United States · United States Congress · 15 September 1993
TABLE OF CONTENTS: Title I: Improved Access to Affordable Health Care Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families Subtitle B: Reform of Health Insurance Marketplace for Small Business Subtitle C: Preemption Subtitle D: Health Deduction Fairness Subtitle E: Improved Access to Community Health Services Subtitle F: Improved Access to Rural Health Services Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program Title II: Health Care Cost Containment and Quality Enhancement Subtitle A: Medical Malpractice Liability Reform Subtitle B: Administrative Cost Savings Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Accounts Subtitle D: Anti-Fraud Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals Subtitle F: Removing Anti-Trust Impediments Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities Subtitle H: Prefunding Government Health Benefits for Certain Annuitants Subtitle I: Miscellaneous Provisions Title III: Long-Term Care Subtitle A: Tax Treatment of Long-Term Care Insurance Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance Subtitle C: Studies Subtitle D: Volunteer Service Credit Demonstration Projects Affordable Health Care Now Act of 1993 - Title I: Improved Access to Affordable Health Care - Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families - Part 1: Required Coverage Options for Eligible Employees, Spouses, and Dependents - Requires each employer to make available to each eligible employee a group health plan under which: (1) coverage of each eligible individual with respect to such employee may be elected on an annual basis; (2) coverage is provided for at least the required coverage specified; and (3) employees may elect to have premiums collected through payroll deduction. Does not require employer contributions to the cost of coverage under such a plan. Provides for the exclusion of: (1) employers who have been employers for less than two years or who have no more than two eligible employees or no more than two eligible employees not covered under any group health plan; and (2) family members under specified circumstances. Specifies that a group health plan shall not be treated as failing to meet the requirements of this Act solely because a period of service by an eligible employee of not more than 60 days is required for coverage. Specifies that the required coverage is standard coverage, except that in the case of a small employer that has not contributed during the previous plan year to the cost of coverage for any eligible employee under any group health plan, the required coverage for the plan year is coverage under a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan. Provides for a five-year transition for existing group health plans. (Sec. 1002) Sets forth provisions regarding: (1) compliance with applicable requirements through multiple employer health arrangements; and (2) coverage options under a State medical health allowance program. Part 2: Preexisting Conditions and Continuity of Coverage; Renewability - Prohibits a group health plan from imposing (and an insurer from requiring an employer from imposing through a waiting period for coverage under a plan or similar requirement) a limitation or exclusion of benefits relating to treatment of a preexisting condition if: (1) the condition relates to a condition that was not diagnosed or treated within three months before the date of coverage under the plan; or (2) the limitation or exclusion extends over more than six month after the date of coverage, applies to an individual who, as of the date of birth, was covered under the plan, or relates to pregnancy. Specifies that, in the case of an individual who is eligible for coverage under a plan but for a waiting period imposed by the employer, the individual shall be treated as having been covered under the plan as of the earliest date of the beginning of the waiting period. (Sec. 1012) Requires each group health plan to waive any period applicable to a preexisting condition for similar benefits with respect to an individual to the extent that the individual, prior to enrollment in such plan, was covered for the condition under any other health plan. (Sec. 1013) Prohibits: (1) a multiemployer plan and an exempted multiple employer health plan from canceling or denying renewal of coverage under such a plan for an employer other than for nonpayment of contributions, fraud or other misrepresentation, noncompliance with plan provisions, or misuse of a provider network provision, or because the plan is ceasing to provide any coverage in a geographic area; (2) an insurer from canceling a health insurance plan or denying renewal of coverage other than as prescribed above; and (3) an insurer who terminates the offering of health insurance plans in an area from offering such a plan to any employer in the area until five years after the date of the termination. Part 3: Enforcement; Effective Dates; Definitions - Makes provisions of the Employee Retirement Income Security Act of 1974 applicable with respect to enforcement of this Act (by the Department of Labor). Amends the Internal Revenue Code (Code) to impose a tax ($100 per day for each individual involved, subject to specified limitations) on the failure of an insurer to comply with the requirements under part 2 unless the Secretary of Health and Human Services (Secretary) determines that the State has in effect a regulatory enforcement mechanism that provides adequate sanctions. Subtitle B: Reform of Health Insurance Marketplace for Small Business - Requires each insurer that makes available a health insurance plan to a small employer in a State to make available to each small employer in the State a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan, with exceptions for health maintenance organizations (HMOs) and if a State provides for guaranteed availability (rather than guaranteed issue). Requires each insurer that offers a MedAccess plan to a small employer in a State to accept: (1) every small employer in the State that applies for coverage; and (2) every eligible individual who applies for enrollment on a timely basis. Sets forth provision regarding: (1) special rules for HMOs; (2) timely enrollment requirements; and (3) enrollment of spouses and dependents. Makes such requirements inapplicable in a State that has provided (in accordance with specified standards) a mechanism under which each insurer offering a health insurance plan to a small employer in the State must participate in a program for assigning high-risk small employer groups (or individuals within such a group) among some or all such insurers, if the insurers comply. (Sec. 1102) Defines "MedAccess plan" as a health insurance plan that: (1) is designed to provide standard coverage with substantial cost-sharing, only catastrophic coverage, or medisave coverage; (2) includes only essential and medically necessary services; (3) meets applicable requirements relating to guaranteed issue; and (4) meets specifies consumer protection standards. Defines "MedAccess standard plan," "MedAccess catastrophic plan," and "MedAccess medisave plan" to mean a MedAccess plan that provides for at least standard coverage, for only catastrophic coverage, or medisave coverage, respectively. Requests the National Association of Insurance Commissioners (NAIC) to submit to the Secretary a set of rules which NAIC determines is sufficient for determining, in the case of any health insurance plan and for purposes of this subtitle, the actuarial value of the coverage offered by the plan. Directs the Secretary to certify such set of rules for use under this subtitle if they meet such requirements or establish such a set of rules. Specifies that a health insurance plan is considered to provide: (1) standard coverage if the benefits are determined, in accordance with certified rules of actuarial equivalence, to have a value that is within five percentage points of an established target actuarial value for standard coverage; (2) catastrophic coverage if benefits are available under the plan for a year only to the extent that expenses for covered services in a year exceed a deductible amount that is consistent with a specified requirement for a catastrophic health plan under the Code, and are determined, in accordance with certified actuarial equivalence rules, to have a value that is within five percentage points of an established target actuarial value for catastrophic coverage; and (3) medisave coverage if such plan consists of a catastrophic health plan within the meaning of the Code and a medical savings account. Requests NAIC to submit to the Secretary target actuarial values for standard and catastrophic coverage. Permits NAIC to submit periodic revisions of, and permits the Secretary to revise, the set of rules of actuarial equivalence and target actuarial values where necessary to take into account changes in the relevant types of health benefits provisions, in deductible levels for catastrophic coverage, or in relevant demographic conditions. (Sec. 1103) Directs the Secretary to request NAIC to develop model regulations that specify standards with respect to requirements: (1) that insurers make available MedAccess plans; (2) of guaranteed availability of MedAccess plans to small employers; (3) relating to limits on premiums and certain consumer protections; and (4) relating to limitation of annual premium increases. Requires the Secretary to review such standards and, if NAIC fails to specify standards meeting such requirements, to promulgate standards. Sets forth provisions regarding: (1) the application of MedAccess standards and consumer protection standards by the States; and (2) the Federal role. (Sec. 1104) Sets forth provisions: (1) regarding limits on premiums and annual premium increases; and (2) requiring an insurer, at the time of offering a health insurance plan to a small employer, to fully disclose rating practices for health insurance plans, including rating practices for different populations and benefit designs. (Sec. 1106) Directs the Secretary to: (1) request NAIC to develop models for reinsurance or allocation of risk mechanisms for health insurance plans made available to small employers for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models or specify models. Sets forth provisions regarding implementation of reinsurance or allocation of risk mechanisms by the States and the Federal role. Amends the Code to provide for the imposition of a tax on any health insurance plan which covers any employee in a Federal reinsurance State. (Sec. 1108) Directs the Secretary to establish an Office of Private Health Care Coverage. Requires the Office Director to submit to the Congress annual reports evaluating health care coverage reform. (Sec. 1109) Authorizes the Director to conduct: (1) research on the impact of this subtitle on the availability of affordable health coverage for employees and dependents in the small employers group health care coverage market and other specified topics; and (2) demonstration projects relating to such topics. Requires the Director to develop: (1) methods for measuring the relative health risks of eligible individuals in terms of the expected costs of providing benefits under health insurance plans and, in particular, MedAccess plans; and (2) a model for equitably distributing health risks among insurers in the small employer health care coverage market. Authorizes appropriations. Subtitle C: Preemption - Part 1: Scope of State Regulation - Prohibits: (1) State benefit mandates for group health plans; and (2) State or local law prohibitions against two or more employers obtaining coverage under an insured multiple employer health plan. (Sec. 1203) Preempts State restrictions concerning: (1) reimbursement rates or selective contracting; (2) differential financial incentives; and (3) utilization review methods. Directs the Comptroller General to conduct a study of the benefits and cost effectiveness of the use of managed care in the delivery of health services. Part 2: Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to allow a limited exemption under preemption rules for multiple employer plans providing health benefits subject to certain Federal standards. (Sec. 1212) Relieves exempted multiple employer plans providing medical care benefits of certain restrictions on preemption of State law. Treats such plans as employee welfare benefit plans. Allows commencement of new arrangements only if such exemption is in effect or an application is pending and the Secretary of Labor determines that provisional protection is appropriate. Sets forth exemption procedures, eligibility requirements, and additional requirements applicable to exempted arrangements. Requires certain disclosures to participating employers, maintenance of reserves, and corrective actions. Provides for expiration, suspension, and revocation of exemptions, and for review of actions by the Secretary. (Sec. 1213) Revises provisions relating to scope of preemption rules, and to treatment of single employer arrangements and of certain collectively bargained arrangements. (Sec. 1215) Establishes special rules for employee leasing healthcare arrangements. Treats such arrangements as multiple employer welfare arrangements except when they are multiple employer health plans. (Sec. 1216) Sets forth enforcement provisions relating to multiple employer welfare arrangements and employee leasing health care arrangements. (Sec. 1217) Sets forth filing requirements for multiple employer welfare arrangements. (Sec. 1218) Provides for cooperation between Federal and State authorities in enforcing ERISA requirements for multiple employer welfare arrangements with the limited exemption. Part 3: Encouragement of Multiple Employer Arrangements Providing Basic Health Benefits - Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax exempt trust status for multiple employer health plans and insured multiple employer health plans if they meet certain requirements under ERISA and this Act. Part 4: Simplifying Filing of Reports for Employers Covered under Insured Multiple Employer Health Plans - Amends ERISA to direct the Secretary of Labor to prescribe an alternative method providing for a single annual report with respect to all employers who are covered under the same insured multiple employer health plan. Part 5: Compliance with Coverage Option Requirements - Provides for compliance with applicable coverage requirements through multiemployer plans and other multiple employer health arrangements. Subtitle D: Health Deduction Fairness - Amends the Internal Revenue Code to provide: (1) for a permanent extension and increase in the health insurance tax deduction for self-employed individuals; and (2) that the deduction for certain health insurance costs be determined without regard to an adjusted gross income threshold. Disallows the deduction to individuals eligible for employer-subsidized coverage. Allows the deduction whether or not the individual itemizes other deductions. Subtitle E: Improved Access to Community Health Services - Part 1: Increased Authorization for Community and Migrant Health Centers - Directs the Secretary to provide for grants to migrant and community health centers to promote primary health care services for underserved individuals. Allows grants to be used to promote the provision of off-site services, to improve birth outcomes in areas with high infant mortality and morbidity, to establish primary care clinics in areas in need, and for recruitment and training costs of necessary providers and operating costs for unreimbursed services. Authorizes appropriations. Directs the Secretary to conduct a study of the impact of such grants on access to health care, birth outcomes, and the use of emergency room services. Part 2: Grants for Projects for Coordinating Delivery of Services - Amends the Public Health Service Act to authorize the Secretary to make grants to public and nonprofit private entities: (1) to carry out demonstration projects to increase access to outpatient primary health services in specified geographic areas (i.e., areas that are rational areas for the delivery of health services, have a population of not more than 500,000 individuals, and have been designated by the Secretary as areas with a shortage of personal health services or that have a significant number of individuals with low incomes or insufficient health care insurance through coordinating the delivery of such services under Federal, State, local, and private programs; and (2) for developing plans to carry out such projects. Authorizes appropriations. Subtitle F: Improved Access to Rural Health Services - Part 1: Establishment of Rural Emergency Access Care Hospitals Under Medicare - Amends title XVIII (Medicare) of the Social Security Act (SSA) to provide for: (1) establishment of rural emergency access care hospitals under Medicare; and (2) coverage of and payment for rural emergency access care hospital services under Medicare part B (Supplementary Medical Insurance). Part 2: Rural Medical Emergencies Air Transport - Amends the Public Health Service Act to direct the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments. Sets forth provisions regarding: (1) application and State plan requirements; (2) considerations in awarding grants; (3) State administration and use of grants; (4) the number of grants; and (5) reporting requirements. Authorizes appropriations. Part 3: Emergency Medical Services Amendments - Amends the Public Health Service Act to direct the Secretary to: (1) establish an Office of Emergency Medical Services, headed by a Director; (2) engage in specified emergency medical services activities, including disseminating information obtained in carrying out specified activities to public and private entities, providing technical assistance to State and local agencies, coordinating Department of Health and Human Services (DHHS) activities with those of other Federal agencies; and (3) ensure that such activities are carried out consistent with certain requirements regarding maintaining an adequate number of health professionals with expertise in the provision of services, developing, periodically reviewing, and revising as appropriate guidelines for the provision of such services, appropriately using available technologies, and serving the unique needs of underserved inner-city and rural areas. (Sec. 1522) Authorizes the Secretary to make grants to States for the purpose of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services, subject to specified matching fund, budgetary, and other requirements. (Sec. 1523) Provides for demonstration projects to establish telecommunications between rural medical facilities and medical facilities with expertise or equipment. Directs the Secretary to ensure that the telecommunications technologies demonstrated include interactive video telecommunications, static video imaging transmitted through the telephone system, and facsimiles transmitted through such system. (Sec. 1524) Authorizes appropriations for: (1) emergency medical services (including for State offices of Emergency Medical Services and for telecommunications demonstrations); and (2) trauma care and certain other activities. Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program - Amends SSA title XIX (Medicaid) to provide for the establishment of State health allowance programs under which the State makes payments to a group health plan which provides coverage to an eligible individual as an allowance towards the costs of providing the individual with benefits under the plan. Subtitle H: Medicaid Program Flexibility - Amends SSA title XIX Medicaid) to modify: (1) Federal requirements to allow States more flexibility in contracting for coordinated care services under Medicaid; and (2) provisions regarding the extension of certain waivers. Title II: Health Care Cost Containment and Quality Enhancement - Subtitle A: Medical Malpractice Liability Reform - Part 1: General Provisions - Makes this subtitle applicable with respect to any medical malpractice liability claim and to any medical malpractice liability action brought in State or Federal court, except a claim or action for damages arising from a vaccine-related injury or death to the extent that title XXI of the Public Health Service Act applies. Sets forth provisions regarding: (1) preemption of State law; (2) effect on sovereign immunity and choice of law or venue; (3) jurisdiction; and (4) effective dates. Part 2: Medical Malpractice and Product Liability Reform - Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified alternative dispute resolution (ADR) system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States under chapter 171 of the Federal judicial code (U.S. Court of Federal Claims). Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 2012) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action. Sets limits on punitive damages and on periodic payments for future losses. (Sec. 2013) Set forth provisions regarding: (1) limits on attorney fees and other costs; (2) joint and several liability (generally, liability may be found only for those damages directly attributable to the person's proportionate share of fault or responsibility for the injury); (3) a statute of limitations of seven years; and (4) a uniform standard for determining negligence (the defendant's conduct at the time of providing the health care services was not reasonable). (Sec. 2017) Specifies that in the case of a medical malpractice liability claim relating to services provided during labor or the delivery of a baby, if the health care professional did not previously treat the injured individual for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. Part 3: Requirements for State Alternative Dispute Resolution Systems - Lists requirements for State ADR systems, including that such a system: (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 2032) Directs the Secretary, by October 1 of each year, to certify State ADR systems that meet such requirements. Directs the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 2033) Directs the Secretary, within five years, to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system, including: (1) information on the effect of the ADR systems on health care costs, access to health care, and quality of care provided within the State; and (2) to the extent that such report does not provide information on no-fault systems operated by States as ADR systems, an analysis of the feasibility and desirability of establishing a system for resolving medical malpractice liability claims on a no-fault basis. Part 4: Other Provisions Relating to Medical Malpractice Liability - Authorizes a State agency responsible for disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies to permit their participation in the licensing of such practitioner and to review any health care malpractice action, claims, or allegation, or other information concerning the practice patterns of any such practitioner. Sets forth agreement requirements. (Sec. 2042) Directs the Secretary to study incentives adopted by State and local governments, insurers, medical societies, and other entities to encourage physicians to volunteer to provide health care services in medically underserved areas. (Sec. 2043) Directs each State to require: (1) each health care professional and health care provider to participate in a risk management program to prevent, and provide early warning of, practices which may result in injuries to patients or endanger patient safety; and (2) each provider of health care professional and provider liability insurance in the State to establish risk management programs or sanction programs of risk management for health care professionals and providers provided by other entities, and require each such professional or provider, as a condition of maintaining insurance, to participate in one such program at least once in each three-year period. (Sec. 2044) Directs the Secretary to make grants: (1) for basic research in the prevention of, and compensation for, injuries resulting from health care professional or provider malpractice and for research of the outcomes of health care procedures; (2) to the States to assist in improving their ability to license and discipline health care professionals; and (3) to States and local governments, private nonprofit organizations, and health professional schools for educating the general public about the appropriate use of health care, realistic expectations of medical intervention, and the resources and role of health care professional licensing and disciplinary boards in investigating claims of incompetence or health care malpractice, and for developing programs of faculty training and curricula for educating health care professionals in quality assurance, risk management, and medical injury prevention. Authorizes appropriations. Subtitle B: Administrative Cost Savings - Part 1: Standardization of Claims Processing - Directs the Secretary to adopt standards relating to: (1) data elements for use in paper and electronic claims processing under health benefit plans and in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. (Sec. 2102) Authorizes the Secretary, two years after standards are adopted for classes of services upon determining that a significant number of claims for benefits for such services under health benefit plans are not being submitted in accordance with such standards, to require that all providers of such services submit claims to health benefit plans in accordance with such standards. (Sec. 2103) Directs the Secretary to: (1) provide for the ongoing receipt and review of comments and suggestions for changes in the standards adopted and promulgated; (2) establish a schedule for the periodic review of such standards; and (3) revise such standards. Part 2: Electronic Medical Data Standards - Directs the Secretary to promulgate standards for hospitals concerning electronic medical data, including standards for transmission of such data and confidentiality of patient-specific information. Authorizes the Secretary to periodically revise such standards. (Sec. 2112) Sets forth requirements with respect to: (1) the sharing of hospital information under Medicare; (2) waiver of such requirements; and (3) application of such requirements to hospitals of the Department of Veterans Affairs. (Sec. 2113) Authorizes the head of a Federal agency to require a provider to present and transmit a required data element electronically in accordance with applicable presentation or transmission standard. (Sec. 2114) Sets forth limitations on data requirements where standards with respect to data elements are in effect. (Sec. 2115) Directs the Secretary to establish an advisory commission on the standards established under this part and operational concerns about the implementation of such standards. Authorizes appropriations. Part 3: Development and Distribution of Comparative Value Information - Directs the Secretary to determine whether each State is developing and implementing a health care value information program that meets specified criteria and a specified schedule. Authorizes the Secretary to: (1) make grants to enable each State to plan development and initiate implementation of its health care value information program; and (2) recover the amount of such a grant by offset against any other amount payable to the State under the Social Security Act under specified circumstances. Authorizes appropriations. (Sec. 2122) Directs the Secretary to take actions necessary to implement a comparable program in a State that fails to develop or implement a health care value information program in accordance with such criteria and schedule. Authorizes the Secretary to charge fees for the information materials provided pursuant to such a program. (Sec. 2123) Directs the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to develop health care value information relating to each program that such head administers and covering the same types of data that a State program meeting such criteria would provide. (Sec. 2124) Directs the Secretary to: (1) develop model systems to facilitate the gathering of data on health care cost, quality, and outcome and the analysis of such data in a manner that will permit the valid comparison of such data among providers and among health plans; (2) support experimentation with different approaches to achieve such objectives in the most cost effective manner; and (3) evaluate the various methods to determine their relative success. Authorizes the Secretary to establish standards for the collective and reporting of data on health care cost, quality, and outcomes. Authorizes appropriations. Part 4: Additional Standards and Requirements; Research and Demonstrations - Directs the Secretary to: (1) adopt standards relating to the design and use of magnetized Medicare identification cards to assist health care providers in determining whether individuals are eligible for benefits for provided services under the Medicare program and in billing the Medicare program for covered services; (2) take steps to encourage and assist States in the design and use of magnetized Medicaid identification cards under their Medicaid plans; and (3) establish a Medicare and Medicaid information system to provide information on group health and other health benefit plans that are primary payors to the Medicare and Medicaid programs. Authorizes appropriations. (Sec. 2132) Specifies that, effective January 1, 1994, no effect shall be given to any provision of State law that requires medical or health insurance records (including billing information) to be maintained in written, rather than electronic, form. (Sec. 2133) Requires, effective January 1, 1995, each health benefit plan: (1) to use a beneficiary's social security number as the personal identifier for claims processing and related purposes (authorizes the Secretary to impose a civil money penalty on any plan that fails to do so); and (2) to use the unique identifier under title XVIII of the Social Security Act (Medicare) for a provider that furnishes health care items or services to a beneficiary under the plan as the identifier of that provider for claims processing and related purposes. (Sec. 2134) Directs the Secretary to: (1) determine, where benefits are payable under two or more health benefit plans, whether problems relating to the rules for determining the liability of plans or the availability of information among plans causes significant administrative costs; and (2) promulgate standards, if the implementation of standards would significantly reduce such administrative costs. Authorizes the Secretary to impose a civil money penalty on plans that fail to comply with such standards. (Sec. 2135) Directs the Secretary to provide grants to qualified entities for research on the application of comprehensive information systems in continuously monitoring and improving patient care. Authorizes the Secretary to make grants to: (1) two to five community organizations or coalitions of health care providers, health benefit plans, and purchasers to establish and document the efficacy of communication links between the information systems of health benefit plans and of health care providers; (2) two to five public or private nonprofit entities for the development of regional or community-based clinical information systems; and (3) public or private nonprofit entities to develop and test the definition of a comprehensive set of data elements and the specification and manner of presentation of the individual data elements of the set, for electronic medical data generated by physicians and other entities (other than hospitals) that provide health care services. Authorizes appropriations. Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Account - Amends the Internal Revenue Code to include under the medical expense deduction the portion of such expense attributable to coverage under a catastrophic health plan. (Sec. 2202) Allows individuals a tax deduction for percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to medical care savings accounts. Subtitle D: Anti-Fraud - Part 1: Criminal Prosecution of Health Care Fraud - Amends the Federal criminal code to: (1) set penalties for health care providers who knowingly engage in any scheme or artifice to defraud any person in connection with the provision of health care; and (2) make activity which, if engaged in by the U.S. Postal Service, would be a violation of mail fraud provisions punishable to the same extent with respect to private or commercial interstate carriers. (Sec. 2303) Authorizes appropriations to hire, equip, and train no fewer than: (1) 225 special agents of the Federal Bureau of Investigation and support staff to investigate health care fraud cases; (2) 50 assistant United States Attorneys and support staff to prosecute such cases; and (3) 25 investigators in the Office of Inspector General, DHHS, to be devoted exclusively to health care fraud cases. (Sec. 2304) Amends the Federal criminal code to authorize the Attorney General to make payments of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution of health care fraud, subject to specified requirements and exceptions. Part 2: Coordination of Health Care Anti-Fraud and Abuse Activities - Directs the Secretary to establish in the Office of the Inspector General of DHHS a program (all-payer fraud and abuse control program) to: (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to the delivery of, and payment for, health care in the United States; (2) conduct investigations, audits, evaluations, and inspections relating to such delivery and payment; and (3) facilitate the enforcement of provisions of the Social Security Act and other statutes applicable to health care fraud and abuse. Directs the Secretary to establish standards to carry out such program, including standards relating to the furnishing of information by health insurers, providers, and other to enable the Secretary to carry out the program and procedures to assure that such information is provided and utilized in a manner that protects the confidentiality of the information and the privacy of individuals receiving health care services. Sets forth provisions regarding: (1) qualified immunity for providing information; (2) ensuring access to documentation; and (3) failure to comply as grounds for exclusion from the Medicare and Medicaid programs. (Sec. 2312) Authorizes additional appropriations to enable the Secretary to conduct investigations of allegations of health care fraud and to carry out the all-payor fraud and abuse control program. (Sec. 2313) Establishes in the Treasury an Anti-Fraud and Abuse Trust Fund to be used to assist the Inspector General of DHHS in carrying out the all-payor fraud and abuse control program in the fiscal year involved. Sets forth provisions regarding: (1) the deposit into the Fund of Federal health anti-fraud and abuse penalties; and (2) the use of such penalties to repay beneficiaries for cost-sharing. (Sec. 2314) Amends SSA title XI to provide for the application of Federal health anti-fraud and abuse sanctions to all fraud and abuse against private health benefit plans. Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals: Part 1 - Medicare Payment Changes - Amends SSA title XVIII to: (1) eliminate the membership limitation for Medicare health maintenance organizations; and (2) revise the Medicare select policy program and provide for a civil money penalty for misrepresentations made in connection with a Medicare select policy. (Sec. 2402) Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) make permanent the Medicare select policy program; and (2) allow access to Medicare select policies in all States. (Sec. 2403) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate the administration of Medicare parts A and B. Part 2: Part B Premium Tax for High-Income Individuals - (Sec. 2411) Amends the Internal Revenue Code to impose a tax on the Medicare part B premiums of high income individuals. Subtitle F: Removing Anti-Trust Impediments - Directs the Attorney General to promulgate guidelines under which a health care joint venture may submit an application requesting that the Attorney General provide the entities participating in the venture with an exemption under which: (1) monetary recovery on an antitrust claim brought against the entity shall be limited to actual damages if specified conditions are met; and (2) the conduct of the entity in making or performing a contract to carry out the venture shall not be deemed illegal per se. Requires the Attorney General to approve or disapprove the application within a specified time frame and to provide a statement explaining the reasons for any disapproval. Directs the Attorney General to approve the application if an entity participating in the venture submits to the Attorney General an application that contains the identities of the parties to the venture; the nature, objectives, and planned activities of the venture; and specified assurances and information. Sets forth provisions regarding: (1) revocation and renewal of exemptions and withdrawal of an application; (2) requirements relating to notice and publication of exemptions; and (3) issuance of health care certificates of public advantage to each eligible health care joint venture that complies with specified requirements. Establishes the Interagency Advisory Committee on Competition, Antitrust Policy, and Health Care to: (1) discuss and evaluate competition and antitrust policy and their implications regarding the performance of health care markets; (2) analyze the effectiveness of health care joint ventures receiving exemptions in reducing costs and expanding access; and (3) make recommendations to the Congress. Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities - Part 1: Application of the Clayton Act to Medical Self-Regulatory Entities - Provides that no damages, cost of suit, or attorney fee may be recovered under section 4, 4A, or 4C of the Clayton Act, or under any similar State law, except by a State or the United States, from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities that are: (1) designed to promote the quality of health care provided to patients; and (2) not conducted for purposes of financial gain. Directs the court to award the cost of such a suit, including a reasonable attorney fee, to a substantially prevailing defendant. Part 2: Consultation by Federal Agencies - Requires any Federal agency engaged in the establishment of medical profession standards to consult with appropriate medical societies or associations, specialty boards, or recognized accrediting agencies, if available, in carrying out medical professional standard setting and guidelines or standards relating to the practice of medicine. Subtitle H: Prefunding Government Health Benefit for Certain Annuitants - Requires that certain agencies prefund Government health benefits contributions for their annuitants. Subtitle I: Miscellaneous Provisions - Amends Civil Service and Federal Employees' Retirement Systems law to increase the minimum age required to be eligible for an immediate retirement annuity. Provides for the conformance of other Federal retirement systems with the minimum age increase made above. Title III: Long-Term Care - Subtitle A: Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation. (Sec. 3002) Excludes from gross income benefits provided under a long-term care insurance contract. Includes in gross income employer-provided coverage for long-term care services. (Sec. 3003) Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions. Includes any parent or grandparent as a dependent for purposes of such expenses. (Sec. 3004) Provides for the nonrecognition of gain or loss on the exchange of any life insurance contract or an endowment or annuity contract for a long-term care insurance contract. (Sec. 3005) Excludes from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangement to pay long-term care premiums. (Sec. 3006) Allows insurance companies to issue accelerated death benefit riders on life insurance contracts. Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance - Amends SSA title XIX to require State Medicaid plans to disregard some or all of the individual's assets attributable to coverage under a qualified long-term care insurance contract in determining the individual's eligibility for long-term care services. Subtitle C: Studies - Requires the Comptroller General to study the feasibility of: (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their home with an income tax credit. (Sec. 3203) Requires the Secretary of Health and Human Services to study and report to the Congress on the feasibility of encouraging or requiring the use of a single designate public or nonprofit agency to coordinate, through case management, the provision of long-term care benefits under current Federal, State, and local programs in a geographic area. Subtitle D: Volunteer Service Credit Demonstration Projects - (Sec. 3301) Amends the Older Americans Act of 1965 to require the Commissioner of the Administration on Aging to establish and operate a volunteer service credit demonstration project in each State.
United States · United States Congress · 15 September 1993
General Aviation Revitalization Act of 1993 - Amends the Federal Aviation Act of 1958 to set forth a 15-year statute of limitations within which a person may bring a civil action against an aircraft manufacturer for damages for death or injury or damage to property arising from an aircraft accident.
United States · United States Congress · 15 September 1993
Amends the Internal Revenue Code and title II of the Social Security Act (Old Age, Survivors and Disability Insurance) to set forth rules for filing returns with respect to domestic service employment taxes and requires such returns to be made on a calendar year basis. Subjects such taxes to estimated tax provisions. Makes filing requirements inapplicable to any employer liable for tax concerning remuneration for services other than domestic service in a private home. Authorizes the Secretary of the Treasury to enter into agreements with States to collect the State unemployment tax imposed on remuneration for domestic service and transfers such amounts to a State's account in the Unemployment Trust Fund. Treats such taxes as domestic service employment taxes. Requires the Secretary to inform domestic service employers in private homes of their tax obligations. Adjusts the threshold (from $50 a calendar quarter to $800 a year) for paying and withholding social security taxes on wages paid for domestic service in a private home. Requires the Secretary of Health and Human Services to adjust such threshold amount in the same manner as adjustments to certain social security insurance amounts. Excludes domestic service in a private home by an individual 16 years and under from amendments made by this Act.
United States · United States Congress · 14 September 1993
Medical Cost Containment Act of 1993 - Amends the Internal Revenue Code to exclude from gross income medical care savings benefits. Describes such benefits as a health plan which provides that all or part of the premium differential realized by instituting a qualified higher deductible health plan is credited to participating employees to pay for medical care for a plan year. Requires amounts remaining at the end of such plan year to be deposited into a tax-exempt medical care savings account (subject to rules similar to those for retirement plans) for use by the participant for medical expenses.
United States · United States Congress · 8 September 1993
Constitutional Amendment - Declares that no person, under any law enacted by the Congress or any rule issued by a Federal entity, shall be liable for conduct occurring, or with respect to income accruing, before the date of enactment of the law or issuance of the rule.
United States · United States Congress · 8 September 1993
Amends rule XXI of the Rules of the House of Representatives to prohibit a bill or joint resolution carrying any provision providing for a retroactive tax increase from being reported in the House. Provides that no amendment in the House or proposed by the Senate carrying a retroactive tax measure shall be in order during the consideration of a bill or joint resolution. Allows a question of order to be raised at any time under this clause.
United States · United States Congress · 6 August 1993
Mount Pleasant National Scenic Area Act - Establishes in the George Washington National Forest, Virginia, the Mount Pleasant National Scenic Area. Sets forth provisions regarding: (1) administration of the Area; (2) roads; (3) vegetation management; (4) motorized travel; (5) fire; (6) insects and disease; and (7) water. Directs the Secretary of Agriculture to develop a management plan for the Area.
United States · United States Congress · 6 August 1993
Federal Regulation Reduction, Reform, and Budget Act of 1993 - Amends the Congressional Budget Act of 1974 to require the Office of Management and Budget (OMB) and the Congressional Budget Office (CBO) to jointly report to the President and the Congress on direct costs to the private sector of complying with Federal regulations. Requires such reports to be issued in five-year intervals. Provides for initial and subsequent annual reports to the President and the Congress on an aggregate regulatory baseline which is a projection of the aggregate direct cost to the private sector of complying with Federal regulations for budget years and outyears. Requires a concurrent resolution on the budget to include reconciliation directives specifying changes in laws and regulations necessary to reduce such direct costs and to reduce regulatory authority from the aggregate regulatory base. Provides for the allocation of aggregate two-year regulatory authority among congressional committees. Requires the CBO to submit to the appropriate committees (except the Committees on Appropriations) an analysis of private sector regulatory costs for each public bill or resolution. Requires the President's annual budget submissions to comply with reconciliation directives. Amends the Regulatory Flexibility Act to require Federal agencies to prepare an analysis of the costs that will be incurred by small entities, other businesses, and individuals in complying with proposed agency rules. Requires the submission to the Congress and CBO and OMB of a cost estimate and cost benefit analysis of any new proposed regulations that would have an aggregate direct cost to the private sector of at least $10 million for any fiscal year.
United States · United States Congress · 6 August 1993
TABLE OF CONTENTS: Title I: Statement of Congressional Purpose Title II: Binding Budget Law Title III: Enforcement Mechanics Subtitle A: Supermajority Required to Break Budget Law Subtitle B: Line Item Reduction Subtitle C: "Blank Check" Appropriations Prohibited Subtitle D: "Pay As You Go" Requirement for New Spending Title IV: Sustaining Mechanism Title V: Protection of Social Security Title VI: Timetable Title VII: Conforming Amendments Title VIII: Definitions and Rules of Interpretation Title IX: Effective Date Budget Process Reform Act - Title I: Statement of Congressional Purpose - Declares that the purpose of this Act is to facilitate rational, informed, and timely decisions by the Congress. Expresses the sense of the Congress that the Federal budget process should focus the attention of policymakers and the public on the aggregate impact of Federal spending on the economy, and on the tradeoffs that must be made among priorities in order to control overall levels of spending. Declares that the budget process should contain safeguards against delay and inaction, so that temporary shut-downs of the Government may be avoided. Title II: Binding Budget Law - Requires the Congress to enact a binding budget law, in the form of a joint resolution, by April 15 of the calendar year before that in which the fiscal period commences. Makes it out of order in the House of Representatives or the Senate to consider any spending bill affecting spending in a major functional category unless and until a joint resolution on the budget is enacted. Amends the Congressional Budget Act of 1974 to prohibit baseline budgeting. Requires the President to submit to the Congress on or before the 15th day after a joint resolution on the budget is enacted a detailed budget for the fiscal period beginning on October 1 of the current calendar year. Title III: Enforcement Mechanics - Subtitle A: Supermajority Required to Break Budget Law - Requires a two-thirds majority vote in the House and the Senate to consider any spending bill prior to the enactment of the budget law. Requires the Congressional Budget Office to provide to the Congress an estimate of the costs in each major functional category of certain spending bills as soon as practicable after its introduction. Requires a two-thirds affirmative vote in the House and the Senate to consider over-budget spending bills. Requires a two-thirds affirmative vote in the House and the Senate to waive any provision of this Act. Subtitle B: Limited Enhanced Rescission Authority - Amends the Impoundment Control Act of 1974 to limit the President's rescission authority to spending that is above the limits of the budget law. Subtitle C: "Blank Check" Appropriations Prohibited - Declares the intent of the Congress to end open-ended, "blank check" appropriations which typically authorize spending "such sums as may be necessary." Requires fixed-dollar appropriations for every account except social security and interest on the debt. Prohibits open-ended appropriations. Requires Executive agencies to adjust benefit levels to ensure that appropriations for entitlement programs are not exceeded. Restricts budget authority and entitlement authority to one fiscal period. Subtitle D: "Pay As You Go" Requirement for New Spending - Prohibits the Congress from considering any legislation which exceeds the budget ceiling unless it offsets such increased spending with an equal amount of reductions. Requires a two-thirds affirmative vote in the House and the Senate to waive such prohibition. Title IV: Sustaining Mechanism - Makes appropriations to provide for an automatic continuing resolution if for any account an appropriation for a fiscal period does not become law before the beginning of such period. Restricts legislation providing funding to the Committees on Appropriations. Title V: Protection of Social Security - Provides that no reduction in benefits under title II of the Social Security Act (Old Age, Survivors and Disability Insurance) shall be made as a consequence of this Act. Title VI: Timetable - Revises the timetable for the congressional budget process. Title VII: Conforming Amendments - Makes various technical and conforming amendments, including changing references to a concurrent resolution on the budget to references to a joint resolution on the budget. Title VIII: Definitions and Rules of Interpretation - Sets forth definitions for specified terms. Title IX: Effective Date - Declares the effective date of this Act to be January 1, 1995, applicable to fiscal years beginning after September 30, 1995.
United States · United States Congress · 6 August 1993
Constitutional Amendment - Directs the President, beginning with FY 1997 or the first fiscal year after ratification, whichever is later, to submit a budget of revenues and outlays to Congress. Requires the Congress to adopt a budget that reduces the deficit existing the year prior to ratification by not less than ten percent per year in order to balance the budget within ten fiscal years. Requires a balanced budget by the 11th year after ratification. Requires, beginning with the 11th year, that revenues exceed outlays in order to provide for the reduction of the outstanding gross Federal debt. Requires the reduction to amortize the debt over the next 20 years in order to repay the entire debt by the end of the 30th year after ratification. Allows the waiver of aforementioned requirements when a declaration of war is in effect. Grants the President line-item veto authority in appropriation bills. Directs the Congress to review revenues on a quarterly basis and make adjustments to comply with this Act.
United States · United States Congress · 4 August 1993
Prohibits the intentional creation of legislative districts based on race, color, or language minority status of voters within such districts. Provides a private right of action for a violation of such prohibition.
United States · United States Congress · 4 August 1993
Amends rule XI of the Rules of the House of Representatives to allow meetings of standing committees and subcommittees to be closed to the public only if approved by a majority of the committee or subcommittee's total membership because disclosure of matters to be considered would endanger national security, tend to defame, degrade, or incriminate any person, jeopardize an ongoing criminal investigation, or compromise a confidential source of any criminal investigation. Repeals provisions making the coverage of committee hearings and meetings by television broadcast, radio broadcast, or still photography a privilege made available by the House. Requires proceedings of open committee hearings or meetings to be open to television broadcast, radio broadcast, and still photography, or by any of such method of coverage. Prohibits a committee or subcommittee chairman from limiting the number of television or still cameras below two representatives from each medium.
United States · United States Congress · 22 July 1993
Prohibits: (1) appropriated funds from being used to purchase U.S. Capitol Historical Society calendars for the House of Representatives; or (2) such calendars from being mailed under the frank of any Member, officer, or employee of the House.
United States · United States Congress · 21 July 1993
Amends Public Law 100-518 and the United States Grain Standards Act to extend Federal Grain Inspection Service administrative fee (and fee limitation) authority.
United States · United States Congress · 1 July 1993
Fall River Visitor Center Act of 1993 - Authorizes the Secretary of the Interior to expend donated or appropriated funds for the operation and maintenance of a visitor center to be constructed with private funds on property owned by H.W. Stewart, Inc., for visitors to, and administration of, Rocky Mountain National Park, Colorado.
United States · United States Congress · 30 June 1993
Amends the Reclamation Reform Act of 1982 to: (1) require only owners of more than 320 acres (currently all landowners) receiving irrigation water to furnish their irrigation district with a certificate of compliance with requirements for the receipt of such water; and (2) empower the Secretary of the Interior to impose penalties not to exceed $1,500 per year for noncompliance with such certification requirements due to error, good faith questions of interpretation, or unintentional omissions. Requires all determinations of noncompliance to be subject to an adjudicatory hearing. Limits all penalties to one year unless the Secretary determines the noncompliance to be the result of fraud or intentional misrepresentation of fact by a landholder.
United States · United States Congress · 17 June 1993
Amends the Internal Revenue Code to allow the deduction for home office expenses if a portion of a dwelling unit is used as the sole fixed location of business for a taxpayer who has no other fixed location of business, regardless of: (1) the amount of time or type of work performed in such location; or (2) the proportion of the total income from the business attributable to such location.
United States · United States Congress · 15 June 1993
Reserve Account for Administrative Savings Act of 1993 - Amends Federal law to require that appropriated salaries and expenses be apportioned. Requires the establishment of reserve accounts equal to five percent of the actual amount incurred for those salaries and expenses in the immediately preceding fiscal year. Provides procedures for such funds to be permanently rescinded, released and spent, or used to offset supplemental appropriations.
United States · United States Congress · 10 June 1993
Repeals the Davis-Bacon Act (an Act which requires that the locally prevailing wage rate be paid to various classes of laborers and mechanics working under federally-financed or federally-assisted contracts for construction, alteration, and repair of public buildings or public works).
United States · United States Congress · 9 June 1993
Amends Federal law to require both the President and the Congress to draft a budget based on estimates of current fiscal year spending, proposing increases or decreases based on this level (rather than on an estimated baseline). Amends the Congressional Budget Act of 1974 to require the Congressional Budget Office to use such a current fiscal year baseline in its report to the congressional budget committees, projecting growth for entitlement and discretionary spending based on current fiscal year spending. Terminates spending authority, effective October 1, 1993, for unearned entitlements and high-cost discretionary spending programs unless such spending authority is reauthorized. Terminates spending authority, effective October 1, 1994, for each discretionary spending program (not including high-cost discretionary spending programs) unless such spending authority is reauthorized. Provides for terminating such spending authorities after the year 2000 unless appropriately reauthorized.
United States · United States Congress · 9 June 1993
Amends the Rules of the House of Representatives to make it out of order to consider any primary expense resolution for the second session of the 103d Congress until the Committee on House Administration has reported and the House has adopted a resolution establishing an overall ceiling for committee staff for that year. Limits the overall ceiling for committee staff for the second session of the 103d Congress to 75 percent of the staff employed at the end of the 102d Congress. Requires the membership of each standing, select, or conference committee and each subcommittee thereof, except for the Committee on Standards of Official Conduct and the bipartisan Subcommittee on Administrative Oversight of the Committee on House Administration, to reflect the ratio of majority to minority party Members of the House. Requires the ratio of the majority staff to minority staff of each committee to be the same as the ratio of majority party members to minority party members on that committee. Prohibits proxy voting by any committee or subcommittee member. Directs the Speaker to refer legislation initially to one committee as the committee of principal jurisdiction. Requires that at least one-half (currently one-third) of the members of a committee (except the Committees on Appropriations, Budget, and Ways and Means) must be present in order to constitute a quorum for taking any action other than the reporting of a measure or recommendation. Requires the chair to order a roll call vote on a motion to report any public bill or resolution at the request of a member of the committee. Limits a Member's service as chairman of a committee to three Congresses. Requires an affirmative vote of two-thirds of the members of a committee or subcommittee before all or part of its meeting can be closed to the public because of national security, personnel information, or a criminal investigation. Calls for a two-thirds' vote by the members of the Committee on Rules before provisions can be waived with respect to: (1) the report on a bill being made available to Members at least three days before it is considered; (2) filing and printing of a conference report and its accompanying statement in the Congressional Record at least three calendar days before the report is considered and a copy of them being made available to Members at least two hours before the consideration; and (3) reporting any rule or order that contains a nongermane amendment or reporting of an unauthorized appropriation in a general appropriation bill or an amendment thereto. Prohibits the Committee on Rules from reporting any rule or order preventing minority party members from offering at least four amendments to any appropriation bill or resolution or to a concurrent resolution on the budget. Makes it out of order to consider any bill or resolution providing for the designation of a commemorative day or other commemorative period. Requires the appropriate House committees with jurisdiction to report legislation requiring periodic reauthorization, for a maximum five-year period, of the: (1) Architect of the Capitol; (2) United States Botanical Garden; (3) Congressional Budget Office; (4) Government Printing Office; (5) General Accounting Office; (6) Library of Congress; (7) Copyright Royalty Tribunal; and (8) Office of Technology Assessment. Directs the Committee on House Administration to establish a toll-free (800) telephone number and a data base to provide public access to information on the substance and present status of each bill and resolution that is before the House.
United States · United States Congress · 8 June 1993
Congratulates the Anti-Defamation League on its 80th anniversary and commends it for effectively pursuing the goal of promoting greater tolerance throughout the world.
United States · United States Congress · 27 May 1993
Expresses opposition to holding the Olympic Summer Games in the year 2000 in the People's Republic of China. Urges the International Olympic Committee to find another, more suitable venue for the Games. Urges the U.S. Representative to the Committee to vote against holding the Games in China.
United States · United States Congress · 25 May 1993
Permanent Performance Review Act of 1993 - Establishes the Permanent Performance Review Commission to: (1) establish and manage a schedule of agency self-studies to be conducted over a fixed period; (2) hold hearings as part of an overall assessment and transformation of the date presented in the study into a performance review to be developed by the Commission; and (3) submit the performance review and legislative recommendations to the President, the Congress, and the public. Specifies the duties of agencies subject to performance review. Sets forth procedures for congressional action on performance reviews received from the Commission. Authorizes appropriations.
United States · United States Congress · 19 May 1993
Amends rule XI of the Rules of the House of Representatives to allow meetings of the standing committees and subcommittees to be closed to the public only if disclosure of matters to be considered would endanger national security or would tend to defame, degrade, or incriminate any person. Repeals provisions making the coverage of committee hearings and meetings by television broadcast, radio broadcast, or still photography a privilege made available by the House. Requires proceedings of open committee hearings or meetings to be open to television broadcast, radio broadcast, and still photography, or by any of such method of coverage. Prohibits a committee or subcommittee chairman from limiting the number of television or still cameras below two representatives from each medium.
United States · United States Congress · 13 May 1993
Negotiated Rates Act of 1993 - Amends Federal transportation law to authorize persons against whom a claim is made by a motor carrier of property (other than a household goods carrier), or by a nonhousehold goods freight forwarder for the collection of rates or charges in addition to the rates originally collected by such carrier or freight forwarder, to elect to satisfy such claim pursuant to a specified formula upon showing that the carrier or forwarder is no longer transporting property or is transporting property for the purpose of avoiding application of this Act. Requires that the claimant have been offered a rate other than the one legally on file with the Interstate Commerce Commission (ICC), have tendered freight in reasonable reliance upon the offered rate, the carrier or forwarder did not properly or timely file a tariff for the rate or failed to execute a valid contract for transportation services, such rate was collected by the carrier or forwarder, and the carrier or forwarder demands additional payment of a higher rate filed in a tariff. Shortens the statute of limitations for the filing of claims: (1) by a motor common carrier or freight forwarder for recovery of transportation or service charges; and (2) by any person to recover overcharges by a motor carrier. Permits motor carriers and shippers to resolve by mutual consent, subject to ICC review and approval, any overcharge and undercharge claims resulting from billing errors or incorrect tariff provisions arising from the inadvertent failure to properly and timely file and maintain agreed upon rates, rules, or classifications. Prohibits a tariff filed with the ICC from being held invalid solely on the basis that it uses a numerical or alpha account code to designate customers or describe the applicability of rates. Requires a motor contract carrier to enter into a written agreement (separate from a bill of lading or receipt) for the provision of transportation services. Sets forth both civil and criminal penalties for violations of this requirement. Requires the ICC to issue regulations prohibiting any motor carrier from reducing a rate set forth in its tariff or contract for any person but the one paying for the transportation service. Sets forth civil penalties. Grants the ICC jurisdiction to resolve disputes arising with respect to certain motor carriers as to whether transportation is provided as a motor common carrier or as a motor contract carrier. Directs the Secretary of Transportation to arrange with the Transportation Research Board to study and report to specified congressional committees on: (1) the public benefits of tariff rate filings by motor carriers of property with the ICC; (2) the extent to which such filing system is used by shippers; (3) the difficulty and cost of determining rates for transportation services under such system; and (4) the number of actions brought before the ICC with respect to such rates.
United States · United States Congress · 12 May 1993
Blue Ribbon Commission to Eliminate Duplicative and Noncompetitive Federal Regulations Act - Establishes the Blue Ribbon Commission to Eliminate Duplicative and Noncompetitive Federal Regulations. Requires the Commission to: (1) survey the private sector to determine which Federal regulations are duplicative or impede competition; (2) conduct in-depth reviews of regulations promulgated by executive agencies; (3) review existing General Accounting Office, Congressional Budget Office, and Inspector General reports and other governmental and nongovernmental recommendations for reducing duplicative or noncompetitive Federal regulations, and, based on such review, periodically report to the President and the Congress on those recommendations, with estimated savings, that the Commission determines are most significant; and (4) submit to the President and the Congress recommendations for streamlining Federal regulations and reducing costs and unnecessary paperwork that result from such regulations for both the Federal Government and the private sector.
United States · United States Congress · 12 May 1993
ESOP Promotion and Improvement Act of 1993 - Amends the Internal Revenue Code to allow S corporations (certain small business corporations) to participate in employee stock ownership plans (ESOPs). Permits ESOP participants whose compensation does not exceed a certain amount to contribute up to 50 percent of it to the plan. Allows ESOP closely-held corporate sponsors to pay estate tax if an estate transferred the stock of the corporation to an ESOP. Allows the deductibility of ESOP dividends in computing alternative minimum tax. Excludes from gross income transfers of qualified securities in connection with the performance of services if such securities are sold to an ESOP within 60 days of the taxable event.
United States · United States Congress · 10 May 1993
Administrative Cost Inclusion Act of 1993 - Amends the Federal Credit Reform Act of 1990 to include administrative costs (which, currently, are expressly excluded) in the estimated long-term costs to the Government of direct loans and loan guarantees. Amends Federal law to require the President's annual budget to contain specified information accounting for such administrative costs.
United States · United States Congress · 6 May 1993
Authorizes the President to present to Red Skelton, on behalf of the Congress, a gold medal in recognition of his performance as an entertainer and humanitarian. Authorizes the Secretary of the Treasury to strike a gold medal with suitable emblems and to strike and sell bronze duplicates of it. Declares such medals national medals. Authorizes appropriations.
United States · United States Congress · 5 May 1993
Qualified Football Coaches Plan Technical Corrections Act of 1993 - Amends the Employee Retirement Income Security Act of 1974 to make technical revisions which restore treatment of a qualified football coaches plan as a multiemployer plan for pension plan purposes.
United States · United States Congress · 29 April 1993
TABLE OF CONTENTS: Title I: Tax Relief for Families Title II: Family Savings Incentives Subtitle A: Increase in Income Limitations for Deductible IRA Contributions; Increase in IRA Contribution Limits; Penalty-Free Withdrawals for Home Ownership, Education, and Medical Expenses Subtitle B: Exclusion for Employer-Provided Educational Assistance to Include Educational Assistance for Spouse and Dependents of Employee Title III: Medical Care Savings Accounts; Health Care Cost Controls; Deduction for Health Insurance Costs of Self-Employed Individuals Title IV: Educational Choice Programs Title V: Grants to Encourage Employers to Adopt Flexible Work and Family Policies Title VI: Reducing the Cost of Capital by Reducing Capital Gains Tax Rates, Indexing the Basis of Certain Assets, and Excluding Gain from Sales of Principal Residences Title VII: Enterprise Zones Subtitle A: Designation of Enterprise Zones Subtitle B: Federal Income Tax Incentives Subtitle C: Regulatory Flexibility Subtitle D: Establishment of Foreign-Trade Zones in Enterprise Zones Family and Economic Recovery Act - Title I: Tax Relief for Families - Amends the Internal Revenue Code to allow taxpayers a credit for each child who has not attained the age of 19. Allows a credit for qualified adoption expenses. Disallows the use of such credits together with other credits or deductions. Title II: Family Savings Incentives - Subtitle A: Increase in Income Limitations for Deductible IRA Contributions; Increase in IRA Contribution Limits; Penalty-Free Withdrawals for Home Ownership, Education, and Medical Expenses - Increases the income limitations on retirement savings deductions and provides a cost-of-living adjustment after 1994 for such limitations. Provides a cost-of-living adjustment for deductible retirement amounts after 1993. Allows distributions from certain retirement plans without penalty to purchase first homes, pay higher education expenses and financially devastating medical expenses, and assist certain unemployed individuals. Treats certain disaster victims as first-time homebuyers. Subtitle B: Exclusion for Employer-Provided Educational Assistance to Include Educational Assistance for Spouse and Dependents of Employee - Excludes from gross income employer-provided educational assistance to spouses and dependents of employees. Makes such exclusion permanent. Title III: Medical Care Savings Accounts; Health Care Cost Controls; Deduction for Health Insurance Costs of Self-Employed Individuals - Excludes from gross income medical care savings benefits. Describes such benefits as a health plan which provides that all or part of the premium differential realized by instituting a qualified higher deductible health plan is credited to participating employees to pay for medical care for a plan year. Requires amounts remaining at the end of such plan year to be deposited into a tax exempt medical care savings account (subject to rules similar to those for retirement plans) for use by the participant for medical expenses. Increases the deduction for health insurance costs of self-employed individuals to 100 percent (50 percent for 1995 and 1996) and makes such deduction permanent. Preempts State laws: (1) requiring the offering of health plans providing certain services; and (2) prohibiting employer groups from purchasing health insurance. Title IV: Educational Choice Programs - Educational Choice Programs Act - Authorizes appropriations for FY 1993 through 2000 for grants and scholarship awards to parents of elementary or secondary school children that may be redeemed at a variety of public and private schools, including religious schools. Sets forth administrative details for such program. Title V: Grants to Encourage Employers to Adopt Flexible Work and Family Policies - Authorizes appropriations for FY 1993 to provide start-up grants to businesses to explore, initiate, or expand flexible work policies in an effort to ease work and family demands on employees. Includes as examples flexitime, part-time, job sharing, telecommuting, flexiplace, or compressed work weeks. Title VI: Reducing the Cost of Capital by Reducing Capital Gains Tax Rates, Indexing the Basis of Certain Assets, and Excluding Gain from Sales of Principal Residences - Reduces the individual and corporate capital gains rate from 34 percent to 15 percent. Reduces such tax to 7.5 percent for low- and middle-income taxpayers. Provides for the phaseout of personal exemptions and the overall limitation on itemized deductions to take into account adjusted gross income which has been reduced by net capital gain. Requires indexing, based on the gross national product deflator, of the adjusted basis of certain assets (corporate stock and tangible property that is a capital asset of property used in a trade or business) that have been held for more than one year at the time of sale or other transfer, solely for the purpose of determining gain or loss. Provides for indexing the limitation of capital losses of noncorporate taxpayers. Excludes from gross income the sale or exchange of property that has been owned and used by the taxpayer as the taxpayer's principal residence. Terminates provisions relating to the rollover of gain on the sale of a principal residence. Title VII: Enterprise Zones - Subtitle A: Designation of Enterprise Zones - Authorizes the Secretary of Housing and Urban Development to designate enterprise zones for purposes of providing tax and regulatory relief and improving local services. Limits choices to areas nominated by States and local governments. Limits the total number of areas that may be designated, and the time period of the designation. Authorizes the Secretary to designate a zone only if the area meets certain locational, demographic, unemployment, and poverty criteria. Requires nominating local governments, as a condition of the Secretary's designation, to agree in writing to follow a course of action that may include reducing tax rates, improving local services, simplifying or streamlining regulation of business, and providing job training to area residents. Describes areas to which the Secretary must give preference in selecting areas for designation. Requires the Secretary to report to the Congress every two years on the effects of such enterprise zones' designation in accomplishing the purposes of this Act. Subtitle B: Federal Income Tax Incentives - Allows a nonrefundable income tax credit to enterprise zone employees for five percent of any qualified wages earned as do not exceed a specified amount. Phases out such credit as total wages increase over $20,000. Provides for the nonrecognition of capital gain on the sale of enterprise zone property. Allows a taxpayer a deduction on the aggregate amount paid for the purchase of enterprise stock on its original issue by a qualified issuer. Requires any gain from the disposition of the stock to be treated as ordinary income. Excludes enterprise zone capital gains from income computation of alternative minimum taxes. Subtitle C: Regulatory Flexibility - Amends Federal law to revise the definition of "small entity" for purposes of the analysis of regulatory functions to include qualified business, government, and nonprofit enterprises operating within enterprise zones. Authorizes Federal agencies, upon request by a designating government, to waive or modify rules and regulations pertaining to the implementation of projects or activities within an enterprise zone. Requires agencies to approve the request if the resulting benefits of job creation, community development, or economical revitalization outweigh the public interest in retaining the rule unchanged. Disallows waiver or modification of a rule that would directly violate a statutory requirement or present a danger to the public health and safety. Subtitle D: Establishment of Foreign-Trade Zones in Enterprise Zones - Requires the Foreign-Trade Zone Board to consider on a priority basis, and to expedite the processing of, applications for the establishment of foreign-trade zones within enterprise zones. Requires the Secretary of the Treasury to give priority to, and expedite applications for, the establishment of ports of entry necessary to establish such zones.
United States · United States Congress · 29 April 1993
Urges the Citizens' Stamp Advisory Committee of the U.S. Postal Service to recommend to the Postmaster General that a postage stamp be issued honoring Americans held as prisoners of war or listed as missing in action.
United States · United States Congress · 28 April 1993
Fairness in Product Liability Act of 1993 - Declares that this Act governs any product liability action brought in any State or Federal court against a manufacturer or product seller for harm caused by a product, but supersedes State law only to the extent that State law applies to an issue covered by this Act. Lists specific laws not superseded, including provisions regarding vaccine injury. Makes a product seller liable to a claimant for harm only if the claimant establishes that: (1) the product which allegedly caused the harm complained of was sold by the product seller who failed to exercise reasonable care with respect to the product and such failure was a proximate cause of the claimant's harm; (2) the product seller made an express warranty applicable to the product which allegedly caused the harm complained of, the product failed to conform to the warranty, and such failure caused the claimant's harm; or (3) the seller engaged in international wrongdoing which was a proximate cause of the harm complained of by the claimant. Makes it a complete defense to a product liability action that the claimant was intoxicated or was under the influence of intoxicating alcohol or any drug and, as a result of such intoxication or influence, was more than 50 percent responsible for causing the accident or event which resulted in such claimant's harm. Directs that the damages for which a manufacturer or product seller is otherwise liable under State law be reduced by the percentage of responsibility for the claimant's harm attributable to misuse or alteration of a product if such percentage was proximately caused by a use or alteration of a product: (1) in violation of, or contrary to, the manufacturer's or product seller's express warnings or instructions if the warnings or instructions are adequate under State law; or (2) involving a risk of harm which was, or should have been, known by the ordinary person who uses the product, with an exception for workplace injuries. Sets forth provisions regarding: (1) limitations on punitive damages; (2) several liability for noneconomic damages; (3) statutes of limitation; (4) workers' compensation offsets; and (5) lack of Federal jurisdiction over civil actions arising under this Act.
United States · United States Congress · 27 April 1993
Family Education Assistance Act of 1993 - Amends the Internal Revenue Code to allow an individual income tax deduction for contributions to a savings account established to pay the educational expenses (tuition, supplies, meals, and lodging) of the taxpayer's child or certain other relatives at an institution of higher education or a vocational school. Limits the deduction to $1,500 annually (adjusted for inflation) for each account. Disallows the deduction for contributions to an account maintained for any individual aged 19 or older. Requires any account balance to be distributed after the beneficiary attains age 30. Permits an exclusion from the gross income of the contributor or the beneficiary of account distributions used to pay educational expenses of the latter. Exempts an account from taxation (except for the tax on unrelated business income of a charitable organization), unless a contributor or the beneficiary engages in specified prohibited transactions in connection with it. Imposes a ten percent surtax on distributions not used for educational purposes. Requires the account trustee to report to the Secretary of the Treasury and to the account's beneficiary concerning the account. Imposes a penalty for failure to report. Allows taxpayers who do not otherwise itemize deductions to deduct for contributions to an education savings account. Imposes penalty taxes in connection with excess contributions or prohibited transactions associated with an account.
United States · United States Congress · 22 April 1993
Amends the Food for Progress Act of 1985 to exempt from specified merchant marine cargo requirements (agricultural commodity) food assistance provided to Russia pursuant to the Vancouver Package.
United States · United States Congress · 22 April 1993
Amends the Merchant Marine Act, 1936 to provide that provisions requiring the use of U.S.-flag commercial vessels for the transport of certain cargoes and agricultural commodities financed by the United States shall not apply to the transport of such items to Russia under the Vancouver Package.
United States · United States Congress · 22 April 1993
Declares that the President should exercise the temporary waiver authority granted in the Merchant Marine Act, 1936 so that the $1,600,000,000 in bilateral assistance to Russia, referred to as the Vancouver Package, may be effected without endangering the stability of the Government or economy of Russia and without adding to the U.S. budget deficit.
United States · United States Congress · 21 April 1993
Deficit Reduction Act of 1993 - Prohibits the annual travel budget for each non-defense executive branch agency (excluding the Postal Service) for FY 1994 from exceeding 90 percent of the budget level available to such agency for FY 1993. Abolishes the Interstate Commerce Commission. Transfers its functions, powers, and duties to the Department of Transportation. Limits the outlays for the legislative branch for FY 1994 to 85 percent of such outlays for FY 1993. Directs the Secretary of the Interior to sell to one or more joint ventures all right, title, and interest of the United States in and to the helium reserves established pursuant to the Helium Act, including facilities and accessories. Limits the administrative and overhead budget (excluding travel expenses) for non-defense executive branch agencies (excluding the Postal Service) for FY 1995 to 99 percent of the budget level available for FY 1994. Repeals the Davis-Bacon Act (an Act which requires that the locally prevailing wage rate be paid to various classes of laborers and mechanics working under federally-financed or federally-assisted contracts for construction, alteration, and repair of public buildings or public works). Eliminates the honey price support and wool and mohair price support programs. Increases rental voucher authority and terminates loan authority for public housing construction. Prohibits the Secretary of Housing and Urban Development from expending or obligating any budget authority for certain special projects. Rescinds such amounts remaining for FY 1993. Amends the United States Housing Act of 1937 to require competitive bidding for public housing modernization activities. Amends the Internal Revenue Code to require the disclosure of tenant income in information returns under housing assistance programs for income-based rent subsidies. Reduces Government contributions to the Thrift Savings Plan. Amends the Communications Act of 1934 to require competitive bidding for the radio spectrum for awarding initial licenses or new construction permits, with exceptions. Authorizes the Federal Communications Commission to consider relative economic values and other public interest benefits in making spectrum allocation decisions among services that are subject to competitive bidding.
United States · United States Congress · 21 April 1993
Repeals rule XLIX of the Rules of the House of Representatives relating to concurrent and joint resolutions that increase or decrease the statutory limit on the public debt.
United States · United States Congress · 20 April 1993
Fresh Cut Flowers and Fresh Cut Greens Promotion and Information Act of 1993 - Authorizes the establishment of a program of promotion, consumer information, and research to strengthen the cut flowers and cut greens industry, including the creation of a Fresh Cut Flowers and Fresh Cut Greens Promotion Council.
United States · United States Congress · 20 April 1993
Sets forth a formula, beginning with the 1991 grazing year, for determining fees for domestic livestock grazing on public rangelands. Bases the formula on the base established by the 1966 Western Livestock Grazing Survey, the Forage Value Index, and the adjusted Beef Cattle Price Index. Prohibits annual fee adjustments greater or less than 25 percent.
United States · United States Congress · 7 April 1993
Dietary Supplement Health and Education Act of 1993 - Amends the Federal Food, Drug, and Cosmetic Act to: (1) define the term "dietary supplement"; and (2) exclude a dietary supplement from the definition of "food additive." Deems a dietary supplement adulterated if it: (1) contains an unsafe dietary ingredient which presents a substantial and unreasonable risk of illness or injury; or (2) contains a dietary ingredient that has not been adequately substantiated for safety. Prohibits the establishment of maximum limits on the potency of any dietary supplement, except in the case of a supplement represented to be for the use of individuals with specific diseases or disorders. Allows a dietary supplement's label to characterize the relationship between the supplement and a disease under specified conditions. Deems food misbranded unless the label lists the daily value of specified nutrients which shall reflect the daily intake of each nutrient that will promote optimal health. Prohibits such value from being less than the U.S. Recommended Daily Allowance. Establishes an Office of Dietary Supplements within the National Institutes of Health.
United States · United States Congress · 1 April 1993
TABLE OF CONTENTS: Title I: Cancellation and Suspension Title II: Data Collection Title III: Amendments to the Federal Food, Drug, and Cosmetic Act Food Quality Protection Act of 1993 - Title I: Cancellation and Suspension - Amends provisions of the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) relating to cancellations, changes in classifications, or other terms of registration with respect to the authority of the Administrator of the Environmental Protection Agency. Requires that a rulemaking under such provisions be based on a validated test or other significant evidence raising prudent concerns of unreasonable adverse effects to man or to the environment. Denies registration applications that are not in compliance with this Act. Title II: Data Collection - Directs the Secretary of Agriculture to collect pesticide use data of statewide or regional significance for all the major crops and crops of dietary significance. Mandates research, development, and dissemination of integrated pest management techniques and other pest control methods that enable producers to reduce or eliminate application of pesticides which pose a greater than negligible dietary risk to humans. Title III: Amendments to the Federal Food, Drug, and Cosmetic Act - Amends the Federal Food, Drug, and Cosmetic Act (FDCA) to define, subject to exception, "pesticide chemical" as it is defined in FIFRA. Deems a food adulterated if it bears or contains: (1) a pesticide chemical residue that is unsafe; or (2) a new animal drug or conversion product that is unsafe. Sets forth requirements relating to tolerances and exemptions from tolerances for pesticide chemical residues in food, including residues of degradation products. Prohibits establishment of a tolerance higher than a level the Administrator determines is adequate to protect the public health. Allows a greater than negligible dietary risk if: (1) use protects from greater adverse health effects to humans or the environment; (2) use avoids greater risks from another pesticide; or (3) the unavailability of the pesticide would reduce the availability of an adequate, wholesome, and economical domestic supply of the food, and the adverse effects from the reduction would outweigh the risk posed by the residue. Allows the Administrator to issue an exemption from the requirement for a tolerance only if a tolerance is not needed to protect the public health, in view of the levels of dietary exposure that could reasonably be expected to occur. Prohibits a final rule that revokes, modifies, or suspends a tolerance or exemption until the Administrator has taken any necessary action under FIFRA with respect to the registration of the pesticide involved. Requires the Administrator, if the Administrator takes certain actions with respect to the registration of a pesticide, to revoke any tolerance or exemption that allows the presence of the chemical or chemical residue. Requires the suspension of any tolerance or exemption upon the suspension of the use of an associated registered pesticide. Provides for: (1) tolerances for unavoidable residues in the case of a residue of a canceled or suspended pesticide chemical that will unavoidably persist in the environment and be present in or on a food; and (2) residues resulting from an application which was lawful at the time of application. Prohibits, subject to exception, a State from enforcing any limit on a qualifying pesticide chemical residue in or on any food which is not identical to Federal requirements. Prohibits a State from enforcing a residue limit which was lawful at the time of application. Authorizes appropriations for increased monitoring of pesticide residues in imported and domestic food.
United States · United States Congress · 31 March 1993
Repeals the Helium Act (an Act concerned mainly with the extraction and recovery of helium for national defense purposes). Directs the Secretary of the Interior to sell or otherwise dispose of: (1) all facilities, equipment, and real or personal property held for activities under such Act; and (2) all helium reserves held by the United States other than those required for specific immediate needs. Requires sale proceeds to be used solely to reduce outstanding Federal debt.
United States · United States Congress · 30 March 1993
Amends the Federal Aviation Act of 1958 to prohibit the Administrator of the Federal Aviation Administration from refusing to issue or renew an airman's certificate, or requiring an air carrier to terminate the employment of an airman, solely by reason of the airman's age if such person is under the age of 65.
United States · United States Congress · 29 March 1993
Agricultural Commodity Export Expansion Act of 1993 - Amends the Agricultural Trade Act of 1978 to revise restrictions for the agricultural export direct credit and credit guarantee programs.
![Official portrait of Sen. Allard, Wayne [R-CO]](https://www.congress.gov/img/member/a000109_200.jpg)