United States · United States Congress · 10 February 1994
TABLE OF CONTENTS: Title I: Saving the Taxpayers Money Subtitle A: Specific Spending Cuts Subtitle B: Reducing the Size of Government Subtitle C: Eliminating Government Printing Monopoly Title II: Streamlining the Federal Bureaucracy Subtitle A: Department of Agriculture Reorganization Subtitle B: Procurement Streamlining Subtitle C: Other Streamlining Reforms Title III: Improving Government Performance and Accountability Title IV: Improving the Legislative Process Title V: Enforcement Government Downsizing, Performance, and Accountability Act of 1994 - Title I: Saving The Taxpayers Money - Subtitle A: Specific Spending Cuts - Rescinds 7.5 percent of remaining FY 1994 appropriations for the legislative branch (except the House of Representatives and the Executive Office of the President). (Sec. 1003) Amends the Legislative Reorganization Act of 1946 to limit annual cost of living adjustments (COLAs) for Members of Congress to those for other Federal employees. (Sec. 1004) Rescinds certain FY 1994 appropriations to provide for reductions in FY 1994 budgetary outlays for, and thereafter through FY 1996 sets general obligational limits on, various specified agency administrative expenses (except Department of Defense (DOD) and other specified expenses), as determined by the Director of the Office of Management and Budget (OMB). (Sec. 1005) Makes specified rescissions in current FY 1994 appropriations for: (1) the Agency for International Development's (AID) Development Assistance Fund; (2) Department of State Diplomatic and Consular Programs; and (3) salaries and expenses of the United States Information Agency (USIA) and USIA's North/South Center. (Sec. 1006) Raises the minimum threshold for application of the prevailing wage requirements of the Davis-Bacon Act from $2,000 to $100,000 for Federal or District of Columbia contracts within the geographical limits of the 48 contiguous States. Prohibits artificially splitting contracts above the $100,000 threshold into contracts smaller than $100,000 for the purpose of evading such Act. (Sec. 1007) Permits the use of funds under the Department of Labor Appropriations Act, 1994 to implement or administer certain regulations pertaining to utilization of helpers on Federal construction projects subject to the Davis-Bacon Act. (Sec. 1008) Amends the National Foundation on the Arts and the Humanities Act of 1965 to phase-in through FY 1998 a ten percent reduction in Federal funding for the National Endowments for the Arts and the Humanities. Requires a phase-in of eight percent funding reductions for the Smithsonian Institution, the National Gallery of Art, and Corporation for Public Broadcasting. (Sec. 1009) Places a one-year moratorium on construction of new Federal buildings and agency leasing of building space, except construction of buildings primarily used for education, and certain pending projects. Rescinds a specified amount of FY 1994 obligational authority from the Federal Buildings Fund for new construction and acquisitions. (Sec. 1010) Makes specified rescissions of FY 1994 funding for: (1) the Appalachian Regional Commission; (2) the Legal Services Corporation; (3) community development block grant programs; (4) the Tennessee Valley Authority; (5) public housing; (6) the Economic Development Administration; (7) the International Developmental Association (IDA); (8) the International Bank for Reconstruction and Development; and (9) United Nations (UN) peacekeeping. (Sec. 1012) Amends the Housing and Community Development Act of 1974 to reauthorize at slightly increased levels and extend through FY 1998 the community development grant program for States, local governments, and Indian tribes. (Sec. 1014) Replaces programs providing Federal assistance for the construction of new non-Indian-related public housing with a tenant-based voucher assistance program. (Sec. 1016) Expands the program which assists Federal employees permanently disabled on the job in order to help them find new employment. Authorizes the Secretary of Labor to expand the Federal Employees' Compensation Act Periodic Roll Management Projects to all offices of the Department of Labor's Office of Workers' Compensation Program. Amends the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1994 to impose limitations on the availability of funding for the IDA in FY 1994 and 1995. (Sec. 1018) Amends the National Energy Conservation Policy Act to allow the use of any cogeneration process for other than federally owned buildings or other federally owned facilities when entering into contracts for achieving energy savings at Federal agencies. (Sec. 1019) Amends the National Housing Act to revise mortgage refinancing provisions to authorize the Secretary of the Department of Housing and Urban Development (HUD) to use amounts recaptured under such provisions for the refinancing incentives and costs payments authorized under them. Subtitle B: Reducing the Size of Government - Alaska Power Administration Sale Authorization Act - Authorizes the Secretary of Energy, in accordance with specified purchase agreements, to sell: (1) the Snettisham Hydroelectric Project to Alaska; and (2) the Eklutna Hydroelectric Project to the Anchorage Municipal Light and Power, the Chugach Electric Association, Inc., and the Matanuska Electric Association, Inc. (Sec. 1101) Directs the Secretary to: (1) close out the Alaska Power Administration; (2) report to the Congress on the sales; and (3) return to the Treasury unused balances of funds appropriated for the Alaska Power Administration. Repeals specified Federal law concerning water resources investigations in Alaska by the Secretary of the Interior. (Sec. 1102) Rescinds a specified amount of funds available for the National Oceanic and Atmospheric Administration fleet for research. (Sec. 1103) Directs the Secretary of Veterans Affairs to phase-out and close certain Department of Veterans Affairs supply depots in New Jersey, Illinois, and California and transfer funding back to the Treasury. (Sec. 1104) Repeals the State Justice Institute Act of 1984, thereby terminating the State Justice Institute. Rescinds half the FY 1994 appropriations for salaries and expenses of the State Justice Institute. (Sec. 1105) Eliminates the National Small Business Tree Planting Program. (Sec. 1106) Amends Federal law to: (1) permit DOD to contract for certain non-core functions such as data processing, billing, and payroll; (2) authorize appropriations out of a special fund credited with a portion of the delinquent debts collected in order to improve debt collection activities; (3) allow the U.S. Customs Service to utilize private debt collection companies; (4) subject the Internal Revenue Service, the Social Security Administration, and the U.S. Customs Service to statutorily prescribed debt collection reporting requirements; and (5) repeal requirements pertaining to Department of Justice contracting for private legal services in connection with indebtedness cases. Subtitle C: Eliminating Government Printing Monopoly - Government Information Dissemination and Printing Improvement Act of 1994 - Transfers the position of Superintendent of Documents (SD) and all its functions to the Library of Congress, to be carried out by an official of the same title under the direction of the Librarian of Congress. (Sec. 1202) Revokes all existing authorized printing plant charters. (Sec. 1203) Requires all Government publications to be available for use throughout the Government. (Sec. 1204) Requires each department, agency, and other entity of the Government to: (1) establish a comprehensive inventory of its publications; (2) make it available via the electronic directory; and (3) furnish its publications to the SD. (Sec. 1205) Imposes additional specified responsibilities on the: (1) Public Printer with respect to the executive and judicial branches; and (2) SD with respect to dissemination of Government publications. (Sec. 1206) Requires the head of a Government department, agency, or entity to furnish any of its publications to the SD. (Sec. 1207) Requires the SD to make Government publications available to designated depository libraries and State libraries. Title II: Streamlining The Federal Bureaucracy - Subtitle A: Department of Agriculture Reorganization - Directs the Secretary of Agriculture to: (1) consolidate field, regional, and national offices within the Department of Agriculture; and (2) reduce personnel in order to achieve a specified expenditure reduction by FY 2000. Subtitle B: Procurement Streamlining - Replaces armed forces provisions giving preference to nondevelopmental items in supply procurements with provisions for the acquisition of commercial items (property regularly used by the general public or non-governmental entities for non-governmental purposes) in equipment or supply procurements. Authorizes the Secretary of Defense to develop and acquire non-commercial equipment or supplies only if no commercial items are available. Makes cost accounting standards under the Office of Federal Procurement Policy Act (OFPPA) inapplicable to acquisitions of commercial items. (Sec. 2052) Amends the Federal Property and Administrative Services Act of 1949 (FPASA) to make similar changes with respect to civilian agency acquisitions. (Sec. 2061) Amends OFPPA to raise the small purchase threshold (renamed the simplified acquisition threshold (SAT)) to $100,000. Makes the same change with regard to armed services acquisitions, except with regard to the contingency operation exception for certain contracts and purchases. Extends the new threshold under OFPPA to FPASA. (Sec. 2066) Requires simplified procedures under the Federal Acquisition Regulation (FAR) for SAT acquisitions. (Sec. 2068) Amends OFPPA and the Small Business Act to: (1) repeal references to "the small purchase threshold" and continue existing notice thresholds for procurements over $25,000 (except that the requirement to allow 30 days for bid and proposal submission would apply only to contracts or orders in excess of SAT); and (2) prescribe additional contents for notices with respect to contracts between $25,000 and $100,000. (Sec. 2071) Exempts: (1) subject agency (National Aeronautics and Space Administration, Coast Guard, DOD, and respective military departments) contracts below SAT from contingent fee certifications, prohibitions on limiting subcontractor direct sales and doing business with certain contractors, and requirements for audits, supplier and supply source identification, and use of U.S. vessels for supply transportation; (2) civilian agency contracts below SAT from similar requirements with regard to subcontractor direct sales; (3) prime contracts below SAT from procedural and other requirements of the Anti-Kickback Act of 1986; and (4) contracts below SAT from the Miller Act (MA), the Contract Work Hours and Safety Standards Act, Service Contract Act of 1965, and Drug-Free Workplace Act of 1988, requirements regarding certain disabled veterans, and specified requirements under the Rehabilitation Act of 1973, Buy American Act, and Davis-Bacon Act. Requires the FAR to provide various alternative payment protections, including payment bonds, for suppliers of labor and materials on certain contracts under MA. (Sec. 2081) Requires the Federal Acquisition Regulatory Council to review the FAR to identify and amend regulations applicable to acquisitions below SAT. Requires agency heads to take similar action with respect to applicable supplemental regulations, policies, and procedures. Subtitle C: Other Streamlining Reforms - Amends the Copeland Act to require employers on contracts covered by the Davis-Bacon Act to certify compliance with applicable labor law standards at least once monthly, instead of weekly, to the Department of Labor. (Sec. 2102) Consolidates into the Block Grants to States for Social Services program under title XX of the Social Security Act (SSA) various social services programs under the Community Services Block Grant Act, the Child Care and Development Block Grant Act of 1990, titles III (Grants for State and Community Programs on Aging) and VII (Nutrition Program for the Elderly) of the Older Americans Act of 1965, the State Dependent Care Development Grants Act, and the SSA title IV part A (Aid to Families With Dependent Children) program for at-risk children. (Sec. 2103) Amends SSA title XVIII (Medicare) to revise the contractor system under Medicare, including eliminating the Railroad Retirement Board's authority to contract for processing the Medicare claims of railroad retirees, in order to provide for increased flexibility in contracting for Medicare claims processing. (Sec. 2104) Amends SSA title II (Old Age, Survivors and Disability Insurance) to restructure the current program for death information exchange: (1) to use, for example, a Federal Clearinghouse on Death Information as the vehicle for all such exchanges; and (2) in the case of individuals with respect to whom federally funded benefits are provided by (or through) a Federal or State agency other than under SSA, to require such agency to pay a set fee to cover all costs connected with the provision of such information for them. Ends the exemption from Internal Revenue Code requirements for Social Security Administration sharing of State collected death information with Federal, State, and local agencies granted to two States under the Omnibus Budget Reconciliation Act of 1993. (Sec. 2105) Amends SSA title II to earmark specified levels of administrative funding for continuing disability reviews of disabled beneficiaries. (Sec. 2106) Amends SSA title XI to authorize the Secretary of Veterans Affairs (VA) to use the Medicare and Medicaid Coverage Data Bank (renamed the Health Care Coverage Data Bank) to determine whether veterans receiving VA health care benefits have private insurance. (Sec. 2107) Amends the Housing and Community Development Amendments of 1978 to revise requirements for the management and disposition of Department of Housing and Urban Development (HUD)-held multifamily properties and mortgages. Title III: Improving Government Performance and Accountability - Requires that all authorization and appropriation legislation contain performance goals for any programs they fund. Provides for waivers from such requirement under certain conditions. (Sec. 3002) Amends Federal civil service law to: (1) link Federal within-grade pay increases to job performance; (2) provide for the modification of reduction-in-force (RIF) regulations to give an employee's efficiency or performance rating greater weight than tenure of employment and length of service during a RIF. (Sec. 3003) Requires the Federal Accounting Standards Advisory Board to recommend comprehensive and uniform Federal accounting and financial standards to the Congress and the President. (Sec. 3005) Revises current law regarding annual agency financial statements and agency audits, with changes requiring audited statements covering all accounts and associated activities of each office, bureau, and activity of the concerned agency. (Sec. 3006) Amends the Federal Employees' Compensation Act (FECA) to: (1) make it a felony to lie on FECA benefit applications; (2) bar from FECA program participation those individuals convicted of defrauding it; and (3) generally cut off FECA benefits to individuals in correctional facilities who have been convicted of a felony. (Sec. 3007) Allows Federal agencies to reduce employees or positions below mandated personnel levels. Title IV: Improving the Legislative Process - Amends the Congressional Budget and Impoundment Control Act of 1974 to require that each line-item in an appropriations bill and each tax expenditure in a revenue bill be enrolled as a separate bill to be presented to the President (effectively giving the President line-item veto authority over such measures while ensuring that the override provisions of the U.S. Constitution apply). (Sec. 4002) Amends rule XVI of the Standing Rules of the Senate to allow a point of order against reception or consideration of any appropriations bill or amendment containing a provision that has not been previously authorized by law within the preceding five years. (Sec. 4003) Amends the Congressional Budget Act of 1974 to make congressional consideration of emergency legislation subject to the same budgetary points of order and super-majority waiver requirements as other legislation. Title V: Enforcement - Provides that none of the changes in direct spending and receipts resulting from this Act shall be reflected in OMB estimates under the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act). Directs the Director of OMB, upon enactment of this Act, to make specified downward adjustments in discretionary spending limits under the Congressional Budget Act of 1974 for FY 1994 through 1999. Makes specified reductions in budget outlays and authority for the House and Senate Committees on Appropriations under the Congressional Budget Act of 1974. Authorizes and directs each Committee on Appropriations to adjust its suballocations among its subcommittees for FY 1994 to reflect the lower allocations provided above. Amends the Congressional Budget Act of 1974 and the Gramm-Rudman-Hollings Act to provide for the establishment of a defense firewall through FY 1998.
United States · United States Congress · 9 February 1994
Delays the effective date for imposition of penalties upon States that do not have in effect safety belt and motorcycle helmet traffic safety programs. Exempts a State from certain penalties for failing to meet requirements relating to motorcycle helmet laws if the State has in effect a motorcycle safety program.
United States · United States Congress · 7 February 1994
Expresses the sense of the Congress that a postage stamp should be issued to honor the 100th anniversary of the Jewish War Veterans of the United States and that the Citizens' Stamp Advisory Committee of the U.S. Postal Service should make such recommendation to the Postmaster General.
United States · United States Congress · 27 January 1994
TABLE OF CONTENTS: Title I: Portable and Permanent Private Health Insurance Subtitle A: Portability Subtitle B: Permanence Title II: Expansion of Health Care Choices Subtitle A: Employer-Provided Health Insurance Subtitle B: Medical Savings Accounts Title III: Equal Tax Treatment for Health Insurance of Self-Employed and Uninsured Title IV: Small Business Health Insurance Pools Title V: Assistance to Individuals With Preexisting Conditions in Purchasing Health Insurance Title VI: Encourage Responsible Behavior by the Financially Capable Title VII: Assistance to Low-Income Workers to Purchase Health Insurance Title VIII: Reward Preventive Medicine and Healthy Lifestyles Title IX: Reform Medicaid and Expand Choices Under Medicare Subtitle A: Medicaid Subtitle B: Medicare Title X: Enhanced Efficiency Through Paperwork Reduction Title XI: Meaningful Medical Liability Reform Title XII: Antitrust Reforms Title XIII: Expenditure Targets for the Medicaid and Medicare Programs Comprehensive Family Health Access and Savings Act - Title I: Portable and Permanent Private Insurance - Subtitle A: Portability - Amends the Internal Revenue Code to modify required continuation coverage of group health plans by allowing the offering of annual deductibles for such coverage. Terminates such continuation coverage after an individual is eligible for employer-based coverage for more than 90 days. (Sec. 102) Allows penalty-free withdrawals from qualified retirement plans to pay for health insurance during a continuation period. Subtitle B: Permanence - Prohibits an insurer from cancelling an individual or group health insurance plan or denying renewal of coverage except for specified reasons. Prohibits an employer from cancelling a self-insured group health plan or denying renewal of coverage except for similar reasons. (Sec. 112) Requires individual health insurance plans and group health plans to offer insureds the option to purchase new health insurance plans after enactment of this Act. Title II: Expansion of Health Care Choices - Subtitle A: Employer-Provided Health Insurance - Requires an employer-provided health insurance package to include one of the following options: (1) the health insurance coverage provided by the employer on the date of enactment of this Act; (2) coverage in a health maintenance organization, managed care arrangement, or preferred provider organization; or (3) a medical savings account. Subtitle B: Medical Savings Account - Allows a deduction from gross income for medical expenses attributable to coverage under a catastrophic health insurance plan. (Sec. 212) Allows individuals a tax deduction for contributions made to a medical care savings account established for the benefit of an eligible individual or such individual's spouse and dependents. 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 and for prohibited transactions. Title III: Equal Tax Treatment for Health Insurance of Self-Employed and Uninsured - Allows as an exclusion from gross income such self-employed health insurance costs as do not exceed the national per employee average of the employer-provided contribution excluded from gross income. Excludes certain health insurance costs from employment taxes. Title IV: Small Business Health Insurance Pools - Prohibits: (1) State restrictions on groups purchasing health insurance; (2) State benefit mandates for group health plans; and (3) for five years following enactment, specified State restrictions on managed care. Title V: Assistance to Individuals with Preexisting Conditions in Purchasing Health Insurance - Requires the Secretary to establish and administer a program providing allotments to States for the establishment of State-wide insurance risk pools to provide health insurance coverage to individuals with preexisting conditions. Authorizes appropriations. Title VI: Encourage Responsible Behavior by the Financially Capable - Prohibits any family with an income exceeding 200 percent of the poverty line or who is eligible for a catastrophic health insurance plan as defined in title VII of this Act, but who fails to purchase a plan providing such coverage within one year of enactment from being eligible for the insurance pool program under title V of this Act. Title VII: Assistance to Low-Income Workers to Purchase Insurance - Amends the Internal Revenue Code to allow a refundable tax credit for the cost of premiums for a catastrophic health insurance plan based upon family income and size. Allows the advance payment of such credit. Disallows the use of such credit amount as a medical expense deduction. (Sec. 702) Allows the collection of unpaid debts for medical expenses from individuals who are eligible for such credit but fail to claim it. Title VIII: Reward Preventive Medicine and Healthy Lifestyles - Provides that in the case of any health insurance plan, no provision of State or local law shall apply that restricts the reduction of premiums or the allowance of incentives with respect to such plans for individuals who pursue healthy lifestyles. Title IX: Reform Medicaid and Expand Choices Under Medicare - Subtitle A: Medicaid - Amends title XIX (Medicaid) of the Social Security Act to place a specified formula cap on the Federal payment made each year to a State for furnishing medical assistance to eligible individuals. (Sec. 902) Provides for waivers from Medicaid requirements in order for States to establish innovative and cost-effective programs for furnishing medical assistance to eligible individuals. Subtitle B: Medicare - Amends title XVIII (Medicare) of the Social Security Act to allow an individual to elect health care coverage through either a private health care arrangement or an eligible organization within one year after becoming entitled to benefits under Medicare part A (Hospital Insurance) or forgoing an employer health benefit plan. Details the election process for current Medicare part A beneficiaries. Provides for payments under Medicare to individuals enrolled with such arrangements or organizations, including additional amounts from the Medicare trust funds for individuals enrolled with such arrangements. Title X: Enhanced Efficiency Through Paperwork Reduction - Directs the Secretary of Health and Human Services to adopt standards to reduce the administrative and paperwork burdens of all Federal health care programs by 50 percent within the two-year period following the date of this Act's enactment (initial reduction), and by an additional 50 percent reduction over a subsequent three-year period (subsequent reduction), for a total reduction of 75 percent over the five-year period following such date. Requires the Secretary, to achieve the initial reduction, to adopt standards for Federal health care programs relating to: (1) data elements for use in paper and electronic claims processing under health insurance plans, as well as for use in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements, including protections to assure the confidentiality of patient-specific information and to protect against the unauthorized use and disclosure of information. Directs the Secretary, to achieve the subsequent reduction, to modify by regulation the standards adopted with respect to the initial reduction. Specifies that such modification may include such recommendations as reported by the Standardized Form Commission or any other provisions necessary to meet the goals for reduction in the paperwork burden of Federal health care programs. (Sec. 1002) Requires each State, to be eligible for Federal funds in connection with any State-administered health care program, to standardize the processing of paper and electronic claims to reduce the administrative and paperwork burdens on such programs by 75 percent during the five-year period following enactment of this Act. Sets forth provisions regarding enforcement of this provision and waivers of payment reductions for noncompliance. (Sec. 1003) Directs the Secretary to: (1) establish a Standardized Forms Commission to make recommendations on the standardization of paper and electronic claims processing to reduce the paperwork burden and enhance the efficiency and productivity of claims processing; and (2) submit recommendations to the Congress in the form of an implementing bill. Sets forth procedures for congressional consideration of such bill. Makes a health care provider or insurer that fails to comply with any enacted recommendations of the Commission ineligible for payments of claims submitted under any provision of the Social Security Act or the Public Health Service Act. Title XI: Meaningful Medical Liability Reform - Makes this title applicable with respect to any medical malpractice liability claim or action (such action) brought in State or Federal court, except with respect to certain claims or actions for damages arising from a vaccine-related injury or death. Sets forth provisions regarding: (1) preemption; (2) negotiated liability; (3) effect on sovereign immunity and choice of law or venue; and (4) jurisdiction. (Sec. 1102) Prohibits such action from being initiated after the expiration of: (1) the two-year period that begins on the latter of the date the alleged injury that is the subject of the claim was discovered or the date the injury should reasonably have been discovered; and (2) the four-year period that begins on the date on which the alleged injury occurred. Makes an exception for a minor who has not attained age six. (Sec. 1103) Provides that: (1) the liability of each defendant in such action, with respect to economic and noneconomic damages, shall be several only and not joint; (2) such a defendant shall be liable only for the amount of damages allocated to the defendant in direct proportion to such defendant's percentage of fault or responsibility for the injury; and (3) the trier of fact shall determine and assign a percentage of responsibility for each such defendant. (Sec. 1104) Requires: (1) all requests for discovery pursuant to such action to identify the relevant portion of the complaint, answer, or other pleading to which responses to the discovery requests are expected to relate; and (2) the court, with respect to any motion for an order compelling discovery, to award the prevailing party reasonable fees and expenses incurred in bringing or defending against the motion, including reasonable attorney fees, unless the court finds that the position of the unsuccessful party with substantially justified or that special circumstances make such an award unjust. (Sec. 1105) Limits the total amount of noneconomic damages that may be awarded to a claimant and family members to $250,000, regardless of the number of parties against whom the action is brought or the number of actions brought with respect to the injury. (Sec. 1106) Specifies that a defendant may not be required to pay damages awarded for any economic losses to be incurred after the date on which the judgment is entered exceeding $100,000, in a single, lump-sum payment, but shall be permitted to make such payments periodically based on projections of the amount of damages expected to be incurred by the claimant at appropriate intervals, as determined by the court. Permits the court to require that a defendant purchase an annuity or fund a reversionary trust to make periodic payments if the court determines that a reasonable basis exists for concluding that the defendant may be unable or otherwise fail to make the required periodic payments. Specifies that a court judgment awarding such payments may not be reopened at any time to contest, amend, or modify the schedule or amount of the payments in the absence of fraud or any other basis under which a party may obtain relief from a final judgment. (Sec. 1107) Sets forth provisions regarding costs and fees, including limitations on attorneys charging or collecting contingency fees. Establishes recordkeeping requirements as a prerequisite to the receipt of an award of attorney fees. (Sec. 1108) Sets forth provisions regarding: (1) contribution and indemnification; and (2) collateral sources. (Sec. 1110) Prohibits the award of noneconomic damages with respect to any medical product liability claim alleged against a medical product producer if: (1) the drug or device that is the subject of such claim was subject to specified approval or premarket approval under the Federal Food, Drug, and Cosmetic Act by the Food and Drug Administration (FDA); or (2) the drug or device is generally recognized as safe and effective pursuant to conditions established by the FDA and applicable regulations, including packaging and labeling regulations. Makes exceptions in cases of withheld information, misrepresentation, or illegal payment of FDA officials to secure approval. (Sec. 1111) Provides that, in any medical malpractice liability action that is certified as a class action: (1) the share of damages under any final judgment or settlement that is awarded to any party serving as a representative claimant shall be calculated in the same manner as the shares awarded to all other members of the claimant class (but permits the award of reasonable compensation, costs, and expenses relating to the representation of the class); (2) if a party is represented by an attorney who has a beneficial interest in the subject of the litigation, the court shall make a determination of whether such interest constitutes a conflict of interest sufficient to disqualify the attorney; and (3) an attorney may not represent the class if the attorney has paid, or is obligated to pay, a fee to a third party who assisted the attorney in obtaining the representation of any party to the action (and bars an attorney who knowingly violates this provision from representing the party in such action or any action to which this title applies). Title XII: Antitrust Reforms - 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: (1) the identities of the parties to the venture; (2) the nature, objectives, and planned activities of the venture; and (3) 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. (Sec. 1203) 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. Title XIII: Expenditure Targets for the Medicaid and Medicare Programs - Requires the Director of the Office of Management and Budget, not later than 30 days after the end of each fiscal year beginning with FY 1995, to determine the amount of "medicaid excess expenditures" and "medicare excess expenditures" for such fiscal year. Defines such terms for a fiscal year as the amount by which the Federal expenditures under each such program for such fiscal year exceed the target expenditures for each such program. Sets formulas for determining the target expenditures. (Sec. 1302) Provides that if the Director determines that there are Medicaid or Medicare excess expenditures for a fiscal year, specified categories of health insurance benefits (including certain tax credits and exclusions and assistance to individuals with preexisting conditions in purchasing health insurance) that are effective in the applicable taxable or calendar year beginning after such fiscal year may be delayed until the following year. Makes such provision applicable only to so many of such categories in the order in which such categories are listed such that the savings resulting from such delay at least equal the costs of the Medicaid and Medicare excess expenditures.
United States · United States Congress · 27 January 1994
Amends the Omnibus Budget Reconciliation Act of 1993 to provide that the initial month for which a cost of living increase in retired pay that becomes effective on December 1 of 1993 through 1995 is payable shall be March of the following year.
United States · United States Congress · 22 November 1993
Sets limits on the total number of full-time equivalent executive agency positions in FY 1994 through 1999. Directs the Office of Management and Budget to monitor agency compliance with such employment limit and notify the Congress and President of any noncompliance, in which case future hiring for the agency in question shall be suspended. Provides for waivers from the requirements of this Act under certain conditions.
United States · United States Congress · 20 November 1993
Youth Development Block Grant Act of 1993 - Establishes a youth development block grant program. Authorizes appropriations. Sets forth formulas for allocation of funds to States and for distribution of funds through State commissions to local boards for community-based youth development services. Requires establishment of county or multicounty Local Youth Development Boards to receive such assistance. Requires establishment of a State Youth Development Commission in each State desiring to receive such assistance. Establishes a National Youth Development Commission to advise the Assistant Secretary for Children and Families of the Department of Health and Human Services on implementation of this Act.
United States · United States Congress · 20 November 1993
TABLE OF CONTENTS: Title I: Tax and Insurance Provisions Subtitle A: Tax Treatment of Health Care Expenses Subtitle B: Insurance Provisions Subtitle C: Employer Provisions Subtitle D: Federal Preemption Subtitle E: Report Title II: Medicare and Medicaid Reforms Subtitle A: Medicare Subtitle B: Medicaid Title III: Health Care Liability Reform Title IV: Administrative Cost Savings Subtitle A: Standardization of Claims Processing Subtitle B: Electronic Medical Data Standards Subtitle C: Development and Distribution of Comparative Value Information Subtitle D: Preemption of State Quill Pen Laws Title V: Anti-Fraud Subtitle A: Criminal Prosecution of Health Care Fraud Subtitle B: Coordination of Health Care Anti-Fraud and Abuse Activities Title VI: Antitrust Provisions Title VII: Long-Term Care Consumer Choice Health Security Act of 1994 - Title I: Tax and Insurance Provisions - Subtitle A: Tax Treatment of Health Care Expenses - Amends the Internal Revenue Code to allow a tax credit for health care expenses based upon percentages of qualified health insurance premiums and adjusted gross income. Provides advance payments of such credit by employers. (Sec. 102) Allows individuals a tax credit for a percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Exempts such accounts from taxation. Establishes an excise tax for excess contributions to medical care savings accounts and makes such accounts subject to the tax on prohibited transactions. (Sec. 103) Terminates the medical expense deduction and the exclusion for employer-provided health insurance. Subtitle B: Insurance Provisions - Part I: Federally Qualified Health Insurance Plans - Sets forth requirements for federally qualified health insurance plans, including coverage for acute medical care, cost-sharing, premium rating practices, and guaranteed issuance and renewability. Part II: Certification of Federally Qualified Health Insurance Plans - Requires States to meet standards for regulatory programs for the certification of federally qualified health insurance plans. Subtitle C: Employer Provisions - Requires employers to: (1) withhold health insurance premiums from employee wages and remit such premiums to the employee's chosen insurer; and (2) notify employees of their right to claim an advance refundable tax credit for such premiums. (Sec. 122) Provides for the conversion and continuation of existing insurance plans to required coverage under this Act. (Sec. 125) Establishes the Benefits Cash Out Commission to propose a procedure under which individuals may cash out Federal health benefits. Provides for congressional consideration of such proposal prior to its implementation. (Sec. 126) Imposes excise taxes on employers and health insurance carriers for noncompliance with this Act. Subtitle D: Federal Preemption - Preempts specified State laws concerning health insurance. Subtitle E: Report - Requires the Secretary of Health and Human Services to report to the Congress five years after the enactment of this Act on certain aspects of health insurance coverage. Title II: Medicare and Medicaid Reforms - Subtitle A: Medicare - Directs the Secretary to report to the Congress on the feasibility of allowing future Medicare beneficiaries to elect to receive certificates with which to purchase private health insurance coverage instead of receiving Medicare benefits. (Sec. 202) Eliminates disproportionate share hospital payments under Medicare. (Sec. 203) Provides for a reduction in the adjustment for indirect medical education costs under Medicare. (Sec. 204) Imposes copayments for laboratory services, certain home health visits, and skilled nursing facility services provided under Medicare. (Sec. 207) Moves payment updates to January for all payment rates under Medicare's hospital insurance program. (Sec. 208) Accelerates the transition to prospective rates for facility costs in hospital outpatient departments. Subtitle B: Medicaid - Places a cap on Federal payments for acute medical services furnished under a State's Medicaid program. (Sec. 212) Provides for waivers from Medicaid requirements in order to establish acute medical services programs. (Sec. 213) Terminates disproportionate share hospital payments under Medicaid. (Sec. 214) Directs the Secretary to provide grants to States for programs to provide health insurance coverage, acute medical services, preventive care, and disease prevention services to low-income individuals. Title III: Health Care Liability Reform - Health Care Liability Reform Act of 1994 - Limits payments, damages, and attorney's fees in health care malpractice actions and claims. (Sec. 304) Declares that a manufacturer or seller of a health care product shall not be strictly liable for injury from: (1) a defect in the design of the product; or (2) a failure to warn or instruct regarding a risk posed by the product that was not known or reasonably knowable. (Sec. 305) Limits the amount of noneconomic damages that may be awarded in a health care malpractice claim or a health care product liability claim. Allows several liability for noneconomic loss and for punitive damages. (Sec. 306) Allows punitive damages to be awarded only if the claimant establishes that the harm suffered was the result of conduct manifesting conscious, flagrant indifference to the health of those harmed by the product. Disallows punitive damages against a product approved by the Food and Drug Administration. Title IV: Administrative Cost Savings - Subtitle A: 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. 402) 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. 403) 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. Subtitle B: 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. 412) 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. 413) 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 standards. (Sec. 414) Sets forth limitations on data requirements where standards with respect to data elements are in effect. (Sec. 415) 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. Subtitle C: 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. 422) 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. 423) 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. Subtitle D: Preemption of State Quill Pen Laws - Specifies that, effective January 1, 1996, 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. Title V: Anti-Fraud - Subtitle A: Criminal Prosecution of Health Care Fraud - Amends the Federal criminal code to impose penalties upon a health care provider that knowingly engages in any scheme or artifice to defraud a person in connection with the provision of health care. (Sec. 502) Authorizes the Attorney General to pay a reward of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution for health care fraud, with exceptions. Subtitle B: Coordination of Health Care Anti-Fraud and Abuse Activities - Amends the Social Security Act to provide for: (1) the application of Federal health anti-fraud and abuse sanctions to all fraud and abuse against any health insurance plan; and (2) treble damages for making or causing to be made false statements or representatives involving Medicare or State health care programs, for illegal remuneration, and for false statements or representatives with respect to the condition or operation of health care institutions. Directs the Secretary of Health and Human Services, in consultation with State and local health care officials, to: (1) identify opportunities for the satisfaction of community service obligations that a court may impose upon the conviction of a criminal offense involving Medicare or State health care programs; and (2) make information concerning such opportunities available to Federal and State law enforcement officers and State and local health care officials. Title VI: Antitrust Provisions - Exempts from the antitrust laws specified "safe harbor" activities related to the provision of health care services. Sets forth provisions regarding the award of attorney's fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt. (Sec. 602) Lists as safe harbors specified: (1) activities relating to health care services of combinations of health care providers with market share below a specified threshold; (2) activities of medical self-regulatory entities relating to standard setting or enforcement activities not conducted for purposes of financial gain; (3) participation of a health care provider in a written survey of the prices of services, reimbursement levels, or the compensation and benefits of employees and personnel; (4) activities relating to health care joint ventures for high technology and costly equipment and services; (5) activities relating to hospital mergers; (6) joint purchasing arrangements; and (7) negotiations. (Sec. 603) Directs the Attorney General to publish a notice in the Federal Register soliciting proposals for additional safe harbors and to review and report to the Congress on proposed safe harbors. Sets forth criteria in establishing safe harbors, including: (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. (Sec. 604) Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates. Sets forth provisions regarding applications for, revocation of, and review of determinations regarding such certificates. Limits the disclosure of information. (Sec. 605) Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. (Sec. 606) Directs the Attorney General to: (1) review the safe harbors and certificates of review periodically and (2) promulgate such rules, regulations, and guidelines as necessary to carry out provisions of this title. Title VII: Long-Term Care - Amends the Internal Revenue Code to exclude from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangements to pay long-term care premiums. (Sec. 702) 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. 703) Provides for the exclusion as a death benefit of any amount paid or advanced to an individual under a life insurance contract because such individual is terminally ill or chronically and has been permanently confined to ill and qualified facility.
United States · United States Congress · 19 November 1993
TABLE OF CONTENTS: Title I: Eligible Shareholders of S Corporation Subtitle A: Number of Shareholders Subtitle B: Persons Allowed as Shareholders Subtitle C: Other Provisions Title II: Qualification and Eligibility Requirements for S Corporations Subtitle A: One Class of Stock Subtitle B: Elections and Terminations Subtitle C: Other Provisions Title III: Taxation of S Corporation Shareholders Title IV: Effective Date S Corporation Reform Act of 1993 - Title I: Eligible Shareholders of S Corporation - Subtitle A: Number of Shareholders - Amends the Internal Revenue Code to increase from 35 to 50 the maximum number of shareholders of an S corporation (small business corporation). Allows members of a family to be treated as one shareholder. Subtitle B: Persons Allowed as Shareholders - Allows the following entities to be shareholders of S corporations: (1) certain tax-exempt organizations; (2) financial institutions that do not use the reserve method of accounting for bad debts; (3) nonresident aliens; and (4) certain small business trusts. Subtitle C: Other Provisions - Extends the post-death qualification for certain trusts to be permitted as shareholders from 60 days to two years. Title II: Qualification and Eligibility Requirements for S Corporation - Subtitle A: Once Class of Stock - Allows an S corporation to issue qualified preferred stock. Permits financial institutions to hold safe harbor debt. Subtitle B: Elections and Terminations - Revises the rules on inadvertent terminations by certain trusts of the election to be an S corporation. Authorizes the Secretary of the Treasury to treat certain late elections as timely and to provide an automatic waiver procedure for certain inadvertent terminations. Expands the post-termination transition period until 120 days after a determination is made that the election had terminated in a prior year. Repeals excessive passive investment income as a termination event. Increases the tax imposed on such excessive income. Subtitle C: Other Provisions - Permits an S corporation to own more than 80 percent of another corporation's stock. Repeals the requirement that partnership rules apply for fringe benefit purposes (making C corporation rules applicable). Provides for the treatment of distributions during loss years. Provides a consent dividend for S corporation elections to by-pass amounts in the accumulated adjustments account when making distributions. Eliminates the need to keep records of certain generally small amounts of earnings arising before 1983. Allows S corporations to make charitable contributions of inventory and scientific property. Title III: Taxation of S Corporation Shareholders - Treats losses on liquidations of S corporations as ordinary to the extent the loss created by ordinary income pass-through triggered the liquidation. Title IV: Effective Date - Makes this Act effective after December 31, 1993.
United States · United States Congress · 19 November 1993
Amends title XI of the Social Security Act to delay the penalty for failure of employers to file certain reports with respect to the Medicare and Medicaid Coverage Data Bank.
United States · United States Congress · 19 November 1993
Equitable Escheatment Act of 1993 - Amends specified Federal law to prescribe guidelines under which unclaimed distributions of security interests shall be subject to the custodial taking (escheatment) by the State which contains the principal executive offices of either the issuer or the holder of those securities.
United States · United States Congress · 19 November 1993
Expresses the sense of the Senate that: (1) obstetrician-gynecologists should be included as primary care providers for women in Federal laws relating to the provision of health care; and (2) legislative proposals that define primary care should include primary care services performed by obstetrician-gynecologists in such definition.
United States · United States Congress · 18 November 1993
Spending Reduction Enforcement Act of 1993 - Establishes the Spending Reduction Commission to propose cost savings and changes in law to achieve at least $65 billion of budget outlay reductions for the budget year and each outyear until a balanced budget is reached. Sets forth the procedure for implementation of the Commission's recommendations by the Office of Management and Budget, the President, and the Congress. Makes budget outlay reductions permanent. Establishes sequester provisions if the full amount of savings required by this Act is not achieved in a session of the Congress.
United States · United States Congress · 10 November 1993
Health Care Antitrust Improvements Act of 1993 - Exempts from the antitrust laws specified "safe harbor" activities listed in, or designated by the Attorney General pursuant to, this Act. Sets forth provisions regarding the award of attorney's fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt. Lists as safe harbors specified: (1) activities relating to health care services of combinations of health care providers with market share below a specified threshold; (2) activities of medical self-regulatory entities relating to standard setting or enforcement activities not conducted for purposes of financial gain; (3) participation of a health care provider in a written survey of the prices of services, reimbursement levels, or the compensation and benefits of employees and personnel; (4) activities relating to health care joint ventures for high technology and costly equipment and services; (5) activities relating to hospital mergers; (6) joint purchasing arrangements; and (7) negotiations. Directs the Attorney General to publish a notice in the Federal Register soliciting proposals for additional safe harbors. Sets forth criteria in establishing safe harbors, including: (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates. Sets forth procedures regarding applications for, revocation of, and review of determinations regarding, such certificates. Limits the disclosure of information. Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. Directs the Attorney General to periodically review the safe harbors and certificates of review. Establishes within the Department of Health and Human Services an Office of Health Care Competition Policy.
United States · United States Congress · 28 October 1993
TABLE OF CONTENTS: Title I: Reorganization and Reform of the Defense Acquisition System Subtitle A: Streamlining and Improvement of Acquisition Management Subtitle B: Transfer of Functions Title II: Acquisition Management Policies Title III: Contract Formation and Administration Subtitle A: Performance Based Contracting Subtitle B: Efficient Contracting Process Subtitle C: Procurement Protests Subtitle D: Other Matters Title IV: Conforming Amendments Title V: Effective Dates Department of Defense Acquisition Management Reform Act of 1993 - Title I: Reorganization and Reform of the Defense Acquisition System - Subtitle A: Streamlining and Improvement of Acquisition Management - Revises the duties of the Under Secretary of Defense for Acquisition to include planning, programming, overseeing, prescribing policies for, and assisting in the preparation and integration of budgets for research, development, and acquisition policies of the Department of Defense (DOD). (Sec. 101) Establishes in DOD a Defense Research, Development, and Acquisition Agency (Agency). Requires the Agency Director to conduct all research, development, and acquisition (RDA) activities of DOD. Specifies current Under Secretary activities to be performed by the Agency. Requires the Director to select and evaluate acquisition program executive officers and managers. Requires the Agency's Chief of Engineering and Analysis to ensure that each DOD acquisition functional analytical capacity is the most advanced of its type. Requires the Secretaries of the Army, Navy, and Air Force to be responsible for the procurement of property and services within their departments and authorizes each to conduct such procurements only to the extent that the Secretary of Defense determines necessary to sustain their individual operations. (Sec. 102) Directs the Secretary to provide a simplified acquisition program cycle that is results oriented and follows specified phases, with phase funding provided. Requires the DOD acquisition program approval process to include one major decision point which shall occur before a program proceeds into product integration and development. (Sec. 103) Directs the Chairman of the Joint Chiefs of Staff to make recommendations to the Under Secretary regarding the desirability of joint development with foreign countries of proposed defense programs. Subtitle B: Transfer of Functions - Transfers to the: (1) Secretary all RDA functions of the Secretaries of the military departments; and (2) Agency specified defense procurement agencies, commands, and offices. Title II: Acquisition Management Policies - Provides as a DOD acquisition policy goal that, on and after January 1, 2000: (1) DOD should achieve, on average, 90 percent of the cost and schedule goals established for the RDA programs; and (2) the average time for converting an emerging technology into initial operational capability should not exceed eight years. Outlines procedures for the implementation of such goals. Urges the Secretary to expedite the implementation of specified Federal provisions relating to the defense acquisition workforce and requires the Secretary to review and enhance the incentives available for encouraging workforce excellence. Specifies the grades to be carried by acquisition program executive officers and managers. Authorizes the Secretary to base the pay rate of an acquisition employee on the employee's contribution to policy goals. Limits, with an exception for critical positions, the reassignment authority for program and deputy program managers. Title III: Contract Formation and Administration - Subtitle A: Performance Based Contracting - Requires the acquisition program executive officer to use an incentive type contract unless it would inhibit the achievement of acquisition performance goals. (Sec. 303) Authorizes the Secretary to establish a contractor certification system for property and services procured by DOD on a repetitive basis, providing for the termination of such certification due to poor quality of contractor performance. Requires the maintenance of a contractor performance data base. Subtitle B: Efficient Contracting Process - Provides simplified contracting and acquisition procedures for contracts not exceeding $100,000, allowing small business contracts to utilize such procedures if there are at least two small businesses competing. Requires certain notification of such procurement contracts not exceeding such amount. (Sec. 313) Allows the Secretary to develop and acquire noncommercial or nondevelopmental items only if no such items are available to meet requirements. Authorizes the Secretary to use flexible acquisition procedures to acquire commercial and nondevelopmental items. Makes cost accounting standards of the Office of Federal Procurement Policy Act inapplicable to the acquisition of commercial and nondevelopmental items. Requires the Secretary to use innovative procedures, techniques, and strategies in DOD acquisition programs. (Sec. 316) Expresses the sense of the Congress that the Defense Logistics Agency should be commended for its use of process-oriented contract administration services. Subtitle C: Procurement Protests - Provides for the debriefing by a defense agency employee of an unsuccessful offeror on a defense contract awarded by the agency on the basis of competitive proposals, as long as a written request for such debriefing is received within seven days after the contract award. Authorizes the Comptroller General, with respect to a contract solicitation or proposed award, to: (1) recommend that a Federal agency recompete a contract immediately; or (2) declare an appropriate party eligible for damages and costs for protest filing and bid and proposal preparation. Subtitle D: Other Matters - Directs the Administrator for Federal Procurement Policy to submit to the Congress proposed legislation concerning the unification of procurement laws applicable to DOD, the Coast Guard, and the National Aeronautics and Space Administration with those applicable to the other Federal agencies and departments. Title IV: Conforming Amendments - Repeals specified Federal provisions concerning the general authorities and responsibilities of the defense acquisition workforce. Makes conforming amendments with respect to the transfer of certain RDA functions made earlier under this Act. Title V: Effective Dates - Sets forth effective dates.
United States · United States Congress · 27 October 1993
Deficit Reduction Assurance Act of 1993 - Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to require the budget submitted for FY 1995, 1996, 1997, and 1998 to reduce discretionary spending limits by the amount of any reductions made in existing programs, projects, and activities during the previous fiscal year.
United States · United States Congress · 27 October 1993
Constitutional Amendment - Prohibits the Federal Government from requiring States or local governments to take any action that requires them to engage in additional or expanded activities or services, unless they receive from the Federal Government compensation equal to the net additional costs. Waives provisions of this Act during a fiscal emergency of up to 180 days that is declared in a joint resolution adopted by a two-thirds vote of each House of Congress and signed by the President.
United States · United States Congress · 21 October 1993
TABLE OF CONTENTS: Title I: Family Tax Credit Title II: Reducing the Cost of Capital by Reducing Capital Gains Tax Rates and Indexing the Basis of Certain Assets Title III: Neutral Cost Recovery Title IV: Increasing National Savings Through Individual Retirement Plus Accounts, Indexing for Inflation the Income Thresholds for Taxing Social Security Benefits, Etc. Title V: Cap on Federal Spending and Establishment of Commission to Reduce Federal Spending Title VI: Elimination of Social Security Earnings Test Family, Investment, Retirement, Savings, and Tax Fairness Act of 1993 - Title I: Family Tax Credit - Amends the Internal Revenue Code to allow individuals a tax credit of $500 multiplied by the number of qualifying children who have not attained age 18. Places limitations on such credit and adjusts it for inflation. Title II: Reducing the Cost of Capital by Reducing Capital Gains Tax Rates and Indexing the Basis of Certain Assets - 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. (Sec. 204) 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. (Sec. 205) Provides for indexing the limitation on capital losses of noncorporate taxpayers. Title III: Neutral Cost Recovery - Allows the depreciation deduction to be computed based on a neutral recovery basis for property placed in service after December 31, 1993. (Sec. 302) Establishes special depreciation rules applicable under the adjusted current earnings provisions of the minimum tax for 1994. Title IV: Increasing National Savings Through Individual Retirement Plus Accounts, Indexing for Inflation the Income Thresholds for Taxing Social Security Benefits, etc. - Allows individuals to establish individual retirement plus accounts with tax treatment similar to that for individual retirement plans. Makes contributions to such account nondeductible. Provides for qualified distributions from such accounts, other than for general retirement purposes, including special purpose distributions made for the purchase of a first home and for medical or educational purposes. Prohibits special purpose distributions from being made during the first five years of the account. (Sec. 402) Provides an inflation adjustment after 1996 for income thresholds in determining the taxation of social security benefits. Excludes income from individual retirement plans when determining modified adjusted gross income. (Sec. 403) Provides an inflation adjustment after 1996 for the maximum amount allowable as a deduction for retirement savings. Title V: Cap on Federal Spending and Establishment of Commission to Reduce Federal Spending - Establishes the Commission on Reduction of Federal Spending to: (1) recommend specific reductions in Federal activities to assure that spending does not grow at a rate in excess of two percent per year through FY 1998; and (2) report a bill to the Congress with changes necessary to achieve such reductions. (Sec. 504) Establishes an advisory council to assist the Commission. (Sec. 509) Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to set forth sequestration procedures when the increase in annual Federal spending exceeds the amount resulting from an annual rate of inflation of two percent. Title VI: Elimination of Social Security Earnings Test - Amends title II (Old Act, Survivors and Disability Insurance) of the Social Security Act to remove the limitation on the amount of outside income which beneficiaries who have attained retirement age may earn without incurring a reduction in benefits.
United States · United States Congress · 13 October 1993
Prohibits the U.S. Postal Service or the Attorney General from fining or otherwise penalizing any person who transmits by private express or other unlawful means, delivers to any agent thereof, or deposits at any appointed place any letter or packet. Amends the Federal criminal code to conform with this Act.
United States · United States Congress · 13 October 1993
1995 Franklin Delano Roosevelt Commemorative Coin Act - Directs the Secretary of the Treasury to issue commemorative one-dollar silver coins bearing a likeness of Franklin Delano Roosevelt. Requires the Secretary to distribute proceeds from surcharges ($10 per coin) in equal allocations to: (1) the National Park Foundation Restricted Account for the Franklin Delano Roosevelt Memorial; and (2) the National Park Service Restricted Construction Account for the Franklin Delano Roosevelt Memorial.
United States · United States Congress · 7 October 1993
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 Subtitle H: Medicaid Program Flexibility 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 · 7 October 1993
Amends the Internal Revenue Code to repeal the retroactive application of income, estate, and gift tax rate increases. Requires a reduction in administrative expenses of Federal departments and agencies for FY 1994 through 1996.
United States · United States Congress · 6 October 1993
TABLE OF CONTENTS: Title I: Ensuring the Integrity of the Listing, Critical Habitat Designation, and Consultation Processes Title II: Providing Significance to the Recovery Planning Process Title III: Ensuring that the Compliance Procedures and Standards for Non-Federal Persons Are Not More Burdensome than the Procedures and Standards Applicable to Federal Agencies Title IV: Providing for Habitat Conservation Incentive Programs Title V: Reauthorization and Other Amendments Endangered Species Act Procedural Reform Amendments of 1993 - Title I: Ensuring the Integrity of the Listing, Critical Habitat Designation, and Consultation Processes - Amends the Endangered Species Act of 1973 to establish a peer review (upon request) requirement with respect to a determination of endangered or threatened species status. (Sec. 103) Establishes discretionary priorities for determining and conserving endangered or threatened species. (Sec. 105) Requires that the economic impact be considered in making a critical habitat determination. (Sec. 107) Revises consultation and related provisions, including establishing procedures with respect to private actions. Title II: Providing Significance to the Recovery Planning Process - Requires the Secretary of the Interior to develop and implement a recovery plan for each endangered or threatened species, unless the Secretary determines such plan to be unnecessary. Gives priority to multispecies plans. Title III: Ensuring that the Compliance Procedures and Standards for Non-Federal Persons Are Not More Burdensome than the Procedures and and Standards Applicable to Federal Agencies - Establishes consultation and permit conditions for non-Federal activities concerning endangered or threatened species. (Sec. 306) Exempts non-Federal persons under specified circumstances from prohibitions against the taking of an endangered species. (Sec. 307) Provides for compensation of property owners adversely affected by specified determinations pursuant to such Act. Title IV: Providing for Habitat Conservation Incentive Programs - Authorizes the Secretary to: (1) enter into an agreement (Cooperative Management Agreement) with any affected non-Federal person (currently, only with a State) for the management of a species' habitat; and (2) provide grants to any non-Federal person for habitat preservation of endangered or threatened species. Title V: Reauthorization and Other Amendments - Sets forth provisions regarding: (1) experimental population release; (2) captive propagation, including grants; and (3) citizen suits. (Sec. 505) Authorizes appropriations for activities under such Act.
United States · United States Congress · 5 October 1993
Designates December 7, 1993, as National Pearl Harbor Remembrance Day. Requests the President to urge that the U.S. flag be flown at half staff on December 7, 1993, in honor of the individuals who died as a result of their service at Pearl Harbor.
United States · United States Congress · 5 October 1993
Calls for: (1) the President to encourage the United Nations (UN) to permit representatives of Taiwan to participate fully in UN activities; and (2) cabinet-level exchanges between Taiwan and the United States.
United States · United States Congress · 4 October 1993
Prohibits funds from being expended for deployment of U.S. armed forces outside the United States under United Nations command unless the use of funds for such deployment is expressly authorized in a law enacted after enactment of this Act.
United States · United States Congress · 23 September 1993
United States Grain Standards Act Amendments of 1993 - Amends the United States Grain Standards Act and the United States Grain Standards Act Amendments of 1988 to extend: (1) Federal Grain Inspection Service authority to collect fees for administrative and supervisory costs; and (2) authorization of appropriations for grain inspection services. Authorizes inspection and weighing activities in Canadian ports. Authorizes a pilot program to permit more than one official agency to carry out inspections within a single geographical area. Prohibits, with specified exceptions, the addition of water to grain.
United States · United States Congress · 22 September 1993
Satellite Carrier Compulsory License Extension Act of 1993 - Amends copyright law with respect to satellite carrier compulsory licenses to require the subscriber information list submitted by a satellite carrier that makes secondary transmissions of a primary transmission by a network station to include the names of the subscribers. Requires, upon the request of a network, such a satellite carrier to conduct, jointly with the network, measurements of the reception of over-the-air television broadcast signals of network-affiliated stations. Prescribes guidelines for conducting such measurements. Revises: (1) the formula used by the satellite carrier to compute the royalty fee to be deposited semiannually with the Register of Copyrights; and (2) dates and procedures regarding the adjustment of such royalty fee. Makes provisions governing such royal fees permanent. Defines, for purposes of cable and satellite carrier compulsory license provisions, "network station" as a television broadcast station, including any translator station or terrestrial satellite station that rebroadcasts all or substantially all of the programming broadcast by a network station, that is owned or operated by or affiliated with, one or more of the U.S. television networks which offer an interconnected program service on a regular basis for 15 or more hours per week to at least 25 of its affiliated television licensees in ten or more States. Revises the definition of: (1) "satellite carrier" to specify that such a carrier operates in the Fixed Satellite Service or the Direct Broadcast Satellite Service; and (2) "cable system" to include a facility that makes secondary transmissions of broadcast signals by microwave cables and terrestrially based transmission paths.
United States · United States Congress · 21 September 1993
TABLE OF CONTENTS: Title I: Data Collection and Procedures to Ensure that Tolerances Safeguard the Health of Infants and Children Title II: Cancellation and Suspension Title III: Amendments to the Federal Food, Drug, and Cosmetic Act Food Quality Protection Act of 1993 - Title I: Data Collection and Procedures to Ensure that Tolerances Safeguard the Health of Infants and Children - Directs the Administrator of the Environmental Protection Agency and the Secretaries of Agriculture and Health and Human Services to establish procedures to ensure that pesticide tolerances adequately safeguard the health of infants and children based on the recommendations of a specified report prepared by the National Research Council of the National Academy of Sciences. (Sec. 102) 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. (Sec. 103) Amends the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) to mandate 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 II: Cancellation and Suspension - Amends FIFRA provisions relating to cancellations, changes in classifications, or other terms of registration with respect to the authority of the Administrator. 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 the environment. Denies registration applications that are not in compliance with this Act. 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. (Sec. 304) 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. (Sec. 305) 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. (Sec. 306) Authorizes appropriations for increased monitoring of pesticide residues in imported and domestic food.
United States · United States Congress · 21 September 1993
Hagerman Fossil Beds National Monument Boundary Revision Act of 1993 - Amends the Arizona-Idaho Conservation Act of 1988 to authorize the Secretary of the Interior to acquire specified lands for inclusion within the Hagerman Fossil Beds National Monument.
![Official portrait of Sen. Craig, Larry E. [R-ID]](https://www.congress.gov/img/member/c000858_200.jpg)