United States · United States Congress · 4 January 1995
Constitutional Amendment - Requires a balanced Federal budget, unless a three-fifths roll call vote of both Houses of Congress provides for a specific excess of outlays over receipts. Prohibits an increase in the public debt limit except by a three-fifths roll call vote by both Houses of Congress. Requires the President to submit a balanced budget to the Congress. Prohibits any bill increasing revenue from becoming law unless approved by a majority roll call vote of both Houses.
United States · United States Congress · 4 January 1995
Constitutional Amendment - Requires the Congress, prior to each fiscal year, to adopt a statement in which total Federal outlays do not exceed total receipts, unless a three-fifths vote of both Houses authorizes a specific excess. Prohibits a bill to increase receipts from becoming law unless approved by a three-fifths majority in each House. Directs the President to submit a balanced budget. Sets a permanent limit on the amount of Federal public debt, prohibiting any increase unless legislation enacted by a three-fifths majority of both Houses becomes law. Requires roll call votes in the House and Senate under this amendment.
United States · United States Congress · 7 October 1994
Expresses the sense of the Senate in support of the Schindler Project's efforts to provide high school seniors with the opportunity to view the film "Schindler's List" and discuss its historical implications and the application of those lessons to contemporary society.
United States · United States Congress · 6 October 1994
Revises rule XXXV of the Standing Rules of the Senate to prohibit any Member, officer, or employee of the Senate (Member) from accepting a gift, knowing that such gift is provided by a lobbyist, a registered lobbyist under the Federal Regulation of Lobbying Act, a lobbying firm, or an agent of a foreign principal. Sets forth provisions regarding what: (1) constitutes a prohibited gift (including anything provided by a lobbyist which is paid for, charged to, or reimbursed by a client or firm of such lobbyist, certain charitable contributions or other payments by a lobbyist relating to a retreat sponsored by or affiliated with an official congressional organization); and (2) does not constitute a gift (including anything for which the recipient pays the market value, anything the recipient does not use and promptly returns to the donor, food or refreshments of nominal value offered other than as part of a meal, and pension and other benefits resulting from continued participation in an employee welfare and benefits plan maintained by a former employer). Sets forth provisions regarding gifts given for a nonbusiness purpose, motivated by family relationship or close personal friendship (generally permitted). Prohibits any Member from knowingly accepting a gift from any other person except as provided in this rule. Lists circumstances where such restrictions shall not apply. Considers a gift to the spouse or dependent of a Member to be a gift to such Member if given with the knowledge and acquiescence of, and with reason to believe the gift was given because of official position as, a Member. Permits Members to accept: (1) offers of free attendance at a widely attended convention, symposium, reception, or similar event, subject to specified requirements; and (2) a sponsor's unsolicited offer of free attendance at a charity event, except for reimbursement for transportation and lodging in connection with the event. Directs the Select Committee on Ethics to provide guidance setting forth reasonable steps that may be taken by Members, with a minimum of paperwork and time, to prevent the acceptance of prohibited gifts from lobbyists.
United States · United States Congress · 22 September 1994
Farm, Ranch, and Homestead Protection Act of 1994 - Amends the Endangered Species Act of 1973 to prohibit, until its reauthorization, the Secretary of the Interior from: (1) determining a species as an endangered or threatened species; or (2) designating a species habitat as a critical habitat. Requires the Secretary to compensate, upon request, persons and entities for the loss in market value of land that has been designated a critical habitat. Limits the current requirement that Federal agencies insure that any action (regardless of its expense) they authorize, fund, or carry out is not likely to jeopardize the continued existence of an endangered or threatened species, or result in the destruction or adverse modification of habitat of such species determined to be critical, without an express exemption. Restricts such requirement to agency actions that result in expenditures of $500,000 or more.
United States · United States Congress · 13 September 1994
Crime Control Improvement Act of 1994 - Amends the Violent Crime Control and Law Enforcement Act of 1994 (the Act) to eliminate the Model Intensive Grant Program, the Local Partnership Grant Program, the Local Crime Prevention Block Grant Program, the Family and Community Endeavor Schools Program, the Community-Based Justice Grant Program, the Urban Recreation Program, the At-Risk Youth Program, the Police Recruitment Program, the National Community Economic Partnership Program, the Community Schools Program, the Ounce of Prevention Program, the Gang Resistance Education and Training Program, the Drug Courts Program, and the Family Unity Demonstration Project. Revises the Act to authorize the Attorney General to make grants to construct, expand, modify, operate, or improve conventional prisons (currently, correctional facilities). Repeals provisions regarding the transfer of unused funds. Increases Federal mandatory minimum sentences for using or carrying a firearm during and in relation to a crime of violence or drug trafficking crime, employing minors in drug trafficking, and selling illegal drugs to minors. Bars the court from placing on probation or suspending the sentence of any person convicted of such offenses. Amends the Immigration and Nationality Act to expand the definition of "aggravated felony." Authorizes the Attorney General to issue a final order of deportation against any alien who was not lawfully admitted for permanent residence, or who had permanent resident status on a conditional basis, whom the Attorney General determines to be deportable under provisions relating to conviction of an aggravated felony. Limits judicial review of such determinations. Provides for deportation of permanent resident aliens under specified circumstances. Grants a U.S. district court jurisdiction to enter a judicial order of deportation at the time of sentencing against an alien whose criminal conviction causes such alien to be deportable if requested prior to sentencing by the U.S. Attorney. Restricts defenses to deportation. Enhances penalties for failing to depart or reentering after a final order of deportation. Limits collateral attacks on deportation orders. Directs the Attorney General to operate a criminal alien tracking center. Authorizes appropriations. Revises provisions of the Act pertaining to the non-application of mandatory minimum sentences in certain cases involving nonviolent drug offenses. Expresses the sense of the Congress that all grants authorized under the Act and not required to be distributed according to a formula prescribed by law shall be distributed in a fair and equitable manner that ensures that rural States receive a fair and proportional share of the funds.
United States · United States Congress · 24 August 1994
Commends the U.S. rice industry for its decision to establish an industry organization. Recognizes the success such decision will have in promoting the interests of the rice industry and the rice-consuming public.
United States · United States Congress · 19 August 1994
Private Property Rights Restoration Act - Grants the owner of real property a cause of action against the United States if: (1) the application of a statute, regulation, rule, guideline, or policy of the United States restricts, limits, or otherwise infringes a right to real property that would otherwise exist; and (2) such application would result in a discrete and non-negligible reduction in the fair market value of the affected portion of real property. Specifies that a prima facie case shall be established if the Government action results in a temporary or permanent diminution of fair market value of the affected portion of real property of the lesser of 25 percent or more, or $10,000 or more. Sets forth provisions regarding: (1) jurisdiction; (2) recovery amount; (3) a public nuisance exception; (4) award of costs to a prevailing plaintiff; and (5) the applicable statute of limitations.
United States · United States Congress · 10 August 1994
Humanitarian Aid Corridor Act - Prohibits funds for foreign assistance from being made available for any country whose government prohibits or restricts the transport or delivery of U.S. humanitarian assistance. Waives such prohibition if the President notifies the Congress that providing such assistance is in the national security interest. Provides for a resumption of assistance when the President certifies to the Speaker of the House and the Senate Foreign Relations Committee that such country is no longer prohibiting or restricting such transports or deliveries.
United States · United States Congress · 21 July 1994
TABLE OF CONTENTS: Title I: Retirement Savings Incentives Subtitle A: Restoration of IRA Deduction Subtitle B: Nondeductible Tax-Free IRAs Title II: Penalty-Free Distributions Title III: Aid to Families With Dependent Children Savings and Investment Incentive Act of 1994 - Title I: Retirement Savings Incentives - Subtitle A: Restoration of IRA Deduction - Amends the Internal Revenue Code to remove the limitation on the deductibility of contributions to individual retirement plans (IRAs) by active participants in employer-maintained plans, thereby restoring the IRA deduction. Provides an inflation adjustment after 1995. Allows certain spouses a full deduction for contributions to an IRA. Makes certain coins and bullion ineligible as collectible investments for purposes of distributions from an IRA. Subtitle B: Nondeductible Tax-Free IRAs - Allows individuals to establish individual retirement plus (IRA plus) accounts with tax treatment similar to that for individual retirement plans. Makes contributions to such accounts nondeductible. Title II: Penalty-Free Distributions - Allows distributions from certain retirement plans without penalty to purchase first homes, pay higher education expenses and financially devastating medical expenses, and assist certain unemployed individuals. Title III: Aid to Families with Dependent Children - Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act to exclude from AFDC eligibility determinations certain income and resources that are to be used for education, training, and employability purposes. Requires the Secretary of Health and Human Services to report to the Congress on a revision of the AFDC limit on automobiles in order to increase the employability of AFDC recipients.
United States · United States Congress · 19 July 1994
Expresses the sense of the Congress that the President should refrain from signing, on behalf of the United States, the seabed mining agreement that will be open for signature on July 29, 1994, relating to the United Nations Convention on the Law of the Sea.
United States · United States Congress · 23 June 1994
Congratulates the Houston Rockets for their outstanding heart, resolve, and determination in winning the 1994 National Basketball Association Championship.
United States · United States Congress · 16 June 1994
Declares that the discretionary spending limits (new budget authority and outlays) for each of FY 1994 through 1998 set forth in the Congressional Budget Act of 1974, as adjusted in strict conformance with the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act), shall be reduced, as calculated by the Director of the Office of Management and Budget, in amounts equal to the aggregate amount of rescissions in any Act enacted on or after the enactment of this Act for such fiscal years. Waives such reductions with respect to any rescissions enacted in any Act designated by the President and the Congress as emergency appropriations to the extent that the aggregate amount of rescissions in such Act reduces the aggregate amount of budget authority and outlays designated as emergency appropriation by the President.
United States · United States Congress · 14 June 1994
World War II Peace Accords Commemorative Coin Act - Expresses the sense of the Congress that: (1) the 50th anniversary of the signing of the World War II peace accords on the U.S.S. Missouri should not go unrecognized at the national level; and (2) the United States should recognize such anniversary by minting and issuing a commemorative coin. Sets forth specifications for half dollar clad coins. Mandates that the surcharges received from the sale of such coins be paid by the Secretary of the Treasury to the Admiral Nimitz Foundation for the purpose of preserving the Pacific War heritage of the United States.
United States · United States Congress · 25 May 1994
Establishes the Special Subcommittee on Certain Allegations Concerning Whitewater Development Corporation, Madison Guaranty Savings and Loan Association, and Capital Management Services, Inc., and Related Issues within the Senate Committee on Banking, Housing, and Urban Affairs. Declares that the purpose of such Subcommittee shall be to conduct an investigation into, and study matters related to: (1) Whitewater, Madison, Capital Management, the Arkansas Development Finance Authority, and Value Partners I; (2) the conduct and policies of specified Federal executive and regulatory agencies; and (3) the circumstances surrounding Hillary Rodham Clinton's commodities-futures trading activities. Requires the Subcommittee to report its findings to the Senate.
United States · United States Congress · 10 May 1994
Amends the Internal Revenue Code to exclude from income military moving and storage expense reimbursements without regard to the deductibility of such expenses.
United States · United States Congress · 10 May 1994
Calls for the Citizens' Stamp Advisory Committee of the U.S. Postal Service to recommend to the Postmaster General that a postage stamp be issued to honor coach Paul "Bear" Bryant.
United States · United States Congress · 11 April 1994
Designates the Federal building located at 100 East Houston Street in Marshall, Texas, as the Sam B. Hall, Jr. Federal Building and United States Courthouse.
United States · United States Congress · 25 March 1994
Private Property Rights Act of 1994 - States that the Congress declares that it is the policy of the Federal Government to use all practicable means and measures to minimize Federal takings of private property. Directs Federal agencies to certify to the Attorney General that a private property taking impact analysis has been completed before initiating any action which could result in a taking or diminution of use or value of private property. Requires that the policies, regulations, and public laws of the United States be interpreted and administered in accordance with the policies under this Act. Specifies the content of such an analysis and requires a copy to be transmitted to the owner of the affected property, as well as made available to the public. Creates a rebuttable presumption that unmodified analyses five years or older are outdated for purposes of any agency action or administrative or judicial proceeding. Sets the statute of limitations for court actions for enforcing this Act.
United States · United States Congress · 22 March 1994
TABLE OF CONTENTS: Title I: Statement of Congressional Purpose Title II: Binding Budget Law Title III: Enforcement Mechanics Title IV: Sustaining Mechanism Title V: Protection of Social Security Title VI: Timetable Title VII: Conforming Amendments Title VIII: Definitions and Rules of Interpretation Title IX: Effective Date Budget Process Reform Act - Title I: Statement of Congressional Purpose - Declares that the purpose of this Act is to facilitate rational, informed, and timely decisions by the Congress in the course of the Federal budget process. (Sec. 102) Expresses the sense of the Congress that the Federal budget process should focus the attention of policymakers and the public on the aggregate impact of Federal spending on the economy, and on the tradeoffs that must be made among priorities in order to control overall levels of spending. (Sec. 103) Declares that the budget process should contain safeguards against delay and inaction, so that temporary shut-downs of the Government may be avoided. Title II: Binding Budget Law - Requires the Congress to enact a binding budget law, in the form of a joint resolution, by April 15 of the calendar year before that in which the fiscal period commences. (Sec. 202) Makes it out of order in the House of Representatives of the Senate to consider any spending bill affecting spending in a major functional category unless and until a joint resolution on the budget is enacted. (Sec. 203) Amends the Congressional Budget Act of 1974 to prohibit baseline budgeting. (Sec. 204) Requires the President to submit to the Congress on or before the 15th day after a joint resolution on the budget is enacted a detailed budget for the fiscal period beginning on October 1 of the current calendar year. Title III: Enforcement Mechanics - Subtitle A: Supermajority Required to Break Budget Law - Requires a three-fifths majority vote in the House and the Senate to consider any spending bill prior to the enactment of the budget law. (Sec. 302) Requires the Congressional Budget Office to provide to the Congress an estimate of the costs in each major functional category of certain spending bills as soon as practicable after its introduction. Requires a three-fifths affirmative vote in the House and the Senate to consider over-budget spending bills. Requires a three-fifths affirmative vote in the House and the Senate to waive any provision of this Act. Subtitle B: Limited Enhanced Rescission Authority - Amends the Impoundment Control Act of 1974 to limit the President's rescission authority to spending that is above the limits of the budget law. Subtitle C: "Blank Check" Appropriations Prohibited - Declares the intent of the Congress to end open-ended, "blank check" appropriations which typically authorize spending "such sums as may be necessary." Requires fixed-dollar appropriations for every account except social security and interest on the debt. Prohibits open-ended appropriations. Requires Executive agencies to adjust benefit levels to ensure that appropriations for entitlement programs are not exceeded. (Sec. 309) Restricts budget authority and entitlement authority to one fiscal period. Subtitle D: "Pay As You Go" Requirement for New Spending - Prohibits the Congress from considering any legislation which exceeds the budget ceiling unless it offsets such increased spending with an equal amount of reductions. Requires a three-fifths affirmative vote in the House and the Senate to waive such prohibition. Title IV: Sustaining Mechanism - Makes appropriations to provide for an automatic continuing resolution if for any account an appropriation for a fiscal period does not become law before the beginning of such period. (Sec. 403) Restricts legislation providing funding to the Committees on Appropriations. Title V: Protection of Social Security - Provides that no reduction in benefits under title II of the Social Security Act (Old Age, Survivors and Disability Insurance) shall be made as a consequence of this Act. Title VI: Timetable - Revises the timetable for the congressional budget process. Title VII: Conforming Amendments - Makes various technical and conforming amendments, including changing references to a concurrent resolution on the budget to references to a joint resolution on the budget. Title VIII: Definitions and Rules of Interpretation - Sets forth definitions for specified terms. Title IX: Effective Date - Declares the effective date of this Act to be January 1, 1995, applicable to fiscal years beginning after September 30, 1995.
United States · United States Congress · 25 February 1994
National Security Budgeting and Deficit Control Act of 1994 - Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to extend the caps on defense and nondefense discretionary spending through FY 1998.
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 · 26 January 1994
TABLE OF CONTENTS: Title I: Increased Use of Existing Prison Space Title II: Construction of Regional Prisons for Violent Criminals Title III: Effective Mandatory Minimum Prison Sentences Title IV: Violent Crime Reduction Trust Fund Predator Criminal Imprisonment Act - Title I: Increased Use of Existing Prison Space - Amends the Federal criminal code to prohibit a Federal court from: (1) holding prison or jail crowding unconstitutional under the eighth amendment except to the extent that an individual plaintiff inmate proves that the crowding causes the infliction of cruel and unusual punishment of that inmate; and (2) placing a ceiling on the inmate population of any Federal, State, or local detention facility as an equitable remedial measure for conditions that violate the eighth amendment unless crowding is inflicting cruel and unusual punishment on particular identified prisoners. Directs that each Federal court order or consent decree seeking to remedy an eighth amendment violation be reopened at the behest of a defendant for recommended modification at a minimum of two-year intervals. Title II: Construction of Regional Prisons for Violent Criminals - Directs the Attorney General: (1) to construct and operate a minimum of ten regional prisons, situated throughout the United States, each containing space for at least 2,500 inmates; and (2) in determining the location of such prisons, to consider the feasibility of converting Federal correctional complexes currently in the planning or construction phase. Sets forth provisions regarding: (1) consideration of cost-effective alternatives and State and local re-use plans; and (2) acceptance of qualifying prisoners. Prohibits the Attorney General from certifying a State as a qualifying State unless the State is providing: (1) "truth in sentencing" with respect to specified felony crimes of violence which provides that defendants will serve at least 85 percent of the sentence ordered and which limits the sentencing judges' discretion; (2) pretrial detention similar to that provided in the Federal system; (3) sentences at least as long as those imposed under Federal law for murderers, firearm offenders where death or serious bodily injury results, sex offenders, and child abuse offenders; and (4) suitable recognition for victims' rights, including consideration of the victim's perspective at all appropriate stages of criminal proceedings. Title III: Effective Mandatory Minimum Prison Sentences - Amends the Federal criminal code to set mandatory prison terms for: (1) using or carrying a firearm during a crime of violence or a drug trafficking crime; and (2) distributing illegal drugs to minors or using minors in drug trafficking activities. Amends the Controlled Substances Act to provide for mandatory life imprisonment without release for drug felons and violent criminals convicted a third time. Title IV: Violent Crime Reduction Trust Fund - Directs: (1) the President, through the Office of Management and Budget (OMB), to ensure that the number of full-time equivalent positions in all executive agencies (excluding the General Accounting Office) does not exceed specified levels for FY 1994-1998; and (2) OMB to continuously monitor all agencies for compliance and to notify the President and the Congress of any failure to comply. Establishes as a separate account in the Treasury the Violent Crime Reduction Trust Fund, which: (1) may be appropriated exclusively for the purposes authorized in this Act and the Violent Crime Control and Law Enforcement Act of 1993; and (2) shall be excluded from, and not taken into account for purposes of, any budget enforcement procedures under the Congressional Budget Act of 1974 or the Balanced Budget and Emergency Deficit Control Act of 1985. Requires: (1) the President to report annually on the status of the Fund; and (2) the Director of OMB to reduce discretionary spending limits for FY 1994-1998 as specified.
United States · United States Congress · 25 January 1994
TABLE OF CONTENTS: Title I: Applicant Job Search, Voucher Program, Transition and Work Program, Etc. Title II: Provisions Relating to Paternity Establishment Title III: Child Support Enforcement Title IV: Expansion of Statutory Flexibility of States Title V: Expedited State Waiver Authority Title VI: Welfare Restrictions for Aliens Title VII: Miscellaneous Welfare Reform Act of 1994 - Title I: Applicant Job Search, Voucher Program, Transition and Work Program, Etc. - Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act (SSA) to: (1) require State AFDC plans to require AFDC applicants to search for a job while their application for AFDC is being processed; (2) make reimbursable job search expenses for transportation and child care; and (3) require the State to have in effect an employment voucher program under which eligible individuals receiving AFDC or food stamps shall receive vouchers in lieu of such benefits after they have obtained employment with a qualified employer. (Sec. 103) Amends SSA title IV part F (Job Opportunities and Basic Skills Training Program) (JOBS) to require State JOBS programs to include specified transition and work supplementation components. Amends the community work experience and work supplementation programs. (Sec. 104) Revises State AFDC plan requirements for: (1) sanctions for an individual's failure to participate in the JOBS program; and (2) exemptions from JOBS program participation requirements. (Sec. 106) Increases State JOBS program and work program participation rates with regard to AFDC-eligible individuals and unemployed parents, respectively. Extends to all States the option to limit AFDC-UP (AFDC for Unemployed Parents). (Sec. 107) Provides for additional payments to States for JOBS programs. Title II: Provisions Relating to Paternity Establishment - Amends SSA title IV part A to provide for reduction of AFDC for the parents or guardians of children whose paternity is not established. (Sec. 202) Amends SSA title IV part D (Child Support and Establishment of Paternity) to require each State to have in effect laws requiring outreach to pregnant, unmarried women regarding paternity establishment and eligibility for benefits under Federal and State programs, including assistance under AFDC. (Sec. 203) Increases the paternity establishment percentage. Title III: Child Support Enforcement - Makes various specified changes with regard to State child support order registries, the Parent Locator Service, regulations for sharing child support information, income withholding orders, and noncustodial parents with child support arrearages who are applying for, or are already on, AFDC. Title IV: Expansion of Statutory Flexibility of States - Amends SSA title IV part A to give States the option to: (1) disallow the increases or decreases in AFDC payments that are mandated by this Act on the basis of childhood preventive health care examinations and immunizations; (2) increase or decrease AFDC payments on the basis of attendance at educational or vocational training institutions; (3) deny AFDC for additional children; (4) provide for a married couple transitional benefit in cases where an AFDC recipient marries an individual who is not a parent of the recipient's child and the resulting family would become ineligible for AFDC by reason of the marriage; (5) treat families moving interstate who apply for AFDC in their new State of residence, where they have resided for less than one year, under the AFDC rules of their former State of residence; (6) condition the receipt of AFDC on the recipient's attendance at appropriate parenting and money management classes; (7) deny AFDC to unmarried individuals under 18 who are pregnant or have a dependent child (if the State does not opt to deny AFDC eligibility in such case, then it must require that the individuals live at home to be AFDC-eligible); and (8) disregard certain savings of a family on AFDC designated for education in determining eligibility for AFDC. (Sec. 401) Requires States to conduct appropriate education and outreach activities designed to increase public awareness of the importance of preventive health care and immunizations for pre-school children. Requires the Surgeon General to issue, and periodically revise, recommendations for the immunization of children under six. Title V: Expedited State Waiver Authority - Establishes an Interagency Waiver Request Board to provide a focal point within the Federal Government for the development and coordination of waiver requests designed to improve opportunities for low-income individuals and families. (Sec. 502) Prescribes contents of applications to implement Federal assistance plans, as well as the review, approval, implementation, and evaluation processes. (Sec. 505) Requires any entity applying for plan approval to establish a Public-Private Partnership Committee to advise it on plan development and implementation. Title VI: Welfare Restrictions for Aliens - Prohibits, generally, the payment of direct Federal financial benefits, food stamps, and unemployment benefits to individuals who are not U.S. citizens, permanent residents, or refugees. (Sec. 601) Requires any lawful alien receiving any such benefits for over one year to be reported to the Immigration and Naturalization Service (INS) and be treated as a public charge for purposes of the Immigration and Nationality Act with regard to deportation for failing to notify the Attorney General of a current address. Deems the income and resources of any person who agrees to sponsor and provide support to a lawful alien as unearned income and resources of such alien until the alien is naturalized as an U.S. citizen. (Sec. 602) Amends SSA title IV part A to require State AFDC agencies to provide INS with information on illegal aliens. Title VII: Miscellaneous - Amends SSA title II (Old Age, Survivors and Disability Insurance) (OASDI) to prohibit the payment of OASDI benefits to individuals confined by court order to public institutions pursuant to verdicts of not guilty by reason of insanity (or other similar finding) or guilty, but insane. (Sec. 702) Amends SSA title IV part A to require AFDC applicants and recipients to undergo any necessary substance abuse treatment and submit to unannounced drug tests afterwards as a condition of receiving AFDC. (Sec. 703) Directs the Secretary of Health and Human Services to: (1) conduct research projects to evaluate education and training programs with respect to participation in the AFDC program; (2) conduct demonstration projects and report to the Congress on whether providing benefits based on need through the use of electronic cards and automatic teller machines would reduce administrative costs and fraud; and (3) establish a commission to determine the cost and feasibility of creating an interstate system to compare the social security numbers of all AFDC recipients in order to identify those recipients receiving AFDC from multiple States. (Sec. 705) Amends SSA title XVI (Supplemental Security Income) (SSI) to make: (1) ineligible for SSI benefits individuals receiving SSI on the basis of a disability caused by illegal drugs who are on illegal drugs or refuse to be tested for such; and (2) changes with regard to government agencies as paid representative payees (RPs) and RP fees. (Sec. 706) Amends SSA title IV part A to: (1) make State AFDC fraud control programs mandatory; and (2) permanently bar individuals found guilty of fraud in connection with the AFDC program from being considered in determining their families' eligibility for AFDC.
United States · United States Congress · 25 January 1994
TABLE OF CONTENTS: Title I: Portable and Permanent Private Health Insurance Subtitle A: Portability Subtitle B: Permanence Title II: Small Business Health Insurance Pools Title III: Enhanced Efficiency Through Paperwork Reduction Title IV: Antitrust Reforms Consensus Interim Health Act - Title I: Portable and Permanent Health Insurance - Subtitle A: Portability - Amends COBRA provisions of the Internal Revenue Code with respect to continuation coverage requirements to permit the options of: (1) identical coverage; (2) coverage with an annual $1,000 deductible; and (3) coverage with an annual $3,000 deductible. Permits penalty-free withdrawals from qualified retirement plans for such coverage. Subtitle B: Permanence - Prohibits either an insurer or an employer from cancelling a health plan other than for: (1) nonpayment of premiums; (2) fraud; (3) noncompliance; or (4) the plan will no longer be provided in a geographic area. (Sec. 112) Requires an insurer, with respect to any individual health plan as of enactment, to offer the insured the option to purchase a new individual health insurance plan. (Sec. 113) Requires an insurer, with respect to any group health plan in effect as of enactment, to offer the option to purchase upon leaving the group a new individual health insurance plan. Title II: Small Business Health Insurance Pools - Prohibits any State or local law from applying that: (1) prohibits two or more employers or groups from obtaining coverage under a multiple employer health plan; and (2) requires the coverage of one or more specific benefits, services, or categories of health care or provider. (Sec. 203) Preempts, for five years, the following provisions of State law: (1) restrictions on reimbursement rates or selective contracting; (2) restrictions on differential financial incentives; and (3) restrictions on utilization review methods. Title III: 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 a total of 75 percent over a five-year period. (Sec. 302) Requires any State-administered health care program, in order to be eligible for funds in connection with such program, to standardize the processing of paper and electronic claims by 75 percent over a five-year period. (Sec. 303) Provides for the establishment of a Standardized Forms Commission to make recommendations on the standardization of paper and electronic claims processing. Title IV: Antitrust Reforms - Provides for the promulgation of guidelines under which a health care joint venture may request that the entities participating in the joint venture receive specified exemptions under the antitrust laws. (Sec. 402) Permits the Attorney General to issue a certificate of public advantage to an eligible health care joint venture, exempting such venture under the antitrust laws, if: (1) the benefits that are likely to result outweigh any likely reduction in competition; and (2) any such reduction is reasonably necessary to obtain such benefits. (Sec. 403) Establishes the Interagency Advisory Committee on Competition, Antitrust Policy, and Health Care in order to: (1) evaluate competition and antitrust policy; (2) analyze the effectiveness of health care joint ventures receiving exemptions; and (3) make recommendations.
United States · United States Congress · 25 January 1994
American Free Trade Act - Requires the President to initiate trade agreement negotiations with Western Hemisphere countries for the reduction and elimination of tariffs and nontariff trade barriers and the establishment of a Western Hemisphere free trade area. Declares that this Act shall not apply to Cuba unless the President certifies that: (1) freedom has been restored in Cuba; and (2) the claims of U.S. citizens for compensation for expropriated property have been appropriately addressed. Sets forth determinations the President must make about Cuba before certifying that freedom has been restored. Requires that, once such certification is made, priority be given to negotiation of a free trade agreement with Cuba. Applies the fast-track procedures of the Trade Act of 1974 to implementing bills for trade agreements entered under this Act.
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 · 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 · 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 · 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 · 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 · 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.
![Official portrait of Sen. Gramm, Phil [R-TX]](https://www.congress.gov/img/member/g000365_200.jpg)