TABLE OF CONTENTS: Title I: Provisions Primarily Affecting Individuals Title II: Provisions Primarily Affecting Businesses Subtitle A: Certain Expiring Provisions Modified and Made Permanent Subtitle B: Credit for Clinical Testing Research Expenses Attributable to Certain Qualified Academic Institutions Including Teaching Hospitals Tax Relief for Working Americans Act of 1998 - Title I: Provisions Primarily Affecting Individuals - Amends the Internal Revenue Code to make the basic standard deduction for married individuals twice the deduction for unmarried individuals. (Sec. 102) Provides for the full deduction for health insurance costs of individuals not eligible to participate in employer-subsidized health plans. (Sec. 103) Revises provisions concerning the aggregate amount of nonrefundable personal credits allowed to provide that the aggregate amount of such credits shall not exceed the sum of the taxpayer's regular tax liability and the alternative minimum tax. (Sec. 104) Amends title II (Old Age, Survivors and Disability Insurance) of the Social Security Act to increase, for any taxable year ending after 1998 and before 2000, the monthly exempt amount for individuals who have attained retirement age. Title II: Provisions Primarily Affecting Businesses - Subtitle A: Certain Expiring Provisions Modified and Made Permanent - Makes permanent the credit for increasing research activities. Increases the alternative incremental credit rate. (Sec. 202) Makes permanent the work opportunity credit. Sets forth, as a general rule, that the amount equal to the work opportunity credit amount with respect to any wages paid for any calendar quarter by an eligible tax-exempt employer shall be treated as payment by such employer of such employer's tax liability for such calendar quarter. (Sec. 203) Extends permanently the special rule for contributions of stock for which market quotations are readily available. (Sec. 204) Excludes from the definition of "foreign personal holding company income" income which is derived in the active conduct by a controlled foreign corporation of a banking, financing, or similar business, subject to stated conditions. Subtitle B: Credit for Clinical Testing Research Expenses Attributable to Certain Qualified Academic Institutions Including Teaching Hospitals - Establishes a medical innovation credit equal to 20 percent of the excess (if any) of: (1) the qualified medical innovation expenses for the taxable year; over (2) the medical innovation base period amount. Defines terms.

Bill· HRH.R. 4545 (105th)open

Code of Conduct Arms Transfer Act of 1998

United States · United States Congress · 10 September 1998

Code of Conduct on Arms Transfers Act of 1998 - Prohibits U.S. military assistance and arms transfers to a foreign government unless the President certifies to the Congress that the government: (1) meets specified conditions regarding democracy, including that it was chosen by free and fair elections and promotes civilian control of the military, the rule of law, and respect for individual rights; (2) does not engage in human rights violations, investigates and prosecutes those responsible for human rights violations, permits access to political prisoners by international organizations, and provides access to such organizations in situations of conflict or famine; (3) is not engaged in acts of armed aggression in violation of international law; and (4) is participating in the United Nations Register of Conventional Arms. Authorizes the President to request from the Congress an exemption from such prohibition, stating that: (1) it is in the national security interest to provide military assistance and arms transfers to a government; or (2) an emergency exists under which it is vital to the U.S. interest to do so. Makes the exemption effective upon such request, unless disapproved by the Congress. Directs the President to: (1) compile a list of countries that do not meet the requirements of this Act; (2) notify the governments participating in the Wassenaar Arrangement on Export Controls for Conventional Arms and Dual Use Goods and Technologies, done at Vienna, July 11 and 12, 1996, that the listed countries are ineligible to receive U.S. arms sales and military assistance; and (3) request that the notified countries also declare the listed countries as ineligible for arms sales and military assistance. Requires the President to continue efforts through the United Nations and other international fora, such as the Wassenaar Arrangement, to limit arms transfers worldwide, particularly transfers to the listed countries, for the purpose of establishing a permanent multilateral regime to govern the transfer of conventional arms. Directs the President, in conjunction with the submission of the annual congressional presentation documents for foreign assistance programs, to report to the Congress on progress made toward establishing such regime.

Resolution· HCONRESH.Con.Res. 316 (105th)referred

To express the sense of Congress that State and local governments and local educational agencies are encouraged to dedicate a day of learning to the study and understanding of the Declaration of Independence, the United States Constitution, and the Federalist Papers.

United States · United States Congress · 4 August 1998

Expresses the sense of Congress that State and local governments and local educational agencies are encouraged to: (1) dedicate at least one day of learning to the study and understanding of the significance of the Declaration of Independence, the Constitution, and the Federalist Papers; and (2) include a requirement that, before receiving a certificate or diploma of graduation from high school, students be tested on their competency in understanding those works.

Bill· HRH.R. 4271 (105th)open

Community Services Authorization Act of 1998

United States · United States Congress · 17 July 1998

Community Services Authorization Act of 1998 - Amends the Community Services Block Grant Act (CSBGA) to reauthorize and revise its programs. (Sec. 2) Extends through FY 2003 the authorization of appropriations for community services block grants. Directs the Secretary of Health and Human Services (HHS) to reserve specified portions of annual appropriations for payments to territories, training and technical assistance and other activities, and discretionary activities. Revises or adds provisions relating to: (1) program authorization; (2) apportionment of funds to territories; (3) allotment and payment of funds to States; (4) use of funds by States for grants to eligible entities; (5) State applications and plans; (6) designation and redesignation by States of eligible entities in unserved areas of the State; (7) tripartite boards for eligible entities; (8) direct payment of funds by the Secretary to Indian tribes and tribal organizations; (9) the Secretary's carrying out certain functions of the Act through the Office of Community Services, and through grants, contracts, or cooperative agreements; (10) the Secretary's use of set-aside funds for training, technical assistance, planning, evaluation, and data collection activities; (11) State monitoring of eligible entities to determine whether such entities meet performance goals, administrative standards, financial management requirements, and other State requirements; (12) corrective action, termination and reduction of funding, in cases where a State determines that an eligible entity materially fails to comply with the terms of an agreement or the State plan, or to meet appropriate standards, goals, and other State requirements; (13) fiscal controls, audits, and withholding of Federal funds; (14) Federal and State accountability and reporting on the performance of eligible entities; (15) limitations on the use of funds; (16) participation of faith-based organizations in programs under the Act; and (17) the Secretary's use of set-aside funds for discretionary activities involving community economic development, rural community development, and neighborhood innovation projects. (Sec. 3) Extends through FY 2003 the authorization of appropriations, under CSBGA, for the Secretary to make grants for: (1) community food and nutrition programs; and (2) national or regional programs designed to provide instructional activities for low-income youth. Allows State drug testing of participants in programs, activities and services under CSBGA. Requires eligible entities to make certain paternity determinations. (Sec. 5) Repeals requirements of the Human Services Reauthorization Act of 1986 relating to: (1) interest rates payable on certain rural development loans, and assignment of loan contracts; and (2) demonstration partnership agreements addressing the needs of the poor.

Bill· HRH.R. 4241 (105th)reported

Head Start Amendments of 1998

United States · United States Congress · 16 July 1998

Head Start Amendments of 1998 - Amends the Head Start Act to reauthorize and revise its programs. (Sec. 3) Revises the statement of purpose to promote school readiness by enhancing the social and cognitive development of low-income children. (Sec. 4) Revises definitions of family literacy services and of full-working-day. Adds definitions of child with a disability and of reliable and replicable research. (Sec. 5) Provides for financial assistance to Head Start programs that enable children to attain school readiness (as well as to attain their full potential). (Sec. 6) Extends through FY 2003 the authorization of appropriations for Head Start program activities. Directs the Secretary of Education to make available certain amounts for such program activities, transition activities, impact studies, other research and evaluation activities, and family literacy services. (Sec. 7) Revises requirements for allotment of funds. Allows set-aside funds to be used for: (1) activities related to correcting deficiencies and conducting proceedings to terminate the designation of Head Start agencies; and (2) research and evaluation. Revises funding for Indian and migrant and seasonal Head Start programs. Directs the Secretary to: (1) continue the administrative arrangement for meeting the needs of migrant and Indian children; and (2) assure that appropriate funds are provided to meet the needs of such children. Revises requirements relating to use of quality improvement funds for: (1) children with disabilities; (2) encouraging staff training; and (3) staff training related to promoting language skills and literacy growth of children and the acquisition of English by children from non-English-speaking backgrounds, fostering school readiness skills, and addressing children's problems, including dysfunction, violence, and substance abuse in their families and communities. Requires that each State initially receive an amount of Head Start funds equal to the amount received in FY 1998. Revises various requirements for collaboration grants. Directs the Secretary to provide supplemental funding to States that engage in other innovative collaborations, including plans for collaborative training and professional development initiatives for child care, early childhood education, and Head Start service managers, providers, and staff. Requires the Secretary to: (1) review barriers to collaboration; and (2) develop initiatives to eliminate such barriers. Increases the amount of funds set-aside for Early Head Start. Authorizes the Secretary to reduce these amounts, if necessary to avoid a reduction in Head Start services or quality, subject to certain conditions. Revises requirements relating to enrollment of children with disabilities. Directs the Secretary to consider specified factors concerning applicants in awarding expansion funds. (Sec. 8) Revises requirements relating to designation of Head Start agencies. Allows designation of for-profit organizations. Revises priority designation requirements and considerations. Directs the Secretary to designate an interim Head Start grantee until a qualified applicant from the community is designated. (Sec. 9) Requires education performance standards to ensure children's school readiness and development of a minimum level of literacy and numeracy awareness and understanding. Requires performance measures to assess the impact of the services provided to children and their families. Revises monitoring provisions to require: (1) review teams to include individuals knowledgeable about the needs of children with disabilities; (2) reviews to include a review and assessment of program effectiveness in accordance with results-based performance measures and performance standards; and (3) seeking out information from the community and the State on the program's performance and its collaboration with other entities in carrying out early childhood education and child care programs in the community. Requires Head Start agencies to: (1) correct any identified deficiencies that threaten health or safety or the integrity of Federal funds within 90 days, if the Secretary determines that 90 days is reasonable; and (2) develop and obtain approval for a quality improvement plan, if required by the Secretary. (Sec. 10) Revises powers and functions of Head Start agencies. (Sec. 11) Requires each Head Start agency to coordinate with the local education agency and schools in which participating Head Start children will enroll. (Sec. 12) Allows State Governors 60 days in which to disapprove any plan to carry out a Head Start program within the State through contract, agreement, grant, or other assistance. Prohibits the Secretary from overruling a Governor's disapproval in cases in which the disapproval is because of failure to comply with State health, safety and child care laws and regulations applicable to comparable programs within the State. (Sec. 13) Eliminates a Head Start Act requirement that all laborers and mechanics employed by contractors or subcontractors in construction or renovation of Head Start program facilities be paid at least prevailing local wages for such work in accordance with Davis-Bacon Act requirements. (Sec. 14) Revises requirements for participation in Head Start regarding continuing eligibility of children who have participated in the Head Start program and whose families have met the low-income criteria. (Sec. 15) Revises requirements for Early Head Start programs for families with infants and toddlers. Provides for infants and toddlers with disabilities. Limits eligibility to pregnant women and families with children under age three. Directs the Secretary to use a portion of Early Head Start funds for monitoring, training, technical assistance, and evaluation. (Sec. 16) Provides for certain technical assistance and training with respect to collaborative efforts toward full-day, full-year Head Start services, early childhood education, child care, and family literary services. (Sec. 17) Establishes a program of grants and other assistance for family literacy services under the Head Start Act. Directs the Secretary to make competitive grants for up to 100 Head Start agencies to initiate provision of family literacy services through collaborative partnerships with entities that provide: (1) adult education services; (2) Even Start programs under the Elementary and Secondary Education Act of 1965; or (3) other services deemed necessary for providing family literacy services. Authorizes the Secretary to provide: (1) training and technical assistance to Head Start agencies that already provide family literacy services; (2) financial assistance to designated mentor Head Start agencies that demonstrate effective implementation of family literacy services, in order to provide training and technical assistance to other agencies; and (3) grants or other assistance to facilitate training and technical assistance to programs for development of collaboration agreements with other service providers. (Sec. 18) Requires each Head Start classroom to have a teacher with demonstrated competency to perform certain functions. Directs the Secretary to: (1) ensure, by the end of FY 2003, that the majority of all Head Start classrooms in a center-based program are assigned one teacher who has an associate, baccalaureate, or an advanced degree in early childhood education or development; and (2) require Head Start agencies to demonstrate continuing progress each year to reach that result. Requires, in the remaining balance of such classrooms, that there be assigned one teacher who has: (1) a child development associate (CDA) credential that is appropriate to the age of the children being served in center-based programs; (2) a State-awarded certificate for preschool teachers that meets or exceeds the requirements for a CDA credential; or (3) a degree in a field related to early childhood education with experience in teaching preschool children and a State-awarded certificate to teach in a preschool program. (Sec. 19) Requires research and evaluation studies and reports on the following: (1) models for integrating family literacy services with Head Start programs; (2) comparisons of children participating in Head Start with eligible children who did not participate; (3) national Head Start impact; and (4) use of quality improvement funds. (Sec. 20) Repeals a consultation requirement. (Sec. 22) Repeals the Head Start Transition Project Act.

Bill· HRH.R. 4250 (105th)open

Patient Protection Act of 1998

United States · United States Congress · 16 July 1998

TABLE OF CONTENTS: Title I: Amendments to the Employee Retirement Income Security Act of 1974 Subtitle A: Patient Protections Subtitle B: Patient Access to Information Subtitle C: New Procedures and Access to Courts for Grievances Arising under Group Health Plans Subtitle D: Affordable Health Coverage for Employees of Small Businesses Title II: Amendments to Public Health Service Act Subtitle A: Patient Protections and Point of Service Coverage Requirements Subtitle B: Patient Access to Information Subtitle C: HealthMarts Subtitle D: Community Health Organizations Title III: Amendments to the Internal Revenue Code of 1986 Subtitle A: Patient Protections Subtitle B: Patient Access to Information Subtitle C: Medical Savings Accounts Title IV: Health Care Lawsuit Reform Subtitle A: General Provisions Subtitle B: Uniform Standards for Health Care Liability Actions Title V: Confidentiality of Health Information Title VI: Medical Savings Accounts for Federal Employees Patient Protection Act of 1998 - Title I: Amendments to the Employee Retirement Income Security Act of 1974 - Subtitle A: Patient Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to prohibit a group health plan, or a health insurance issuer offering group coverage, from imposing on a health professional any prohibition on advice provided to a participant or beneficiary. Requires a plan or issuer, if it provides benefits for: (1) emergencies, to provide benefits (without preauthorization) for emergency medical screening examinations if a prudent layperson would determine them necessary; (2) routine gynecological or obstetric specialist care, to provide those benefits without authorization or referral by a primary care provider; or (3) routine pediatric specialist care, to allow designation of a pediatric specialist as the primary provider. Subtitle B: Patient Access to Information - Requires plans to include specified information in summary plan descriptions. Mandates advance notice of exclusion from a drug formulary of a drug or biological that is used in the treatment of a chronic illness or disease. Subtitle C: New Procedures and Access to Courts for Grievance Arising Under Group Health Plans - Requires group health plans to: (1) provide written notice to participants or beneficiaries and providers of adverse coverage decisions; and (2) meet specified time limits for responding to routine, urgent, and emergency benefit payment requests, coverage advance determinations, and medical necessity determinations. Provides for initial coverage decision internal and, in certain circumstances, external review. Makes a plan's fiduciary who, after an external review recommends coverage, causes a failure to provide a benefit liable to the participant or beneficiary for a civil penalty and attorney's fees and costs. Allows assessment of a civil penalty against a fiduciary for any pattern or practice of repeated adverse coverage decisions in violation of the terms of the plan or ERISA. Allows an action before exhaustion of administrative remedies. Provides for concurrent Federal-State court jurisdiction for actions relating to certain amendments made by this Act. Subtitle D: Affordable Health Coverage for Employees of Small Businesses - Small Business Affordable Health Coverage Act of 1998 - Defines "association health plan" to mean a group health plan meeting specified requirements, including being sponsored by a trade, industry, or professional association, a chamber of commerce (or a similar business association) organized and maintained for substantial purposes other than obtaining or providing medical care. Provides for association plan certification and mandates a class certification procedure. Regulates association plans' boards of trustees and sponsors. Prohibits, for plans in existence on the date of enactment of this Act, a sponsor's affiliated members from being offered coverage unless the member: (1) was affiliated on the certification date; or (2) did not maintain or contribute to a group health plan during the 12 months before the offering of coverage. Prohibits a participating employer from providing health coverage in the individual market for any employee who is eligible for plan coverage if the exclusion from plan coverage is based on health status. Prohibits excluding an employer from an association plan if the employer and plan each meet specified requirements. Prohibits contribution rates for any participating small employers from varying on the basis of claims experience or type of business. Requires, if any plan benefit option does not consist of health coverage, that the plan have at least 1,000 participants and beneficiaries. Requires, if a benefit option consisting of health coverage is offered under the plan, that State-licensed insurance agents be used to distribute to small employers coverage that is not health coverage in a manner comparable to the manner in which those agents are used to distribute health coverage. Requires that a plan consist only of health coverage or, if the plan provides any additional benefit options, that the plan meet certain reserve and excess stop loss insurance and solvency indemnification requirements regarding the additional benefit options for which risk has not yet been transferred. Requires that all plans maintain a specified surplus. Requires association plans providing additional options to make annual payments to the Association Health Plan Fund. Requires that, when there is or will be a failure to maintain such reserves, excess stop loss insurance, and indemnification, the Secretary of Labor pay amounts as necessary to maintain the excess stop loss insurance or indemnification. Establishes the Fund. Mandates advance notice to participants and beneficiaries of certified plan termination. Requires, when a plan has failed or will fail to maintain required reserves, excess stop loss insurance, and indemnification, either corrective action or plan termination. Provides for court appointment of the Secretary as trustee to administer a plan during insolvency. Allows a State to impose a contribution tax on an association plan providing additional options if the plan began operations in the State after enactment of this Act. Sets forth special rules for church plans. Declares that the provisions of this subtitle supersede certain related State laws. (Sec. 1303) Modifies the circumstances in which two or more trades or businesses must be deemed a single employer. (Sec. 1304) Excludes from the definition of "multiple employer welfare arrangement" any arrangement: (1) established or maintained under specified Federal (or similar State) labor relations provisions; or (2) meeting certain collective bargaining and other requirements. (Sec. 1305) Imposes criminal penalties for falsely representing any benefit as: (1) being a certified association plan; or (2) having been established or maintained under certain collective bargaining agreements. (Sec. 1306) Allows a State to enter into an agreement with the Secretary for delegation to the State of some or all of the Secretary's enforcement or certification authority. Title II: Amendments to Public Health Service Act - Subtitle A: Patient Protections and Point of Service Coverage Requirements - Amends the Public Health Service Act to prohibit a group health plan, or a health insurance issuer offering group coverage, from imposing on a health professional any prohibition on advice provided to a participant or beneficiary. Requires a plan or issuer, if it provides benefits for: (1) emergencies, to provide benefits (without preauthorization) for emergency medical screening examinations if a prudent layperson would determine them necessary; (2) routine gynecological or obstetric specialist care benefits, to provide those benefits without an authorization or referral by a primary provider; or (3) routine pediatric specialist benefits, to allow designation of a pediatric specialist as the primary provider. (Sec. 2002) Requires health maintenance organizations (HMOs) that provide coverage under a group health plan only if services are furnished exclusively through members of a closed panel to make available to the plan sponsor an option covering services without regard to whether the providers are panel members. Requires HMOs, when a plan sponsor declines that option, to make optional supplemental coverage available in the individual market to each plan participant. Subtitle B: Patient Access to Information - Requires plans to include specified information in summary plan descriptions. Mandates advance notice of exclusion from a drug formulary of a drug or biological that is used in the treatment of a chronic illness or disease. (Sec. 2102) Requires the General Accounting Office to report to a specified congressional committee on the compliance of: (1) the Department of Justice and all U.S. Attorneys with a specified guideline relating to false claims and civil health care; and (2) the Office of the Inspector General of the Department of Health and Human Services with specified protocols and best practice guidelines. Subtitle C: HealthMarts - Health Care Consumer Empowerment Act of 1998 - Requires that HealthMarts: (1) be nonprofit legal entities composed of small employers, employees of small employers, health care providers, and entities that underwrite or administer health benefits coverage; and (2) make available health coverage to all small employers and eligible employees at rates established by the insurance issuer on a policy or product specific basis. Deems HealthMarts group health plans for purposes of specified provisions of ERISA and the Internal Revenue Code. Requires that coverage made available to an eligible employee in a geographic area be offered to all eligible employees in the same area. Declares that the HealthMart: (1) provides coverage only through contracts with issuers and does not assume insurance risk; (2) provides administrative services for purchasers; and (3) collects and disseminates consumer information on all coverage options offered through the Healthmart. Requires that HealthMart coverage provide full portability of creditable coverage for individuals who remain members of the same HealthMart notwithstanding that they change employers. Allows HealthMart coverage to include coverage: (1) through an HMO, a preferred provider or licensed provider-sponsored organization, an insurance company, a medical savings or flexible spending account, or a community health organization; (2) that includes a point-of- service option; or (3) any combination of those coverages. Requires a HealthMart to permit any small employer to contract for coverage and prohibits varying eligibility conditions. Prohibits the purchaser from obtaining or sponsoring coverage other than through the HealthMart. Prohibits enrollment discrimination based on health. Supersedes certain related State laws. Provides for the application of: (1) certain existing ERISA and Public Health Service Act requirements; and (2) renewability requirements when the contract between a HealthMart and an issuer is terminated. Directs the Secretary of Health and Human Services to administer this subtitle through a separate Health Care Marketplace Division. Subtitle D: Community Health Organizations - Allows a community health organization to offer health coverage in a State in spite of not being licensed in that State if the organization has received a licensure waiver from the Secretary of Health and Human Services and other requirements are met. Mandates the establishment of Federal financial solvency and capital adequacy standards. Title III: Amendments to the Internal Revenue Code of 1986 - Subtitle A: Patient Protections - Amends the Internal Revenue Code to prohibit a group health plan from imposing on a health professional any prohibition on advice provided to a participant or beneficiary. Requires a plan, if it provides benefits for: (1) emergencies, to provide benefits (without preauthorization) for emergency medical screening examinations if a prudent layperson would determine the examinations necessary; or (2) routine gynecological or obstetric specialist care, to provide those benefits without an authorization or referral by a primary provider. Requires a plan or issuer, if it provides benefits for routine pediatric specialist care, to allow designation of a pediatric specialist as the primary provider. Subtitle B: Patient Access to Information - Requires plans to include specified information in summary plan descriptions. Mandates advance notice of exclusion from a drug formulary of a drug or biological that is used in the treatment of a chronic illness or disease. (Sec. 3102) Requires the General Accounting Office to report to specified congressional committees on the compliance of: (1) the Department of Justice and all U.S. Attorneys with a specified guideline relating to false claims and civil health care; and (2) the Office of the Inspector General of the Department of Health and Human Services with specified protocols and best practice guidelines. Subtitle C: Medical Savings Accounts - Repeals provisions limiting the number of individuals having medical savings accounts. Allows all employers to offer the accounts. Modifies requirements regarding: (1) the monthly limitation on related deductions; (2) coordination with the exclusion for employer contributions; and (3) the deductible amounts that will qualify as a high deductible plan. Allows the accounts to be included in cafeteria plans. Sets forth special rules for individuals receiving immediate Federal annuities. (Sec. 3202) Allows medical savings accounts to be used by persons with incomes under a certain amount to pay for insurance offered by a community health center. Title IV: Health Care Lawsuit Reform - Subtitle A: General Provisions - Declares that this title applies to any health care liability action in any State or Federal court, except actions: (1) relating to vaccine-related injury to which title XXI (Vaccines) of the Public Health Service Act applies; or (2) under the Employee Retirement Income Security Act of 1974 (ERISA). Preempts State laws inconsistent with this title, but not that impose greater restrictions than those in this title. Excludes economic or punitive damages and attorneys' fees or costs from the determination of the amount in controversy. Subtitle B: Uniform Standards for Health Care Liability Actions - Establishes a statute of limitations for bringing a health care liability action. (Sec. 4012) Limits non-economic damages. Substitutes any different level set by a State after enactment of this Act. Makes defendants liable only for the proportion of the damages due to the defendant's fault. Allows punitive damages, to the extent permitted by State law, if the claimant establishes by clear and convincing evidence that the defendant's conduct intended to cause harm or manifested a conscious, flagrant indifference to the rights or safety of others. Prohibits punitive damages against a manufacturer or product seller of a drug or medical device where the drug or device was subject to Food and Drug Administration (FDA) premarket approval or the drug is generally recognized as safe and effective by the FDA. Prohibits punitive damages relating to packaging or labeling of a drug that is required to have tamper-resistant packaging unless the packaging or labeling is found by clear and convincing evidence to be substantially out of compliance. Prohibits requiring lump-sum payment of future economic and non-economic damages over $50,000. Allows any defendant to introduce evidence of collateral source payments. Prohibits any collateral source payments provider from recovering any amount against the claimant, receiving any lien or credit against the recovery, or being subrogated to the claimant's rights. (Sec. 4013) Requires any alternative dispute resolution used to resolve a health care liability action or claim to contain provisions consistent with this title. Title V: Confidentiality of Health Information - Amends title XI of the Social Security Act to require health care providers, health plans, employers, health or life insurers, or educational institutions to permit an individual who is the subject of protected health information to inspect and copy the information. Requires, if the individual requests addition of a supplemental statement to the information, that those parties: (1) add the statement and make reasonable efforts to inform any person to whom the information was disclosed during the preceding year; or (2) if addition of the statement is refused, allow the individual to file a statement of disagreement. Requires health care providers, health plans, health oversight agencies, public health authorities, employers, health or life insurers, health researchers, or educational institutions to maintain safeguards to ensure the confidentiality, security, accuracy, and integrity of protected health information. Requires any person who maintains protected health information to disclose the information to a health care provider or health plan to permit the provider or plan to conduct health care operations. Preempts State law provisions that: (1) are inconsistent with certain provisions of this title under Article VI (dealing with national supremacy, among other matters) of the Constitution; or (2) relate to specified matters dealt with in this title. Imposes civil fines for substantially and materially failing to comply with the above provisions of this title. Amends title XVIII (Medicare) of the Social Security Act to authorize the Secretary of Health and Human Services to refuse to enter into, terminate, or refuse to renew an agreement with a physician or supplier that has violated the above provisions of this title. Requires compliance with certain provisions of this title by Medicare+Choice organizations, Medicare providers, and HMOs with risk- sharing contracts. (Sec. 5002) Requires the Comptroller General to report to the Congress on the effect of State laws on health-related research subject to review by an institutional review board or institutional review committee with regard to the protection of human subjects. (Sec. 5003) Requires the Comptroller General to submit to the Congress a compilation of State laws on the confidentiality of protected health information and an analysis of the effect of those laws on the provision of, and securing payment for, health care. (Sec. 5004) Exempts information developed by a health care provider in response to a serious, adverse, patient-related event and for specified purposes (health care response information) from any disclosure requirement, in connection with a civil or administrative proceeding under Federal or State law, to the same extent as information developed by the provider regarding peer review, utilization review, quality management or improvement, quality control, risk management, or internal review to reduce mortality, morbidity, or patient care or safety. Prohibits deeming the protection of health care response information from disclosure modified by the development of such information in connection with a request or requirement of an accrediting body or the transfer of that information to an accrediting body. Title VI: Medical Savings Accounts for Federal Employees - Amends Federal law relating to Federal employees' health insurance to entitle an employee or annuitant enrolled in a high deductible health plan to have a Government contribution made to the employee's or annuitant's medical savings account, subject to exceptions and limitations. Requires that, at the employee's or annuitant's request, an amount specified by the employee or annuitant be withheld from their pay or annuity and contributed to their medical savings account. Requires the Office of Management and Budget (OMB) to contract for a high deductible health plan with any qualified carrier that offers such a plan and offers a plan under provisions relating to Federal employees' health insurance. Allows OMB to contract for a high deductible plan with any qualified carrier that offers such a plan but does not offer a plan under those provisions.

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