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101 records in 1985

Records

Bill· SS. 1556 (99th)open

Budget Procedures Improvement Act of 1985

United States · United States Congress · 1 August 1985

Budget Procedures Improvement Act of 1985 - Declares that the purpose of this Act is to establish a more thorough and timely process for the adoption of the Federal budget. Amends the Congressional Budget Act of 1974 to revise the timetable with respect to the congressional budget process to provide for a two-year budget cycle, beginning with the 100th Congress. Defines the term 'two-fiscal-year budget period' to be the period of two consecutive fiscal years beginning on October 1 of any even-numbered year. Requires the Director of the Congressional Budget Office, on or before April 15 of each odd-numbered year, to transmit to the Committees on the Budget of the House and of the Senate a fiscal policy report for each fiscal year in the succeeding two-fiscal-year budget period. Requires the Director, on March 31 of each even-numbered year, to transmit to such Committees any revisions necessary due to changing economic conditions or to any revisions in the President's budget. Requires the Congress to complete action on the first concurrent resolution on the budget by July 31 of each odd-numbered year. Makes it out of order in either the Senate or the House to consider any first concurrent resolution on the budget which: (1) directs any committee to determine and recommend changes in bills, laws, or resolutions; or (2) includes any matter with respect to any subject other than budget outlays or authority, budget surplus or deficit, revenues, or the level of the public debt. Declares similarly out of order consideration of any revision to the first budget resolution before adoption of the second concurrent resolution on the budget for a two-fiscal-year budget period. Requires all bills and resolutions providing budget authority or spending authority for any two-fiscal-year budget period to be reported: (1) to the House no later than March 31 of the year in which such period begins; and (2) to the Senate no later than April 15 of the year in which such period begins. Prohibits bills and resolutions providing new budget or spending authority for any two-fiscal-year budget period from being enrolled until the concurrent resolution on the budget has been agreed to, and if a reconciliation bill or resolution, or both, are required to be reported for such period, until the Congress has completed action on such legislation. Makes it out of order in the Senate or the House to consider any budget resolution if it directs any committee to determine and recommend changes in laws, bills, or resolutions directly or indirectly authorizing the enactment of new budget authority. Requires the Congress to complete action on all bills and resolutions directly or indirectly authorizing the enactment of new budget authority for a two-fiscal-year budget period not later than December 1 of the year preceding the year in which such period begins. Requires the up-to-date tabulation of congressional budget actions by the Congressional Budget Office to compare the gross obligations for direct loans and loan guarantees for such fiscal years on which the Congress has completed action to the gross obligations set forth in the most recently agreed to budget resolution. Limits the enrollment of bills and resolutions providing new budget or new spending authority for any two-fiscal-year budget period until the concurrent resolution for such two-fiscal-year period has been agreed to. Makes it out of order in either House to consider any bill or resolution which provides, extends, or enlarges authority to incur obligations for direct loans or loan guarantees unless the bill or resolution also provides that such authority is to be effective for any fiscal year only to the extent provided in appropriation Acts. Sets forth the information to be included in the budget of the United States submitted pursuant to the Budget and Accounting Act, 1921 for the two-fiscal-year budget period beginning on October 1, 1988. Amends the Budget and Accounting Act, 1921 to require the President to transmit to the Congress, by January 15 of each odd-numbered year, beginning with 1987, the budget for the two-fiscal-year budget period beginning on October 1 of the succeeding calendar year. Requires that all essential facts regarding direct loans and loan guarantees be included within such report. Requires the President to transmit revisions in the budget by January 15 of each even-numbered year. Sets forth the title and style of all appropriation Acts. Amends the Legislative Reorganization Act of 1946 to require each standing committee of the Senate and the House (except specified committees), during the period beginning on January 15th of each odd-numbered year and ending October 1 of the following year, to review and study: (1) the application, administration, execution, and effectiveness of those laws the subject matter of which is within the jurisdiction of such committee; and (2) the organization and operation of the Federal agencies and entities having responsibilities in or for the administration and execution thereof. Requires the findings to be reported to the House or the Senate no later than October 1 of such even-numbered year. Provides that such findings shall constitute the basis for such committee's legislative work during the succeeding Congress. Amends the Rules of the House and of the Senate to conform to this Act. Sets forth the effective dates for the provisions of this Act. Requires the President to submit a budget for FY 1988 to the Congress, and the Congress to act on it, according to current law.

Bill· SS. 1600 (99th)open

A bill to provide that certain of the Social Security Trust Funds be excluded from the Federal budget process for fiscal years beginning on or after October 1, 1985, and to clarify that specifications and directions with respect to such Trust Funds may not be included in any concurrent resolution on the budget adopted with respect to fiscal years beginning after such date.

United States · United States Congress · 1 August 1985

Amends the Social Security Amendments of 1983 to accelerate the removal from the unified budget of the Federal Old-Age and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, and the Federal Hospital Insurance Trust Fund. Amends title VII (Administration) of the Social Security Act to prohibit the inclusion in any concurrent resolution on the budget adopted on or after October 1, 1985, of any specifications and directions with respect to such Trust Funds.

Resolution· HRESH.Res. 253 (99th)passed

A resolution waiving points of order against and providing procedures for the consideration of the conference report on (S.Con.Res. 32) setting forth the congressional budget for the United States Government for the fiscal years 1986, 1987, and 1988 and revising the congressional budget for the United States Government for the fiscal year 1985, or any amendment in disagreement thereto.

United States · United States Congress · 1 August 1985

Waives points of order against and sets forth the rule for the consideration of the conference report on S. Con. Res. 32 (congressional budget).

Bill· SS. 1540 (99th)open

A bill providing a statutory basis for a budget that requires that any increase in outlays be financed by an equivalent increase in revenues, and for other purposes.

United States · United States Congress · 31 July 1985

Prohibits the Federal budget for a fiscal year, as proposed by the President or as adopted by the Congress in a concurrent resolution on the budget, from: (1) providing for total budget outlays exceeding the total outlays for the preceding fiscal year, unless it provides at least equal increases in revenues and identifies the source of such revenues; or (2) providing for a reduction in revenues from the preceding fiscal year, unless it provides at least equal reductions in outlays and identifies the programs or activities for which outlays will be reduced. Authorizes the Congress, by a two-thirds vote of each House, to waive such prohibition concerning the budget adopted under a concurrent resolution.

Law· HRH.R. 3128 (99th)enacted

Consolidated Omnibus Budget Reconciliation Act of 1985

United States · United States Congress · 31 July 1985

Deficit Reduction Amendments of 1985 - Title I: Medicare Program - Medicare Budget Reconciliation Amendments of 1985 - Part A: Changes Relating Primarily to Part A of the Medicare Program - Amends part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act to provide that the applicable percentage increase for cost reporting periods beginning during FY 1986 with respect to payments for inpatient hospital services, shall be one percent. Provides for a one-year extension of the DRG transitional period by maintaining the current blend of rates for an additional year. Directs the Secretary of Health and Human Services to adjust payment amounts for hospitals for discharges occurring during FY 1986 to reflect changes the Secretary has proposed in specified regulations respecting the hospital wage index. Provides for a study and report to the Congress from the Secretary concerning hospital wages in central cities. Revises the formula which provides for additional payments to hospitals for indirect costs of medical education. Provides for an additional payment to an urban hospital of 100 or more beds that serves a disproportionate share of low-income patients. Treats as a rural referral center a rural osteopathic hospital having 3,000 or fewer discharges annually. Prohibits the Secretary from limiting, for a period of one year, the costs that may be recognized as reasonable with respect to the net costs of approved educational activities for a cost reporting period based upon the net costs of those activities for any previous cost reporting period. Prohibits including in the reasonable costs of inpatient hospital services the return on equity capital for hospitals. Permits, in other cases, payment for a return on equity capital, provided that such rate of return equals the average of the rates of interest on obligations issued for purchase by the Federal Hospital Insurance Trust Fund. Provides for the continuation of State hospital reimbursement control demonstration systems, provided certain conditions are met. Permits States with such a system an extra year within which to fulfill certain assurances. Provides for a special rule for the treatment of depreciation and interest on capital indebtedness, in the case of the transfer of ownership of a hospital or skilled nursing facility without monetary consideration from a State to a nonprofit corporation, which would not take into account the acquisition costs to the new owner. Requires a report from the Secretary to the Congress with respect to the impact of policies respecting outliers and patient transfers on payments to rural hospitals. Directs the Secretary to make available to the Prospective Payment Assessment Commission, the Congressional Budget Office, the Committee on Ways and Means of the House, and the Committee on Finance of the Senate the most current information on payments being made under the prospective payment system. Amends the Tax Equity and Fiscal Responsibility Act of 1982, with respect to payment for hospice care, to eliminate the sunset provision. Increases the payment rate for daily hospice care. Limits the time period within which the ten percent penalty for late enrollment under part A can be assessed. Amends the Internal Revenue Code to provide for the application of the hospital insurance tax to State and local employment. Requires any hospital with an emergency department to provide for the examination and stabilizing treatment of emergency conditions (including treatment for active labor) for any individual (whether or not eligible for Medicare) coming to such department. Provides for the termination of a hospital's Medicare agreement and civil penalties, if the hospital does not comply. Provides criminal penalties for noncomplying physicians. Part B: Changes Relating to Parts A and B of the Medicare Program - Requires, in the case of all covered employed individuals, that payment for health care items or services, to the extent possible, be made by the individual's group health plan before any Medicare payments will be made. Amends part B (Supplementary Medical Insurance) of title XVIII to define the "special enrollment period" as the period beginning with the first day of the first month in which an individual is no longer enrolled in a group health plan by reason of current employment and ending seven months later. Amends the Age Discrimination in Employment Act of 1967 to prohibit an employer from discriminating against an employee over age 65 under the employer's group health plan. Requires that in the case of an individual who is receiving inpatient hospital services as of the effective date of the individual's enrollment under Medicare with a health maintenance organization (HMO) or competitive medical plan (CMP): (1) payment for such services until the date of the individual's discharge shall be made under Medicare as if the individual were not enrolled with the HMO or CMP; (2) the HMO or CMP shall not be financially responsible for payment of such services until the date after the date of an individual's discharge; and (3) the HMO or CMP shall nonetheless be paid the full amount otherwise payable to the HMO or CMP. Requires that in the case of an individual who is receiving inpatient hospital services as of the effective date of the individual's termination of enrollment with an HMO or CMP: (1) the HMO or CMP shall be financially responsible for payment of such services after such date and until the date of the individual's discharge; (2) payment for such services shall not be made under the prospective payment system; and (3) the HMO or CMP shall not receive any payment with respect to the individual during the period the individual is not enrolled. Requires all marketing material of an HMO or CMP to be reviewed by the Secretary prior to its distribution. Directs the Secretary to evaluate: (1) the relative effectiveness of peer review organizations that require preadmission certification of 100 percent of elective inpatient surgical procedures as compared with other peer review organizations that require such certification of a lesser percentage of such procedures; and (2) the feasibility of extending the pre-procedure certification activities of peer review organizations to cover elective surgical procedures conducted in outpatient and ambulatory care settings. Requires a report to the Congress. Prohibits the Secretary from providing for the merger of any renal disease network into a utilization and quality control peer review organization or another entity without express statutory authority. Directs the Secretary to extend, for three additional years, approval of three specified municipal health services demonstration projects. Part C: Changes Relating Primarily to Part B of the Medicare Program - Extends, for one year, the current freeze on physician charge levels for nonparticipating physicians under part B, while providing incentives for participating physicians. Increases from 15 to 23 the number of members of the Prospective Payment Assessment Commission. Directs the Chairman of the Commission to provide for two subcommittees of the Commission, one with functions and responsibilities relating primarily to hospital payment issues and the other with functions and responsibilities relating primarily to physician payment issues. Directs the Commission to: (1) annually make recommendations to the Congress regarding adjustments to the reasonable charge levels for physicians' services under part B and changes in the methodology for determining the rates of payment, and for making payment for physicians' services; and (2) advise and make recommendations to the Secretary respecting the development of the relative value scale. Directs the Secretary to: (1) develop a relative value scale that establishes a numerical relationship among the various physicians' services for which payment may be made under part B; and (2) report to the Congress concerning such scale. Extends for an additional year provisions under which part B premiums shall equal 25 percent of program costs. Directs the Secretary by regulation to: (1) describe the factors to be used in determining if a reasonable charge is inherently reasonable; and (2) provide, in those cases where the reasonable charge is not inherently reasonable, for factors that will be considered in establishing a reasonable charge that is realistic and equitable. Revises the computation of customary charges with respect to certain former hospital-compensated physicians. Provides coverage for outpatient occupational therapy services. Revises payment provisions with respect to durable medical equipment. Provides, among other things, that, with respect to durable medical equipment furnished on or after October 1, 1986, the prevailing charge level may not exceed the percentage increase in the Consumer Price Index. Prohibits coverage for an assistant in a cataract operation unless, before surgery, the appropriate utilization and quality control peer review organization has approved the use of an assistant because of a complicating medical condition. Directs the Secretary: (1) after consultation with the Prospective Payment Assessment Commission, to develop recommendations and guidelines respecting other surgical procedures for which an assistant at surgery is generally not medically necessary and the circumstances under which an assistant is appropriate; and (2) to report to the Congress with recommendations and guidelines. Provides that, with respect to the payment for replacement cataract eyeglasses and cataract contact lenses: (1) payment may be made for the replacement of lost or damaged cataract eyeglasses only once every year; and (2) payment may be made, in the first year after surgery, for one original cataract contact lens for each eye and for the replacement only twice of a lost or damaged cataract contact lens for each eye, and in each subsequent year, for the replacement only twice of a lost or damaged cataract contact lens for each eye. Directs the Secretary to establish a demonstration program designed to reduce disability and dependency through the provision of preventive health services to Medicare beneficiaries. Sets forth provisions relating to: (1) preventive health services to be made available under the demonstration program; (2) the conduct of the program; (3) evaluation of the program; (4) reports to the Congress; (5) funding; and (6) waiver of Medicare requirements. Part D: Private Health Insurance Continuation - Amends the Internal Revenue Code to prohibit the expenses paid or incurred by an employer for a group health plan from being allowed as a deduction unless each qualified beneficiary who would lose coverage because of a qualifying event is given the option of electing continued coverage under the plan. Sets forth specifics concerning such continuation, including: (1) five-year maximum length of coverage; and (2) allowing the plan to provide for payment of the total premium by the beneficiary. Title II: Trade and Customs Laws Amendments - Part A: Trade Adjustment Assistance - Amends the Trade Act of 1974 to require trade adjustment assistance for workers if increases in imports like or directly competitive with articles produced by such workers' firm contributed importantly to the total or partial separation of such workers or to the threat of total or partial separation of such workers or to a decline in sales and production of the firm. Provides that workers shall be eligible for trade adjustment assistance if a significant number or proportion of the workers in a workers' firm or subdivision have become totally or partially separated or are threatened with becoming totally or partially separated because of the relocation of the production functions of that firm or subdivision to a foreign country or instrumentality. Limits to seven the number of weeks during which the employee was on employer-authorized leave or was serving as a labor organization representative which may be treated as qualifying weeks of employment. Extends the duration of trade adjustment allowances from 52 to 104 weeks. Defines "reasonable expectation of employment" for purposes of determining if job training should be approved. Requires each State agency that is providing adversely affected workers with testing, counseling, training, and placement services to: (1) advise each adversely affected worker to apply for training under the trade adjustment assistance program at the time the worker applies for trade readjustment allowances; and (2) interview the adversely affected worker within 60 days on suitable training opportunities available under the trade adjustment assistance program. Directs the Secretary of Commerce to certify a firm as eligible for adjustment assistance if sales or production or both of an article that accounted for at least 25 percent of the total production or sales of the firm have decreased during a specified time period. Authorizes making financial assistance available to firms either through a single loan or a combination of loans. Deletes the provision that prohibits granting adjustment assistance or financial assistance to a firm unless the owners, partners, or officers of the firm bind themselves to avoid certain conflicts of interest. Extends adjustment assistance programs for workers and firms until September 30, 1989. Sets forth the effective dates for the provisions of this part. Part B: Authorization of Appropriations for Trade and Customs Agencies - Amends the Tariff Act of 1930 to authorize appropriations for FY 1986 for the International Trade Commission. Amends the Customs Procedural Reform and Simplification Act of 1978 to authorize appropriations for FY 1986 for the U.S. Customs Service. Earmarks specified amounts for: (1) additional inspectors, import specialists, customs patrol officers, and special agents; (2) the operation and maintenance of the air interdiction program of the Service; and (3) programs to enforce or monitor export controls under the Export Administration Act of 1979. Prohibits using any Customs Service funds to close any port of entry at which, during FY 1985: (1) not less than 2,500 merchandise entries were made; and (2) not less than $1,500,000 in customs revenues were assessed. Prohibits using any funds authorized for FY 1985 for the Customs Service for further research and development or acquisition of F-15 avionics for the P-3 aircraft and related equipment until 60 days after specified congressional committees have received a comparative assessment of the suitability of certain aircraft for use by the Customs Service in its air drug interdiction program. Prohibits using any such funds to consolidate the drawback liquidation centers within the Customs Service to less than four centers. Authorizes appropriations to the Department of the Treasury for FY 1986 for: (1) making payments out of the Customs Forfeiture Fund, including an amount for modifying aircraft for drug interdiction; and (2) providing customs services at airports. Requires the General Accounting Office to report to specified congressional committees within 12 months of enactment of this Act on a study that evaluates the air detection and interdiction capability of the Customs Service. Directs the Commissioner of Customs to use any savings resulting from administrative consolidations to strengthen the commercial operations of the Customs Service by increasing the number of inspector, import specialist, patrol officer, and other line operational positions. Prohibits the Commissioner from publishing or taking any other action to give force and effect to a final rule that would revise the current rule relating to the requirement for sureties on customs bonds: (1) unless the Commissioner submits a report to the Congress containing specified information; and (2) until 90 days of continuous session of the Congress after such report is submitted. Amends the Trade Act of 1974 to limit the number of officers and employees that the U.S. Trade Representative may appoint without regard to civil service regulations. Authorizes appropriations for the Office of the United States Trade Representative for FY 1986. Decreases the amount earmarked for entertainment and representation expenses. Part C: User Fees for Customs Services - Amends the Customs Procedural Reform and Simplification Act of 1978 to direct the Secretary of the Treasury to charge and collect specified fees for a period of three years to cover the expenses incurred by the Customs Service in processing arrivals at U.S. ports of entry of commercial vessels of 100 or more tons, commercial trucks, railroad cars, private aircraft or private vessels, each passenger aboard a commercial vessel or aircraft from a place outside the United States, and each passenger aboard a commercial vessel, aircraft, or train from Canada, Mexico, a U.S. territory or possession, or certain islands. Directs the Secretary of the Treasury to establish an advisory committee to advise the Secretary on issues related to the performance of the customs services. Title III: Provisions Relating to Aid to Families with Dependent Children - Amends part A (Aid to Families with Dependent Children) of title IV of the Social Security Act to require each State, in order to establish and maintain improved quality control standards and procedures in the operation and administration of its plan, to: (1) annually collect a statistically reliable sample of the cases under its approved State plan for purposes of quality control review; (2) review the sample and make findings; and (3) submit the findings to the Secretary. Requires the Secretary to review the records submitted and determine the State's error rate. Requires the State to develop a corrective action plan, submit such plan to the Secretary, and, after receiving the Secretary's approval, implement such plan. Specifies AFDC error rates. Provides for disallowances of payments to a State which has an error rate above the tolerance level. Permits a State to request a waiver of any disallowance, upon showing: (1) a good faith effort to reduce erroneous payments; or (2) that the Secretary's determination of the State's error rate was incorrect. Authorizes appropriations for FY 1986 and 1987 to be used by the Secretary for grants to assist States and localities in establishing and carrying out programs: (1) to reduce the rate of teenage pregnancies in AFDC families; and (2) to help pregnant individuals and teenage parents of young children in such families, who might otherwise become long-term recipients of AFDC, in achieving self-sufficiency. Requires a State to use such grants only in areas of high teenage pregnancy or high infant mortality. Requires a State to apply for such grants. Sets forth the objectives of a State's program, including requiring voluntary program participants to seek a high school diploma or equivalent training and providing program participants with job counseling and placement services. Limits participation in the high school and job placement and counseling programs to those individuals who are under the age of 25 or who are teenage parents of dependent children under the age of six. Sets forth: (1) program requirements; and (2) reporting requirements. Requires that the current AFDC program for unemployed parents be implemented in all States. Permits a State to substitute education for work in the definition of "quarters of work." Title IV: Provisions Relating to Railroad Unemployment Repayment Tax and Unemployment Compensation - Amends the Internal Revenue Code to revise provisions relating to the railroad unemployment repayment tax. Revises the formulas for determining the rate of such tax by combining a basic rate and a surtax rate. Provides that "rail wages" for purposes of such tax shall be determined by: (1) reference to the same compensation used in determining the railroad retirement tax; (2) taking into account only employment covered by the Railroad Unemployment Insurance Act; and (3) using a specified wage base during certain periods. Amends the Railroad Retirement Revenue Act of 1983 to revise provisions relating to the use of such tax to repay loans made to the railroad unemployment insurance account. Provides that such taxes attributable to the basic rate be used to reduce the outstanding balance of such loans made before October 1, 1985, and that such taxes attributable to the surtax rate be used to reduce the outstanding balance of such loans made on or after such date. Amends the Railroad Unemployment Insurance Act to extend the borrowing authority under such Act by deleting a prohibition against specified transfers after a certain date from the Railroad Retirement Account to the Railroad Unemployment Insurance Account. Provides that National Guard members who perform temporary disaster services related to a specified major disaster shall not lose their eligibility for Federal supplemental unemployment compensation, under the phase-out of such program benefits, because of certain consecutive-weeks-of-unemployment requirements under the Federal Supplemental Compensation Act of 1972. Title V: Revenue Provisions - Expresses the sense of the Congress that proposed reductions in the budget for the Internal Revenue Service for FY 1986 should be restored and increases in such budget should be approved for revenue enforcement and related purposes. Amends the Internal Revenue Code to make permanent the increase in the excise tax on cigarettes. (Present law terminates such increase as of October 1, 1985.) Establishes in the Treasury the Tobacco Equalization Trust Fund. Appropriates to such trust fund a specified portion of the excise tax on cigarettes. Allows expenditures from such trust fund for the reimbursement of the Commodity Credit Corporation for any net losses sustained with respect to the tobacco price support program. Increases the excise tax on coal. Sets specified per ton rates of such tax for coal from underground mines from 1986 through 1995. Allows for a reduction in such tax after 1995 if loans made to the Black Lung Disability Trust Fund are repaid. Provides that only the amount of railroad retirement benefits which are equivalent to social security benefits shall be treated as tier 1 benefits. Provides for a temporary increase in Pension Benefit Guaranty Corporation premiums for single employer plans for plan years beginning after December 31, 1985, and before January 1, 1989.

Resolution· HRESH.Res. 246 (99th)referred

A resolution to amend the Rules of the House of Representatives to prohibit the Committee on Rules from reporting any rule or order waiving any section 303 point of order contained in the Congressional Budget Act of 1974 with respect to general appropriation bills.

United States · United States Congress · 31 July 1985

Amends the Rules of the House of Representatives to prohibit any waiver of the Congressional Budget Act which allows the consideration of general appropriations bills without the adoption of the first concurrent resolution on the budget.

Bill· HRH.R. 3101 (99th)open

Medicare and Medicaid Budget Reconciliation Amendments of 1985

United States · United States Congress · 30 July 1985

Medicare and Medicaid Budget Reconciliation Amendments of 1985 - Title I: Medicare Programs - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to direct the Director of the Congressional Office of Technology Assessment to provide for the appointment of a Physician Payment Review Commission which shall include physicians, other health professionals, health researchers, and consumer representatives. Requires the Commission to annually make recommendations to the Congress regarding adjustments to the reasonable charge levels for physicians' services and changes in the methodology for determining the rates of payment, and for making payment, for physicians' services under Medicare and other items and services under part B. Requires the Commission to also advise and make recommendations to the Secretary concerning the development of the relative value scale. Authorizes appropriations. Directs the Secretary to develop a relative value scale that establishes a numerical relationship among the various physicians' services for which payment may be made under part B or State plans approved under title XIX (Medicaid) of the Act. Requires a report from the Secretary to Congress concerning the relative value scale. Revises provisions relating to the dates for revising payments for clinical laboratory services. Sets limits on regional payment rates. Requires a report from the Secretary to the Congress concerning standards for clinical laboratories. Revises payment provisions with respect to durable medical equipment. Provides that, among other things, with respect to durable medical equipment furnished on or after October 1, 1986, the prevailing charge level may not exceed the percentage increase in the Consumer Price Index. Requires payment on an assignment basis for durable medical equipment furnished on a rental basis and for oxygen therapy services. Extends, for one year, the current freeze on physician charge levels for nonparticipating physicians under part B, while providing incentives for participating physicians. Eliminates the physician assignment rate list. Requires, in the case of all covered employed individuals, that payment for health care items or services, to the extent possible, be made by the individual's group health plan before Medicare payments will be made. Defines the "special enrollment period" referred to in part B as the period beginning with the first day of the first month in which an individual is no longer enrolled in a group health plan by reason of current employment and ending seven months later. Amends the Age Discrimination in Employment Act of 1967 to prohibit an employer from discriminating against an employee over age 65 under the employer's group health plan. Prohibits payment for a surgical procedure listed by the Secretary unless a second opinion regarding such surgery is obtained. Provides that the second opinion need not agree with the first opinion in order for payment to be made. Directs the Secretary to establish a list of at least ten surgical procedures to which the second opinion requirement applies. Directs the Secretary to enter into contracts with utilization and quality control peer review organizations under which such organizations serve as referral centers for the second opinions required by this Act. Permits the patient to choose any qualified physician, except one affiliated with the initial physician, to provide the second opinion. Provides that a second opinion need not be obtained if: (1) to delay surgery would be a risk to the patient; (2) no physician is available, within reasonable limits, to provide the second opinion; and (3) the surgery is to be performed on a patient who is a member of a health maintenance organization or competitive medical plan having a risk sharing contract with the Secretary. Requires physicians, hospitals, and ambulatory surgical centers to notify patients of the second opinion requirement. Sets forth sanctions for noncompliance. Directs the Secretary to notify physicians, hospitals, ambulatory surgical centers, and Medicare beneficiaries of the requirements of this Act. Waives the deductible and copayments with respect to the second opinion. Sets forth effective date, regulation, and study provisions. Prohibits coverage for an assistant in a cataract operation unless, before surgery, the appropriate utilization and quality control peer review organization has approved the use of an assistant because of a complicating medical condition. Directs the Secretary: (1) after consultation with the Prospective Payment Assessment Commission, to develop recommendations and guidelines respecting other surgical procedures for which an assistant at surgery is generally not medically necessary and the circumstances under which an assistant is appropriate; and (2) to report to the Congress with recommendations and guidelines. Provides coverage for all services provided by a doctor of optometry. Permits an individual to be represented by a provider during a Medicare related hearing or appeal. Permits, under part B, an administrative hearing if the amount in controversy is more than $500 and judicial review if the amount in controversy is more than $1,000. Directs the Secretary to establish a Task Force on Long-Term Health Care Policies. Requires the Task Force to develop guidelines for long-term health care policies and report to the Secretary and Congress. Requires the Secretary: (1) to provide for the dissemination of the report to each of the States; and (2) annually report to Congress concerning such guidelines. Directs the Secretary to provide for the extension of the waiver of certain Medicare and Medicaid (title XIX of the Act) requirements with respect to the On Lok Senior Health Services program. Title II: Medicaid Program - Amends title XIX (Medicaid) of the Act to: (1) include within the definition of "qualified pregnant woman" any woman who meets the income and resources requirements under part A (Aid to Families with Dependent Children) of title IV of the Act; (2) provide that the making available to covered pregnant women of pregnancy-related services shall not require the making available of such services to other individuals; and (3) provide that a woman who, while pregnant, is eligible for, has applied for, and has received Medicaid, shall be deemed, for purposes of the provision of all pregnancy-related and post-partum medical assistance under Medicaid, to remain pregnant until the end of the 60-day period beginning on the last day of her pregnancy. Defines the term "habilitation services" as used in title XIX. Provides for the coverage as home or community-based services of services provided to individuals who would otherwise continue to receive inpatient hospital services because they are dependent on ventilator support the cost of which is reimbursed under Medicaid. Makes other revisions concerning home and community-based services with respect to: (1) total expenditures for such services; (2) expenditures for certain disabled patients; and (3) maintenance income standards. Permits an eligible individual to receive hospice care under Medicaid. Requires a State's Medicaid plan to provide for payment to hospitals for direct medical education costs. Sets forth the procedures to be followed in determining the amount of such payments, including the determination of an approved full-time equivalent resident amount. Sets forth special rules for foreign medical graduates. Requires a report from the Secretary to the Congress. Sets forth provisions relating to the eligibility of an individual with a trust. Prohibits payment for organ transplant procedures unless the State plan provides for written standards respecting the coverage of such procedures and unless such standards contain specified provisions. Provides that for Medicaid purposes, any individual receiving aid or assistance under part E (Foster Care and Adoption Assistance) of title IV of the Act shall be deemed to be receiving such aid or assistance from the State in which the individual actually resides. Requires a report from the Secretary to the Congress concerning Medicaid payments for hospitals serving disproportionate numbers of low income patients. Lists provisions of laws directly affecting Medicaid.

Resolution· HRESH.Res. 231 (99th)passed

A resolution providing special budget procedures for the Fiscal Year 1986 Congressional Budget Process.

United States · United States Congress · 23 July 1985

Provides that for the purposes of the Congressional Budget Act of 1974 as it applies to the House of Representatives, the Congress shall be considered to have adopted H. Con. Res. 152 (revising the congressional budget for FY 1985 and setting forth the congressional budget for FY 1986 through 1988) as adopted by the House. Declares that for the purposes of this resolution, the allocations of budget authority and new entitlement authority printed in the Congressional Record of July 23, 1985, by Representative Gray of Pennsylvania shall be considered as allocations made pursuant to such Act. Terminates applicability of this resolution upon final adoption by the House and the Senate of a concurrent resolution for the applicable fiscal years.

Bill· HRH.R. 2845 (99th)referred

A bill to provide for a two-year budget cycle for the Department of Defense beginning with fiscal year 1988.

United States · United States Congress · 21 June 1985

Directs the President to include within his FY 1988 budget submitted to the Congress a two-year Department of Defense proposed budget for FY 1988 and 1989. Directs the President to thereafter submit a proposed two-year budget for such Department every other year. Requires the Secretary of Defense, not later than July 1, 1986, to report to the Committees on Armed Services and on Appropriations of the Senate and House of Representatives on a proposed two-year budget cycle for the Department of Defense.

Bill· HRH.R. 2642 (99th)open

A bill to amend the District of Columbia Self-Governmental Reorganization Act, to establish a formula-based annual Federal Payment, to require the District to budget to offset any deficit occurring in its General Fund and for other purposes.

United States · United States Congress · 3 June 1985

Amends the District of Columbia Self-Government and Governmental Reorganization Act to allow the District of Columbia to expend funds proposed for a fiscal year before such funds are approved by an Act of the Congress and signed into law. Eliminates certain budget-submission requirements of the Mayor of the District of Columbia to the D.C. Council and the President. Authorizes annual appropriations beginning with FY 1986 as the annual Federal payment to the District of Columbia. Requires the District of Columbia to take budgetary action to offset any deficit occurring in its general fund.

Resolution· HCONRESH.Con.Res. 154 (99th)referred

A concurrent resolution to revise the congressional budget for the United States Government for the fiscal year 1985 and setting forth the congressional budget for the United States Government for the fiscal years 1986, 1987, and 1988.

United States · United States Congress · 21 May 1985

Revises the concurrent resolution on the budget for FY 1985 and sets forth the first concurrent resolution on the budget for FY 1986 and the appropriate budgetary levels for FY 1987 and 1988. Recommends levels of Federal revenues of $736,200,000,000 for FY 1985, $794,200,000,000 for FY 1986, $866,000,000,000 for FY 1987, and $954,200,000,000 for FY 1988. Sets the amounts by which the aggregate levels of Federal revenues should be increased at zero for FY 1985, $1,500,000,000 for FY 1986, $1,700,000,000 for FY 1987, and $1,700,000,000 for FY 1988. Sets the amounts for Federal Insurance Contributions Act (FICA) revenues for hospital insurance within the recommended levels of Federal revenues at $44,800,000,000 for FY 1985, $50,900,000,000 for FY 1986, $56,100,000,000 for FY 1987, and $61,200,000,000 for FY 1988. Sets the amount for FICA revenues for old-age, survivors and disability insurance within the recommended levels of Federal revenues at $186,200,000,000 for FY 1985, $200,400,000,000 for FY 1986, $216,800,000,000 for FY 1987, and $248,000,000,000 for FY 1988. Sets the appropriate levels of total new budget authority at $1,055,500,000,000 for FY 1985, $1,060,000,000,000 for FY 1986, $1,129,100,000,000 for FY 1987, and $1,209,300,000,000 for FY 1988. States that the appropriate levels of total budget outlays are $949,300,000,000 for FY 1985, $970,800,000,000 for FY 1986, $1,021,600,000,000 for FY 1987, and $1,074,400,000,000 for FY 1988. Sets the amounts of the deficits in the budget which are appropriate in the light of economic conditions and all other relevant factors at $213,100,000,000 for FY 1985, $176,600,000,000 for FY 1986, $155,600,000,000 for FY 1987, and $120,200,000,000 for FY 1988. States that appropriate levels of the public debt are $1,857,400,000,000 for FY 1985, $2,089,700,000,000 for FY 1986, $2,320,700,000,000 for FY 1987, and $2,536,500,000,000 for FY 1988. Sets the amounts by which the statutory limits on such limit should be increased at $33,600,000,000 for FY 1985, and $232,300,000,000 for FY 1986, $231,000,000,000 for FY 1987, and $215,800,000,000 for FY 1988. Sets forth the appropriate levels of total Federal credit activity as follows: (1) $51,937,223,000 for new direct loan obligations, $68,805,405,000 for new primary loan guarantee commitments, and $41,251,600,000 for new secondary loan guarantee commitments for FY 1985; (2) $34,258,541,000 for new direct loan obligations, $74,036,605,000 for new primary loan guarantee commitments, and $43,107,900,000 for new secondary loan guarantee commitments for FY 1986; (3) $34,376,759,000 for new direct loan obligations, $76,966,574,000 for new primary loan guarantee commitments, and $44,904,200,000 for new secondary loan guarantee commitments for FY 1987; and (4) $34,172,944,000 for new direct loan obligations, $81,175,571,000 for new primary loan guarantee commitments, and $46,861,800,000 for new secondary loan guarantee commitments, for FY 1988. Sets forth the levels of budget authority, budget outlays, new direct loan obligations, and new loan guarantee commitments for each major functional category for FY 1985 through 1988. Requires certain House and Senate committees to report changes in laws within their jurisdictions sufficient to achieve savings of specified amounts of budget authority and outlays in FY 1986. Specifies changes in budget authority and outlays under laws within such committees' jurisdictions which the Congress finds necessary in FY 1987 and 1988 to achieve budget levels under this resolution. Requires such House committees to submit their recommendations to the House Budget Committee not later than 30 days after adoption of jurisdiction. Requires the House Budget Committee to report a reconciliation bill carrying out such recommendations without any substantive revision. Declares that, effective October 1, 1985, this concurrent resolution shall be deemed to be the second concurrent budget resolution for FY 1986 required to be reported under the Congressional Budget Act of 1974. Permits the enrollment of any bill or resolution providing new discretionary budget authority or new spending authority for FY 1986 if it would not cause the appropriate allocation for a committee to be exceeded. Terminates such provisions when the Congress completes action on a subsequent concurrent resolution on the budget for FY 1986. Prohibits the House of Representatives from considering any measure providing new budget authority, new entitlement authority, or new credit activity for FY 1986 within the jurisdiction of a committee until such committee makes the allocations or subdivisions required by the Congressional Budget Act. Declares that such prohibition shall not apply until 21 days of continuous session after the Congress completes action on this concurrent resolution.

Resolution· HCONRESH.Con.Res. 152 (99th)open

A concurrent resolution revising the congressional budget for the United States Government for the fiscal year 1986 and setting forth the congressional budget for the United States Government for the fiscal years 1986, 1987, and 1988.

United States · United States Congress · 20 May 1985

Revises the concurrent resolution on the budget for FY 1985 and sets forth the first concurrent resolution on the budget for FY 1986 and the appropriate budgetary levels for FY 1987 and 1988. Recommends levels of Federal revenues of $736,050,000,000 for FY 1985, $794,100,000,000 for FY 1986, $866,000,000,000 for FY 1987, and $955,600,000,000 for FY 1988. Sets the amounts by which the aggregate levels of Federal revenues should be increased at zero for FY 1985, $1,450,000,000 for FY 1986, $1,700,000,000 for FY 1987, and $3,100,000,000 for FY 1988. Sets the amounts for Federal Insurance Contributions Act (FICA) revenues for hospital insurance within the recommended levels of Federal revenues at $44,800,000,000 for FY 1985, $51,000,000,000 for FY 1986, $56,100,000,000 for FY 1987, and $61,300,000,000 for FY 1988. Sets the amount for FICA revenues for old-age, survivors, and disability insurance within the recommended levels of Federal revenues at $186,150,000,000 for FY 1985, $200,700,000,000 for FY 1986, $216,850,000,000 for FY 1987, and $248,250,000,000 for FY 1988. Sets the appropriate levels of total new budget authority at $1,039,100,000,000 for FY 1985, $1,051,500,000,000 for FY 1986, $1,125,700,000,000 for FY 1987, and $1,205,300,000,000 for FY 1988. States that the appropriate levels of total budget outlays are $941,000,000,000 for FY 1985, $959,100,000,000 for FY 1986, $1,022,450,000,000 for FY 1987, and $1,073,650,000,000 for FY 1988. Sets the amounts of the deficits in the budget which are appropriate in light of economic conditions and all other relevant factors at $205,600,000,000 for FY 1985, $165,000,000,000 for FY 1986, $156,450,000,000 for FY 1987, and $118,050,000,000 for FY 1988. States that appropriate levels of the public debt are $1,857,400,000,000 for FY 1985, $2,089,700,000,000 for FY 1986, $2,320,700,000,000 for FY 1987, and $2,536,500,000,000 for FY 1988. Sets the amounts by which the statutory limits on such limit should be increased at $33,600,000,000 for FY 1985, $232,300,000,000 for FY 1986, $231,000,000,000 for FY 1987, and $215,800,000,000 for FY 1988. Sets forth the appropriate levels of total Federal credit activity as follows: (1) $51,950,000,000 for new direct loan obligations, $68,800,000,000 for new primary loan guarantee commitments, and $68,250,000,000 for new secondary loan guarantee commitments for FY 1985; (2) $38,050,000,000 for new direct loan obligations, $74,600,000,000 for new primary loan guarantee commitments, and $68,250,000,000 for new secondary loan guarantee commitments for FY 1986; (3) $37,000,000,000 for new direct loan obligations, $73,000,000,000 for new primary loan guarantee commitments, and $68,250,000,000 for new secondary loan guarantee commitments for FY 1987; and (4) $36,450,000,000 for new direct loan obligations, $76,900,000,000 for new primary loan guarantee commitments, and $68,250,000,000 for new secondary loan guarantee commitments for FY 1988. Sets forth the levels of budget authority, budget outlays, new direct loan obligations, and new loan guarantee commitments for each major functional category for FY 1985 through 1988. Sets forth revised budgetary levels reflecting both the unified budget and off-budget transactions for FY 1986 through 1987. Recommends revised levels of Federal revenues of $794,100,000,000 for FY 1986, $866,000,000,000 for FY 1987, and $955,600,000,000 for FY 1988. Sets the revised amounts by which the aggregate level of revenues should be increased at $1,450,000,000 for FY 1986, $1,700,000,000 for FY 1987, and $3,100,000,000 for FY 1988. Sets the revised amounts for FICA revenues for hospital insurance within the recommended levels of Federal revenues at $51,000,000,000 for FY 1986, $56,100,000,000 for FY 1987, and $61,300,000,000 for FY 1988. Sets the revised amount for FICA revenues for old-age, survivors and disability insurance within the recommended levels of Federal revenues at $200,700,000,000 for FY 1986, $216,850,000,000 for FY 1987, and $248,250,000,000 for FY 1988. Sets the revised levels of total new budget authority at $1,062,900,000,000 for FY 1986, $1,134,300,000,000 for FY 1987, and $1,212,800,000,000 for FY 1988. States that the revised levels of total budget outlays are $967,250,000,000 for FY 1986, $1,028,500,000,000 for FY 1987, and $1,080,000,000,000 for FY 1988. Sets the revised amounts of the deficits in the budget which are appropriate in light of economic conditions and all other relevant factors at $173,150,000,000 for FY 1986, $162,500,000,000 for FY 1987, and $124,400,000,000 for FY 1988. Sets forth the revised levels of budget authority and budget outlays for each major functional category. Requires certain House committees to report changes in laws within their jurisdictions sufficient to achieve savings of specified amounts of budget authority and outlays in FY 1986. Specifies changes in budget authority and outlays under laws within such committees' jurisdictions which the Congress finds necessary in FY 1987 and 1988 to achieve budget levels under this resolution. Requires such committees to submit to their recommendations to the House Budget Committee not later than 30 days after final action on this resolution. Requires the Budget Committee to report a reconciliation bill carrying out such recommendations without any substantive revision. Declares that, effective October 1, 1985, this concurrent resolution shall be deemed to be the second concurrent budget resolution for FY 1986 required to be reported under the Congressional Budget Act of 1974. Permits the enrollment of any bill or resolution providing new discretionary budget authority or new spending authority for FY 1986 if it would not cause the appropriate allocation for a committee to be exceeded. Makes exceptions for legislation that would cause budget authority and outlays for certain off-budget spending programs to be included in the unified budget. Terminates such provisions when the Congress completes action on a subsequent concurrent resolution on the budget for FY 1986. Expresses the sense of the Congress that: (1) the Office of Management and Budget should release and apportion to the States the amount appropriated for the Special Supplemental Food Program (WIC program) for FY 1985; (2) the Administration should call for the convening of an international monetary conference this year for the purpose of exploring options to stabilize currency exchange rates, reduce interest rates, promote maximum domestic and world economic growth, and help assure domestic price stability; and (3) budget functional totals should be reduced to reflect a limitation on the amount of social security benefits paid to illegal and nonresident aliens. Expresses the sense of the House of Representatives that tax reform should be adopted as soon as possible incorporating the following objectives; (1) responsiveness to market conditions; (2) simplicity of structure and lower marginal tax rates; (3) fair and equitable distribution of the tax burden; (4) a broader tax base; and (5) increased incentives for work, saving, and investment. Expresses the sense of the House of Representatives that: (1) each of its standing committees should review, on a continuing basis and when considering public bills or resolutions, those portions of the President's Private Sector Survey on Cost Control (Grace Commission report) pertaining to such committee's jurisdiction; and (2) each committee report on a public bill or resolution should contain an identification of each recommendation of the Survey to be implemented and the resulting estimated program cost savings or revenue enhancement and a statement setting forth the disposition of each recommendation pertaining to such bill or resolution.

Resolution· HCONRESH.Con.Res. 151 (99th)referred

A concurrent resolution to revise the congressional budget for the United States Government for the fiscal year 1985 and setting forth the congressional budget for the United States Government for the fiscal years 1986, 1987, and 1988.

United States · United States Congress · 16 May 1985

Revises the concurrent resolution on the budget for FY 1985 and sets forth the first concurrent resolution on the budget for FY 1986 and the appropriate budgetary levels for FY 1987 and 1988. Recommends levels of Federal revenues of $736,200,000,000 for FY 1985, $794,200,000,000 for FY 1986, $866,000,000,000 for FY 1987, and $954,200,000,000 for FY 1988. Sets the amounts by which the aggregate levels of Federal revenues should be increased at zero for FY 1985, $1,500,000,000 for FY 1986, $1,700,000,000 for FY 1987, and $1,700,000,000 for FY 1988. Sets the amounts for Federal Insurance Contributions Act (FICA) revenues for hospital insurance within the recommended levels of Federal revenues at $44,800,000,000 for FY 1985, $50,900,000,000 for FY 1986, $56,100,000,000 for FY 1987, and $61,200,000,000 for FY 1988. Sets the amount for FICA revenues for old-age, survivors, and disability insurance within the recommended levels of Federal revenues at $186,200,000,000 for FY 1985, $200,400,000,000 for FY 1986, $216,800,000,000 for FY 1987, and $248,000,000,000 for FY 1988. Sets the appropriate levels of total new budget authority at $1,055,500,000,000 for FY 1985, $1,060,000,000,000 for FY 1986, $1,119,800,000,000 for FY 1987, and $1,189,300,000,000 for FY 1988. States that the appropriate levels of total budget outlays are $949,300,000,000 for FY 1985, $970,800,000,000 for FY 1986, $1,018,500,000,000 for FY 1987, and $1,064,300,000,000 for FY 1988. Sets the amounts of the deficits in the budget which are appropriate in the light of economic conditions and all other relevant factors at $213,100,000,000 for FY 1985, $176,600,000,000 for FY 1986, $152,500,000,000 for FY 1987, and $110,100,000,000 for FY 1988. States that appropriate levels of the public debt are $1,849,800,000,000 for FY 1985, $2,085,900,000,000 for FY 1986, $2,308,400,000,000 for FY 1987, and $2,512,300,000,000 for FY 1988. Sets the amounts by which the statutory limits on such limit should be increased at $26,000,000,000 for FY 1985, $236,100,000,000 for FY 1986, $222,500,000,000 for FY 1987, and $203,900,000,000 for FY 1988. Sets forth the appropriate levels of total Federal credit activity as follows: (1) $51,937,223,000 for new direct loan obligations, $68,805,405,000 for new primary loan guarantee commitments, and $41,251,600,000 for new secondary loan guarantee commitments for FY 1985; (2) $34,258,541,000 for new direct loan obligations, $74,036,665,000 for new primary loan guarantee commitments, and $43,107,900,000 for new secondary loan guarantee commitments for FY 1986; (3) $34,376,759,000 for new direct loan obligations, $76,966,574,000 for new primary loan guarantee commitments, and $44,964,200,000 new primary loan guarantee commitments, and $46,061,800,000 for new secondary loan guarantee commitments for FY 1987; and (4) $34,172,944,000 for new direct loan obligations, $81,175,571,000 for new secondary loan guarantee commitments for FY 1988. Sets forth the levels of budget authority, budget outlays, new direct loan obligations, and new loan guarantee commitments for each major functional category for FY 1985 through 1988. Requires certain Senate and House committees to report changes in laws within their jurisdictions sufficient to achieve savings of specified amounts of budget authority and outlays in FY 1986. Sets forth decreases in budget authority and outlays under laws within such committees' jurisdictions which the Congress finds necessary in FY 1987 and 1988 to achieve budget levels under this resolution. Requires such committees to submit their recommendations to the Committees on the Budget of their respective Houses not later than 30 days after adoption of this resolution. Requires the Budget Committees to report to the House and Senate a reconciliation bill carrying out such recommendations without any substantive revision. Declares that, effective October 1, 1985, this concurrent resolution shall be deemed to be the second concurrent budget resolution for FY 1986 required to be reported under the Congressional Budget Act of 1974. Permits the enrollment of any bill or resolution providing new discretionary budget authority or new spending authority for FY 1986 if it would not cause the appropriate allocation for a committee to be exceeded. Terminates such provisions when the Congress completes action on a subsequent concurrent resolution on the budget for FY 1986. Prohibits the House of Representatives from considering any measure providing new budget authority, new entitlement authority, or new credit activity for FY 1986 within the jurisdiction of a committee until such committee makes the allocations or subdivisions required by the Congressional Budget Act. Declares that such prohibition shall not apply until 21 days of continuous session after the Congress completes action on this concurrent resolution.

Resolution· SRESS.Res. 159 (99th)open

An original resolution to establish a select committee to study and make recommendations with respect to a two-year budget process.

United States · United States Congress · 9 May 1985

Establishes for the first session of the 99th Congress the Senate Select Committee on the Two Year Budget to review and recommend legislative proposals to improve the operation of the congressional budget process, including proposals for the two-year budget. Requires a report from such committee within 180 days after adoption of this resolution.

Regulation· Rechtsverordnung224/85open

Verordnung zur Regelung der Krankenhauspflegesätze (Bundespflegesatzverordnung - BPflV) (G-SIG: 10021495)

Germany · Bundesrat · 8 May 1985

Vergütung von Krankenhausleistungen durch im voraus vereinbartes Budget mit Festlegung der Pflegesätze vor Beginn des Pflegesatzzeitraums in Eigenverantwortung der Krankenhäuser und Krankenkassen; Einrichtung unabhängiger Schiedsstellen für den Fall der Nichteinigung. Umstellung der Pflegesätze auf leistungsbezogenere Vergütungsformen, Eröffnung von Gewinn- und Verlustmöglichkeiten. Schaffung höherer Transparenz der Krankenhauskosten, verstärkte Berücksichtigung von Kosten und Leistungen vergleichbarer Krankenhäuser, von Empfehlungen zur Wirtschaftlichkeit und Leistungsfähigkeit sowie der Möglichkeit der Kostendämpfung bei Pflegesatzverhandlungen

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