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51 records in 1986

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Bill· Gesetzgebung11/7320open

Gesetz über die Feststellung eines Zweiten Nachtrags zum Wirtschaftsplan des ERP-Sondervermögens für das Jahr 1990 (Zweites ERP-Nachtragsplangesetz 1990) (G-SIG: 11020595)

Germany · German Bundestag · 1 January 1987

<b>Bezug:</b> Siehe auch den textidentischen Gesetzentwurf der Fraktionen der CDU/ CSU und FDP E27 Vergleiche auch E03, E08, E17, E25, E26, E30, E33, E34 und D61 <br><br><b>Inhalt:</b> Bereitstellung von zusätzlichen Mitteln in Höhe von 4,8 Mrd DM zur Förderung von Investitionen in der DDR und in Berlin (Ost); Finanzierung der Ausgaben durch Kreditaufnahme, Verbilligung der Zinsen für ERP-Kredite um durchschnittlich 2,75 Prozentpunkte aus dem Bundeshaushalt, dafür Ausbringung einer Verpflichtungsermächtigung von 1,55 Mrd DM im Zweiten Nachtragshaushaltsgesetz 1990. Es entstehen Kosten von 4,8 Mrd DM. <br><br><b>Nebenschlagwörter:</b> Deutsche Demokratische Republik/Investitionsförderung durch 2. ERP- Nachtragsplangesetz 1990 * Investitionsförderung/Förderung der DDR durch 2. ERP-Nachtragsplangesetz 1990 * Nachtragshaushalt/ Zinsverbilligung für ERP-Kredite durch Zweites Nachtragshaushaltsgesetz 1990

Resolution· Entschließungsantrag BT11/8246rejected

Entschließungsantrag zum Gesetz über die Feststellung eines Dritten Nachtrags zum Bundeshaushalt für das Haushaltsjahr 1990 (Drittes Nachtragshaushaltsgesetz 1990) (G-SIG: 11005518)

Germany · German Bundestag · 1 January 1987

Erhebung der Gedenkstätte Hadamar für die Opfer der NS-Euthanasieverbrechen in den Rang einer nationalen Gedenkstätte noch im Jahr 1990, Einstellung eines mit 500 000 DM dotierten Haushaltstitels in den Epl 06 und einer Verpflichtungsermächtigung von jeweils 1 Mio DM für die Folgejahre

Bill· HRH.R. 5725 (99th)referred

A bill to provide that the disaster relief personnel of the Small Business Administration shall be treated as performing essential services for purposes of allowing such Administration to operate for temporary periods without budget authority.

United States · United States Congress · 16 October 1986

Requires disaster relief personnel of the Small Business Administration to be treated as performing essential services with respect to allowing such Administration to operate for temporary periods without budget authority.

Bill· HRH.R. 5699 (99th)referred

Budget Process Sunset Review Act of 1986

United States · United States Congress · 14 October 1986

Budget Process Sunset Review Act of 1986 - Title I: Commission on Budget Process Review - Establishes a Commission on Budget Process Review to: (1) review the operation and effectiveness of the Congressional Budget and Impoundment Control Act of 1974 and the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act); (2) study the impact of such Acts on executive and congressional operations; (3) determine whether such Acts should be continued, modified, or terminated; and (4) determine how such Acts might be amended to improve congressional and executive control of budgetary outlay and receipt totals and to reduce Federal deficits. Directs the Commission to report its findings and recommendations to the Congress by September 30, 1987. Terminates the Commission by December 31, 1987. Authorizes appropriations. Title II: Congressional Review and Action on Commission Report - Provides for congressional committee referral and hearings on the Commission's report. Requires the appropriate committee, by December 31, 1987, to report to its House a bill, resolution, or report containing its recommendations with respect to the Commission's report. Repeals the Congressional Budget and Impoundment Control Act of 1974 and the Balanced Budget and Emergency Deficit Control Act of 1985 on March 15, 1988, unless legislation has been enacted, following the issuance of such committee report, continuing or modifying such Acts.

Bill· SS. 2921 (99th)open

A bill to amend the Public Law 99-396 exception to the Balanced Budget Emergency Deficit Control Act of 1985, and for other purposes.

United States · United States Congress · 10 October 1986

Amends Federal law to prohibit reduction by the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) of economic development funds paid into the treasuries of Puerto Rico, Guam, the Virgin Islands, and the Northern Mariana Islands pursuant to specified Federal laws.

Bill· SS. 2843 (99th)referred

A bill to amend the Congressional Budget Act of 1974 to minimize the impact on State and local governments of unexpected provisions of legislation proposing the imposition of large unfunded costs on such governments, and for other purposes.

United States · United States Congress · 19 September 1986

Amends the Congressional Budget Act of 1974 to provide that it shall not be in order for either House of Congress to consider any legislation which would impose any requirement on State or local governments which is likely to result in an annual cost to such governments of $50,000,000 or more for any particular program, project, or activity, except for legislation which complies with any sequestration order issued under the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act). Requires the report of the Committee on the Budget of each House accompanying the concurrent resolution on the budget to identify changes in federal aid programs for State and local governments on a program-by-program basis.

Bill· HRH.R. 5535 (99th)referred

A bill to amend the Congressional Budget Act of 1974 to minimize the impact on State and local governments of unexpected provisions of legislation proposing the imposition of large unfunded costs on such governments, and for other purposes.

United States · United States Congress · 17 September 1986

Amends the Congressional Budget Act of 1974 to provide that it shall not be in order for either House of Congress to consider any legislation which would impose any requirement on State or local governments which is likely to result in an annual cost to such governments of $50,000,000 or more for any particular program, project, or activity, except for legislation which complies with any sequestration order issued under the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act). Requires the report of the Committee on the Budget of each House accompanying the concurrent resolution on the budget to identify changes in federal aid programs for State and local governments on a program-by-program basis.

Bill· SJRESS.J.Res. 412 (99th)open

An original joint resolution complying with the requirements of section 274(f)(1) of the Balanced Budget and Emergency Deficit Control Act of 1985.

United States · United States Congress · 12 September 1986

Provides that this joint resolution shall be deemed to set forth the contents of the joint Office of Management and Budget-Congressional Budget Office sequestration report for FY 1987 transmitted to the Congress on August 20, 1986. Requires such report to serve as the sole basis for the sequestration order required to be issued by the President under the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act).

Bill· HJRESH.J.Res. 723 (99th)open

A joint resolution complying with the requirements of section 274(f)(1) of the Balanced Budget and Emergency Deficit Control Act of 1985.

United States · United States Congress · 12 September 1986

Provides that this joint resolution shall be deemed to set forth the contents of the joint Office of Management and Budget-Congressional Budget Office sequestration report for FY 1987 transmitted to the Congress on August 20, 1986. Requires such report to serve as the sole basis for the sequestration order required to be issed by the President under the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act).

Resolution· HRESH.Res. 529 (99th)referred

A resolution to facilitate compliance with congressional intent expressed in the Balanced Budget and Emergency Deficit Control Act of 1985 with respect to fiscal year 1987.

United States · United States Congress · 5 August 1986

Declares that each standing committee of the House of Representatives may, not later than September 12, 1986, submit to the House Budget Committee alternatives to the joint report of the Directors of the Office of Management and Budget and the Congressional Budget Office under the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act), insofar as such order affects laws within the jurisdiction of the committee. Requires the Budget Committee, not later than September 19, 1986, to report a resolution containing instructions to committees sufficient to achieve the total level of deficit reduction contained in the Director's report for FY 1987. Provides that such instructions shall require that each committee (and each subcommittee of the Committee on Appropriations) achieve the same level of deficit reduction with respect to programs under its jurisdiction as would have been saved under the Director's report. Requires committees to submit recommendations to the Budget Committee by September 26, 1986, sufficient to meet deficit reductions. Requires the Budget Committee to promptly report a reconciliation bill carrying out such recommendations. Authorizes the Budget Committee to include legislative language within the jurisdiction of any noncomplying committee. Requires such reconciliation bill to include a provision which states that if it is enacted on or before October 15, 1986, then the President's sequestration order for FY 1987 is null and void. Establishes procedures for floor consideration of such reconciliation bill, including limitation on debates and amendments.

Bill· SS. 2706 (99th)open

Sixth Omnibus Budget Reconciliation Act, 1986

United States · United States Congress · 31 July 1986

Sixth Omnibus Budget Reconciliation Act 1986 - Title I: Agricultural Securities - Directs the Secretary of Agriculture to sell notes and other obligations held in the Rural Development Insurance Fund in such amounts as to realize specified minimum net proceeds from sales during FY 1987 through 1989. Amends the Consolidated Farm and Rural Development Act to permit the sale of such notes on a nonrecourse basis. Relieves the Secretary and any subsequent purchaser of such notes of any responsibilities that might have been imposed had the borrower remained indebted to the Secretary. Makes institutions of the Farm Credit System eligible to purchase such notes and to service, collect, and dispose of them, subject only to such terms and conditions as may be agreed to by the Secretary and such purchasing institutions, with the approval of the Farm Credit Administration. Title II: Committee on Banking, Housing, and Urban Affairs - Directs the Secretary of Agriculture to ensure that rural housing loans are sold to the public in amounts sufficient to provide from the sales specified minimum proceeds and net reductions in outlays for FY 1988 through 1989. Directs the Secretary to establish specific guidelines for the sale of such loans. Requires the Secretary to submit periodic reports on such loan sales to the congressional banking committees. Requires the Comptroller General of the United States to audit and evaluate such sales activities and to report on each audit to the congressional banking committees. Amends the Export-Import Bank Act of 1945 to direct the Board of Directors of the Export-Import Bank of the United States to: (1) ensure and establish guidelines for the public sale of Bank loans sufficient to reduce FY 1987 outlays by a specified amount; (2) report to specified congressional committees on such activity every 60 days during FY 1987; and (3) file reports required by the Securities and Exchange Commission on such loan sales which shall be deemed to be sales of exempted securities under the Securities Exchange Act of 1933. Authorizes the Bank to issue an amount of capital stock equal to any resulting reduction in Bank capital and reserves. Requires the Secretary of the Treasury to purchase such stock. Directs the Comptroller General to audit such activities of the Board of Directors and report on the results of such audit to specified congressional committees. Title III : Directs the Secretary of the Department in which the Coast Guard is operating (the Secretary) to establish and implement a system for the collection, beginning January 1, 1987, of specified amounts in FY 1987 through 1989 of payments by users of Coast Guard services (other than emergency search and rescue). Directs the Secretary, also by January 1, 1987, to issue regulations to carry out this provision, including a schedule of user fees. Directs the Secretary to report to the Congress: (1) no later than December 1, 1986, regarding activities undertaken to establish and implement such system; and (2) no later than December 1, 1987, regarding the implementation and effects of such system. Amends Federal bankruptcy law to provide that an action brought against a debtor by either the Secretary of Transportation or the Secretary of Commerce under the Ship Mortgage Act, 1920 to foreclose a security interest held by either Secretary in a fishing vessel or facility shall operate as an automatic stay to any Federal bankruptcy proceeding against such debtor. Title IV: Committee on Energy and Natural Resources - Subtitle A: Department of Energy Programs - Amends the Emergency Petroleum Allocation Act of 1973 to bar the commencement of an enforcement action relating to overcharges resulting from crude oil pricing violations unless such action is filed before the later of January 1, 1987, or six years after the date of such violations. Bars an action for the enforcement of a final Federal agency action under the Economic Stabilization Act of 1970 unless a complaint is filed (or an application for modification is filed under the Federal Energy Administration Act of 1974) within one year after the order has been issued or one year after the final compliance date prescribed by the order, whichever is later. Confers jurisdiction upon Federal district courts over petitions for review of final agency actions brought under the Department of Energy Organization Act, if the petition is filed within 60 days of either the effective date of the agency action or the date of enactment of this Act, whichever occurs later. Prescribes the distribution procedure for restitutionary amounts held or received as a result of a settlement, order or judgment involving overcharges resulting from alleged crude oil pricing violations under the Emergency Petroleum Allocation Act of 1973 or the Economic Stabilization Act of 1970. Directs the Secretary of Energy to: (1) disburse specified restitutionary amounts during FYs 1987 through 1989 for State energy conservation programs; (2) distribute such amounts in such fiscal years in a manner that will provide funding in the same proportionate amount that was provided by the Congress for FY 1986; and (3) require that the States use the funds to supplement rather than supplant funds otherwise available for energy conservation activities. Amends the National Energy Conservation Policy Act to direct the Secretary to establish a life cycle cost methodology for Federal buildings using average fuel costs. Amends the Department of Energy Organization Act to direct the Administrator of the Energy Information Administration to conduct and publish on a triennial basis the results of a survey of energy consumption in the manufacturing industries in the United States. Amends the Energy Policy and Conservation Act to repeal provisions relating to industrial energy conservation. Directs the Secretary of Energy (acting through the Energy Information Administration) to conduct a study of domestic crude oil production and petroleum refining capacity and the effects of imports thereon in order to determine whether such production and capacity are adequate to protect the national security. Requires the Secretary to transmit such study to the President and the Congress within 60 days after enactment of this Act. Requires the President to advise the Congress within 45 days after receipt of such study on what actions will be required to prevent imports of crude oil and petroleum from exceeding import levels that threaten national security. Subtitle B: Federal Energy Regulatory Commission - Directs the Federal Energy Regulatory Commission to assess fees and annual charges in amounts sufficient to reimburse the United States for all costs incurred by the Commission. Subtitle C: Department of the Interior Program - Directs the Secretary of the Interior to appoint an interagency task force to develop a systematic and comprehensive environmental clean-up plan for the Great Swamp National Wildlife Refuge in New Jersey. Title V: Committee on Environment and Public Works - Authorizes the Administrator of the Environmental Protection Agency to assess and collect fees for services and activities implemented by the Agency for FY 1987 through 1989. Requires the Administrator to report to the Congress regarding such fees by September 30. 1987. Authorizes the Nuclear Regulatory Commission to assess and collect annual charges from its licensees on a fiscal year basis for costs incurred by the Commission with respect to such licensees in an amount limited to 38 percent of the funds appropriated to the Commission for each of FYs 1987 through 1989. Directs the Secretary of Commerce to sell defaulted notes held in the Economic Development Administration's Revolving Fund in such amounts as to realize minimum net proceeds of $50,000,000 from such sales during fiscal year 1987. Authorizes the Secretary to sell such notes on a nonrecourse basis. Authorizes appropriations for Federal-aid highways and highway safety construction programs for FY 1987 through 1989. Sets forth obligation limitations, with specified exceptions, for such fiscal years. Requires the Secretary to: (1) provide all States with sufficient authority to prevent lapses of sums authorized to be appropriated for Federal-aid highways and highway safety construction which have been apportioned or allocated to a State; (2) revise the distribution of authorized funds to those States able to obligate amounts (giving priority to those States having either large unobligated balances, or which have experienced substantial reductions in their apportionments and allocations); and (3) refrain from distributing amounts authorized for administrative expenses, Federal land highways, and the Strategic Highway Research Program. Title VI: Committee on Finance: Outlay Provisions - Subtitle A: Provisions Relating to the Medicare Program - Part I: Provisions Relating to Part A of Medicare - Amends title XVIII (Medicare) of the Social Security Act to raise the payment rates for inpatient hospital services by one and one-half percent for cost reporting periods in FY 1987. Requires that total out lier payments to sole community hospitals with an average occupancy of 50 beds or less and to small rural hospitals be no less than five percent nor more than six percent of the total payments expected to be made to such hospitals on the basis of prospective payment rates for discharges in that year. Alters the formula used to calculate the average standardized amounts for urban and rural hospitals under the prospective payment system (PPS) so that such amounts are based on the number of patients discharged rather than the number of hospitals. Provides that hospitals designated as rural referral centers as of the enactment of this Act shall retain that designation from FY 1987 until the close of FY 1989. Reduces payments for hospital capital costs of inpatient services by three percent in FY 1987, five percent in FY 1988, and six percent in FY 1989. Exempts sole community hospitals from such reductions. Sets the inpatient hospital deductible at $520 in 1987. Ties future increases in the deductible to the annual increase in the average cost of a Medicare hospital discharge instead of the cost of an average day of hospital care. Requires a hospital to give Medicare beneficiaries, upon their admission to the hospital, a written statement explaining: (1) the individual's rights to benefits for inpatient hospital and post-hospital Medicare services; (2) the circumstances under which such individual will be liable for charges for a continued hospital stay; (3) the individual's right to appeal denials of continued hospital services; and (4) the individual's liability for payment for services if such a denial of benefits is upheld on appeal. Directs the Secretary of Health and Human Services to conduct a demonstration project to determine whether the use of prior and concurrent authorization for skilled nursing facility and home health services, instead of current waiver of liability provisions, will protect beneficiaries from claim denial liabilities and delayed services. Requires the Secretary to report to the Congress on the results of the project by April 2, 1988. Part 2: Provisions Relating to Parts A and B of Medicare - Prohibits workers' compensation laws, insurance policies, or large group health plans (covering at least 20 employees) from taking an individual's status as a Medicare beneficiary into account in providing coverage. Prohibits group health plans from taking into account an individual's end stage renal disease benefits under Medicare. Makes Medicare the secondary payor for all Medicare beneficiaries covered by workers' compensation, insurance policies, and group health plans. Authorizes the Federal government to bring an action and collect double damages from primary payors. Amends the Internal Revenue Code to impose an excise tax equal to 25 percent of group health plan expenses if such a plan restricts its coverage of Medicare beneficiaries in violation of this Act. Amends title XIX (Medicaid) of the Act to reduce payments to a State contributing to group plans which provide such restrictive coverage. Specifies the benefits Medicare pays when other payors are primary but do not pay full charge. Requires Medicare intermediaries and carriers to process and pay at least 95 percent of all clean Medicare claims within 24 days of receiving such claims or, if shorter, within their average payment time for such claims during the first half of 1986. Assesses interest on claims paid beyond 24 days of their receipt. Eliminates periodic interim payments for PPS hospitals when prompt payments have been achieved for three consecutive months. Authorizes the reinstatement of interim payments when prompt payment is absent for three consecutive months. Sets limits on Medicare payments for home health services, but requires that such limits be applied on an aggregate rather than a discipline-specific basis for home health agencies. Requires providers of home health services to be paid if they did not and could not have been expected to know that payment would be denied on the basis that the individual was not homebound or did not require skilled nursing care on an intermittent basis. Requires the Secretary to publish final regulations specifying the criteria used in determining whether an individual is homebound or in need of such intermittent care. Permits beneficiary appeals of the Secretary's denials of claims for home health service benefits. Prohibits providers who represent beneficiaries in unsuccessful appeals of claim denials from charging beneficiaries for representation costs or treating such costs as reasonable costs covered by Medicare. Requires the Secretary to establish a program providing for research regarding outcomes of selected medical treatments and surgical procedures so as to assess their quality and effectiveness. Places a priority on the selection of procedures and treatments with significant costs, risks, hospitalization periods, and utilization patterns. Authorizes appropriations from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund for FY 1987 through 1989 to carry out such research. Requires that at least 90 percent of the funds available in any fiscal year be used to fund grants to, and cooperative agreements with, non-Federal research entities. Directs that the program be administered by the National Center for Health Services Research and Health Care Technology (Center). Requires the Center to report to the Congress, within 18 months of enactment of this Act and annually thereafter, on the findings of the project. Part 3: Provisions Relating to Part B of Medicare - Amends part B of the Medicare Program to set forth factors which must be considered by carriers in determining reasonable charges for physicians' services. Authorizes the Secretary, when faced with a charge the Secretary believes is not inherently reasonable, to propose a reasonable charge or methodology for arriving at such a charge and, after giving the public and the Physician Payment Review Commission an opportunity to comment on such proposal, make a final determination regarding the charge or methodology. Requires the Secretary to review, by October 1, 1987, the inherent reasonableness of the reasonable charges for each of the ten most costly procedures paid for under Part B of the Medicare program. Directs the Secretary to simplify the HCFA (Health Care Financing Administration) Common Procedure Coding System by July 1, 1987, to minimize the possibility that such system overstates the intensity or volume of services provided. Requires hospitals to adopt such system to code the part B services they perform. Requires the Secretary, in making recommendations regarding the relative value scale for physicians' services, to establish an index which considers justifiable geographic differences in the costs of practice without exacerbating the geographic maldistribution of physicians. Provides for the implementation of certain adjustments in the Medicare economic index for physicians' services. Requires the Secretary to: (1) implement changes in monthly capitation payments and the method of computing such payments for physicians' outpatient maintenance dialysis services; and (2) reduce the prospective payment rates for dialysis facilities and providers. Directs the Comptroller General to study the appropriateness of such payment rates and report to the Congress by September 30, 1987. Provides that the payment to hospitals for outpatient hospital services furnished in connection with surgery approved for performance in an ambulatory surgical center (ASC) shall equal the lesser of: (1) the reasonable costs for surgery minus 20 percent of the actual charge; or (2) the prospective rate for ASCs minus 20 percent of that rate. Requires the Secretary to annually review and revise ASC prospective rates as well as the surgical procedures approved for ASC performance and reimbursement. Requires peer review organizations to review the necessity and quality of ambulatory surgical procedures. Imposes the standard part B coinsurance and deductible for ambulatory surgery services. Directs the Secretary to: (1) develop packages of pre - and post - operative services for each surgical procedure performed in a hospital outpatient department; (2) develop a PPS methodology for all outpatient procedures; and (3) report to the Congress on these developments by 1991. Requires the Secretary to report to the Congress within two years of enactment of this Act regarding educational activities in hospital outpatient settings and the reimbursement of graduate medical education in such settings. Provides Medicare coverage for outpatient occupational therapy services in the same manner in which outpatient physical therapy services are covered. Part 4: Peer Review Organizations - Amends part B (Peer Review) of title XI of the Act to require peer review organizations receiving a hospital inpatient's request for review of a hospital's decision that the patient no longer needs inpatient care to inform the patient of its decision within two days of receiving the request. Prohibits hospitals from charging patients for inpatient hospital services provided while patients wait for a peer review organization to respond to their timely review requests. Requires fiscal intermediaries to submit data to peer review organizations on a monthly basis. Requires peer review organizations to review selected cases where individuals are readmitted to a hospital within 30 days of their most recent hospital discharge to determine if the previous inpatient hospital services and post-hospital services met professionally recognized health care standards. Directs each peer review organization to commit a reasonable proportion of its activities to review of the quality of services provided in cases and settings where potential quality problems have been identified. Requires the Secretary to identify methods facilitating the discovery of such cases. Requires peer review organizations to share data with organizations responsible for accrediting providers or State licensing authorities responsible for assuring quality care if such data reflects a substantial failure by providers or practitioners to provide quality care. Subtitle B: Provisions Relating to the Medicaid Program - Amends title XIX (Medicaid) of the Act to give States the option of extending coverage to women in need of pregnancy-related medical services and children up to age five whose family income exceeds current income eligibility thresholds, but does not exceed a State maximum income level to be established at or below the Federal poverty level. Leaves to each State's discretion the decision as to whether a resource standard shall be applied in determining the eligibility of such women and children. Prohibits States which provide coverage pursuant to this Act from reducing Aid to Families with Dependent Children (AFDC) payment levels after enactment of this Act. Gives States the option of extending Medicaid coverage to elderly and disabled individuals whose income is too high for them to qualify for Medicaid under current income tests, but does not exceed a State maximum income level to be established at or below the Federal poverty level. Requires States providing coverage under this Act to provide Medicaid coverage, to pregnant women and infants whose income does not exceed a State maximum income level which, while at or below the Federal poverty level, is not necessarily the same as the level established for newly eligible aged and disabled individuals. Authorizes the States to provide Medicaid coverage for Medicare premiums, deductibles, and coinsurance payments for which Medicare-eligible individuals whose income does not exceed the State maximum income level would otherwise be accountable. Requires States to cover home respiratory services for individuals who: (1) are medically dependent on a ventilator for life support for at least six hours a day; (2) have been so dependent for at least 30 consecutive days as inpatients; and (3) wish, and have adequate social support services to be cared for at home. Amends the Consolidated Budget Reconciliation Act of 1985 to hold a State harmless in FY 1987 against changes that Act effected in the annual calculation of the Federal medical assistance percentage under the Medicaid program if such changes would cause a reduction of Medicaid payments to the State in FY 1987. Directs the Secretary to enter into an agreement with New Jersey to conduct a Medicaid demonstration project which shall be administered by a State health agency and which provides respite care services, including: (1) short-term sitter, homemaker, and personal-care services, adult day care, inpatient care, and emergency respite; and (2) peer support and training for family caregivers. Provides such services to elderly and disabled Medicaid-eligible individuals and to other elderly and disabled individuals, for a reasonable fee, who would otherwise require institutional care. Provides that priority, among the latter group, shall be given to those who would be eligible for Medicaid benefits upon institutionalization. Provides that the State and Federal governments shall each cover one-half of project costs, but sets a fiscal year limit on Federal outlays. Limits the duration of the project to four years, plus an additional period of up to six months for final evaluation and reporting. Sets forth reporting requirements. Permits States to provide ambulatory prenatal care to women during a presumptive eligibility period not to exceed 45 days if: (1) the woman has begun maternity care with a qualified provider; (2) the provider determines that the woman's family income falls below the applicable Medicaid standard and notifies the State of the woman's eligibility within five working days; and (3) the woman applies for such benefits within 14 days of being presumed eligible. Subtitle C: Miscellaneous Provisions - Amends part D (Child Support) of title IV of the Act to prohibit the retroactive modification of child support arrearages except with respect to such arrearages which accumulate after the obligee and entity which issued the child support order receive notice that the obligor has pending an active application for modification of such order. Amends the Consolidated Budget Reconciliation Act of 1985 to hold a State harmless in FY 1987 against changes that Act effected in the annual calculation of the Federal medical assistance percentage under part A (Aid to Families with Dependent Children) of title IV of the Act if such changes would cause a reduction of AFDC payments to the State in FY 1987. Title VI-A: Committee on Finance Revenue Provisions - Amends the Internal Revenue Code to provide for Medicare coverage of, and the application of the hospital insurance tax to, all State and local government employees. Increases the excise tax on cigarettes from: (1) $8 to $12 per thousand for small cigarettes; and (2) $16.80 to $25.20 per thousand for large cigarettes. Imposes a floor stocks tax on cigarettes. Title VII: Governmental Affairs - Part A: Postal Service Matters - Amends Federal law to revise the method by which revenue forgone is computed for reduced-rate mail and mailers. Assumes that the combination of postage and appropriations to be received for each of the reduced-rate categories will bear the same ratio to the costs attributed to such respective categories as the revenues to be received from the most closely corresponding regular-rate category bear to the costs attributed to that regular-rate category. Part B: Federal Employees Retirement System - Amends the Federal Employees' Retirement System Act of 1986 to move up from June 30, 1987, to March 31, 1987, the date by which one must be a Federal Employee to be eligible to elect to be subject to such Act. Moves up from July 1, 1987, to April 1, 1987, the earliest date on which an eligible Federal employee may make such an election. Moves up from June 30, 1987, to March 31, 1987, the earliest date on which certain Federal employees serving continuously since December 31, 1983, may elect to become subject to such Act. Moves up from July 1, 1987 to April 1, 1987, the commencement date for the period during which a Federal employee or a Member of Congress may elect to participate in the Thrift Savings Plan. Permits the Executive Director of the Federal Retirement Thrift Investment Board to prescribe such election period. Part C: Program Civil Fraud - Program Civil Fraud Remedies Act of 1986 - Establishes penalties and assessments to be imposed against any person who knowingly makes a false claim or statement to: (1) an authority of the United States; (2) a recipient of property, services, or money from such authority; (3) a party to a contract with such authority; or (4) an authority which has the effect of decreasing an obligation to pay or account for property, services or money. Declares that such penalties and assessments are in addition to criminal and civil penalties and assessments provided by other laws. Directs the investigating official of a Federal authority to investigate allegations that a person made a false claim or statement and to report findings to the reviewing official designated for that authority. Directs the reviewing official to refer such allegations to a hearing examiner for that authority upon determining there is adequate evidence to believe that the person is liable for a penalty or assessment. Requires the reviewing official, prior to notifying the hearing examiner, to notify the Attorney General of any intention to refer such allegations to a hearing examiner. Allows the reviewing official to refer allegations of liability to a hearing examiner only if, within 90 days of receipt of notice, the Attorney General or designated Assistant Attorney General approves the referral. Prohibits the referral of allegations to a hearing examiner if the Attorney General transmits a statement to such effect. Authorizes the Attorney General, by written statement, to stay any hearing already in progress if such hearing adversely affects a pending or potential civil action related to a fraudulent claim. Prohibits the referral of allegations to a hearing examiner when a fraudulent claim exceeds $100,000. Specifies the authority of the investigating official and the official conducting the hearing, and the procedure for judicial review of the determination reached in the hearing. Authorizes the Attorney General to commence a civil action to recover a penalty or assessment determined by such a hearing. Authorizes the authority head to settle a final penalty or assessment determined by hearing. Grants the Attorney General exclusive authority to settle a claim subject to judicial review or collection procedures. Authorizes the deduction from any sum owed to a person by the United States, except Federal tax refunds, the amount of any penalty or assessment owed by that person to the United States. Specifies time limitations for commencing a hearing concerning a false statement or claim and for commencing an action to recover any penalty or assessment. Requires each authority head to report annually to the appropriate congressional committees on actions taken under this Act during the most recent 12-month period ending September 30. Prohibits the delegation to any other officer or employee of the Department of Justice of any function, duty, or responsibility specified to be carried out by the Attorney General or by an Associate or Assistant Attorney General designated by the Attorney General. Title VIII: Committee on Labor and Human Resources - Education Budget Savings Act of 1986 - Amends title IV (Student Assistance) of the Higher Education Act of 1965 (HEA) to require that all applicants undergo a financial needs test to receive a Guaranteed Student Loan (GSL). (Current law makes a student from a family with an annual income under $30,000 automatically eligible for a GSL loan.) Repeals the current GSL expected family contribution schedule under the Student Financial Technical Amendments of 1982. (Provides that the financial needs test for expected family contribution used for other Federal student aid programs be used for GSL determinations of need.) Permits student auxiliary loans or parent loans to be used to offset the expected family contribution for GSL loans. Increases the interest rate for GSL new borrowers after September 30, 1986, from eight percent to ten percent when the loan enters repayment. Lowers the rate of Federal reimbursement (or "reinsurance") of claims paid on defaulted loans to guarantee agencies from 100%-90%-80% to 100%-80%-70%. (Retains the 100% reimbursement in cases of a less than five percent default rate). Revises the formula for determining special allowances paid to banks for participation in the GSL program so as to decrease such allowances from three and one-half to three percent of specified amounts. Revises the definition of independent student to require unmarried students under age 23 without dependents to prove two prior years of financial independence from their parents. Directs the Secretary of Education during FY 1987 to recover, and deposit in the treasury, a specified amount of outstanding advances to State guaranty agencies. Amends title VII (Construction, Reconstruction, and Renovation of Academic Facilities) of HEA to redesignate the current part D as part E and to add a new part D: Housing and Other Educational Facilities Loans. (These provisions are similar in many respect to those under title IV (Housing for Educational Institutions) of the Housing Act of 1950 which is repealed by this Act.) Authorizes the Secretary of Education to make loans to undergraduate postsecondary institutions for the construction, reconstruction, or renovation of housing, undergraduate academic facilities, and other educational facilities for students and faculties. Sets forth: (1) conditions for the making of such loans; and (2) provisions governing the use of such loans for previously made contracts, and the amount and conditions of such loans. Provides that funds obtained pursuant to specified provisions of title IV of the Housing Act of 1950 shall be available to carry out part D. Provides that the total amount of notes and obligations which the Secretary of Education may continue to issue and have outstanding for purchase by the Secretary of the Treasury shall not exceed the amount issued and outstanding under such provisions as of September 30, 1985. Requires that at least ten percent of such funds held by the Secretary be made available for loans under part D for each fiscal year. Authorizes appropriations to the Secretary of Education of such sums as may be necessary, together with principal and interest payments made by postsecondary educational institutions assisted with loans made under part D (or under title IV of the Housing Act of 1950), for payment on notes and obligations issued by the Secretary under such part or title. Sets forth general provisions relating to budget and accounting, use of funds, legal powers, computation of allowable discounts, contracts for supplies or services, applicability of the Government Corporation Control Act, and wage rates. Directs the Secretary of Education to sell college housing and higher education facilities loan obligations held under title VII of HEA so as to carry out the directions in the concurrent resolution on the budget for the FY 1987. Directs the Secretary, in awarding loans under part D, to give priority to loans for renovation or reconstruction of: (1) undergraduate academic facilities; and (2) older undergraduate academic facilities and undergraduate academic facilities that have gone without major renovation or reconstruction for an extended period. Prohibits any loan application under part D until ten years after the date on which an undergraduate postsecondary educational institution received a loan under such part. Repeals title IV (Housing for Educational Institutions) of the Housing Act of 1950. Title IX: Committee on Small Business - Amends the Small Business Investment Act of 1958 to require the Secretary of the Treasury to sell to the public all right, title, and interest in debentures guaranteed by the Small Business Administration and issued by State or local development companies and held by the Federal Financing Bank in such amounts as to realize specified net proceeds for FY 1987 through 1989. Sets forth specified requirements with respect to the sale of such debentures.

Law· HRH.R. 5300 (99th)enacted

Omnibus Budget Reconciliation Act of 1986

United States · United States Congress · 31 July 1986

Title I: Short Title and Table of Contents - Omnibus Budget Reconciliation Act of 1986 - Sets forth the table of contents. Title II: House Committee on Agriculture - Subtitle A: Sale of Notes Held in the Rural Development Insurance Fund - Directs the Secretary of Agriculture to sell notes and other obligations held in the Rural Development Insurance Fund in such amounts as to realize specified minimum net proceeds from sales during FY 1988 and FY 1989. Amends the Consolidated Farm and Rural Development Act to permit the sale of such notes on a nonrecourse basis. Relieves the Secretary and any subsequent purchaser of such notes of any responsibilities that might have been imposed had the borrower remained indebted to the Secretary. Makes institutions of the Farm Credit System eligible to purchase such notes and to service, collect, and dispose of them, subject only to such terms and conditions as may be agreed to by the Secretary and such purchasing institutions, with the approval of the Farm Credit Administration. Prohibits, during FY 1987 through 1989, the sale of any note out of the Agricultural Credit Insurance Fund, except in connection with transactions with the Secretary of the Treasury, without prior approval by Congress. Subtitle B: Prepayment of Loans - Amends the Rural Electrification Act of 1936 to permit a borrower of a guaranteed loan made by the Federal Financing Bank to prepay such loan by paying the outstanding principal balance due, if: (1) the loan is outstanding on July 2, 1986; (2) private capital, with the existing loan guarantee, is used to replace the loan; and (3) the borrower certifies that such prepayment will result in substantial savings to its customers or lessen the threat of bankruptcy to the borrower. Declares that no sums in addition to the payment of the outstanding principal balance due shall be charged as the result of such prepayment against the borrower, the fund, or the Rural Electrification Administration. Prohibits any borrower from qualifying for prepayment if, in the Secretary of the Treasury's opinion, prepayment in the borrower's case would adversely affect the Bank's operation. Limits this prohibition, during FY 1987, to any loan the prepayment of whose principal amount will cause the cumulative amount of principal on loans prepaid under such Act to exceed $2,415,000,000. Directs the Administrator of the Rural Electric Administration to permit prepayment during FY 1987 in a cumulative amount not less than the amount that, added to the cumulative amount of principal prepayments in FY 1986, equals $2,415,000,000. Declares that a direct or insured loan made under such Act shall not be sold or prepaid at less than the face value of any outstanding principal balance of such loan. Directs the Secretary of Agriculture to issue regulations to implement this subtitle within 15 days after enactment of this Act. Subtitle C: Federal Meat Inspection - Processed Products Inspection Improvement Act of 1986 - Amends the Federal Meat Inspection Act to redescribe the manner and frequency of inspection of meat food products to include the requirement that the Secretary of Agriculture take into account for each establishment: (1) the nature and frequency of processing operations; (2) the adequacy and reliability of processing controls and sanitary procedures; and (3) the history of inspection compliance. Changes the requirement that condemned meat food products be destroyed for "food purposes," to a requirement that they be destroyed for "human food purposes." Authorizes a court, upon the Secretary's request, to issue a temporary order forbidding operational control of a facility subject to Federal inspection by any person convicted of a felony involving intentional adulteration of food, extortion, or bribery, if control by such person would pose a threat to public health or safety or a clear likelihood of significant economic harm to consumers. Authorizes the Secretary to commence civil actions for inspection suspensions in cases of: (1) repeated offenses; and (2) assaults or threats of assault on inspectors. Provides for judicial review of such suspension in courts of appeal. Provides that amendments made by this Act shall not be construed to authorize the Secretary to refuse to provide inspection solely because an establishment does not participate in a total plant quality-control program. Amends such Act, six years after enactment of these amendments, to read as the respective provisions of such Act read immediately before these amendments were made. Declares that it is the sense of the Congress that the Secretary of Agriculture should: (1) carry out a program to detect residues in livestock subject to inspection; and (2) evaluate the feasibility of and develop a program that would enable the Secretary to trace any particicular livestock subject to inspection, in order to identify the producer of such livestock. Requires an annual report from the Secretary to the congressional agriculture committees on actions taken to implement these amendments. Directs the Congress to evaluate the effects of this Act not later than six years after its enactment. Title III: House Committee on Banking, Finance and Urban Affairs - Directs the Secretary of Agriculture to ensure that rural housing loans are sold to the public in amounts sufficient to provide from the sales specified minimum net reductions in outlays for FY 1987 through 1989. Directs the Secretary to establish specific guidelines of the sale of such loans. Requires the Secretary to use the Federal Financing Bank as an agent to sell such loans, unless the Secretary can sell them directly for a higher rate of return to the Government. Requires the Secretary, at least 20 days before the initial sale of such loans, to report to the congressional banking committees estimates of the discounts at which loans will be sold at such initial sale and at each subsequent sale during FY 1987. Requires the Secretary to submit periodic reports on such loan sales to such committees. Requires the Comptroller General of the United States to audit and evaluate such sales activities and to report on each audit to the congressional banking committees. Amends the Export-Import Bank Act of 1945 to direct the Board of Directors of the Export-Import Bank of the United States to: (1) ensure and establish guidelines for the public sale of Bank loans sufficient to reduce FY 1987 outlays by a specified amount; (2) use the Federal Financing Bank as an agent to sell the loans or notify the Federal Financing Bank of its determination to sell loans itself in order to receive a higher rate of return; (3) report to specified congressional committees on the estimated discount at which loans will be sold at the initial sale and at each subsequent sale during FY 1987; and (4) report to specified congressional committees on such activity every 60 days during FY 1987. Directs the Comptroller General to audit such activity and report the results of such audit to specified congressional committees. Exempts such loan sales from any Federal or State securities law. Title IV: House Committee on Energy and Commerce - Subtitle A: Nuclear Regulatory Commission Annual Charges - Directs the Nuclear Regulatory Commission to assess and collect annual charges from its licensees on a fiscal year basis, beginning with FY 1987, in amounts sufficient to recover all of the regulatory costs of the Commission budgeted for such fiscal year. Subtitle B: Federal Energy Regulatory Commission Annual Charges - Directs the Federal Energy Regulatory Commission to assess and collect annual charges on a fiscal year basis, beginning with FY 1987, from interstate natural gas pipelines, interstate oil pipeline carriers, and public utilities. Authorizes the Commission to use the amounts collected for administrative costs. Directs the Commission to provide that such assessments shall be included in the rates of an interstate natural gas pipeline as a uniform charge on each thousand cubic feet sold or transported. Subtitle C: Petroleum Overcharge Distribution - Petroleum Overcharge Distribution and Restitution Act of 1986 - Requires that amounts paid as restitution for petroleum pricing and allocation violations, with specified exceptions, be referred to the Secretary of Energy (the Secretary) and held in escrow accounts for such Secretary by the Secretary of the Treasury. Prescribes guidelines for the disbursement of such restitutionary amounts. Mandates the disbursement of excess restitutionary amounts to the States for energy conservation programs in a manner that will provide funding in the same proportion as was provided by the Congress for FY 1986. Directs the Secretary to: (1) require that the States use the funds to supplement rather than supplant funds otherwise available for energy conservation activities; (2) report to the Congress within 60 days after enactment of this Act regarding all receipts, disbursements and commitments of funds related to the enforcement of petroleum pricing and allocation regulations; and (3) report to the Congress each fiscal year beginning in FY 1987 regarding the status of certain deficiency funds. Terminates this subtitle 90 days after the Secretary: (1) determines that all restitutionary funds have been collected and disbursed; and (2) submits to the Congress the final receipts, disbursements and deficiency reports. Exempts from such termination the use by any State of excess restitutionary amounts for energy conservation programs. Subtitle D: Information and Study Requirements - Amends the Energy Policy and Conservation Act to repeal provisions relating to industrial energy conservation. Directs the Secretary of Energy to conduct on a triennial basis a survey of energy consumption in the manufacturing industries in the United States. Directs the Secretary (acting through the Energy Information Administration) to conduct a study of domestic crude oil production and petroleum refining capacity, and to report the results of such study to the President and to the Congress within 60 days after the date of enactment of this Act. Requires the President (within 45 days after such report is transmitted to the Congress) to determine the levels at which imports of crude oil and refined petroleum products threaten national security. Subtitle E: Strategic Petroleum Reserve - Authorizes appropriations for FY 1987 through 1989 for the acquisition, transportation and injection of petroleum products for the Strategic Petroleum Reserve (SPR) and for any drawdown and distribution of such Reserve. Requires the Secretary to purchase stripper well oil for FY 1987 through 1989 if the Secretary determines that such purchase is in the national interest and will prevent significant permanent loss of petroleum production from stripper well property. Mandates that at least 75 percent of such crude oil be purchased from independent producers. Amends the Energy Policy and Conservation Act to provide that beginning in FY 1987 and continuing through FY 1988 and 1989 (until the quantity of crude oil in storage within the Reserve is at least 750,000,000 barrels) the President shall implement petroleum acquisition, transportation, and injection activities (to the extent of the availability of appropriated funds) at a level which assures a minimum average annual fill-rate of at least 100,000,000 barrels per day. Increases from 527,000,000 barrels to 600,000,000 barrels the quantity of crude oil that must be in storage within the SPR before any Federal share of crude oil in Naval Petroleum Reserve Numbered 1 (Elk Hills) may be disposed of (other than to the SPR) during any fiscal year. Decreases from 100,000,000 barrels per day to 80,000,000 barrels per day the average rate increase of crude oil in storage in the SPR before the Federal share of crude oil in Elk Hills may be disposed of (other than to the SPR) during any fiscal year. Repeals the requirement that the fill rate reach a specified level before the Federal share of crude oil in Elk Hills may be disposed of (other than to the SPR) during any fiscal year. Delineates the contents of the Secretary's annual and quarterly reports to the President and the Congress regarding the status of the SPR. Directs the President to establish a minimum sales price according to prescribed guidelines for the Federal share of petroleum produced from Naval Petroleum Reserves Numbered 1, 2, and 3. Authorizes the President to establish a production rate that is less than the maximum efficient rate with respect to petroleum produced from such Naval Reserves, if the Secretary determines that the established minimum sales price cannot be attained for the Federal share of petroleum produced from such Reserves. Authorizes the Secretary to enter into a contract regarding the established minimum sales price after notifying the Attorney General of the proposed agreement. Subtitle F: Medicare - Part 1: Provisions Relating to Parts A and B - Amends title XVIII (Medicare) of the Social Security Act to count, for the purpose of reimbursing hospitals for direct costs of medical education, all the time a resident spends in patient care activities regardless of the setting of those activities, provided the hospital is incurring costs for such training. Reduces the weighting factor used to compute the costs of training fifth-year residents. Requires that limitations on Medicare payments for home health services be applied on an aggregate rather than a discipline-specific basis for home health agencies. Requires the Secretary of Health and Human Services, in establishing such limitations, to take into account: (1) recent cost data; and (2) changes in costs resulting from changes in billing and verification procedure requirements. Directs the Secretary to establish a program providing for research regarding outcomes of selected medical treatments and surgical procedures so as to assess their appropriateness, necessity, and effectiveness. Places a priority on the selection of procedures and treatments with significant costs, risks, hospitalization periods, and utilization patterns. Authorizes appropriations from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund for FY 1987 through 1989 to carry out such research. Requires that at least 90 percent of the funds available in any fiscal year be used to fund grants to, and cooperative agreements with, non-Federal research entities. Directs that the program be administered by the National Center for Health Services Research and Health Care Technology (Center). Requires the Center to: (1) report its findings to the Congress within 18 months of enactment of this Act and annually thereafter; and (2) disseminate its findings as widely as possible. Amends title XIX (Medicaid) of the Act and the Medicare program to exempt amounts paid by vendors of goods and services to authorized purchasing agents for entities reimbursed under either program from the Act's kickback prohibitions if the purchasing agent: (1) has a written contract with each vendor and each Medicare or Medicaid-reimbursed client specifying the amount or percentage to be paid to the vendor; and (2) discloses the amount it received from the vendor. Amends part A (General Provisions) of title XI of the Act to expand the doctrine of collateral estoppel to make it applicable when an individual has entered a plea of nolo contendere in a Federal criminal prosecution and attempts to relitigate the essential elements of the offense in civil monetary penalty proceedings charging such individual with presenting false or improper claims under the Medicare, Medicaid, or Maternal and Child Health Services (title V of the Act) programs. Authorizes officials conducting such civil monetary penalty proceedings to impose limited sanctions on any party or attorney for failing to comply with orders, failing to defend an action, or other misconduct interfering with the speedy, orderly, or fair conduct of the hearing. Defines the term "convicted", for the purposes of excluding providers convicted of Medicare or Medicaid-related crimes from participating in such programs, to include: (1) convictions entered in a local, State, or Federal court, regardless of whether an appeal is pending or the conviction has been expunged from an individual's criminal record; (2) findings of guilt by a Federal, State, or local court; (3) a plea of guilty or nolo contendere accepted by a Federal, State, or local court; and (4) convictions withheld by reason of such individual's participation in a first offender or similar program. Authorizes the Secretary to adjust the composite rates used to determine Medicare payments for renal dialysis services, but prohibits reductions, for free-standing and hospital-based facilities, below specified base rates. Requires that facility requests for exceptions from such rates be disapproved within 45 days of their receipt or otherwise be deemed to have been approved. Directs the Secretary to adjust the formula for determining payment rates to physicians for services furnished to renal disease patients so that the average monthly capitation rate equals $180. Requires the Secretary to provide for a study and report to the Congress by 1988 on the effect reductions in facility and physician payment rates have on the care provided to renal disease patients. Covers immunosuppressive drugs furnished within one year of an individual's Medicare-covered organ transplant. Directs the Secretary to consolidate existing renal disease network areas into no fewer than 17 areas, giving existing network organizations the first opportunity to perform network functions in a newly designated area. Requires that the network council and medical review board established by each network organization have at least one patient representative. Expands the list of network organization responsibilities to include the: (1) encouragement of patient and provider participation in vocational rehabilitation programs; (2) implementation of a procedure for evaluating and resolving patient grievances; (3) necessary on-site review of facility and provider compliance with standards of care; and (4) collection of data for specified reports. Requires the Secretary to establish a national end-stage renal disease registry for the purpose of collecting uniform and comprehensive data on all dialysis and transplant patients. Alters the methods of funding network organization by requiring the Secretary to supply such organizations with 50 cents from each payment otherwise made to a dialysis facility for dialysis services. (Currently, organization funds are provided from the Medicare trust funds.) Requires the Secretary to: (1) establish conditions on the reuse of dialyzer filters by facilities and providers which voluntarily refuse such filters; and (2) consider establishing standards for the reuse of other dialysis supplies. Requires hospitals to establish protocols for encouraging organ and tissue donation by identifying and assisting potential donors in a manner considerate of such donors' families. Precludes Medicare or Medicaid payments for organ procurement, if the organ procurement agency fails to meet specified standards. Makes technical corrections in the Consolidated Omnibus Budget Reconciliation Act of 1985. Authorizes the Secretary to waive the requirement that health maintenance organizations (HMOs) or competitive medical plans (CMPs) have at least 50 percent non-Medicare or non-Medicaid enrollees only to the extent that more than 50 percent of the population in the area served by the organization consists of Medicare and Medicaid-eligible persons. Authorizes the Secretary to suspend Medicare payments for new enrollees if the 50 percent enrollment rule is violated. (Currently, the Secretary's sanction authority is limited to terminating the risk-sharing contract with the HMO or CMP.) Part 2: Provisions Relating to Part B - Amends the Medicare program to extend coverage to include the items and services which an optometrist is legally authorized to provide. Provides coverage, under part B (Supplementary Medical Insurance) of the Medicare program, for outpatient occupational therapy services in the same manner in which outpatient physical therapy services are covered. Provides part B coverage of physician-supervised services performed by a physician's assistant in a hospital, skilled nursing facility, or as an assistant at surgery. Provides part B coverage for anesthesia services and related care provided by a registered nurse anesthetist. Requires the Secretary to adjust the reasonable charge for anesthesia services when necessary to maintain total payments at the level they would be at if such services were still reimbursed as inpatient hospital services under part A (Hospital Insurance) of the Medicare program. Requires the Secretary to treat the one percent increase, permitted on May 1, 1986, in prevailing charges of participating physicians as having been justified by economic changes. Prohibits the Secretary from making a specified adjustment in the Medical Economic Index. Limits the increase in the prevailing and actual charges for the unassigned claims of nonparticipating physicians to one percent for 1987. Lists tests and comparisons which may be made and effects which must be considered before the Secretary adjusts the reasonable charge for a physician's service on the grounds that it is not inherently reasonable. Requires consultation with the Physician Payment Review Commission and public notice and comment before such an adjustment is made. Prohibits nonparticipating physicians from charging Medicare beneficiaries more than 125 percent of the adjusted prevailing charge for a service when the Secretary has reduced the reasonable charge for such service. Limits the prevailing charge for cataract surgery with intraoccular lens implantation to 110 percent of the prevailing charge for such surgery without lens implantation. Limits the number of base units which may be used in computing the payment for anesthesia services during cataract surgery. Prohibits nonparticipating physicians from charging Medicare beneficiaries at more than 125 percent of the adjusted prevailing charge resulting from such limitations. Eliminates the expiration date on fee schedules for clinical laboratory tests performed by hospital laboratories. Eliminates the payment differential between independent laboratory tests and hospital laboratory tests on outpatients. Removes the deadline for the establishment of a national fee schedule. Requires the Secretary to report to the Congress by April 1, 1988, on the advisability and feasibility of establishing national fee schedules for such tests. Authorizes payments for transportation and personnel expenses incurred in collecting laboratory samples from certain immobile beneficiaries. Allows laboratories to qualify for Medicare reimbursement if they satisfy State standards regarding the qualifications of the laboratory's director. Directs the Secretary to pay for parenteral and entoral nutrition supplies at the lowest charge levels at which such supplies are widely and consistently available in a locality. Requires the Secretary to establish monthly capitation fee schedules on a regional, Statewide, or carrier service area basis for Medicare oxygen therapy services. Requires payments to be made on the basis of the number of units of oxygen prescribed for a patient per month. Prohibits payments for oxygen therapy services prescribed by a physician who has a significant ownership in, or a significant financial or contractual relationship with, the entity furnishing oxygen therapy services, unless such entity is the sole supplier of such services in a community. Requires the Secretary to pay, or notify the entity providing such services of a defect in, a payment claim within 22 days of its receipt. Imposes interest penalties on late payments. Bases the oxygen therapy fee schedule on the reasonable charge level for oxygen therapy services determined for the 12-month period ending June 30, 1986. Provides Medicare coverage for 80 percent of the fee schedule amount. Directs the Secretary to provide a minimum monthly amount to assure the availability of oxygen therapy services for individuals requiring only small amounts of oxygen. Requires the Secretary to report to the Congress on the implementation and effects of these provisions by July 1, 1988. Provides for the appointment of two additional members to the Physician Payment Review Commission. (Currently, there are 11 Commission members.) Establishes an appeals procedure for part B claim denials which provides for: (1) review by an administrative law judge if the amount in controversy equals or exceeds $500; and (2) judicial review if the amount in controversy equals or exceeds $1000. Directs the Secretary to conduct at least five demonstration projects to determine the feasibility and effectiveness of providing comprehensive services to Medicare beneficiaries who are victims of Alzheimer's disease or related disorders. Sets forth reporting requirements. Subtitle G: Medicaid and Maternal and Child Health - Part 1: Coverage of Individuals - Amends title XIX (Medicaid) of the Social Security Act to give States the option of extending coverage to women in need of pregnancy-related medical services and infants up to age one whose family income exceeds current income eligibility thresholds, but does not exceed a State maximum income level to be established at or below the Federal poverty level. Allows States to continue such coverage for women until 60 days after pregnancy without regard to any change in her family income. Requires the State maximum income level for eligibility under this program to be no less than the payment level applicable to a family with no income under part A (Aid to Families with Dependent Children) of title IV of the Act. Prohibits States which provide coverage pursuant to this Act from reducing AFDC payment levels. Gives States the option of extending Medicaid coverage to elderly and disabled individuals whose income is too high for them to qualify for Medicaid under current income tests, but does not exceed a State maximum income level to be established at or below the Federal poverty level. Requires States providing such coverage to provide Medicaid coverage to pregnant women and infants whose income does not exceed the State maximum income level. Authorizes the States to provide Medicaid coverage for Medicare premiums, deductibles, and coinsurance payments for which Medicare-eligible individuals whose income does not exceed the State maximum income level would otherwise be accountable. Provides Medicaid coverage to "qualified severely impaired individuals", defined as individuals under age 65 who received benefits under title XVI (Supplemental Security Income) (SSI) of the Act and who: (1) continue to be blind or have a disabling physical or mental impairment; (2) except for earnings, continue to meet all other SSI eligibility requirements; (3) without Medicaid coverage, would be seriously inhibited from continuing or obtaining employment; and (4) have earnings which are insufficient to provide a reasonable equivalent of the Medicaid, SSI, and attendant care benefits (under title XX of this Act) which would be available in the absence of such earnings. Prohibits otherwise eligible individuals from being denied Medicaid benefits by reason of their failure to maintain a fixed address. Excludes, in determining an institutionalized individual's Medicaid eligibility, the income or resources which a court order requires to be used for the support of such individual's spouse or children. Prohibits Federal Medicaid participation payments for State expenditures on aliens who are not lawfully admitted for permanent residence or permanently residing in the United States under color of law. Part 2: Provision of Services Under Waiver Authority - Permits States to provide home and community-based Medicaid services to: (1) individuals diagnosed as having acquired immune deficiency syndrome (AIDS) or AIDS-related conditions; and (2) Medicaid-eligible individuals with chronic mental illness who would otherwise continue to require inpatient hospital or nursing facility services. Waives certain Medicaid requirements to authorize the establishment of demonstration programs receiving specified private and public funding and providing a wide-range of services to chronically mentally ill Medicaid beneficiaries. Limits such programs to a three-year term with a possible two-year extension. Requires the Secretary to report to the Congress by 1993 on the services provided by such programs. Continues, through June 30, 1989, the waiver of certain Medicare and Medicaid requirements for a Massachusetts demonstration project providing alternatives to hospital care for Medicaid-eligible nursing home patients. Part 3: Payments - Amends the Consolidated Budget Reconciliation Act of 1985 to hold a State harmless in FY 1987 against changes that Act effected in the annual calculation of the Federal medical assistance percentage under the Medicaid program if such changes would cause a reduction of Medicaid payments to the State in FY 1987. Part 4: Other Quality and Efficiency Measures - Requires States to provide for independent, external reviews by peer review organizations (under part B of title XI) or private accreditation bodies, of the quality of services provided by health maintenance organizations (HMOs). Makes it clear that the Secretary has no authority to require States to operate second surgical opinion programs or inpatient hospital preadmission review programs. Directs the Secretary to report, by 1992, on: (1) surgical procedure utilization patterns; (2) surgical procedures for which second opinion programs may be appropriate; and (3) the number of physicians willing and qualified to perform second opinions. Makes it clear that the Secretary has no authority to limit the payments which may be made with respect to inpatient hospital services or skilled nursing or intermediate care facility services under a State plan. Requires nonqualified HMOs to disclose to the State all transactions between the organization and a party in interest. Subjects all contracts with HMOs under which total Federal and State expenditures will exceed $100,000 to the prior approval of the Secretary. Directs the Secretary to delegate administrative responsibilities over State Medicaid Fraud Control Units to the Inspector General of the Department of Health and Human Services. Makes several technical corrections to, and clarifications of, the Consolidated Omnibus Budget Reconciliation Act of 1985. Authorizes New York to pay the inpatient rate for hospital patients receiving services at an inappropriate level of care if the Secretary determines that enough hospital beds in the State have been decertified so as to reduce Medicaid payments to hospitals by an amount equal to or greater than any increase in such payments occasioned by reimbursements for inappropriate levels of care. Part 5: Maternal and Child Health - Amends title V (Maternal and Infant Welfare) of the Act to increase the authorization level for the Maternal and Child Health Block Grant for FY 1987, 1988, and 1989. Sets aside a specified amount in each such fiscal year for screening newborns for sickle-cell anemia and other genetic disorders. Directs the Secretary to establish a National Adoption Information Clearinghouse which collects, maintains, and disseminates information on various aspects of adoption. Title V: House Committee on Interior and Insular Affairs - Directs the Nuclear Regulatory Commission to assess and collect a specified annual charge from certain licensees. Mandates that the amounts collected be deposited in the general fund of the Treasury to reimburse the United States for amounts appropriated for use by the Commission. Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to repeal provisions relating to the submission by the Commission of a report evaluating the feasibility of establishing annual charges. Transfers the research and development authorities of the Department of the Interior regarding abandoned mine reclamation to the Bureau of Mines, to be implemented by the Director of such Bureau. Title VI: House Committee on Merchant Marine and Fisheries - Subtitle A: Ocean Dumping Application and Special Fees - Amends the Marine Protection, Research, and Sanctions Act of 1972 to direct the Administrator of the Environmental Protection agency or the Secretary of the Army, as the case may be, to collect from an applicant for ocean dumping an amount commensurate with the reasonable administrative costs incurred by the Administrator or Secretary in processing the permit. Authorizes the collection of special fees connected with permit enforcement and monitoring costs. Subtitle B: Amendments of the Merchant Ship Sales Act of 1946 - Amends the Merchant Ship Sales Act of 1946 to direct the Secretary of Transportation to maintain a National Defense Reserve Fleet consisting of those vessels that the Secretary determines are of value for national defense purposes. Allows such vessels to be used for national defense purposes only during a period of national emergency as declared by the President. Subtitle C: Amendments to the Merchant Marine Act of 1920 - Amends the Merchant Marine Act of 1920 to authorize the United States as mortgagee to enforce a preferred mortgage lien in a suit in rem in admiralty for the recovery of a mortgaged vessel mortgaged under the provisions of such Act and of the Merchant Marine Act, 1936. Subtitle D: Load Line and Tonnage Measurement User Fees - Amends Federal shipping provisions to require that an ocean vessel may be operated only if the vessel has been assigned load lines (load weights as measured by lines on the side of a ship near the waterline). Directs the Secretary of Transportation to assign load lines for a vessel so that they indicate the minimum safe freeboard (distance from the load line to the deck) to which the vessel may be loaded. Allows existing vessels to retain their load lines assigned before January 1, 1986, unless the Secretary deems otherwise. Authorizes the Secretary to reduce the minimum freeboard for vessels operating in areas of less severe weather and sea conditions. Authorizes the Secretary to provide for annual, renewal, and other load line surveys. Directs the Secretary to issue a vessel a load line certificate on a survey's finding that a load line for such vessel is satisfactory and correctly marked. Provides for the delegation of the Secretary's load line authority to the American Bureau of Shipping, certain other qualified organizations, or to a foreign country that is a party to the International Convention on Load Lines, 1966. Outlines conditions for special exemptions by the Secretary from such load line requirements, and for reciprocity for foreign vessels operating under similar load line requirements. Authorizes the Secretary to prescribe regulations for submersible vessels to provide minimum safety levels. Authorizes the Secretary to require vessel owners, operators, or agents to provide loading information to the person in charge of the vessel. Sets forth certain vessel loading restrictions. Authorizes the Secretary to detain vessels believed to be in violation of these load line provisions. Authorizes the use of U.S. Customs Service personnel for enforcement purposes. Authorizes the Secretary to prescribe regulations to carry out these provisions, and provides penalties for violations. Authorizes the Secretary to delegate to a qualified person the authority to measure a vessel and issue an International Tonnage Certificate or other appropriate certificate of measurement. Authorizes the Secretary to delegate such authority to a foreign country that is party to the International Convention on Tonnage Measurement of Ships, 1969, for ships engaged on a foreign voyage. Requires a vessel to be measured under these provisions when the application of a U.S. law to a vessel depends on the vessel's tonnage. Directs the Secretary, after measuring a vessel, to issue to a vessel owner or master an International Tonnage Certificate. Outlines conditions requiring remeasurement of a vessel. Provides for optional regulatory measurement by the Secretary for certain documented vessels, specifying those provisions of Federal law to which such tonnage determinations will apply. Provides reciprocity in the measurement of vessels for foreign countries whose laws are similar or who are a party to the aforementioned International Convention. Authorizes the Secretary to inspect foreign vessels to determine measurement compliance. Outlines provisions concerning vessel measurement by the Secretary in accordance with specified measurement requirements. Provides for vessel remeasurement in appropriate circumstances. Provides for the standard tonnage measurement and the dual tonnage measurement of such vessels. Provides for the tonnage measurements of vessels not otherwise covered under the above provisions. Provides civil penalties for general violations and false statements related to vessel measurement under these provisions. Requires amounts collected as Coast Guard user fees by either the Secretary of Transportation or the Secretary of the department in which the Coast Guard is operating to be deposited in the general fund of the Treasury as proprietary. Outlines conditions under which such fees may and may not be charged. Directs the Secretary of Transportation, before January 1 of each year, to report to the Senate Commerce, Science, and Transportation Committee and the House Merchant Marine and Fisheries Committee concerning the application and collection of such user fees. Authorizes the Secretary to issue a temporary certificate of documentation for a vessel before it is measured. Requires the Secretary, before July 19, 1990, to submit to the Congress a study concerning vessel tonnage requirements and thresholds. Requires an interim progress report on such study to be submitted before July 19, 1988. Repeals specified Federal provisions made inconsistent by the above provisions. Subtitle E: Adjustment of the U.S. Investment Base in the Panama Canal on Which Interest Payments to the U.S. Treasury are Computed - Amends the Panama Canal Act of 1979 to increase the U.S. investment base in the Panama Canal (upon which interest payments to the U.S. Treasury are computed) by certain amounts deposited in the Panama Canal Commission Fund as of December 31, 1985. Subtitle F: Comprehensive Oil Pollution Liability and Compensation - Comprehensive Oil Pollution Liability and Compensation Act - Part 1: Oil Pollution Liability and Compensation - States that this title is inapplicable to the United States regarding oil pollution damages during any period in which both the International Convention on Civil Liability for Oil Pollution Damage, 1984 and the International Convention on the Establishment of an International Fund for Compensation for Oil Pollution Damage, 1984 are in force with respect to the United States and compensation is available. Permits claims for damages for economic loss arising from oil pollution for: (1) removal costs; (2) injury to or destruction of real or personal property; (3) reasonable costs incurred in assessing injury or destruction of natural resources and in planning, restoring, or acquiring the equivalent of the damaged resources; (4) loss of subsistence use of natural resources; (5) loss of profits or impairment of earning capacity due to such injury or destruction; and (6) loss of tax revenue for a period of one year due to injury to real or personal property. Specifies the potential claimants who have standing to assert claims involving such damages. Imposes joint, several, and strict liability on the party responsible for the source of oil pollution. Specifies liability limits (except in cases of gross negligence or willful misconduct) for vessels. Sets forth defenses to liability. Makes the Oil Liability Trust Fund (Trust Fund) liable for damages not otherwise compensated. Requires the responsible party for certain vessels over 3000 gross tons and the party responsible for offshore facilities to establish and maintain evidence of financial responsibility in an amount sufficient to satisfy applicable liability limits. Limits the liability of a guarantor to the aggregate amount of financial responsibility that the guarantor provided. Specifies procedures whereby the Secretary of Transportation shall designate oil pollution sources. Directs the Secretary to advertise claims to be presented initially to the responsible party or to such person's guarantor in instances in which: (1) the responsible party and guarantor both deny involvement; (2) the source of the discharge is a public vessel; or (3) the Secretary is unable to designate the pollution source. Permits claimants either to present a claim to the Trust Fund or to bring an action in an appropriate U.S. court if liability is denied or the claim is not settled within a specified period. Sets forth procedures for the disposition and appeal of claims submitted to the Trust Fund. Requires both the plaintiff and the defendant in a court action brought against a responsible party or guarantor to forward copies of all pleadings to the Trust Fund. Permits the Trust Fund to intervene in such actions. Requires a claim to be presented within three years of discovery of an economic loss, or within six years of the date of the incident, whichever is earlier. Subrogates any person, including the Trust Fund, to all the claimant's claims and rights under this title. Sets forth the measure of recovery for actions brought by the Trust Fund against any responsible party or guarantor. Grants U.S. district courts exclusive original jurisdiction over all controversies arising under parts 1, 2, and 3 of this Act, without regard to the citizenship of the parties or the amount in controversey. Makes the rights and remedies under this title exclusive with respect to economic loss caused by oil pollution (but does not preclude State funds to finance oil pollution cleanup). Sets penalties for persons failing to comply with specified provisions of this Act. Authorizes appropriations for this part. Part 2: Report and Coordination With Other Provisions - Directs the Secretary to report to the Congress annually on the activities of the Trust Fund. Part 3: Regulations, Effective Dates, and Savings Provisions - Specifies the effective dates of specified provisions of this Act. Eliminates the Trans-Alaska Pipeline Liability Fund and provides that all unused assets of such Fund shall be rebated directly to the operator of the Trans-Alaska oil pipeline for pro-rata payments to those owners who had paid into such Fund. Amends specified laws, including the Deepwater Port Act of 1974, the Federal Water Pollution Control Act, the Intervention on the High Seas Act, the Outer Continental Shelf Lands Act Amendments of 1978 and the Trans-Alaska Pipeline Authorization Act, to conform with the provisions of this Act. Transfers to the Trust Fund amounts remaining in the Deepwater Port Liability Fund and the Offshore Oil Pollution Compensation Fund (both having been eliminated by the above repeals). Part 4: Implementation of Conventions - Recognizes the International Oil Pollution Compensation Fund (International Fund) as a legal person under the laws of the United States. Requires, in any action brought in the United States against the owner of a ship or his guarantor under the International convention on Civil Liability for Oil Pollution Damage that the International Fund and the Oil Spill Liability Trust Fund be served a copy of the complaint and any subsequent pleading. Entitles the International Fund to intervene as a party in any such action. Exempts the International Fund from all direct taxation in the United States. Requires any contribution to the International Fund to be paid from the Oil Spill Liability Trust Fund. Sets forth the jurisdiction of the U.S. district courts for controversies arising under the Civil Liability Convention or the International Fund Convention. Requires U.S. courts to recognize final judgments of courts of nations which are a party to the Civil Liability Convention or the International Fund Convention. Requires the owner of each U.S. documented ship, or any ship, wherever registered, which enters or leaves a U.S. port or terminal carrying more than 2,000 tons of oil in bulk as cargo to establish and maintain evidence of financial responsibility in amounts sufficient to cover the maximum liability arising from one incident under the Civil Liability Convention. Imposes a civil penalty for noncompliance with such financial responsibility requirement. States that the United States waives all defenses based on its status as a sovereign state with respect to any controversy arising under the Civil Liability Convention or the International Fund Convention relating to any ship owned by the United States and used for commercial purposes. Part 5: Oil Spill Liability Trust and its Revenue Sources - Amends the Internal Revenue Code to increase tax rates on petroleum according to a specified formula to fund the Oil Spill Liability Trust Fund, established by this part. Limits expenditures from such Fund per incident. Limits the liability of the United States for claims against such Fund to the amount in such Fund. Subtitle G: National Offshore Vessel Operators Safety Advisory Committee - Establishes a National Offshore Vessel Operators Safety Advisory Committee (the Committee) to advise, consult with, and make recommendations to the Secretary of the department in which the Coast Guard is operating (the Secretary) on matters relating to the safety aspects of offshore oil, gas, and other mineral operations subject to regulation by the Secretary. Directs the Secretary, whenever practicable, to consult with the Committee before taking any significant action related to these offshore operations. Requires the Committee to meet at least once during each calendar year. Outlines organizational and administrative aspects of the Committee. Terminates the Committee on September 30, 1992. Subtitle H: Repeal of the Act Establishing the National Advisory Committee on Oceans and Atmosphere - Repeals the National Advisory Committee on Oceans and Atmosphere Act of 1977. Subtitle I: Establishment of a Timetable for Compensation of Coast Guard Offshore Safety Studies - Directs the Secretary of the department in which the Coast Guard is operating (the Secretary) to issue final regulations pursuant to the advance notice of proposed rulemaking regarding the revision of the regulations on outer Continental Shelf activities, taking into consideration the use of standby vessels for personnel evacuations from manned installations on the outer Continental Shelf. Requires an interim report from the Secretary to the Congress, before December 31, 1986, and a final report, before September 1, 1987, concerning such regulations and evacuation procedures. Subtitle J: Requirement for the Use of American Built Rigs for Exploration and Development on the U.S. Outer Continental Shelf - Amends the Outer Continental Shelf Lands Act to require that any structure used for oil or gas production (or exploration) be built in the United States from materials which by cost have been at least 50 percent produced in the United States. Makes this requirement inapplicable to structures being built (or for which a building contract has been executed) before October 1, 1986. Authorizes the Secretary of Energy to waive such requirement under certain conditions. Title VII: House Committee on Post Office and Civil Service - Amends the Federal Employees' Retirement System Act of 1986 with respect to participation by a Federal employee or a Member of Congress in the Thrift Savings Plan to make the effective date of an election to participate in such plan the first day of the employee's or Member's first pay period beginning after the last day of that election period. Repeals the prohibition on contributions to the Thrift Savings Plan by an employing agency for the benefit of an employee or Member. Amends Federal law to revise the method by which revenue forgone is computed for reduced-rate mail and mailers. Assumes that the combination of postage and appropriations to be received for each of the reduced-rate categories will bear the same ratio to the costs attributed to such respective categories as the revenues to be received from the most closely corresponding regular-rate category bear to the costs attributed to that regular-rate category. Title VIII: House Committee on Public Works and Transportation - Subtitle A: Highway Program - Sets limitations upon contract authority for programs funded out of the Highway Trust Fund (other than the Mass Transit Account) for FY 1987 through 1989. Exempts from such limitations: (1) the traffic safety grant program implemented by the National Highway Traffic Safety Administration; (2) a certain railroad-highway crossings maintenance program; (3) a certain motor carrier safety grant program; and (4) a certain university transportation centers program. Sets an obligation limitation for FY 1987 through 1989 for Federal-aid highways and highway safety construction programs. Sets an obligation limitation of $100,000,000 for emergency funds with respect to natural disasters and catastrophic failures occurring in calendar year 1986. Subtitle B: Federal Energy Regulatory Commission Annual Charges - Prohibits the Federal Energy Regulatory Commission from assessing or collecting any charges from an interstate natural gas pipeline or an interstate oil pipeline carrier, except for certain charges assessed before the date of enactment of this Act. Subtitle C: Ocean Dumping Amendments - Ocean Dumping Amendments Act of 1986 - Amends the Marine Protection, Research, and Sanctuaries Act of 1972 to include "wetlands" among the factor considered in assessing the effects of dumping. Prohibits the issuance of permits for the dumping of radiological, chemical, and biological warfare agents and for high-level radioactive waste. Prohibits after December 31, 1986, the issuance of any permit for the dumping of municipal sludge unless: (1) the applicant is in compliance with those requirements of the Federal Water Pollution Control Act related to the quality of municipal sludge; and (2) there is not available any land-based alternative to the ocean disposal of the sludge. Makes dumping site designations by the Administrator of the Environmental Protection Agency (EPA) mandatory. Includes the following factors in dump site selection: (1) waste types and quantities; (2) detoxification ability of site water; (3) importance of the site to the surrounding biological community; and (4) effects on human health and adjacent ecosystems. Requires the Administrator at appropriate sites to : (1) monitor the effects of the dumping; and (2) make three-year dumping estimates. States that the Administrator shall close a site or limit dumping as necessary, upon consultation with the Secretary of the Army. Prohibits the ocean dumping of all harmful municipal sludge after 18 months of the date of enactment of this Act. Defines "harmful municipal sludge" as municipal sludge which fails to meet EPA's environmental impact criteria. Permits certain minimal dumping or dumping for research or emergency purposes, as specified. Requires the Secretary of the Army to consider the relative environmental impact of alternative methods of disposing of dredged material in other than the ocean. Requires the Secretary to monitor dump sites. Requires the Administrator or the Secretary to impose on permittees any special provisions deemed necessary to minimize the harm from dumping, including measures to find alternative disposal methods, eliminate contaminants, or recycle such materials. Makes permit processing fees mandatory. Directs the Administrator and the Secretary to establish quality assurance programs to ensure the validity, accuracy, and sufficiency of information submitted with permit applications. Sets forth the congressional finding that the New York Bight Apex is no longer suitable for municipal sludge dumping. Requires applicants seeking permits to dump municipal sludge within the Apex to be eligible authorities. Prohibits the Administrator from issuing or renewing permits for the dumping of municipal sludge within the Apex after the earlier of: (1) December 15, 1987; or (2) the first day the Administrator determines sludge can reasonably be dumped at a designated site outside the Apex. Directs the Administrator to develop, after public hearings, and report to the Congress within three years on a New York Bight Apex Restoration Plan for improving the overall water quality and marine resources of the Apex. Sets forth various activities which must be covered by the plan. Directs the Administrator to submit to the Congress within six months a schedule for completing the plan and an estimate of the cost for developing and, where possible, implementing the plan. Directs the Administrator to report to the Congress within one year on the economic and technical feasibility of establishing and implementing quality standards for the disposal of municipal sludge through ocean or land-based methods. Authorizes appropriations for FY 1986 through 1988 to EPA for purposes of preparing the New York Bight Apex Restoration Plan. Prohibits any but an eligible authority from dumping municipal sludge within the 106-mile Ocean Waste Dump Site. States that the Administrator and the Secretary shall adhere to the requirements of the London Dumping Convention that are binding upon the United States to the extent they are consistent with the requirements of U.S. ocean dumping law. Sets forth transitional provisions, including "grandfathering" (with certain exceptions) specified dumping sites from amendments under this Act. Defines "monitoring" and "municipal sludge" for purposes of such Act. Amends the definition of "ocean waters" to include "subjacent areas." Establishes criminal penalties for the knowing falsification of information or tampering with testing devices required by this Act. Grants jurisdiction to U.S. district courts to issue writs of mandamus to compel the Administrator to designate dumping sites. Directs the Administrator to establish and submit to the Congress a dumping designation schedule within 180 days. Requires a separate annual report to the Congress by the Administrator and the Secretary. Authorizes appropriations for FY 1986 and 1988. Extends specified provisions of the Marine Protection, Research, and Sanctuaries Act of 1972 concerning ocean dumping of materials transported by any person from a location outside the United States into the U.S. exclusive economic zone. Requires the Administrator to report to the Congress within 18 months on the permit fee systems which implement the Federal waste disposal program to determine if the distribution of costs is appropriate and the extent to which such fees should be used to promote environmentally sound choices. Subtitle D: Water Resources - Amends Federal law with respect to the flood control project for the Kings River and Tulare Lake Basin, California, to authorize the Secretary of the Army, acting through the Chief of Engineers, to undertake studies for engineering and design with appropriate non-Federal sponsors for a project not to exceed 200,000 acre feet of additional flood control and other storage benefits at the existing facility and not to exceed 800,000 acre feet of additional flood control and other storage benefits to alleviate flood and irrigation problems in the existing service area. Requires a report to the Congress on such studies. Subtitle E: Highway, Airport, and Inland Waterways Trust Funds - Declares that the receipts and disbursements of the Highway Trust Fund, the Airport and Airway Trust Fund, and the Inland Waterways Trust Fund allocable to the transportation-related operations of each such Fund: (1) shall not be included in the totals of the Federal budget as submitted by the President or the congressional budget; and (2) shall be exempt from any general budget limitation imposed by statute. Amends the Airport and Airway Improvement Act of 1982 to prescribe procedures under which the Secretary of Transportation shall annually adjust authorizations and apportionments based upon estimates of unfunded aviation authorizations and net aviation receipts from the Airport and Airway Trust Fund. Requires the Secretary to report to specified congressional committees regarding such adjustments. Prescribes procedures under which the Secretary of the Army shall annually adjust authorizations and apportionments based upon estimates of unfunded inland waterways authorizations and net inland waterways receipts out of the Inland Waterways Trust Fund. Directs such Secretary to report to specified congressional committees regarding such adjustments. Amends the Congressional Budget and Impoundment Control Act of 1974 to provide that for deficit calculation purposes the receipts of the Highway Trust Fund (including the Mass Transit Account), the Airport and Airway Trust Fund, and the Inland Waterways Trust Fund allocable to transportation-related operations shall be included in the total fiscal year revenues, and the disbursement allocable to such operations shall be included in total fiscal year budget outlays. Declares that it shall not be in order for either House of the Congress to consider any concurrent resolution or reconciliation legislation with respect to any amount of budget authority or budget outlays from the Highway Trust Fund, the Airport and Airway Trust Fund, or the Inland Waterways Trust Fund. Subtitle F: Comprehensive Oil Pollution Liability and Compensation - Comprehensive Oil Pollution Liability and Compensation Act - Part 1: Oil Pollution Liability and Compensation - States that this title is inapplicable to the United States regarding oil pollution damages during any period in which both the International Convention on Civil Liability for Oil Pollution Damage, 1984 and the International Convention on the Establishment of an International Fund for Compensation for Oil Pollution Damage, 1984 are in force with respect to the United States and compensation is available. Permits claims for damages for economic loss arising from oil pollution for: (1) removal costs; (2) injury to or destruction of real or personal property; (3) reasonable costs incurred in assessing injury or destruction of natural resources and in planning, restoring, or acquiring the equivalent of the damaged resources; (4) loss of subsistence use of natural resources; (5) loss of profits or impairment of earning capacity due to such injury or destruction; and (6) loss of tax revenue for a period of one year due to injury to real or personal property. Specifies the potential claimants who have standing to assert claims involving such damages. Imposes joint, several, and strict liability on the party responsible for the source of oil pollution. Specifies liability limits (except in cases of gross negligence or willful misconduct) for vessels. Sets forth defenses to liability. Makes the Oil Spill Liability Trust Fund (Trust Fund) liable for damages not otherwise compensated. Requires the responsible party for certain vessels over 300 gross tons and the party responsible for offshore facilities to establish and maintain evidence of financial responsibility in an amount sufficient to satisfy applicable liability limits. Limits the liability of a guarantor to the aggregate amount of financial responsibility that the guarantor provided. Specifies procedures whereby the Secretary of Transportation shall designate oil pollution sources. Directs the Secretary to advertise claims to be presented initially to the responsible party or to such person's guarantor in instances in which: (1) the responsible party and guarantor both deny involvement; (2) the source of the discharge is a public vessel; or (3) the Secretary is unable to designate the pollution source. Permits claimants either to present a claim to the Trust Fund or to bring an action in an appropriate U.S. court if liability is denied or the claim is not settled within a specified period. Sets forth procedures for the disposition and appeal of claims submitted to the Trust Fund. Requires both the plaintiff and the defendant in a court action brought against a responsible party or guarantor to forward copies of all pleadings to the Trust Fund. Permits the Trust Fund to intervene in such actions. Requires a claim to be presented within three years of discovery of an economic loss, or within six years of the date of the incident, whichever is earlier. Subrogates any person, including the Trust Fund, to all the claimant's claims and rights under this title. Sets forth the measure of recovery for actions brought by the Trust Fund against any responsible party or guarantor. Grants U.S. district courts exclusive original jurisdiction over all controversies arising under parts 1, 2, and 3 of this Act, without regard to the citizenship of the parties or the amount in controversy. Makes the rights and remedies under this title exclusive with respect to economic loss caused by oil pollution (but does not preclude State funds to finance oil pollution cleanup). Sets penalties for persons failing to comply with specified provisions in this Act. Authorizes appropriations for this part. Part 2: Report and Coordination With Other Provisions - Directs the Secretary to report to the Congress annually on the activities of the Trust Fund. Part 3: Regulations, Effective Dates, and Savings Provisions - Specifies the effective dates of specified provisions of this Act. Eliminates the Trans-Alaska Pipeline Liability Fund and provides that all unused assets of such Fund shall be rebated directly to the operator of the Trans-Alaska oil pipeline for pro-rata payments to those owners who had paid into such Fund. Amends specified laws, including the Deepwater Port Act of 1974, the Federal Water Pollution Control Act, the Intervention on the High Seas Act, the Outer Continental Shelf Lands Act Amendments of 1978 and the Trans-Alaska Pipeline Authorization Act, to conform with the provisions of this Act. Transfers to the Trust Fund amounts remaining in the Deepwater Port Liability Fund and the Offshore Oil Pollution Compensation Fund (both having been eliminated by the above repeals). Part 4: Implementation of Conventions - Recognizes the International Oil Pollution Compensation Fund (International Fund) as a legal person under the laws of the United States. Requires, in any action brought in the United States against the owner of a ship or his guarantor under the International Convention on Civil Liability for Oil Pollution Damage that the International Fund and the Oil Spill Liability Trust Fund be served a copy of the complaint and any subsequent pleading. Entitles the International Fund to intervene as a party in any such action. Exempts the International Fund from all direct taxation in the United States. Requires any contribution to the International Fund to be paid from the Oil Spill Liability Trust Fund. Sets forth the jurisdiction of the U.S. district courts for controversies arising under the Civil Liability Convention or the International Fund Convention. Requires U.S. courts to recognize final judgments of courts of nations which are a party to the Civil Liability Convention or the International Fund Convention. Requires the owner of each U.S. documented ship, or any ship, wherever registered, which enters or leaves a U.S. port or terminal carrying more than 2,000 tons of oil in bulk as cargo to establish and maintain evidence of financial responsibility in amounts sufficient to cover the maximum liability arising from one incident under the Civil Liability Convention. Imposes a civil penalty for noncompliance with such financial responsibility requirement. States that the United States waives all defenses based on its status as a sovereign state with respect to any controversy arising under the Civil Liability Convention or the International Fund Convention relating to any ship owned by the United States and used for commercial purposes. Part 5: Oil Spill Liability Trust Fund and Its Revenue Sources - Amends the Internal Revenue Code to increase tax rates on petroleum according to a specified formula to fund the Oil Spill Liability Trust Fund, established by this part. Limits expenditures from such Fund per incident. Limits the liability of the United States for claims against such Fund to the amount in such Fund. Subtitle G: Prohibition on Loan Sales - Declares that any loan made under the Public Works and Economic Development Act of 1965 or under section 254 of the Trade Act of 1974 shall not be sold to private interests, except with the consent of the borrower, and a contract shall not be entered into with private interests to sell or administer such a loan. Title IX: House Committee on Small Business - Corporation for Small Business Investment Charter Act - Amends the Small Business Investment Act of 1958 to include in the terms "small business investment company," "company," and "license" any company that is qualified to conduct business with the Corporation for Small Business Investment. Defines "small business concern" with respect to the Small Business Investment Act of 1958. Sets forth procedures for the qualification of small business investment companies (licensees) to conduct business with the Corporation for Small business Investment and the termination, suspension, or revocation of the license of such companies that do not qualify under the provisions of this Act. Establishes the Corporation for Small Business Investment. Requires the President, within 60 days after enactment of this Act, to appoint an interim Board of Directors of the Corporation. Authorizes the Corporation to issue common and preferred stock and certain other obligations to small business investment companies. Authorizes the Secretary of the Treasury to purchase obligations issued by the Corporation. Exempts from U.S. securities laws all stocks and obligations issued by the Corporation. Deems the Corporation to be a U.S. agency. Authorizes the Corporation to: (1) make loans to small business investment companies; (2) purchase preferred securities, debentures, and guaranteed debentures issued by such companies; and (3) act as issuer of such securities. Requires the Corporation to establish criteria for the qualification of: (1) small business investment companies to conduct business with such Corporation; and (2) special small business investment companies whose investments will be made soley in disadvantaged small businesses. Establishes a special-purpose trust for the benefit of special small business investment companies. Authorizes: (1) the trustees to purchase preferred securities; and (2) the Corporation to purchase or to guaranteed debentures issued by special small business investment companies. Permits the purchase of ownership interests in small business investment companies by national banks. Authorizes small business investment companies to: (1) purchase stock issued by the Corporation; (2) borrow money; and (3) issue debenture bonds, promissory notes, or other obligations under conditions as prescribed by the Corporation. Authorizes the Corporation to enter into agreements regarding the operation of small business investment companies. Authorizes small business investment companies to provide equity capital and loans to small businesses. Requires the Corporation to adopt rules on conflicts of interest which may be detrimental to: (1) small businesses; (2) small business investment companies; or (3) the Corporation. Provides that the Small Business Administration (SBA) shall have review authority over the Corporation. Requires the accounts of the Corporation to be audited annually. Requires a report of each audit to be: (1) furnished to the Secretary of the Treasury; and (2) made by the Secretary to the President and the Small Business Committees of the Congress not later than six months following the close of each fiscal year. Requires the Corporation, after the end of each fiscal year, to transmit to the President, the Small Business Committees of the Congress, and the Small Business Administration a report of its operations and activities during each year. Transfers to the Corporation all title to small business investment company securities that are guaranteed by the SBA and held by the Federal Financing Bank. Requires the Corporation to establish a participating incentive revolving fund. Terminates such fund 15 years after enactment of this Act. Amends the Small Business Act to prohibit the SBA from making payments to the Department of the Treasury on account of debentures guaranteed under the Small Business Investment Act of 1958 after the date such debentures are sold to the Corporation. Provides that nothing in this Act shall be construed to authorize the SBA to sell, pledge, or in any way encumber loans or debentures made or issued by the SBA except as authorized under the Small Business Investment Act of 1958. Provides that the central registration of trust certificates sold by the SBA shall include the identification of each licensee and the interest rate paid by such licensee. Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to make technical changes. Amends the Revised Statutes of the United States to authorize a national banking association to deal with obligations or other instruments or securities of the Corporation for Small Business Investment. Title X: House Committee on Ways and Means - Subtitle A: OASDI Provisions - Amends title II (Old Age, Survivors and Disability Insurance) of the Social Security Act to eliminate the requirement that there be at least a three-percent rise in the Consumer Price Index before a cost-of-living adjustment of benefits is made. Amends the Internal Revenue Code to permit State and local government employers to directly deposit social security contributions with the Federal Government. (Currently, the State is responsible for collecting the contributions of its political subdivisions.) Places State and local government employers under a depositing schedule that conforms with the frequency required of private employers. Subtitle B: Provisions Relating to Public Assistance and Unemployment - Amends part A (Aid to Families with Dependent Children) of title IV of the Social Security Act to require States to make AFDC payments with respect to dependent children of unemployed parents in two-parent families. Includes within the definition of "quarter of work", for the purpose of determining a family's eligibility for assistance under this program, the parent's: (1) full-time attendance as an elementary or secondary school student; (2) full-time attendance in a vocational or technical training course; and (3) participation in a Job Training Partnership Act education or training program. Amends title XI (General Provisions) of the Act to eliminate the requirement that States use information provided by income and eligibility verification systems, used for certain public assistance programs, to verify the eligibility of all beneficiaries of such programs. Amends the Consolidated Budget Reconciliation Act fo 1985 to hold a State harmless in FY 1987 against charges that Act effected in the annual calculation of the Federal medical assistance percentage under the AFDC program if such changes would cause a reduction of AFDC payments to the State in FY 1987. Amends the Federal Unemployment Tax Act to extend, until 1989, the current Federal Unemployment Tax rate. Subtitle C: Medicare and Health Programs - Part 1: Provisions Relating to Medicare Part A Only - Amends part A (Hospital Insurance) of the Medicare program to set the hospital deductible at $500 for 1987. Increases hospital prospective payment rates by 1.3 percent for FY 1987 and by the market basket percentage minus two percent for FY 1988. Provides for the same increases in cost levels for hospitals exempt from the prospective payment system (PPS). Requires the Secretary to recalibrate the Diagnosis Related Groups (DRGs) annually. (Currently, DRGs must be recalibrated at least every four years.) Requires the Secretary to ensure that the aggregate payment amount for capital-related costs associated with inpatient hospital services for PPS hospitals do not exceed specified target limits set for FY's 1987, 1988, and 1989. Requires the inclusion of Puerto Rican hospitals into the PPS. Sets the prospective payment rate for such hospitals at 75 percent of the Puerto Rican standardized rate and 25 percent of the national standardized rate, providing for adjustments necessitated by certain cost and care variations among hospitals. Prohibits the Secretary from adjusting the national standardized rate to reflect the inclusion of Puerto Rico in the PPS. Requires the Secretary to develop and submit to the Congress a legislative proposal to improve the PPS so that it more accurately approximates the costs of inpatient hospital services and accounts for variations in case complexity. Requires a hospital to give Medicare beneficiaries, upon their admission to the hospital, a written statement explaining: (1) the individual's rights to benefits for inpatient hospital and post-hospital Medicare services; (2) the circumstances under which such individual will be liable for charges for a continued hospital stay; (3) the individual's right to appeal denials of continued hospital services; and (4) the individual's liability for payment for services if such denial of benefits is upheld on appeal. Requires hospitals to implement a discharge planning process which meets guidelines and standards, to be established by the Secretary, ensuring patients a timely and smooth transition to the most appropriate type of, and setting for, post-hospital or rehabilitative care. Directs the Secretary to study the adequacy of standards used for hospital compliance with Medicare participation conditions in assuring the quality of hospital services. Requires the Secretary to study the adequacy with which the PPS compensates hospitals, and distributes such compensation among hospitals, for costs attributable to patients' extended hospital stays necessitated by delays in patient placement in skilled nursing facilities. Provides that skilled nursing facilities, home health agencies, and hospice programs that keep their services for which Medicare coverage is denied below specified percentages and comply with certain administrative requirements shall not subsequently be denied payment for care provided. Sets forth reporting requirements. Extends such limitations on provider liability for disallowed Medicare claims to home health services provided to individuals who are not homebound or did not require skilled nursing care on an intermittent basis. Directs the Secretary to develop a uniform needs assessment instrument enabling health care providers and fiscal intermediaries to evaluate an individual's need and ability to pay for post-hospital extended care, home-health, and long-term care services. Requires the Secretary to develop procedures to expedite fiscal intermediaries' determinations as to whether provider claims for post-hospital extended care and home health services may be reimbursed under the Medicare program. Amends the Social Security Amendments of 1983 to extend through 1989 the annual report on the impact of the PPS and require the inclusion of information in such reports regarding the quality, and accessibility to Medicare beneficiaries, of post-hospital services. Directs the Secretary to conduct, and report to the Congress by 1989, on a demonstration program concerning prior authorization for Medicare post-hospital extended care and home health services. Accelerates, from FY 1993 to FY 1987, the removal of the receipts and disbursements of the Federal Hospital Insurance Trust Fund from the Federal budget. Exempts such trust fund from statutory budget limitations on Government expenditures. Sets forth technical amendments and miscellaneous provisions. Part 2: Provisions relating to Parts A and B - Amends part A (Hospital Insurance) of the Medicare program to eliminate periodic interim payments for inpatient hospital services in PPS hospitals, except for services provided in disproportionate share hospitals, safe community hospitals, and hospitals paid under certain State hospital reimbursement systems. Requires the Secretary to make accelerated payments to PPS hospitals having significant cash flow problems. Amends part A and B (Supplementary Medical Insurance) of the Medicare program to require intermediaries and carriers to pay the claims of Medicare providers and beneficiaries, and give such providers and beneficiaries notice of improperly submitted claims, within 22 days of receiving such claims. Requires the Government to pay the interest accruing on such claims for the period during which the payment or notice is past due. Prohibits the Secretary from modifying certain regulations relating to the periodic interim payment method of reimbursing providers. Directs the Secretary to develop an optional interim periodic payment system for participating physicians who have at least one year of claims experience. Amends the Tax Equity and Fiscal Responsibility Act of 1982 to repeal the requirement that health maintenance organizations (HMOs) which had a Medicare cost contract but sign a risk contract enroll two new risk contract enrollees before they convert one cost contract member. Amends the Medicare program to require HMOs and competitive medical plans (CMPs) to provide Medicare beneficiaries with an explanation of their rights as enrollees when they enroll and at least annually thereafter. Prohibits new waivers of the requirement that no more than 50 percent of such enrollees be Medicare or Medicaid-eligible, unless more than 50 percent of the population in the area served by the organization consists of Medicare or Medicaid-eligible individuals. Provides that where a waiver has already been granted for some other purpose, such waiver may only be extended if the Secretary determines that the organization is making reasonable efforts to meet scheduled enrollment goals. Authorizes the Secretary to suspend the enrollment of Medicare beneficiaries in organizations failing to comply with the enrollment requirements. Requires HMOs and CMPs to pay providers' clean claims within 22 days of their receipt, except where the HMO or CMP is under contract with the provider. Requires HMOs and CMPs to give the Secretary access to the financial records of certain subcontractors and notification as to their loans and special financial arrangements with subcontractors, affiliates, and related parties. Authorizes the Secretary to impose a civil monetary penalty on HMOs or CMPs which substantially fail to provide medically necessary items and services, provided such failure adversely affects HMO or CMP enrollees. Requires a study into methods by which adjusted average per capita cost and adjusted community rate calculations (used in calculating payments to HMOs and CMPs) can be refined. Permits beneficiaries to disenroll from an HMO at any local office of the Social Security Administration. Prohibits providers from representing beneficiaries on appeals of claim denials if such representatation involves issues which concern the beneficiary's possible obligation to pay the provider for services not covered by the Medicare program. Gives Medicare beneficiaries the right to appeal any payment denial for home health services. Amends part A (General Provisions) of title XI of the Act to prohibit hospitals, HMOs, and CMPs from making payments to a physician as an inducement to reduce or limit services to beneficiaries under the physician's care. Directs the Secretary to report to the Congress by April 1, 1987, on providing HMOs and CMPs with an appropriate exception to the incentive payment prohibition. Directs the Secretary to arrange a study which would serve as the basis for a strategy assuring the quality of Medicare services. Sets forth technical amendments and miscellaneous provisions. Part 3: Provisions Relating to Medicare Part B - Amends part B (Supplementary Medical Insurance) of the Medicare program to extend, until 1990, the requirement that the part B premium equal 25 percent of part B costs for enrollees age 65 and over. Provides that, beginning in 1987, all physicians will receive the same increase in prevailing charges based on the percentage increase in the Medicare Economic Index (MEI). Gives participating physicians an additional annual one percent increase in prevailing charges, but prohibits such increase from being included in the base for subsequent charge increases. Authorizes nonparticipating physicians to increase their actual charges by an additional one percent in 1987 (included in the base for subsequent increases). Prohibits the implementation of a specified retroactive adjustment in the MEI. Prohibits the Secretary from requiring carriers to reduce payments for part B items or services upon the Secretary's determination that charges for such items and services are excessive. Directs the Secretary to submit to the Congress, by April 1, 1987, recommendations concerning payment reductions for overpriced part B items and services. Requires carriers to implement programs to recruit participating physicians and familarize beneficiaries with the participating physician program. Provides bonuses to carriers successful in increasing the proportion of physicians in their service area. Requires the distribution of participating physician directories to Medicare beneficiaries and hospitals. Requires hospitals to make the directory available to beneficiaries and, when referring a patient to a nonparticipating physician on an outpatient basis, provide the patient with the name of at least one participating physician. Prohibits physicians who do not accept assignment on a claim for charging a beneficiary for unnecessary services unless: (1) the physician did not know and could not reasonably have been expected to know that the services would be deemed unnecessary; or (2) the beneficiary was informed that Medicare coverage would be denied, but agreed to pay for the services. Requires physicians providing elective surgical procedures (at an actual charge of $500 or more) on an unassigned basis to provide the individual with a written form disclosing charges in excess of the Medicare approved charge. Sets limits on reductions the Secretary may make in payment rates for free-standing and hospital-based renal disease facilities. Provides that an application by an isolated essential facility for an exception to such rates shall be deemed to be approved unless the Secrtary disapproves of it within 45 days of its being filed. Requires the Secretary to adjust the home/facility physician treatment capability ratio in order to reduce the payment rate for physicians' services to outpatient maintenance dialysis patients. Directs the Secretary to report to the Congress by 1988 on the results of a study evaluating the effects of such rate reductions on access to, and the quality of, care provided to renal disease patients. Directs the Secretary of Health and Human Services to consolidate existing renal disease network areas into no fewer than 17 areas, giving existing network organizations the first opportunity to perform network functions in a newly designated area. Requires that the network council and medical review board established by each network organization have at least one patient representative. Expands the list of network organization responsibilities to include the: (1) encouragement of patient and provider participation in vocational rehabilitation programs; (2) implementation of a procedure for evaluating and resolving patient grievances; (3) necessary on-site review of facility and provider compliance with standards of care; and (4) collection of data for specified reports. Requires the Secretary to establish, by 1988, a national end-stage renal disease registry for the purpose of collecting uniform and comprehensive data on all dialysis and transplant patients. Alters the methods of funding network organizations by requiring the Secretary to supply such organizations with 50 cents from each payment otherwise made to a dialysis facility for dialysis services. (Currently, organization funds are provided from the Medicare trust funds.) Requires the Secretary to: (1) establish conditions on the reuse of dialysis filters by facilities and providers which voluntarily reuse such filters; and (2) consider establishing standards for the reuse of other dialysis supplies. Sets forth technical amendments and miscellaneous provisions. Part 4: Improved Review of Quality by Peer Review Organizations - Amends part B (Peer Review) of title XI of the Act to require peer review organizations (PROs) receiving a hospital inpatient's request for review of a hospital's decision that the patient no longer needs inpatient care to inform the patient of its decision within one full working day of receiving the request and the patient's medical records. Prohibits hospitals from charging patients for inpatient hospital services provided while patients wait for a PRO to respond to their timely review requests. Requires hospitals to submit data to PROs on a monthly basis. Requires PROs to review selected cases where individuals are readmitted to a hospital within 30 days of their most recent hospital discharge to determine whether the previous inpatient hospital services and post-hospital services met professionally recognized health care standards. Directs each PRO to commit a reasonable proportion of its activities to review of the quality of services provided, concentrating on cases and settings which have a high potential of yielding quality of care problems. Requires PROs to review inpatient and outpatient services provided by HMOs and CMPs to determine whether the quality of such care meets professionally recognized standards of health care. Requires the Secretary to identify methods facilitating the discovery of cases which are more likely than others to involve substandard care. Requires each PRO to have at least one consumer representative on its board of directors. Directs such organizations to review all written beneficiary complaints about the quality of Medicare services which are filed with the organization. Requires PROs to share data with organizations responsible for licensing or accrediting providers or State officials responsible for assuring quality care if such data relates to a specific case or to a possible pattern of substandard care. Directs providers to execute agreements with PROs for the provision of such new review activities. Reimburses providers for the costs of such agreements. Part 5: Assuring Access to Health Care - Expresses the congressional intent that each State establish a health insurance pool which: (1) is open to all State residents who are not eligible for benefits under part A of the Medicare program; and (2) provides levels of health insurance typical of levels provided by large employer groups. Amends the Internal Revenue Code to impose a five percent tax on the gross wages of large employers who do not participate in the State pool. Amends the Internal Revenue Code to make certain technical amendments relating to the continuation of employer-based health insurance coverage. Allows retirees to continue their coverage under an employer-based health insurance plan in the event of such employer's bankruptcy. Subtitle D: Revenue Provisions - Extends the excise tax on communications services for two years from 1987 to 1989. Requires the Secretary of the Treasury to conduct a study of communication services not subject to such excise tax. Requires the Secretary to submit a report of such study to certain committees of the Congress not later than December 31, 1987.

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