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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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 .
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
United States · United States Congress · 11 July 2000
Amends the Employee Retirement Income Security Act of 1974 (ERISA) to establish an Office of Pension Participant Advocacy in the Department of Labor under the supervision and direction of a Pension Participant Advocate who shall: (1) have demonstrated experience in the area of pension participant assistance; (2) be selected by the Secretary of Labor after consultation with pension participant advocacy organizations; and (3) report directly to the Secretary.
United States · United States Congress · 11 July 2000
Children's Dental Health Preservation Act of 2000 - Directs the Secretary of Health and Human Services to make grants to States for the purpose of: (1) identifying children, eligible for Federal programs, at risk of developing dental caries and for the provision of preventative and therapeutic services in accordance with State practice acts to reduce oral disease occurrence; and (2) training of health care professionals to educate parents on oral disease prevention.
United States · United States Congress · 29 June 2000
Ryan White CARE Act Amendments of 2000 - Title I: Emergency Relief for Areas with Substantial Need for Services - Subtitle A: HIV Health Services Planning Councils - Amends the Public Health Service Act to require that an HIV (human immunodeficiency virus) planning council reflect the demographics of the population of individuals with HIV disease (currently, the demographics of the epidemic) in the eligible area involved. Modifies requirements regarding council composition, including requiring representatives of former prisoners. Requires that at least 33 percent of the council be people who: (1) are receiving HIV-related services pursuant to a grant under provisions relating to emergency relief for areas with a substantial need for services (substantial need grant); and (2) are not officers, employees, consultants, or representatives of any entity that receives substantial need grant amounts. (Sec. 102) Modifies council duties, including regarding: (1) determining the size, demographics, and needs of the HIV disease population; (2) council establishment of fund allocation priorities; and (3) coordination with Federal grantees that provide HIV-related services in the area. Directs the Secretary of Health and Human Services to: (1) develop epidemiologic measures for establishing the number of individuals with HIV disease who are not receiving HIV-related health services and for carrying out council duties; and (2) provide to the chief elected official receiving a substantial need grant guidelines and materials for training council members regarding council duties. (Sec. 103) Requires that council meetings and records be open to the public, subject to exception. Subtitle B: Type and Distribution of Grants - Makes permanent provisions requiring expedited disbursement of certain substantial need grant amounts. Requires, after fiscal year 2004, that the substantial need grant amount formula use the number of cases of HIV disease in the most recent year rather than the number of cases of acquired immune deficiency syndrome (AIDS) in the most recent ten years, but until FY 2007 conditions that change on the Secretary's determination that there is sufficiently accurate and reliable data on HIV disease cases from all eligible areas, requiring the Secretary to consider: (1) the findings of a study mandated by title V of this Act; (2) the fiscal impact of using or of not using that data; and (3) the impact of the use of that data on the organization and delivery of HIV-related services. Modifies requirements regarding increases in the amount of a substantial need grant under expedited disbursement provisions. (Sec. 112) Requires that the amount of supplemental substantial need grants be determined by the Secretary based on a weighting of specified factors, with severe need counting one-third. Includes the current HIV disease prevalence, an increasing need for services, and unmet need for services as factors the Secretary must consider in determining severe need. Directs the Secretary, in determining the required factors, to develop a mechanism to use national, quantitative incidence data by 18 months after enactment of this Act (currently, by May 20, 1998). Requires mechanism modification based on the findings of a study mandated by title V of this Act. Removes provisions basing the amount of substantial need grants on substantial need grant applications. Subtitle C: Other Provisions - Requires that substantial need grant funds be used, among other purposes, for: (1) outreach to identify individuals with HIV disease who are not receiving HIV-related services; and (2) early intervention services. Requires that substantial need grants be used to provide health and support services to infants, children, youth, and women (currently, infants, children, and women) with HIV disease in the same ratio as those groups with HIV disease bear to those groups in the general population. Requires that the chief elected official of a substantial need grant-receiving area establish a quality management program to assess whether HIV health services under the substantial need grant are consistent with the most recent Public Health Service guidelines. (Sec. 123) Requires that official to ensure that the area's planning council: (1) reviews existing, available data on expenditures by substantial need grant recipient entities from their overall budget for administrative costs; and (2) makes a determination whether the financial compensation of any of those entity's officers or employees exceeds that of the official. Title II: Care Grant Program - Subtitle A: General Grant Provisions - Requires that grants to States to improve the quality, availability and organization of health care and support services for individuals with HIV disease (care grants) be used to provide health and support services to infants, children, youth, and women (currently, infants, children, and women) with HIV disease in the same ratio as those groups with HIV disease bear to those groups in the general population. (Sec. 202) Allows care grants to be used for support services, outreach activities, early intervention, and quality management. (Sec. 203) Modifies requirements regarding grants to establish HIV care consortia. (Sec. 204) Allows a State to meet a requirement to use a portion of its care grant to provide therapeutics to treat HIV disease or prevent related health deterioration (including prevention and treatment of opportunistic infections) by paying for health insurance or plans whose coverage includes a full range of such therapeutics and primary care. (Sec. 205) Requires care grant applications to contain determinations of the size, demographics, and needs of the population of individuals with HIV disease in the State. Modifies requirements regarding the comprehensive plan. Requires the public health agency that administers care grants for a State to engage in a public advisory planning process. (Sec. 206) Doubles, subject to appropriations, the minimum care grant allotment to each State and U.S. territory. Requires, after fiscal year 2004, that the care grant amount formula use the number of cases of HIV disease in the most recent year rather than the number of cases of acquired immune deficiency syndrome (AIDS) in the most recent ten years, but until FY 2007 conditions that change on the Secretary's determination that there is sufficiently accurate and reliable data on HIV disease cases. Provides for increases in the formula amount. Requires, if an appropriations Act provides an amount exclusively for treatment drug grants, that two percent of that exclusive amount be reserved for supplemental grants to States whose HIV population's need is greater than the quantities available under treatment drug grants from the remaining unreserved 98 percent. Adds the Federated States of Micronesia and the Republic of Palau to the list of U.S. territories. Adds the Commonwealth of Puerto Rico to the list of territories for minimum allotment provisions but keeps it in the list of States for other care grant provisions. (Sec. 207) Replaces provisions mandating coordination by specified Federal agencies of Federal HIV programs with provisions directing the Secretary to make grants to States to supplement care grants for comprehensive services for communities that have a severe need for supplemental financial assistance to combat the HIV epidemic. Provides for funding for the supplemental grants. Subtitle B: Provisions Concerning Pregnancy and Perinatal Transmission of HIV - Removes provisions prohibiting (after testing of pregnant women and newborns has become a routine practice in U.S. health care) care grants to a State unless the State meets certain requirements regarding such testing. (Sec. 212) Adds HIV disease treatment services to the uses for which the Secretary may make a grant to a State that is following the recommendations of the Centers for Disease Control and Prevention (CDC) regarding HIV counseling and voluntary testing for pregnant women. Authorizes appropriations. Prohibits using care grant appropriations for grants under this section. (Sec. 213) Directs the Secretary to provide for a study and report to appropriate congressional committees regarding: (1) the number of newborns with HIV born in the United States in the most recent year for which the information is available; (2) barriers that prevent or discourage an obstetrician from routinely offering pregnant women an HIV test and routinely testing newborns when the mother's HIV status is unknown; and (3) recommendations for each State for reducing perinatal HIV transmission. Requires States to make reasonable progress toward meeting the recommendations. Subtitle C: Certain Partner Notification Programs - Authorizes the Secretary to make grants to States for partner counseling and referral services, provided the State meets certain requirements regarding: (1) partner notification and (for the partner and the infected individual) testing, counseling, and referral; (2) health entity reporting of positive test results to the State; (3) reporting to the CDC regarding partner notification; and (4) State cooperation with the CDC national partner notification. Prohibits grants to a State after fiscal year 2003 unless the State's reporting system for HIV cases produces sufficiently accurate and reliable data. Authorizes appropriations. Title III: Early Intervention Services - Subtitle A: Formula Grants for States - Repeals provisions mandating formula grants to States for outpatient early intervention services regarding HIV disease. Subtitle B: Categorical Grants - Requires giving preference to rural or underserved areas in making currently-authorized categorical grants for outpatient early intervention services. Allows planning grants to be used, subject to limitation, to assist the recipients to expand their capacity to provide services, including early intervention services, in low income communities and affected subpopulations that are underserved. Subtitle C: General Provisions - Requires that the counseling that categorical grant recipients are required to provide to HIV-infected individuals emphasize that it is the duty of infected individuals to disclose their status to their sexual and needle-sharing partners, provide advice on how to make the disclosures and emphasize that it is the infected individual's continuing duty to avoid behaviors that expose others to HIV. (Sec. 322) Increases the percentage limit on administrative expenses. Requires recipients to establish a quality management program to assess the extent to which medical services are consistent with Public Health Service guidelines for treatment of HIV disease and related opportunistic infections. Title IV: Other Programs and Activities - Subtitle A: Certain Programs for Research, Demonstrations, or Training - Replaces a requirement that, with regard to grants for providing opportunities for women, infants, children, and youth to participate in HIV research and for providing to those groups outpatient health care and additional services, that a significant number of individuals in those groups be participating in research with a requirement that the grant applicant demonstrate linkages to research and how access to research is being offered to patients. Directs the Secretary to examine the distribution and availability of research regarding grantees to enhance and expand HIV-related research, especially in underrepresented communities. Requires grantees to implement a quality management program. Authorizes appropriations. (Sec. 402) Includes, as a use of currently-authorized grants and contracts for training health personnel: (1) training in prenatal and other gynecological care for women with HIV disease; and (2) developing protocols for the medical care of such women. Directs the Secretary to implement a strategy for the dissemination of HIV treatment information to care providers and patients. Adds accredited dental hygiene programs as possible recipients of currently-authorized grants with respect to oral health care to (sic) patients with HIV disease. Authorizes appropriations. Authorizes grants to dental schools, post-doctoral dental education programs, and accredited dental hygiene programs that partner with community-based dentists to provide care to HIV patients in underserved areas. Authorizes appropriations. Authorizes appropriations for grants and contracts to assist public and nonprofit private entities and schools and academic health science centers to train health personnel, train faculty, and develop and disseminate curricula and resource materials regarding the care of HIV patients and prevention of HIV infection among at risk individuals. Subtitle B: General Provisions in Title XXVI - Extends the authorization of appropriations for grants and contracts to evaluate programs carried out under title XXVI of the Public Health Service Act (HIV Health Care Services Program). (Sec. 412) Authorizes appropriations for collecting and providing data for program planning and evaluation under title XXVI. (Sec. 413) Adds the Substance Abuse and Mental Health Services Administration and the Health Care Financing Administration to the list of agencies (currently, the Health Resources and Services Administration and the Centers for Disease Control and Prevention) charged with coordinating the planning, funding, and implementation (currently, coordinating the planning of the funding) of Federal HIV programs to enhance continuity of care and prevention services (currently, continuity of care). Requires that State, local, or private entities receiving title XXVI funds enhance continuity of care and prevention services (currently, continuity of care). (Sec. 414) Directs the Secretary to develop and submit to Congress a plan for the medical case management of and the provision of support services to individuals who had HIV disease on their date of release from the Federal or State penal system. (Sec. 415) Authorizes the Secretary to reduce title XXVI grants to a State or political subdivision if the State or subdivision fails to prepare audits. (Sec. 416) Directs the Secretary to: (1) develop and submit to Congress a plan for coordinating the disbursement of appropriations for substantial need grants with the disbursement for care grants; (2) within two years after enactment of this Act, implement the disbursement plan, notwithstanding any title XXVI provision inconsistent with the plan; (3) determine whether administration of those grants by the Secretary and grantee compliance efficiency would be improved by requiring biennial rather than annual applications; (4) develop and submit to Congress a plan for simplifying the application process for those grants; and (5) within two years after enactment of this Act, implement the simplified application plan, notwithstanding any title XXVI provision inconsistent with the plan. (Sec. 417) Removes provisions directing the Secretary to develop and implement a method for adjusting the percentages allocated to substantial need grants and care grants to account for substantial need grants to new areas and other relevant factors. Authorizes appropriations for substantial need and care grants. Title V: General Provisions - Directs the Secretary to provide for studies, and report to the appropriate congressional committees, on: (1) whether the surveillance system of each State provides for the reporting of HIV infection cases in a way that provides information on the number and demographic characteristics of the cases that is sufficiently accurate for the formula grants under substantial need and care grant provisions and, if not, recommendations for improvements; and (2) the appropriate epidemiological measures and their relationship to the financing and delivery of primary care and health related support services for low income, uninsured, and underinsured individuals with HIV disease. (Sec. 502) Requires the Director of the National Institutes of Health (NIH) to expand, intensify, and coordinate research and other NIH activities regarding development of reliable and affordable HIV tests that can be rapidly administered and whose results can be rapidly obtained (rapid HIV tests). Authorizes appropriations. Directs the Secretary: (1) to report to appropriate congressional committees on the progress made toward, and barriers to, the premarket review and commercial distribution of rapid HIV tests; and (2) promptly after rapid HIV test commercial distribution begins, to establish or update guidelines for States, hospitals, and other entities regarding the availability of those tests for administration to pregnant women in labor or late stage pregnancy and whose HIV status is unknown. (Sec. 503) Directs the Secretary, of the amounts available to the Secretary for program management at the Health Resources and Services Administration, to spend amounts necessary to ensure at least a 20 percent increase in fiscal year 2001 over fiscal year 2000 of full- time-equivalent staff of the Bureau of HIV/AIDS who administer programs under title XXVI. Title VI: Effective Date - Sets forth the effective dates for this Act and its amendments.
United States · United States Congress · 26 June 2000
John H. Chafee Environmental Education Act of 2000 - Amends the National Environmental Education Act to rename it the John H. Chafee Environmental Education Act (the Act). (Sec. 4) Requires the Office of Environmental Education (OEE), within the Environmental Protection Agency (EPA), to: (1) develop and support balanced and scientifically sound programs; and (2) provide for implementation of the Act through the headquarters and regional offices of the EPA. Eliminates provisions for: (1) OEE administration of environmental internship and fellowship programs (internship programs are eliminated and fellowship program administration is transferred elsewhere later in this Act); (2) an OEE Director who is a member of the Senior Executive Service; and (3) a minimum of six full-time equivalent employees on the OEE headquarters staff (retains the maximum of ten). Authorizes the EPA Administrator to carry out OEE activities directly or through awards of grants, cooperative agreements, or contracts. (Sec. 5) Requires the environmental education and training program funded under the Act to be of sufficient intensity and duration to have a positive and lasting impact on program participants. (Sec. 6) Revises requirements for environmental education grants to authorize design, demonstration, or dissemination of: (1) education and training programs to support the development of more environmentally effective business practices and employees; and (2) employ the environment as an integrating context for education in science, mathematics, social studies and language arts. Requires that 25 percent of program funds be for grants of not more than $10,000 (currently $5,000). Prohibits environmental education grants from being used to support lobbying activities. Requires the EPA Science Advisory Board to review and approve the guidance before the EPA Administrator issues any guidance to grant applicants. (Sec. 7) Directs the EPA Administrator to establish and administer the John H. Chafee Memorial Fellowship Program for the award and administration of five annual one-year graduate education fellowships in environmental sciences. (Eliminates provisions for OEE-administered environmental internships and fellowships.) Provides that such Fellowships are to stimulate innovative graduate level study and the development of expertise in complex, relevant, and important environmental issues and effective approaches to addressing those issues through organized programs of guided independent study and environmental research. Requires each $25,000 Fellowship to be made available to individual candidates to attend a sponsoring institution of higher education through an annual competitive selection process. Requires each Fellowship to focus on: (1) resource management; (2) open space preservation; (3) international environmental issues such as global climate change and sustainable marine resources; or (4) any other environmental issue that a sponsoring institution determines to be appropriate. Directs the National Environmental Education Advisory Council to establish selection process criteria, receive and review applications, and select Fellowship recipients. (Sec. 8) Revises and renames certain national environmental education awards. (Eliminates awards named for Theodore Roosevelt, Henry David Thoreau, Rachel Carson, and Gifford Pinchot.) Changes from discretionary to mandatory the authority of the EPA Administrator to establish the (renamed) President's Environmental Education Youth Achievement Awards program, for young people in grades six through 12 (currently kindergarten through grade 12). Changes from discretionary to mandatory the authority of the Chair of the Council on Environmental Quality to establish the (renamed) President's Environmental Education Teacher Achievement Awards program, for elementary and secondary school teachers and their local educational agencies (and continues to authorize cash awards under such program). Directs the EPA Administrator to establish a new program of President's Environmental Education Business Achievement Awards, to recognize outstanding achievements by a business or industry in improving business environmental performance through training and education programs. (Sec. 9) Revises requirements for the National Environmental Education Advisory Council and for the Federal Task Force on Environmental Education. Directs the EPA Administrator to appoint to the Advisory Council a representative of the National Environmental Learning Foundation, and up to ten additional members to represent specified sectors of education. Revises requirements for Advisory Council meetings and reports. Opens membership on the Task Force to representatives of any Federal agency actively engaged in environmental education. (Sec. 10) Renames the National Environmental Education and Training Foundation as the National Environmental Learning Foundation. Increases the number of directors on the Foundation's Board. Allows the Foundation to acknowledge receipt of donations by listing the names of donors (including a logo, letterhead, or other commercial symbol) in materials it distributes; but prohibits such acknowledgment from appearing in educational material presented to students. (Sec. 11) Establishes accountability requirements. Directs the EPA Administrator to establish indicators of program quality, meeting specified minimum requirements, for programs and activities funded under the Act (other than fellowship awards). Requires entities that receive grants or enter into contracts or cooperative agreements under the Act (other than fellowship awards) to establish benchmarks of performance on such indicators of program quality and report annually to the EPA Administrator. (Sec. 12) Extends through FY 2006 the authorization of appropriations to EPA to carry out the Act. Allows funds under the Act to be made available to the National Environmental Learning Foundation to match contributions made by private persons and State and local governments.
United States · United States Congress · 26 June 2000
Veterans Cold Weather Injury Compensation Act - Directs the Secretary of Veterans Affairs to establish and maintain a registry of veterans who, while in active military service, were exposed for a significant period of time to sustained periods of extremely cold weather (seven days or more of average temperatures of 32 degrees or lower). Requires such registry to be used to determine the association, if any, between the disabilities of such veterans and the exposure to such weather. Presumes cold-weather injuries in such veterans to be service-connected and therefore compensable through veterans' disability compensation. Directs the Secretary, within 90 days, to prescribe initial regulations on injuries determined to have a positive association with sustained exposure to cold weather.
United States · United States Congress · 23 June 2000
Insular Areas Oversight Avoidance Act - Requires the Director of the Office of Management and Budget (OMB) to publish with respect to each covered statement issued by OMB (including executive orders and agreements, presidential proclamations or directives, treaties, and submitted legislation) that does not include any U.S. insular area in any definition of "United States," "United States of America," or "State": (1) an explanation of the reasons for that omission; and (2) a recommendation of whether the definition should include such insular area.
United States · United States Congress · 23 June 2000
Military Deployment Health Research Act of 2000 - Title I: National Center for Military Deployment Health Research - Establishes the National Center for Military Deployment Health Research to coordinate and conduct private and public research on deployment-related health issues of members of the armed forces, veterans, and their families. Requires the Center to report to the Military and Veterans Health Coordinating Board, established by prior presidential directive. Requires the Research Working Group of such Board to be disestablished, and their functions assumed by the Center. Establishes a Center Governing Board. Requires the Center's research activities to include Federal research programs as well as Center-initiated research. Requires an annual Center activities report from the Governing Board to Congress. Title II: Centers for Research on Post-Deployment Illnesses in Department of Veterans Affairs - Directs the Secretary of Veterans Affairs to establish and operate centers for research, education, and clinical activities related to post-deployment illnesses, designating such centers as National Centers for Military Post-Deployment Illness Research. Defines a "post-deployment illness" as one having an association or relation to a military mission, including a peacekeeping mission. Allows the designation of no more than 25 centers, and requires geographical diversity of such centers. Requires the Under Secretary for Health of the Department of Veterans Affairs to establish a peer review panel to assess the scientific and clinical merit of proposals submitted for center designation. Authorizes appropriations.
United States · United States Congress · 23 June 2000
National and Community Service Amendments Act of 2000 - Title I: Amendments to National and Community Service Act of 1990 - Amends the National and Community Service Act of 1990 (NCSA) to reauthorize and revise various programs. (Sec. 103) Revises provisions for school-based and community-based service-learning programs to: (1) include Indian tribes as qualified organizations for program participation; and (2) eliminate a requirement that the Corporation for National and Community Service (CNCS) give priority to grant applications containing specified proposals. (Sec. 104) Revises provisions for the national service trust program to: (1) eliminate provisions authorizing CNCS to transfer funds to another Federal agency to support a national service program; (2) limit the CNCS's share of the aggregate cost of national service positions, through a formula based on a specified amount per participant; (3) eliminate Federal agency positions from eligibility for approval for national service positions or educational awards; (4) establish a State minimum for national service grant awards; (5) provide for grants to increase the participation of individuals with disabilities, and for demonstration programs of outreach to such individuals; (6) reserve certain funds to support programs reducing CNCS costs; and (7) modify provisions relating to participant performance, selection, terms of service, and living allowances. (Sec. 105) Revises provisions for the national service trust to include, as an allowable use of trust funds, national service scholarships (under the program established by this Act). Makes expenditures from the trust available for interest payments during forbearance on loan repayment and for national service scholarship awards. Provides that a prohibition against using the educational award to pay off loans made to parents also applies to loans made to parents under the direct student loan program. Allows educational awards to be used to pay off private or State loans. Permits the trust to be used to support a national service scholarship program to recognize secondary school juniors and seniors engaged in community service activities. (Sec. 106)Authorizes the Director of the Civilian Community Corps (CCC) to select individuals with prior supervisory or service experience to be team leaders. Requires team leaders to be selected without regard to a specified age limitation. Revises authorized benefits for CCC members. (Sec. 107) Repeals the authority of State commissions and any division of CNCS to enter into agreements for coordinating functions. (Sec. 108) Eliminates a provision relating to staggered terms for CNS board members. Allows appointed board members whose terms have expired to continue to serve for a specified limited period. Authorizes the chief executive officer (CEO) of CNCS to enter into agreements with other agencies to carry out activities to implement national service laws. (Sec. 109) Authorizes the CEO of CNCS to serve as an ex officio, nonvoting member of the board of directors of the Points of Light Foundation. (Sec. 110) Extends through FY 2005 the authorization of appropriations for programs under NCSA. Title II: Amendments to the Domestic Volunteer Service Act of 1973 - Amends the Domestic Volunteer Service Act of 1973 (DVSA) to reauthorize and revise: (1) title I National Volunteer Antipoverty Programs, part A Volunteers in Service to America (VISTA) including VISTA Literacy Corps, part B University Year for VISTA, part C Special Volunteer Programs including literacy challenge grants; and (2) title II National Senior Service Corps (currently National Senior Volunteer Corps), part A Retired and Senior Volunteer Program (RSVP), part B Foster Grandparent Program (FGP), and part C Senior Companion Program (SCP). (Sec. 203) Includes as a VISTA objective the encouragement of supportive efforts by local agencies and organizations to achieve long-term sustainability of programs in the absence of Federal assistance. Encourages the VISTA Director to enter into agreements under which public agencies and private organizations pay all or part of the direct cost of supporting volunteers. Authorizes the VISTA Director to provide a stipend of a maximum of $200 per month to individuals designated as volunteer leaders. (Sec. 204) Renames the National Senior Volunteer Corps as the National Senior Service Corps (NSSC). Eliminates the priority for enrolling individuals age 60 and older (but continues to allow individuals age 55 and older to enroll). Allows individuals age 55 (currently 60) or older to enroll in FGP, but gives priority to enrolling individuals age 60 or older. Requires any stipend under FGP to be at least $2.55 per hour and be adjusted for inflation once prior September 30, 2005. Allows individuals age 55 (currently 60) or older to enroll in SCP, but gives priority to enrolling individuals age 60 or older. Requires the SCP Director spend certain amounts each year to promote SCP. Prohibits awarding national significance grants for RSVP, FGP, or SCP unless the appropriated allocation for each program exceeds the appropriated allocations for each of the two preceding years. (Sec. 206) Extends through 2005 the authorization of appropriations for programs under DVSA. Title III: Technical Amendments to Other Laws - Revises references and makes other technical and conforming amendments to various other Federal laws.
United States · United States Congress · 22 June 2000
Equal Access to Medicare Home Health Care Act of 2000 - Amends title XVIII (Medicare) of the Social Security Act with respect to payments made under the prospective payment system (PPS) for Medicare home health services: (1) eliminating the 15 percent reduction in payment rates under such PPS; (2) requiring repayment with interest of Medicare overpayments by home health agencies after a 36-month grace period during which no interest shall accrue; and (3) providing for ten percent additional payments under the PPS for services in rural areas and security 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 for purposes of payment for such services under the PPS, and of requirements with respect to physician certification of the need for home health services.
United States · United States Congress · 21 June 2000
Legal Immigrant Children's Health Improvement Act of 2000 - Amends titles XIX (Medicaid) and XXI (Children's Health Insurance) (CHIP) of the Social Security Act (SSA) to grant States the option of covering certain categories of eligible women and child resident aliens under the Medicaid and CHIP programs.
United States · United States Congress · 14 June 2000
Puerto Rico Land and Water Conservation Act of 2000 - Establishes the Karst Resource Protection Area in Puerto Rico. Directs the Secretary of Agriculture to administer a cooperative program of land conservation and protection, research, and public use within the Area. Declares that federally-owned lands within the Area shall be subject to this Act and the laws, rules, and regulations applicable to the National Forest System. Establishes the Puerto Rico Land Conservation Fund which shall be used for the protection of the Area and other National Forest and National Wildlife Refuge units in Puerto Rico. Allocates certain amounts from the Treasury to the Fund. Establishes, as part of the National Wildlife Refuge System, the Rio Encantado National Wildlife Refuge in the municipalities of Ciales, Manati, Florida, and Arecibo, Puerto Rico. Requires the acquisition of sufficient lands within the Refuge to enable management in furtherance of fish and wildlife conservation, particularly the reintroduction of the endangered Puerto Rican parrot. Provides for the study of certain named rivers in Puerto Rico for possible addition to the National Wild and Scenic Rivers System. Authorizes appropriations.
United States · United States Congress · 8 June 2000
National Historic Lighthouse Preservation Act of 2000 - Amends the National Historic Preservation Act to prescribe guidelines under which the Secretary of the Interior (Secretary) shall implement a national historic light station program. Directs the Secretary and the Administrator of General Services (Administrator) to establish a process and policy for identifying and selecting an eligible entity for: (1) conveyance of historic light stations for preservation purposes; and (2) monitoring the use of such stations. Prescribes application review and conveyance procedures. States that the conveyance recipient shall not be required to maintain any Federal aid to navigation associated with a historic light station (except certain statutorily permitted private aids). Precludes submerged lands from any such conveyance. Mandates offer for sale of any historic light station for which no applicants for conveyance are approved. Sets forth guidelines under which net sale proceeds shall be distributed to either the National Maritime Heritage Grant Program or the Coast Guard's Operating Expenses appropriation account. Authorizes appropriations.
United States · United States Congress · 25 May 2000
Expresses the sense of Congress that the Medicare program should cover the treatment and removal of actinic keratoses based on the appropriate standard of care as determined by a beneficiary's treating physician.
United States · United States Congress · 24 May 2000
Holocaust Education and Awareness Act of 2000 - Directs the Secretary of Education to make matching grants to carry out education and awareness programs about the Holocaust. Authorizes appropriations.
United States · United States Congress · 24 May 2000
Physical Education for Progress Act - Amends title X (Programs of National Significance) of the Elementary and Secondary Education Act of 1965 (ESEA) to authorize the Secretary of Education to award grants to, and enter into contracts with, local educational agencies (LEAs) to initiate, expand, and improve physical education programs for all kindergarten through 12th grade students. Requires such grants and contracts to be used for: (1) providing equipment and support to enable students to actively participate in physical education activities; (2) developing or enhancing physical education curricula to meet national goals developed by the Secretary; and (3) providing funds for staff and teacher training and education. Requires LEA assistance applications for such assistance to contain plans for helping school physical education programs make progress toward meeting State standards for physical education or specified goals. Prohibits extracurricular activities such as team sports and Reserve Officers' Training Corps (ROTC) program activities from consideration as part of the curriculum of a physical education program assisted under this Act. Authorizes appropriations.
United States · United States Congress · 23 May 2000
Amends Federal law to instruct the Postal Service to establish a special (semipostal) postal rate for first-class mail in order to afford the public a convenient way to contribute voluntarily to funding for the American Battle Monuments Commission. Expresses the sense of Congress that this Act should not: (1) cause a net decrease in Federal funding for the American Battle Monuments Commission; or (2) affect regular first-class, or any other postage rates.
United States · United States Congress · 19 May 2000
Teaching Children to Save Lives Act - Directs the Secretary of Education to make grants to State departments of education to establish cardiopulmonary resuscitation (CPR) training, using nationally recognized training courses, in public schools which include students in any of grades six through 12 (targeted schools). Limits such grants to not more than $6,000 per targeted school. Requires such grants to provide funding for two-year programs in targeted schools, with a majority of the funding to be provided in the first year to pay for start-up costs, including initial teacher training in CPR instruction and purchase of printed informational or instructional materials, manikins, and other equipment. and the remainder in the second year to pay for upkeep, continued or additional teacher training, and other subsidiary cost. Requires such grants to be used to encourage and foster new and existing community partnerships with and among public and private organizations (such as local school districts, nonprofit organizations, public health organizations like the American Heart Association and the American Red Cross, emergency medical service providers, fire and police departments, and parent-teacher associations) to aid in providing CPR training in targeted schools. Authorizes appropriations.
United States · United States Congress · 18 May 2000
Insulin-Free World Medicare Pancreas Transplantation Coverage Act of 2000 - Requires any medically necessary pancreas transplantation procedure to be a covered benefit under title XVIII (Medicare) of the Social Security Act, whether or not such procedure is done in conjunction with another organ transplantation procedure that is a covered Medicare benefit.
United States · United States Congress · 18 May 2000
Amends Federal law to direct the Postal Service to establish a special (semipostal) postage rate for first-class mail in order to afford the public a convenient way to contribute to funding for the establishment of the World War II Memorial. Expresses the sense of Congress that nothing in this Act should: (1) directly or indirectly cause a net decrease in total funds received by the American Battle Monuments Commission below the level that would otherwise have been received but for the enactment of this section; or (2) affect regular first-class rates of postage or any other regular rates of postage.
United States · United States Congress · 17 May 2000
Women's Health Office Act of 2000 - Amends the Public Health Service Act to establish: (1) within the Office of the Secretary of Health and Human Services an Office on Women's Health (2) within the Office of the Director of the Centers for Disease Control and Prevention an office to be known as the Office of Women's Health; and (3) establish within the Office of the Director of the Agency for Healthcare Research and Quality an office to be known as the Office of Women's Health. Amends the Social Security Act to establish within the Office of the Administrator of the Health Resources and Services Administration an office to be known as the Office of Women's Health. Amends the Federal Food, Drug, and Cosmetic Act to establish within the Office of the Commissioner of the Food and Drug Administration an office to be known as the Office of Women's Health. Authorizes appropriations.
United States · United States Congress · 17 May 2000
Directs the Secretary of Health and Human Services to promulgate a national coverage determination under title XVIII (Medicare) of the Social Security Act in order to mandate Medicare coverage of augmentative communication devices (also known as alternative communication devices) for individuals with a severe speech disability.
United States · United States Congress · 17 May 2000
Dual Degree Achievement Act - Amends the Higher Education Act of 1965 to establish a Dual Degree Achievement program of assistance for partnerships between minority-serving institutions (MSIs) and other institutions of higher education (IHEs) that enable students attending MSIs to earn dual degrees and enter fields in which students from MSIs are underrepresented. Directs the Secretary of Education to make five-year grants to eligible partnerships to carry out the program activities. Requires such partnerships to include one or more MSIs that award baccalaureate degrees and one or more partner IHEs that offer baccalaureate or post-baccalaureate degrees not awarded by the MSIs with which they are partnered. Allows such partnerships also to include other public and private entities, including MSIs (such as community colleges) that do not award baccalaureate degrees, community-based organizations, and businesses. Sets forth application requirements, including assurances that each participating student: (1) is enrolled in an academic program that leads to a five-year baccalaureate or post-baccalaureate degree not awarded by the MSI; and (2) upon successful completion of the program, will be awarded a baccalaureate degree from the MSI and a baccalaureate degree or a master's degree from the partner IHE that the student attends. Directs the Secretary to publish an annual list of baccalaureate and post-baccalaureate degree fields of study associated with professions in which students attending MSIs are underrepresented. Requires grants to be used for: (1) support services for participating students, including tutoring, mentoring, academic and personal counseling, and transition services; (2) scholarships to students in their fourth and fifth years in the program; (3) reimbursement to MSIs for the amount of tuition that they would have received had participating students attended those MSIs during their fourth year of the program instead of the partner IHE; and (4) academic program enhancements at the MSI that increase program quality and the number of student participants in the dual degree program. Requires that such scholarships: (1) reflect any additional amount of tuition and fees charged the participating student by the partner IHE compared to that charged by the MSI during the student's third year in the program; and (2) not be considered for the purposes of awarding Federal Pell Grants. Requires a majority of funds received under this program to be expended for such scholarships to students and such reimbursement to MSIs. Authorizes appropriations.
United States · United States Congress · 11 May 2000
Latina Adolescent Suicide Prevention Act - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to award grants to, or enter into cooperative agreements or contracts with, public and nonprofit private entities for programs to reduce suicide attempts and deaths among Latina adolescents. Requires a preference for applicants that: (1) demonstrate a strong link with schools and are actually supported by and operated within a school facility or associated setting; and (2) involve direct services to Latina adolescents. Limits the program to five years. Requires the Secretary to disseminate information gathered under the program to State and local governmental agencies and private providers of mental health and substance abuse services.
United States · United States Congress · 11 May 2000
Expresses the sense of Congress that, among other things: (1) the recommendations in the report "The State of Hispanic Girls" by the National Alliance for Hispanic Health be endorsed; and (2) more resources should be provided through Federal grants and other mechanisms to community-based partnerships and innovative programs designed to promote the health and well-being of Hispanic adolescent girls at risk.
United States · United States Congress · 10 May 2000
Medicaid Community Attendant Services and Supports Act of 2000 - Amends title XIX (Medicaid) of the Social Security Act to provide for Medicaid coverage of community attendant services and supports for eligible individuals with disabilities. Directs the Secretary of Health and Human Services to award grants to eligible States which have established a Consumer Task Force to assist the State in its development of real choice systems change initiatives with regard to consumer-responsive long-term services to eligible individuals. Authorizes appropriations. Directs the National Council on Disability to review and report to Congress on: (1) certain Medicaid regulations on home health and personal care services; and (2) how excessive use of medical services can be reduced by using community attendant services and supports. Directs the Secretary to establish a task force to examine appropriate methods for financing long-term services and supports.
United States · United States Congress · 10 May 2000
Declares that Federal funding for diabetes research should be increased in accordance with the recommendations of the Diabetes Research Working Group so that a cure for juvenile diabetes can be found.
![Official portrait of Rescom. Romero-Barcelo, Carlos A. [D-PR-At Large]](https://www.congress.gov/img/member/r000417_200.jpg)