United States · United States Congress · 16 February 1995
TABLE OF CONTENTS: Title I: Time-Limited Transitional Assistance Title II: Make Work Pay Title III: The Work First Program Title IV: Family Responsibility and Improved Child Support Enforcement Title V: Teen Pregnancy and Family Stability Title VI: Program Simplification Title VII: Financing Title VIII: SSI Reform Title IX: Effective Date Individual Responsibility Act of 1995 - Title I: Time-Limited Transitional Assistance - Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act (SSA) to: (1) require States opting to have work first programs to make ineligible for AFDC any family with a member who has participated in such work program, generally, for two years (and so is prohibited from further participation), while preserving the eligibility of such families for Medicaid; (2) condition eligibility for AFDC on participation in job search activities except during unsubsidized full-time private sector employment; and (3) direct the Secretary of Health and Human Service (Secretary) to establish a database of work first and community service programs participants for use by States opting to have work first programs. Title II: Make Work Pay - Amends SSA titles XIX (Medicaid) and IV part A (AFDC), as well as the Internal Revenue Code (IRC) and other specified Federal law, to make various specified changes with regard to certain program aspects, among them: (1) extended Medicaid enrollment for former AFDC recipients; (2) increased AFDC earned income disregards; (3) limited AFDC income and resource disregards of savings for education, first time home purchase, or microenterprise initiatives; (4) child care, including replacement of current Federal child care programs with State-administered block grant programs for child care services, as well as child care for work first program participants; and (5) refundable tax credits for dependent care and other expenses connected with gaining employment in order to enable AFDC recipients to become self-sufficient. Title III: The Work First Program - Amends SSA title IV to replace the current Job Opportunities and Basic Skills Training Program under part F with a new Work First Program that allows participating States to establish one of two types of work programs, with one type similar to the programs operated by Riverside County, California, and the State of Oregon. (Sec. 301) Adds a new part G under which States establishing a work first program have the option to establish community service programs with requirements for securing unsubsidized full-time employment in the private sector. Requires a work supplementation component under such programs that provides for subsidized private sector or State or local government jobs. Requires States to provide program participants with the necessary case management services to ensure integrated benefits and services provided under such programs. Expresses the sense of the Congress that: (1) States should target individuals who have not attained 25 years of age for participation in work first programs; and (2) the Secretary and the States should consider the needs of rural areas in designing State plans under SSA title IV parts F and G. Title IV: Family Responsibility And Improved Child Support Enforcement - Amends SSA title IV parts A and D (Child Support and Establishment of Paternity) with regard to: (1) AFDC recipient cooperation in establishing paternity of out-of-wedlock children; (2) various State and Federal locate services, including the Federal Parent Locator Service (FPLS) (which, along with the databases accessed by it, is expanded to form a national network based on comprehensive statewide child support enforcement systems); (3) private access to locate and child support enforcement services; (4) availability of parenting social services for new fathers; (5) the $50 child support disregard (which is eliminated); (6) Federal matching payments and State performance-based incentives and penalties; and (7) State law on paternity establishment. (Sec. 401) Expresses the sense of the Congress that: (1) certain actions pursuant to a child support order, such as denial of visitation rights, should be treated as irrelevant in actions brought to enforce other provisions of the order; (2) the Secretary should investigate accessing Federal data banks not linked to FPLS which are more than marginally useful in handling locate requests; (3) the national network for handling such requests should be used to access State records only through the appropriate State agency; (4) social services should be provided in hospitals to women whose pregnancy results from rape or incest; and (5) States should develop programs like the State of Wisconsin's program for noncustodial parents unable to meet support obligations. (Sec. 421) Establishes the National Child Support Guidelines Commission to study, develop, and report to the President and the Congress a national child support guideline, if one proves advisable. (Sec. 422) Provides under State laws for expedited administrative and judicial procedures for establishing paternity and for establishing, modifying, and enforcing support obligations. (Sec. 431) Requires the Secretary of the Treasury to establish a system for enabling child support information to be obtained at the workplace via W-4 form reporting by employees. Amends IRC to require employers to: (1) deduct and withhold child support obligations from employee wages; (2) pay withholdings to the appropriate payee; and (3) include withheld obligations on the employee's W-2 form. Makes various other specified changes to SSA title IV part D and other applicable Federal laws involving: (1) State procedures for comparing information in the national registry of child support orders (NR) established under this title with information obtained from W-4 form reporting, and for imposing monetary penalties on employees who fail to report support obligations; (2) development of uniform withholding orders; (3) garnishment of certain Federal benefits and seizure of lottery winnings and other payouts to satisfy support arrearages; (4) State reporting of support obligations to credit bureaus; (5) liability of grandparents for financial support of children of their minor children; (6) distribution of child support payments through State child support enforcement agencies to former assistance recipients; (7) due process rights of the parties to child support cases; (8) use of social security numbers under State law for recording marriage licenses, divorce decrees, birth records, and child support and paternity orders; (9) interstate enforcement of child support orders; (10) State suspension of driver's and other types of licenses for nonpayment of support or failure to appear at child support proceedings; (11) treatment of support obligations under the bankruptcy code; (12) the mechanism for offsetting past-due support against income tax overpayments, with changes in the order of refund distributions; and (13) the treatment of assigned and non-assigned support arrearages. Title V: Teen Pregnancy and Family Stability - Amends SSA title IV part A with respect to Federal and State roles in reducing teenage pregnancy and promoting family stability, among other things by: (1) giving States the option to deny AFDC for additional children (except those born as a result of rape or incest) of AFDC families while preserving their eligibility for Medicaid; and (2) providing for unmarried minors who are pregnant or who have children to live under adult supervision in order to receive AFDC. (Sec. 503) Directs the Secretary of Education to establish a task force to reduce teenage pregnancy. (Sec. 508) Places restrictions on Federal housing benefits to minors who bear children out-of-wedlock. (Sec. 509) Give States the option of denying AFDC to minor parents. (Sec. 511) Expresses the sense of the Congress that: (1) children should be educated about the risks of early parenthood; (2) reproductive family planning and education should be made available to potential parents; and (3) States should use SSA title XX (Block Grants to States for Social Services) funds to provide comprehensive services to high-risk youth and work with schools for early identification and referral of such children. Title VI: Program Simplification - Amends SSA titles IV part A and XI, as well as the Food Stamp Act of 1977, among other things to give States increased flexibility in providing AFDC benefits (including restoring those wrongfully terminated) through, among other means, use of electronic benefit transfers, quicker action on waiver requests, and coordination with food stamp rules. (Sec. 631) Expresses the support of the Congress for certain efforts by the Social Security Administration to reduce fraud and abuse in the Supplemental Security Income (SSI) Program under SSA title XVI. (Sec. 632) Requires the Commissioner of Social Security to study and report to the Congress on the feasibility of issuing a single counterfeit-resistant ID card to replace the current social security card and any health security card issued under health reform legislation. (Sec. 641) Sets forth additional AFDC changes involving: (1) State payment options under the program for dependent children of unemployed parents; (2) State determination of the needs of the dependent child and relative with whom the child is living; (3) "fill- the-gap" budgeting; (4) repeal of the requirement for supplemental payments in States paying less than their needs standards; (5) collection of AFDC overpayments from Federal tax refunds; and (6) disregard of student and nonrecurring lump-sum income. (Sec. 646) Amends SSA title XI to raise the limitations on payments under SSA titles I (Old Age Assistance), X (Aid to the Blind), XIV (Aid to the Permanently and Totally Disabled), and XVI (Supplemental Security Income)(SSI), and IV parts A and E (Foster Care and Adoption Assistance). Title VII: Financing - Amends the SSA, the IRC, and the Food Stamp Act of 1977 to make certain aliens ineligible for AFDC, SSI, Medicaid, and food stamps. (Sec. 711) Sets forth special rules concerning aliens and general public assistance. (Sec. 714) Authorizes grants to States to compensate for resident lawful aliens. Provides for allocation of such financial assistance to each State and the District of Columbia. Authorizes appropriations. (Sec. 721) Amends SSA title IV part A (AFDC) to revise: (1) the definition of "emergency assistance to needy families with children;" and (2) the limitation on State expenditures for such assistance. (Sec. 731) Amends the National School Lunch Act to: (1) modify family and group day care home reimbursement provisions under the child and adult care food program; and (2) provide grants to States for making grants to family and day care homes. (Sec. 741) Requires the Director of the Office of Management and Budget to make specified downward adjustments in discretionary spending limits under the Congressional Budget Act of 1974 for FY 1996 through 1998. (Sec. 751) Amends IRC to: (1) provide for the inclusion of certain Federal assistance in gross income, assistance such as AFDC and food stamps; (2) make payments of certain assistance reportable to the Internal Revenue Service; (3) deny the earned income tax credit to individuals not authorized to be employed in the United States; (4) phaseout the earned income credit for individuals having more than $2,500 of taxable interest and dividends; and (5) provide for the treatment of children receiving AFDC benefits under the earned income credit. Title VIII: SSI Reform - Amends SSA title XVI to limit the payment of SSI benefits for children by reason of disability. Title IX: Effective Date - Sets forth the effective date of this Act.
United States · United States Congress · 15 February 1995
TABLE OF CONTENTS: Title I: Research and Related Programs Title II: Construction Grants Title III: Standards and Enforcement Title IV: Permits and Licenses Title V: General Provisions Title VI: State Water Pollution Control Revolving Funds Title VII: Miscellaneous Provisions Title VIII: Wetlands Conservation and Management Clean Water Amendments of 1995 - Title I: Research and Related Programs - Amends the Federal Water Pollution Control Act (the Clean Water Act or CWA) to add national goal and policy provisions with respect to water quality programs. Directs the Administrator of the Environmental Protection Agency (EPA) to assess and document alternative regulatory approaches for protecting water quality and to develop regulations and guidance based upon the best obtainable information, including risk reduction benefits achievable by alternatives. (Sec. 102) Authorizes appropriations through FY 2000 for grants to States and interstate agencies for assistance in administering pollution control programs. Title II: Construction Grants - Removes limitations on the use of grants for the construction of publicly owned treatment works and authorizes the use of such grants for purposes for which grants may be made under nonpoint source management and groundwater quality programs. (Sec. 201) Requires grant applicants to demonstrate, along with other existing requirements, that wastewater reduction and other water use efficiency options have been studied and evaluated and, if cost-effective, implemented. (Sec. 202) Authorizes the Administrator to negotiate an annual budget with a State for purposes of administering a closeout of the State's construction grants program. (Sec. 205) Requires value engineering reviews to be conducted for any treatment works construction projected in excess of $25 million (currently, $10 million). Title III: Standards and Enforcement - Revises provisions concerning the use of innovative technology to comply with effluent reduction requirements to authorize the Administrator, if a facility achieves reductions with an innovative system that has the potential for reducing the release of pollutants to other media, to extend the date of compliance for such facility for up to three (currently, two) years if the system has industry-wide application potential. (Sec. 301) Prohibits discharges from, or affected by, remining operations from exceeding State water quality standards except where monitoring demonstrates that the receiving waters do not meet such standards prior to commencement of remining and where the water quality of the receiving stream is projected to be improved by remining. (Current law provides no exception.) (Sec. 302) Directs the Administrator to publish guidance for States on the development and adoption of water quality standards applicable to navigable waters that contain little or no water during low flow periods. Allows city, county, or local government employees or officials to be members of boards that approve discharge permit applications notwithstanding a prohibition on membership for persons who have received a significant portion of income from permit holders or applicants. (Sec. 303) Directs the Administrator or the Secretary responsible for a regulatory requirement, in developing standards, effluent limitations, or other regulatory requirements (other than permit or procedural requirements), to perform risk assessments consistent with guidelines issued by the Administrator. Requires such assessments to be performed in conjunction with any proposed regulation. Prohibits the issuance of any regulatory requirement or guidance where the social, environmental, and economic benefits are not reasonably related to anticipated costs. Provides that such guidelines shall require: (1) use of all relevant and available scientific data and information; (2) identification and discussion of assumptions and models used in the risk assessment as well as alternatives and sensitivity of results to such assumptions and models; (3) a quantitative estimate of the uncertainty inherent in the risk assessment; (4) a comparison of the risk with other risks to human health or the environment; (5) an estimate of the incremental risk avoided by the standard, effluent limitation, or requirement and the anticipated social, environmental, and economic benefits; and (6) an estimate of the social, environmental, and economic costs of complying with the standard, limitation, or requirement. Exempts standards, effluent limitations, or other regulatory requirements that are issued in final form within one year of this Act's enactment date from risk assessment requirements. (Sec. 304) Requires effluent standards for toxic pollutants to take into account the bioaccumulation potential of, and magnitude and risk of exposure to, a pollutant. Directs State Governors or water pollution control agencies to hold public hearings for purposes of reviewing, modifying, or adopting water quality standards at least once every five (currently, three years). Authorizes the Administrator to develop and issue guidance that States may use in: (1) issuing fish consumption advisories and scientific protocols for testing contamination levels of fish; (2) developing a monitoring program for contaminants in fish and shellfish; and (3) monitoring water quality at beaches and issuing health advisories with respect to beaches. (Sec. 305) Permits (currently, requires) a State to be joined as a party to a civil action brought by the United States under the CWA against a municipality located in such State. (Sec. 306) Revises provisions regarding water pollution control at Federal facilities to waive the sovereign immunity of the United States with respect to any requirement, administrative authority, or sanctions that may be imposed for violations. Provides that Federal employees may be subject to criminal sanctions, but exempts Federal agencies from such sanctions. Authorizes the Administrator to commence administrative enforcement actions against Federal agencies under this Act. Includes Federal agencies in the definition of "person." (Sec. 307) Authorizes appropriations for FY 1996 through 2000 for the clean lakes program. (Sec. 308) Revises the required elements of nonpoint source management programs and includes within such programs: (1) a schedule containing interim goals and milestones for making reasonable progress toward the attainment of standards; (2) a description of monitoring or assessment of program effectiveness; and (3) an identification of activities on Federal lands that are inconsistent with such programs. Grants States six (currently, three) months to submit revised programs in cases where modifications are required for approval. Requires the Administrator to prepare nonpoint source management programs for States that fail to do so or whose plans are not approved. Authorizes (currently, requires) the Administrator to make grants to States for preparing and implementing such management programs and preparing assessment reports. Increases the maximum Federal share of the cost of such programs to 75 (currently, 60) percent of the cost incurred by a State in preparing and implementing such reports and programs. Directs the Administrator to establish maximum and minimum grants for any fiscal year to promote equity between States and effective nonpoint source management. Sets forth limitations on the use of such grants. Requires the Administrator to study and report to the Congress on whether the allocation of funds for such grants reflects the costs of nonpoint source control measures for different nonpoint source categories and on options for better reflecting such costs in the allotment of funds. Increases the maximum amount of Federal assistance for grants to States for groundwater quality protection. Extends the authorization of appropriations for grants for assessment reports, nonpoint source management programs, and groundwater protection programs through FY 2000. Directs the Administrator to publish guidance to identify model management practices and measures which may be undertaken under such management programs. Requires compliance deadlines for nonpoint source management requirements to be postponed for one year for each fiscal year for which amounts appropriated to carry out grant programs for nonpoint source pollution and groundwater quality are less than the total amounts authorized to be appropriated. (Sec. 310) Authorizes States to submit watershed management programs to the Administrator for approval. Sets forth minimum requirements for such programs and lists activities that are eligible for assistance under the CWA. Permits States to adopt watershed management plans to be effective for up to ten years and to include planning and implementation schedules with milestones. Authorizes the issuance of pollutant discharge permits with limitations that do not meet applicable water quality standards if: (1) the receiving water is in a watershed with an approved plan; (2) the plan includes enforceable requirements under a State or local law for nonpoint source pollutant load reductions that will meet applicable water quality standards before the plan's expiration date; and (3) the point source does not have a history of significant noncompliance with its effluent limitations under a permit. Sets forth provisions regarding permit terms. Provides that if a State with an approved watershed management program makes a showing satisfactory to the Administrator that the State watershed and nonpoint source management programs will provide for the protection of coastal waters generally and contain other specified elements, such watershed program shall be deemed to be in compliance with the CWA and the Coastal Zone Act Reauthorization Amendments of 1990. Authorizes the Administrator to provide multipurpose grants to States with approved watershed management programs. Permits point source dischargers, as part of an approved watershed management program, to offset the impact of a pollutant discharge by entering into arrangements, including the payment of funds, for the implementation of source controls by another discharger through a pollution reduction credits trading program so long as safeguards are included to ensure compliance with technology based controls and to protect the quality of receiving waters. Directs the Administrator to allocate sums to carry out pollution reduction credits trading programs in selected areas of the country. Title IV: Permits and Licenses - Provides that, for purposes of provisions regarding pollutant discharge permits, waste treatment systems, including retention ponds or lagoons used to meet CWA requirements for concentrated animal feeding operations, are not waters of the United States. Authorizes an existing concentrated animal feeding operation that uses a natural topographic impoundment or structure, which is not hydrologically connected to any other U.S. waters, to continue to use the natural topographic feature for waste storage regardless of its size, capacity, or previous use. (Sec. 402) Revises stormwater discharge permitting provisions. Lists discharges composed entirely of stormwater for which permits are required under this section. Makes other such discharges subject to requirements for nonpoint source management programs. Establishes additional requirements for permits for municipal separate storm sewer systems, including that they: (1) require reasonable progress toward attainment of water quality standards; and (2) have additional requirements for the implementation of cost-effective controls for the control of discharges to attain or maintain such standards if they are renewed after this Act's enactment. Directs the Administrator to issue a consolidated permit for discharges from a storm sewer system owned by a municipality and the stormwater discharges from industrial sources owned by the same municipality. Authorizes the issuance of general or group permits for any discharges, other than those from municipal separate storm sewer systems, if the discharges are similar in nature and application of similar management measures will reduce pollution occurring from such discharges or if the Administrator finds that the issuance of general permits is appropriate. Prohibits the Administrator from requiring, as a permit condition for a discharge from a municipal separate storm sewer system, compliance with a numeric effluent limitation or an applicable water quality standard before December 31, 2009, except to implement management measures under regulations for municipal separate storm sewer systems. Sets forth requirements for regulations regarding permit application requirements for industrial and specified municipal stormwater discharges. Authorizes the Administrator to make grants to operators of municipal storm sewer systems for which permits are required for projects for the assessment of cost-effective controls. Extends compliance deadlines with respect to numeric effluent limitations or water quality standards required for specified municipal separate storm sewer systems if such grants total less than $20 million in any fiscal year. (Sec. 403) Requires each permit issued for a discharge from a combined storm and sanitary sewer to conform with the combined sewer overflow control policy signed by the Administrator on April 11, 1994. Authorizes the Administrator, notwithstanding specified compliance schedules and permit limitations, to issue a permit for discharges from such sewers that includes a schedule for compliance with a long-term control plan for a term of up to 15 years. Provides for extensions of such term, as appropriate. Modifies any consent decree or court order issued before this Act's enactment date by a district court that establishes any deadlines or timetables for the construction of treatment works for control of discharges from a municipal combined sewer system to make deadlines or timetables conform with this section's requirements. (Sec. 404) Requires the discharge permit program to provide that an owner or operator of a point source subject to a permit will not be required to remove or reduce the level of pollutants in a discharge if such pollutants are present in or caused by the intake waters for such source. (Sec. 405) Requires the Administrator to issue guidance on the beneficial use of sewage sludge. Title V: General Provisions - Directs the Administrator to involve State, tribal, and local governments in EPA decisionmaking, priority setting, policy and guidance development, and implementation under the CWA. (Sec. 502) Requires the President or head of any agency, in promulgating rules or establishing interpretations, guidelines, standards, or criteria for oil and grease under the CWA or the Oil Pollution Act of 1990, to: (1) differentiate animal fats and vegetable oils from other oils, including petroleum-based oils; and (2) consider differences in the physical, chemical, biological, or other properties and environmental effects of animal fats and vegetable oils from those other oils. (Sec. 503) Requires a CWA cost and needs estimate to be submitted quadrennially (currently, biennially) to the Congress. (Sec. 504) Reauthorizes the CWA through FY 2000. (Sec. 505) Directs the Administrator, prior to issuing any proposed or final regulation or other requirement pursuant to the CWA, to conduct: (1) an analysis of the direct and indirect costs for State and local governments to comply with the requirement in the five-year period following implementation; (2) an estimate of the amounts that will be authorized for providing Federal financial assistance for implementation of and compliance with the requirement for such period; (3) an estimate of the amounts that will be appropriated for such assistance for such period based on funding levels adopted as part of a concurrent resolution setting forth the congressional budget; (4) an assessment of the availability of other sources of funding for State and local governments to comply with such requirement; (5) an estimate of the amounts that will be authorized and appropriated for providing Federal assistance for the requirement for the fiscal year during which the requirement is to be implemented and the two preceding fiscal years; and (6) a certification that the amounts that will be appropriated exceed 90 percent of the costs for State and local governments to comply with the requirement. Requires the Administrator, if such certification is not made, to transmit to specified congressional committees a report explaining the reasons for not making such certification and the likely impacts of not adequately funding State and local governmental efforts to comply with the requirement. Title VI: State Water Pollution Control Revolving Funds - Authorizes State revolving funds (SRFs) to be used for water use efficiency measures whose principal purpose is improving or protecting water quality. (Sec. 602) Requires the Administrator to establish simplified procedures for small systems to obtain assistance from SRFs. (Sec. 603) Provides for an extended repayment period for loans made from SRFs to disadvantaged communities. Authorizes negative interest rates for such loans. Permits SRFs to be used to provide technical, planning, and other specified assistance to small systems. (Sec. 604) Authorizes and allocates appropriations for the SRF program through FY 2000. Title VII: Miscellaneous Provisions - Requires the Administrator to study and report to the Congress on future funding options for financing infrastructure projects under the CWA. Authorizes appropriations. Title VIII: Wetlands Conservation and Management - Comprehensive Wetlands Conservation and Management Act of 1995 - Prohibits, unless such activity is undertaken pursuant to a permit issued by the Secretary of the Army: (1) the discharge of dredged or fill material into U.S. waters; or (2) the draining, channelization, or excavation of wetlands. (Sec. 803) Requires the Secretary, upon receiving permit applications, to: (1) classify as Type A wetlands wetlands that are of critical significance to the long-term conservation of an ecosystem; (2) classify as Type B wetlands wetlands that provide habitat for a significant population of wildlife or provide other significant wetlands functions; and (3) classify as Type C wetlands wetlands that serve marginal functions but exist in such abundance that regulation of activities is not necessary to conserve wetlands values and functions, or are lands that do not serve significant wetlands functions. Permits owners of interests in Type A wetlands to seek compensation for the fair market value of such lands. Provides that title for such lands shall pass to the United States upon acceptance of an offer for compensation. Requires the Secretary to deny a permit authorizing activities in Type A wetlands unless: (1) such activities can be undertaken with minimal alteration or disturbance; (2) there are public interest concerns that require use of the lands for purposes other than conservation; or (3) the proposed use of the land will result in overall environmental benefits. Authorizes the Secretary to issue a permit for activities in Type B wetlands subject to conditions that ensure that the wetland ecosystem does not suffer loss or degradation. Imposes requirements for mitigation when such activities result in permanent wetland loss or degradation. Directs the Secretary to establish a mitigation banking program in each State to ensure compensation for loss and degradation of wetlands. Requires the primary objective of such programs to be to provide for the restoration, enhancement, or creation of ecologically significant wetlands on an ecosystem basis. Exempts specified activities from this Act's requirements. Prohibits more than 20 percent of any county, parish, or borough from being classified as Type A wetlands. Requires wetlands located on agricultural and associated nonagricultural lands to be delineated by the Secretary of Agriculture in accordance with the Food Security Act of 1985. Requires the Director of the U.S. Fish and Wildlife Service to undertake a project to identify and classify U.S. wetlands. Directs the Secretary to establish procedures pursuant to which: (1) landowners may appeal determinations of regulatory jurisdiction over a parcel of property, wetlands classifications with respect to property, or determinations that an activity is not regulated under a general permit; (2) any person may appeal a determination that a proposed activity is not exempt (non-exempt activities require permits); (3) permit applicants may appeal determinations to deny issuance of a permit or to impose a requirement under the permit; and (4) landowners or others required to restore or alter property may appeal an order to do so. Provides that persons who have filed appeals shall not be required to pay penalties or perform mitigation or restoration until the appeal has been decided. Authorizes civil actions and prescribes penalties for permit violations. Authorizes States to administer permit programs for activities covered by this Act, subject to the Secretary's approval. Directs the Secretary, in implementing responsibilities under the regulatory program, to balance the objective of conserving functioning wetlands with the objectives of ensuring continued economic growth, providing essential infrastructure, maintaining strong State and local tax bases, and protecting against the diminishment and value of private property. Requires the Secretary and the heads of Federal agencies to seek to minimize the effects of the regulatory program on the use and value of private property.
United States · United States Congress · 13 February 1995
Forest Stewardship Tax Act of 1995 - Amends the Internal Revenue Code to provide for the determination of material participation in timber activities for purposes of passive loss limitations.
United States · United States Congress · 7 February 1995
Increases the authorization of appropriations for the National Park Service to assist Georgia in relocating a highway affecting the Chickamauga and Chattanooga National Military Park.
United States · United States Congress · 7 February 1995
Truth in Budgeting Act - Prohibits the receipts and disbursements of the Highway Trust Fund, the Airport and Airway Trust Fund, the Inland Waterways Trust Fund, and the Harbor Maintenance Trust Fund from being included in either the Federal budget as submitted by the President or in the congressional budget. Exempts such trust funds from any general statutory budget limitation. (Sec. 3) Amends Federal transportation law to require the Secretary of Transportation to estimate annually what, but for this Act, would be at the close of the next fiscal year: (1) the amount of unfunded aviation authorizations; and (2) the net aviation receipts. Requires the Secretary to: (1) determine the amount by which unfunded aviation authorizations does or does not exceed net aviation receipts; and (2) make appropriate adjustments to amounts authorized to be appropriated and the amounts available for obligation from the Airport and Airway Trust Fund based on the difference. (Sec. 4) Sets forth similar provisions with respect to the Inland Waterways and the Harbor Maintenance Trust Funds.
United States · United States Congress · 3 February 1995
Spending Reduction Enforcement Act of 1995 - Establishes the Spending Reduction Commission to propose cost savings and changes in law to achieve at least $45 billion of budget outlay reductions for the budget year and each outyear until a balanced budget is reached. Subjects such reductions to the following guidelines: (1) elimination of redundant and outdated programs, including those whose missions can be accomplished by the private sector; (2) reduction of programs with excessive administrative costs or that can be consolidated with other programs; (3) elimination of programs that provide subsidies that benefit narrow special interest groups at the expense of the national interest; and (4) reduction or elimination of programs that have low priority in meeting a national interest criterion. Sets forth the procedure for implementation of the Commission's recommendations by the Office of Management and Budget, the President, and the Congress. Makes budget outlay reductions permanent. Establishes sequester provisions if the full amount of savings required by this Act have not been achieved in a session of the Congress.
United States · United States Congress · 3 February 1995
Superfund Recycling Equity Act of 1995 - Amends the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 to absolve persons (other than owners or operators) who arranged for the recycling of recyclable material from liability for environmental response actions. Deems transactions involving scrap paper, plastic, glass, textiles, or rubber (other than whole tires) to be arranging for recycling if the person who arranged the transaction demonstrates that the following criteria were met: (1) the recyclable material met a commercial specification grade and a market existed for the material; (2) a substantial portion of the material was made available for use as a feedstock for the manufacture of a new saleable product; (3) the material (or product to be made from the material) could have been a replacement for a virgin raw material; and (4) with respect to transactions occurring 90 days after this Act's enactment, the person exercised reasonable care to determine that the facility where the material would be managed by another was in compliance with Federal, State, or local environmental laws or regulations. Deems transactions involving scrap metal to be arranging for recycling if the person who arranged the transaction demonstrates that: (1) the criteria for scrap materials were met; (2) he or she complied with applicable standards regarding activities associated with the recycling of scrap metals; and (3) the scrap metal was not melted prior to the transaction. Deems transactions involving spent lead-acid, nickel-cadmium, or other batteries to be arranging for recycling if the person involved demonstrates that: (1) the criteria for scrap materials were met; and (2) he or she complied with applicable Federal environmental regulations or standards regarding such batteries. Makes the exemptions from liability under this Act inapplicable if the person: (1) had an objectively reasonable basis to believe at the time of the recycling transaction that the recyclable material would not be recycled or would be burned as fuel or for energy recovery or incineration or that the consuming facility was not in compliance with Federal, State, or local environmental laws or regulations; (2) added hazardous substances to the material for purposes other than processing for recycling; or (3) failed to exercise reasonable care with respect to the management of the material. Makes such exemptions inapplicable if the recyclable material contained polychlorinated biphenyls in excess of 50 parts per million or any new Federal standard.
United States · United States Congress · 3 February 1995
Expresses the sense of the Congress that the current link should be maintained between: (1) the levels of earnings allowed for blind individuals entitled to disability insurance benefits; and (2) the exempt amounts allowed for purposes of the social security earnings test for individuals who have attained retirement age.
United States · United States Congress · 2 February 1995
Congressional Members' Pension Limitation Act of 1995 - Amends Federal civil service retirement system (CSRS) provisions to prohibit deductions and withholdings from the pay of a Member of Congress with respect to any pay period beginning after: (1) such Member has completed five years of civilian service; or (2) the effective date of this Act in the case of a Member whose service exceeds five years. Removes provisions regarding eligibility for annuities of Members of Congress under CSRS. Requires the level of individual and Government contributions under the Thrift Savings Plan (TSP) to be the percentage of pay specified under existing law (up to ten percent and one percent plus matching contributions, respectively) for Members from whom deductions from pay may not be made by reason of this Act and who have 12 or fewer years of service. Prohibits Government and matching contributions to the TSP for Members with more than 12 years of service. Makes parallel amendments to provisions regarding the Federal Employees' Retirement System, including a prohibition on making deductions under such system from the pay of individuals who become Members on or after this Act's effective date. Excludes any period of service for which such deductions may not be made from the total period of service used in any computation of a basic annuity or other benefits based on service.
United States · United States Congress · 31 January 1995
Commercial Aviation Fuel Tax Repeal Act of 1995 - Amends the Internal Revenue Code to repeal the increase in tax on fuel used in commercial aviation scheduled to take effect after September 30, 1995.
United States · United States Congress · 30 January 1995
Teamwork for Employees and Managers Act of 1995 - Amends the National Labor Relations Act to allow employers to establish, assist, maintain, or participate in an organization or entity in which employees participate to address matters of mutual interest (including issues of quality, productivity, and efficiency) if such organizations or entities cannot negotiate, enter into, or amend collective bargaining agreements.
United States · United States Congress · 30 January 1995
First-time Homebuyer Affordability Act of 1995 - Amends the Internal Revenue Code to make the tax on prohibited transactions inapplicable to a qualified home equity participation arrangement. Describes such arrangement as one in which the eligible participant in an individual retirement plan directs the plan trustee to acquire an ownership interest in all or part of any dwelling unit which within a reasonable period of time is to be used as the principal residence for a first-time homebuyer. Requires such ownership interest to be a fee interest which requires full repayment. Describes the first-time homebuyer as an eligible participant or a qualified family member (child, parent, grandparent, or spouse) who had no present ownership interest in a principal residence during the 36-month period before the date of the arrangement. Allows the use of amounts in an individual retirement plan to make loans to purchase a home for a first-time homebuyer on behalf of an eligible participant or a qualified family member. Requires the repayment of first-time homebuyer loans within 15 years.
United States · United States Congress · 27 January 1995
Constitutional Amendment - Provides that no person who has been elected to the Senate two times shall be eligible for election or appointment to the Senate. Provides that no person who has been elected to the House of Representatives six times shall be eligible for election to the House. Authorizes States to establish limitations on the length of service of Members of Congress provided such limits do not exceed the limits set forth in this amendment.
United States · United States Congress · 26 January 1995
Amends the Immigration and Nationality Act to limit citizenship at birth to persons born in the United States to a mother who is a U.S. citizen or legal resident.
United States · United States Congress · 26 January 1995
A to Z Spending Cuts Plan - Reduces discretionary spending limits for FY 1995 in amounts equal to rescissions under this Act. Declares that reductions in outlays shall not be taken into account for sequestration purposes of the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act). Reduces discretionary spending limits for FY 1995 through 1998 by the amount of rescissions and additional savings under this Act. Expresses the sense of the Congress that each reduction in the discretionary spending caps caused by the spending cuts of this Act shall result in reduction in future spending for that particular program only.
United States · United States Congress · 20 January 1995
Pharmacy Compounding Preservation Act of 1994 - Amends the Federal Food, Drug, and Cosmetic Act to make such Act inapplicable to: (1) licensed retail pharmacies that compound drugs in conformance with applicable local laws regulating the practice of pharmacy and medicine; and (2) bulk drug products intended to be used by pharmacies for compounding, except to the extent that such provisions relate directly to the purity and quality of such bulk drug products.
United States · United States Congress · 18 January 1995
TABLE OF CONTENTS: Title I: Immigration and Law Enforcement Title II: Immigration Document Fraud Prevention Title III: Restrictions on Alien Eligibility for Welfare Immigration Reform Act of 1995 - Title I: Immigration and Law Enforcement - Increases: (1) FY 1996 personnel levels and funding for the Border Patrol; and (2) personnel levels for the Immigration and Naturalization Service (INS). (Sec. 103) Amends the Immigration and Nationality Act (Act) to provide for inservice training to familiarize Border Patrol personnel with the rights and varied cultural backgrounds of aliens and citizens. Authorizes FY 1996 appropriations. (Sec. 105) Increases FY 1996 personnel levels in: (1) the Wage and Hour Division with the Employment Standards Administration of the Department of Labor, and assigns such additional personnel to areas with high concentrations of undocumented aliens; and (2) the Investigations Division within INS, and assigns such additional personnel to investigate violations of the employer sanctions provisions of the Act. (Sec. 107) Increases the number of Assistant United States Attorney positions, and assigns such additional personnel to prosecute persons who harbor or bring illegal aliens into the United States. (Sec. 108) Prohibits the transportation of illegal aliens for employment purposes. (Sec. 109) Prohibits Federal financial assistance to localities whose officials refuse to cooperate in the arrest and deportation of illegal aliens. (sec. 110) Expresses the sense of the Congress that the Attorney General and the Secretary of State should initiate programs with Mexico and Canada to prevent and prosecute the smuggling of aliens into the United States. Title II: Immigration Document Fraud Prevention - Provides for: (1) the replacement of current alien registration cards with new counterfeit-resistant identification cards (which shall not be considered national identity cards) for all resident aliens eligible to work in the United States; (2) a national program to educate employers about their responsibilities under the Immigration and Nationality Act and the uses of such cards; and (3) a demonstration program to determine the feasibility of a computerized telephone worker verification system for employers. Authorizes FY 1996 and 1997 appropriations. Title III: Restrictions on Alien Eligibility for Welfare - Prohibits direct Federal financial benefits or social insurance benefits (including aid to families with dependent children, supplemental security income, food stamps, and public housing assistance) to aliens who are not lawful permanent residents. Prohibits unemployment benefits to aliens who have not been granted employment authorization under Federal law. Makes a limited exception from this prohibition for benefits under the old age, survivors, and disability insurance (OASDI) program, but prohibits taking into account unauthorized wages paid on or after enactment of this Act in crediting quarters of coverage for the OASDI program under the Social Security Act.
United States · United States Congress · 13 January 1995
Repeals the Davis-Bacon Act (an Act which requires that the locally prevailing wage rate be paid to various classes of laborers and mechanics working under federally-financed or federally-assisted contracts for construction, alteration, and repair of public buildings or public works). Repeals the Copeland Act (an Act which requires the Secretary of Labor to regulate contractors and subcontractors engaged in the construction or repair of public buildings, public works, or federally financed or assisted buildings or works).
United States · United States Congress · 11 January 1995
Social Security Trust Funds Integrity Act of 1995 - Amends titles II (Old Age, Survivors and Disability Insurance) (OASDI) and XVIII (Medicare) of the Social Security Act to restructure the Board of Trustees of the trust funds supporting the OASDI and Medicare programs, with each Board composed of members appointed by the President, by and with the advice and consent of the Senate, on a bipartisan basis at the recommendation of House and Senate leadership and the five largest organizations representing senior citizens. Makes it the duty of the Managing Trustee chairing the Board to invest trust fund amounts according to an annual investment plan the Board is required to formulate and submit to the President and the Congress. Removes restrictions on investment and disinvestment of amounts in such trust funds.
United States · United States Congress · 9 January 1995
Regulatory Transition Act of 1995 - Establishes a moratorium on Federal regulatory rulemaking actions from November 9, 1994, through June 30, 1995, with certain emergency exceptions for presidentially designated imminent threats to health or safety, or actions necessary for enforcement of criminal laws. Suspends until July 1, 1995, starting 30 days after enactment of this Act, the effectiveness of any such action taken or made effective after November 9, 1994, but before enactment of this Act. Extends for five months or until July 1, 1995, whichever is later, any statutory, regulatory, or judicial deadline for, relating to, or involving any action dependent upon, any regulatory rulemaking actions authorized or required to be taken before the end of the moratorium period. Requires the President to inventory and publish in the Federal Register a list of all covered regulatory rulemaking actions taken or made effective during the moratorium period but before the date of enactment of this Act. Excludes from the meaning of rule: (1) the approval or prescription, on a case-by-case or consolidated basis, for the future of rates, wages, corporation, or financial structures or reorganizations thereof, prices, facilities, appliances, services or allowances therefor, or of valuations costs, or accounting, or practices bearing on any of the foregoing; and (2) the granting of an application for a license, registration, or similar authority, the granting or recognition of an exception, the granting of a variance or petition for relief from a regulatory requirement, or other action relieving a restriction, or any action necessary to permit new or improved applications of technology. Authorizes civil actions by anyone adversely affected by any conduct of a Federal agency in violation of this Act.
United States · United States Congress · 4 January 1995
Amends the Internal Revenue Code to provide that the burden of proof with respect to all issues, in the case of any court proceeding, is on the Secretary of the Treasury. Requires the Secretary to identify in writing the specific kind or type of tax, and its specific implementing regulations, within 14 days upon the written request from any person made liable for such tax. Increases the limitation on the amount of recovery for civil damages for unauthorized collection actions by the Internal Revenue Service. Excludes such damages from gross income.
United States · United States Congress · 4 January 1995
Immigration Moratorium Act of 1995 - Restricts U.S. immigration levels to specified numbers of family-sponsored immigrants, employment-based immigrants, and refugees.
United States · United States Congress · 4 January 1995
Language of Government Act of 1995 - Declares English to be the official language of the U.S. Government. States that the Government has an affirmative obligation to preserve and enhance the role of English as the official language. Requires the Government to conduct its official business in English. Prohibits anyone from being denied Government services because he or she communicates in English.
United States · United States Congress · 4 January 1995
Amends Federal law to exclude the Civil Service Retirement and Disability Fund from the Federal and congressional budgets, and exempt it from any general budget limitation imposed by statute on U.S. budget outlays and from certain orders issued under the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act).
United States · United States Congress · 4 January 1995
Provides that any amount remaining in an official allowance of a Member of the House of Representatives at the end of the session of Congress or other period for which the allowance is made available shall be returned to the Treasury to be used for deficit reduction.
United States · United States Congress · 4 January 1995
COLA Equity Act - Amends the Omnibus Budget Reconciliation Act of 1993 to: (1) provide that the initial month for which a cost of living increase in military retired pay that becomes effective on December 1 of 1993, 1994, or 1995 is payable shall be March (currently, September) of the following year for persons who first became a member of a uniformed service before August 1, 1986; and (2) provide that such special rule shall apply only through FY 1996 (currently, FY 1998).
United States · United States Congress · 4 January 1995
Amends the Internal Revenue Code to allow taxpayers primarily engaged in a farming-related business an investment tax credit for a percentage of: (1) the costs of agricultural environmental property; and (2) the amount allowed as a deduction for soil and water conservation expenditures.
United States · United States Congress · 4 January 1995
Constitutional Amendment - Provides that no person who has been elected to the Senate two times shall be eligible for election or appointment to the Senate. Provides that no person who has been elected to the House of Representatives six times shall be eligible for election to the House.
United States · United States Congress · 4 January 1995
Constitutional Amendment - Provides for staggered four-year terms for Members of the House of Representatives. Prohibits persons from being elected to the House more than four times or more than three times to four-year terms. Prohibits persons from being elected to the Senate more than twice.
United States · United States Congress · 4 January 1995
Constitutional Amendment - Prohibits outlays for a fiscal year (except those for repayment of debt principal) from exceeding total receipts (except those derived from borrowing) for that fiscal year unless the Congress, by a three-fifths roll call vote of each House, authorizes a specific excess of outlays over receipts. Requires a three-fifths roll call vote of each House to increase the public debt. Directs the President to submit a balanced budget to the Congress. Requires the approval of a majority of each House by roll call vote before any bill to increase revenue may become law. Waives these provisions when a declaration of war is in effect. Waives these provisions when the United States is engaged in a military conflict which poses a threat to national security as declared by a joint resolution adopted by a majority of each House.
United States · United States Congress · 4 January 1995
Repeals rule XLIX of the Rules of the House of Representatives relating to concurrent and joint resolutions that increase or decrease the statutory limit on the public debt.
United States · United States Congress · 4 January 1995
Restricts the use of any travel award that accrues by reason of official travel of a Member, officer, or employee of the House of Representatives to official travel only.
United States · United States Congress · 6 October 1994
TABLE OF CONTENTS: Title I: Assuring Availability and Continuity of Health Coverage Subtitle A: Insurance Reforms Subtitle B: Benefits Subtitle C: Employer Responsibilities Subtitle D: Standards and Certification; Enforcement; Preemption Subtitle E: Multiple Employer Health Benefits Protection and Related Provisions Subtitle F: Definitions; General Provisions Title II: Removal of Financial Barriers to Access Subtitle A: Tax Deductibility for Individuals and Self- Employed Subtitle B: Premiums and Cost-Sharing Subsidy Program for Low-Income Individuals Title III: Medicaid Reforms Subtitle A: Treatment of Acute Care Benefits for AFDC and Non-cash Beneficiaries Subtitle B: Flexibility in Expenditures for Supplemental Benefits for AFDC and Non-cash Beneficiaries Subtitle C: Increased State Flexibility in Contracting for Coordinated Care Subtitle D: Additional Medicaid Reforms Title IV: Access Improvements Subtitle A: Expanding Access in Underserved Areas Subtitle B: Improved Access in Rural Areas Subtitle C: Academic Health Centers Subtitle D: United States-Mexico Border Health Commission Title V: Health Care Quality Enhancement Subtitle A: Quality Assurance Subtitle B: Primary Care Provider Education Title VI: Market Incentives to Containing Costs Subtitle A: Facilitating Establishment of Health Plan Purchasing Organization (HPPOs) Subtitle B: Preemption of State Benefit Mandates and Anti-Managed Care Laws Subtitle C: Malpractice Reform Subtitle D: Administrative Simplification Subtitle E: Fair Health Information Practices Subtitle F: Antitrust Subtitle G: Fraud and Abuse Subtitle H: Billing for Laboratory Services Title VII: Medicare Subtitle A: Increased Beneficiary Choice; Improved Program Efficiency Subtitle B: Savings Title VIII: Incentives to Purchase Long-Term Care Insurance Subtitle A: Establishment of Federal Standards for Long-term Care Insurance Subtitle B: Tax Treatment of Long-term Care Insurance Title IX: Department of Veterans Affairs Title X: Miscellaneous Savings Provisions Subtitle A: Automobile Insurance Coordination Subtitle B: Prefunding Government Health Benefits Contributions Bipartisan Health Care Reform Act of 1994 - Title I: Assuring Availability and Continuity of Health Coverage - Subtitle A: Insurance Reform - Part 1: Guaranteed Access to Health Coverage - Requires carriers that offer health insurance coverage in the individual-small group market in a fair rating area to make available qualified standard coverage and high-deductible coverage to qualifying individuals or small employers. (Sec. 1001) Exempts federally qualified health maintenance organizations (HMOs) and HMOs or managed care organizations recognized by State laws from the requirement to provide high-deductible coverage. Prohibits the offer of high-deductible coverage unless the carrier also makes standard coverage available with identical benefits and the individual or employee demonstrates that they have available assets equal to at least the deductible amount under the high-deductible coverage. Requires carriers to provide for coverage of benefits for items and services furnished throughout the fair rating area. Prohibits carriers from limiting coverage to portions of interstate metropolitan statistical areas (MSAs), requiring them to provide coverage throughout the entire MSA. Requires coverage offers to include a family coverage option. Prohibits carriers from requiring employers under group health plans to impose waiting periods for health coverage or require conditions on health coverage based on an individual's: (1) health status; (2) claims experience; (3) receipt of health care; (4) medical history; (5) receipt of public subsidies; or (6) lack of evidence of insurability. (Sec. 1002) Requires carriers to accept every small employer and qualifying individual that applies for enrollment during the required enrollment period. Provides that in the case of coverage offered by carriers or under group health plans that provide benefits through a managed care arrangement, the carriers or plans: (1) need not establish health care facilities throughout the fair rating area if the facilities are located in a manner that does not discriminate on the basis of health status of individuals residing in proximity to such facilities; and (2) may deny coverage under certain conditions. Permits carriers to deny coverage if they do not have the necessary financial reserves. (Sec. 1003) Prohibits carriers from denying, cancelling, or refusing to renew health coverage except on the basis of nonpayment of premiums or fraud or because they are not providing a particular coverage option in the market. Sets limitations on market exit and re-entry by carriers. Establishes similar conditions for cancellation or denial by multiemployer plans and multiple employer health plans. (Sec. 1004) Prohibits carriers or group health plans from excluding coverage with respect to services provided for preexisting conditions, except as provided by this Act. Provides for exclusion periods of up to six months subject to certain conditions. Makes exclusions inapplicable to pregnancy, newborns, adopted children, and certain individuals enrolled or enrolling during an open enrollment period. (Sec. 1005) Sets forth provisions regarding enrollment periods. Part 2: Provision of Benefits - Establishes: (1) standards for managed care arrangements and requirements and utilization review programs; and (2) requirements for arrangements with essential community providers. (Sec. 1014) Provides for the establishment of medical savings accounts. Makes the account beneficiary the owner of the account and includes distributions not used for qualified medical expenses in the beneficiary's gross income. Sets forth uses and limitations for such accounts. Excludes: (1) employer contributions to any medical savings account of an eligible employee from gross income (to the extent such contributions do not exceed the excess of premiums for standard coverage over the premiums for high-deductible coverage); and (2) health benefit payments made by employers from employment taxes. Part 3: Fair Rating Practices - Provides that the premium rate established by carriers for health insurance coverage in the individual-small group market may not vary except by the following: (1) age; (2) geographic area; (3) family class; (4) benefit design of coverage and by type of coverage option; and (5) permitted expense category. (Sec. 1022) Directs carriers and group health plans to accept and apply premium certificates issued under State premium assistance programs under title XXI of the Social Security Act (as established by this Act). (Sec. 1023) Requires the Secretary of Health and Human Services to request the National Association of Insurance Commissioners (NAIC) to develop a model risk adjustment system under which premiums applicable to coverage in the individual-small group market and coverage under small employer pooling arrangements and multiple employer welfare arrangements that are fully insured would be adjusted to take into account factors to predict the future need and efficient use of services by covered individuals in the market. Incorporates such model into a rule that specifies risk adjustment mechanisms. Requires each State to develop systems that conform with the Federal model. Part 4: Consumer Protections - Requires carriers and group health plans to provide information relating to their performance in providing coverage to specified individuals, including prospective enrollees. (Sec. 1032) Prohibits carriers from varying the commission or other remuneration to a person based on the claims experience or health status of individuals enrolled by or through such person. Subtitle B: Benefits - Sets forth provisions regarding standard coverage, preventive benefits to be covered without any deductible or cost-sharing, and high-deductible coverage. (Sec. 1105) Sets forth conditions under which supplemental benefits may be provided. (Sec. 1106) Requires carriers and group health plans to provide for an option under which children under 26 (without regard to whether they are students or disabled) will be treated as family members. Authorizes additional premiums for such option. (Sec. 1107) Includes coverage provided by Christian Science practitioners or in a Christian Science sanitorium within benefits under standard coverage. Subtitle C: Employer Responsibilities - Requires employers to make available to qualifying employees coverage under a group health plan that meets specified requirements, including: (1) an annual offering of coverage; (2) a choice of coverage and family coverage options; (3) an annual enrollment period; and (4) payroll withholding of premiums. (Sec. 1201) Provides that an employer is not required, subject to provisions regarding an equal contribution rule, to make any contribution to the cost of health coverage. Makes requirements regarding choice of coverage inapplicable if a group health plan is in effect as of July 1, 1994, and the employer makes contributions on behalf of employees under a collective bargaining agreement or similar contract. Excludes from this subtitle's requirements certain new and small employers. (Sec. 1202) Imposes an excise tax for failures of employers to comply with this subtitle. Subtitle D: Standards and Certification; Enforcement; Preemption; General Provisions - Directs the Secretary to request the NAIC to develop model regulations that specify standards with respect to this subtitle for carriers and health insurance coverage. (Sec. 1304) Imposes a tax on carriers that fail to comply with Parts 1 through 4 of Subtitle A and Subtitle B of this title unless a State has in effect a regulatory mechanism that provides sanctions. (Sec. 1305) Prohibits a single employer plan from offering health coverage other than through a carrier unless the plan has at least 100 eligible employees. Subtitle E: Multiple Employer Health Benefits Protections and Related Provisions - Part 1: Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to establish certification standards under title I (Protection of Employee Benefit Rights) for multiple employer welfare arrangements (MEWAs) providing health benefits. (Sec. 1401) Treats as employee welfare benefits plans, and exempts from certain restrictions on preemption, a MEWA which provides benefits consisting solely of specified medical care, which is not fully insured, and which applies for and receives a specified certification. Requires certain disclosures to participating employers. Requires certified MEWAs which are not fully insured to maintain excess-stop loss coverage and specified types of reserves. Sets forth corrective actions which such MEWAs' operating committees must take: (1) to avoid depletion of reserves; or (2) in connection with termination of the MEWA. Provides for review of actions by the Secretary of Labor with respect to denials of applications for, or suspensions or revocations of, such certifications. Requires, in cases where coverage is provided under a multiple employer health plan and more than ten percent of the participating employers are small employers, that the arrangement is maintained in the form of a small employer pooling arrangement. Sets forth requirements for such arrangements. (Sec. 1402) Revises ERISA with respect to: (1) a specified exemption from preemption; (2) treatment of single employer arrangements; and (3) treatment of certain collectively bargained arrangements. (Sec. 1405) Sets forth ERISA requirements relating to employee leasing health care arrangements (ELHAs). Provides for treatment of ELHAs as MEWAs, with certain exceptions. Sets forth special rules under which an ELHA may receive a MEWA certification. (Sec. 1408) Allows delegation to a State of some or all of the Secretary's enforcement authority with respect to MEWAs with certifications. Directs the Secretary to provide enforcement and technical assistance to the States with respect to MEWAs. Part 2: Simplifying Filing of Reports for Employers Covered under Multiple Employer Welfare Arrangements Providing Fully Insured Coverage Consisting of Medical Care - Directs the Secretary to prescribe an alternative method for the filing of a single annual report for all participating employers under MEWAs under which all coverage consists of medical care and is fully insured. Subtitle F: Definitions; General Provisions - Part 1: Definitions - Sets forth specified definitions. (Sec. 1905) Makes this title effective for plan years beginning on or after 1997 with respect to group health plans and as of January 1, 1997, with respect to carriers (for coverage other than under a group health plan). Part 2: Report and Recommendations on Health Coverage and Access - Provides that it is an objective of this Act to assure by 2002 that: (1) all eligible individuals in the United States have access to health coverage; and (2) at least 95 percent of such individuals have such coverage. (Sec. 1912) Requires the Secretary of Health and Human Services to report to the Congress on the extent to which eligible individuals have, or have access to, health care coverage. Title II: Removal Of Financial Barriers To Access - Subtitle A: Tax Deductibility for Individuals and Self-Employed - Amends the Internal Revenue Code to: (1) increase on a graduated basis the tax deduction for health insurance costs of self-employed individuals; (2) make the deduction permanent; (3) allow a tax deduction, regardless of whether the taxpayer itemizes other deductions, for health insurance costs of non-self-employed individuals not eligible to participate in any subsidized employer health plan; and (4) subject to taxation certain health benefits provided through cafeteria plans and flexible spending arrangements. Subtitle B: Premium and Cost-Sharing Subsidy Program for Low-Income Individuals - States that the amendments made by this subtitle and title III below provide for a transition from the current Medicaid system to a new system of acute care low-income assistance. (Sec. 2101) Amends the Social Security Act (SSA) to add a new title XXI providing for the establishment of new State programs under which, as a requirement for State participation in Medicaid, certain low-income eligible individuals who are not Medicare beneficiaries, SSI recipients, prison inmates, or unlawful aliens will be eligible for premium and cost-sharing assistance for use in obtaining qualifying coverage of the standard and preventive health benefits discussed above under title I of this Act. Sets forth specific requirements for such programs, allowing waivers in the case of any demonstration project which in the judgment of the Secretary of Health and Human Services is likely to assist in promoting the objectives of new SSA title XXI. Creates in the Treasury the Health Care Assurance Trust Fund to contain the savings resulting from this Act and other specified amounts for use in paying States operating subsidy and supplemental acute care benefits programs. Establishes a mechanism for financing such programs that is designed to be deficit neutral. Prohibits the use of funds appropriated to carry out new SSA title XXI to provide premium or cost-sharing assistance or supplemental acute care benefits under part B added below in connection with any abortion, except in cases where an abortion is necessary to save the life of the mother or where the pregnancy results from rape or incest. Title III: Medicaid Reforms - Subtitle A: Treatment of Acute Care Benefits for AFDC and Non-Cash Beneficiaries - Amends SSA title XIX (Medicaid) to: (1) establish Medicaid rules for benefits for acute medical services for AFDC recipients and non-cash Medicaid beneficiaries; (2) provide for the division of acute medical service benefits into core benefits and supplemental acute care benefits; (3) limit the amount of Federal financial participation for benefits for acute medical services for AFDC recipient and non-cash Medicaid beneficiaries; (4) condition Federal financial participation on State maintenance-of-effort; and (5) provide for the continuation of State Medicaid eligibility categories. Subtitle B: Flexibility in Expenditures for Supplemental Benefits for AFDC and Non-Cash Beneficiaries - Amends new SSA title XXI to require each State to establish a State supplemental acute care benefits program. Subtitle C: Increased State Flexibility in Contracting for Coordinated Care - Amends SSA title XIX to modify Federal requirements to allow States more flexibility in contracting for coordinated care services. Subtitle D: Additional Medicaid Reforms - Amends SSA title XIX to make various specified changes providing for: (1) a reduction in the amount of payment adjustments for disproportionate share hospitals; (2) elimination of the medically needy program for individuals not in an institution; and (3) elimination of the Medicaid pediatric immunization program, and establishment of alternative delivery programs. Title IV: Access Improvements - Subtitle A: Expanding Access in Underserved Areas - Amends SSA title XI to provide for community health authorities demonstration projects for providing access to cost-effective preventive and primary care and related services for various areas and populations, including low-income residents of medically underserved areas or for medically underserved populations. Amends the Public Health Service Act to authorize the Secretary to make grants to migrant and community health centers for the development of health service networks for serving high impact areas, medically underserved areas, or medically underserved populations within the area they serve. Subtitle B: Improved Access in Rural Areas - Part 1: Grants to Encourage Community Rural Health Networks - Directs the Secretary of Health and Human Services to make grants to an eligible State for the development of plans to increase access to health care services for residents of areas in the State designated as chronically underserved areas. Provides for technical assistance for entities establishing or enhancing a community rural health network in an underserved rural area. Provides financial assistance to entities to provide for the development and implementation of community rural health networks. Authorizes appropriations. Part 2: Incentives for Health Professionals to Practice in Rural Areas - Subpart A: National Health Service Corps Program - Amends the Internal Revenue Code to exclude National Health Service Corps Loan Repayments from gross income. (Sec. 4113) Increases the authorization of appropriations for the National Health Service Corps Scholarship and Loan Repayment Programs. Subpart B: Incentives Under Other Programs - Amends title XVIII (Medicare) of the Social Security Act to provide incentives under such Act to physicians in former shortage areas. Directs the Secretary to develop and publish a model law for adoption by States to increase the access of individuals residing in underserved rural areas to health care services by expanding the services which non-physician health care professionals may provide in such areas. Part 3: Assistance for Institutional Providers - Subpart A: Community and Migrant Health Centers - Extends and increases the authorizations of appropriations for migrant health centers and community health centers. Subpart B: Emergency Medical Systems - Revises title XII (Trauma Care) of the Public Health Service Act. Renames such title Emergency Medical and Trauma Care Services. Directs the Secretary to establish the Office of Emergency Medical and Trauma Care Services. Requires the Secretary to: (1) conduct and support research and demonstration projects; (2) foster development of appropriate modern systems of services; (3) assist States; and (4) coordinate and sponsor related activities. Requires that activities meet the unique needs of underserved inner-city and rural areas. (Sec. 4141) Authorizes grants to States to improve the availability and quality of emergency medical services through the operation of State offices of emergency medical services. Authorizes appropriations for emergency medical services. (Sec. 4142) Directs the Secretary to make grants to assist States in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments for injuries resulting from such emergencies. Authorizes appropriations. Subpart C: Assistance to Rural Providers Under Medicare - Amends title XVIII (Medicare) of the Social Security Act to: (1) increase by two the number of States eligible to participate in the essential access community hospital program; and (2) make other revisions concerning such program, including permitting the participation of hospitals in urban areas and the participation of hospitals in States adjoining participating States. Extends, by three years, the deadline for the development of prospective payment systems for both inpatient and outpatient rural primary care hospital services. (Sec. 4152) Defines a rural emergency access care hospital and rural emergency access care hospital services for purposes of title XVIII. Provides for the coverage of such services under part B (Supplementary Medical Insurance) of title XVIII. Subpart D: Demonstration Projects to Encourage Primary Care and Rural-Based Graduate Medical Education - Directs the Secretary to establish and conduct a demonstration project to increase the number and percentage of medical students entering primary care practice. Authorizes appropriations. Part 4: Hospital Affiliated Primary Care Center - Requires the Secretary to make grants and provide technical assistance to community hospitals for the development and operation of primary care services in medically underserved areas. Provides for a plan to allow primary care centers to retain income earned from operation under certain conditions. Authorizes appropriations. Subtitle C: Academic Health Centers - Directs the Secretary to study and report to the Congress on: (1) the feasibility and desirability of making payments to facilities that are not hospitals for the costs of graduate medical education attributable to residents trained at such facilities; and (2) determining the funding needs of health professions schools. Subtitle D: United States-Mexico Border Health Commission - Authorizes the President to conclude an agreement with Mexico to establish a binational commission to be known as the United States-Mexico Border Health Commission. (Sec. 4302) Declares that it should be the duty of the Commission to: (1) conduct a needs assessment in the U.S.-Mexican border area to identify and resolve health problems that affect the general population of the area; and (2) formulate recommendations for a fair method by which the government of one country could reimburse a public or private entity in the other country for the cost of a health care service furnished to a citizen of the first country who is unable to pay for the service. States that the Commission should establish at least two regional border offices in selected locations. Title V: Health Care Quality Enhancement - Subtitle A: Quality Assurance - Directs the Secretary to establish a Health Quality Advisory Council to develop an initial set of quality measures to be used to assess the quality of carriers, group health plans, and multiple employer welfare arrangements. Provides for auditing of such entities to determine compliance with certain quality measure and reporting requirements. Subtitle B: Primary Care Provider Education - Amends the Public Health Service Act to extend through FY 1999 authorized funding for training for certain health service providers. Title VI: Market Incentives to Containing Costs - Subtitle A: Facilitating Establishment of Health Plan Purchasing Organization (HPPOs) - Part 1: Health Plan Purchasing Organizations - Authorizes the establishment of health plan purchasing organizations (HPPOs) in accordance with this part. (Sec. 6002) Requires HPPOs to enter into agreements with carriers that desire to make health coverage available through HPPOs. (Sec. 6004) Requires HPPOs to offer enrollment for coverage for carriers. Authorizes HPPOs to impose administrative fees for enrollment. (Sec. 6006) Requires States to: (1) review the access of residents who are not employees of large employers or Medicare beneficiaries to obtain standard health insurance coverage through an HPPO; and (2) take actions to ensure that public or private entities provide access to residents who are unable to obtain such coverage. Part 2: 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 certified multiple employer health plans, fully-insured multiple employer welfare arrangements, and other specified plans described by ERISA. Part 3: Tax Exemption for High Risk Pools - Provides tax-exempt status to corporations or similar legal entities created by States or political subdivisions to establish risk pools to provide health insurance coverage to persons unable to obtain such insurance because of health conditions. Subtitle B: Preemption of State Benefit Mandates and Anti-Managed Care Laws - Preempts State laws that: (1) mandate health insurance benefits; (2) restrict managed care arrangements and utilization review programs; and (3) prohibit two or more employers from obtaining coverage that is fully-insured under multiple employer health plans. (Sec. 6105) Prohibits States from enforcing standards for health insurance coverage that differ from those established under title I of this Act. (Sec. 6106) Directs the Comptroller General to study and report to the Congress on the benefits and cost effectiveness of the use of managed care in the delivery of health care services. Subtitle C: Malpractice Reform - Part 1: Uniform Standards for Malpractice Claims - Makes this part applicable to any medical malpractice liability action brought in a Federal or State court and to any medical malpractice claim subject to an alternative dispute resolution (ADR) system that is initiated on or after January 1, 1996. (Sec. 6202) 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 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. 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. 6203) Authorizes States to develop specialty clinical practice guidelines to be certified by the Secretary. (Sec. 6204) 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. (Sec. 6206) Sets forth provisions regarding: (1) limits on attorney fees and other costs; and (2) statutes of limitations. (Sec. 6208) Specifies that in the case of a medical malpractice claim relating to services provided during labor or the delivery of a baby, if the health care professional or provider did not previously treat the claimant 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. (Sec. 6210) Provides that this part preempts State law, except for State law that imposes greater restrictions than those provided in this part. Part 2: Requirements for State Alternative Dispute Resolution Systems (ADR) - 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. 6222) Directs the Secretary to certify State ADR systems that meet such requirements on an annual basis. Requires 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. 6223) Directs the Secretary to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system. Part 3: Definitions - Sets forth definitions for this subtitle. Subtitle D: Administrative Simplification - Part 1: Standards for Data Elements and Transactions - Directs the Secretary to adopt standards for: (1) the electronic transmission of health information data; and (2) information transactions. Part 2: Requirements with Respect to Certain Transactions and Information - Lists transactions to be considered as standard transactions with respect to plan sponsors and HPPOs. (Sec. 6322) Requires certified health information security organizations to make available to Federal or State agencies, pursuant to a cost-type contract, any non-identifiable health information that is held by the service, consists of data elements that are subject to a standard under part 1, and is requested by such an agency to fulfill a requirement under this Act. (Sec. 6323) Directs the Secretary to establish a procedure under which a plan sponsor or health provider that does not have the ability to transmit standard data elements and does not have access to a certified health information network may comply with this part. Part 3: Miscellaneous Provisions - Requires the Secretary to establish standards and a certification procedure for health information network services. (Sec. 6333) Provides that this subtitle supersedes State law. Prohibits the enforcement of any State law that requires medical or health plan records to be maintained or transmitted in written rather than electronic form, except as provided by the Secretary. (Sec. 6334) Authorizes the Secretary to make grants for demonstration projects to promote the development and use of electronically integrated community-based clinical information systems and computerized patient medical records. Part 4: Assistance to the Secretary - Establishes the Health Care Information Advisory Committee to: (1) provide assistance to the Secretary in complying with the requirements imposed on the Secretary under this subtitle and subtitle E; (2) be responsible for advising the Secretary and the Congress on the status of the health information network; and (3) make recommendations to correct any problems that may occur in the network's implementation and operations and to refine and improve the network. Subtitle E: Fair Health Information Practices - Part 1: Duties of Health Information Trustees - Sets forth rights of individuals with respect to inspection of protected health information maintained by a health information trustee (specified entities, including health care providers, health benefit plan sponsors, and public health authorities). Makes exceptions to inspection rights if: (1) the information relates to mental health treatment notes or persons other than the protected individual; (2) the inspection could be expected to threaten an individual's life or personal safety; (3) the information could lead to the identification of a confidential source; (4) the information is used solely for administrative purposes or is duplicative; or (5) the information is compiled principally in anticipation of a legal proceeding. (Sec. 6402) Sets forth conditions under which a trustee must correct or amend information at the request of a protected individual. (Sec. 6404) Provides for: (1) recordkeeping with respect to health information disclosures; and (2) safeguards to ensure confidentiality and protection of information. Part 2: Use and Disclosure of Protected Health Information - Permits a health information trustee to use protected health information only for a purpose that is compatible with and related to the purpose for which the information was collected or received or for which the trustee is authorized to disclose under this subtitle. (Sec. 6411) Limits the use or disclosure of protected health information by a health information trustee to the minimum amount of information necessary. (Sec. 6412) Authorizes a health information trustee to disclose protected health information pursuant to an authorization executed by the individual who is the subject of the information if specified requirements are met. (Sec. 6413) Authorizes the disclosure of protected health information, subject to specified restrictions: (1) in connection with treatment and payment; or (2) for use in an action against or investigation of an individual relating to receipt of or payment for health care. (Sec. 6414) Sets forth provisions regarding the disclosure of protected health information to next of kin and others. (Sec. 6415) Establishes requirements with respect to the reporting of protected health information: (1) to a public health authority; (2) for a health research project; (3) in emergency circumstances; (4) for judicial and administrative purposes; (5) to a law enforcement agency; (6) pursuant to subpoena or warrant; and (7) to a health information service organization. Part 3: Access Procedures and Challenge Rights - Sets forth access procedures and challenge rights with respect to attempts to obtain protected health information. Part 4: Miscellaneous Provisions - Provides that if a protected individual pays a health information trustee for health care by presenting a debit, credit, or other payment card or by other electronic means, the trustee may only disclose protected health information as is necessary for the processing of the payment transaction. (Sec. 6442) Sets forth conditions under which protected health information may be released to persons outside the United States. (Sec. 6443) Directs the Secretary to establish standards with respect to the creation, transmission, receipt, and maintenance, in electronic and magnetic form, of documents required or authorized under this subtitle. (Sec. 6444) Sets forth duties of affiliated persons to whom health information trustees are authorized to provide protected health information. (Sec. 6445) Sets forth the rights of persons acting as agents or attorneys of protected individuals or on behalf of minors. Part 5: Enforcement - Authorizes persons whose rights under this subtitle have been knowingly or negligently violated to maintain civil actions. Sets forth penalty provisions. (Sec. 6453) Directs the Secretary to develop alternative dispute resolution methods for use by individuals, health information trustees, and others in resolving claims made in civil actions. (Sec. 6454) Amends the Federal criminal code to provide penalties for offenses related to protected health information. Part 6: Amendments to Title 5, United States Code - Requires Federal agencies that are health information trustees to promulgate rules to exempt systems of records within such agencies, to the extent that such systems contain protected health information, from certain provisions regarding access and other requirements with respect to an individual's records. Part 7: Regulations, Research, and Education; Effective Dates; Applicability; and Relationship to Other Laws - Directs the Secretary to prescribe regulations to carry out this subtitle. (Sec. 6471) Authorizes the Secretary to sponsor: (1) research relating to the privacy and security of protected health information; (2) the development of consent forms governing the disclosure of such information; and (3) the development of technology to implement standards regarding such information. Directs the Secretary to establish education and awareness programs to: (1) foster security practices by health information trustees; (2) train personnel of health information trustees respecting their duties with respect to such information; and (3) inform individuals and employers who purchase health care respecting their rights with respect to such information. (Sec. 6474) Prohibits States from enforcing any law that is inconsistent with certain requirements of this subtitle or imposes additional requirements with respect to health information trustees. Subtitle F: Antitrust - Directs the Attorney General to: (1) provide for the development of guidelines on the application of antitrust laws to the activities of health plans; and (2) establish a review process under which a health plan may request the Department of Justice's opinion on the plan's conformity with the Federal antitrust laws. (Sec. 6502) Requires the Attorney General to issue a certificate of public advantage to each eligible health care collaborative activity that complies with this section's requirements. Provides that such activity shall not be liable under the antitrust laws for conduct described in the certificate if such conduct occurs while the certificate is in effect. Directs the Attorney General to issue such a certificate if: (1) the benefits that are likely to result from the activity outweigh the reduction in competition that is likely to result; and (2) such reduction is necessary to obtain such benefits. Sets forth activity eligibility requirements. (Sec. 6503) Directs the Attorney General to report annually to the Congress as part of the annual budget oversight proceedings concerning the Antitrust Division of the Department of Justice. Requires the report to enable the Congress to determine how enforcement of antitrust laws is affecting the formation of efficient, cost-saving joint ventures and if the certificate of public advantage procedure has resulted in undesirable reduction in competition in the health care marketplace. Subtitle G: Fraud and Abuse - Directs the Attorney General to establish a 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 the delivery of and payment for health care in the United States; and (3) facilitate the enforcement of certain SSA title XI mandatory exclusion and other provisions applicable to health care fraud and abuse. Requires the Attorney General in carrying out such program to provide for coordination with law enforcement agencies, State Medicaid Fraud Control Units, State licensing agencies, as well as with third party insurers. (Sec. 6602) Authorizes additional appropriations for the Attorney General to investigate allegations of health care fraud and otherwise carry out the program established above. (Sec. 6603) Creates in the Treasury the Anti-Fraud and Abuse Trust Fund consisting of Federal health anti-fraud and abuse penalties for use in: (1) carrying out the program above; (2) supporting educational activities to prevent the occurrence of violations of anti-fraud and abuse laws; and (3) repaying beneficiaries for cost- sharing. (Sec. 6611) Amends SSA title XI to revise current sanctions for health care fraud and abuse, among other changes, providing for: (1) mandatory exclusion from participation in Medicare and State health care programs of any individuals convicted of a felony relating to fraud or the unlawful manufacture, distribution, prescription, or dispensing of a controlled substance; and (2) establishment of a minimum period of exclusion for certain individuals and entities subject to permissive exclusion from Medicare and State health care programs. (Sec. 6615) Amends SSA title XVIII to modify the limitations on physician self-referral. (Sec. 6616) Directs the Comptroller General to study and report to the Congress on the costs incurred by eligible organizations with risk-sharing contracts of complying with the requirement of entering into a written agreement with an entity providing peer review services with respect to services provided by the organization. (Sec. 6621) Amends the Federal criminal code to provide for: (1) penalties for health care fraud, including making it a felony; (2) rewards for information leading to prosecution relating to health care fraud; and (3) broadened application of mail fraud statute provisions. (Sec. 6631) Amends SSA titles XI and XVIII to authorize the issuance of advisory opinions by the Secretary according to specified guidelines. (Sec. 6641) Requires each State to establish and maintain a State agency to act as a Health Care Fraud and Abuse Control Unit for: (1) investigating and prosecuting violations under any Federally-funded or mandated health care program relating to fraud under State laws; (2) reviewing complaints of abuse or neglect involving patients of facilities receiving Federal payments and, where appropriate, investigate and prosecute such complaints; and (3) providing for the collection, or referral for collection, of overpayments made under any such program and found by the Unit. Subtitle H: Billing for Laboratory Services - Amends the Public Health Service Act to make it unlawful for any person who furnishes ancillary health services to present a bill or demand for payment to any person other than the patient receiving such services, with specified exceptions. Exempts ancillary health services for which payment may be made under Medicare. (Sec. 6701) Defines "ancillary health services" as clinical laboratory services, diagnostic x-rays and other diagnostic tests, durable medical equipment, and physical therapy services. Sets forth conditions under which a person who furnishes ancillary health services may present a bill or demand for payment to specified entities other than the patient. Imposes civil penalties for repeated and knowing demands for payment in violation of this subtitle. Provides for other sanctions for such violations, including the suspension of laboratory certifications and exclusion from participation in Medicare programs. Title VII: Medicare - Subtitle A: Increased Beneficiary Choice; Improved Program Efficiency - Amends SSA title XVIII to revise provisions for payments to health maintenance organizations (HMOs) to: (1) provide for the use of metropolitan statistical areas to determine adjusted average per capita cost; (2) require the Secretary to develop additional specified model packages of health benefits providing coverage for catastrophic illness, prescription drugs, and preventive services which an HMO may provide at its option; and (3) make various specified changes in HMO membership requirements, including changes in associated waiver provisions, and enrollment periods. (Sec. 7002) Amends the Omnibus Budget Reconciliation Act of 1990 to permit Medicare supplemental policies in all States. Modifies Medicare supplemental policy provisions. (Sec. 7003) Includes notice of available HMOs and carriers offering Medicare supplemental policies in the annual notice of Medicare benefits mailed to Medicare beneficiaries. (Sec. 7004) Directs the Secretary to: (1) develop and submit to the Congress a proposal for legislation which provides for the voluntary enrollment of Medicare beneficiaries in private health insurance plans; (2) provide for a monthly payment to a qualified private health insurance plan on behalf of enrolled Medicare beneficiaries who choose to enroll in such a plan (with the enrollee paying any difference between the monthly premium charged under the plan and the amount paid for under Medicare for the enrollee's class, while maintaining budget-neutrality); and (3) take such steps as may be necessary to consolidate the administration of Medicare parts A (Hospital Insurance) and B (Supplementary Medical Insurance). (Sec. 7003) Includes notice of an individual's rights under State law with regard to the formulation of advance directives in the annual notice of Medicare benefits mailed to Medicare beneficiaries. Subtitle B: Savings - Amends Medicare provisions relating to Medicare part A to provide for reductions in: (1) the update for payments for inpatient hospital services; and (2) payments for capital-related costs for inpatient hospital services. (Sec. 7111) Amends Medicare part B provisions on payment for physicians' services to provide for: (1) use of cumulative performance standards; (2) treatment of default update; (3) use of real GDP to adjust for volume and intensity; (4) repeal of restriction on maximum reduction under conversion factor update adjustment provisions; and (5) reduction in the conversion factor for the physician fee schedule for 1995. (Sec. 7112) Provides for the imposition of coinsurance on laboratory services. (Sec. 7113) Amends the Internal Revenue Code to provide for an increase in the Medicare part B premiums for high-income individuals. (Sec. 7114) Amends Medicare to provide for: (1) the extension of the 25 percent part B premium; (2) a reduction in hospital outpatient services and home health services through the establishment of a prospective payment system; and (3) various specified changes with regard to Medicare as secondary payer. Title VIII: Incentives to Purchase Long-Term Care Insurance - Subtitle A: Establishment of Federal Standards for Long-Term Care Insurance - Amends SSA to provide for model standards incorporating specified requirements for sales practices, benefits, and other matters that long-term care insurance policies must meet. Establishes civil monetary penalties for violations. Requires the National Association of Insurance Commissioners to issue guidelines for endorsements of long-term care insurance policies, or that permit such policies to be offered for sale through the organization or association. Subtitle B: Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of long-term care insurance contracts as accident or health insurance contracts generally, with qualified long-term services treated as medical care, among other changes with regard to long-term care insurance. Subtitle C: Studies - Requires the Comptroller General to conduct a study on the feasibility of: (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their homes with a tax credit. (Sec. 8203) Directs the Secretary to conduct a study and report to the Congress on: (1) case management of current long-term care benefits; and (2) subacute care. Title IX: Department of Veterans Affairs - Authorizes each veteran residing in the United States, certain surviving spouses and children of such veterans (also living in the United States) who are not otherwise eligible for medical care under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), and family members thereof to be enrolled with a Department of Veterans Affairs (VA) health care plan. Requires the payment of appropriate premiums, deductibles, copayments, or coinsurance with respect to such family members. Continues the eligibility of family members after the death of the veteran originally enrolled. Directs the Secretary of Veterans Affairs (Secretary, for purposes of this title) to establish enrollment ceilings to limit the number of eligible individuals enrolling for such coverage. Requires conformity of such plans with health plan requirements set forth in this Act and inclusion of all the items and services in the standard coverage under this Act. Directs the Secretary to continue to provide to veterans authorized VA care and services which are not included in the standard coverage provided under this Act. Provides for the continuation in the VA of specialized disabled veteran treatment and rehabilitative needs and facilities and requires a report on such continuation from the Secretary to specified congressional committees. Allows such plans to offer supplemental health benefits and cost-sharing policies consistent with this Act. Provides a limitation with regard to veterans who elect not to enroll to obtain such coverage. Prohibits the imposition of a cost-share charge of any kind upon a veteran for the treatment of a service-connected disability that requires specialized treatment by the VA. Prohibits funds appropriated to carry out this title from being used to provide abortions except when necessary to save the life of the mother or when the pregnancy is the result of rape or incest. Prohibits the imposition of cost-sharing charges of any kind upon veterans who are disabled to a degree of ten percent or more, veterans released from service due to a service-connected disability, veterans receiving disability compensation from the VA, former prisoners of war, veterans of the Mexican border period or World War I, and veterans unable to defray the costs of such care. Directs the Secretary to establish rates for premiums and other applicable charges with respect to all other enrollees. Empowers the Secretary to recover from third parties the cost of providing such care and services if such care and services would have been required to be provided by such third party. Establishes in the Treasury the Department of Veterans Affairs Health Coverage Fund to be used for VA health plan payments and services. Preserves existing health care benefits for facilities not offering qualified health coverage under this Act. Authorizes the Secretary to organize VA health plans and facilities as plans and facilities offering qualified health coverage under this Act. Requires any health insurance program provided for Federal employees to include as an option enrollment to obtain VA coverage. Requires the Secretary to take appropriate steps to ensure the financial solvency and stability of the VA coverage and of the contractors and subcontractors providing services as part of such coverage. Preempts certain State action with respect to standards and requirements of such coverage. Requires VA health care facilities to serve as providers to individuals residing in a State that operates as a single payer system, with appropriate reimbursement. Authorizes the head official offering VA health coverage or the director of a VA health care facility to enter into agreements with health care plans, insurers, health care providers, and other entities to furnish or obtain any health-care resource. Provides certain other administrative and personnel flexibility to the Secretary in providing or obtaining such services. Directs the Secretary of the Treasury to: (1) credit to a special fund specified amounts for FY 1995 and 1996 to be used for providing VA health coverage under this Act; and (2) report to the Congress on the operation of the VA health care system with respect to national health care reform as set forth under this Act. Authorizes the Secretary to apply for and accept grants and other forms of assistance to meet the needs of special populations. (Sec. 9003) Makes veterans enrolled with a VA plan under this title eligible for nursing home care, outpatient care, and care provided to obviate the need for hospital admission. (Sec. 9004) Makes any herbicide-exposed veteran eligible for hospital and nursing home care for any disease for which the National Academy of Sciences has determined: (1) that there is a positive association between disease occurrence and herbicide exposure; (2) that there is evidence suggesting such an association, though the evidence is limited; or (3) that available studies are insufficient to permit a conclusion about the presence or absence of such an association. Limits the authorized length of such care for eligible veterans. (Sec. 9005) Extends the authority to provide priority outpatient health care to veterans for exposure to environmental hazards until October 1, 1998, for any disability which becomes manifest before October 1, 1996. (Sec. 9006) Directs the Secretary to report to the Congress on the desirability and feasibility of waiving any requirement for cost-sharing under a VA health plan in the case of medical care provided to a family member of a Persian Gulf War veteran for any disease or disability which may be related to such service. (Sec. 9007) Directs the Secretary, during FY 1995 through 1997, to carry out and report to specified congressional committees on a study of the effect of telemedicine on the delivery of VA health care services. (Sec. 9008) Directs the Secretary of Health and Human Services to develop and submit to the Congress a proposal for legislation which provides for obtaining VA health coverage for Medicare beneficiaries who are veterans. (Sec. 9009) Directs the Secretary to carry out a pilot program to reduce waiting times for patients seeking health-care services in VA outpatient clinics and the traveling distance to such clinics by providing for operation of approximately 20 new outpatient clinics around two VA medical centers. Authorizes appropriations for FY 1998 through 2004. Title X: Miscellaneous Savings Provisions - Subtitle A: Automobile Insurance Coordination - Requires individuals enrolled in a health plan to receive automobile insurance medical services exclusively through the health plan. Makes such services subject to all quality, cost containment, and anti-fraud and abuse provisions that apply generally to medical services provided by or through health plans. (Sec. 10002) Permits an individual and an automobile insurance carrier to agree that treatment for bodily injury sustained in an automobile accident shall be provided by other than the health plan through which such individual is enrolled. Authorizes States to require such carriers to make direct payment to health care providers for automobile insurance medical services that are covered by Medicare or Medicaid and an automobile insurance contract that provides for direct payment of medical services regardless of fault. (Sec. 10003) Requires carriers liable for payment for automobile insurance medical services to make payment to health plans to the extent of obligations under the contract. Grants federally funded health care plans first priority to receive payment pursuant to any obligation under an automobile insurance policy covering such medical services. (Sec. 10004) Directs States to establish systems for prompt payment for automobile insurance medical services by such carriers to health plans, including mechanisms for resolution of disputes. Requires sanctions to be prescribed for failures to comply with this subtitle's requirements. (Sec. 10005) Requires the Secretary of Health and Human Services to provide for allotments to States for administrative expenses in carrying out this subtitle. Subtitle B: Prefunding Government Health Benefits Contributions - Directs each Federal agency within the executive branch whose receipts and disbursements are not generally included in the totals of the Government budget submitted by the President, effective FY 1994 (or February 1, 1995, in the case of the agency with the greatest number of employees), to prepay the Government contributions which will be required in connection with providing health-benefits coverage for annuitants of such agency.
United States · United States Congress · 21 August 1994
TABLE OF CONTENTS: Title I: Grants for Correctional Facilities Title II: State and Local Law Enforcement Grants Title III: Protection Against Sexually Violent Predators Title IV: Eliminating Excessive and Redundant Appeals Title V: Reform of 'Exclusionary Rule' Title VI: Truth-In-Sentencing Title VII: Prison Work Required; Luxuries Abolished Title VIII: Improving Border Controls Title IX: Enhanced Gun Penalties Title X: Violent Crime Reduction Trust Fund Title XI: Mandatory Life Imprisonment for Persons Convicted of Certain Felonies Back-To-Basics Crime Control Act of 1994 - Title I: Grants for Correctional Facilities - Directs the Attorney General to make grants to States to construct, expand, and improve prisons and jails. Authorizes specified sums to each State without conditions imposed by the Federal Government, except requirements to comply with this title and to use such funds exclusively for the construction of prisons and jails. Authorizes appropriations. Sets forth formulas for the distribution of funds in FY 1995 and in FY 1996 through 1999 based on violent crimes reported by the States to the Federal Bureau of Investigation (FBI). (Sec. 102) Specifies that 25 percent of total funds appropriated under this title shall be allocated to each eligible State according to a formula which takes into account the percentage change in the time to be served by persons convicted of violent crimes. Directs that States which have achieved a truth in sentencing standard of violent criminals serving 85 percent of prison time assessed receive the incentive funds, subject to specified requirements. Title II: State and Local Law Enforcement Grants - Requires the Attorney General to make grants to States to increase the number of law enforcement officers in service. Authorizes specified funds, without conditions imposed by the Federal Government (except that the funds be used exclusively to increase the number of law enforcement officers in service). Requires States to allocate 80 percent of their grants to local government for use by local law enforcement, as nearly as possible in proportion to the populations served by such local law enforcement agencies (LEAs). Title III: Protection Against Sexually Violent Predators - Directs the Attorney General to: (1) establish guidelines for State programs to require a sexually violent predator to register a current address with a designated State LEA upon being released from prison or being placed on parole or supervised release; and (2) approve each State program that complies with the guidelines. Makes States that do not implement and maintain such programs ineligible to receive ten percent of the funds that would otherwise be allocated to the State in drug control and system improvement grants under the Omnibus Crime Control and Safe Streets Act of 1968. Requires: (1) the determination that a person is, or is no longer, a sexually violent predator to be made by the sentencing court after receiving a report by a board of experts on sexual offenses; and (2) each State to establish a board composed of experts in the field of the behavior and treatment of sexual offenders. Sets forth provisions regarding: (1) notification regarding the duty of an offender to register and to provide any new address to a designated State LEA and of a State prison official to obtain specified information; (2) the transfer of information to the State LEA and to the FBI; (3) quarterly verification of the released offender's address; (4) penalties for failing to register and keep the registration current; (5) termination of the obligation to register; (6) community notification concerning a predator required to register; and (7) immunity for good faith conduct by LEAs, their employees, and State officials. Title IV: Eliminating Excessive and Redundant Appeals - Amends the Federal judicial code to establish a one-year statute of limitations for habeas corpus actions brought by State prisoners. Vests authority to issue certificates for probable cause for appeal of habeas corpus orders exclusively in the courts of appeals. Permits denial on the merits of habeas corpus writs notwithstanding the failure to exhaust State remedies. Establishes a two-year statute of limitations for Federal prisoners filing for collateral relief. (Sec. 406) Sets forth special habeas corpus procedures in capital cases brought by prisoners in State custody who are subject to a capital sentence. Makes such procedures contingent upon: (1) a State establishing by rule of its court of last resort or by statute a mechanism for the appointment, compensation, and payment of reasonable litigation expenses of competent counsel in State post convictions and sentences have been upheld on direct appeal to such court or have otherwise become final; and (2) such rule or statute providing standards of competency for the appointment of counsel. Provides for a mandatory stay of execution during the post-conviction review initiated pursuant to this title. Details conditions which will cause such stay to expire. Prohibits a Federal court from entering a stay of execution or granting relief in a capital case unless specified conditions are met. Sets forth lime limits for determining petitions. Authorizes the State or Government to enforce such time limits by applying to the court of appeals or the Supreme Court for a writ of mandamus. Title V: Reform of 'Exclusionary Rule' - Amends the Federal criminal code to prohibit the exclusion of evidence obtained as a result of a search or seizure, in a proceeding in a court of the United States, on the grounds that the search or seizure was in violation of the Fourth Amendment of the Constitution if it was carried out in circumstances justifying an objectively reasonable belief that it was in conformity with such amendment. Makes the fact that evidence was obtained pursuant to and within the scope of a warrant prima facie evidence of the existence of such circumstances. Prohibits the exclusion of evidence, in a proceeding in a U.S. court, on the ground that it was obtained in violation of a statute, administrative rule or regulation, or rule of procedure unless exclusion is expressly authorized by statute or by a rule prescribed by the Supreme Court pursuant to statutory authority. Title VI: Truth in Sentencing - Amends the Federal criminal code to permit the Bureau of Prisons to add, in its discretion, additional time to a prisoner's sentence of up to 15 percent of the prisoner's term for unsatisfactory behavior. Prohibits a sentence from being reduced for satisfactory behavior to a term less than the original sentence nominally imposed. Title VII: Prison Work Required; Luxuries Abolished - Directs the Attorney General to implement and enforce regulations which: (1) mandate prison work for all able-bodied inmates in Federal penal and correctional institutions; and (2) prohibit the Government provision in inmates' cells of television, radio, telephone, stereo, or similar amenities. (Sec. 702) Amends the Higher Education Act of 1965 to prohibit awards of Pell grants to prisoners in Federal or State penal institutions. Title VIII: Improving Border Controls - Authorizes appropriations. Authorizes and directs the Attorney General to use such funds to permit the commander of the Border Patrol to increase by at least 6,000 the number of border patrol agent positions above the number of such positions as July 1, 1994. (Sec. 802) Amends the Immigration and Nationality Act to provide for expedited deportation and exclusion of criminal aliens. Prohibits reentry of an alien into the United States during the minimum period of confinement to which the alien was sentenced. Authorizes the Attorney General to prescribe special regulations for the registration and fingerprinting of aliens on criminal probation or parole. Expands the definitions of "aggravated felony." (Sec. 805) Sets forth deportation procedures for certain criminal aliens who are not permanent residents. Grants a U.S. district court jurisdiction to enter a judicial order of deportation at the time of sentencing against an alien whose criminal conviction causes such alien to be deportable under provisions relating to conviction of an aggravated felony if requested prior to sentencing by the U.S. Attorney. (Sec. 807) Restricts defenses to deportation for certain criminal aliens. Enhances penalties for failing to depart or reentering after a final order of deportation. (Sec. 810) Authorizes appropriations for a criminal alien information system. Title IX: Enhanced Gun Penalties - Amends the Federal criminal code to enhance penalties imposed upon persons convicted of using or carrying a firearm during and in relation to the commission of a felony. (Sec. 902) Sets a mandatory minimum sentence for unlawful possession of a firearm by a convicted felon, fugitive from justice, addict or unlawful user of a controlled substance, or transferor or receiver of a stolen firearm. (Sec. 903) Increases the general penalty for violation of Federal firearms laws. Title X: Violent Crime Reduction Trust Fund - Establishes a Violent Crime Reduction Trust Fund as a separate account in the Treasury into which shall be transferred savings realized from implementation of provisions of the Federal Workforce Restructuring Act of 1994. Sets forth provisions regarding: (1) transfers into, and appropriations from, the Fund; (2) annual reporting requirements on the status of the Fund; and (3) allocation of sums in the Fund. Extends authorizations of appropriations for fiscal years for which the full amount authorized is not appropriated. Title XI: Mandatory Life Imprisonment for Persons Convicted of Certain Felonies - Amends the Federal criminal code to provide for mandatory life imprisonment for persons convicted in Federal court of a serious violent felony if: (1) the person has been convicted (and the conviction has become final) on separate prior occasions in a Federal or State court of two or more serious violent felonies, or one or more serious violent felonies and one or more serious drug offenses; and (2) each serious violent felony or serious drug offense used as a basis for sentencing under this title, other than the first, was committed after the defendant's conviction of the preceding serious violent felony or serious drug offense. Sets forth provisions regarding: (1) persons subject to the criminal jurisdiction of an Indian tribal government; and (2) resentencing upon the overturning of a prior conviction. (Sec. 1102) Prohibits the court from reducing the sentence of a defendant unless specified conditions are met, including that defendant is at least age 70, has served at least 30 years in prison for the offense or offenses for which the defendant is currently imprisoned, and a determination has been made by the Director of the Bureau of Prisons that the defendant is not a danger to the safety of any other person or the community.
United States · United States Congress · 21 August 1994
Expresses the sense of the House of Representatives that a commemorative stamp should be issued in honor of Dr. Benjamin Elijah Mays, educator, civil and human rights nonviolent leader, and public theologian.
United States · United States Congress · 21 August 1994
Expresses the sense of the House of Representatives that the President should award Benjamin Elijah Mays the Presidential Medal of Freedom posthumously in honor of his distinguished career as an educator, civil and human rights nonviolent leader, and public theologian and his many contributions to the improvement of American society and the world.
United States · United States Congress · 20 August 1994
Commends the U.S. rice industry for its decision to establish an industry organization. Recognizes the success such decision will have in promoting the interests of the rice industry and the rice-consuming public.
United States · United States Congress · 8 August 1994
Reduces discretionary spending limits for new budget authority for FY 1995. Reduces adjusted discretionary spending limits for outlays for FY 1995 through 1998. Sets forth programmatic assumptions for such reductions.
United States · United States Congress · 4 August 1994
Sexually Violent Predators Act - Directs the Attorney General to: (1) establish guidelines for State programs to require a sexually violent predator (a person convicted of a sexually violent offense who suffers from a mental abnormality or personality disorder (condition) that makes the person likely to engage in predatory sexually violent offenses) to register a current address with a designated State law enforcement agency (agency) upon being released from prison, being placed on parole, or being placed on supervised release; and (2) approve each State program that complies with the guidelines. Makes a State that does not implement and maintain such a program ineligible to receive ten percent of the funds that would otherwise be allocated to it under the Drug Control and System Improvement Grant Program. Provides for reallocation of such funds to States in compliance. Requires: (1) the sentencing court to make the determination that a person is or is no longer a sexually violent predator after receiving a report by a board of experts on sexual offenses; and (2) each State to establish such a board. Directs a State prison officer, if a person required to register is anticipated to be released from prison, paroled, or placed on supervised release, to: (1) inform the person of the duty to register and to provide any change of address to a designated State agency in writing; (2) obtain the person's name, identifying factors, anticipated future residence, and offense history and documentation of any treatment received for the condition; and (3) require the person to read and sign a form stating that the duty to register has been explained. Requires the officer to forward the information to a designated State agency which shall enter the information into the appropriate State law enforcement record system, notify the appropriate agency with jurisdiction over the area in which the person expects to reside, and transmit the information to the Identification Division of the Federal Bureau of Investigation. Sets forth provisions regarding: (1) quarterly address verification; (2) notification of local agencies of address changes; (3) penalties for failing to register and keep registration current; (4) termination of the obligation to register; (5) community notification; and (6) immunity for good faith conduct under this Act.
United States · United States Congress · 3 August 1994
Expresses the sense of the Congress that the President is: (1) required to obtain the prior approval of the Congress before U.S. armed forces may undertake offensive military action against the military leadership of Haiti in accordance with United Nations Security Council Resolution 940; and (2) recognized as having the inherent authority to use such forces to protect or evacuate U.S. citizens from imminent danger or for humanitarian purposes.
United States · United States Congress · 19 July 1994
TABLE OF CONTENTS: Title I: General Provisions Title II: Federal Reform of Health Care Malpractice Title III: Requirements for ADR Medical Malpractice Fairness Act of 1994 - Title I: General Provisions - Sets forth provisions regarding definitions and the period of applicability of this Act. Title II: Federal Reform of Health Care Malpractice - Prohibits a health care malpractice action from being brought in any: (1) State court unless the claim that is the subject of the action has been initially resolved under an alternative dispute resolution (ADR) system certified by the Secretary of Health and Human Services (or, in the case of a State in which such a system is not in effect, under the alternative Federal system established under this Act); and (2) Federal court based on diversity of citizenship unless the claim has been initially resolved under the system that applied in the State whose law applies. Directs the Attorney General to establish an ADR process for the resolution of tort claims consisting of such claims brought against the United States. Prohibits an 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. Makes each defendant in such an action severally but not jointly liable. Directs that each defendant's fault be determined on the basis of the defendant's percentage of responsibility. Limits to $250,000 the total of noneconomic damages that may be awarded to a claimant and the claimant's family for losses resulting from the injury, regardless of the number of parties or actions brought with respect to the injury. Prohibits the award of punitive damages except in cases of gross or criminal negligence. Limits such awards against the manufacturer or seller of a medical product causing injury. Directs that any punitive damages awarded be: (1) paid to the State in which the action is brought or, in a case brought in Federal court, the State in which the health care services that caused the injury were provided; and (2) used for activities to assure the safety and quality of health care services. Sets forth provisions regarding: (1) reductions for contributions from collateral sources; (2) periodic payment of damages for future expenses; (3) a uniform statute of limitations; (4) attorney's fees and costs; (5) expert witness qualifications; (6) preemption; and (7) sovereign immunity and choice of law or venue. Title III: Requirements for ADR - Sets requirements for State ADR systems. Provides for the certification of State systems and the applicability of the alternative Federal system, as well as the treatment of States with an alternative system already in effect.
![Official portrait of Rep. Deal, Nathan [R-GA-9]](https://www.congress.gov/img/member/d000168_200.jpg)