public or private nonprofit entities to develop and test the definition of a comprehensive set of data elements and the specification and manner of presentation of the individual data elements of the set, for electronic medical data generated by physicians and other entities (other than hospitals) that provide health care services. Authorizes appropriations. Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Account - Amends the Internal Revenue Code to include under the medical expense deduction the portion of such expense attributable to coverage under a catastrophic health plan. (Sec. 2202) Allows individuals a tax deduction for percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to medical care savings accounts. Subtitle D: Anti-Fraud - Part 1: Criminal Prosecution of Health Care Fraud - Amends the Federal criminal code to: (1) set penalties for health care providers who knowingly engage in any scheme or artifice to defraud any person in connection with the provision of health care; and (2) make activity which, if engaged in by the U.S. Postal Service, would be a violation of mail fraud provisions punishable to the same extent with respect to private or commercial interstate carriers. (Sec. 2303) Authorizes appropriations to hire, equip, and train no fewer than: (1) 225 special agents of the Federal Bureau of Investigation and support staff to investigate health care fraud cases; (2) 50 assistant United States Attorneys and support staff to prosecute such cases; and (3) 25 investigators in the Office of Inspector General, DHHS, to be devoted exclusively to health care fraud cases. (Sec. 2304) Amends the Federal criminal code to authorize the Attorney General to make payments of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution of health care fraud, subject to specified requirements and exceptions. Part 2: Coordination of Health Care Anti-Fraud and Abuse Activities - Directs the Secretary to establish in the Office of the Inspector General of DHHS a program (all-payer fraud and abuse control program) to: (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to the delivery of, and payment for, health care in the United States; (2) conduct investigations, audits, evaluations, and inspections relating to such delivery and payment; and (3) facilitate the enforcement of provisions of the Social Security Act and other statutes applicable to health care fraud and abuse. Directs the Secretary to establish standards to carry out such program, including standards relating to the furnishing of information by health insurers, providers, and other to enable the Secretary to carry out the program and procedures to assure that such information is provided and utilized in a manner that protects the confidentiality of the information and the privacy of individuals receiving health care services. Sets forth provisions regarding: (1) qualified immunity for providing information; (2) ensuring access to documentation; and (3) failure to comply as grounds for exclusion from the Medicare and Medicaid programs. (Sec. 2312) Authorizes additional appropriations to enable the Secretary to conduct investigations of allegations of health care fraud and to carry out the all-payor fraud and abuse control program. (Sec. 2313) Establishes in the Treasury an Anti-Fraud and Abuse Trust Fund to be used to assist the Inspector General of DHHS in carrying out the all-payor fraud and abuse control program in the fiscal year involved. Sets forth provisions regarding: (1) the deposit into the Fund of Federal health anti-fraud and abuse penalties; and (2) the use of such penalties to repay beneficiaries for cost-sharing. (Sec. 2314) Amends SSA title XI to provide for the application of Federal health anti-fraud and abuse sanctions to all fraud and abuse against private health benefit plans. Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals: Part 1 - Medicare Payment Changes - Amends SSA title XVIII to: (1) eliminate the membership limitation for Medicare health maintenance organizations; and (2) revise the Medicare select policy program and provide for a civil money penalty for misrepresentations made in connection with a Medicare select policy. (Sec. 2402) Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) make permanent the Medicare select policy program; and (2) allow access to Medicare select policies in all States. (Sec. 2403) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate the administration of Medicare parts A and B. Part 2: Part B Premium Tax for High-Income Individuals - (Sec. 2411) Amends the Internal Revenue Code to impose a tax on the Medicare part B premiums of high income individuals. Subtitle F: Removing Anti-Trust Impediments - Directs the Attorney General to promulgate guidelines under which a health care joint venture may submit an application requesting that the Attorney General provide the entities participating in the venture with an exemption under which: (1) monetary recovery on an antitrust claim brought against the entity shall be limited to actual damages if specified conditions are met; and (2) the conduct of the entity in making or performing a contract to carry out the venture shall not be deemed illegal per se. Requires the Attorney General to approve or disapprove the application within a specified time frame and to provide a statement explaining the reasons for any disapproval. Directs the Attorney General to approve the application if an entity participating in the venture submits to the Attorney General an application that contains the identities of the parties to the venture; the nature, objectives, and planned activities of the venture; and specified assurances and information. Sets forth provisions regarding: (1) revocation and renewal of exemptions and withdrawal of an application; (2) requirements relating to notice and publication of exemptions; and (3) issuance of health care certificates of public advantage to each eligible health care joint venture that complies with specified requirements. Establishes the Interagency Advisory Committee on Competition, Antitrust Policy, and Health Care to: (1) discuss and evaluate competition and antitrust policy and their implications regarding the performance of health care markets; (2) analyze the effectiveness of health care joint ventures receiving exemptions in reducing costs and expanding access; and (3) make recommendations to the Congress. Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities - Part 1: Application of the Clayton Act to Medical Self-Regulatory Entities - Provides that no damages, cost of suit, or attorney fee may be recovered under section 4, 4A, or 4C of the Clayton Act, or under any similar State law, except by a State or the United States, from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities that are: (1) designed to promote the quality of health care provided to patients; and (2) not conducted for purposes of financial gain. Directs the court to award the cost of such a suit, including a reasonable attorney fee, to a substantially prevailing defendant. Part 2: Consultation by Federal Agencies - Requires any Federal agency engaged in the establishment of medical profession standards to consult with appropriate medical societies or associations, specialty boards, or recognized accrediting agencies, if available, in carrying out medical professional standard setting and guidelines or standards relating to the practice of medicine. Subtitle H: Prefunding Government Health Benefit for Certain Annuitants - Requires that certain agencies prefund Government health benefits contributions for their annuitants. Subtitle I: Miscellaneous Provisions - Amends Civil Service and Federal Employees' Retirement Systems law to increase the minimum age required to be eligible for an immediate retirement annuity. Provides for the conformance of other Federal retirement systems with the minimum age increase made above. Title III: Long-Term Care - Subtitle A: Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation. (Sec. 3002) Excludes from gross income benefits provided under a long-term care insurance contract. Includes in gross income employer-provided coverage for long-term care services. (Sec. 3003) Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions. Includes any parent or grandparent as a dependent for purposes of such expenses. (Sec. 3004) Provides for the nonrecognition of gain or loss on the exchange of any life insurance contract or an endowment or annuity contract for a long-term care insurance contract. (Sec. 3005) Excludes from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangement to pay long-term care premiums. (Sec. 3006) Allows insurance companies to issue accelerated death benefit riders on life insurance contracts. Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance - Amends SSA title XIX to require State Medicaid plans to disregard some or all of the individual's assets attributable to coverage under a qualified long-term care insurance contract in determining the individual's eligibility for long-term care services. Subtitle C: Studies - Requires the Comptroller General to study the feasibility of: (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their home with an income tax credit. (Sec. 3203) Requires the Secretary of Health and Human Services to study and report to the Congress on the feasibility of encouraging or requiring the use of a single designate public or nonprofit agency to coordinate, through case management, the provision of long-term care benefits under current Federal, State, and local programs in a geographic area. Subtitle D: Volunteer Service Credit Demonstration Projects - (Sec. 3301) Amends the Older Americans Act of 1965 to require the Commissioner of the Administration on Aging to establish and operate a volunteer service credit demonstration project in each State.
United States · United States Congress · 15 September 1993
General Aviation Revitalization Act of 1993 - Amends the Federal Aviation Act of 1958 to set forth a 15-year statute of limitations within which a person may bring a civil action against an aircraft manufacturer for damages for death or injury or damage to property arising from an aircraft accident.
United States · United States Congress · 15 September 1993
Amends the Internal Revenue Code and title II of the Social Security Act (Old Age, Survivors and Disability Insurance) to set forth rules for filing returns with respect to domestic service employment taxes and requires such returns to be made on a calendar year basis. Subjects such taxes to estimated tax provisions. Makes filing requirements inapplicable to any employer liable for tax concerning remuneration for services other than domestic service in a private home. Authorizes the Secretary of the Treasury to enter into agreements with States to collect the State unemployment tax imposed on remuneration for domestic service and transfers such amounts to a State's account in the Unemployment Trust Fund. Treats such taxes as domestic service employment taxes. Requires the Secretary to inform domestic service employers in private homes of their tax obligations. Adjusts the threshold (from $50 a calendar quarter to $800 a year) for paying and withholding social security taxes on wages paid for domestic service in a private home. Requires the Secretary of Health and Human Services to adjust such threshold amount in the same manner as adjustments to certain social security insurance amounts. Excludes domestic service in a private home by an individual 16 years and under from amendments made by this Act.
United States · United States Congress · 15 September 1993
Government Employee Limitation Act - Sets limits on the average total number of civilian employees in the executive branch in decreasing numbers from FY 1994 through 1998. Expresses the sense of the House of Representatives that appropriate measures should be taken to provide for a reduction in the number of permanent positions authorized for each Member under the Clerk Hire Allowance.
United States · United States Congress · 14 September 1993
Medical Cost Containment Act of 1993 - Amends the Internal Revenue Code to exclude from gross income medical care savings benefits. Describes such benefits as a health plan which provides that all or part of the premium differential realized by instituting a qualified higher deductible health plan is credited to participating employees to pay for medical care for a plan year. Requires amounts remaining at the end of such plan year to be deposited into a tax-exempt medical care savings account (subject to rules similar to those for retirement plans) for use by the participant for medical expenses.
United States · United States Congress · 9 September 1993
Executive Office Accountability Act of 1993 - Amends the Inspector General Act of 1978 to: (1) establish an Office of Inspector General (IG) in the Executive Office of the President; (2) require the IG to serve under the President's authority, direction, and control with respect to matters concerning ongoing criminal investigations, policy making, and national security (unless the President notifies the IG that disclosure of pertinent information would interfere with the core functions of his or her constitutional responsibilities); and (3) require the IG to comply with the same semiannual reporting requirements that all other IGs are subject to, plus, at a minimum, supply additional specified information as well. Requires the President to appoint a Chief Financial Officer (CFO) of the Executive Office of the President. Requires the: (1) Director of the Office of Management and Budget (OMB) to direct the CFO to review the financial management activities within the Executive Office of the President for the purpose of consolidating its accounting, budgeting, and other financial management activities under the CFO; (2) CFO to submit to the Director of OMB a proposal for reorganizing the Executive Office of the President for such purposes; (3) Director of OMB to approve or disapprove such proposal; and (4) CFO to implement the proposal upon such approval.
![Official portrait of Rep. Armey, Richard K. [R-TX-26]](https://www.congress.gov/img/member/a000217_200.jpg)