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
Provides for the termination of tax changes made in the Omnibus Budget Reconciliation Act of 1993 if the Secretary of the Treasury determines that the Federal budget deficit shrank nominally less than receipts attributable to such Act or the budget deficit increased.
United States · United States Congress · 22 September 1993
Veterans' Long-Term Care Act of 1993 - Defines "long-term care," for veterans' benefits purposes, as a continuum of institutional and noninstitutional programs and services that provide restorative care and support through a time period generally exceeding 90 days. Makes eligible for long-term care provided through the Department of Veterans Affairs any veteran: (1) being treated for a service-connected disability (SCD); (2) who has an SCD of 50 percent or more, for the treatment of any disability; (3) who is eligible for pension from the Department, for the treatment of any disability; and (4) for any disability resulting from Department treatment. Authorizes the Secretary to provide long-term care to certain nonqualifying veterans when medically necessary and subject to facility availability. Requires the Secretary to establish a schedule of long-term care copayments, and a long-term care coinsurance plan. Deems Department long-term care providers to be Medicare participating providers for purposes of Medicare payments under the Social Security Act. Authorizes the Secretary to contract with non-Department facilities for the provision of long-term care for veterans when Department facilities are inaccessible or otherwise incapable of providing such care. Requires such facilities to meet certain standards. Authorizes the provision of in-kind assistance to such facilities in lieu of payments. Authorizes the Secretary to provide social support services, including personal care and homemaker services, as part of long-term care services provided. Directs the Secretary to designate geographic areas of the United States as veterans' service areas in which long-term care will be available. Requires a report. Requires operation of such service areas by October 1, 1999. Directs the Secretary to regularly assess Department needs for new long-term care services. Establishes in the Treasury the Veterans' Long-Term Care Fund. Authorizes the Secretary to enter into agreements for the establishment on Department property of veterans' continuing care facilities in which veterans reside while receiving appropriate care. Requires a Department medical center, outpatient clinic, or nursing home to be colocated with such facilities. Requires at such facilities the establishement of a team of primary care providers to be known as the Veterans' Continuing Care Center Health team. Requires congressional reports.
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 · 8 September 1993
Amends the Omnibus Budget Reconciliation Act of 1993 to revise provisions concerning limitations on cost of living adjustments for military retirees to set forth special rules concerning such adjustments for FY 1994 through 1996 (currently, special rules are set forth for FY 1994 through 1998).
United States · United States Congress · 8 September 1993
Amends rule XXI of the Rules of the House of Representatives to prohibit a bill or joint resolution carrying any provision providing for a retroactive tax increase from being reported in the House. Provides that no amendment in the House or proposed by the Senate carrying a retroactive tax measure shall be in order during the consideration of a bill or joint resolution. Allows a question of order to be raised at any time under this clause.
United States · United States Congress · 8 September 1993
Expresses the sense of the Congress that the Federal Government should terminate the policy of allowing resettlement of members of the Iraqi armed forces in the United States.
United States · United States Congress · 6 August 1993
Adds Hodgkin's disease and porphyria cutanea tarda, both becoming manifest to a degree of ten percent or more, to the list of diseases that will be presumed to be service-connected, and, therefore, compensable under veterans' disability provisions, when suffered by Vietnam era veterans after serving on active duty in Vietnam.
United States · United States Congress · 6 August 1993
Older Americans Preventive Health Act of 1993 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of a comprehensive health assessment and certain immunizations under Medicare part B (Supplementary Medical Insurance). Amends the Public Health Service Act to authorize additional appropriations for the provision of education and information regarding cancer to health professionals and the public.
United States · United States Congress · 6 August 1993
TABLE OF CONTENTS: Title I: Statement of Congressional Purpose Title II: Binding Budget Law Title III: Enforcement Mechanics Subtitle A: Supermajority Required to Break Budget Law Subtitle B: Line Item Reduction Subtitle C: "Blank Check" Appropriations Prohibited Subtitle D: "Pay As You Go" Requirement for New Spending Title IV: Sustaining Mechanism Title V: Protection of Social Security Title VI: Timetable Title VII: Conforming Amendments Title VIII: Definitions and Rules of Interpretation Title IX: Effective Date Budget Process Reform Act - Title I: Statement of Congressional Purpose - Declares that the purpose of this Act is to facilitate rational, informed, and timely decisions by the Congress. Expresses the sense of the Congress that the Federal budget process should focus the attention of policymakers and the public on the aggregate impact of Federal spending on the economy, and on the tradeoffs that must be made among priorities in order to control overall levels of spending. Declares that the budget process should contain safeguards against delay and inaction, so that temporary shut-downs of the Government may be avoided. Title II: Binding Budget Law - Requires the Congress to enact a binding budget law, in the form of a joint resolution, by April 15 of the calendar year before that in which the fiscal period commences. Makes it out of order in the House of Representatives or the Senate to consider any spending bill affecting spending in a major functional category unless and until a joint resolution on the budget is enacted. Amends the Congressional Budget Act of 1974 to prohibit baseline budgeting. Requires the President to submit to the Congress on or before the 15th day after a joint resolution on the budget is enacted a detailed budget for the fiscal period beginning on October 1 of the current calendar year. Title III: Enforcement Mechanics - Subtitle A: Supermajority Required to Break Budget Law - Requires a two-thirds majority vote in the House and the Senate to consider any spending bill prior to the enactment of the budget law. Requires the Congressional Budget Office to provide to the Congress an estimate of the costs in each major functional category of certain spending bills as soon as practicable after its introduction. Requires a two-thirds affirmative vote in the House and the Senate to consider over-budget spending bills. Requires a two-thirds affirmative vote in the House and the Senate to waive any provision of this Act. Subtitle B: Limited Enhanced Rescission Authority - Amends the Impoundment Control Act of 1974 to limit the President's rescission authority to spending that is above the limits of the budget law. Subtitle C: "Blank Check" Appropriations Prohibited - Declares the intent of the Congress to end open-ended, "blank check" appropriations which typically authorize spending "such sums as may be necessary." Requires fixed-dollar appropriations for every account except social security and interest on the debt. Prohibits open-ended appropriations. Requires Executive agencies to adjust benefit levels to ensure that appropriations for entitlement programs are not exceeded. Restricts budget authority and entitlement authority to one fiscal period. Subtitle D: "Pay As You Go" Requirement for New Spending - Prohibits the Congress from considering any legislation which exceeds the budget ceiling unless it offsets such increased spending with an equal amount of reductions. Requires a two-thirds affirmative vote in the House and the Senate to waive such prohibition. Title IV: Sustaining Mechanism - Makes appropriations to provide for an automatic continuing resolution if for any account an appropriation for a fiscal period does not become law before the beginning of such period. Restricts legislation providing funding to the Committees on Appropriations. Title V: Protection of Social Security - Provides that no reduction in benefits under title II of the Social Security Act (Old Age, Survivors and Disability Insurance) shall be made as a consequence of this Act. Title VI: Timetable - Revises the timetable for the congressional budget process. Title VII: Conforming Amendments - Makes various technical and conforming amendments, including changing references to a concurrent resolution on the budget to references to a joint resolution on the budget. Title VIII: Definitions and Rules of Interpretation - Sets forth definitions for specified terms. Title IX: Effective Date - Declares the effective date of this Act to be January 1, 1995, applicable to fiscal years beginning after September 30, 1995.
United States · United States Congress · 5 August 1993
Amends the Congressional Budget Act of 1974 to require a three-fifths vote in the House of Representatives to waive the applicability of provisions of that Act to the House.
United States · United States Congress · 5 August 1993
Amends rule XI of the Rules of the House of Representatives to require the affirmative percentage of those voting that is required to adopt any rule or order reported by the Committee on Rules providing for the consideration of any legislation that waives any rule of the House to be the same as the affirmative percentage of those voting that is required by the rules of the House to waive that rule.
United States · United States Congress · 5 August 1993
Amends rule X of the Rules of the House of Representatives to require the membership of the Committee on Rules (and of each of its subcommittees) to reflect the ratio of the majority to minority party Members of the House at the beginning of the Congress.
United States · United States Congress · 5 August 1993
Amends rule XI of the Rules of the House of Representatives to require a three-fifths vote to adopt any rule or order reported by the Committee on Rules providing for the consideration of legislation that limits the rights of Members to offer germane amendments if the legislation would otherwise be subject to amendment under House rules.
United States · United States Congress · 4 August 1993
Natural Disaster Protection Act of 1993 - Amends the Robert T. Stafford Disaster Relief and Emergency Assistance Act (the Act) to require the Director of the Federal Emergency Management Agency to develop programs to carry out specified multihazard mitigation and emergency management initiatives, including the development of model building codes and other hazard mitigation measures for catastrophic natural disasters, training and research in such areas, hazard mitigation technology, and local emergency response operations. Allows local communities five years after the date of enactment of this Act to comply with multihazard building and safety codes outlined under this Act, after which public assistance funds will be withheld for noncompliance. Requires the Director to identify States which are prone to damages from hurricanes, windstorms, earthquakes, volcanic eruptions, and flooding (natural disasters), and to designate each State appropriately as hurricane-, windstorm-, earthquake-, volcanic eruption-, or flood-prone. Requires each State so designated to either: (1) adopt the relevant natural disaster hazard mitigation portions of the newest building codes for such State for all new or substantially modified building construction in such State; or (2) certify that the local communities have adopted building codes which meet or exceed such requirements. Requires each State designated as disaster-prone to either: (1) develop a hazard mitigation plan with accompanying schedules for improving the State's ability to reduce the hazards of future natural disasters; or (2) designate an existing plan which meets such requirements. Requires a completed plan to be submitted to the Director within two years after designation. Outlines State compliance procedures, and imposes penalties for hazard mitigation plan noncompliance. Establishes the Self-Sustaining Mitigation Fund for Federal and State support of hazard mitigation and emergency management activities, with amounts provided by the Director to each disaster-prone State for appropriate purposes. Establishes the Natural Disaster Mitigation and Planning Advisory Committee as an independent advisory committee to advise the Director on hazard mitigation and disaster planning, and to review hazard mitigation regulations issued by the Director. Requires the Director to establish and carry out a national multihazard insurance program (the Primary Insurance Program) to provide insurance against real or personal property loss in any State resulting from an earthquake or volcanic eruption. Requires the Director to evaluate the feasibility of including flood as a covered peril under the Primary Insurance Program. Outlines specified procedures for increased participation in the Federal flood insurance program under the National Flood Insurance Act, with a required report. Outlines further provisions with respect to the Primary Insurance Program, including program scope (initially limited to residential housing), terms and limitations, covered hazards, and insurance actuarial rates. Establishes in the Treasury the Primary Insurance Program Fund to carry out such Program. Provides for Fund uses, investments, and disbursements, authorizing the Director, when necessary, to borrow from the Treasury for Fund purposes. Requires the Director, in carrying out the Program, to provide certain insurance mitigation incentives, including the charging of lower premiums for residential property located in disaster-prone States. Requires the Director to make available to eligible entities excess reinsurance coverage for any direct and indirect losses that arise from a hurricane, earthquake, volcanic eruption, or tsunami (tidal wave). Outlines provisions concerning eligible entities and reinsurance coverage terms, limitations, and obligations, including the covered lines of insurance. Requires the establishment of actuarially sound rates for such coverage. Establishes in the Treasury the Reinsurance Fund for implementation of such reinsurance coverage. Requires the Director to develop a plan of operation to ensure the fair, reasonable, and equitable administration of the Primary Insurance Program Fund, the Reinsurance Fund, and other activities outlined in this Act. Establishes the Federal Insurance and Reinsurance Advisory Committee as an independent committee and requires the plan to be submitted to such Committee for review and recommendations. Requires a Committee report.
United States · United States Congress · 4 August 1993
Amends rule XI of the Rules of the House of Representatives to allow meetings of standing committees and subcommittees to be closed to the public only if approved by a majority of the committee or subcommittee's total membership because disclosure of matters to be considered would endanger national security, tend to defame, degrade, or incriminate any person, jeopardize an ongoing criminal investigation, or compromise a confidential source of any criminal investigation. Repeals provisions making the coverage of committee hearings and meetings by television broadcast, radio broadcast, or still photography a privilege made available by the House. Requires proceedings of open committee hearings or meetings to be open to television broadcast, radio broadcast, and still photography, or by any of such method of coverage. Prohibits a committee or subcommittee chairman from limiting the number of television or still cameras below two representatives from each medium.
United States · United States Congress · 3 August 1993
Expresses the sense of the House of Representatives that: (1) obstetrician-gynecologists should be designated as primary care providers for women in Federal laws relating to the provision of health care; and (2) legislative proposals that define primary care should include services performed by obstetrician-gynecologists in such definition.
United States · United States Congress · 2 August 1993
Directs the President to: (1) investigate and report to the Congress on the whereabouts of U.S. citizens and others who have been missing from Cyprus since 1974; and (2) do everything possible to return such persons (including remains of those no longer alive) to their families.
United States · United States Congress · 30 July 1993
TABLE OF CONTENTS: Title I: Tax Treatment of Long-Term Care Insurance Title II: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance Title III: Studies Long-Term Care Security Act of 1993 - Title I: 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. 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. 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. 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. Excludes from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangements to pay long-term care premiums. 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 confined to a qualified facility. Allows insurance companies to issue accelerated death benefit riders on life insurance contracts. Title II: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance - Amends title XIX (Medicaid) of the Social Security Act to disregard assets which are attributable to coverage under a qualified long-term care insurance contract for purposes of eligibility. Title III: Studies - Directs 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 homes with a tax credit.
United States · United States Congress · 15 July 1993
Requires the effective date and time for any change in benefits under the Servicemen's Group Life Insurance program to be based on the International Date Line, with respect to benefit changes made after November 29, 1992.
United States · United States Congress · 15 July 1993
Air Traffic Controller Incentive and Retention Act - Increases the premium pay differential for certain air traffic control system employees and other specified employees of the Federal Aviation Administration and the Department of Defense from five to 15 percent of the applicable rate of basic pay. Entitles such employees to Sunday premium pay for work performed on Saturday.
United States · United States Congress · 15 July 1993
Expresses the sense of the Congress that the United States should use its influence as a permanent member of the United Nations Security Council to support the efforts of Greece, in its negotiations with the Former Yugoslav Republic of Macedonia, to find a solution which promotes a cooperative relationship between the two countries.
United States · United States Congress · 30 June 1993
TABLE OF CONTENTS: Title I: Adjudication Improvements Title II: Board of Veterans' Appeals Improvements Title III: Court of Veterans Appeals Improvements Veterans' Adjudication and Appeals Improvements Act of 1993 - Title I: Adjudication Improvements - Authorizes (currently, directs) the Secretary of Veterans Affairs to require an annual income statement from persons receiving pension benefits from the Department of Veterans Affairs. Reduces from one year to 120 days the time period for a Department claim applicant to respond to a notice of an incomplete application. Limits the review of reopened claims to the issue to which the new and material evidence is related. Limits the retroactive effective date of an award based on clear error to ten years before receipt of the allegation of such error. Directs the Secretary to: (1) report to specified congressional committees a plan for the reorganization of adjudication divisions located within the regional offices of the Veterans Benefits Administration; and (2) enter into an agreement with the Secretary of Defense for the immediate transfer to the Department of the service medical records of individuals separated from the armed forces. Title II: Board of Veterans' Appeals Improvements - Repeals the current 65-person limit on the size of the Board of Veterans' Appeals. Requires the Chairman of the Board to be subject to the same ethical and legal limitations that apply to judges of the U.S. Court of Veterans Appeals. Repeals the requirement of an annual report on the number of temporary members appointed to the Board. Revises provisions concerning: (1) assignment of matters before the Board from the Chairman to other Board members; (2) determinations made by Board members (with a review of each decision by the Chairman or Vice Chairman); and (3) Board jurisdiction. Reduces from one year to 120 days: (1) the period for the filing of a notice of disagreement and appeal to a Board decision; and (2) administrative appeals of decisions by designated officials of the Department. Provides procedures for a Board hearing of an applicant's appeal, allowing such hearing to take place at either the Board's principal location or a regional office of the Department. Title III: Court of Veterans Appeals Improvements - Requires the U.S. Court of Veterans Appeals to review the entire record (currently, the record) of the previous proceedings before the Secretary and the Board. Prohibits the Court from considering an issue not presented on appeal to the Board.
United States · United States Congress · 29 June 1993
Firefighters and Police Retirement Security Act of 1993 - Amends the Age Discrimination in Employment Amendments of 1986 to repeal a provision which would have terminated an exemption for certain bona fide hiring and retirement plans applicable to State and local fire fighters and law enforcement officers. (This Act thereby preserves such exemption beyond 1993.)
United States · United States Congress · 28 June 1993
Directs the Secretary of Veterans Affairs to provide hospital care, and authorizes the Secretary to provide nursing home care, to a veteran exposed to an environmental hazard. Makes a veteran who the Secretary finds may have been exposed to a toxic substance or an environmental hazard during the Persian Gulf War eligible for hospital and nursing home care for any disability which becomes manifest before October 1, 1996, notwithstanding whether it is medically evident that such disability is associated with such exposure. Extends through FY 1998 the provision of such care. Makes such veterans eligible for outpatient care for any disability through such period, if the disability becomes manifest before October 1, 1996.
United States · United States Congress · 24 June 1993
POW/MIA Full Accounting Act of 1993 - Expresses the sense of the Congress that the President should not normalize diplomatic relations with the Government of Vietnam until he certifies to the Congress that the U.S. Government has received the fullest possible accounting of American POW/MIAs from the Vietnam conflict. Provides for the following actions until the President certifies to the Congress that the U.S. Government has received such accounting: (1) a continuation of the trade embargo in effect as of June 1, 1993, against Vietnam; (2) an instruction to the U.S. executive director of the International Monetary Fund to defer consideration of a resolution to allow Vietnam to pay off loans that are in arrears; and (3) an instruction to the U.S. executive directors of appropriate multilateral financial institutions to deny any new loans, grants, or credits to Vietnam.
United States · United States Congress · 24 June 1993
Designates September 17, 1993, as National POW/MIA Recognition Day. Requires the display of the National League of Families POW/MIA flag at: (1) all national cemeteries and the National Vietnam Veterans Memorial on May 31, 1993 (Memorial Day), September 17, 1993 (National POW/MIA Recognition Day), and November 11, 1993 (Veterans Day); and (2) the White House and the buildings containing the primary offices of the Secretaries of State, Defense, and Veterans Affairs and the Director of the Selective Service Commission (sic) on September 17, 1993 (National POW/MIA Recognition Day).
United States · United States Congress · 18 June 1993
Vietnam Women's Memorial Coin Act of 1994 - Directs the Secretary of the Treasury to issue silver coins emblematic of the Vietnam Women's Memorial sculpture. Requires all surcharges received from the sale of such coins to be used for: (1) an endowment for the Memorial; (2) education and research concerning veterans and their families; and (3) the identification and documentation of women who served in the armed forces during the Vietnam era. Expresses the sense of the Congress that this coin program shall be self-sustaining and administered to result in no net cost to the Numismatic Public Enterprise Fund.
United States · United States Congress · 17 June 1993
Equitable Escheatment Act of 1993 - Amends specified Federal law to prescribe guidelines under which unclaimed distributions of security interests shall be subject to the custodial taking (escheatment) by the State which contains the principal executive offices of either the issuer or the holder of those securities.
![Official portrait of Rep. Bilirakis, Michael [R-FL-9]](https://www.congress.gov/img/member/b000463_200.jpg)