United States · United States Congress · 5 May 1994
Amends title XIX (Medicaid) of the Social Security Act to declare that the Secretary of Health and Human Services is not authorized to require a State plan for medical assistance to ensure the provision of necessary non-emergency medical transportation services. Denies Federal payment for such services.
United States · United States Congress · 5 May 1994
Amends title XI of the Social Security Act, as amended by the Omnibus Budget Reconciliation Act of 1993, to repeal the requirement that employers report certain employee information to the Medicare and Medicaid Coverage Data Bank.
United States · United States Congress · 5 May 1994
House Administration Reform Resolution of 1994 - Transfers specified functions and entities to the Director of Non-Legislative and Financial Services of the House of Representatives. Requires the House Information Systems (HIS), upon transfer to the Director, to be responsible for video teleconferencing, INTERNET access, and related technology services. Directs the Committee on House Administration (Committee) to provide for implementation of recommendations contained in a certain report of the House Task Force on Printing (regarding review of the majority and minority print facilities), provided that such operations are used only for official purposes and are eliminated as soon as practicable or as otherwise directed by the House Subcommittee on Administrative Oversight (Subcommittee). Transfers such operations to the Director. Provides for the elimination of such operations by January 22, 1997. Transfers responsibility for the operation of the Democratic and Republican cloakrooms to the Speaker of the House and the Republican leader, respectively. Amends Rule VI of the Rules of the House of Representatives to require the Director to report to the Subcommittee on all matters (currently, the Director is subject to the policy direction and oversight of the Committee) and makes the Director responsible for simultaneous bipartisan notification of subcommittee members. Requires the Director to review, on a continuing basis, the implementation of employment standards and to report any violation to the Subcommittee. Makes employment and other administrative decisions of the Director final unless otherwise directed by a majority of Subcommittee members. Directs the Committee to conduct a comprehensive, bipartisan review of Committee regulations and eliminate ambiguities and obsolete provisions. Requires the Subcommittee to provide for transfers of functions and entities to the Director as necessary for the improvement of non-legislative and financial services in the House. Deems any action taken by the Subcommittee with regard to any functions and entities within its jurisdiction to be taken on behalf of the full committee, except in the case of proposals to report to the House. Expresses the sense of the House that the changes in public law necessary to delineate the authorities affected by this resolution should be enacted as soon as possible.
United States · United States Congress · 28 April 1994
Amends the Defense Base Closure and Realignment Act of 1990 to postpone until 1997 (currently 1995) scheduled military base closures and realignments announced by the Defense Base Closure and Realignment Commission.
United States · United States Congress · 20 April 1994
National Security Budgeting and Deficit Control Act of 1994 - Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings) to extend the caps on defense and nondefense discretionary spending through FY 1998. Requires the special budget authority adjustment required in the final sequestration report for FY 1995 under such Act to be equally divided between the defense and nondefense categories for each applicable fiscal year.
United States · United States Congress · 14 April 1994
NATO Expansion Act of 1994 - Expresses the sense of the Congress with respect to NATO membership of Poland, Hungary, the Czech Republic, and Slovakia. Authorizes the President to establish a program to assist the transition to full NATO membership for Poland, Hungary, the Czech Republic, Slovakia, and other European countries emerging from communist domination designated pursuant to this Act. Permits the President to provide specified security assistance to such countries, including excess defense articles, economic support fund assistance, international military education and training, and foreign military financing. Authorizes the President to provide additional assistance from the Nonproliferation and Disarmament Fund and Countries in Transition accounts. Permits the President to designate other European countries emerging from communist domination to receive assistance under this Act if he reports to the appropriate congressional committees that such countries: (1) have made significant progress toward establishing democratic institutions, free market economies, civilian control of their armed forces, and the rule of law; and (2) are likely to be in a position to further the principles of the North Atlantic Treaty and to contribute to the security of the North Atlantic area. Authorizes the President to confer, pursuant to agreement with any country eligible to participate in the Partnership for Peace, rights with respect to the military and related civilian personnel and activities of that country in the United States comparable to those conferred by that country with respect to the United States.
United States · United States Congress · 14 April 1994
Amends the Internal Revenue Code to increase the retirement savings deduction and the maximum individual retirement account contribution from $2,000 to $2,500. Raises income phase-out limits. Allows such a deduction for nonemployed spouses. Provides an inflation adjustment for retirement savings deductions. Excludes from gross income qualified distributions from certain retirement plans for first-time homebuyers and higher education expenses of the taxpayer, spouse, or child. Requires the repayment of such amounts with interest.
United States · United States Congress · 13 April 1994
TABLE OF CONTENTS: Title I: Insurance Reform Subtitle A: Insurance Provisions Subtitle B: Promoting Development of Voluntary Health Plan Purchasing Cooperatives Subtitle C: Federal Preemption Subtitle D: Rules of Construction Regarding Abortion Services; Inseverability Title II: Amendments of Internal Revenue Code of 1986 Subtitle A: Limitations on Employer Deduction for Health Care Coverage for Employees and on Employee Exclusion for Employer-Provided Health Care Coverage Subtitle B: Credits for Contributions to Medical Savings Accounts, for Purchase of High Deductible Umbrella Insurance, and for Routine Preventive Care Subtitle C: Repeal of Medical Expense Deduction Subtitle D: Veterans Medical Benefits and Services Unaffected Title III: Savings In Medicare and Medicaid Programs Subtitle A: Medicare Program Subtitle B: Medicaid Program Title IV: Containing Health Care Costs Subtitle A: Medical Malpractice Liability Reform Subtitle B: Treatment of Certain Activities Under the Antitrust Laws Title V: Special Assistance for Frontier, Rural, and Urban Underserved Areas Subtitle A: Frontier, Rural, and Urban Underserved Areas Subtitle B: Primary Care Provider Education Subtitle C: Programs Relating to Primary and Preventive Care Services Subtitle D: Limitation on Funding for Abortions Title VI: Administrative Cost Savings Subtitle A: Standardization of Claims Processing Subtitle B: Electronic Medical Data Standards Subtitle C: Development and Distribution of Comparative Value Information Subtitle D: Preemption of State Quill Pen Laws Title VII: Anti-Fraud and Anti-Rationing Subtitle A: Criminal Prosecution of Health Care Fraud Subtitle B: Coordination of Health Care Anti-Fraud and Abuse Activities Subtitle C: Protection Against Rationing of Treatment Health Savings and Security Act of 1994 - Title I: Insurance Reform - Subtitle A: Insurance Provisions - Part 1: Requirements for Tax-Favored Health Plans - Authorizes a State to establish or operate a managed health care plan. (Sec. 102) Requires such a plan to provide for all medically necessary acute medical care (including physician services; inpatient, outpatient, and emergency hospital services and appropriate alternatives to hospitalization; and inpatient and outpatient prescription drugs), to not exclude coverage for selected illnesses or selected treatments if consistent with medically accepted practices, and to meet applicable cost-sharing requirements of this Act. Requires that such plan, in the case of a high deductible umbrella insurance plan, provide a deductible amount for benefits provided in any plan year which is at least $1,500 (but not to exceed $3,000) for items and services furnished to a family (composed of one or more individuals) enrolled under the plan in a year. Specifies that a health insurance plan may not require the payment of any copayment or coinsurance for an item or service for which coverage is required after an individual or a family has incurred out-of-pocket expenses equal to a specified limit for a plan year. (Sec. 103) Requires that such a plan provide: (1) for a variation in premium rates only on the basis of age, sex, geography, and family enrollment, individual and group coverage, and in the case of group coverage, on the basis of the number of individuals covered within the group; (2) for a charge of the same premium rates to new applicants and existing policyholders with the same age, sex, geographic characteristics, and family enrollment; and (3) that the highest premium for the plan for a particular class of family enrollment and geographic characteristics may not exceed four times the lowest premium for such plan for the same enrollment and geographic characteristics. Permits incentive discounts of not more than ten percent for participating in an approved program to promote healthy behavior, prevent or delay the onset of illness, or provide for screening or early detection of illness. (Sec. 104) Requires that such plan: (1) provide guaranteed issue at standard rates to all applicants; and (2) not exclude from coverage, or limit coverage for, any preexisting condition, with exceptions. (Sec. 105) Requires that such plan provide the policyholder with a contractual right to renew the coverage which stipulates that the insurer cannot cancel or refuse to renew the coverage except for cases of nonpayment of premiums, or fraud or misrepresentation, by the policyholder. (Sec. 106) Sets forth restrictions on agent compensation and broker activities. Part 2: Certification of High Deductible Umbrella Insurance Plans and Managed Care Health Plans - Requires each State to submit to the Secretary of Health and Human Services a report on steps the State is taking to implement and enforce a regulatory program with respect to high deductible umbrella insurance plans and managed care health plans by a specified deadline. Directs the Secretary, upon determining that a State has failed to submit a report by the deadline or that the State has not implemented and provided adequate enforcement of the regulatory program, to give the State 60 days to submit such report or implement and enforce such program. Sets forth procedures for Federal enforcement if such failure has not been corrected. (Sec. 112) Directs the Secretary to develop State regulatory program standards, in the form of model Acts and model regulations, which include: (1) procedures for certifying that the requirements of part 1 of this subtitle have been met by a health insurance plan applying for certification as a high deductible umbrella insurance plan or a managed care health plan; (2) specified requirements regarding marketing practices and reinsurance or allocation of risk mechanisms with respect to such a plan; (3) requirements regarding solvency standards and guaranty funds for carriers of such plans; and (4) reporting requirements under which carriers report to the Internal Revenue Service regarding the acquisition and termination by individuals of coverage under such plans. Directs the Secretary to: (1) request the National Association of Insurance Commissioners to develop models for reinsurance or allocation of risk mechanisms for high deductible umbrella insurance plans and managed care health plans made available to individuals for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models to determine if they provide for an effective reinsurance or allocation of risk mechanism. Requires each State to establish one or more reinsurance or allocation of risk mechanisms consistent with such a model. Permits a State to establish and maintain such a mechanism jointly with other States. Directs the Secretary to establish and maintain a reinsurance or allocation of risk mechanism if a State has failed to establish or maintain such a mechanism. Amends the Internal Revenue Code to impose a tax on the providing of any high deductible umbrella insurance plan or managed care health plan which covers any individual in a Federal reinsurance State. Directs that the tax imposed equal the applicable percentage of the amount received by the insurer for providing such plan in such Federal reinsurance State. Makes the insurer liable for payment of the tax. Subtitle B: Promoting Development of Voluntary Health Plan Purchasing Cooperatives - Directs the Secretary to establish standards relating to the establishment of health plan purchasing cooperatives (HPPCs), qualifications for qualified health carriers, and the roles of States under this subtitle. Sets forth provisions regarding deadlines, revision of standards, application of standards through States, the Federal role, and implementation of the standards. (Sec. 122) Requires each State to establish boundaries for HPPC areas in the State. (Sec. 123) Authorizes the establishment of one or more State-chartered, nonprofit private corporations to serve as an HPPC for each HPPC area for the benefit of small employers and eligible individuals in the area. Specifies that a carrier may not form, underwrite, or possess a majority vote of an HPPC, but may administer an HPPC. Sets forth provisions regarding: (1) the establishment by each HPPC of bylaws; (2) the election of members of its board of directors; (3) limitation of liability for good faith actions taken by any member of the board, its employees, or agent in the performance of duties of HPPCs; (4) appointment of officers and an executive director; (5) reporting, recordkeeping, and audit requirements; and (6) general authorities and limits on the authority of HPPCs. (Sec. 124) Requires each HPPC to: (1) enter into contracts and hold policies with qualified health carriers which elect to offer HPPC plans to members; (2) provide for the enrollment of eligible employees of small employers and eligible individuals in HPPC plans of qualified health carriers offered by the HPPC; (3) provide to its members and eligible employees of small employer members comparison sheets with clear standardized information on each qualified health carrier and each HPPC plan offered by a qualified health carrier; (4) establish requirements for participation of small employers and eligible individuals as HPPC members consistent with any standards established by the Secretary and to maintain eligibility records; and (5) establish dispute resolution procedures to resolve disputes between the HPPC and its members or qualified health carriers. Sets forth requirements concerning: (1) contracts with members; (2) contracts with plans; (3) overhead allowance; (4) uniform administrative and accounting procedures; and (5) contracts for administrative services. (Sec. 125) Requires each State to establish a process whereby a carrier that demonstrates to the satisfaction of the State insurance commissioner that it has the capability to fulfill specified requirements (with regard to licensure, administrative capacity, access, grievance procedures, utilization management procedures, quality, information, and data elements) is designated as a qualified health carrier. Sets forth the functions of qualified health carriers. Requires that coverage under an HPPC plan offered by a qualified health carrier be available to any member of the HPPC at the anniversary date of each member's coverage under an HPPC plan, with exceptions and subject to specified conditions. (Sec. 126) Requires each: (1) HPPC to use efficient and standardized means to notify small employers of the availability of plans through the HPPC and to notify the State insurance commissioner of any marketing practices or materials that it finds contrary to the fair marketing of qualified health carriers and HPPC plans; and (2) State insurance commissioner to monitor compliance with marketing requirements. (Sec. 127) Requires: (1) each HPPC to submit specified data to the State on a quarterly basis; and (2) the Secretary to establish uniform standards for data that an HPPC collects from qualified health carriers and providers and disseminates. (Sec. 128) Requires each State to: (1) assure compliance of HPPCs, small employers, and eligible employees and individuals with the requirements of this subtitle and to conduct reviews at least annually on the performance of each HPPC in assuring access to health coverage to small employers and eligible individuals in the HPPC area; (2) receive, review, and act on appeals of unresolved disputes between an HPPC and a member; (3) analyze information collected from qualified health carriers and other sources and report findings that assist consumers, HPPCs, qualified health carriers, or health care providers in improving the delivery or purchase of cost-effective health care; (4) prepare and make available to HPPCs and employers located in the State (and to eligible individuals upon request) information, in comparative form, concerning the HPPC plans in the State and HPPCs operating in the State; (5) report to the Secretary annually on the impact of the reform under this subtitle in expanding the availability and affordability of health coverage to eligible employees and individuals; and (6) supervise HPPCs to ensure that actions that affect market competition accomplish the objectives of this title, so as to provide State and Federal protection to HPPCs and HPPC boards of directors against Federal and State antitrust laws. Subtitle C: Federal Preemption - Bars applicability of any provision of State or local law that: (1) in the case of a group health plan, requires the coverage of one or more specific benefits, services, or categories of health care, or services of any class or type of provider of health care; and (2) prohibits two or more employers from obtaining coverage under an insured multiple employer health plan. (Sec. 143) Preempts and makes unenforceable specified State law restrictions with respect to reimbursement rates or selective contracting, differential financial incentives, and 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. 144) Specifies that nothing in this subtitle shall be construed to invalidate any State law that has the effect of preventing the denial of lifesaving medical treatment pending transfer to another health care provider. Subtitle D: Rules of Construction Regarding Abortion Services; Inseverability - Specifies that: (1) nothing in this title or title II may be construed to require any health plan to include any abortion services or to condition tax deductibility on the inclusion of such services; and (2) if such provision is judicially determined to be invalid all the provisions of this title and title II shall be deemed to be invalid. Title II: Amendments of Internal Revenue Code of 1986 - Subtitle A: Limitations on Employer Deduction for Health Care Coverage for Employees and on Employee Exclusion for Employer-Provided Health Care Coverage - Amends the Internal Revenue Code to allow an employer a deduction: (1) for health care coverage for employees under a high deductible umbrella insurance plan or a managed health care plan; (2) for contribution to a medical savings account for an employee; or (3) for payment of permitted coverage. Prohibits such deduction from exceeding the health care tax benefit limitation imposed on individuals receiving coverage under a tax-qualified health care plan. (Sec. 202) Excludes from the gross income of an employee only coverage under a tax-qualified health care plan, contributions to a medical savings account, or permitted coverage payments. (Sec. 203) Prohibits the provision of health benefits under cafeteria plans. Subtitle B: Credits for Contributions to Medical Savings Accounts, for Purchase of High Deduction Umbrella Insurance, and for Routine Preventive Care - Allows individuals a tax credit (with limitation) for a percentage of contributions to a medical savings account. Makes such account tax-exempt and excludes other employer payments from the individual's tax base. (Sec. 212) Allows individuals a tax credit for a percentage of the amount paid for coverage under a tax-qualified health care plan. Requires the establishment of a program to provide health insurance certificates for low-income individuals eligible for such credit. (Sec. 213) Allows certain individuals a tax credit for a percentage of the amount paid for routine preventive care for the taxpayer, spouse, and dependents. Subtitle C: Repeal of Medical Expense Deduction - Repeals the deduction for medical, dental, etc., expenses. Subtitle D: Veterans Medical Benefits and Services Unaffected - Declares that nothing in this title affects veterans' medical benefits and services. Title III: Savings in Medicare and Medicaid Programs - Subtitle A: Medicare Program - Amends the Internal Revenue Code to impose an annual tax on the Medicare part B (Supplementary Medical Insurance) premiums of high-income and certain other individuals covered by such part. (Sec. 302) Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) impose a co-payment for clinical diagnostic laboratory tests; (2) eliminate mandatory assignment for test payment and billing; and (3) provide for annual indexing of the part B deductible. Subtitle B: Medicaid Program - Amends SSA title XIX (Medicaid) to: (1) cap Federal payments for acute medical services; (2) discontinue reimbursement standards for inpatient hospital services; (3) provide for optional enrollment of low-income individuals under high deductible umbrella insurance plans and managed care plans (with reduced payment adjustments for States providing such enrollment); (4) allow States more flexibility in contracting for coordinated care services; and (5) prohibit Medicaid funding of abortions not necessary to prevent the death of the mother. Title IV: Containing Health Care Costs - Subtitle A: Medical Malpractice Liablity Reform - Part 1: General Provisions - Makes this subtitle applicable with respect to any medical malpractice liability claim and action brought in any State or Federal court, with exceptions (such as a claim or action for damages arising from a vaccine-related injury or death). Sets forth provisions regarding preemption, effect on sovereign immunity and choice of law or venue, and Federal court jurisdiction. Part 2: Medical Malpractice and Product Liability Reform - Prohibits a medical malpractice liability action from being brought in any: (1) State court during a calendar year unless the medical malpractice liability claim that is the subject of the action has been initially resolved under a State's alternative dispute resolution (ADR) system certified for the year by the Secretary or under the alternative Federal system established by this Act; and (2) Federal court during a calendar year unless such claim that is the subject of the action has been initially resolved under such ADR system in the State whose law applies. Directs the Attorney General to establish an ADR process for the resolution of medical malpractice liability claims brought against the United States, which shall occur after the completion of the administrative claim process. 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 the ADR process established by the Attorney General. Sets forth provisions regarding: (1) procedures for filing actions; and (2) the legal effect of uncontested ADR decisions. (Sec. 412) Sets a $250,000 limit on noneconomic damages that may be awarded to a claimant and the members of the claimant's family for losses resulting from the injury which is the subject of a medical malpractice liability action. Prohibits the award of punitive or exemplary damages in such an action: (1) unless the claimant establishes by clear and convincing evidence that the injury suffered was the direct result of conduct manifesting a malicious, wanton, willful, or excessively reckless disregard of the safety of others; and (2) against the manufacturer of a medical product. Requires that: (1) any punitive or exemplary damages awarded in a medical malpractice liability action be paid to the State in which the action is brought or, in a case brought in Federal court, in the State in which the health care services that caused the injury that is the subject of the action were provided; and (2) such State use such amounts to carry out activities to assure the safety and quality of health care services provided in the State. Prohibits a defendant, in any medical malpractice liability action in which the damages awarded for future economic loss exceed $100,000, from being required to pay such damages in a single, lump-sum payment, but permits periodic payments based on when the damages are found likely to occur, as determined by the court. Authorizes a court to waive the application of such provision if it is not in the best interests of the plaintiff to receive periodic payments. (Sec. 413) Directs the court in a medical malpractice liability action to require the party that contested an ADR ruling with respect to the medical malpractice liability claim that is the subject of the action to: (1) pay attorney fees and other costs, with exceptions; and (2) post a performance bond, subject to waiver by the court upon determining that the posting of such a bond is not necessary to ensure that the party pay the costs incurred by the opposing party under the action. Sets forth provisions regarding: (1) limits on attorney's fees paid; and (2) recordkeeping requirements. (Sec. 414) Allows a defendant to be held severally but not jointly liable in a medical malpractice action for noneconomic damages, and only for those damages directly attributable to the person's proportionate share of fault or responsibility for the injury. (Sec. 415) Establishes a seven-year statute of limitations for medical malpractice liability claims beginning on the date the alleged injury occurred. (Sec. 416) Prohibits a defendant in a medical malpractice liability action from being found to have acted negligently unless the defendant's conduct at the time of providing the health care services was not reasonable. (Sec. 417) Prohibits the trier of fact, in the case of a medical malpractice liability claim relating to services provided during labor or the delivery of a baby where the health care professional against whom the claim is brought did not previously treat the individual alleged to have been injured for the pregnancy, from finding that the defendant committed malpractice and assessing damages unless the malpractice is proven by clear and convincing evidence. Specifies that a health care professional shall be considered to have previously treated an individual for a pregnancy if the professional is a member of a group practice whose members previously treated the individual for the pregnancy or is providing services to the individual during labor or the delivery pursuant to an agreement with another health care professional. Part 3: Requirements for State Alternative Dispute Resolution Systems - Sets requirements for a State's ADR system, including that the system: (1) apply to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) require that a written opinion resolving the dispute be issued within six months of receipt of notice of the claim by each party against whom the claim is filed; (3) require that individuals who hear and resolve claims under the system meet specified qualifications; (4) be approved by the State or local governments; (5) with respect to a State system consisting of multiple dispute resolution procedures, permit the parties to a dispute to select the procedure to be used (and, if they do not agree, assign a particular procedure); (6) transmit to the State agency responsible for monitoring or disciplining health care professionals and providers any findings that such professional or provider committed malpractice, with exceptions; and (7) transmit to the Administrator for Health Care Policy and Research information on disputes resolved in a manner that assures that the identity of the parties to a dispute shall not be revealed. Makes the provisions of part 2 (malpractice liability standards) applicable with respect to claims brought under a State or alternative Federal ADR system in the same manner as such provisions apply to medical malpractice liability actions brought in the State. (Sec. 422) Directs the Secretary to: (1) determine, by October 1 of each year (beginning with 1995), whether a State's ADR system meets the requirements of this part for the following calendar year, and certify such system if it does; and (2) establish an alternative Federal ADR system for the resolution of medical malpractice liability claims during a calendar year in States that do not have in effect an alternative ADR system certified for the year. Sets forth provisions regarding: (1) requirements for the alternative Federal ADR system; and (2) the treatment of States with the alternative system in effect. (Sec. 423) Directs the Secretary to submit to the Congress a report describing and evaluating State ADR systems operated pursuant to this part and the alternative Federal system. Part 4: Other Provisions Relating to Medical Malpractice Liability - Permits a State agency responsible for the conduct of disciplinary actions for a type of health care practitioner to enter into agreements to permit State or county professional societies to participate in the licensing of such practitioner and to review any health care malpractice action, claim, allegation, or other information concerning the practice patterns of any such practitioner. (Sec. 432) Requires the Secretary to conduct a study analyzing the existence and effectiveness of incentives adopted by State and local governments, insurers, medical societies, and other entities to encourage physicians (whether practicing or retired) to volunteer to provide health care services in medically underserved areas. (Sec. 433) Directs each State to require each: (1) health care professional and provider in the State to participate in a risk management program to prevent, and provide early warning of, practices which may injure or otherwise endanger a patient; and (2) entity which provides health care professional or provider liability insurance in the State to establish risk management programs based on available data or sanction such programs provided by other entities and to require each such professional or provider, as a condition of maintaining insurance, to participate in at least one such program every three years. (Sec. 434) Requires 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 assist States 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 public about the appropriate use of health care and realistic expectations of medical intervention and about the resources and role of health care professional licensing and disciplinary boards in investigating claims of incompetence or malpractice, and for developing programs of faculty training and curricula for educating health are professionals in quality assurance, risk management, and medical injury prevention. Authorizes appropriations. Subtitle B: Treatment of Certain Activities Under the Antitrust Laws - Exempts from the antitrust laws specified "safe harbor" activities listed in, or designated by the Attorney General pursuant to, this subtitle. 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. (Sec. 452) Lists as safe harbors specified: (1) activities relating to health care services of combinations of health care providers with market share below a specified threshold; (2) activities of medical self-regulatory entities relating to standard setting or enforcement activities not conducted for purposes of financial gain; (3) participation of a health care provider in a written survey of the prices of services, reimbursement levels, or the compensation and benefits of employees and personnel; (4) activities relating to health care joint ventures for high technology and costly equipment and services; (5) activities relating to hospital mergers; (6) joint purchasing arrangements; and (7) negotiations. (Sec. 453) Directs the Attorney General to publish a notice in the Federal Register soliciting proposals for additional safe harbors and to review and report on proposed safe harbors. Sets forth criteria in establishing safe harbors, including: (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. (Sec. 454) 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. (Sec. 455) Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. (Sec. 456) Directs the Attorney General to periodically review the safe harbors and certificates of review. (Sec. 458) Establishes within the Department of Health and Human Services an Office of Health Care Competition Policy. Title V: Special Assistance for Frontier, Rural, and Urban Underserved Areas - Subtitle A: Frontier, Rural, and Urban Underserved Areas - Amends the Public Health Service Act to direct the Secretary to establish and administer a program to provide allotments to enable States to provide grants for the creation or enhancement of community-based primary health care entities that provide services to low-income or medically underserved populations. Directs the Secretary to award grants to Federally Qualified Health Centers (FQHCs) and other entities and organizations for the purpose of providing access to services for medically underserved populations or in high impact areas not currently being served by an FQHC. Authorizes appropriations. Directs the Secretary to provide for a study to examine the relationship and interaction between community health centers and hospitals in providing services to individuals residing in medically underserved areas, ensuring that the National Rural Research Centers participate in such study. (Sec. 502) Amends the Internal Revenue Code to allow a qualified primary health services provider (physician, physician assistant, or nurse practitioner who provides full time primary health services in a health professional shortage area, subject to specified requirements) a credit against tax for a period of 60 consecutive calendar months from the time the taxpayer becomes a qualified provider. Sets forth rules regarding the recapture of credit and the expensing of medical equipment. Excludes National Health Service Corps loan repayments from gross income. Provides a deduction for student loan payments by medical professionals practicing in rural areas. (Sec. 503) Amends the SSA to include rural emergency access care hospital services among the benefits provided under the Supplementary Medical Insurance Program for the Aged and Disabled. (Sec. 504) Amends the Public Health Service Act to direct the Secretary to make grants to assist States in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments. (Sec. 505) Authorizes the Secretary to: (1) conduct a demonstration project under which public and private entities may apply for waivers of provisions of the SSA in order to operate rural health networks which improve the access of Medicare and Medicaid beneficiaries to, and the quality and outcomes of, health care services; and (2) grant waivers to operate rural health networks under the demonstration project to a number of public and private entities. Directs the Secretary to award grants to public and private entities which have received a waiver for planning, developing, and operation of rural health networks. Authorizes appropriations. Subtitle B: Primary Care Provider Education - Amends the Public Health Service Act to direct the Secretary to provide for the establishment of demonstration projects: (1) in up to seven States for the purpose of testing and evaluating mechanisms to increase the number and percentage of medical students entering primary care practice through the use of funds otherwise available for direct graduate medical education costs under the SSA; and (2) for up to seven health care training consortia for such purpose. Directs the Secretary to award grants to such consortia for developing and evaluating such projects. Authorizes appropriations. (Sec. 512) Amends the SSA to count residency training time in nonhospital-owned facilities in determining full-time equivalent residents for direct graduate medical education payments, and for certain indirect medical education payments, under Medicare. (Sec. 513) Amends the Public Health Service Act to increase: (1) National Health Service Corps funding; and (2) health professions funding for primary care physicians, nurse practitioners, and physician assistants. Authorizes the Secretary to award grants to enable public and nonprofit private entities to meet the cost of providing traineeships for individuals in baccalaureate and advanced-degree programs to educate such individuals to serve in and prepare for practice as physician assistants. Authorizes appropriations. (Sec. 516) Directs the Secretary to award grants to States or nonprofit entities to fund not less than ten demonstration projects to enable such States or entities to evaluate: (1) State mechanisms, including changes in the scope of practice laws, to enhance the delivery of primary care by nurse practitioners or physician assistants; (2) the feasibility of and most effective means of training subspecialists to deliver primary care as primary care providers; and (3) State mechanisms to increase the supply or improve the distribution of primary care providers. Authorizes appropriations. Subtitle C: Programs Relating to Primary and Preventive Care Services - Authorizes the Secretary to award grants to enable States to plan and implement coordinated, multidisciplinary, and comprehensive primary health care and social service programs targeted to pregnant women and infants. Authorizes appropriations. (Sec. 522) Authorizes frontier States (including Alaska, Wyoming, and Montana) to: (1) implement proposals to offer preventive services, including mobile preventive health centers, which may be located on aircraft, watercraft, or other forms of transportation; and (2) participate in demonstration projects to improve recruitment, retention, and training of rural providers, including nurse partitioners and physician assistants. Subtitle D: Limitation on Funding for Abortions - Specifies that: (1) nothing in this title shall be construed to authorize funding for any abortion, except to prevent the death of the mother; and (2) the provision of abortion services by a State or other entity shall not be regarded as a condition for participation in any grant or benefit authorized in this title. Title VI: Administrative Cost Savings - Subtitle A: 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 insurance plans, as well as for use in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. Directs the Secretary, in adopting such standards, to take into account the recommendations of current task forces, consult with the National Association of Insurance Commissioners, and seek to make the standards consistent with any uniform clinical data sets which have been adopted and are widely recognized. Sets forth provisions regarding: (1) deadlines for promulgation; and (2) application of the standards. (Sec. 603) Directs the Secretary to provide for the periodic review and revision of such standards. Subtitle B: Electronic Medical Data Standards - Directs the Secretary to promulgate standards for hospitals concerning electronic medical data, including confidentiality standards. Authorizes the Secretary to periodically revise the standards and to promulgate (and periodically revise) standards for providers that are not hospitals. (Sec. 612) Requires each hospital, as of January 1, 1996 to: (1) maintain clinical data included in the set of comprehensive data elements in electronic form on all inpatients; (2) upon request of the Secretary or a utilization and quality control peer review organization, transmit electronically the data set; and (3) upon request of the Secretary or a fiscal intermediary or carrier, transmit electronically any data with respect to a claim from such data set in accordance with specified standards. Grants the Secretary waiver authority under specified circumstances. Directs the Secretary of Veterans Affairs to provide that each hospital of the Department of Veterans Affairs shall comply with requirements of this subtitle as if it were participating in the Medicare program. Grants such Secretary waiver authority under specified circumstances. (Sec. 613) Authorizes, effective January 1, 2000, a Federal agency to require a provider to transmit required data elements electronically in accordance with applicable presentation or transmission standards. (Sec. 614) Prohibits a health insurance plan, if standards for data elements are promulgated with respect to a class of provider, from requiring for the purpose of utilization review or as a condition of providing benefits under the plan that a provider in the class: (1) provide any data element not in the set of comprehensive data elements specified under such standards; or (2) transmit or present any such data element in a manner inconsistent with the applicable transmission or presentation standards. Authorizes the Secretary to impose a civil monetary penalty on any health insurance plan (with exceptions) that fails to comply with such provision. (Sec. 615) Directs the Secretary to establish an advisory commission in collection and use of data and operation of data systems to monitor and advise the Secretary concerning the standards established under this subtitle and operational concerns about the implementation of such standards. Authorizes appropriations. Subtitle C: 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 (to assure the availability of comparative value information to purchasers of health care in each State) that meets specified criteria. Authorizes the Secretary to make grants to enable each State to plan the development of, and initiate the implementation of its health care value information program. Authorizes appropriations. (Sec. 622) Directs the Secretary, if a State has failed to develop or implement such program, to implement a comparable program in the State. (Sec. 623) Requires the head of each Federal agency with responsibility for the provision of health insurance or health care services to promptly develop and make available to States and to providers and consumers of health care services relevant to health care value information. Subtitle D: Preemption of State Quill Pen Laws - Provides that, effective January 1, 1996, no effect shall be given to any State law provision that requires medical or health insurance records (including billing information) to be maintained in written rather than electronic form. Title VII: Anti-Fraud and Anti-Rationing - Subtitle A: Criminal Prosecution of Health Care Fraud - Amends the Federal criminal code to set penalties for health care fraud. (Sec. 702) Authorizes the Attorney General, in special circumstances, to make payments of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution for health care fraud, subject to specified limitations. Subtitle B: Coordination of Health Care Anti-Fraud and Abuse Activities - Amends the SSA to apply Federal health anti-fraud and abuse sanctions to all fraud and abuse against any health insurance plan. Directs the Secretary to: (1) identify opportunities for the satisfaction of community service obligations that a court may impose upon the conviction of a criminal ofense involving Medicare or State health care programs; and (2) make information concerning such opportunities available to Federal and State law enforcement officers and State and local health care officials. Subtitle C: Protection Against Rationing of Treatment - Prohibits a health care provider or health insurance plan from denying medical treatment or insurance coverage that a patient is otherwise qualified to receive against the wishes of a patient (or if the patient is incompetent, against the wishes of the patient's guardian) on the basis of the patient's present or predicted age, disability, degree of medical need, or quality of life. (Sec. 722) Makes specified remedies and procedures under the Civil Rights Act of 1964 applicable to any person who is denied medical treatment or insurance coverage, or who has reasonable grounds for believing that such person is about to be subjected to such denial, in violation of this subtitle. Permits an individual subjected to such denial (or a person who would be entitled to bring a cause of action for the individual's wrongful death) to obtain damages.
United States · United States Congress · 24 March 1994
Requires the Secretary of the Interior to offer to transfer all lands administered by the Bureau of Land Management (BLM) to the State in which such lands are located. Requires a State to accept or reject the total offer of all the lands. Makes the transfer effective on September 30, 1998. Requires each State receiving such lands to honor valid existing leases, permits, and mining claims. Restricts the transferred lands to public purpose use if they are not encumbered by a lease or permit. Reverts such lands to the United States if a State does not use them for public purposes. Exempts BLM lands from transfer under this Act if they are: (1) wilderness; (2) wilderness study areas; (3) areas of critical environmental concern; or (4) determined by the Secretary to be too costly for the United States to decontaminate.
United States · United States Congress · 24 March 1994
United States Botanic Garden Commemorative Coin Act of 1995 - Directs the Secretary of the Treasury to: (1) issue one-dollar silver coins to commemorate the 175th anniversary of the founding of the United States Botanic Garden; and (2) pay all surcharges received from such coin sales to the National Fund for the United States Botanic Garden.
United States · United States Congress · 18 March 1994
Expresses the sense of the Congress that: (1) executive branch entities should not officially recognize, encourage, promote, or fund homosexual events or homosexuality, directly or indirectly, male or female, without explicit congressional mandate; (2) the Office of Personnel Management should administer the civil service system in a way such that quotas, minority status, affirmative action, and other similar concepts do not apply with respect to homosexuality or any claim thereof; and (3) no person should be required to comply with, participate in, or endorse any employee sensitivity training or education relating to homosexuality or cultural diversity, or other similar program, as a condition for appointment, job retention, or advancement in the Federal civil service.
United States · United States Congress · 16 March 1994
TABLE OF CONTENTS: Title I: Definitions Title II: Compliance and Increased Participation Title III: Ratings and Incentives for Community Floodplain Management Programs Title IV: Mitigation of Flood and Erosion Risks Title V: Task Force, Advisory Council, and Studies Title VI: Miscellaneous Provisions National Flood Insurance Program Improvement Act of 1994 - Title I: Definitions - Defines specified terms under the Flood Disaster Protection Act of 1973 and the National Flood Insurance Act of 1968. Title II: Compliance and Increased Participation - Amends the Flood Disaster Protection Act of 1973 to expand flood insurance purchase requirements for borrowers securing loans through the Federal National Mortgage Association, the Federal Home Loan Mortgage Corporation, and Federal agency mortgage lenders. Requires residential real estate lenders to establish flood insurance premium escrow accounts. Requires Federal lenders and regulated lending institutions (banks, savings and loans, credit unions) and loan servicers to notify borrowers of special flood hazards and of the need to purchase and maintain flood insurance. Requires such entities, after 60 days' notice, to purchase such insurance on behalf of the borrower and charge the borrower for premium costs. Provides for review of special hazards determinations by the Director of the Federal Emergency Management Agency (FEMA). Requires the Director to develop a standard flood hazard determination form for use in connection with loans for residential properties located in an area of special flood hazards and in which flood insurance is available. Amends the Federal Deposit Insurance Act and the Federal Credit Union Act to require regulated lending institutions to conduct examinations and report to the Congress with respect to compliance with the National Flood Insurance Program. Provides penalties for lenders who fail to require flood insurance, maintain escrow accounts, or provide appropriate borrower notification with respect to the need for flood insurance. Amends the Federal Financial Institutions Examinations Council Act of 1978 to direct the Financial Examinations Council to coordinate with Federal entities for lending regulation to develop uniform lender standards. Title III: Ratings and Incentives for Community Floodplain Management Programs - Amends the National Flood Insurance Act of 1968 to provide for a community rating system and premium rate incentives for community floodplain management. Requires the FEMA Director to carry out a community erosion hazard management program which provides incentives for reduction of erosion damage and promotes the reduction of Federal flood insurance losses related to erosion hazards. Provides program funding. Title IV: Mitigation of Flood and Erosion Risks - Amends the Housing and Urban Development Act of 1968 to require the FEMA Director to coordinate all flood and erosion mitigation activities under the Federal Insurance Administrator. Provides funding for such activities. Amends the National Flood Insurance Act of 1968 to require the FEMA Director to develop and implement a State, community, and individual flood and erosion mitigation financial assistance program for structures insured under such Act. Requires such activities to be technically feasible and cost-effective. Provides assistance limitations. Repeals (with a transition period) the current program for the purchase of certain insured properties, as well as the current program for the demolition or relocation of threatened structures. Title V: Task Force, Advisory Council, and Studies - Establishes a two-year interagency Flood Insurance Task Force to: (1) develop standardized flood insurance enforcement procedures; (2) study Federal agency and secondary mortgage market assistance with respect to such enforcement; and (3) study the possibility of existing Federal and corporate flood insurance programs as models for new programs. Establishes the Technical Mapping Advisory Council to undertake certain activities with respect to the preparation, dissemination, and use of flood insurance rate maps. Authorizes appropriations. Requires the FEMA Director to report to the Congress on whether it would be feasible for the national flood insurance program to be administered by the private insurance industry, as well as on such industry's impact on the availability and affordability of flood insurance. Title VI: Miscellaneous Provisions - Amends the National Flood Insurance Act of 1968 to: (1) increase flood insurance coverage amounts for nonresidential, single family, and multifamily structures; (2) allow additional coverage for compliance with land use and control measures; (3) permit flood insurance private sector participation; and (4) require an assessment (and revision if necessary) of flood insurance maps (with identification of erosion hazard areas) at least every five years. Amends the National Flood Insurance Act of 1968 to: (1) allow for the repair and restoration of certain flood damaged agricultural structures; (2) require the National Flood Insurance Fund to be maintained as a separate account in the Treasury; (3) require the FEMA Director to establish a ten-day waiting period for the initial purchase of flood insurance; and (4) require the Director to include in a certain biennial report the effects of provisions of this Act on the national flood insurance program. Amends the Robert T. Stafford Disaster Relief and Emergency Assistance Act to prohibit the waiver of flood insurance purchase requirements for recipients of Federal disaster assistance.
United States · United States Congress · 16 March 1994
TABLE OF CONTENTS: Title I: Eligible Shareholders of S Corporation Subtitle A: Number of Shareholders Subtitle B: Persons Allowed as Shareholders Subtitle C: Other Provisions Title II: Qualification and Eligibility Requirements for S Corporations Subtitle A: One Class of Stock Subtitle B: Elections and Terminations Subtitle C: Other Provisions Title III: Taxation of S Corpporation Shareholders Title IV: Effective Date S Corporation Reform Act of 1993 - Title I: Eligible Shareholders of S Corporation - Subtitle A: Number of Shareholders - Amends the Internal Revenue Code to increase from 35 to 50 the maximum number of shareholders of an S corporation (small business corporation). Allows members of a family to be treated as one shareholder. Subtitle B: Persons Allowed as Shareholders - Allows the following entities to be shareholders of S corporations: (1) certain tax-exempt organizations; (2) financial institutions that do not use the reserve method of accounting for bad debts; (3) nonresident aliens; and (4) certain small business trusts. Subtitle C: Other Provisions - Extends the post-death qualification for certain trusts to be permitted as shareholders from 60 days to two years. Title II: Qualification and Eligibility Requirements for S Corporation - Subtitle A: One Class of Stock - Allows an S corporation to issue qualified preferred stock. Permits financial institutions to hold safe harbor debt. Subtitle B: Elections and Terminations - Revises the rules on inadvertent terminations by certain trusts of the election to be an S corporation. Authorizes the Secretary of the Treasury to treat certain late elections as timely and to provide an automatic waiver procedure for certain inadvertent terminations. Expands the post-termination transition period until 120 days after a determination is made that the election had terminated in a prior year. Repeals excessive passive investment income as a termination event. Increases the tax imposed on such excessive income. Subtitle C: Other Provisions - Permits an S corporation to own more than 80 percent of another corporation's stock. Repeals the requirement that partnership rules apply for fringe benefit purposes (making C corporation rules applicable). Provides for the treatment of distributions during loss years. Provides a consent dividend for S corporation elections to by-pass amounts in the accumulated adjustments account when making distributions. Eliminates the need to keep records of certain generally small amounts of earnings arising before 1983. Allows S corporations to make charitable contributions of inventory and scientific property. Title III: Taxation of S Corporation Shareholders - Treats losses on liquidations of S corporations as ordinary to the extent the loss created by ordinary income pass-through triggered the liquidation. Title IV: Effective Date - Makes this Act effective after December 31, 1994.
United States · United States Congress · 11 March 1994
Amends the Internal Revenue Code to allow penalty-free distributions from certain retirement plans to pay for the repair or replacement of qualified disaster-damaged property.
United States · United States Congress · 8 March 1994
Amends the Federal criminal code to require that a person convicted in a U.S. court of a serious violent felony be sentenced to life imprisonment if: (1) the person has been convicted of such a felony on two or more prior occasions in a Federal or State court; and (2) each serious violent felony used as a basis for sentencing under such provision, other than the first, was committed after the defendant's conviction of the preceding serious violent felony. Lists non-qualifying felonies, including: (1) robbery or an attempt, conspiracy, or solicitation to commit robbery if the defendant establishes by clear and convincing evidence that no firearm or other dangerous weapon was involved in the offense and the offense did not result in death or serious bodily injury to any person; and (2) arson if the defendant establishes by such evidence that the offense posed no threat to human life and that the defendant reasonably believed the offense posed no threat to human life. Makes provisions of the Controlled Substances Act regarding information filed by the U.S. Attorney in proceedings to establish previous convictions applicable to the imposition of sentence under this Act. Specifies that this Act shall not be construed to preclude imposition of the death penalty.
United States · United States Congress · 8 March 1994
Amends the Federal Insecticide, Fungicide, and Rodenticide Act to extend the compliance date for certain provisions of the worker protection standard relating to pesticide safety requirements to October 23, 1995. Directs the Administrator of the Environmental Protection Agency to: (1) develop and distribute pesticide safety training materials that convey, at a minimum, specified information set forth in the Code of Federal Regulations; and (2) assist the appropriate State, Federal, and tribal agencies in implementing pesticide safety training programs. Extends the compliance date for meeting a requirement for worker protection labeling statements on certain pesticide products from April 21, 1994, to October 23, 1995.
United States · United States Congress · 8 March 1994
Amends rule XXI of the Rules of the House of Representatives to require a three-fifths majority vote to agree to any bill, joint resolution, amendment, or conference report that raises revenues.
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 · 3 March 1994
Designates March 23, 1994, the 92d birthday of the Rabbi Menachem Mendel Schneerson (leader of the worldwide Lubavitch movement), as Education and Sharing Day, U.S.A.
United States · United States Congress · 3 March 1994
Honors James Norman Hall for his outstanding contributions to the United States, France, Tahiti, and the South Pacific. Requests the President to provide for the presentation of a copy of this concurrent resolution to the President of Tahiti Nui (French Polynesia) to be publicly displayed at the James Norman Hall Museum in Tahiti.
United States · United States Congress · 2 March 1994
Senior Citizens Housing Safety Act - Amends the United States Housing Act of 1937 to prohibit persons with drug or alcohol problems from occupying dwelling units in assisted housing designated for elderly families.
United States · United States Congress · 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
Prohibits the Secretary of Health and Human Services from finding that a State Medicaid plan fails to meet Medicaid requirements solely because it does not cover abortions for pregnancies resulting from rape or incest if coverage for such an abortion is inconsistent with State law.
United States · United States Congress · 22 February 1994
Repeals the substantiation requirement for the deduction of certain charitable contributions as added to the Internal Revenue Code by the Revenue Reconciliation Act of 1993 (title XIII of the Omnibus Budget Reconciliation Act of 1993).
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 · 8 February 1994
Disability Insurance Reform Act of 1994 - Amends title II (Old Age, Survivors and Disability Insurance) of the Social Security Act to prohibit the payment of benefits based on disability to any individual who is a drug addict or alcoholic until such individual: (1) undergoes appropriate substance abuse treatment at an approved facility; (2) has complied with the terms of such treatment; and (3) either recovers or makes progress towards recovery, with benefits terminated if the individual fails to continue treatment. Requires lump sum disability payments to be made only through a qualified governmental or nonprofit care facility or community-based social service agency representative payees. Makes other changes with regard to representative payees, including allowing them to collect monthly fees for expenses in providing service. Requires the Secretary of Health and Human Services to provide for a monitoring and testing program to ensure individual compliance with treatment requirements.
United States · United States Congress · 3 February 1994
Social Security Immigration Fraud Protection Act of 1994 - Amends title II (Old Age, Survivors and Disability Insurance) of the Social Security Act to create a mandatory minimum sentence of a fine or five years' imprisonment, or both, for illegal alien social security documentation fraud.
United States · United States Congress · 2 February 1994
Prohibits the Department of Transportation or any other Federal department, agency, or instrumentality from requiring any State or political subdivision to convert highway signs to metric units.
United States · United States Congress · 2 February 1994
Amends the Federal Election Campaign Act of 1971 to abolish the Federal Election Commission's ex officio positions (the Secretary of the Senate and the Clerk of the House of Representatives).
United States · United States Congress · 26 January 1994
Capital Formation and Jobs Creation Act of 1994 - Amends the Internal Revenue Code to allow a 50 percent income tax deduction for the net capital gain of both corporate and noncorporate taxpayers. Requires indexing, based on the gross national product deflator, of the adjusted basis of certain assets (corporate stock and tangible property that is a capital asset or property used in a trade or business) that have been held for more than one year at the time of sale or other transfer, solely for the purpose of determining gain or loss. Allows an itemized deduction for losses arising from the sale or exchange of a principal residence.
United States · United States Congress · 25 January 1994
Education Bureaucracy Reduction Act - Directs the Secretary of Education, for FY 1995 and 1996, to reduce personnel costs of the Department of Education by ten percent. Requires savings from such reduction to be used as follows: (1) 90 percent transferred to local educational agencies according to State distribution formulas; and (2) ten percent to reduce the Federal budget deficit.
United States · United States Congress · 25 January 1994
Expresses the sense of the Congress that a postage stamp should be issued to honor the 100th anniversary of the Jewish War Veterans of the United States and that the Citizens' Stamp Advisory Committee of the U.S. Postal Service should make such recommendation to the Postmaster General.
![Official portrait of Rep. Livingston, Bob [R-LA-1]](https://www.congress.gov/img/member/l000371_200.jpg)