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United States · Official source
2,386 records where Rep. Kolbe, Jim [R-AZ-8] is listed as a sponsor, author, or other actor. Search with topics and years
United States · United States Congress · 21 March 1994
Abolishes the Medicare and Medicaid Coverage Data Bank established under the Omnibus Budget Reconciliation Act of 1993. Directs the Secretary of Health and Human Services to study and report to the Congress on how to achieve the former objectives of such entity in the most cost-effective manner.
United States · United States Congress · 10 March 1994
Forest Service Equity Study Act of 1994 - Directs the Secretary of Agriculture to study the equity of funding allocations among the National Forest System regions. Authorizes appropriations.
United States · United States Congress · 9 March 1994
Supplemental Appropriations Rescissions Act of 1994 - Rescinds FY 1994 funds made available to: (1) the Federal Bureau of Investigation for the automation of fingerprint identification services; (2) the Federal Railroad Administration for the conversion of a post office to a train station and commercial center; and (3) the Department of Housing and Urban Development for assistance to sugarcane mills on the Hilo-Hamakua Coast of Hawaii. Repeals the authority of the Secretary of Transportation to use specified funds to relocate, repair, and lay up the nuclear ship SAVANNAH.
United States · United States Congress · 9 March 1994
Amends rule XI of the Rules of the House of Representatives to apply primary expense resolution requirements and personnel ceilings to the Committee on Appropriations and the Committee on the Budget. Repeals provisions authorizing the Committees to appoint committee staff. Requires funds for the appointment of committee staff to be provided by primary and additional expense resolutions. Provides that by the beginning of the 106th Congress, not less than one-third of the funding made available to each standing, select, special, ad hoc, or other House committee shall be allocated to the minority party. Exempts the Committee on Standards of Official Conduct.
United States · United States Congress · 3 March 1994
TABLE OF CONTENTS: Title I: Insurance Reform Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families Subtitle B: Reform of Health Insurance Marketplace for Small Business Subtitle C: Preemption Subtitle D: Health Deduction Fairness Title II: Preventing Fraud and Abuse Subtitle A: Establishment of All-Payer Health Care Fraud and Abuse Control Program Subtitle B: Revisions to Current Sanctions for Fraud and Abuse Subtitle C: Administrative and Miscellaneous Provisions Subtitle D: Amendments to Criminal Law Title III: Malpractice Reform Subtitle A: Findings; Purpose; Definitions Subtitle B: Uniform Standards for Malpractice Claims Subtitle C: Requirements for State Alternative Dispute Resolution Systems (ADE) Title IV: Paperwork Reduction and Administrative Simplification Title V: Expanding Access/Preventive Care Subtitle A: Expanding Access Through Community Health Authorities Subtitle B: Expansion of Public Health Programs on Preventive Health Title VI: Antitrust Provisions Title VII: Prefunding Government Health Benefits for Certain Annuitants Health Reform Consensus Act of 1994 - Title I: Insurance Reform - Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families - Requires each employer to make available to each eligible employee a group health plan under which: (1) coverage of each eligible individual with respect to such employee may be elected on an annual basis; (2) coverage is provided for at least the required coverage specified; and (3) employees may elect to have premiums collected through payroll deduction. Does not require employer contributions to the cost of coverage under such a plan. Provides for the exclusion of: (1) employers who have been employers for less than two years or who have no more than two eligible employees or no more than two eligible employees not covered under any group health plan; and (2) family members under specified circumstances. Specifies that a group health plan shall not be treated as failing to meet the requirements of this Act solely because a period of service by an eligible employee of not more than 60 days is required for coverage. Specifies that the required coverage is standard coverage, except that in the case of a small employer that has not contributed during the previous plan year to the cost of coverage for any eligible employee under any group health plan, the required coverage for the plan year is coverage under a standard plan and a catastrophic plan. Provides for a five-year transition for existing group health plans. (Sec. 1002) Sets forth provisions regarding: (1) compliance with applicable requirements through multiple employer health arrangements; and (2) coverage options under a State medical health allowance program. (Sec. 1011) Prohibits a group health plan from imposing (and an insurer from requiring an employer from imposing through a waiting period for coverage under a plan or similar requirement) a limitation or exclusion of benefits relating to treatment of a preexisting condition if: (1) the condition relates to a condition that was not diagnosed or treated within three months before the date of coverage under the plan; or (2) the limitation or exclusion extends over more than six month after the date of coverage, applies to an individual who, as of the date of birth, was covered under the plan, or relates to pregnancy. Specifies that, in the case of an individual who is eligible for coverage under a plan but for a waiting period imposed by the employer, the individual shall be treated as having been covered under the plan as of the earliest date of the beginning of the waiting period. (Sec. 1012) Requires each group health plan to waive any period applicable to a preexisting condition for similar benefits with respect to an individual to the extent that the individual, prior to enrollment in such plan, was covered for the condition under any other health plan. (Sec. 1013) Prohibits: (1) a multiemployer plan and an exempted multiple employer health plan from canceling or denying renewal of coverage under such a plan for an employer other than for nonpayment of contributions, fraud or other misrepresentation, noncompliance with plan provisions, failure to maintain minimum participation rates (in the case of a small employer) misuse of a provider network provision, or because the plan is ceasing to provide any coverage in a geographic area; (2) an insurer from canceling a health insurance plan or denying renewal of coverage other than as prescribed above; and (3) an insurer who terminates the offering of health insurance plans in an area from offering such a plan to any employer in the area until five years after the date of the termination. (Sec. 1021) Makes provisions of the Employee Retirement Income Security Act of 1974 applicable with respect to enforcement of this Act (by the Department of Labor). Imposes a civil penalty ($100 per day for each individual involved, subject to specified limitations) on the failure of an insurer to comply with the requirements of sections 1011 through 1013, unless the Secretary of Health and Human Services (Secretary) determines that the State has in effect a regulatory enforcement mechanism that provides adequate sanctions. Subtitle B: Reform of Health Insurance Marketplace for Small Business - Requires each insurer that makes available a health insurance plan to a small employer in a State to make available to each small employer in the State a standard plan and a catastrophic plan, with exceptions for health maintenance organizations (HMOs) and if a State provides for guaranteed availability (rather than guaranteed issue). Requires each insurer that offers a standard or catastrophic plan to a small employer in a State to accept: (1) every small employer in the State that applies for coverage; and (2) every eligible individual who applies for enrollment on a timely basis. Sets forth provision regarding: (1) special rules for HMOs; (2) timely enrollment requirements; and (3) enrollment of spouses and dependents. Makes such requirements inapplicable in a State that has provided (in accordance with specified standards) a mechanism under which each insurer offering a health insurance plan to a small employer in the State must participate in a program for assigning high-risk small employer groups (or individuals within such a group) among some or all such insurers, if the insurers comply. (Sec. 1102) Defines "health plan" as a health insurance plan that: (1) is designed to provide standard coverage with substantial cost-sharing or only catastrophic coverage; (2) meets applicable requirements relating to guaranteed issue; (3) meets specified consumer protection standards; and (4) meets any participation requirements with respect to an applicable reinsurance or allocation of risk mechanism. States that standard coverage includes: (1) inpatient and outpatient hospital care; (2) inpatient and outpatient physicians' services; (3) diagnostic tests; (4) specified preventive services; and (5) specified inpatient hospital care for mental disorders. Sets forth coverage scope, including that there be no limits on the amount, scope, or duration of items number one, two, and three in the preceding sentence. Sets forth exceptions. Sets forth limitations on deductibles, copayments and coinsurance, and out-of-pocket expenses. Defines a catastrophic benefits package. Provides for the determination of target actuarial values for standard and catastrophic coverage. (Sec. 1103) Directs the Secretary to request NAIC to develop model regulations that specify standards with respect to requirements: (1) that insurers make available health plans; (2) of guaranteed availability of health plans to small employers; (3) relating to limits on premiums and certain consumer protections; (4) relating to limitation of annual premium increases; and (5) for standard and catastrophic coverage. Requires the Secretary to review such standards and, if NAIC fails to specify standards meeting such requirements, to promulgate standards. Sets forth provisions regarding: (1) the application of health plan standards and consumer protection standards by the States; (2) the Federal role; and (3) consumer protection standards. (Sec. 1104) Sets forth provisions: (1) regarding limits on premiums and annual premium increases; and (2) requiring an insurer, at the time of offering a health insurance plan to a small employer, to fully disclose rating practices for health insurance plans, including rating practices for different populations and benefit designs. (Sec. 1106) Directs the Secretary to: (1) request NAIC to develop models for reinsurance or allocation of risk mechanisms for health insurance plans made available to small employers for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models or specify models. Sets forth provisions regarding implementation of reinsurance or allocation of risk mechanisms by the States and the Federal role. (Sec. 1108) Directs the Secretary to establish an Office of Private Health Care Coverage. Requires the Office Director to submit to the Congress annual reports evaluating health care coverage reform. (Sec. 1109) Authorizes the Director to conduct: (1) research on the impact of this subtitle on the availability of affordable health coverage for employees and dependents in the small employers group health care coverage market and other specified topics; and (2) demonstration projects relating to such topics. Requires the Director to develop: (1) methods for measuring the relative health risks of eligible individuals in terms of the expected costs of providing benefits under health insurance plans and, in particular, health plans; (2) a model for equitably distributing health risks among insurers in the small employer health care coverage market. Authorizes appropriations. Subtitle C: Preemption - Prohibits: (1) State benefit mandates for group health plans; and (2) State or local law prohibitions against two or more employers obtaining coverage under an insured multiple employer health plan. (Sec. 1203) Preempts State restrictions concerning: (1) reimbursement rates or selective contracting; (2) differential financial incentives; and (3) utilization review methods. Directs the Comptroller General to conduct a study of the benefits and cost effectiveness of the use of managed care in the delivery of health services. (Sec. 1211) Amends the Employee Retirement Income Security Act of 1974 (ERISA) to allow a limited exemption under preemption rules for multiple employer plans providing health benefits subject to certain Federal standards. Relieves exempted multiple employer plans providing medical care benefits of certain restrictions on preemption of State law. Treats such plans as employee welfare benefit plans. Allows commencement of new arrangements only if such exemption is in effect or an application is pending and the Secretary of Labor determines that provisional protection is appropriate. Sets forth exemption procedures, eligibility requirements, and additional requirements applicable to exempted arrangements. Requires certain disclosures to participating employers, maintenance of reserves, and corrective actions. Provides for expiration, suspension, and revocation of exemptions, and for review of actions by the Secretary. (Sec. 1213) Revises provisions relating to scope of preemption rules, and to treatment of single employer arrangements and of certain collectively bargained arrangements. (Sec. 1215) Establishes special rules for employee leasing healthcare arrangements. Treats such arrangements as multiple employer welfare arrangements except when they are multiple employer health plans. (Sec. 1216) Sets forth enforcement provisions relating to multiple employer welfare arrangements and employee leasing health care arrangements. (Sec. 1217) Sets forth filing requirements for multiple employer welfare arrangements. (Sec. 1218) Provides for cooperation between Federal and State authorities in enforcing ERISA requirements for multiple employer welfare arrangements with the limited exemption. (Sec. 1221) Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax exempt trust status for multiple employer health plans and insured multiple employer health plans if they meet certain requirements under ERISA and this Act. (Sec. 1231) Amends ERISA to direct the Secretary of Labor to prescribe an alternative method providing for a single annual report with respect to all employers who are covered under the same insured multiple employer health plan. (Sec. 1241) Provides for compliance with applicable coverage requirements through multiemployer plans and other multiple employer health arrangements. Subtitle D: Health Deduction Fairness - Amends the Internal Revenue Code to provide for a permanent extension and increase in the health insurance tax deduction for self-employed individuals. Title II: Preventing Fraud and Abuse - Subtitle A: Establishment of All-Payer Health Care Fraud and Abuse Control Program - Directs the Attorney General to establish a program to: (1) coordinate Federal, State, and local law enforcement programs to control health care fraud and abuse; (2) conduct investigations, audits, and inspections relating to the delivery of payment for health care; and (3) facilitate enforcement of provisions of the Social Security and other Acts applicable to health care fraud and abuse. Authorizes additional appropriations as necessary. (Sec. 2003) Establishes the Anti-Fraud and Abuse Trust Fund. Subtitle B: Revisions to Current Sanctions for Fraud and Abuse - Excludes from participation in Medicare and State health care programs any individual or entity convicted of: (1) fraud in connection the delivery of a health care item or service; or (2) a felony related to a controlled substance. (Sec. 2103) Subjects to a civil monetary penalty any individual or entity offering inducements to individuals to receive any service or supply from a particular provider. (Sec. 2104) Permits the imposition of intermediate sanctions in addition to the current option of termination, for Medicare health maintenance organizations. Subtitle C: Administrative and Miscellaneous Provisions - Directs the Secretary to establish a national health care fraud and abuse data collection program for the reporting of final adverse actions against health care providers, suppliers, or practitioners. Requires each government agency and health care plan to report to the Secretary any final adverse action taken against a health care provider, supplier, or practitioner. Subtitle D: Amendments to Criminal Law - Establishes a penalty of up to five years' imprisonment for knowingly: (1) defrauding any health care plan; or (2) fraudulently obtaining money or property in connection with the delivery of health care items, benefits, or services. Permits a payment of up to $10,000 to any person furnishing information relating to any such crime. Title III: Malpractice Reform - Subtitle A: Findings; Purpose; Definitions - Sets forth, for this title, findings, purposes, and definitions. Subtitle B: Uniform Standards for Malpractice Claims - Makes this subtitle applicable to any medical malpractice liability action brought in a Federal or State court and to any medical malpractice claim subject to an alternative dispute resolution system. (Sec. 3102) Prohibits bringing a medical malpractice liability action in either a State or Federal court unless there has been an initial resolution of the action under an alternative dispute resolution system. Directs the Attorney General to establish an alternative dispute resolution process for medical malpractice liability claims brought against the United States. (Sec. 3104) Sets limits on both noneconomic damages and punitive damages. (Sec. 3105) Provides for the periodic payment of future losses. (Sec. 3106) Limits attorney's fees. (Sec. 3108) Sets forth special provisions for certain obstetric services. Subtitle C: Requirements for State Alternative Dispute Resolution System (ADR) -Requires a State's alternative dispute resolution system, among other things to: (1) apply to all medical malpractice liability claims within the jurisdiction of the State's courts; (2) issue a written opinion resolving the dispute within six months of a defendant receiving notice; (3) qualify individuals who hear and resolve claims under the system; and (4) notify the appropriate State agency if there is a finding of malpractice, unless the provider contests the ADR decision. (Sec. 3202) Directs the Secretary to establish an Alternative Dispute Resolution Advisory Board in order to advise the Secretary regarding the establishment of State and Federal ADR systems. Provides for the certification of State ADR systems by the Board. Title IV: Paperwork Reduction and Administrative Simplification - Preempts State quill pen laws. (Sec. 4102) Provides for the confidentiality of electronic health care information. (Sec. 4003) Directs the Secretary to establish national goals for the health care industry concerning: (1) standardization for the electronic receipt and transmission of health plan information; (2) use of uniform health claims forms and identification numbers; (3) priority of insurers when benefits are payable under two or more health plans; and (4) availability of information among health plans when benefits are payable under two more plans. Requires the Secretary to promulgate requirements if the industry does not meet the goals. Provides for monetary penalties on any health plan that does not meet the Secretary's requirements. Title V: Expanding Access/Preventive Care - Subtitle A: Expanding Access Through Community Health Authorities - Amends title XIX (Medicaid) of the Social Security Act to direct the Secretary to operate a program under which States establish projects to demonstrate the effectiveness of various innovative health care delivery approaches through the operation of community health authorities. Requires a community health authority to be a nonprofit entity that: (1) serves a geographic area that includes those designated by the Public Health Service Act as medically underserved or as being in a health professions shortage area; (2) enrolls the Medicaid eligible; and (3) provides for the provision of at least preventive services, primary care services, inpatient and outpatient hospital services, and other services. (Sec. 5002) Authorizes the Secretary to make grants to migrant and community health centers for the development of health service networks to serve high impact areas, medically underserved areas, or medically underserved populations. Authorizes appropriations through FY 1999. Subtitle B: Expansion of Public Health Programs on Preventive Health - Authorizes appropriations, under the Public Health Service Act, for the following: (1) immunizations against vaccine-preventable diseases; (2) prevention, control, and elimination of tuberculosis; (3) lead poisoning prevention; (4) preventive health measures with respect to breast and cervical cancers; (5) the Office of Minority Health Disease Prevention and Health Promotion; and (6) the Office of Minority Health; and (7) the preventive health and health services block grant. Title VI: Antitrust Provisions - Directs the Attorney General to: (1) provide for the development and publication of explicit guidelines on the application of antitrust laws to the activities of health plans; and (2) establish a review process under which the administrator or sponsor of a health plan may submit a request to the Attorney General to obtain a prompt opinion from the Department of Justice on the plan's conformity with Federal antitrust laws. (Sec. 6002) Authorizes the issuance of a certificate of public advantage by the Attorney General to each eligible health care collaborative activity if there is a finding that the benefits that are likely to result from carrying out the activity outweigh any reduction in competition that is likely to result and such reduction is reasonably necessary. Title VII: Prefunding Government Health Benefits for Certain Annuitants - Requires certain executive branch agencies to prefund government health benefits contributors for their annuitants.
United States · United States Congress · 24 February 1994
Amends title XIX (Medicaid) of the Social Security Act to make technical corrections to provisions added by the Omnibus Budget Reconciliation Act of 1990 in order to allow children and pregnant women to receive Medicaid services from osteopathic physicians.
United States · United States Congress · 23 February 1994
Private Property Owners Bill of Rights - Requires Federal agency heads to: (1) comply with applicable State and tribal government laws in implementing and enforcing the Endangered Species Act of 1973 (ESA) and the permitting program for dredged or filled material under the Federal Water Pollution Control Act (FWPCA); (2) administer and implement the Acts in a manner that least affects the private property owners' constitutional and other legal rights; (3) develop and implement rules and regulations for ensuring that such rights are protected when making any final decision that restricts the use of private property; (4) obtain the consent of the property owner and provide appropriate notice before entering privately-owned property in order to collect information on it; and (5) give the property owner an opportunity to review and dispute the data collected before using it to implement or enforce any of the Acts. Amends ESA and FWPCA to provide for administrative appeals of certain actions, including those related to the denial of permits and the imposition of administrative penalties. Entitles a private property owner deprived of 50 percent or more of the fair market value or the economically viable use of a portion of property as a consequence of a final qualified agency action to receive compensation upon request in accordance with specified guidelines. Amends ESA to require the Secretary of the Interior to notify all private property owners or lessees of property subject to a management agreement and provide an appropriate opportunity for their participation in such an agreement when the Secretary enters into it with any non-Federal person establishing restrictions on property use.
United States · United States Congress · 23 February 1994
Designates June 4, 1994, as National Trails Day.
United States · United States Congress · 22 February 1994
Criminal Aliens Federal Responsibility Act of 1994 - Requires the Federal Government to incarcerate or to reimburse State and local governments for the cost of incarcerating specified criminal aliens.
United States · United States Congress · 8 February 1994
World War II Peace Accords Commemorative Coin Act - Expresses the sense of the Congress that: (1) the 50th anniversary of the signing of the World War II peace accords on the U.S.S. Missouri should not go unrecognized at the national level; and (2) the United States should recognize such anniversary by minting and issuing a commemorative coin. Sets forth specifications for half dollar clad coins. Mandates that the surcharges received from the sale of such coins be paid by the Secretary of the Treasury to the Admiral Nimitz Foundation for the purpose of preserving the Pacific War heritage of the United States.
United States · United States Congress · 2 February 1994
Designates May 30 through June 6, 1994, as a Time for the National Observance of the Fiftieth Anniversary of World War II.
United States · United States Congress · 2 February 1994
Declares that it is the sense of the Congress that any federally-mandated health care reform should be on-budget.
United States · United States Congress · 1 February 1994
Designates March 25, 1994, as Greek Independence Day: A National Day of Celebration of Greek and American Democracy.
United States · United States Congress · 22 November 1993
Health Plan Purchasing Cooperative Act of 1993 - Provides for a system whereby States establish voluntary health plan purchasing cooperatives (HPPCs), in which individuals without insurance and small employers could enroll and select from competing health plans providing a standard benefit plan (with a managed care, fee-for-service, and medisave option). (Sec. 2) Directs the Secretary of Health and Human Services to establish standards relating to the establishment of HPPCs, qualifications for Accountable Health Plans (AHPs) (carriers designated by a State insurance commissioner), the role of States, and a standard benefit package for small employers. Authorizes an HPPC to sue or be sued and to accept and expend grants or funds from public or private agencies. Sets forth limitations on an HPPC's authority. (Sec. 3) Requires each: (1) State to establish boundaries for HPPC areas and HPPCs for each area and a process whereby a carrier demonstrates that it has the capability to fulfill specified requirements; and (2) HPPC to establish bylaws, enter into contracts and hold policies with AHPs, provide for enrollment of eligible employees and individuals in qualified health benefit plans (HBPs), establish requirements for participation, and establish dispute resolution procedures, a fixed overhead allowance percentage, and uniform administrative and accounting procedures. (Sec. 7) Specifies that a health plan is not a qualified HBP unless the plan meets applicable financial requirements established under State law, is marketed only in accordance with specified standards, and submits to the HPPC data in accordance with uniform standards to be established by the Secretary. (Sec. 8) Requires each HPPC to use efficient and standardized means to notify small employers of the availability of health coverage through the HPPC. (Sec. 9) Directs each HPPC to submit to the State specified data on eligible employers, enrolled employers, eligible individuals, and premium ranges. (Sec. 10) Requires each State to designate an entity to monitor adverse selection in enrollment among qualified HBPs offered through HPPCs and the need for risk adjustment mechanisms. (Sec. 11) Sets forth provisions regarding: (1) oversight, dispute resolution, assuring availability of coverage and comparable treatment in and out of HPPCs, and certain antitrust protection of HPPCs; and (2) medisave coverage requirements and tax treatment of such coverage.
United States · United States Congress · 22 November 1993
Federal Regulation Cost-Benefit Assessment Act of 1993 - Provides for the application of Executive Order 12291 of February 17, 1981, as in effect on that date, to each agency, with respect to the issuance and review of Federal regulations.
United States · United States Congress · 22 November 1993
Health Care Anti-Fraud Act of 1993 - Amends the Federal criminal code and title XI of the Social Security Act to extend, respectively, criminal RICO and Medicare criminal penalties to fraud under health care programs for members of the armed forces, veterans, Native Americans, and Federal employees.
United States · United States Congress · 10 November 1993
Health Care Antitrust Improvements Act of 1993 - Exempts from the antitrust laws specified "safe harbor" activities listed in, or designated by the Attorney General pursuant to, this Act. Sets forth provisions regarding the award of attorney's fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt. Lists as safe harbors specified: (1) activities relating to health care services of combinations of health care providers with market share below a specified threshold; (2) activities of medical self-regulatory entities relating to standard setting or enforcement activities not conducted for purposes of financial gain; (3) participation of a health care provider in a written survey of the prices of services, reimbursement levels, or the compensation and benefits of employees and personnel; (4) activities relating to health care joint ventures for high technology and costly equipment and services; (5) activities relating to hospital mergers; (6) joint purchasing arrangements; and (7) negotiations. Directs the Attorney General to publish a notice in the Federal Register soliciting proposals for additional safe harbors. Sets forth criteria in establishing safe harbors, including: (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates. Sets forth procedures regarding applications for, revocation of, and review of determinations regarding, such certificates. Limits the disclosure of information. Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. Directs the Attorney General to periodically review the safe harbors and certificates of review. Establishes within the Department of Health and Human Services an Office of Health Care Competition Policy.
United States · United States Congress · 10 November 1993
TABLE OF CONTENTS: Title I: AFDC Transition and Work Program Title II: Paternity Establishment Title III: Expansion of Statutory Flexibility of States Title IV: Expansion of State and Local Flexibility Title V: Child Support Enforcement Title VI: Welfare Restrictions for Aliens Title VII: Controlling Welfare Costs Title VIII: Consolidated Block Grant to States for Food Assistance Title IX: Miscellaneous Responsibility and Empowerment Support Program Providing Employment, Child Care, and Training Act - Title I: AFDC Transition and Work Program - Amends part F (Job Opportunities and Basic Skills Training Program) (JOBS) of title IV of the Social Security Act (SSA) to give the JOBS program the new purpose of assuring that needy families with children obtain not only the education and training needed to prepare them for a life without welfare, but the work experience as well. (Sec. 101) Requires State JOBS programs to include a transition component and a work supplementation component that: (1) are each allowed to include any State work experience program approved by the Secretary; and (2) with respect to the first component, must include the State's job search program, and, with respect to the second component, may include the State's work supplementation or community work experience program. Amends part A (Aid to Families with Dependent Children) (AFDC) of SSA title IV to revise State AFDC plan participation requirements to incorporate participation in the two JOBS program components above under specified guidelines as a requirement for qualified individuals to receive AFDC. Imposes sanctions for a qualified individual's failure to participate in the JOBS program as required under such guidelines, which include a reduction in AFDC benefits and eventual benefit termination for repeated failures. Revises the exemptions from JOBS program participation requirements. Extends to all States the option to limit AFDC-UP. Increases State JOBS program and work program participation rates with regard to, respectively, AFDC-eligible individuals and unemployed parents. Provides for additional payments to States for JOBS programs. (Sec. 102) Amends community work experience and work supplementation program provisions. Title II: Paternity Establishment - Amends SSA title IV part A to: (1) provide for denial or reduction of AFDC for children whose paternity is not established; and (2) require unmarried individuals under 19 who are eligible for AFDC and are pregnant or with dependent children under their care to reside at home in order to receive AFDC. (Sec. 203) Amends SSA title IV part D (Child Support and Establishment of Paternity) to require earlier specified paternity establishment efforts by States. Expresses the encouragement of the Congress for States to develop procedures in public hospitals and clinics to facilitate the acknowledgment of paternity. (Sec. 204) Increases the paternity establishment percentage. Title III: Expansion of Statutory Flexibility of States - Amends SSA title IV part A to give States the option to: (1) convert AFDC into a block grant program; (2) exempt themselves from otherwise mandatory denial of AFDC where either parent is a minor; (3) treat families moving interstate who apply for AFDC in their new State of residence (where they have resided for less than on year) under the AFDC rules of their former State of residence; (4) reduce AFDC for parents under 21 who have dropped out of school and dependent children who, without good cause, do not maintain minimum school attendance; (5) exempt themselves from otherwise mandatory denial of AFDC for additional children; (6) modify certain AFDC income disregard rules; (7) provide for a married couple transitional benefit in cases where an AFDC recipient marries an individual who is not a parent of the recipient's child, and the resulting family would become ineligible for AFDC by reason of the marriage; (8) disregard certain savings and income of a family on AFDC designated for education, training, employability, home purchase, or residence change in determining eligibility for AFDC; and (9) condition the receipt of AFDC on the recipient's attendance at parenting and money management classes and prior approval of any action requiring a change in the educational institution attended by the recipient's dependent child. Title IV: Expansion of State and Local Flexibility -Establishes an Interagency Waiver Request Board in order to provide a focal point within the Federal Government for the development and coordination of waiver requests to improve opportunities for low-income individuals and families. (Sec. 402) Prescribes contents of applications to implement Federal assistance plans, as well as the review, approval, implementation, and evaluation processes. (Sec. 405) Requires any entity applying for plan approval to establish a Public Private Partnership Committee to advise it on plan development and implementation. Title V: Child Support Enforcement - Provides for a national system for employee reporting of any child support owed, the obligee involved, and other specified related information on W-4 forms for employer withholding and distribution of support owed, and reporting of related information to the State involved for availability to other States through the Interstate Locate Network established under this title. (Sec. 502) Makes various changes with regard to State child support order registries, the Parent Locater Service, regulations for sharing child support information, withholding orders, and noncustodial parents with child support arrearages who are receiving certain public welfare assistance. Title VI: Welfare Restrictions for Aliens - Makes aliens (except refugees, permanent residents, and certain current residents) ineligible for various specified types of public welfare assistance, including non-emergency related assistance under Medicaid, food stamps, and job training assistance. (Sec. 602) Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act (SSA) to require State AFDC agencies to provide information on illegal aliens to the Immigration and Naturalization Service. Title VII: Controlling Welfare Costs - Amends the Congressional Budget Act of 1974, the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act), and other Federal law to establish various specified measures for controlling welfare costs, including Federal spending caps. Title VIII: Consolidated Block Grant to States for Food Assistance - Repeals the Food Stamp Act of 1977, National School Lunch Act, Commodity Distribution Reform Act and WIC Amendments of 1987, and other specified Federal laws and replaces them with a: (1) State food assistance block grant program to provide food assistance to economically disadvantaged individuals and families (eligible populations); and (2) new food coupon program. Authorizes appropriations. (Sec. 803) Grants the Secretary of Agriculture and the Commodity Credit Corporation the authority to sell surplus commodities and foodstuffs to the States to provide food assistance to eligible populations. Title IX: Miscellaneous - Amends SSA title IV part A to require AFDC applicants and recipients to undergo any necessary substance abuse treatment as a condition of receiving AFDC. (Sec. 902) Amends SSA title XVI (Supplemental Security Income) (SSI) to: (1) make ineligible for SSI benefits individuals receiving SSI on the basis of a disability resulting from illegal drug addiction who continue to use illegal drugs or refuse to be tested for them; and (2) make representative payee changes. (Sec. 903) Directs the Secretary of Health and Human Services to: (1) conduct research projects to evaluate the impact of education and training programs on the ability of individuals to end participation in the AFDC program; (2) conduct demonstration projects and report to the Congress on whether providing benefits based on need through the use of electronic cards and automatic teller machines would reduce administrative costs and fraud; and (3) establish a commission to determine the cost and feasibility of creating an interstate system to compare the social security numbers of all AFDC recipients in order to identify those recipients receiving AFDC from multiple States. (Sec. 904) Amends SSA to require State AFDC applicants to participate in job search activities while the application is pending, unless a State by law exempts itself from this requirement. (Sec. 906) Public Housing Rent Reform and Empowerment Act - Amends the United States Housing Act of 1937 with regard to the determination of income and rent charges. Authorizes the Secretary of Housing and Urban Development to allow, upon request, under certain circumstances, a public housing agency or resident management corporation to carry out a demonstration program to determine the feasibility and desirability of providing such entities with the authority to establish policies for agency-administered public housing projects, without regard to the public housing requirements of the United States Housing Act of 1937. (Sec. 907) Amends SSA title IV part A to deny AFDC for certain children who have not received appropriate medical examinations and immunizations. Amends the Child Care and Development Block Grant Act with regard to childhood immunizations. Requires the Surgeon General to issue and periodically revise recommendations for the immunization of children under age six.
United States · United States Congress · 8 November 1993
Amends the Federal Election Campaign Act of 1971 to: (1) prohibit Federal election activities by political action committees (PACs); (2) limit House of Representatives election contributions from persons other than local individual residents; (3) limit soft money contributions; (4) permit political party contributions to challengers that match any campaign funds carried forward by the incumbent from an earlier election; (5) eliminate, in specified circumstances, limitations on contributions to candidates whose opponents use more than $100,000 from personal funds; (6) permit expenditures by labor organizations only if the organization meets specified requirements; (7) set forth a transition rule relating to excess funds for House of Representative candidates; (8) require disclosure of election related activity by corporations, labor organizations, and nonprofit organizations; (9) prohibit bundling of contributions to candidates by PACs and lobbyists; (10) prohibit transfers among noncandidate, nonparty political committees; (11) prohibit a candidate from establishing a leadership committee; and (12) prohibit contributions between principal campaign committees.
United States · United States Congress · 3 November 1993
Authorizes the Secretary of Agriculture (Secretary) to enter into agreements with other Federal agencies to acquire firefighting goods and services without regard to certain commercial contracting provisions. Directs the Secretary to report to the Congress on Forest Service and Department of Agriculture firefighting capabilities and methods.
United States · United States Congress · 1 November 1993
Federal Mandate Reduction, Reform, and Budget Act of 1993 - Amends the Congressional Budget Act of 1974 to set forth reporting requirements for the Office of Management and Budget and the Congressional Budget Office (CBO) with respect to reducing the direct costs to States and local governments of complying with Federal mandates. Requires concurrent resolutions on the budget to provide for such reductions until such costs do not exceed three percent of the estimated gross national product for the same fiscal year as the costs will be incurred. Requires CBO to prepare an analysis of mandated costs for States and local governments for each public bill or resolution reported in the Congress (except those from Appropriations Committees). Requires a similar analysis in the President's annual budget submissions. Requires initial regulatory flexibility analyses for proposed rules that establish or implement new Federal mandates to contain a description of the nature and amount of monetary costs to be incurred by State and local governments. Requires Federal agencies to prepare a cost estimate and cost benefit analysis of such mandates that would cost State and local governments at least $10 million for a fiscal year.
United States · United States Congress · 28 October 1993
Home Office Deduction Act - Amends the Internal Revenue Code to provide qualifications for a home office as a principal place of business for purposes of the deductibility of expenses.
United States · United States Congress · 27 October 1993
Safe Drinking Water Act Amendments of 1993 - Amends the Safe Drinking Water Act to require the Administrator of the Environmental Protection Agency, in the case of specified contaminants listed in the Federal Register for which national primary drinking water regulations have not been promulgated, to: (1) publish maximum contaminant level goals and promulgate such regulations for those contaminants that occur in drinking water and are of public health concern; and (2) eliminate monitoring, compliance, and enforcement requirements for those contaminants that do not occur in drinking water at levels of public health concern. (Current law requires the promulgation of such goals and regulations for specified numbers of such contaminants by certain dates.) Directs the Administrator to promulgate such goals and regulations for new contaminants every five years. Requires the Administrator to establish in each national primary drinking water regulation best technology treatment techniques for public water systems serving fewer than 1,000, between 1,000 and 10,000, and more than 10,000 people, respectively. Directs the Administrator to promulgate national primary drinking water regulations for radionuclides, disinfection and corrosion byproducts, and sulfate. Revises provisions concerning variances from national drinking water regulations to permit the issuance of a variance by a State only if the water system cannot afford to install the best available technology to meet the maximum contaminant level and it is not feasible for the system to connect with another source of water that will meet the standards. Requires variances to be reviewed by the State at least every three years. Repeals provisions that authorize States to exempt public water systems from requirements respecting maximum contaminant levels or treatment techniques. Prohibits treated drinking water from being removed from a public water system or routed through any device or pipes outside the system and returned to the system. Includes such action in the definition of "tampering," a violation for which criminal penalties are imposed. Makes such prohibition inapplicable to pipes and devices totally within the control of one or more public water systems or to connections between water mains. Requires (currently, authorizes) the Administrator to conduct research relating to diseases and other impairments resulting from contaminants in drinking water or to the provision of a safe supply of drinking water. Authorizes appropriations. Extends the authorization of appropriations for grants for State public water system supervision programs. Requires the Administrator to promulgate revised regulations every five years that list up to 30 unregulated contaminants to be monitored by public water systems. Directs the Administrator to assemble a national drinking water occurrence data base to include information on the occurrence of regulated and unregulated contaminants.
United States · United States Congress · 20 October 1993
Federal Retirement Reform Act - Revises age and service requirements for entitlement to an immediate annuity under the Civil Service and Federal Employees' Retirement Systems; eliminates such requirements specific to Members of Congress; and makes other changes in service requirements with regard to immediate annuity entitlement and mandatory separation with respect to fire fighters, law enforcement officers, and air traffic controllers.
United States · United States Congress · 20 October 1993
Expresses the sense of the House of Representatives that the Department of Justice should repudiate its reinterpretation of Federal child pornography laws, defend the conviction won in lower courts in Knox v. United States, and vigorously prosecute sexual exploitation of children.
United States · United States Congress · 13 October 1993
Reduces discretionary spending limits for FY 1994 by the amount of rescissions under this Act.
United States · United States Congress · 12 October 1993
Amends the Internal Revenue Code to make Internal Revenue Service employees personally liable for a portion of litigation costs resulting from arbitrary, capricious, or malicious acts. Increases (from $100,000 to $1 million) the limitation on recovery of civil damages for certain unauthorized collection actions. Places the burden of proof upon the Secretary of the Treasury with respect to the issue of whether any person has been guilty of fraud with intent to evade tax.
United States · United States Congress · 7 October 1993
Amends title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act (SSA) to revise the limitation on payment of OASDI benefits to prisoners to prohibit the payment of such benefits to all individuals imprisoned throughout at least one month upon conviction of a criminal offense, regardless of the prisoner's participation in a rehabilitation program. Amends SSA title XVI (Supplemental Security Income) (SSI) to make the same changes with respect to the payment of SSI benefits to such individuals.
United States · United States Congress · 6 October 1993
TABLE OF CONTENTS: Title I: Managed Competition in Employer-Based Health Plans: Incentives to Control Costs Subtitle A: Use of Tax Incentives to Purchase Cost-Effective Plans Subtitle B: Health Plan Purchasing Cooperatives (HPPCs) Subtitle C: Accountable Health Plans (AHPs) Subtitle D: Health Care Standards Commission Subtitle E: Managed Competition in Rural and Urban Underserved Areas Subtitle F: Treatment of Chronically Underserved Areas Subtitle G: Repeal of COBRA Continuation Requirements Subtitle H: Definitions Title II: Low-Income Assistance for Health Coverage Subtitle A: Low-Income Assistance Subtitle B: Long-Term Care Phase-Down Assistance to States Subtitle C: Financing Subtitle D: Repeal of Medicaid Program Title III: Training and Education of Health Care Professionals Subtitle A: Reform of Federal Funding for Medical Residency Training Subtitle B: Other Medical Education Grants and Programs Title IV: Preventive Health and Individual Responsibility Subtitle A: Expansion of Public Health Programs Subtitle B: Medicare Title V: Malpractice Reform Subtitle A: Findings; Purpose; Definitions Subtitle B: Uniform Standards for Malpractice Claims Subtitle C: Requirements for State Alternative Dispute Resolution Systems (ADR) Subtitle D: Grants to States for Development of Practice Guidelines Title VI: Paperwork Reduction and Administrative Simplification Title VII: Additional Benefits On a Pay-As-You-Go Basis Managed Competition Act of 1993 - Title I: Managed Competition in Employer-Based Health Plans: Incentives to Control Costs - Subtitle A: Use of Tax Incentives to Purchase Cost-Effective Plans - Amends the Internal Revenue Code to impose a tax on the excess health plan expenses of any employer which are health plan expenses exceeding specific limits under an accountable health plan for a defined geographical area. (Sec. 1002) Increases to 100 percent and makes permanent the deduction for health plan premium expenses of self-employed individuals. (Sec. 1003) Permits the deduction for medical, dental, etc. expenses without regard to the limitation on such deduction with respect to amounts paid for premiums under an accountable health plan. (Sec. 1004) Provides for the exclusion from gross income of contributions by a partnership or S corporation to a health plan covering partners or shareholders. (Sec. 1006) Eliminates the commonality of interest and geographic location requirements with respect to group purchasing by large tax-exempt organizations. Subtitle B: Health Plan Purchasing Cooperatives (HPPCs) - Provides for the establishment of Health Plan Purchasing Cooperatives (HPPCs). Considers each State to be a HPPC, except that a State may subdivide into HPPC areas, and that there may be interstate HPPCs, as specified. Requires HPPCs to enter into agreements with accountable health plans and small employers, offer enrollment in accountable health plans, and charge premiums. Subtitle C: Accountable Health Plans (AHPs) - Directs the Health Care Standards Commission to provide a process whereby a health plan may be registered with the Commission by its sponsor as an accountable health plan. Sets forth requirements for a plan to be registered, including: (1) coverage for a specified uniform set of benefits, including cost-sharing for low-income individuals; (2) standard premiums for the uniform benefits; (3) grievance procedures; (4) collecting and providing specified information; (5) prohibiting discrimination in enrollment or benefits; and (6) financial solvency. (Sec. 1208) Sets forth additional requirements for open AHPs, which is any plan which is not closed. Defines a closed plan as one limited by structure or law to one or more large employers. (Sec. 1211) Requires each AHP to provide for payment of one percent of gross premium receipts to the National Medical Education Fund. (Sec. 1221) Sets forth provisions concerning the preemption of State laws for AHPs. (Sec. 1231) Directs the President to provide for the development and publication of guidelines on the application of Federal antitrust laws to AHPs. (Sec. 1232) Provides for the issuance of certificates of public advantage by the Attorney General to eligible health care joint ventures which, if followed, exempt such ventures from antitrust liability. Subtitle D: Health Care Standards Commission - Establishes, as an independent agency in the Executive Branch, a Health Care Standards Commission. Requires the Commission to transmit annually to the Congress recommendations for the uniform set of effective benefits. States that such recommendations shall apply unless the Congress passes a joint resolution of disapproval. (Sec. 1303) Directs the Commission to provide for the initial organization, as a nonprofit corporation, of the Benefits, Evaluations, and Data Standards Board in order to make recommendations to the Commission concerning the uniform set of effective benefits and matters related to the evaluation of health care services. (Sec. 1304) Directs the Commission to provide for the initial organization, as a nonprofit organization of the Health Plan Standards Board in order to make recommendations to the Commission concerning the standards for AHPs and concerning its assessment of risk-adjustment factors. (Sec. 1305) Sets forth provisions concerning the registration of AHPs. (Sec. 1306) Directs the Commission to establish rules for the process of risk-adjustment of premiums among AHPs by HPPCs. (Sec. 1307) Directs the Commission to publish information concerning procedures, their prices, and their quality. (Sec. 1309) Establishes, within the Department of Health and Human Services, the Agency for Clinical Evaluations which shall assume the responsibilities of the Director of the Office of Medical Applications of Research at the National Institutes of Health, the Director of the Office of Research and Demonstrations of the Health Care Financing Administration (insofar as such responsibilities relate to clinical evaluations), the Administrator for Health Care Policy and Research under title IX of the Public Health Service Act, as well as other specified responsibilities. Authorizes appropriations. (Sec. 1311) Prohibits the Commission from establishing or enforcing any controls on health care spending. (Sec. 1313) Authorizes appropriations for the Commission through FY 2000. Terminates the Commission on December 31, 1999. Subtitle E: Managed Competition in Rural and Urban Underserved Areas - Authorizes the Governor of any State to designate rural and urban areas of a State as underserved areas. Permits a HPPC serving such an area to require AHPs offered by the HPPC and with a service area adjoining such area to include the area as part of their service area. (Sec. 1411) Authorizes appropriations for: (1) technical assistance for entities seeking to establish a network plan in an underserved area; (2) financial assistance to eligible entities in order to provide for the development and implementation of AHPs in rural areas; and (3) under the Public Health Service Act, migrant health centers and community health centers. (Sec. 1422) Provides coverage under part B of title XVIII (Medicare) of the Social Security Act for rural emergency access care hospital services. (Sec. 1431) Directs the Secretary of Health and Human Services to make payments for transitional assistance to eligible hospitals. Requires any hospital accepting such assistance to provide a significant volume of services to persons unable to pay for services. Authorizes appropriations. Subtitle F: Treatment of Chronically Underserved Areas - Directs the Health Care Standards Commission to develop standards for the identification of chronically underserved areas. Makes provisions for addressing health care delivery in such areas. Subtitle G: Repeal of COBRA Continuation Requirements - Repeals the COBRA continuation requirements for group health plans and title XXII of the Public Health Service Act. Subtitle H: Definitions - Sets forth definitions for this title and title II. Title II: Low-Income Assistance for Health Coverage - Subtitle A: Low-Income Assistance - Provides premium assistance for very-low income individuals and moderately low-income individuals. Provides for nominal cost-sharing for such individuals and special assistance for certain items and services. Subtitle B: Long-Term Care Phase-Down Assistance to States - Provides for long-term care phase-down assistance to eligible States for each calendar quarter in 1995 through 1998. Subtitle C: Financing - Amends title XVIII (Medicare) of the Social Security Act to achieve savings under such program by: (1) reducing the update for inpatient hospital services; (2) reducing the conversion factor for the physician fee schedule for non-primary care services; and (3) reducing hospital outpatient services through establishing a prospective payment system. (Sec. 2204) Amends the Internal Revenue Code to impose a Medicare part B premium tax on higher-income individuals. (Sec. 2205) Achieves additional Medicare savings through the: (1) phased-in elimination of Medicare disproportionate share adjustment payments; (2) reduction of routine cost limits for home health services; (3) reduction in routine cost limits for extended care services; and (4) reductions in payments for hospice services. Subtitle D: Repeal of Medicaid Program - Repeals title XIX (Medicaid) of the Social Security Act. Title III: Training and Education of Health Care Professionals - Subtitle A: Reform of Federal Funding for Medical Residency Training - Directs the Health Care Standards Commission to approve a resident training position in medical residency program for purposes of funding approved medical residency training programs under this title. Provides funding, in addition, for physician retraining. Sets forth provisions concerning: (1) the allocation of entry positions among programs; and (2) the general distribution of positions among specialties. (Sec. 3004) Requires payment by AHPs of one percent of gross premium receipts to the National Medical Education Fund. Requires payments from the Medicare trust funds to the National Medical Education Fund. (Sec. 3005) Establishes the National Medical Education Fund. Subtitle B: Other Medical Education Grants and Programs - Authorizes appropriations under the Public Health Service Act for medical education programs, including: (1) the scholarship and loan repayment programs of the National Health Service Corps; (2) area education centers; (3) public health and preventive medicine; (4) family medicine; (5) general internal medicine and pediatrics; (6) physician assistants; (7) allied health projects grants and contracts; and (8) nurse practitioner and nurse midwife programs. Title IV: Preventive Health and Individual Responsibility - Subtitle A: Expansion of Public Health Programs - Authorizes appropriations under the Public Health Service Act for the following public health programs: (1) immunizations against vaccine-preventable diseases; (2) prevention, control, and elimination of tuberculosis; (3) lead poisoning prevention; (4) preventive health measures with respect to breast and cervical cancers; (5) the Office of Disease Prevention and Health Promotion; (6) the Office of Minority Health; (7) preventive health and health services block grant; (8) categorical grants for early intervention regarding acquired immune deficiency syndrome; and (9) programs of the Centers for Disease Control regarding the smoking of tobacco products. Directs the Office of Disease Prevention and Health Promotion to promote individual responsibility in personal health care and in the use of valuable health care resources. Subtitle B: Medicare - Provides Medicare coverage for: (1) screening fecal-occult blood tests and screening flexible sigmoidoscopies for the purpose of the early detection of cancer; (2) tetanus-diphtheria boosters; (3) well-child services; and (4) an annual screening mammography for women over age 64. Title V: Malpractice Reform - Subtitle A: Findings; Purpose; Definitions - Sets forth the findings, purpose, and definitions for this title. Subtitle B: Uniform Standards for Malpractice Claims - Prohibits bringing a medical malpractice liability action in a State court unless there has been an initial resolution under an alternative dispute resolution system. Limits the total noneconomic damages in such actions to $250,000. Sets limits on attorney's fees. Makes special provision for obstetric services. Subtitle C: Requirements for State Alternative Dispute Resolution Systems (ADR) - Establishes requirements for State alternative dispute resolution systems. Provides for grants to States to assist in implementation of such systems. Subtitle D: Grants to States for Development of Practice Guidelines - Directs the Secretary to make grants to States for the development of medical practice guidelines for health care professionals that may be applied to resolve medical malpractice liability claims. Title VI: Paperwork Reduction and Administrative Simplification - Preempts State quill pen laws. Ensures the confidential treatment of electronic health care information. Sets forth provisions which provide for: (1) the standardization of electronic health information; (2) uniform claims forms; (3) the liability of insurers when benefits are payable under two or more plans; and (4) the uniformity of the availability of information among health plans when benefits are payable under two or more plans. (Sec. 6007) Amends the Internal Revenue Code to impose a tax on a health plan not in compliance with specified requirements of this title. Title VII: Additional Benefits On a Pay-As-You-Go Basis - Expresses the sense of the Congress that additional benefits should be provided by the Federal Government to the extent that additional financing is made available on a pay-as-you-go basis.
United States · United States Congress · 6 October 1993
Directs the Secretary of Agriculture to replace the Modular Airborne Fire Fighting System (System). Repeals the Helium Act. Directs the Secretary of the Interior to: (1) sell related property and helium reserves; and (2) transfer the proceeds to the Secretary of Agriculture to pay for replacement of the System.
United States · United States Congress · 30 September 1993
Designates November of each year as National American Indian Heritage Month.
United States · United States Congress · 23 September 1993
Designates October 19, 1993, as National Mammography Day.
United States · United States Congress · 23 September 1993
Supports President Yeltsin's insistence on free and fair elections to allow the peoples of the Russian Federation the opportunity to elect a representative legislature. Applauds President Clinton for voicing his support for President Yeltsin. Expects that President Yeltsin will ensure that elections are held as planned in December 1993. Calls upon the President of the United States, the Secretary General of the United Nations, and the community of nations to offer assistance in facilitating the electoral process in the Russian Federation.
United States · United States Congress · 15 September 1993
TABLE OF CONTENTS: Title I: Improved Access to Affordable Health Care Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families Subtitle B: Reform of Health Insurance Marketplace for Small Business Subtitle C: Preemption Subtitle D: Health Deduction Fairness Subtitle E: Improved Access to Community Health Services Subtitle F: Improved Access to Rural Health Services Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program Title II: Health Care Cost Containment and Quality Enhancement Subtitle A: Medical Malpractice Liability Reform Subtitle B: Administrative Cost Savings Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Accounts Subtitle D: Anti-Fraud Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals Subtitle F: Removing Anti-Trust Impediments Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities Subtitle H: Prefunding Government Health Benefits for Certain Annuitants Subtitle I: Miscellaneous Provisions Title III: Long-Term Care Subtitle A: Tax Treatment of Long-Term Care Insurance Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance Subtitle C: Studies Subtitle D: Volunteer Service Credit Demonstration Projects Affordable Health Care Now Act of 1993 - Title I: Improved Access to Affordable Health Care - Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families - Part 1: Required Coverage Options for Eligible Employees, Spouses, and Dependents - Requires each employer to make available to each eligible employee a group health plan under which: (1) coverage of each eligible individual with respect to such employee may be elected on an annual basis; (2) coverage is provided for at least the required coverage specified; and (3) employees may elect to have premiums collected through payroll deduction. Does not require employer contributions to the cost of coverage under such a plan. Provides for the exclusion of: (1) employers who have been employers for less than two years or who have no more than two eligible employees or no more than two eligible employees not covered under any group health plan; and (2) family members under specified circumstances. Specifies that a group health plan shall not be treated as failing to meet the requirements of this Act solely because a period of service by an eligible employee of not more than 60 days is required for coverage. Specifies that the required coverage is standard coverage, except that in the case of a small employer that has not contributed during the previous plan year to the cost of coverage for any eligible employee under any group health plan, the required coverage for the plan year is coverage under a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan. Provides for a five-year transition for existing group health plans. (Sec. 1002) Sets forth provisions regarding: (1) compliance with applicable requirements through multiple employer health arrangements; and (2) coverage options under a State medical health allowance program. Part 2: Preexisting Conditions and Continuity of Coverage; Renewability - Prohibits a group health plan from imposing (and an insurer from requiring an employer from imposing through a waiting period for coverage under a plan or similar requirement) a limitation or exclusion of benefits relating to treatment of a preexisting condition if: (1) the condition relates to a condition that was not diagnosed or treated within three months before the date of coverage under the plan; or (2) the limitation or exclusion extends over more than six month after the date of coverage, applies to an individual who, as of the date of birth, was covered under the plan, or relates to pregnancy. Specifies that, in the case of an individual who is eligible for coverage under a plan but for a waiting period imposed by the employer, the individual shall be treated as having been covered under the plan as of the earliest date of the beginning of the waiting period. (Sec. 1012) Requires each group health plan to waive any period applicable to a preexisting condition for similar benefits with respect to an individual to the extent that the individual, prior to enrollment in such plan, was covered for the condition under any other health plan. (Sec. 1013) Prohibits: (1) a multiemployer plan and an exempted multiple employer health plan from canceling or denying renewal of coverage under such a plan for an employer other than for nonpayment of contributions, fraud or other misrepresentation, noncompliance with plan provisions, or misuse of a provider network provision, or because the plan is ceasing to provide any coverage in a geographic area; (2) an insurer from canceling a health insurance plan or denying renewal of coverage other than as prescribed above; and (3) an insurer who terminates the offering of health insurance plans in an area from offering such a plan to any employer in the area until five years after the date of the termination. Part 3: Enforcement; Effective Dates; Definitions - Makes provisions of the Employee Retirement Income Security Act of 1974 applicable with respect to enforcement of this Act (by the Department of Labor). Amends the Internal Revenue Code (Code) to impose a tax ($100 per day for each individual involved, subject to specified limitations) on the failure of an insurer to comply with the requirements under part 2 unless the Secretary of Health and Human Services (Secretary) determines that the State has in effect a regulatory enforcement mechanism that provides adequate sanctions. Subtitle B: Reform of Health Insurance Marketplace for Small Business - Requires each insurer that makes available a health insurance plan to a small employer in a State to make available to each small employer in the State a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan, with exceptions for health maintenance organizations (HMOs) and if a State provides for guaranteed availability (rather than guaranteed issue). Requires each insurer that offers a MedAccess plan to a small employer in a State to accept: (1) every small employer in the State that applies for coverage; and (2) every eligible individual who applies for enrollment on a timely basis. Sets forth provision regarding: (1) special rules for HMOs; (2) timely enrollment requirements; and (3) enrollment of spouses and dependents. Makes such requirements inapplicable in a State that has provided (in accordance with specified standards) a mechanism under which each insurer offering a health insurance plan to a small employer in the State must participate in a program for assigning high-risk small employer groups (or individuals within such a group) among some or all such insurers, if the insurers comply. (Sec. 1102) Defines "MedAccess plan" as a health insurance plan that: (1) is designed to provide standard coverage with substantial cost-sharing, only catastrophic coverage, or medisave coverage; (2) includes only essential and medically necessary services; (3) meets applicable requirements relating to guaranteed issue; and (4) meets specifies consumer protection standards. Defines "MedAccess standard plan," "MedAccess catastrophic plan," and "MedAccess medisave plan" to mean a MedAccess plan that provides for at least standard coverage, for only catastrophic coverage, or medisave coverage, respectively. Requests the National Association of Insurance Commissioners (NAIC) to submit to the Secretary a set of rules which NAIC determines is sufficient for determining, in the case of any health insurance plan and for purposes of this subtitle, the actuarial value of the coverage offered by the plan. Directs the Secretary to certify such set of rules for use under this subtitle if they meet such requirements or establish such a set of rules. Specifies that a health insurance plan is considered to provide: (1) standard coverage if the benefits are determined, in accordance with certified rules of actuarial equivalence, to have a value that is within five percentage points of an established target actuarial value for standard coverage; (2) catastrophic coverage if benefits are available under the plan for a year only to the extent that expenses for covered services in a year exceed a deductible amount that is consistent with a specified requirement for a catastrophic health plan under the Code, and are determined, in accordance with certified actuarial equivalence rules, to have a value that is within five percentage points of an established target actuarial value for catastrophic coverage; and (3) medisave coverage if such plan consists of a catastrophic health plan within the meaning of the Code and a medical savings account. Requests NAIC to submit to the Secretary target actuarial values for standard and catastrophic coverage. Permits NAIC to submit periodic revisions of, and permits the Secretary to revise, the set of rules of actuarial equivalence and target actuarial values where necessary to take into account changes in the relevant types of health benefits provisions, in deductible levels for catastrophic coverage, or in relevant demographic conditions. (Sec. 1103) Directs the Secretary to request NAIC to develop model regulations that specify standards with respect to requirements: (1) that insurers make available MedAccess plans; (2) of guaranteed availability of MedAccess plans to small employers; (3) relating to limits on premiums and certain consumer protections; and (4) relating to limitation of annual premium increases. Requires the Secretary to review such standards and, if NAIC fails to specify standards meeting such requirements, to promulgate standards. Sets forth provisions regarding: (1) the application of MedAccess standards and consumer protection standards by the States; and (2) the Federal role. (Sec. 1104) Sets forth provisions: (1) regarding limits on premiums and annual premium increases; and (2) requiring an insurer, at the time of offering a health insurance plan to a small employer, to fully disclose rating practices for health insurance plans, including rating practices for different populations and benefit designs. (Sec. 1106) Directs the Secretary to: (1) request NAIC to develop models for reinsurance or allocation of risk mechanisms for health insurance plans made available to small employers for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models or specify models. Sets forth provisions regarding implementation of reinsurance or allocation of risk mechanisms by the States and the Federal role. Amends the Code to provide for the imposition of a tax on any health insurance plan which covers any employee in a Federal reinsurance State. (Sec. 1108) Directs the Secretary to establish an Office of Private Health Care Coverage. Requires the Office Director to submit to the Congress annual reports evaluating health care coverage reform. (Sec. 1109) Authorizes the Director to conduct: (1) research on the impact of this subtitle on the availability of affordable health coverage for employees and dependents in the small employers group health care coverage market and other specified topics; and (2) demonstration projects relating to such topics. Requires the Director to develop: (1) methods for measuring the relative health risks of eligible individuals in terms of the expected costs of providing benefits under health insurance plans and, in particular, MedAccess plans; and (2) a model for equitably distributing health risks among insurers in the small employer health care coverage market. Authorizes appropriations. Subtitle C: Preemption - Part 1: Scope of State Regulation - Prohibits: (1) State benefit mandates for group health plans; and (2) State or local law prohibitions against two or more employers obtaining coverage under an insured multiple employer health plan. (Sec. 1203) Preempts State restrictions concerning: (1) reimbursement rates or selective contracting; (2) differential financial incentives; and (3) utilization review methods. Directs the Comptroller General to conduct a study of the benefits and cost effectiveness of the use of managed care in the delivery of health services. Part 2: Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to allow a limited exemption under preemption rules for multiple employer plans providing health benefits subject to certain Federal standards. (Sec. 1212) Relieves exempted multiple employer plans providing medical care benefits of certain restrictions on preemption of State law. Treats such plans as employee welfare benefit plans. Allows commencement of new arrangements only if such exemption is in effect or an application is pending and the Secretary of Labor determines that provisional protection is appropriate. Sets forth exemption procedures, eligibility requirements, and additional requirements applicable to exempted arrangements. Requires certain disclosures to participating employers, maintenance of reserves, and corrective actions. Provides for expiration, suspension, and revocation of exemptions, and for review of actions by the Secretary. (Sec. 1213) Revises provisions relating to scope of preemption rules, and to treatment of single employer arrangements and of certain collectively bargained arrangements. (Sec. 1215) Establishes special rules for employee leasing healthcare arrangements. Treats such arrangements as multiple employer welfare arrangements except when they are multiple employer health plans. (Sec. 1216) Sets forth enforcement provisions relating to multiple employer welfare arrangements and employee leasing health care arrangements. (Sec. 1217) Sets forth filing requirements for multiple employer welfare arrangements. (Sec. 1218) Provides for cooperation between Federal and State authorities in enforcing ERISA requirements for multiple employer welfare arrangements with the limited exemption. Part 3: Encouragement of Multiple Employer Arrangements Providing Basic Health Benefits - Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax exempt trust status for multiple employer health plans and insured multiple employer health plans if they meet certain requirements under ERISA and this Act. Part 4: Simplifying Filing of Reports for Employers Covered under Insured Multiple Employer Health Plans - Amends ERISA to direct the Secretary of Labor to prescribe an alternative method providing for a single annual report with respect to all employers who are covered under the same insured multiple employer health plan. Part 5: Compliance with Coverage Option Requirements - Provides for compliance with applicable coverage requirements through multiemployer plans and other multiple employer health arrangements. Subtitle D: Health Deduction Fairness - Amends the Internal Revenue Code to provide: (1) for a permanent extension and increase in the health insurance tax deduction for self-employed individuals; and (2) that the deduction for certain health insurance costs be determined without regard to an adjusted gross income threshold. Disallows the deduction to individuals eligible for employer-subsidized coverage. Allows the deduction whether or not the individual itemizes other deductions. Subtitle E: Improved Access to Community Health Services - Part 1: Increased Authorization for Community and Migrant Health Centers - Directs the Secretary to provide for grants to migrant and community health centers to promote primary health care services for underserved individuals. Allows grants to be used to promote the provision of off-site services, to improve birth outcomes in areas with high infant mortality and morbidity, to establish primary care clinics in areas in need, and for recruitment and training costs of necessary providers and operating costs for unreimbursed services. Authorizes appropriations. Directs the Secretary to conduct a study of the impact of such grants on access to health care, birth outcomes, and the use of emergency room services. Part 2: Grants for Projects for Coordinating Delivery of Services - Amends the Public Health Service Act to authorize the Secretary to make grants to public and nonprofit private entities: (1) to carry out demonstration projects to increase access to outpatient primary health services in specified geographic areas (i.e., areas that are rational areas for the delivery of health services, have a population of not more than 500,000 individuals, and have been designated by the Secretary as areas with a shortage of personal health services or that have a significant number of individuals with low incomes or insufficient health care insurance through coordinating the delivery of such services under Federal, State, local, and private programs; and (2) for developing plans to carry out such projects. Authorizes appropriations. Subtitle F: Improved Access to Rural Health Services - Part 1: Establishment of Rural Emergency Access Care Hospitals Under Medicare - Amends title XVIII (Medicare) of the Social Security Act (SSA) to provide for: (1) establishment of rural emergency access care hospitals under Medicare; and (2) coverage of and payment for rural emergency access care hospital services under Medicare part B (Supplementary Medical Insurance). Part 2: Rural Medical Emergencies Air Transport - Amends the Public Health Service Act to direct the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments. Sets forth provisions regarding: (1) application and State plan requirements; (2) considerations in awarding grants; (3) State administration and use of grants; (4) the number of grants; and (5) reporting requirements. Authorizes appropriations. Part 3: Emergency Medical Services Amendments - Amends the Public Health Service Act to direct the Secretary to: (1) establish an Office of Emergency Medical Services, headed by a Director; (2) engage in specified emergency medical services activities, including disseminating information obtained in carrying out specified activities to public and private entities, providing technical assistance to State and local agencies, coordinating Department of Health and Human Services (DHHS) activities with those of other Federal agencies; and (3) ensure that such activities are carried out consistent with certain requirements regarding maintaining an adequate number of health professionals with expertise in the provision of services, developing, periodically reviewing, and revising as appropriate guidelines for the provision of such services, appropriately using available technologies, and serving the unique needs of underserved inner-city and rural areas. (Sec. 1522) Authorizes the Secretary to make grants to States for the purpose of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services, subject to specified matching fund, budgetary, and other requirements. (Sec. 1523) Provides for demonstration projects to establish telecommunications between rural medical facilities and medical facilities with expertise or equipment. Directs the Secretary to ensure that the telecommunications technologies demonstrated include interactive video telecommunications, static video imaging transmitted through the telephone system, and facsimiles transmitted through such system. (Sec. 1524) Authorizes appropriations for: (1) emergency medical services (including for State offices of Emergency Medical Services and for telecommunications demonstrations); and (2) trauma care and certain other activities. Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program - Amends SSA title XIX (Medicaid) to provide for the establishment of State health allowance programs under which the State makes payments to a group health plan which provides coverage to an eligible individual as an allowance towards the costs of providing the individual with benefits under the plan. Subtitle H: Medicaid Program Flexibility - Amends SSA title XIX Medicaid) to modify: (1) Federal requirements to allow States more flexibility in contracting for coordinated care services under Medicaid; and (2) provisions regarding the extension of certain waivers. Title II: Health Care Cost Containment and Quality Enhancement - Subtitle A: Medical Malpractice Liability Reform - Part 1: General Provisions - Makes this subtitle applicable with respect to any medical malpractice liability claim and to any medical malpractice liability action brought in State or Federal court, except a claim or action for damages arising from a vaccine-related injury or death to the extent that title XXI of the Public Health Service Act applies. Sets forth provisions regarding: (1) preemption of State law; (2) effect on sovereign immunity and choice of law or venue; (3) jurisdiction; and (4) effective dates. Part 2: Medical Malpractice and Product Liability Reform - Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified alternative dispute resolution (ADR) system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States under chapter 171 of the Federal judicial code (U.S. Court of Federal Claims). Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 2012) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action. Sets limits on punitive damages and on periodic payments for future losses. (Sec. 2013) Set forth provisions regarding: (1) limits on attorney fees and other costs; (2) joint and several liability (generally, liability may be found only for those damages directly attributable to the person's proportionate share of fault or responsibility for the injury); (3) a statute of limitations of seven years; and (4) a uniform standard for determining negligence (the defendant's conduct at the time of providing the health care services was not reasonable). (Sec. 2017) Specifies that in the case of a medical malpractice liability claim relating to services provided during labor or the delivery of a baby, if the health care professional did not previously treat the injured individual for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. Part 3: Requirements for State Alternative Dispute Resolution Systems - Lists requirements for State ADR systems, including that such a system: (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 2032) Directs the Secretary, by October 1 of each year, to certify State ADR systems that meet such requirements. Directs the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 2033) Directs the Secretary, within five years, to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system, including: (1) information on the effect of the ADR systems on health care costs, access to health care, and quality of care provided within the State; and (2) to the extent that such report does not provide information on no-fault systems operated by States as ADR systems, an analysis of the feasibility and desirability of establishing a system for resolving medical malpractice liability claims on a no-fault basis. Part 4: Other Provisions Relating to Medical Malpractice Liability - Authorizes a State agency responsible for disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies to permit their participation in the licensing of such practitioner and to review any health care malpractice action, claims, or allegation, or other information concerning the practice patterns of any such practitioner. Sets forth agreement requirements. (Sec. 2042) Directs the Secretary to study incentives adopted by State and local governments, insurers, medical societies, and other entities to encourage physicians to volunteer to provide health care services in medically underserved areas. (Sec. 2043) Directs each State to require: (1) each health care professional and health care provider to participate in a risk management program to prevent, and provide early warning of, practices which may result in injuries to patients or endanger patient safety; and (2) each provider of health care professional and provider liability insurance in the State to establish risk management programs or sanction programs of risk management for health care professionals and providers provided by other entities, and require each such professional or provider, as a condition of maintaining insurance, to participate in one such program at least once in each three-year period. (Sec. 2044) Directs the Secretary to make grants: (1) for basic research in the prevention of, and compensation for, injuries resulting from health care professional or provider malpractice and for research of the outcomes of health care procedures; (2) to the States to assist in improving their ability to license and discipline health care professionals; and (3) to States and local governments, private nonprofit organizations, and health professional schools for educating the general public about the appropriate use of health care, realistic expectations of medical intervention, and the resources and role of health care professional licensing and disciplinary boards in investigating claims of incompetence or health care malpractice, and for developing programs of faculty training and curricula for educating health care professionals in quality assurance, risk management, and medical injury prevention. Authorizes appropriations. Subtitle B: Administrative Cost Savings - Part 1: Standardization of Claims Processing - Directs the Secretary to adopt standards relating to: (1) data elements for use in paper and electronic claims processing under health benefit plans and in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. (Sec. 2102) Authorizes the Secretary, two years after standards are adopted for classes of services upon determining that a significant number of claims for benefits for such services under health benefit plans are not being submitted in accordance with such standards, to require that all providers of such services submit claims to health benefit plans in accordance with such standards. (Sec. 2103) Directs the Secretary to: (1) provide for the ongoing receipt and review of comments and suggestions for changes in the standards adopted and promulgated; (2) establish a schedule for the periodic review of such standards; and (3) revise such standards. Part 2: Electronic Medical Data Standards - Directs the Secretary to promulgate standards for hospitals concerning electronic medical data, including standards for transmission of such data and confidentiality of patient-specific information. Authorizes the Secretary to periodically revise such standards. (Sec. 2112) Sets forth requirements with respect to: (1) the sharing of hospital information under Medicare; (2) waiver of such requirements; and (3) application of such requirements to hospitals of the Department of Veterans Affairs. (Sec. 2113) Authorizes the head of a Federal agency to require a provider to present and transmit a required data element electronically in accordance with applicable presentation or transmission standard. (Sec. 2114) Sets forth limitations on data requirements where standards with respect to data elements are in effect. (Sec. 2115) Directs the Secretary to establish an advisory commission on the standards established under this part and operational concerns about the implementation of such standards. Authorizes appropriations. Part 3: Development and Distribution of Comparative Value Information - Directs the Secretary to determine whether each State is developing and implementing a health care value information program that meets specified criteria and a specified schedule. Authorizes the Secretary to: (1) make grants to enable each State to plan development and initiate implementation of its health care value information program; and (2) recover the amount of such a grant by offset against any other amount payable to the State under the Social Security Act under specified circumstances. Authorizes appropriations. (Sec. 2122) Directs the Secretary to take actions necessary to implement a comparable program in a State that fails to develop or implement a health care value information program in accordance with such criteria and schedule. Authorizes the Secretary to charge fees for the information materials provided pursuant to such a program. (Sec. 2123) Directs the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to develop health care value information relating to each program that such head administers and covering the same types of data that a State program meeting such criteria would provide. (Sec. 2124) Directs the Secretary to: (1) develop model systems to facilitate the gathering of data on health care cost, quality, and outcome and the analysis of such data in a manner that will permit the valid comparison of such data among providers and among health plans; (2) support experimentation with different approaches to achieve such objectives in the most cost effective manner; and (3) evaluate the various methods to determine their relative success. Authorizes the Secretary to establish standards for the collective and reporting of data on health care cost, quality, and outcomes. Authorizes appropriations. Part 4: Additional Standards and Requirements; Research and Demonstrations - Directs the Secretary to: (1) adopt standards relating to the design and use of magnetized Medicare identification cards to assist health care providers in determining whether individuals are eligible for benefits for provided services under the Medicare program and in billing the Medicare program for covered services; (2) take steps to encourage and assist States in the design and use of magnetized Medicaid identification cards under their Medicaid plans; and (3) establish a Medicare and Medicaid information system to provide information on group health and other health benefit plans that are primary payors to the Medicare and Medicaid programs. Authorizes appropriations. (Sec. 2132) Specifies that, effective January 1, 1994, no effect shall be given to any provision of State law that requires medical or health insurance records (including billing information) to be maintained in written, rather than electronic, form. (Sec. 2133) Requires, effective January 1, 1995, each health benefit plan: (1) to use a beneficiary's social security number as the personal identifier for claims processing and related purposes (authorizes the Secretary to impose a civil money penalty on any plan that fails to do so); and (2) to use the unique identifier under title XVIII of the Social Security Act (Medicare) for a provider that furnishes health care items or services to a beneficiary under the plan as the identifier of that provider for claims processing and related purposes. (Sec. 2134) Directs the Secretary to: (1) determine, where benefits are payable under two or more health benefit plans, whether problems relating to the rules for determining the liability of plans or the availability of information among plans causes significant administrative costs; and (2) promulgate standards, if the implementation of standards would significantly reduce such administrative costs. Authorizes the Secretary to impose a civil money penalty on plans that fail to comply with such standards. (Sec. 2135) Directs the Secretary to provide grants to qualified entities for research on the application of comprehensive information systems in continuously monitoring and improving patient care. Authorizes the Secretary to make grants to: (1) two to five community organizations or coalitions of health care providers, health benefit plans, and purchasers to establish and document the efficacy of communication links between the information systems of health benefit plans and of health care providers; (2) two to five public or private nonprofit entities for the development of regional or community-based clinical information systems; and (3) public or private nonprofit entities to develop and test the definition of a comprehensive set of data elements and the specification and manner of presentation of the individual data elements of the set, for electronic medical data generated by physicians and other entities (other than hospitals) that provide health care services. Authorizes appropriations. Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Account - Amends the Internal Revenue Code to include under the medical expense deduction the portion of such expense attributable to coverage under a catastrophic health plan. (Sec. 2202) Allows individuals a tax deduction for percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to medical care savings accounts. Subtitle D: Anti-Fraud - Part 1: Criminal Prosecution of Health Care Fraud - Amends the Federal criminal code to: (1) set penalties for health care providers who knowingly engage in any scheme or artifice to defraud any person in connection with the provision of health care; and (2) make activity which, if engaged in by the U.S. Postal Service, would be a violation of mail fraud provisions punishable to the same extent with respect to private or commercial interstate carriers. (Sec. 2303) Authorizes appropriations to hire, equip, and train no fewer than: (1) 225 special agents of the Federal Bureau of Investigation and support staff to investigate health care fraud cases; (2) 50 assistant United States Attorneys and support staff to prosecute such cases; and (3) 25 investigators in the Office of Inspector General, DHHS, to be devoted exclusively to health care fraud cases. (Sec. 2304) Amends the Federal criminal code to authorize the Attorney General to make payments of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution of health care fraud, subject to specified requirements and exceptions. Part 2: Coordination of Health Care Anti-Fraud and Abuse Activities - Directs the Secretary to establish in the Office of the Inspector General of DHHS a program (all-payer fraud and abuse control program) to: (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to the delivery of, and payment for, health care in the United States; (2) conduct investigations, audits, evaluations, and inspections relating to such delivery and payment; and (3) facilitate the enforcement of provisions of the Social Security Act and other statutes applicable to health care fraud and abuse. Directs the Secretary to establish standards to carry out such program, including standards relating to the furnishing of information by health insurers, providers, and other to enable the Secretary to carry out the program and procedures to assure that such information is provided and utilized in a manner that protects the confidentiality of the information and the privacy of individuals receiving health care services. Sets forth provisions regarding: (1) qualified immunity for providing information; (2) ensuring access to documentation; and (3) failure to comply as grounds for exclusion from the Medicare and Medicaid programs. (Sec. 2312) Authorizes additional appropriations to enable the Secretary to conduct investigations of allegations of health care fraud and to carry out the all-payor fraud and abuse control program. (Sec. 2313) Establishes in the Treasury an Anti-Fraud and Abuse Trust Fund to be used to assist the Inspector General of DHHS in carrying out the all-payor fraud and abuse control program in the fiscal year involved. Sets forth provisions regarding: (1) the deposit into the Fund of Federal health anti-fraud and abuse penalties; and (2) the use of such penalties to repay beneficiaries for cost-sharing. (Sec. 2314) Amends SSA title XI to provide for the application of Federal health anti-fraud and abuse sanctions to all fraud and abuse against private health benefit plans. Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals: Part 1 - Medicare Payment Changes - Amends SSA title XVIII to: (1) eliminate the membership limitation for Medicare health maintenance organizations; and (2) revise the Medicare select policy program and provide for a civil money penalty for misrepresentations made in connection with a Medicare select policy. (Sec. 2402) Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) make permanent the Medicare select policy program; and (2) allow access to Medicare select policies in all States. (Sec. 2403) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate the administration of Medicare parts A and B. Part 2: Part B Premium Tax for High-Income Individuals - (Sec. 2411) Amends the Internal Revenue Code to impose a tax on the Medicare part B premiums of high income individuals. Subtitle F: Removing Anti-Trust Impediments - Directs the Attorney General to promulgate guidelines under which a health care joint venture may submit an application requesting that the Attorney General provide the entities participating in the venture with an exemption under which: (1) monetary recovery on an antitrust claim brought against the entity shall be limited to actual damages if specified conditions are met; and (2) the conduct of the entity in making or performing a contract to carry out the venture shall not be deemed illegal per se. Requires the Attorney General to approve or disapprove the application within a specified time frame and to provide a statement explaining the reasons for any disapproval. Directs the Attorney General to approve the application if an entity participating in the venture submits to the Attorney General an application that contains the identities of the parties to the venture; the nature, objectives, and planned activities of the venture; and specified assurances and information. Sets forth provisions regarding: (1) revocation and renewal of exemptions and withdrawal of an application; (2) requirements relating to notice and publication of exemptions; and (3) issuance of health care certificates of public advantage to each eligible health care joint venture that complies with specified requirements. Establishes the Interagency Advisory Committee on Competition, Antitrust Policy, and Health Care to: (1) discuss and evaluate competition and antitrust policy and their implications regarding the performance of health care markets; (2) analyze the effectiveness of health care joint ventures receiving exemptions in reducing costs and expanding access; and (3) make recommendations to the Congress. Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities - Part 1: Application of the Clayton Act to Medical Self-Regulatory Entities - Provides that no damages, cost of suit, or attorney fee may be recovered under section 4, 4A, or 4C of the Clayton Act, or under any similar State law, except by a State or the United States, from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities that are: (1) designed to promote the quality of health care provided to patients; and (2) not conducted for purposes of financial gain. Directs the court to award the cost of such a suit, including a reasonable attorney fee, to a substantially prevailing defendant. Part 2: Consultation by Federal Agencies - Requires any Federal agency engaged in the establishment of medical profession standards to consult with appropriate medical societies or associations, specialty boards, or recognized accrediting agencies, if available, in carrying out medical professional standard setting and guidelines or standards relating to the practice of medicine. Subtitle H: Prefunding Government Health Benefit for Certain Annuitants - Requires that certain agencies prefund Government health benefits contributions for their annuitants. Subtitle I: Miscellaneous Provisions - Amends Civil Service and Federal Employees' Retirement Systems law to increase the minimum age required to be eligible for an immediate retirement annuity. Provides for the conformance of other Federal retirement systems with the minimum age increase made above. Title III: Long-Term Care - Subtitle A: Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation. (Sec. 3002) Excludes from gross income benefits provided under a long-term care insurance contract. Includes in gross income employer-provided coverage for long-term care services. (Sec. 3003) Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions. Includes any parent or grandparent as a dependent for purposes of such expenses. (Sec. 3004) Provides for the nonrecognition of gain or loss on the exchange of any life insurance contract or an endowment or annuity contract for a long-term care insurance contract. (Sec. 3005) Excludes from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangement to pay long-term care premiums. (Sec. 3006) Allows insurance companies to issue accelerated death benefit riders on life insurance contracts. Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance - Amends SSA title XIX to require State Medicaid plans to disregard some or all of the individual's assets attributable to coverage under a qualified long-term care insurance contract in determining the individual's eligibility for long-term care services. Subtitle C: Studies - Requires the Comptroller General to study the feasibility of: (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their home with an income tax credit. (Sec. 3203) Requires the Secretary of Health and Human Services to study and report to the Congress on the feasibility of encouraging or requiring the use of a single designate public or nonprofit agency to coordinate, through case management, the provision of long-term care benefits under current Federal, State, and local programs in a geographic area. Subtitle D: Volunteer Service Credit Demonstration Projects - (Sec. 3301) Amends the Older Americans Act of 1965 to require the Commissioner of the Administration on Aging to establish and operate a volunteer service credit demonstration project in each State.
United States · United States Congress · 15 September 1993
General Aviation Revitalization Act of 1993 - Amends the Federal Aviation Act of 1958 to set forth a 15-year statute of limitations within which a person may bring a civil action against an aircraft manufacturer for damages for death or injury or damage to property arising from an aircraft accident.
United States · United States Congress · 14 September 1993
Medical Cost Containment Act of 1993 - Amends the Internal Revenue Code to exclude from gross income medical care savings benefits. Describes such benefits as a health plan which provides that all or part of the premium differential realized by instituting a qualified higher deductible health plan is credited to participating employees to pay for medical care for a plan year. Requires amounts remaining at the end of such plan year to be deposited into a tax-exempt medical care savings account (subject to rules similar to those for retirement plans) for use by the participant for medical expenses.
United States · United States Congress · 8 September 1993
Amends rule XXI of the Rules of the House of Representatives to prohibit a bill or joint resolution carrying any provision providing for a retroactive tax increase from being reported in the House. Provides that no amendment in the House or proposed by the Senate carrying a retroactive tax measure shall be in order during the consideration of a bill or joint resolution. Allows a question of order to be raised at any time under this clause.
United States · United States Congress · 6 August 1993
Federal Regulation Reduction, Reform, and Budget Act of 1993 - Amends the Congressional Budget Act of 1974 to require the Office of Management and Budget (OMB) and the Congressional Budget Office (CBO) to jointly report to the President and the Congress on direct costs to the private sector of complying with Federal regulations. Requires such reports to be issued in five-year intervals. Provides for initial and subsequent annual reports to the President and the Congress on an aggregate regulatory baseline which is a projection of the aggregate direct cost to the private sector of complying with Federal regulations for budget years and outyears. Requires a concurrent resolution on the budget to include reconciliation directives specifying changes in laws and regulations necessary to reduce such direct costs and to reduce regulatory authority from the aggregate regulatory base. Provides for the allocation of aggregate two-year regulatory authority among congressional committees. Requires the CBO to submit to the appropriate committees (except the Committees on Appropriations) an analysis of private sector regulatory costs for each public bill or resolution. Requires the President's annual budget submissions to comply with reconciliation directives. Amends the Regulatory Flexibility Act to require Federal agencies to prepare an analysis of the costs that will be incurred by small entities, other businesses, and individuals in complying with proposed agency rules. Requires the submission to the Congress and CBO and OMB of a cost estimate and cost benefit analysis of any new proposed regulations that would have an aggregate direct cost to the private sector of at least $10 million for any fiscal year.
United States · United States Congress · 6 August 1993
TABLE OF CONTENTS: Title I: Authorization of Appropriations Title II: Reducing the Burden of Federal Paperwork on the Public Title III: Enhancing Federal Agency Responsibility and Accountability for Reducing the Burden of Federal Paperwork Title IV: Enhancing Government Responsibility and Accountability for Reducing the Burden of Federal Paperwork Title V: Enhancing Agency Responsibility for Sharing and Disseminating Public Information Title VI: Additional Government Information Management Responsibility Title VII: Effective Dates Paperwork Reduction Act of 1993 - Title I: Authorization of Appropriations - Amends the Paperwork Reduction Act of 1980 to authorize appropriations to the Office of Information and Regulatory Affairs. Title II: Reducing the Burden of Federal Paperwork on the Public - Applies the Act to all federally sponsored paperwork. Requires a Government-wide paperwork reduction goal of at least five percent and individual agency goals that aggregate to the Government-wide goal. Title III: Enhancing Federal Agency Responsibility and Accountability for Reducing the Burden of Federal Paperwork - Makes the senior official charged with carrying out the responsibilities of a Federal agency under the Act the head of a separate office with qualified staff responsible for assuring agency compliance with requirements under the Act. Requires each agency to: (1) prepare estimates of the burden that will result from proposed collections of information; (2) develop a strategic Information Resources Management Plan; and (3) establish oversight procedures for agency information systems. Requires each agency head to establish a certification process for the review of each information collection request before it is submitted to the Director of the Office of Management and Budget (OMB) for approval. Title IV: Enhancing Government Responsibility and Accountability for Reducing the Burden of Federal Paperwork - Makes the OMB Director responsible for ensuring that all information collection requests display an estimate of the paperwork burden for each response. Requires OMB procedures in order for agencies to estimate such burden. Requires OMB pilot projects to test approaches to improve information management practices and related activities. Reduces the time afforded the OMB Director for approving a routine agency request to collect information. Provides for greater participation by the public and Federal agencies in the review of proposed paperwork burdens generated by agency information requests. Requires the OMB Director to make publicly available any decision to disapprove a collection of information requirement contained in an agency rule, together with the reasons for such decision. Provides protection for whistleblowers of unauthorized Federal paperwork burdens. Provides for expedited OMB review of an agency information request with a reduced paperwork burden. Title V: Enhancing Agency Responsibility for Sharing and Disseminating Public Information - Provides for Government-wide standards for sharing and disseminating public information. Imposes certain responsibilities on Federal agencies for sharing and disseminating public information. Abolishes the Federal Information Locator System established in the Office of Information and Regulatory Affairs and replaces it with a system in each agency for providing public access via electronic and other means to a comprehensive inventory of agency information dissemination products. Title VI: Additional Government Information Management Responsibility - Revises the statistical policy and coordination functions of the OMB Director. Requires the OMB Director to: (1) establish an interagency working group on statistical policy to coordinate agency statistical activities; and (2) provide training in the statistical policy functions of the chief statistician to Federal employees. Provides for the use of electronic information collection and dissemination techniques to reduce the Federal paperwork burden. Requires the OMB Director's annual report to the Congress to list any increased Federal paperwork burdens and describe each agency's plans to implement the applicable policies, standards, and guidelines under the Act. Requires the OMB Director to develop a plan for meeting the automatic data processing needs of the Federal Government in accordance with the Act and certain requirements of the Federal Property and Administrative Services Act of 1949. Title VII: Effective Dates - Sets forth the effective dates for this Act.
United States · United States Congress · 6 August 1993
Directs the Secretary of Commerce to propose to the Coordinating Committee for Multilateral Export Controls that exports of telecommunications technology for civil end uses shall not require a validated license for export to any of the republics of the former Soviet Union, China, Poland, the Czech Republic, Slovakia, Bulgaria, Romania, Albania, Estonia, Lithuania, or Latvia. Requires the President to submit to specified congressional committees a report that certifies that such proposal was made and that outlines plans to gain the concurrence of other Coordinating Committee members in the proposal.
United States · United States Congress · 6 August 1993
Repeals the tax increase on social security benefits made under the Revenue Reconciliation Act of 1993.
United States · United States Congress · 6 August 1993
TABLE OF CONTENTS: Title I: Statement of Congressional Purpose Title II: Binding Budget Law Title III: Enforcement Mechanics Subtitle A: Supermajority Required to Break Budget Law Subtitle B: Line Item Reduction Subtitle C: "Blank Check" Appropriations Prohibited Subtitle D: "Pay As You Go" Requirement for New Spending Title IV: Sustaining Mechanism Title V: Protection of Social Security Title VI: Timetable Title VII: Conforming Amendments Title VIII: Definitions and Rules of Interpretation Title IX: Effective Date Budget Process Reform Act - Title I: Statement of Congressional Purpose - Declares that the purpose of this Act is to facilitate rational, informed, and timely decisions by the Congress. Expresses the sense of the Congress that the Federal budget process should focus the attention of policymakers and the public on the aggregate impact of Federal spending on the economy, and on the tradeoffs that must be made among priorities in order to control overall levels of spending. Declares that the budget process should contain safeguards against delay and inaction, so that temporary shut-downs of the Government may be avoided. Title II: Binding Budget Law - Requires the Congress to enact a binding budget law, in the form of a joint resolution, by April 15 of the calendar year before that in which the fiscal period commences. Makes it out of order in the House of Representatives or the Senate to consider any spending bill affecting spending in a major functional category unless and until a joint resolution on the budget is enacted. Amends the Congressional Budget Act of 1974 to prohibit baseline budgeting. Requires the President to submit to the Congress on or before the 15th day after a joint resolution on the budget is enacted a detailed budget for the fiscal period beginning on October 1 of the current calendar year. Title III: Enforcement Mechanics - Subtitle A: Supermajority Required to Break Budget Law - Requires a two-thirds majority vote in the House and the Senate to consider any spending bill prior to the enactment of the budget law. Requires the Congressional Budget Office to provide to the Congress an estimate of the costs in each major functional category of certain spending bills as soon as practicable after its introduction. Requires a two-thirds affirmative vote in the House and the Senate to consider over-budget spending bills. Requires a two-thirds affirmative vote in the House and the Senate to waive any provision of this Act. Subtitle B: Limited Enhanced Rescission Authority - Amends the Impoundment Control Act of 1974 to limit the President's rescission authority to spending that is above the limits of the budget law. Subtitle C: "Blank Check" Appropriations Prohibited - Declares the intent of the Congress to end open-ended, "blank check" appropriations which typically authorize spending "such sums as may be necessary." Requires fixed-dollar appropriations for every account except social security and interest on the debt. Prohibits open-ended appropriations. Requires Executive agencies to adjust benefit levels to ensure that appropriations for entitlement programs are not exceeded. Restricts budget authority and entitlement authority to one fiscal period. Subtitle D: "Pay As You Go" Requirement for New Spending - Prohibits the Congress from considering any legislation which exceeds the budget ceiling unless it offsets such increased spending with an equal amount of reductions. Requires a two-thirds affirmative vote in the House and the Senate to waive such prohibition. Title IV: Sustaining Mechanism - Makes appropriations to provide for an automatic continuing resolution if for any account an appropriation for a fiscal period does not become law before the beginning of such period. Restricts legislation providing funding to the Committees on Appropriations. Title V: Protection of Social Security - Provides that no reduction in benefits under title II of the Social Security Act (Old Age, Survivors and Disability Insurance) shall be made as a consequence of this Act. Title VI: Timetable - Revises the timetable for the congressional budget process. Title VII: Conforming Amendments - Makes various technical and conforming amendments, including changing references to a concurrent resolution on the budget to references to a joint resolution on the budget. Title VIII: Definitions and Rules of Interpretation - Sets forth definitions for specified terms. Title IX: Effective Date - Declares the effective date of this Act to be January 1, 1995, applicable to fiscal years beginning after September 30, 1995.
United States · United States Congress · 5 August 1993
Amends the Higher Education Act of 1965 to exempt Federal Family Education Loans from the Federal Trade Commission's holder rule.
United States · United States Congress · 4 August 1993
TABLE OF CONTENTS: Title I: Protection of Neighborhoods, Families, and Children Subtitle A: Safe Schools Subtitle B: Secure Neighborhoods Subtitle C: Crimes Against Children Subtitle D: Punishment of Serious Juvenile Offenders Title II: Equal Protection for Victims Subtitle A: Victims' Rights Subtitle B: Admissibility of Evidence Subtitle C: Protecting the Integrity of the Judicial Process Title III: Protection of Women Subtitle A: Spouse Abuse and Stalking Subtitle B: Victims of Sexual Violence Subtitle C: Punishment of Sex Offenders Title IV: Prevention of Terrorism Subtitle A: Enhanced Controls on Entry into the United States Subtitle B: Deportation of Alien Terrorists Subtitle C: Penalties for Engaging in Terrorism Title V: Criminal Aliens and Alien Smuggling Subtitle A: Deportation of Criminal Aliens Subtitle B: Prevention and Punishment of Alien Smuggling Title VI: Taking Criminals Off the Street Subtitle A: Expanding Prison Capacity Subtitle B: Miscellaneous Title VII: Punishment and Deterrence Subtitle A: Capital Offenses Subtitle B: Violent Felonies and Drug Offenses Subtitle C: Enhanced Penalties for Criminal Use of Firearms and Explosives Subtitle D: Miscellaneous Title VIII: Elimination of Delays in Carrying Out Sentences Subtitle A: Post Conviction Petitions: General Habeas Corpus Reform Subtitle B: Special Procedures for Collateral Proceedings in Capital Cases Subtitle C: Funding for Litigation of Federal Habeas Corpus Petitions in Capital Cases Title IX: Public Corruption Title X: Funding Crime Control Act of 1993 - Title I: Protection of Neighborhoods, Families, and Children - Subtitle A: Safe Schools - Amends the Controlled Substances Act (CSA) to increase penalties for drug trafficking in or near schools. (Sec. 102) Authorizes: (1) a school district to elect to qualify as a Federal safe school district by decision of a local educational agency or by referendum of the voters in a school district served by such an agency; and (2) the Attorney General to make grants to local educational agencies or local law enforcement agencies of Federal safe school districts to pay for enhanced school security measures. (Sec. 103) Increases penalties for violation of the Gun-Free School Zones Act. Subtitle B: Secure Neighborhoods - Amends the Omnibus Crime Control and Safe Streets Act of 1968 (Omnibus Act) to authorize the Director of the Bureau of Justice Assistance (BJA) to make grants to local governments and to community groups for increasing the police presence in communities. Requires the Director to develop a written model that informs community members regarding how to identify the existence of a drug or gang house and what civil remedies and mediation techniques are available. Authorizes appropriations. (Sec. 114) Amends the Federal criminal code to prohibit: (1) committing specified "predicate gang crimes" (including murder, assault, kidnapping, arson, and retaliating against a witness, victim, or informant) with intent to promote or further the activities of a criminal street gang or for the purpose of gaining entrance to, or maintaining or increasing position in, a gang; (2) participating in, or inducing any individual to participate in, a gang; (3) employing or inducing any individual to commit a predicate gang crime with such intent; or (4) using any communication facility in causing or facilitating the commission of such a crime with such intent. Sets penalties for violations. Authorizes the Attorney General and the Secretary of the Treasury to investigate such offenses. Directs the U.S. Sentencing Commission to amend the sentencing guidelines to increase the base offense level for any felony committed for the purpose of gaining entrance into, or maintaining or increasing position in, a gang. (Sec. 115) Amends: (1) the Federal criminal code to set penalties for drive-by shootings; (2) the Omnibus Act to include among drug control and system improvement grant funding objectives law enforcement and prevention programs relating to gangs or to youth who are involved or at risk of being involved in gangs; and (3) the CSA to increase penalties for drug trafficking in or near public housing. Subtitle C: Crimes Against Children - Provides for imposition of the death penalty for murder during the sexual exploitation of children. (Sec. 132) Increases penalties for sex offenses against victims below age 16. (Sec. 133) Sets penalties for international trafficking in child pornography. (Sec. 134) Directs the Attorney General to establish guidelines for State legislation prohibiting the production, distribution, receipt, or possession of materials depicting a person under age 18 engaging in sexually explicit conduct and providing for a maximum imprisonment of at least one year and for the forfeiture of assets used in, or gained from, such offenses. Requires each State to enact and maintain legislation complying with such guidelines in order to receive assistance under provisions of the Victims of Crime Act and the Child Abuse Prevention and Treatment Act. (Sec. 135) Provides for national registration of convicted child abusers. Requires the Attorney General to establish guidelines for State registration programs. Authorizes a State to permit qualified entities to obtain from an authorized State agency a nationwide background check on a provider. (Sec. 136) Increases penalties for: (1) assaults against children; (2) using minors in drug trafficking; (3) drug distribution to minors; and (4) using a minor in the commission of a Federal offense. (Sec. 137) Amends the CSA to set penalties for physical trainers or advisers who attempt to persuade or induce a person to possess or use anabolic steroids. (Sec. 139) Provides for interstate enforcement of child support orders. (Sec. 140) Makes certain crimes involving the use of persons below age 18 predicates to an offense under the Racketeer Influenced and Corrupt Organizations Act (RICO). (Sec. 143) Makes it a Federal offense to remove a child from, or to retain a child outside, the United States to obstruct the lawful exercise of parental rights. Authorizes appropriations to carry out State court programs regarding international parental child abduction. Subtitle D: Punishment of Serious Juvenile Offenders - Makes serious juvenile drug offenses Armed Career Criminal Act predicates. (Sec. 152) Provides for adult prosecution of serious juvenile offenders. (Sec. 153) Requires that juveniles found guilty of certain offenses be fingerprinted and photographed, with such fingerprints and photographs sent to the Federal Bureau of Investigation (FBI), Identification Division. Directs the court to transmit to such division information concerning the adjudication. Title II: Equal Protection for Victims - Subtitle A: Victims' Rights - Enacts Rules of Professional Conduct for Lawyers in Federal Practice, including provisions regarding: (1) a prohibition on attorneys engaging in actions deemed abusive to clients or others; (2) a duty of enquiry (to elicit from the client a truthful account of the material facts concerning the matters in issue); (3) a duty to expedite litigation; and (4) a duty to disclose information necessary to prevent the commission of a crime. (Sec. 202) Revises Federal Rule of Criminal Procedure: (1) 24(b) to entitle each side to six peremptory challenges (currently, six for the Government and ten for the defendant or defendants jointly); and (2) 32 to provide for a victim's right of allocution in sentencing for a crime of violence or sexual abuse. (Sec. 204) Provides for the enforcement of restitution orders through the suspension of Federal benefits. (Sec. 205) Sets penalties for retaliatory killings of witnesses, victims, and informants. Subtitle B: Admissibility of Evidence - Amends the Federal Rules of Evidence (FRE) to allow evidence of similar offenses in criminal or civil sexual assault and child molestation cases. (Sec. 212) Revises FRE 412 (sex offense cases; relevance of victim's past behavior) to: (1) expand the scope of the rape shield law and to require that an order admitting evidence of a victim's past sexual behavior explain the reasoning leading to a finding of relevance and the basis of a finding that the probative value of the evidence outweighs the danger of unfair prejudice; and (2) make inadmissible evidence to show invitation or provocation by a victim in sexual abuse cases. (Sec. 214) Specifies that evidence obtained as a result of a search or seizure shall not be excluded on the ground that the search or seizure was in violation of the fourth amendment to the Constitution if carried out in circumstances justifying an objectively reasonable belief that it was in conformity with the fourth amendment. Subtitle C: Protecting the Integrity of the Judicial Process - Provides that in a criminal trial in any Federal or State court: (1) on motion of the defense attorney or prosecutor, the risk of racial prejudice or bias shall be examined on voir dire if there is a substantial likelihood that such prejudice will affect the jury; (2) on motion of the defense attorney or prosecutor, a change of venue shall be granted if an impartial jury cannot be obtained in the original venue because of such prejudice; and (3) neither the prosecutor nor the defense attorney shall make any appeal to such prejudice in statements before the jury. (Sec. 222) Amends the Federal criminal code to provide that a list of veniremen and witnesses need not be furnished in capital cases if the court finds by a preponderance of the evidence that providing the list may jeopardize the life or safety of any person. (Sec. 223) Increases penalties for attempting to influence or injure court officers or jurors. (Sec. 224) Provides for the imposition of the death penalty for the murder of a Federal witness. Title III: Protection of Women - Subtitle A: Spouse Abuse and Stalking - Amends the Federal criminal code to: (1) set penalties for interstate travel to commit spouse abuse or to violate a protective order; and (2) provide for full faith and credit of protective orders among the States. Subtitle B: Victims of Sexual Violence - Establishes a civil remedy for victims of sexual violence. (Sec. 312) Authorizes the restitution of victims of sex offenses. (Sec. 313) Provides for pretrial detention in sex offense cases. Subtitle C: Punishment of Sex Offenders - Provides for imposition of the death penalty for persons engaging in sexual abuse resulting in death. (Sec. 322) Increases penalties for recidivist sex offenses. (Sec. 323) Directs the Sentencing Commission to amend the sentencing guidelines to increase the base offense level for sex offenses. (Sec. 324) Provides for testing for human immunodeficiency virus for persons charged in sex offense cases and the disclosure of the test results to the victim. Directs the Sentencing Commission to amend existing guidelines for sentences for sex offenses where the offender knew or had reason to know that he was infected with such virus, except where the offender did not engage or attempt to engage in conduct creating a risk of transmission of the virus to the victim. Title IV: Prevention of Terrorism - Subtitle A: Enhanced Controls on Entry into the United States - Amends the Immigration and Nationality Act (INA) to require exclusion from admission to the United States of anyone who is a member of an organization that engages in terrorist activity or who actively supports or advocates terrorist activity. (Sec. 402) Provides for the exclusion of an alien for presenting fraudulent documents, or for failing to present documents used to board a common carrier, to an immigration officer upon arrival at a port of entry into the United States. Specifies that any alien who is excludable under such provisions may not apply for or be granted asylum, with exceptions. (Sec. 404) Limits court jurisdiction with respect to habeas corpus review, other judicial review and action, and collateral enforcement proceedings. Subtitle B: Deportation of Alien Terrorists - Establishes procedures to apply whenever the Attorney General certifies under seal to a special court (established pursuant to this subtitle) that: (1) the Attorney General or Deputy Attorney General has approved of the deportation proceeding; (2) an alien terrorist is physically present in the United States; and (3) removal of such terrorist by deportation proceedings would pose a risk to national security because such proceedings would disclose classified information. Directs the Chief Justice of the United States to publicly designate up to seven judges to hear and decide such cases. Sets forth procedures for a special removal hearing, including provisions for appointment of counsel and appeals. Subtitle C: Penalties for Engaging in Terrorism - Amends the Federal criminal code to: (1) prohibit providing material support to terrorists; and (2) extend the statute of limitations for certain terrorism offenses. (Sec. 422) Directs the Sentencing Commission to provide for an increase in the base offense level for any felony involving or intended to promote international terrorism, unless such involvement or intent is itself an element of the crime. (Sec. 424) Increases penalties under the International Emergency Economic Powers Act for violation of orders with respect to the declaration of a national emergency and the Federal criminal code for passport and visa-related violations. (Sec. 425) Sets penalties for: (1) specified acts of violence at international airports; (2) violence against maritime navigation; (3) violence against maritime fixed platforms; and (4) the use of weapons of mass destruction. (Sec. 429) Directs the President to establish a National Task Force on Counterterrorism. (Sec. 430) Provides for imposition of the death penalty for causing death through the use of a bomb or other destructive device. Title V: Criminal Aliens and Alien Smuggling - Subtitle A: Deportation of Criminal Aliens - Amends the INA to permit an alien sentenced to imprisonment to be deported prior to the termination of such imprisonment if the Immigration and Naturalization Service (INS) petitions the appropriate court or other authority to release the alien into INS custody for execution of a deportation order. Prohibits the deportation until all direct appeals of the conviction have been exhausted. (Sec. 502) Authorizes the registration of aliens on criminal probation or criminal parole within the United States. (Sec. 503) Expands the definition of "aggravated felony" to include illicit trafficking in explosive materials and a crime of violence for which the term of imprisonment imposed is at least five years. (Sec. 504) Amends the INA to authorize the Attorney General to issue a final order of deportation without an administrative hearing or administrative review for any alien who was not lawfully admitted for permanent residence, or who had permanent resident status on a conditional basis, and whom the Attorney General determines is deportable and has been convicted of an aggravated felony. Limits judicial review of such determinations. Provides that an alien convicted of an aggravated felony shall be conclusively presumed to be deportable. (Sec. 505) Grants a U.S. district court jurisdiction to enter a judicial order of deportation at the time of sentencing against an alien convicted of an aggravated felony, if such order has been requested prior to sentencing by the U.S. Attorney. (Sec. 506) Restricts defenses to exclusion and deportation for certain aliens convicted of aggravated felonies. (Sec. 507) Enhances penalties for failing to depart or reentering after a final order of deportation. Limits collateral attacks on deportation orders. (Sec. 509) Authorizes appropriations for a criminal alien information system. Subtitle B: Prevention and Punishment of Alien Smuggling - Authorizes appropriations for Border Patrol agents and investigators. (Sec. 513) Includes alien smuggling as a predicate to an offense under RICO. (Sec. 514) Increases penalties for: (1) employers who knowingly employ smuggled aliens; and (2) bringing in and harboring certain aliens. (Sec. 516) Expands forfeiture for smuggling or harboring illegal aliens. Title VI: Taking Criminals Off the Street - Subtitle A: Expanding Prison Capacity - Amends the Internal Revenue Code to include within the definition of "exempt facility bond" certain bonds issued to provide for correctional facilities. (Sec. 602) Directs the Attorney General to: (1) establish a Regional Prison Task Force; and (2) create a plan for the establishment of a nationwide regional prison system. Sets forth provisions regarding State and prisoner eligibility requirements. Establishes in the Treasury a Regional Prison Fund. Authorizes appropriations. (Sec. 603) Amends the Davis-Bacon Act to make provisions concerning the rate of wages for laborers and mechanics inapplicable to prison construction. Subtitle B: Miscellaneous - Amends the Federal judicial code to deny the district court, in any action challenging the constitutionality of conditions of confinement in any correctional institution housing persons accused or convicted of a crime or juveniles adjudicated delinquent, jurisdiction to: (1) impose a ceiling on the population of any correctional institution or to require any adjustment of the release dates of inmates; or (2) prohibit the use of tents or prefabricated structures for housing inmates. Prohibits any consent decree in any such action from providing relief greater than the minimum required to bring the conditions of confinement into substantial compliance with the Constitution. Provides for modification of orders or decrees. Title VII: Punishment and Deterrence - Subtitle A: Capital Offenses - Amends the Federal criminal code to establish criteria for the imposition of the death penalty for Federal crimes. Requires the attorney for the Government, whenever the Government intends to seek the death penalty for an offense punishable by death, to file with the court and serve on the defendant a notice of such intent and the aggravating factors the Government will seek to prove as the basis for such penalty. Requires the judge who presided at the trial or before whom the guilty plea was entered, or another judge if that judge is unavailable, to conduct a separate sentencing hearing when the attorney for the Government has filed such notice and the defendant is found guilty of an offense punishable by death. Permits information to be presented as to any matter relating to any mitigating factor and any aggravating factor for which notice has been provided, except that information may be excluded if its probative value is outweighed by the danger of creating unfair prejudice, confusing the issues, or misleading the jury (but permits the Government to present information concerning the effect of the offense on the victim and the victim's family). Specifies mitigating and aggravating factors. Sets forth special aggravating factors for: (1) treason, espionage, homicide, and the attempted murder of the President; and (2) drug offenses punishable by death (including previous serious drug felony convictions, use of a firearm in committing or furthering certain continuing criminal enterprises, use of minors in trafficking, and lethal adulteration of controlled substances). Requires the court to instruct the jury not to consider the race, color, religion, national origin, or sex of the defendant or victim in considering whether to recommend a sentence of death. Sets forth procedures for the imposition, appeal, and implementation of a sentence of death. Prohibits: (1) a death sentence from being carried out upon a pregnant woman or a person who lacks the mental capacity to understand the death penalty and why it was imposed; and (2) requiring any employee of, or any person providing services under contract to, any State department of corrections, the Federal Bureau of Prisons, and the U.S. Marshals Service to be in attendance or to participate in any execution if such participation is contrary to such employee's moral or religious convictions. Sets forth provisions regarding: (1) appointment of counsel; (2) collateral attacks on judgments imposing a death sentence; and (3) stays of execution. Limits the circumstances under which a person subject to the criminal jurisdiction of an Indian tribal government may be executed under this Act. Declares that the death penalty and all other penalties shall be administered by the United States and by every State without regard to the race or color of the defendant or victim, and that neither the United States nor any State shall prescribe any racial quota or statistical test for the imposition or execution of the death penalty or any other penalty. Specifies that, in a prosecution for an offense against the United States for which a death sentence is authorized, the fact that the killing was motivated by racial prejudice or bias shall be deemed an aggravating factor. Amends specified civil rights provisions to cover conspiracy against the rights, and deprivation of rights under color of law, of any person in (currently, inhabitant of) a State, territory, or district. Provides for the imposition of the death penalty for specified Federal crimes, including: (1) murders committed by prisoners in Federal correctional institutions; (2) murders of Federal, State, and local law enforcement officers; (3) civil rights murders; (4) gun murders; (5) murders by escaped prisoners; (6) torture under specified circumstances where death results; and (7) carjackings which result in death. Subtitle B: Violent Felonies and Drug Offenses - Amends the Federal criminal code to require: (1) the Director of the Administrative Office of the U.S. Courts to establish a program of drug testing of criminal defendants on post-conviction release; and (2) the chief probation officer in each district to arrange for the drug testing of such defendants. Requires, as an explicit condition of probation, parole, or supervised release for a felony or a specified violent or drug offense, that the defendant refrain from any unlawful use of a controlled substance and submit to periodic drug tests. (Sec. 712) Requires the court to sentence a defendant convicted of a Federal violent felony to life imprisonment or, if death results, subject such defendant to the death penalty, if the defendant had previously been convicted of two other violent felonies. (Sec. 713) Amends the Armed Career Criminal Act to include within the definition of "serious drug offense" an offense under State law which, if it had been prosecuted as a CSA violation at the time of the offense and because of the type and quantity of the controlled substance involved, would have been punishable by a maximum term of imprisonment of ten years or more. (Sec. 714) Provides an enhanced penalty for the use of a semiautomatic firearm during a crime of violence or drug trafficking crime. (Sec. 715) Sets mandatory penalties for firearms possession by persons previously convicted of a violent felony or a serious drug offense, and a mandatory minimum sentence for unlawful possession of a firearm by a convicted felon, fugitive from justice, or transferor or receiver of a stolen firearm. (Sec. 717) Increases: (1) the general penalty for violation of Federal firearms laws; and (2) enhanced penalties for possession of a firearm in connection with a crime of violence or a drug trafficking crime. (Sec. 719) Sets penalties for smuggling firearms in aid of drug trafficking or violent crime. (Sec. 723) Establishes: (1) a temporary prohibition against possession of a firearm by, or transfer of a firearm to, persons convicted of a drug crime; and (2) enhanced penalties for possession of a firearm during a drug crime. Subtitle C: Enhanced Penalties for Criminal Use of Firearms and Explosives - Chapter 1: Instant Check System for Handgun Purchases - Requires each State to establish and maintain an instant criminal check system for handgun purchases. Sets forth: (1) prohibitions on uses of such information; and (2) identification procedure requirements for licensed importers, manufacturers, and dealers once a State system becomes operational and specified notice requirements are met. Sets penalties for noncompliance. (Sec. 734) Requires each State to establish a system accessible by telephone that any licensee, law enforcement officer, or court may contact for criminal history information. (Sec. 735) Provides for the correction of erroneous system information as well as a private course of action after all administrative remedies are exhausted and records are not corrected. (Sec. 736) Directs the Attorney General to expedite: (1) the incorporation of the remaining State criminal history records into the Federal criminal records systems maintained by the FBI; and (2) the development of hardware and software systems to link State criminal history check systems into the National Crime Information Center. (Sec. 737) Sets forth provisions regarding: (1) access to State criminal records; and (2) funding for improvements in State records systems. Chapter 2: Other Firearms Provisions - Increases penalties for: (1) interstate gun trafficking; (2) making knowingly false, material statements in connection with the purchase of a firearm from a licensed dealer; and (3) a second offense of using an explosive to commit a felony. (Sec. 742) Prohibits: (1) transactions involving stolen firearms which have moved in interstate or foreign commerce; (2) the receipt of firearms by non-residents of the State in which the transferor resides, unless such receipt is for lawful sporting purposes; (3) the possession of explosives by felons and others; and (4) the possession of explosives during the commission of a felony. (Sec. 745) Provides for mandatory revocation of supervised release for possession of a firearm in violation of a condition of release. (Sec. 756) Authorizes the summary destruction of explosives subject to forfeiture under specified circumstances. Subtitle D: Miscellaneous - Increases penalties for Travel Act crimes involving racketeering and conspiracy to commit contract killings. (Sec. 762) Makes it a criminal offense to fail to obey an order to land an aircraft issued by an authorized Federal law enforcement officer under specified circumstances. (Sec. 764) Provides enhanced penalties for drug trafficking in prisons. (Sec. 765) Directs the Federal Communications Commission: (1) in its review of applications for renewal of television broadcast licenses, to consider the extent to which the licensee has participated in efforts to educate the public as to the dangers of drug abuse and appropriate methods for obtaining treatment; and (2) not to find that a renewal of such a licensee is consistent with the public interest unless the applicant demonstrates that the station has broadcast public service announcements concerning drug abuse and treatment. Title VIII: Elimination of Delays in Carrying Out Sentences - Subtitle A: Post Conviction Petitions: General Habeas Corpus Reform - Amends the Federal judicial code to establish a one-year statute of limitations for habeas corpus actions brought by State prisoners. (Sec. 802) Vests authority to issue certificates of probable cause for appeal of habeas corpus orders exclusively in the courts of appeals. (Sec. 804) Permits the denial of a habeas corpus petition on the merits notwithstanding the failure of the applicant to exhaust State court remedies. (Sec. 805) Imposes a two-year period of limitation for filing for collateral relief by Federal prisoners. Subtitle B: Special Procedures for Collateral Proceedings in Capital Cases - Amends the Federal judicial code to set forth special habeas corpus procedures in capital cases. Subtitle C: Funding for Litigation of Federal Habeas Corpus Petitions in Capital Cases - Amends the Omnibus Act to require the Director of BJA to provide grants to the States to support litigation pertaining to Federal habeas corpus petitions in capital cases. Title IX: Public Corruption - Amends the Federal criminal code to prescribe criminal penalties to be imposed upon: (1) anyone who uses any facility of, or affects, interstate or foreign commerce to deprive or defraud the inhabitants of a State of the honest services of a State official or of a fair and impartially conducted election process; and (2) any State or Federal official who, in order to carry out or conceal any scheme or artifice to defraud, discriminates, harasses, or takes adverse action against another official. Authorizes such adversely affected official to obtain relief through a civil action, provided such person did not participate in the scheme or artifice. (Sec. 902) Amends mail fraud provisions to prohibit the use of any facility of interstate or foreign commerce in the execution of a scheme or artifice to defraud. (Sec. 903) Sets forth prohibitions regarding narcotics-related public corruption. Title X: Funding - Requires each head of a Federal agency making a grant to, or entering into a contract with, an institution of higher education for research and development to reduce the overhead payment rate under the grant or contract to 90 percent of the current level and return the amount saved to the general fund of the Treasury. (Sec. 1002) Reduces the overhead expenses identified and reduced by the President in Executive Order 12837 by an additional five percent.
United States · United States Congress · 3 August 1993
Expresses the sense of the House of Representatives that: (1) obstetrician-gynecologists should be designated as primary care providers for women in Federal laws relating to the provision of health care; and (2) legislative proposals that define primary care should include services performed by obstetrician-gynecologists in such definition.
United States · United States Congress · 28 July 1993
Medicaid Health Allowance Act of 1993 - Amends title XIX (Medicaid) of the Social Security Act to create State health allowance programs under which the State makes payments to an insurer of an eligible individual as an allowance towards the cost of providing the individual with benefits under an approved health benefit plan.
United States · United States Congress · 26 July 1993
Authorizes the President to issue a proclamation designating September 1993 as Classical Music Month.
United States · United States Congress · 14 July 1993
Health Care Cooperative Antitrust Protection Act of 1993 - Directs the Secretary of Health and Human Services to promulgate guidelines under which a health care joint venture may submit an application requesting that the Secretary provide the entities participating in the venture with an exemption under which: (1) monetary recovery on an antitrust claim brought against the entity shall be limited to actual damages if specified conditions are met and the conduct of the entity in making or performing a contract to carry out the venture shall not be deemed illegal per se; or (2) the antitrust laws shall not apply to conduct within the scope of the venture for a five-year period. Requires the Secretary to approve or disapprove the application within a specified time frame and, with respect to a disapproval, to provide a statement explaining the reasons for such disapproval. Directs the Secretary and the Attorney General to approve the application if: (1) in the case of a venture seeking the five-year exemption, the Secretary finds that such venture meets specified criteria, such as promoting enhancement of the quality of health care services to individuals residing in the geographic area served by the participating entities, preserving meaningful competition among health care providers, reducing costs or increasing efficiency, improving utilization of services, and eliminating costly and unnecessary duplication in the delivery of health care services in such area; and (2) an entity participating in the venture submits to the Secretary, the Attorney General, and the Interagency Advisory Committee on Competition, Antitrust Policy, and Health Care (created by this Act) an application that contains the identities of the parties to the venture; the nature, objectives, and planned activities of the venture; and specified assurances and information. Sets forth provisions regarding: (1) revocation and renewal of exemptions, and withdrawal of an application; and (2) requirements relating to notice and publication of exemptions. Establishes the Advisory Committee to: (1) discuss and evaluate competition and antitrust policy and their implications regarding the performance of health care markets; (2) analyze the effectiveness of health care joint ventures receiving exemptions in reducing costs and expanding access; and (3) make recommendations to the Congress.
United States · United States Congress · 24 June 1993
Amends the Internal Revenue Code to reduce the rates of occupational taxes relating to the production or sale of distilled spirits, wines, and beer beginning July 1, 1994. Repeals such taxes effective July 1, 1995.
United States · United States Congress · 24 June 1993
Designates September 17, 1993, as National POW/MIA Recognition Day. Requires the display of the National League of Families POW/MIA flag at: (1) all national cemeteries and the National Vietnam Veterans Memorial on May 31, 1993 (Memorial Day), September 17, 1993 (National POW/MIA Recognition Day), and November 11, 1993 (Veterans Day); and (2) the White House and the buildings containing the primary offices of the Secretaries of State, Defense, and Veterans Affairs and the Director of the Selective Service Commission (sic) on September 17, 1993 (National POW/MIA Recognition Day).