Bill· HRH.R. 101 (103rd)open
United States · United States Congress · 5 January 1993
TABLE OF CONTENTS: Title I: Improved Access to Affordable Health Care Coverage Subtitle A: Increased Affordability and Availability for Employees Subtitle B: Improved Small Employer Purchasing Power of Affordable Health Insurance Subtitle C: Health Deduction Fairness Subtitle D: Improved Access to Community Health Services Subtitle E: Improved Access to Rural Health Services Title II: Health Care Cost Containment and Quality Enhancement Subtitle A: Medical Malpractice Liability Reform Subtitle B: Administrative Cost Savings Subtitle C: Medical Savings Accounts (Medisave) Subtitle D: Medicaid Program Flexibility Subtitle E: Limitations on Physician Self-Referrals Subtitle F: Removing Restrictions on Managed Care Subtitle G: Medicare Payment Changes Subtitle H: Limitation of Antitrust Recovery for Certain Hospital Joint Ventures Subtitle I: Encouraging Enforcement Activities of Medical Self-Regulatory Entities Action Now Health Care Reform Act of 1993 - Title I: Improved Access to Affordable Health Care Coverage - (Sec. 102) Preempts inconsistent State laws. (Sec. 103) Requires small employer health insurance carriers to offer a MedAccess basic plan (providing only benefits for essential preventive and medical services and having an actuarial value not over 60 percent of a MedAccess standard plan) and a MedAccess standard plan (providing benefits typical of the small employer market). Amends the Internal Revenue Code (IRC) to tax the failure of a carrier or plan to comply with related standards. Mandates: (1) acceptance of every small employer and full-time employee; or (2) in States that so provide, allocation of risk. (Sec. 104) Regulates pre-existing condition requirements, premiums, rating practices disclosure, minimum participation requirements, and renewability. (Sec. 108) Mandates development of models for reinsurance or allocation of risk mechanisms. Requires State (or Federal) establishment of at least one mechanism in each State. Amends the IRC to impose a tax in any such Federal reinsurance State. (Sec. 110) Establishes the Office of Private Health Care Coverage and a related advisory committee. (Sec. 111) Authorizes research and demonstration projects on the impact of these provisions on the availability of affordable small employer coverage. Requires: (1) methods for measuring the relative health risks of eligible individuals; and (2) a model for equitably distributing health risks among small employer carriers. Authorizes appropriations. (Sec. 121) Preempts State laws: (1) requiring the offering of health plans providing certain services; and (2) prohibiting employer groups from purchasing health insurance. (Sec. 131) Amends the IRC to increase and make permanent deductions for the health insurance costs of self-employed individuals. (Sec. 141) Amends the Public Health Service Act (PHSA) to provide for grants to: (1) migrant and community health centers and to entities providing health services for the homeless to promote primary health services for underserved individuals; and (2) increase access to outpatient primary services in certain geographic areas. Authorizes appropriations. (Sec. 171) Changes the heading of title XII (Trauma Care) of the PHSA to "Emergency Medical Services" and makes similar changes to references within the title. (Sec. 172) Authorizes grants to States for State offices of emergency medical services. (Sec. 173) Requires projects under existing provisions to include demonstrations on telecommunications between rural medical facilities and other medical facilities with useful expertise or equipment. (Sec. 174) Authorizes appropriations to carry out specified provisions of title XII. (Sec. 181) Mandates grants to States for rural air medical transport systems. Authorizes appropriations. (Sec. 191) Amends title XVIII (Medicare) of the Social Security Act to extend special payments for the inpatient services of small, rural Medicare-dependent hospitals. Title II: Health Care Cost Containment and Quality Enhancement - (Sec. 211) Reforms medical malpractice regarding: (1) a statute of limitations; (2) use of alternative dispute resolution systems (ADRs), including for claims against the United States; (3) settlement offers and conferences; (4) noneconomic and punitive damages; (5) periodic payment for future damages; (6) mandatory offsets for collateral source payments; (7) contingent attorney's fees; (8) several and joint liability; (9) findings of negligence; (10) practice guidelines sanctioned as affirmative defenses; (11) the standard of proof regarding certain labor and delivery circumstances; (12) supersedure of certain State laws; and (13) establishment and certification of State ADRs. (Sec. 241) Amends title II (Old Age, Survivors, and Disability Insurance) (OASDI) of the Social Security Act to authorize appropriations for sanctioning guidelines as affirmative defenses. Mandates: (1) research and demonstrations on the use of data on malpractice actions; and (2) development of a standard reporting form for State ADRs in transmitting information on disputes resolved. (Sec. 242) Authorizes State professional disciplinary agencies to make agreements with professional societies to allow the societies to: (1) participate in licensing; and (2) review malpractice allegations or other information on the practice patterns of a practitioner. (Sec. 243) Requires each health professional and provider to participate in a risk management program. (Sec. 244) Mandates grants: (1) for basic research on malpractice prevention and compensation and outcomes research; (2) to States to improve licensing and discipline; and (3) for public education on appropriate health care use and realistic expectations, public education on the resources and role of licensing and disciplinary boards, and development of faculty training and curricula regarding quality assurance, risk management, and medical injury protection. Authorizes appropriations. (Sec. 245) Mandates a study on factors preventing or discouraging physicians from volunteering in medically underserved areas. (Sec. 251) Regulates: (1) data elements, uniform claims forms, and uniform electronic transmission of data elements; (2) provider claims submission; and (3) hospital and non-hospital electronic medical data. (Sec. 262) Requires hospitals, in order to participate in Medicare, to maintain and electronically transmit clinical data on patients in a set of electronic comprehensive data elements. (Sec. 263) Provides for electronic transmission of data elements to Federal agencies. (Sec. 264) Prohibits plans from requiring that a provider provide any data element not in the set or transmit any data element in a manner inconsistent with standards. (Sec. 265) Establishes an advisory commission. Authorizes appropriations. (Sec. 271) Provides for a comparative health care value program in each State. Authorizes grants and appropriations. (Sec. 273) Requires each Federal agency concerned with health insurance or care to develop comparative value information. (Sec. 274) Mandates model systems for the gathering and analysis of data on health care cost, quality, and outcome. Authorizes appropriations. (Sec. 281) Provides for standards regarding Medicare and Medicaid identification cards. Establishes a Medicare and Medicaid system to provide information on primary payors. Authorizes appropriations. (Sec. 282) Nullifies any State law requiring that medical or health insurance records be maintained in written rather than electronic form. (Sec. 283) Provides for standards regarding: (1) beneficiary and provider identification numbers; and (2) coordination of benefits. (Sec. 285) Mandates grants to demonstrate the application of comprehensive information systems in continuously monitoring patient care and improving patient care. Authorizes appropriations from the Federal Hospital Insurance Trust Fund. Authorizes grants for: (1) communication links between plan and provider information systems; (2) regional or community-based clinical information systems; and (3) developing and testing, for physicians and non-hospital entities, the definition of a comprehensive data set and the specification and presentation of individual data elements. Authorizes appropriations. (Sec. 291) Amends the IRC to exclude from an employee's gross income any amount contributed by the employer to a trust created exclusively to pay an individual's medical expenses (medical savings account). Sets contribution limits. Subjects the employee to taxation as owner of the account. (Sec. 301) Amends Medicaid provisions to modify contracting requirements for coordinated care services. (Sec. 311) Amends Medicare provisions to extend physician self-referral limitations to all payors and certain additional services. Revises exceptions. (Sec. 314) Mandates a study to estimate the changes in aggregate costs that will result from the amendments made by these provisions. (Sec. 321) Preempts managed care restrictions under State law. Mandates a study of managed care benefits and cost effectiveness. (Sec. 331) Amends Medicare provisions to revise the method for determining prospective payment updates to hospitals. (Sec. 332) Lowers the limitation amount and suspends certain annual adjustments regarding clinical diagnostic laboratory tests. (Sec. 343) Limits antitrust recovery to actual damages if certain requirements are met, including the filing and publication of information regarding hospital joint ventures. (Sec. 345) Establishes the Interagency Committee on Competition, Antitrust Policy, and Health Care. (Sec. 351) Prohibits, subject to exception, damages and other recovery under the Clayton Act or similar State laws from a medical self-regulatory entity engaging in standard setting or enforcement activities designed to promote the quality of health care and not conducted for financial gain.
Bill· HRH.R. 6171 (102nd)referred
United States · United States Congress · 5 October 1992
Action Now Health Care Reform Act of 1992 - Title I: Improved Access to Affordable Health Care Coverage - Subtitle A: Increased Affordability and Availability for Employees - Directs the Secretary of Health and Human Services (the Secretary) to request the National Association of Insurance Commissioners (the NAIC) to develop model regulations requiring each carrier that makes available in a State any small employer health benefit plan to make available to each small employer in the State a MedAccess basic plan and a MedAccess standard. Directs the Secretary to develop such regulations, if the NAIC does not. Defines MedAccess plan as a health benefits plan that: (1) provides benefits typical of the benefits offered in the small employer health coverage market or provides only benefits for essential preventive and medical services and has an average actuarial value not exceeding 60 percent of the average actuarial value of the typical benefits offered in the small employer health coverage market; (2) accepts every small employer in the State applying for coverage and accepts for enrollment every eligible individual (defined as an individual who is a full-time employee and, if family coverage is offered, covers the employee's spouse and dependents under age 19 or under age 25 for students); and (3) meets consumer protection standards established by this Act relating to limitation of pre-existing condition clauses, continuity of coverage, renewability, and premium limitations. Prohibits the imposition, by a carrier, of a limitation of benefits based on the fact a condition pre-existed the effectiveness of the policy if: (1) the condition relates to a condition not diagnosed within three months before coverage under the plan; (2) the limitation extends beyond six months after coverage under the plan; (3) the limitation applies to an individual who, as of date of birth, was covered under the plan; and (4) the limitation relates to pregnancy. Requires continuous coverage. Prohibits cancellation of a plan or denial of coverage unless there is: (1) nonpayment of premiums; (2) fraud; (3) noncompliance with plan provisions; (4) failure to maintain the required number of enrollees; (5) misuse of a provider network provision; or (6) a cessation by the carrier of the provision of any plan in a State. Amends the Internal Revenue Code to impose an excise tax which shall be paid by the carrier on the failure of a carrier or an employer health benefit plan to comply with the provisions of the Act. Directs the Secretary to request the NAIC to develop models for reinsurance or allocation of risk mechanisms for individuals and small employers who are enrolled under a small employer health benefit plan that meets the consumer protection standards and for whom a carrier is at risk of incurring high costs under the plan. Requires each State to establish and fund one or more reinsurance or allocation or allocation of risk mechanisms that are consistent with a model. Directs the Secretary to develop models, if the NAIC does not. Permits a State, in order to insure the financial solvency of the mechanism, to impose charges on any entity, including a self-insured entity, providing employee-related health benefits, so long as such charges do not discriminate with respect to entities that would not be subject to such charges. Directs the Secretary to establish a reinsurance or allocation of risk mechanism, if a State does not. Imposes an excise tax which shall be paid by the carrier on the providing of any health benefit plan which covers any employee in a Federal reinsurance State. Permits either a State or the Secretary (in a Federal reinsurance State) to require each employer health benefit plan to: (1) be registered; and (2) provide such information as is necessary for the reinsurance or allocation of risk mechanisms. Directs the Secretary to: (1) establish an Office of Private Health Coverage to be headed by a Director appointed by the Secretary; and (2) provide for the appointment of an advisory committee to advise the Director. Permits the Director to research the impact of this subtitle and conduct related demonstration projects. Requires the Director to develop: (1) methods of measuring, in terms of the expected costs of providing benefits under small employer health benefit plans and, in particular, MedAccess plans, the relative health risks of eligible individuals; and (2) a model for equitably distributing health risks among carriers in the small employer health care coverage market. Authorizes appropriations for the purposes of this paragraph. Subtitle B: Improved Small Employer Purchasing Power of Affordable Health Insurance - Preempts from insurance mandates a qualified small employer purchasing group, if the group consists of employers with not more than 100 employees, the group consists of not fewer than 100 employers, and the health benefit plans with respect to the employer members are in compliance with applicable State laws relating to health benefit plans. Subtitle C: Health Deduction Fairness - Amends the Internal Revenue Code to make permanent and, in phases, increase from 25 to 100 percent the health insurance tax deduction for the self-employed. Subtitle D: Improved Access to Community Health Services - Directs the Secretary to provide for a program of grants to migrant and community health centers receiving grants or contracts under provisions of the Public Health Service Act in order to promote the provision of primary health care services for underserved individuals. Authorizes appropriations. Amends the Public Health Service Act to deem as an employee of the Public Health Service, for purposes of civil actions against commissioned officers or employees, any officer, employee, or contractor who is a physician or other licensed health care practitioner while performing functions for an entity receiving Federal funds under provisions of the Public Health Service Act relating to migrant or community health centers, health services for the homeless, or health services for residents of public housing. Requires an entity, in order to receive a grant under such provisions, to implement certain policies to assure against malpractice. Requires: (1) the Attorney General to estimate, for specified fiscal years, the amount of all claims expected, during each year, to arise against such an entity from acts of officers or employees; (2) the Secretary to withhold from grants to such entities the amount estimated; and (3) the withheld amount to be transferred to the Treasury to pay judgments against the United States arising from such claims. Directs the Secretary to make grants to public and nonprofit private entities to carry out demonstration projects for the purpose of increasing access to outpatient primary health services in geographic areas with a: (1) population of not more than 500,000 individuals; (2) shortage of personal health services; and (3) significant number of low-income or underinsured individuals. Sets forth requirements for receiving such grants. Authorizes appropriations. Subtitle E: Improved Access to Rural Health Services - Retitles title XII of the Public Health Service Act "Emergency Medical Services" (formerly, "Trauma Care") and directs the Secretary to establish the Office of Emergency Medical Services which shall, with respect to emergency medical services (including trauma care): (1) conduct research; (2) sponsor workshops; (3) assist States; and (4) coordinate activities. Authorizes the Secretary to make grants to States for the purposes of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services. Sets forth matching fund requirements. Provides for demonstration projects to establish telecommunications between rural medical facilities and other medical facilities that have equipment that can be utilized through telecommunications. Authorizes appropriations for purposes of the programs of this paragraph. Directs the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas access to treatments for the injuries or other conditions arising from such emergencies. Sets forth requirements for grant applications. Authorizes appropriations. Amends title XVIII (Medicare) of the Social Security Act to extend for one year special treatment rules for Medicare-dependent small rural hospitals. Title II: Health Care Cost Containment and Quality Enhancement - Subtitle A: Medical Malpractice Liability Reform - Prohibits bringing a medical malpractice claim: (1) more than two years after the alleged injury should reasonably have been discovered and in no event more than four years after the alleged injury occurred; and (2) in any State court unless there has been an initial resolution through a certified alternative dispute resolution system (ADR). Directs the Attorney General to establish an ADR for the resolution of Federal medical malpractice claims, to be used after completion of the administrative process under specified provisions. Requires a pre-trial settlement conference in any medical malpractice liability action. Sets limits on: (1) noneconomic damages; (2) punitive damages; and (3) attorney's fees. Requires offsets for damages paid by a collateral source. Requires liability in a medical malpractice action to be several and not joint. Provides a complete defense to any allegation of negligence in a medical malpractice liability action to any defendant who followed the appropriate practice guideline. Prohibits finding a defendant guilty in a medical malpractice liability action relating to services provided during labor or delivery of a baby if the defendant did not previously treat the plaintiff during the pregnancy, unless the malpractice is proven by clear and convincing evidence. Establishes requirements for and provides for annual certification of State ADRs. Directs the Secretary to establish an alternative Federal ADR for claims in States without certified ADRs. Amends title XI (General Provisions and Professional Standards Review) of the Social Security Act to earmark funds for sanctioning practice guidelines for purposes of an affirmative defense in medical malpractice liability actions. Permits a State agency responsible for the conduct of disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies for such type of health care practitioner to permit such societies to participate in the licensing of such health care practitioner and to review health care malpractice allegations. Requires each State to require each health care professional and provider to participate in a risk management program to prevent and provide early warning of practices which may result in injuries to patients or which otherwise endanger patient safety. Directs the Secretary to make grants for the conduct of basic research in the prevention of and compensation for injuries resulting from health care professional or health care provider malpractice, and research of the outcomes of health care procedures. Authorizes appropriations. Directs the Secretary to study the factors discouraging physicians from volunteering to provide health care services in medically underserved areas. Subtitle B: Administrative Cost Savings - Directs the Secretary to adopt standards relating to each of the following: (1) data elements for use in claims processing under health benefits plans; (2) uniform claim forms; and (3) uniform electronic transmission of the data elements. Authorizes the Secretary to require providers to submit claims to health benefit plans in accordance with such standards. Provides for periodic review of the standards. States that the term "health benefit plan," in this subtitle, includes the Medicare and Medicaid programs (titles XVIII and XIX of the Social Security Act) programs and Medicare supplemental health insurance. Requires the Secretary to promulgate standards for hospitals concerning electronic medical data. Permits the Secretary to promulgate standards concerning electronic medical data for providers that are not hospitals. Requires hospitals, in order to participate in Medicare, to: (1) maintain clinical data in a set of comprehensive data elements in electronic form on all patients; and (2) upon the Secretary's request, transmit electronically the data set and any data from such set. Provides for electronic transmission to Federal agencies. Prohibits a health benefit plan, if standards with respect to data elements are promulgated with respect to a class of provider, from requiring for the purpose of utilization review or as a condition of providing benefits under the plan that a provider in the class: (1) provide any data element not in the set of comprehensive data elements; or (2) transmit or present any such data element in a manner inconsistent with applicable standards. Directs the Secretary to establish an advisory commission of hospital executive and data base managers, physicians, health services researchers, and technical experts in the collection and use of data and operation of data systems. Authorizes appropriations for such commission. Requires the Secretary, in order to assure the availability of comparative value information to purchasers of health care in each State, to determine whether each State is developing and implementing a health care value information program that meets stated criteria. Permits grants to a State for the development of its health care value information program. Authorizes appropriations for such grants. Requires the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to promptly develop health care value information relating to each program that such head administers. Directs the Secretary to develop model systems to facilitate: (1) the gathering of data on health care cost, quality, and outcome; and (2) analyzing such data to permit the valid comparison of such data. Authorizes appropriations for the development of such model systems. Directs the Secretary to adopt standards relating to the design and use of magnetized Medicare identification cards for the purpose of assisting health care providers in determining eligibility and billing. Authorizes appropriations. Nullifies any State law requiring that medical or health insurance records be maintained in written rather than electronic form. Requires each health benefit plan: (1) for each of its beneficiaries that has a social security number, to use that number as an identification number for claims processing; and (2) for each provider that has a unique identifier for Medicare purposes, to use that identifier for claims processing. Requires the Secretary to determine whether problems relating to the rules for determining liability when benefits are payable under two or more plans or the availability of information among such plans causes significant administrative problems, and if so, directs the Secretary to promulgate standards concerning liability and the transfer of information among plans. Directs the Secretary to provide grants to qualified entities to demonstrate the application of comprehensive information systems in continuously monitoring patient care and in improving patient care. Authorizes appropriations from the Federal Hospital Insurance Trust Fund. Subtitle C: Medical Savings Accounts (Medisave) - Amends the Internal Revenue Code to exclude from the gross income of an employee any amount contributed by the employer to a medical savings account pursuant to a qualified medical savings account plan. Sets contribution limits. Defines a "medical savings account" as a trust created exclusively for purpose of paying an individual's medical expenses. Permits expenses from such account only to the extent such amounts are not compensated for by insurance. Imposes a penalty on distributions not used for that individual's medical expenses. Subjects the employee to taxation as owner of the account. Subtitle D: Medicaid Program Flexibility - Amends title XIX (Medicaid) of the Social Security Act to modify Medicaid contracting requirements for coordinated care services. Subtitle E: Limitations on Physician Self-Referrals - Amends title XVIII (Medicare) of the Social Security Act to extend physician self-referral limitations to all payors as well as to certain additional services. Revises exceptions. Requires the Secretary to conduct a study in order to estimate the changes in aggregate costs for designated health services, under the Medicare program and other health plans, which will result from the implementation of the amendments made by this subtitle. Subtitle F: Removing Restrictions on Managed Care - Preempts managed care restrictions under State law. Requires the Comptroller General to conduct a study of the benefits and cost effectiveness of the use of managed care in the delivery of health services. Subtitle G: Medicare Payment Changes - Amends the Medicare program to make revisions in the methodology for determining updates to Medicare hospital payments. Provides for a reduction in Medicare payment for clinical diagnostic laboratory tests. Subtitle H: Limitation of Antitrust Recovery for Certain Hospital Joint Ventures - Limits antitrust recovery to actual damages if the requirements of this subtitle are met, including the filing and publication of certain information regarding hospital joint ventures. Establishes the Interagency Committee on Competition, Antitrust Policy, and Health Care to make recommendations to the Congress regarding antitrust and health care. Subtitle I: Encouraging Enforcement Activities of Medical Self-Regulatory Entities - Prohibits damages, interest on damages, costs, or attorney's fees from being recovered (except for actual damages, interest on damages, costs, or attorney's fees for injury sustained) under the Clayton Act or any similar State law from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities designed to promote the quality of health care provided to patients and not conducted for financial gain.
Bill· HRH.R. 5919 (102nd)referred
United States · United States Congress · 9 September 1992
Comprehensive Health Reform Act of 1992 - Title I: Deduction of Health Insurance Costs of Self-Employed Individuals - Health Benefits for Self-Employed Individuals Act of 1992 - Amends the Internal Revenue Code with respect to the income tax deduction for the health insurance costs of self-employed individuals to: (1) make the deduction permanent; and (2) phase in an increase in it, reaching 100 percent of costs for taxable years beginning in 1996. Title II: Health Insurance Market Reform - Health Insurance Market Reform Act of 1992 - Amends the Social Security Act (SSA) to add a new title XXI, Requirements Concerning Health Insurance. States that the purposes of part A of new SSA title XXI are to increase the availability, portability, and affordability of health insurance, particularly to small employers and their employees and dependents, by seeking to ensure, among other things, that: (1) affordable health insurance is available to individuals and groups, and premiums do not vary substantially, regardless of health status or claims experience; (2) States regulating health insurance do not place an undue burden on small employers; and (3) insurers, providers, purchasers, and consumers are encouraged to contain costs of health care and health insurance. Applies the provisions of new SSA title XXI to health insurance plans offered in any State and to insurers offering such plans. Provides for the establishment of Federal and State regulatory programs implementing the requirements of parts B and C of new SSA title XXI. Requires the Secretary of Health and Human Services to: (1) request the National Assoication of Insurance Commissioners (NAIC) to recommend model standards for compliance with such requirements; and (2) using such model standards, with revisions as necessary, publish implementing regulations. Requires the Secretary to determine whether each State has established a regulatory program adequate to ensure compliance with such requirements. Allows State programs to establish standards more stringent than those required under new title XXI, if the Secretary finds them consistent with its purposes. Provides that an approved State program shall take effect, in lieu of the above mentioned implementing regulations, as of a specified date: (1) with respect to all insurers and health insurance plans subject to part B of new SSA title XXI; and (2) with respect to all insurers and health insurance plans subject to part C, except for employee welfare benefit plans which are not multiple employer welfare arrangements (MEWAs). Requires the Secretary to implement a program: (1) under part C in all States with respect to those insurers and health insurance plans not subject to State regulation; and (2) under both parts B and C with respect to all insurers and health insurance plans in each State without an approved program. Authorizes the Secretary to waive, with respect to one or all States, any provision of new SSA title XXI, or of Medicare or Medicaid (SSA titles XVIII and XIX, respectively), to the extent and for the period he or she finds likely to promote the purposes and facilitate the administration of new title XXI. Provides for Federal oversight over State programs. Makes the requirements of parts A, B, and C of new SSA title XXI generally effective with respect to health insurance plans offered, issued, or renewed in a State on or after January 1, 1994 (or certain later dates necessary to allow for enactment of State legislation). Provides that certain provisions concerning variations in premiums among and within blocks of business, and the rate of premium increases shall not apply, until two years after the general effective date, to a renewal of a health insurance plan that was in effect before the effective date. Provides that under part B of new SSA title XXI each insurer must register with the Secretary and the appropriate official for each State in which it issues or offers any health insurance plan to a small employer. Requires, subject to specified exceptions, any insurer offering a health insurance plan to any small employer in a State (or to any small employer in a local service area within the State, in the case of an insurer offering health insurance only within such an area) to: (1) make such plan available to every small employer in the State or local service area; (2) make available to every small employer any basic insurance plan a State may require; and (3) not cancel or refuse to renew any small employer health insurance plan. Requires an insurer providing small employer health insurance to notify the employer, at least 60 days before expiration, of the terms for renewal, and the extent to which any premium increase is based on actual or expected claims experience of covered individuals. Requires, subject to specified exceptions, that each health insurance plan offered to a small employer accept for enrollment, on the same terms as any other enrollee, every eligible employee and (in the case of a family plan) the employee's spouse and any dependent child under age 19 or, if older, under age 25 and a full-time student. Prohibits a small employer that made health insurance available to employees from using criteria related to health status or claims experience to determine eligibility for, benefits under, or terms of such health insurance for individual employees. Permits a State to define a basic benefit plan, and to require that it be offered to small employers in the State by insurers (other than health insurance networks (HINs) or MEWAs) offering heatlh insurance plans to small employers in the State. Subjects the plan to review and approval by the Secretary to ensure that it is affordable by small employers. Requires that the regulatory program established with respect to a State require all insurers offering health insurance plans to small employers, during a specified period, to: (1) participate in an interim risk pooling mechanism; and (2) comply with requirements designed to limit variations among and increases in premium rates for such health insurance plans. Permits the interim risk pooling mechanism to be either a reinsurance program or an assigned risk program. Provides for funding such a mechanism. States that no Federal entity shall be at risk as a guarantor of the solvency of a reinsurance fund or otherwise, for all or any part of the cost of health insurance plans subject to intermin risk pooling. Provides that, for any rating period, no base premium rate for any small employer block of business may exceed the equivalent base premium rate for any other block of the insurer by more than 20 percent. Provides that the highest premium rate for a specific health insurance plan that an insurer can charge any small employer in a block of business for a rating period shall not exceed the corresponding base premium rate by more than: (1) 50 percent, for a period ending before January 1, 1997; and (2) 35 percent, for a period thereafter. Limits annual percentage increases in the premium rate charged to a small employer. Sets forth requirements concerning rate-setting methodology, including requirements for full disclosure of rating practices and actuarial certification. Establishes requirements for the permanent health risk pool system in a State. Provides continued health insurance coverage for certain college students. Provides under part C of new SSA title XXI that, except to the extent permitted under an assigned risk program, an insurer may not refuse to offer, refuse to renew, cancel, or condition the coverage under any employment-based health insurance plan on the basis of the health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability, of one or more individuals. Sets limits on exclusions under employment-based health insurance plans for pre-existing conditions. Preempts certain State laws relating to health insurance. Sets forth requirements an entity must meet in order to be entitled to certification as an HIN. Permits the Secretary to fund health risk pooling demonstrations in as many as four States. Authorizes the Secretary to develop model health risk pooling systems. Requires the Secretary to develop methods for measuring the health risk differential of individuals. Authorizes appropriations. Amends the Internal Revenue Code to impose an excise tax of $1000 per covered employee on insurers for noncompliance with the requirements of part B or C of SSA new title XXI. Title III: Medical And Health Insurance Information Reform - Medical and Health Insurance Information Reform Act of 1992 - Adds a new SSA title XXII, Medical and Health Insurance Information Reform. Requires the Secretary, in order to assure the availability of comparative value information to health care purchasers, to determine whether each State is developing and implementing a health care value information program. Enumerates the criteria for State programs. Provides that if the Secretary finds that a State has not developed or implemented a health care value information program that comports with such criteria, the Secretary must take necessary actions to implement a comparable program in the State. Allows fees to be charged for the informational materials provided pursuant to such program. Directs the head of any Federal agency with responsibility for the provision of health insurance or health care services to develop and make comparative value information available to States, health care providers, and consumers. Directs the Secretary to promulgate requirements for health insurers to furnish periodically to the Secretary, on a sample basis, health care data relevant to health care services research. Requires the Secretary to make available, under the Freedom of Information Act, all Medicare claims records, without regard to the consent of the physician or other individual who furnished the item or service in question. Maintains in force Privacy Act protections against the release of information that identifies Medicare beneficiaries. Applies this new requirement for release of records only to information received after the enactment of this Act. Directs the Secretary, directly or through grant or contract, to develop model systems: (1) for gathering health care cost, quality, and outcomes data; and (2) for analyzing such data in a manner that would allow valid comparisons among providers and among health plans. Requires the Secretary to support and evaluate experiments with different approaches to achieve the most cost-effective method. Provides that, when appropriate, the Secretary may establish standards for data gathering in order to facilitate analysis and comparisons across the nation. Authorizes appropriations. Authorizes the Secretary to make grants to States to enable them to plan and initiate implementation of their health care information programs. Authorizes appropriations. Nullifies any State law which requires medical or health insurance records (including billing information) to be kept in written, rather than electronic, form. Directs the Secretary, after taking into consideration the Insurance Information and Privacy Protection Model Act of NAIC to promulgate requirements concerning health insurance information privacy and confidentiality. Includes among such requirements that information identifying individuals shall not be redisclosed (with such limited exceptions as the Secretary may provide) except to the extent necessary to carry out the purpose for which the information was collected. Requires the Secretary to take into consideration specified principles concerning information that identifies individuals when promulgating such requirements. Directs the Secretary to determine whether problems relating to standards for the electronic receipt and transmission of health insurance information cause significant administrative costs. Requires the Secretary, if such costs are generated, to promulgate standards for the electronic receipt and transmission of claims, payment, eligibility, and enrollment information (including privacy and confidentiality protection requirements). Directs the Secretary to determine whether problems relating to the receipt and transmission of health insurance eligibility verification cause significant administrative costs. Requires the Secretary, if such costs are generated, to promulgate requirements for the receipt and transmission of health insurance eligibility verification. Directs the Secretary to determine whether the proportion of health insurance claims and payment information received and transmitted by paper will continue to cause significant administrative costs. Directs the Secretary, if such costs are generated, to require a specified proportion of (or all of) such information to be received and transmitted electronically (with such exceptions as the Secretary might specify). Directs the Secretary to promulgate requirements for the format and content of basic claim forms under health insurance plans. Directs the Secretary to determine whether the variety of information requested by health insurers (in addition to information requested in basic claims forms) causes administrative costs disproportionate to the benefits derived. Requires the Secretary, if such costs are generated, to publish recommendations concerning what additional information should be allowed to be requested and in what format. Directs the Secretary, after consulting with NAIC, to promulgate rules for determining the relative liability of insurers and the priority of payment when several health insurance policies cover the same individual. Directs the Secretary to determine whether problems relating to the transfer of information among health insurers that cover the same individual cause significant mistaken payments or administrative costs. Requires the Secretary, if such payments or costs are generated, to promulgate requirements concerning the transfer among insurers (and annual updating) of information (which may include requirements for the use of unique identifiers, and for the listing of all individuals covered under a health insurance plan). Directs the Secretary to determine, for each State, whether there were in effect State requirements substantially the same as those enumerated below and whether the State effectively enforced them. Applies the requirements enumerated below to administrators of self-insured employee plans. Provides for Federal backup authority to be effective in a State (with respect to a section) only if the Secretary makes a negative finding with respect to certain requirements or if the State does not provide sufficient information to enable the Secretary to make the determination. Requires health insurers (in States that do not have an equivalent program) to: (1) meet the Federal requirements concerning the protection of privacy and confidentiality; (2) use social security numbers for their beneficiaries and Medicare unique identifiers for each provider that furnishes items and services; (3) meet the standards and requirements (if any) concerning the receipt and transmission of health insurance information; (4) meet the requirements concerning the form and content of health insurance claim forms; (5) follow the rules determining the priority of payment when several health insurance policies cover the same individual; and (6) meet the requirements (if any) concerning the furnishing of information among insurers. Requires the Secretary, after consulting with the American National Standards Institute (ANSI) and others, to promulgate requirements for hospitals concerning electronic medical data. Specifies the data sets to be included in such requirements. Permits the Secretary, after consulting with ANSI and others, to promulgate requirements for health care entities other than hospitals concerning electronic medical data. Requires hospitals that participate in the Medicare program to maintain an electronic patient care information system that meets certain data set requirements promulgated by the Secretary for hospitals, and to transmit data electronically to the Secretary, peer review organizations, carriers, and intermediaries, from the appropriate data sets. Permits waivers of such requirements for hospitals in the process of developing an electronic patient care information system, for small rural hospitals, and for certain hospitals that agree to subject their data transfer processes to specified quality assurance procedures. Permits Federal agencies to require electronic transmission of data elements utilized for certain agency health care or research programs. Amends the Internal Revenue Code to subject insurers to an excise tax for any failure to comply with requirements under SSA new title XXII respecting health insurance. Specifies the amount of such tax for administrators of self-insured employee welfare benefit plans and other insurers. Provides that the excise tax generally shall not apply if the violation could not have been discovered through the exercise of reasonable diligence, or if the violation was corrected within 30 days after it had been discovered. Gives the Secretary authority to waive the tax if the violations were due to reasonable cause and not willful neglect, to the extent payment of the tax would be excessive relative to the failure involved. Authorizes the Secretary to make grants to: (1) community organizations or coalitions of health care providers, insurers, and purchasers to establish, and document the efficacy of, communication links between the information systems of health insurers and of health care providers; and (2) public and private non-profit entities for the development of regional- and community-based clinical information systems, and for the development and testing of certain ambulatory care data sets. Authorizes appropriations. Title IV: MEWA Enforcement Improvements - Multiple Employer Welfare Arrangements Enforcement Improvements Act of 1992 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to revise provisions relating to MEWAs and other employee welfare benefit plans. Revises the definition of employee welfare benefit plan to: (1) allow up to five percent of the aggregate number of covered individuals to be individuals who are not employees or former employees of the employer, or members or former members of the employee organization which established or maintains the plan; and (2) include a plan, fund, or program established or maintained by a franchise network or by two or more trades or businesses that are within the same control group or were within it at any time during the preceding one-year period. Amends the definition of MEWA to: (1) limit the exclusion of collective bargaining agreements, under specified conditions; (2) exclude franchise networks; (3) exclude insurers, or health maintenance organizations licensed to do business in a State; (4) exclude trades and businesses within the same control group at any time during the preceding one-year period (as well as those currently in the same group), by deeming them a single employer; and (5) provide that single employer plans shall not be deemed MEWAs solely because they cover individuals who are not employees or former employees, or their beneficiaries, if the number of such individuals never exceeds five percent of the aggregate covered during the plan year. Makes ERISA title I (Protection of Employee Benefit Rights) applicable to any MEWA engaged in commerce or in any industry or activity affecting commerce, with specified exceptions. Requires MEWAs which provide medical care benefits to file annual registration statements with the Secretary of Labor (the Secretary), including: (1) certain information on persons involved in its operation and States where it conducts business; (2) certification that copies of the registration have been filed with the appropriate State insurance commissioners; and (3) indication of whether the MEWA has obtained, applied for, or intends to apply for a certain exemption from State regulation. Authorizes the Secretary, to assess a civil penalty for a trustee's or other responsible person's failure or refusal to file such registration statement. Authorizes district courts, upon the Secretary's showing that a MEWA is neither licensed under State insurance laws nor operating in accordance with the terms of a certain Federal exemption fron State regulation, to order the MEWA to cease activities and to grant additional equitable or remedial relief, unless the MEWA can show that it is fully insured, meets the specified State or Federal requirements, and operates in accordance with applicable State insurance laws that are not superseded under ERISA. Sets forth an exemption procedure under which the Secretary is authorized to exempt from State regulation, for up to three years, individually, or by class, MEWAs which are not fully insured and which provide medical care benefits. Allows such exemption to be renewed upon application. Prohibits such an exemption unless the Secretary finds that it is: (1) administratively feasible; (2) not adverse to the interests of participants and beneficiaries; and (3) protective of participant and beneficiary rights and benefits. Requires published and adequate notification and opportunity for a hearing for interested persons before any such exemption is granted. Postpones, until 18 months after enactment of this Act, the required applicability of State insurance laws to MEWAs that provide medical care benefits if such MEWAs: (1) file for the exemption within 180 days after such enactment; and (2) the Secretary does not find such application to be materially deficient. Terminates such exclusion from State requirements for any such MEWA at any time when the Secretary determines it would be detrimental to the interests of participants or beneficiaries. Places any determination relating to such exclusion in the Secretary's sole discretion. Provides that States may require disclosure of information from any employee welfare benefit plan (in connection with an investigation to determine if violations of the State insurance law have or are about to occur) as to whether such plan is a MEWA or is in compliance with the MEWA exemption or 18-month exclusion. Title V: Health Care Liability Reform And Quality of Care Improvement - Health Care Liability Reform and Quality of Care Improvement Act of 1992 - Requires, in order to receive a notification of compliance with this title, that States have in effect the health care liability reforms set forth below. Requires, in any health care liability action, the liability of each defendant for noneconomic damages to be several and not joint, with each defendant liable only for the proportion of that defendant's fault and a separate judgment against that defendant in that amount. Prohibits awarding noneconomic damages over $250,000 in any health care liability action, subject to waiver. Reduces the total damages received by a plaintiff by the amount of any collateral source benefits. Allows: (1) future economic damage awards to be paid periodically based on when the damages are likely to occur or at the time the damages accrue; and (2) in certain circumstances, the court to require the health care provider to purchase an annuity or fund a reversionary trust to make such periodic payments. Prohibits reopening a judgment awarding periodic payments to contest, amend, or modify the schedule or amount in the absence of fraud or any ground permitting relief after entry of a final judgment. Declares it U.S. policy to encourage alternative dispute resolution (ADR). Requires a State to establish at least one ADR mechanism. Requires each State to: (1) cooperate with Federal research efforts regarding patient outcomes, clinical effectiveness, and clinical practice guidelines; (2) collect, analyze, and supply the Secretary of Health and Human Services with information regarding State medical board performance; and (3) impose continuing education requirements on disciplined physicians. Allows alternatives to these requirements regarding medical board performance and continuing education if the Secretary finds such alternatives at least as effective in reducing the incidence of negligence as compliance with the requirements. Allows States three years from the adoption of this Act to enact, adopt, or otherwise comply with the requirements of this title. Requires withholding of State payments for noncompliance. Allows waiver of the requirements of this title for any experimental, pilot, or demonstration project which is likely to assist in promoting this title's objectives for health care liability reform. Sets forth the framework for establishing a system of mandatory nonbinding arbitration in each State for the resolution of health care liability claims. Amends Federal law to prohibit, in a health care liability action, finding the United States jointly and severally liable for noneconomic damages. Allows liability only for those noneconomic damages directly attributable to its pro rata share of fault. Reduces damages paid by the United States by the amount of any collateral source benefits. Prohibits awarding noneconomic damages, in an action against the United States, over $250,000. Requires, at the request of the United States when future economic damages are awarded in excess of $100,000, an order that such damages be paid by periodic payments based on when the damages are likely to occur. Allows the United States, in such cases, to pay the judgment periodically, purchase an annuity, or fund a reversionary trust. Prohibits reopening the judgment to contest, amend, or modify the schedule or amount in the absence of fraud or any ground permitting relief after entry of a final judgment.
Resolution· HRESH.Res. 539 (102nd)referred
United States · United States Congress · 4 August 1992
Directs the Committee on Standards of Official Conduct to investigate whether Representative Henry B. Gonzalez has publicly disclosed classified information in the Congressional Record, and in so doing violated the Rules of the House of Representatives or any duly constituted committees during the Second Session of the 102d Congress. Directs all other House committees, Members, officers, or employees who may have information relevant to this investigation to cooperate promptly with the Committee subject to procedures it shall adopt necessary to protect from unauthorized disclosure of classified information which may be transmitted to the Committee.
Bill· HRH.R. 5657 (102nd)referred
United States · United States Congress · 22 July 1992
Amends the Internal Revenue Code to exclude a deposit made by a policyholder under a qualified perpetual insurance policy from provisions governing the treatment of loans with below-market interest rates. Describes such a policy as one: (1) which provides insurance for property damage or casualty with respect to certain residential property (or the contents thereof); and (2) which is funded only by the policyholder placing a cash deposit (and does not provide for any periodic premiums) and such deposit is fully refundable upon cancellation.
Bill· HRH.R. 5664 (102nd)referred
United States · United States Congress · 22 July 1992
Federal Grants for State and Local "G.I. Bills" for Children - Requires the Secretary of Education to use specified funds to make competitive grants to States and localities for educational choice programs. Authorizes reservation of a specified portion of such funds for national evaluation of such programs. Authorizes appropriations. Makes a State or locality eligible for such a grant if it: (1) has taken significant steps to provide a choice of schools to families with school children in the program area, including those not eligible for scholarships under this Act; (2) will, if awarded a grant, provide scholarships to parents of eligible children that may be redeemed for elementary or secondary education at a broad variety of public and private (including religious) schools serving that area; and (3) permits all such lawfully operating schools serving the area to participate in its program under this Act if they so choose. Requires grantees to provide scholarships to parents of eligible children, with a value of $1,000 from Federal funds under this Act and an additional amount, if any, of State, local, and nongovernmental funds. Excludes such scholarships from consideration as income for Federal income tax or Federal program eligibility purposes. Requires such scholarships to be provided to parents of children who reside in the program area, will attend a participating public or private school, and are from a middle- or low-income family (as determined by the grantees, in accordance with the Secretary's regulations). Limits the maximum family income for eligibility to not more than the higher of the State or national median family income. Provides for continuation of such scholarship aid to a child in each program year, unless the child no longer resides in the program area or no longer attends school, or the child's family income exceeds by 20 percent or more than the maximum income of families who received scholarships in the preceding year. Requires the grantee to provide scholarships to the lowest income families if the grant amount is insufficient to provide such aid to each child up to the income level for which the grantee applied. Sets forth application requirements, including descriptions of program areas and economic profiles of children residing there. Requires that programs be selected to receive such grants on the basis of: (1) number and variety of educational choices they make available to families of eligible children; (2) extent to which choices among public, private, and religious schools are available to all families in the area, including those not eligible for scholarships; (3) proportion of children from low-income families among participants; and (4) applicant's financial support of the program, including, State, local, and nongovernmental supplementary funds, not only for scholarships but also for other economic incentives such as tax relief (taking local conditions into account). Requires awards to programs in urban and rural areas and in different areas of the Nation. Requires award of annual grants, taking account of availability of appropriations, number and quality of applications, and other appropriate factors. Allows each grant to be for up to four years and to be renewed for an additional four-year period. Requires the following sequence for use of the Federal portion of such a scholarship: (1) for tuition and fees at the school selected by the parents, and for reasonable transportation costs (at the parent's option); (2) if the parent's so choose, for supplementary academic services for the child (up to $500 in cost) from any provider chosen by the parents that the grantee determines is capable to do so and has an appropriate refund policy; and (3) any remaining funds to be used either by the public school the child attends for student academic achievement programs, or, if the child attends private school, by the grantee for additional scholarships. Sets forth the effect of this Act on other programs. Requires a local educational agency to provide to any child in an educational choice program the same services that it would otherwise provide to that child under chapter 1 title I Elementary and Secondary Education Act of 1965 provisions for educationally disadvantaged children. Declares that this Act does not affect specified requirements under the Individuals with Disabilities Education Act. Provides that such scholarships are aid to families, not institutions, so that their expenditure shall not be construed as Federal financial aid or assistance to a school or provider of supplementary academic services. Requires schools or providers of academic services, in order to receive scholarship funds under this Act, to comply with antidiscrimination requirements under specified Federal laws. Directs the Secretary to promulgate regulations to implement this requirement, taking into account the purposes of this Act and the nature, variety, and missions of schools and providers that may participate. Prohibits consideration of Federal funds provided under this Act in Federal, State, or local agency determination of other assistance to such grantees or schools attended. Provides that no State constitution or law shall be construed or applied to prohibit any grantee from: (1) paying administrative costs of a program under this Act; or (2) providing any Federal funds received under this Act to parents for use at a religious or other private institution. Declares that nothing in this Act authorizes the Secretary to exercises direction, supervision, or control over any participating school or educational institution as to curriculum, instructional program, administration or personnel. Directs the Secretary to conduct with specified reserved funds, a national evaluation of the program authorized by this Act. Directs the Secretary to promulgate regulations to enforce this Act. Prohibits such enforcement through a private cause of action.
Bill· HRH.R. 5586 (102nd)referred
United States · United States Congress · 9 July 1992
Makes the legal defense of discretionary function provided under specified Federal law inapplicable to any legal or administrative proceeding for damages arising out of U.S. violation of occupational safety or health standards or U.S. negligence at any workplace owned or operated by or under contract with the United States.
Bill· HRH.R. 5501 (102nd)referred
United States · United States Congress · 25 June 1992
Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act (SSA) to revise State plan provisions to mandate State programs that provide AFDC recipients with education, training, and work experience needed to prepare them to do without AFDC assistance after four years of program participation. Outlines the administrative framework for such programs, along with conditions for program participation and penalties for violations of such conditions. Requires parental initiatives in ensuring that children of families on AFDC receive proper immunizations and well-child care and attend school in order for such families to continue receiving AFDC assistance. Provides for mitigation of the marriage penalty in certain cases where the parent of a family receiving AFDC assistance (original parent) marries an individual who, at the time of the marriage, is not the biological parent of any child of the original parent. Revises SSA title IV part F (Job Opportunities and Basic Skills Training Program), with changes that allow States to reserve food stamp benefit funds and use them instead to provide subsidized jobs under work supplementation programs (work programs). Amends the Food Stamp Act of 1977 with respect to employment cashout of food stamp benefits under part F work programs.
Bill· HRH.R. 5495 (102nd)referred
United States · United States Congress · 25 June 1992
National Institutes of Health Revitalization Amendments of 1992 - Title I: General Provisions Regarding title IV of Public Health Service Act - Subtitle A: Research Freedom - Part I: Review of Proposals for Biomedical and Behavioral Research - Amends the Public Health Service Act to prohibit the Secretary of Health and Human Services from approving certain research or financial assistance to conduct research unless specified review has taken place and the review entity has recommended approval. Prohibits the Secretary from withholding, on ethical grounds, funding for research that has received such review approval unless: (1) an ethics advisory board recommends the withholding; or (2) such a board recommends against withholding, but the Secretary finds that the recommendation is arbitrary and capricious. Part II: Research on Transplantation of Fetal Tissue - Permits the Secretary to conduct or support research on the transplantation of human fetal tissue for therapeutic purposes regardless of whether the tissue is obtained from a spontaneous or induced abortion or a stillbirth, in accordance with State and local law. Requires the researcher, if the tissue bank established under a specified executive order is in operation, to obtain the tissue from that bank, unless the bank does not provide requested tissue within a specified time of a request. Requires certain statements by the woman providing the tissue, the researcher, and the donee. Imposes criminal penalties for certain commercial transactions involving the transfer or directed donation of human fetal tissue. Prohibits: (1) any official of the executive branch from imposing a policy prohibiting the Department of Health and Human Services from conducting or supporting any research on the transplantation of human fetal tissue for therapeutic purposes; and (2) the Secretary from withholding funds for research which is in accordance with this Act. Deems a specified report of the Human Fetal Tissue Transplantation Research Panel to be a report issued by an ethics advisory board finding, on a basis that is neither arbitrary nor capricious, that there are no ethical grounds for withholding funds for such research. Part III: Miscellaneous Repeals - Removes certain provisions of the Public Health Service Act relating to: (1) biomedical ethics; (2) a study by the Biomedical Ethics Advisory Committee on waiver of a specified risk standard; and (3) the construction of title IV (National Research Institutes) of the Act. Subtitle B: Clinical Research Equity Regarding Women and Minorities - Part I: Women and Minorities as Subjects in Clinical Research - Requires that women and minorities be included as subjects in each clinical research project under such title IV. Requires projects to be designed and carried out so as to provide for an analysis of whether the variables being tested affect women or minorities differently than other subjects. Requires the establishment of inclusion guidelines. Requires that technical and scientific peer review conducted under existing provisions include an evaluation of the merit of the proposal regarding women and minorities. Part II: Office of Research on Women's Health - Establishes in the National Institutes of Health (NIH) the Office of Research on Women's Health. Requires the Director of the Office to establish: (1) the Coordinating Committee on Research on Women's Health; and (2) the Advisory Committee on Research on Women's Health. Mandates: (1) a determination of the extent to which women are represented among senior physicians and scientists of the national research institutes and among those conducting research supported by the institutes; and (2) as appropriate, activities to increase the extent of such representation. Requires establishment of: (1) a data system, available to the public, for the collection, analysis, and dissemination of information regarding research on women's health conducted or supported by the institutes; and (2) a program to provide information on research and prevention activities of the institutes relating to women's health research. Subtitle C: Scientific Integrity - Replaces provisions relating to protection against scientific fraud with provisions establishing as an independent entity in the Department of Health and Human Services the Office of Scientific Integrity. Requires: (1) applicants for a grant, contract, or cooperative agreement under the Act for biomedical or behavioral research to have an administrative process to review reports of scientific misconduct and agree to report any investigation of such reports; and (2) a response process for the Office. Establishes the Commission on Scientific Integrity. Provides for employee whistle blower protection. Mandates measures for identifying, responding to, and reporting the existence of a financial interest that will or may create a bias in favor of obtaining results, in a project to evaluate the safety or effectiveness of a drug, medical device, or treatment, that are consistent with the interest. Title II: Protection of Health Facilities - Prohibits stealing or otherwise converting personal property or damaging real property of a health facility assisted under the Public Health Service Act, or deterring, through physical restraint, any individual from entering or exiting the facility. Includes in the prohibitions various acts interfering with the use of animals for research. Provides for fines, imprisonment, restitution, and private civil actions. Title III: National Institutes of Health in General - Modifies the duties of the NIH's Associate Director for Prevention. Establishes a program to enhance the competitiveness of research entities in States which have historically had low success in obtaining funds from the national research institutes for biomedical and behavioral research. Mandates activities, consistent with the global Children's Vaccine Initiative, to develop affordable new and improved vaccines. Authorizes appropriations. Requires a plan regarding research methods that do not require the use of animals, reduce the number of animals used, and produce less distress in the animals. Establishes the Interagency Coordinating Committee on the Use of Animals in Research. Repeals similar provisions. Authorizes the Secretary of Health and Human Services to conduct and support research, research training, recruitment, and other activities to increase the number of women and individuals from disadvantaged backgrounds in biomedical and behavioral research. Requires that any survey of human sexual behavior conducted or supported through NIH: (1) undergo review in accordance with specified provisions; and (2) have been determined by the Secretary to assist in reducing the incidence of infectious disease or improve health conditions. Establishes a fund for use by the NIH Director to carry out NIH activities. Authorizes appropriations. Modifies the term of office of members of advisory councils of the national research institutes. Requires that at least half of all new or revised health education and promotion materials developed or funded by NIH be in a form that does not exceed a level of functional literacy. Authorizes a program to provide day care service for NIH employees. Title IV: General Provisions Respecting National Research Institutes - Requires that the Secretary receive from the President and the Office of Management and Budget directly all funds appropriated by the Congress for obligation and expenditure by the Institute. Removes provisions authorizing the Director of the National Cancer Institute to directly receive such funds. Modifies the authority of the directors of the national research institutes to establish and appoint the members of technical and scientific peer review groups in addition to those appointed under specified provisions. Makes the Federal Advisory Committee Act inapplicable to such additional groups. Requires expansion and intensification of programs of research and related activities concerning osteoporosis, Paget's disease, and related bone disorders. Provides for the establishment, through a grant, cooperative agreement, or contract, of a clearinghouse to enhance knowledge and understanding of professionals, patients, and the public. Authorizes appropriations. Establishes: (1) a comprehensive program of conducting basic and clinical research on trauma, including diagnosis, treatment, rehabilitation, and general management of trauma; and (2) the Trauma Research Interagency Coordinating Committee. Title V: National Cancer Institute - Requires expanding, intensifying, and coordinating the activities of the National Cancer Institute (NCI) regarding breast and ovarian cancer, other cancers of the reproductive system of women, and prostate cancer. Requires inclusion of the conduct and support of research and demonstration centers. Authorizes appropriations. Removes provisions authorizing appropriations for NCI and the National Heart, Lung, and Blood Institute (NHLBI). Title VI: National Heart, Lung, and Blood Institute - Requires NHLBI to conduct intramural training and education. Authorizes development of three centers for basic and clinical research into, training in, and demonstration of, advanced diagnosis, prevention, and treatment for cardiovascular diseases in children. Authorizes appropriations for NHLBI. Title VII: National Institute on Diabetes and Digestive and Kidney Diseases - Establishes a program of conducting and supporting research, training, health information dissemination, and other activities regarding nutritional disorders, including obesity. Provides for the development or substantial expansion of centers for research and training. Title VIII: National Institute on Arthritis and Musculoskeletal and Skin Diseases - Removes provisions stating that the purpose of the National Institute on Arthritis and Musculoskeletal and Skin Diseases (NIAMSD) includes sports-related injuries. Requires NIAMSD to place emphasis on arthritis affecting children. Establishes a multipurpose arthritis and musculoskeletal disease center focusing on children. Modifies the composition of the National Arthritis Advisory Board and its annual report requirements. Title IX: National Institute on Aging - Transfers to the Public Health Service Act provisions of the Health Research Extension Act of 1985 authorizing a grant to develop a registry for epidemiological data on Alzheimer's disease and related data collection training. Removes the existing authorization of appropriations. Mandates research into the aging processes of women, with particular emphasis on menopause and into the diagnosis, disorders, and complications related to aging and loss of ovarian hormones. Authorizes appropriations for the National Institute on Aging. Title X: National Institute of Allergy and Infectious Diseases - Includes programs regarding tropical diseases in the purposes of the National Institute of Allergy and Infectious Diseases. Authorizes grants or contracts for centers to conduct basic and clinical research on chronic fatigue syndrome. Establishes an extramural study section for the syndrome. Title XI: National Institute of Child Health and Human Development - Subtitle A: Research Centers with Respect to Contraception and Research Centers with Respect to Infertility - Mandates grants or contracts for three centers to conduct activities to improve methods of contraception and two centers to conduct activities to improve methods of diagnosis and treatment of infertility. Authorizes appropriations. Establishes a program of agreements with health professionals, including graduate students, to conduct research on contraception or infertility in consideration of the Government repaying a limited amount of the educational loans of the professionals. Subtitle B: Program Regarding Obstetrics and Gynecology - Establishes in the National Institute of Child Health and Human Development (NICHHD) an intramural laboratory and clinical research program in obstetrics and gynecology. Subtitle C: Child Health Research Centers - Mandates development of and support for centers for conducting research on child health. Subtitle D: Study Regarding Adolescent Health - Mandates a longitudinal, large-scale study on the general health and well-being of adolescents in the United States. Allocates funding from amounts appropriated to NICHHD. Title XII: National Eye Institute - Authorizes not more than three grants for the establishment and support of centers for clinical research on eye care for individuals with diabetes. Allows grant funds to be used for equipment and for construction and modification of facilities. Title XIII: National Institute of Neurological Disorders and Stroke - Mandates the conduct and support of research on multiple sclerosis. Title XIV: National Institute of Environmental Health Sciences - Establishes the Applied Toxicological Research and Testing Program. Title XV: National Library of Medicine - Subtitle A: General Provisions - Directs the Secretary to promote the use of computers and telecommunications by health professionals. Increases the dollar limit on grants to medical libraries and related instrumentalities. Authorizes appropriations for the National Library of Medicine (NLM). Subtitle B: Financial Assistance - Mandates grants for research on, and development and demonstration of, new educational technologies. Requires recipient institutions to make grant projects available for: (1) training health professions students; and (2) enhancing the capabilities of health professionals regarding research and teaching. Authorizes appropriations to carry out provisions relating to medical libraries and related matters. Subtitle C: National Center for Biotechnology Information - Authorizes appropriations to carry out provisions relating to the National Center for Biotechnology Information. Subtitle D: National Information Center on Health Services Research and Health Care Technology - Establishes in NLM the National Information Center on Health Services Research and Health Care Technology to collect, analyze, and disseminate information on health services research and health care technology. Authorizes appropriations. Requires the Administrator of the existing information center on health care technologies and health care technology assessment and the NLM Director to enter into an agreement on the implementation of these provisions. Title XVI: Other Agencies of National Institutes of Health - Subtitle A: Division of Research Resources - Redesignates the Division of Research Resources as the National Center for Research Resources. Authorizes grants to alter existing or construct new research facilities. Establishes the Scientific and Technical Review Board on Biomedical and Behavioral Research Facilities to advise the Center director and the existing advisory council. Conditions grant approval on Board approval. Authorizes appropriations. Requires the NIH Director to reserve a specified sum from amounts appropriated under this authorization for grants and contracts to construct or improve regional centers for research on primates. Subtitle B: National Center for Nursing Research - Redesignates the National Center for Nursing Research as the National Institute for Nursing Research and adds the Institute to the list of NIH's national research institutes. Subtitle C: National Center for Human Genome Research - Adds the National Center for Human Genome Research to the list of NIH agencies. Declares the purpose of the Center to be to characterize the structure and function of the human genome, including the mapping and sequencing of individual genes. Title XVII: Awards and Training - Subtitle A: National Research Service Awards - Directs the Secretary to carry out provisions relating to National Research Service Awards in a manner that will recruit into biomedical or behavioral research, and provide research training to, women and individuals from disadvantaged backgrounds. Subtitle B: Acquired Immune Deficiency Syndrome - Modifies a program of agreements (under which certain health professionals conduct research regarding acquired immune deficiency syndrome (AIDS) as NIH employees in consideration of Government repayment of educational loans) to remove provisions requiring a minimum of three years as an NIH employee. Authorizes appropriations. Authorizes the Commissioner of Food and Drugs to carry out a similar program regarding the review of applications concerning AIDS. Subtitle C: Loan Repayment for Research Generally - Mandates a program of agreements with health professionals who have a substantial amount of educational loans relative to income and who meet other requirements to conduct research, as NIH employees, in consideration of Government repayment of a limited amount of the educational loans of the professionals. Authorizes appropriations. Subtitle D: Scholarship and Loan Repayment Programs Regarding Professional Skills Needed by Certain Agencies - Authorizes a program of contracts with individuals from disadvantaged backgrounds for scholarships for undergraduate programs for professions needed by NIH in consideration of service by the individuals as NIH employees. Authorizes a program of contracts with health professionals from disadvantaged backgrounds who have a substantial amount of educational loans relative to income to conduct clinical research as NIH employees in consideration of the Government repaying a limited amount of the educational loans of the professionals. Subtitle D: (SIC) Funding - Authorizes appropriations for making payments under National Research Service Awards and under grants for such Awards. Modifies set-aside amounts and requires a set-aside for provisions relating to residency programs in the general practice of dentistry. Title XVIII: National Foundation for Biomedical Research - Excludes from voting rights the ex officio members of the National Foundation for Biomedical Research. Authorizes appropriations. Title XIX: Research with Respect to Acquired Immune Deficiency Syndrome - Modifies the duties of the AIDS Clinical Research Review Committee, including requiring the Committee to: (1) give advice to other agencies of NIH as well as to the National Institute of Allergy and Infectious Diseases (NIAID); and (2) make recommendations on research projects regarding diagnosing immune deficiency and predicting, diagnosing, preventing, and treating opportunistic cancers and infectious diseases. States that the requirement that the clinical evaluation units at the National Cancer Institute and NIAID conduct evaluations of treatments for acquired immune deficiency syndrome (AIDS) includes evaluations of methods of: (1) diagnosing immune deficiency; and (2) predicting, diagnosing, preventing, and treating opportunistic cancers and infectious diseases. Modifies provisions relating to the support of international efforts to add to the purpose of grants, cooperative agreements, and contracts for such efforts provisions promoting and expediting: (1) international training; (2) research and training concerning the natural history and pathogenesis of the human immunodeficiency virus; and (3) the development and evaluation of vaccines and treatments for opportunistic infections. Authorizes appropriations for each fiscal year. Requires that model protocols (developed with grants under existing provisions) for the clinical care of individuals infected with the etiologic agent for AIDS include treatment and prevention of human immunodeficiency virus (HIV) infection and related conditions among women. Authorizes appropriations. Adds collection of data on the natural history of infection with the etiologic agent to the purposes of the epidemiological data base mandated by current provisions. Authorizes appropriations for each fiscal year. Requires the Director of NIH to develop and implement a comprehensive plan for the conduct and support of AIDS research by NIH agencies. Authorizes appropriations for each fiscal year for fellowship and training programs relating to AIDS under existing provisions. Title XX: Certain Authorities of Centers for Disease Control - Authorizes grants to States and local health departments for programs for specified activities relating to prostate cancer, including screening, public information, and improving professional training. Authorizes appropriations. Authorizes: (1) grants or contracts for population-based, statewide cancer registries; (2) grants for developing plans that meet the requirements of specified provisions; and (3) technical assistance to States, either directly or through grants and contracts. Mandates a study on the factors contributing to elevated breast cancer mortality rates in specified States. Authorizes appropriations. Requires a survey to determine which entities collect data on traumatic brain injuries and the nature of their data collection systems. Authorizes cooperation and assistance to establish traumatic brain injury as a specific reportable condition or disability. Authorizes appropriations. Title XXI: Studies - Mandates studies on: (1) the impact, with regard to acquired immune deficiency syndrome (AIDS), of parallel-track drug-release mechanisms on clinical research and on the activities of the Commissioner of Food and Drugs regarding drug approval; (2) third-party payor policies regarding payment of costs incident to the participation of individuals as subjects in AIDS drug clinical trials; and (3) whether AIDS advisory committees in NIH are being sufficiently coordinated. Requires a plan for the inclusion of HIV-infected women, infants, and children in HIV vaccine studies conducted by or through NIH. Authorizes appropriations. Mandates an annual report on the leading causes of death in the United States and related spending by the Department of Health and Human Services for research, prevention, and education. Requires three-year studies on: (1) nutrition screening and intervention regarding the elderly; and (2) the extent of malnutrition in hospitals, in long-term care facilities, and among those living independently. Establishes an advisory panel to oversee the studies. Mandates a report on the feasibility of developing a plan for the conduct of research at NIH on the prevention of traumatic injuries. Directs the Secretary to: (1) review existing data and research concerning whether there is a relationship between legal and illegal drug use; and (2) if necessary, conduct additional research. Mandates reports on: (1) research conducted or supported by NIH on chronic fatigue syndrome; (2) the appropriateness and impact of NIH assuming responsibility for the conduct of all Federal research, development, testing, and evaluation relating to medical countermeasures against biowarfare threat agents. Requires a study on the potential for, the prevalence of, and the issues related to the contamination of worker's homes with substances from their work places. Requires: (1) establishment of the Worker's Family Protection Task Force to take specified actions, including developing an investigative strategy for obtaining any needed additional data; and (2) each Federal department or agency to fulfill the role assigned by the strategy. Authorizes appropriations. Mandates studies: (1) of the retention, recruitment, vacancy and turnover rates of NIH support staff, including fire fighters, law enforcement, procurement officers, technicians, nurses, and clerical employees; and (2) to develop a streamlined procurement system for NIH. Title XXII: Miscellaneous Provisions - Redesignates the Senior Biomedical Research Service as the Silvio Conte Senior Biomedical Research Service and increases the limit on the number of its members. Renames the AIDS Clinical Research Review Committee as the AIDS Research Advisory Committee. Prohibits the Secretary from conducting or supporting the SHARP survey of adult sexual behavior. Requires that a report on carcinogens be submitted biennially (currently, annually). Mandates a report analyzing the report of the National Committee on Sleep Disorders Research and presenting a plan for the conduct and support of sleep disorders research at NIH. Mandates presentation to the Congress of a master plan to provide for the replacement or refurbishment of less than adequate buildings, utility equipment and distribution systems, roads, walkways, parking areas, and grounds of NIH laboratory and clinical facilities. Allows the plan to make recommendations for the undertaking of new projects consistent with the objectives of these provisions. Title XXIII: Effective Date - Sets forth the effective date of this Act.
Bill· HRH.R. 5325 (102nd)referred
United States · United States Congress · 4 June 1992
Action Now Health Care Reform Act of 1992 - Title I: Improved Access to Affordable Health Care Coverage - Subtitle A: Increased Affordability and Availability for Employees - Directs the Secretary of Health and Human Services (the Secretary) to request the National Association of Insurance Commissioners (the NAIC) to develop model regulations requiring each carrier that makes available in a State any small employer health benefit plan to make available to each small employer in the State a MedAccess basic plan and a MedAccess standard. Directs the Secretary to develop such regulations, if the NAIC does not. Defines MedAccess plan as a health benefits plan that: (1) provides benefits typical of the benefits offered in the small employer health coverage market or provides only benefits for essential preventive and medical services and has an average actuarial value not exceeding 60 percent of the average actuarial value of the typical benefits offered in the small employer health coverage market; (2) accepts every small employer in the State applying for coverage and accepts for enrollment every eligible individual (defined as an individual who is a full-time employee and, if family coverage is offered, covers the employee's spouse and dependents under age 19 or under age 25 for students); and (3) meets consumer protection standards established by this Act relating to limitation of pre-existing condition clauses, continuity of coverage, renewability, and premium limitations. Prohibits the imposition, by a carrier, of a limitation of benefits based on the fact a condition pre-existed the effectiveness of the policy if: (1) the condition relates to a condition not diagnosed within three months before coverage under the plan; (2) the limitation extends beyond six months after coverage under the plan; (3) the limitation applies to an individual who, as of date of birth, was covered under the plan; and (4) the limitation relates to pregnancy. Requires continuous coverage. Prohibits cancellation of a plan or denial of coverage unless there is: (1) nonpayment of premiums; (2) fraud; (3) noncompliance with plan provisions; (4) failure to maintain the required number of enrollees; (5) misuse of a provider network provision; or (6) a cessation by the carrier of the provision of any plan in a State. Amends the Internal Revenue Code to impose an excise tax which shall be paid by the carrier on the failure of a carrier or an employer health benefit plan to comply with the provisions of the Act. Directs the Secretary to request the NAIC to develop models for reinsurance or allocation of risk mechanisms for individuals and small employers who are enrolled under a small employer health benefit plan that meets the consumer protection standards and for whom a carrier is at risk of incurring high costs under the plan. Requires each State to establish and fund one or more reinsurance or allocation or allocation of risk mechanisms that are consistent with a model. Directs the Secretary to develop models, if the NAIC does not. Permits a State, in order to insure the financial solvency of the mechanism, to impose charges on any entity providing employee-related health benefits, so long as such charges do not discriminate with respect to entities that would not be subject to such charges. Directs the Secretary to establish a reinsurance or allocation of risk mechanism, if a State does not. Imposes an excise tax which shall be paid by the carrier on the providing of any health benefit plan which covers any employee in a Federal reinsurance State. Permits either a State or the Secretary (in a Federal reinsurance State) to require each employer health benefit plan to: (1) be registered; and (2) provide such information as is necessary for the reinsurance or allocation of risk mechanisms. Directs the Secretary to: (1) establish an Office of Private Health Coverage to be headed by a Director appointed by the Secretary; and (2) provide for the appointment of an advisory committee to advise the Director. Permits the Director to research the impact of this subtitle and conduct related demonstration projects. Requires the Director to develop: (1) methods of measuring, in terms of the expected costs of providing benefits under small employer health benefit plans and, in particular, MedAccess plans, the relative health risks of eligible individuals; and (2) a model for equitably distributing health risks among carriers in the small employer health care coverage market. Authorizes appropriations for the purposes of this paragraph. Subtitle B: Improved Small Employer Purchasing Power of Affordable Health Insurance - Preempts from insurance mandates a qualified small employer purchasing group, if the group consists of employers with not more than 100 employees, the group consists of not fewer than 100 employers, and the health benefit plans with respect to the employer members are in compliance with applicable State laws relating to health benefit plans. Subtitle C: Health Deduction Fairness - Amends the Internal Revenue Code to make permanent and increase from 25 to 100 percent the health insurance tax deduction for the self-employed. Subtitle D: Improved Access to Community Health Services - Directs the Secretary to provide for a program of grants to migrant and community health centers receiving grants or contracts under provisions of the Public Health Service Act in order to promote the provision of primary health care services for underserved individuals. Authorizes appropriations. Amends the Public Health Service Act to deem as an employee of the Public Health Service, for purposes of civil actions against commissioned officers or employees, any officer, employee, or contractor who is a physician or other licensed health care practitioner while performing functions for an entity receiving Federal funds under provisions of the Public Health Service Act. Requires an entity, in order to receive a grant under such provisions, to implement certain policies to assure against malpractice. Requires: (1) the Attorney General to estimate the amount of all claims expected, during each year, to arise against such an entity from acts of officers or employees; (2) the Secretary to withhold from grants to such entities the amount estimated; and (3) the withheld amount to be transferred to the Treasury to pay judgments against the United States arising from such claims. Directs the Secretary to make grants to public and nonprofit private entities to carry out demonstration projects for the purpose of increasing access to outpatient primary health services in geographic areas with a: (1) population of not more than 500,000 individuals; (2) shortage of personal health services; and (3) significant number of low-income or underinsured individuals. Sets forth requirements for receiving such grants. Authorizes appropriations. Subtitle E: Improved Access to Rural Health Services - Retitles title XII of the Public Health Service Act "Emergency Medical Services" (formerly, "Trauma Care") and directs the Secretary to establish the Office of Emergency Medical Services which shall, with respect to emergency medical services (including trauma care): (1) conduct research; (2) sponsor workshops; (3) assist States; and (4) coordinate activities. Authorizes the Secretary to make grants to States for the purposes of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services. Sets forth matching fund requirements. Provides for demonstration projects to establish telecommunications between rural medical facilities and other medical facilities that have equipment that can be utilized through telecommunications. Authorizes appropriations for purposes of the programs of this paragraph. Directs the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas access to treatments for the injuries or other conditions arising from such emergencies. Sets forth requirements for grant applications. Authorizes appropriations. Amends title XVIII (Medicare) of the Social Security Act to extend for one year special treatment rules for Medicare-dependent small rural hospitals. Title II: Health Care Cost Containment and Quality Enhancement - Subtitle A: Medical Malpractice Liability Reform - Prohibits bringing a medical malpractice claim: (1) more than two years after the alleged injury should reasonably have been discovered and in no event more than four years after the alleged injury occurred; and (2) in any State court unless there has been an initial resolution through a certified alternative dispute resolution system (ADR). Requires the use of ADR in a Federal medical malpractice liability claim. Requires a pre-trial settlement conference in any medical malpractice liability action. Sets limits on: (1) noneconomic damages; (2) punitive damages; and (3) attorney's fees. Requires offsets for damages paid by a collateral source. Requires liability in a medical malpractice action to be several and not joint. Provides a complete defense to any allegation of negligence in a medical malpractice liability action to any defendant who followed the appropriate practice guideline. Prohibits finding a defendant guilty in a medical malpractice liability action relating to services provided during labor or delivery of a baby if the defendant did not previously treat the plaintiff during the pregnancy, unless the malpractice is proven by clear and convincing evidence. Directs the Secretary to determine whether a States' ADR meets ADR system requirements established by this Act. Establishes such requirements. Amends title XI (General Provisions and Professional Standards Review) of the Social Security Act to earmark funds for sanctioning practice guidelines for purposes of an affirmative defense in medical malpractice liability actions. Permits a State agency responsible for the conduct of disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies for such type of health care practitioner to permit such societies to participate in the licensing of such health care practitioner and to review health care malpractice allegations. Requires each State to require each health care professional and provider to participate in a risk management program to prevent and provide early warning of practices which may result in injuries to patients or which otherwise endanger patient safety. Directs the Secretary to make grants for the conduct of basic research in the prevention of and compensation for injuries resulting from health care professional or health care provider malpractice, and research of the outcomes of health care procedures. Authorizes appropriations. Directs the Secretary to study the factors discouraging physicians from volunteering to provide health care services in medically underserved areas. Subtitle B: Administrative Cost Savings - Directs the Secretary to adopt standards relating to each of the following: (1) data elements for use in claims processing under health benefits plans; (2) uniform claim forms; and (3) uniform electronic transmission of the data elements. Authorizes the Secretary to require providers to submit claims to health benefit plans in accordance with such standards. Provides for periodic review of the standards. States that the term "health benefit plan," in this subtitle, includes the Medicare and Medicaid programs (titles XVIII and XIX of the Social Security Act). Requires the Secretary to promulgate standards for hospitals concerning electronic medical data. Permits the Secretary to promulgate standards concerning electronic medical data for providers that are not hospitals. Requires hospitals, in order to participate in Medicare, to: (1) maintain clinical data in a set of comprehensive data elements in electronic form on all patients; and (2) upon the Secretary's request, transmit electronically the data set and any data from such set. Provides for electronic transmission to Federal agencies. Prohibits a health benefit plan, if standards with respect to data elements are promulgated with respect to a class of provider, from requiring for the purpose of utilization review or as a condition of providing benefits under the plan that a provider in the class: (1) provide any data element not in the set of comprehensive data elements; or (2) transmit or present any such data element in a manner inconsistent with applicable standards. Directs the Secretary to establish an advisory commission of hospital executive and data base managers, physicians, health services researchers, and technical experts in the collection and use of data and operation of data systems. Authorizes appropriations for such commission. Requires the Secretary, in order to assure the availability of comparative value information to purchasers of health care in each State, to determine whether each State is developing and implementing a health care value information program that meets stated criteria. Permits grants to a State for the development of its health care value information program. Authorizes appropriations for such grants. Requires the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to promptly develop health care value information relating to each program that such head administers. Directs the Secretary to develop model systems to facilitate: (1) the gathering of data on health care cost, quality, and outcome; and (2) analyzing such data to permit the valid comparison of such data. Authorizes appropriations for the development of such model systems. Directs the Secretary to adopt standards relating to the design and use of magnetized Medicare identification cards for the purpose of assisting health care providers in determining eligibility and billing. Authorizes appropriations. Nullifies any State law requiring that medical or health insurance records be maintained in written rather than electronic form. Requires each health benefit plan: (1) for each of its beneficiaries that has a social security number, to use that number as an identification number for claims processing; and (2) for each provider that has a unique identifier for Medicare purposes, to use that identifier for claims processing. Requires the Secretary to determine whether problems relating to the rules for determining liability when benefits are payable under two or more plans or the availability of information among such plans causes significant administrative problems, and if so, directs the Secretary to promulgate standards concerning liability and the transfer of information among plans. Directs the Secretary to provide grants to qualified entities to demonstrate the application of comprehensive information systems in continuously monitoring patient care and in improving patient care. Authorizes appropriations from the Federal Hospital Insurance Trust Fund. Subtitle C: Medical Savings Accounts (Medisave) - Amends the Internal Revenue Code to exclude from the gross income of an employee any amount contributed by the employer to a medical savings account pursuant to a qualified medical savings account plan. Sets contribution limits. Defines a "medical savings account" as a trust created exclusively for purpose of paying an individual's medical expenses. Permits expenses from such account only to the extent such amounts are not compensated for by insurance. Subjects the employee to taxation as owner of the account. Subtitle D: Medicaid Program Flexibility - Amends title XIX (Medicaid) of the Social Security Act to modify Medicaid contracting requirements for coordinated care services. Authorizes the Secretary to waive specified Medicaid requirements with respect to nursing facilities located in a State if the State provides assurances satisfactory to the Secretary that the waiver of such requirements will not adversely affect the quality of life of the residents in such facilities. Subtitle E: Limitations on Physician Self-Referrals - Amends title XVIII (Medicare) of the Social Security Act to extend physician self-referral limitations to all payors as well as to certain additional services. Revises exceptions. Requires the Secretary to conduct a study in order to estimate the changes in aggregate costs for designated health services, under the Medicare program and other health plans, which will result from the implementation of the amendments made by this subtitle. Subtitle F: Removing Restrictions on Managed Care - Preempts managed care restrictions under State law. Requires the Comptroller General to conduct a study of the benefits and cost effectiveness of the use of managed care in the delivery of health services. Subtitle G: Medicare Payment Changes - Amends the Medicare program to make revisions in the methodology for determining updates to Medicare hospital payments. Provides for a reduction in Medicare payment for clinical diagnostic laboratory tests. Subtitle H: Modification of the Operation of the Antitrust Laws to Hospitals - Permits two or more hospitals, without violating the antitrust laws, to share expensive medical services or high technology equipment. Directs the Secretary to grant waivers to exempt hospitals from the antitrust laws in order to carry out agreements permitting such sharing. Sets forth reporting requirements. Subtitle I: Encouraging Enforcement Activities of Medical Self-Regulatory Entities - Prohibits damages, interest on damages, costs, or attorney's fees from being recovered under the Clayton Act or any similar State law from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities designed to promote the quality of health care provided to patients.
Bill· HRH.R. 5270 (102nd)open
United States · United States Congress · 27 May 1992
Foreign Income Tax Rationalization and Simplification Act of 1992 - Title I: Treatment of U.S. Businesses Operating Abroad - Subtitle A: Interest Allocation Rules - Amends the Internal Revenue Code to allow each member of an expanded affiliated group to take into account the interest expenses and assets of foreign subsidiaries for purposes of allocating and apportioning interest expenses between gross income from U.S. and foreign sources. Expands the types of corporations that are treated as financial institutions for purposes of applying the one-taxpayer rule separately to financial institutions in a related group. Subtitle B: Foreign Tax Credit Rules - Repeals the 90-percent limitation on the utilization of the alternative minimum tax foreign tax credit. Provides for recharacterizing as foreign source taxable income, in the case of a taxpayer that has incurred an overall domestic loss, that portion of the taxpayer's U.S.-source taxable income for each succeeding taxable year which is equal to the lesser of: (1) the amount of the unrecaptured overall domestic loss; or (2) 50 percent of the taxpayer's U.S. source taxable income for such succeeding taxable year. Extends the excess foreign tax credit carryback period from two to three years and extends the carryforward period from five to 15 years. Makes similar extensions for excess oil and gas extraction taxes. Permits a domestic corporation that normally would treat a foreign company as a noncontrolled section 902 corporation to elect to treat that company, for foreign credit limitation and subpart F (controlled foreign corporations) purposes, as a controlled foreign corporation of which the electing domestic corporation is a U.S. shareholder. Subtitle C: Other Provisions - Limits the application to foreign persons of the uniform capitalization rules in determining earnings and profits. Modifies the look-through rules that apply under the passive foreign corporation regime by reducing the ownership thresholds from 25 to 20 percent in the general look-through rule and the special domestic-subsidiary look-through rule. Title II: Treatment of Controlled Foreign Corporations -Repeals deferral on controlled foreign corporations by treating as subpart F income generally all of a controlled foreign corporation's earnings and profits for the taxable year. Repeals provisions which provided for a reduction of subpart F income of export trade corporations. Allows certain foreign corporations to be treated as domestic corporations for U.S. tax purposes. Provides for determining the source of income for the sale of inventory property to a related person and the sale of inventory property between U.S. residents for use in the United States. Title III: Taxation of Foreign Persons Having U.S. Related Income - Provides that where a foreign stockholder owns or has owned, at any time during the previous five years, ten percent or more of the stock of a U.S. corporation, gain or loss from the disposition of the stock is treated as income effectively connected with the conduct of a U.S. trade or business and attributable to a U.S. permanent establishment. Requires tax withholding on certain stock dispositions by such stockholders. Prohibits a foreign entity from being entitled to any benefits granted by the United States under any treaty between the United States and a foreign country unless such entity is a qualified resident of such foreign country. Prohibits any person from being entitled to such benefits with respect to any income of such person if such income bears a significantly lower tax under the laws of the foreign country than similar income arising from sources within such foreign country derived by residents of such foreign country. Increases the excise tax on certain premiums paid to foreign persons in low-tax countries for reinsurance covering casualty insurance and indemnity bonds. Grants the Secretary of the Treasury enforcement authority. Sets a minimum amount of taxable income to be reported by 25-percent foreign-owned domestic corporations that engage in more than a threshold level of transactions with foreign related parties. Provides an exception where an alternative method is approved by the Secretary. Title IV: Other Reforms - Subtitle A: Provisions Affecting Individuals - Establishes a foreign tax credit limitation for individuals whose gross income is from sources outside the United States, consists entirely of qualified passive income, and the amount of creditable foreign taxes does not exceed $200. Excludes certain personal transactions from foreign currency rules. Provides that income received by an individual in the form of a sholarship or fellowship grant for study, training, or research is treated as derived from sources in the location of the funded activity. Requires that income received as a prize or award made primarily in recognition of religious, charitable, scientific, educational, artistic, literary or civil achievement to be treated as derived from sources in the location of the activities that formed the basis of the prize or award. Allows certain deductions, based on the standard deduction and multiple personal exemptions, to offset certain U.S. source gross income of visiting foreign individuals received in the form of scholarships and fellowships granted by certain tax-exempt or governmental entities. Provides a limited estate tax marital credit for certain employees of international organizations. Subtitle B: Other Provisions - Reduces the Puerto Rico and Possession tax credit from 100 percent to 85 percent of precredit U.S. tax on a company's possession-based operations and qualified possession source investment income. Declares that foreign oil and gas extraction income does not include any passive income. Title V: Foreign Simplification Provisions - Subtitle A: Simplification of Treatment of Passive Foreign Corporations - Repeals foreign personal holding company rules and foreign investment company rules. Exempts foreign corporations from the accumulated earnings tax and personal holding company rules. Replaces repealed provisions with revised rules for passive foreign corporations. Provides for taxing U.S. income on stock in passive foreign corporations through three alternative methods: (1) mark-to-market; (2) current inclusion; and (3) interest charge on excess distributions. Subjects less-than-25-percent shareholders of passive foreign corporations that are not U.S.-controlled, and who do not elect current inclusion, to the mark-to-market methods or the interest-charge method for taxing income. Provides that if a passive foreign corporation is U.S.-controlled then every U.S. person owning stock in such corporation is subject to income inclusions under a modified version of controlled foreign corporation rules. Declares with regard to the mark-to-market method that: (1) if the fair market value of stock exceeds its adjusted basis, then the U.S. person shall include in gross income an amount equal to the amount of the excess; and (2) if the adjusted basis of stock exceeds the fair market value then the person shall be allowed a deduction equal to the lesser of the amount of such excess, or the unreversed inclusions. Describes a passive foreign corporation as any foreign corporation if: (1) 60 percent or more of its gross income is passive income; (2) the average percentage of assets which produce passive income or which are held for the production of passive income is at least 50 percent; or (3) such corporation is registered under the Investment Company Act of 1940, either as a management company or as a unit investment trust. Provides for the treatment of mark-to-market gain for purposes of the excise tax on undistributed income of regulated investment companies. Subtitle B: Treatment of Controlled Foreign Corporations - Provides that if a controlled foreign corporation sells or exchanges stock in other foreign corporations, then gain recognized on such sale or exchange shall be included in the gross income of such corporation as a dividend to the same extent that it would have been included if such corporation were a U.S. person. Authorizes the Secretary to prescribe simplified methods for determining the amount of increase of limitations on the foreign tax credit. Revises provisions concerning: (1) determining pro rata share of gain from certain sales or exchanges of stock in certain foreign corporations; (2) basis adjustments in stock held by lower-tier foreign corporations; (3) determination of previously taxed income in redemptions through use of related corporations; and (4) treatment of branch profits tax exemptions or reductions. Extends the application of the indirect foreign tax credit to certain controlled corporations below the third tier. Subtitle C: Other Provisions - Establishes new rules for the translation of certain accrued foreign taxes. Modifies present rules for translating all other foreign taxes. Permits the use of the simplified limitation on the foreign tax credit in determining the alternative minimum tax foreign tax credit. Repeals the excise tax on outbound transfers to avoid income tax. Requires the full recognition of gain on a transfer of property by a U.S. person to a foreign corporation as paid-in surplus, or as a contribution to capital, or to a foreign estate, trust, or partnership. Allows the Secretary, in lieu of applying the full recognition rule, to provide regulations with principles similar to the principles for foreign corporations transferring property from the United States. Title VI: Studies - Directs the Secretary to study and report to the House Committee on Ways and Means and the Senate Committee on Finance not later than January 1, 1994, on: (1) tax issues relating to the maintenance and enhancement of the competitiveness of the American economy in light of changing economic policies in Europe and the increasing globalization of the world economy; (2) administrative and compliance issues related to a value added tax; and (3) transfer pricing rules and the proper taxation of foreign persons conducting business in the United States.
Law· HJRESH.J.Res. 492 (102nd)enacted
United States · United States Congress · 21 May 1992
Designates September 1992 as Childhood Cancer Month.
Law· HRH.R. 5126 (102nd)enacted
United States · United States Congress · 7 May 1992
Civil War Battlefield Commemorative Coin Act of 1992 - Directs the Secretary of the Treasury to issue a specified number of five-dollar gold coins, one-dollar silver coins, and half-dollar clad coins to commemorate the 100th anniversary of Civil War battlefield preservation. Sets forth certain features of such coins and provides for their design, issuance, and sale. Requires that all sales include a surcharge of $35 per coin for the five-dollar coins, $7 per coin for the one-dollar coins, and $1 per coin for the half-dollar coins. Requires that all surcharges be paid to the Civil War Battlefield Foundation for the preservation of historically significant Civil War battlefields.
Bill· HJRESH.J.Res. 476 (102nd)referred
United States · United States Congress · 29 April 1992
Designates October 4 through 10, 1992, as Mental Illness Awareness Week.
Resolution· HCONRESH.Con.Res. 309 (102nd)referred
United States · United States Congress · 9 April 1992
Expresses the sense of the Congress that the United States should: (1) as part of the Uruguay Round and North American Free Trade Agreement negotiations, negotiate tariffication of Canada's chicken supply management system and the elimination of processed chicken from Canada's Import Control List; (2) seek the elimination of new duties imposed by Canada on chicken imports in accordance with the United States-Canada Free Trade Agreement; and (3) oppose any Canadian activity which results in lost sales for U.S. chicken exporters and restricts U.S. access to Canadian markets.
Bill· HRH.R. 4479 (102nd)referred
United States · United States Congress · 17 March 1992
Directs the Administrator of the Small Business Administration to review and modify regulatory certification guidelines (including minimum population requirements) to ensure that their application does not adversely affect certification of a qualified development company in a rural area. Requires the Administrator to report to the Congress on the results of such review.
Bill· HRH.R. 4406 (102nd)open
United States · United States Congress · 5 March 1992
Trucking Regulatory Reform Act of 1992 - Amends the Interstate Commerce Act to include as objectives of U.S. transportation policy in regulating transportation by motor carrier, the promotion of competitive and efficient transportation services in order to: (1) allow, to the maximum extent possible, competition and the demand for services to establish reasonable rates for transportation by motor carriers of property; and (2) minimize the need for Federal regulatory control over the motor carrier transportation system and require fair and expeditious regulatory decisions when regulation is required. Requires the Interstate Commerce Commission (ICC) to exempt motor carriers providing transportation of non-household goods from its jurisdiction whenever it finds that: (1) its jurisdiction is not necessary to carry out U.S. transportation policy; and (2) either such transaction or service of the motor carrier is of limited scope, or ICC jurisdiction is not needed to protect shippers from the abuse of market power. Authorizes the ICC to exempt transportation provided by such motor carriers as a part of a continuous intermodal movement. Declares that the fact that a rate, classification, rule, or practice relating to motor common carriers was included in a tariff duly filed with the ICC shall not relieve such carriers from liability or any remedy under the antitrust laws in instances where the conditions of an agreement between such carriers regarding such rate, classification, rule, or practice are not met, unless the ICC has determined its reasonableness. Prohibits agreements approved by the ICC from providing for docketing of the independent actions of carriers of non-household goods, or for discussion of or voting upon such actions. Excepts from the general reasonableness standard: (1) independently determined rates or rates determined by the independent action of motor carriers providing transportation of property of non-household goods; and (2) the establishment of through routes by such carriers. Excludes divisions of joint rates by such carriers from the general requirement that they be made without unreasonable discrimination against a participating carrier, and that they must be reasonable. Requires the ICC to prescribe only the maximum rate of the classification, rule, or practice to be followed in the case of a motor common carrier providing transportation of non-household goods which establishes rates collectively in an organization established or continued under an approved agreement or by certain independent action. Declares that the ICC is not authorized to begin immediately on its own initiative or on application of an interested party a proceeding to determine the lawfulness of proposed rates, classifications, rules, and practices that are independently determined, or established by independent action, by motor common carriers providing transportation of non-household goods. Authorizes the ICC to make such a determination when a new rate, classification, rule, or practice established by independent action or collectively by an approved agreement is filed with the ICC by or on behalf of a motor common carrier or two or more interlining motor common carriers of non-household goods. Prohibits the ICC from investigating, suspending, revising, or revoking any rate proposed by a motor common carrier providing transportation of household goods on the grounds that such rate is unreasonable because too high or too low if specified requirements are met. Allows the ICC to take such action with respect to rates proposed by motor carriers providing transportation of non-household goods. Subjects the docketing of rates by independent actions by motor common carriers of property other than household goods to the U.S. antitrust laws. Bars construction as a violation of such antitrust laws the docketing of independent actions by motor carriers providing transportation of non-household goods. Prohibits the ICC from investigating, suspending, revising, or revoking any rate proposed by a motor common carrier providing transportation of non-household goods on the grounds that such a rate is unreasonable because too high, unless the proposed rate is established by independent action or established collectively under an agreement approved by the ICC. Declares that certain limitations on the establishment of rates, classifications, and rules by freight forwarders shall not apply if they are independently determined, or established by independent action, by a motor common carrier providing transportation of non-household goods. Authorizes such a motor common carrier to establish any transportation rate if it is independently determined or established by independnent action. Authorizes the ICC to grant relief, if consistent with the public interest and U.S. transportation policy, from any requirement that a motor common carrier providing transportation of non-household goods have in effect a rate for transportation service which does not limit its liability. Prohibits the ICC from prescribing the maximum reasonable charge or allowance that may be paid for certain shipper-furnished transportation services or facilities by motor common carriers providing transportation of non-household goods under rates that are independently determined or established by independent action. Prescribes alternative ways to satisfy a claim made by a motor carrier of non-household goods or by a non-household goods freight forwarder regarding the collection of rates in addition to those originally billed and collected. Provides for settlement of any dispute about such claims. Sets forth a statute of limitations for civil actions for the recovery of motor carrier charges and overcharges. Authorizes motor carriers and shippers to resolve overcharge and undercharge claims resulting from billing errors or incorrect tariff provisions arising from the inadvertent failure to timely file and maintain agreed upon rates, rules, or classifications. Requires a specified report to the Congress. Excepts motor contract carriers of property from the general requirement that contract carriers establish, and file with the ICC, rates for transportation and rules and practices related to such rates. Excepts a motor common carrier providing transportation of non-household goods under independently determined rates or rates established by independent action from the general requirement that carriers providing transportation or service include the rate for such transportation or service in a tariff. Declares any such rate, determined collectively by an agreement approved by the ICC or by independent action, to be considered a maximum rate. Excepts a motor common carrier providing transportation of non-household goods under independently determined rates or rates established by independent action from general tariff requirements. Declares that a motor contract carrier of property is not required to publish or file with the ICC actual or minimum rates. Excepts a motor contract carrier of property or of passengers from the requirement that contract carriers publish, file, and keep open for public inspection a notice of any proposed new or reduced rates. Declares that a published or filed rate shall be conclusive proof against a motor common carrier providing transportation of non-household goods that such rate is the maximum legal rate for the transportation or service with respect to civil actions involving transportation rebates and rate, discrimination, and tariff violations. Requires the Secretary of Transportation (Secretary) and the ICC to determine jointly by rule, after notice and opportunity for comment, the proper use of safety ratings (especially conditional and unsatisfactory ratings) in determining whether a motor carrier owner or operator or an applicant for an operating certificate meets certain safety fitness requirements. Amends the conditions for issuing a certificate or permit authorizing a person to provide transportation as a motor common or contract carrier of property or a motor contract carrier. Requires such an issuance if the person is able to comply with existing ICC regulations as well as: (1) certain safety fitness requirements established by the Secretary; and (2) certain minimum financial responsibility requirements. Requires the ICC in making such a finding to consider any evidence that the applicant is unable to comply with such requirements. Authorizes a person to protest an application on the basis that the applicant fails or will fail to comply with such requirements. Requires the ICC to find an applicant unfit if the applicant does not meet the safety fitness requirements. Subjects to certain commercial motor vehicle safety regulations motor carriers providing transportation of shipments weighing 100 pounds or less transported in a motor vehicle in which no one package exceeds 100 pounds and operating one or more commercial motor vehicles with a gross vehicle weight rating of 10,000 pounds or more. Authorizes one or more motor contract carriers of property providing transportation subject to ICC jurisdiction to enter into a contract with one or more purchasers of motor carrier services to provide specified services under specified rates and conditions to the extent permitted by the common law of contracts and the Uniform Commercial Code. Authorizes the ICC to suspend a certificate or permit of a motor carrier for failure to comply with certain safety fitness and minimum financial responsibility requirements. Authorizes States to exercise exclusive jurisdiction over intrastate motor carrier transportation of non-household goods. Requires the ICC to establish guidelines for determining whether the standards and procedures that a State authority will use in exercising jurisdiction over such transportation are in accordance with the standards and procedures applicable to regulation of motor carriers by the ICC. Sets forth specified State requirements. Authorizes any motor carrier providing transportation of non-household goods, and any party to an administrative proceeding of any State authority in which the lawfulness of intrastate motor carrier transportation of non-household goods is decided, to petition the ICC to review such decision. Grants the ICC authority to issue a certificate and permit authorizing a motor carrier providing transportation of non-household goods to provide such transportation of household goods to provide such transportation intrastate. Grants the ICC exclusive authority to prescribe an intrastate rate for such transportation when specified conditions are met.
Bill· HJRESH.J.Res. 427 (102nd)referred
United States · United States Congress · 27 February 1992
Designates March 17, 1992, as Irish Brigade Day.
Bill· HJRESH.J.Res. 431 (102nd)referred
United States · United States Congress · 27 February 1992
Designates the week beginning April 19, 1992, as National Credit Education Week.
Bill· HJRESH.J.Res. 406 (102nd)open
United States · United States Congress · 5 February 1992
Designates May 1992 as National Huntington's Disease Awareness Month.
Resolution· HRESH.Res. 293 (102nd)passed
United States · United States Congress · 22 November 1991
Commends: (1) the people of Guam for their patriotism, bravery, loyalty to the United States, and many sacrifices during World War II, particularly during the invasion and occupation of the Guam territory; (2) the members of the Navy Insular Force and U.S. Navy and Marine Corps for the efforts and sacrifices they made in defense of the U.S.; (3) the Hawaiians for their sacrifices and contributions to the U.S. war effort during the attack on Pearl Harbor on December 7, 1941; and (4) the Hawaii Territorial Guard members, Varsity Victory Volunteers, the civilian workers at the Pearl Harbor Naval Ship Yard and other Hawaiian military installations, 100th Infantry Battalion, Military Intelligence Service, and 442nd Regimental Combat Team for their sacrifices and contributions to the U.S. war effort during such attack.
Bill· HRH.R. 3838 (102nd)open
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.
Bill· HJRESH.J.Res. 376 (102nd)referred
United States · United States Congress · 19 November 1991
Designates December 1, 1991, as World AIDS Day.
Bill· HRH.R. 3770 (102nd)referred
United States · United States Congress · 14 November 1991
Amends the Federal Election Campaign Act of 1971 to prohibit candidates for the House of Representatives from accepting contributions from persons other than local individual residents totaling in excess of the total contributions accepted from local individual residents. Limits contributions to candidates for Federal office by nonparty multicandidate political committees to $1,000. Subjects to limitation and reporting requirements payments by a national committee of a political party or a State committee of a political party for a mixed political activity. Repeals the office facility exception (building fund) from the definition of contribution. Requires the deposit of excess funds of candidates for the House of Representatives into a separate account to be used for any lawful purpose other than for such candidate's election.
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