The world's political record
Person
![Official portrait of Rep. Clinger, William F., Jr. [R-PA-5]](https://www.congress.gov/img/member/c000523_200.jpg)
United States · Official source
2,821 records where Rep. Clinger, William F., Jr. [R-PA-5] is listed as a sponsor, author, or other actor. Search with topics and years
United States · United States Congress · 28 April 1994
Amends the Defense Base Closure and Realignment Act of 1990 to postpone until 1997 (currently 1995) scheduled military base closures and realignments announced by the Defense Base Closure and Realignment Commission.
United States · United States Congress · 28 April 1994
TABLE OF CONTENTS: Title I: Welfare Reform Subtitle A: Aid To Families With Dependent Children Subtitle B: Earned Income Tax Credit Subtitle C: Microenterprise and Small Business Development Subtitle D: Effective Date Title II: Federal Job Training Program Reforms Subtitle A: Studies and Reports Subtitle B: Economic Self-Sufficiency Standards for Federal Job Training Programs Subtitle C: Effective Date Title III: Child Support Enforcement Working Off Welfare Act of 1994 - Title I: Welfare Reform - Subtitle A: Aid to Families with Dependent Children - Amends parts A (Aid to Families with Dependent Children) (AFDC) and F (Job Opportunities and Basic Skills Training Program) (JOBS) of title IV of the Social Security Act (SSA) to make various specified changes with regard to, among other things, income disregards, support services and case management, school attendance and child care, and job training and education in order to enable families on welfare to become self-sufficient. Subtitle B: Earned Income Tax Credit - Directs the Secretary of the Treasury (Secretary) to submit to the Congress recommendations for procedures under which the Federal Government may make quarterly advance payments of earned income credit. Subtitle C: Microenterprise and Small Business Development - Amends SSA title IV part A to give States the option of disregarding certain income and resources related to microenterprise initiatives or designated for education, training, or employability through the use of a qualified asset account. (Sec. 141) Requires the Secretary of Health and Human Services (HHS) to: (1) study and report to the Congress on the use of such accounts; and (2) report to the Congress on the AFDC asset limit on automobiles. Provides for the inclusion of microenterprise training and activities in the JOBS program. Subtitle D: Effective Date - Sets forth effective dates for this title. Title II: Federal Job Training Program Reforms - Subtitle A: Studies and Reports - Requires the Secretaries of Education, of HHS, and of Labor (Secretaries) each to study the effectiveness of the job training programs under their respective jurisdictions for a report to the Congress. (Sec. 202) Requires the Comptroller General to study and report to the Congress on the effectiveness of such programs, including the extent to which they are successful at placing participants into certain unsubsidized employment. Subtitle B: Economic Self-Sufficiency Standards for Federal Job Training Programs - Requires the Secretaries jointly to develop and publish in the Federal Register proposed standards for measuring the minimum amount of wages and employment benefits that a participant should receive after termination from such program in order to ensure his or her long-term economic self-sufficiency. Subtitle C: Effective Date - Sets forth the effective date for this title. Title III: Child Support Enforcement - Directs the Secretary to establish in the Internal Revenue Service (IRS) a national registry (NR) of all child support orders, maintaining an abstract of each order containing certain specified information. (Sec. 301) Amends SSA title IV part D (Child Support and Establishment of Paternity) to require certain State procedures, including procedures for ensuring that: (1) a copy of each child support order issued, modified, or being enforced in the State is transmitted to the NR; and (2) a notice of court or administrative review and, under certain conditions, a statement of arrears owed are included with each order transmitted. Requires NR, upon the receipt from an employer of a W-4 form completed by an employee, to report to the employer information on: (1) whether the employee is subject to a child support order for wage withholding; and (2) the aggregate amount of support involved. (Sec. 302) Requires the Secretary to establish a system for enabling such information, as well as information identifying the person to whom any child support is owed, to be obtained at the workplace via W-4 form reporting by employees. Amends the Internal Revenue Code to: (1) require employers to deduct and withhold child support obligations from employee wages, pay withholdings to the Secretary, forward individual W-4 forms to NR, and include withheld obligations on the employee's W-2 form; (2) require individuals with monthly shortfalls in child support payments because of inadequate wage withholding to make payments directly to the Secretary, with the full amount due by the end of the applicable tax year subject to the same collection process and penalties applicable to back taxes; and (3) provide for a tax credit for withholdings and payments in excess of applicable obligations. (Sec. 304) Directs the Secretary to pay to the appropriate payee on a monthly basis a portion of the amount of child support received on account of an obligation payable to such payee, with interest payable on late payments. (Sec. 305) Amends SSA title IV part D to require: (1) certain individuals applying for child support collection or paternity determination services to use a new Federal application form in applying for such services; (2) State part D plans to provide for ongoing outreach programs to persons eligible for plan services; and (3) the separate organizational unit under the direction of the Secretary of HHS' designee to issue regulations for ensuring State plans for serving underserved populations and accommodations for assisting non-English speaking persons and the hearing impaired. (Sec. 306) Establishes the Commission on Child Support Guidelines to recommend to the Congress national child support guidelines to be followed by State courts and administrative bodies in setting child support award amounts. (Sec. 307) Directs the Secretary of HHS to: (1) establish by a certain deadline the staffing requirements already required for State child support programs; (2) streamline the child support audit process; and (3) jointly issue with the Secretary regulations governing coordination of State child support collection activities with those of the IRS. Provides for: (1) an increase in the Federal matching rate as an incentive for States increasing paternity establishment and meeting staffing requirements for child support programs; and (2) inclusion in consumer credit reports of information on individual consumers' overdue support obligations. Adds: (1) maintenance of effort requirements for State child support and AFDC programs; and (2) additional specified requirements with respect to procedures for paternity establishment and acknowledgment affidavits.
United States · United States Congress · 21 April 1994
Designates April 25 to May 1, 1994, as Let's Stop Kids Killing Kids Week.
United States · United States Congress · 20 April 1994
National Security Budgeting and Deficit Control Act of 1994 - Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings) to extend the caps on defense and nondefense discretionary spending through FY 1998. Requires the special budget authority adjustment required in the final sequestration report for FY 1995 under such Act to be equally divided between the defense and nondefense categories for each applicable fiscal year.
United States · United States Congress · 18 April 1994
Designates 1995 as the Year of the Grandparent.
United States · United States Congress · 24 March 1994
TABLE OF CONTENTS: Title I: Credit for Rural Business Enterprises Title II: Credit for Rural Infrastructure Title III: Credit for Rural Housing Rural Credit and Development Act of 1994 - Title I: Credit for Rural Business Enterprises - Amends the Farm Credit Act of 1971 to permit farm credit banks and production credit associations to purchase loans and loan interests from non-Farm Credit System institutions. Enlarges the scope of farm-related business for credit availability purposes. Authorizes banks for cooperatives to provide loans and other financial services to entities providing certain farm-related services or products under specified conditions. Title II: Credit for Rural Infrastructure - Authorizes Farm Credit banks to make community facility loans. Authorizes banks for cooperatives to finance utility-related services. Title III: Credit for Rural Housing - Enlarges rural housing credit availability by: (1) increasing eligible population areas; (2) increasing farm credit bank and production credit association loan portfolios for non-farmer rural housing loans; and (3) authorizing loans to rural residents for personal, family, or household needs other than housing finance.
United States · United States Congress · 24 March 1994
TABLE OF CONTENTS: Title I: Liability Title II: State Implementation Title III: Remedy Selection Title IV: Funding Comprehensive Superfund Improvement Act - Title I: Liability - Amends the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) to limit liability under such Act to actions involving hazardous substance releases occurring after December 11, 1980 (thus, eliminating retroactive liability), subject to the conditions of this Act. Makes such limit inapplicable to actions occurring before such date which were contrary to law. Provides for reimbursement from the Retroactive Liability Fund as provided by this Act. (Sec. 102) Sets forth retroactive liability provisions for actions which occurred before December 11, 1980. Bars reimbursement from the Retroactive Liability Fund to potentially responsible parties (PRPs) for construction costs if construction of the response action has been completed by January 1, 1994. Requires the President, if a PRP is conducting operation and maintenance (O&M) related to the action as of January 1, 1994, to assume the future costs of O&M and reimburse the party for costs incurred. Provides for reimbursement of construction costs for response actions not completed by such date, but only after the construction is completed. Directs the President to use the Retroactive Liability Fund to pay for all response action costs for sites discovered after such date. Establishes provisions for actions for which liability occurred before and after December 11, 1980. Permits PRPs conducting O&M related to the response action as of January 1, 1994, to petition the President for an allocation of O&M costs. Provides for reimbursement from the Retroactive Liability Fund of O&M costs attributable to actions occurring before December 11, 1980. Permits PRPs to petition for allocations of construction and O&M costs where actions have not been completed by January 1, 1994. Provides for reimbursement of O&M and construction costs attributable to actions occurring before December 11, 1980. Directs the President to use the Retroactive Liability Fund to pay for all costs attributable to actions occurring before December 11, 1980, for sites discovered after January 1, 1994. (Sec. 103) Provides that persons considered to be qualified organizations under provisions of the Internal Revenue Code governing charitable contributions who are grantees of conservation easements with respect to real property on which a facility is located shall not be considered as owners or operators, for purposes of determining liability for removal and response costs, unless they have caused or contributed to the release of hazardous substances. Establishes a rebuttable presumption that a defendant who has acquired real property has made all appropriate inquiry into previous ownership and uses of the property if he establishes that, immediately prior to or at the time of acquisition, he obtained an environmental assessment of the property to determine the presence of hazardous substances, including a review of specified records of the previous ownership and use of such property. (Sec. 104) Absolves persons who have resolved liability to the United States or a State in an approved settlement proceeding of liability for cost recovery regarding matters addressed in the settlement. (Sec. 105) Provides that persons who own or operate real property that is contiguous to or otherwise situated with respect to real property on which there has been a release of a hazardous substance and that may be contaminated shall not be considered to be an owner or operator for purposes of determining liability. Authorizes the President to issue assurances of no enforcement action to such persons and grant protection against cost recovery and contribution actions. (Sec. 106) Requires the President to issue regulations to define certain terms as they apply to liability of lenders and financial service providers. Excludes from the definition of "owner or operator" (thus, protecting from individual liability) fiduciaries who hold legal title to, are the mortgagees or secured parties with respect to, control, or manage, any facility or vessel at which a release occurred for purposes of administering an estate or trust of which such vessel or facility is a part. (Sec. 108) Makes liable parties who accept or successfully appeal the results of the allocation of responsibility under title V of this Act to be liable only for, with respect to National Priority List (NPL) sites, their assigned share of the costs of: (1) removal or remedial action incurred by the United States, a State, or an Indian tribe; (2) response incurred by any other person; and (3) any health assessment or health effects study. Requires the orphan share of an NPL site to be paid out of the Hazardous Substance Superfund (Fund) or the Retroactive Liability Fund. (Sec. 109) Makes PRPs or liable parties who fail to perform response actions at NPL sites subject to specified civil action. Requires reimbursement by Superfund of PRPs who perform and pay for response actions at NPL sites. Authorizes liable parties who perform and pay for such actions to recover costs as creditor parties as provided under title V of this Act. (Sec. 110) Directs the Administrator of the Environmental Protection Agency (EPA) to appoint panels of administrative law judges to perform expedited administrative proceedings, to be known as "binding allocations of responsibility (BARs)," for purposes of determining the liability of PRPs at NPL sites. Provides that BARs shall not address or affect liability concerning damages to natural resources. Provides for the initiation of a BAR by the filing of a petition with the EPA Office of Administrative Law Judges by the Administrator or a State where the site is located. Exempts de micromis parties (parties that a panel determines contributed only 100 pounds or liters of material containing hazardous substances at the facility or such amount as determined by the Administrator) from liability to the United States or to any other person for response actions or for past, present, or future costs incurred at the site. Requires final BARs to be issued within 18 months of the publication of a notice of petition (or 24 months for cases of exceptional complexity). Bases the assigned share of liability on specified allocation factors, including the ability to pay. Requires the Administrator to make firm offers of settlement to all de minimis parties (parties that contributed only one percent or less of the total quantity of hazardous substances present at the site). Makes a BAR decision binding as to all past, present, and future liability for response costs and for contributions in civil proceedings. Permits judicial review of final BAR decisions. Sets forth procedures for recovery by creditor parties. Provides for stays of certain pending enforcement actions and private party litigation until a BAR is issued. Authorizes any group of PRPs to submit a private allocation for the NPL site, to be known as a "voluntary binding allocation of responsibility," to the allocation panel. Provides that a BAR shall constitute a permanent determination of the assigned share of a liable party and of the orphan share and, except for specified additions to the orphan share and judicially mandated changes, shall not be subject to any change for at least five years after the date of final decision. Permits a new BAR only if the request demonstrates that due to new information not reasonably available during the first BAR, a 35 percent or greater increase in total waste-in volume has been discovered. (Sec. 111) Exempts qualified redevelopers from liability for costs or damages with respect to hazardous substance releases. (Sec. 112) Extends a current exemption from liability for response action contractors under Federal law to State and local law and expands the activities considered to be response actions. Excludes such contractors from the definition of "owner or operator" for purposes of limiting liability. Provides a limitation on actions against response action contractors. Title II: State Implementation - Authorizes States to apply to the Administrator to carry out response actions and enforcement activities at all facilities listed or proposed for listing on the NPL. Grants a State such authority if it possesses the legal authority, technical capability, and resources necessary to conduct response actions in a manner consistent with this Act. Makes such States eligible for response action financing from the Fund and the Retroactive Liability Fund. Requires States to pay ten percent of the costs of all response actions for which the State receives funds from the Fund. Makes such cost-sharing requirement inapplicable to States that receive funds from the Retroactive Liability Fund. (Sec. 201) Authorizes a State to select a response action that achieves a level of cleanup that is more stringent than required if it agrees to pay for the incremental increase in response cost attributable to achieving the more stringent level. (Sec. 203) Directs the President to: (1) maintain records of the costs incurred in connection with any oversight contract or arrangement for remedial investigations or feasibility studies; and (2) establish an administrative procedure under which a party that conducts a response action may contest the costs incurred in such oversight. Requires oversight costs exceeding 50 percent of the response costs incurred by the responsible party to be paid by the Fund. Title III: Remedy Selection - Authorizes the President or an authorized State to take immediate risk reduction measures whenever a release poses an imminent and substantial danger to public health. Prohibits the President or a State from instituting long-term remediation measures. Authorizes the use of the Fund for such measures, but permits the President to recover costs from liable parties as well. (Sec. 302) Applies the hazard ranking system to a site or facility only after the site or facility has undergone immediate risk reduction measures. Applies such requirement to sites and facilities to be newly listed on the NPL and to any sites already listed for which remedial investigation and feasibility studies have not been conducted. (Sec. 303) Directs the President or a State, as appropriate, to prepare a long-term response plan for an affected facility. Authorizes PRPs to prepare and carry out certain elements of such plan. Requires such plans to address: (1) site characterization; (2) risk assessment; (3) recommendations made by community advisory councils; and (4) response option identification. Requires plans for: (1) facilities to be newly listed on the NPL after this Act's enactment date; (2) facilities or sites listed on the NPL for which remedial investigations and feasibility studies have not been conducted; and (3) facilities or sites on the NPL for which such investigations and studies have been conducted but for which contracts have not been executed for remedial design and action. Directs persons carrying out remedial investigations to assess risks to human health and the environment, separately evaluating current and likely future risks. Directs the Administrator to create a Community Advisory Council for each facility listed on the NPL to provide information to PRPs, the Administrator, and the State regarding the future use of the facility and affected off-site areas and resources. Requires response option identifications under long-term remediation plans to provide for cost-benefit analyses on containment, remediation, monitoring, delisting, and institutional controls. Directs the President to promulgate and include in the national contingency plan guidelines for conducting cost/benefit analyses of response actions conducted under CERCLA. (Sec. 304) Revises provisions regarding selection of remedial actions to require the President or a State, after completion of a long-term response plan, to select the response that best achieves an acceptable level of residual risk reduction at the facility or site. Sets forth factors to be considered in selecting such actions, including site-specific impacts, economic impacts on PRPs, and costs and benefits of options. Provides preferences for actions that significantly reduce the volume, toxicity, or mobility of the hazardous substances or the exposure to such substances. Extends site or facility boundaries to include areas subject to easements or other institutional controls with respect to response actions. Makes selections subject to judicial review. Requires implementation of an action within 60 days after the selection has been made and: (1) an appeal has been filed and a court has acted on the appeal; or (2) the time for filing an appeal has expired and no appeal has been filed. Repeals certain cleanup standards. (Sec. 305) Requires the review of selected response actions at least once every five years to assure that human health and the environment are being protected. (Currently, such review is required for actions that result in hazardous substances remaining at the site.) (Sec. 306) Provides for delisting of sites or facilities from the NPL after an action achieves the cleanup goal. Title IV: Funding - Amends the Internal Revenue Code to extend environmental tax and certain Superfund provisions for a period of five years. Increases the aggregate tax which may be collected and credited to the Fund. Extends the deadline for repayment of advances made to the Fund from December 31, 1995, to December 31, 2000. Extends the authorization of appropriations for the Fund through FY 2000. (Sec. 402) Increases the environmental income tax. Provides that only 50 percent of such taxes received in the Treasury shall be deposited into the Fund in tax years between December 31, 1994, and January 1, 2000. (Sec. 404) Establishes the Retroactive Liability Fund. Appropriates 50 percent of revenues from the environmental tax to such fund in addition to certain environmental fees and assessments on insurance companies.
United States · United States Congress · 24 March 1994
United States Botanic Garden Commemorative Coin Act of 1995 - Directs the Secretary of the Treasury to: (1) issue one-dollar silver coins to commemorate the 175th anniversary of the founding of the United States Botanic Garden; and (2) pay all surcharges received from such coin sales to the National Fund for the United States Botanic Garden.
United States · United States Congress · 24 March 1994
Amends Federal monetary law to require that all recurring Federal payments shall be paid by electronic funds transfer, according to regulations prescribed by the Secretary of the Treasury (except with respect to the Congress). Prescribes procedural guidelines for such transfers.
United States · United States Congress · 17 March 1994
Interstate Municipal Solid Waste Control Act - Amends the Solid Waste Disposal Act to authorize State Governors to limit the quantity of out-of-State municipal solid waste (MSW) received for disposal at landfills or incinerators to an annual quantity equal to that received during 1990, 1991, or 1992, whichever is less. Limits the quantity of out-of-State MSW received to an annual quantity no greater than 30 percent of all MSW received in 1990, 1991, or 1992, whichever is less, if, during such year, the landfill or incinerator received documented shipments of more than 50,000 tons of out-of-State MSW representing more than 30 percent of all MSW received during the calendar year concerned. Provides for further limits in 1995 through 1997. Authorizes State Governors to prohibit the disposal of out-of-State MSW in: (1) new landfills or incinerators; or (2) landfills or incinerators that do not meet certain requirements of Federal and State laws. Permits State Governors to treat any out-of-State industrial solid waste as out-of-State MSW if it is disposed of at a landfill or incinerator that receives MSW. Authorizes counties to exercise the same authorities with respect to out-of-State MSW as State Governors, except that the 30 percent limitation described in this Act shall be 20 percent. Prohibits discrimination against shipments of out-of-State solid waste on the basis of State of origin. Authorizes a State Governor to limit or prohibit the exportation outside the State of MSW generated in the State, except for materials that have been separated from MSW for recycling. Exempts from the requirements of this Act: (1) material that has been separated or diverted from MSW and has been transported into the State for purposes of recycling and any material returned from a dispenser or distributor to the manufacturer for credit, evaluation, or reuse (this section does not apply to material disposed of in a landfill or incinerator); (2) solid waste generated by an industrial facility and transported for purposes of treatment, storage, or disposal to a facility owned or operated by the waste generator; and (3) solid waste generated incident to the provision of air transportation.
United States · United States Congress · 16 March 1994
Requests the President to designate Victoria Van Meter as an honorary goodwill ambassador from the United States to the countries that she visits in the course of her transatlantic flight.
United States · United States Congress · 10 March 1994
Designates May 11, 1994, as Vietnam Human Rights Day in support of efforts by the Non-Violent Movement for Human Rights in Vietnam.
United States · United States Congress · 9 March 1994
Designates July 27 of each year as National Korean War Veterans Armistice Day.
United States · United States Congress · 9 March 1994
Amends rule XI of the Rules of the House of Representatives to apply primary expense resolution requirements and personnel ceilings to the Committee on Appropriations and the Committee on the Budget. Repeals provisions authorizing the Committees to appoint committee staff. Requires funds for the appointment of committee staff to be provided by primary and additional expense resolutions. Provides that by the beginning of the 106th Congress, not less than one-third of the funding made available to each standing, select, special, ad hoc, or other House committee shall be allocated to the minority party. Exempts the Committee on Standards of Official Conduct.
United States · United States Congress · 3 March 1994
Designates March 23, 1994, the 92d birthday of the Rabbi Menachem Mendel Schneerson (leader of the worldwide Lubavitch movement), as Education and Sharing Day, U.S.A.
United States · United States Congress · 2 March 1994
Senior Citizens Housing Safety Act - Amends the United States Housing Act of 1937 to prohibit persons with drug or alcohol problems from occupying dwelling units in assisted housing designated for elderly families.
United States · United States Congress · 28 February 1994
Expresses the sense of the Congress that telephone directories within the eastern and midwestern United States should include a natural disaster survival guide. Provides that Federal, State, and local disaster management agencies should establish effective mechanisms to respond to citizen inquiries in natural disasters and periodically distribute to the public survival guide information.
United States · United States Congress · 23 February 1994
Private Property Owners Bill of Rights - Requires Federal agency heads to: (1) comply with applicable State and tribal government laws in implementing and enforcing the Endangered Species Act of 1973 (ESA) and the permitting program for dredged or filled material under the Federal Water Pollution Control Act (FWPCA); (2) administer and implement the Acts in a manner that least affects the private property owners' constitutional and other legal rights; (3) develop and implement rules and regulations for ensuring that such rights are protected when making any final decision that restricts the use of private property; (4) obtain the consent of the property owner and provide appropriate notice before entering privately-owned property in order to collect information on it; and (5) give the property owner an opportunity to review and dispute the data collected before using it to implement or enforce any of the Acts. Amends ESA and FWPCA to provide for administrative appeals of certain actions, including those related to the denial of permits and the imposition of administrative penalties. Entitles a private property owner deprived of 50 percent or more of the fair market value or the economically viable use of a portion of property as a consequence of a final qualified agency action to receive compensation upon request in accordance with specified guidelines. Amends ESA to require the Secretary of the Interior to notify all private property owners or lessees of property subject to a management agreement and provide an appropriate opportunity for their participation in such an agreement when the Secretary enters into it with any non-Federal person establishing restrictions on property use.
United States · United States Congress · 23 February 1994
Designates June 4, 1994, as National Trails Day.
United States · United States Congress · 22 February 1994
Designates January 16, 1995, as National Good Teen Day.
United States · United States Congress · 11 February 1994
Designates the week beginning April 3, 1994, as National Earthquake Awareness Week.
United States · United States Congress · 3 February 1994
Prohibits the U.S. Postal Service or the Attorney General from fining or otherwise penalizing any person who transmits by private express or other unlawful means, delivers to any agent thereof, or deposits at any appointed place any letter or packet. Amends the Federal criminal code to conform with this Act. Prohibits the U.S. Postal Service from authorizing any officer or employee to make searches of mail matter transported in violation of law in any store or office of a customer of a common carrier or transportation company.
United States · United States Congress · 3 February 1994
Social Security Immigration Fraud Protection Act of 1994 - Amends title II (Old Age, Survivors and Disability Insurance) of the Social Security Act to create a mandatory minimum sentence of a fine or five years' imprisonment, or both, for illegal alien social security documentation fraud.
United States · United States Congress · 2 February 1994
Prohibits the Department of Transportation or any other Federal department, agency, or instrumentality from requiring any State or political subdivision to convert highway signs to metric units.
United States · United States Congress · 2 February 1994
Small Business Empowerment Act - Amends the Internal Revenue Code to allow an individual retirement account to be pledged as security for a qualified business loan.
United States · United States Congress · 2 February 1994
Declares that it is the sense of the Congress that any federally-mandated health care reform should be on-budget.
United States · United States Congress · 22 November 1993
TABLE OF CONTENTS: Title I: Basic Reforms to Expand Access to Health Insurance Coverage and to Ensure Universal Coverage Subtitle A: Universal Access Subtitle B: Qualified General Access Plans in the Small Employer and Individual Marketplace Subtitle C: Qualified Health Plans in the Large Employer Marketplace Subtitle D: Benefits; Benefits Commission Subtitle E: State and Federal Responsibilities in Relation to Qualified Health Plans Subtitle F: Universal Coverage Subtitle G: Definitions Title II: Tax and Enforcement Provisions Subtitle A: General Tax Provisions Subtitle B: Provisions Relating to Acceleration of Death Benefits Subtitle C: Long-Term Care Tax Provisions Subtitle D: Enforcement Provisions Title III: Quality Assurance and Simplification Subtitle A: Quality Assurance Subtitle B: Administrative Simplification Title IV: Judicial Reforms Subtitle A: Medical Liability Reform Subtitle B: Anti-Fraud and Abuse Control Program Subtitle C: Treatment of Certain Activities Under the Antitrust Laws Title V: Special Assistance for Frontier, Rural, and Urban Underserved Areas Subtitle A: Frontier, Rural, and Urban Underserved Areas Subtitle B: Primary Care Provider Education Subtitle C: Programs Relating to Primary and Preventive Care Services Title VI: Treatment of Existing Federal Programs Subtitle A: Medicaid Program Subtitle B: Medicare Title VII: Patient's Right to Self-Determination Regarding Health Care Health Equity and Access Reform Today Act of 1993 - Title I: Basic Reforms to Expand Access to Health Insurance Coverage and to Ensure Universal Coverage - Subtitle A: Universal Access - Provides access to health insurance coverage under a qualified health plan for every citizen and lawful permanent resident of the United States. (Sec. 1003) Establishes a program under which persons with low incomes (and who are not eligible for Medicaid) will receive vouchers to buy insurance through purchasing groups. (Sec. 1004) Requires each employer to make available, either directly, through a purchasing group, or otherwise, enrollment in a qualified health plan to each eligible employee. Subtitle B: Qualified General Access Plan in the Small Employer and Individual Marketplace - Requires the National Association of Insurance Commissioners to develop specific standards to implement requirements concerning: (1) guaranteed eligibility, availability, and renewability of health insurance coverage; (2) nondiscrimination based on health status; (3) benefits offered; (4) insurer financial solvency; (5) enrollment process; (6) premium rating limitations; (7) risk adjustment; and (8) consumer protection. (Sec. 1119) Requires each qualified general access plan to: (1) establish and maintain a quality assurance program and a mediation procedures program; and (2) contain assurances of service to designated underserved areas. (Sec. 1141) Provides for individuals and small employers to form purchasing groups. (Sec. 1161) Requires brokers or insurers to provide specified information to prospective enrollees. (Sec. 1162) Prohibits insurers from creating improper financial incentives and from selling duplicate coverage. Subtitle C: Qualified Health Plans in the Large Employer Marketplace - Requires the Secretary of Health and Human Services, in consultation with the Secretary of Labor, to establish standards for large employer plans similar to requirements applicable to small employer plans. (Sec. 1203) Requires large employers to offer to employees at least a standard package and a catastrophic package. (Sec. 1205) Allows two or more large employers to form purchasing groups, but not through an individual or small employer purchasing group. (Sec. 1206) Requires a semi-annual review of each large employer plan to determine whether requirements are being met and what corrective actions need to be taken. (Sec. 1221) Amends the Employee Retirement Income Security Act of 1974 and the Public Health Service Act to revise provisions to conform to this Act. Subtitle D: Benefits; Benefits Commission - Requires each qualified health plan to provide a standard package and a catastrophic package. Specifies items and services to be covered. (Sec. 1311) Establishes the Benefits Commission to develop and propose legislation that provides a clarification of covered items and services and includes specifications for cost sharing. (Sec. 1314) Provides for congressional consideration and implementation of such legislation. Subtitle E: State and Federal Responsibilities in Relation to Qualified Health Plans - Requires each State to establish a program to: (1) certify insured health plans; (2) disseminate information on health care coverage areas; (3) establish procedures for purchasing groups; (4) prepare information concerning plans and purchasing groups; (5) provide for a risk adjustment program, including an adjustment for differences in nonpayments among qualified insured health plans; (6) develop a binding arbitration process; and (7) specify an annual general enrollment period. (Sec. 1421) Allows the waiver of specified requirements. (Sec. 1431) Provides preemptions from certain State laws. (Sec. 1441) Specifies the Federal responsibilities with respect to multi-state employer plans and in case of State defaults. Subtitle F: Universal Coverage - Requires each citizen or lawful permanent resident to be covered under a qualified health plan or equivalent health care program by January 1, 2005. Provides an exception for any individual who is opposed for religious reasons to health plan coverage, including those who rely on healing using spiritual means through prayer alone. Subtitle G: Definitions - Defines terms used in this Act. Title II: Tax and Enforcement Provisions - Subtitle A: General Tax Provisions - Amends the Internal Revenue Code to exclude from an employee's gross income employer-provided coverage under a qualified health plan or employer-provided contributions to the employee's medical savings account. Includes excess employer contributions in such gross income. (Sec. 2002) Allows a business expense deduction for employer costs of qualified health plans or contributions to an employee's medical savings account. Increases the allowable deduction (from 25 percent to 100 percent) for the qualified health insurance costs of self-employed individuals. Makes such deduction permanent. (Sec. 2003) Allows individuals a tax deduction for 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. (Sec. 2004) Eliminates the commonality of interest and geographic location requirements with respect to group purchasing by large tax-exempt organizations. (Sec. 2005) Revises and repeals provisions concerning continuation coverage requirements of group health plans upon implementation of this Act. Subtitle B: Provisions Relating to Acceleration of Death Benefits - Requires payment under a life insurance contract on the life of an insured who is terminally ill to be treated as a death benefit, making such payment eligible for tax exclusion from gross income. (Sec. 2102) Provides that any reference to life insurance shall be treated as referring to a qualified terminal illness rider. Subtitle C: Long-Term Care Tax Provisions - Treats qualified long-term care services as medical care for purposes of the medical expense deduction. (Sec. 2202) Provides for the treatment of long-term care insurance as accident and health insurance. (Sec. 2301) Sets forth consumer protection provisions to be satisfied by qualified long-term care insurance contracts, including the model regulation and Act promulgated by National Association of Insurance Commissioners (NAIC). Requires NAIC to promulgate standards for the use of uniform language and definitions in such policies, with certain variations permitted. Subtitle D: Enforcement Provisions - Amends part A (General Provisions) of Social Security Act title XI to establish the Health Insurance Coverage Data Bank to: (1) further the purposes of coverage requirements under this Act; and (2) collect certain information reported by employers about individual employee group health plan coverage for purposes of identifying and collecting from responsible third parties any amounts owed to reimburse Medicare or Medicaid for health care items and services furnished to their beneficiaries. (Replaces the Medicare and Medicaid Coverage Data Bank.) (Sec. 2402) Amends the Internal Revenue Code to impose excise taxes on failures by employers and insurers to comply with provisions of this Act. (Sec. 2411) Amends the Employee Retirement Income Security Act of 1974 to make conforming changes regarding enforcement of employer failures. Title III: Quality Assurance and Simplification - Subtitle A: Quality Assurance - Directs the Secretary of Health and Human Services, in consultation with relevant agencies, to develop and publish standards for quality assurance programs and ensure that appropriate performance measures are established. Requires the standards to contain provider risk programs to prevent or provide early warning of practices that may result in injury. (Sec. 3002) Provides for the standardization of information through a national health data system. (Sec. 3003) Requires the Secretary to establish measures to determine quality of care in specialized centers of care. (Sec. 3004) Authorizes appropriations to examine the feasibility of creating an Agency for Clinical Evaluations by consolidating the responsibilities of specified other offices. (Sec. 3005) Requires the Secretary to report annually to the Congress on factors affecting universal coverage and make recommendations for increasing such coverage. (Sec. 3006) Requires the Secretary to monitor the reinsurance market for qualified health plans and periodically report to Congress on the financial implications. (Sec. 3101) Amends the Public Health Service Act to establish within the Agency for Health Care Policy and Research a clearinghouse for information and research data concerning clinical trials. Requires the appointment of a fund investigator for the Agency. (Sec. 3201) Amends the Internal Revenue Code to establish the National Fund for Medical Research and provide for the designation of tax overpayments to such fund. Subtitle B: Administrative Simplification - Establishes a health care data interchange system to make data available on a uniform basis to all participants in the health care system. (Sec. 3302) Requires the Health Care Data Panel to develop regulations for the operation of an integrated electronic health care data interchange system. (Sec. 3304) Sets forth requirements for such system including: data and transaction standards, uniform, working files, code sets, unique identifiers, standards for confidentiality, rules for the transfer of information, and periodic reviews. (Sec. 3313) Establishes the Health Care Data Panel and a National Health Informatics Commission to advise the Panel on its activities. Title IV: Judicial Reforms - Subtitle A: Medical Liability Reform - Requires a qualified health plan to provide effective mediation procedures for hearing and resolving health care malpractice claims. (Sec. 4013) Requires each State to adopt an alternative dispute resolution method for the resolution of health care malpractice claims and consumer grievances. (Sec. 4021) Establishes provisions with respect to liability under health care malpractice actions brought in State or Federal courts. (Sec. 4022) Limits attorney contingency fees and award amounts for noneconomic damages. (Sec. 4024) Establishes a two-year statute of limitations for health care malpractice claims, except in the case of minors. (Sec. 4025) Requires each State to establish a set of specialty clinical guidelines. Allows the use of such guidelines as a rebuttable presumption in a claim or action, if the service provided was the appropriate standard of medical care. (Sec. 4026) Prohibits the award of punitive damages against the producer of a drug or device that is approved by the Food and Drug Administration. (Sec. 4027) Requires a report to the appropriate congressional committees on the operation of this subtitle. Subtitle B: Anti-Fraud and Abuse Control Program - Requires the Secretary to establish in the Office of the Inspector General of the Department of Health and Human Services a program to control fraud and abuse under the universal health care plan. Establishes the Anti-Fraud and Abuse Trust Fund. (Sec. 4102) Amends title XI of the Social Security Act (SSA) to provide for the application of the penalties for Medicare and Medicaid fraud to all health care programs. (Sec. 4103) Requires the Secretary to establish a program through which Medicare-eligible individuals may report instances of suspected fraud under Medicare. (Sec. 4111) Revises current SSA title XI sanctions for fraud and abuse involving Medicare and State health care programs, with changes providing for: (1) program exclusion for individuals convicted of a felony relating to fraud or the unlawful manufacture or dispensing of a controlled substance; (2) new offenses under civil monetary penalty provisions, such as the presenting of claims for items or services which are not medically necessary; (3) establishment of a minimum period of exclusion for practitioners and persons who fail to meet statutory obligations; (4) intermediate sanctions on eligible health maintenance organizations for program violations; and (5) procedures for imposing such sanctions. Directs the Attorney General to establish a national health care fraud and abuse data collection program for the reporting by each government agency and health care plan of final adverse actions against health care providers, suppliers, and practitioners. (Sec. 4122) Amends SSA title XI to require the Secretary to publish in the Federal Register a listing of all final adverse actions taken during the quarter. (Sec. 4131) Amends the Federal criminal code to establish penalties for a health care provider that knowingly engages in any scheme or artifice to defraud a person in connection with the provision of health care. (Sec. 4132) Extends the application of the mail fraud statute to cover matter sent or delivered by private or commercial carriers. (Sec. 4133) Authorizes appropriations to hire, equip, and train no fewer than: (1) 275 Federal Bureau of Investigation special agents and support staff to investigate health care fraud cases; and (2) 50 assistant U.S. attorneys and staff to prosecute such cases. (Sec. 4134) Authorizes the Attorney General to pay a reward of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution for health care fraud, with exceptions. (Sec. 4135) Directs the court to order a person convicted of a Federal health care offense that poses a serious threat to the health of any individual or that has a significant detrimental impact on the health care system, to forfeit property that was used in the commission of the offense or that constitutes or was derived from proceeds traceable to the offense and that is of a value proportionate to the seriousness of the offense. (Sec. 4136) Authorizes the Attorney General to commence a civil action in Federal court to enjoin a violation constituting a Federal health care offense. Subtitle C: Treatment of Certain Activities Under the Antitrust Laws - Exempts from the antitrust laws specified "safe harbor" activities related to the provision of health care services. Sets forth provisions regarding the award of attorney fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt. (Sec. 4202) Lists as safe harbors specified: (1) activities relating to health care services of combinations of health care providers with market share below a specified threshold; (2) activities of medical self-regulatory entities relating to standard setting or enforcement activities not conducted for purposes of financial gain; (3) participation of a health care provider in a written survey of the prices of services, reimbursement levels, or the compensation and benefits of employees and personnel; (4) activities relating to health care joint ventures for high technology and costly equipment and services; (5) activities relating to hospital mergers; (6) joint purchasing arrangements; and (7) negotiations. (Sec. 4203) Directs the Attorney General to publish a notice in the Federal Register soliciting proposals for additional safe harbors and to review and report to the Congress on proposed safe harbors. Sets forth criteria in establishing safe harbors, including: (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. (Sec. 4204) Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates. Sets forth provisions regarding applications for, revocation of, and review of determinations regarding such certificates. Limits the disclosure of information. (Sec. 4205) Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. (Sec. 4206) Directs the Attorney General to: (1) review the safe harbors and certificates of review periodically; and (2) promulgate such rules, regulations, and guidelines as necessary to carryout provisions of this subtitle. (Sec. 4208) Establishes within the Department of Health and Human Services an Office of Health Care Competition Policy. Title V: Special Assistance for Frontier, Rural, and Urban Underserved Areas - Subtitle A: Frontier, Rural, and Urban Underserved Areas - Amends the Public Health Service Act to establish a program of allotments to States for grants for community-based primary health services to low-income or medically underserved populations regarding infant mortality and referrals for the health management of infants and pregnant women. Earmarks for the allotments specified percentages of appropriations under certain provisions added by this Act. (Sec. 5002) Mandates grants to federally qualified health centers (FQHCs) and other entities for providing access to services for medically underserved populations or in high impact areas not currently being served by a FQHC. Authorizes appropriations. Directs the Secretary to report to the appropriate congressional committees on the relationship and interaction between community health centers and hospitals in providing services to such populations. (Sec. 5003) Amends the Internal Revenue Code to: (1) allow a nonrefundable credit for certain primary health services providers for mandatory service periods in health professional shortage areas; (2) exclude from gross income qualified loan repayments to the National Health Service Corps; (3) increase the dollar limitation allowed for expensing medical equipment used in rural health shortage areas; and (4) allow a deduction for student loan payments by medical professionals practicing in rural areas. (Sec. 5004) 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). (Sec. 5005) 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 or 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. (Sec. 5006) Authorizes the Secretary to conduct a demonstration project and grant program to encourage the development and operation of rural health networks. Authorizes appropriations. (Sec. 5007) Requires the Secretary to report to the Congress on improving access to benefits under qualified health plans for individuals residing in rural areas. Subtitle B: Primary Care Provider Education - Requires the Secretary to provide for the establishment of demonstration projects to evaluate mechanisms to increase the number and percentage of medical students entering primary care practice through funds otherwise available for direct graduate medical education costs under the Medicare program. (Sec. 5102) Allows funding under Medicare for training in nonhospital-owned facilities. (Sec. 5103) Increases authorized funding for the National Health Service Corps Scholarship and Loan Repayment Programs. Authorizes funding through FY 1998. (Sec. 5104) Increases and extends through FY 1997 authorized funding for training for certain health service providers. Subtitle C: Programs Relating to Primary and Preventive Care Services - Authorizes appropriations for a grant program to improve coordination of maternal and infant care. (Sec. 5202) Amends the Elementary and Secondary Education Act of 1965 to authorize appropriations to carry out a comprehensive school health education and prevention program for elementary and secondary school students. (Sec. 5203) Allows frontier States (including Alaska, Wyoming and Montana) to implement proposals and participate in demonstration projects which give special consideration to their diverse needs. Title VI: Treatment of Existing Federal Programs - Subtitle A: Medicaid Program - Gives States the option of allowing the enrollment of Medicaid-eligible individuals (including a limited number of AFDC- and SSI-eligible individuals) in the standard benefit package under a qualified health plan, instead of enrollment in the State's Medicaid program. (Sec. 6001) Sets forth requirements for States exercising such option. Places a cap on Federal payments for acute medical services furnished under a State's Medicaid program. (Sec. 6011) Discontinues reimbursement standards for inpatient hospital services. Revises the Federal medical assistance percentage for certain States. Modifies Federal requirements to allow States more flexibility in contracting for coordinated care services under Medicaid. (Sec. 6021) Provides for waivers from requirements on coordinated care programs. Gives States the option to guarantee the continued Medicaid eligibility of individuals enrolled with risk contracting and other managed care entities. (Sec. 6031) Provides for phased-in elimination of Medicaid hospital disproportionate share adjustment payments. Subtitle B: Medicare - Requires the Secretary to: (1) submit to the Congress a proposal for legislation which provides for the enrollment of Medicare beneficiaries in qualified health plans; and (2) provide for a monthly payment to a qualified health plan on behalf of enrolled Medicare beneficiaries. (Sec. 6111) Amends the Omnibus Budget Reconciliation Act of 1990 (OMBRA '90) to revise provisions for a modified payment methodology for risk contractors. (Sec. 6112) Requires the Secretary to provide for adjustment in Medicare capitation payments to take into account secondary payer status. Authorizes the Secretary to make additional payments to eligible organizations with risk-sharing contracts. (Sec. 6121) Amends OMBRA '90 to: (1) make permanent the Medicare select policy program; and (2) allow access to Medicare select policies in all States. Amends Medicare to revise the Medicare select policy program and provide for a civil penalty for misrepresentations made in connection with such a policy. (Sec. 6131) Makes specified changes with regard to monthly Medicare part B premium determinations for part B enrollees. (Sec. 6132) Amends the Internal Revenue Code to provide for an increase in the Medicare part B premium for individuals with high income. (Sec. 6133) Makes permanent certain payment reductions relating to outpatient hospital services furnished under Medicare. (Sec. 6135) Imposes copayments for laboratory services and certain home health visits provided under Medicare. (Sec. 6137) Provides for phased-in elimination of Medicare disproportionate share hospital payments. (Sec. 6138) Directs the Secretary to discontinue hospital reimbursements for costs relating to the recovery of bad debts. (Sec. 6139) Makes specified changes with regard to Medicare as secondary payer. Title VII: Patient's Right to Self-Determination Regarding Health Care - Provides for the treatment of advance directives and other measures, including a study by the Secretary on issues relating to health care decisions by the patient, in addressing the patient's right to self-determination regarding health care.
United States · United States Congress · 22 November 1993
Public Finance and Infrastructure Investment Act of 1993 - Amends the Internal Revenue Code with respect to private activity bonds to repeal: (1) the disproportionate private business use test; and (2) the lower private business test for certain output facilities. Increases the private loan financing test for such bonds. Increases the annual issuance limit for small issuers whose governmental bonds are not subject to rebate. Repeals the $100,000 limitation on unspent proceeds under the one-year exception from arbitrage rebate requirements. Repeals the debt service-based limitation on investment in certain nonpurpose investments. Exempts the following bonds from the arbitrage rebate requirements under specified circumstances: (1) tax-exempt bonds; (2) bonds which are not private activity bonds; and (3) private activity bonds issued to finance property to be owned by a governmental unit or a tax-exempt organization. Increases the amount of tax-exempt obligations excepted from the pro rata allocation of interest expense of financial institutions to tax-exempt interest for qualified small issuers. Lowers the State ceiling on the volume cap for private activity bonds and provides an inflation adjustment. Provides a tax-exemption for distressed community economic development bonds. Excepts 50 percent of such bonds from the volume cap. Allows a deduction for such bonds as qualified tax-exempt obligations.
United States · United States Congress · 22 November 1993
Designates June 6, 1994, as D-Day National Remembrance Day.
United States · United States Congress · 10 November 1993
TABLE OF CONTENTS: Title I: AFDC Transition and Work Program Title II: Paternity Establishment Title III: Expansion of Statutory Flexibility of States Title IV: Expansion of State and Local Flexibility Title V: Child Support Enforcement Title VI: Welfare Restrictions for Aliens Title VII: Controlling Welfare Costs Title VIII: Consolidated Block Grant to States for Food Assistance Title IX: Miscellaneous Responsibility and Empowerment Support Program Providing Employment, Child Care, and Training Act - Title I: AFDC Transition and Work Program - Amends part F (Job Opportunities and Basic Skills Training Program) (JOBS) of title IV of the Social Security Act (SSA) to give the JOBS program the new purpose of assuring that needy families with children obtain not only the education and training needed to prepare them for a life without welfare, but the work experience as well. (Sec. 101) Requires State JOBS programs to include a transition component and a work supplementation component that: (1) are each allowed to include any State work experience program approved by the Secretary; and (2) with respect to the first component, must include the State's job search program, and, with respect to the second component, may include the State's work supplementation or community work experience program. Amends part A (Aid to Families with Dependent Children) (AFDC) of SSA title IV to revise State AFDC plan participation requirements to incorporate participation in the two JOBS program components above under specified guidelines as a requirement for qualified individuals to receive AFDC. Imposes sanctions for a qualified individual's failure to participate in the JOBS program as required under such guidelines, which include a reduction in AFDC benefits and eventual benefit termination for repeated failures. Revises the exemptions from JOBS program participation requirements. Extends to all States the option to limit AFDC-UP. Increases State JOBS program and work program participation rates with regard to, respectively, AFDC-eligible individuals and unemployed parents. Provides for additional payments to States for JOBS programs. (Sec. 102) Amends community work experience and work supplementation program provisions. Title II: Paternity Establishment - Amends SSA title IV part A to: (1) provide for denial or reduction of AFDC for children whose paternity is not established; and (2) require unmarried individuals under 19 who are eligible for AFDC and are pregnant or with dependent children under their care to reside at home in order to receive AFDC. (Sec. 203) Amends SSA title IV part D (Child Support and Establishment of Paternity) to require earlier specified paternity establishment efforts by States. Expresses the encouragement of the Congress for States to develop procedures in public hospitals and clinics to facilitate the acknowledgment of paternity. (Sec. 204) Increases the paternity establishment percentage. Title III: Expansion of Statutory Flexibility of States - Amends SSA title IV part A to give States the option to: (1) convert AFDC into a block grant program; (2) exempt themselves from otherwise mandatory denial of AFDC where either parent is a minor; (3) treat families moving interstate who apply for AFDC in their new State of residence (where they have resided for less than on year) under the AFDC rules of their former State of residence; (4) reduce AFDC for parents under 21 who have dropped out of school and dependent children who, without good cause, do not maintain minimum school attendance; (5) exempt themselves from otherwise mandatory denial of AFDC for additional children; (6) modify certain AFDC income disregard rules; (7) provide for a married couple transitional benefit in cases where an AFDC recipient marries an individual who is not a parent of the recipient's child, and the resulting family would become ineligible for AFDC by reason of the marriage; (8) disregard certain savings and income of a family on AFDC designated for education, training, employability, home purchase, or residence change in determining eligibility for AFDC; and (9) condition the receipt of AFDC on the recipient's attendance at parenting and money management classes and prior approval of any action requiring a change in the educational institution attended by the recipient's dependent child. Title IV: Expansion of State and Local Flexibility -Establishes an Interagency Waiver Request Board in order to provide a focal point within the Federal Government for the development and coordination of waiver requests to improve opportunities for low-income individuals and families. (Sec. 402) Prescribes contents of applications to implement Federal assistance plans, as well as the review, approval, implementation, and evaluation processes. (Sec. 405) Requires any entity applying for plan approval to establish a Public Private Partnership Committee to advise it on plan development and implementation. Title V: Child Support Enforcement - Provides for a national system for employee reporting of any child support owed, the obligee involved, and other specified related information on W-4 forms for employer withholding and distribution of support owed, and reporting of related information to the State involved for availability to other States through the Interstate Locate Network established under this title. (Sec. 502) Makes various changes with regard to State child support order registries, the Parent Locater Service, regulations for sharing child support information, withholding orders, and noncustodial parents with child support arrearages who are receiving certain public welfare assistance. Title VI: Welfare Restrictions for Aliens - Makes aliens (except refugees, permanent residents, and certain current residents) ineligible for various specified types of public welfare assistance, including non-emergency related assistance under Medicaid, food stamps, and job training assistance. (Sec. 602) Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act (SSA) to require State AFDC agencies to provide information on illegal aliens to the Immigration and Naturalization Service. Title VII: Controlling Welfare Costs - Amends the Congressional Budget Act of 1974, the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act), and other Federal law to establish various specified measures for controlling welfare costs, including Federal spending caps. Title VIII: Consolidated Block Grant to States for Food Assistance - Repeals the Food Stamp Act of 1977, National School Lunch Act, Commodity Distribution Reform Act and WIC Amendments of 1987, and other specified Federal laws and replaces them with a: (1) State food assistance block grant program to provide food assistance to economically disadvantaged individuals and families (eligible populations); and (2) new food coupon program. Authorizes appropriations. (Sec. 803) Grants the Secretary of Agriculture and the Commodity Credit Corporation the authority to sell surplus commodities and foodstuffs to the States to provide food assistance to eligible populations. Title IX: Miscellaneous - Amends SSA title IV part A to require AFDC applicants and recipients to undergo any necessary substance abuse treatment as a condition of receiving AFDC. (Sec. 902) Amends SSA title XVI (Supplemental Security Income) (SSI) to: (1) make ineligible for SSI benefits individuals receiving SSI on the basis of a disability resulting from illegal drug addiction who continue to use illegal drugs or refuse to be tested for them; and (2) make representative payee changes. (Sec. 903) Directs the Secretary of Health and Human Services to: (1) conduct research projects to evaluate the impact of education and training programs on the ability of individuals to end participation in the AFDC program; (2) conduct demonstration projects and report to the Congress on whether providing benefits based on need through the use of electronic cards and automatic teller machines would reduce administrative costs and fraud; and (3) establish a commission to determine the cost and feasibility of creating an interstate system to compare the social security numbers of all AFDC recipients in order to identify those recipients receiving AFDC from multiple States. (Sec. 904) Amends SSA to require State AFDC applicants to participate in job search activities while the application is pending, unless a State by law exempts itself from this requirement. (Sec. 906) Public Housing Rent Reform and Empowerment Act - Amends the United States Housing Act of 1937 with regard to the determination of income and rent charges. Authorizes the Secretary of Housing and Urban Development to allow, upon request, under certain circumstances, a public housing agency or resident management corporation to carry out a demonstration program to determine the feasibility and desirability of providing such entities with the authority to establish policies for agency-administered public housing projects, without regard to the public housing requirements of the United States Housing Act of 1937. (Sec. 907) Amends SSA title IV part A to deny AFDC for certain children who have not received appropriate medical examinations and immunizations. Amends the Child Care and Development Block Grant Act with regard to childhood immunizations. Requires the Surgeon General to issue and periodically revise recommendations for the immunization of children under age six.
United States · United States Congress · 10 November 1993
Designates the division of the Department of Veterans Affairs medical center at University Drive in Pittsburgh, Pennsylvania, constituting the Aspinwall long-term care facility as the Mathew B. Ridgway Division of the Department of Veterans Affairs Medical Center.
United States · United States Congress · 27 October 1993
Safe Drinking Water Act Amendments of 1993 - Amends the Safe Drinking Water Act to require the Administrator of the Environmental Protection Agency, in the case of specified contaminants listed in the Federal Register for which national primary drinking water regulations have not been promulgated, to: (1) publish maximum contaminant level goals and promulgate such regulations for those contaminants that occur in drinking water and are of public health concern; and (2) eliminate monitoring, compliance, and enforcement requirements for those contaminants that do not occur in drinking water at levels of public health concern. (Current law requires the promulgation of such goals and regulations for specified numbers of such contaminants by certain dates.) Directs the Administrator to promulgate such goals and regulations for new contaminants every five years. Requires the Administrator to establish in each national primary drinking water regulation best technology treatment techniques for public water systems serving fewer than 1,000, between 1,000 and 10,000, and more than 10,000 people, respectively. Directs the Administrator to promulgate national primary drinking water regulations for radionuclides, disinfection and corrosion byproducts, and sulfate. Revises provisions concerning variances from national drinking water regulations to permit the issuance of a variance by a State only if the water system cannot afford to install the best available technology to meet the maximum contaminant level and it is not feasible for the system to connect with another source of water that will meet the standards. Requires variances to be reviewed by the State at least every three years. Repeals provisions that authorize States to exempt public water systems from requirements respecting maximum contaminant levels or treatment techniques. Prohibits treated drinking water from being removed from a public water system or routed through any device or pipes outside the system and returned to the system. Includes such action in the definition of "tampering," a violation for which criminal penalties are imposed. Makes such prohibition inapplicable to pipes and devices totally within the control of one or more public water systems or to connections between water mains. Requires (currently, authorizes) the Administrator to conduct research relating to diseases and other impairments resulting from contaminants in drinking water or to the provision of a safe supply of drinking water. Authorizes appropriations. Extends the authorization of appropriations for grants for State public water system supervision programs. Requires the Administrator to promulgate revised regulations every five years that list up to 30 unregulated contaminants to be monitored by public water systems. Directs the Administrator to assemble a national drinking water occurrence data base to include information on the occurrence of regulated and unregulated contaminants.
United States · United States Congress · 27 October 1993
Amends the Revenue Reconciliation Act of 1993 to delay the effective date of the change in the point of imposition of the tax on diesel fuel from January 1, 1994, to: (1) July 1, 1994; or (2) the 60th day after final regulations are prescribed. Amends the Internal Revenue Code to allow vendors of diesel fuel sold for any nontaxable use to claim tax refunds on behalf of ultimate users. Provides a similar rule for vendors of gasoline sold to State and local governments.
United States · United States Congress · 20 October 1993
Expresses the sense of the House of Representatives that the Department of Justice should repudiate its reinterpretation of Federal child pornography laws, defend the conviction won in lower courts in Knox v. United States, and vigorously prosecute sexual exploitation of children.
United States · United States Congress · 15 October 1993
Declares that steps must be taken to alleviate the financial impact of unfunded Federal mandates on State, county, and municipal governments.
United States · United States Congress · 13 October 1993
Veterans Adjudication Procedures Act of 1993 - Directs the Secretary of Veterans Affairs to provide that, under the work rate standards that apply to Department of Veterans Affairs employees who adjudicate claims for benefits that have been submitted to the Secretary, such employees shall not receive credit for work on a claim until the claim decision becomes final. Requires the Secretary to report annually to the Congress the status of claims for benefits before the Department during the preceding fiscal year, including the average length of time required for such adjudications. Requires a rating official to make the initial determination of the Secretary on all original and reopened claims filed with the Secretary. Allows a single member (currently three) of the Board of Veterans' Appeals to be assigned to and make a determination on a proceeding before such Board. Makes such decision final unless the Chairman of such Board orders reconsideration, in which case three other Board members must hear the proceeding. Subjects decisions made by the Secretary or the Board to revision or reversal on the grounds of clear and unmistakable error.
United States · United States Congress · 13 October 1993
Reduces discretionary spending limits for FY 1994 by the amount of rescissions under this Act.
United States · United States Congress · 12 October 1993
Amends the Internal Revenue Code to make Internal Revenue Service employees personally liable for a portion of litigation costs resulting from arbitrary, capricious, or malicious acts. Increases (from $100,000 to $1 million) the limitation on recovery of civil damages for certain unauthorized collection actions. Places the burden of proof upon the Secretary of the Treasury with respect to the issue of whether any person has been guilty of fraud with intent to evade tax.
United States · United States Congress · 12 October 1993
Designates May 1 through 7, 1994, as National Walking Week.
United States · United States Congress · 7 October 1993
Amends Federal law with respect to the Civil Service and Federal Employees' Retirement Systems to provide that certain requirements relating to reemployed annuitants shall not apply with respect to postal retirees who are reemployed, on a temporary basis, as rural postmasters or rural letter carriers.
United States · United States Congress · 7 October 1993
Amends title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act (SSA) to revise the limitation on payment of OASDI benefits to prisoners to prohibit the payment of such benefits to all individuals imprisoned throughout at least one month upon conviction of a criminal offense, regardless of the prisoner's participation in a rehabilitation program. Amends SSA title XVI (Supplemental Security Income) (SSI) to make the same changes with respect to the payment of SSI benefits to such individuals.
United States · United States Congress · 6 October 1993
TABLE OF CONTENTS: Title I: Managed Competition in Employer-Based Health Plans: Incentives to Control Costs Subtitle A: Use of Tax Incentives to Purchase Cost-Effective Plans Subtitle B: Health Plan Purchasing Cooperatives (HPPCs) Subtitle C: Accountable Health Plans (AHPs) Subtitle D: Health Care Standards Commission Subtitle E: Managed Competition in Rural and Urban Underserved Areas Subtitle F: Treatment of Chronically Underserved Areas Subtitle G: Repeal of COBRA Continuation Requirements Subtitle H: Definitions Title II: Low-Income Assistance for Health Coverage Subtitle A: Low-Income Assistance Subtitle B: Long-Term Care Phase-Down Assistance to States Subtitle C: Financing Subtitle D: Repeal of Medicaid Program Title III: Training and Education of Health Care Professionals Subtitle A: Reform of Federal Funding for Medical Residency Training Subtitle B: Other Medical Education Grants and Programs Title IV: Preventive Health and Individual Responsibility Subtitle A: Expansion of Public Health Programs Subtitle B: Medicare Title V: Malpractice Reform Subtitle A: Findings; Purpose; Definitions Subtitle B: Uniform Standards for Malpractice Claims Subtitle C: Requirements for State Alternative Dispute Resolution Systems (ADR) Subtitle D: Grants to States for Development of Practice Guidelines Title VI: Paperwork Reduction and Administrative Simplification Title VII: Additional Benefits On a Pay-As-You-Go Basis Managed Competition Act of 1993 - Title I: Managed Competition in Employer-Based Health Plans: Incentives to Control Costs - Subtitle A: Use of Tax Incentives to Purchase Cost-Effective Plans - Amends the Internal Revenue Code to impose a tax on the excess health plan expenses of any employer which are health plan expenses exceeding specific limits under an accountable health plan for a defined geographical area. (Sec. 1002) Increases to 100 percent and makes permanent the deduction for health plan premium expenses of self-employed individuals. (Sec. 1003) Permits the deduction for medical, dental, etc. expenses without regard to the limitation on such deduction with respect to amounts paid for premiums under an accountable health plan. (Sec. 1004) Provides for the exclusion from gross income of contributions by a partnership or S corporation to a health plan covering partners or shareholders. (Sec. 1006) Eliminates the commonality of interest and geographic location requirements with respect to group purchasing by large tax-exempt organizations. Subtitle B: Health Plan Purchasing Cooperatives (HPPCs) - Provides for the establishment of Health Plan Purchasing Cooperatives (HPPCs). Considers each State to be a HPPC, except that a State may subdivide into HPPC areas, and that there may be interstate HPPCs, as specified. Requires HPPCs to enter into agreements with accountable health plans and small employers, offer enrollment in accountable health plans, and charge premiums. Subtitle C: Accountable Health Plans (AHPs) - Directs the Health Care Standards Commission to provide a process whereby a health plan may be registered with the Commission by its sponsor as an accountable health plan. Sets forth requirements for a plan to be registered, including: (1) coverage for a specified uniform set of benefits, including cost-sharing for low-income individuals; (2) standard premiums for the uniform benefits; (3) grievance procedures; (4) collecting and providing specified information; (5) prohibiting discrimination in enrollment or benefits; and (6) financial solvency. (Sec. 1208) Sets forth additional requirements for open AHPs, which is any plan which is not closed. Defines a closed plan as one limited by structure or law to one or more large employers. (Sec. 1211) Requires each AHP to provide for payment of one percent of gross premium receipts to the National Medical Education Fund. (Sec. 1221) Sets forth provisions concerning the preemption of State laws for AHPs. (Sec. 1231) Directs the President to provide for the development and publication of guidelines on the application of Federal antitrust laws to AHPs. (Sec. 1232) Provides for the issuance of certificates of public advantage by the Attorney General to eligible health care joint ventures which, if followed, exempt such ventures from antitrust liability. Subtitle D: Health Care Standards Commission - Establishes, as an independent agency in the Executive Branch, a Health Care Standards Commission. Requires the Commission to transmit annually to the Congress recommendations for the uniform set of effective benefits. States that such recommendations shall apply unless the Congress passes a joint resolution of disapproval. (Sec. 1303) Directs the Commission to provide for the initial organization, as a nonprofit corporation, of the Benefits, Evaluations, and Data Standards Board in order to make recommendations to the Commission concerning the uniform set of effective benefits and matters related to the evaluation of health care services. (Sec. 1304) Directs the Commission to provide for the initial organization, as a nonprofit organization of the Health Plan Standards Board in order to make recommendations to the Commission concerning the standards for AHPs and concerning its assessment of risk-adjustment factors. (Sec. 1305) Sets forth provisions concerning the registration of AHPs. (Sec. 1306) Directs the Commission to establish rules for the process of risk-adjustment of premiums among AHPs by HPPCs. (Sec. 1307) Directs the Commission to publish information concerning procedures, their prices, and their quality. (Sec. 1309) Establishes, within the Department of Health and Human Services, the Agency for Clinical Evaluations which shall assume the responsibilities of the Director of the Office of Medical Applications of Research at the National Institutes of Health, the Director of the Office of Research and Demonstrations of the Health Care Financing Administration (insofar as such responsibilities relate to clinical evaluations), the Administrator for Health Care Policy and Research under title IX of the Public Health Service Act, as well as other specified responsibilities. Authorizes appropriations. (Sec. 1311) Prohibits the Commission from establishing or enforcing any controls on health care spending. (Sec. 1313) Authorizes appropriations for the Commission through FY 2000. Terminates the Commission on December 31, 1999. Subtitle E: Managed Competition in Rural and Urban Underserved Areas - Authorizes the Governor of any State to designate rural and urban areas of a State as underserved areas. Permits a HPPC serving such an area to require AHPs offered by the HPPC and with a service area adjoining such area to include the area as part of their service area. (Sec. 1411) Authorizes appropriations for: (1) technical assistance for entities seeking to establish a network plan in an underserved area; (2) financial assistance to eligible entities in order to provide for the development and implementation of AHPs in rural areas; and (3) under the Public Health Service Act, migrant health centers and community health centers. (Sec. 1422) Provides coverage under part B of title XVIII (Medicare) of the Social Security Act for rural emergency access care hospital services. (Sec. 1431) Directs the Secretary of Health and Human Services to make payments for transitional assistance to eligible hospitals. Requires any hospital accepting such assistance to provide a significant volume of services to persons unable to pay for services. Authorizes appropriations. Subtitle F: Treatment of Chronically Underserved Areas - Directs the Health Care Standards Commission to develop standards for the identification of chronically underserved areas. Makes provisions for addressing health care delivery in such areas. Subtitle G: Repeal of COBRA Continuation Requirements - Repeals the COBRA continuation requirements for group health plans and title XXII of the Public Health Service Act. Subtitle H: Definitions - Sets forth definitions for this title and title II. Title II: Low-Income Assistance for Health Coverage - Subtitle A: Low-Income Assistance - Provides premium assistance for very-low income individuals and moderately low-income individuals. Provides for nominal cost-sharing for such individuals and special assistance for certain items and services. Subtitle B: Long-Term Care Phase-Down Assistance to States - Provides for long-term care phase-down assistance to eligible States for each calendar quarter in 1995 through 1998. Subtitle C: Financing - Amends title XVIII (Medicare) of the Social Security Act to achieve savings under such program by: (1) reducing the update for inpatient hospital services; (2) reducing the conversion factor for the physician fee schedule for non-primary care services; and (3) reducing hospital outpatient services through establishing a prospective payment system. (Sec. 2204) Amends the Internal Revenue Code to impose a Medicare part B premium tax on higher-income individuals. (Sec. 2205) Achieves additional Medicare savings through the: (1) phased-in elimination of Medicare disproportionate share adjustment payments; (2) reduction of routine cost limits for home health services; (3) reduction in routine cost limits for extended care services; and (4) reductions in payments for hospice services. Subtitle D: Repeal of Medicaid Program - Repeals title XIX (Medicaid) of the Social Security Act. Title III: Training and Education of Health Care Professionals - Subtitle A: Reform of Federal Funding for Medical Residency Training - Directs the Health Care Standards Commission to approve a resident training position in medical residency program for purposes of funding approved medical residency training programs under this title. Provides funding, in addition, for physician retraining. Sets forth provisions concerning: (1) the allocation of entry positions among programs; and (2) the general distribution of positions among specialties. (Sec. 3004) Requires payment by AHPs of one percent of gross premium receipts to the National Medical Education Fund. Requires payments from the Medicare trust funds to the National Medical Education Fund. (Sec. 3005) Establishes the National Medical Education Fund. Subtitle B: Other Medical Education Grants and Programs - Authorizes appropriations under the Public Health Service Act for medical education programs, including: (1) the scholarship and loan repayment programs of the National Health Service Corps; (2) area education centers; (3) public health and preventive medicine; (4) family medicine; (5) general internal medicine and pediatrics; (6) physician assistants; (7) allied health projects grants and contracts; and (8) nurse practitioner and nurse midwife programs. Title IV: Preventive Health and Individual Responsibility - Subtitle A: Expansion of Public Health Programs - Authorizes appropriations under the Public Health Service Act for the following public health programs: (1) immunizations against vaccine-preventable diseases; (2) prevention, control, and elimination of tuberculosis; (3) lead poisoning prevention; (4) preventive health measures with respect to breast and cervical cancers; (5) the Office of Disease Prevention and Health Promotion; (6) the Office of Minority Health; (7) preventive health and health services block grant; (8) categorical grants for early intervention regarding acquired immune deficiency syndrome; and (9) programs of the Centers for Disease Control regarding the smoking of tobacco products. Directs the Office of Disease Prevention and Health Promotion to promote individual responsibility in personal health care and in the use of valuable health care resources. Subtitle B: Medicare - Provides Medicare coverage for: (1) screening fecal-occult blood tests and screening flexible sigmoidoscopies for the purpose of the early detection of cancer; (2) tetanus-diphtheria boosters; (3) well-child services; and (4) an annual screening mammography for women over age 64. Title V: Malpractice Reform - Subtitle A: Findings; Purpose; Definitions - Sets forth the findings, purpose, and definitions for this title. Subtitle B: Uniform Standards for Malpractice Claims - Prohibits bringing a medical malpractice liability action in a State court unless there has been an initial resolution under an alternative dispute resolution system. Limits the total noneconomic damages in such actions to $250,000. Sets limits on attorney's fees. Makes special provision for obstetric services. Subtitle C: Requirements for State Alternative Dispute Resolution Systems (ADR) - Establishes requirements for State alternative dispute resolution systems. Provides for grants to States to assist in implementation of such systems. Subtitle D: Grants to States for Development of Practice Guidelines - Directs the Secretary to make grants to States for the development of medical practice guidelines for health care professionals that may be applied to resolve medical malpractice liability claims. Title VI: Paperwork Reduction and Administrative Simplification - Preempts State quill pen laws. Ensures the confidential treatment of electronic health care information. Sets forth provisions which provide for: (1) the standardization of electronic health information; (2) uniform claims forms; (3) the liability of insurers when benefits are payable under two or more plans; and (4) the uniformity of the availability of information among health plans when benefits are payable under two or more plans. (Sec. 6007) Amends the Internal Revenue Code to impose a tax on a health plan not in compliance with specified requirements of this title. Title VII: Additional Benefits On a Pay-As-You-Go Basis - Expresses the sense of the Congress that additional benefits should be provided by the Federal Government to the extent that additional financing is made available on a pay-as-you-go basis.
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 · 27 September 1993
Health Care Information Modernization and Security Act of 1993 - Amends the Social Security Act to establish the Health Care Data Panel to: (1) develop and submit to the Office of Management and Budget for implementation proposed regulations for an integrated electronic health care data interchange system; (2) select and establish data and transaction standards, conventions, and requirements for the data interchange system; and (3) provide for appointment of a National Health Informatics Commission to advise the Panel on its activities. Authorizes appropriations.
United States · United States Congress · 23 September 1993
Designates October 19, 1993, as National Mammography Day.
United States · United States Congress · 23 September 1993
Declares that any law enacted pertaining to the reform of our Nation's health care system should apply to Members of Congress.
United States · United States Congress · 22 September 1993
Traumatic Brain Injury Act of 1993 - Amends the Public Health Service Act to direct the Secretary of Health and Human Services, acting through the Administrator of the Agency for Health Care Policy and Research, to conduct a study concerning traumatic brain injury. Requires the study to seek to: (1) identify common therapeutic interventions which are used for the rehabilitation of individuals with traumatic brain injuries; and (2) develop practice guidelines for the rehabilitation of traumatic brain injury. Authorizes appropriations. Directs the Secretary, acting through the Director of the Centers for Disease Control and Prevention, to conduct studies concerning traumatic brain injury and establish a uniform reporting system. Authorizes appropriations. Directs the Secretary to cooperate with, and provide assistance to, public and private nonprofit entities to reduce the incidence of traumatic brain injury through the establishment and effectuation of prevention projects. Authorizes the Secretary to award grants to State and local entities, and to public or nonprofit private entities, to support: (1) special prevention and public awareness initiative projects; (2) model traumatic brain injury prevention, research, and support programs; (3) projects that study the service needs of individuals with traumatic brain injury; and (4) projects involving grants for services coordination. Authorizes appropriations. Authorizes the Secretary, acting through the Director of the National Institutes of Health, to provide assistance to public and private nonprofit entities to support the conduct of basic and applied research concerning traumatic brain injury, especially with respect to the biomechanics of brain injury. Authorizes appropriations. Directs the Secretary to award grants to States for the establishment of programs related to traumatic brain injury. Authorizes appropriations. Designates October 1993 as National Head Injury Month.
United States · United States Congress · 15 September 1993
TABLE OF CONTENTS: Title I: Improved Access to Affordable Health Care Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families Subtitle B: Reform of Health Insurance Marketplace for Small Business Subtitle C: Preemption Subtitle D: Health Deduction Fairness Subtitle E: Improved Access to Community Health Services Subtitle F: Improved Access to Rural Health Services Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program Title II: Health Care Cost Containment and Quality Enhancement Subtitle A: Medical Malpractice Liability Reform Subtitle B: Administrative Cost Savings Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Accounts Subtitle D: Anti-Fraud Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals Subtitle F: Removing Anti-Trust Impediments Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities Subtitle H: Prefunding Government Health Benefits for Certain Annuitants Subtitle I: Miscellaneous Provisions Title III: Long-Term Care Subtitle A: Tax Treatment of Long-Term Care Insurance Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance Subtitle C: Studies Subtitle D: Volunteer Service Credit Demonstration Projects Affordable Health Care Now Act of 1993 - Title I: Improved Access to Affordable Health Care - Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families - Part 1: Required Coverage Options for Eligible Employees, Spouses, and Dependents - Requires each employer to make available to each eligible employee a group health plan under which: (1) coverage of each eligible individual with respect to such employee may be elected on an annual basis; (2) coverage is provided for at least the required coverage specified; and (3) employees may elect to have premiums collected through payroll deduction. Does not require employer contributions to the cost of coverage under such a plan. Provides for the exclusion of: (1) employers who have been employers for less than two years or who have no more than two eligible employees or no more than two eligible employees not covered under any group health plan; and (2) family members under specified circumstances. Specifies that a group health plan shall not be treated as failing to meet the requirements of this Act solely because a period of service by an eligible employee of not more than 60 days is required for coverage. Specifies that the required coverage is standard coverage, except that in the case of a small employer that has not contributed during the previous plan year to the cost of coverage for any eligible employee under any group health plan, the required coverage for the plan year is coverage under a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan. Provides for a five-year transition for existing group health plans. (Sec. 1002) Sets forth provisions regarding: (1) compliance with applicable requirements through multiple employer health arrangements; and (2) coverage options under a State medical health allowance program. Part 2: Preexisting Conditions and Continuity of Coverage; Renewability - Prohibits a group health plan from imposing (and an insurer from requiring an employer from imposing through a waiting period for coverage under a plan or similar requirement) a limitation or exclusion of benefits relating to treatment of a preexisting condition if: (1) the condition relates to a condition that was not diagnosed or treated within three months before the date of coverage under the plan; or (2) the limitation or exclusion extends over more than six month after the date of coverage, applies to an individual who, as of the date of birth, was covered under the plan, or relates to pregnancy. Specifies that, in the case of an individual who is eligible for coverage under a plan but for a waiting period imposed by the employer, the individual shall be treated as having been covered under the plan as of the earliest date of the beginning of the waiting period. (Sec. 1012) Requires each group health plan to waive any period applicable to a preexisting condition for similar benefits with respect to an individual to the extent that the individual, prior to enrollment in such plan, was covered for the condition under any other health plan. (Sec. 1013) Prohibits: (1) a multiemployer plan and an exempted multiple employer health plan from canceling or denying renewal of coverage under such a plan for an employer other than for nonpayment of contributions, fraud or other misrepresentation, noncompliance with plan provisions, or misuse of a provider network provision, or because the plan is ceasing to provide any coverage in a geographic area; (2) an insurer from canceling a health insurance plan or denying renewal of coverage other than as prescribed above; and (3) an insurer who terminates the offering of health insurance plans in an area from offering such a plan to any employer in the area until five years after the date of the termination. Part 3: Enforcement; Effective Dates; Definitions - Makes provisions of the Employee Retirement Income Security Act of 1974 applicable with respect to enforcement of this Act (by the Department of Labor). Amends the Internal Revenue Code (Code) to impose a tax ($100 per day for each individual involved, subject to specified limitations) on the failure of an insurer to comply with the requirements under part 2 unless the Secretary of Health and Human Services (Secretary) determines that the State has in effect a regulatory enforcement mechanism that provides adequate sanctions. Subtitle B: Reform of Health Insurance Marketplace for Small Business - Requires each insurer that makes available a health insurance plan to a small employer in a State to make available to each small employer in the State a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan, with exceptions for health maintenance organizations (HMOs) and if a State provides for guaranteed availability (rather than guaranteed issue). Requires each insurer that offers a MedAccess plan to a small employer in a State to accept: (1) every small employer in the State that applies for coverage; and (2) every eligible individual who applies for enrollment on a timely basis. Sets forth provision regarding: (1) special rules for HMOs; (2) timely enrollment requirements; and (3) enrollment of spouses and dependents. Makes such requirements inapplicable in a State that has provided (in accordance with specified standards) a mechanism under which each insurer offering a health insurance plan to a small employer in the State must participate in a program for assigning high-risk small employer groups (or individuals within such a group) among some or all such insurers, if the insurers comply. (Sec. 1102) Defines "MedAccess plan" as a health insurance plan that: (1) is designed to provide standard coverage with substantial cost-sharing, only catastrophic coverage, or medisave coverage; (2) includes only essential and medically necessary services; (3) meets applicable requirements relating to guaranteed issue; and (4) meets specifies consumer protection standards. Defines "MedAccess standard plan," "MedAccess catastrophic plan," and "MedAccess medisave plan" to mean a MedAccess plan that provides for at least standard coverage, for only catastrophic coverage, or medisave coverage, respectively. Requests the National Association of Insurance Commissioners (NAIC) to submit to the Secretary a set of rules which NAIC determines is sufficient for determining, in the case of any health insurance plan and for purposes of this subtitle, the actuarial value of the coverage offered by the plan. Directs the Secretary to certify such set of rules for use under this subtitle if they meet such requirements or establish such a set of rules. Specifies that a health insurance plan is considered to provide: (1) standard coverage if the benefits are determined, in accordance with certified rules of actuarial equivalence, to have a value that is within five percentage points of an established target actuarial value for standard coverage; (2) catastrophic coverage if benefits are available under the plan for a year only to the extent that expenses for covered services in a year exceed a deductible amount that is consistent with a specified requirement for a catastrophic health plan under the Code, and are determined, in accordance with certified actuarial equivalence rules, to have a value that is within five percentage points of an established target actuarial value for catastrophic coverage; and (3) medisave coverage if such plan consists of a catastrophic health plan within the meaning of the Code and a medical savings account. Requests NAIC to submit to the Secretary target actuarial values for standard and catastrophic coverage. Permits NAIC to submit periodic revisions of, and permits the Secretary to revise, the set of rules of actuarial equivalence and target actuarial values where necessary to take into account changes in the relevant types of health benefits provisions, in deductible levels for catastrophic coverage, or in relevant demographic conditions. (Sec. 1103) Directs the Secretary to request NAIC to develop model regulations that specify standards with respect to requirements: (1) that insurers make available MedAccess plans; (2) of guaranteed availability of MedAccess plans to small employers; (3) relating to limits on premiums and certain consumer protections; and (4) relating to limitation of annual premium increases. Requires the Secretary to review such standards and, if NAIC fails to specify standards meeting such requirements, to promulgate standards. Sets forth provisions regarding: (1) the application of MedAccess standards and consumer protection standards by the States; and (2) the Federal role. (Sec. 1104) Sets forth provisions: (1) regarding limits on premiums and annual premium increases; and (2) requiring an insurer, at the time of offering a health insurance plan to a small employer, to fully disclose rating practices for health insurance plans, including rating practices for different populations and benefit designs. (Sec. 1106) Directs the Secretary to: (1) request NAIC to develop models for reinsurance or allocation of risk mechanisms for health insurance plans made available to small employers for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models or specify models. Sets forth provisions regarding implementation of reinsurance or allocation of risk mechanisms by the States and the Federal role. Amends the Code to provide for the imposition of a tax on any health insurance plan which covers any employee in a Federal reinsurance State. (Sec. 1108) Directs the Secretary to establish an Office of Private Health Care Coverage. Requires the Office Director to submit to the Congress annual reports evaluating health care coverage reform. (Sec. 1109) Authorizes the Director to conduct: (1) research on the impact of this subtitle on the availability of affordable health coverage for employees and dependents in the small employers group health care coverage market and other specified topics; and (2) demonstration projects relating to such topics. Requires the Director to develop: (1) methods for measuring the relative health risks of eligible individuals in terms of the expected costs of providing benefits under health insurance plans and, in particular, MedAccess plans; and (2) a model for equitably distributing health risks among insurers in the small employer health care coverage market. Authorizes appropriations. Subtitle C: Preemption - Part 1: Scope of State Regulation - Prohibits: (1) State benefit mandates for group health plans; and (2) State or local law prohibitions against two or more employers obtaining coverage under an insured multiple employer health plan. (Sec. 1203) Preempts State restrictions concerning: (1) reimbursement rates or selective contracting; (2) differential financial incentives; and (3) utilization review methods. Directs the Comptroller General to conduct a study of the benefits and cost effectiveness of the use of managed care in the delivery of health services. Part 2: Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to allow a limited exemption under preemption rules for multiple employer plans providing health benefits subject to certain Federal standards. (Sec. 1212) Relieves exempted multiple employer plans providing medical care benefits of certain restrictions on preemption of State law. Treats such plans as employee welfare benefit plans. Allows commencement of new arrangements only if such exemption is in effect or an application is pending and the Secretary of Labor determines that provisional protection is appropriate. Sets forth exemption procedures, eligibility requirements, and additional requirements applicable to exempted arrangements. Requires certain disclosures to participating employers, maintenance of reserves, and corrective actions. Provides for expiration, suspension, and revocation of exemptions, and for review of actions by the Secretary. (Sec. 1213) Revises provisions relating to scope of preemption rules, and to treatment of single employer arrangements and of certain collectively bargained arrangements. (Sec. 1215) Establishes special rules for employee leasing healthcare arrangements. Treats such arrangements as multiple employer welfare arrangements except when they are multiple employer health plans. (Sec. 1216) Sets forth enforcement provisions relating to multiple employer welfare arrangements and employee leasing health care arrangements. (Sec. 1217) Sets forth filing requirements for multiple employer welfare arrangements. (Sec. 1218) Provides for cooperation between Federal and State authorities in enforcing ERISA requirements for multiple employer welfare arrangements with the limited exemption. Part 3: Encouragement of Multiple Employer Arrangements Providing Basic Health Benefits - Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax exempt trust status for multiple employer health plans and insured multiple employer health plans if they meet certain requirements under ERISA and this Act. Part 4: Simplifying Filing of Reports for Employers Covered under Insured Multiple Employer Health Plans - Amends ERISA to direct the Secretary of Labor to prescribe an alternative method providing for a single annual report with respect to all employers who are covered under the same insured multiple employer health plan. Part 5: Compliance with Coverage Option Requirements - Provides for compliance with applicable coverage requirements through multiemployer plans and other multiple employer health arrangements. Subtitle D: Health Deduction Fairness - Amends the Internal Revenue Code to provide: (1) for a permanent extension and increase in the health insurance tax deduction for self-employed individuals; and (2) that the deduction for certain health insurance costs be determined without regard to an adjusted gross income threshold. Disallows the deduction to individuals eligible for employer-subsidized coverage. Allows the deduction whether or not the individual itemizes other deductions. Subtitle E: Improved Access to Community Health Services - Part 1: Increased Authorization for Community and Migrant Health Centers - Directs the Secretary to provide for grants to migrant and community health centers to promote primary health care services for underserved individuals. Allows grants to be used to promote the provision of off-site services, to improve birth outcomes in areas with high infant mortality and morbidity, to establish primary care clinics in areas in need, and for recruitment and training costs of necessary providers and operating costs for unreimbursed services. Authorizes appropriations. Directs the Secretary to conduct a study of the impact of such grants on access to health care, birth outcomes, and the use of emergency room services. Part 2: Grants for Projects for Coordinating Delivery of Services - Amends the Public Health Service Act to authorize the Secretary to make grants to public and nonprofit private entities: (1) to carry out demonstration projects to increase access to outpatient primary health services in specified geographic areas (i.e., areas that are rational areas for the delivery of health services, have a population of not more than 500,000 individuals, and have been designated by the Secretary as areas with a shortage of personal health services or that have a significant number of individuals with low incomes or insufficient health care insurance through coordinating the delivery of such services under Federal, State, local, and private programs; and (2) for developing plans to carry out such projects. Authorizes appropriations. Subtitle F: Improved Access to Rural Health Services - Part 1: Establishment of Rural Emergency Access Care Hospitals Under Medicare - Amends title XVIII (Medicare) of the Social Security Act (SSA) to provide for: (1) establishment of rural emergency access care hospitals under Medicare; and (2) coverage of and payment for rural emergency access care hospital services under Medicare part B (Supplementary Medical Insurance). Part 2: Rural Medical Emergencies Air Transport - Amends the Public Health Service Act to direct the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments. Sets forth provisions regarding: (1) application and State plan requirements; (2) considerations in awarding grants; (3) State administration and use of grants; (4) the number of grants; and (5) reporting requirements. Authorizes appropriations. Part 3: Emergency Medical Services Amendments - Amends the Public Health Service Act to direct the Secretary to: (1) establish an Office of Emergency Medical Services, headed by a Director; (2) engage in specified emergency medical services activities, including disseminating information obtained in carrying out specified activities to public and private entities, providing technical assistance to State and local agencies, coordinating Department of Health and Human Services (DHHS) activities with those of other Federal agencies; and (3) ensure that such activities are carried out consistent with certain requirements regarding maintaining an adequate number of health professionals with expertise in the provision of services, developing, periodically reviewing, and revising as appropriate guidelines for the provision of such services, appropriately using available technologies, and serving the unique needs of underserved inner-city and rural areas. (Sec. 1522) Authorizes the Secretary to make grants to States for the purpose of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services, subject to specified matching fund, budgetary, and other requirements. (Sec. 1523) Provides for demonstration projects to establish telecommunications between rural medical facilities and medical facilities with expertise or equipment. Directs the Secretary to ensure that the telecommunications technologies demonstrated include interactive video telecommunications, static video imaging transmitted through the telephone system, and facsimiles transmitted through such system. (Sec. 1524) Authorizes appropriations for: (1) emergency medical services (including for State offices of Emergency Medical Services and for telecommunications demonstrations); and (2) trauma care and certain other activities. Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program - Amends SSA title XIX (Medicaid) to provide for the establishment of State health allowance programs under which the State makes payments to a group health plan which provides coverage to an eligible individual as an allowance towards the costs of providing the individual with benefits under the plan. Subtitle H: Medicaid Program Flexibility - Amends SSA title XIX Medicaid) to modify: (1) Federal requirements to allow States more flexibility in contracting for coordinated care services under Medicaid; and (2) provisions regarding the extension of certain waivers. Title II: Health Care Cost Containment and Quality Enhancement - Subtitle A: Medical Malpractice Liability Reform - Part 1: General Provisions - Makes this subtitle applicable with respect to any medical malpractice liability claim and to any medical malpractice liability action brought in State or Federal court, except a claim or action for damages arising from a vaccine-related injury or death to the extent that title XXI of the Public Health Service Act applies. Sets forth provisions regarding: (1) preemption of State law; (2) effect on sovereign immunity and choice of law or venue; (3) jurisdiction; and (4) effective dates. Part 2: Medical Malpractice and Product Liability Reform - Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified alternative dispute resolution (ADR) system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States under chapter 171 of the Federal judicial code (U.S. Court of Federal Claims). Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 2012) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action. Sets limits on punitive damages and on periodic payments for future losses. (Sec. 2013) Set forth provisions regarding: (1) limits on attorney fees and other costs; (2) joint and several liability (generally, liability may be found only for those damages directly attributable to the person's proportionate share of fault or responsibility for the injury); (3) a statute of limitations of seven years; and (4) a uniform standard for determining negligence (the defendant's conduct at the time of providing the health care services was not reasonable). (Sec. 2017) Specifies that in the case of a medical malpractice liability claim relating to services provided during labor or the delivery of a baby, if the health care professional did not previously treat the injured individual for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. Part 3: Requirements for State Alternative Dispute Resolution Systems - Lists requirements for State ADR systems, including that such a system: (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 2032) Directs the Secretary, by October 1 of each year, to certify State ADR systems that meet such requirements. Directs the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 2033) Directs the Secretary, within five years, to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system, including: (1) information on the effect of the ADR systems on health care costs, access to health care, and quality of care provided within the State; and (2) to the extent that such report does not provide information on no-fault systems operated by States as ADR systems, an analysis of the feasibility and desirability of establishing a system for resolving medical malpractice liability claims on a no-fault basis. Part 4: Other Provisions Relating to Medical Malpractice Liability - Authorizes a State agency responsible for disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies to permit their participation in the licensing of such practitioner and to review any health care malpractice action, claims, or allegation, or other information concerning the practice patterns of any such practitioner. Sets forth agreement requirements. (Sec. 2042) Directs the Secretary to study incentives adopted by State and local governments, insurers, medical societies, and other entities to encourage physicians to volunteer to provide health care services in medically underserved areas. (Sec. 2043) Directs each State to require: (1) each health care professional and health care provider to participate in a risk management program to prevent, and provide early warning of, practices which may result in injuries to patients or endanger patient safety; and (2) each provider of health care professional and provider liability insurance in the State to establish risk management programs or sanction programs of risk management for health care professionals and providers provided by other entities, and require each such professional or provider, as a condition of maintaining insurance, to participate in one such program at least once in each three-year period. (Sec. 2044) Directs the Secretary to make grants: (1) for basic research in the prevention of, and compensation for, injuries resulting from health care professional or provider malpractice and for research of the outcomes of health care procedures; (2) to the States to assist in improving their ability to license and discipline health care professionals; and (3) to States and local governments, private nonprofit organizations, and health professional schools for educating the general public about the appropriate use of health care, realistic expectations of medical intervention, and the resources and role of health care professional licensing and disciplinary boards in investigating claims of incompetence or health care malpractice, and for developing programs of faculty training and curricula for educating health care professionals in quality assurance, risk management, and medical injury prevention. Authorizes appropriations. Subtitle B: Administrative Cost Savings - Part 1: Standardization of Claims Processing - Directs the Secretary to adopt standards relating to: (1) data elements for use in paper and electronic claims processing under health benefit plans and in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. (Sec. 2102) Authorizes the Secretary, two years after standards are adopted for classes of services upon determining that a significant number of claims for benefits for such services under health benefit plans are not being submitted in accordance with such standards, to require that all providers of such services submit claims to health benefit plans in accordance with such standards. (Sec. 2103) Directs the Secretary to: (1) provide for the ongoing receipt and review of comments and suggestions for changes in the standards adopted and promulgated; (2) establish a schedule for the periodic review of such standards; and (3) revise such standards. Part 2: Electronic Medical Data Standards - Directs the Secretary to promulgate standards for hospitals concerning electronic medical data, including standards for transmission of such data and confidentiality of patient-specific information. Authorizes the Secretary to periodically revise such standards. (Sec. 2112) Sets forth requirements with respect to: (1) the sharing of hospital information under Medicare; (2) waiver of such requirements; and (3) application of such requirements to hospitals of the Department of Veterans Affairs. (Sec. 2113) Authorizes the head of a Federal agency to require a provider to present and transmit a required data element electronically in accordance with applicable presentation or transmission standard. (Sec. 2114) Sets forth limitations on data requirements where standards with respect to data elements are in effect. (Sec. 2115) Directs the Secretary to establish an advisory commission on the standards established under this part and operational concerns about the implementation of such standards. Authorizes appropriations. Part 3: Development and Distribution of Comparative Value Information - Directs the Secretary to determine whether each State is developing and implementing a health care value information program that meets specified criteria and a specified schedule. Authorizes the Secretary to: (1) make grants to enable each State to plan development and initiate implementation of its health care value information program; and (2) recover the amount of such a grant by offset against any other amount payable to the State under the Social Security Act under specified circumstances. Authorizes appropriations. (Sec. 2122) Directs the Secretary to take actions necessary to implement a comparable program in a State that fails to develop or implement a health care value information program in accordance with such criteria and schedule. Authorizes the Secretary to charge fees for the information materials provided pursuant to such a program. (Sec. 2123) Directs the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to develop health care value information relating to each program that such head administers and covering the same types of data that a State program meeting such criteria would provide. (Sec. 2124) Directs the Secretary to: (1) develop model systems to facilitate the gathering of data on health care cost, quality, and outcome and the analysis of such data in a manner that will permit the valid comparison of such data among providers and among health plans; (2) support experimentation with different approaches to achieve such objectives in the most cost effective manner; and (3) evaluate the various methods to determine their relative success. Authorizes the Secretary to establish standards for the collective and reporting of data on health care cost, quality, and outcomes. Authorizes appropriations. Part 4: Additional Standards and Requirements; Research and Demonstrations - Directs the Secretary to: (1) adopt standards relating to the design and use of magnetized Medicare identification cards to assist health care providers in determining whether individuals are eligible for benefits for provided services under the Medicare program and in billing the Medicare program for covered services; (2) take steps to encourage and assist States in the design and use of magnetized Medicaid identification cards under their Medicaid plans; and (3) establish a Medicare and Medicaid information system to provide information on group health and other health benefit plans that are primary payors to the Medicare and Medicaid programs. Authorizes appropriations. (Sec. 2132) Specifies that, effective January 1, 1994, no effect shall be given to any provision of State law that requires medical or health insurance records (including billing information) to be maintained in written, rather than electronic, form. (Sec. 2133) Requires, effective January 1, 1995, each health benefit plan: (1) to use a beneficiary's social security number as the personal identifier for claims processing and related purposes (authorizes the Secretary to impose a civil money penalty on any plan that fails to do so); and (2) to use the unique identifier under title XVIII of the Social Security Act (Medicare) for a provider that furnishes health care items or services to a beneficiary under the plan as the identifier of that provider for claims processing and related purposes. (Sec. 2134) Directs the Secretary to: (1) determine, where benefits are payable under two or more health benefit plans, whether problems relating to the rules for determining the liability of plans or the availability of information among plans causes significant administrative costs; and (2) promulgate standards, if the implementation of standards would significantly reduce such administrative costs. Authorizes the Secretary to impose a civil money penalty on plans that fail to comply with such standards. (Sec. 2135) Directs the Secretary to provide grants to qualified entities for research on the application of comprehensive information systems in continuously monitoring and improving patient care. Authorizes the Secretary to make grants to: (1) two to five community organizations or coalitions of health care providers, health benefit plans, and purchasers to establish and document the efficacy of communication links between the information systems of health benefit plans and of health care providers; (2) two to five public or private nonprofit entities for the development of regional or community-based clinical information systems; and (3) public or private nonprofit entities to develop and test the definition of a comprehensive set of data elements and the specification and manner of presentation of the individual data elements of the set, for electronic medical data generated by physicians and other entities (other than hospitals) that provide health care services. Authorizes appropriations. Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Account - Amends the Internal Revenue Code to include under the medical expense deduction the portion of such expense attributable to coverage under a catastrophic health plan. (Sec. 2202) Allows individuals a tax deduction for percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to medical care savings accounts. Subtitle D: Anti-Fraud - Part 1: Criminal Prosecution of Health Care Fraud - Amends the Federal criminal code to: (1) set penalties for health care providers who knowingly engage in any scheme or artifice to defraud any person in connection with the provision of health care; and (2) make activity which, if engaged in by the U.S. Postal Service, would be a violation of mail fraud provisions punishable to the same extent with respect to private or commercial interstate carriers. (Sec. 2303) Authorizes appropriations to hire, equip, and train no fewer than: (1) 225 special agents of the Federal Bureau of Investigation and support staff to investigate health care fraud cases; (2) 50 assistant United States Attorneys and support staff to prosecute such cases; and (3) 25 investigators in the Office of Inspector General, DHHS, to be devoted exclusively to health care fraud cases. (Sec. 2304) Amends the Federal criminal code to authorize the Attorney General to make payments of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution of health care fraud, subject to specified requirements and exceptions. Part 2: Coordination of Health Care Anti-Fraud and Abuse Activities - Directs the Secretary to establish in the Office of the Inspector General of DHHS a program (all-payer fraud and abuse control program) to: (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to the delivery of, and payment for, health care in the United States; (2) conduct investigations, audits, evaluations, and inspections relating to such delivery and payment; and (3) facilitate the enforcement of provisions of the Social Security Act and other statutes applicable to health care fraud and abuse. Directs the Secretary to establish standards to carry out such program, including standards relating to the furnishing of information by health insurers, providers, and other to enable the Secretary to carry out the program and procedures to assure that such information is provided and utilized in a manner that protects the confidentiality of the information and the privacy of individuals receiving health care services. Sets forth provisions regarding: (1) qualified immunity for providing information; (2) ensuring access to documentation; and (3) failure to comply as grounds for exclusion from the Medicare and Medicaid programs. (Sec. 2312) Authorizes additional appropriations to enable the Secretary to conduct investigations of allegations of health care fraud and to carry out the all-payor fraud and abuse control program. (Sec. 2313) Establishes in the Treasury an Anti-Fraud and Abuse Trust Fund to be used to assist the Inspector General of DHHS in carrying out the all-payor fraud and abuse control program in the fiscal year involved. Sets forth provisions regarding: (1) the deposit into the Fund of Federal health anti-fraud and abuse penalties; and (2) the use of such penalties to repay beneficiaries for cost-sharing. (Sec. 2314) Amends SSA title XI to provide for the application of Federal health anti-fraud and abuse sanctions to all fraud and abuse against private health benefit plans. Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals: Part 1 - Medicare Payment Changes - Amends SSA title XVIII to: (1) eliminate the membership limitation for Medicare health maintenance organizations; and (2) revise the Medicare select policy program and provide for a civil money penalty for misrepresentations made in connection with a Medicare select policy. (Sec. 2402) Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) make permanent the Medicare select policy program; and (2) allow access to Medicare select policies in all States. (Sec. 2403) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate the administration of Medicare parts A and B. Part 2: Part B Premium Tax for High-Income Individuals - (Sec. 2411) Amends the Internal Revenue Code to impose a tax on the Medicare part B premiums of high income individuals. Subtitle F: Removing Anti-Trust Impediments - Directs the Attorney General to promulgate guidelines under which a health care joint venture may submit an application requesting that the Attorney General provide the entities participating in the venture with an exemption under which: (1) monetary recovery on an antitrust claim brought against the entity shall be limited to actual damages if specified conditions are met; and (2) the conduct of the entity in making or performing a contract to carry out the venture shall not be deemed illegal per se. Requires the Attorney General to approve or disapprove the application within a specified time frame and to provide a statement explaining the reasons for any disapproval. Directs the Attorney General to approve the application if an entity participating in the venture submits to the Attorney General an application that contains the identities of the parties to the venture; the nature, objectives, and planned activities of the venture; and specified assurances and information. Sets forth provisions regarding: (1) revocation and renewal of exemptions and withdrawal of an application; (2) requirements relating to notice and publication of exemptions; and (3) issuance of health care certificates of public advantage to each eligible health care joint venture that complies with specified requirements. Establishes the Interagency Advisory Committee on Competition, Antitrust Policy, and Health Care to: (1) discuss and evaluate competition and antitrust policy and their implications regarding the performance of health care markets; (2) analyze the effectiveness of health care joint ventures receiving exemptions in reducing costs and expanding access; and (3) make recommendations to the Congress. Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities - Part 1: Application of the Clayton Act to Medical Self-Regulatory Entities - Provides that no damages, cost of suit, or attorney fee may be recovered under section 4, 4A, or 4C of the Clayton Act, or under any similar State law, except by a State or the United States, from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities that are: (1) designed to promote the quality of health care provided to patients; and (2) not conducted for purposes of financial gain. Directs the court to award the cost of such a suit, including a reasonable attorney fee, to a substantially prevailing defendant. Part 2: Consultation by Federal Agencies - Requires any Federal agency engaged in the establishment of medical profession standards to consult with appropriate medical societies or associations, specialty boards, or recognized accrediting agencies, if available, in carrying out medical professional standard setting and guidelines or standards relating to the practice of medicine. Subtitle H: Prefunding Government Health Benefit for Certain Annuitants - Requires that certain agencies prefund Government health benefits contributions for their annuitants. Subtitle I: Miscellaneous Provisions - Amends Civil Service and Federal Employees' Retirement Systems law to increase the minimum age required to be eligible for an immediate retirement annuity. Provides for the conformance of other Federal retirement systems with the minimum age increase made above. Title III: Long-Term Care - Subtitle A: Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation. (Sec. 3002) Excludes from gross income benefits provided under a long-term care insurance contract. Includes in gross income employer-provided coverage for long-term care services. (Sec. 3003) Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions. Includes any parent or grandparent as a dependent for purposes of such expenses. (Sec. 3004) Provides for the nonrecognition of gain or loss on the exchange of any life insurance contract or an endowment or annuity contract for a long-term care insurance contract. (Sec. 3005) Excludes from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangement to pay long-term care premiums. (Sec. 3006) Allows insurance companies to issue accelerated death benefit riders on life insurance contracts. Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance - Amends SSA title XIX to require State Medicaid plans to disregard some or all of the individual's assets attributable to coverage under a qualified long-term care insurance contract in determining the individual's eligibility for long-term care services. Subtitle C: Studies - Requires the Comptroller General to study the feasibility of: (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their home with an income tax credit. (Sec. 3203) Requires the Secretary of Health and Human Services to study and report to the Congress on the feasibility of encouraging or requiring the use of a single designate public or nonprofit agency to coordinate, through case management, the provision of long-term care benefits under current Federal, State, and local programs in a geographic area. Subtitle D: Volunteer Service Credit Demonstration Projects - (Sec. 3301) Amends the Older Americans Act of 1965 to require the Commissioner of the Administration on Aging to establish and operate a volunteer service credit demonstration project in each State.
United States · United States Congress · 15 September 1993
General Aviation Revitalization Act of 1993 - Amends the Federal Aviation Act of 1958 to set forth a 15-year statute of limitations within which a person may bring a civil action against an aircraft manufacturer for damages for death or injury or damage to property arising from an aircraft accident.
United States · United States Congress · 15 September 1993
Amends the Internal Revenue Code and title II of the Social Security Act (Old Age, Survivors and Disability Insurance) to set forth rules for filing returns with respect to domestic service employment taxes and requires such returns to be made on a calendar year basis. Subjects such taxes to estimated tax provisions. Makes filing requirements inapplicable to any employer liable for tax concerning remuneration for services other than domestic service in a private home. Authorizes the Secretary of the Treasury to enter into agreements with States to collect the State unemployment tax imposed on remuneration for domestic service and transfers such amounts to a State's account in the Unemployment Trust Fund. Treats such taxes as domestic service employment taxes. Requires the Secretary to inform domestic service employers in private homes of their tax obligations. Adjusts the threshold (from $50 a calendar quarter to $800 a year) for paying and withholding social security taxes on wages paid for domestic service in a private home. Requires the Secretary of Health and Human Services to adjust such threshold amount in the same manner as adjustments to certain social security insurance amounts. Excludes domestic service in a private home by an individual 16 years and under from amendments made by this Act.