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Official portrait of Rep. Nussle, Jim [R-IA-2]

Rep. Nussle, Jim [R-IA-2]

United States · Official source

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1,003 records where Rep. Nussle, Jim [R-IA-2] is listed as a sponsor, author, or other actor. Search with topics and years

Bill· HRH.R. 3642 (103rd)referred

Commercial Mortgage Capital Availability Act of 1993

United States · United States Congress · 22 November 1993

Commercial Mortgage Capital Availability Act of 1993 - Sets forth a regulatory scheme under which qualified insured depository institutions meeting prescribed reserve and capital requirements may execute mortgage loan transfers with a recourse arrangement. Amends the Securities Exchange Act of 1934 to modify the definition of "mortgage related security" to include notes directly secured by a first lien on real estate with commercial structures located upon it (thus bringing such securities within the purview of the Act). Directs the Secretary of Labor to exempt commercial mortgage related securities transactions from: (1) certain restrictions of the Employee Retirement Income Security Act of 1974; and (2) certain taxes imposed under the Internal Revenue Code. Mandates that securities relying on the provisions of this Act comply with all Federal securities laws relating to disclosure to investors, registrations, reporting and anti-fraud provisions. Requires insured depository institutions to maintain the minimum adequate capital prescribed by regulatory banking agencies when executing mortgage backed securities transactions.

Bill· HRH.R. 3486 (103rd)open

Health Care Antitrust Improvements Act of 1993

United States · United States Congress · 10 November 1993

Health Care Antitrust Improvements Act of 1993 - Exempts from the antitrust laws specified "safe harbor" activities listed in, or designated by the Attorney General pursuant to, this Act. Sets forth provisions regarding the award of attorney's fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt. Lists as safe harbors specified: (1) activities relating to health care services of combinations of health care providers with market share below a specified threshold; (2) activities of medical self-regulatory entities relating to standard setting or enforcement activities not conducted for purposes of financial gain; (3) participation of a health care provider in a written survey of the prices of services, reimbursement levels, or the compensation and benefits of employees and personnel; (4) activities relating to health care joint ventures for high technology and costly equipment and services; (5) activities relating to hospital mergers; (6) joint purchasing arrangements; and (7) negotiations. Directs the Attorney General to publish a notice in the Federal Register soliciting proposals for additional safe harbors. Sets forth criteria in establishing safe harbors, including: (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates. Sets forth procedures regarding applications for, revocation of, and review of determinations regarding, such certificates. Limits the disclosure of information. Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. Directs the Attorney General to periodically review the safe harbors and certificates of review. Establishes within the Department of Health and Human Services an Office of Health Care Competition Policy.

Bill· HRH.R. 3500 (103rd)referred

Responsibility and Empowerment Support Program Providing Employment, Child Care, and Training Act

United States · United States Congress · 10 November 1993

TABLE OF CONTENTS: Title I: AFDC Transition and Work Program Title II: Paternity Establishment Title III: Expansion of Statutory Flexibility of States Title IV: Expansion of State and Local Flexibility Title V: Child Support Enforcement Title VI: Welfare Restrictions for Aliens Title VII: Controlling Welfare Costs Title VIII: Consolidated Block Grant to States for Food Assistance Title IX: Miscellaneous Responsibility and Empowerment Support Program Providing Employment, Child Care, and Training Act - Title I: AFDC Transition and Work Program - Amends part F (Job Opportunities and Basic Skills Training Program) (JOBS) of title IV of the Social Security Act (SSA) to give the JOBS program the new purpose of assuring that needy families with children obtain not only the education and training needed to prepare them for a life without welfare, but the work experience as well. (Sec. 101) Requires State JOBS programs to include a transition component and a work supplementation component that: (1) are each allowed to include any State work experience program approved by the Secretary; and (2) with respect to the first component, must include the State's job search program, and, with respect to the second component, may include the State's work supplementation or community work experience program. Amends part A (Aid to Families with Dependent Children) (AFDC) of SSA title IV to revise State AFDC plan participation requirements to incorporate participation in the two JOBS program components above under specified guidelines as a requirement for qualified individuals to receive AFDC. Imposes sanctions for a qualified individual's failure to participate in the JOBS program as required under such guidelines, which include a reduction in AFDC benefits and eventual benefit termination for repeated failures. Revises the exemptions from JOBS program participation requirements. Extends to all States the option to limit AFDC-UP. Increases State JOBS program and work program participation rates with regard to, respectively, AFDC-eligible individuals and unemployed parents. Provides for additional payments to States for JOBS programs. (Sec. 102) Amends community work experience and work supplementation program provisions. Title II: Paternity Establishment - Amends SSA title IV part A to: (1) provide for denial or reduction of AFDC for children whose paternity is not established; and (2) require unmarried individuals under 19 who are eligible for AFDC and are pregnant or with dependent children under their care to reside at home in order to receive AFDC. (Sec. 203) Amends SSA title IV part D (Child Support and Establishment of Paternity) to require earlier specified paternity establishment efforts by States. Expresses the encouragement of the Congress for States to develop procedures in public hospitals and clinics to facilitate the acknowledgment of paternity. (Sec. 204) Increases the paternity establishment percentage. Title III: Expansion of Statutory Flexibility of States - Amends SSA title IV part A to give States the option to: (1) convert AFDC into a block grant program; (2) exempt themselves from otherwise mandatory denial of AFDC where either parent is a minor; (3) treat families moving interstate who apply for AFDC in their new State of residence (where they have resided for less than on year) under the AFDC rules of their former State of residence; (4) reduce AFDC for parents under 21 who have dropped out of school and dependent children who, without good cause, do not maintain minimum school attendance; (5) exempt themselves from otherwise mandatory denial of AFDC for additional children; (6) modify certain AFDC income disregard rules; (7) provide for a married couple transitional benefit in cases where an AFDC recipient marries an individual who is not a parent of the recipient's child, and the resulting family would become ineligible for AFDC by reason of the marriage; (8) disregard certain savings and income of a family on AFDC designated for education, training, employability, home purchase, or residence change in determining eligibility for AFDC; and (9) condition the receipt of AFDC on the recipient's attendance at parenting and money management classes and prior approval of any action requiring a change in the educational institution attended by the recipient's dependent child. Title IV: Expansion of State and Local Flexibility -Establishes an Interagency Waiver Request Board in order to provide a focal point within the Federal Government for the development and coordination of waiver requests to improve opportunities for low-income individuals and families. (Sec. 402) Prescribes contents of applications to implement Federal assistance plans, as well as the review, approval, implementation, and evaluation processes. (Sec. 405) Requires any entity applying for plan approval to establish a Public Private Partnership Committee to advise it on plan development and implementation. Title V: Child Support Enforcement - Provides for a national system for employee reporting of any child support owed, the obligee involved, and other specified related information on W-4 forms for employer withholding and distribution of support owed, and reporting of related information to the State involved for availability to other States through the Interstate Locate Network established under this title. (Sec. 502) Makes various changes with regard to State child support order registries, the Parent Locater Service, regulations for sharing child support information, withholding orders, and noncustodial parents with child support arrearages who are receiving certain public welfare assistance. Title VI: Welfare Restrictions for Aliens - Makes aliens (except refugees, permanent residents, and certain current residents) ineligible for various specified types of public welfare assistance, including non-emergency related assistance under Medicaid, food stamps, and job training assistance. (Sec. 602) Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act (SSA) to require State AFDC agencies to provide information on illegal aliens to the Immigration and Naturalization Service. Title VII: Controlling Welfare Costs - Amends the Congressional Budget Act of 1974, the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act), and other Federal law to establish various specified measures for controlling welfare costs, including Federal spending caps. Title VIII: Consolidated Block Grant to States for Food Assistance - Repeals the Food Stamp Act of 1977, National School Lunch Act, Commodity Distribution Reform Act and WIC Amendments of 1987, and other specified Federal laws and replaces them with a: (1) State food assistance block grant program to provide food assistance to economically disadvantaged individuals and families (eligible populations); and (2) new food coupon program. Authorizes appropriations. (Sec. 803) Grants the Secretary of Agriculture and the Commodity Credit Corporation the authority to sell surplus commodities and foodstuffs to the States to provide food assistance to eligible populations. Title IX: Miscellaneous - Amends SSA title IV part A to require AFDC applicants and recipients to undergo any necessary substance abuse treatment as a condition of receiving AFDC. (Sec. 902) Amends SSA title XVI (Supplemental Security Income) (SSI) to: (1) make ineligible for SSI benefits individuals receiving SSI on the basis of a disability resulting from illegal drug addiction who continue to use illegal drugs or refuse to be tested for them; and (2) make representative payee changes. (Sec. 903) Directs the Secretary of Health and Human Services to: (1) conduct research projects to evaluate the impact of education and training programs on the ability of individuals to end participation in the AFDC program; (2) conduct demonstration projects and report to the Congress on whether providing benefits based on need through the use of electronic cards and automatic teller machines would reduce administrative costs and fraud; and (3) establish a commission to determine the cost and feasibility of creating an interstate system to compare the social security numbers of all AFDC recipients in order to identify those recipients receiving AFDC from multiple States. (Sec. 904) Amends SSA to require State AFDC applicants to participate in job search activities while the application is pending, unless a State by law exempts itself from this requirement. (Sec. 906) Public Housing Rent Reform and Empowerment Act - Amends the United States Housing Act of 1937 with regard to the determination of income and rent charges. Authorizes the Secretary of Housing and Urban Development to allow, upon request, under certain circumstances, a public housing agency or resident management corporation to carry out a demonstration program to determine the feasibility and desirability of providing such entities with the authority to establish policies for agency-administered public housing projects, without regard to the public housing requirements of the United States Housing Act of 1937. (Sec. 907) Amends SSA title IV part A to deny AFDC for certain children who have not received appropriate medical examinations and immunizations. Amends the Child Care and Development Block Grant Act with regard to childhood immunizations. Requires the Surgeon General to issue and periodically revise recommendations for the immunization of children under age six.

Bill· HRH.R. 3445 (103rd)referred

Hazard Mitigation and Flood Damage Reduction Act of 1993

United States · United States Congress · 4 November 1993

Hazard Mitigation and Flood Damage Reduction Act of 1993 - Amends the Robert T. Stafford Disaster Relief and Emergency Assistance Act to increase from 50 to 75 percent of the cost of hazard mitigation measures the amount authorized to be contributed by the President when determined to be cost-effective while substantially reducing the damage or loss suffered in a major disaster. Increases the total Federal contributions authorized for damages from a major disaster to 15 percent of the estimated aggregate amounts of grants to be provided under such Act for such disaster. Authorizes the Director of the Federal Emergency Management Agency to provide property acquisition and relocation assistance for projects meeting specified requirements. Directs the Secretary of the Army to conduct studies to: (1) assess national flood control and floodplain management policies; and (2) determine appropriate flood control measures on the Upper Mississippi and Lower Missouri rivers and their tributaries. Requires congressional reports after both studies.

Bill· HRH.R. 3394 (103rd)open

To amend title 5, United States Code, to require disclosure of information by the Congress.

United States · United States Congress · 27 October 1993

Applies the Freedom of Information Act to the legislative branch. Establishes the Disclosure Review Board in the legislative branch to decide complaints relating to disclosure of information withheld by a legislative agency. Requires Board members to be appointed by the Speaker and minority leader of the House of Representatives and the minority and majority leaders of the Senate from among Federal retired administrative law judges. Authorizes a Board member to assess reasonable attorney's fees and other litigation costs incurred in any case in which the complainant substantially prevails under this Act against the United States. Requires the Board to designate one of its members to serve a one-year term as the Complaint Referral Officer. Requires such officer to appoint individuals to serve as Investigation Counsels to investigate and determine unresolved complaints received alleging failure by the legislative agency to make material available as required by this Act and to determine whether there is reasonable cause to believe that any such complaint is true. Requires the Investigation Counsel to meet U.S. magistrate qualifications.

Bill· HRH.R. 3392 (103rd)open

Safe Drinking Water Act Amendments of 1994

United States · United States Congress · 27 October 1993

Safe Drinking Water Act Amendments of 1993 - Amends the Safe Drinking Water Act to require the Administrator of the Environmental Protection Agency, in the case of specified contaminants listed in the Federal Register for which national primary drinking water regulations have not been promulgated, to: (1) publish maximum contaminant level goals and promulgate such regulations for those contaminants that occur in drinking water and are of public health concern; and (2) eliminate monitoring, compliance, and enforcement requirements for those contaminants that do not occur in drinking water at levels of public health concern. (Current law requires the promulgation of such goals and regulations for specified numbers of such contaminants by certain dates.) Directs the Administrator to promulgate such goals and regulations for new contaminants every five years. Requires the Administrator to establish in each national primary drinking water regulation best technology treatment techniques for public water systems serving fewer than 1,000, between 1,000 and 10,000, and more than 10,000 people, respectively. Directs the Administrator to promulgate national primary drinking water regulations for radionuclides, disinfection and corrosion byproducts, and sulfate. Revises provisions concerning variances from national drinking water regulations to permit the issuance of a variance by a State only if the water system cannot afford to install the best available technology to meet the maximum contaminant level and it is not feasible for the system to connect with another source of water that will meet the standards. Requires variances to be reviewed by the State at least every three years. Repeals provisions that authorize States to exempt public water systems from requirements respecting maximum contaminant levels or treatment techniques. Prohibits treated drinking water from being removed from a public water system or routed through any device or pipes outside the system and returned to the system. Includes such action in the definition of "tampering," a violation for which criminal penalties are imposed. Makes such prohibition inapplicable to pipes and devices totally within the control of one or more public water systems or to connections between water mains. Requires (currently, authorizes) the Administrator to conduct research relating to diseases and other impairments resulting from contaminants in drinking water or to the provision of a safe supply of drinking water. Authorizes appropriations. Extends the authorization of appropriations for grants for State public water system supervision programs. Requires the Administrator to promulgate revised regulations every five years that list up to 30 unregulated contaminants to be monitored by public water systems. Directs the Administrator to assemble a national drinking water occurrence data base to include information on the occurrence of regulated and unregulated contaminants.

Bill· HRH.R. 3328 (103rd)referred

To prohibit the United States Postal Service from expending any further funds in connection with instituting a new logo until such time as its operations are no longer being conducted at an annual loss.

United States · United States Congress · 21 October 1993

Prohibits the U.S. Postal Service from expending, in any year, any amounts in connection with instituting a new logo if its total obligations and expenditures incurred in the previous year exceeded its total revenues.

Resolution· HRESH.Res. 281 (103rd)open

Respecting child pornography.

United States · United States Congress · 20 October 1993

Expresses the sense of the House of Representatives that the Department of Justice should repudiate its reinterpretation of Federal child pornography laws, defend the conviction won in lower courts in Knox v. United States, and vigorously prosecute sexual exploitation of children.

Bill· HRH.R. 3288 (103rd)referred

Public Accommodations Exception Act of 1993

United States · United States Congress · 14 October 1993

Public Accommodations Exception Act of 1993 - Exempts from consideration as copyright infringement communication of a transmission by radio or television embodying a performance or display of a work by the public reception of the transmission on a receiving or recording apparatus in a restaurant, tavern, or other commercial establishment serving food or drink, the performance of which is incidental to the main purpose of such establishment, unless a direct charge is made to see or hear the transmission.

Bill· HRH.R. 3222 (103rd)open

Managed Competition Act of 1993

United States · United States Congress · 6 October 1993

TABLE OF CONTENTS: Title I: Managed Competition in Employer-Based Health Plans: Incentives to Control Costs Subtitle A: Use of Tax Incentives to Purchase Cost-Effective Plans Subtitle B: Health Plan Purchasing Cooperatives (HPPCs) Subtitle C: Accountable Health Plans (AHPs) Subtitle D: Health Care Standards Commission Subtitle E: Managed Competition in Rural and Urban Underserved Areas Subtitle F: Treatment of Chronically Underserved Areas Subtitle G: Repeal of COBRA Continuation Requirements Subtitle H: Definitions Title II: Low-Income Assistance for Health Coverage Subtitle A: Low-Income Assistance Subtitle B: Long-Term Care Phase-Down Assistance to States Subtitle C: Financing Subtitle D: Repeal of Medicaid Program Title III: Training and Education of Health Care Professionals Subtitle A: Reform of Federal Funding for Medical Residency Training Subtitle B: Other Medical Education Grants and Programs Title IV: Preventive Health and Individual Responsibility Subtitle A: Expansion of Public Health Programs Subtitle B: Medicare Title V: Malpractice Reform Subtitle A: Findings; Purpose; Definitions Subtitle B: Uniform Standards for Malpractice Claims Subtitle C: Requirements for State Alternative Dispute Resolution Systems (ADR) Subtitle D: Grants to States for Development of Practice Guidelines Title VI: Paperwork Reduction and Administrative Simplification Title VII: Additional Benefits On a Pay-As-You-Go Basis Managed Competition Act of 1993 - Title I: Managed Competition in Employer-Based Health Plans: Incentives to Control Costs - Subtitle A: Use of Tax Incentives to Purchase Cost-Effective Plans - Amends the Internal Revenue Code to impose a tax on the excess health plan expenses of any employer which are health plan expenses exceeding specific limits under an accountable health plan for a defined geographical area. (Sec. 1002) Increases to 100 percent and makes permanent the deduction for health plan premium expenses of self-employed individuals. (Sec. 1003) Permits the deduction for medical, dental, etc. expenses without regard to the limitation on such deduction with respect to amounts paid for premiums under an accountable health plan. (Sec. 1004) Provides for the exclusion from gross income of contributions by a partnership or S corporation to a health plan covering partners or shareholders. (Sec. 1006) Eliminates the commonality of interest and geographic location requirements with respect to group purchasing by large tax-exempt organizations. Subtitle B: Health Plan Purchasing Cooperatives (HPPCs) - Provides for the establishment of Health Plan Purchasing Cooperatives (HPPCs). Considers each State to be a HPPC, except that a State may subdivide into HPPC areas, and that there may be interstate HPPCs, as specified. Requires HPPCs to enter into agreements with accountable health plans and small employers, offer enrollment in accountable health plans, and charge premiums. Subtitle C: Accountable Health Plans (AHPs) - Directs the Health Care Standards Commission to provide a process whereby a health plan may be registered with the Commission by its sponsor as an accountable health plan. Sets forth requirements for a plan to be registered, including: (1) coverage for a specified uniform set of benefits, including cost-sharing for low-income individuals; (2) standard premiums for the uniform benefits; (3) grievance procedures; (4) collecting and providing specified information; (5) prohibiting discrimination in enrollment or benefits; and (6) financial solvency. (Sec. 1208) Sets forth additional requirements for open AHPs, which is any plan which is not closed. Defines a closed plan as one limited by structure or law to one or more large employers. (Sec. 1211) Requires each AHP to provide for payment of one percent of gross premium receipts to the National Medical Education Fund. (Sec. 1221) Sets forth provisions concerning the preemption of State laws for AHPs. (Sec. 1231) Directs the President to provide for the development and publication of guidelines on the application of Federal antitrust laws to AHPs. (Sec. 1232) Provides for the issuance of certificates of public advantage by the Attorney General to eligible health care joint ventures which, if followed, exempt such ventures from antitrust liability. Subtitle D: Health Care Standards Commission - Establishes, as an independent agency in the Executive Branch, a Health Care Standards Commission. Requires the Commission to transmit annually to the Congress recommendations for the uniform set of effective benefits. States that such recommendations shall apply unless the Congress passes a joint resolution of disapproval. (Sec. 1303) Directs the Commission to provide for the initial organization, as a nonprofit corporation, of the Benefits, Evaluations, and Data Standards Board in order to make recommendations to the Commission concerning the uniform set of effective benefits and matters related to the evaluation of health care services. (Sec. 1304) Directs the Commission to provide for the initial organization, as a nonprofit organization of the Health Plan Standards Board in order to make recommendations to the Commission concerning the standards for AHPs and concerning its assessment of risk-adjustment factors. (Sec. 1305) Sets forth provisions concerning the registration of AHPs. (Sec. 1306) Directs the Commission to establish rules for the process of risk-adjustment of premiums among AHPs by HPPCs. (Sec. 1307) Directs the Commission to publish information concerning procedures, their prices, and their quality. (Sec. 1309) Establishes, within the Department of Health and Human Services, the Agency for Clinical Evaluations which shall assume the responsibilities of the Director of the Office of Medical Applications of Research at the National Institutes of Health, the Director of the Office of Research and Demonstrations of the Health Care Financing Administration (insofar as such responsibilities relate to clinical evaluations), the Administrator for Health Care Policy and Research under title IX of the Public Health Service Act, as well as other specified responsibilities. Authorizes appropriations. (Sec. 1311) Prohibits the Commission from establishing or enforcing any controls on health care spending. (Sec. 1313) Authorizes appropriations for the Commission through FY 2000. Terminates the Commission on December 31, 1999. Subtitle E: Managed Competition in Rural and Urban Underserved Areas - Authorizes the Governor of any State to designate rural and urban areas of a State as underserved areas. Permits a HPPC serving such an area to require AHPs offered by the HPPC and with a service area adjoining such area to include the area as part of their service area. (Sec. 1411) Authorizes appropriations for: (1) technical assistance for entities seeking to establish a network plan in an underserved area; (2) financial assistance to eligible entities in order to provide for the development and implementation of AHPs in rural areas; and (3) under the Public Health Service Act, migrant health centers and community health centers. (Sec. 1422) Provides coverage under part B of title XVIII (Medicare) of the Social Security Act for rural emergency access care hospital services. (Sec. 1431) Directs the Secretary of Health and Human Services to make payments for transitional assistance to eligible hospitals. Requires any hospital accepting such assistance to provide a significant volume of services to persons unable to pay for services. Authorizes appropriations. Subtitle F: Treatment of Chronically Underserved Areas - Directs the Health Care Standards Commission to develop standards for the identification of chronically underserved areas. Makes provisions for addressing health care delivery in such areas. Subtitle G: Repeal of COBRA Continuation Requirements - Repeals the COBRA continuation requirements for group health plans and title XXII of the Public Health Service Act. Subtitle H: Definitions - Sets forth definitions for this title and title II. Title II: Low-Income Assistance for Health Coverage - Subtitle A: Low-Income Assistance - Provides premium assistance for very-low income individuals and moderately low-income individuals. Provides for nominal cost-sharing for such individuals and special assistance for certain items and services. Subtitle B: Long-Term Care Phase-Down Assistance to States - Provides for long-term care phase-down assistance to eligible States for each calendar quarter in 1995 through 1998. Subtitle C: Financing - Amends title XVIII (Medicare) of the Social Security Act to achieve savings under such program by: (1) reducing the update for inpatient hospital services; (2) reducing the conversion factor for the physician fee schedule for non-primary care services; and (3) reducing hospital outpatient services through establishing a prospective payment system. (Sec. 2204) Amends the Internal Revenue Code to impose a Medicare part B premium tax on higher-income individuals. (Sec. 2205) Achieves additional Medicare savings through the: (1) phased-in elimination of Medicare disproportionate share adjustment payments; (2) reduction of routine cost limits for home health services; (3) reduction in routine cost limits for extended care services; and (4) reductions in payments for hospice services. Subtitle D: Repeal of Medicaid Program - Repeals title XIX (Medicaid) of the Social Security Act. Title III: Training and Education of Health Care Professionals - Subtitle A: Reform of Federal Funding for Medical Residency Training - Directs the Health Care Standards Commission to approve a resident training position in medical residency program for purposes of funding approved medical residency training programs under this title. Provides funding, in addition, for physician retraining. Sets forth provisions concerning: (1) the allocation of entry positions among programs; and (2) the general distribution of positions among specialties. (Sec. 3004) Requires payment by AHPs of one percent of gross premium receipts to the National Medical Education Fund. Requires payments from the Medicare trust funds to the National Medical Education Fund. (Sec. 3005) Establishes the National Medical Education Fund. Subtitle B: Other Medical Education Grants and Programs - Authorizes appropriations under the Public Health Service Act for medical education programs, including: (1) the scholarship and loan repayment programs of the National Health Service Corps; (2) area education centers; (3) public health and preventive medicine; (4) family medicine; (5) general internal medicine and pediatrics; (6) physician assistants; (7) allied health projects grants and contracts; and (8) nurse practitioner and nurse midwife programs. Title IV: Preventive Health and Individual Responsibility - Subtitle A: Expansion of Public Health Programs - Authorizes appropriations under the Public Health Service Act for the following public health programs: (1) immunizations against vaccine-preventable diseases; (2) prevention, control, and elimination of tuberculosis; (3) lead poisoning prevention; (4) preventive health measures with respect to breast and cervical cancers; (5) the Office of Disease Prevention and Health Promotion; (6) the Office of Minority Health; (7) preventive health and health services block grant; (8) categorical grants for early intervention regarding acquired immune deficiency syndrome; and (9) programs of the Centers for Disease Control regarding the smoking of tobacco products. Directs the Office of Disease Prevention and Health Promotion to promote individual responsibility in personal health care and in the use of valuable health care resources. Subtitle B: Medicare - Provides Medicare coverage for: (1) screening fecal-occult blood tests and screening flexible sigmoidoscopies for the purpose of the early detection of cancer; (2) tetanus-diphtheria boosters; (3) well-child services; and (4) an annual screening mammography for women over age 64. Title V: Malpractice Reform - Subtitle A: Findings; Purpose; Definitions - Sets forth the findings, purpose, and definitions for this title. Subtitle B: Uniform Standards for Malpractice Claims - Prohibits bringing a medical malpractice liability action in a State court unless there has been an initial resolution under an alternative dispute resolution system. Limits the total noneconomic damages in such actions to $250,000. Sets limits on attorney's fees. Makes special provision for obstetric services. Subtitle C: Requirements for State Alternative Dispute Resolution Systems (ADR) - Establishes requirements for State alternative dispute resolution systems. Provides for grants to States to assist in implementation of such systems. Subtitle D: Grants to States for Development of Practice Guidelines - Directs the Secretary to make grants to States for the development of medical practice guidelines for health care professionals that may be applied to resolve medical malpractice liability claims. Title VI: Paperwork Reduction and Administrative Simplification - Preempts State quill pen laws. Ensures the confidential treatment of electronic health care information. Sets forth provisions which provide for: (1) the standardization of electronic health information; (2) uniform claims forms; (3) the liability of insurers when benefits are payable under two or more plans; and (4) the uniformity of the availability of information among health plans when benefits are payable under two or more plans. (Sec. 6007) Amends the Internal Revenue Code to impose a tax on a health plan not in compliance with specified requirements of this title. Title VII: Additional Benefits On a Pay-As-You-Go Basis - Expresses the sense of the Congress that additional benefits should be provided by the Federal Government to the extent that additional financing is made available on a pay-as-you-go basis.

Bill· HRH.R. 3099 (103rd)referred

Federal Workforce Reduction and Realignment Commission Act

United States · United States Congress · 21 September 1993

Federal Workforce Reduction and Realignment Commission Act - Establishes an independent Federal Workforce Reduction and Realignment Commission to develop and submit to the President and the Congress recommendations for reducing the number of Federal employees nationwide in non-defense-related agencies by 250,000.

Bill· HRH.R. 3080 (103rd)open

Affordable Health Care Now Act of 1993

United States · United States Congress · 15 September 1993

TABLE OF CONTENTS: Title I: Improved Access to Affordable Health Care Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families Subtitle B: Reform of Health Insurance Marketplace for Small Business Subtitle C: Preemption Subtitle D: Health Deduction Fairness Subtitle E: Improved Access to Community Health Services Subtitle F: Improved Access to Rural Health Services Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program Title II: Health Care Cost Containment and Quality Enhancement Subtitle A: Medical Malpractice Liability Reform Subtitle B: Administrative Cost Savings Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Accounts Subtitle D: Anti-Fraud Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals Subtitle F: Removing Anti-Trust Impediments Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities Subtitle H: Prefunding Government Health Benefits for Certain Annuitants Subtitle I: Miscellaneous Provisions Title III: Long-Term Care Subtitle A: Tax Treatment of Long-Term Care Insurance Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance Subtitle C: Studies Subtitle D: Volunteer Service Credit Demonstration Projects Affordable Health Care Now Act of 1993 - Title I: Improved Access to Affordable Health Care - Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families - Part 1: Required Coverage Options for Eligible Employees, Spouses, and Dependents - Requires each employer to make available to each eligible employee a group health plan under which: (1) coverage of each eligible individual with respect to such employee may be elected on an annual basis; (2) coverage is provided for at least the required coverage specified; and (3) employees may elect to have premiums collected through payroll deduction. Does not require employer contributions to the cost of coverage under such a plan. Provides for the exclusion of: (1) employers who have been employers for less than two years or who have no more than two eligible employees or no more than two eligible employees not covered under any group health plan; and (2) family members under specified circumstances. Specifies that a group health plan shall not be treated as failing to meet the requirements of this Act solely because a period of service by an eligible employee of not more than 60 days is required for coverage. Specifies that the required coverage is standard coverage, except that in the case of a small employer that has not contributed during the previous plan year to the cost of coverage for any eligible employee under any group health plan, the required coverage for the plan year is coverage under a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan. Provides for a five-year transition for existing group health plans. (Sec. 1002) Sets forth provisions regarding: (1) compliance with applicable requirements through multiple employer health arrangements; and (2) coverage options under a State medical health allowance program. Part 2: Preexisting Conditions and Continuity of Coverage; Renewability - Prohibits a group health plan from imposing (and an insurer from requiring an employer from imposing through a waiting period for coverage under a plan or similar requirement) a limitation or exclusion of benefits relating to treatment of a preexisting condition if: (1) the condition relates to a condition that was not diagnosed or treated within three months before the date of coverage under the plan; or (2) the limitation or exclusion extends over more than six month after the date of coverage, applies to an individual who, as of the date of birth, was covered under the plan, or relates to pregnancy. Specifies that, in the case of an individual who is eligible for coverage under a plan but for a waiting period imposed by the employer, the individual shall be treated as having been covered under the plan as of the earliest date of the beginning of the waiting period. (Sec. 1012) Requires each group health plan to waive any period applicable to a preexisting condition for similar benefits with respect to an individual to the extent that the individual, prior to enrollment in such plan, was covered for the condition under any other health plan. (Sec. 1013) Prohibits: (1) a multiemployer plan and an exempted multiple employer health plan from canceling or denying renewal of coverage under such a plan for an employer other than for nonpayment of contributions, fraud or other misrepresentation, noncompliance with plan provisions, or misuse of a provider network provision, or because the plan is ceasing to provide any coverage in a geographic area; (2) an insurer from canceling a health insurance plan or denying renewal of coverage other than as prescribed above; and (3) an insurer who terminates the offering of health insurance plans in an area from offering such a plan to any employer in the area until five years after the date of the termination. Part 3: Enforcement; Effective Dates; Definitions - Makes provisions of the Employee Retirement Income Security Act of 1974 applicable with respect to enforcement of this Act (by the Department of Labor). Amends the Internal Revenue Code (Code) to impose a tax ($100 per day for each individual involved, subject to specified limitations) on the failure of an insurer to comply with the requirements under part 2 unless the Secretary of Health and Human Services (Secretary) determines that the State has in effect a regulatory enforcement mechanism that provides adequate sanctions. Subtitle B: Reform of Health Insurance Marketplace for Small Business - Requires each insurer that makes available a health insurance plan to a small employer in a State to make available to each small employer in the State a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan, with exceptions for health maintenance organizations (HMOs) and if a State provides for guaranteed availability (rather than guaranteed issue). Requires each insurer that offers a MedAccess plan to a small employer in a State to accept: (1) every small employer in the State that applies for coverage; and (2) every eligible individual who applies for enrollment on a timely basis. Sets forth provision regarding: (1) special rules for HMOs; (2) timely enrollment requirements; and (3) enrollment of spouses and dependents. Makes such requirements inapplicable in a State that has provided (in accordance with specified standards) a mechanism under which each insurer offering a health insurance plan to a small employer in the State must participate in a program for assigning high-risk small employer groups (or individuals within such a group) among some or all such insurers, if the insurers comply. (Sec. 1102) Defines "MedAccess plan" as a health insurance plan that: (1) is designed to provide standard coverage with substantial cost-sharing, only catastrophic coverage, or medisave coverage; (2) includes only essential and medically necessary services; (3) meets applicable requirements relating to guaranteed issue; and (4) meets specifies consumer protection standards. Defines "MedAccess standard plan," "MedAccess catastrophic plan," and "MedAccess medisave plan" to mean a MedAccess plan that provides for at least standard coverage, for only catastrophic coverage, or medisave coverage, respectively. Requests the National Association of Insurance Commissioners (NAIC) to submit to the Secretary a set of rules which NAIC determines is sufficient for determining, in the case of any health insurance plan and for purposes of this subtitle, the actuarial value of the coverage offered by the plan. Directs the Secretary to certify such set of rules for use under this subtitle if they meet such requirements or establish such a set of rules. Specifies that a health insurance plan is considered to provide: (1) standard coverage if the benefits are determined, in accordance with certified rules of actuarial equivalence, to have a value that is within five percentage points of an established target actuarial value for standard coverage; (2) catastrophic coverage if benefits are available under the plan for a year only to the extent that expenses for covered services in a year exceed a deductible amount that is consistent with a specified requirement for a catastrophic health plan under the Code, and are determined, in accordance with certified actuarial equivalence rules, to have a value that is within five percentage points of an established target actuarial value for catastrophic coverage; and (3) medisave coverage if such plan consists of a catastrophic health plan within the meaning of the Code and a medical savings account. Requests NAIC to submit to the Secretary target actuarial values for standard and catastrophic coverage. Permits NAIC to submit periodic revisions of, and permits the Secretary to revise, the set of rules of actuarial equivalence and target actuarial values where necessary to take into account changes in the relevant types of health benefits provisions, in deductible levels for catastrophic coverage, or in relevant demographic conditions. (Sec. 1103) Directs the Secretary to request NAIC to develop model regulations that specify standards with respect to requirements: (1) that insurers make available MedAccess plans; (2) of guaranteed availability of MedAccess plans to small employers; (3) relating to limits on premiums and certain consumer protections; and (4) relating to limitation of annual premium increases. Requires the Secretary to review such standards and, if NAIC fails to specify standards meeting such requirements, to promulgate standards. Sets forth provisions regarding: (1) the application of MedAccess standards and consumer protection standards by the States; and (2) the Federal role. (Sec. 1104) Sets forth provisions: (1) regarding limits on premiums and annual premium increases; and (2) requiring an insurer, at the time of offering a health insurance plan to a small employer, to fully disclose rating practices for health insurance plans, including rating practices for different populations and benefit designs. (Sec. 1106) Directs the Secretary to: (1) request NAIC to develop models for reinsurance or allocation of risk mechanisms for health insurance plans made available to small employers for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models or specify models. Sets forth provisions regarding implementation of reinsurance or allocation of risk mechanisms by the States and the Federal role. Amends the Code to provide for the imposition of a tax on any health insurance plan which covers any employee in a Federal reinsurance State. (Sec. 1108) Directs the Secretary to establish an Office of Private Health Care Coverage. Requires the Office Director to submit to the Congress annual reports evaluating health care coverage reform. (Sec. 1109) Authorizes the Director to conduct: (1) research on the impact of this subtitle on the availability of affordable health coverage for employees and dependents in the small employers group health care coverage market and other specified topics; and (2) demonstration projects relating to such topics. Requires the Director to develop: (1) methods for measuring the relative health risks of eligible individuals in terms of the expected costs of providing benefits under health insurance plans and, in particular, MedAccess plans; and (2) a model for equitably distributing health risks among insurers in the small employer health care coverage market. Authorizes appropriations. Subtitle C: Preemption - Part 1: Scope of State Regulation - Prohibits: (1) State benefit mandates for group health plans; and (2) State or local law prohibitions against two or more employers obtaining coverage under an insured multiple employer health plan. (Sec. 1203) Preempts State restrictions concerning: (1) reimbursement rates or selective contracting; (2) differential financial incentives; and (3) utilization review methods. Directs the Comptroller General to conduct a study of the benefits and cost effectiveness of the use of managed care in the delivery of health services. Part 2: Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to allow a limited exemption under preemption rules for multiple employer plans providing health benefits subject to certain Federal standards. (Sec. 1212) Relieves exempted multiple employer plans providing medical care benefits of certain restrictions on preemption of State law. Treats such plans as employee welfare benefit plans. Allows commencement of new arrangements only if such exemption is in effect or an application is pending and the Secretary of Labor determines that provisional protection is appropriate. Sets forth exemption procedures, eligibility requirements, and additional requirements applicable to exempted arrangements. Requires certain disclosures to participating employers, maintenance of reserves, and corrective actions. Provides for expiration, suspension, and revocation of exemptions, and for review of actions by the Secretary. (Sec. 1213) Revises provisions relating to scope of preemption rules, and to treatment of single employer arrangements and of certain collectively bargained arrangements. (Sec. 1215) Establishes special rules for employee leasing healthcare arrangements. Treats such arrangements as multiple employer welfare arrangements except when they are multiple employer health plans. (Sec. 1216) Sets forth enforcement provisions relating to multiple employer welfare arrangements and employee leasing health care arrangements. (Sec. 1217) Sets forth filing requirements for multiple employer welfare arrangements. (Sec. 1218) Provides for cooperation between Federal and State authorities in enforcing ERISA requirements for multiple employer welfare arrangements with the limited exemption. Part 3: Encouragement of Multiple Employer Arrangements Providing Basic Health Benefits - Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax exempt trust status for multiple employer health plans and insured multiple employer health plans if they meet certain requirements under ERISA and this Act. Part 4: Simplifying Filing of Reports for Employers Covered under Insured Multiple Employer Health Plans - Amends ERISA to direct the Secretary of Labor to prescribe an alternative method providing for a single annual report with respect to all employers who are covered under the same insured multiple employer health plan. Part 5: Compliance with Coverage Option Requirements - Provides for compliance with applicable coverage requirements through multiemployer plans and other multiple employer health arrangements. Subtitle D: Health Deduction Fairness - Amends the Internal Revenue Code to provide: (1) for a permanent extension and increase in the health insurance tax deduction for self-employed individuals; and (2) that the deduction for certain health insurance costs be determined without regard to an adjusted gross income threshold. Disallows the deduction to individuals eligible for employer-subsidized coverage. Allows the deduction whether or not the individual itemizes other deductions. Subtitle E: Improved Access to Community Health Services - Part 1: Increased Authorization for Community and Migrant Health Centers - Directs the Secretary to provide for grants to migrant and community health centers to promote primary health care services for underserved individuals. Allows grants to be used to promote the provision of off-site services, to improve birth outcomes in areas with high infant mortality and morbidity, to establish primary care clinics in areas in need, and for recruitment and training costs of necessary providers and operating costs for unreimbursed services. Authorizes appropriations. Directs the Secretary to conduct a study of the impact of such grants on access to health care, birth outcomes, and the use of emergency room services. Part 2: Grants for Projects for Coordinating Delivery of Services - Amends the Public Health Service Act to authorize the Secretary to make grants to public and nonprofit private entities: (1) to carry out demonstration projects to increase access to outpatient primary health services in specified geographic areas (i.e., areas that are rational areas for the delivery of health services, have a population of not more than 500,000 individuals, and have been designated by the Secretary as areas with a shortage of personal health services or that have a significant number of individuals with low incomes or insufficient health care insurance through coordinating the delivery of such services under Federal, State, local, and private programs; and (2) for developing plans to carry out such projects. Authorizes appropriations. Subtitle F: Improved Access to Rural Health Services - Part 1: Establishment of Rural Emergency Access Care Hospitals Under Medicare - Amends title XVIII (Medicare) of the Social Security Act (SSA) to provide for: (1) establishment of rural emergency access care hospitals under Medicare; and (2) coverage of and payment for rural emergency access care hospital services under Medicare part B (Supplementary Medical Insurance). Part 2: Rural Medical Emergencies Air Transport - Amends the Public Health Service Act to direct the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments. Sets forth provisions regarding: (1) application and State plan requirements; (2) considerations in awarding grants; (3) State administration and use of grants; (4) the number of grants; and (5) reporting requirements. Authorizes appropriations. Part 3: Emergency Medical Services Amendments - Amends the Public Health Service Act to direct the Secretary to: (1) establish an Office of Emergency Medical Services, headed by a Director; (2) engage in specified emergency medical services activities, including disseminating information obtained in carrying out specified activities to public and private entities, providing technical assistance to State and local agencies, coordinating Department of Health and Human Services (DHHS) activities with those of other Federal agencies; and (3) ensure that such activities are carried out consistent with certain requirements regarding maintaining an adequate number of health professionals with expertise in the provision of services, developing, periodically reviewing, and revising as appropriate guidelines for the provision of such services, appropriately using available technologies, and serving the unique needs of underserved inner-city and rural areas. (Sec. 1522) Authorizes the Secretary to make grants to States for the purpose of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services, subject to specified matching fund, budgetary, and other requirements. (Sec. 1523) Provides for demonstration projects to establish telecommunications between rural medical facilities and medical facilities with expertise or equipment. Directs the Secretary to ensure that the telecommunications technologies demonstrated include interactive video telecommunications, static video imaging transmitted through the telephone system, and facsimiles transmitted through such system. (Sec. 1524) Authorizes appropriations for: (1) emergency medical services (including for State offices of Emergency Medical Services and for telecommunications demonstrations); and (2) trauma care and certain other activities. Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program - Amends SSA title XIX (Medicaid) to provide for the establishment of State health allowance programs under which the State makes payments to a group health plan which provides coverage to an eligible individual as an allowance towards the costs of providing the individual with benefits under the plan. Subtitle H: Medicaid Program Flexibility - Amends SSA title XIX Medicaid) to modify: (1) Federal requirements to allow States more flexibility in contracting for coordinated care services under Medicaid; and (2) provisions regarding the extension of certain waivers. Title II: Health Care Cost Containment and Quality Enhancement - Subtitle A: Medical Malpractice Liability Reform - Part 1: General Provisions - Makes this subtitle applicable with respect to any medical malpractice liability claim and to any medical malpractice liability action brought in State or Federal court, except a claim or action for damages arising from a vaccine-related injury or death to the extent that title XXI of the Public Health Service Act applies. Sets forth provisions regarding: (1) preemption of State law; (2) effect on sovereign immunity and choice of law or venue; (3) jurisdiction; and (4) effective dates. Part 2: Medical Malpractice and Product Liability Reform - Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified alternative dispute resolution (ADR) system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States under chapter 171 of the Federal judicial code (U.S. Court of Federal Claims). Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 2012) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action. Sets limits on punitive damages and on periodic payments for future losses. (Sec. 2013) Set forth provisions regarding: (1) limits on attorney fees and other costs; (2) joint and several liability (generally, liability may be found only for those damages directly attributable to the person's proportionate share of fault or responsibility for the injury); (3) a statute of limitations of seven years; and (4) a uniform standard for determining negligence (the defendant's conduct at the time of providing the health care services was not reasonable). (Sec. 2017) Specifies that in the case of a medical malpractice liability claim relating to services provided during labor or the delivery of a baby, if the health care professional did not previously treat the injured individual for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. Part 3: Requirements for State Alternative Dispute Resolution Systems - Lists requirements for State ADR systems, including that such a system: (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 2032) Directs the Secretary, by October 1 of each year, to certify State ADR systems that meet such requirements. Directs the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 2033) Directs the Secretary, within five years, to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system, including: (1) information on the effect of the ADR systems on health care costs, access to health care, and quality of care provided within the State; and (2) to the extent that such report does not provide information on no-fault systems operated by States as ADR systems, an analysis of the feasibility and desirability of establishing a system for resolving medical malpractice liability claims on a no-fault basis. Part 4: Other Provisions Relating to Medical Malpractice Liability - Authorizes a State agency responsible for disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies to permit their participation in the licensing of such practitioner and to review any health care malpractice action, claims, or allegation, or other information concerning the practice patterns of any such practitioner. Sets forth agreement requirements. (Sec. 2042) Directs the Secretary to study incentives adopted by State and local governments, insurers, medical societies, and other entities to encourage physicians to volunteer to provide health care services in medically underserved areas. (Sec. 2043) Directs each State to require: (1) each health care professional and health care provider to participate in a risk management program to prevent, and provide early warning of, practices which may result in injuries to patients or endanger patient safety; and (2) each provider of health care professional and provider liability insurance in the State to establish risk management programs or sanction programs of risk management for health care professionals and providers provided by other entities, and require each such professional or provider, as a condition of maintaining insurance, to participate in one such program at least once in each three-year period. (Sec. 2044) Directs the Secretary to make grants: (1) for basic research in the prevention of, and compensation for, injuries resulting from health care professional or provider malpractice and for research of the outcomes of health care procedures; (2) to the States to assist in improving their ability to license and discipline health care professionals; and (3) to States and local governments, private nonprofit organizations, and health professional schools for educating the general public about the appropriate use of health care, realistic expectations of medical intervention, and the resources and role of health care professional licensing and disciplinary boards in investigating claims of incompetence or health care malpractice, and for developing programs of faculty training and curricula for educating health care professionals in quality assurance, risk management, and medical injury prevention. Authorizes appropriations. Subtitle B: Administrative Cost Savings - Part 1: Standardization of Claims Processing - Directs the Secretary to adopt standards relating to: (1) data elements for use in paper and electronic claims processing under health benefit plans and in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. (Sec. 2102) Authorizes the Secretary, two years after standards are adopted for classes of services upon determining that a significant number of claims for benefits for such services under health benefit plans are not being submitted in accordance with such standards, to require that all providers of such services submit claims to health benefit plans in accordance with such standards. (Sec. 2103) Directs the Secretary to: (1) provide for the ongoing receipt and review of comments and suggestions for changes in the standards adopted and promulgated; (2) establish a schedule for the periodic review of such standards; and (3) revise such standards. Part 2: Electronic Medical Data Standards - Directs the Secretary to promulgate standards for hospitals concerning electronic medical data, including standards for transmission of such data and confidentiality of patient-specific information. Authorizes the Secretary to periodically revise such standards. (Sec. 2112) Sets forth requirements with respect to: (1) the sharing of hospital information under Medicare; (2) waiver of such requirements; and (3) application of such requirements to hospitals of the Department of Veterans Affairs. (Sec. 2113) Authorizes the head of a Federal agency to require a provider to present and transmit a required data element electronically in accordance with applicable presentation or transmission standard. (Sec. 2114) Sets forth limitations on data requirements where standards with respect to data elements are in effect. (Sec. 2115) Directs the Secretary to establish an advisory commission on the standards established under this part and operational concerns about the implementation of such standards. Authorizes appropriations. Part 3: Development and Distribution of Comparative Value Information - Directs the Secretary to determine whether each State is developing and implementing a health care value information program that meets specified criteria and a specified schedule. Authorizes the Secretary to: (1) make grants to enable each State to plan development and initiate implementation of its health care value information program; and (2) recover the amount of such a grant by offset against any other amount payable to the State under the Social Security Act under specified circumstances. Authorizes appropriations. (Sec. 2122) Directs the Secretary to take actions necessary to implement a comparable program in a State that fails to develop or implement a health care value information program in accordance with such criteria and schedule. Authorizes the Secretary to charge fees for the information materials provided pursuant to such a program. (Sec. 2123) Directs the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to develop health care value information relating to each program that such head administers and covering the same types of data that a State program meeting such criteria would provide. (Sec. 2124) Directs the Secretary to: (1) develop model systems to facilitate the gathering of data on health care cost, quality, and outcome and the analysis of such data in a manner that will permit the valid comparison of such data among providers and among health plans; (2) support experimentation with different approaches to achieve such objectives in the most cost effective manner; and (3) evaluate the various methods to determine their relative success. Authorizes the Secretary to establish standards for the collective and reporting of data on health care cost, quality, and outcomes. Authorizes appropriations. Part 4: Additional Standards and Requirements; Research and Demonstrations - Directs the Secretary to: (1) adopt standards relating to the design and use of magnetized Medicare identification cards to assist health care providers in determining whether individuals are eligible for benefits for provided services under the Medicare program and in billing the Medicare program for covered services; (2) take steps to encourage and assist States in the design and use of magnetized Medicaid identification cards under their Medicaid plans; and (3) establish a Medicare and Medicaid information system to provide information on group health and other health benefit plans that are primary payors to the Medicare and Medicaid programs. Authorizes appropriations. (Sec. 2132) Specifies that, effective January 1, 1994, no effect shall be given to any provision of State law that requires medical or health insurance records (including billing information) to be maintained in written, rather than electronic, form. (Sec. 2133) Requires, effective January 1, 1995, each health benefit plan: (1) to use a beneficiary's social security number as the personal identifier for claims processing and related purposes (authorizes the Secretary to impose a civil money penalty on any plan that fails to do so); and (2) to use the unique identifier under title XVIII of the Social Security Act (Medicare) for a provider that furnishes health care items or services to a beneficiary under the plan as the identifier of that provider for claims processing and related purposes. (Sec. 2134) Directs the Secretary to: (1) determine, where benefits are payable under two or more health benefit plans, whether problems relating to the rules for determining the liability of plans or the availability of information among plans causes significant administrative costs; and (2) promulgate standards, if the implementation of standards would significantly reduce such administrative costs. Authorizes the Secretary to impose a civil money penalty on plans that fail to comply with such standards. (Sec. 2135) Directs the Secretary to provide grants to qualified entities for research on the application of comprehensive information systems in continuously monitoring and improving patient care. Authorizes the Secretary to make grants to: (1) two to five community organizations or coalitions of health care providers, health benefit plans, and purchasers to establish and document the efficacy of communication links between the information systems of health benefit plans and of health care providers; (2) two to five public or private nonprofit entities for the development of regional or community-based clinical information systems; and (3) public or private nonprofit entities to develop and test the definition of a comprehensive set of data elements and the specification and manner of presentation of the individual data elements of the set, for electronic medical data generated by physicians and other entities (other than hospitals) that provide health care services. Authorizes appropriations. Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Account - Amends the Internal Revenue Code to include under the medical expense deduction the portion of such expense attributable to coverage under a catastrophic health plan. (Sec. 2202) Allows individuals a tax deduction for percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to medical care savings accounts. Subtitle D: Anti-Fraud - Part 1: Criminal Prosecution of Health Care Fraud - Amends the Federal criminal code to: (1) set penalties for health care providers who knowingly engage in any scheme or artifice to defraud any person in connection with the provision of health care; and (2) make activity which, if engaged in by the U.S. Postal Service, would be a violation of mail fraud provisions punishable to the same extent with respect to private or commercial interstate carriers. (Sec. 2303) Authorizes appropriations to hire, equip, and train no fewer than: (1) 225 special agents of the Federal Bureau of Investigation and support staff to investigate health care fraud cases; (2) 50 assistant United States Attorneys and support staff to prosecute such cases; and (3) 25 investigators in the Office of Inspector General, DHHS, to be devoted exclusively to health care fraud cases. (Sec. 2304) Amends the Federal criminal code to authorize the Attorney General to make payments of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution of health care fraud, subject to specified requirements and exceptions. Part 2: Coordination of Health Care Anti-Fraud and Abuse Activities - Directs the Secretary to establish in the Office of the Inspector General of DHHS a program (all-payer fraud and abuse control program) to: (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to the delivery of, and payment for, health care in the United States; (2) conduct investigations, audits, evaluations, and inspections relating to such delivery and payment; and (3) facilitate the enforcement of provisions of the Social Security Act and other statutes applicable to health care fraud and abuse. Directs the Secretary to establish standards to carry out such program, including standards relating to the furnishing of information by health insurers, providers, and other to enable the Secretary to carry out the program and procedures to assure that such information is provided and utilized in a manner that protects the confidentiality of the information and the privacy of individuals receiving health care services. Sets forth provisions regarding: (1) qualified immunity for providing information; (2) ensuring access to documentation; and (3) failure to comply as grounds for exclusion from the Medicare and Medicaid programs. (Sec. 2312) Authorizes additional appropriations to enable the Secretary to conduct investigations of allegations of health care fraud and to carry out the all-payor fraud and abuse control program. (Sec. 2313) Establishes in the Treasury an Anti-Fraud and Abuse Trust Fund to be used to assist the Inspector General of DHHS in carrying out the all-payor fraud and abuse control program in the fiscal year involved. Sets forth provisions regarding: (1) the deposit into the Fund of Federal health anti-fraud and abuse penalties; and (2) the use of such penalties to repay beneficiaries for cost-sharing. (Sec. 2314) Amends SSA title XI to provide for the application of Federal health anti-fraud and abuse sanctions to all fraud and abuse against private health benefit plans. Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals: Part 1 - Medicare Payment Changes - Amends SSA title XVIII to: (1) eliminate the membership limitation for Medicare health maintenance organizations; and (2) revise the Medicare select policy program and provide for a civil money penalty for misrepresentations made in connection with a Medicare select policy. (Sec. 2402) Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) make permanent the Medicare select policy program; and (2) allow access to Medicare select policies in all States. (Sec. 2403) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate the administration of Medicare parts A and B. Part 2: Part B Premium Tax for High-Income Individuals - (Sec. 2411) Amends the Internal Revenue Code to impose a tax on the Medicare part B premiums of high income individuals. Subtitle F: Removing Anti-Trust Impediments - Directs the Attorney General to promulgate guidelines under which a health care joint venture may submit an application requesting that the Attorney General provide the entities participating in the venture with an exemption under which: (1) monetary recovery on an antitrust claim brought against the entity shall be limited to actual damages if specified conditions are met; and (2) the conduct of the entity in making or performing a contract to carry out the venture shall not be deemed illegal per se. Requires the Attorney General to approve or disapprove the application within a specified time frame and to provide a statement explaining the reasons for any disapproval. Directs the Attorney General to approve the application if an entity participating in the venture submits to the Attorney General an application that contains the identities of the parties to the venture; the nature, objectives, and planned activities of the venture; and specified assurances and information. Sets forth provisions regarding: (1) revocation and renewal of exemptions and withdrawal of an application; (2) requirements relating to notice and publication of exemptions; and (3) issuance of health care certificates of public advantage to each eligible health care joint venture that complies with specified requirements. Establishes the Interagency Advisory Committee on Competition, Antitrust Policy, and Health Care to: (1) discuss and evaluate competition and antitrust policy and their implications regarding the performance of health care markets; (2) analyze the effectiveness of health care joint ventures receiving exemptions in reducing costs and expanding access; and (3) make recommendations to the Congress. Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities - Part 1: Application of the Clayton Act to Medical Self-Regulatory Entities - Provides that no damages, cost of suit, or attorney fee may be recovered under section 4, 4A, or 4C of the Clayton Act, or under any similar State law, except by a State or the United States, from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities that are: (1) designed to promote the quality of health care provided to patients; and (2) not conducted for purposes of financial gain. Directs the court to award the cost of such a suit, including a reasonable attorney fee, to a substantially prevailing defendant. Part 2: Consultation by Federal Agencies - Requires any Federal agency engaged in the establishment of medical profession standards to consult with appropriate medical societies or associations, specialty boards, or recognized accrediting agencies, if available, in carrying out medical professional standard setting and guidelines or standards relating to the practice of medicine. Subtitle H: Prefunding Government Health Benefit for Certain Annuitants - Requires that certain agencies prefund Government health benefits contributions for their annuitants. Subtitle I: Miscellaneous Provisions - Amends Civil Service and Federal Employees' Retirement Systems law to increase the minimum age required to be eligible for an immediate retirement annuity. Provides for the conformance of other Federal retirement systems with the minimum age increase made above. Title III: Long-Term Care - Subtitle A: Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation. (Sec. 3002) Excludes from gross income benefits provided under a long-term care insurance contract. Includes in gross income employer-provided coverage for long-term care services. (Sec. 3003) Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions. Includes any parent or grandparent as a dependent for purposes of such expenses. (Sec. 3004) Provides for the nonrecognition of gain or loss on the exchange of any life insurance contract or an endowment or annuity contract for a long-term care insurance contract. (Sec. 3005) Excludes from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangement to pay long-term care premiums. (Sec. 3006) Allows insurance companies to issue accelerated death benefit riders on life insurance contracts. Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance - Amends SSA title XIX to require State Medicaid plans to disregard some or all of the individual's assets attributable to coverage under a qualified long-term care insurance contract in determining the individual's eligibility for long-term care services. Subtitle C: Studies - Requires the Comptroller General to study the feasibility of: (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their home with an income tax credit. (Sec. 3203) Requires the Secretary of Health and Human Services to study and report to the Congress on the feasibility of encouraging or requiring the use of a single designate public or nonprofit agency to coordinate, through case management, the provision of long-term care benefits under current Federal, State, and local programs in a geographic area. Subtitle D: Volunteer Service Credit Demonstration Projects - (Sec. 3301) Amends the Older Americans Act of 1965 to require the Commissioner of the Administration on Aging to establish and operate a volunteer service credit demonstration project in each State.

Bill· HRH.R. 3087 (103rd)open

General Aviation Revitalization Act of 1993

United States · United States Congress · 15 September 1993

General Aviation Revitalization Act of 1993 - Amends the Federal Aviation Act of 1958 to set forth a 15-year statute of limitations within which a person may bring a civil action against an aircraft manufacturer for damages for death or injury or damage to property arising from an aircraft accident.

Bill· HRH.R. 3023 (103rd)open

To amend title 10, United States Code, to eliminate the disparity between civilian and military retiree cost-of-living adjustments caused by the Omnibus Budget Reconciliation Act 1993.

United States · United States Congress · 8 September 1993

Amends the Omnibus Budget Reconciliation Act of 1993 to revise provisions concerning limitations on cost of living adjustments for military retirees to set forth special rules concerning such adjustments for FY 1994 through 1996 (currently, special rules are set forth for FY 1994 through 1998).

Bill· HJRESH.J.Res. 256 (103rd)referred

Proposing an amendment to the Constitution of the United States prohibiting Federal laws and rules that impose liability for conduct occurring before the date of enactment or issuance.

United States · United States Congress · 8 September 1993

Constitutional Amendment - Declares that no person, under any law enacted by the Congress or any rule issued by a Federal entity, shall be liable for conduct occurring, or with respect to income accruing, before the date of enactment of the law or issuance of the rule.

Resolution· HRESH.Res. 247 (103rd)open

Amending the Rules of the House of Representatives to establish a point of order against considering any provision of any measure that contains a retroactive tax increase.

United States · United States Congress · 8 September 1993

Amends rule XXI of the Rules of the House of Representatives to prohibit a bill or joint resolution carrying any provision providing for a retroactive tax increase from being reported in the House. Provides that no amendment in the House or proposed by the Senate carrying a retroactive tax measure shall be in order during the consideration of a bill or joint resolution. Allows a question of order to be raised at any time under this clause.

Law· HRH.R. 2942 (103rd)enacted

George Washington National Forest Mount Pleasant Scenic Area Act

United States · United States Congress · 6 August 1993

Mount Pleasant National Scenic Area Act - Establishes in the George Washington National Forest, Virginia, the Mount Pleasant National Scenic Area. Sets forth provisions regarding: (1) administration of the Area; (2) roads; (3) vegetation management; (4) motorized travel; (5) fire; (6) insects and disease; and (7) water. Directs the Secretary of Agriculture to develop a management plan for the Area.

Bill· HRH.R. 2927 (103rd)open

Plant Variety Protection Act Amendments of 1994

United States · United States Congress · 6 August 1993

Plant Variety Protection Act Amendments of 1993 - Amends the Plant Variety Protection Act to revise definitions and establish rules of construction concerning: (1) the sale and disposition of harvesting material, varieties, and hybrid seeds; (2) the filing of applications for the protection or entering of a variety in an official register; and (3) the basis of determining the distinctness of a variety or whether a variety is publicly known. Entitles breeders of sexually reproduced plant varieties (other than fungi or bacteria) (currently, other that fungi, bacteria, or first generation hybrids) who have reproduced a variety to plant variety protection if the variety is new, distinct, uniform, and stable. Provides that if two or more applicants for plant variety protection submit applications on the same filing date for indistinguishable varieties that fulfill the conditions for protection established by this Act, the applicant who first complies with this Act's requirements shall be entitled to protection to the exclusion of any other applicant. Issues a single protection certificate jointly to two or more applicants who comply with requirements on the same date for varieties that are indistinguishable. Lengthens the term of plant variety protection from 18 to 20 years from the date of issuance of the protection certificate (25 years for trees or vines). Adds the following activities to the list of actions which constitute infringement of an owner's right to plant variety protection if performed without an owner's authorization: (1) conditioning the variety for purposes of propagation; and (2) stocking the variety for any existing purpose which constitutes infringement. Permits owners to authorize the use of a variety subject to their own limitations. Provides that it shall not be an infringement of an owner's rights to perform any act: (1) concerning propagating material of a protected variety that has been marketed in the United States unless the act involves further propagation of the variety or involves an export into a country that does not protect such varieties of the plant genus or species (unless the export is for final consumption); or (2) done privately and for noncommercial purposes. Removes a provision that declares that it is not an infringement for a person whose primary farming occupation is the growing of crops for sale other than reproductive purposes to sell saved seed for reproductive purposes.

Resolution· HCONRESH.Con.Res. 139 (103rd)referred

To express the sense of the Congress that activities performed by the White House Travel and Telegraph Office should be procured from the private sector.

United States · United States Congress · 6 August 1993

Declares that all activities that were performed by the White House Travel and Telegraph Office before the adoption of this resolution that can be performed by private business should be procured from the private sector and that Federal White House personnel should not perform any of those activities.

Resolution· HRESH.Res. 238 (103rd)passed

Calling on the Committee on Standards of Official Conduct to conduct an investigation into activity at the House Post Office to determine whether House rules were broken or whether public funds were embezzled by Members.

United States · United States Congress · 4 August 1993

Instructs the Committee on Standards of Official Conduct to investigate allegations that the House Post Office provided cash to any Member in exchange for official vouchers, stamps purchased with official vouchers, campaign account checks, or in any other way inconsistent with the Rules of the House. Requires the Committee to: (1) determine which Members are alleged by the former Postmaster to have engaged in improper conduct in connection with the House Post Office and whether these Members are the subjects of any current investigation by the Department of Justice; and (2) defer further inquiry into a Member's conduct if that be the case, pending conclusion of the investigation. Requires the Committee to report to the House on its investigations and makes such report available to the public.

Bill· HRH.R. 2808 (103rd)open

Depository Institutions Disaster Relief Act of 1993

United States · United States Congress · 29 July 1993

Depository Institutions Disaster Relief Act of 1993 - Authorizes the Board of Governors of the Federal Reserve System to make exceptions for a specified period of time to the Truth in Lending Act and to the Expedited Funds Availability Act with respect to transactions and depository institutions located within either a federally declared major disaster area or certain areas damaged by the 1993 flooding of the Mississippi River and its tributaries (disaster areas). Cites conditions under which: (1) an insured depository institution may subtract from its total assets a specified amount attributable to insurance proceeds when it is calculating compliance with prescribed leverage limits; and (2) a qualifying regulatory agency may deviate from certain statutory requirements with respect to regulated entities located in disaster areas. Directs the Comptroller General to study and report to the Congress on the efficacy of certain disaster relief Acts with respect to facilitating recovery from major disasters. Expresses the sense of the Congress that specified Federal banking regulatory agencies should encourage depository institutions to meet the financial services needs of their communities and customers located in areas affected by the 1993 flooding of the Mississippi River and its tributaries.

Bill· HRH.R. 2708 (103rd)referred

To amend the Internal Revenue Code of 1986 to provide taxpayers engaged in certain agriculture-related activities a credit against income tax for property used to control environmental pollution and for soil and water conservation expenditures.

United States · United States Congress · 22 July 1993

Amends the Internal Revenue Code to allow taxpayers primarily engaged in a farming-related business an investment tax credit for a percentage of: (1) the costs of agricultural environmental property; and (2) the amount allowed as a deduction for soil and water conservation expenditures.

Bill· HRH.R. 2661 (103rd)referred

Depository Institutions Disaster Relief Act of 1993

United States · United States Congress · 15 July 1993

Depository Institutions Disaster Relief Act of 1993 - Amends the Federal Deposit Insurance Act to cite circumstances under which a Federal banking regulatory agency may waive regulatory requirements for insured depository institutions located in federally declared major disaster areas. Limits the waivers to a three-year period. Requires such agency to give notice of the waiver in the Federal Register.

Bill· HRH.R. 2579 (103rd)open

Agricultural Disaster Assistance Act

United States · United States Congress · 1 July 1993

Amends the Food, Agriculture, Conservation and Trade Act of 1990 to entitle Chapter 3 of Title XXII as the "Agricultural Disaster Assistance Act." Extends emergency crop loss assistance for: (1) wheat, feed grains, upland and extra long staple cotton, and rice; (2) peanuts, sugar, and tobacco; (3) oilseeds and nonprogram crops; (4) orchards; and (5) forest crops. Extends related program provisions, including quality reduction assistance. Authorizes appropriations. Extends emergency grant assistance coverage to low-income packinghouse workers. Amends the Agricultural Act of 1949 to make beekeepers eligible for emergency livestock assistance.

Bill· HRH.R. 2512 (103rd)referred

Social Security Trust Funds Integrity Act of 1993

United States · United States Congress · 23 June 1993

Social Security Trust Funds Integrity Act of 1993 - Amends titles II (Old Age, Survivors and Disability Insurance) (OASDI) and XVIII (Medicare) of the Social Security Act to: (1) restructure the Board of Trustees of the trust funds supporting the OASDI and Medicare programs, with each Board composed of members appointed by the President, by and with the advice and consent of the Senate, on a bipartisan basis at the recommendation of House and Senate leadership and the five largest organizations representing senior citizens; (2) make it the duty of the Managing Trustee chairing the Board to invest trust fund amounts according to an annual investment plan the Board is required to formulate and submit to the President and the Congress; and (3) remove restrictions on investment and disinvestment of amounts in such trust funds.

Bill· HRH.R. 2443 (103rd)open

Equitable Escheatment Act of 1993

United States · United States Congress · 17 June 1993

Equitable Escheatment Act of 1993 - Amends specified Federal law to prescribe guidelines under which unclaimed distributions of security interests shall be subject to the custodial taking (escheatment) by the State which contains the principal executive offices of either the issuer or the holder of those securities.

Bill· HRH.R. 2326 (103rd)referred

Bankruptcy Amendments of 1993

United States · United States Congress · 27 May 1993

Bankruptcy Amendments of 1993 - Amends Federal bankruptcy law to raise to $1 million the ceiling on debts for eligibility to file as a chapter 13 debtor (bankrupt consumer repayment of debt under court supervision). (Currently the ceiling is $100,000 for unsecured debts, or $350,000 for certain secured debts.) Modifies the guidelines for: (1) chapter 13 bankruptcies; (2) automatic stays; (3) exemptions; (4) discharges; and (5) preferences. Directs the Administrative Office of the United States Courts to compile and make available to the public statistical information regarding bankruptcy cases.

Bill· HRH.R. 2130 (103rd)referred

Small Business 503 Loan Refinancing Assistance Act of 1993

United States · United States Congress · 17 May 1993

Small Business 503 Loan Refinancing Assistance Act of 1993 - Amends the Small Business Investment Act of 1958 to permit a qualified State or local development company that issues a debenture purchased by the Federal Financing Bank (Bank) and guaranteed by the Small Business Administration (SBA), at the election of the small business borrower whose loan secures such debenture, to: (1) continue to make payments under the original debenture terms; (2) make payments at an adjusted interest rate; or (3) prepay the debenture to the Bank by paying the unpaid principal balance and the amount of the repurchase premium (determined under this Act). Prohibits any fees or penalties other than those specified in this Act from being imposed against the issuer, borrower, or the SBA as a condition for adjusting the interest rate or prepayment.

Bill· HRH.R. 2113 (103rd)referred

Regulatory Relief and Reform Act

United States · United States Congress · 12 May 1993

Regulatory Relief and Reform Act - Amends Federal law to require approval by law of agency rules and regulations.

Bill· HRH.R. 1811 (103rd)open

To provide that requirements relating to transport of certain agricultural commodities and other items shall not apply to certain assistance provided to Russia.

United States · United States Congress · 22 April 1993

Amends the Merchant Marine Act, 1936 to provide that provisions requiring the use of U.S.-flag commercial vessels for the transport of certain cargoes and agricultural commodities financed by the United States shall not apply to the transport of such items to Russia under the Vancouver Package.

Resolution· HCONRESH.Con.Res. 85 (103rd)open

To express the sense of Congress that the President should exercise the temporary waiver authority that an emergency exists under the Merchant Marine Act, 1936 and justifying the waiver of cargo preference rates in transporting the $1.6 billion in bilateral assistance to Russia as agreed to in the "Vancouver Package" between President Clinton and President Yeltsin of the Russian Federation.

United States · United States Congress · 22 April 1993

Declares that the President should exercise the temporary waiver authority granted in the Merchant Marine Act, 1936 so that the $1,600,000,000 in bilateral assistance to Russia, referred to as the Vancouver Package, may be effected without endangering the stability of the Government or economy of Russia and without adding to the U.S. budget deficit.

Bill· HRH.R. 1770 (103rd)referred

Rural Physicians' Incentives Act of 1993

United States · United States Congress · 21 April 1993

Rural Physicians' Incentives Act of 1993 - Amends the Internal Revenue Code to allow a deduction on medical education loan interest of a physician which accrues while the physician is living in and providing primary care to residents of a medically underserved rural area. Amends title XVIII (Medicare) of the Social Security Act to exempt services furnished in a rural area from a special fee schedule applicable to new physicians. Amends the Higher Education Act of 1965 to extend beyond the normal two-year limit, for borrowers serving an internship or residency program in preparation for practice in an area of primary care, the deferral of payments on: (1) insured student loans (Stafford Loans), including those eligible for interest subsidies; and (2) low-interest student loans (Perkins Loans). Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to modify provisions setting forth requirements concerning billing by one physician for services rendered by another physician in specified circumstances.

Bill· HRH.R. 1771 (103rd)referred

Rural Access to Obstetrical Care Act of 1993

United States · United States Congress · 21 April 1993

Rural Access to Obstetrical Care Act of 1993 - Directs the Secretary of Health and Human Services to: (1) provide for demonstration projects to improve access to obstetric services in underserved rural areas for eligible pregnant women under title XIX (Medicaid) of the Social Security Act; (2) develop and make public each year a compendium of State initiatives to address the obstetric access crisis in rural areas; and (3) provide a grant for the study of obstetrical malpractice claims.

Bill· HRH.R. 1627 (103rd)open

Food Quality Protection Act of 1993

United States · United States Congress · 1 April 1993

TABLE OF CONTENTS: Title I: Cancellation and Suspension Title II: Data Collection Title III: Amendments to the Federal Food, Drug, and Cosmetic Act Food Quality Protection Act of 1993 - Title I: Cancellation and Suspension - Amends provisions of the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) relating to cancellations, changes in classifications, or other terms of registration with respect to the authority of the Administrator of the Environmental Protection Agency. Requires that a rulemaking under such provisions be based on a validated test or other significant evidence raising prudent concerns of unreasonable adverse effects to man or to the environment. Denies registration applications that are not in compliance with this Act. Title II: Data Collection - Directs the Secretary of Agriculture to collect pesticide use data of statewide or regional significance for all the major crops and crops of dietary significance. Mandates research, development, and dissemination of integrated pest management techniques and other pest control methods that enable producers to reduce or eliminate application of pesticides which pose a greater than negligible dietary risk to humans. Title III: Amendments to the Federal Food, Drug, and Cosmetic Act - Amends the Federal Food, Drug, and Cosmetic Act (FDCA) to define, subject to exception, "pesticide chemical" as it is defined in FIFRA. Deems a food adulterated if it bears or contains: (1) a pesticide chemical residue that is unsafe; or (2) a new animal drug or conversion product that is unsafe. Sets forth requirements relating to tolerances and exemptions from tolerances for pesticide chemical residues in food, including residues of degradation products. Prohibits establishment of a tolerance higher than a level the Administrator determines is adequate to protect the public health. Allows a greater than negligible dietary risk if: (1) use protects from greater adverse health effects to humans or the environment; (2) use avoids greater risks from another pesticide; or (3) the unavailability of the pesticide would reduce the availability of an adequate, wholesome, and economical domestic supply of the food, and the adverse effects from the reduction would outweigh the risk posed by the residue. Allows the Administrator to issue an exemption from the requirement for a tolerance only if a tolerance is not needed to protect the public health, in view of the levels of dietary exposure that could reasonably be expected to occur. Prohibits a final rule that revokes, modifies, or suspends a tolerance or exemption until the Administrator has taken any necessary action under FIFRA with respect to the registration of the pesticide involved. Requires the Administrator, if the Administrator takes certain actions with respect to the registration of a pesticide, to revoke any tolerance or exemption that allows the presence of the chemical or chemical residue. Requires the suspension of any tolerance or exemption upon the suspension of the use of an associated registered pesticide. Provides for: (1) tolerances for unavoidable residues in the case of a residue of a canceled or suspended pesticide chemical that will unavoidably persist in the environment and be present in or on a food; and (2) residues resulting from an application which was lawful at the time of application. Prohibits, subject to exception, a State from enforcing any limit on a qualifying pesticide chemical residue in or on any food which is not identical to Federal requirements. Prohibits a State from enforcing a residue limit which was lawful at the time of application. Authorizes appropriations for increased monitoring of pesticide residues in imported and domestic food.

Bill· HRH.R. 1595 (103rd)open

Vegetable Ink Printing Act of 1993

United States · United States Congress · 1 April 1993

Vegetable Ink Printing Act of 1993 - Requires all Federal lithographic printing to be performed using the maximum amount of vegetable-based ink that is technologically feasible and commercially cost-competitive with printing using petroleum-based inks.

Bill· HRH.R. 1545 (103rd)open

Citizen Representative Reform Act Stop Special Treatment Provision

United States · United States Congress · 31 March 1993

TABLE OF CONTENTS: Title I: Congressional Exemptions Title II: Congressional Perks Title III: Miscellaneous Citizen Representative Reform Act Stop Special Treatment Provision - Title I: Congressional Exemptions - Makes applicable to the Congress the following Federal laws, to the extent that they relate to the terms and conditions of employment, the health and safety of employees, and the rights and responsibilities of employers and employees: (1) Social Security Act; (2) National Labor Relations Act; (3) Fair Labor Standards Act of 1938; (4) Civil Rights Act of 1964; (5) Age Discrimination in Employment Act of 1967; (6) Occupational Safety and Health Act of 1970; (7) title IX of the Education Amendments of 1972; (8) Rehabilitation Act of 1973; (9) Privacy Act of 1974; (10) Age Discrimination Act of 1975; (11) Ethics in Government Act of 1978 and (12) Americans with Disabilities Act of 1990. Makes applicable to the Congress the Freedom of Information Act and specified provisions of Federal law relating to the independent counsel. Title II: Congressional Perks - Directs all Members of Congress to pay full market value for all medical services, medical tests, and medications provided by the Office of the Attending Physician. Establishes the Office of Attending Physician Revolving Fund in the Treasury (within the contingent fund of the House of Representatives) for deposit of such payments and monies received from any other source. Orders the closing of all beauty and barber shops on the premises of any property belonging to the House of Representatives. Expresses the sense of the House of Representatives that: (1) Members of Congress should be charged rates comparable to those in other parking facilities at Washington National Airport; and (2) records of such expenses should be made accessible to the public. Directs all Members of the House to pay full market value for the use of the health facilities on the premises of the Capitol or any House office building. Expresses the sense of the House of Representatives that the Federal Government shall not bear any of the cost of health insurance for its Members. Directs the General Accounting Office to: (1) identify and report to the Congress on all benefits that accrue to Members of the House; and (2) determine the market value or a close approximation of each of those benefits and to what extent tax dollars are used to pay for them. Title III: Miscellaneous - Requires the House and the Senate to promulgate rules and regulations to carry out this Act.

Bill· HRH.R. 1548 (103rd)referred

Citizen Representative Act Go Home Provision

United States · United States Congress · 31 March 1993

Citizen Representative Act Go Home Provision - Amends the Legislative Reorganization Act of 1946 to prohibit compensation of a Member of Congress for service after September 30 of a year and before January 3 of the succeeding year unless such service follows the sine die adjournment of the last regular session of the Congress which began before the start of that period.

Bill· HRH.R. 1546 (103rd)referred

Citizen Representative Reform Act Merit Pay Provision

United States · United States Congress · 31 March 1993

Citizen Representative Reform Act Merit Pay Provision - Amends the Legislative Reorganization Act of 1946 to reduce the annual salary of a Member of Congress by five percent if the total expenditures of the Federal Government exceed its total receipts for a fiscal year. Requires such reductions in salary to be disregarded the first pay period beginning on or after the date the Congress receives a report indicating that total receipts of the Federal Government are greater than or equal to its total expenditures for a fiscal year. Requires restoration of the Member's salary for such position to the level which would then be in effect without enactment of this Act. Mandates such pay adjustments before any other adjustment scheduled to take effect on the same day for the same position. Makes it out of order for the House of Representatives or the Senate to consider any bill or resolution increasing the salary for Members of Congress, with specified exceptions, unless the bill or resolution deals with no subject matter other than a pay increase for members. Requires a recorded vote by the House or Senate in the passage or adoption of such bill or resolution.