United States · United States Congress · 6 January 1993
Requests the Occupational Safety and Health Administration to publish, within one year, proposed amended regulations that specify the components of an adequate operator training program and that provide that only trained employees be authorized to operate powered industrial trucks.
United States · United States Congress · 5 January 1993
Amends the Internal Revenue Code to increase the personal exemption for a dependent child who has not attained age 18 from $2,000 to $3,500. Provides for rounding inflation adjustments to tax tables to the nearest multiple of $10 (currently rounded to the next lowest multiple of $50).
United States · United States Congress · 5 January 1993
Securities Private Enforcement Reform Act - Amends the Securities Exchange Act of 1934 to declare that a defendant may be liable jointly and severally for damages in an implied private action only if the trier of fact specifically determines that the defendant knowingly engaged in securities fraud. Sets forth a liability allocation scheme to determine the percentage of responsibility among the defendants if the trier of fact finds that the defendant did not engage in knowing securities fraud. Prescribes guidelines for the award of reasonable fees and expenses incurred by the prevailing party in any implied private action. Declares that in any implied right of action that is certified as a plaintiff class action: (1) the share that is awarded to the representative plaintiff shall be calculated in the same manner as the share awarded to all other members of the plaintiff class; (2) a party may not be represented by any attorney who owns or has a beneficial interest in the securities that are the subject of the litigation, or who is obligated to pay remuneration to a third party for assistance in obtaining the representation of any party to the action; and (3) funds disgorged as a result of Securities and Exchange Commission action shall not be distributed as payment for attorneys' fees or expenses incurred by private parties seeking distribution of the disgorged funds. Sets a statute of limitations on private rights of action under this Act.
United States · United States Congress · 5 January 1993
Older Americans' Freedom to Work Act of 1993 - Amends title II (Old Age, Survivors and Disability Insurance) of the Social Security Act to remove the limitation on the amount of outside income which beneficiaries who have attained retirement age may earn without incurring a reduction in benefits.
United States · United States Congress · 5 January 1993
Jacob Wetterling Crimes Against Children Registration Act - Directs the Attorney General to establish guidelines for State programs requiring persons convicted of a criminal offense against a minor to register a current address with a designated State law enforcement agency (LEA) for ten years after release from prison, parole, or being placed on supervised release. Sets forth requirements for an approved State registration program, including fingerprint cards and entry of information into the State law enforcement system and National Crime Information Center computer networks. Provides that the information provided under this Act is private and may be used for law enforcement purposes, including confidential background checks by child care service providers. Specifies that the allocation of Bureau of Justice Assistance grant funds under the Omnibus Crime Control and Safe Streets Act of 1968 received by a State not complying with the provisions of this Act within three years shall be reduced by 25 percent. Requires such unallocated funds to be reallocated to the States in compliance with this Act.
United States · United States Congress · 5 January 1993
Amends the Internal Revenue Code to make the targeted jobs credit permanent. Increases the maximum age requirement for employment of economically disadvantaged youth from 23 years to 25 years. Establishes economically disadvantaged veterans as members of targeted groups for purposes of the credit.
United States · United States Congress · 5 January 1993
Amends Internal Revenue Code provisions governing the income tax deduction for the health insurance costs of self-employed individuals to: (1) make the deduction permanent; and (2) phase in an increase in the allowable deduction, reaching 100 percent for taxable years beginning in 1996 and thereafter.
United States · United States Congress · 5 January 1993
Federal Mandate Relief Act of 1993 - Provides that any requirement under a Federal statute or regulation that a State or local government conduct an activity (including a requirement that a government meet national standards in providing a service) shall apply to the government only if all funds necessary to pay the direct costs incurred by the government in conducting the activity are provided by the Federal Government.
United States · United States Congress · 5 January 1993
TABLE OF CONTENTS: Title I: Improved Access to Affordable Health Care Coverage Subtitle A: Increased Affordability and Availability for Employees Subtitle B: Improved Small Employer Purchasing Power of Affordable Health Insurance Subtitle C: Health Deduction Fairness Subtitle D: Improved Access to Community Health Services Subtitle E: Improved Access to Rural Health Services Title II: Health Care Cost Containment and Quality Enhancement Subtitle A: Medical Malpractice Liability Reform Subtitle B: Administrative Cost Savings Subtitle C: Medical Savings Accounts (Medisave) Subtitle D: Medicaid Program Flexibility Subtitle E: Limitations on Physician Self-Referrals Subtitle F: Removing Restrictions on Managed Care Subtitle G: Medicare Payment Changes Subtitle H: Limitation of Antitrust Recovery for Certain Hospital Joint Ventures Subtitle I: Encouraging Enforcement Activities of Medical Self-Regulatory Entities Action Now Health Care Reform Act of 1993 - Title I: Improved Access to Affordable Health Care Coverage - (Sec. 102) Preempts inconsistent State laws. (Sec. 103) Requires small employer health insurance carriers to offer a MedAccess basic plan (providing only benefits for essential preventive and medical services and having an actuarial value not over 60 percent of a MedAccess standard plan) and a MedAccess standard plan (providing benefits typical of the small employer market). Amends the Internal Revenue Code (IRC) to tax the failure of a carrier or plan to comply with related standards. Mandates: (1) acceptance of every small employer and full-time employee; or (2) in States that so provide, allocation of risk. (Sec. 104) Regulates pre-existing condition requirements, premiums, rating practices disclosure, minimum participation requirements, and renewability. (Sec. 108) Mandates development of models for reinsurance or allocation of risk mechanisms. Requires State (or Federal) establishment of at least one mechanism in each State. Amends the IRC to impose a tax in any such Federal reinsurance State. (Sec. 110) Establishes the Office of Private Health Care Coverage and a related advisory committee. (Sec. 111) Authorizes research and demonstration projects on the impact of these provisions on the availability of affordable small employer coverage. Requires: (1) methods for measuring the relative health risks of eligible individuals; and (2) a model for equitably distributing health risks among small employer carriers. Authorizes appropriations. (Sec. 121) Preempts State laws: (1) requiring the offering of health plans providing certain services; and (2) prohibiting employer groups from purchasing health insurance. (Sec. 131) Amends the IRC to increase and make permanent deductions for the health insurance costs of self-employed individuals. (Sec. 141) Amends the Public Health Service Act (PHSA) to provide for grants to: (1) migrant and community health centers and to entities providing health services for the homeless to promote primary health services for underserved individuals; and (2) increase access to outpatient primary services in certain geographic areas. Authorizes appropriations. (Sec. 171) Changes the heading of title XII (Trauma Care) of the PHSA to "Emergency Medical Services" and makes similar changes to references within the title. (Sec. 172) Authorizes grants to States for State offices of emergency medical services. (Sec. 173) Requires projects under existing provisions to include demonstrations on telecommunications between rural medical facilities and other medical facilities with useful expertise or equipment. (Sec. 174) Authorizes appropriations to carry out specified provisions of title XII. (Sec. 181) Mandates grants to States for rural air medical transport systems. Authorizes appropriations. (Sec. 191) Amends title XVIII (Medicare) of the Social Security Act to extend special payments for the inpatient services of small, rural Medicare-dependent hospitals. Title II: Health Care Cost Containment and Quality Enhancement - (Sec. 211) Reforms medical malpractice regarding: (1) a statute of limitations; (2) use of alternative dispute resolution systems (ADRs), including for claims against the United States; (3) settlement offers and conferences; (4) noneconomic and punitive damages; (5) periodic payment for future damages; (6) mandatory offsets for collateral source payments; (7) contingent attorney's fees; (8) several and joint liability; (9) findings of negligence; (10) practice guidelines sanctioned as affirmative defenses; (11) the standard of proof regarding certain labor and delivery circumstances; (12) supersedure of certain State laws; and (13) establishment and certification of State ADRs. (Sec. 241) Amends title II (Old Age, Survivors, and Disability Insurance) (OASDI) of the Social Security Act to authorize appropriations for sanctioning guidelines as affirmative defenses. Mandates: (1) research and demonstrations on the use of data on malpractice actions; and (2) development of a standard reporting form for State ADRs in transmitting information on disputes resolved. (Sec. 242) Authorizes State professional disciplinary agencies to make agreements with professional societies to allow the societies to: (1) participate in licensing; and (2) review malpractice allegations or other information on the practice patterns of a practitioner. (Sec. 243) Requires each health professional and provider to participate in a risk management program. (Sec. 244) Mandates grants: (1) for basic research on malpractice prevention and compensation and outcomes research; (2) to States to improve licensing and discipline; and (3) for public education on appropriate health care use and realistic expectations, public education on the resources and role of licensing and disciplinary boards, and development of faculty training and curricula regarding quality assurance, risk management, and medical injury protection. Authorizes appropriations. (Sec. 245) Mandates a study on factors preventing or discouraging physicians from volunteering in medically underserved areas. (Sec. 251) Regulates: (1) data elements, uniform claims forms, and uniform electronic transmission of data elements; (2) provider claims submission; and (3) hospital and non-hospital electronic medical data. (Sec. 262) Requires hospitals, in order to participate in Medicare, to maintain and electronically transmit clinical data on patients in a set of electronic comprehensive data elements. (Sec. 263) Provides for electronic transmission of data elements to Federal agencies. (Sec. 264) Prohibits plans from requiring that a provider provide any data element not in the set or transmit any data element in a manner inconsistent with standards. (Sec. 265) Establishes an advisory commission. Authorizes appropriations. (Sec. 271) Provides for a comparative health care value program in each State. Authorizes grants and appropriations. (Sec. 273) Requires each Federal agency concerned with health insurance or care to develop comparative value information. (Sec. 274) Mandates model systems for the gathering and analysis of data on health care cost, quality, and outcome. Authorizes appropriations. (Sec. 281) Provides for standards regarding Medicare and Medicaid identification cards. Establishes a Medicare and Medicaid system to provide information on primary payors. Authorizes appropriations. (Sec. 282) Nullifies any State law requiring that medical or health insurance records be maintained in written rather than electronic form. (Sec. 283) Provides for standards regarding: (1) beneficiary and provider identification numbers; and (2) coordination of benefits. (Sec. 285) Mandates grants to demonstrate the application of comprehensive information systems in continuously monitoring patient care and improving patient care. Authorizes appropriations from the Federal Hospital Insurance Trust Fund. Authorizes grants for: (1) communication links between plan and provider information systems; (2) regional or community-based clinical information systems; and (3) developing and testing, for physicians and non-hospital entities, the definition of a comprehensive data set and the specification and presentation of individual data elements. Authorizes appropriations. (Sec. 291) Amends the IRC to exclude from an employee's gross income any amount contributed by the employer to a trust created exclusively to pay an individual's medical expenses (medical savings account). Sets contribution limits. Subjects the employee to taxation as owner of the account. (Sec. 301) Amends Medicaid provisions to modify contracting requirements for coordinated care services. (Sec. 311) Amends Medicare provisions to extend physician self-referral limitations to all payors and certain additional services. Revises exceptions. (Sec. 314) Mandates a study to estimate the changes in aggregate costs that will result from the amendments made by these provisions. (Sec. 321) Preempts managed care restrictions under State law. Mandates a study of managed care benefits and cost effectiveness. (Sec. 331) Amends Medicare provisions to revise the method for determining prospective payment updates to hospitals. (Sec. 332) Lowers the limitation amount and suspends certain annual adjustments regarding clinical diagnostic laboratory tests. (Sec. 343) Limits antitrust recovery to actual damages if certain requirements are met, including the filing and publication of information regarding hospital joint ventures. (Sec. 345) Establishes the Interagency Committee on Competition, Antitrust Policy, and Health Care. (Sec. 351) Prohibits, subject to exception, damages and other recovery under the Clayton Act or similar State laws from a medical self-regulatory entity engaging in standard setting or enforcement activities designed to promote the quality of health care and not conducted for financial gain.
United States · United States Congress · 5 January 1993
Amends the Child Nutrition Act of 1966 (CNA) and the National School Lunch Act (NSLA) to extend certain authorities. Extends the authorization of appropriations under CNA for: (1) start-up costs for school breakfast programs; (2) State administrative expenses; (3) the special supplemental food program for women, infants, and children (WIC); and (4) nutrition education and training. Extends the authorization of appropriations under NSLA for: (1) the summer food service program for children; (2) a distribution program; (3) statewide demonstration projects under the child and adult care food program; (4) pilot projects; and (5) training, technical assistance, and the Food Service Management Institute.
United States · United States Congress · 5 January 1993
Language of Government Act of 1993 - Declares English to be the official language of the U.S. Government. States that the Government has an affirmative obligation to preserve and enhance the role of English as the official language. Requires the Government to conduct its official business in English. Prohibits anyone from being denied Government services because they communicate in English.
United States · United States Congress · 5 January 1993
Life Imprisonment for Egregious Recidivists Act of 1993 - Amends the Federal criminal code to require the court, in the case of a conviction for a Federal violent felony, to sentence the defendant to life imprisonment if the defendant has previously been convicted of two other violent felonies. Specifies that this provision shall not be construed to prevent the imposition of the death penalty.
United States · United States Congress · 5 January 1993
Merchant Mariners Fairness Act of 1993 - Provides that certain qualified service of a member of the U.S. merchant marine, including a vessel crewmember of the U.S. Army Transport Service, during World War II constituted active military service for purposes of eligibility for various veterans' benefits under the GI Bill Improvement Act of 1977. Requires the Secretary of Defense to issue an honorable discharge under such Act to each merchant marine member whose qualified service warrants such a discharge. Prohibits the payment of any retroactive benefits under this Act. Mandates a processing fee for any benefit application for such qualified service.
United States · United States Congress · 5 January 1993
TABLE OF CONTENTS: Title I: Provisions Relating to Part A Title II: Provisions Relating to Part B Subtitle A: Physicians' Services Subtitle B: Ambulatory Surgical Services Subtitle C: Durable Medical Equipment Subtitle D: Other Provisions Title III: Provisions Relating to Parts A and B Title IV: Provisions Relating to Medicare Supplemental Insurance Policies Miscellaneous and Technical Medicare Amendments of 1993 - Amends title XVIII (Medicare) of the Social Security Act (SSA) parts A (Hospital Insurance) and B (Supplementary Medical Insurance). Title I: Provisions Relating to Part A - (Sec. 101) Requires the Secretary of Health and Human Services (HHS) to use the day outlier methodology in effect for: (1) FY 1992 for payment of discharges occurring on or after April 1, 1993, and before September 30, 1993; and (2) the first six months of FY 1993 for payment of discharges occurring during FY 1994. (Sec. 102) Modifies the Essential Access Community Hospital program. (Sec. 103) Provides that a change in classification of hospitals from one area to another may not result in a reduction in the wage index for an urban area under certain circumstances. (Sec. 104) Amends the Omnibus Budget Reconciliation Act of 1987 (OBRA-1987) to extend authorized appropriations for the rural health transition grant program. (The Omnibus Budget Reconciliation Acts of different years amended by this Act shall be denoted "OBRA-(year).") (Sec. 105) Permits hospitals to decline reclassification from rural to urban referral centers. (Sec. 106) Revises Medicare-dependent, small rural hospital payment provisions. (Sec. 107) Amends OBRA-1989 to extend additional Medicare payments for the hemophilia clotting factor. (Sec. 108) Prohibits the Secretary from recouping from or otherwise reducing Medicare payments to hospitals in New Jersey because of alleged overpayments during a hospital reimbursement demonstration project, until all relevant data are given to the State and hospitals located in it. (Sec. 109) Allows the care of hospital inpatients receiving qualified psychologist services to be supervised by a clinical psychologist to the extent such supervision is permitted under State law. (Sec. 110) Allows graduate medical education to be provided in a hospital-owned community health center. (Sec. 111) Requires a study on the feasibility and desirability of establishing joint medical facilities among the Department of Defense, the Department of Veterans' Affairs, and other public and private entities. (Sec. 112) Requires home health agencies and skilled nursing facilities to notify Medicare beneficiaries of the hospice benefit, except in certain circumstances. (Sec. 113) Directs the Secretary to begin collecting data on employee compensation and paid hours of employment in skilled nursing facilities (SNFs) to compute a wage index to adjust Medicare SNFs payments. (Sec. 115) Amends OBRA-1990 to require the Secretary to continue any rural hospital demonstration project at least through December 31, 1995. Title II: Provisions Relating to Part B - Subtitle A: Physicians' Services - (Sec. 201) Reinstates separate payment for electrocardiogram interpretations performed or ordered to be performed as part of or in conjunction with a visit to or consultation with a physician. (Sec. 202) Repeals provisions for reduced Medicare payments to new physicians and other practitioners during their first four years of practice. (Sec. 203) Prohibits the Secretary from modifying the methodology for determining the amount of time that may be billed under Medicare for anesthesia services. (Sec. 204) Requires the Secretary to study and report to specified congressional committees on the data necessary to review and revise geographical indices. (Sec. 205) Prohibits nonparticipating physicians and suppliers from billing or collecting an actual charge in excess of the Medicare limiting charge. (Sec. 206) Requires the Secretary to study, develop, and report to the Congress on relative values for pediatric services. (Sec. 208) Prohibits the Secretary and carriers from imposing user fees. Subtitle B: Ambulatory Surgical Services - (Sec. 211) Extends eligibility for designation as eye or eye and ear hospitals to certain hospitals. (Sec. 212) Amends OBRA-1990 to extend the cap on payments for intraocular lenses. Subtitle C: Durable Medical Equipment - (Sec. 221) Requires the Secretary to prescribe national standards which suppliers of medical equipment and supplies must meet to receive payment under Medicare for items furnished. (Sec. 222) Prohibits carrier forum shopping by suppliers filing claims. (Sec. 223) Prohibits unsolicited telephone contacts from suppliers of durable medical equipment to Medicare beneficiaries. (Sec. 224) Modifies SSA anti-kickback provisions. (Sec. 225) Specifies the circumstances under which Medicare beneficiaries are not liable for covered items furnished by suppliers on an unassigned basis. (Sec. 226) Revises special payment rules for particular items and services to provide for adjustments to final payment amounts for inherent reasonableness. (Sec. 227) Freezes reasonable charges for parenteral and enteral nutrients, supplies, and equipment. (Sec. 228) Removes aspirators and nebulizers from the category of durable medical equipment (DME) items requiring frequent and substantial servicing and includes accessories relating to aspirators and nebulizers in the category of inexpensive and other routinely purchased equipment. (Sec. 229) Adds payment rules for ostomy supplies, tracheostomy supplies, urologicals, and surgical dressings. (Sec. 230) Changes payment rates for tens devices. Subtitle D: Other Provisions - (Sec. 241) Revises payment conversion factors for services furnished by a medically directed certified registered nurse anesthetist. (Sec. 242) Amends OBRA-1990 to extend Alzheimer's disease demonstration projects. (Sec. 243) Modifies the limitation on the late enrollment penalty. (Secs. 244 and 245) Provides for Medicare coverage of: (1) oral cancer drugs that contain the same active ingredients as anticancer drugs covered by Medicare when administered intravenously; and (2) speech-language pathology and audiology services. (Sec. 246) Amends OBRA-1985, as amended by OBRA-1989, to extend municipal health service demonstration projects. (Sec. 247) Treats certain Indian health programs and facilities as federally-qualified health centers. (Sec. 248) Amends OBRA-1987 to extend the influenza vaccination demonstration project. Title III: Provisions Relating to Parts A and B - (Sec. 301) Modifies provisions relating to physician ownership and referral. Requires the Comptroller General to study and report to the Congress on shared facility arrangements. (Sec. 302) Adjusts procedures to determine graduate medical education costs. (Sec. 303) Extends the periods during which Medicare covers immunosuppressive drug therapy following a transplant procedure. Reduces Medicare payments for erythropoietin. (Sec. 304) Revises provisions with respect to Medicare secondary payers. (Secs. 305 and 306) Requires the Secretary to: (1) establish a method for obtaining information with a view to Medicaid payment of the Medicare out-of-pocket expenses of eligible Medicare beneficiaries; and (2) extend waivers for social health maintenance organization (HMO) demonstration projects. (Sec. 307) Repeals peer review organization precertification requirements for certain surgical procedures. (Sec. 308) Modifies hospital conditions of participation with respect to discharge planning under Medicare to require informing a patient of his or her entitlement to hospice services. (Sec. 309) Provides that there must be interest payments on clean claims if the claims are not paid within 30 days of receipt. (Sec. 311) Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to adjust discretionary spending limits with respect to Medicare administrative costs. (Sec. 312) Adjusts Medicare capitation payments with respect to HMOs to account for regional variations in application of the secondary payor provisions. (Sec. 313) Amends the Employee Retirement Income Security Act of 1974 with regard to certain health care programs of the State of Hawaii. Title IV: Provisions Relating to Medicare Supplemental Insurance Policies - (Sec. 401) Revises certain standards for Medicare supplemental insurance policies.
United States · United States Congress · 5 January 1993
Employee Educational Assistance Act of 1993 - Amends the Internal Revenue Code to make permanent the income tax exclusion of amounts paid under employee educational assistance programs.
United States · United States Congress · 5 January 1993
Amends the Internal Revenue Code to allow an income tax deduction for interest on any indebtedness incurred to pay the educational expenses of the taxpayer, spouse, or dependent. Allows such deduction only for the first 48 months of loan repayment.
United States · United States Congress · 5 January 1993
Declares that the Congress opposes any attempt to lower the estate tax exemption or raise the effective rate of taxes on estates because such measures contradict the fundamental goal of the United States Government of encouraging long-term private saving through which productive investment that promotes economic growth can be realized.
United States · United States Congress · 2 October 1992
John Heinz Neighorhood Development Program Amendments Act - Amends the Housing and Urban-Rural Recovery Act of 1983 to redesignate the Neighborhood Development Demonstration as the John Heinz Neighborhood Development Program. Provides for increased Program coordination between community funding organizations and local development organizations.
United States · United States Congress · 18 September 1992
Regulatory Flexibility Amendments Act of 1992 - Amends Federal law to eliminate provisions respecting judicial review of Federal agency compliance with regulatory flexibility analysis requirements. Requires an agency to consider the direct and indirect effects of a rule in determining whether or not it is likely to have a significant impact on a substantial number of small entities. Sets forth guidelines governing agency transmittal of proposed rules to the Chief Counsel for Advocacy of the Small Business Administration. Authorizes such official to transmit to the agency a statement of opposition to the proposed rule. Requires publication of such statement and the agency's response in the Federal Register. Expresses the sense of the Congress that the Chief Counsel for Advocacy of the Small Business Administration should be permitted to appear as amicus curiae in any action or case brought in a U.S. court for the purpose of reviewing a rule.
United States · United States Congress · 9 July 1992
Supports the planting of 500 redwood trees from California on the northwest coast of Spain in commemoration of the quincentenary of the voyage of Christopher Columbus to the New World. Designates such trees as a gift to the people of Spain made in the name of the people of the United States.
United States · United States Congress · 24 June 1992
World University Games Commemorative Coin Act - Authorizes the minting and issuance of five dollar gold coins and one dollar silver coins (at no net cost to the Government) to commemorate American participation in the World University Games. Requires that all surcharges from the sale of such coins be paid to the Greater Buffalo Athletic Corporation to support amateur athletic programs, erect facilities for the use of such athletes, and to underwrite the cost of sponsoring the World University Games.
United States · United States Congress · 23 June 1992
Open Space Preservation Act of 1992 - Amends the Internal Revenue Code to exclude from the gross estate tax the value of land subject to a qualified conservation easement (less the amount of any indebtedness secured by such land). Includes in the gross estate tax the value of each development right retained by the donor in the conveyance of the easement. Makes such tax due upon the disposition of the property. Provides that such land subject to the exclusion will have a carryover basis for purposes of determining gain or loss. Excludes from the gift tax transfers by gift of land subject to a conservation easement (other than development rights retained by the donor of such easement). Defers the reduction in certain estate tax rates after 1993 and before 1998.
United States · United States Congress · 23 June 1992
Urban Entrepreneurial Opportunities Act - Amends the Internal Revenue Code to allow a deduction for equity contributions made by a corporation to an urban entrepreneurial opportunity financing subsidiary of such corporation. Requires the subsidiary to use such contribution in making qualified enterprise zone business loans to qualified small business concerns. Establishes an overall program limitation among the contributing corporations to be allocated by the Secretary of Housing and Urban Development.
United States · United States Congress · 9 June 1992
Dire Emergency Supplemental Appropriations Act, 1992, for Disaster Assistance To Meet Urgent Needs Because of Calamities Such as Those Which Occurred in Los Angeles and Chicago - Makes dire supplemental appropriations for FY 1992 for: (1) disaster loans program account and business loans programs account of the Small Business Administration; (2) the Federal Bureau of Investigation of the Department of Justice; (3) the Federal Emergency Management Agency (FEMA) for disaster relief and the disaster assistance direct loan program account; (4) the Employment and Training Administration of the Department of Labor for training and employment services; and (5) salaries and expenses of the Federal Law Enforcement Training Center and salaries and expenses of the Bureau of Alcohol, Tobacco and Firearms of the Department of the Treasury. Rescinds funds made available to the Department of the Treasury for: (1) the United States Customs Service for Air and Marine interdiction programs; (2) salaries and expenses of the United States Mint; (3) salaries and expenses of the Bureau of the Public Debt; and (4) salaries and expenses of the United States Secret Service. Rescinds funds made available to the Executive Office of the President for salaries and expenses of the Office of National Drug Control Policy. Exempts certain funds provided to the Federal Transit Administration and Federal Highway Administration of the Department of Transportation from requirements for any non-Federal share and payback otherwise required. Expresses the sense of the Congress that the President should exercise authority to make emergency designations for rural agricultural disasters, as well as the urban disasters in Chicago and Los Angeles. Expresses the sense of the Senate that the Congress should adopt Federal enterprise zone legislation. Provides for the treatment of funds appropriated to a State for the control of outdoor advertising. Prohibits the use of funds to provide assistance to persons arrested or subject to pending charges for, or convicted of, riot-related crime in the City or County of Los Angeles, California. Makes funds available to provide humanitarian assistance to Bosnia-Hercegovina.
United States · United States Congress · 9 June 1992
Declares that the Congress acknowledges and appreciates the commitment, devotion, and sacrifices of present and former military families. Designates November 23, 1992, as National Military Families Recognition Day.
United States · United States Congress · 4 June 1992
Action Now Health Care Reform Act of 1992 - Title I: Improved Access to Affordable Health Care Coverage - Subtitle A: Increased Affordability and Availability for Employees - Directs the Secretary of Health and Human Services (the Secretary) to request the National Association of Insurance Commissioners (the NAIC) to develop model regulations requiring each carrier that makes available in a State any small employer health benefit plan to make available to each small employer in the State a MedAccess basic plan and a MedAccess standard. Directs the Secretary to develop such regulations, if the NAIC does not. Defines MedAccess plan as a health benefits plan that: (1) provides benefits typical of the benefits offered in the small employer health coverage market or provides only benefits for essential preventive and medical services and has an average actuarial value not exceeding 60 percent of the average actuarial value of the typical benefits offered in the small employer health coverage market; (2) accepts every small employer in the State applying for coverage and accepts for enrollment every eligible individual (defined as an individual who is a full-time employee and, if family coverage is offered, covers the employee's spouse and dependents under age 19 or under age 25 for students); and (3) meets consumer protection standards established by this Act relating to limitation of pre-existing condition clauses, continuity of coverage, renewability, and premium limitations. Prohibits the imposition, by a carrier, of a limitation of benefits based on the fact a condition pre-existed the effectiveness of the policy if: (1) the condition relates to a condition not diagnosed within three months before coverage under the plan; (2) the limitation extends beyond six months after coverage under the plan; (3) the limitation applies to an individual who, as of date of birth, was covered under the plan; and (4) the limitation relates to pregnancy. Requires continuous coverage. Prohibits cancellation of a plan or denial of coverage unless there is: (1) nonpayment of premiums; (2) fraud; (3) noncompliance with plan provisions; (4) failure to maintain the required number of enrollees; (5) misuse of a provider network provision; or (6) a cessation by the carrier of the provision of any plan in a State. Amends the Internal Revenue Code to impose an excise tax which shall be paid by the carrier on the failure of a carrier or an employer health benefit plan to comply with the provisions of the Act. Directs the Secretary to request the NAIC to develop models for reinsurance or allocation of risk mechanisms for individuals and small employers who are enrolled under a small employer health benefit plan that meets the consumer protection standards and for whom a carrier is at risk of incurring high costs under the plan. Requires each State to establish and fund one or more reinsurance or allocation or allocation of risk mechanisms that are consistent with a model. Directs the Secretary to develop models, if the NAIC does not. Permits a State, in order to insure the financial solvency of the mechanism, to impose charges on any entity providing employee-related health benefits, so long as such charges do not discriminate with respect to entities that would not be subject to such charges. Directs the Secretary to establish a reinsurance or allocation of risk mechanism, if a State does not. Imposes an excise tax which shall be paid by the carrier on the providing of any health benefit plan which covers any employee in a Federal reinsurance State. Permits either a State or the Secretary (in a Federal reinsurance State) to require each employer health benefit plan to: (1) be registered; and (2) provide such information as is necessary for the reinsurance or allocation of risk mechanisms. Directs the Secretary to: (1) establish an Office of Private Health Coverage to be headed by a Director appointed by the Secretary; and (2) provide for the appointment of an advisory committee to advise the Director. Permits the Director to research the impact of this subtitle and conduct related demonstration projects. Requires the Director to develop: (1) methods of measuring, in terms of the expected costs of providing benefits under small employer health benefit plans and, in particular, MedAccess plans, the relative health risks of eligible individuals; and (2) a model for equitably distributing health risks among carriers in the small employer health care coverage market. Authorizes appropriations for the purposes of this paragraph. Subtitle B: Improved Small Employer Purchasing Power of Affordable Health Insurance - Preempts from insurance mandates a qualified small employer purchasing group, if the group consists of employers with not more than 100 employees, the group consists of not fewer than 100 employers, and the health benefit plans with respect to the employer members are in compliance with applicable State laws relating to health benefit plans. Subtitle C: Health Deduction Fairness - Amends the Internal Revenue Code to make permanent and increase from 25 to 100 percent the health insurance tax deduction for the self-employed. Subtitle D: Improved Access to Community Health Services - Directs the Secretary to provide for a program of grants to migrant and community health centers receiving grants or contracts under provisions of the Public Health Service Act in order to promote the provision of primary health care services for underserved individuals. Authorizes appropriations. Amends the Public Health Service Act to deem as an employee of the Public Health Service, for purposes of civil actions against commissioned officers or employees, any officer, employee, or contractor who is a physician or other licensed health care practitioner while performing functions for an entity receiving Federal funds under provisions of the Public Health Service Act. Requires an entity, in order to receive a grant under such provisions, to implement certain policies to assure against malpractice. Requires: (1) the Attorney General to estimate the amount of all claims expected, during each year, to arise against such an entity from acts of officers or employees; (2) the Secretary to withhold from grants to such entities the amount estimated; and (3) the withheld amount to be transferred to the Treasury to pay judgments against the United States arising from such claims. Directs the Secretary to make grants to public and nonprofit private entities to carry out demonstration projects for the purpose of increasing access to outpatient primary health services in geographic areas with a: (1) population of not more than 500,000 individuals; (2) shortage of personal health services; and (3) significant number of low-income or underinsured individuals. Sets forth requirements for receiving such grants. Authorizes appropriations. Subtitle E: Improved Access to Rural Health Services - Retitles title XII of the Public Health Service Act "Emergency Medical Services" (formerly, "Trauma Care") and directs the Secretary to establish the Office of Emergency Medical Services which shall, with respect to emergency medical services (including trauma care): (1) conduct research; (2) sponsor workshops; (3) assist States; and (4) coordinate activities. Authorizes the Secretary to make grants to States for the purposes of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services. Sets forth matching fund requirements. Provides for demonstration projects to establish telecommunications between rural medical facilities and other medical facilities that have equipment that can be utilized through telecommunications. Authorizes appropriations for purposes of the programs of this paragraph. Directs the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas access to treatments for the injuries or other conditions arising from such emergencies. Sets forth requirements for grant applications. Authorizes appropriations. Amends title XVIII (Medicare) of the Social Security Act to extend for one year special treatment rules for Medicare-dependent small rural hospitals. Title II: Health Care Cost Containment and Quality Enhancement - Subtitle A: Medical Malpractice Liability Reform - Prohibits bringing a medical malpractice claim: (1) more than two years after the alleged injury should reasonably have been discovered and in no event more than four years after the alleged injury occurred; and (2) in any State court unless there has been an initial resolution through a certified alternative dispute resolution system (ADR). Requires the use of ADR in a Federal medical malpractice liability claim. Requires a pre-trial settlement conference in any medical malpractice liability action. Sets limits on: (1) noneconomic damages; (2) punitive damages; and (3) attorney's fees. Requires offsets for damages paid by a collateral source. Requires liability in a medical malpractice action to be several and not joint. Provides a complete defense to any allegation of negligence in a medical malpractice liability action to any defendant who followed the appropriate practice guideline. Prohibits finding a defendant guilty in a medical malpractice liability action relating to services provided during labor or delivery of a baby if the defendant did not previously treat the plaintiff during the pregnancy, unless the malpractice is proven by clear and convincing evidence. Directs the Secretary to determine whether a States' ADR meets ADR system requirements established by this Act. Establishes such requirements. Amends title XI (General Provisions and Professional Standards Review) of the Social Security Act to earmark funds for sanctioning practice guidelines for purposes of an affirmative defense in medical malpractice liability actions. Permits a State agency responsible for the conduct of disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies for such type of health care practitioner to permit such societies to participate in the licensing of such health care practitioner and to review health care malpractice allegations. Requires each State to require each health care professional and provider to participate in a risk management program to prevent and provide early warning of practices which may result in injuries to patients or which otherwise endanger patient safety. Directs the Secretary to make grants for the conduct of basic research in the prevention of and compensation for injuries resulting from health care professional or health care provider malpractice, and research of the outcomes of health care procedures. Authorizes appropriations. Directs the Secretary to study the factors discouraging physicians from volunteering to provide health care services in medically underserved areas. Subtitle B: Administrative Cost Savings - Directs the Secretary to adopt standards relating to each of the following: (1) data elements for use in claims processing under health benefits plans; (2) uniform claim forms; and (3) uniform electronic transmission of the data elements. Authorizes the Secretary to require providers to submit claims to health benefit plans in accordance with such standards. Provides for periodic review of the standards. States that the term "health benefit plan," in this subtitle, includes the Medicare and Medicaid programs (titles XVIII and XIX of the Social Security Act). Requires the Secretary to promulgate standards for hospitals concerning electronic medical data. Permits the Secretary to promulgate standards concerning electronic medical data for providers that are not hospitals. Requires hospitals, in order to participate in Medicare, to: (1) maintain clinical data in a set of comprehensive data elements in electronic form on all patients; and (2) upon the Secretary's request, transmit electronically the data set and any data from such set. Provides for electronic transmission to Federal agencies. Prohibits a health benefit plan, if standards with respect to data elements are promulgated with respect to a class of provider, from requiring for the purpose of utilization review or as a condition of providing benefits under the plan that a provider in the class: (1) provide any data element not in the set of comprehensive data elements; or (2) transmit or present any such data element in a manner inconsistent with applicable standards. Directs the Secretary to establish an advisory commission of hospital executive and data base managers, physicians, health services researchers, and technical experts in the collection and use of data and operation of data systems. Authorizes appropriations for such commission. Requires the Secretary, in order to assure the availability of comparative value information to purchasers of health care in each State, to determine whether each State is developing and implementing a health care value information program that meets stated criteria. Permits grants to a State for the development of its health care value information program. Authorizes appropriations for such grants. Requires the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to promptly develop health care value information relating to each program that such head administers. Directs the Secretary to develop model systems to facilitate: (1) the gathering of data on health care cost, quality, and outcome; and (2) analyzing such data to permit the valid comparison of such data. Authorizes appropriations for the development of such model systems. Directs the Secretary to adopt standards relating to the design and use of magnetized Medicare identification cards for the purpose of assisting health care providers in determining eligibility and billing. Authorizes appropriations. Nullifies any State law requiring that medical or health insurance records be maintained in written rather than electronic form. Requires each health benefit plan: (1) for each of its beneficiaries that has a social security number, to use that number as an identification number for claims processing; and (2) for each provider that has a unique identifier for Medicare purposes, to use that identifier for claims processing. Requires the Secretary to determine whether problems relating to the rules for determining liability when benefits are payable under two or more plans or the availability of information among such plans causes significant administrative problems, and if so, directs the Secretary to promulgate standards concerning liability and the transfer of information among plans. Directs the Secretary to provide grants to qualified entities to demonstrate the application of comprehensive information systems in continuously monitoring patient care and in improving patient care. Authorizes appropriations from the Federal Hospital Insurance Trust Fund. Subtitle C: Medical Savings Accounts (Medisave) - Amends the Internal Revenue Code to exclude from the gross income of an employee any amount contributed by the employer to a medical savings account pursuant to a qualified medical savings account plan. Sets contribution limits. Defines a "medical savings account" as a trust created exclusively for purpose of paying an individual's medical expenses. Permits expenses from such account only to the extent such amounts are not compensated for by insurance. Subjects the employee to taxation as owner of the account. Subtitle D: Medicaid Program Flexibility - Amends title XIX (Medicaid) of the Social Security Act to modify Medicaid contracting requirements for coordinated care services. Authorizes the Secretary to waive specified Medicaid requirements with respect to nursing facilities located in a State if the State provides assurances satisfactory to the Secretary that the waiver of such requirements will not adversely affect the quality of life of the residents in such facilities. Subtitle E: Limitations on Physician Self-Referrals - Amends title XVIII (Medicare) of the Social Security Act to extend physician self-referral limitations to all payors as well as to certain additional services. Revises exceptions. Requires the Secretary to conduct a study in order to estimate the changes in aggregate costs for designated health services, under the Medicare program and other health plans, which will result from the implementation of the amendments made by this subtitle. Subtitle F: Removing Restrictions on Managed Care - Preempts managed care restrictions under State law. Requires the Comptroller General to conduct a study of the benefits and cost effectiveness of the use of managed care in the delivery of health services. Subtitle G: Medicare Payment Changes - Amends the Medicare program to make revisions in the methodology for determining updates to Medicare hospital payments. Provides for a reduction in Medicare payment for clinical diagnostic laboratory tests. Subtitle H: Modification of the Operation of the Antitrust Laws to Hospitals - Permits two or more hospitals, without violating the antitrust laws, to share expensive medical services or high technology equipment. Directs the Secretary to grant waivers to exempt hospitals from the antitrust laws in order to carry out agreements permitting such sharing. Sets forth reporting requirements. Subtitle I: Encouraging Enforcement Activities of Medical Self-Regulatory Entities - Prohibits damages, interest on damages, costs, or attorney's fees from being recovered under the Clayton Act or any similar State law from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities designed to promote the quality of health care provided to patients.
United States · United States Congress · 21 May 1992
Designates February 21 through 27, 1993, as American Wine Appreciation Week. Commends the winegrape and fruit growers and vintners of the United States for the production of high quality agricultural products.
United States · United States Congress · 20 May 1992
National Triad Program Act - Requires the Director of the National Institute of Justice to conduct a national assessment of: (1) the nature and extent of crimes against the elderly; (2) the needs of law enforcement, health, and social service organziations, in working to prevent, identify, investigate, and provide assistance to victims of such crimes; and (3) promising strategies to respond effectively to those challenges. Specifies that such assessment shall address: (1) the analysis and synthesis of data from a range of sources; (2) the problems of elderly who are living alone or in high crime areas and who are abused and neglected, and the fear of victimization; (3) the identification of strategies and techniques tht have been shown to be effective or which show promise; (4) the analysis of the factors that enhance or inhibit development of a coordinated response by law enforcement, health care, and social service providers; and (5) the research agenda needed to develop a comprehensive understanding of the problems of crimes against the elderly. Requires the Director to disseminate the results of such assessment. Authorizes the Director to make awards to coalitions of local law enforcement agencies, victim service providers, and organizations representing the elderly for pilot programs and field tests of promising strategies and models for forging partnerships for crime prevention and service provision. Specifies that pilot programs funded under this Act may include existing general service coalitions of law enforcement, victim service, and elder advocate organizations that wish to use additional funds to work at a particular problem in their community or to target a particular geographic area in need of intensive services. Authorizes the Director to make awards to: (1) coalitions of national law enforcement, victim service, and elder advocate organizations for training and technical assistance in implementing pilot programs; (2) research organizations to investigate the types of elder victimization shown by the assessment to present particularly critical problems or to be emerging crimes about which little is known, to evaluate the effectiveness of selected pilot programs, and to conduct research and development identified as being critical; and (3) public service advertising coalitions to increase public awareness of, and promote ideas or programs to prevent, crimes against the elderly. Authorizes appropriations.
![Official portrait of Rep. McDade, Joseph M. [R-PA-10]](https://www.congress.gov/img/member/m000399_200.jpg)