Bill· HRH.R. 5650 (106th)referred
United States · United States Congress · 8 December 2000
Amends the Floyd D. Spence National Defense Authorization Act for Fiscal Year 2001 to revise requirements relating to Navy activities on the Island of Vieques, Puerto Rico, to direct the Secretary of the Navy to: (1) report to the General Services Administration (GSA) as excess lands for disposal all lands on the eastern side of the Island, with the exception of all Department of Defense real properties identified as conservation zones, the Live Impact Area, and any other real properties that the Secretary of the Interior identifies as necessary for the management of these areas; and (2) transfer such zones, Area, and any such other properties to such Secretary. Requires DOD to conduct all environmental response actions on such transferred lands, properties, and excess lands. States that neither the Department of the Interior nor GSA shall be liable for environmental contamination, including unexploded ordnance, that is present at the time such properties are transferred or reported as excess, including contamination resulting from DOD activities that is discovered after transfer or subsequent conveyance. Makes the Secretary of Defense exclusively responsible for funding and implementing any necessary response actions (including operation and maintenance) to address environmental contamination resulting from DOD's presence or which is present at the time of any such conveyance, including contamination subsequently discovered, unless such contamination was caused by the Interior Department.
Bill· HRH.R. 5651 (106th)referred
United States · United States Congress · 8 December 2000
Conveys to the Commonwealth of Puerto Rico the conservation zones on the western end of the Island of Vieques, Puerto Rico, designated for transfer or transferred to the Secretary of the Interior. Requires that: (1) the conveyed areas be managed for conservation purposes subject to a cooperative agreement between Puerto Rico and the Secretary; (2) areas adjacent to such areas be considered for inclusion under the agreement; and (3) such agreement be implemented in cooperation with the Puerto Rico Conservation Trust and other interested parties. Requires all conveyed lands to be managed to protect and preserve their natural resources. Permits amounts necessary to carry out the cooperative agreement to be made available to the National Fish and Wildlife Foundation to establish and manage an endowment for the management of such lands.
Bill· HRH.R. 5612 (106th)referred
United States · United States Congress · 1 November 2000
Medicare, Medicaid, and SCHIP Benefits Improvement and Beneficiary Protection Act of 2000 - Title I: Medicare Beneficiary Improvements - Subtitle A: Improved Preventive Benefits - Amends title XVIII (Medicare) of the Social Security Act (SSA) to provide for: (1) coverage of biennial screening pap smear and pelvic exams; (2) coverage of screening for glaucoma; (3) coverage of screening colonoscopy for average risk individuals; (4) revision of payments and standards for screening mammography; (5) coverage of medical nutrition therapy services for beneficiaries with diabetes or a renal disease; and (6) extension of Medicare part A (Hospital Insurance) coverage for workers with disabilities. Subtitle B: Other Beneficiary Improvements - Amends SSA title XVIII to provide for: (1) acceleration of reduction of beneficiary copayment for hospital outpatient department (OPD) services; (2) preservation of coverage of drugs and biologicals under Medicare part B (Supplementary Medical Insurance); (3) elimination of time limitation on Medicare benefits for immunosuppressive drugs; (4) imposition of billing limits on drugs; and (5) availability of application forms for medical assistance for Medicare cost-sharing. (Sec. 116) Amends SSA title II (Old Age, Survivors and Disability Insurance) (OASDI) to provide for a waiver of 24-month waiting period for Medicare coverage of individuals disabled with amyotrophic lateral sclerosis. Subtitle C: Demonstration Projects and Studies - Outlines: (1) a Health and Human Services (HHS) demonstration project for disease management for severely chronically ill Medicare beneficiaries; (2) HHS demonstration projects for cancer prevention and treatment for ethnic and racial minorities; (3) a National Academy of Sciences study on the addition of coverage of routine thyroid screening using a thyroid stimulating hormone test as a preventive benefit provided to Medicare beneficiaries; (4) a Medicare Payment Advisory Commission (MEDPAC) study on consumer coalitions in marking Medicare+Choice (SSA title XVIII part C) plans; (5) an HHS study on the effect of limitations on State payment for Medicare cost-sharing on access to services for qualified Medicare beneficiaries; (6) HHS studies on preventive interventions in primary care for older Americans; and (7) a MEDPAC study on Medicare coverage of cardiac and pulmonary rehabilitation therapy services. Title II: Rural Health Care Improvements - Subtitle A: Critical Access Hospital Provisions - Amends SSA title XVII to: (1) prohibit beneficiary cost-sharing for clinical diagnostic laboratory tests furnished by critical access hospitals; (2) increase the amount a critical access hospital may elect to be paid for outpatient critical access hospital (OCAH) services with respect to the fee schedule payment for OCAH professional services; (3) exempt critical access hospital swing beds from the skilled nursing facility (SNF) prospective payment system (PPS); (4) provide for payment in critical access hospitals for emergency room on-call physicians; and (5) provide for the treatment of ambulance services furnished by certain critical access hospitals. (Sec. 206) Requires the General Accounting Office (GAO) to conduct a study on certain eligibility requirements for critical access hospitals. Subtitle B: Other Rural Hospitals Provisions - Amends SSA title XVIII with regard to payment to hospitals for inpatient hospital services to provide for: (1) application of a uniform threshold for urban and rural hospitals to be classified as disproportionate share hospitals (DSHs) for discharges occurring on or after October 1, 2001; (2) adjustment of payment formulas for various specified hospitals, including hospitals that are both sole community hospitals and rural referral centers for discharges occurring during such period; (3) an option to base eligibility for the Medicare dependent, small rural hospital program on discharges during two of the three most recently audited cost reporting periods; and (4) extension of the option to use rebased target amounts to all sole community hospitals. (Sec. 214) Directs MEDPAC, in its study and report to Congress on rural providers under the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999, to analyze the impact of volume on the per unit cost of rural hospitals with psychiatric units, and recommend whether special treatment for such hospitals may be warranted. Subtitle C: Other Rural Provisions - Amends SSA title XVIII with regard to special payment rules for particular items and services to provide transitional assistance for providers of ambulance services in rural areas. (Sec. 222) Amends SSA title XVIII part B with regard to the use of carriers for administration of benefits concerning payment for certain physician assistant services. (Sec. 223) Amends BBA'97 to: (1) set a time limit for Medicare reimbursement for telehealth services; and (2) provide for an expansion of Medicare payment for such services. (Sec. 224) Amends SSA title XVIII part B to provide for expanding access to rural health clinics. (Sec. 225) Directs MEDPAC to study the effect of low patient and procedure volume on the financial status of low-volume, isolated rural health care providers participating in Medicare. Title III: Provisions Relating to Part A - Subtitle A: Inpatient Hospital Services - Amends SSA title XVIII to provide for elimination of the reduction in the PPS hospital payment update. (Sec. 301) Directs the Secretary, when rebasing and revising the hospital market basket index, to consider the prices of blood and blood products purchased by hospitals and to determine whether those prices are adequately reflected in such index. Amends SSA title XVIII with respect to payment to hospitals for inpatient hospital services and updating previous standardized amounts to provide for: (1) an adjustment for inpatient case mix changes; (2) modification of the transition for indirect medical education percentage adjustment for DSHs; and (3) decreases in reductions for DSH payments. (Sec. 304) Provides for a three-year effective period for any decision of the Medicare Geographic Classification Review Board to reclassify a DSH for purposes of adjusting the diagnosis-related group (DRG) prospective payment rate for hospital wage level area differences for FY 2001 or any fiscal year thereafter. Requires the Secretary to establish procedures under which a DSH hospital may elect to terminate such reclassification before the end of such period. Directs the Secretary to: (1) establish a process under which an appropriate statewide entity may apply to have all the geographic areas in a State treated as a single geographic area for purposes of computing and applying the area wage index; and (2) provide for the collection of data every three years on occupational mix for employees of each DSH in the provision of inpatient hospital services in order to construct an occupational mix adjustment in the applicable hospital area wage index. (Sec. 305) Amends SSA title XVIII with respect to prospective payment for inpatient rehabilitation hospital services and: (1) assistance with administrative costs associated with completion of patient assessment; as well as (2) a rehabilitation facility election to apply full prospective payment rate without phase-in. (Sec. 306) Provides that, with respect to the inpatient services of psychiatric hospitals and certain psychiatric units, in making incentive payments to such hospitals for cost reporting periods from October 1, 2000, through October 1, 2001, the Secretary shall increase the percent of the target amount used in determining such payments. (Sec. 307) Amends SSA title XVIII to provide for: (1) increased target amounts and caps for long-term care hospitals before implementation of the PPS required under the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 for payment for inpatient hospital services provided in long-term care hospitals; (2) alternative implementation of such PPS by the Secretary based on the use of existing hospital DRGs that have been modified; and (3) increase in the base payment for Puerto Rico DSH hospitals. Subtitle B: Adjustments to PPS Payments for Skilled Nursing Facilities - Amends SSA title XVIII with respect to payment to SNFs for routine service costs to revise updating requirements, among other changes eliminating the reduction in the skilled nursing facility market basket update in 2001. (Sec. 311) Directs the Comptroller General to report to Congress on the adequacy of Medicare payment rates to SNFs and the extent to which Medicare contributes to the financial viability of such facilities. (Sec. 312) Directs the Secretary to increase the nursing component of the case-mix adjusted Federal prospective payment rate specified in the final rule published in the Federal Register by the Health Care Financing Administration on July 31, 2000, effective for services furnished on or after April 1, 2001, and before October 1, 2002. Requires the Comptroller General to conduct an audit for Congress of nursing staffing ratios in a representative sample of Medicare SNFs. (Sec. 313) Amends SSA title XVIII to limit application of the SNF consolidated billing requirement to a period during which the resident is provided Medicare part A (Hospital Insurance) covered post-hospital extended care services. Requires the Secretary to monitor payments made under Medicare part B for items and services furnished to SNF residents during a time in which they are not being provided Medicare covered post-hospital extended care services, in order to ensure that there is not duplicate billing for services or excessive services provided. (Sec. 314) Provides that, for purposes of computing payments for certain covered SNF services, the Secretary shall increase the adjusted Federal per diem rate for covered SNF services for specified RUG-III (resource utilization group) rehabilitation groups furnished to an individual during the period in which such individual is classified in such a RUG-III category. Directs the HHS Inspector General to review the Medicare payment structure for services classified within RUGs and report to Congress on whether payment incentives exist for the delivery of inadequate care. (Sec. 315) Authorizes the Secretary to establish a procedure for the geographic reclassification of a SNF for purposes of payment for covered SNF services under the PPS for SNFs for routine service costs. Subtitle C: Hospice Care - Amends SSA title XVIII to provide for a full market basket increase for hospice care for FY 2001 and 2002. (Sec. 322) Requires that the certification regarding an individual's terminal illness be based on the physician's or medical director's clinical judgment regarding the normal course of the illness. (Sec. 323) Directs MEDPAC to conduct a study on the factors affecting the use of hospice benefits under Medicare program and differences in such use between urban and rural hospice programs and based upon the presenting condition of the patient. Subtitle D: Other Provisions - Amends SSA title XVIII to provide for a reduction in Medicare part A late enrollment premium increases (penalty) for a qualified State or local government retiree group in the case where a State, a local government, or an agency or instrumentality of a State or local government, determines to pay, for the life of each individual in such a group, the monthly premiums due. (Sec. 332) Outlines provisions for hospital geographic reclassification for labor costs applicable to other PPS systems and for grants to States for improvements in nursing home staffing and quality. Title IV: Provisions Relating to Part B - Subtitle A: Hospital Outpatient Services - Amends SSA title XVIII with respect to the PPS for hospital OPD services to provide for: (1) a full market basket increase for such services for 2001; (2) adjustment for service mix changes; (3) use of categories in determining eligibility of a device for pass-through payments; (4) application of OPD PPS transitional corridor payments to certain hospitals that did not submit a 1996 cost report; (5) treatment of children's hospitals under the PPS; (6) inclusion of temperature monitored cryoablation in transitional pass-through for certain medical devices, drugs, and biologicals under the PPS; and (7) the Secretary to create additional groups of covered OPD services that classify separately those procedures that utilize contrast media from those that do not. (Sec. 404) Provides that, for purposes of making determinations of provider-based status under Medicare on or after October 1, 2000, any facility or organization that is treated as provider-based in relation to a hospital or critical access hospital under Medicare as of October 1, 2000: (1) shall continue to be treated as provider-based in relation to such hospital or critical access hospital under Medicare during the two year period beginning on October 1, 2000; and (2) the requirements, limitations, and exclusions specified in appropriate Federal regulations detailing requirements for a determination that a facility or an organization has provider-based status shall not apply to such facility or organization in relation to such hospital or critical access hospital until after the end of such two- year period. Prohibits a facility or organization for which a determination of provider-based status in relation to a hospital or critical access hospital is requested during FY 2001 or 2002 from being treated as not having such status in relation to such a hospital for any period before a determination is made with respect to such status pursuant to such request and in making a determination with respect to such status for any facility or organization in relationship to such a hospital on or after October 1, 2000, the facility or organization shall be treated as satisfying any requirements and standards for geographic location in relation to such a hospital if the facility or organization: (1) satisfies appropriate Federal regulations pertaining to location in immediate vicinity or is located not more than 35 miles from the main campus of the hospital or critical access hospital; and (2) is owned and operated by a hospital or critical access hospital that meets specified criteria. Subtitle B: Provisions Relating to Physicians' Services - Directs the Comptroller General to conduct a study on: (1) the appropriateness of furnishing in physicians' offices specialist physicians' services which are ordinarily furnished in hospital outpatient departments; and (2) the refinements to the practice expense relative value units during the transition to a resource-based practice expense system for physician payments under Medicare. (Sec. 412) Amends SSA title XVIII to require the Secretary to conduct demonstration projects to test and, if proven effective, expand the use of incentives to health care groups participating in Medicare that: (1) encourage coordination of the care furnished to individuals under Medicare parts A and B by institutional and other providers, practitioners, and suppliers of health care items and services; (2) encourage investment in administrative structures and processes to ensure efficient service delivery; and (3) reward physicians for improving health outcomes. (Sec. 413) Directs the Comptroller General to study the current Medicare enrollment process for groups that retain independent contractor physicians with particular emphasis on hospital-based physicians. Subtitle C: Other Services - Amends SSA title XVIII to provide for a one-year extension of the moratorium on certain physical therapy services caps. (Sec. 421) Directs the Secretary to study the implications: (1) of eliminating the "in the room" supervision requirement for Medicare payment for services of physical therapy assistants supervised by physical therapists; and (2) of such requirement on the cap imposed under Medicare on physical therapy services. (Sec. 422) Amends SSA title XVIII with respect to Medicare coverage for end stage renal disease (ESRD) patients to increase the update for dialysis services furnished on or after January 1, 2001. Directs the Secretary to: (1) collect data and develop an ESRD market basket whereby the Secretary can estimate, before the beginning of a year, the percentage by which the costs for the year of the mix of labor and nonlabor goods and services included in the ESRD composite rate will exceed the costs of such mix for the preceding year; and (2) develop a system which includes in such composite rate, to the maximum extent feasible, payment for clinical diagnostic laboratory tests and drugs that are routinely used in furnishing dialysis services to Medicare beneficiaries, but which are currently separately billable by renal dialysis facilities. (Sec. 423) Amends SSA title XVIII with respect to payment for ambulance services to provide for: (1) restoration of the full consumer price index (CPI) increase for 2001; and (2) continued phase-in of the application of the payment rates under the ambulance services fee schedule in an efficient and fair manner; except that when the Secretary implements such fee schedule, such phase-in shall provide for full payment of any national mileage rate for ambulance services provided by suppliers that are paid by carriers in any of the 50 States where payment by a carrier for such services for all such suppliers in such State, before the fee schedule's implementation, did not include a separate amount for all mileage within the county from which the beneficiary is transported. (Sec. 424) Prohibits the Secretary from implementing a revised PPS for services of ambulatory surgical facilities before January 1, 2002. Amends the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 with respect to the phase-in of the PPS for ambulatory surgical centers to: (1) extend the phase-in to four years; and (2) direct the Secretary, by January 1, 2003, to incorporate data from a 1999 Medicare cost survey or a subsequent cost survey for purposes of implementing or revising such PPS. (Sec. 425) Amends SSA title XVIII, with respect to special payment rules for particular items and services, to provide for: (1) the full update for durable medical equipment, orthotics, and prosthetics in 2001; and (2) addition of special payment provisions and requirements for prosthetics and certain custom fabricated orthotic items. (Sec. 428) Amends SSA title XVIII to provide for the replacement of, and payment for, prosthetic devices and parts. (Sec. 429) Directs the Comptroller General to study the reimbursement for drugs and biologicals under the current Medicare payment methodology and for related services under Medicare part B, with recommendations for revised payment methodologies. Directs the Secretary to revise such payment methodology based on such recommendations. (Sec. 430) Amends SSA title XVIII part D (Miscellaneous) to revise the qualifications for community mental health centers under provisions defining partial hospitalization services. (Sec. 431) Makes a hospital or a free-standing ambulatory care clinic, whether operated by the Indian Health Service or by an Indian tribe or tribal organization, eligible for payments for services for which payment is made under Medicare part B for physicians' services if and for so long as it meets all of the requirements which are applicable generally to such payments, services, hospitals, and clinics. (Sec. 432) Directs the Comptroller General to study the effect on Medicare and on Medicare beneficiaries of coverage of surgical first assisting services of certified registered nurse first assistants. (Sec. 433) Directs MEDPAC to study the appropriateness of: (1) the current Medicare payment rates for services provided by a certified nurse-midwife, a physician assistant, a nurse practitioner, and a clinical nurse specialist; and (2) Medicare coverage for services provided by a surgical technologist, a marriage counselor, a marriage and family therapist, a pastoral care counselor, and a licensed professional counselor of mental health. (Sec. 435) Directs the Comptroller General to study: (1) the costs of providing emergency and medical transportation services across the range of acuity levels of conditions for which such transportation services are provided; (2) the post-payment audit process under Medicare as such process applies to physicians; and (3) the aggregate effects of regulatory, audit, oversight, and paperwork burdens on physicians and other health care providers participating in Medicare. (Sec. 437) Directs MEDPAC to study the barriers to coverage and payment for outpatient interventional pain medicine procedures under Medicare. Title V: Provisions Relating to Parts A and B - Subtitle A: Home Health Services - Amends SSA title XVIII to provide for a two-year additional delay in the application of the 15 percent reduction on payment limits for home health services. (Sec. 501) Amends the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 to delay for an additional year the 15 percent reduction in payment rates for home health services after implementation of the PPS. Requires the Comptroller General, instead of the Secretary (as currently required), to report to Congress an analysis of the need for such a reduction. Amends SSA title XVIII with regard to the PPS for home health services concerning the annual update to provide for an adjustment for case mix changes. (Sec. 502) Amends SSA title XVIII to provide for restoration of the full home health market basket update for home health services for FY 2001. Establishes a special rule for payment under the PPS for home health services for FY 2001 based on adjusted prospective payment amounts. (Sec. 503) Provides for a temporary two-month extension of periodic interim payments under BBA '97 in the case of a home health agency receiving periodic interim payments as of September 30, 2000. (Sec. 504) Amends SSA title XVIII to provide for the use of telehealth in the delivery of home health services. (Sec. 505) Directs the Comptroller General to study variations in prices paid by home health agencies furnishing home health services under Medicare in purchasing nonroutine medical supplies and volumes if such supplies used determine the effect (if any) of variations on prices and volumes in the provision of such services. (Sec. 506) Provides that, in determining for Medicare purposes whether an office of a home health agency constitutes a branch office or a separate home health agency, neither the time nor distance between a parent office of the home health agency and a branch office shall be the sole determinant of a home health agency's branch office status. (Sec. 507) Amends SSA title XVIII with regard to the Medicare home health benefit to declare that absences from home to receive medical treatment shall not disqualify an individual from such benefit. (Sec. 508) Provides for a temporary payment increase for home health services furnished in a rural area for2001 and 2002. Subtitle B: Direct Graduate Medical Education - Amends SSA title XVIII to provide for an increase in the floor for direct graduate medical education payments for FY 2002. (Sec. 512) Changes the distribution formula for Medicare+Choice-related nursing and allied health education costs. Subtitle C: Changes in Medicare Coverage and Appeals Process - Amends SSA title XVIII to revise the Medicare appeals process. Provides for initial determinations of entitlement and benefits by the Secretary, by a utilization and quality control peer review organization, or by an independent contractor. Provides for redeterminations of denied benefit claims. Specifies appeal rights, including the right of an individual to request a medically exigent review from the contractor who made the initial determination. (Sec. 522) Provides for the review of coverage determinations under the Medicare appeals process. Amends SSA title XI to require any advisory committee on certain Medicare coverage exclusions to: (1) assure the full participation of a nonvoting member in its deliberations; and (2) provide such nonvoting member access to all information and data (with certain exceptions) made available to the committee's voting members. Provides that, if such committee organizes into panels of experts according to types of items or services, any such panel may report directly to the Secretary without prior approval. Subtitle D: Improving Access to New Technologies - Amends SSA title XVIII to establish a new payment rule for any clinical diagnostic laboratory test performed on or after January 1, 2001, that is a new test for which no limitation amount has previously been established. (Sec. 531) Directs the Secretary to: (1) establish procedures for coding and payment determinations for the categories of new clinical diagnostic laboratory tests and new durable medical equipment under Medicare part B that permit public consultation in a manner consistent with the procedures established for implementing coding modifications for ICD-9-CM; and (2) report to Congress on the specific procedures used under Medicare part B to adjust payments for clinical diagnostic laboratory tests and durable medical equipment which are classified to existing codes where, because of a technology advance, there has been a significant increase or decrease in the resources used in the test or in the manufacture of the equipment, and a significant improvement in test or equipment performance. (Sec. 532) Directs the Secretary to: (1) maintain and continue through December 31, 2003, the use of level III codes of the HCPCS (Health Care Financing Administration (HCFA) Common Procedure Coding System) coding system (as such system was in effect on August 16, 2000); and (2) make such codes publicly available. (Sec. 533) Directs the Secretary to: (1) report to Congress on methods of expeditiously incorporating new medical services and technologies into the clinical coding system used with respect to Medicare payment for inpatient hospital services, together with a detailed description of the Secretary's preferred methods to achieve this purpose; and (2) implement such preferred methods. Amends SSA title XVIII to direct the Secretary to establish a mechanism to recognize the costs of new medical services and technologies with respect to inpatient hospital services under the hospital reimbursement control system. Subtitle E: Other Provisions - Amends SSA title XVIII to reduce from 45 percent to 30 percent the reduction in the amount of bad debts otherwise treated as allowable costs attributable to the deductibles and coinsurance amounts under Medicare for FY 2001 and subsequent fiscal years in determining the reasonable costs of outpatient hospital services (thus increasing by 15 percent the amount that may be reimbursed). (Sec. 542) Provides for the treatment of certain physician pathology services under Medicare. (Sec. 543) Amends SSA title XI to make permanent the authority for the Secretary to issue written advisory opinions under provisions for guidance regarding application of health care fraud and abuse sanctions. (Sec. 544) Amends SSA title XVIII to make various specified changes in annual MEDPAC reporting with regard to revision of deadlines for submission of reports and on the record votes on recommendations. (Sec. 545) Directs the Secretary to report to specified congressional committees on the development of standard instruments for the assessment of the health and functional status of patients, for whom specified items and services are furnished. (Sec. 546) Directs the Comptroller General to report to specified congressional committees on the effect of the Emergency Medical Treatment and Active Labor Act on hospitals, emergency physicians, and physicians covering emergency department call throughout the United States. (Sec. 547) Amends SSA title XVIII with respect to agreements with providers of services to provide for the application of the bloodborne pathogen standard to certain hospitals. Title VI: Provisions Relating to Part C (Medicare+Choice Program) and Other Medicare Managed Care Provisions - Subtitle A: Medicare+Choice Payment Reforms - Amends SSA title XVIII part C with regard to payments to Medicare+Choice organizations to: (1) increase the payment amount for 2001 through 2003 for accountable Medicare+Choice coordinated care plans; and (2) provide for a ten-year phase-in of risk adjustment. (Sec. 603) Provides for a transition to revised Medicare+Choice payment rates. (Sec. 604) Amends SSA title XVIII part C to provide for revision of payment rates for ESRD patients enrolled in Medicare+Choice plans. (Sec. 605) Amends SSA title XVIII part C with regard to premiums to permit Medicare part B premium reductions as additional benefits under Medicare+Choice plans. (Sec. 606) Amends SSA title XVIII part C with regard to payments to Medicare+Choice organizations to: (1) ensure full implementation of risk adjustment methodology for congestive heart failure enrollees for 2001; and (2) provide for the expansion of the application of Medicare+Choice's new entry bonus. (Sec. 608) Directs the Secretary to report to Congress on a method to phase-in the costs of military facility services furnished by the Department of Veterans Affairs, and those furnished by the Department of Defense, to Medicare-eligible beneficiaries in the calculation of an area's Medicare+Choice capitation payment. Subtitle B: Other Medicare+Choice Reforms - Amends SSA title XVIII part C to provide for payment of additional amounts for new Medicare+Choice benefits covered during a contract term. (Sec. 612) Prohibits the Secretary from implementing, other than at the beginning of a calendar year, regulations that impose significant regulatory requirements on a Medicare+Choice organization or plan. (Sec. 613) Provides for timely approval of marketing material that follows model marketing language, and for avoiding duplicative regulation with respect to plan requirements. (Sec. 615) Provides that, in the case of a Medicare+Choice organization that offers a Medicare+Choice plan in an area in which more than one local coverage policy is applied with respect to different parts of the area, the organization may elect to have the local coverage policy for the part of the area that is most beneficial to Medicare+Choice enrollees apply with respect to all Medicare+Choice enrollees enrolled in the plan. (Sec. 616) Requires: (1) the quality assurance program under the Medicare+Choice program to include a separate focus on racial and ethnic minorities; and (2) the Secretary to submit to Congress a report regarding how such quality assurance programs focus on racial and ethnic minorities. (Sec. 617) Authorizes the Secretary to waive or to modify requirements that hinder the design of, the offering of, or enrollment in Medicare+Choice plans under contracts between Medicare+Choice organizations and employers, labor organizations, or the trustees of a fund established by one or more employers or labor organizations (or combination thereof) to furnish benefits to the entity's employees, former employees (or combination thereof) or to members or former members (or combination thereof) of the labor organizations. (Sec. 618) Amends SSA title XVIII part D with regard to special Medicare supplemental health insurance enrollment anti-discrimination provision for certain beneficiaries. (Sec. 619) Amends SSA title XVIII part C to restore the effective date of elections and changes of elections of Medicare+Choice plans. (Sec. 620) Permits ESRD beneficiaries to enroll in another Medicare+Choice plan if the plan in which they are enrolled is terminated. (Sec. 621) Provides that, in covering post-hospital extended care services, a Medicare+Choice plan shall provide for such coverage through a home SNF if: (1) the enrollee elects to receive such coverage through such SNF; and (2) the SNF has a contract with the Medicare+Choice organization for the provision of such services, or the SNF agrees to accept substantially similar payment under the same terms and conditions that apply to similarly situated SNFs under contract with the Medicare+Choice organization through which the enrollee would otherwise receive such services. (Sec. 622) Directs HCFA's Chief Actuary to review the actuarial assumptions and data used by the Medicare+Choice organization with respect to such rates, amounts, and values to determine the appropriateness of such assumptions and data. (Sec. 623) Amends SSA title XVIII to provide for civil monetary penalties for contract default by a Medicare+Choice organization. Subtitle C: Other Managed Care Reforms - Amends the Omnibus Budget Reconciliation Act of 1987 to provide for a one-year extension of the social health maintenance organization demonstration project authority. (Sec. 632) Amends the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 to provide for revised terms and conditions for extension of Medicare community nursing organization demonstration project. (Sec. 633) Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to provide for a two-year extension of Medicare municipal health services demonstration projects. (Sec. 634) Amends SSA title XVIII part D with regard to payments to health maintenance organizations and competitive medical plans and service area expansion for Medicare cost contracts during transition period. Title VII: Medicaid - Amends SSA title XIX with respect to DSH payments and: (1) continuation of Medicaid DSH allotments at FY 2000 levels for FY 2001 and 2002; and (2) a special rule for Medicaid DSH allotment for extremely low DSH States. (Sec. 701) Outlines provisions for: (1) assuring identification of Medicaid managed care patients for purposes of making DSH payments; (2) application of the Medicaid DSH transition rule to public hospitals in all States; (3) assistance for certain public hospitals; and (4) DSH payment accountability standards. (Sec. 702) Amends SSA title XIX to create a new PPS for Federally-qualified health centers and rural health clinics. (Sec. 703) Amends SSA XI to establish an approval process for a State's application for an extension of any State-wide comprehensive demonstration project for which a waiver of compliance with Medicaid requirements is granted. (Sec. 704) Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 with respect to Medicaid county-organized health systems. (Sec. 705) Directs the Secretary to issue a final regulation based on the proposed rule announced on October 5, 2000, that: (1) modifies the upper payment limit test applied to State Medicaid spending for inpatient hospital services, outpatient hospital services, nursing facility services, intermediate care facility services for the mentally retarded, and clinic services by applying an aggregate upper payment limit to payments made to government facilities that are not State-owned or operated facilities; and (2) provides for a specified transition period. (Sec. 706) Prescribes a formula for the Federal medical assistance percentage for Alaska for purposes of SSA titles XIX and XXI (State Children's Health Insurance Program) (SCHIP), which shall apply only for FY 2001 through 2005. (Sec. 707) Amends SSA title XIX to provide for optional coverage of legal immigrants under Medicaid. (Sec. 708) Makes additional entities qualified to determine Medicaid presumptive eligibility for low-income children. (Sec. 709) Provides for a one year extension of provisions on eligibility for medical assistance under Medicaid. (Sec. 710) Includes as Medicaid medical assistance any services furnished by a physician assistant which the assistant is legally authorized to perform under State law and with the supervision of a physician. (Sec. 711) Gives States the option of allowing families of disabled children to purchase Medicaid coverage for such children. Title VIII: State Children's Health Insurance Program - Amends SSA title XXI to: (1) establish a rule for redistribution and extended availability of unused FY 1998 and 1999 SCHIP allotments; (2) provide authority to pay Medicaid expansion SCHIP costs from SCHIP appropriations; (3) eliminate requirement to reduce a SCHIP allotment by Medicaid expansion SCHIP costs; (4) provide authority to transfer SCHIP appropriations to the Medicaid appropriation account as reimbursement for Medicaid expenditures for Medicaid expansion SCHIP services; and (5) provide optional coverage of certain legal immigrants under SCHIP. Title IX: Other Provisions - Subtitle A: PACE Program - Amends BBA '97 with respect to programs of all-inclusive care for the elderly (PACE programs) to provide for an extension of transition for the current PACE demonstration project waiver authority. (Sec. 902) Amends SSA title XVIII with respect to payments to, and coverage of benefits under, PACE programs, and regulations and use of PACE protocol to provide for the continuation of modifications or waivers of operational requirements under demonstration status. (Sec. 903) Directs the Secretary to approve or deny a request for a modification or a waiver of provisions of the PACE protocol not later than 90 days after the Secretary receives the request, in order to provide flexibility in exercising waiver authority. Permits the Secretary to exercise authority to modify or to waive such provisions in a manner that responds promptly to the needs of PACE programs relating to areas of employment and the use of community-based primary care physicians in order to provide flexibility in exercising waiver authority. Subtitle B: Outreach to Eligible Low-Income Medicare Beneficiaries - Amends SSA title XI to direct the Commissioner of Social Security to: (1) conduct outreach efforts to identify individuals entitled to Medicare benefits who may be eligible for medical assistance for payment of the cost of Medicare cost-sharing under Medicaid; and (2) notify such individuals of the availability of such medical assistance. (Sec. 911) Directs the Comptroller General to study the impact of such outreach efforts on the enrollment of individuals for Medicare cost-sharing under Medicaid. Subtitle C: Maternal and Child Health Block Grant - Amends SSA title V (Maternal and Child Health Services) to increase the authorization of appropriations for the Maternal and Child Health Services block grant for FY 2001 and each fiscal year thereafter. Subtitle D: Diabetes - Amends the Public Health Service Act to increase FY 2001 through 2003 appropriations for special diabetes programs for children with type I diabetes and for special diabetes programs for Indians. (Sec. 931) Amends BBA '97 to extend the final report on diabetes grant programs. (Sec. 932) Amends the Ricky Ray Hemophilia Relief Fund Act of 1998 to make appropriations to the Ricky Ray Hemophilia Relief Fund for FY 2001.
Resolution· HRESH.Res. 661 (106th)referred
United States · United States Congress · 28 October 2000
Declares that the House of Representatives: (1) supports youth civic literacy in the United States; and (2) urges U.S. educational institutions, students, teachers, elected officials, community leaders, and other interested parties to participate in local and national youth civic education projects.
Bill· HRH.R. 5595 (106th)referred
United States · United States Congress · 27 October 2000
Hispanic Health Act of 2000 - Title I: Annual Report to Congress on Programs for Improving Health Status of Hispanic Individuals - Requires the Secretary of Health and Human Services to report to Congress on programs carried out through the Public Health Service for improving the health status of Hispanic individuals regarding diabetes, HIV infection, AIDS, substance abuse, and mental health. Title II: Diabetes Control and Prevention - Authorizes appropriations for: (1) diabetes education and prevention activities for Hispanic individuals; and (2) implementation of recommendations of the Diabetes Research Working Group. Title III: HIV Prevention Activities Regarding Hispanic Individuals - Directs the Secretary to: (1) carry out activities relating to HIV prevention activities among Hispanic individuals; and (2) make grants to Hispanic-serving institutions for carrying out HIV- related projects among racial and ethnic minority groups. Title IV: Prevention of Latina Adolescent Suicides - Directs the Secretary to carry out a grant program for reducing suicide attempts among Latina adolescents. Authorizes appropriations. Title V: Bilingual Health Professionals - Directs the Secretary to carry out a program for training bilingual health professionals in the treatment of minority health conditions. Authorizes appropriations. Title VI: Cultural Competence - Directs the Secretary to: (1) develop educational materials on providing health services in a culturally competent manner; (2) establish a Center for Linguistic and Cultural Competence in Health Care; and (3) carry out cultural competence demonstration projects at two hospitals. Authorizes appropriations. Title VII: Hispanic-Serving Health Professions Schools - Directs the Secretary to make grants to Hispanic-serving health professions schools to recruit Hispanic individuals for enrollment. Authorizes appropriations. Title VIII: Data Regarding Race and Ethnicity - Amends the Public Health Service Act to require the Secretary to collect and maintain health care race and ethnicity data. (Sec. 802) Directs the Secretary to develop outcome measures used to evaluate, by race and ethnicity, the performance of health care programs and projects to individuals under Medicare and Medicaid programs (titles XVIII and XIX of the Social Security Act). Title IX: General Provisions - Provides definitions and an effective date.
Bill· HRH.R. 5549 (106th)referred
United States · United States Congress · 25 October 2000
Retirement Enhancement Act of 2000 - Title I: Improved Participation and Vesting - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide for: (1) minimum coverage requirements; (2) revised minimum participation requirements; (3) faster vesting of benefits under defined contribution plans; (4) model simplified pension plans, including ones for groups of small employers; and (5) enforcement of requirements for simplified employee pensions. Title II: Improved Pension Protections For Women - Amends ERISA to: (1) prohibit employee pension plan benefits from varying on the basis of amounts received under workers' compensation, unemployment compensation, or disability insurance; (2) require spousal consent for distributions from defined contribution plans; (3) revise joint and survivor annuity requirements; (4) set forth special rules and procedures for determining the division of pension benefits upon divorce, in cases where domestic relations orders do not do so; (5) treat periods of family and medical leave as hours of service for pension participation and vesting; (6) establish the right of a spouse to know distribution information; (7) repeal a reduction in military survivor benefit plan annuities at age 62; (8) revise provisions relating to survivor annuities for widows, widowers, and former spouses of Federal employees who die before attaining age for deferred annuity under Civil Service Retirement System; (9) set forth an order of precedence for disposition of amounts remaining in the thrift savings account of a Federal employee (or former employee) who dies before making an effective election controlling such disposition; and (10) provide for interest on amounts paid to make up for certain civil service annuity benefits wrongfully denied. Amends the Civil Service Retirement Spouse Equity Act of 1984 to revise certain effective date provisions to: (1) eliminate certain bars to eligibility; (2) set a new deadline for certain applications; and (3) authorize the Director of the Office of Personnel Management to waive such deadline. Title III: Simplified Investment Standards - Amends ERISA to provide under certain conditions: (1) an exemption from prohibited transaction rules for emergent transactions; (2) an alternative method for publishing the pendency of prohibited transaction exemptions; (3) employer protection from liability for the provision of investment advice; (4) participation of participants in trusteeship of defined contribution plans; (5) removal of $500,000 cap on bonding requirement; (6) disclosure regarding investments and voting of proxies; (7) diversification in defined contribution investments; and (8) diversification of investments under employee stock ownership plans by participants and beneficiaries over 55 years of age. Title IV: Improvements in Pension Information and Enforcement - Amends ERISA to: (1) revise provisions for periodic pension benefit statements; and (2) require benefit statements to include information on investment performance. Requires disclosures to the Secretary of Labor relating to plan termination, and to plan sponsors after acquisition or merger of plans. Provides for adjustment of the amount of operating income of employers required to be reported annually with respect to defined benefit pension plans, and requires such information to be provided annually to participants and beneficiaries. Requires certain information regarding multiemployer plans to be included in annual reports. Limits the scope of certain required audits in specified cases. Requires direct reporting by plan administrators of certain events. Requires certain pension survey reports by the Secretary. Establishes an early resolution program for pension benefit claims. Requires de novo review of benefit determinations. Revises allowable relief. Revises provisions for civil penalties for breaches of fiduciary responsibility. Authorizes the Secretary to assess additional penalties against plan administrators or employers for failures to meet disclosure requirements. Directs the Pension Benefit Guaranty Corporation (PBGC) to prescribe certain rules for covered multiemployer plans that terminate. Allows an administrator of a plan not otherwise covered to elect to transfer a missing participant's benefits to the PBGC upon plan termination. Increases the guaranteed benefit level for multiemployer plans. Title V: Improved Pension Protections for the Changing Workforce - Amends ERISA to require pension plans to make qualified loans for health insurance and job training expenses of participants or beneficiaries. Allows immediate distributions only if they are rolled over to qualified plans. Requires prompt distributions from defined contribution plans upon termination of participants' covered employment. Provides for an extended period for recoupment of overpayments. Title VI: General Provisions - Sets forth provisions for effective dates, with special rules for collectively bargained agreements and plan amendments.
Bill· HRH.R. 5546 (106th)referred
United States · United States Congress · 25 October 2000
Retirement Enhancement Revenue Act of 2000 - Title I: Public Employee Pension Plans - Amends the Internal Revenue Code, with respect to public employee pension plans, to set forth additional reporting and disclosure requirements and provide for the review of employee contribution changes by qualified review boards. Title II: Pension Improvements - Requires 401(k) plans to be offered to all eligible employees and to meet minimum coverage requirements. Makes other revisions concerning pension plans, including: (1) raising the contribution limit on simplified employee pensions; (2) increasing from the age of 70-and-one-half to age 75 the requirement to begin mandatory pension distributions; (3) repealing specified coordination requirements for deferred compensation plans of State and local governments and tax-exempt organizations; (4) permitting rollovers from and to various types of plans. Title III: Additional Amendments - Makes additional revisions to pension provisions, including: (1) concerning cash-outs from section 457 plans (deferred compensation plans of State and local governments and tax-exempt organizations) to qualified plans; and (2) permitting loans from a pension plan for involuntarily separated employees for health insurance and job training expenses. Title IV: General Provisions - Sets forth effective date provisions.
Resolution· HCONRESH.Con.Res. 435 (106th)referred
United States · United States Congress · 24 October 2000
Recognizes and honors Ernesto "Tito" Puente Jr. as one of the greatest American musicians.
Bill· HRH.R. 5397 (106th)referred
United States · United States Congress · 5 October 2000
Veterans Commemoration Act of 2000 - Directs the Secretary of the Treasury to mint and issue a maximum of 500,000 $1 coins to commemorate the service of veterans of the United States armed forces. Mandates that the proceeds from sale surcharges be paid promptly to the Disabled American Veterans to fund the transportation of veterans to and from hospitals administered by the Secretary of Veterans Affairs.
Bill· HRH.R. 5324 (106th)referred
United States · United States Congress · 27 September 2000
Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 2000 - Title I: Provisions Relating to Part A - Subtitle A: Skilled Nursing Facilities - Amends title XVIII (Medicare) of the Social Security Act (SSA) with regard to eliminating the reduction in the skilled nursing facility (SNF) market basket update. (Sec. 102) Amends the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA) to revise the BBRA increase for SNFs in FY 2001 and 2002. (Sec. 103) Requires a Medicare Payment Advisory Commission (MedPAC) study and report to the Secretary of Health and Human Services (HHS) and Congress on nursing home costs to determine the adequacy of Medicare payment rates for items and services furnished by SNFs. Grants the Secretary the authority to make payment adjustments for covered SNF services if appropriate as a result of the study. Subtitle B: PPS Hospitals - Amends SSA title XVIII to: (1) revise the reduction of indirect graduate medical education payments; (2) eliminate the reduction in the Prospective Payment System (PPS) hospital payment update; (3) eliminate the reduction in disproportionate share hospital (DSH) payments; and (4) change the payment formulas for DSH hospitals; and (5) modify the payment rate for Puerto Rico hospitals. (Sec. 115) Increases the DSH allotments under Medicaid for the District of Columbia. Amends SSA title XIX (Medicaid) and XXI (State Children's Health Insurance) (SCHIP) to provide for the optional eligibility of certain alien pregnant women and children for Medicaid and SCHIP. (Sec. 117) Requires a MedPAC study on hospital area wage indexes for a report to the Secretary and Congress. Subtitle C: PPS Exempt Hospitals - Amends SSA title XVIII to provide for the treatment of certain cancer hospitals (Sec. 122) Makes certain changes with regard to the PPS for inpatient rehabilitation services and payment during the transition period under current law. Subtitle D: Hospice Care - Amends SSA title XVIII to revise payments for hospice care. Subtitle E: Other Provisions - Amends SSA title XVIII to outline various provisions concerned with: (1) hospital compliance with the Bloodborne Pathogens standard; (2) an Informatics and Data Systems Grant Program; and (3) relief from the Medicare part A (Hospital Insurance) late enrollment penalty for a group buy-in for State and local retirees. Authorizes appropriations. Subtitle F: Transitional Provisions - Reclassifies certain counties and areas in specified States (including the Boston and Barnstable-Yarmouth Metropolitan Statistical Areas) for purposes of reimbursement under the Medicare program. Title II: Provisions Relating to Part B - Subtitle A: Hospital Outpatient Services - Amends SSA title XVIII to provide for reduction of the effective hospital outpatient department (HOPD) coinsurance rate to 20 percent by 2019. (Sec. 202) Revises the formula for calculating the base payment-to-cost-ratio component of HOPD PPS transitional corridor payments to include in such formula (and so cover) certain hospitals that did not submit cost reports for 1996. (Sec. 203) Provides a permanent guarantee of pre-Balanced Budget Act of 1997 (BBA '97) payment levels for HOPD services furnished by children's hospitals. Subtitle B: Provisions Relating to Physicians - Amends the Higher Education Act of 1965 to grant medical students a deferment on their student loans for a period not to exceed the length of their full initial residency period. (Sec. 212) Directs the Comptroller General to study and report to the Secretary and Congress on: (1) the post-payment audit process under Medicare as it applies to physicians; and (2) the aggregate effects of regulatory, audit, oversight, and paperwork burdens on physicians and other health care providers participating in Medicare. (Sec. 213) Directs MEDPAC to study and report to the Secretary and Congress on the refinements to the practice expense relative value units during the transition to a resource-based practice expense system for physician payments under Medicare. Subtitle C: Ambulance Services - Amends SSA title XVIII with regard to the establishment of a fee schedule for ambulance services to allow a supplier of ambulance services to elect to forego phase-in of such schedule and receive payments based only upon it. (Sec. 222) Establishes a prudent layperson standard for emergency ambulance services. (Sec. 223) Eliminates the reduction in inflation adjustments for ambulance services. (Sec. 224) Directs the Secretary to study and report to Congress on the means by which rural areas with low population densities can be identified for the purpose of designating areas in which the cost of providing ambulance services would be expected to be higher than similar services provided in more heavily populated areas because of low usage. (Sec. 225) Outlines provisions for interim payments for rural ground ambulance services until such time as the established fee schedule is modified by a specified regulation. (Sec. 226) Directs the Comptroller General to study and report to the Secretary and Congress on the costs of providing emergency and medical transportation services across the range of acuity levels of conditions for which such transportation services are provided. Subtitle D: Preventive Services - Amends SSA title XVIII to: (1) prohibit deductibles and coinsurance for various specified preventive benefits; (2) add lancets to the definition of durable medical equipment; and (3) provide coverage of counseling for cessation of tobacco use, glaucoma detection tests, and medical nutrition therapy services for beneficiaries with diabetes, a cardiovascular disease, or a renal disease. (Sec. 235) Directs the Secretary to: (1) conduct a series of studies, for an annual report to the Congress, designed to identify preventive interventions that can be delivered in the primary care setting that are most valuable to older Americans; and (2) contract with the Institute of Medicine of the National Academy of Sciences to study and report periodically to the President on current literature and best practices in the field of health promotion and disease prevention among Medicare beneficiaries. (Sec. 237) Provides for fast-track consideration of preventive benefit legislation resulting from recommendations accompanying such study reports. Subtitle E: Other Services - Amends SSA title XVIII with regard to: (1) revision of the moratorium on caps for therapy services; (2) revision of coverage of immunosuppressive drugs; (3) extension of certain secondary payer requirements; (4) State accreditation of diabetes self-management training programs; (5) elimination of the reduction in payment amounts for orthotics and prosthetics, parenteral and enteral nutrients, supplies, and equipment and oxygen and oxygen equipment; (6) standards regarding payment for certain orthotics and prosthetics; (7) revision of the definition of orthotics; (8) new pap smear technologies and other new clinical laboratory test technologies; (9) increase in payments for certified nurse-midwife services; and (10) payment for administration services associated with chemotherapy and for blood clotting drug-related activities. (Sec. 249) Directs MEDPAC to study and report to the Secretary and Congress on the provision of in-home infusion therapy nursing services. (Sec. 250) Amends SSA title XVIII to provide for Medicare coverage of vision rehabilitation services. (Sec. 251) Amends SSA title XVIII part B (Supplementary Medical Insurance) with respect to the amounts of part B premiums to limit the Medicare late enrollment penalty to ten percent and twice the period of no enrollment. Title III: Provisions Relating to Parts A and B - Subtitle A: Home Health Services - Amends SSA title XVIII to eliminate a specified 15 percent reduction in cost and per beneficiary limits with respect to payment rates for home health services under the Medicare PPS. (Sec. 302) Provides for additional payments: (1) for outliers; and (2) under the PPS for services furnished in rural areas and security services. (Sec. 304) Excludes from the Medicare PPS certain nonroutine medical supplies furnished by a home health agency. Details certain study and reporting requirements with regard to such exclusion. (Sec. 305) Declares that, with regard to eligibility for Medicare home health benefits, any absence of an individual from the home attributable to health care treatment, including regular absences for such treatment in an adult day-care program, shall not disqualify the individual from being considered confined to home. (Sec. 306) Directs the Secretary to establish standards for the operation of a branch office, a service site for home health services controlled and supervised by a home health agency. (Sec. 307) Provides for the treatment of home health services provided in certain counties in the State of New York. (Sec. 308) Permits a home health agency to receive Medicare payments for a home health service furnished via a telecommunications system. Subtitle B: Direct Graduate Medical Education - Provides that, for cost reporting periods between October 1, 2000, and October 1, 2005, in applying the limitations regarding the total number of full-time equivalent interns and residents in the field of allopathic or osteopathic medicine under Medicare for a hospital, the Secretary shall not take into account a maximum of three interns or residents in the field of geriatric medicine to the extent the hospital increases the number of geriatric interns or residents above the number of such interns or residents for the hospital's most recent cost reporting period ending before October 1, 2000. (Sec. 312) Amends SSA title XI part A (General Provisions) to establish a program of payments to children's hospitals that operate graduate medical education programs. Authorizes appropriations. (Sec. 313) Provides that, effective for cost reporting periods beginning on or after October 1, 1999, for purposes of Medicare payments to hospitals for costs of approved educational activities, such activities shall include the clinical portion of professional educational training programs recognized by the Secretary for clinical psychologists. (Sec. 314) Amends SSA title XVIII to provide for the treatment of certain newly established residency programs in computing Medicare payments for the costs of medical education. (Sec. 315) Revises the limitation during FY 1997 on allopathic and osteopathic residents for payment of both the indirect and direct costs of graduate medical education at an accredited community health center, if the hospital conducting the residency program incurred all or substantially all of the training costs. Subtitle C: Miscellaneous Provisions - Amends SSA title II (Old Age, Survivors and Disability Insurance) (OASDI) to provide for a waiver of the 24-month waiting period for Medicare coverage of individuals disabled with amyotrophic lateral sclerosis. Title IV: Rural Provider Provisions - Subtitle A: Critical Access Hospitals - Amends SSA title XVIII with regard to payments to critical access hospitals for clinical diagnostic laboratory tests. (Sec. 402) Amends SSA title XVIII, as amended by BBRA, to revise the payment for professional services provided by a critical access hospital. (Sec. 403) Amends SSA title XVIII to permit critical access hospitals to operate PPS-exempt distinct part psychiatric and rehabilitation units. Subtitle B: Medicare Dependent, Small Rural Hospital Program - Amends SSA title XVIII to: (1) make the Medicare-dependent, small rural hospital program permanent; and (2) give any hospital under such program the option of basing eligibility for payment on discharges during any of the three most recent audited cost reporting periods in lieu of the current basing of eligibility for payment on discharges during the cost reporting period beginning in FY 1987. Subtitle C: Sole Community Hospitals - Amends SSA title XVIII to extend the option to use rebased target amounts to all sole community hospitals. (Sec. 422) States that, for purposes of discharges occurring on or after October 1, 2000, the Greensville Memorial Hospital located in Emporia, Virginia, shall be deemed to have satisfied the travel time criteria under applicable Medicare provisions for classification as a sole community hospital. Subtitle D: Other Rural Hospital Provisions - Amends SSA title XVIII to exempt Medicare swing bed hospitals from the PPS for skilled nursing facilities (SNFs). (Sec. 431) Amends BBRA to make January 1, 2001, the effective date of the elimination of certain restrictions with respect to the hospital swing bed program. (Sec. 432) Amends SSA title XVIII to mandate pre-BBA '97 payment levels for outpatient services furnished by rural hospitals. (Sec. 433) Provides for the treatment of certain physician pathology services under Medicare. Subtitle E: Other Rural Provisions - Amends SSA title XVIII with regard to bonus payments in the case of physicians' services furnished to an individual who is covered under Medicare part B (Supplementary Medical Insurance) and who incurs expenses for such services in a health professional shortage area. Extends such bonus payments to physician assistant and nurse practitioner services. Eliminates the requirement to make such payments on a monthly or a quarterly basis. (Sec. 442) Modifies: (1) the exemption to the limits established on payment for provider-based rural health clinic services in the case of such clinics in rural hospitals with less than 50 beds; and (2) payment for certain physician assistant services. (Sec. 444) Excludes clinical social worker services and worker services performed under a contract with a rural health clinic or a Federally-qualified health center from the PPS for SNFs. (Sec. 445) Covers marriage and family therapist services provided in rural health clinics under Medicare. (Sec. 446) Amends the Public Health Service Act (PHSA) to: (1) create a capital infrastructure revolving loan program for rural entities for projects for capital improvements; (2) provide for grants to assist eligible small rural hospitals in offsetting the costs of establishing data systems to implement PPSs under Medicare, and to comply with administrative simplification requirements under Medicare part C (Medicare+Choice), or to reduce medication errors; (3) provide for grants to eligible small rural hospitals to provide relief for financial distress that has a negative impact on access to care for Medicare beneficiaries who reside in a rural area. Authorizes appropriations. (Sec. 449) Amends BBA '97 to revise provisions for Medicare reimbursement for telehealth services with respect to: (1) the methodology for determining the amount of payments; (2) reimbursement for Medicare beneficiaries who do not reside in a health professional shortage area; (3) telehealth coverage for direct patient care; (4) eligibility for telehealth reimbursement for all physicians and practitioners; and (5) telehealth services provided using store-and-forward technologies. (Sec. 450) Directs MEDPAC to study and report to the Secretary and Congress on the effect of low patient and procedure volume on the financial status of low-volume, isolated rural health care providers participating in Medicare. Title V: Provisions Relating to Part C (Medicare+Choice Program) and Other Medicare Managed Care Provisions - Amends SSA title XVIII part C (Medicare+Choice) with regard to eligibility, election, and enrollment to provide for restoring the effective date of elections and changes of elections of Medicare+Choice plans. (Sec. 502) Amends SSA title XVIII part D (Miscellaneous) with regard to certification of Medicare supplemental health insurance (Medigap) policies. Sets forth a special Medigap enrollment anti-discrimination provision for certain beneficiaries. (Sec. 503) Amends SSA title XVIII part C with regard to payments to Medicare+Choice organizations to: (1) increase the national per capita Medicare+Choice growth percentage in 2001 and 2002; and (2) modify area-specific and national percentages provisions with respect to calculation of annual Medicare+Choice capitation rates. (Sec. 505) Delays from July 1, 2000, to November 1, 2000, the deadline for a Medicare+Choice organization to withdraw the offering of a Medicare+Choice plan under part C (or otherwise to submit information required for the offering of such a plan) for 2001. (Sec. 506) Amends SSA title XVIII to make certain amounts in the Medicare trust funds available for the Secretary's share of Medicare+Choice education and enrollment-related costs. (Sec. 507) Amends BBRA to revise terms and conditions for extension of Medicare community nursing organization demonstration projects. (Sec. 508) Amends SSA title XVIII part C with regard to payments to Medicare+Choice organizations to modify payment rules for certain frail elderly Medicare beneficiaries. Title VI: Provisions Relating to Individuals with End-Stage Renal Disease - Amends SSA title XVIII part D with respect to Medicare coverage for end-stage renal disease (ESRD) patients to change the methodology for determining the update in the renal dialysis composite rate for end state renal dialysis services furnished after January 1, 2001. (Sec. 602) Amends SSA title XVIII part C with regard to payments to Medicare+Choice organizations to provide for revision of payment rates for ESRD patients enrolled in Medicare+Choice plans. (Sec. 603) Permits ESRD beneficiaries to enroll in another Medicare+Choice plan if the plan in which they are enrolled is terminated. (Sec. 604) Amends SSA title XVIII part B to provide for the coverage of certain vascular access services for ESRD beneficiaries provided by ambulatory surgical centers. (Sec. 605) Directs the Secretary to: (1) collect information on the satisfaction of each ESRD Medicare beneficiary with the quality of health care under the original fee-for-service Medicare program and the Medicare+Choice program, and the access of each beneficiary to that care; (2) analyze such information to determine, among other things, the kinds of health care that each nondialysis health care provider provides to each ESRD Medicare beneficiary for the treatment of ESRD and each comorbidity and the quality of health care provided to each such beneficiary enrolled under the Medicare+Choice program compared to each beneficiary enrolled under the original fee-for-service Medicare program; and (3) make such information collected and analysis conducted available to the public each year. Title VII: Access to Care Improvements Through Medicaid and SCHIP - Amends SSA title XIX (Medicaid) to create a new PPS for federally-qualified health centers and rural health clinics. (Sec. 702) Amends SSA title XIX to make permanent the extension of eligibility for medical assistance, and give States the option of electing a 12-month initial eligibility period in lieu of the current six month initial eligibility period. (Sec. 703) Amends SSA title XIX with regard to State Medicaid plans to provide for coordination with Medicaid and the State Children's Health Insurance Program (SCHIP) under SSA title XXI of the application of resource and income eligibility standards for certain Medicaid-eligible individuals under certain conditions, as well as providing for the automatic reassessment of eligibility for Medicaid and SCHIP benefits for children losing Medicaid- or SCHIP-eligibility. (Sec. 704) Amends SSA titles XIX and XXI to qualify additional entities to determine presumptive eligibility for low-income children under Medicaid and SCHIP. (Sec. 705) Amends SSA title V (Maternal and Child Health Services) to: (1) increase the authorization of appropriations; and (2) provide for coordination with Medicaid and SCHIP. (Sec. 706) Amends SSA title XIX to provide for increased access to Medicare cost-sharing assistance for low-income beneficiaries. (Sec. 707) Provides for: (1) optional State Medicaid coverage of breast and cervical cancer prevention and treatment coverage for certain breast and cervical cancer patients; (2) optional State Medicaid presumptive eligibility for certain breast or cervical cancer patients; and (3) an enhanced Federal match to be used under SCHIP with respect to medical assistance provided to such breast and cervical cancer patients receiving such optional State Medicaid coverage. (Sec. 708) Revises Medicaid coverage of services furnished by certified nurse practitioners, including coverage of services furnished by clinical nurse specialists. Title VIII: Other Provisions - Amends the Ricky Ray Hemophilia Relief Fund Act of 1998 to make appropriations to the Ricky Ray Hemophilia Relief Fund for FY 2001. (Sec. 802) Amends the Public Health Service Act (PHSA) to increase appropriations for special diabetes programs for children with type 1 diabetes and for Indians. (Sec. 803) Directs the Secretary to award demonstration grants to up to seven States to conduct innovative programs designed to improve outreach to homeless individuals and families under specified Social Security programs with respect to enrollment and the provision of services under such programs. Makes appropriations. (Sec. 804) Amends the Employee Retirement Income Security Act of 1974 (ERISA) and PHSA to prohibit health insurance provided through a managed care organization under a group health plan, or through a health insurance issuer providing coverage in connection with a group health plan, (and, for the PHSA, health insurance in the individual market) from denying coverage of services provided by a continuing care retirement community or other qualified facility if they are: (1) post-hospitalization services in the same community or facility as in pre-hospitalization; (2) skilled nursing services, without a preceding hospitalization, which are necessary to prevent hospitalization; or (3) furnished in the same facility the participant's or beneficiary's spouse already resides in. Makes the prohibition: (1) depend on whether such services are otherwise covered; and (2) regardless of whether the organization is under contract with the community or facility. Prohibits related denial of enrollment or renewal, incentives to enrollees, and penalties or incentives to physicians. Declares that State laws are not preempted which meet certain requirements, including any more protective of participants or beneficiaries than those of this Act. Provides for enforcement. (Sec. 805) Directs the Secretary to award grants to eligible States to support real choice systems change initiatives that establish specific action steps and specific timetables to: (1) achieve enduring system improvements; and (2) provide consumer-responsive long-term services and supports to eligible individuals in the most integrated setting appropriate based on the unique strengths and needs of the individual, the priorities and concerns of the individual (or, as appropriate, the individual's representative), and the individual's desires with regard to participation in community life. Requires each State, in order to receive such a grant, to establish a Consumer Task Force to assist in the development, implementation, and evaluation of real choice systems change initiatives. Provides funding.
Bill· HRH.R. 5268 (106th)referred
United States · United States Congress · 22 September 2000
Vietnam Veterans Memorial Education Act - Authorizes the Vietnam Veterans Memorial Fund, Inc., to construct a temporary education center for educating people about the Memorial. Requires the center to remain for ten years, after which Congress may reevaluate the continuing need for the center. Requires the Fund, in designing the center, to consult with the Commission on Fine Arts.
Law· HRH.R. 5178 (106th)enacted
United States · United States Congress · 14 September 2000
Needlestick Safety and Prevention Act - Revises the bloodborne pathogens standard, in effect under the Occupational Safety and Health Act of 1970 (OSHA), to include safer medical devices, such as sharps with engineered sharps injury protections and needleless systems, as examples of engineering controls designed to eliminate or minimize occupational exposure to bloodborne pathogens through needlestick and other percutaneous injuries. Requires certain employers to: (1) review and update exposure control plans to reflect changes in technology that eliminate or reduce such exposure, and document their consideration and implementation of appropriate commercially available and effective safer medical devices for such purpose; (2) maintain a sharps injury log, noting the type and brand of device used, where the injury occurred, and an explanation of the incident (exempting employers who are not required to maintain specified OSHA logs); and (3) seek input on such engineering and work practice controls from the affected health care workers (exempting employers who are not required to establish exposure control plans). Requires such modifications of the standard to: (1) be in force until superseded by regulations promulgated by the Secretary of Labor under OSHA; and (2) take effect without regard to specified procedural requirements.
Bill· HRH.R. 5163 (106th)referred
United States · United States Congress · 13 September 2000
Home Health Refinement Amendments of 2000 - Amends title XVIII (Medicare) of the Social Security Act to: (1) eliminate the 15 percent reduction in payment rates under the Medicare prospective payment system (PPS) for home health services; (2) provide for additional payments for outliers; (3) provide for additional payments under the PPS for home health services furnished in a rural area; (4) provide for exclusion of nonroutine medical supplies under the PPS for home health services; and (5) set forth a rule of construction relating to telehomehealth services. Directs the Secretary of Health and Human Services to report to Congress on the feasibility and advisability of including home health services furnished by telecommunications systems as a home health service.
Bill· HRH.R. 5126 (106th)referred
United States · United States Congress · 7 September 2000
Amends title XIX (Medicaid) of the Social Security Act to repeal the cap on Medicaid payments for Puerto Rico, the Virgin Islands, Guam, and American Samoa. Increases the minimum Federal medical assistance percentage (FMAP) (including for such territories) from 50 percent to 77 percent .
Bill· HRH.R. 5043 (106th)referred
United States · United States Congress · 27 July 2000
Book Stamp Act - Directs the Secretary of Health and Human Services (HHS) to establish a program to promote child literacy and improve children's access to books at home and in early learning and other child care programs, by making books available through early learning and other child care programs. Directs the Secretary to carry out such program by allotting grants to applicant State agencies on the basis of relative amounts received by States under specified provisions of the Child Care and Development Block Grant Act of 1990. Requires State agencies to use such grants to enter into contracts with local child care resource and referral agencies to carry out program activities. Allows State agencies to reserve up to three percent of grant funds to support a public awareness campaign relating to program activities. Requires local agencies which receive such contracts to use grant funds to provide payments for eligible early learning program and other child care providers, on the basis of local needs, to enable the providers to make books available, to promote child literacy and improve children's access to books at home and in early learning and other child care programs. Amends Federal law relating to the U.S. Postal Service (USPS) to require USPS to establish special postage stamps for child literacy, at the regular first-class rate plus a differential amount. Makes patron use of such special-rate postage stamp voluntary. Requires the USPS to pay all of certain amounts raised by sales such stamp to HHS for child literacy promotion activities. Expresses the sense of Congress that nothing in this section should: (1) cause a net decrease in total funds received by HHS or any other Federal agency, component, or program; and (2) affect regular first-class or other regular postage rates. Authorizes appropriations.
Bill· HRH.R. 5010 (106th)referred
United States · United States Congress · 27 July 2000
District of Columbia and United States Territories Circulating Quarter Dollar Program Act - Amends Federal monetary law to mandate that quarter dollar coins issued beginning in 2009 have designs on the reverse side emblematic of the District of Columbia and the territories: (1) the Commonwealth of Puerto Rico; (2) Guam; (3) American Samoa; (4) the United States Virgin Islands; and (5) the Commonwealth of the Northern Mariana Islands. Prescribes implementation guidelines.
Bill· HRH.R. 4981 (106th)referred
United States · United States Congress · 26 July 2000
Chronic Illness Care Improvement Act of 2000 - Title I: National Commission on Improving Chronic Illness Care - Establishes the National Commission on Improving Chronic Illness Care to: (1) develop a national policy to coordinate the multiple Federal resources devoted to health care for persons with serious and disabling chronic illnesses in order to facilitate a comprehensive continuum of care; (2) review and analyze whether coordination of the multiple Federal resources is best accomplished by a completely new governmental structure, or a new structure within an existing department, or a new mechanism for coordination of the various Government programs; (3) identify statutory and regulatory barriers to effective care for serious and disabling chronic illness and to develop legislative and regulatory recommendations; (4) develop a plan to integrate Medicare and Medicaid (titles XVIII and XIX of the Social Security Act (SSA)) Federal budget functions for purposes of projecting future costs of serious and disabling chronic conditions and cost savings from improved care of the chronically ill;(5) develop guidelines for payment methods that establish compatible financial incentives among health care providers and professionals serving the same chronically ill persons; (6) commission an expert panel to make recommendations for the design of the prototypes (the National Diabetes Pilot Initiative to Improve Chronic Illness Care and the National Alzheimer's Disease Pilot Initiative To Improve Chronic Illness Care established under title III of this Act) in order to enhance the design of the later expanded program (The National Initiative to Improve Chronic Illness Care); (7) commission an expert panel to develop a plan to introduce a single, integrated medical record for patients with chronic conditions; (8) commission an expert panel to recommend new outcome measures of cost-effectiveness based on improvements in or maintenance of functional status, delayed dependency, and other appropriate related matters; (9) contract for reports detailing the need for changes in current laws and regulations; (10) recommend national goals for reduction in serious and disabling chronic illness and cost savings over the next generation; (11) analyze the impact of emerging trends in the management of serious and disabling chronic illness, disability, and long-term care; and (12) report to the President and Congress. (Sec. 101) Authorizes appropriations. (Sec. 102) Defines "serious and disabling chronic illness," which includes Alzheimer's Disease and related disorders, arthritis, cancer, diabetes, hypertension, multiple sclerosis, and renal disease. Title II: Preparing the Groundwork for the National Initiative to Improve Chronic Illness Care - Subtitle A: Expansion of Preventive Benefits - Amends SSA title XVIII concerning authority to provide preventive services under part B (Supplemental Medical Insurance) of the Medicare program to prevent, reduce, delay, or detect serious and disabling chronic illness. Defines "qualified preventive services" to include smoking cessation services, screening for hypertension, screening for cholesterol, screening for end stage renal disease and kidney function, screening for reduced visual and audio acuity and low vision rehabilitation services, and screening for glaucoma. (Sec. 201) Provides for alternative payment for preventive services, authorizing the Secretary of Health and Human Services (HHS) to waive copayments for certain preventive services. Waives the deductible applicable to such services. Adds lancets to the definition of durable medical equipment. (Sec. 202) Directs the Secretary to carry out a nationwide education campaign to promote awareness about the nature of chronic diseases and disabilities and strategies for preventing, delaying, or minimizing disability progression at various stages of chronic conditions, including health promotion and self-care activities. (Sec. 203) Directs the Secretary to study and report to Congress on what preventive care services, if furnished to individuals before Medicare eligibility, could reasonably be expected to save Medicare and other Government programs more in future discounted costs under those programs than the cost of furnishing such preventive services. (Sec. 204) Requires the Director of the Congressional Budget Office to report to Congress on methodologies to measure aggregate savings, to both society and the individual, in payments that would otherwise be made under the Medicare, Medicaid, and other Federal health care programs that are attributable to certain preventive services, if such services were furnished over the course of an individual's life before entitlement to benefits under those programs. Subtitle B: Development of National Goals and Measures for the Effective Management of Chronic Illness - Establishes within HHS the Office of Integration and Coordination of Care for Chronic Illness. (Sec. 212) Directs the Secretary to develop the National Database for Serious and Disabling Chronic Illness to: (1) generate accurate information about the prevalence, demographics, health status, functional status, financial status, support systems, and quality of life of persons suffering from serious and disabling chronic illnesses; (2) compile aggregate data on the utilization, cost, and outcomes of chronic illness; and (3) enable the Secretary to set goals and measure progress in reducing the cost to society of improving care of the chronically ill. (Sec. 213) Directs the Secretary to establish and report annually on targets for reducing the prevalence of the highest-cost and fastest-growing chronic illnesses, as well as national goals for reducing the prevalence of high-cost chronic care conditions. (Sec. 214) Directs the Secretary to: (1) identify risk factors associated with progression of serious and disabling chronic illnesses, and identify interventions for primary, secondary, and tertiary prevention; (2) conduct patient-oriented research trials that will have the greatest and most immediate impact on the largest number of people with chronic illness; (3) develop disease prevention guidelines for the highest-cost chronic diseases and disabilities, measured by severity and prevalence; and (4) develop disability-based outcome measures that evaluate effectiveness in preventing, delaying, or minimizing the progression of chronic diseases and disabilities and associated comorbidities and loss of independence on a longitudinal basis. Requires each Medicare+Choice organization under SSA title XVIII part C (Medicare+Choice) to conduct annually: (1) at least one new continuous quality improvement initiative involving chronic care focusing on delaying the progression of disability and preventing the emergence of disease-related complications; or (2) at least one new initiative to reduce preventable medical errors involving chronic care. (Sec. 215) Directs the Secretary to establish and implement standard patient assessment instruments under the Medicare program that provide comparability of information and reduce the need for repeated evaluations and data entry at each new site of service. Provides that by January 1, 2005, standard patient assessment instruments established under this section shall be the sole patient assessment instrument utilized by the Secretary with respect to Medicare and Medicaid items and services. (Sec. 216) Directs the Agency of Healthcare Research and Quality to develop and make available in electronic format an authoritative, reliable national resource center for serious and disabling chronic illnesses, to be used by patients and their families that include information necessary for patient education and facilitate self-management. Subtitle C: Payment Incentives for Furnishing Quality Services to the Chronically Ill - Creates within the Federal Supplemental Medical Insurance Trust Fund the Performance Bonus Pool Account to consist of amounts attributable to certain reductions in payments to Medicare+Choice organizations. Provides for bonus payments from such account to organizations that meet or exceed chronic illness target goals. (Sec. 223) Directs the Secretary to study and report to Congress on the need for additional physician and nonphysician health care staff and expertise in the management of chronic illness for Medicare beneficiaries. Grants the Secretary authority to adjust graduate medical education payments for approved medical residency training programs under certain conditions. Title III: Development of Prototypes of Integration and Coordination of Care for 2 Chronic Illness Subpopulations to be Expanded in 2007 to All Serious and Disabling Chronic Illnesses - Amends SSA title XVIII to provide for disease management services for eligible individuals for serious and disabling chronic illness through the National Initiative to Improve Chronic Illness Care program which the Secretary shall establish and implement in accordance with specified guidelines that involve specified initial pilot projects. Provides for coverage of disease management services as a Medicare part B medical service. Authorizes appropriations. Title IV: Integrating Medicare and Medicaid for Dual Eligibles - Amends SSA title XVIII to allow a State, health plan, or provider to request the Secretary to waive Medicare requirements to permit States to enhance the coordination and integration of Medicare and Medicaid items and services and administration.
Bill· HRH.R. 4950 (106th)referred
United States · United States Congress · 25 July 2000
Amends title XVIII (Medicare) of the Social Security Act to increase the proportion of charges Medicare recognizes in connection with the treatment of certain mental health services of a qualified Medicare beneficiary who resides in a skilled nursing facility, a nursing facility, or a custodial care facility.
Bill· HRH.R. 4926 (106th)referred
United States · United States Congress · 24 July 2000
Requires the Speaker of the House of Representatives and the President Pro Tempore of the Senate to make arrangements for the presentation, on behalf of Congress, of a gold medal to Tiger Woods in recognition of his service to the Nation in promoting excellence and good sportsmanship, and in breaking barriers with grace and dignity by showing that golf is a sport for all people. Authorizes funding.
Resolution· HCONRESH.Con.Res. 376 (106th)open
United States · United States Congress · 18 July 2000
Expresses the sense of Congress that: (1) a Liberty Day should be celebrated annually in the United States as a remembrance of both the freedom that Americans were given in the Declaration of Independence and the rights and liberties that Americans were given in the Constitution; and (2) elected and previously-elected representatives of the people who voluntarily give of their time to speak to Americans about those founding documents deserve our thanks.
Law· HRH.R. 4864 (106th)enacted
United States · United States Congress · 17 July 2000
Veterans Claims Assistance Act of 2000 - Amends Federal veterans benefits provisions to require the Secretary of Veterans Affairs to take specified steps to assist claimants. Requires the Secretary: (1) to notify a claimant whose application is incomplete of the evidence necessary to complete the application (existing law), including the information and medical and lay evidence necessary to substantiate the claim and, as part of such notice, to indicate which portion of such evidence is to be provided by the claimant and which portion the Secretary will attempt to obtain on behalf of the claimant; (2) to make reasonable efforts to assist in obtaining evidence necessary to establish a claimant's eligibility for a benefit (but allows the Secretary to decide a claim without providing such assistance when no reasonable possibility exists that such assistance will aid in the establishment of eligibility) and to obtain relevant records that the claimant adequately identifies to the Secretary and authorizes the Secretary to obtain; and (3) to inform the claimant whenever the Secretary is unable to obtain such records and to request the claimant to notify the Secretary if the claimant intends to obtain such records independently. Requires, in the case of a veteran's claim for disability compensation, the Secretary to: (1) obtain the claimant's existing service medical records and, if the claimant has furnished sufficient information, other relevant service records, existing records of relevant medical treatment or examination of the veteran at Department of Veterans Affairs health care facilities or at the expense of the Department, and specified information to be furnished by other agencies; and (2) provide a medical examination or obtain a medical opinion when the evidence of record before the Secretary establishes that the claimant has a current disability or has current symptoms and that there was an event, injury, or disease (or combination thereof) during the claimant's active military, naval, or air service capable of causing or aggravating the claimant's current disability or symptoms, but is insufficient to establish service-connection. (Sec. 4) Places on the claimant the burden of proving entitlement to benefits (currently, of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded). (Sec. 5) Prohibits any Federal department or agency from imposing any charge for providing to the Secretary information for purposes of determining benefit eligibility. (Sec. 6) Provides for: (1) the applicability of provisions of this Act concerning the burden of proof to claims filed before, and not final as of, the date of enactment of this Act; and (2) the readjudication of claims for benefits that were denied, because the claims were not well grounded, during the period between July 14, 1999, and this Act's enactment date.
Resolution· HCONRESH.Con.Res. 372 (106th)referred
United States · United States Congress · 17 July 2000
Recognizes the 210th anniversary of the establishment of the Coast Guard. Commends: (1) the Coast Guard's effectiveness in protecting the public, the environment, and U.S. economic and security interests; and (2) the men and women serving in the Coast Guard. Expresses support for the Coast Guard in its efforts to remain "Semper Paratus" Always Ready -- as it moves forward to meet the demands of the 21st century.
Bill· HRH.R. 4844 (106th)open
United States · United States Congress · 13 July 2000
Railroad Retirement and Survivors' Improvement Act of 2000 - Title I: Amendments to the Railroad Retirement Act of 1974 - Amends the Railroad Retirement Act of 1974 to increase benefits to railroad employees and their beneficiaries and to revise financing of the pension part (tier II) of the railroad retirement system. (Sec. 101) Increases benefits for widows and widowers by guaranteeing to them all of the tier II annuity the employee was entitled to at the time of the death. (Sec. 102) Makes employees with 30 years of service eligible to retire at age 60 with unreduced tier I and tier II annuities. Makes spouses of such employees eligible for unreduced annuities at age 60. (Sec. 103) Reduces the vesting requirement for tier II retirement annuities from ten years to five years of service after December 1995. Makes employees with at least five years of such service, but less than ten years of total service, eligible for a tier I disability annuity if their combined railroad retirement and social security earnings credits would satisfy social security eligibility requirements. Makes spouses, divorced spouses, and survivors of employees with at least five years of such service, but less than ten years of total service, eligible for a tier I annuity if they would have been entitled to a social security benefit based on combined service. (Sec. 104) Repeals a limit on the total amount of monthly railroad retirement benefits payable to an employee and spouse at the time the employee's annuity begins. (Sec. 105) Establishes a Railroad Retirement Trust Fund (the Fund) and a Railroad Retirement Investment Trust (RRIT) to manage and invest the assets of the Fund. Declares that RRIT is not an agency, department, or instrumentality of the U.S. Government. Requires RRIT to be administered by a Board of Trustees (the Trustees) with seven members (three representing labor, three representing employers, and one representing the general public) with experience and expertise in the management of financial investments and pension plans. Requires the Trustees to be appointed by a unanimous vote of the Railroad Retirement Board (RRB). Prohibits RRB members from being Trustees. Applies specified reporting requirements and fiduciary standards to the RRIT. Requires the Trustees to diversify investments so as to minimize the risk of large losses. Authorizes the Trustees to invest Fund assets in non-Governmental assets. (Sec. 106) Abolishes the Railroad Retirement Supplemental Annuity Account and provides for transfer of its funds to the Fund. (Sec. 107) Requires the RRB, upon the establishment of the Fund, to determine the portion of the Railroad Retirement Account not needed to pay current administrative expenses and direct the Secretary of the Treasury to transfer that amount into the Fund. Requires the Fund to transfer the necessary amount of funds to pay benefits and related administrative expenses to the disbursing agent. Transfers to the Fund Social Security Equivalent Benefit account funds not needed to pay current benefits, but requires that such funds only be used to pay benefits or to invest in U.S. Government or Government-guaranteed securities. Transfers to the disbursing agent from the Dual Benefit Account the amount necessary to make dual benefit payments. Requires the Trustees to consult with the Secretary of the Treasury to develop an appropriate method for transferring or converting existing account obligations. (Sec. 108) Requires the RRB to calculate the ratio of assets to benefits to determine annual tier II tax rates for employers, employee representatives, and employees. Establishes schedules for: (1) decreasing tax rates if the average account benefits ratio, based on the ratios for the ten most recent fiscal years, is above six; and (2) increasing employer and employee representatives' tax rates if the ratio is below four. Title II: Amendments to the Internal Revenue Code of 1986 - Amends the Internal Revenue Code to exempt the Railroad Retirement Trust Fund (the Fund) from taxation. (Sec. 203) Repeals a supplemental annuity tax that railroad employers pay to finance a benefit for long-time rail employees. (Sec. 204) Provides for adjustments to railroad employers, employee representatives, and employee tier II tax rates. Decreases such rates in 2001 and in 2002 for employers and employee representatives. Provides in the years after 2002 for tax rate schedules, based on the ten-year average account benefit ratio, for employers, employee representatives, and employees.
Bill· HRH.R. 4848 (106th)referred
United States · United States Congress · 13 July 2000
Violence Against Women Office Act - Establishes within the Department of Justice (DOJ) a Violence Against Women Office, headed by a Director. Specifies the duties of the Director, including serving as special counsel to the Attorney General on the subject of, and carrying out DOJ functions under the Violence Against Women Act of 1994 and on matters relating to, violence against women.
Showing the 24 most recent records of 1,049. Browse the full list
![Official portrait of Rescom. Romero-Barcelo, Carlos A. [D-PR-At Large]](https://www.congress.gov/img/member/r000417_200.jpg)