United States · United States Congress · 22 January 1992
Amends the Emergency Unemployment Compensation Act of 1991 (Public Law 102-164) to add 13 weeks to the number of weeks of benefits payable under the emergency unemployment compensation program. Provides for a total number of weeks of such emergency benefits as follows: (1) 33 weeks (currently 20) in higher unemployment States (with a total unemployment rate of nine percent or higher or an adjusted insured unemployment rate of five percent or higher, for specified periods); and (2) 26 weeks (currently 13) for all other States. Extends to October 3, 1992, the expiration date of the emergency unemployment program (currently June 13, 1992). (Makes a conforming amendment extending provisions for unemployment insurance benefits for certain railroad workers during periods of high national unemployment.) Requires that the provisions of (and amendments made by) this Act be treated as emergency requirements designated by the President and the Congress under the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act). Requires that any amount of new budget authority, outlays, or receipts resulting from the provisions of (and amendments made by) this Act not be considered for any purpose under the Balanced Budget and Emergency Deficit Control Act of 1985.
United States · United States Congress · 3 January 1992
Amends the Railroad Retirement Solvency Act of 1983 to make permanent the transfer to the Railroad Retirement Account of income tax revenues attributable to the taxation of tier II railroad retirement benefits.
United States · United States Congress · 3 January 1992
Emergency Community Development Act of 1991 - Title I: Temporary Assistance for Community Development Activities - Authorizes the Secretary of Housing and Urban Development to make grants to States, local governments, and Indian tribes for community development assistance. Authorizes appropriations. Title II: Housing Programs - Authorizes funds, in addition to other specified authorizations, for: (1) public housing vacancy reduction; (2) the National Homeownership Trust; and (3) the Flexible Subsidy Fund. Title III: Single Family Mortgage Insurance - Amends the National Housing Act with regard to single family mortgage insurance to prohibit a limitation on financed closing costs. Directs the Secretary to establish single premium payments for refinanced mortgages. Title IV: Rural Housing - Authorizes and increases funding for: (1) insured or guaranteed rural housing loans; (2) supplemental grants for remote rural housing; (3) housing improvement loans; (4) rural housing loans for elderly, handicapped, or low-income persons; (5) housing for rural homeless and migrant farmworkers; and (6) rental assistance payment contracts. Title V: Homeless Assistance - Authorizes and increases funding for: (1) Federal Emergency Management Agency emergency food and shelter grants; (2) emergency shelter grants; (3) the supportive housing demonstration program; (4) supplemental assistance for facilities to assist the homeless; and (5) section 8 assistance for single room occupancy dwellings. Title VI: Department of Housing and Urban Development Administration - Exempts multifamily project assistance from certain certification of limitation provisions under specified circumstances. Authorizes appropriations for multifamily housing mortgage insurance regional, field, or zone staff. Title VII: Financial Institutions Housing Provisions - Authorizes appropriations for the Federal Home Loan Banks' affordable housing program.
United States · United States Congress · 3 January 1992
Amends the Internal Revenue Code to allow an individual a tax credit for State or local sales taxes and interest paid in connection with the purchase, after December 31, 1991, of a domestically-produced automobile for personal use.
United States · United States Congress · 3 January 1992
Amends the Internal Revenue Code to allow a deduction for personal interest on loans used to purchase new passenger motor vehicles and small trucks wholly assembled in the United States.
United States · United States Congress · 25 November 1991
Consumer Products Safe Testing Act - Declares the policy that Federal departments and agencies shall encourage the development and use of product testing procedures that accurately reflect the acute health effects on humans of certain products, including consumer products and products containing hazardous or toxic substances, but which do not rely upon animals. Directs each Federal department or agency head (head), within one year, to: (1) review and evaluate any regulation, guideline, or recommendation issued by such department or agency which requires, recommends, or encourages the use of the Draize or other animal acute toxicity test for the purpose of evaluation of the safety of a regulated product; (2) review and evaluate nonanimal alternatives with the potential for partial or full replacement of the products regulated; and (3) promulgate regulations, guidelines, or recommendations that specify that a nonanimal acute toxicity test or battery of tests (NATT) should be used instead of an animal acute toxicity test unless that head determines that the NATT is less likely to predict the acute health effects on humans of a product than the animal acute toxicity test. Requires the appropriate head, if a determination is made that no NATT is as likely to predict the human reaction to the regulated product as the Draize or other animal acute toxicity test, to publish in the Federal Register an explanation of all options considered and the justification for continuing the animal acute toxicity test, which shall be subject to public comment. Provides for periodic review of animal acute toxicity testing regulations. Makes this Act inapplicable to regulations, guidelines, or recommendations related to medical research.
United States · United States Congress · 22 November 1991
Low-Income Housing Revitalization Act - Amends Internal Revenue Code (IRC) provisions relating to the low-income housing credit to increase the credit from four percent to nine percent with respect to new buildings that are federally subsidized. Extends the low-income housing credit permanently. Amends IRC accounting provisions to exempt low-income housing credit activities from limitations on passive losses. Revises the accelerated cost recovery system in connection with low-income residential rental property to reduce the applicable recovery period from 27.5 to 20 years. Disallows an income tax deduction for any expense relating to residential rental units unless such units are suitable for occupancy. Excludes deductions for business expenses, interest on indebtedness, and taxes from calculations to determine the passive loss limitation in connection with rental real estate activity relating to a qualified low-income housing project in which a noncorporate taxpayer actively or materially participates.
United States · United States Congress · 21 November 1991
Federal Program Improvement Act of 1991 - Title I: Provisions Relating To The Medicare Program - Subtitle A: Durable Medical Equipment - Amends the Social Security Act to: (1) prohibit unsolicited telephone contacts from suppliers of items of durable medical equipment to Medicare (title XVIII of the Social Security Act) beneficiaries; (2) require suppliers to provide information to the Secretary of Health and Human Services (HHS) on sales and billing practices; (3) prohibit carrier forum shopping; (4) prohibit issuance of multiple provider numbers; (5) require a description of such items in forms explaining benefits; (6) require the Secretary to develop a standardized prescription for such items; (7) mandate adjustments to final payments amounts which the Secretary determines are not inherently reasonable; (8) require an advanced determination for decubitus care mattresses; (9) require the Secretary to report to specified congressional committees on implementation of advanced determination requirements; and (10) set forth miscellaneous study and reporting requirements respecting item definitions and quality standards, supplier costs, and items treated as prosthetics devices. Subtitle B: Secondary Payer Identification and Enforcement - Amends the Social Security Act to: (1) make changes to aid the identification of Medicare secondary payer situations and the recovery of erroneous payments from primary payers; and (2) set forth miscellaneous study and reporting requirements respecting carrier recovery efforts and contractor eligibility requirements. Title II: Customs Overtime Pay Reform - Revises the overtime pay system for U.S. Customs Service inspectors. Amends the Customs Procedural Reform and Simplification Act of 1978 to require the authorization for the Customs Service to specify the maximum amount available for payment of overtime. Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to terminate reimbursement of appropriations for overtime costs. Requires a General Accounting office study and report to specified congressional committees on overtime costs. Title III: Availability And Use of Death Information Under The Old-Age, Survivors, And Disability Insurance Program - Amends title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act to: (1) eliminate State restrictions on the use of death certificates to correct OASDI and other Federal benefit program information; (2) provide for the provision of Social Security Administration death information to States free of charge; and (3) restrict the use of social security account numbers by States which have not contracted to participate in the program providing for the exchange of death information. Requires an HHS study and report to specified congressional committees on improvements in gathering and reporting such information. Title IV: PBGC Report On Employers With Underfunded Plans - Requires the Pension Benefit Guaranty Corporation to submit an annual report to the Congress on employers with underfunded pension plans.
United States · United States Congress · 21 November 1991
Taxpayer Bill of Rights Act of 1991 - Title I: Additional Safeguards to Protect Taxpayers' Rights - Subtitle A: Taxpayers' Advocate - Amends the Internal Revenue Code to establish in the Internal Revenue Service (IRS) the Office of Taxpayers' Advocate, headed by the Taxpayers' Advocate, appointed by the President, by and with the advice and consent of the Senate. Requires the Office to: (1) assist taxpayers in resolving problems with the IRS; (2) identify areas in which taxpayers have problems in dealings with the IRS; (3) propose changes in the administrative practices of the IRS to mitigate such problems; and (4) identify potential legislative changes which may be appropriate to mitigate such problems. Requires the Taxpayers' Advocate to annually report to specified congressional committees on Office activities. Requires the Commissioner of Internal Revenue to establish procedures requiring a formal response to all recommendations submitted to the Commissioner by the Taxpayers' Advocate. Authorizes the terms of a Taxpayer Assistance Order to require the Secretary of the Treasury to take certain actions (currently, only to cease or refrain from taking such actions). Subtitle B: Modifications to Installment Agreement Provisions - Requires prior notification to taxpayers under an installment agreement to pay tax liability before altering, modifying, or terminating such an agreement. Provides for administrative review of denials of requests for installment agreements. Suspends the failure to pay penalty during any period an installment agreement is in effect. Subtitle C: Interest - Extends from ten days to 21 days the period for which interest will not be imposed after notice and demand for payment, if such payment is less than $100,000. Provides for the abatement of interest in the case of an assessment due to the error or delay of an IRS managerial act. Increases the interest rate for overpayment of tax from two percent to three percent (making such rate equal to the interest rate for underpayment of tax). Waives interest on all overpayments refunded within 45 days after a return is filed. Subtitle D: Joint Returns - Requires separate deficiency notices in the case of a joint income tax return if the most recent data available to the IRS shows that such spouses did not file a joint return with each other. Allows the disclosure of collection activities to an individual requesting such information in the case of a joint return where such individual is no longer married to or resides in the same household as the other joint filer. Removes limitations on filing a joint return after filing separate returns. Subtitle E: Collection Activities - Authorizes the Secretary, if it is determined to be in the best interest of the taxpayer and the United States, to: (1) withdraw a notice of a lien; (2) return property that has been levied upon; and (3) offer compromises in civil or criminal cases. Requires the Secretary, at the request of the taxpayer, to make reasonable efforts to notify credit reporting agencies and financial institutions of such withdrawal notice. Subtitle E (sic): Erroneous and Fraudulent Information Returns - Requires payee statements to provide the phone number of the person providing payment. Establishes civil damages for the fraudulent filing of information returns. Requires the Secretary to take reasonable steps to corroborate the accuracy of an information return when making a determination of a deficiency by a third party, when such return is disputed by the taxpayer. Subtitle F: Modifications to Penalty for Failure to Collect and Pay Over Tax - Declares that a person shall not be liable for any penalty for failure to collect and pay over tax if such person: (1) is not a significant owner, or highly compensated employee of the trade or business; (2) notifies the Secretary within ten days after such failure; and (3) such notification was before any notice by the Secretary with respect to such failure. Requires the Secretary to disclose certain information where more than one person is liable for a penalty. Subtitle G: Awarding of Costs and Certain Fees - Repeals the "substantially justified" test for determining whether a taxpayer may recover costs and fees incurred as part of an administrative or court proceeding. Provides for the awarding of reasonable litigation or administrative costs to a prevailing party who represents himself in an administrative or court proceeding. Makes IRS employees personally liable in certain cases. Provides that any failure to agree to an extension of time for the assessment of any tax shall not be taken into account in determining whether a prevailing party has exhausted all administrative remedies. Subtitle H: Other Provisions - Revises provisions on the required content of tax due, deficiency, and other notices. Provides for the treatment of returns prepared for or executed by the Secretary for purposes of certain tax penalties. Provides protection for taxpayers who rely on certain guidance published by the IRS. Title II: Form Modifications, Studies - Subtitle A: Form Modifications - Directs the Secretary to: (1) ensure that taxpayers are aware of permission to pay tax in installments, extensions of time for payment of tax, and compromises of tax liability; (2) improve procedures for taxpayers to notify the Secretary of changes in names and addresses; (3) include in a specified publication a section on the rights and responsibilities of divorced individuals; (4) ensure that employees are aware of their responsibilities under the Federal tax system and that the public is aware of penalties for failure to collect and pay over tax; and (5) notify taxpayers any payments that cannot be associated with any outstanding tax liability. Subtitle B: Studies - Requires the Secretary to report to the tax-writing committees on: (1) a pilot program for appeals of certain enforcement actions (including lien, levy, and seizure actions; (2) a study on ways to assist the elderly, physically impaired, foreign-language speaking, and other taxpayers with special needs to comply with IRS laws; (3) the scope and content of the IRS taxpayer-rights education program for its officers and employees; and (4) cases involving complaints about misconduct of IRS employees and the disposition of such complaints. Requires the Comptroller General to report to the tax-writing committees on: (1) a study of notices of deficiency; (2) the accuracy and clarity of 25 of the most commonly used IRS forms, notices, and publications; and (3) a study of IRS employee-suggestion programs.
United States · United States Congress · 21 November 1991
Haitian Refugee Protection Act of 1991 - Directs the President to: (1) assure the protection of Haitian nationals under U.S. control; and (2) reallocate at least 2000 federally funded FY 1992 refugee admissions to Haiti. Provides for temporary protected status for certain Haitian nationals.
United States · United States Congress · 21 November 1991
Calls upon the President, as part of the Uruguay Round General Agreement on Tariffs and Trade (GATT) talks, to initiate negotiations to make GATT compatible with the Marine Mammal Protection Act and other U.S. health, safety, labor, and environmental laws, including laws to protect the environment outside of the United States. Declares that the Congress will not approve legislation to implement any trade agreement (including the Uruguay Round of the GATT and the U.S.-Mexico Free Trade Agreement) that jeopardizes such laws, including the Federal Food, Drug, and Cosmetic Act and the Clean Air Act.
United States · United States Congress · 18 November 1991
Expresses the sense of the House of Representatives that: (1) there is a need for the development of a comprehensive, coordinated strategy to encourage investment in human and material resources, to harness our inventive genius to the marketplace, to secure the education and training of a competitive citizenry and workforce, and to stimulate cooperative efforts between the private and public sectors at all levels of business, education, and government; and (2) such a strategy will help the United States achieve its goal of being the strongest Nation on Earth economically and militarily, so that it remains the greatest Nation in support of human dignity, freedom, and democratic ideals.
United States · United States Congress · 12 November 1991
Amends the Internal Revenue Code to extend for one year the following expiring provisions: (1) the credit for increasing research activities; (2) the targeted jobs credit; (3) the tax exclusion for employer-provided educational assistance; (4) the authority to issue qualified small issue bonds to finance manufacturing facilities and farm property; (5) the itemized deduction for health insurance costs of self-employed individuals; (6) the authority to issue mortgage revenue bonds and mortgage credit certificates; (7) the rules on allocating research and experimental expenditures in determining income from sources within or without the United States; (8) the low-income housing credit; (9) the energy investment credit for solar and geothermal property; (10) the credit for clinical testing expenses for certain drugs for rare diseases or conditions; (11) the minimum tax exception for gifts of appreciated tangible property; and (12) the tax exclusion for employer-provided group legal services plans.
United States · United States Congress · 12 November 1991
Justice for Wards Cove Workers Act - Amends the Civil Rights Act of 1991 to remove a provision excluding from application of the Act any disparate impact case filed before March 1, 1975, and decided after October 30, 1983. (Wards Cove Packing Co. Inc. v. Atonio, 1989, held that, in cases brought under Title VII of the Civil Rights Act, the burden is on the plaintiff to prove an employer had no business necessity for a practice with discriminatory effects.)
United States · United States Congress · 7 November 1991
Budget Process Reform Act of 1991 - Amends the Congressional Budget Act of 1974 to: (1) eliminate the division of discretionary appropriations into three categories (defense, international, and domestic) for purposes of discretionary spending limits for FY 1993; and (2) consolidate them into a single limit for budget authority and outlay. Directs the Office of Management and Budget to recalculate any adjustments made to such spending limits before enactment of this Act under the sequestration provisions of the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act). Requires the President to report revised discretionary spending limits for FY 1993 to the Congress by the fifth day after enactment of this Act.
United States · United States Congress · 4 November 1991
Prohibits the President from recommending for a 12-month period in 1992 continuation of a waiver of human rights and emigration requirements for nondiscriminatory treatment (most-favored-nation treatment) for the Soviet Union under the Trade Act of 1974 unless a specified report is submitted to the Congress stating that the Soviet Union has: (1) terminated all military and economic aid to Cuba; or (2) will terminate such aid to it within a reasonable time. Provides for the termination of such waiver if such requirements are not met.
United States · United States Congress · 29 October 1991
1996 Atlanta Centennial Olympic Games Commemorative Coin Act - Provides for the minting and sale of commemorative gold and silver coins to support the 1996 Atlanta Centennial Olympic Games and the programs of the United States Olympic Committee.
United States · United States Congress · 24 October 1991
Health Insurance Reform and Cost Control Act of 1991 - Title I: Increase in Deduction for Health Insurance For Self-Employed Individuals - Amends the Internal Revenue Code to extend the current 25 percent tax deduction for health insurance costs of self-employed individuals through 1992, and to increase the deduction to 50 percent in 1993, 75 percent in 1994, and 100 percent in 1995 and thereafter. Title II: Improvements In Health Insurance For Small Employers - Subtitle A: Standards And Requirements of Small Employer Health Insurance Reform - Amends the Social Security Act to add a new title XXI (Health Insurance Standards) under part A (Small Employer Health Insurance Standards) of which the Secretary of Health and Human Services (HHS) is required to develop specific standards to implement the requirements outlined in the three successive paragraphs below and in part B (Prohibition of Discrimination Based on Health Status for Certain Services) of such new title as added below which health insurance plans provided by entities employing from two to 50 employees (small employer plans) must be certified as meeting in order to be issued. Requires each insurer to register with the Secretary and any applicable regulatory authority for each State in which it issues or offers a small employer plan. Specifies that no issuer may exclude from coverage any eligible employee or such employee's spouse or any dependent child to whom coverage is made available by a small employer. Requires, with respect to small employer plans, that insurers offering such plans guarantee that: (1) the same plans are available throughout the insurer's service area on a continuous, year-round basis; and (2) such plans are renewable, with specified exceptions. Requires a notice prior to expiration of the terms for renewal of the plan. Provides that except with respect to rates and administrative changes, such terms (including benefits) shall be the same as the terms of issuance. Requires that the period of renewal of each small employer plan be for a period of not less than 12 months. Details requirements with respect to the treatment of health maintenance organizations. Provides that an insurer may not offer to, or issue with respect to, a small employer a small employer plan with a term of less than 12 months. Provides that the premium index rate for any block of business of an insurer may not exceed the index rate for any other block of business by more than 20 percent, with specified exceptions. Requires small employer plan premiums within a block of business to be community-rated for a given geographical area, with limited adjustments for age and sex permitted under specified guidelines. Specifies that, in defining communities for rating purposes, no insurer may use a geographic area that is smaller than a metropolitan statistical area. Requires small employer plans to permit enrollment of (and compute premiums separately for) individuals based on specified beneficiary classes. Places restrictions on transfers of small employers among blocks of business. Requires that any variation in annual small employer plan premium increases be limited to five percent. Requires full disclosure of rating practices and other premium rate information when a small employer plan is offered to the employer. Requires annual actuarial certification of an insurer's compliance with the premium rate requirements of this paragraph for filing with the Secretary and any applicable regulatory authority. Requires small employer plans offered to contain a benefit package similar to the benefit package under Medicare (title XVIII of the Social Security Act), plus unlimited inpatient hospital services for children and specified pregnancy-related services, as well as the new preventive benefits added to the Medicare program by title V of this Act. Sets a single annual deductible of $250 per individual and $500 per family, indexed to annual increases in the contribution and benefit base. Makes deductibles inapplicable for preventive services provided consistent with any applicable periodicity schedules. Makes co-payments inapplicable for: (1) preventive services provided consistent with any applicable periodicity schedules; and (2) inpatient hospital services furnished to children. Sets an overall annual limit on deductibles and co-payments of $2,500 per individual and $3,000 per family, indexed in the manner described above. Preempts State mandates prohibiting the offering of the benefit package required to be contained in small employer plans. Directs the Secretary to provide for the establishment of a toll-free telephone information and complaint system which provides for: (1) a system for the receipt and disposition of consumer complaints or inquiries regarding compliance of small employer plans with the requirements outlined above; and (2) information to small employers about insurers in the local area that offer those plans that meet such requirements. Subtitle B: Tax Penalty on Noncomplying Insurers - Amends the Internal Revenue Code to impose an excise tax on: (1) insurers which issue small employer plans that do not comply with the requirements outlined above; and (2) small employers who self-insure for employee health benefits. Sets the amount of such excise tax for: (1) insurers at 25 percent of the gross premiums received from small employers in a year; and (2) small employers at 25 percent of the expenditures made for employee health benefits in a year. Subtitle C: Studies and Reports - Directs the Comptroller General of the United States to study and report to the Congress on the impact of the rating requirements for small employer plans outlined above on the availability and price of insurance offered to small employers along with recommendations for adjusting such requirements to eliminate variation in premiums associated with demographic factors. Title III: Improvements In Portability Of Private Health Insurance - Amends new title XXI (Health Insurance Standards) of the Social Security Act to add a part B (Prohibition of Discrimination Based on Health Status for Certain Services) under which all employer health plans (including self-insured plans) are barred from denying, limiting, or conditioning the coverage under (or benefits of) the plan with respect to standard health services based on the health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability, of an individual. Provides that group health plan exclusions for pre-existing conditions shall be limited to six months, except with respect to newborns. Reduces such six-month period by up to three months of a period of continuous coverage of an individual for services with respect to a pre-existing condition. Amends the Internal Revenue Code to impose the same excise tax as imposed above on insurers who violate a requirement of part A (Small Employer Health Insurance Standards) on insurers who violate a requirement of part B (Prohibition of Discrimination Based on Health Status for Certain Services). Title IV: Health Care Cost Containment - Establishes in HHS the National Health Care Cost Containment Commission to: (1) review and make recommendations to the Secretary on the optional payments required below; and (2) report annually to the President and the Congress on increases in health care costs. Authorizes appropriations. Directs the Secretary to establish maximum payment rates based upon existing Medicare payment methodologies, including the extra billing limits for physician services, that purchasers may elect to pay for health care services. Requires service providers to accept the rates as payment in full, subject to civil monetary penalty. Directs the Secretary to develop uniform claims forms for use by beneficiaries and providers and uniform reporting standards to be employed by providers. Title V: Medicare Prevention Benefits - Amends the Medicare program to add annual screenings for colon cancer for individuals over age 50 and for breast cancer for women over age 64, vaccinations for influenza and tetanus-diphtheria, and well-child care services as program benefits. Directs the Secretary to establish and provide for ongoing demonstration projects providing for the coverage of other specified preventive services under Medicare to determine whether to include the coverage of such services for all individuals enrolled under Mediare part B (Supplementary Medical Insurance). Requires reports to specified congressional committees describing the findings made under such demonstration projects and the Secretary's plans for future such demonstration projects. Authorizes appropriations. Requires an Office of Technology Assessment study to develop a process for the regular review of Medicare coverage of preventive services. Requires a report to the Congress on such study.
United States · United States Congress · 24 October 1991
Unremunerated Work Act of 1991 - Directs the Commissioner of the Bureau of Labor Statistics to: (1) conduct time use surveys of unremunerated work performed in the United States (including household, agricultural, and volunteer work and work related to child care and other care services, food production, and family businesses); and (2) calculate the monetary value of such unremunerated work, separately for men and women, and include such value in statistics used to determine the gross national product.
United States · United States Congress · 24 October 1991
Clean Water Act Research Amendments of 1991 - Amends the Federal Water Pollution Control Act to revise the authorized activities of the Administrator of the Environmental Protection Agency with respect to water pollution control and investigations. Establishes a National Water Quality Research Committee to advise the Administrator on research activities. Requires the Committee to report annually to the Congress on: (1) research conducted in the preceding year; (2) highest priority research needs for the following five-year period; (3) planned research activities; and (4) opportunities to coordinate Federal and State research. Establishes a Water Quality Monitoring Council to ensure the coordination of Federal and State surface and groundwater quality monitoring programs. Directs the Administrator to conduct a program of research and development of methods for the control of nonpoint sources of pollution. Requires the Administrator to: (1) conduct a national survey of data regarding bottom sediment contamination; and (2) conduct a program of research and development of methods for improved remediation and control of pollution problems resulting from contaminated sediments. Directs the Administrator to conduct a program of research and investigation concerning groundwater quality. Requires the Administrator to: (1) conduct a program of research and development to improve understanding of the status and trends of ecosystems and to develop improved predictive models upon which to base standardized protocols; and (2) issue protocols based on such program for use by States in conducting water quality assessments. Requires protocols to include requirements for monitoring rivers, streams, estuaries, coastal waters, and lakes. Directs the Administrator to conduct a research technology development and demonstration program to identify and demonstrate cost-effective preventive measures for sources of pollution in complex watersheds having a mix of land use types. Requires the Adminstrator to conduct a basic research, development, and demonstration program for wetlands. Revises provisions concerning grants for research and development to require the Administrator to establish a program to demonstrate practices for the prevention and control of industrial and municipal sources of water pollution. Authorizes the Administrator to make grants or enter into contracts with persons to demonstrate such practices. Sets forth conditions for the receipt of such assistance. Requires the Administrator to publish annual solicitations for proposals to demonstrate practices which may be effective in controlling sources of water pollution. Sets forth application and approval procedures. Limits the amount of Federal funding for projects. Authorizes appropriations. Authorizes appropriations to carry out this Act.
United States · United States Congress · 24 October 1991
Nuclear Testing Moratorium Act - Prohibits the Secretary of Energy from conducting any explosive nuclear weapons test during the one-year period following the enactment of this Act unless the President certifies to the Congress that the Soviet Union has conducted such a test during such period.
United States · United States Congress · 23 October 1991
Expresses the sense of the Congress that the President should: (1) encourage the Contracting Parties to the General Agreement on Tariffs and Trade (GATT) to support the world environment and world wildlife by discouraging trade in goods and services harmful to them; and (2) oppose any GATT action which impinges on the ability of the United States to protect them.
United States · United States Congress · 22 October 1991
Family Preservation Act of 1991 - Title I: Child Welfare Services - Amends part B (Child Welfare Services) of title IV of the Social Security Act to convert the Child Welfare program from an authorization to a capped entitlement program. Requires maintenance of State effort under such program. Sets forth a new formula for allotments to States under such program. Repeals provisions for incentive payments to States which maintain a foster care inventory, information system, and case review system, but requires States to provide such protections and other services designed to keep families together or reunify them, or to place children for adoption, with a legal guardian, or in some other planned, permanent living arrangement. Requires States to submit the following types of reports on child welfare services and expenditures: (1) pre-expenditure reports; (2) post-expenditure reports; and (3) comparative financial contributions reports. Requires the Secretary of Health and Human Services (HHS) to annually transmit to specified congressional committees a summary of the information contained in such comparative financial contributions reports. Requires such information to be made available to the public. Reserves funds for entitlement grants to States to plan for and provide child welfare services designed to strengthen and preserve families. Requires use of part of such funds to develop or expand specialized child welfare services programs for families in crisis due to substance abuse that: (1) emphasize comprehensive services geared to the whole family; and (2) support or expand availability of programs for pregnant women and programs that allow mothers (and other caretaker relatives) to reside with their children while receiving services or treatment. Requires uses of the remaining part of such funds to develop or expand: (1) service programs to help children, where appropriate, return to families from which they have been removed, or be placed for adoption, with a legal guardian, or in some other planned, permanent living arrangement; (2) preplacement preventive services programs to help children at risk of foster care placement to remain with their families; or (3) service programs for follow-up care for families to whom a child has been returned after a foster care placement. Reserves funds for grants to State court systems to assess and improve procedures in child welfare cases, in carrying out the Child Welfare Services program and part E (Foster Care and Adoption Assistance) of title IV of the Social Security Act. Sets forth application requirements and formulas for determining the amount of such grants for FY 1993 through 1997. Directs the Secretary of HHS to submit interim and final reports to the Congress on the information obtained from assessments conducted with such grants and the impact of such grant programs on State court procedures and functions. Requires each State to periodically compile a detailed directory of programs designed to keep families together or reunify them or place children permanently, identifying which of such programs provides specialized child welfare services to families in crisis due to substance abuse. Requires States to report on measures taken to comply with the Indian Child Welfare Act. Title II: Foster Care and Adoption Assistance - Amends title IV (Grants to States for Aid and Services to Needy Families with Children and for Child Welfare Services) of the Social Security Act to add a new part C, Comprehensive Service Projects, to grant States flexibility and resources to develop comprehensive and coordinated services designed to: (1) preserve and strengthen families with children at risk of placement outside their homes; (2) reunite children with their families expeditiously if an out-of-home placement is found to be necessary; and (3) place children in adoptive homes or other permanent arrangements in a timely fashion if reunification with their families is not appropriate. Permits any State to apply to the Secretary of HHS for permission to: (1) conduct a comprehensive service project in a selected area or areas; and (2) suspend certain child welfare services and foster care and adoption assistance requirements with respect to State activities in such area or areas during the project. Sets forth application requirements and administrative provisions for such projects. Prohibits the Secretary of HHS from requiring as a condition of approval of a project application: (1) the State to select any area or areas in which to conduct the project; or (2) the project to comply with any requirements not specified in the project authorization. Sets forth those requirements with which such a project must comply. Provides for determining the expenses for which a State might properly seek reimbursement, for purposes of calculating such grant amount. Authorizes the Secretary of HHS to increase such grant amount, to the extent appropriate, by taking specified factors into account. Sets forth requirements for notification to States of grant amounts, and for grant payments in equal quarterly installments. Prohibits a State from carrying out such a project in a manner that impairs the entitlement of any child to: (1) the foster care benefits he or she would have received if the Secretary had approved the State plan for the fiscal year and had not authorized the State to conduct such a project; or (2) any other benefit to which the child is legally entitled. Deems a State to have in effect an approved foster care and adoption assistance plan during the period in which it conducts such a project for purposes of State plan requirements under part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act. Requires States to report annually on funds expended under such projects to the Secretary of HHS and the Advisory Commission on Children and Families. Provides for administrative remedies for unsuccessful projects. Provides for project termination. Requires a State to discontinue the project at the end of a fiscal year: (1) if it has notified the Secretary that it intends to do so; or (2) if the Secretary has determined for the fiscal year that the State is not conducting the project in accordance with requirements and is not making satisfactory progress toward achieving the State plans, and the Secretary does not plan to pursue an administrative remedy with respect to the project. Makes abandoned children entering foster care eligible for foster care maintenance payments. Makes the adoptive parents of any such child with respect to whom foster care maintenance payments may be made eligible for adoption assistance payments. Makes technical revisions in the foster care maintenance payments program and the adoption assistance program to expand the removal from home requirement to include removal from legal custody. Provides for retroactive application of such new requirement under the adoption assistance program. Makes children whose adoption has been set aside by a court eligible for foster care maintenance payments. Makes the adoptive parents of any such child with respect to whom foster care maintenance payments may be made eligible for adoption assistance payments. Establishes a respite care program for foster parents with children who have special needs. Limits the expenses eligible for reimbursement under such program. Expands the definition of children with special needs, for purposes of the adoption assistance program, to include: (1) those children for whom information is known and available about their genetic or social history indicating a high risk of medical conditions or physical, mental or emotional handicaps (which makes it reasonable to conclude they cannot be placed for adoption without providing part E adoption assistance or Medicaid (title XIX of the Social Security Act) medical assistance; and (2) those children that have been adopted, that were under the care and responsibility of the State agency responsible for administering the State's part E programs prior to being adopted, and that have a mental, physical, or emotional handicap that either existed before the adoption but was not diagnosed until afterwards or first manifests itself after the adoption but is congenital or was caused beforehand. Includes relatives (as well as foster parents) who are prospective adoptive parents and with whom the child has significant emotional ties while in their care for purposes of an exception to the requirement that an effort be made to place special needs children with appropriate adoptive parents without providing adoption assistance or Medicaid assistance. Requires each State to submit to the Secretary of HHS the factors and conditions it uses to identify children with special needs, for purposes of the adoption assistance program, and any modifications to such factors and conditions. Directs the Secretary of HHS to establish an Advisory Committee on Foster Care Placement to study and report to the Secretary and the Congress on the implementation of specified requirements, under State plans for foster care and adoption assistance, that reasonable efforts be made: (1) prior to placement of a child in a foster home, to prevent or eliminate the need for removal of the child from the child's home; and (2) to make it possible for the child to return to the child's home. Provides Federal coverage of 90 percent of State costs in developing and installing statewide mechanized data collection and information retrieval systems which: (1) the Secretary determines are likely to enhance the administration of such programs; (2) are capable of interfacing with the State data collection system for information on child abuse and neglect; and (3) meet other specified requirements. Covers 50 percent of State costs for operation of such systems. Provides that all State expenditures for development, installation, and operation of such systems shall be treated as necessary for proper and efficient administration of the State plan, without regard to whether the systems may be used with respect to foster or adoptive children other than those on behalf of whom payments may be made for foster care maintenance or adoption assistance. Reduces, after three years, from 90 to 50 percent the Federal matching payment for development and installation of such systems. Defers a deadline for implementation of automated systems until one year after certain regulations are promulgated. Directs the Secretary to establish a work group, including representatives of specified organizations, to advise on planning and implementation of the system to be used for collection of data relating to adoption and foster care in the United States. Requires the State plan to provide for: (1) a triennial review of the amounts paid as foster care maintenance payments and adoption assistance to assure their continuing appropriateness; and (2) a report to the Secretary of HHS on the results. Requires that the dispositional hearing to determine the final status of a foster child: (1) occur within 12 months of his or her original placement, rather than the current 18 months; (2) determine and document the measures needed to enhance the likelihood of making the child legally eligible for adoption and of finding an adoptive home for the child, if the hearing determines that the child should be placed for adoption, and the specific measures which have been or need to be taken to make an adoptive placement or a finding that placement of the child in an adoptive family would be inappropriate, if the child is legally eligible for adoption. Revises the time frame for judicial determinations on voluntary placements. Sets forth case plan requirements for placement of children in out-of-State foster care, including a finding that the child needs services not available in the State. Requires annual review, with the child present, of the status of children in out-of-State foster care placements. Requires States to collect data on the numbers of children in out-of-State foster care placements. Requires a State, in order to receive payments for expenditures after FY 1994 for foster care maintenance payments made with respect to children placed in foster care outside the State, to conduct and submit a study to the Secretary of HHS, by the end of such fiscal year, identifying the number and common characteristics of such children and the reason why they were not placed in foster care in the State. Sets forth provisions with respect to the treatment of assets of youth participating in the independent living program. Eliminates the ceilings on Federal foster care payments to States and the States' authority to transfer unused foster care funds to the Child Welfare Services program. Directs the Secretary of HHS to: (1) establish an advisory committee; and (2) issue final regulations for training of staff of agencies responsible for administering foster care and adoption assistance programs and for training of foster and adoptive parents. Requires such committee to include representatives of public agencies and nonprofit organizations with an interest in child welfare. Directs the Secretary to annually publish information, on a State-by-State basis, on expenditures for, and the operation of, the Child Welfare Services program, the Foster Care and Adoption Assistance program, and Comprehensive Service Projects. Amends title IV of the Social Security Act to add a new part G, Child Welfare Review System. Directs the Secretary of HHS to establish such system to: (1) review each State child welfare program to assess whether the requirements of such Act are being carried out; (2) impose financial penalties in cases of substantial failure to comply; and (3) provide technical assistance to any such program. Requires the Secretary to complete such a review for each State program not less frequently than once every three years. Sets forth provisions relating to effects of noncompliance, suspension and recision of financial penalties, and administrative and judicial review. Requires that all State child welfare programs be reviewed at least once by the end of FY 1997. Prohibits the Secretary from reducing or withholding any payment or seeking any repayment from any State under part B or E by reason of a determination made in connection with specified reviews or audits for certain periods. Prohibits suspension of payments with respect to any claim for reimbursement 30 days after the Secretary of HHS receives the quarterly statement of expenditures that contains the report of the claim. Provides that within ten months after the Secretary takes any action to suspend payment with respect to such a claim, the Secretary shall: (1) determine the allowability of the claim; or (2) if unable to make such a determination, make payment with respect to the claim, subject to a later determination of allowability. Title III: Emergency Assistance - Amends the AFDC program to require States to provide emergency assistance to needy families with children, including services designed to prevent homelessness. Title IV: Social Services Block Grant - Amends title XX (Block Grants to States for Social Services) of the Social Security Act to authorize increased appropriations at specified levels under such program for FY 1993 through 1996 and at levels indexed to increases in the Consumer Price Index thereafter. Provides for the allocation to tribal organizations of program funds otherwise allotted to the State in which the Indians represented by such organization reside. Title V: Research, Demonstration, and Evaluation Activities - Amends part A (General Provisions) of title XI (General Provisions and Professional Standards Review) of the Social Security Act to require the Director of the Office of Technology Assessment (OTA) to establish an Advisory Commission on Children and Families (the Commission). Requires the Commission to collect and assess specified types of information in order to identify cost-effective approaches to protect and enhance the physical, mental, emotional, and financial well-being of children and their families. Directs OTA to report annually to the Congress on the Commission and its assessment. Requires the Commission to conduct, through contracts with independent research organizations, the following research and evaluation projects: (1) an evaluation of child welfare service programs, including intensive family preservation programs; (2) foster care evaluations; (3) longitudinal child welfare data bases, and studies of child welfare population dynamics; and (4) comprehensive service projects evaluations. Requires the Commission to conduct a study concerning child separation guidelines. Directs the Secretary of HHS to conduct the following research and evaluations: (1) a study (under contract with an independent research organization) to assess the prevalence and nature of risks to the safety of employees of child welfare systems; and (2) a three-year study (under contract with an organization with demonstrated appropriate experience) to examine methodologies for measuring the workloads of providers of child welfare services and community mental health services. Directs the Secretary of HHS to authorize child welfare demonstration projects concerning each of the following: (1) abandoned infants' permanent placement; (2) termination of parental rights; (3) child welfare worker training in U.S. areas that border on Mexico; (4) staff recruitment and retention; and (5) joint training for staff of child welfare, mental health, and juvenile justice agencies. Directs the Secretary of HHS to authorize demonstration projects to test the feasibility of eliminating income and resource requirements respecting foster care and adoption assistance payments. Directs the Secretary of HHS to provide technical assistance to States for: (1) interpreting and implementating parts B, C, and E; (2) disseminating information on innovative child welfare agencies; (3) correcting problems identified through Federal audits and reviews and carrying out corrective action plans under part E; (4) implementing the foster care and adoption data collection system; and (5) addressing other matters identified by such Secretary. Title VI: Miscellaneous Human Resources Amendments - Amends the AFDC program to give States the option of using retrospective budgeting without monthly reporting under AFDC. Increases the amount of stepparent income disregarded under AFDC. Amends the Family Support Act of 1988 to extend demonstration projects for evaluating model procedures for reviewing child support awards. Amends the Omnibus Budget Reconciliation Act of 1989 and the Omnibus Budget Reconciliation Act of 1990 to make technical corrections relating to human resource and income security provisions. Repeals the technical amendment made by the Omnibus Budget Reconciliation Act of 1990 with respect to the National Commission on Children. Title VII: Budget Compliance Provisions - Specifies the applicable cost estimate of this Act for purposes of the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act). States that the conversion by this Act of the Child Welfare program from an authorization to a capped entitlement program shall not be treated as a change in concept or definition under the Gramm-Rudman-Hollings Act.
United States · United States Congress · 21 October 1991
Medicaid Moratorium Amendments of 1991 - Amends the Technical and Miscellaneous Revenues Act of 1988 to: (1) delay until September 30, 1992, the issuance of regulations changing the treatment under the Medicaid program (title XIX of the Social Security Act) of voluntary contributions and provider-specific taxes; and (2) maintain current regulations that allow intergovernmental transfers as a source of a State's expenditures for which Federal matching funds are available under the Medicaid program. Directs the Secretary of Health and Human Services to submit to specified congressional committees a report on: (1) regulations to limit the use of voluntary contributions and provider-specific taxes to obtain Federal financial participation; (2) specific types of voluntary contributions and provider-specific taxes that may be used as sources of State expenditures for which Federal financial participation is available; and (3) any legislation that the Secretary believes is appropriate. Sets forth budget compliance provisions.
United States · United States Congress · 17 October 1991
Directs the Administrator of the Environmental Protection Agency (EPA), acting through the Office of Research and Development, to enter into an arrangement with the National Academy of Sciences to conduct a study of the environmental research basis for wetlands delineation. Requires the Academy to report the findings of the study to the Congress, along with recommendations for legislative and administrative actions. Authorizes appropriations. Expresses the sense of the Congress that the EPA should not adopt proposed revisions to the Federal Manual for Delineating Wetlands until six months after the Academy submits such report.
United States · United States Congress · 10 October 1991
Emergency Job Creation Appropriations Act, 1992 - Title I: Meeting Our Economic Problems Coming from Changing Conditions with Essential Productive Jobs - Directs the appropriate congressional committees to study the current economic crisis, with emphasis on long-term recovery and and a strong private sector based on Government/industry partnership, and present their findings to the Congress as expeditiously as possible for appropriate action. Declares that the Board of Governors of the Federal Reserve and the Federal Open Market Committee should take necessary actions to achieve and maintain a level of interest rates low enough to achieve significant economic growth and reduce the current level of unemployment. Makes appropriations for FY 1992, in order to create productive jobs and protect public investment, for various activities relating to: (1) Federal buildings; (2) interstate highways; (3) air transportation; (4) mass transportation; (5) rehabilitation of highway bridges crossing over Northeast corridor rail transportation properties; (6) railroad infrastructure and rights-of-way improvement; (7) veterans' medical facilities and services; (8) public housing modernization; (9) community development; (10) international trade competition; (11) local economic development; (12) small business loans and investments; (13) small business oriented employment or national resources development programs; (14) parks and recreational areas and facilities; (15) the National Forest System; (16) Indian health facilities; (17) Fish and Wildlife Service facilities; (18) rural development and resource conservation, including rural water and waste disposal; (19) soil conservation, including watershed and flood prevention operations; (20) Federal, State, and local prison modernization; (21) water resource and hydroelectric power, flood control, shore protection, harbor channel and navigable waterway maintenance; (22) reclamation and irrigation projects; (23) Federal agricultural research facilities; (24) tree-planting and other natural resources development programs; (25) historic properties restoration; and (26) Bureau of Land Management facilities. Makes appropriations for FY 1992 to the Department of Labor to provide productive jobs for unemployed individuals under specified conditions, in various types of public service employment. Provides for allocation of such funds to eligible local governments, rural area concentrated employment program grantees, or States. Makes appropriations in additional amounts for FY 1992 for: (1) employment and training services; (2) grants to States for unemployment insurance and employment services; (3) higher education academic and research facilities; and (4) the Federal Emergency Management Agency's emergency food and shelter program. Makes appropriations for FY 1991 for: (1) construction and modernization of military family housing; (2) low-income energy conservation weatherization activities (in an additional amount) and (3) Federal motor vehicle procurement. Title II: Technical Provisions - Provides that no part of any appropriation contained in this Act shall remain available for obligation beyond the current fiscal year unless expressly so provided herein.
United States · United States Congress · 9 October 1991
USHealth Program Act of 1991 - Title I: Provision And Expansion Of Hospital, Medical, And Preventive Services To Cover All Americans Either Through A USHealth Program Or Qualified Employer Health Plans - Subtitle A: Coverage of Elderly, Disabled, Retired, and Other Non-Employed Individuals Through a USHealth Program - Part 1: Eligibility - Amends title XVIII (Medicare) of the Social Security Act to establish the USHealth Program (Program) for the provision of hospital as well as long-term care and certain preventive benefits to U.S. citizens and permanent U.S. residents. Provides for incorporating into the Program for hospital care: (1) aliens who are employed with a foreign government or an international organization and reside in the United States; and (2) foreign visitors. Provides for low-income assistance under the Program. Repeals provisions of various other benefit programs rendered superfluous by the comprehensive nature of the Program. Makes conforming amendments to the Railroad Retirement Act of 1974. Provides transitional Medicaid (title XIX of the Social Security Act) coverage of pregnant women and infants up to 185 percent of the Federal poverty level. Increases to 100 percent the Federal medical assistance percentage for additional populations covered. Part 2: Benefits - Revises the scope of benefits under Medicare part A (Hospital Insurance). Lists under such part Program benefits which comprise: (1) inpatient hospital services; (2) medical and other health services; (3) comprehensive outpatient rehabilitation facility services and home intravenous drug therapy services; (4) alcohol and drug abuse rehabilitation services; (5) outpatient mental health services; and (6) home health services. Changes payment provisions. Expands covered medical and other health services under Medicare to include the following preventive services as Program benefits: (1) prenatal care; (2) well-child care; (3) screening mammographies; (4) screening pap smears; (5) family planning services and supplies furnished to individuals of child-bearing age who desire such services and supplies; (6) colorectal cancer screening services; (7) counseling to modify risk factors for heart disease, cancer, and stroke, including dietary measures, weight reduction, smoking restriction, and physical conditioning; and (8) such other health services as the USHealth Board finds are cost-effective in the prevention of disease or illness. Directs the USHealth Board to establish: (1) frequency schedules for the provision of certain preventive services listed above; and (2) standards for entities furnishing preventive service under Medicare who otherwise are not qualified to provide other services under Medicare. Includes prescription drugs within such expanded coverage as Program benefits. Sets forth certification standards for comprehensive outpatient rehabilitation facility services, outpatient physical therapy services, outpatient speech pathology services, and home intravenous drug therapy services. Eliminates all mandatory benefits under the Medicaid program. Part 3: Payments For Services - Sets forth payment rules for inpatient hospital services, medical and other health services generally, prescription drugs, and home intravenous drug therapy services, which include no co-payments for inpatient hospital services. Directs the USHealth Board to: (1) establish a program to assure appropriate prescribing and dispensing practices; (2) prepare and update annually a guide for physicians concerning wholesale prices of commonly prescribed drugs; (3) establish a fee schedule for home intravenous drug therapy services; and (4) adjust Medicare payment rates for inpatient hospital services and physicians' services to reflect changes in the population served and other special circumstances. Requires the Prospective Payment Assessment Commission to conduct a study concerning appropriate adjustments in payments for inpatient hospital services to account for reduced hospital costs resulting from Medicare payment of prescription drugs and home intravenous drug therapy services. Provides protection against out-of-pocket expenses which exceed specified individual and family catastrophic limits. Prohibits service providers from imposing charges when a catastrophic limit has been reached. Details provisions with respect to the treatment of health maintenance organizations (HMOs). Repeals Medicare payment rules for outpatient mental health services. Subtitle B: Coverage of Employed Individuals Through Qualified Employer Health Plans - Part 1: General Provisions - Amends the Social Security Act to add a new title XXI (Access to Health Insurance For Health Services Through Employment) under which employers are required to enroll their employees and dependents in a qualified employer health plan or in the Program. Sets forth rules for the enrollment of full- and part-time, seasonal, and temporary employees, including rules applicable in cases of families with more than one worker and where both employers offer enrollment under a qualified employer health plan. Phases in implementation of enrollment requirements according to a schedule based on the size of the employer. Sets forth enforcement provisions. Outlines requirements for qualified employer health plan premiums and cost-sharing, including limitations on the amount that may be charged for premiums. Gives qualified employer health plans the option of electing Program rules governing payments for services. Sets forth the requirements for standards to certify a health plan provided by an employer or sold to an individual as a qualified health plan, including: (1) requirements that plan benefits must at least mirror the Medicare part A health services provided under the Program; (2) requirements respecting limits on pre-existing condition exclusions and coverage standards for such required plan benefits; and (3) disclosure and other requirements to protect consumers. Prohibits certain State benefit and coverage rules under a qualified health plan. Amends the Internal Revenue Code to allow a full deduction for health insurance costs of the self-employed and to make such deduction permanent. Part 2: Insurance Reform - Subpart A: General Reforms - Amends the Public Health Service Act to add a new title XXVII (Group Health Insurance Standards) under which insured and self-insured employment-related health plans must be ascertained as meeting certain standards established below in order to be, respectively, issued or offered. Provides sanctions for plans that fail to meet such standards, including possible loss of their qualified status. Requires the USHealth Board to request the National Association of Insurance Commissioners (NAIC) to develop specific standards to implement the requirements in the remaining paragraphs below which such plans must be ascertained as meeting. Provides that if NAIC fails to develop such standards or if the Board finds that such standards do not implement such requirements, the Board shall develop such standards. Requires that such plans may not discriminate on the basis of health status for certain services. Requires that pre-existing condition exclusions under such plans be treated in the same manner as is mandated under the Social Security Act for qualified health plans. Requires any carrier which offers such a plan to register with the applicable State regulatory authority. Requires that such carriers offer the same plans to all employers within their individual service areas. Details separate requirements with respect to HMOs. Specifies that a carrier may not offer or issue to an employer such a plan with a term of less than 12 months. Requires guaranteed renewability with some exceptions. Lists notice and other requirements applicable to renewals, including the requirement that the period of renewal for each employer plan be for a period of not less than 12 months. Provides an exception to the requirements in this paragraph for self-insured carriers and self-insured employment-related health plans. States that such requirements do apply to reinsurance carriers and employment-related reinsurance plans offered to such carriers or underwriting such self-insured plans. Requires that the premiums for all employer plans of the same entity shall be: (1) established based on a single cohesive rating system which is applied consistently for all employer groups and is designed not to treat groups, after a certain period, differently based on health or risk status; and (2) actuarially certified each year. Requires employer health plan premiums to be community-rated for a given geographical area. Disallows adjustments to premium rates based on age and gender of covered individuals. Requires a Program reimbursement election before employer health plan premium rates may be adjusted otherwise. Requires employer health plans to permit enrollment of individuals based on specified beneficiary classes. Provides an exception to the requirements in this paragraph for self-insured carriers and self-insured employment-related health plans. States that such requirements do apply to reinsurance carriers and employment-related reinsurance plans offered to such carriers or underwriting such self-insured plans. Prescribes a basic benefit package for employer health plans, with exceptions for employment-related reinsurance plans, self-insured plans, and HMO plans. Sets forth miscellaneous disclosure and recordkeeping requirements for employer health plans. Subpart B: Encouraging Establishment of Managed Care - Adds a new part 3 (Favorable Treatment of Network Plans and Utilization Review Programs) to new title XXVII of the Public Health Service Act added above to provide for favorable treatment of network plans and utilization review programs. Subpart C: Repeal of COBRA Continuation Requirements - Repeals COBRA continuation requirements under the Public Health Service Act, the Internal Revenue Code, and the Employee Retirement Income Security Act of 1974. Title II: Provision of Long-Term Home and Community-Based Care, Nursing Home Care, And Other Benefits For All Americans Through the USHealth Program - Adds a new part B (Long-Term Care Protection And Certain Preventive Benefits) to Medicare under which U.S. citizens and permanent U.S. residents are eligible for long-term care, without regard to age or disability status, and certain preventive benefits. Sets forth provisions respecting long-term care protection under new part B. Details eligibility criteria for long-term care which include requirements that only those individuals applying for benefits who have been determined by a Screening Agency to be limited in daily living activities or so cognitively impaired as to require ongoing supervision will be eligible for: (1) home and community-based services; (2) respite care; and (3) nursing facility services. Provides that the duration of such services shall be unlimited as long as the Case Management Agency determines, through its periodic review of a patient, that the patient continues to require such services. Requires that the determination of the need of an individual for such services shall be made by the Case Management Agency. Places limitations on coverage for respite care. Directs the USHealth Board to contract with States or other entities to act as Long-Term Care Screening Agencies for the State. Makes such agency responsible for assessing the eligibility of individuals for such services. Directs the USHealth Board to contract with a State or private nonprofit organization to establish and administer a Long-Term Care Case Management Agency for each designated area of a State. Requires such agency to: (1) provide case management services for eligible individuals directly or through contracts with home care or home health agencies; (2) develop a care plan for each individual determined to be eligible by a Screening Agency or approve such a plan which has been developed by a qualified service provider; (3) maintain a registry of qualified providers of home and community-based care and nursing facilities in the State; and (4) assist individuals in choosing qualified providers to carry out the care plan and in locating alternative providers if the individual becomes dissatisfied with the provider initially chosen. Requires a State, in addition to the USHealth Board, to monitor the performance of all designated Case Management Agencies and assure the fiscal stability of such agencies. Requires services provided to eligible individuals pursuant to a plan of care to be provided by qualified service providers. Lists service providers qualified to provide home and community-based services. Sets forth payment rules for home and community-based services and nursing facility services. Sets forth requirements for the certification of providers of such long-term care services. Establishes the Home and Community-Based Care Advisory Council to: (1) assist the USHealth Board in assuring the prompt and efficient implementation of long-term care protection under new part B; (2) regularly review the implementation of such protection; and (3) recommend to the Board and to the Congress any necessary modifications to such protection with respect to home and community-based services. Sets forth home- and community-based provider quality assurance requirements and case management agency quality assurance requirements. Directs the USHealth Board to develop and implement a standard and extended survey of home care agencies certified to receive payments for such long-term care services provided under new part B. Sets forth provisions respecting certain preventive benefits under new part B. Entitles U.S. citizens and permanent U.S. residents to the following preventive benefits: (1) routine physical checkups; (2) routine eye care (including the dispensing of corrective lenses); (3) dental care; and (4) hearing care. Specifies the specific items and services which comprise each such benefit. Sets forth special rules for children. Directs the USHealth Board to provide for a program for the certification of the safety and efficacy of hearing aids for which payment may be made under new part B. Sets forth payment rules, including rules prohibiting the application of deductibles or co-payments to payments for such preventive benefits. Directs the USHealth Board to make grants to: (1) educational institutions for programs to train individuals in the provision of home- and community-based care and nursing facility services; (2) State approved programs to develop and conduct programs to train individuals in the provision of home health aide services; and (3) accredited university schools of nursing to develop model consumer training programs to provide information and training about the delivery of home care services for caregivers as well as general information about the home- and community-based care service system. Authorizes appropriations for such grants. Directs the Board to assist public or private nonprofit entities in meeting the costs of planning, developing, and operating centers for long-term care planning and technical assistance. Authorizes appropriations. Directs the USHealth Board to conduct long-term home care demonstration projects for seriously mentally ill individuals and family caregivers. Authorizes appropriations. Title III: Low-Income Assistance - Adds a new part C (Assistance For Low-Income Individuals) to Medicare under which low-income U.S. citizens and permanent U.S. residents who are enrolled under part A or under a qualified employer health plan or are entitled to benefits under part B may apply for assistance to limit or eliminate their financial obligations for premiums, deductibles, and co-payments. Title IV: USHealth Program Administration - Subtitle A: USHealth Administration - Adds a new part D (USHealth Administration) to Medicare to establish, as an independent agency in the executive branch of the Government, a USHealth Administration, to be governed by a USHealth Board, to administer the USHealth Program created under this Act. Abolishes the Health Care Financing Administration. Subtitle B: Miscellaneous - Repeals provisions regarding the use of public agencies or private organizations to facilitate payment to providers of services. Permits States to be carriers for administration of part A benefits. Makes miscellaneous conforming changes in carrier provisions. Adds additional administrative provisions to part A relating to prescription drugs. Directs the Director of the Congressional Office of Technology Assessment to provide for the appointment of a Prescription Drug Payment Review Commission to report annually to the Congress on methods of determining payment for prescription drugs. Authorizes appropriations. Requires the Secretary of Health and Human Services to conduct various studies with respect to prescription drugs, including a study on the possible inclusion of experimental drugs under the Program, and to report to the Congress on the results of each such study. Requires General Accounting Office studies on wholesale prescription drug prices and the costs to pharmacies of doing business. Directs the USHealth Board to develop a standard prescription drug claims form. Subjects home intravenous drug therapy services to review by peer review organizations. Revises administrative provisions under Medicare regarding home intravenous drug therapy services. Makes miscellaneous and technical changes with respect to HMO coverage and payment. Sets forth special rules for frail elderly demonstration projects and similar projects. Title V: Quality Assurance And Cost Containment - Subtitle A: Quality Assurance - Amends part B (Peer Review) of title XI of the Social Security Act to require contracts with peer review organizations to provide that: (1) major organizational efforts be devoted to quality assurance activities; and (2) quality assurance activities be conducted with respect to all the different types of health and long-term care covered by Medicare or through a private payor. Revises the definition of the term "peer review organization" to require such an entity to include representatives of providers of services for which quality assurance activities are conducted. Provides funding for increased quality assurance activities. Requires each utilization and quality control peer review organization to establish and staff a quality assurance board that will monitor the quality of care provided under Medicare in the area served by the organization. Amends the Medicare program to: (1) prohibit payments to health care providers which are not licensed and certified by the State; (2) direct the USHealth Board to promulgate a consumers' bill of rights which shall recognize specified rights as rights of consumers which may be asserted by the consumer or his or her representative or guardian; (3) revise the hospital discharge planning process to require a discharge planning process which meets guidelines and standards to be established by the USHealth Board that guard against early inappropriate hospital discharges and ensure a timely and smooth transition to the most appropriate type of and setting for post-hospital care; and (4) require HMOs to make outpatient mental health services available to their clients and ensure that quality assurance activities include such services. Amends the Peer Review program to require peer review organizations to monitor hospitals' compliance with discharge planning process requirements. Subtitle B: Cost-Containment - Sets forth a formula to determine the overall annual health care amount allowed to be spent under the Program. Directs the USHealth Board to conduct negotiations each year with representatives of the classes of health care providers in order to allocate overall spending among the different classes of providers. Requires a report to the Congress on negotiation results along with a specification of the amount to be allocated to each class of provider. Requires the Board to adjust each year the payment rates by each class of provider. Title VI: Financing - Amends the Medicare program to: (1) set forth rules for determining the premiums to be charged individuals and employers for enrollment under part A; (2) specify the early year premiums for aged and disabled part A enrollees and set forth rules for determining the premiums for later years; and (3) revise procedures for collecting part B premiums to provide for the collection of delinquent premiums. Amends the Internal Revenue Code to: (1) eliminate the limit on wages and self-employment income subject to social security and railroad retirement taxes; and (2) increase the health insurance tax rate. Requires State maintenance of effort payments. Redesignates the Federal Hospital Insurance Trust Fund as the USHealth Program Trust Fund. Provides for off-budget treatment of the Fund. Extends the borrowing authority of the Fund. Dedicates additional specified revenues to the support of the Program. Repeals the Federal Supplementary Medical Insurance Trust Fund and transfers the funds in, and obligations of, such Fund to the USHealth Program Trust Fund. Repeals the separate authorization of appropriations to cover Government contributions and provide a contingency reserve applicable to the former Federal Supplementary Medical Insurance Trust Fund. Title VII: Rural And Central City Demonstration Projects And Expansion Of Primary Care And Public Health Delivery Capacity - Directs the Administrator of the Health Care Financing Administration to provide for additional research and demonstration projects into how Medicare could be changed to better cover care for beneficiaries residing in rural areas and in central city areas of large cities. Requires an annual report to the Congress on the progress of such projects. Extends the authorizations for the following programs or services under the Public Health Service Act through the year 2000: (1) immunization programs; (2) tuberculosis prevention and control programs; (3) lead poisoning prevention programs; (4) programs (and projects) for the prevention and control of sexually transmitted diseases; (5) migrant and community health center services; (6) homeless programs; (7) public housing programs; (8) family planning services; and (9) early intervention services for individuals with HIV disease. Directs the USHealth Board to make grants to public and nonprofit private entities for projects to plan and develop primary care centers and public health clinics which will serve medically underserved populations. Directs the USHealth Board, every five years, beginning with 1994, to submit to the Congress a report on the impact of this Act in meeting the following Goals for the Nation stated in "Health People, 2000": (1) to increase the span of healthy life for Americans; (2) to reduce health disparities among Americans; and (3) to achieve access to preventive services for all Americans. Requires each report to include such recommendations with respect to changes in the benefits and payment policies under this Act as will best promote achievement of national health promotion and disease prevention goals and objectives.
United States · United States Congress · 2 October 1991
Expresses the sense of the House of Representatives that: (1) the President should make clear that the United States supports the restoration of the democratically elected government of President Aristide in Haiti; (2) all U.S. assistance to the Haitian Government should remain suspended until democratic government is restored; (3) the Haitian military should respect the human rights of the Haitian people; (4) the Organization of American States should be commended for condemning the coup and for its Santiago commitment creating a new automatic mechanism to respond to the interruption of legitimate elected government; and (5) the international community should take all appropriate action to restore democratic government in Haiti.
United States · United States Congress · 1 October 1991
Breast Cancer Screening Safety Act of 1991 - Amends the Public Health Service Act to require certification in order for a facility to perform or interpret mammograms, inspect equipment, perform needle localizations or other procedures using mammography equipment, or conduct quality assurances oversight related to mammography. Authorizes the Secretary of Health and Human Services to issue and renew certificates for up to two years. Allows the Secretary to approve a private nonprofit organization to be an accreditation body which meets certain requirements, including inspecting facilities. Directs the Secretary to: (1) establish standards for facilities to assure the safety and accuracy of mammography; (2) specify organizations eligible to certify individuals to perform radiological procedures; (3) specify boards eligible to certify individuals to interpret screening mammograms; (4) establish standards regarding the qualifications for individuals to interpret screening mammograms; and (5) specify boards eligible to certify individuals to inspect screening mammography equipment and oversee quality assurance practices. Directs the Secretary to conduct annual announced and unannounced inspections of certified facilities. Provides for: (1) intermediate sanctions for certain violations; (2) suspension, revocation, and limitation of certificates; and (3) injunctions. Requires fees for certificate issuance and renewal, and for inspections, sufficient to cover costs. Requires annual publication of a list of facilities convicted of fraud and abuse, false billings, or kickbacks, facilities that have had certificates revoked, suspended, or limited, and facilities that have been the subject of a sanction or other similar matters. Allows the Secretary to exempt facilities in a State with more stringent requirements from compliance with this Act. Directs the Secretary to: (1) make grants for research on new methods of establishing a Mammography Registry; and (2) based on the research, establish the Registry. Amends title XVIII (Medicare) of the Social Security Act to require that screening mammographies paid for under Medicare be performed by a facility: (1) certified under this Act; and (2) in compliance with specified provisions of this Act.
United States · United States Congress · 1 October 1991
Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act to: (1) increase the exclusion limit on the net worth of a microenterprise for purposes of AFDC eligibility; (2) require that caseworkers advise AFDC recipients of the option to begin a microenterprise; (3) add definitions of "microenterprise" and "net profits" to the list of definitions under such part; (4) include microenterprise training and activities in the JOBS program; and (5) mandate adjustment of performance standards for microenterprises to take account of time required for their establishment. Requires a Health and Human Services study to identify administrative barriers to development of microenterprises among interested AFDC recipients.
United States · United States Congress · 24 September 1991
Fair Competition in Broadcasting Act of 1991 - Amends the Communications Act of 1934 to prohibit, one year after the enactment of the Local Broadcast Service Protection Act of 1991, any cable system (system) or other multichannel video programming distributor (MVPD) from retransmitting the signal of a commercial broadcasting station, or any part thereof, without the express authority of the originating station, with exceptions. Makes such prohibition inapplicable to the retransmission of the signal of a broadcasting station to a home satellite antenna by a cable operator (operator) or other MVPD of the signal of a superstation if the originating station was a superstation on May 1, 1991, and the system or other MVPD does not obtain the signal directly from the originating station. Directs the Federal Communications Commission (FCC) to establish regulations to govern the exercise by television (TV) stations of the right to grant retransmission authority and the right to signal carriage under such Act. Specifies that: (1) such regulations shall require that TV stations make an election between such rights; (2) if an originating TV station elects to exercise its right to grant retransmission authority, such Act shall not require the carriage of the signal of such station by such system; (3) such election shall not interfere with or supersede the rights of any station electing to assert the right of signal carriage; and (4) such provisions shall not be construed as affecting program licensing agreements between broadcasters and program suppliers. Requires each system operator with: (1) 12 or fewer usable activated channels to carry the signals of at least three local commercial TV stations, with exceptions where there are 300 or fewer subscribers; and (2) more than 12 such channels to carry the signals of local commercial TV stations up to one third of the aggregate number of usable activated channels of such system. Grants the operator discretion in selecting which signals to carry on its system whenever the number of local commercial TV stations exceeds the maximum number of signals a system is required to carry under such provision, with exceptions. Requires an operator to carry: (1) in its entirety, on the system of that operator, the primary video and accompanying audio transmission of each of the local commercial TV stations carried on the system and, to the extent technically feasible, program-related material carried in the vertical blanking interval or on subcarriers; and (2) the entirety of the program schedule of any TV station carried on the system unless carriage of specific programming is prohibited, and other programming authorized to be substituted, under Federal regulations. Requires that: (1) the signals of local commercial TV stations that an operator carriers be carried without material degradation; (2) the FCC adopt carriage standards to ensure that, to the extent technically feasible, the quality of signal processing and carriage provided by a system for the carriage of local commercial TV stations will be no less than that provided for carriage of any other type of signal; and (3) the FCC, at such time as it prescribes modifications of the standards for TV broadcast signals, initiate a proceeding to establish any changes in the signal carriage requirements of cable TV systems necessary to ensure cable carriage of such broadcast signals of local commercial TV stations which have been changed to conform with such modified standards. Specifies that an operator shall not be required to carry the signal of any local commercial TV station that substantially duplicates the signal of another local commercial TV station which is carried on its system, or to carry the signals of more than one local commercial TV station affiliated with a particular broadcast network. Sets forth provisions with respect to: (1) channel positioning; (2) signal availability; (3) identification of signals carried; and (4) notification of a local commercial TV station prior to deleting carriage or repositioning the station. Bars an operator from accepting or requesting compensation for carriage of local commercial TV stations or for channel positioning rights, with exceptions. Establishes procedures for complaints by broadcast stations against operators. Directs the FCC to: (1) afford the operator an opportunity to respond to the allegations; and (2) make a determination and take appropriate action with respect to the complaint. States that no operator shall be required to provide or make available, or provide information to subscribers about, any input selector switch or comparable device. Directs the FCC to issue regulations implementing the requirements established by this Act. Specifies that nothing in this Act shall require (or prohibit) an operator to (or from) carrying on any tier the signal of any commercial TV station or video programming service that is predominantly utilized for the transmission of sales presentations or program length commercials. Requires an operator with: (1) 12 or fewer usable activated channels to carry the signal of at least one qualified local noncommercial educational TV station; and (2) 13 to 36 such channels to carry the signal of at least one such station (but does not require carriage of the signals of more than three such stations). Sets forth additional requirements where a system operates beyond the presence of any qualified local noncommercial educational TV station. Requires all operators to continue to provide carriage to all qualified local noncommercial educational TV stations whose signals were carried on their systems as of March 29, 1990, subject to waiver under specified circumstances. Specifies that: (1) an operator required to add the signals of qualified local noncommercial educational TV stations to a system may do so by placing such additional stations on public, educational, or governmental channels not in use for their designated purposes; (2) an operator of a system with a capacity of more than 36 usable activated channels which is required to carry the signals of three qualified local noncommercial educational TV stations shall not be required to carry the signals of additional such stations the programming of which substantially duplicates the programming broadcast by another qualified local noncommercial educational TV station requesting carriage; and (3) a qualified local noncommercial educational TV station whose signal is carried by an operator shall not assert any network nonduplication rights it may have under specified Federal regulations to require the deletion of programs aired on other qualified local noncommercial educational TV stations whose signals are carried by such operator. Requires an operator to: (1) retransmit in its entirety the primary video and accompanying audio transmission of each qualified local noncommercial educational TV station whose signal is carried on the system and, to the extent technically feasible, program-related material carried in the vertical blanking interval, or on subcarriers, that may be necessary for receipt of programming by handicapped persons or for educational or language purposes; and (2) provide each qualified local noncommercial educational TV station whose signal is carried with bank-width and technical capacity equivalent to that provided to commercial TV broadcast stations carried on the system, and carry the signal of each qualified local noncommercial educational TV station without material degradation. Sets forth additional provisions with respect to: (1) notification of changes in carriage; (2) signal quality; (3) channel positioning; (4) availability of signals; (5) payment for carriage (which is generally prohibited); (6) complaint procedures and remedies; and (7) signal identification.
United States · United States Congress · 24 September 1991
Children and Pregnant Women Health Insurance Act of 1991 - Title I: Requiring Employers To Provide Health Insurance Coverage For Pregnant Women And Children - Amends the Social Security Act to: (1) add a new title XXI under which employers are required to either enroll their employees and family members in a qualified employer health plan or provide information to the State in which such individuals reside for enrollment instead in the new universal State health insurance plan (the State plan) created below. Amends the Internal Revenue Code to: (1) impose a premium tax on employers who fail to enroll their employees and family members in a qualified employer health plan and on such employers' employees, with employers paying as their portion of such tax 3.2 percent of each individual employee's wages and employees paying as their portion one percent of their wages for coverage provided under the State plan; (2) impose an excise tax (set at $100 per day) on those employers who fail to provide to the applicable State the information for enrollment under the State plan; and (3) set forth special rules and exceptions applicable in the imposition of such premium and excise taxes. Sets forth, under new title XXI of the Social Security Act, the rules for the enrollment of full- and part-time, seasonal, and temporary employees, including rules applicable in cases of families with more than one worker and where both employers offer enrollment under a qualified employer health plan. Phases in implementation of enrollment requirements and tax payments beginning on January 1, 1993 for employers with more than 100 employees. Requires that as of January 1, 1996 all employers must provide coverage or pay the premium tax for coverage under the State plan. Allows the qualified employer health plan under which the employer must provide coverage to be either a private health plan or a self-insured plan, dependent upon the employer's size. Outlines requirements for qualified employer health plan premiums and cost-sharing, including limitations on the amount that may be charged for premiums. Sets forth in the next two paragraphs below the requirements for which the Secretary must develop standards to certify a health plan as a qualified employer health plan. Requires the Secretary to: (1) establish procedures for the periodic review and recertification of plans as qualified employer health plans; and (2) terminate the certification of any such plan that no longer meets such requirements. Requires employers to provide their employees and family members with a health benefit package that at least mirrors the services mandated under the State plan. Outlines plan requirements respecting: (1) treatment of employee families; (2) period of coverage; (3) health plan cards; (4) limits on pre-existing condition exclusions and coverage standards for required health services; (5) limits on cost-sharing; (6) payment rates; (7) coordination and portability of health insurance coverage; (8) notification of premium subsidies for low-income individuals and other disclosures for consumers; (9) expense accounting; (10) grievance procedures; (11) certain physician incentive plans; (12) enrollee financial protection; and (13) use of uniform claims forms. Prohibits certain State benefit and coverage rules under a qualified employer health plan. Sets forth the definitions of terms used in this title. Makes the provisions of this title inapplicable to an employee who is not a resident of one of the 50 States or the District of Columbia. Title II: Provision of Health Insurance For Pregnant Women And Children Through State Children And Pregnant Women Health Plans - Amends the Social Security Act to add a new title XXII under which each State is required to establish and maintain a health insurance plan (the State plan) under which pregnant women and children and other individuals lawfully residing in the State who have not already been enrolled as a result of their connection to the work force or are not already covered under a qualified employer or Federal health plan are eligible to enroll for the health and other services outlined below. Requires each State to also establish and maintain a program under which low-income individuals enrolled in any of the health plans mentioned above will be eligible to apply for assistance to limit or eliminate their financial obligations for premiums, deductibles, and co-payments, depending upon the type of plan in which such individuals are enrolled. Provides that if a State fails to establish and maintain the plan mandated above under new title XXII, the Secretary of Health and Human Services shall establish and maintain one for it and the State shall be liable to the Secretary for a specified portion of the amount the Secretary determines the State would have been required to expend to establish and maintain such a health insurance plan. Sets forth provisions detailing the application process for enrollment under the State plan. Requires the State plan to provide for a coverage period that mirrors the coverage period specified for qualified employer health plans. Requires individuals who are eligible to enroll in the State plan but have not applied for enrollment by January 1, 1996 to be automatically enrolled on a retroactive basis and subjected to a penalty of twice any premiums otherwise due. Requires the State plan to provide for payments for the following services: (1) specified preventive care services, including routine immunizations and prenatal care, for children and pregnant women, furnished in accordance with applicable periodicity schedules to be established by the Secretary and without application of deductibles or co-payments; (2) specified major medical services, subject to such deductibles and co-payments as the State may impose in accordance with specified limitations; (3) specified extended medical services, including mental health services, provided only in accordance with a plan of care and subject to such deductibles and co-payments as the State may impose in accordance with specified limitations; (4) outreach services to link low-income enrolled individuals with such required health services without application of deductibles or copayments; and (5) at the option of the State, social services without application of deductibles or co-payments. Directs the Secretary to establish standards with respect to such required health services for application under new titles XXI and XXII of the Social Security Act. Prohibits a State from imposing any limitation on the amount, duration, or scope for such required health services. Allows individuals covered under the State plan to choose any qualified plan provider or practitioner to obtain such required health services. Incorporates the use of Medicare (title XVIII of the Social Security Act) payment rates for reimbursing providers for required health services and requires the Secretary to adjust such rates to take into account differences in the Medicare population and the population receiving benefits under State or qualified employer plans. Provides that in the case of required health services for which payment may not be made under Medicare, the Secretary shall establish payment rules similar to those used under Medicare for application under State plans. Requires each State to establish adequate payment rates with respect to outreach and social services. Sets the maximum annual deductible and co-payment amount for major medical services and extended medical services. Sets an overall annual limit on cost-sharing for such medical services. Applies new title XXI qualified employer health plan requirements relating to the treatment of family members, coverage period, health plan cards, and coordination and portability of health care coverage to State plans in the same manner as they apply to qualified employer plans. Sets forth provisions for: (1) determining the amount of premiums to be charged individuals not connected to the work force and individuals who are employed on a part-time, seasonal, or temporary basis; and (2) collecting current and delinquent premium payments. Creates in the Treasury the Federal Children and Pregnant Women Health Insurance Trust Fund (the Fund) to receive the funds generated from the premium and excise taxes imposed above as well as from other specified revenues dedicated to the support of the State plan. Outlines provisions regarding Fund transfer payments in the case of multiple employers. Requires each State plan to provide for submission of claims based on uniform forms developed by the Secretary. Requires that payments from the Fund to reimburse States for health and other service and administrative expenditures be made in accordance with rules similar to those used for reimbursement under Medicaid (title XIX of the Social Security Act). Details the assistance mentioned above to be provided to low-income individuals and the application process to obtain such assistance. Sets forth administrative provisions applicable to the State plan, including provisions authorizing States, subject to the approval of the Secretary, to conduct demonstration projects to: (1) improve the delivery and quality of health care services under new title XXII; and (2) increase the efficiency and effectiveness of the methods for paying for such services. Sets forth the definitions of terms used in this title. Makes the provisions of this title inapplicable to an individual who is not a resident of one of the 50 States or the District of Columbia. Amends the Medicaid program to provide for coordination between State plans and Medicaid plans. Title III: Health Insurance Reform For Small Employers - Amends the Social Security Act and the Internal Revenue Code to, respectively: (1) add a new title XXIII under which health insurance plans provided by small employers (small employer plans) must be ascertained as meeting the standards established below in order to be issued, avoid loss of their qualified status under new title XXI, and escape disqualification from State plan administration under new title XXII; and (2) impose an excise tax (set at 50 percent of all gross health plan premiums received during the taxable year) on the issuer of a small employer plan which fails to meet such standard, with specified exceptions. Directs the Secretary to request the National Association of Insurance Commissioners (NAIC) to: (1) develop specific standards to implement the requirements set forth in the next paragraph below which small employer plans must be certified by the Secretary as meeting if the State has not established a regulatory program for applying such standards to such plans (program); and (2) report to the Secretary on such development. Provides that if NAIC fails to develop and report on such standards or the Secretary finds that such standards do not implement such requirements, the Secretary must develop such standards. Specifies additional program elements. Subjects programs to periodic review by the Secretary for determining their compliance with such elements and in applying such NAIC standards. Requires periodic program audits by the General Accounting Office. Requires any carrier which offers a small employer plan to register with the applicable State regulatory authority. Requires that such carriers offer the same plans to all small employers within their individual service areas. Details separate requirements with respect to the treatment of health maintenance organizations. Prohibits a carrier from offering to, or issuing with respect to, a small employer a small employer plan with a term of less than 12 months. Requires that small employer plans be guaranteed renewable, with specified exceptions. Details notice and other requirements applicable to renewals, including the requirement that the period of renewal for each small employer plan shall be for a period of not less than 12 months. Declares that no small employer plans may discriminate on the basis of health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability of an individual. Requires that the premiums for all small employer plans of the same entity be: (1) established based on a single cohesive rating system which is applied consistently for all employer groups and is designed not to treat groups differently based on health or risk status; and (2) actuarially certified each year. Requires small employer plan premiums within a block of business to be community-rated for a given geographical area. Sets limits on premium reference rate variation among blocks of business, with specified exceptions. Allows a small employer plan carrier, for purposes of establishing premiums for small employer plans with similar coverage, to establish blocks of business only on the basis of specified criteria. States that no small employer plan may be issued unless it: (1) provides for a minimum benefit package that mirrors the health services required under new title XXII; (2) prohibits cost-sharing with respect to such benefits in excess of allowable limits; and (3) includes such additional items and services as the carrier can demonstrate will facilitate appropriate hospital discharges or avoid unnecessary hospitalization. Sets forth miscellaneous disclosure and recordkeeping requirements for small employer health plans. Makes this title inapplicable outside the 50 States or the District of Columbia. Sets forth the definitions of terms used in this title.
United States · United States Congress · 24 September 1991
Medicare EKG Payment Restoration Act of 1991 - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to: (1) reestablish separate payment for the interpretation of electrocardiograms (EKGs) that are ordered or performed during an office visit or consultation with a physician; and (2) require the Secretary of Health and Human Services to establish separate fee schedule amounts for EKG interpretations and to adjust the relative values established for office visits to or consultations with a physician to reflect the establishment of such separate fee schedule amounts. Directs the Secretary to: (1) establish practice guidelines for the use of EKGs for dissemination along with other educational information relating to the use of EKGs to physicians; (2) develop a profile of the use of EKGs by physicians; and (3) conduct a study and report to the Congress on the utilization and costs of EKGs.
United States · United States Congress · 24 September 1991
Expresses the sense of the Congress that it is inappropriate for the Federal Government to take actions that have the effect of preempting the tax decisions of State governments. Protests the decision of the Secretary of Health and Human Services to prohibit Federal payments under the Medicaid program (title XIX of the Social Security Act) relating to State Medicaid expenditures that are made from revenues derived from provider-specific taxes. Urges the Secretary to drop the proposed rule implementing his decision.
United States · United States Congress · 17 September 1991
Amends the title VI (International Education Programs) of the Higher Education Act of 1965 to add a new part D, Minority Foreign Service Professional Development. Authorizes the establishment of a programs significantly increase the numbers of African Americans and other minorities in the foreign service of the United States. Requires such academic and professional program to be established in the Institute for International Public Policy at Howard University (Washington, D.C.) (the Institute), created by this Act, and to be in consortium with other specified institutions of higher education. Allows any institution of higher education that wishes to participate in any or all aspects of such program to enter into a Memorandum of Understanding with Howard University. Sets forth the components of the academic program of the Institute, including a junior year abroad, academic year and summer internships, a master degree to serve two years in the U.S. foreign service for each year of the fellowship. Requires appointment of a Board of Visitors for the Institute. Sets forth matching requirements and provisions for gifts and donations. Requires Howard University and institutions of higher education in consortium with it to delegate to a nonprofit institution in the District of Columbia the administration of the Foreign Service Examination preparative and the International Careers Program, which may include the Junior Year Abroad and the Academic Year and Summer Internship programs. Authorizes appropriations.
United States · United States Congress · 12 September 1991
Perkins Loan Improvement Act of 1991 - Amends the Higher Education Act of 1965 to eliminate the 50-percent limitation on the number of schools that may be designated in any State as an institution where teacher service qualifies for the Perkins student loan forgiveness program.
![Official portrait of Rep. Ford, Harold E. [D-TN-9]](https://www.congress.gov/img/member/f000261_200.jpg)