United States · United States Congress · 4 May 1993
Calls for the U.S. Trade Representative to insist that any trade agreement negotiated pursuant to the Uruguay Round must provide U.S. copyright-based industries with: (1) fair and equal access to the markets of the nations that are party to the General Agreement on Tariffs and Trade; (2) equal opportunities to obtain government funding; (3) adequate and effective copyright protection, including full national treatment and recognition of contractual rights; and (4) a mechanism to resolve expeditiously disputes concerning market access, national treatment, and copyright protection.
United States · United States Congress · 29 April 1993
King Holiday and Service Act of 1993 - Amends Federal law to: (1) authorize appropriations for the Martin Luther King, Jr. Federal Holiday Commission; (2) extend the Commission; and (3) revise its membership. Amends the National and Community Service Act of 1990 to authorize the Commission to make grants to eligible entities to carry out service opportunities on Martin Luther King, Jr.'s birthday. Authorizes appropriations.
United States · United States Congress · 29 April 1993
Amends the Internal Revenue Code to allow farmers' cooperatives to include gains or losses from the sale or other disposition of assets in net earnings from business done with or for patrons if the assets were used to facilitate the conduct of business.
United States · United States Congress · 28 April 1993
Amends the Job Training Partnership Act to direct the Secretary of Labor to enter into a cooperative agreement with the National Center for Housing Management to provide for a training program to assist recently discharged members of the armed forces to obtain training and employment as managers and employees with public housing authorities and management companies. Authorizes appropriations.
United States · United States Congress · 28 April 1993
Privacy for Consumers and Workers Act - Establishes certain privacy protections for employees and customers with respect to electronic monitoring in the workplace by employers. Directs the Secretary of Labor to enforce such protections. Provides for coverage of employees of the House of Representatives and the Senate under this Act.
United States · United States Congress · 22 April 1993
TABLE OF CONTENTS: Title I: Trust Fund Interest Payments Title II: Indian Trust Fund Management Demonstration Program Title III: Recognition of Trust Responsibility Title IV: Training and Personnel Title V: Responsibility to Account for Indian Trust Funds Native American Trust Fund Accounting and Management Reform Act of 1993 - Title I: Trust Fund Interest Payments - Amends Federal law to change from discretionary to mandatory the authority of the Secretary of the Interior to invest Indian trust funds in debt obligations issued or guaranteed by the United States. Requires the Secretary to pay interest periodically on such deposited or invested funds to the appropriate Indian tribe or individual Indian. Repeals Federal law that relieves the United States from any liability relating to the interest payable on such invested funds. Authorizes the Secretary to make payments to an Indian tribe or individual Indian in full satisfaction of any claim of such tribe or Indian for any interest owed on amounts deposited or invested on their behalf before the enactment of this Act. Title II: Indian Trust Fund Management Demonstration Program - Authorizes an Indian tribe to submit to the Secretary a demonstration plan for new approaches to management of tribal or individual funds held in trust by the United States and managed by the Bureau of Indian Affairs (BIA) for a tribe or its members. Sets forth: (1) plan approval criteria; and (2) Federal trust responsibility in the case of tribal trust fund management. Provides for voluntary withdrawal of program funds. Title III: Recognition of Trust Responsibility - Amends Federal law to require the Secretary to take specified actions to properly discharge U.S. trust responsibilities with regard to Indian funds investment. States that the Congress recognizes a trust responsibility with respect to natural resources on Indian reservations and trust lands. Title IV: Training and Personnel - Directs the Secretary to establish a trust fund management training program for Indians. Title V: Responsibility to Account for Indian Trust Funds - Requires the Secretary to: (1) account for daily and annual balances of Indian trust funds; and (2) provide periodic performance statements.
United States · United States Congress · 22 April 1993
Lead Battery Recycling Incentives Act - Amends the Solid Waste Disposal Act to direct the Administrator of the Environmental Protection Agency (EPA) to promulgate regulations for persons who generate, transport, store, recycle, or dispose of spent lead-acid batteries. Sets forth required elements of such regulations, including specific requirements for battery storage and transfers and recordkeeping and management practices. Directs battery retailers to accept from customers spent lead-acid batteries of the same type and quantity as the batteries sold. Requires the Administrator to implement education activities to inform the public about the environmental and safety hazards associated with improper handling and disposal of spent lead-acid batteries. Authorizes appropriations. Applies such requirements to batteries which are transported to or managed by a lead-acid battery recycling facility, a secondary lead smelter, or any facility that prepares batteries for recycling. Requires producers or importers of lead-acid batteries to recycle, for the ten-year period beginning 24 months after this Act's enactment, an amount of spent lead equal to at least the amount determined by multiplying the amount of lead in the batteries produced or imported by such persons by the recycling percentage established by the Administrator. Authorizes compliance with such requirement by: (1) reclaiming lead and using it in the production of new batteries; (2) purchasing reclaimed lead from secondary lead smelters to produce new batteries or shielding; or (3) purchasing recycling credits. Sets the recycling percentage at 80 percent. Increases such percentage by two points annually. Authorizes the Administrator to reduce or waive the two percent increase if the rate exceeds 95 percent. Directs the Administrator to allow: (1) producers of lead-acid batteries to create credits for recycling an amount of batteries greater than required; and (2) producers of new batteries to purchase such credits for purposes of complying with this Act. Applies battery recycling requirements to persons who produce or import more than 10,000 pounds of new lead-acid batteries annually. Sets the recycling percentage at 90 percent if the Administrator fails to promulgate recycling regulations.
United States · United States Congress · 21 April 1993
Hospital Antitrust Fairness Act - Exempts from the antitrust laws combinations of, or contracts to allocate hospital services by, two or more hospitals if: (1) each such hospital is located outside of a city or in a city of less than 150,000 inhabitants; (2) in the most recently concluded calendar year, each such hospital received more than 40 percent of its gross revenue from payments made under Federal programs; and (3) there is in effect with respect to each such hospital a certificate issued by the Health Care Financing Administration (HCFA) specifying that HCFA has determined that Federal expenditures would be reduced, and consumer costs would not increase, if such hospitals merge or allocate the services specified in the request.
United States · United States Congress · 21 April 1993
Essential Access Community Hospital (EACH) Amendments of 1993 - Amends title XVIII (Medicare) of the Social Security Act to make miscellaneous and technical changes with respect to Medicare's Essential Access Community Hospital Program and other Medicare provisions, including those relating to Medicare part A (Hospital Insurance) deductibles and co-payments. Authorizes appropriations.
United States · United States Congress · 7 April 1993
Expresses the sense of the Congress that an important factor in improving relations, including trade relations, with Romania should be actions by the Government of Romania to: (1) improve the welfare of institutionalized children; and (2) ease bureaucratic impediments to adoption not required by consideration of the welfare of the children concerned.
United States · United States Congress · 5 April 1993
Women in Military Service for America Memorial Commemorative Coin Act - Directs the Secretary of the Treasury to issue five-dollar gold coins and one-dollar silver coins symbolic of women's service in the armed forces.
United States · United States Congress · 2 April 1993
Independence Hall Commemorative Coin Act - Directs the Secretary of the Treasury to issue one-dollar coins emblematic of the shrines of liberty, showing the Liberty Bell on one side and the Independence Hall on the other. Mandates that surcharges from the sale of coins be distributed equally between the Treasury and the Independence Hall Preservation Fund.
United States · United States Congress · 1 April 1993
1994 Vietnam Veterans Memorial Commemorative Coin Act - Directs the Secretary of the Treasury to issue one-dollar silver coins emblematic of the Vietnam Veterans Memorial. Mandates that surcharges from the sale of such coins be paid to the Vietnam Veterans Memorial Fund to help raise an endowment to be a permanent source of support for the Memorial.
United States · United States Congress · 1 April 1993
Comprehensive Child Immunization Act of 1993 - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to promulgate: (1) a list of vaccines that provide immunization against naturally occurring infectious diseases which are recommended for universal use in children; and (2) recommendations regarding the appropriate dosage and the ages of children at which each vaccine should be administered. Directs the Secretary to: (1) periodically purchase recommended childhood vaccines in amounts necessary for distribution to meet anticipated needs and for maintenance of a six-month reserve supply; and (2) negotiate a reasonable price for such vaccine. Requires a manufacturer of recommended childhood vaccine to provide costs or pricing data. Sets forth provisions regarding: (1) the confidentiality of such data; (2) the prohibition of additional shipping or handling charges; (3) multiple suppliers; and (4) reporting requirements. Directs the Secretary to provide for the distribution without charge of such vaccines to health care providers who serve children and meet other specified requirements. Permits a health care provider receiving a vaccine under such provisions to: (1) use such vaccine only for administration to children; and (2) impose a fee for the administration of the vaccine, but not for the vaccine itself, subject to specified limitations. Directs the Secretary to establish a national system to track the immunization status of children. Establishes in the Treasury a Comprehensive Child Immunization Account. Makes funds from such account available for vaccine purchases by the Secretary. Authorizes appropriations. Amends title XIX (Medicaid) of the Social Security Act to: (1) provide coverage of immunizations under early and periodic screening, diagnosis, and testing provisions of State Medicaid programs; and (2) require that payments to providers include reimbursement for administration of such vaccines. Sets forth provisions regarding: (1) termination of the vaccine purchase program; (2) use of the Vaccine Injury Compensation Trust Fund; (3) the permanent extension of authority to impose taxes for the Trust Fund; (4) the addition of vaccines to the vaccine injury table; (5) the extension of time for decision in proceedings on petitions for vaccine-related injuries or deaths; and (6) vaccine information materials (requiring a concise description of vaccine risks and benefits and a statement of program availability).
United States · United States Congress · 30 March 1993
Petroleum Marketing Practices Act Amendments of 1993 - Amends the Petroleum Marketing Practices Act to allow as grounds for nonrenewal of a franchise relationship the failure of the parties to agree to changes to the franchise provisions as long as such failure is not the result of the franchisor's insistence for the purpose of converting a franchisee operation into one operated by the franchisor's employees or agents (that is, turning the franchise into a company-owned station). Prohibits a State or any political subdivision from implementing any law or regulation which requires payment for a franchisee's goodwill upon either termination or nonrenewal of a franchise. Permits State law to specify the terms and conditions under which a franchise or franchise relationship may be transferred to a franchisee's designated successor upon the franchisee's death. Requires a franchisor that does not wish to exercise its underlying lease options to lease or purchase the marketing premises, to offer to assign them to the franchisee as a prerequisite to termination or nonrenewal of the franchise relationship. Bars a franchisor from requiring, as a condition of the franchise relationship, that the franchisee waive or release its rights under Federal or State law. Declares invalid and unenforceable any franchise provision which specifies that franchise interpretation or enforcement shall be governed by the law of any State other than the one in which the franchisee has its principal place of business.
United States · United States Congress · 24 March 1993
Assault Weapons Limitation Act of 1993 - Amends the Federal criminal code to prohibit the: (1) transfer or possession of an assault weapon, with exceptions; (2) sale, shipment, or delivery of an assault weapon to a person who has not completed a form 4473 (prescribed by the Secretary of the Treasury) in connection with the disposition of such weapon; and (3) purchase, possession, or acceptance of delivery of an assault weapon by a person who has not completed such form, with exceptions. Sets penalties for: (1) the use of an assault weapon during and in relation to any crime of violence or drug trafficking crime; and (2) knowingly violating requirements regarding the completion of form 4473. Prohibits persons convicted of the latter offense from shipping or transporting firearms or ammunition in interstate or foreign commerce. Directs the Attorney General to investigate the effect of this Act and determine its impact on violent and drug trafficking crime.
United States · United States Congress · 23 March 1993
Expresses the sense of the Congress that any legislation enacted to reform the health care delivery system of the United States should: (1) ensure that the unique needs of rural residents are addressed and solved, that people who live in rural areas receive the same quality health care as others, and that rural health care services are coordinated effectively with existing systems and programs of medical, income, residential, and social support at the Federal, State, and local levels; (2) increase funding for programs that train health care professionals for rural practice and provide incentives for them to practice in rural areas, increase coordination among transportation programs, and increase funding to rural transit programs and to emergency medical services; and (3) encourage telecommunications consortia and other measures to ensure rural access to emerging medical technologies.
United States · United States Congress · 18 March 1993
Amends the Family and Medical Leave Act of 1993 (Public Law 103-3) to repeal an exemption concerning highly compensated employees. (Under such exemption an employer could deny restoration of equivalent employment status upon return from family or medical leave to such highly compensated employees under certain circumstances.)
United States · United States Congress · 8 March 1993
Tobacco Health Tax Act of 1993 - Amends the Internal Revenue Code to increase the excise tax on the following tobaccos and tobacco-related products: (1) cigars; (2) cigarettes (including an additional tax on packs containing fewer than 20 cigarettes); (3) cigarette papers and tubes; and (4) smokeless and pipe tobacco. Imposes a new tax on cigarette tobacco. Provides, for each calendar year after 1993, an inflation adjustment of the tobacco tax rates. Provides a floor stock tax on the following tobaccos and tobacco products manufactured in or imported into the United States which are removed from stocks before January 1, 1994: (1) cigars; (2) cigarettes (including packs containing fewer than 20 cigarettes); (3) cigarette papers and tubes; (4) snuff; and (5) chewing, pipe, and cigarette tobacco. Establishes in the Treasury the Tobacco Health Tax Trust Fund which shall consist of funds resulting from tobacco tax increases under this Act. Outlines authorized expenditures from the Fund, including the use of 80 percent of such proceeds for Medicaid (title XIX of the Social Security Act) eligibility and payment expansions. Outlines actions authorized to be taken by the Secretary of Health and Human Services in connection with such expansions, including the authority to require an increase in Medicaid payment rates to hospitals and physicians. Provides conforming provisions imposing a floor on Medicaid payment levels for inpatient hospital services and physicians' services. Authorizes expenditures from the Fund for: (1) grants to State and local governments to compensate for any reduction in revenues to such governments caused by the Federal tobacco tax increase under this Act; (2) specified health promotion and illness prevention programs; and (3) public education and other activities to discourage the use of tobacco products, especially among youths. Authorizes the Secretary of Agriculture to make certain offset payments to tobacco producers if the domestic consumption of tobacco declines by at least five percent of that calculated in 1993. Directs the Secretary to encourage such producers to convert their operations to alternative crops. Authorizes the Secretary to make grants to States submitting alternative crop conversion plans. Provides funding for such alternative crop program through the Fund.
United States · United States Congress · 3 March 1993
TABLE OF CONTENTS: Title I: Establishment of a State-Based American Health Security Program; Universal Entitlement; Enrollment Title II: Comprehensive Benefits, Including Preventive Benefits and Benefits for Long Term Care Title III: Provider Participation Title IV: Administration Subtitle A: General Administrative Provisions Subtitle B: Control Over Fraud and Abuse Title V: Quality Assessment Title VI: National Health Security Budget; Payments; Cost Containment Measures Subtitle A: Budgeting and Payments to States Subtitle B: Payments by States to Providers Subtitle C: Mandatory Assignment and Administrative Provisions Title VII: Promotion of Primary Health Care; Development of Health Service Capacity; Programs to Assist the Medically Underserved Subtitle A: Promotion and Expansion of Primary Care Professional Training Subtitle B: Direct Health Care Delivery Subtitle C: Primary Care and Outcomes Research Title VIII: Financing Provisions, American Health Security Trust Fund Subtitle A: American Health Security Trust Fund Subtitle B: Increases in Corporate and Individual Income Tax Rates; Health Security Premium; and Surtax on Individuals with Incomes Over $1,000,000 Subtitle C: Employment Tax Changes Subtitle D: Other Revenue Increases Primarily Affecting Individuals Subtitle E: Other Revenue Increases Primary Affecting Businesses Subtitle F: Estimated Tax Provisions Subtitle G: Alternative Taxable Years Subtitle H: Deduction for Charitable Contribution of Appreciated Property Limited to Adjusted Basis Subtitle I: Minimum 5 Percent Rate of Tax on Interest Paid to Foreign Persons American Health Security Act of 1993 - Title I: Establishment of a State-Based American Health Security Program; Universal Entitlement; Enrollment - Establishes in the United States an American Health Security Program (AHSP) to be administered by the States (including the District of Columbia and, if they so choose, U.S. territories) in accordance with Federal standards established under this Act. Requires a State to establish a State health security program (program) in accordance with this Act to receive Federal health care funding. (Sec. 102) Entitles every individual who is a resident of the United States and is a U.S. citizen or national or a lawful resident alien to benefits for health care services under this Act under the appropriate State program. Sets forth provisions regarding the treatment of nonimmigrants and other individuals. (Sec. 103) Requires each State program to: (1) provide a mechanism for the enrollment of individuals entitled or eligible for benefits (which includes a process for the automatic enrollment of individuals at the time of birth, immigration, or other acquisition of lawful resident status in the United States and provides for the enrollment of all individuals who are eligible to be enrolled as of January 1, 1995); and (2) issue a health security card to enrolled individuals. (Sec. 104) Makes benefits portable when enrollees move or travel between States. Prohibits imposition of a minimum residence or waiting period in excess of three months for program benefit eligibility. Allows reciprocal arrangements between programs in adjacent States for coverage for enrollees residing in the border region. (Sec. 105) Makes benefits available under this Act for items and services furnished on or after January 1, 1995. (Sec. 106) Supersedes Medicare, Medicaid, the Federal Employee Health Benefits Program, and CHAMPUS, which must pay for completion of services they covered before January 1, 1995. Specifies that nothing in this Act affects the eligibility of veterans for Veterans Administration health benefits and services, or of Indians for benefits and services of the Indian Health Service. Title II: Comprehensive Benefits, Including Preventive Benefits and Benefits for Long Term Care - Entitles all eligible individuals to have payment made (if medically necessary and appropriate for the maintenance of health or for the diagnosis, treatment, or rehabilitation of a health condition) for inpatient and outpatient hospital services, professional services of State-authorized practitioners, community-based primary health services, preventive services, long-term and chronic care services, prescription drugs, biologicals, insulin, and medical foods, dental services, mental health services, substance abuse treatment services, diagnostic tests, and other specified items and services, including outpatient therapy, durable medical equipment, home dialysis, ambulance, prosthetic devices, and other items and services specified by the American Health Security Standards Board (Board) (established by title IV of this Act). Specifies that: (1) no deductibles, coinsurance, or copayments may be charged for acute care benefits; (2) no provider may charge a patient for covered services; (3) no private insurance may duplicate program benefits; and (4) States and employers may provide additional benefits at their own expense. (Sec. 203) Covers home and community-based long-term care services for persons unable to perform at least two of five listed activities of daily living without assistance. Limits the cost of such services to 65 percent (or an alternative percentage determined by the Board) of the cost of nursing home care for an individual in the same area in which the services were provided. (Sec. 204) Makes mental health, substance abuse, nursing facility, and home health services subject to utilization review. Directs the Board to make national determinations on coverage of experimental services, with professional and public input. Specifies that where the Board has recognized practice guidelines, coverage is limited to services provided according to the guidelines or any established exception process. Allows the Board to limit quantities of eyeglasses, contact lenses, hearing aids, and durable medical equipment that will be covered. Excludes from coverage cosmetic procedures, personal comfort items, and services furnished in non-participating facilities. (Sec. 205) Specifies that: (1) States may require providers to certify that covered services were provided according to program requirements; (2) quality review programs must meet Federal standards; and (3) States may require plans of care for coverage of certain services. Title III: Provider Participation - Requires providers, to receive payment, to agree: (1) not to discriminate based on race, national origin, income, religion, age, sex or sexual orientation, disability, handicapping condition, or (subject to the professional qualifications of the provider) illness; (2) not to charge patients for covered services; (3) to furnish necessary information to the Board or program; (4) not to employ other providers whose participation has been terminated for cause; and (5) to submit bills within a specified time frame. (Sec. 302) Considers a health care provider to be qualified if it is licensed or certified and meets State law requirements, applicable Federal requirements, and additional standards that the Board may specify. Requires: (1) the Board to establish, evaluate, and update national minimum standards to assure the quality of services provided and to monitor efforts by programs to assure such quality; (2) a reasonable transition period for any new standards; and (3) the Board to provide for an exchange of information among programs with respect to quality assurance and cost containment. (Sec. 303) Defines a "comprehensive health service organization" (CHSO) as a public or private organization which, in return for a capitated payment amount, furnishes or arranges a full range of health services and out-of-area coverage in the case of urgently needed services to an identified population in a specified service area which enrolls voluntarily in the organization. Sets forth various CHSO requirements regarding enrollment, withdrawal for cause, accessibility of services, continuity of care, consumer and provider representation on the board of directors, a patient grievance program, medical standards committees, premiums, utilization and bonus information, provision of services to enrollees at institutions operating under global budgets, marketing of services, and provision of emergency services to nonenrollees. (Sec. 304) Extends current Medicare prohibitions on physician self-referrals for clinical laboratory services to other services and applies such prohibitions to AHSP. Title IV: Administration - Subtitle A: General Administrative Provisions - Establishes the American Health Security Standards Board to develop policies and procedures for enrollment, benefits, provider participation, national and State funding levels, assisting programs with planning for capital expenditures and service delivery, and other functions and to establish uniform reporting standards for health services and programs. Authorizes the Board to make statistical and other studies, test alternative payment methods, and develop and test information and budget systems. Provides for the appointment of an Executive Director of the Board and an Inspector General. (Sec. 402) Directs the Board to provide for an American Health Security Advisory Council to advise the Board on matters of general policy, in the formulation of regulations, and in the performance of the Board's duties and to study the operation of, and utilization of health services under, this Act. (Sec. 403) Directs the Board to appoint advisory committees on benefits, cost containment, primary care and the medically underserved, mental health and substance abuse treatment, and prescription drugs. Authorizes the Board to appoint other temporary advisory committees. (Sec. 404) Establishes an American Health Security Quality Council which shall be responsible for quality review activities (under title V). Directs the Quality Council to report to the Board annually on activities and findings from outcomes research and development of practice guidelines that may affect the Board's determination of coverage of services. (Sec. 405) Requires: (1) each State to submit to the Board a plan for a program for providing health care services to residents of the State (but allows neighboring States to join in regional plans); (2) the Board to provide incentives for States to develop regional planning mechanisms to promote the rational distribution of, adequate access to, and efficient use of, tertiary care facilities, equipment, and services; (3) State programs to meet Federal standards, including single-agency administration, a State health security budget, provider payment and quality review methodologies consistent with Federal standards, freedom to choose providers, a consumer ombudsman, an annual report, and a fraud and abuse prevention and control unit; and (4) the Governor of each State to provide for appointment of a State Health Security Advisory Council to advise and make recommendations to the Governor and State regarding program implementation. Allows: (1) programs not meeting Federal requirements, after notice, to be placed in receivership under the Board's jurisdiction; and (2) States to use fiscal agents, after competitive bidding, to process claims. (Sec. 406) Requires the Secretary of Health and Human Services (Secretary) to direct all activities of the Department of Health and Human Services toward contributions to health of the people in a manner complementary to this Act. Subtitle B: Control Over Fraud and Abuse - Authorizes the Board to exclude providers from participation, impose civil monetary penalties, and seek criminal prosecution for fraud or abuse, based on current Medicaid standards. Requires providers to disclose relevant information about their ownership interest in health facilities and services, based on current Medicaid standards. (Sec. 412) Requires the Board: (1) through the Inspector General, to establish a national health care fraud and abuse data base, including the identity of any provider who has been convicted, had a license revoked, has been excluded or suspended from participation, or has been subjected to a civil penalty with respect to a State program, Medicare, Medicaid, or any other federally funded health program; and (2) to establish rules to protect the confidentiality of information in the data base. Requires States to provide relevant information for this purpose and to periodically inquire of the data base to determine provider qualifications to participate in programs. Sets penalties for submitting false information. (Sec. 413) Requires each program to establish and maintain a health care fraud and abuse unit. (Sec. 414) Directs the Board to provide for the assignment of a unique identifier to each participating provider and to each individual eligible for services, which shall be used for claims and payment. Title V: Quality Assessment - Directs the Quality Council to: (1) collect data from outcomes research on an ongoing basis and develop practice guidelines on the basis of such data and existing clinical knowledge; (2) adopt methodologies for profiling the patterns of practice of health care professionals and for identifying outliers (i.e., health care providers whose patterns of practice suggest quality deficiencies); (3) develop standards for the development of centers of excellence for designated procedures and for education of and sanctions for outliers; and (4) disseminate all quality guidelines and standards to the States for implementation. (Sec. 502) Requires each participating State to establish an entity to conduct quality reviews of persons providing covered services under its program which meet Federal standards for the adoption of practice guidelines, identification of outliers, development of remedial programs and monitoring for outliers, and the application of sanctions. Allows the State to adopt alternative methodologies to those adopted by the Quality Council provided that the State can demonstrate that the efficacy of such review and education programs meets Federal standards. Mandates that the quality review entity be administratively independent of the individual or board that administers the program and not provide any financial incentive to reviewers to favor one pattern of practice over another. (Sec. 503) Expresses the intent to replace random utilization controls with a systematic review of patterns of practice that compromise the quality of care by January 1, 1998. Supercedes all existing Federal utilization review programs, including random case-by-case reviews and programs requiring pre-certification of medical procedures on a case-by-case basis, with exceptions. Specifies that nothing in this section shall preclude case management of catastrophic, mental health, or substance abuse cases where necessary to achieve appropriate, cost-effective, and beneficial comprehensive medical care. (Sec. 504) Requires: (1) each State program to develop and use a uniform electronic data base which uses software designated by the Board and which assures confidentiality for all patient records to enable systematic quality review and outcomes analysis; and (2) the Board to designate such software and establish standards designed to protect the privacy of patients. Limits access by government agencies to patient records. Title VI: Health Security Budget; Payments; Cost Containment Measures - Subtitle A: Budgeting and Payments to States - Directs the Board to establish a national health security budget which specifies the total expenditures to be made by the Federal Government and the States for covered health care services, and allocates those expenditures among the States. Prohibits such budget from exceeding the budget for the preceding year increased by the percentage increase in gross domestic product. Divides the budget into quality assessment, professional education, administrative, and operating components. (Sec. 602) Provides for the allocation of funds in the budget by the Board to the States, based on the national average per capita costs of covered services adjusted for differences among the States in costs and the health status of populations. Permits the use of statistical models to estimate State capitation amounts. Sets forth State adjustment factors to reflect differences in relative needs for funds and directs that such factors be applied in a budget-neutral manner resulting in no change in total Federal expenditures from the national per capita average. (Sec. 603) Requires each program to submit to the Board a proposed and final annual budget broken into quality assessment, professional training, administrative, and operating components, with the operating component broken into facility-based services, individual practitioner payments, payments to CHSOs, and payments for other items and services. Sets forth provisions regarding proposed and final budget deadlines, adjustments in allocations, and expenditure limits. Permits programs to provide for a process for the approval of capital expenditures based on information derived from regional planning agencies. (Sec. 604) Provides for programs to receive Federal funds equal to a weighted average of 86 percent of their population-based share of the budget, which the Board may adjust between 81 and 91 percent based on State economic conditions. (Sec. 605) Requires each program to establish a separate budget account for health professional education expenditures and to distribute funds consistent with the achievement of specified national and program goals, including the receipt by the Board of reports to monitor compliance, and taking into account the potentially higher costs of placing health professional students in clinical education programs in health professional shortage areas. Subtitle B: Payments by States to Providers - Directs that: (1) payment for operating expenses for institutional and facility-based care under State programs be made directly to each institution or facility under an annual prospective global budget approved under the program; (2) such budgets take into account discharges by diagnosis-related group, prior expenditures, the extent to which debt service for capital expenditures has been included in the proposed operating budget, change in the consumer price index and other price indices, compensation, occupancy levels, past financial and clinical performance, training, technological changes, and incentives to maintain costs without reducing care; and (3) facility budgets be adjusted to reflect payments made by CHSOs. Allows programs to permit institutions and facilities to raise funds from private sources to pay for newly constructed facilities, major renovations, and equipment. (Sec. 612) Requires: (1) State programs to pay individual practitioners on a fee-for-service basis, as negotiated between States and practitioner representatives; (2) the Board to establish models for such payment and for global fee payment methodologies to encourage payment for combinations of services; and (3) practitioners to bill State programs within 30 days of providing services. Permits States to require electronic billing. (Sec. 613) Authorizes programs to pay CHSOs based on annual budgets or risk-adjusted capitation payments, reduced by the costs of covered services not provided by the CHSO. (Sec. 614) Directs that programs pay for community-based primary health services based on global budgets, basic primary care capitation amounts for enrollees, or fee-for-service, taking into account costs of serving non-covered patients, providing case management, transportation, and translation, and providing health professional education programs. (Sec. 615) Requires: (1) the Board to establish a list of approved prescription drugs based on the recommendations of the Advisory Committee on Prescription Drugs and to negotiate maximum prices with manufacturers; and (2) each program to pay for such drugs based on such maximum prices and to pay separate dispensing fees to pharmacies. (Sec. 616) Directs the Board to establish a list of approved durable medical equipment and therapeutic devices and equipment and programs to pay for such items based on maximum prices determined by the Board. (Sec. 617) Requires State programs to pay for other items and services based on methodologies to be adopted by the Board, consistent with the State health security budget. (Sec. 618) Directs the Board to establish model payment methodologies and other incentives to promote the provision of services in medically underserved areas. Permits programs to adjust payments amounts within their budgets to encourage provision of appropriate services in underserved areas. (Sec. 619) Authorizes programs to utilize alternative payment methodologies, provided that such methodologies do not affect the entitlement of individuals to coverage, the weighting of fee schedules to encourage an increase in the number of primary care providers, the ability of individuals to choose among qualified providers, the benefits covered under the Program, or compliance with the State health security budget. Requires States to report on the operation and effectiveness of alternative methodologies to enable the Board to evaluate the appropriateness of applying such methodologies to other States. Subtitle C: Mandatory Assignment and Administrative Provisions - Specifies that participating providers: (1) must accept payment from a program as full payment for covered services; and (2) may not impose additional charges on patients. Permits the Board to exclude from participation and subject to civil penalties violators of such provision. (Sec. 632) Requires programs to establish: (1) procedures for reimbursing providers within 60 days of bill submission; and (2) an appeals process to handle grievances pertaining to provider payments. Title VII: Promotion of Primary Health Care; Development of Health Service Capacity; Programs to Assist the Medically Underserved - Subtitle A: Promotion and Expansion of Primary Care Professional Training - Makes the Board responsible for: (1) coordinating health professional education policies and goals to achieve national goals; (2) overseeing program health professional education expenditures; (3) developing and maintaining a system to monitor the number and specialties of individuals through their health professional education, any postgraduate training, and professional practice; and (4) developing, coordinating, and promoting other policies that expand the number of primary care practitioners. Sets as national goals that: (1) at least 50 percent of graduate medical residencies be in primary care within five years of this Act's enactment; and (2) there be a certain number, specified by the Board, of midlevel primary care practitioners employed in the health care system as of January 1, 2000. Directs the Board to: (1) establish a method of applying such goals to program goals for each medical residency program or consortium of programs and reducing payments for residency programs failing to meet their goals; (2) advise the Public Health Service on allocations of funding under specified programs to increase the supply of midlevel primary care practitioners; and (3) commission a study of the potential benefits and disadvantages of expanding the scope of practice authorized under State laws for any class of midlevel primary care practitioners. (Sec. 702) Requires the Board to establish an Advisory Committee on Health Professional Education to advise the Board concerning graduate medical education policies under this title. (Sec. 703) Directs the Board to transfer specified revenues from the American Health Security Trust Fund (Trust Fund) for specified existing programs supporting health professional education and nursing education and for the National Health Service Corps. Subtitle B: Direct Health Care Delivery - Requires the Board to transfer specified Trust Fund revenues to the Public Health Service for: (1) maternal and child health block grants, preventive health block grants, grants to States for community mental health services and prevention and treatment of substance abuse, and grants for HIV health care services; and (2) grants to nonprofit community health centers and similar facilities. (Sec. 713) Directs the Board to make grants to primary care centers (i.e., nonprofit community health centers, migrant health centers, and other federally qualified health centers) to serve medically underserved populations in urban and rural areas. Specifies that grant funds may be used to plan, develop, and deliver primary care in such areas. Subtitle C: Primary Care and Outcomes Research - Requires the Board to transfer specified Trust Fund revenues to the Agency for Health Care Policy and Research for health outcomes research. (Sec. 722) Amends the Public Health Service Act to establish within the Office of the Director of the National Institutes of Health (NIH) an Office of Primary Care and Prevention Research to be headed by a Director who shall identify and coordinate research activities relating to primary care and prevention, including care provided by multidisciplinary teams. Authorizes appropriations. Requires the Director of NIH to establish a national data system and clearinghouse on primary care and prevention research. Title VIII: Financing Provisions; American Health Security Trust Fund - Subtitle A: American Health Security Trust Fund - Amends the Internal Revenue Code to create the American Health Security Trust Fund. Appropriates to the trust fund the increase in tax liabilities attributable to the application of amendments made by this title and receipts from the following programs: Medicare, Medicaid, Federal employees health benefit program, and the CHAMPUS program. Transfers to such trust fund amounts in the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund. Subtitle B: Increases in Corporate and Individual Income Tax Rates; Health Security Premium; Surtax on Individuals With Incomes Over $1,000,000 - Increases individual and corporate income tax rates, including the imposition of a health premium on such increased rates. Imposes a surtax on individuals with incomes over $1 million. Subtitle C: Employment Tax Changes - Increases the tax on employers for hospital insurance. Modifies self-employment and railroad retirement tax provisions. Makes State and local employees subject to the hospital insurance tax. Subtitle D: Other Revenue Increases Primarily Affecting Individuals - Makes permanent the overall limitation on itemized deductions for high-income taxpayers. Makes permanent the phaseout of the deduction for personal exemptions for such taxpayers. Removes residence sale, purchase, or lease expenses and meals while traveling from the deduction for moving expenses. Increases the overall dollar limitation for moving expenses in connection with the commencement of work. Makes the highest estate and gift tax rates permanent. Denies any deduction for club membership fees as an entertainment expense. Includes increased social security benefits in gross income. Provides for the collection of a monthly long-term health care premium for the elderly (other than the low-income elderly) for deposit into the American Health Security Trust Fund. Subtitle E: Other Revenue Increases Primarily Affecting Businesses - Applies mark-to-market accounting method rules for certain securities held by dealers in securities (with specified exceptions for certain types of securities such as those held for investment or as a hedge). Increases the applicable recovery period for depreciation of nonresidential real property under the accelerated cost recovery system. Includes imported property income of a controlled foreign corporation or related person as foreign base company income. Requires the separate application of the limitation on the foreign tax credit on imported property income. Applies the look-thru rules in the case of controlled foreign corporations to such income. Repeals: (1) the deduction for intangible drilling and development costs in the case of oil and gas wells and geothermal wells; (2) the percentage depletion for oil and gas wells; and (3) the application of like-kind exchange rules to real property. Disallows the capitalization of a percentage of advertising expenses. Allows the amortization of such disallowed amount. Subtitle F: Estimated Tax Provisions - Increases individual and corporate estimated tax payments. Repeals special rules which denied the use of a previous year's liability safe harbor for certain individuals with significant increases in tax liability from one year to the next. Modifies corporate annualized income installment provisions. Subtitle G: Alternative Taxable Years - Provides that the taxable year for an S corporation of partnership must be the same as an entity's reporting period if an entity has annual reports or statements which ascertain income profit or loss and are provided to shareholders or used for credit purposes. Revises computation of the amount of the required payment that must be made by a partnership or S corporation that elects a taxable year other than the required taxable year. Subtitle H: Deduction for Charitable Contribution of Appreciated Property Limited to Adjusted Basis - Limits the deduction for charitable contribution of appreciated property to the amount which would have been gained had the property been sold by the taxpayer at its fair market value. Subtitle I: Minimum 5 Percent Rate of Tax on Interest Paid to Foreign Persons - Sets a minimum rate of tax on interest paid to foreign persons notwithstanding any treaty obligations.
United States · United States Congress · 2 March 1993
Justice for Wards Cove Workers Act - Amends the Civil Rights Act of 1991 to remove a provision excluding from application of the Act any disparate impact case filed before March 1, 1975, and decided after October 30, 1983. (Wards Cove Packing Co. v. Atonio, 1989, held that, in cases brought under title VII of the Civil Rights Act, the burden is on the plaintiff to prove an employer had no business necessity for a practice with discriminatory effects.)
United States · United States Congress · 2 March 1993
Prohibits claims for any Postal Savings System deposit from being brought after December 31, 1998 (currently, within one year of the date of enactment of the Postal Savings Systems Statute of Limitations Act). Directs the Secretary of the Treasury to prepare a plan relating to the dissemination of information on the payment of claims with respect to Postal Savings System certificates of deposit.
United States · United States Congress · 25 February 1993
Requires any foreign nation that conducts a nuclear weapons test in the United States to pay the costs associated with such test, including environmental restoration costs.
United States · United States Congress · 24 February 1993
Declares that it is the sense of the Congress that any legislation enacted to reform the health care system must: (1) ensure that every person has access to coverage for medically and psychologically necessary treatments for mental disorders that is equitable to the coverage provided for treatments of physical illnesses; and (2) meet specified requirements concerning coverage, consumer choice, financial protection, financing policies, and coordination across Federal, State, and local programs.
United States · United States Congress · 23 February 1993
Directs the Secretary of Health and Human Services, through the Social Security Administration and with the Attorney General and the Secretary of Labor, to develop a counterfeit-resistant social security card. Directs the Attorney General to designate the social security card as the single acceptable work authorization document under the Immigration Reform and Control Act.
United States · United States Congress · 22 February 1993
Brady Handgun Violence Prevention Act - Amends the Federal criminal code to prohibit (until the Attorney General certifies that a national instant criminal background check system (System) is established pursuant to this Act) any licensed importer, manufacturer, or dealer from selling, delivering, or transferring a handgun to an unlicensed individual unless: (1) after the most recent proposal of such transfer by the individual, the transferor has received a statement of eligibility from the individual, verified the identity of such individual, provided notice of the contents, and transmitted a copy of the statement to the chief law enforcement officer (chief) of the place of residence of the individual within one day after the individual furnishes the statement; and five business days have elapsed from the date the transferor furnished notice of the contents of the statement to the chief, during which period the transferor has not received information from the chief that receipt or possession of the handgun by the individual would be in violation of Federal, State, or local law or has received notice from the chief that the chief has no information indicating that such receipt or possession would violate such law; (2) the individual has presented to the transferor a statement from the chief, issued in the past ten days, stating that the individual requires a handgun because of a threat to such individual or such individual's family; (3) the individual has presented to the transferor a permit to possess a handgun that has been issued in the past five years by the State in which the transfer is to take place under a State law which requires law enforcement verification of the individual's legal qualification to possess a handgun; (4) State law requires that an authorized government official verifies that the information available to such official does not indicate that possession of a handgun by the purchaser would be unlawful, with exceptions; (5) the Secretary of the Treasury has approved the transfer under provisions of the Internal Revenue Code; or (6) the Secretary has certified, on application of the transferor, that compliance with the notice requirement is impracticable for specified reasons. Directs the Attorney General to: (1) establish the System; (2) expedite the upgrading and indexing of State criminal history records in the Federal criminal records system maintained by the Federal Bureau of Investigation (FBI), the development of hardware and software systems to link State criminal history check systems into the System, and the current revitalization initiatives by the FBI for technologically advanced fingerprint and criminal records identification; and (3) ensure the privacy and security of System information. Amends the Omnibus Crime Control and Safe Streets Act of 1968 to authorize the use of justice system improvement formula grants for the improvement of State record systems and the sharing with the Attorney General of specified records for the purpose of implementing this Act.
United States · United States Congress · 16 February 1993
Authorizes the Air Force Memorial Foundation to establish a memorial on Federal land in the District of Columbia or its environs to honor the men and women who have served in the U.S. Air Force.
United States · United States Congress · 4 February 1993
National Wildlife Refuge System Management and Policy Act of 1993 - Amends the National Wildlife Refuge System Administration Act of 1966 to prohibit the Secretary of the Interior (Secretary) from initiating or permitting a new use of a refuge or expanding, renewing, or extending an existing use unless it is determined that it is compatible with the purposes of the System and the refuge. Allows existing uses of such refuge system lands that have been determined compatible under this Act, or the Refuge Recreation Act, to continue under specified conditions. Terminates such use and revokes permits for it within five years after the enactment of this Act unless the Secretary determines that such use is compatible. Directs the Secretary, acting through the Director of the U.S. Fish and Wildlife Service, to establish a formal process for governing determinations of compatibility of an existing or proposed new use in a refuge with the purposes of the System and the refuge. Requires the head of each Federal agency that has, with respect to a refuge, an equivalent or secondary jurisdiction with the Department of the Interior, or conducts activities within any refuge, to ensure that any actions authorized, funded, or carried out will not impair the resources of the refuge or be incompatible with system or refuge purposes, unless the action is specifically authorized by law or necessary for national security. Directs the Secretary to: (1) prepare (and revise every ten years) a comprehensive plan for the System; and (2) prepare (and revise every 15 years) a comprehensive conservation plan for each refuge or ecologically related complex of refuges in the System, except those in Alaska. Authorizes appropriations. Grants the Secretary emergency power to suspend any activity in any range in the National Wildlife Refuge System that constitutes an imminent danger to the health and safety of any wildlife population, refuge, or to public health and safety.
United States · United States Congress · 4 February 1993
Government Performance and Results Act of 1993 - Amends Federal law to require the head of each agency to submit to the Director of the Office of Management and Budget (OMB) a strategic plan for performance goals of program activities. Requires the inclusion of performance plans in the President's budget. Directs the Director to require each agency to prepare annual performance plans covering each program activity set forth in the agency's budget. Requires the head of each agency to submit to the President and the Congress a report on program performance for the previous fiscal year. Authorizes the Director to exempt any agency with annual outlays of $20,000,000 or less from strategic and performance plan reporting requirements. Allows performance plans to include proposals to waive administrative procedural requirements and controls in return for specific individual or organization accountability to achieve a performance goal. Outlines proposal requirements. Requires the Director to designate: (1) not less than ten agencies (representing a range of Government functions) as pilot projects in performance measurement; (2) not less than five agencies (selected from agencies in performance measurement pilot projects) as pilot projects in managerial accountability and flexibility; and (3) not less than five agencies (selected from agencies in performance measurement pilot projects) as pilot projects in performance budgeting. Requires the Director, as an alternative budget presentation in the budget for FY 1999, to include the performance budgets of the designated agencies for this fiscal year. Directs the Office of Personnel Management to develop a strategic planning and performance measurement training component for its management training program and otherwise provide managers with an orientation on the development and use of strategic planning and program performance measurement.
United States · United States Congress · 3 February 1993
Mandates that, in the administration of any benefits program established by or under Federal law which requires the use of data obtained in the most recent decennial census, the 1990 adjusted census data be considered the official data for such census.
United States · United States Congress · 2 February 1993
TABLE OF CONTENTS: Title I: Shenandoah Valley National Battlefields Title II: Shenandoah Valley National Battlefields Commission Title III: Authorization Of Appropriations Shenandoah Valley National Battlefields Partnership Act of 1993 - Title I: Shenandoah Valley National Battlefields - Establishes the Shenandoah Valley National Battlefields as a unit of the National Park Service (NPS). Sets forth the areas and battlefields included within the Battlefields. Directs the Shenandoah Valley National Battlefields Commission (established in title II) to identify lands in the historic core and the contributing battlefield area in the vicinity that shall comprise the Battlefields. Requires the Secretary and the Commission to: (1) encourage heritage preservation within the regional area of the Battlefields by landowners, local governments, organizations, and businesses; and (2) cooperate to promote heritage tourism in the Shenandoah Valley of Virginia that is compatible with resource protection. Sets forth provisions regarding: (1) restoration of property within the Battlefields; (2) grant awards to property owners and governmental entities and provision of technical assistance to promote and maintain the historic character of the Battlefields; (3) reimbursement of planning costs; and (4) implementation grants to government entities and the private sector. Authorizes the Secretary to acquire lands and interests in lands within the historic core by donation. Directs the Commission to submit to the Congress a Shenandoah Valley Civil War Sites Heritage Plan that describes the appropriate protection, management, uses, and development of the Battlefields consistent with the purposes of this Act. Title II: Shenandoah Valley National Battlefields Commission - Establishes the Shenandoah Valley National Battlefields Commission to: (1) advise and actively participate with the NPS in developing a Heritage Plan; (2) assist in the implementation, coordination, protection, promotion, and management of Battlefield resources; and (3) administer donated funds. Title III: Authorization of Appropriations - Authorizes appropriations.
United States · United States Congress · 2 February 1993
National Park Revitalization Act - Amends the National Park Service Concessions Policy Act (the Act) to limit the period of a concession contract in a National Park System unit to ten years to a maximum of 15 years if the Secretary of the Interior finds that a longer period is necessary for the acquisition of possessory interest. Sets forth certain requirements of such contracts. Repeals provisions of the Act to release the United States from any obligation to compensate concessioners for loss of specified investments. Provides that franchise fees shall be based on annual gross receipts from the concession and shall not be less than a specified percentage of such receipts. Makes the concessioner responsible for all utility costs incurred in the operation of the concession under such contracts. Amends Federal law to prohibit the Secretary from reimbursing concessioners for utility services in the National Park System. Prohibits the Secretary from granting preferential rights to concessioners with respect to additional contracts, and renewal of contracts or permits. Vests in the United States all right, title, and interest to any structure, fixture, or improvement acquired or constructed on federally-owned land within an area administered by the National Park Service. Directs the Secretary to acquire any possessory interest relating to concession contracts established before the enactment of this Act. Prohibits the Secretary from approving the direct or indirect transfer of the possessory interest to a contract subject to this Act, with exceptions. Requires that a record of each audit under the Act be available to the public in a way that prevents revealing trade secrets and commercial or financial information that is privileged or confidential. Specifies allocations, at the end of a fiscal year, of such franchise fees deposited into a special account established in the Treasury, during that year.
![Official portrait of Rep. Synar, Mike [D-OK-2]](https://www.congress.gov/img/member/s001139_200.jpg)