United States · United States Congress · 8 February 1994
Environmental Export Promotion Act of 1994 - Amends the Export Enhancement Act of 1988 to direct the President to establish the Environmental Technologies Trade Advisory Committee to advise and guide the Environmental Trade Promotion Working Group in the development and administration of programs to expand U.S. exports of environmental technologies, goods, and services. Requires the Working Group to assess annually which foreign countries have markets with the greatest potential for such exports, and select five of them as priority countries for the application of U.S. Government export promotion resources. Requires the Group to create annual plans for each priority country, detailing ways to increase U.S. environmental exports to such country. Directs the Secretary of Commerce to assign a specialist in environmental technologies to the office of the United States and Foreign Commercial Service in each of the five priority countries, and authorizes similar assignments in any countries that are promising markets for such exports. Specifies the duties of such specialists. Requires the Secretary to establish: (1) a mechanism to give environmental technology and international environmental marketplace training to Commercial Service Officers assigned to one-stop shops and to district offices in districts with large numbers of environmental businesses; and (2) ensure that such officers receive appropriate training under such mechanism. Directs the Trade Promotion Coordinating Committee (TPCC) to establish international regional environmental initiatives to coordinate Federal activities with State, local, and private sector activities to build environmental partnerships between the United States and the geographic region outside the United States for which such an initiative is established. Specifies TPCC activities in carrying out such initiatives. Directs the Working Group to maintain an environmental technologies project advocacy calendar, updated quarterly, identifying significant project opportunities for U.S. environmental businesses in foreign markets and trade promotion events.
United States · United States Congress · 8 February 1994
World War II Peace Accords Commemorative Coin Act - Expresses the sense of the Congress that: (1) the 50th anniversary of the signing of the World War II peace accords on the U.S.S. Missouri should not go unrecognized at the national level; and (2) the United States should recognize such anniversary by minting and issuing a commemorative coin. Sets forth specifications for half dollar clad coins. Mandates that the surcharges received from the sale of such coins be paid by the Secretary of the Treasury to the Admiral Nimitz Foundation for the purpose of preserving the Pacific War heritage of the United States.
United States · United States Congress · 8 February 1994
Provides for the conveyance by the Secretary of Commerce to the Commonwealth of Massachusetts of the National Marine Fisheries Service laboratory located on Emerson Avenue in Gloucester, Massachusetts.
United States · United States Congress · 7 February 1994
Expresses the sense of the Congress that: (1) the Low-Income Home Energy Assistance Program (LIHEAP) should be a high priority; (2) all FY 1995 appropriations made for LIHEAP should be expended; and (3) LIHEAP expenditures for FY 1996 should ensure the provision of services at or above the level provided in FY 1995.
United States · United States Congress · 3 February 1994
Recreational Boating Safety Improvement Act of 1994 - Amends Federal boating safety law to prohibit a person from operating a recreational vessel under 26 feet in length unless each individual 12 years or younger wears a personal flotation device while on the vessel's deck. Declares that such prohibition shall not be construed to limit a State's authority to establish more stringent requirements for the wearing of personal flotation devices on recreational vessels. Sets forth a formula for the allocation of State recreational boating safety program funds based upon State adoption of laws prohibiting the operation of recreational vessels while under the influence of alcohol or drugs. Directs the Secretary of Transportation (Secretary) to submit to specified congressional committees a plan to increase reporting of vessel accidents to appropriate State law enforcement officials. Establishes penalties for violation of reporting requirements. Declares that any individual operating a recreational vessel in a negligent manner shall complete a boating safety course approved by the Secretary. Declares that any person operating a recreational vessel in violation of Federal shipping code recreational boating provisions may be ordered to complete a qualified recreational boating safety course.
United States · United States Congress · 2 February 1994
Gun Exchange Tax Incentive Act of 1994 - Amends the Internal Revenue Code to allow an itemized tax deduction for charitable contributions of property under qualified gun exchange programs. Directs the Attorney General to develop a written model program for business-sponsored gun exchange programs.
United States · United States Congress · 2 February 1994
Merchant Marine Revitalization Act of 1994 - Amends the Merchant Marine Act, 1936 to require that a specified percentage of imported oil and motor vehicles transported on seagoing vessels be transported on vessels that are documented under the laws of the United States.
United States · United States Congress · 2 February 1994
Provides amounts for expenses of investigations and studies by the House Committee on Merchant Marine and Fisheries in the second session of the 103d Congress.
United States · United States Congress · 25 January 1994
Designates 1994 as a year to honor the memory and leadership qualities of the Honorable Thomas P. "Tip" O'Neill, Jr., the late Speaker of the House of Representatives.
United States · United States Congress · 25 January 1994
Expresses the sense of the Congress that a postage stamp should be issued to honor the 100th anniversary of the Jewish War Veterans of the United States and that the Citizens' Stamp Advisory Committee of the U.S. Postal Service should make such recommendation to the Postmaster General.
United States · United States Congress · 22 November 1993
Deauthorizes specified portions of the project for navigation, Falmouth, Massachusetts, as authorized under the River and Harbor Act of 1948. Redesignates a portion of such project as an anchorage area.
United States · United States Congress · 22 November 1993
Dietary Supplement Access and Claims Moratorium Act of 1993 - Title I: Access to Dietary Supplements - Amends the Federal Food, Drug, and Cosmetic Act to prohibit the Secretary of Health and Human Services from requiring: (1) a prescription for a dietary supplement marketed on or before November 15, 1993; and (2) premarket approval for dietary supplements. Specifies that a food shall be deemed to be adulterated if it contains a dietary ingredient at a level that may be injurious to health or is a dietary supplement which when used in accordance with the conditions of use may be injurious to health. Title II: Moratorium on Dietary Supplement Claims - Amends the Prescription Drug User Fee Act of 1992 to prohibit the Secretary from implementing the Nutrition Labeling and Education Act of 1990 or any amendment made by such Act earlier than June 30, 1994, with respect to dietary supplements of vitamins, minerals, herbs, amino acids, or other similar nutritional substances. Prohibits the Secretary from issuing any final regulations applicable to such substances before that date. Specifies that any such proposed regulations shall not be considered to be final regulations until that date. Makes the effective date for provisions dealing with State enforcement with respect to such substances June 30, 1994. Permits the Secretary, earlier than that date, to approve specified health claims made with respect to such substances.
United States · United States Congress · 22 November 1993
TABLE OF CONTENTS: Title I: Telecommunications Infrastructure and Competition Title II: Communications Competitiveness National Communications Competition and Information Infrastructure Act of 1993 - Title I: Telecommunications Infrastructure and Competition - Amends the Communications Act of 1934 (the Act) to state that the duty of a common carrier to furnish communications services includes the duty to furnish that service in accordance with such regulations concerning openness and accessibility of common carrier networks as the Federal Communications Commission (FCC) may prescribe in the public interest. (Sec. 102) Requires local telephone exchange service carriers to provide equal access to and interconnection with the facilities of the carrier's networks to any other carrier or person providing telecommunications services reasonably requesting such equal access and interconnection, so that the networks are fully interoperable. Directs the FCC to: (1) establish and implement regulations for such equal access and interconnection; and (2) establish reasonable compensation rates to the carrier for such services. Requires the convening of a Federal-State Joint Board to determine equal access and interconnection standards. Preempts contrary State law. Requires local carriers to prepare and file tariffs with respect to services or elements offered to comply with such standards, along with supporting information. Requires the FCC to determine whether a telecommunications service or provider of such service is or will be subject to reasonable competition and to take appropriate action thereafter. Requires the establishment of a Federal-State Joint Board to recommend actions to the FCC and State commissions for the preservation of universal service. Directs the FCC, at least once every three years, to review standards and requirements concerning equal access, interconnection, and the preservation of universal service, and take appropriate action thereafter. Requires such review to include a study of rural phone service. Includes among the duties of a communications service provider the duty to furnish such service in accordance with regulations concerning functionality and reliability as established by the FCC. Directs the FCC to initiate an inquiry to consider rules and policies necessary to make open platform service (a switched, end-to-end digital telecommunications service) available to all subscribers at reasonable rates. Provides for regulations, oversight, and determination as to whether such requirements would result in adverse competitive impact. Directs the FCC to establish network reliability and quality performance measures to ensure the continued maintenance and evolution of common carrier facilities and service. Provides certain regulatory exemptions for rural areas. (Sec. 103) Directs the FCC to: (1) issue a final determination within 180 days after a complaint concerning an alleged discriminatory interconnection; and (2) provide for the expedited licensing of new technologies or services related to the furnishing of telecommunications services. (Sec. 105) Requires any application filed by a provider of telephone exchange service for authority to construct or extend a line to address the means by which such construction or extension will meet the network access needs of individuals with disabilities. Title II: Communications Competitiveness - Amends the Act to allow a common telecommunications services carrier to provide video programming (cable TV service) directly to subscribers in its telephone service area, as long as the video programming is provided through a video programming affiliate that is separate from such carrier (with separate books, records and accounts). Sets forth rules and regulations concerning interaction and business transactions between a common carrier and an affiliate with respect to the provision of video programming services. Requires the common carrier with a video programming affiliate to establish a video platform (a listing and description of video services offered) and to provide capacity (open channels) in its video programming for unaffiliated video program providers. Prohibits a common carrier from: (1) cross-subsidizing costs of telephone service with costs of video programming service among its customers; and (2) buying out a cable system located within its telephone exchange area and owned by an unaffiliated person. (Sec. 201) Directs the FCC to convene a Federal-State Joint Board to establish practices, classifications, and regulations necessary to ensure proper jurisdictional separation and cost allocation of establishing and providing a video platform and allocations of those costs between regulated and unregulated services, including affiliated video programming. Provides for: (1) the applicability of franchising and other requirements; and (2) rural area exemptions from certain provisions of this title.
United States · United States Congress · 22 November 1993
Haitian Refugee Fairness Act - Expresses the sense of the Congress with respect to U.S. obligations in support of the international law requirement of nonrefoulement. Prohibits the U.S. Government from returning or causing to be returned to Haiti any Haitian national (with specified exceptions for certain felons and persons who participated in persecutions) outside U.S. territorial waters, or inside territorial waters of another country, unless the Government has first determined the individual not to be a refugee. (Sec. 3) Provides: (1) temporary protected status for qualifying Haitians; and (2) reimbursement for related State and local costs. (Sec. 5) Obligates specified funds for: (1) the Community Relations Service; and (2) primary and secondary resettlement services for paroled Cubans and Haitians. (Sec. 6) Amends the Immigration and Nationality Act to authorize appropriations for a Cuban/Haitian Entrant Emergency Fund to be established in the Treasury. Requires the Attorney General to provide an annual estimation of Cuban and Haitian parolees.
United States · United States Congress · 22 November 1993
Expresses the sense of the Congress that the national policy of the United States should be to: (1) increase energy efficiency, as specified; (2) increase renewable energy technologies to 20 percent of the overall national energy mix by 2010; and (3) achieve these goals by adopting a specified national strategy.
United States · United States Congress · 20 November 1993
TABLE OF CONTENTS: Title I: Health Care Security Subtitle A: Universal Coverage and Individual Responsibility Subtitle B: Benefits Subtitle C: State Responsibilities Subtitle D: Health Alliances Subtitle E: Health Plans Subtitle F: Federal Responsibilities Subtitle G: Employer Responsibilities Subtitle J (sic): General Definitions; Miscellaneous Provisions Title II: New Benefits Subtitle A: Medicare Outpatient Prescription Drug Benefit Subtitle B: Long-Term Care Title III: Public Health Initiatives Subtitle A: Workforce Priorities Under Federal Payments Subtitle B: Academic Health Centers Subtitle C: Health Research Initiatives Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health Subtitle E: Health Services for Medically Underserved Populations Subtitle F: Mental Health; Substance Abuse Subtitle G: Comprehensive School Health Education; School-Related Health Services Subtitle H: Public Health Service Initiative Subtitle I: Coordination With COBRA Continuation Coverage Title IV: Medicare and Medicaid Subtitle A: Medicare and the Alliance System Subtitle B: Savings in Medicare Program Subtitle C: Medicaid Subtitle D: Increase in SSI Personal Needs Allowance Title V: Quality and Consumer Protection Subtitle A: Quality Management and Improvement Subtitle B: Information Systems, Privacy, and Administrative Simplification Subtitle C: Remedies and Enforcement Subtitle D: Medical Malpractice Subtitle E: Fraud and Abuse Subtitle F: McCarran-Ferguson Reform Title VI: Premium Caps; Premium-Based Financing; and Plan Payments Subtitle A: Premium Caps Subtitle B: Premium-Related Financing Subtitle C: Payments to Regional Alliance Health Plans Title VII: Revenue Provisions Subtitle A: Financing Provisions Subtitle B: Tax Treatment of Employer-Provided Health Care Subtitle C: Employment Status Provisions Subtitle D: Tax Treatment of Funding of Retiree Health Benefits Subtitle E: Coordination with COBRA Continuing Care Provisions Subtitle F: Tax Treatment of Organizations Providing Health Care Services and Related Organizations Subtitle G: Tax Treatment of Long-term Care Insurance and Services Subtitle H: Tax Incentives for Health Services Providers Subtitle I: Miscellaneous Provisions Title VIII: Health and Health-Related Programs of the Federal Government Subtitle A: Military Health Care Reform Subtitle B: Department of Veterans Affairs Subtitle C: Federal Employees Health Benefits Program Subtitle D: Indian Health Service Subtitle E: Amendments to the Employee Retirement Income Security Act of 1974 Subtitle F: Special Fund for WIC Program Title IX: Aggregate Government Payments to Regional Alliances Subtitle A: Aggregate State Payments Subtitle B: Aggregate Federal Alliance Payments Subtitle C: Borrowing Authority to Cover Cash-Flow Shortfalls Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance Subtitle A: Workers Compensation Insurance Subtitle B: Automobile Insurance Subtitle C: Commission on Integration of Health Benefits Subtitle D: Federal Employees' Compensation Act Subtitle E: Davis-Bacon Act and Service Contract Act Subtitle F: Effective Dates Title XI: Transitional Insurance Reform Health Security Act - Title I: Health Care Security - Subtitle A: Universal Courage and Individual Responsibility - Entitles each eligible individual to: (1) the benefit provided under subtitle B through the applicable health plan in which the individual is enrolled; and (2) a health security card to be issued by the alliance or other entity that offers the applicable health plan in which the individual is enrolled. Defines an eligible individual as an individual who resides in the United States and is: (1) a citizen or national of the United States; (2) an alien permanently residing in the U.S. under color of law; or (3) a long-term nonimmigrant. Entitles a Medicare-eligible individual to benefits under Medicare instead of the above provisions of this Act. (Sec. 1002) Requires each eligible individual to enroll in an applicable health plan and pay any required premium. Prohibits disenrollment of an eligible individual until the individual is either enrolled in another plan or in Medicare. (Sec. 1003) States that nothing in this Act shall be construed as prohibiting: (1) an individual from purchasing any health services; (2) an individual from purchasing supplemental insurance; (3) an individual who is not an eligible individual from purchasing health insurance; or (4) employers from providing additional coverage. (Sec. 1004) States that a regional alliance health plan is the applicable plan for a family, unless a family member is eligible for a corporate alliance health plan. Allows military personnel, veterans, and Indians to enroll either with an alliance or with a military, veteran, or Indian plan respectively. (Sec. 1005) Prohibits an undocumented alien from enrolling in a health plan under this Act. (Sec. 1011) Defines a family as an eligible individual's eligible spouse and children. Defines couple as meaning an individual and the individual's spouse. Defines a child as being under age 18, or under age 24 in the case of a full-time student. Subtitle B: Benefits - Includes the following terms and services in the comprehensive benefit package: (1) hospital services; (2) services of health professionals; (3) emergency and ambulatory medical and surgical services; (4) clinical preventive services; (5) mental illness and substance abuse services; (6) family planning services and services for pregnant women; (7) hospice care; (8) home health care; (9) extended care services; (10) ambulance services; (11) outpatient laboratory, radiology, and diagnostic services; (12) outpatient prescription drugs and biologicals; (13) outpatient rehabilitation services; (14) durable medical equipment and prosthetic and orthotic devices; (15) vision care; (16) dental care; (17) health education classes; and (18) investigational treatments. Describes such items and services. (Sec. 1131) Requires each health plan to offer to its enrollees only one of the following cost sharing schedules: (1) lower cost sharing; (2) higher cost sharing; or (3) combination cost sharing. Provides that the annual maximum out-of-pocket expenses for an individual in any of the plans shall be $1500 and for a family the annual maximum shall be $3000. (Sec. 1135) Sets forth a table of copayments and coinsurance. (Sec. 1141) Excludes the following items and services: (1) an item or service that is not medically necessary or appropriate; (2) an item or service that the National Health Board may determine is not medically necessary or appropriate; (3) custodial care, except hospice care; (4) surgery performed solely for cosmetic purposes, unless required to correct a congenital anomaly or performed to correct a part of the body injured by either disease or accident; (5) hearing aids; (6) eyeglasses and contact lenses for individuals at least 18 years of age; (7) in vitro fertilization; (8) sex change surgery and related services; (9) private duty nursing; (10) personal comfort items, except in the case of hospice care; and (11) any dental procedures involving orthodontic care, inlays, gold or platinum fillings, bridges, crowns, pin/post retention, dental implants, surgical periodontal procedures, or the preparation of the mouth for the fitting or continued use of dentures, except as specified. (Sec. 1151) Gives the National Health Board the authority to promulgate such regulations or establish such guidelines as necessary to assure uniformity in the application of the comprehensive benefit package across all health plans. Permits the Board to expand the benefit package. (Sec. 1162) Permits a health professional or facility to refuse to provide a benefit if the professional or facility objects on the basis of a religious belief or moral conviction. Subtitle C: State Responsibilities - Requires a State, in order to be approved as a participating State, to submit a document describing the State's health care system. (Sec. 1201) Requires a participating State to: (1) establish one or more regional alliances; (2) establish and publish the criteria used in the certification of its health plan; (3) meet minimum financial solvency requirements for health plans established by the National Health Board; (4) designate an agency or official to coordinate State responsibilities under this Act; (5) conform State laws to meet the requirements of title X of this Act with respect to workers' compensation and automobile insurance; and (6) carry out all the responsibilities of a participating State specified in this Act. (Sec. 1221) Permits a State, with the Board's approval, to operate a single-payer system if specified requirements are met. Subtitle D: Health Alliances - Provides for regional alliances and corporate alliances. (Sec. 1302) Requires a regional alliance to be governed by a Board of Directors consisting of: (1) employers, including self-employed individuals; and (2) members who represent individuals purchasing coverage. Requires each regional alliance to establish a provider advisory board consisting of health care providers and professionals. (Sec. 1311) Includes in a corporate alliance an eligible sponsor who is either a large employer (more than 5,000 full-time employees) or a multiemployer plan (a plan with more than 5000 active participants). Excludes: (1) an employer whose primary business is employee leasing; (2) the Federal Government (other than the U.S. Postal Service); and (3) a State or local government. Excludes from corporate alliance eligibility the following classes of individuals: (1) AFDC recipients; (2) SSI recipients; (3) military personnel and families, veterans, and Indians who elect to enroll in specified plans specifically designed for them; and (4) seasonal or temporary employees. (Sec. 1321) Directs each regional alliance to enter into a contract with any State-certified health plan to contract with the alliance for the enrollment under the plan of eligible individuals. (Sec. 1322) Requires each regional alliance to offer a choice of health plans, including at least one fee-for-service plan. (Sec. 1326) Requires each regional alliance to establish and maintain an office of an ombudsman to assist consumers in dealing with problems that arise with health plans and the alliance. (Sec. 1329) Permits a regional alliance to adjust payments to plans or use other financial incentives to encourage health plans to expand into areas that have inadequate health services. (Sec. 1341) Set forth provisions concerning the collection of funds by regional alliances from individuals, employers, and others. (Sec. 1351) Requires each regional alliance to compute a blended plan per capita payment amount for each regional alliance health plan for enrollment in the alliance. (Sec. 1353) Requires each regional alliance to make payments to the Federal Government for academic health centers and graduate medical education. (Sec. 1361) Requires each regional alliance to comply with specified standards relating to the management of finances, maintenance of records, accounting practices, auditing procedures, financial reporting, and employer payments. (Sec. 1371) Provides for a reduction in cost sharing for low-income families. (Sec. 1373) Provides for premium discounts and reduction in liabilities for low-income families. (Sec. 1381) Permits each corporate alliance to: (1) offer coverage under either an appropriate self-insured health plan; or (2) negotiate with a State-certified plan to enter into a contract with the plan. (Sec. 1382) Requires each corporate alliance to provide a choice of health plans, including at least one fee-for-service plan and two health plans that are not fee-for-service plans. (Sec. 1385) Requires each corporate alliance to make an additional contribution towards the enrollment in health plans of the alliance by certain low-wage families. (Sec. 1386) Sets forth provisions relating to corporate alliances concerning: (1) consumer information and marketing; (2) plan and information requirements; (3) management of funds; (4) cost control; (5) payments by corporate alliance employers to corporate alliances; (6) ERISA; (7) disclosure and reserve requirements; (8) trusteeship of insolvent corporate alliance health plans; (9) imposition and collection of periodic assessments on self-insured corporate alliance plans; and (10) payments to the Federal Government by multiemployer corporate alliances for academic health centers and gradual medical education. Subtitle E: Health Plans - Requires a health plan to: (1) be either a self-insured plan (meaning a group health plan as defined by a the Employee Retirement Income Security Act of 1974) or a State-certified plan (meaning a plan certified by a State or the National Health Board); and (2) meet the applicable regulatory requirements. (Sec. 1402) Requires each health plan offered by either a regional or corporate alliance to accept for enrollment every alliance eligible individual, unless the plan has reached its enrollment limit. Prohibits the limit from being imposed on the basis of any personal characteristics of enrollees such as health status, need for health care, age, occupation, or affiliation with any person or entity. Prohibits a plan from: (1) restricting or terminating coverage for any reason, including nonpayment of premiums; (2) cancelling coverage for any eligible individual until that individual is enrolled in another plan; (3) excluding an eligible individual because of an existing medical condition; (4) imposing a waiting period before coverage begins; or (5) imposing a rider that excludes the coverage of particular eligible individuals. Prohibits discrimination by a health plan on the basis of race, national origin, sex, language, socio-economic status, age, disability, health status, or anticipated need for health services. (Sec. 1405) Requires each plan to have a grievance procedure. (Sec. 1421) Permits an entity to offer a supplemental insurance policy if the policy and the entity meet specified requirements. (Sec. 1431) Requires each health plan, with respect to each electing essential community provider located within the plan's service area, to either: (1) enter into a written provider participation agreement; or (2) enter into a written agreement under which the plan will make payment to the provider as specified. Provides a special rule for providers of school health services. Makes the provisions of the proceeding sentence applicable only to health plans offered by a health alliance during the five year period beginning with the first year in which any health plan is offered by the alliance. Directs the Secretary of Health and Human Services to study essential community providers and to make recommendations concerning such providers to the Congress. Provides that such recommendations shall apply unless a joint resolution of disapproval is enacted by the Congress. (Sec. 1441) Requires each health plan to meet specified requirements of title X of this Act with respect to workers' compensation and automobile medical liability services. Subtitle F: Federal Responsibilities - Establishes the National Health Board in the Executive Branch. Directs the President to appoint the Board's seven members. (Sec. 1503) Directs the Board to: (1) interpret the comprehensive benefit package; (2) adjust the delivery of preventive services; (3) take steps to assure that the comprehensive benefit package is available on a uniform national basis; (4) recommend to the President and the Congress appropriate revisions to the package; (5) oversee cost containment requirements; (6) develop and implement eligibility standards; (7) establish a performance based system of quality management; (8) develop and implement standards for a national health information system; (9) establish State requirements and monitor State compliance; (10) establish premium class factors; (11) develop a methodology for the risk-adjustment of premium payments; (12) establish financial requirements for guaranty funds; (13) establish standards for health plan grievance procedures; and (14) report annually to the President and the Congress. (Sec. 1506) Authorizes appropriations for the Board. (Sec. 1511) Requires the Board to approve a State health care system if the system meets the applicable requirements of this Act. Prohibits approval of a State health care system prior to 1996. (Sec. 1512) Provides for sanctions for States failing to meet conditions for compliance. (Sec. 1515) Provides for planning grants to States for implementation assistance. (Sec. 1521) Provides for the Federal assumption of responsibilities in the absence of a State system. Provides for increased premiums of 15 percent during Federal operation of a State system to provide reimbursement for the Federal cost of operating the system. (Sec. 1541) Directs the Board to develop a risk adjustment and reinsurance methodology. Sets forth guidelines for developing such methodology. (Sec. 1543) Directs the Board to establish an advisory committee to provide technical advice and recommendations regarding the risk adjustment and reinsurance methodology. (Sec. 1551) Directs the Board to establish minimum capital requirements for regional alliance health plans under which at least $500,000 of capital must be maintained for each plan in the area. Permits the Board to require additional capital. (Sec. 1552) Requires the Board to establish standards for guaranty funds established by the States. (Sec. 1571) Sets forth the responsibilities of the Secretary of Health and Human Services. Directs the Secretary to administer and implement all provisions of this Act, except those duties delegated to the Board, any other executive agency, or to any State. (Sec. 1572) Directs the Secretary to appoint an Advisory Council on Breakthrough Drugs that will examine the reasonableness of launch prices of new breakthrough drugs. (Sec. 1581) Provides for the certification of essential community providers. Sets forth the following categories of providers automatically certified (under provisions of the Public Health Service Act): (1) migrant health centers; (2) community health centers; (3) homeless program providers; (4) public housing providers; (5) family planning clinics; and (6) AIDS providers under the Ryan White Act. Includes as automatically certified (under other Acts) following: (1) Indian health programs under the Indian Health Act; and (2) maternal and child health providers and a federally qualified health center or rural health clinic under the Social Security Act. Includes as automatically certified (under provisions of this Act) the following: (1) providers of school health services; and (2) a qualified community practice network. Provides for the setting of standards for additional health providers. (Sec. 1591) Sets forth the responsibilities of the Secretary of Labor. Includes among those responsibilities the following: (1) enforcement requirements applicable to employers; (2) elections to become corporate alliances; (3) temporary assumption of insolvent self-insured corporate alliance health plans; (4) establishment and administration of the Corporate Alliance Health Plan Insolvency Fund; and (5) administering title I of ERISA as it relates to group health plans maintained by corporate alliances. Subtitle G: Employer Responsibilities - Requires employers to provide for the payments required under title VI of this Act. Sets forth other employer responsibilities including: (1) information reporting requirements; (2) requirements relating to new employees; (3) recordkeeping requirements; and (4) antidiscrimination requirements. (Sec. 1606) Prohibits self-funding of cost sharing benefits by regional alliance employers. (Sec. 1607) Requires an employer to make equal employer premium payments to all qualifying employees, if a voluntary premium payment is made. Places a limit on such voluntary employer premium payments. (Sec. 1608) Sets forth an employer's obligation to a qualifying retired beneficiary where the employer, as of October 1, 1993, was providing a threshold payment. (Sec. 1609) Authorizes the Secretary of Labor to impose a civil penalty of up to $10,000 for each violation of this subtitle with respect to each individual. Subtitle J (sic): General Definitions; Miscellaneous Provisions - Sets forth the definitions and rules used in this Act. Subtitle B: Miscellaneous Provisions (sic) - (Sec. 1911) Grants the National Health Board, the Secretary of Health and Human Services, and the Secretary of Labor authority to issue regulations as necessary to permit the timely implementation of this Act. Title II: New Benefits - Subtitle A: Medicare Outpatient Prescription Drug Benefit - (Secs. 2001 through 2005) Amends title XVIII of the Social Security Act to provide for: (1) Medicare coverage of covered outpatient prescription drugs and biologicals as well as home infusion drug therapy services; (2) payment rules and related requirements, such as those pertaining to deductibles, for covered outpatient prescription drugs; (3) manufacturer rebates to the Secretary under Medicare part B for covered outpatient prescription drugs; and (4) determination of the Medicare part B premium attributable to covered outpatient prescription drugs. Subtitle B: Long-Term Care - Establishes requirements for State plans for home and community-based services to individuals with disabilities. Includes among those requirements the following: (1) a prohibition of limiting eligibility of individuals with disabilities based on income, age, geography, severity of disability, residential setting, or other grounds specified by the Secretary; (2) a requirement to serve low-income individuals; (3) a requirement to specify how Federal and State funds will be managed; (4) quality assurance requirements; and (5) reporting requirements. Requires a State to consult with individuals and groups of individuals with disabilities when developing the plan in order to have the plan approved. (Sec. 2103) Defines "individuals with disabilities" to mean any individual within one or more of the following four categories: (1) individuals requiring help with the activities of daily living; (2) individuals with severe cognitive or mental impairment; (3) individuals with severe or profound mental retardation; and (4) severely disabled children. (Sec. 2104) Requires a State plan to specify the services available. Requires each individualized plan to be developed in close consultation with the individual and the individual's family. Prohibits a State plan from covering: (1) room and board; (2) services furnished in a hospital, nursing facility, intermediate care facility for the mentally retarded, or other specified institutional setting; or (3) items or services to the extent coverage is provided for an individual under a health plan or Medicare. (Sec. 2105) Sets forth provisions relating to: (1) cost sharing; (2) quality assurance and safeguards; (3) advisory groups; (4) payments to States; and (5) the total Federal budget for State plans and allotments to States. (Sec. 2301) directs the Secretary, with the advice and assistance of the National Long-Term Care Insurance Advisory Council to promulgate regulations as necessary to implement provisions concerning private long-term care insurance. Directs the Secretary to make appointments to such Council. Authorizes appropriations for such Council. (Sec. 2321) Directs the Secretary, after considering the Council's recommendations to promulgate regulations designed to: (1) standardize formats and terminology used in long-term care policies; (2) require insurers to provide information to customers on the range of public and private long-term care coverage available; and (3) establish other requirements promoting consumer understanding of benefits. (Sec. 2322) Directs the Secretary to promulgate regulations establishing requirements with respect to the terms of and benefits under long-term care policies, which shall include the following requirements that the policy may not: (1) limit coverage based on a preexisting condition, subject to an exception for a six month period; (2) condition eligibility for benefits based on the need or receipt of any other service; (3) condition eligibility for any benefit on any particular diagnosis; (4) condition eligibility for benefits by providers on compliance with requirements not required by State or Federal law; and (5) condition coverage of any service by a provider on the provision of such service at a higher level of care than required by the insured individual. Prohibits discrimination by diagnosis in the treatment of: (1) Alzheimer's disease; (2) any organic or inorganic mental illness; (3) mental retardation or any other cognitive or mental impairment; or (4) HIV infection or AIDS. Sets forth other requirements for such policies, including requirements related to: (1) premiums; (2) sales practices; (3) continuation, renewal, replacement, conversion, and cancellation of policies; and (4) payment of benefits. (Sec. 2342) Provides for grants to States to enforce the Federal standards concerning long-term care policies. Sets forth requirements for receiving such grants. Authorizes appropriations. Prohibits the sale of a long-term care policy in a State without a regulatory program. (Sec. 2361) Authorizes the Secretary to make grants for the development and implementation of long-term care information, counseling, and other programs to: (1) States; (2) regional alliances (at the option of States within which such alliances are located; and (3) national organizations representing insurance consumers, long-term care providers, and insurers. Authorizes appropriations for such grants. (Sec. 2601) Authorizes the Secretary to conduct a demonstration program to test the effectiveness of various approaches to financing and providing integrated acute and long-term care services for the chronically ill and disabled. Sets forth the services and benefits to be provided, including: (1) all benefits of the comprehensive benefit package provided under title I of this Act; (2) transitional benefits, including assessment and home care; (3) long-term care benefits, including adult day care, home-delivered meals, and nursing facility services in specialized care units; and (4) habilitation services. Permits any of the following to be eligible for such services under criteria to be established by the Secretary: (1) individuals with disabilities under a State program; (2) individuals entitled to benefits under the Medicare program; and (3) individuals entitled to Medicaid and who are also either entitled to Medicare or Supplemental Security Income benefits. Requires reports to the Congress on the demonstration program. Title III: Public Health Initiatives - Subtitle A: Workforce Priorities Under Federal Payments - Establishes within the Department of Health and Human Services the National Council on Graduate Medical Education. Directs the National Council to designate for each academic year the number of individuals nationwide who are authorized to be enrolled in each specified approval physician training program for each medical specialty. Sets forth provisions specifying: (1) Federal formula payments to approved physician training programs; (2) application for payments; and (3) amount of payments. (Sec. 3061) Directs the Secretary to carry out a program with respect to graduate nurse training programs that is equivalent to the program for approved physician training programs. Establishes a National Council on Graduate Nurse Education. (Sec. 3071) Authorizes appropriations for the following programs: (1) primary care physician and physician assistant training; (2) training of underrepresented minorities and disadvantaged persons; and (3) nurse training. (Sec. 3072) Authorizes appropriations for the following programs: (1) a program of skill upgrading and occupational retraining for health care workers; (2) a demonstration program to assist workers in health care institutions in obtaining advanced career positions; (3) a program to develop and operate health-worker job banks in local employment services agencies, subject to certain conditions; (4) a program to provide joint labor-management decision-making in the health care sector on workplace matters related to the restructuring of the health care delivery system of this Act; and (5) a program to facilitate the comprehensive workforce adjustment initiative. (Sec. 3073) Directs the Secretary of Health and Human Services and the Secretary of Labor to jointly establish the National Institute for Health Care Workforce Development. States that the Director of the Institute shall make recommendations to the Secretaries regarding: (1) the supply of health care workers; (2) the impact of this Act; and (3) the development and implementation of high-performance, high-quality health care delivery systems. Directs the Secretaries to establish an advisory board to assist in the development of such recommendations. Subtitle B: Academic Health Centers - Directs the Secretary to make payments to a qualified academic health center or qualified teaching hospital in order to assist such eligible institutions with costs that are not routinely incurred by other entities in providing health services, but are incurred by such institutions by virtue of the academic nature of such institutions. States that such costs include: (1) costs resulting from reduced staff productivity due to teaching responsibilities; (2) the uncompensated costs of clinical research; and (3) exceptional costs associated with an institutions specialized expertise. Provides that the funding for such payments will come from transfers from the Federal Hospital Insurance Trust Fund, payments made by regional alliances to the Federal government for academic health centers and graduate medical education, and payments from corporate alliances. (Sec. 3131) Provides for the access of regional and corporate alliance patients to academic health centers. Subtitle C: Health Research Initiatives - Amends the Public Health Service Act to ensure that the National Institutes of Health conducts and supports biomedical and behavioral research on promoting health and preventing diseases, disorders, and other health conditions. Provides for health services research. Authorizes appropriations for such research. Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health - Authorizes appropriations for the core functions of public health programs and national initiatives regarding health promotion and disease prevention. (Sec. 3312) Authorizes the Secretary to make grants to States to carry out one or more of the following core functions: (1) data collection; (2) activities to protect the environment and to assure the safety of housing, workplaces, and food and water; (3) investigation and control of adverse health conditions; (4) public information and education programs to reduce risks to health such as use of tobacco, alcohol, and drugs, sexual activities that increase the risk of HIV transmission and other sexually transmitted diseases, poor diet, physical inactivity, and low childhood immunization levels; (5) accountability and quality assurance activities; (6) provision of public health laboratory services to complement private clinical laboratory services that screen for diseases and conditions; (7) training and education to assure provision of care by all health professionals; and (8) leadership policy development and administrative activities. (Sec. 3331) Authorizes the Secretary to make grants to agencies of State or local government, private nonprofit organizations, and coalitions that link two or more of these groups for the purpose of carrying out projects to develop and implement innovative community-based strategies to provide for health promotion and disease prevention activities for which there is a significant need. Subtitle E: Health Services for Medically Underserved Populations - Directs the Secretary to make grants to migrant health centers and community health centers, which shall be in addition to other funds available to such centers. Authorizes appropriations. (Sec. 3412) Authorizes appropriations for: (1) grants and contracts for the development of qualified community health plans and practice networks; and (2) loans and guaranteeing the principal and interest to Federal and non-Federal lenders on behalf of public and private entities for the capital costs of developing qualified community health plans and practice networks. (Sec. 3461) Authorizes the Secretary to make grants and enter into contracts with qualified community health groups to provide enabling services such as transportation, community and patient outreach, patient education, and translation services in order to increase the capacity of individuals to utilize the items and services under title I of this Act. Authorizes appropriations. (Sec. 3471) Authorizes appropriations for: (1) the National Health Service Corps; and (2) such amounts as are necessary to ensure that at least 20 percent of participants in the Scholarship Program or the Loan Repayment Program of the Corps are nurses. (Sec. 3481) Entitles a hospital with a low-income utilization rate in a base year of at least 25 percent to a payment as specified. Requires 75 percent of the total available to be allocated to hospitals for low-income assistance. Requires 25 percent of the total available to be allocated to hospitals for assistance in furnishing inpatient hospital services that are not covered services under title I of this Act. Subtitle F: Mental Health; Substance Abuse - Authorizes appropriations to carry out this part. Provides for grants to: (1) increase access to mental health and substance abuse services; (2) improve State and local capacity to coordinate and monitor such services; (3) provide incentives to integrate public and private service systems; and (4) supplement any activity under part B (Alcohol and Drug Abuse and Mental Services Block Grant) of title XIX of the Public Health Service Act. (Sec. 3503) Authorizes the Secretary to make loans for the capital costs incurred in the development of non-acute, residential treatment centers and community-based ambulatory clinics. (Sec. 3521) Requires the establishment of a pilot program demonstrating the integration of the mental illness and substance abuse services of the States with the services included under title I of this Act. Subtitle G: Comprehensive School Health Education; School-Related Health Services - Authorizes appropriations for the programs of this subtitle. States that the purposes of the programs shall be to: (1) support, in kindergarten through grade 12, the provision of comprehensive health educator programs; (2) establish a national framework within which States can create comprehensive school health education programs that target the health risk behaviors of youth, including tobacco use, alcohol and drug abuse, sexual behaviors resulting in infections, injury prevention, dietary patterns, and sedentary lifestyles; (3) pay the initial costs of planning and establishing such programs; (4) support related Federal demonstrations and training; (5) motivate youth to stay in school, avoid teen pregnancy, and strive for success; (6) improve the knowledge of health education among youth; and (7) further the National Education Goals set forth in title I of the Goals 2000: Educate America Act. Defines "comprehensive school health education program." Requires such programs to be sensitive to cultural and ethnic issues, promote involvement by families, and promote personal responsibility. Sets forth requirements for applying for grants and selection of grantees. Subtitle H: Public Health Service Initiative - Establishes a Public Health Service Initiative consisting of specified amounts authorized to be appropriated for the Initiative. States that: (1) the Initiative includes the programs of subtitles C through G of this title and the programs of subtitle D of title VIII; and (2) amounts appropriated to carry out the Initiative, including subtitles A through F of this title, are available to carry out specific programs for which the amounts are appropriated. Subtitle I: Coordination with COBRA Continuation Coverage - Amends title XXII (Requirements for Certain Group Health Plans for Certain State and Local Employees) of the Public Health Service Act to provide for coordination with COBRA continuation coverage. Repeals such title XXII upon implementation of this Act. Title IV: Medicare and Medicaid - Subtitle A: Medicare and the Alliance System - Amends title XVIII of the Social Security Act to provide for optional State integration of Medicare beneficiaries into regional alliance plans. (Sec. 4002) Allows individuals to elect to remain in certain plans. (Sec. 4003) Provides for payments to regional alliances on behalf of certain Medicare-eligible individuals. (Sec. 4004) Extends protections for working aged and disabled individuals to group health plans of all employers. Repeals the limitation on the period of protection for individuals with end stage renal disease. Prohibits Medicare payment for items and services provided under any health plan under this Act. Simplifies Medicare benefit coordination in cases where the individual is also eligible for benefits under this Act's health plans. (Sec. 4011) Makes various changes concerning eligible organization and Medicare supplemental policy enrollment and comparative informational materials, eligible organization outlier payments, and participating provider point-of-service networks. (Sec. 4022) Provides for expanded Medicare coverage for physician assistant, nurse practitioner, and clinical nurse specialist services. (Sec. 4031) Amends title XI of the Social Security Act to: (1) provide for termination of the separate Medicare peer review program upon adoption of the National Quality Management Program above under subtitle A of title V of this Act; and (2) repeal provisions on surgical procedure review and second opinions. (Sec. 4032) Amends title XVIII of the Social Security Act to provide for mandatory assignment for all Medicare part B services. (Sec. 4033) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate administration of Medicare parts A and B and supersedes certain conflicting requirements to the extent required to achieve such purpose. (Sec. 4035) Prohibits the Secretary from implementing any change in procedures for billing and processing Medicare claims within six months of implementing any previous change. Adds advanced notification to providers as a requirement for carriers and fiscal intermediaries under Medicare. (Sec. 4041) Amends title XI of the Social Security Act to: (1) provide for civil monetary penalties for kickback violations under Medicare and State health care programs (the programs); (2) make other penalty-related changes, including increases in criminal and civil monetary penalties, a new criminal penalty exception for certain providers, additional civil monetary penalty offenses related to alliance systems, and requirements for the deposit of penalties collected into the All-Payer Account established above under title V of this Act; (3) revise exclusion provisions, with changes establishing a minimum period of exclusion for certain individuals and entities subject to permissive exclusion from the programs, and providing for program exclusions based on actions under alliance systems; and (4) modify sanction provisions, with changes removing certain conditions for imposing sanctions and setting specified civil money penalties for use in lieu of authorized sanctions. (Sec. 4042) Amends title XVIII of the Social Security Act to revise the limitations on physician self-referrals. (Sec. 4051) Provides for the termination of payments under Medicare for medical education costs and directs the Secretary to make specified transfers from certain Medicare trust funds to the new accounts established above for funding physician training programs and academic health centers. (Sec. 4061) Amends title XVIII of the Social Security Act to provide for the treatment of: (1) uniformed services and VA health plans as eligible organizations under Medicare; and (2) health care facilities of the Department of Veterans Affairs as providers under Medicare. Subtitle B: Savings in Medicare Program - Amends title XVIII of the Social Security Act to provide for: (1) reductions in the update for inpatient hospital services and the adjustment for indirect medical education costs, in payments for capital-related costs for inpatient hospital services; (2) revisions to payment adjustments for disproportionate share hospitals in States participating under this Act; and (3) an extension of the freeze on updates to routine service costs of skilled nursing facilities. (Sec. 4111) Amends title XVIII of the Social Security Act to provide for: (1) establishment of cumulative expenditure goals for physician services; (2) use of real gross domestic product for volume adjustments; (3) repeal of restrictions on the maximum reduction permitted in default update; (4) reduction in the conversion factor for the physician fee schedule for 1995; (5) place limitations on payment for physicians' services furnished by high-cost hospital medical staffs; (6) requirements for physicians to identify the hospital at which the service was furnished; (7) an increase in practice expense relative value units for certain services while assuring budget neutrality; (8) a study and report to the Congress by the Secretary on a resource-based system for determining practice expense relative value units for each physician's service; (9) an increase in work relative value units for office visits while assuring budget neutrality; (10) a reduction in relative values for office consultations; (11) adjustment of outlier intensity of relative values; (12) changes in underserved area bonus payments; (13) elimination of formula-driven payments for certain outpatient hospital services; (14) copayments for laboratory services; and (15) competitive acquisition procedures for Medicare part B items and services (including clinical diagnostic laboratory tests). (Sec. 4131) Makes changes with respect to: (1) Medicare as secondary payer; (2) payments for health maintenance organizations and competitive medical plans with risk-sharing contracts; and (3) routine cost limits and copayments for, respectively, home health services and visits. (Sec 4135) Directs the Secretary to use a competitive process to contract with centers of excellence for cataract surgery, coronary artery by-pass surgery, and such other services as the Secretary determines to be appropriate. (Sec. 4141) Amends title XVIII of the Social Security Act to revise Medicare part B premium provisions. (Sec. 4151) Requires the Secretary to submit a report to the Congress on the growth in spending under Medicare for FY 2000 through 2003. Subtitle C: Medicaid - Amends title XIX (Medicaid) of the Social Security Act to provide that if a State Medicaid plan provides for payment to regional alliances of the amounts required above it is not required to provide payment for items and services covered under the comprehensive benefit package for alliance eligible individuals and will receive no Federal financial assistance with respect to such items and services. (Sec. 4211) Provides for: (1) spenddown eligibility and increased income and resource disregard for nursing facility residents; and (2) informing such residents about the availability of assistance for home and community-based services. (Sec. 4221) Provides for: (1) treatment of items and services not covered under the comprehensive benefit package; and (2) establishment of a program under Medicare of noncovered items and services for poor children. (Sec. 4231) Discontinues certain payment policies under Medicaid. (Sec. 4241) Limits the frequency of changes in a State's billing and claims processing system, and provides for advance notification to providers of any major billing change. (Sec. 4251) Establishes the Medicaid Commission to study, report, and make recommendations with respect to options involving block grant use, integration of long-term care services, and consolidation of institutional and home- and community-based long-term care in relation to the Medicaid program. Authorizes appropriations. Subtitle D: Increase in SSI Personal Needs Allowance - Amends title XVI (Supplemental Security Income) (SSI) to provide for an increase in the SSI personal needs allowance. Title V: Quality and Consumer Protection - Subtitle A: Quality Management and Improvement - Requires the National Health Board to establish and oversee a performance-based program of quality management and improvement designed to enhance the quality, appropriateness, and effectiveness of heath care services and access to such services which will be called the National Quality Management Program. (Sec. 5002) Establishes the National Quality Management Council which shall: (1) administer the National Quality Management Program; (2) perform any other duty specified in this subtitle; and (3) advise the National Health Board with respect to its duties under this subtitle. Requires the Council to develop a set of national measures of quality performance to be used in the assessment of and the provision of access to health care services. Requires the Council, in addition, to: (1) recommend to the Board establishing goals for performance by health plans and health care providers on a subset of national measures of quality performance; (2) direct the Administrator for Health Care Policy and Research to develop, review, and disseminate practice guidelines to determine how diseases can most effectively be prevented, diagnosed, treated, and managed; and (3) direct the Administrator for Health Care Policy and Research to support research related to a five year priority list of performance measures. (Sec. 5008) Directs the National Health Board to: (1) establish and oversee regional professional foundations to perform such duties as develop lifetime learning programs for health professionals and conduct research on health care quality; and (2) establish the National Quality Consortium to perform such duties as establishing continuing education for health professionals and provide advice on research priorities. (Sec. 5012) Requires each regional alliance and each corporate alliance to: (1) disseminate specified information to consumers; and (2) ensure that performance and quality standards are continually improved. Subtitle B: Information Systems, Privacy, and Administrative Simplification - Directs the National Health Board to develop and implement a health information system, in consultation with Federal agencies, States, employers, health plans, and others, by which the Board shall collect, report, and regulate the collection and dissemination of health care information which shall be used for: (1) health care planning by Federal, State, and local government; (2) establishing and monitoring payments for health services; (3) assessing and improving the quality of health care; (4) managing and containing costs at the alliance and plan levels; and (5) other specified purposes. Requires the establishment of an electronic data network to collect, compile, and transmit information. (Sec. 5120) Sets forth provisions providing for health information privacy standards. (Sec. 5130) Directs the National Health Board to develop the following standard health care benefit forms: (1) an enrollment and disenrollment form; (2) a clinical encounter record; and (3) a claim form. (Sec. 5140) Establishes the National Privacy and Health Data Advisory Council in order to advise the National Health Board with respect to its duties under this subtitle. (Sec. 5141) Sets forth monetary penalties for violating health information system standards. Subtitle C: Remedies and Enforcement - Sets forth provisions with respect to the review of benefit determinations for enrolled individuals, including provisions: (1) regulating the time limits for notice of disposition of a claim; (2) governing a plan's duty to review claim denials; (3) concerning urgent requests for preauthorization; and (4) concerning other time limits with respect to time limits and notice. (Sec. 5202) Requires each State to establish a complaint review office for each regional alliance established by a State. Permits aggrieved individuals to file complaints with the appropriate review office. (Sec. 5205) Provides for a Federal Health Plan Review Board to review the decisions of complaint review office hearing officers. (Sec. 5207) Sets monetary penalties for a plan which unreasonably denies or delays payment or provision of benefits. (Sec. 5211) Directs each State to establish and maintain an Early Resolution Program in each complaint review office. Requires a program to include: (1) forums for mediation disputes; and (2) other forums of alternative dispute resolution as may be prescribed. Establishes guidelines for the eligibility of cases for submission to the Early Resolution Program. States that conclusions of the mediation proceedings shall be treated as nonbinding and shall not affect any rights to review. (Sec. 5231) Sets forth additional remedies and enforcement provisions. Subtitle D: Medical Malpractice - Prohibits any medical malpractice liability action until the final resolution of the claim under alternative dispute resolution. Requires each regional alliance health plan and corporate alliance health plan to adopt at least one specified method of alternative dispute resolution. Prohibits an individual from bringing a medical malpractice liability action unless the individual submits an affidavit that includes a report by a qualified specialist that states that there is a meritorious cause for filing the action. (Sec. 5311) Directs the Secretary to establish: (1) a project to demonstrate whether substituting liability for medical malpractice on the part of the health plan in which a physician participates for the personal liability of the physician will result in improvements in the quality of care, reductions in defense medical practices, and better risk management; (2) a pilot program under which the Secretary provides funds to one or more eligible States to determine the effect of applying practice guidelines in the resolution of medical malpractice liability actions. Subtitle E: Fraud and Abuse - Directs the Secretary and the Attorney General to establish a program: (1) to coordinate the functions of the Attorney General, the Secretary, and other organizations with respect to the prevention, detection, and control of health care fraud and abuse; (2) to conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for health care; and (3) to facilitate the enforcement of this and other statutes applicable to health care fraud. (Sec. 5402) Creates, in the Treasury, the All-Payer Health Care Fraud and Abuse Control Account which shall consist of: (1) gifts and bequests; (2) administrative penalties and assessments and portions of civil monetary penalties imposed under provisions of the Social Security Act; (3) all criminal fines imposed in cases involving a Federal health care offense; (4) penalties imposed under the False Claims Act involving claims related to the provision of health care items and services; and (5) amounts resulting from the forfeiture of property by reason of Federal health care offense. States that amounts in the fund may be used to cover costs incurred in operating the Program. (Sec. 5411) Excludes from participation in any health plan any individual or entity excluded from participation in a public program under provisions of the Social Security Act. (Sec. 5413) Sets forth physician self-referral limitations. (Sec. 5431) Amends the Federal criminal code to set penalties for knowingly executing a scheme or artifice to: (1) defraud any health alliance, health plan, or other person (alliance) in connection with the delivery of, or payment for, health care benefits, items, or services (benefits); and (2) obtain, by false or fraudulent means, money or property owned by, or under the custody of control of, any such alliance in connection with the delivery of, or payment for, health care benefits. (Sec. 5432) Amends: (1) the Federal criminal code to require the court, in imposing sentence on a person convicted of a Federal health care offense that poses a serious threat to the health of any person or has a significant detrimental impact on the health care system, to order such person to forfeit property used in the commission of the offense or that constitutes, or is derived from, proceeds traceable to the commission of the offense which is of a value proportionate to the seriousness of the offense; and (2) the Federal judicial code to require that all proceeds of forfeiture relating to Federal health care offenses be deposited into the Department of Justice Assets Forfeiture Fund. (Sec. 5433) Amends the Federal criminal code to set penalties for: (1) knowingly and willfully falsifying, concealing, or covering up a material fact, making any false, fictitious, or fraudulent statements or representations, or making or using any false writing or document knowing it to contain any false, fictitious, or fraudulent statement or entry, in any matter involving a health alliance or health plan; and (2) bribery of, and graft by, a health care official. (Sec. 5435) Authorizes: (1) the Attorney General to commence a civil action in Federal court to enjoin a Federal health care offense; and (2) a person privy to certain grand jury information concerning a health law violation to disclose that information to an attorney for the Government to use in any civil proceeding related to a Federal health care offense. (Sec. 5437) Sets penalties for: (1) theft or embezzlement in connection with a health alliance, health plan, or fund connected with such alliance or plan; and (2) misuse of a health security card issued, or unique identifier provided, pursuant to this Act. (Sec. 5441) Makes provisions of the Civil False Claims Act applicable to the use of false records or statements made to a health plan. Includes within the definition of "claim" for purposes of such Act any request or demand for money or property which is made or presented to a health plan. Subtitle F: McCarran-Ferguson Reform - Amends the McCarran-Ferguson Act to repeal the exemption under specified antitrust laws for the business of insurance to the extent that such business relates to the provision of health benefits. Title VI: Premium Caps; Premium-Based Financing; and Plan Payments - Subtitle A: Premium Caps - Sets forth provisions which provide for the computation of factors that limit the growth of premiums for the comprehensive benefit package in regional alliance health plans, including the computation of a: (1) regional alliance inflation factor; and (2) general health care inflation factor. (Sec. 6002) Directs the Board to determine: (1) a national per capita baseline premium target; (2) the national average per capita current coverage health expenditures; and (3) current health care expenditures. (Sec. 6003) Directs the Board to determine a regional alliance per capita premium. (Sec. 6004) Requires a regional alliance to annually obtain premium bids from each plan seeking to participate as a regional alliance health plan with respect to the alliance. (Sec. 6005) Permits any participating State to assume responsibility for containment of health care expenditures in the State consistent with this Act. (Sec. 6006) Directs the chair of the Board to establish an advisory commission on regional variations in health expenditures. Requires the commission to examine methods of eliminating variation in regional alliance per capita premium targets due to variation in practice patterns, not due to other factors. Requires the Board to submit its recommendations to the Congress. Requires such recommendations to apply unless a joint resolution of disapproval is passed. (Sec. 6011) Subjects each noncomplying regional alliance health plan for a year to a reduction in plan payment as specified, in order to assure that payments to regional alliance health plans by a regional alliance are consistent. Defines a noncomplying plan to include a plan in which the final accepted bid exceeds the maximum complying bid for the per capita target premium. Defines "maximum complying bid." (Sec. 6021) Directs the Board to develop a methodology for calculating an annual per capita expenditure equivalent for amounts paid for coverage for the comprehensive benefit package within a corporate alliance. (Sec. 6022) Terminates a corporate alliance with two excess years in a three year period. Provides that employers that were corporate alliance employers with respect to a terminated alliance shall become regional alliance employers. Defines an excess year as one in which the rate of increase for the corporate alliance exceeds the national corporate inflation factor. Defines rate of increase and national corporate inflation factor. (Sec. 6031) Sets forth special rules for a single-payer State. (Sec. 6041) Directs the Secretary to establish a program to monitor prices and expenditures in the U.S. health care system. Subtitle B: Premium-Related Financings - Makes each family enrolled in a regional health alliance plan or in a corporate alliance health plan in a class of family enrollment responsible for payment of the family share of premium payable for enrollment. Provides for income related discounts and specified credits. (Sec. 6102) Establishes the formula for determining the premiums. (Sec. 6111) Provides for the repayment of credit by certain families. (Sec. 6114) Provides for the special treatment of certain retirees and qualified spouses and children. (Sec. 6121) Requires each regional alliance employer to pay a monthly premium to the regional alliance for a qualifying employee. Sets forth provisions for determining such premium. Varies the premium depending upon such factors as the employer's size and average wages paid. (Sec. 6126) Sets forth provisions applicable to self-employed individuals. (Sec. 6131) Sets forth provisions for determining the corporate employer premium. Subtitle C: Payments to Regional Alliance Health Plans - Sets forth provisions to determine the computation of: (1) the blended plan per capita payment amount; and (2) the plan bid, AFDC, and SSI proportions. Title VII: Revenue Provisions - Subtitle A: Financing Provisions - Amends the Internal Revenue Code to increase the excise taxes on cigarettes and other tobacco products. (Sec. 7113) Imposes an excise tax on the manufacture or importation of roll-your-own tobacco. (Sec. 7121) Imposes an assessment on each corporate alliance employer and a temporary assessment on employers with retiree health benefit costs. Requires such assessments to be paid in the same manner as employment taxes. (Sec. 7131) Provides for the recapture of certain health care subsidies received by high-income individuals. Transfers such amounts to the Supplemental Medical Insurance Trust Fund. (Sec. 7141) Requires certain shareholders of S corporations and limited partners who materially participate in corporate activities to include their share of income or loss from such corporation when determining net earnings from self-employment. (Sec. 7142) Provides for extending Medicare coverage and applying the hospital insurance tax to all State and local government employees. Subtitle B: Tax Treatment of Employer-Provided Health Care - Provides exceptions to the exclusion of employer-provided contributions to an accident or health plan from the gross income of an employee. (Sec. 7202) Prohibits the provision of health benefit under cafeteria plans. (Sec. 7203) Makes permanent the deduction for health insurance costs of self-employed individuals. Increases such deduction to 100 percent of the basic coverage purchased from a health alliance with limitations. Subtitle C: Employment Status Provisions - Requires the Secretary of the Treasury to prescribe regulations defining an employee for employment tax purposes. (Sec. 7302) Increases the penalty for failure to file correct returns involving payments for services. (Sec. 7303) Sets forth rules to limit retroactive employment tax reclassifications. Subtitle D: Tax Treatment of Funding of Retiree Health Benefits - Requires additional reserves for post-retirement medical and life insurance benefits to cover not less than ten years of the working lives of covered employees and to be maintained as separate accounts. (Sec. 7402) Terminates the authority of pension plans to maintain health benefits accounts. Subtitle E: Coordination with COBRA Continuing Care Provisions - Repeals provisions concerning continuation coverage requirements of group health plans upon implementation of this Act. Subtitle F: Tax Treatment of Organizations Providing Health Care Services and Related Organizations - Provides for the tax treatment of charitable organizations providing health care services, insurance provided by health maintenance organizations, and certain private foundations. (Sec. 7602) Sets forth transitional rules for taxing certain organizations providing health insurance and other prepaid health care services as insurance companies other than life insurance companies. (Sec. 7603) Exempts regional alliances from income tax. Subtitle G: Tax Treatment of Long-term Care Insurance and Services - Treats qualified long-term care services as medical care for purposes of the medical expense deduction. (Sec. 7702) Provides for the treatment of long-term care insurance as accident and health insurance. (Sec. 7703) Allows accelerated death benefits under life insurance contracts to be paid to terminally ill individuals. Subtitle H: Tax Incentives for Health Service Providers - Allows a tax credit for certain qualified individuals who provide primary health services full time in a health professional shortage area. (Sec. 7802) Increases the allowable depreciation deduction for expensing certain medical equipment. Subtitle I: Miscellaneous Provisions - Allows a tax credit for the cost of personal assistance services required by an employed individual who for medical reasons is unable to engage in substantial gainful activity. (Sec. 7902) Denies tax-exempt status for private activity bonds of regional alliances, corporate alliances, or guaranty funds established under this Act. Title VIII: Health and Health-Related Programs of the Federal Government - Subtitle A: Military Health Care Reform - Directs the Secretary of Defense to establish one or more uniformed services health plans in order to provide health care services to members of the armed forces on active duty for 30 or more days as well as their covered beneficiaries. Requires conformity of such plans with health plan requirements set forth in this Act. (Sec. 8001b) Allows any such plan to rely upon the use of military health care facilities, supplemented by civilian health care providers or health plans under agreements entered into by the Secretary. Requires at least the items and services in the comprehensive benefit package under this Act to be included in each such plan. Preempts any conflicting State health plan requirements. Provides for plan enrollment, effect of failure to enroll, and choosing between a uniformed services health plan and other available plans. Prohibits the imposition of plan charges to an active-duty member other than subsistence charges, but allows the Secretary to impose limited charges for covered beneficiaries. Establishes in the Department of Defense a financial account for payments received in connection with a uniformed services health plan, allowing such funds to be used only for purposes directly related to the delivery and financing of health care services under this Subtitle. Subtitle B: Department of Veterans Affairs - Allows each veteran who is an eligible individual under this Act and individuals currently enrolled in a health plan under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to be enrolled with a Department of Veterans Affairs (VA) health plan. Requires conformity of such plans with health plan requirements set forth in this Act, with all the items and services of the comprehensive benefit package under this Act included. Allows such plans to offer supplemental health benefits and cost-sharing policies as consistent with this Act. Provides a limitation with regard to veterans enrolled with health plans outside the VA. Prohibits the imposition of any plan enrollment charges upon service-connected disabled veterans, veterans receiving disability compensation from the VA, former prisoners of war, and veterans unable to defray the costs of such care. Allows the Secretary of Veterans Affairs to establish plan charges for other veterans. Deems a VA facility to be a Medicare provider for purposes of any program administered by the Secretary of Health and Human Services. Allows for the recovery of certain care and services provided under a VA plan in the case of an individual who has coverage under another plan. Establishes in the Treasury the Department of Veterans Affairs Health Plan Fund to be used for VA health plan payments and services. Preserves existing benefits for VA facilities not operating within a health plan certified under this Act. (Sec. 8102) Directs the Secretary of Veterans Affairs to organize health plans and operate VA facilities as, or within, health plans under this Act. Preempts existing State health plan standards or requirements. Authorizes the Secretary to contract for the provision of services by a VA health plan when cost-effective, or to share resources with other health care plans, providers, or organizations. Authorizes appropriations to the VA for FY 1995 through 1997 for VA health plans under this Subtitle, subject to availability of appropriations. Requires a report from the Secretary to the Congress concerning the operation of the VA health care system within the requirements of this Act. Authorizes the Secretary to accept and use grants for health care services provided to special populations if used by the VA while operating under a VA health plan. Subtitle C: Federal Employees Health Benefits Programs - (Secs. 8202 through 8204) Provides for termination of the Federal Employees Health Benefits Program (FEHB) and treatment of Federal employees, annuitants, and other individuals (including those residing abroad) who would otherwise have been eligible for FEHBP under this Act's health plans. Subtitle D: Indian Health Service - Makes qualifying Indians eligible to enroll in a comprehensive benefits health program of the Indian Health Service. (Sec. 8303) Authorizes appropriations for supplemental Indian health care benefits. (Sec. 8305) Exempts tribal governments and organizations from making employer payments. (Sec. 8306) Sets forth provisions regarding health service to non-enrollees and non-Indians. (Sec. 8311) Requires each health program of the Indian Health Service to establish a comprehensive benefit package fund. (Sec. 8313) Authorizes appropriations for the Indian Health Service programs. Subtitle E: Amendments to the Employee Retirement Income Security Act of 1974 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to revise and limit the coverage of group health plans under ERISA. Makes certain ERISA provisions inapplicable with respect to State-certified health plans. Provides for an exception from ERISA civil action provisions where review is otherwise available under the Health Security Act (this Act, HSA). (Sec. 8402) Establishes ERISA requirements for expeditious reporting and disclosure applicable to group health plans, through special rules consistent with ERISA and HSA purposes. Excludes plans maintained by regional alliances from treatment as multiple employer welfare arrangements. (Sec. 8403) Revises certain ERISA provisions relating to continuation coverage under group health plans. Repeals such provisions upon implementation of HSA. (Sec. 8404) Makes ERISA standards for group health plans regarding: (1) cases of adoption applicable except to the extent otherwise provided in regulations of the National Health Board under HSA; and (2) coverage of pediatric vaccines inapplicable to a group health plan upon its becoming a corporate alliance health plan under HSA. (Sec. 8405) Requires group health plans under ERISA to comply with HSA requirements relating to health plan claims procedure. Subtitle F: Special Fund for WIC Program - Authorizes appropriations through FY 2000 for the special supplemental food program for women, infants, and children under the Child Nutrition Act of 1966. Title IX: Aggregate Government Payments - Subtitle A: Aggregate State Payments - Sets forth provisions which have formulas for determining each participating State's payment to regional alliances within the State. Provides two different formulas. Establishes one payment formula for non-cash assistance recipients. Establishes another formula relating to cash assistance recipients. Defines a non-cash assistance adult as an individual who is: (1) over 21 years; (2) a U.S. citizen or lawful alien; and (3) is not an AFDC or SSI recipient or a Medicare-eligible individual. (Sec. 9022) Directs the National Health Board to review appropriateness of such payments. Subtitle B: Aggregate Federal Alliance Payments - Sets forth the formula for determining Federal payments to regional alliances for cash assistance recipients. (Sec. 9102) States that this section constitutes budget authority in advance of appropriation Acts and obligates the Federal Government to provide for the payment to regional alliances of a capped Federal alliance payment amount. Defines "capped Federal alliance payment amount." Subtitle C: Borrowing Authority to Cover Cash-flow Shortfalls - Authorizes the Secretary to make available loans to regional alliances to cover any period of temporary cash-flow shortfall attributable to: (1) any estimation discrepancy; (2) a period of temporary cash-flow shortfall attributable to an administrative error; or (3) a period of temporary cash-flow shortfall relating to the relative timing during the year in which amounts are received and payments are required. Sets forth loan terms and conditions. Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance - Subtitle A: Workers Compensation Insurance - Requires each health plan that provides services to enrollees through participating providers to make arrangements to provide workers compensation to such enrollees. (Sec. 10002) Requires each workers' compensation carrier that is liable for payment for workers' compensation services furnished by or through a health plan, regardless of whether or not the services are included in the comprehensive benefit package, to make payment for such services. (Sec. 10011) Sets forth requirements for participating States. (Sec. 10031) Authorizes demonstration projects in one or more States with respect to the treatment of work-related injuries and illnesses. Subtitle B: Automobile Insurance - Requires an individual entitled to automobile insurance medical benefits and enrolled in a health plan to receive automobile insurance medical services through the provision of such services by the health plan. (Sec. 10102) Requires each automobile insurance carrier that is liable for payment for automobile insurance medical services furnished by or through a health plan, regardless of whether or not the services are included in the comprehensive benefit package, to make payment for such services. (Sec. 10111) Requires each participating State to develop a fee schedule applicable to payment for automobile insurance medical services for which a fee is not included in the applicable fee schedule. Subtitle C: Commission on Integration of Health Benefits - Establishes the Commission on Integration of Health Benefits which shall study and report on the feasibility and appropriateness of transferring financial responsibility for all medical benefits, including those currently covered by workers compensation and automobile insurance, to health plans. Authorizes appropriations. Subtitle D: Federal Employees' Compensation Act - Requires the Federal Employees' Compensation Act to be interpreted and administered consistent with the provisions of subtitle A. Subtitle E: Davis-Bacon Act and Service Contract Act - Amends the Davis-Bacon Act and the Service Contract Act of 1965 to require Health Security Act benefits. Subtitle F: Effective Dates - Sets forth effective date provisions. Title XI: Transitional Insurance Reform - Sets forth transitional provisions concerning: (1) enforcement; (2) preservation of current coverage; (3) restrictions on premium increases during transition; (4) portability requirements; (5) restrictions limiting benefit reductions; and (6) the establishment of the National Transitional Health Insurance Risk Pool.
United States · United States Congress · 18 November 1993
Code of Conduct on Arms Transfers Act of 1993 - 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 in 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 by annually reporting to the Register the number and type of conventional weapons possessed by, and transferred to and from, the country during the preceding year. Authorizes an exemption from such prohibition for a fiscal year if: (1) the President requests an exemption from the Congress stating that it is in the national security interest to provide military assistance and arms transfers to a government; and (2) the Congress enacts a law approving such request. Requires the President to submit initial certifications and requests for exemptions in conjunction with the submission of the annual request for enactment of authorizations and appropriations for foreign assistance. Expresses the sense of the Congress that the House Foreign Affairs Committee and the Senate Foreign Relations Committee should hold hearings on controversial certifications and all requests for exemptions.
United States · United States Congress · 17 November 1993
Public Safety and Recreational Firearms Use Protection Act - Amends the Federal criminal code to prohibit the manufacture, transfer, or possession of a semiautomatic assault weapon as defined or listed under this Act. Sets penalties for violations and for use or possession of such a weapon during a crime of violence or drug trafficking crime. Requires the serial number of any such weapon manufactured after enactment of this Act to clearly show the date on which the weapon was manufactured. Makes such provisions inapplicable to: (1) the transfer or possession of any firearm lawfully possessed before the effective date of this Act; (2) certain hunting and sporting firearms; (3) the United States or a department or agency of the United States, or a State or department, agency, or political subdivision of a State; and (4) the manufacture, transfer, or possession of a firearm by a licensed manufacturer or importer for purposes of testing or experimentation authorized by the Secretary of the Treasury. Prohibits: (1) the sale, shipment, or delivery of an assault weapon to a person who does not fill out a form 4473 (prescribed by the Secretary) in connection with the purchase of an assault weapon; and (2) the purchase, possession, or acceptance of delivery of such weapon by a person who has not completed such form. Sets forth: (1) additional recordkeeping requirements; and (2) penalties for violations. Prohibits the transfer or possession of a large capacity ammunition feeding device, with exceptions. Treats such devices as firearms. Sets penalties for violations. Requires any such device manufactured after the date of this Act's enactment to be identified by a serial number that clearly shows that the device was manufactured or imported after the effective date of this Act. Directs the Attorney General to: (1) investigate and study the effect of this Act and determine its impact, if any, on violent and drug trafficking crime; and (2) report to the Congress. Itemizes firearms under various categories as an appendix to Federal firearms provisions.
United States · United States Congress · 17 November 1993
Prohibits the shipment in interstate or foreign commerce of steel jaw leghold traps and of articles of fur derived from animals trapped in such traps. Prescribes criminal penalties for violations of this Act. Directs the Secretary of the Interior to reward nongovernment informers for information leading to a conviction under this Act. Empowers enforcement officials to detain, search, and seize suspected merchandise or documents and to make arrests with and without warrants. Subjects seized merchandise to forfeiture.
United States · United States Congress · 16 November 1993
National Environmental Policy Act Administrative Reorganization Amendments of 1993 - Amends the National Environmental Policy Act of 1969 (the Act) to replace provisions regarding the Council on Environmental Quality with those establishing an Office of National Environmental Policy (NEPA) Compliance in the Executive Office of the President. Requires the Office to be headed by a Director appointed by the President. Requires the Director to: (1) promulgate regulations governing the implementation of the Act by all Federal agencies; (2) mediate interagency disputes; and (3) monitor Federal agency implementation of the Act and regulations. Amends the Environmental Quality Improvement Act of 1970 to remove provisions regarding the Office of Environmental Quality. Authorizes appropriations for the Office of NEPA Compliance. Transfers certain duties of the Council, including making an annual report on the state of the environment, to the Secretary of the Environment. Authorizes appropriations. Terminates the Council and the Office of Environmental Quality and transfers functions to the Office of NEPA Compliance. Makes existing Council funds available for the Director.
United States · United States Congress · 15 November 1993
Authorizes renewal, until May 1, 1994, of the Agreement between the Government of the United States and the Government of the Russian Federation on Mutual Fisheries Relations, which expired on October 28, 1993.
United States · United States Congress · 9 November 1993
National Environmental Policy Act Administrative Reorganization Amendments of 1993 - Amends the National Environmental Policy Act of 1969 (the Act) to replace provisions regarding the Council on Environmental Quality with those establishing an Office of National Environmental Policy (NEPA) Compliance in the Executive Office of the President. Requires the Office to be headed by a Director appointed by the President. Requires the Director to: (1) promulgate regulations governing the implementation of the Act by all Federal agencies; (2) mediate interagency disputes; (3) monitor Federal agency implementation of the Act and regulations; and (4) perform other functions related to environmental laws, policies, and programs as specified by the President. Amends the Environmental Quality Improvement Act of 1970 to remove provisions regarding the Office of Environmental Quality. Authorizes appropriations for the Office of NEPA Compliance. Transfers certain duties of the Council, including making an annual report on the state of the environment, to the Secretary of the Environment. Authorizes appropriations. Terminates the Council and the Office of Environmental Quality and transfers functions to the Office of NEPA Compliance. Makes existing Council funds available for the Director.
United States · United States Congress · 8 November 1993
Wetlands Protection and Management Act - Prohibits the revision of the 1987 Corps of Engineers Wetlands Delineation Manual before the Committee on Wetlands Characterization of the National Research Council publishes a specified report. Permits revisions afterward if the revisions: (1) take into account the findings and recommendations of the report; and (2) are made after field testing and public notice and comment. Requires wetlands identification and delineation to be carried out through the Manual until revised in accordance with this Act. Directs the Chief of the Soil Conservation Service (SCS), the Administrator of the Environmental Protection Agency, and the Secretaries of the Army and the Interior to issue a memorandum of agreement which sets forth procedures for identifying and delineating wetlands on agricultural lands. Requires the SCS Chief, after the issuance of the memorandum, to carry out such activities on agricultural lands and on non-agricultural lands which are contiguous to, or contained within, agricultural lands. Amends the Federal Water Pollution Control Act to authorize grants to States for wetlands conservation planning. Requires the Secretary of the Army, acting through the Chief of Engineers, to ensure, in issuing permits for the discharge of dredged or fill material into navigable waters, that there is no net loss of wetland acreage, functions, and values. Establishes procedures for the issuance of permits for minor discharges into wetlands. Creates a Small Landowners Assistance Account to provide technical assistance to private landowners to aid in compliance with permit requirements. Authorizes the issuance of general permits on a State or nationwide basis for any category of activities involving discharges of dredged or fill material if the activities are similar in nature and will cause only minimal adverse environmental effects when performed separately and cumulatively. Exempts prior converted cropland (unless abandoned) and certain waters and activities from regulation under dredged and fill permit provisions. Establishes administrative appeal procedures for determinations of regulatory jurisdiction over property, permit issuance or denial, and imposition of administrative penalties. Requires the Administrator to establish compensatory wetlands mitigation guidelines. Provides for mitigation banks (wetlands restoration projects that provide advance mitigation to offset foreseeable wetlands losses from future discharges of dredged or fill material). Establishes wetlands delineator training and certification programs and wetlands education and outreach programs. Includes "wetlands" in the definition of navigable waters. Expresses the sense of the Congress that the Wetlands Reserve Program is an effective program and should be fully funded.
United States · United States Congress · 8 November 1993
Expresses the sense of the Congress that the United States should: (1) seek an international agreement to ban the deliberate ocean dumping of low-level radioactive waste and encourage a periodic international scientific review of the environmental impacts of such dumping; and (2) urge all nations to comply with existing and future international agreements prohibiting the deliberate ocean dumping of low- and high-level radioactive waste.
United States · United States Congress · 3 November 1993
Establishes within the Department of the Interior the Presidio Corporation to manage the leasing, maintenance, rehabilitation, repair, and improvement of the following properties within the Presidio in California leaseholds to which shall be transferred under this Act to the Corporation by the Secretary of the Interior: (1) the Letterman-LAIR complex; (2) Fort Scott; (3) Main Post; (4) Cavalry Stables; (5) Presidio Hill; (6) Wherry Housing; (7) East Housing; (8) the structures at Crissy Field; and (9) such other buildings within the Presidio as the Secretary determines appropriate. Requires the Corporation to establish competitive bidding procedures for issuance of leases and contracts under this Act. Reverts all interests and assets of the Corporation to the United States in the event the Corporation fails or defaults. Authorizes appropriations.
United States · United States Congress · 3 November 1993
TABLE OF CONTENTS: Title I: Redesignation of Environmental Protection Agency as Department of Environmental Protection Title II: Administrative Provisions Department of Environmental Protection Act - Title I: Redesignation of Environmental Protection Agency as Department of Environmental Protection - Redesignates the Environmental Protection Agency (EPA) as the Department of Environmental Protection to be headed by a Secretary of the Environment. (Sec. 109) Requires the Secretary to establish a permanent information resources management steering committee and to designate a Chief Information Officer. (Sec. 110) Directs the Secretary to develop policies for encouraging greater public access to departmental information and to maintain a public access system that provides an inventory of the Department's information services and other holdings. (Sec. 111) Establishes a Bureau of Environmental Statistics, an Office of Environmental Justice, and an Advisory Committee on Environmental Justice. Requires the Director of the Office to promote environmental justice for all people wherever they are located or work in the United States and regardless of income, race, ethnicity, or national origin. (Sec. 113) Requires the Secretary to: (1) provide for the acquisition and development of the best credible and unbiased scientific information; and (2) implement peer review and quality assurance guidelines. (Sec. 114) Establishes conflict-of-interest reporting requirements for members of Department advisory committees who are not Federal employees. (Sec. 115) Permits the Department to enter into an umbrella contract only if the contract: (1) does not exceed five years (ten years for a response action contract or a longer period under unusual and compelling circumstances); (2) is awarded pursuant to full and open competition, except under specified conditions; and (3) does not authorize the contractor to procure items on behalf of the Federal Government, other than items procured under and for response action contracts and in which the Government has all rights and interests. Defines an "umbrella contract" as a contract that: (1) provides for the performance of specific advisory and assistance services but does not procure or specify a firm quantity of services; (2) provides for services to be supplied in response to Federal task orders; (3) requires the contractor to provide a stated amount of effort over a given period of time; and (4) has a maximum potential value of at least $1 million, is not a fixed price contract, and is for a period longer than one year. Lists subcontracting requirements. (Sec. 116) Declares that it shall be the policy of the Department to prevent the transfer of inherently governmental functions to private sector contractors. (Sec. 117) Disallows indirect costs incurred by a Department contractor if a cost submitted is unallowable because it is in violation of a cost principle in the Federal Acquisition Regulation or other law. Applies this requirement to contracts in excess of $100,000 other than fixed-price contracts without cost incentives. Prescribes penalties for the submission of unallowable costs. (Sec. 118) Lists unallowable costs as costs of entertainment, gifts, or recreation for contractor employees. Title II: Administrative Provisions - Sets forth provisions governing: (1) the acquisition of copyrights and patents by the Secretary; (2) the acceptance of gifts; (3) the departmental seal; and (4) the use of existing stationery, forms, and other EPA supplies.
United States · United States Congress · 2 November 1993
Authorizes the Secretary of the Navy to transfer to the U.S. Navy Shipbuilding Museum in Quincy, Massachusetts, the obsolete heavy cruiser U.S.S. Salem, notwithstanding a required waiting period for such transfers.
United States · United States Congress · 26 October 1993
Urges the Attorney General and the Director of the Federal Bureau of Investigation (FBI) to cooperate with the U.S. Postal Service and the Polly Klaas Search Center to use nationwide mailings to disseminate information concerning the kidnapping of Polly Klaas. Commends the community of Petaluma, California, the Petaluma Police Department, and the FBI for their hard work on this case.
United States · United States Congress · 21 October 1993
Establishes a toll-free number to inform consumers regarding: (1) whether a product is made in America; (2) where products may be purchased; and (3) the purchase of products. Allows registration of American-made products.
United States · United States Congress · 20 October 1993
Declares the sense of the Congress regarding: (1) conservation and management of Atlantic bluefin tuna in the Atlantic Ocean and the Mediterranean Sea; (2) certain actions by the United States; (3) compliance with measures adopted by the International Commission for the Conservation of Atlantic Tunas; (4) certification under the Fishermen's Protective Act of 1967; and (5) encouragement of countries that fish for bluefin or other highly migratory species in the Atlantic Ocean or the Mediterranean Sea to participate in the International Convention for the Conservation of Atlantic Tunas and the Commission.
United States · United States Congress · 19 October 1993
Natural Resource Management on Military Lands Act of 1993 - Amends the Act of September 15, 1960 (Sikes Act) to direct (current law authorizes) the Secretary of Defense to carry out a program of wildlife, fish, and game conservation on each U.S. military installation. Requires an integrated natural resources management plan to be included in each program. Requires the plan to address the needs for fish and wildlife management, land management, forest management, and wildlife-oriented recreation. Requires an opportunity for public comment on each plan prepared. Requires certain reviews and reports by the Secretary with respect to such plans. Directs the Secretary of the Interior to: (1) monitor the implementation of each integrated natural resource management plan of the Department of Defense; (2) conduct investigations of alleged plan violations; (3) report violations; and (4) enter into agreements specifying appropriate measures to remedy any violation or failure to implement the plan. Requires the Secretary to report annually to the Congress on plan violations. Requires the Secretary of each military department to ensure that sufficient numbers of trained natural resources management and law enforcement personnel are available and assigned to perform tasks necessary to ensure plan compliance. Extends through FY 1998 the authorization of appropriations for natural resources conservation programs on military installations, as well as equivalent programs on other public lands.
United States · United States Congress · 15 October 1993
Prohibits the imposition of additional charges or fees for attendance at the U.S. Military, Naval, Air Force, Coast Guard, or Merchant Marine Academies, unless such charge or fee is specifically authorized by law.
United States · United States Congress · 14 October 1993
Towing Vessel Navigational Safety Act of 1993 - Amends Federal marine safety law to require each towing vessel to be equipped with certain navigational publications and equipment. Directs the Secretary of Transportation to require applicants for issuance or renewal of a towing vessel operators license to demonstrate proficiency in the use of navigational safety equipment. Requires marine casualties to be reported as soon as practicable, but in no case later than within five days (currently, within five days). Requires the Secretary to report to the Congress on: (1) the effectiveness of manning and licensing requirements for the operation of towing vessels; and (2) the feasibility of establishing a differential global positioning satellite navigation system for U.S. inland waterways.
United States · United States Congress · 13 October 1993
1995 Franklin Delano Roosevelt Commemorative Coin Act - Directs the Secretary of the Treasury to issue commemorative one-dollar silver coins bearing a likeness of Franklin Delano Roosevelt. Requires the Secretary to distribute proceeds from surcharges ($10 per coin) in equal allocations to: (1) the National Park Foundation Restricted Account for the Franklin Delano Roosevelt Memorial; and (2) the National Park Service Restricted Construction Account for the Franklin Delano Roosevelt Memorial.
United States · United States Congress · 7 October 1993
Provides for an adjournment of the House of Representatives from October 7 or 8, 1993, until October 12, 1993, and a recess or adjournment of the Senate from October 7, 1993, until October 13, 1993.
United States · United States Congress · 30 September 1993
Women's Health Services Act of 1993 - Amends title XVIII (Medicare) of the Social Security Act to: (1) provide for coverage under Medicare part B (Supplementary Medical Insurance) of bone mass measurements and annual screening mammography for women over age 64; and (2) make permanent the coverage of certain osteoporosis drugs under such part.
United States · United States Congress · 29 September 1993
Sea of Okhotsk Fisheries Enforcement Act of 1993 - Amends the Central Bering Sea Fisheries Enforcement Act of 1992 to prohibit U.S. vessels and nationals from fishing in the Central Sea of Okhotsk except in accordance with an international fishery agreement to which the United States and the Russian Federation are parties.
United States · United States Congress · 21 September 1993
Maritime Competitiveness Commission Act of 1993 - Amends the Merchant Marine Act, 1936 to establish the National Commission to Ensure a Strong and Competitive United States Maritime Industry. Terminates the Commission after transmittal of its report.
United States · United States Congress · 15 September 1993
General Aviation Revitalization Act of 1993 - Amends the Federal Aviation Act of 1958 to set forth a 15-year statute of limitations within which a person may bring a civil action against an aircraft manufacturer for damages for death or injury or damage to property arising from an aircraft accident.
United States · United States Congress · 15 September 1993
Amends the Internal Revenue Code to provide that amounts previously appropriated, but not distributed, from the Aquatic Resources Trust Fund for boat safety programs will not be treated as amounts in the Boat Safety Account when determining whether such Account would be increased to a sum that exceeds limitations.
United States · United States Congress · 14 September 1993
TABLE OF CONTENTS: Title I: Research on Women's Health Subtitle A: NIH Women Scientist Employment Opportunities Act Subtitle B: Women and AIDS Research Initiative Amendments of 1993 Subtitle C: Women and Alcohol Research Equity Act of 1993 Subtitle D: National Breast Cancer Strategy Act of 1993 Subtitle E: Lupus Research Amendments of 1993 Subtitle F: Women's Midlife Health Research Act Subtitle G: Osteoporosis and Related Bone Disorders Research Education, and Health Services Act of 1993 Subtitle H: Ovarian Cancer Research and Information Amendments of 1993 Subtitle I: Antiprogestin Testing Act of 1993 Subtitle J: Women's Health Environmental Factors Research Act of 1993 Subtitle K: Federal Risk Assessment in Women's Health Act of 1993 Subtitle L: Pharmaceutical Interactions Safety Act Subtitle M: Pharmaceutical Testing Fairness Act Subtitle N: Tobacco Advertising and Promotion Studies Act of 1993 Title II: Services Regarding Women's Health Subtitle A: Equity in Health Professions Education Act Subtitle B: Women's Health Office Act of 1993 Subtitle C: Women's Health Information Act of 1993 Subtitle D: Breast and Cervical Cancer Amendments of 1993 Subtitle E: Women's Preventive Health Amendments of 1993 Subtitle F: Postreproductive Health Care Act Subtitle G: Medicare Bone Mass Measurement Coverage Act of 1993 Subtitle H: Mickey Leland Adolescent Pregnancy Prevention and Parenthood Act of 1993 Subtitle I: Adolescent Health Demonstrations Projects Act of 1993 Subtitle J: Eating Disorders Information and Education Act of 1993 Subtitle K: Women and HIV Outreach and Prevention Act Subtitle L: Standby Guardianship Act Subtitle M: Federal Prohibition of Female Genital Mutilation Act of 1993 Subtitle N: Smoking Prevention and Cessation in WIC Clinics Act Subtitle O: Family and Medical Leave Health Care Reform Resolution of 1993 Subtitle P: Veteran Women's Health Improvement Act of 1993 Subtitle Q: Defense Women's Health Improvement Act of 1993 Subtitle R: International Population Stabilization and Reproductive Health Act Women's Health Equity Act of 1993 - Title I: Research on Women's Health - Subtitle A: Women Scientists Employment Opportunities Act - NIH Women Scientists Employment Opportunity Act - Amends the Public Health Service Act to require the Director of the National Institutes of Health to: (1) establish policies for NIH on matters relating to the employment of women scientists by NIH; and (2) monitor compliance with such policies and take appropriate actions if the policies have been violated. Authorizes appropriations. Subtitle B: Women and AIDS Research Initiative Amendments of 1993 - Women and Aids Research Initiative Amendments of 1993 - Directs the Secretary of Health and Human Services, with respect to cases of infection with the human immunodeficiency virus, to establish a program, under the Public Health Service Act, for the purpose of conducting biomedical and behavioral research on such cases in women, especially on the prevention of such cases. Authorizes appropriations. Subtitle C: Women and Alcohol Research Equity Act of 1993 - Women and Alcohol Research Equity Act of 1993 - Amends the Public Health Service Act to direct the Director of the National Institute on Alcohol Abuse and Alcoholism to obligate a specified amount to carry out research projects on alcohol abuse and alcoholism among women. Subtitle D: National Breast Cancer Strategy Act of 1993 - National Breast Cancer Strategy Act of 1993 - Establishes an Office of Breast Cancer within the Office of the Assistant Secretary for Health to coordinate activities of Federal agencies relating to breast cancer. (Sec. 118) Establishes the National Breast Cancer Commission to conduct a study on current efforts on both the public and private sectors relating to the prevention, early detection, treatment, education, and research relating to breast cancer. (Sec. 119) Authorizes appropriations for FY 1994 through 1996 for conducting and supporting research on breast cancer through the National Cancer Institute. (Sec. 120) Requires the Director of the National Cancer Institute to: (1) conduct and support biomedical and behavioral research and research training, the dissemination of health information, and other programs with respect to breast cancer; and (2) establish the Rose Kushner Scholarship Program for the purpose of entering into contracts with individuals under which the Institute provides scholarships to individuals for attending health professions schools and the individuals agree to study oncology and serve as employees of the National Institutes of Health for a specified period. (Sec. 121) Authorizes appropriations for FY 1994 through 1996 for at least ten research programs on breast cancer, lung cancer, or prostate cancer under designated programs. Subtitle E: Lupus Research Amendments of 1993 - Lupus Research Amendments of 1993 - Requires the Director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases to expand and intensify research and related activities of the Institute with respect to lupus. Authorizes appropriations. Subpart F: Women's Midlife Health Research Act - Women's Midlife Health Research Act - Requires the Director of the National Institute on Aging to provide for the development or expansion of not less than five centers for research on: (1) the process by which the functioning of the ovaries diminishes or ceases completely; and (2) conditions arising from the diminished or complete cessation of the functioning of the ovaries. Subtitle G: Osteoporosis and Related Bone Disorders Research Education, and Health Services Act of 1993 - Osteoporosis and Related Bone Disorders Research, Education, and Health Services Act of 1993 - Requires the Director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the Director of the National Institute on Aging, and the Director of the National Institute of Diabetes and Digestive and Kidney Diseases to expand and intensify research on osteoporosis and related bone disorders. Authorizes appropriations. Establishes in the Department of Health and Human Services an Interagency Council on Osteoporosis and Related Disorders. Sets forth the duties of such Council. Establishes in the Department of Health and Human Services an Advisory Panel on Osteoporosis and Related Disorders. Authorizes appropriations. Requires the Director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases to make grants or enter into contracts with eligible organizations to establish a Resource Center on Osteoporosis and Related Disorders. Authorizes appropriations. Subtitle H: Ovarian Cancer Research and Information Amendments of 1993 - Ovarian Cancer Research and Information Amendments of 1993 - Amends provisions of the National Institutes of Health Revitalization Act of 1993 which added provisions to the Public Health Service Act to make revisions concerning ovarian cancer funding and public information education. Subtitle I: Antiprogestin Testing Act of 1993 - Antiprogestin Testing Act of 1993 - Provides for research on antiprogestin drugs for any potential use, including termination of pregnancy and contraception and when used therapeutically for cancer, endocrine disorders, and endometriosis. Subtitle J: Women's Health Environmental Factors Research Act of 1993 - Women's Health Environmental Factors Research Act of 1993 - Requires the Director of the National Institute of Environmental Health Sciences to carry out research on the effects that environmental factors have on women's health conditions. Authorizes appropriations. Subtitle K: Federal Risk Assessment in Women's Health Act of 1993 - Federal Risk Assessment in Women's Health Act of 1993 - Directs the Office of Science and Technology Policy to conduct a review of all Federal programs that assess or mitigate the risks to women's health from environmental exposures. Subtitle L: Pharmaceutical Interactions Safety Act - Pharmaceutical Interactions Safety Act - Amends the Federal Food, Drug, and Cosmetic Act and the Public Health Service Act to require clinical investigations to include investigations of the possible interaction of the drug or biological product with relevant female or male hormones, unless inappropriate. Subtitle M: Pharmaceutical Testing Fairness Act - Pharmaceutical Testing Fairness Act - Requires new drug clinical investigations, device clinical investigations, and biological products clinical investigations to include women and minority groups as subjects, unless inappropriate. Subtitle N: Tobacco Advertising and Promotion Studies Act of 1993 - Tobacco Advertising and Promotion Studies Act of 1993 - Directs the Federal Trade Commissions to conduct specified studies concerning tobacco advertising and its effect on women and minorities, as well as its targeting of women and girls concerning weight loss, and the demographics of such advertising. Title II: Services Regarding Women's Health - Subtitle A: Equity in Health Professions Education Act - Equity in Health Professions Education Act - Directs the Secretary of Health and Human Services to conduct a study to determine the extent to which health professions schools provide adequate education to students on women's health conditions. Subtitle B: Women's Health Office Act of 1993 - Women's Health Office Act of 1993 - Amends the Public Health Service Act to establish within the Office of the Assistant Secretary for Health an Office of Women's Health. Sets forth the duties of such Office. Authorizes appropriations. (Sec. 208) Establishes within the Office of the Director of the Centers for Disease Control and Prevention an Office of Women's Health. Sets forth the duties of such Office. Requires the Director of such Office to establish the Coordinating Committee on Research on Women's Health. Sets forth the duties of such Committee. (Sec. 209) Establishes within the Office of the Director of the Agency for Health Care Policy and Research an Office of Women's Health. Sets forth the duties of such Office. Requires the Director of such Office to establish the Coordinating Committee on Research on the Women's Health. Sets forth the duties of such Committee. (Sec. 210) Amends title VII of the Social Security Act to provide for the establishment within the Office of the Administrator of the Health Resources and Services Administration an Office of Women's Health. Sets forth the duties of such Office. Requires the Director of the Office to establish the Coordinating Committee on Research on Women's Health. Sets forth the duties of such Committee. (Sec. 210A) Amends the Federal Food, Drug, and Cosmetic Act to establish within the Office of Commissioner of the Food and Drug Administration an Office of Women's Health. Sets forth the duties of such Office. Requires the Director of such Office to establish the Coordinating Committee on Women's Health. Sets forth the duties of such Committee. Subtitle C: Women's Health Information Act of 1993 - Women's Health Information Act of 1993 - Directs the Secretary of Health and Human Services to establish an Interagency Committee on Health Communications to provide advice to the Secretary on developing and coordinating Federal promotion and education activities, including activities within the Public Health Service. Requires the Committee to give priority to carrying out activities regarding women's health. (Sec. 214) Directs the Assistant Secretary for Health to establish the Clearinghouse on Women's Health to compile, archive and disseminate information concerning women's health and to publish a yearly summary of such materials to be made available upon request. Subtitle D: Breast and Cervical Cancer Amendments of 1993 - Breast and Cervical Cancer Amendments of 1993 - Amends provisions of the program under the Public Health Service Act which provides for breast cancer screenings to place certain limits on the amounts which may be paid to promote entities for such screenings. Authorizes appropriations through FY 1998 for the screening program. Subtitle E: Women's Preventive Health Amendments of 1993 - Women's Preventive Health Amendments of 1993 - Provides for grants for demonstration projects relating to preventive health care for women. Authorizes appropriations. Subtitle F: Postreproductive Health Care Act - Postreproductive Health Care Act - Provides for grants to provide specified health services to women who are of menopause age or older. Authorizes appropriations. Subtitle G: Medicare Bone Mass Measurement Coverage Act of 1993 - Medicare Bone Mass Measurement Coverage Act of 1993 - Provides for Medicare coverage of bone mass measurements for qualified individuals. Subtitle H: Mickey Leland Adolescent Pregnancy Prevention and Parenthood Act of 1993 - Mickey Leland Adolescent Pregency Prevention and Parenthood Act of 1993 - Revises title XX of the Public Health Service Act. Renames such title as Adolescent Pregnancy Prevention, Care, and Research Grants. Authorizes the Secretary of Health and Human Services to make grants to provide prevention and care services to pregnant adolescents and their male partners, adolescent parents, and nonpregnant adolescents. Sets forth provisions affecting: (1) how such grants are to be used; (2) priorities, amounts, and duration of such grants; (3) grant application requirements; (4) program coordination; and (5) research. Authorizes appropriations. Subtitle I: Adolescent Health Demonstrations Projects Act of 1993 - Adolescent Health Demonstrations Projects Act of 1993 - Directs the Secretary to make grants to establish or support adolescent health demonstration projects in secondary schools for the purpose of demonstrating how such projects may be established throughout the United States. Requires that priority be given to projects serving low-income or minority populations. Prohibits the use of any project funds to perform or pay for abortions. Subtitle J: Eating Disorders Information and Education Act of 1993 - Eating Disorders Information and Education Act of 1993 - Provides for a program of information and education to the public on the prevention and treatment of eating disorders. Authorizes appropriations. Subtitle K: Women and HIV Outreach and Prevention Act - Women and HIV Outreach and Prevention Act - Authorizes the Secretary to make grants for a program that provides to women preventive health services that are related to acquired immune deficiency. Authorizes appropriations. (Sec. 253) Authorizes the Director of the Center for Substance Abuse Treatment to make grants for the treatment of women for substance abuse, including counseling to prevent infection with and transmission of AIDS. Authorizes appropriations. (Sec. 254) Authorizes appropriations for the AIDs early intervention program for women under the Public Health Service Act. Subtitle L: Standby Guardianship Act - Standby Guardianship Act - Amends part E of title IV of the Social Security Act to require a State, in order to be eligible for payments under such part, to have in effect standby guardianship laws and procedures. Subtitle M: Federal Prohibition of Female Genital Mutilation Act of 1993 - Federal Prohibition of Female Genital Mutilation Act of 1993 - Amends the Federal criminal code to provide for the imprisonment or fining of any individual who knowingly circumcises, excises, or infibulates the whole or any part of the labia majora or labia minora or clitoris of any person under the age of 18. Directs the Secretary to carry out outreach activities in communities that traditionally practice female circumcision. Subtitle N: Smoking Prevention and Cessation in WIC Clinics Act - Smoking Prevention and Cessation in WIC Clinics Act - Amends the Child Nutrition Act of 1966 to require the State agency responsible for nutrition education and drug abuse education to establish a smoking cessation demonstration program for pregnant participants. Subtitle O: Family and Medical Leave Health Care Reform Resolution of 1993 - Expresses the sense of the Congress that any bill to address the ongoing and unmet health insurance needs of this country that is enacted should require that paid or unpaid leave, as detailed in the Family and Medical Leave Act of 1993, be incorporated as a basic or elective option in specified situations. Subtitle P: Veteran Women's Health Improvement Act of 1993 - Veteran Women's Health Improvement Act of 1993 - Includes women's health services within the definition of medical services authorized to be furnished to eligible veterans. Includes as women's health services pap smears, breast examinations, and reproductive health care. Authorizes the Secretary of Veterans Affairs to contract with non-Department of Veterans Affairs facilities for outpatient women's health services when Department facilities are inadequate or inaccessible. Requires information on the provision of women's health services to be included in a report from the Secretary to the Congress concerning women veterans. (Sec. 278) Amends the Veterans Health Care Act of 1992 to: (1) require consultation by the Secretary with various officials, advisory committees, and task forces with regard to appropriate women's health research; (2) expand the research related to women to include specified topics; (3) include certain appropriate personnel of the Department in conducting such research, including women veterans and veteran members of minority groups; and (4) direct that a women veterans population study report required under such Act include an examination of the medical and demographic histories of women veterans comprising the study sample. (Sec. 279) Makes applicable to Department medical facilities provisions of the Public Health Service Act regarding mammography quality standards. Requires all Department facilities to meet such standards within two years. Subtitle Q: Defense Women's Health Improvement Act of 1993 - Requires female members and former members of the armed forces who are entitled to medical care under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to be furnished primary and preventive health care services for women as part of such care. Provides the same coverage for female dependents of members and former members of the armed forces. (Sec. 283) Directs the Secretary of Defense to prepare and submit to the Congress a report evaluating the provision of health care services through military medical treatment facilities and CHAMPUS to female members of the armed forces and female covered beneficiaries. Requires the Secretary to include a study to determine the needs of female members and dependents for health care services, including primary and preventive health care services for women. (Sec. 284) Directs the Secretary to establish a Defense Women's Health Research Center within the Department of the Army to be the coordinating agent for multidisciplinary and multiinstitutional research within the Department of Defense on women's health issues related to service in the armed forces. (Sec. 285) Directs the Secretary of the Army, during FY 1994, to continue the breast cancer research program as established under prior law. (Sec. 286) Directs the Secretary of Defense, in conducting or supporting clinical research, to ensure that women and minority group members of the armed forces are included as research subjects. Provides a waiver of such requirement. (Sec. 287) Directs the Secretary to submit three annual reports on research relating to female members and dependents within the armed forces. (Sec. 288) Directs the Secretary to establish at the F. Edward Hebert School of Medicine of the Uniformed Services University of the Health Sciences a women's health curriculum advisory committee to promote the comprehensive integration of women's health issues into the curriculum. Subtitle R: International Population Stabilization and Reproductive Health Act - International Population Stabilization and Reproductive Health Act - Amends the Foreign Assistance Act of 1961 to set forth population assistance authorities and requirements. (Sec. 292) Makes such assistance available to a country that: (1) accounts for a significant portion of the world's annual population increment; (2) has significant unmet needs for methods of contraception, prevention and treatment of sexually transmitted diseases, and obstetric and gynecological care and requires foreign assistance to sustain quality reproductive health services; or (3) demonstrates a strong commitment to population stabilization and reproductive health strategies. Prohibits nongovernmental and multilateral organizations from being subjected to requirements which are more restrictive than those applicable to foreign governments for such assistance. Makes funds available for: (1) the United Nations Population Fund if it agrees to prohibit the use of funds for coerced abortion or involuntary sterilization; and (2) the Special Programme of Research, Development and Research Training to further international cooperation in the development of contraceptive technology. Authorizes appropriations. (Sec. 294) Makes development assistance available on a priority basis for countries which have agreed to address specific education, literacy, and health issues. Authorizes the President to establish a grant program, to be known as the Safe Motherhood Initiative, to improve the access of girls and women to reproductive health care services. Earmarks amounts of development and economic assistance for programs in support of equalizing male and female levels of primary and secondary school enrollment. Authorizes appropriations for the Child Survival Fund, the Safe Motherhood Initiative, and for research on, and treatment and control of, acquired immune deficiency syndrome (AIDS) in developing countries. (Sec. 296) Requires the U.S. executive directors of specified international financial institutions to report annually to the Congress on allocations to population activities and, if such allocations total less than $1 million, to set forth actions to encourage increased allocations. (Sec. 297) Establishes the Commission on World Population Stabilization and Reproductive Health to coordinate U.S. participation in the 1994 International Conference on Population and Development. Authorizes appropriations. (Sec. 298) Provides for certain actions to support the United Nations Forward Looking Strategies for the Advancement of Women and the United Nations Convention on the Elimination of All Forms of Discrimination Against Women.
![Official portrait of Rep. Studds, Gerry E. [D-MA-10]](https://www.congress.gov/img/member/s001040_200.jpg)