United States · United States Congress · 21 January 1993
Health Freedom Act of 1993 - Amends the Federal Food, Drug, and Cosmetic Act to define "dietary supplement" as an article that: (1) includes, and is intended to supplement the diet with, a vitamin, mineral, or herb; or (2) is intended for ingestion. Prohibits considering a dietary supplement a drug solely because: (1) of the potency of a substance in such supplement; or (2) the labeling or advertising for the supplement contains a claim concerning potency or a health claim permitted under this Act. Specifies that a supplement is not a food additive if it is identified in the labeling of the dietary supplement as a substance provided by the product to supplement the diet. Allows a supplement to be described as a dietary supplement in labeling or advertising. Permits labeling or advertising for such a supplement to include a claim characterizing the relationship of the supplement to a disease or health-related condition, if certain conditions are met. Prohibits any requirement that a claim that meets the requirements of this Act be approved or conform to a regulation before the claim may be used. Allows a declaratory judgment on the validity of an assertion that a claim fails to comply with this Act.
United States · United States Congress · 21 January 1993
Vietnam POW/MIA Rescue Act - Directs the Attorney General to grant asylum to certain nationals of Laos, Vietnam, Cambodia, or Burma (Myanmar) who personally deliver into U.S. custody a living Vietnam POW/MIA (or participate in such a delivery).
United States · United States Congress · 21 January 1993
Limits the period for which expenses of a former Speaker of the House of Representatives may be paid to three years after the expiration of the term of office as Representative. (Provides that in the case of a former Speaker who is receiving such expenses on the date of the enactment of this Act, the period shall end three years after such date.)
United States · United States Congress · 6 January 1993
Amends the Internal Revenue Code to permanently extend the period during which qualified mortgage bonds and mortgage credit certificates may be issued.
United States · United States Congress · 6 January 1993
Requests the Occupational Safety and Health Administration to publish, within one year, proposed amended regulations that specify the components of an adequate operator training program and that provide that only trained employees be authorized to operate powered industrial trucks.
United States · United States Congress · 5 January 1993
Amends the Internal Revenue Code to increase the personal exemption for a dependent child who has not attained age 18 from $2,000 to $3,500. Provides for rounding inflation adjustments to tax tables to the nearest multiple of $10 (currently rounded to the next lowest multiple of $50).
United States · United States Congress · 5 January 1993
Taxpayer Debt Buy-Down Act - Amends the Internal Revenue Code to allow every individual with adjusted income tax liability to designate on their tax returns that a portion of such liability (not to exceed ten percent) be used to reduce the public debt. Establishes a Public Debt Reduction Trust Fund for the deposit of designated amounts. Makes amounts in such Trust Fund available only to pay at maturity, or to redeem or buy before maturity, any obligation of the Federal Government included in the public debt. Prohibits the reissuance of any obligation which is paid, redeemed, or bought with amounts from the Trust Fund. Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to provide for the sequestration of amounts designated to the Trust Fund. Specifies accounts exempt from such sequestration. Includes aggregated amounts designated to the Trust Fund and amounts sequestered to reduce the public debt in sequestration preview and final reports.
United States · United States Congress · 5 January 1993
Amends the Federal criminal code to provide that, with exceptions, anyone at least 18 years of age who uses a child to commit, or to assist in avoiding detection or apprehension for a Federal offense, shall: (1) after a previous conviction for such an offense has become final, be subject to three times the maximum imprisonment and fine otherwise provided for the offense; and (2) in any other case, be subject to twice the maximum imprisonment and fine for the offense.
United States · United States Congress · 5 January 1993
Congressional Accountability Act - Makes applicable to the Congress the following Federal laws to the extent they relate to the terms and conditions of employment, the health and safety of employees, and the rights and responsibilities of employers and employees: (1) Social Security Act; (2) National Labor Relations Act; (3) Fair Labor Standards Act of 1938; (4) Civil Rights Act of 1964; (5) Age Discrimination in Employment Act of 1967; (6) Occupational Safety and Health Act of 1970; (7) title IX of the Education Amendments of 1972; (8) Rehabilitation Act of 1973; (9) Privacy Act of 1974; (10) Age Discrimination Act of 1975; (11) Ethics in Government Act of 1978; and (12) Americans with Disabilities Act of 1990. Makes applicable to the Congress the Freedom of Information Act and specified provisions of Federal law relating to the independent counsel.
United States · United States Congress · 5 January 1993
Authorizes and requests the President to issue proclamations: (1) directing Government officials to display the U.S. flag at half-staff on all Government buildings on Peace Officers Memorial Day; and (2) inviting State and local governments and the people of the United States to display the flag in the same manner on such day.
United States · United States Congress · 5 January 1993
Missing Service Personnel Act of 1993 - Requires the responsible armed forces commander, after receiving notice that a person under his command is missing, to conduct an informal investigation to determine such person's whereabouts and, if appropriate, to place such person in a missing status. Provides for the convening of boards of inquiry to: (1) investigate evidence relating to the disappearance of a person; (2) recommend whether to continue such person in a missing status or make a finding that such person has deserted, is absent without leave, or is dead; and (3) report its recommendations and findings. Provides for the convening of a board of further inquiry, if a board of initial inquiry recommends that such person be continued in a missing status. Directs the Secretary concerned, upon the written request of a member of the immediate family of a missing person who, before the date of the enactment of this Act, was determined by the Secretary to be dead, to: (1) convene a board of further inquiry to determine whether such finding of death should be upheld or such person should be placed in a missing status; and (2) report its findings. Requires the Secretary, within three years after a board of further inquiry recommends a missing status for any person, to reconvene such board to review such status. Directs the Secretary to invite each member of the immediate family of the missing person to board meetings unless attendance would place such member in danger. Prohibits any such board from declaring a missing person dead unless: (1) evidence other than the passage of a period of fewer than 50 years suggests that such person is dead; (2) no evidence which reasonably suggests that such person is alive is in the possession of the Government; (3) Government representatives have made a complete search of the area where such person was last seen (unless the United States is not granted access to such area); and (4) Government representatives have checked the records of the government or entity having control over the area where such person was last seen (unless the Government is not granted access to such records). Provides for judicial review of determinations of death. Sets forth penalties for knowingly withholding information pertaining to a missing person from that person's personnel file. Requires the Secretary concerned to make the contents of such file available to a member of the immediate family of such person upon written request.
United States · United States Congress · 5 January 1993
Amends Internal Revenue Code provisions governing the income tax deduction for the health insurance costs of self-employed individuals to: (1) make the deduction permanent; and (2) phase in an increase in the allowable deduction, reaching 100 percent for taxable years beginning in 1996 and thereafter.
United States · United States Congress · 5 January 1993
Common Sense Budget Act of 1993 - Amends Federal law to require both the President and the Congress to draft a budget based on estimates of current fiscal year spending, proposing increases or decreases based on this level (rather than on an estimated baseline). Amends the Congressional Budget Act of 1974 to require the Congressional Budget Office to use such a current fiscal year baseline in its report to the congressional budget committees, projecting growth for entitlement and discretionary spending based on current fiscal year spending.
United States · United States Congress · 5 January 1993
Federal Mandate Relief Act of 1993 - Provides that any requirement under a Federal statute or regulation that a State or local government conduct an activity (including a requirement that a government meet national standards in providing a service) shall apply to the government only if all funds necessary to pay the direct costs incurred by the government in conducting the activity are provided by the Federal Government.
United States · United States Congress · 5 January 1993
Language of Government Act of 1993 - Declares English to be the official language of the U.S. Government. States that the Government has an affirmative obligation to preserve and enhance the role of English as the official language. Requires the Government to conduct its official business in English. Prohibits anyone from being denied Government services because they communicate in English.
United States · United States Congress · 5 January 1993
Life Imprisonment for Egregious Recidivists Act of 1993 - Amends the Federal criminal code to require the court, in the case of a conviction for a Federal violent felony, to sentence the defendant to life imprisonment if the defendant has previously been convicted of two other violent felonies. Specifies that this provision shall not be construed to prevent the imposition of the death penalty.
United States · United States Congress · 5 January 1993
Merchant Mariners Fairness Act of 1993 - Provides that certain qualified service of a member of the U.S. merchant marine, including a vessel crewmember of the U.S. Army Transport Service, during World War II constituted active military service for purposes of eligibility for various veterans' benefits under the GI Bill Improvement Act of 1977. Requires the Secretary of Defense to issue an honorable discharge under such Act to each merchant marine member whose qualified service warrants such a discharge. Prohibits the payment of any retroactive benefits under this Act. Mandates a processing fee for any benefit application for such qualified service.
United States · United States Congress · 5 January 1993
TABLE OF CONTENTS: Title I: Provisions Relating to Part A Title II: Provisions Relating to Part B Subtitle A: Physicians' Services Subtitle B: Ambulatory Surgical Services Subtitle C: Durable Medical Equipment Subtitle D: Other Provisions Title III: Provisions Relating to Parts A and B Title IV: Provisions Relating to Medicare Supplemental Insurance Policies Miscellaneous and Technical Medicare Amendments of 1993 - Amends title XVIII (Medicare) of the Social Security Act (SSA) parts A (Hospital Insurance) and B (Supplementary Medical Insurance). Title I: Provisions Relating to Part A - (Sec. 101) Requires the Secretary of Health and Human Services (HHS) to use the day outlier methodology in effect for: (1) FY 1992 for payment of discharges occurring on or after April 1, 1993, and before September 30, 1993; and (2) the first six months of FY 1993 for payment of discharges occurring during FY 1994. (Sec. 102) Modifies the Essential Access Community Hospital program. (Sec. 103) Provides that a change in classification of hospitals from one area to another may not result in a reduction in the wage index for an urban area under certain circumstances. (Sec. 104) Amends the Omnibus Budget Reconciliation Act of 1987 (OBRA-1987) to extend authorized appropriations for the rural health transition grant program. (The Omnibus Budget Reconciliation Acts of different years amended by this Act shall be denoted "OBRA-(year).") (Sec. 105) Permits hospitals to decline reclassification from rural to urban referral centers. (Sec. 106) Revises Medicare-dependent, small rural hospital payment provisions. (Sec. 107) Amends OBRA-1989 to extend additional Medicare payments for the hemophilia clotting factor. (Sec. 108) Prohibits the Secretary from recouping from or otherwise reducing Medicare payments to hospitals in New Jersey because of alleged overpayments during a hospital reimbursement demonstration project, until all relevant data are given to the State and hospitals located in it. (Sec. 109) Allows the care of hospital inpatients receiving qualified psychologist services to be supervised by a clinical psychologist to the extent such supervision is permitted under State law. (Sec. 110) Allows graduate medical education to be provided in a hospital-owned community health center. (Sec. 111) Requires a study on the feasibility and desirability of establishing joint medical facilities among the Department of Defense, the Department of Veterans' Affairs, and other public and private entities. (Sec. 112) Requires home health agencies and skilled nursing facilities to notify Medicare beneficiaries of the hospice benefit, except in certain circumstances. (Sec. 113) Directs the Secretary to begin collecting data on employee compensation and paid hours of employment in skilled nursing facilities (SNFs) to compute a wage index to adjust Medicare SNFs payments. (Sec. 115) Amends OBRA-1990 to require the Secretary to continue any rural hospital demonstration project at least through December 31, 1995. Title II: Provisions Relating to Part B - Subtitle A: Physicians' Services - (Sec. 201) Reinstates separate payment for electrocardiogram interpretations performed or ordered to be performed as part of or in conjunction with a visit to or consultation with a physician. (Sec. 202) Repeals provisions for reduced Medicare payments to new physicians and other practitioners during their first four years of practice. (Sec. 203) Prohibits the Secretary from modifying the methodology for determining the amount of time that may be billed under Medicare for anesthesia services. (Sec. 204) Requires the Secretary to study and report to specified congressional committees on the data necessary to review and revise geographical indices. (Sec. 205) Prohibits nonparticipating physicians and suppliers from billing or collecting an actual charge in excess of the Medicare limiting charge. (Sec. 206) Requires the Secretary to study, develop, and report to the Congress on relative values for pediatric services. (Sec. 208) Prohibits the Secretary and carriers from imposing user fees. Subtitle B: Ambulatory Surgical Services - (Sec. 211) Extends eligibility for designation as eye or eye and ear hospitals to certain hospitals. (Sec. 212) Amends OBRA-1990 to extend the cap on payments for intraocular lenses. Subtitle C: Durable Medical Equipment - (Sec. 221) Requires the Secretary to prescribe national standards which suppliers of medical equipment and supplies must meet to receive payment under Medicare for items furnished. (Sec. 222) Prohibits carrier forum shopping by suppliers filing claims. (Sec. 223) Prohibits unsolicited telephone contacts from suppliers of durable medical equipment to Medicare beneficiaries. (Sec. 224) Modifies SSA anti-kickback provisions. (Sec. 225) Specifies the circumstances under which Medicare beneficiaries are not liable for covered items furnished by suppliers on an unassigned basis. (Sec. 226) Revises special payment rules for particular items and services to provide for adjustments to final payment amounts for inherent reasonableness. (Sec. 227) Freezes reasonable charges for parenteral and enteral nutrients, supplies, and equipment. (Sec. 228) Removes aspirators and nebulizers from the category of durable medical equipment (DME) items requiring frequent and substantial servicing and includes accessories relating to aspirators and nebulizers in the category of inexpensive and other routinely purchased equipment. (Sec. 229) Adds payment rules for ostomy supplies, tracheostomy supplies, urologicals, and surgical dressings. (Sec. 230) Changes payment rates for tens devices. Subtitle D: Other Provisions - (Sec. 241) Revises payment conversion factors for services furnished by a medically directed certified registered nurse anesthetist. (Sec. 242) Amends OBRA-1990 to extend Alzheimer's disease demonstration projects. (Sec. 243) Modifies the limitation on the late enrollment penalty. (Secs. 244 and 245) Provides for Medicare coverage of: (1) oral cancer drugs that contain the same active ingredients as anticancer drugs covered by Medicare when administered intravenously; and (2) speech-language pathology and audiology services. (Sec. 246) Amends OBRA-1985, as amended by OBRA-1989, to extend municipal health service demonstration projects. (Sec. 247) Treats certain Indian health programs and facilities as federally-qualified health centers. (Sec. 248) Amends OBRA-1987 to extend the influenza vaccination demonstration project. Title III: Provisions Relating to Parts A and B - (Sec. 301) Modifies provisions relating to physician ownership and referral. Requires the Comptroller General to study and report to the Congress on shared facility arrangements. (Sec. 302) Adjusts procedures to determine graduate medical education costs. (Sec. 303) Extends the periods during which Medicare covers immunosuppressive drug therapy following a transplant procedure. Reduces Medicare payments for erythropoietin. (Sec. 304) Revises provisions with respect to Medicare secondary payers. (Secs. 305 and 306) Requires the Secretary to: (1) establish a method for obtaining information with a view to Medicaid payment of the Medicare out-of-pocket expenses of eligible Medicare beneficiaries; and (2) extend waivers for social health maintenance organization (HMO) demonstration projects. (Sec. 307) Repeals peer review organization precertification requirements for certain surgical procedures. (Sec. 308) Modifies hospital conditions of participation with respect to discharge planning under Medicare to require informing a patient of his or her entitlement to hospice services. (Sec. 309) Provides that there must be interest payments on clean claims if the claims are not paid within 30 days of receipt. (Sec. 311) Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to adjust discretionary spending limits with respect to Medicare administrative costs. (Sec. 312) Adjusts Medicare capitation payments with respect to HMOs to account for regional variations in application of the secondary payor provisions. (Sec. 313) Amends the Employee Retirement Income Security Act of 1974 with regard to certain health care programs of the State of Hawaii. Title IV: Provisions Relating to Medicare Supplemental Insurance Policies - (Sec. 401) Revises certain standards for Medicare supplemental insurance policies.
United States · United States Congress · 5 January 1993
Legislative Line Item Veto Act of 1993 - Amends the Congressional Budget and Impoundment Control Act of 1974 to grant the President legislative line item veto rescission authority. Makes such a rescission effective unless the Congress, during a review period of 20 calendar days, enacts a rescission disapproval bill.
United States · United States Congress · 5 January 1993
Legislative Line Item Veto Act of 1993 - Grants the President legislative line item veto rescission authority. Authorizes the President to rescind all or part of any budget authority if the President determines that such rescission: (1) would help balance the Federal budget, reduce the Federal budget deficit, or reduce the public debt; (2) will not impair any essential Government functions; (3) will not harm the national interest; and (4) will directly contribute to the purpose of this Act of limiting discretionary spending in FY 1994 or 1995. Requires the President to notify the Congress of such a rescission by special message after enactment of appropriations legislation for FY 1994 or 1995. Makes such a rescission effective unless the Congress enacts a rescission disapproval bill. Describes: (1) information to be included in the President's message; and (2) procedures to govern consideration of rescission disapproval legislation in the Senate and the House of Representatives.
United States · United States Congress · 5 January 1993
Employee Educational Assistance Act of 1993 - Amends the Internal Revenue Code to make permanent the income tax exclusion of amounts paid under employee educational assistance programs.
United States · United States Congress · 5 January 1993
Amends the Internal Revenue Code to allow an income tax deduction for interest on any indebtedness incurred to pay the educational expenses of the taxpayer, spouse, or dependent. Allows such deduction only for the first 48 months of loan repayment.
United States · United States Congress · 5 January 1993
Constitutional Amendment - Requires the Congress, prior to each fiscal year, to adopt a statement in which total Federal outlays do not exceed total receipts, unless a three-fifths vote of both Houses authorizes a specific excess. Limits the rate of increase in receipts in the statement to that of the increase in national income in the previous calendar year, unless law is enacted solely to approve specific additional receipts. Directs the President to submit a balanced budget. Authorizes waiver of these provisions in time of war. Sets a permanent limit on the amount of Federal public debt, prohibiting any increase unless legislation enacted by a three-fifths majority of both Houses become law.
United States · United States Congress · 5 January 1993
Constitutional Amendment - Prohibits in any fiscal year total Federal outlays from exceeding total receipts, unless a three-fifths roll call vote of both Houses authorizes a specific excess. Prohibits any increase in the public debt unless a three-fifths roll call vote of both Houses of the Congress enacts legislation permitting otherwise. Directs the President to submit a balanced budget to the Congress. Permits any revenue-increasing bill to become law only if approved by a majority of the whole number of each House of Congress by roll call vote. Waives these provisions when a declaration of war is in effect.
United States · United States Congress · 5 January 1993
Constitutional Amendment - Prohibits a person who has been elected to: (1) the Senate two times from being eligible for election or appointment to the Senate; and (2) the House of Representatives six times from being eligible for election to the House.
United States · United States Congress · 5 January 1993
Amends rule XXIII of the Rules of the House of Representatives to make it out of order to put the question upon final passage of any bill or resolution until printed copies of the measure have been available for all Members for at least one day. Provides for the suspension of this Act for a particular bill or resolution in a national emergency upon the joint request of the Speaker and Minority Leader and with an affirmative two-thirds vote.
United States · United States Congress · 5 January 1993
Declares that the Congress opposes any attempt to lower the estate tax exemption or raise the effective rate of taxes on estates because such measures contradict the fundamental goal of the United States Government of encouraging long-term private saving through which productive investment that promotes economic growth can be realized.
United States · United States Congress · 5 January 1993
Expresses the sense of the Congress that the current Federal income tax deduction for interest paid on debt secured by a first or second home should not be further restricted.
United States · United States Congress · 2 October 1992
Taxpayer Debt Buy-Down Act - Amends the Internal Revenue Code to allow individuals with adjusted income tax liability to designate on their tax returns that a portion of such liability (not to exceed ten percent) be used to reduce the public debt. Establishes a Public Debt Reduction Trust Fund for the deposit of designated amounts. Makes amounts in such Trust Fund available only to pay at maturity, or to redeem or buy before maturity, any obligation of the Federal Government included in the public debt. Prohibits the reissuance of any obligation which is paid, redeemed, or bought with amounts from the Trust Fund. Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to provide for the sequestration of amounts designated to the Trust Fund. Specifies accounts exempt from such sequestration. Includes aggregated amounts designated to the Trust Fund and amounts sequestered to reduce the public debt in sequestration preview and final reports.
United States · United States Congress · 25 September 1992
Expresses the sense of the Congress that if Saudi Arabia acquires F-15 aircraft from the United States it should demonstrate its peaceful intentions by lifting its economic boycott against Israel and against U.S. companies that trade with Israel.
United States · United States Congress · 18 September 1992
Regulatory Flexibility Amendments Act of 1992 - Amends Federal law to eliminate provisions respecting judicial review of Federal agency compliance with regulatory flexibility analysis requirements. Requires an agency to consider the direct and indirect effects of a rule in determining whether or not it is likely to have a significant impact on a substantial number of small entities. Sets forth guidelines governing agency transmittal of proposed rules to the Chief Counsel for Advocacy of the Small Business Administration. Authorizes such official to transmit to the agency a statement of opposition to the proposed rule. Requires publication of such statement and the agency's response in the Federal Register. Expresses the sense of the Congress that the Chief Counsel for Advocacy of the Small Business Administration should be permitted to appear as amicus curiae in any action or case brought in a U.S. court for the purpose of reviewing a rule.
United States · United States Congress · 9 September 1992
Authorizes the President to direct that any funds available for foreign assistance programs be used for emergency disaster assistance payments for expenses related to Hurricane Andrew or other natural disasters in the United States. Makes such funds available only to such extent or in such amount as provided in advance in an appropriation Act. Continues to consider such funds as funds within the international category for purposes of the Balanced Budget and Emergency Deficit Control Act of 1985.
United States · United States Congress · 4 August 1992
Amends the Internal Revenue Code to allow all individuals with adjusted income tax liability to designate on their tax returns that a portion of such liability (not to exceed ten percent) be used to reduce the public debt. Establishes a Public Debt Reduction Trust Fund for the deposit of designated amounts. Makes amounts in such Trust Fund available only to pay at maturity, or to redeem or buy before maturity, any obligation of the Federal Government included in the public debt. Prohibits the reissuance of any obligation which is paid, redeemed, or bought with amounts from the Trust Fund. Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to provide for the sequestration of amounts designated to the Trust Fund. Specifies accounts exempt from such sequestration. Includes aggregated amounts designated to the Trust Fund and amounts sequestered to reduce the public debt in sequestration preview and final reports.
United States · United States Congress · 22 July 1992
State Health Care Reform Incentive Act of 1992 - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to permit States to seek waivers of program requirements in order to provide health care coverage under certain regular or alternative State programs. Establishes Federal requirements for such State programs. Sets forth payment provisions.
United States · United States Congress · 4 June 1992
Action Now Health Care Reform Act of 1992 - Title I: Improved Access to Affordable Health Care Coverage - Subtitle A: Increased Affordability and Availability for Employees - Directs the Secretary of Health and Human Services (the Secretary) to request the National Association of Insurance Commissioners (the NAIC) to develop model regulations requiring each carrier that makes available in a State any small employer health benefit plan to make available to each small employer in the State a MedAccess basic plan and a MedAccess standard. Directs the Secretary to develop such regulations, if the NAIC does not. Defines MedAccess plan as a health benefits plan that: (1) provides benefits typical of the benefits offered in the small employer health coverage market or provides only benefits for essential preventive and medical services and has an average actuarial value not exceeding 60 percent of the average actuarial value of the typical benefits offered in the small employer health coverage market; (2) accepts every small employer in the State applying for coverage and accepts for enrollment every eligible individual (defined as an individual who is a full-time employee and, if family coverage is offered, covers the employee's spouse and dependents under age 19 or under age 25 for students); and (3) meets consumer protection standards established by this Act relating to limitation of pre-existing condition clauses, continuity of coverage, renewability, and premium limitations. Prohibits the imposition, by a carrier, of a limitation of benefits based on the fact a condition pre-existed the effectiveness of the policy if: (1) the condition relates to a condition not diagnosed within three months before coverage under the plan; (2) the limitation extends beyond six months after coverage under the plan; (3) the limitation applies to an individual who, as of date of birth, was covered under the plan; and (4) the limitation relates to pregnancy. Requires continuous coverage. Prohibits cancellation of a plan or denial of coverage unless there is: (1) nonpayment of premiums; (2) fraud; (3) noncompliance with plan provisions; (4) failure to maintain the required number of enrollees; (5) misuse of a provider network provision; or (6) a cessation by the carrier of the provision of any plan in a State. Amends the Internal Revenue Code to impose an excise tax which shall be paid by the carrier on the failure of a carrier or an employer health benefit plan to comply with the provisions of the Act. Directs the Secretary to request the NAIC to develop models for reinsurance or allocation of risk mechanisms for individuals and small employers who are enrolled under a small employer health benefit plan that meets the consumer protection standards and for whom a carrier is at risk of incurring high costs under the plan. Requires each State to establish and fund one or more reinsurance or allocation or allocation of risk mechanisms that are consistent with a model. Directs the Secretary to develop models, if the NAIC does not. Permits a State, in order to insure the financial solvency of the mechanism, to impose charges on any entity providing employee-related health benefits, so long as such charges do not discriminate with respect to entities that would not be subject to such charges. Directs the Secretary to establish a reinsurance or allocation of risk mechanism, if a State does not. Imposes an excise tax which shall be paid by the carrier on the providing of any health benefit plan which covers any employee in a Federal reinsurance State. Permits either a State or the Secretary (in a Federal reinsurance State) to require each employer health benefit plan to: (1) be registered; and (2) provide such information as is necessary for the reinsurance or allocation of risk mechanisms. Directs the Secretary to: (1) establish an Office of Private Health Coverage to be headed by a Director appointed by the Secretary; and (2) provide for the appointment of an advisory committee to advise the Director. Permits the Director to research the impact of this subtitle and conduct related demonstration projects. Requires the Director to develop: (1) methods of measuring, in terms of the expected costs of providing benefits under small employer health benefit plans and, in particular, MedAccess plans, the relative health risks of eligible individuals; and (2) a model for equitably distributing health risks among carriers in the small employer health care coverage market. Authorizes appropriations for the purposes of this paragraph. Subtitle B: Improved Small Employer Purchasing Power of Affordable Health Insurance - Preempts from insurance mandates a qualified small employer purchasing group, if the group consists of employers with not more than 100 employees, the group consists of not fewer than 100 employers, and the health benefit plans with respect to the employer members are in compliance with applicable State laws relating to health benefit plans. Subtitle C: Health Deduction Fairness - Amends the Internal Revenue Code to make permanent and increase from 25 to 100 percent the health insurance tax deduction for the self-employed. Subtitle D: Improved Access to Community Health Services - Directs the Secretary to provide for a program of grants to migrant and community health centers receiving grants or contracts under provisions of the Public Health Service Act in order to promote the provision of primary health care services for underserved individuals. Authorizes appropriations. Amends the Public Health Service Act to deem as an employee of the Public Health Service, for purposes of civil actions against commissioned officers or employees, any officer, employee, or contractor who is a physician or other licensed health care practitioner while performing functions for an entity receiving Federal funds under provisions of the Public Health Service Act. Requires an entity, in order to receive a grant under such provisions, to implement certain policies to assure against malpractice. Requires: (1) the Attorney General to estimate the amount of all claims expected, during each year, to arise against such an entity from acts of officers or employees; (2) the Secretary to withhold from grants to such entities the amount estimated; and (3) the withheld amount to be transferred to the Treasury to pay judgments against the United States arising from such claims. Directs the Secretary to make grants to public and nonprofit private entities to carry out demonstration projects for the purpose of increasing access to outpatient primary health services in geographic areas with a: (1) population of not more than 500,000 individuals; (2) shortage of personal health services; and (3) significant number of low-income or underinsured individuals. Sets forth requirements for receiving such grants. Authorizes appropriations. Subtitle E: Improved Access to Rural Health Services - Retitles title XII of the Public Health Service Act "Emergency Medical Services" (formerly, "Trauma Care") and directs the Secretary to establish the Office of Emergency Medical Services which shall, with respect to emergency medical services (including trauma care): (1) conduct research; (2) sponsor workshops; (3) assist States; and (4) coordinate activities. Authorizes the Secretary to make grants to States for the purposes of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services. Sets forth matching fund requirements. Provides for demonstration projects to establish telecommunications between rural medical facilities and other medical facilities that have equipment that can be utilized through telecommunications. Authorizes appropriations for purposes of the programs of this paragraph. Directs 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 access to treatments for the injuries or other conditions arising from such emergencies. Sets forth requirements for grant applications. Authorizes appropriations. Amends title XVIII (Medicare) of the Social Security Act to extend for one year special treatment rules for Medicare-dependent small rural hospitals. Title II: Health Care Cost Containment and Quality Enhancement - Subtitle A: Medical Malpractice Liability Reform - Prohibits bringing a medical malpractice claim: (1) more than two years after the alleged injury should reasonably have been discovered and in no event more than four years after the alleged injury occurred; and (2) in any State court unless there has been an initial resolution through a certified alternative dispute resolution system (ADR). Requires the use of ADR in a Federal medical malpractice liability claim. Requires a pre-trial settlement conference in any medical malpractice liability action. Sets limits on: (1) noneconomic damages; (2) punitive damages; and (3) attorney's fees. Requires offsets for damages paid by a collateral source. Requires liability in a medical malpractice action to be several and not joint. Provides a complete defense to any allegation of negligence in a medical malpractice liability action to any defendant who followed the appropriate practice guideline. Prohibits finding a defendant guilty in a medical malpractice liability action relating to services provided during labor or delivery of a baby if the defendant did not previously treat the plaintiff during the pregnancy, unless the malpractice is proven by clear and convincing evidence. Directs the Secretary to determine whether a States' ADR meets ADR system requirements established by this Act. Establishes such requirements. Amends title XI (General Provisions and Professional Standards Review) of the Social Security Act to earmark funds for sanctioning practice guidelines for purposes of an affirmative defense in medical malpractice liability actions. Permits a State agency responsible for the conduct of disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies for such type of health care practitioner to permit such societies to participate in the licensing of such health care practitioner and to review health care malpractice allegations. Requires each State to require each health care professional and provider to participate in a risk management program to prevent and provide early warning of practices which may result in injuries to patients or which otherwise endanger patient safety. Directs the Secretary to make grants for the conduct of basic research in the prevention of and compensation for injuries resulting from health care professional or health care provider malpractice, and research of the outcomes of health care procedures. Authorizes appropriations. Directs the Secretary to study the factors discouraging physicians from volunteering to provide health care services in medically underserved areas. Subtitle B: Administrative Cost Savings - Directs the Secretary to adopt standards relating to each of the following: (1) data elements for use in claims processing under health benefits plans; (2) uniform claim forms; and (3) uniform electronic transmission of the data elements. Authorizes the Secretary to require providers to submit claims to health benefit plans in accordance with such standards. Provides for periodic review of the standards. States that the term "health benefit plan," in this subtitle, includes the Medicare and Medicaid programs (titles XVIII and XIX of the Social Security Act). Requires the Secretary to promulgate standards for hospitals concerning electronic medical data. Permits the Secretary to promulgate standards concerning electronic medical data for providers that are not hospitals. Requires hospitals, in order to participate in Medicare, to: (1) maintain clinical data in a set of comprehensive data elements in electronic form on all patients; and (2) upon the Secretary's request, transmit electronically the data set and any data from such set. Provides for electronic transmission to Federal agencies. Prohibits a health benefit plan, if standards with respect to data elements are promulgated with respect to a class of provider, from requiring for the purpose of utilization review or as a condition of providing benefits under the plan that a provider in the class: (1) provide any data element not in the set of comprehensive data elements; or (2) transmit or present any such data element in a manner inconsistent with applicable standards. Directs the Secretary to establish an advisory commission of hospital executive and data base managers, physicians, health services researchers, and technical experts in the collection and use of data and operation of data systems. Authorizes appropriations for such commission. Requires the Secretary, in order to assure the availability of comparative value information to purchasers of health care in each State, to determine whether each State is developing and implementing a health care value information program that meets stated criteria. Permits grants to a State for the development of its health care value information program. Authorizes appropriations for such grants. Requires the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to promptly develop health care value information relating to each program that such head administers. Directs the Secretary to develop model systems to facilitate: (1) the gathering of data on health care cost, quality, and outcome; and (2) analyzing such data to permit the valid comparison of such data. Authorizes appropriations for the development of such model systems. Directs the Secretary to adopt standards relating to the design and use of magnetized Medicare identification cards for the purpose of assisting health care providers in determining eligibility and billing. Authorizes appropriations. Nullifies any State law requiring that medical or health insurance records be maintained in written rather than electronic form. Requires each health benefit plan: (1) for each of its beneficiaries that has a social security number, to use that number as an identification number for claims processing; and (2) for each provider that has a unique identifier for Medicare purposes, to use that identifier for claims processing. Requires the Secretary to determine whether problems relating to the rules for determining liability when benefits are payable under two or more plans or the availability of information among such plans causes significant administrative problems, and if so, directs the Secretary to promulgate standards concerning liability and the transfer of information among plans. Directs the Secretary to provide grants to qualified entities to demonstrate the application of comprehensive information systems in continuously monitoring patient care and in improving patient care. Authorizes appropriations from the Federal Hospital Insurance Trust Fund. Subtitle C: Medical Savings Accounts (Medisave) - Amends the Internal Revenue Code to exclude from the gross income of an employee any amount contributed by the employer to a medical savings account pursuant to a qualified medical savings account plan. Sets contribution limits. Defines a "medical savings account" as a trust created exclusively for purpose of paying an individual's medical expenses. Permits expenses from such account only to the extent such amounts are not compensated for by insurance. Subjects the employee to taxation as owner of the account. Subtitle D: Medicaid Program Flexibility - Amends title XIX (Medicaid) of the Social Security Act to modify Medicaid contracting requirements for coordinated care services. Authorizes the Secretary to waive specified Medicaid requirements with respect to nursing facilities located in a State if the State provides assurances satisfactory to the Secretary that the waiver of such requirements will not adversely affect the quality of life of the residents in such facilities. Subtitle E: Limitations on Physician Self-Referrals - Amends title XVIII (Medicare) of the Social Security Act to extend physician self-referral limitations to all payors as well as to certain additional services. Revises exceptions. Requires the Secretary to conduct a study in order to estimate the changes in aggregate costs for designated health services, under the Medicare program and other health plans, which will result from the implementation of the amendments made by this subtitle. Subtitle F: Removing Restrictions on Managed Care - Preempts managed care restrictions under State law. Requires 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. Subtitle G: Medicare Payment Changes - Amends the Medicare program to make revisions in the methodology for determining updates to Medicare hospital payments. Provides for a reduction in Medicare payment for clinical diagnostic laboratory tests. Subtitle H: Modification of the Operation of the Antitrust Laws to Hospitals - Permits two or more hospitals, without violating the antitrust laws, to share expensive medical services or high technology equipment. Directs the Secretary to grant waivers to exempt hospitals from the antitrust laws in order to carry out agreements permitting such sharing. Sets forth reporting requirements. Subtitle I: Encouraging Enforcement Activities of Medical Self-Regulatory Entities - Prohibits damages, interest on damages, costs, or attorney's fees from being recovered under the Clayton Act or any similar State law from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities designed to promote the quality of health care provided to patients.
United States · United States Congress · 28 May 1992
Animal Medicinal Drug Use Clarification Act of 1992 - Amends the Federal Food, Drug, and Cosmetic Act to allow, on order of a veterinarian: (1) a new animal drug approved for one use to be used for a different purpose, provided the use does not result in residues in food in violation of established safe levels for the drug; and (2) a new drug approved for human use to be used in non-food producing animals.
United States · United States Congress · 28 May 1992
Used Oil Recycling Act of 1992 - Amends the Solid Waste Disposal Act to prohibit the listing or identification of used oil destined for recycling, used oil to be burned for energy recovery, recycled oil, or affiliated material as hazardous wastes. Requires the Administrator of the Environmental Protection Agency to: (1) promulgate regulations for the management of used oil and to encourage recycling of such oil; and (2) take into account the effect of such regulatons on small businesses. Exempts from such regulations used oil generated, collected, or stored by an individual who removes oil from the engine of a motor vehicle, aircraft, household appliance, or item of domestic equipment if owned by such individual and used only for personal purposes. Sets forth regulation requirements for used oil generators, including to: (1) prohibit the storage of used oil in an underground tank unless it meets specified requirements of the Solid Waste Disposal Act; (2) prohibit the storage of used oil for more than 12 months; (3) make used oil in above ground tanks subject to the Spill Prevention and Countermeasure Control Plan requirements of the Federal Water Pollution Control Act; and (4) require owners or operators of such tanks or other used oil containers to notify the Administrator of releases of used oil in excess of 25 gallons and to clean up such releases and comply with closure or disposal requirements. Authorizes the transfer of used oil by generators only to: (1) a permitted used oil recycling facility or a burner of used oil for energy recovery that complies with specifed regulations; (2) a permitted hazardous waste management facility; or (3) a used oil transporter obligated by contract to deliver used oil to another such transporter or to one of the aforementioned facilities. Sets forth recordkeeping requirements for generators, transporters, and recyclers and requires records to be maintained for at least three years. Applies used oil storage and transfer requirements for generators to transporters, except permits transporters to store such oil for only 60 days before transferring it to another transporter or authorized facility. Requires transporters to: (1) comply with all requirements of the Secretary of Transportation for the shipping of used oil; (2) comply with financial responsibility requirements of the Hazardous Materials Transportation Act; and (3) have identification numbers provided by the Administrator. Sets forth regulation requirements for recyclers of used oil. Exempts from regulations used oil generated by: (1) petroleum refining or exploration, production or transportation facilities, or bulk terminals which is to be refined or processed along with normal process streams at a refining facility; and (2) a manufacturer or processor or by an electric or gas utility that is processed, reclaimed, or refined by such generator or its parent, subsidiary, or corporate affiliate, provided that the oil is reused by such entities and such activities meet certain storage, shipping, financial responsibility, contingency, and release detection requirements under this Act. Applies storage requirements similar to those for generators and transporters to recyclers, as well as requiring: (1) aboveground storage tanks and containers of used oil recyclers to comply with hazardous waste storage standards; (2) recyclers to maintain contingency plans to minimize unanticipated damage from used oil; (3) recyclers to comply with requirements for maintenance and operation of used oil recycling facilities and training of personnel; (4) detection of releases of used oil at recycling facilities and cleanup; (5) testing by recyclers, prior to processing, of all used oil received for levels of arsenic, cadmium, chromium, lead, halogens, polychlorinated biphenyls (PCBs), and other materials, as appropriate, and for the testing of fuel for such materials before it leaves the facility; (6) the separate storage of used oil contaminated with any hazardous waste for a specified time period; (7) financial responsibility equivalent to that required for hazardous waste facilities; and (8) class permits for recycling facilities. Requires the Administrator to conduct annual inspections of used oil recycling facilities to determine compliance with permit requirements. Makes a facility ineligible to apply for a permit if: (1) the facility has utilized any pit, pond, lagoon, or other surface impoundment for containing used oil; and (2) there has been a release from such impoundments which requires corrective action or is otherwise subject to post closure care requirements. Permits States to be authorized by the Administrator to carry out permit programs. Prohibits: (1) the placement of used oil in such impoundments or in any uncovered tank; (2) the mixing of used oil with a hazardous waste unless the mixture is managed as a hazardous waste; and (3) the use of used oil as a dust suppressant. Requires the Administrator to promulgate regulations for the closure of such impoundments and tanks containing used oil, to include requirements for: (1) corrective action or postclosure care; (2) allowable fuel specification levels for lead and halogens for the burning of used oil for energy recovery; and (3) lead levels for the burning of industrial specification used oil. Requires oil fuels failing to meet lead limitations to be burned in specified facilities. Directs the Administrator to implement education activities to inform the public about the hazards associated with the improper handling and disposal of used oil and the benefits derived from legitimate used oil recycling. Authorizes appropriations. Requires the Administrator to publish guidelines to assist State and local governments and other public service organizations in the development of used oil collection programs. Makes used oil generators who comply with this Act eligible for an exclusion from cost recovery authorities of the Comprehensive Environmental Response, Compensation and Liability Act. Directs the Administrator to propose regulations establishing guidelines for the procurement of used oil by Federal agencies and other governmental entities.
United States · United States Congress · 21 May 1992
Rural Electrification Administration Improvement Act of 1992 - Amends the Rural Electrification Act of 1936 to provide that if a borrower of a loan made or guaranteed by the Rural Electrification Administration (REA) applies for an electric or telephone service loan from a private lender, REA shall grant the private lender a lien accommodation on the total assets securing the unpaid balance on an equal and pro rata basis with the Government lien, except if such private loan will adversely affect the borrower's ability to repay the Government. Subordinates the REA lien to a lien made by a private lender on a non-electric or non-telephone rural development loan if the borrower's revenues will be sufficient to meet all loan obligations. Revises discounted loan prepayment provisions to permit prepayment or sale of a loan that was advanced before a certain date or has been fully advanced for not less than two years. Limits future loan eligibility for prepaying borrowers. Repeals provisions regarding: (1) borrower net worth; and (2) the prepayment privatization demonstration program.
United States · United States Congress · 21 May 1992
Designates February 21 through 27, 1993, as American Wine Appreciation Week. Commends the winegrape and fruit growers and vintners of the United States for the production of high quality agricultural products.
![Official portrait of Rep. Camp, Dave [R-MI-4]](https://www.congress.gov/img/member/c000071_200.jpg)