Education

Lieutenant General William W. Quinn, United States Army, Retired, of Maryland, to be a Member of the Board of Trustees of the Barry Goldwater Scholarship and Excellence in Education Foundation for a term expiring October 13, 1999. (Reappointment).

United States · United States Senate · 1 December 1994

Howard W. Cannon, of Nevada, to be a Member of the Board of Trustees of the Barry Goldwater Scholarship and Excellence in Education Foundation for a term expiring March 3, 1998. (Reappointment)

United States · United States Senate · 1 December 1994

Lynda Hare Scribante, of Nebraska, to be a Member of the Board of Trustees of the Barry Goldwater Scholarship and Excellence in Education Foundation for a term expiring October 13, 1999, vice Dean Burch.

United States · United States Senate · 1 December 1994

Peggy Goldwater-Clay, of California, to be a Member of the Board of Trustees of the Barry Goldwater Scholarship and Excellence in Education Foundation for a term expiring June 5, 2000, vice Barry M. Goldwater, Jr., term expired.

United States · United States Senate · 1 December 1994

Niranjan Shamalbhai Shah, of Illinois, to be a Member of the Board of Trustees of the Barry Goldwater Scholarship and Excellence in Education Foundation for a term expiring August 11, 1998, vice Timothy W. Tong, term expired.

United States · United States Senate · 1 December 1994

Stanley K. Sheinbaum, of California, to be a Member of the National Security Education Board for a term of four years, vice John P. Roche, resigned.

United States · United States Senate · 1 December 1994

Herschelle Challenor, of Georgia, to be a Member of the National Security Education Board for a term of four years, vice Steven Muller.

United States · United States Senate · 1 December 1994

Dale Minami, of California, to be a Member of the Board of Directors of the Civil Liberties Public Education Fund for a term of three years. (New Position)

United States · United States Senate · 1 December 1994

Robert F. Drinan, of Massachusetts, to be a Member of the Board of Directors of the Civil Liberties Public Education Fund for a term of three years. (New Position)

United States · United States Senate · 1 December 1994

Don T. Nakanishi, of California, to be a Member of the Board of Directors of the Civil Liberties Public Education Fund for a term of two years. (New Position)

United States · United States Senate · 1 December 1994

Yeiichi Kuwayama, of the District of Columbia, to be a Member of the Board of Directors of the Civil Liberties Public Education Fund for a term of three years. (New Position)

United States · United States Senate · 1 December 1994

Elsa H. Kudo, of Hawaii, to be a Member of the Board of Directors of the Civil Liberties Public Education Fund for a term of two years. (New Position)

United States · United States Senate · 1 December 1994

Susan Hayase, of California, to be a Member of the Board of Directors of the Civil Liberties Public Education Fund for a term of three years. (New Position)

United States · United States Senate · 1 December 1994

Cherry T. Kinoshita, of Washington, to be a Member of the Board of Directors of the Civil Liberties Public Education Fund for a term of two years. (New Position)

United States · United States Senate · 1 December 1994

Affordable Health Care Now Act of 1994

United States · United States Congress · 29 November 1994

TABLE OF CONTENTS: Title I: Improved Access to Affordable Health Care Subtitle A: Increased Availability and Continuity of Health Coverage for Individuals and Their Families Subtitle B: Reform of Health Insurance Subtitle C: Preemption Subtitle D: Health Deduction Fairness Subtitle E: Improved Access to Community Health Services Subtitle F: Improved Access to Rural Health Services Subtitle G: Assistance in Enrolling Uninsured Children in Health Insurance Subtitle H: Medicaid Reform Subtitle I: Remedies and Enforcement with Respect to Group Health Plans Subtitle J: Delivery of Health Care Services to Illegal Immigrants Title II: Health Care Cost Containment and Quality Enhancement Subtitle A: Medical Malpractice Liability Reform Subtitle B: Administrative Cost Savings and Fair Health Information Practices Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Accounts Subtitle D: Anti-Fraud Subtitle E: Increased Medicare Beneficiary Choice; Additional Medicare Reforms Subtitle F: Health Care Antitrust Improvements Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities Subtitle H: Reform of Clinical Laboratory Requirements for Simple Tests Subtitle I: Miscellaneous Provisions Title II: Long-Term Care Subtitle A: Tax Treatment of Long-Term Care Insurance Subtitle B: Establishment of Federal Standards for Long-Term Care Insurance Subtitle C: Protection of Assets Under Medicaid Through Use of Qualified Long-term Care Insurance Subtitle D: Studies Subtitle E: Volunteer Service Credit Demonstration Projects Affordable Health Care Now Act of 1994 - Title I: Improved Access to Affordable Health Care - Subtitle A: Increased Availability and Continuity of Health Coverage for Individuals and Their Families - Part 1: Required Coverage Options for Eligible Employees, Spouses, and Dependents - Requires each employer to make available to each eligible employee a group health plan under which: (1) coverage of each eligible individual with respect to such employee may be elected on an annual basis; (2) coverage is provided for at least the required coverage specified; and (3) employees may elect to have premiums collected through payroll deduction. Does not require employer contributions to the cost of coverage under such a plan. Provides for the exclusion of: (1) employers who have been employers for less than two years or who have no more than two eligible employees or no more than two eligible employees not covered under any group health plan; and (2) family members under specified circumstances. Specifies that a group health plan shall not be treated as failing to meet the requirements of this Act solely because a period of service by an eligible employee of not more than 60 days is required for coverage. Specifies that the required coverage is standard coverage, except that in the case of a small employer that has not contributed during the previous plan year to the cost of coverage for any eligible employee under any group health plan, the required coverage for the plan year is coverage under a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan. Requires standard coverage to include at least one option, either a fee-for-service option and if available, a point-of-service option and a managed care option. Provides for a five-year transition for existing group health plans. (Sec. 1002) Sets forth provisions regarding: (1) compliance with applicable requirements through multiple employer health arrangements; and (2) coverage options under a State medical health allowance program. Part 2: Portability and Nondiscrimination - Prohibits a group health plan from imposing (and an insurer from requiring an employer from imposing through a waiting period for coverage under a plan or similar requirement) a limitation or exclusion of benefits relating to treatment of a preexisting condition if: (1) the condition relates to a condition that was not diagnosed or treated within three months before the date of coverage under the plan; (2) the limitation or exclusion extends over more than six months after the date of coverage, applies to an individual who, as of the date of birth, was covered under the plan, or relates to pregnancy; or (3) an eligible individual has such coverage at the time the individual first became eligible. Specifies that, in the case of an individual who is eligible for coverage under a plan but for a waiting period imposed by the employer, the individual shall be treated as having been covered under the plan as of the earliest date of the beginning of the waiting period. Provides a one-time amnesty period for pre-existing condition exclusions. (Sec. 1012) Requires each group health plan to waive any period applicable to a preexisting condition for similar benefits with respect to an individual to the extent that the individual, prior to enrollment in such plan, was covered for the condition under any other health plan. (Sec. 1013) Prohibits: (1) a multiemployer plan and an exempted multiple employer health plan from canceling or denying renewal of coverage under such a plan for an employer other than for nonpayment of contributions, fraud or other misrepresentation, noncompliance with plan provisions, or because the plan is ceasing to provide any coverage in a geographic area; (2) an insurer from canceling a health insurance plan or denying renewal of coverage other than as prescribed above; and (3) an insurer who terminates the offering of health insurance plans in an area from offering such a plan to any employer in the area until five years after the date of the termination. Part 3: Standards for Managed Care Arrangements and Essential Community Providers - Sets forth requirements for group health plans and insurers that provide health care coverage through managed care arrangements. Requires such arrangements to assure that covered individuals have reasonably prompt access through the entity's provider network to the benefits package and to centers of excellence. (Sec. 1022) Requires the Secretary of Health and Human Services (Secretary) to establish standards for utilization review programs and periodically review and update such standards to reflect changes in the delivery of health care services. Part 4: Enforcement; Effective Dates; Definitions - Makes provisions of the Employee Retirement Income Security Act of 1974 applicable with respect to enforcement of this Act (by the Department of Labor). Amends the Internal Revenue Code (Code) to impose a tax ($100 per day for each individual involved, subject to specified limitations) on the failure of an insurer to comply with the requirements under part 2, unless the Secretary determines that the State has in effect a regulatory enforcement mechanism that provides adequate sanctions. Subtitle B: Reform of Health Insurance - Part I: Marketplace for Small Business - Requires each insurer that makes available a health insurance plan to a small employer in a State to make available to each small employer in the State a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan, with exceptions for health maintenance organizations (HMOs) and if a State provides for guaranteed availability (rather than guaranteed issue). Requires each insurer that offers a MedAccess plan to a small employer in a State to accept: (1) every small employer in the State that applies for coverage; and (2) every eligible individual who applies for enrollment on a timely basis. Sets forth provisions regarding: (1) special rules for HMOs; (2) timely enrollment requirements; and (3) enrollment of spouses and dependents. Makes such requirements inapplicable in a State that has provided (in accordance with specified standards) a mechanism under which each insurer offering a health insurance plan to a small employer in the State must participate in a program for assigning high-risk small employer groups (or individuals within such a group) among some or all such insurers, if the insurers comply. (Sec. 1102) Defines "MedAccess coverage" as a health insurance plan that: (1) is designed to provide standard coverage with substantial cost-sharing, only catastrophic coverage, or medisave coverage; (2) includes only essential and medically necessary services; (3) meets applicable requirements relating to guaranteed issue; and (4) meets specifies consumer protection standards. Defines "MedAccess standard coverage," "MedAccess catastrophic coverage," and "MedAccess medisave coverage" to mean a MedAccess plan that provides for at least standard coverage, for only catastrophic coverage, or medisave coverage, respectively. Requests the National Association of Insurance Commissioners (NAIC) to submit to the Secretary a set of rules which is sufficient for determining the actuarial value of coverage offered by a plan. Directs the Secretary to certify such set of rules for use under this subtitle if they meet such requirements or establish such a set of rules. Specifies that a health insurance plan is considered to provide: (1) standard coverage if the benefits are determined, in accordance with certified rules of actuarial equivalence, to have a value that is within five percentage points of an established target actuarial value for standard coverage; (2) catastrophic coverage if benefits are available under the plan for a year only to the extent that expenses for covered services in a year exceed a deductible amount that is consistent with a specified requirement for a catastrophic health plan under the Code, and are determined, in accordance with certified actuarial equivalence rules, to have a value that is within five percentage points of an established target actuarial value for catastrophic coverage; and (3) medisave coverage if such plan consists of a catastrophic health plan within the meaning of the Code and a medical savings account. Requests NAIC to submit to the Secretary target actuarial values for standard and catastrophic coverage. Permits NAIC to submit periodic revisions of, and permits the Secretary to revise, the set of rules of actuarial equivalence and target actuarial values where necessary to take into account changes in the relevant types of health benefits provisions, in deductible levels for catastrophic coverage, or in relevant demographic conditions. (Sec. 1103) Directs the Secretary to request NAIC to develop model regulations that specify standards with respect to requirements: (1) that insurers make available MedAccess plans; (2) of guaranteed availability of MedAccess plans to small employers; (3) relating to limits on premiums and certain consumer protections; and (4) relating to limitation of annual premium increases. Requires the Secretary to review such standards and, if NAIC fails to specify standards meeting such requirements, to promulgate standards. Sets forth provisions regarding: (1) the application of MedAccess standards and consumer protection standards by the States; and (2) the Federal role. (Sec. 1104) Sets forth provisions: (1) regarding limits on premium rate variations, including discounts for employer wellness programs; and (2) requiring an insurer, at the time of offering a health insurance plan to a small employer, to fully disclose rating practices for health insurance plans, including rating practices for different populations and benefit designs. (Sec. 1105) Requires the Secretary of Labor to monitor the prevalence and impact of adverse risk selection in the full insured plans made available to small employers resulting from the decision of small employers to self-insure. (Sec. 1106) Directs the Secretary to: (1) request NAIC to develop models for reinsurance or allocation of risk mechanisms for health insurance plans made available to small employers for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models or specify models. Sets forth provisions regarding implementation of reinsurance or allocation of risk mechanisms by the States and the Federal role. Part : Marketplace for Individuals - Makes the provisions of Part 1 applicable to insurers offering health insurance coverage to individuals and their dependents. Part 3: Voluntary Health Purchasing Arrangements - Provides for the establishment of voluntary health purchasing arrangements. (Sec. 1124) Requires such arrangements to offer enrollment in health insurance coverage only to: (1) all eligible employees employed by small employers in a service area; and (2) all eligible individuals residing in such area. Part 4: Definitions and Miscellaneous Provisions - Provides definitions for purposes of this subtitle. (Sec. 1134) Requires the Secretary to make annual reports to the Congress on the implementation of this subtitle and the need for additional reforms to assure and expand coverage. (Sec. 1135) Authorizes the Director to conduct: (1) research on the impact of this subtitle on the availability of affordable health coverage for employees and dependents in the small employers group health care coverage market and other specified topics; and (2) demonstration projects relating to such topics. Requires the Director to develop: (1) methods for measuring the relative health risks of eligible individuals in terms of the expected costs of providing benefits under health insurance plans and, in particular, MedAccess plans; and (2) a model for equitably distributing health risks among insurers in the small employer health care coverage market. Authorizes appropriations. Subtitle C: Preemption - Part 1: Scope of State Regulation - Makes inapplicable to a group health plan any State or local law requiring coverage of specific benefits, services, or categories of health care, or services of any class or type of provider of health care. (Sec. 1202) Makes inapplicable any State or local law prohibiting two or more employers from obtaining coverage under a multiple employer welfare arrangement under which all coverage: (1) consists of medical care described under specified provisions of the Employee Retirement Income Security Act of 1974 (ERISA); and (2) is fully insured. (Sec. 1203) Preempts, for a five-year period, State law provisions which restrict: (1) reimbursement rates or selective contracting; (2) differential financing incentives; and (3) utilization review methods. Directs the Comptroller General to study benefits and cost effectiveness of use of managed care in health services delivery and to report to the Congress, including recommendations as to whether such preemption should be extended. Part 2: Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide a limited exemption from certain restrictions on ERISA preemption of State law for health plans maintained by multiple employers subject to certain Federal standards. Relieves such exempted multiple employer health plans of certain restrictions on preemption of State law, and treats them as employee welfare benefit plans. Sets forth exemption procedures, application and eligibility requirements, and additional notice, reporting, and actuarial requirements applicable to exempted multiple employer health plans. Requires multiple employer welfare arrangements providing certain medical care benefits to issue specified disclosures to participating employers. Requires each multiple employer welfare arrangement which is or has been an exempted multiple employer health plan, and under which coverage is not fully insured, to establish certain minimum reserves. Authorizes the Secretary of Labor to permit alternative means of compliance. Sets forth corrective actions, including actions to avoid depletion of reserves and actions in connection with termination of arrangements. Provides for expirations, renewals, suspensions, and revocations of exemptions. Provides for review of actions of the Secretary, including denials of applications and suspensions or revocations of exemptions. Provides for alternative means of distribution of summary plan descriptions. (Sec. 1212) Revises provisions relating to scope of preemption rules, treatment of single employer arrangements, and treatment of certain collectively bargained arrangements. (Sec. 1215) Sets forth special rules for employee leasing health care arrangements, providing that they be treated as multiple employer welfare arrangements. (Sec. 1216) Sets forth enforcement provisions relating to multiple employer welfare arrangements and employee leasing health care arrangements, including enforcement of filing requirements, actions by States in Federal court, criminal penalties for certain willful misrepresentations, cease activities orders, and responsibility for claims procedures. (Sec. 1217) Sets forth solvency requirements for certain self- insured group health plans. (Sec. 1218) Sets forth filing requirements for multiple employer welfare arrangements providing health benefits. (Sec. 1219) Provides for cooperation between Federal and State authorities, including: (1) agreements for State enforcement of ERISA provisions applicable to multiple employer welfare arrangements which are or have been exempted multiple employer health plans; and (2) enforcement and technical assistance to States with respect to issues involving multiple employer welfare arrangements. (Sec. 1220) Sets forth transitional rules. Part 3: Encouragement of Multiple Employer Arrangements Providing Basic Health Benefits - Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax-exempt trust status in the case of determining whether any multiple employer health plan or insured multiple employer health plan is a voluntary employees' beneficiary association meeting certain requirements, if: (1) such plan provides at least standard coverage consistent with specified provisions of this Act (the Affordable Health Care Now Act of 1994); and (2) in the case of such an insured plan, it meets specified ERISA requirements not preempted by this Act. (Sec. 1222) Amends ERISA to direct the Secretary of Labor to prescribe an alternative method for the filing of a single annual report with respect to all employers participating under a multiple employer welfare arrangement under which all coverage consists of medical care and is fully insured. (Sec. 1223) Sets forth provisions for determining compliance with coverage requirements through multiple employer health arrangements. Subtitle D: Health Deduction Fairness - Amends the Internal Revenue Code to provide for: (1) a permanent extension and an increase in the health insurance tax deduction for self-employed individuals; and (2) a deduction of health insurance premiums for certain previously uninsured individuals. Subtitle E: Improved Access to Community Health Services - Part 1: Increased Authorization for Community and Migrant Health Centers - Directs the Secretary to provide for grants to migrant and community health centers to promote primary health care services for underserved individuals. Allows grants to be used to promote the provision of off-site services, to improve birth outcomes in areas with high infant mortality and morbidity, to establish primary care clinics in areas in need, and for recruitment and training costs of necessary providers and operating costs for unreimbursed services. Authorizes appropriations. Directs the Secretary to conduct a study of the impact of such grants on access to health care, birth outcomes, and the use of emergency room services. Part 2: Grants for Projects for Coordinating Delivery of Services - Amends the Public Health Service Act to authorize the Secretary to make grants to public and nonprofit private entities: (1) to carry out demonstration projects to increase access to outpatient primary health services in specified geographic areas (i.e., areas that are rational areas for the delivery of health services, have a population of not more than 500,000 individuals, and have been designated by the Secretary as areas with a shortage of personal health services or that have a significant number of individuals with low incomes or insufficient health care insurance) through coordinating the delivery of services under Federal, State, local, and private programs; and (2) for developing plans to carry out such projects. Authorizes appropriations. Part 3: Community Health Networks - Sets forth qualifications for community health network arrangements. Subtitle F: Improved Access to Rural Health Services - Part 1: Establishment of Rural Emergency Access Care Hospitals Under Medicare - Amends title XVIII (Medicare) of the Social Security Act (SSA) to provide for: (1) establishment of rural emergency access care hospitals under Medicare; and (2) coverage of and payment for rural emergency access care hospital services under Medicare part B (Supplementary Medical Insurance). Part 2: Rural Medical Emergencies Air Transport - Amends the Public Health Service Act to direct the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments. Sets forth provisions regarding: (1) application and State plan requirements; (2) considerations in awarding grants; (3) State administration and use of grants; (4) the number of grants; and (5) reporting requirements. Authorizes appropriations. Part 3: Emergency Medical Services Amendments - Amends the Public Health Service Act to direct the Secretary to: (1) establish an Office of Emergency Medical Services, headed by a Director; (2) engage in specified emergency medical services activities, including disseminating information obtained in carrying out specified activities to public and private entities, providing technical assistance to State and local agencies, coordinating Department of Health and Human Services (DHHS) activities with those of other Federal agencies; and (3) ensure that such activities are carried out consistent with certain requirements regarding maintaining an adequate number of health professionals with expertise in the provision of services, developing, periodically reviewing, and revising as appropriate guidelines for the provision of such services, appropriately using available technologies, and serving the unique needs of underserved inner-city and rural areas. (Sec. 1522) Authorizes the Secretary to make grants to States for the purpose of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services, subject to specified matching fund, budgetary, and other requirements. (Sec. 1523) Provides for demonstration projects to establish telecommunications between rural medical facilities and medical facilities with expertise or equipment. Directs the Secretary to ensure that the telecommunications technologies demonstrated include interactive video telecommunications, static video imaging transmitted through the telephone system, and facsimiles transmitted through such system. (Sec. 1524) Authorizes appropriations for: (1) emergency medical services (including for State offices of Emergency Medical Services and for telecommunications demonstrations); and (2) trauma care and certain other activities. Part : Additional Rural Health Care Provisions - Authorizes the Secretary to make grants to public and nonprofit private entities to develop health plans to provide services exclusively in rural and frontier areas. Authorizes appropriations. (Sec. 1532) Authorizes the Secretary to make grants to public and nonprofit private hospitals in medically underserved rural communities, and to public and nonprofit outpatient facilities in such communities, to develop or increase capacity to provide primary health services. (Sec. 1533) Authorizes the Secretary to make grants to such entities to conduct research and carry out demonstration projects to develop innovative approaches to the delivery of health care in rural areas, such as the use of telemedicine and mobile delivery units. (Sec. 1534) Authorizes appropriations for the training of rural health professionals other than physicians. Subtitle G: Assistance in Enrolling Uninsured Children in Health Insurance - Amends title XIX (Medicaid) of the Social Security Act (SSA) to provide for the establishment of State premium subsidy programs to assist eligible needy children with premiums for standard health coverage. Subtitle H: Medicaid Reform - Amends SSA title XIX to: (1) provide for the establishment of State health allowance programs under which the State makes payments to an approved group health plan which provides coverage to eligible individuals as an allowance towards the costs of providing the individual with benefits under the plan; (2) modify Federal requirements to allow States more flexibility in contracting for coordinated care services under Medicaid; (3) make changes regarding the period of certain waivers under Medicaid; and (4) reduce the amount of Federal payment adjustments under Medicaid for disproportionate share hospitals. (Sec. 1713) Eliminates the duplicative pediatric immunization program under Medicare. Subtitle I: Remedies and Enforcement with Respect to Group Health Plans - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to set forth claims procedure special rules for group health plans. Directs the Secretary of Labor to establish a mediation program for disputes involving group health plan claims. Requires the Secretary to maintain a list of individuals with expertise to serve as facilitators under such program, and to propose a facilitator for each mediation subject to one objection by each party. Sets forth provisions for participation of attorneys, initiation of mediation, mediation procedures, time limits, costs, legal effect of participation, and confidentiality and admissibility. Sets forth court remedies for participants and beneficiaries with respect to group health plans. Subtitle J: Delivery of Health Care Services to Illegal Immigrants - Directs the Secretary of Health and Human Services to conduct a study of health care to illegal immigrants, including the effect of illegal immigration on health costs and the shifting of health costs. Requires a report to the Congress, with recommendations on appropriate means of: (1) alleviating health problems peculiar to illegal immigrants; (2) financing health care provided to illegal immigrants; and(3) increasing intergovernmental cooperation and coordination of efforts of the United States and other countries to alleviate such health problems and finance such efforts. Title II: Health Care Cost Containment and Quality Enhancement - Subtitle A: Medical Malpractice Liability Reform - Part 1: General Provisions - Makes this subtitle applicable with respect to any medical malpractice liability claim and to any medical malpractice liability action brought in State or Federal court, except a claim or action for damages arising from a vaccine-related injury or death to the extent that title XXI of the Public Health Service Act applies. Sets forth provisions regarding: (1) preemption of State law; (2) effect on sovereign immunity and choice of law or venue; (3) jurisdiction; and (4) effective dates. Part 2: Medical Malpractice and Product Liability Reform - Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified alternative dispute resolution (ADR) system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States under chapter 171 of the Federal judicial code (U.S. Court of Federal Claims). Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 2012) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action. Sets limits on punitive damages and on periodic payments for future losses. Reduces damages by any other payments made to compensate an individual for injuries. (Sec. 2013) Set forth provisions regarding: (1) limits on attorney fees and other costs; (2) joint and several liability (generally, liability may be found only for those damages directly attributable to the person's proportionate share of fault or responsibility for the injury); (3) a statute of limitations of seven years; and (4) a uniform standard for determining negligence (the defendant's conduct at the time of providing the health care services was not reasonable). (Sec. 2017) Specifies that in the case of a medical malpractice liability claim relating to services provided during labor or the delivery of a baby, if the health care professional did not previously treat the injured individual for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. Part 3: Requirements for State Alternative Dispute Resolution Systems - Lists requirements for State ADR systems, including that such a system: (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 2032) Directs the Secretary, by October 1 of each year, to certify State ADR systems that meet such requirements. Directs the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 2033) Directs the Secretary, within five years, to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system, including: (1) information on the effect of the ADR systems on health care costs, access to health care, and quality of care provided within the State; and (2) to the extent that such report does not provide information on no-fault systems operated by States as ADR systems, an analysis of the feasibility and desirability of establishing a system for resolving medical malpractice liability claims on a no-fault basis. Part 4: Other Provisions Relating to Medical Malpractice Liability - Authorizes a State agency responsible for disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies to permit their participation in the licensing of such practitioner and to review any health care malpractice action, claims, or allegation, or other information concerning the practice patterns of any such practitioner. Sets forth agreement requirements. (Sec. 2042) Directs the Secretary to study incentives adopted by State and local governments, insurers, medical societies, and other entities to encourage physicians to volunteer to provide health care services in medically underserved areas. (Sec. 2043) Directs each State to require: (1) each health care professional and health care provider to participate in a risk management program to prevent, and provide early warning of, practices which may result in injuries to patients or endanger patient safety; and (2) each provider of health care professional and provider liability insurance in the State to establish risk management programs or sanction programs of risk management for health care professionals and providers provided by other entities, and require each such professional or provider, as a condition of maintaining insurance, to participate in one such program at least once in each three-year period. (Sec. 2044) Directs the Secretary to make grants: (1) for basic research in the prevention of, and compensation for, injuries resulting from health care professional or provider malpractice and for research of the outcomes of health care procedures; (2) to States to assist in improving their ability to license and discipline health care professionals; and (3) to States and local governments, private nonprofit organizations, and health professional schools for educating the general public about the appropriate use of health care, realistic expectations of medical intervention, and the resources and role of health care professional licensing and disciplinary boards in investigating claims of incompetence or health care malpractice, and for developing programs of faculty training and curricula for educating health care professionals in quality assurance, risk management, and medical injury prevention. Authorizes appropriations. Subtitle B: Administrative Cost Savings and Fair Health Information Practices - Part 1: Administrative Cost Savings - Subpart A: Standards for Data Elements and Transactions - Directs the Secretary to adopt standards and modifications to standards that a: (1) consistent with the objective of reducing the costs of providing and paying for health care; and (2) in use and generally accepted, developed, or modified by the standard-setting organizations accredited by the American National Standard Institute. (Sec. 2104) Directs the Secretary to adopt standards: (1) for data elements of health information; and (2) for transmitting information electronically. Subpart B: Requirements With Respect to Certain Transactions and Information - Specifies standard transactions. Subpart C: Miscellaneous Provisions - Requires the Secretary to establish standards with respect to the operation of health information network services. (Sec. 2124) Authorizes the Secretary to make grants for demonstration projects to promote the development and use of electronically integrated community-based clinical information systems and computerized patient medical records. Subpart D: Assistance to the Secretary - Establishes the Health Care Information Advisory Committee to: (1) assist the Secretary in complying with requirements under this Act; (2) be generally responsible for advising the Secretary and the Congress on the status of the health information network; and (3) make recommendations to correct problems in the network and to refine and improve the network. Part 2: Fair Health Information Practices - Subpart A: Duties of Health Information Trustees - Specifies the duties of health information trustees with respect to inspection of protected health information. (Sec. 2142) Provides a procedure to amend protected health information. Subpart B: Use and Disclosure of Protected Health Information - Sets forth general limitations on the use and disclosure of protected health information by health information trustees. (Sec. 2152) Authorizes a health information trustee to disclose protected health information pursuant to a written authorization by the protected individual. (Sec. 2153) Describes the circumstances under which health information trustees may disclose protected health information to: (1) health plans, health care providers, and oversight agencies; (2) next of kin; (3) public health authorities; (4) health research entities; (5) authorities under emergencies; (6) courts or administrative agencies; (6) law enforcement agencies; (7) entities under subpoenas, warrants, and search warrants; and (8) health information service organizations. Subpart C: Access Procedures and Challenge Rights - Prohibits a government authority from obtaining protected health information about a protected individual from a health information trustee through subpoenas, warrants, and search warrants unless there is probable cause that the information is relevant to the law enforcement inquiry. (Sec. 2172) Establishes challenge procedures to such subpoenas. Subpart D: Miscellaneous Provisions - Restricts the information a health information trustee may disclose when a protected individual pays for health care through a payment card or electronic means. (Sec. 2183) Directs the Secretary to develop standards for electronic documents and communications. (Sec. 2184) Provides for the disclosure of protected health information to affiliated persons and agents and attorneys. (Sec. 2187) Requires States to establish a process for the maintenance of certain protected health information. Subpart : Enforcement - Provides for civil actions against health information trustees. (Sec. 2192) Authorizes the Secretary to impose a civil money penalty against such trustees for a demonstrated pattern of failure to comply with this subpart. (Sec. 2193) Requires the Secretary to develop an alternative dispute resolution method for resolving claims for civil actions. (Sec. 2194) Amends the Federal criminal code to impose penalties for violations in disclosing and obtaining protected health information. Subpart F: Amendments to Title 5, United States Code - Requires certain Federal agency heads to promulgate rules protecting health information. Subpart G: Regulations, Research, and Education; Effective Dates; Applicability; and Relationship to Other Laws - Requires the Secretary to prescribe regulations to carry out this part not later than July 1, 1996. (Sec. 2197) Makes this part effective on January 1, 1997, except for certain provisions that take effect upon enactment. Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Accounts - Amends the Internal Revenue Code to include under the medical expense deduction the portion of such expense attributable to coverage under a catastrophic health plan. (Sec. 2202) Allows individuals a tax deduction for a percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to medical care savings accounts. Subtitle D: Anti-Fraud - Directs the Attorney General to establish an all-payer health care fraud and abuse control program. (Sec. 2302) Authorizes additional appropriations for such program and AG investigations of possible health care fraud. (Sec. 2303) Establishes in the Treasury the Anti-Fraud and Abuse Trust Fund for use in preventing anti-fraud and abuse law violations and repaying Medicaid and other beneficiaries for cost-sharing. (Sec. 2311) Amends SSA title XI and the Federal criminal code to: (1) revise current sanctions to provide for, among other things, mandatory exclusion from Medicare and State health care program participation of individuals or entities convicted of a fraud-related felony in connection with the delivery of a health care item or service, and criminal penalties of fines and imprisonment for health care fraud; and (2) authorize the Secretary of Health and Human Services (Secretary) to issue advisory opinions with regard to specified matters, including matters concerning prohibited remuneration and service inducements. (Sec. 2315) Modifies: (1) current limitations under Medicare (SSA title XVIII) on physician self-referral; and (2) effective date exceptions under the Omnibus Budget Reconciliation Act of 1993 for such referrals made for clinical laboratory services. (Sec. 2316) Directs the Comptroller General to study and report to the Congress on the costs of peer review contracts for Medicare HMOs. (Sec. 2332) Amends SSA title XVIII to require the Secretary to issue advisory opinions relating to prohibited referrals under Medicare. Directs the Secretary to issue regulations establishing systems under SSA titles XI and XVIII for the issuance of advisory opinions. Subtitle E: Increased Medicare Beneficiary Choice; Additional Medicare Reforms - Amends SSA title XVIII and the Omnibus Budget Reconciliation Act of 1990 to make specified changes in HMO and Medicare supplemental policy provisions. Imposes mandates on the Secretary in order to afford Medicare beneficiaries additional avenues for choosing health care coverage, including enrollment in private health insurance plans. (Sec. 2411) Extends current rules for computing Medicare part B (Supplementary Medical Insurance) premiums. (Sec. 2412) Amends the Internal Revenue Code to provide for the imposition of a Medicare part B premium tax for high-income Medicare part B beneficiaries. (Sec. 2413) Directs the Secretary to take such steps as necessary to consolidate administration of Medicare parts A (Hospital Insurance) and B. (Sec. 2414) Makes specified extensions with regard to Medicare as secondary payer, including those concerning data matches. Subtitle F: Health Care Antitrust Improvements - Exempts from all antitrust claims an activity relating to the provision of health care services that is: (1) within a "safe harbor" designated by the Attorney General, except for claims for injunctive relief asserted by the Attorney General or the Chair of the Federal Trade Commission in extraordinary circumstances; and (2) specified in and in compliance with the terms of a certificate of review issued by the Attorney General, where the activity occurs while the certificate is in effect, except for claims for injunctive relief. Sets forth provisions regarding the award of attorney fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt. (Sec. 2502) Directs the Attorney General to develop and designate specified safe harbors relating to the following, as well as to such other categories of activities as the Attorney General may designate (subject to specified requirements): (1) joint purchasing of health care services; (2) small hospital mergers; (3) startup and operation of collaborations between State-licensed providers through partial or full integration; (4) standard setting and enforcement activities by medical self-regulatory entities; (5) health care providers collectively supplying non-price medical information to buyers and consumers; (6) health care provider participation in surveys; (7) health care joint ventures' purchase or use of equipment or provision of advanced tertiary care services; (8) provision of market power screens at appropriate levels below which combinations of providers are too small to pose a realistic antitrust threat; (9) joint purchasing arrangements; and (10) good faith negotiations relating to legitimate collaborative activities. Directs the Attorney General to publish notice in the Federal Register soliciting proposals for additional safe harbors. Authorizes the Attorney General to modify or remove a safe harbor following notice and comment upon a determination that the safe harbor does not meet specified criteria. Sets forth criteria in establishing safe harbors, including: (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. (Sec. 2503) Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates. Sets forth procedures regarding applications for, renovation of, and review of determinations regarding, such certificates. Limits the disclosure of information. (Sec. 2504) Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. (Sec. 2505) Directs the Attorney General to periodically review the safe harbors, certificates of review, and notifications. (Sec. 2507) Establishes within the Department of Health and Human Services an Office of Health Care Competition Policy. Subtitle G: Encouraging Enforcement Activities of Medical Self- Regulatory Entities - Part 1: Application of the Clayton Act to Medical Self-Regulatory Entities - Provides that no damages, cost of suit, or attorney fee may be recovered under section 4, 4A, or 4C of the Clayton Act, or under any similar State law, except by a State or the United States, from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities that are: (1) designed to promote the quality of health care provided to patients; and (2) not conducted for purposes of financial gain. Directs the court to award the cost of such a suit, including a reasonable attorney fee, to a substantially prevailing defendant. Part 2: Consultation by Federal Agencies - Requires any Federal agency engaged in the establishment of medical professional standards to consult with appropriate medical societies or associations, specialty boards, or recognized accrediting agencies, if available, in carrying out medical professional standard setting and guidelines or standards relating to the practice of medicine. Subtitle H: Reform of Clinical Laboratory Requirements for Simple Tests - Amends the Public Health Service Act to exempt clinical laboratories performing only simple examinations and procedures from certificate requirements. (Sec. 2703) Directs the Secretary to use existing appropriations to conduct the study relating to the reliability and quality control procedures of clinical laboratory testing programs and the effect of errors in the testing procedures and results on the diagnosis and treatment of patients. (Sec. 2704) Directs the Secretary to revise the membership of the Clinical Laboratory Improvement Advisory Committee to contain a number of practicing physicians proportionate to the number of physician regulated clinical laboratories. Subtitle I: Miscellaneous Provisions - Requires certain Government agencies to prefund health benefit contributions for their annuitants. (Sec. 2802) Makes aliens ineligible for social security and Medicaid benefits. (Sec. 2803) Limits the eligibility for social security benefits of certain drug and alcohol addicts. Title III: Long-Term Care - Subtitle A: Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation. (Sec. 3002) Excludes from gross income benefits provided under a long-term care insurance contract. Includes in gross income employer-provided coverage for long-term care services. (Sec. 3003) Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions. Includes any parent or grandparent as a dependent for purposes of such expenses. Subtitle B: Establishment of Federal Standards for Long-Term Care Insurance - Amends the Public Health Service Act to mandate the establishment of model Federal standards for long-term care insurance. Prohibits the offering of a long-term care insurance policy in a State unless the State has a regulatory program meeting the requirements of this Act or the policy has been certified by the Secretary of Health and Human Services. Authorizes grants to States for demonstration programs to improve enforcement of the standards. Authorizes appropriations. Imposes on agents selling long-term policies a duty of good faith and fair dealing. Prohibits twisting, high pressure tactics, and cold lead advertising. Mandates minimum financial standards, including income and asset criteria, for advising individuals considering the purchase of a long-term policy. Prohibits sales: (1) to an individual eligible for assistance under title XIX (Medicaid) of the Social Security Act; (2) of duplicate service policies; and (3) of policies that reduce, limit, or coordinate benefits on the basis of eligibility for other coverage or benefits. Provides for: (1) criminal and civil penalties; and (2) agent training and certification. Sets forth additional carrier responsibilities relating to refunding of premiums, mailing of policies, providing information on denials of claims, reporting of information, and limiting compensation to agents for the sale or renewal of policies. Prohibits cancellation or nonrenewal of a long-term care policy except for nonpayment of premium or material misrepresentation. Sets forth continuation and conversion rights for group policies, regulating premiums for converted policies. Requires guaranteed issuance to an individual if the individual meets the minimum medical requirements of the policy. Mandates standards regarding upgraded benefits. Limits cancellation for nonpayment by an incapacitated individual. Requires: (1) subject to exceptions, uniform language and definitions, a uniform format, and at least one standard benefit package; and (2) disclosure of certain matters, including an outline of coverage. Mandates recommendations by the National Association of Insurance Commissioners (NAIC) regarding informing consumers on the long-term economic viability of long-term care insurance carriers. Limits certain conditions on benefits. Requires, if benefits are provided for home health care or community-based services, that certain minimum benefits be provided. Prohibits treating cognitive or mental impairments (including Alzheimer's disease and mental illness) differently from other medical conditions. Limits preexisting condition requirements. Requires: (1) each claimant to have a functional assessment by an individual or entity meeting NAIC qualifications and unconnected to the policy issuer; (2) inflation protection, unless rejected in writing by a policyholder; (3) disclosure of certain premium increases; and (4) nonforfeiture benefits. Prohibits a carrier from contesting a policy or claim based on fraud or misrepresentation unless notice is provided within a time period set by NAIC. Establishes the right of a purchaser to return a policy within a specified period. Defines "long-term care insurance policy," excluding: (1) any basic Medicare supplemental policies; (2) other insurance offered primarily to provide specified types of coverage; and (3) certain life insurance policies. Authorizes grants for programs to provide information, counseling, and assistance regarding the procurement of long-term insurance. Authorizes appropriations. Subtitle : Protection of Assets Under Medicaid Through Use of Qualified Long-term Care Insurance - Amends the title XIX of the Social Security Act to require State Medicaid plans to disregard some or all of the individual's assets attributable to coverage under a qualified long-term care insurance contract in determining the individual's eligibility for long-term care services. Subtitle D: Studies - Requires the Comptroller General to study the feasibility of: (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their home with an income tax credit. (Sec. 3303) Requires the Secretary of Health and Human Services to study and report to the Congress on the feasibility of encouraging or requiring the use of a single designated public or nonprofit agency to coordinate, through case management, the provision of long-term care benefits under current Federal, State, and local programs in a geographic area. Subtitle E: Volunteer Service Credit Demonstration Projects - Amends the Older Americans Act of 1965 to require the Commissioner of the Administration on Aging to establish and operate a volunteer service credit demonstration project in each State.

World War II Home Front Commemorative Act

United States · United States Congress · 8 October 1994

World War II Home Front Commemorative Act - Authorizes the World War II Home Front Council to reissue the World War II "E" Award for Excellence in Industrial Production to individuals, firms, and businesses to which they were originally awarded in celebration of the 50th anniversary of the Allied victory in World War II. Directs the Council to: (1) establish the "Excellence in Production Award Account" to receive all proceeds derived from its activities to commemorate Home Front efforts; (2) implement Home Front education and commemoration programs; (3) establish a volunteer advisory committee; and (4) submit semi-annual status reports to the Congress. Authorizes appropriations.

A resolution to state the sense of the Senate concerning the Government of Japan recognizing American college and university branch campuses in Japan as American Institutions of higher learning.

United States · United States Congress · 7 October 1994

Expresses the sense of the Senate that the Government of Japan should: (1) immediately cease its discriminatory policy toward branch campuses approved by the Association of American Colleges and Universities in Japan; (2) accord official status to such campuses as American institutions of higher education and grant them all the rights and privileges enjoyed by similar Japanese educational institutions; and (3) grant student visas to students wishing to attend such campuses in Japan and accord them all such rights and privileges.

A resolution expressing the sense of the Senate that the Schindler Project should be recognized for its efforts to educate high school seniors about the lessons of the Holocaust and the application of those lessons to contemporary society.

United States · United States Congress · 7 October 1994

Expresses the sense of the Senate in support of the Schindler Project's efforts to provide high school seniors with the opportunity to view the film "Schindler's List" and discuss its historical implications and the application of those lessons to contemporary society.

Jobs and Investment Act of 1994

United States · United States Congress · 7 October 1994

TABLE OF CONTENTS: Title I: Physical Capital Investment Subtitle A: Highways and Mass Transit Subtitle B: Airports Subtitle C: Railroads Subtitle D: Water and Sewage Treatment Facilities Subtitle E: Environmental Restoration Subtitle F: Community Development Assistance Subtitle G: Education Infrastructure Subtitle H: Renewable Energy and Energy Efficiency Title II: Human Capital Investment Subtitle A: Job Training Subtitle B: Education Subtitle C: Head Start Subtitle D: Programs Under Public Health Service Act Title III: Amendments of Internal Revenue Code of 1986 Subtitle A: Reduction in Employee Payroll Taxes; Credit for First-Time Homebuyers Subtitle B: Revenue Increases Title IV: Appropriations Title I: Physical Capital Investment - Subtitle A: Highways and Mass Transit - Amends the Intermodal Surface Transportation Efficiency Act of 1991 to authorize additional appropriations from the Highway Trust Fund (other than the Mass Transit Account) for interstate maintenance, surface transportation, and bridges. (Sec. 1002) Amends the Federal Transit Act to authorize additional appropriations and make available additional funding from the Mass Transit Account for certain formula grants and discretionary grants transit programs. Subtitle B: Airports - Amends the Airport and Airway Improvement Act of 1982 to make available additional amounts for airport improvement program grants (including grants for airport noise compatibility planning). Subtitle C: Railroads - Amends the Department of Transportation Act to increase and extend the authorization of appropriations for local rail freight assistance. Subtitle D: Water and Sewage Treatment Facilities - Amends the Federal Water Pollution Control Act to extend the authorization of appropriations for State water pollution control revolving funds. Subtitle E: Environmental Restoration - Provides funds for environmental restoration at facilities of the Departments of Defense and of Energy. Sets forth various authorizations of appropriations and makes appropriations for such purposes. Subtitle F: Community Development Assistance - Chapter 1: Community Development Block Grants - Authorizes additional appropriations for community development block grants under the Housing and Community Development Act of 1974. Chapter 2: Community Banking and Economic Empowerment Act - Community Banking and Economic Empowerment Act - Directs the Secretary of Housing and Urban Development (HUD) to provide capital, operating, and technical assistance to community development lenders and certain eligible entities in order to: (1) make credit-related services available to low-income persons inadequately served by traditional lending institutions; and (2) promote development and revitalization of low-income neighborhoods. Delineates the purposes for which the Secretary of HUD may provide assistance to community development lenders and to the eligible entities establishing those lenders. Prescribes guidelines for assisted community development lenders, including assistance agreements and auditing procedures. (Sec. 1520) Amends the Community Reinvestment Act to preclude a regulated financial institution from receiving either an "outstanding" or a "satisfactory" rating for meeting community credit needs solely on the basis of its loans or investments in community development lenders. (Sec. 1521) Requires annual reports to the Congress. (Sec. 1524) Authorizes appropriations for: (1) capital and operating assistance for community development lenders; and (2) technical assistance for organizing and operating community development lenders. Subtitle G: Education Infrastructure - Education Infrastructure Act of 1994 - Directs the Secretary of Education to award grants to eligible local educational agencies to meet the National Education Goals through repair, renovation, alteration, and construction of public elementary or secondary school libraries, media centers, or facilities, used for academic or vocational instruction, including certain authorized activities. Authorizes appropriations. (Sec. 1606) Sets forth requirements for: (1) priorities in selection of applications; (2) maintenance of effort, supplementation of non-Federal funds, and general limitations; (3) minority small business participation as project contractors or subcontractors, and payment of wages in accordance with the Davis-Bacon Act; and (4) Federal evaluation. (Sec. 1610) Authorizes the comprehensive regional centers to provide technical assistance to such projects. Subtitle H: Renewable Energy and Energy Efficiency - Authorizes additional appropriations to the Secretary of Energy for renewable energy research, development, and demonstration programs described in specified provisions of the Renewable Energy and Efficiency Technology Competitiveness Act of 1989. (Sec. 1702) Amends the National Energy Conservation Policy Act to increase and extend the authorization of appropriations for the Federal Energy Efficiency Fund and the new technology demonstration program. Title II: Human Capital Investment - Subtitle A: Job Training - Amends the Job Training Partnership Act (JTPA) to establish an allied health professional job training program. Directs the Secretary of Labor to make grants to institutions of higher education to establish job training assistance programs for at-risk youths and long-term welfare recipients to become allied health professionals. Authorizes appropriations. Increases the authorization of appropriations for the following youth job training programs: (1) Youth Fair Chance under JTPA; and (2) Youthbuild under the Homeownership and Opportunity Through HOPE Act. Subtitle B: Education - Extends and increases the authorizations of appropriations for certain programs for educational personnel under the Adult Education Act and the Elementary and Secondary Education Act of 1965. Subtitle C: Head Start - Amends the Head Start Act to extend and increase the authorization of appropriations for Head Start programs. Subtitle D: Programs Under Public Health Service Act - Chapter 1: Funding Initiative for Programs Providing Health Services - Authorizes additional appropriations for the following programs under the Public Health Service Act: (1) community health centers; (2) migrant health centers; (3) health care for the homeless; (4) preventive services regarding tuberculosis, breast and cervical cancer, lead exposure, HIV disease, and prostate cancer; (5) immunization; (6) cancer registries; (7) comprehensive school health education; (8) prevention and control of sexually transmitted diseases, diabetes, and injuries; (9) child day care health and safety; (10) asthma; (11) environmental health, including response to urgent environmental threats to public health and environmental services regarding the health of individuals in the United States in the vicinity of the Mexican border; (12) block grants for community mental health services, prevention and treatment of substance abuse, and preventive health services; and (13) scholarship and loan repayment programs of the National Health Service Corps. Authorizes additional appropriations for the maternal and child health block grant program under the Social Security Act. Chapter 2: Community Health Advisor Program - National Community Health Advisor Act - Directs the Secretary of Health and Human Services, for each State or State-designated entity that submits an appropriate application, to award formula grants for the development and operation of community health advisor (CHA) programs. Requires such States to: (1) operate a clearinghouse to maintain and disseminate information on CHA programs; (2) provide technical assistance for training CHAs; and (3) coordinate all CHA activities carried out by the State under the award. Limits administrative costs to 15 percent of the total award. (Sec. 2314) Provides CHA program objectives and goals. Requires funding agreements for such awards to give priority to developing and operating CHA programs for medically underserved communities (poor rural and inner city areas). (Sec. 2315) Requires a State to provide matching funds of 25 percent of award amounts toward such programs. Requires a CHA program in a State to be carried out in at least one urban area and one rural area. Requires ongoing supervision of CHAs involved in the program. Allows for expenditures under the award for training and continuing education programs. Requires reports from State applicants to the Secretary assessing the effectiveness of CHA programs. (Sec. 2317) Provides for the determination of the amount allotted to each chosen applicant, taking into account the population and poverty level of the area involved. (Sec. 2318) Directs the Secretary to establish guidelines for quality assurance and cost-effectiveness of the CHA programs. (Sec. 2319) Requires evaluations of each such program. (Sec. 2320) Prohibits this chapter from being construed to require the Secretary to modify or terminate the Community Health Representative Program of the Indian Health Service. (Sec. 2322) Authorizes appropriations for the CHA program. Title III: Amendments of Internal Revenue Code of 1986 - Subtitle A: Reduction in Employee Payroll Taxes; Credit for First-Time Homebuyers - Amends the Internal Revenue Code (IRC) to provide a refundable credit for a portion of social security taxes for taxable years 1995 and 1996, equal to 20 percent of the taxpayer's social security taxes for that year, up to a maximum credit of $200, or $400 for a joint return. (Sec. 3002) Allows a nonrefundable personal credit for purchase of a principal residence by a first-time homebuyer. Sets such maximum overall credit at no more than $6,000. Subtitle B: Revenue Increases - Amends the IRC to establish a stock transfer excise tax. (Sec. 3102) Repeals a preferential rate of tax on capital gains. (Sec. 3103) Provides for a carryover basis for certain property acquired from a decedent. Provides for nonrecognition of gain where certain appreciated carryover basis property is used in satisfaction of a pecuniary bequest. Sets forth a procedure for binding determination of initial basis of carryover basis property. Sets forth requirements for information regarding carryover basis property acquired from a decedent. Sets penalties for negligent or fraudulent overstatement of initial basis and for failure to furnish such required information. Makes a $125,000 exclusion available to the spouse of a decedent in certain cases. (Sec. 3104) Allows unused capital loss carryovers to be transferred to an estate. Provides capital gain treatment for inherited art or similar property. Title IV: Appropriations - Appropriates amounts authorized under this Act. (Sec. 4002) Designates the entire amount appropriated under this Act as an emergency requirement under the Balanced Budget and Emergency Deficit Control Act of 1985.

International Narcotics Control Corrections Act of 1994

United States · United States Congress · 7 October 1994

TABLE OF CONTENTS: Title I: International Narcotics Control Title II: NATO Participation Act of 1994 International Narcotics Control Corrections Act of 1994 - Title I: International Narcotics Control - Amends the Foreign Assistance Act of 1961 to redefine a "major illicit drug producing country" as a country in which 1,000 hectares or more of illicit opium poppy or coca is cultivated or harvested annually or 5,000 hectares or more of illicit cannabis is cultivated or harvested annually unless the President determines that such cannabis production does not significantly affect the United States. Provides for advance notification to the appropriate congressional committees of any transfer by the Government to a foreign country, for narcotics control purposes, of property or funds seized or forfeited in connection with narcotics-related activities. Reallocates foreign assistance (currently, security assistance) withheld from countries that fail to take adequate steps to halt illicit drug production or trafficking. Extends certain international narcotics control strategy reporting requirements and annual certification procedures for FY 1993 and 1994 through FY 1995. Makes such requirements and procedures currently applicable after September 30, 1994, effective after September 30, 1995 (the beginning of FY 1996). Repeals specified international narcotics control Acts. Exempts specified narcotics control-related transfers of excess defense articles, foreign military financing, and international military education and training from a prohibition on assistance to foreign law enforcement agencies. Waives all restrictions on assistance (except for countries that are "decertified" under narcotics control certification provisions) with respect to narcotics-related assistance provided during FY 1995 if the President notifies the appropriate congressional committees in advance. Authorizes the President to furnish assistance to any country or international organization during FY 1995 for the prevention and suppression of international criminal activities. Exempts such assistance from the prohibition on assistance to foreign law enforcement agencies. Requires the President to take steps to ensure that the immediate relatives of any individual involved in drug trafficking are not permitted entry into the United States consistent with the Immigration and Nationality Act. Title II: NATO Participation Act of 1994 - NATO Participation Act of 1994 - Authorizes the President to establish a program to assist the transition to full North Atlantic Treaty Organization (NATO) membership of Poland, Hungary, the Czech Republic, Slovakia, and other designated Partnership for Peace countries. Permits the President, in carrying out such program, to provide excess defense articles, international military education and training, and foreign military financing assistance to such countries.

Veterans' Benefits Improvements Act of 1994

United States · United States Congress · 7 October 1994

TABLE OF CONTENTS: Title I: Persian Gulf War Veterans Title II: Board of Veterans' Appeals Administration Title III: Adjudication Improvements Title IV: Veterans' Claims Adjudication Commission Title V: Miscellaneous Provisions Title VI: Education and Training Programs Title VII: Employment Programs Title VIII: Cemeteries and Memorial Affairs Title IX: Housing Programs Title X: Homeless Veterans Programs Title XI: Reductions in Department of Veterans Affairs Personnel Title XII: Technical and Clerical Amendments Veterans' Benefits Improvements Act of 1994 - Title I: Persian Gulf War Veterans - Persian Gulf War Veterans' Benefits Act - Directs the Secretary of Veterans Affairs to develop and implement a uniform and comprehensive medical evaluation protocol that will ensure appropriate medical assessment, diagnosis, and treatment of Persian Gulf War (War) veterans who are suffering from illnesses the origin of which are unknown but may be attributable to service in the Southwest Asia theater of operations during the War. Requires the protocol to include an evaluation of complaints relating to illnesses involving the reproductive system. Requires a report to the Senate and House Veterans' Affairs Committees (veterans' committees) if the protocol has not been developed within 120 days after enactment of this Act. Requires the Secretary to ensure that information collected through the protocol is collected and maintained in a manner that permits the effective and efficient cross-reference of such information with information collected and maintained through the comprehensive clinical protocols of the Department of Defense (DOD) for War veterans. (Sec. 105) Directs the Secretary to implement a comprehensive outreach program to inform War veterans and their families of the medical care and other benefits that may be provided by the Department of Veterans Affairs (VA) and DOD arising from service in the War. Requires such outreach program to include: (1) a semiannual newsletter distributed to veterans listed on the Persian Gulf War Veterans Health Registry; and (2) the establishment of a toll-free telephone number to provide War veterans and their families information on the Registry and health care and other benefits provided by the VA. (Sec. 106) Authorizes the Secretary to pay compensation to any War veteran suffering from a chronic disability resulting from an undiagnosed illness that: (1) became manifest during service on active duty during the War; or (2) became manifest to a degree of ten percent or more within a presumptive period (such period to be prescribed by the Secretary) after such service . Requires a report and appropriate regulations. (Sec. 107) Directs the Secretary to conduct a study of the health status of spouses and children of War veterans, including diagnostic testing and appropriate medical examinations. Requires the Secretary to develop standard protocols and guidelines for such testing and examinations in order to ensure the uniform development of the medical data. Requires study results to be entered into the Registry. Requires the Secretary to: (1) conduct appropriate outreach activities in connection with the study; (2) make the protocols and guidelines developed under such study available outside the VA; and (3) provide study reports to the Congress. (Sec. 108) Amends the Persian Gulf War Veterans' Health Status Act to include diagnostic tests within the allowable scope of health examinations provided under such Act for veterans eligible for inclusion in health-related registries. (Sec. 109) Authorizes the Secretary to carry out a survey of the incidence and nature of health problems occurring in War veterans and their families. (Sec 110) Authorizes the Secretary to carry out an epidemiological study on the health consequences of service in the War if the National Academy of Sciences (NAS) includes in a required report a finding that a sound basis exists for such a study. Requires certain oversight. Authorizes appropriations. (Sec. 111) Allows surviving spouses eligible for dependency and indemnity compensation to elect to instead receive a death pension. Limits the FY 1995 cost-of-living increases for various veterans' compensation to the percentage increase under title II (Old age, survivors and disability insurance) of the Social Security Act beginning on December 1, 1994. Title II: Board of Veterans' Appeals Administration - Requires members of the Board of Veterans' Appeals other than the Chairman to be appointed by the Secretary, with the President's approval, based upon recommendations of the Chairman. Directs the Chairman to establish a panel of Board members to review the performance of each member at least every three years. Provides for the granting of a conditional recertification or recommendation for noncertification of a Board member not meeting the required performance standards. (Sec. 202) Requires Board member performance standards to be established within 90 days after enactment of this Act. Requires a report. (Sec. 203) Allows a Board Chairman to continue in such office until either reappointment or the appointment of a successor. Title III: Adjudication Improvements - Authorizes the Secretary to accept the written statement of a claimant as proof of the existence of a marriage or its dissolution, the birth of a child, or the death of a family member. Authorizes the acceptance of reports of private physician medical examinations in support of a claim for benefits. (Sec. 302) Directs the Secretary to take any necessary action to provide for the expeditious treatment of benefit claims that have been remanded from either the Board or the U.S. Court of Veterans Appeals (Court). (Sec. 303) Allows for the screening of appeals to: (1) determine the adequacy of the record for decisional purposes; or (2) develop a record found to be inadequate for decisional purposes. (Sec. 304) Directs the Secretary to report to specified congressional committees on the feasibility of the reorganization of the adjudication divisions located within the regional offices of the Veterans Benefits Administration. Title IV: Veterans' Claims Adjudication Commission - Establishes the Veterans' Claims Adjudication Commission to study and report to the Congress on the VA system for the disposition of claims for veterans' benefits. Provides Commission funding for FY 1995. Title V: Miscellaneous Provisions - Presumes a service connection (and, therefore, eligibility for veterans' disability compensation) between radiation exposure during the detonation of a nuclear device and radiation-related illness in a veteran, whether or not the nation conducting the nuclear test was the United States. (Sec. 502) Extends through December 31, 1999, the authority to maintain VA regional offices in the Republic of the Philippines. (Sec. 503) Allows for reapplication (without penalty) for veterans' pension benefits or parents' dependency and indemnity compensation within one year after renouncement of such rights. (Sec. 505) Adds to the list of herbicide-exposure related diseases and illnesses presumed to be service-connected and therefore compensable through veterans' disability compensation if they become manifest to a disability degree of ten percent or more: (1) Hodgkin's disease; (2) porphyria cutanea tarda; (3) respiratory cancers; and (4) multiple myeloma. (Sec. 506) Excludes from consideration as income, for purposes of eligibility for veterans' benefits, any cash, stock, land, or other interests received by an individual from a Native Corporation under the Alaska Native Claims Settlement Act. (Sec. 507) Eliminates the requirement for payment in Philippine pesos of certain veterans' compensation for service in the Philippine Scouts. (Sec. 508) Directs the Secretary to enter into an agreement for the Medical Follow-Up Agency of the Institute of Medicine of the NAS to convene a panel to evaluate the feasibility of carrying out a study of the relationship of exposure to certain ionizing radiation while participating in military service and the presence of certain birth- related defects and illnesses. (Sec. 509) Establishes in the VA a Center for Minority Veterans and a Center for Women Veterans. Requires the Secretary to include in annual budget documents detailed information on each Center's budget and a report on each Center's activities and accomplishments. (Sec. 510) Directs the Secretary to establish the Advisory Committee on Minority Veterans with respect to the administration of VA benefits for veterans who are minority group members. Requires an annual report from the Advisory Committee on its programs and activities. Defines "minority group members" as Asian Americans, Blacks, Hispanics, Native Americans, and Pacific-Islander Americans. Terminates the Advisory Committee on December 31, 1997. (Sec. 511) Provides that a notice of appeal of a final Board decision shall be deemed to be received by the Court on the date of its receipt or the date of the U.S. postal service postmark stamped on the envelope. Title VI: Education and Training Programs - Repeals the requirement that a course of flight training must commence before October 1, 1994, in order to be approved as a course of education under the veterans' basic educational assistance program for active-duty, reserve, and post-Vietnam era veterans. (Sec. 602) Authorizes the Secretary to use the facilities of any federally recognized Indian tribe in order to provide training and rehabilitative services for veterans with service-connected disabilities. Allows veterans to pursue on-job training or work experience on such facilities. (Sec. 603) Allows veterans to use basic educational assistance benefits for attending alternative teacher certification programs at educational institutions that provide State-approved programs. (Sec. 604) Prohibits a veteran, in using educational assistance benefits, from enrolling in a course outside the United States unless the institution is an approved institution of higher learning and the course is approved by the Secretary. (Sec. 605) Provides that approved programs of education under veterans' educational assistance benefits shall include certain correspondence programs from approved educational institutions. (Sec. 606) Increases from $12 to $13 million the annual amount authorized to be reimbursed by the VA to State educational approving agencies for travel and administrative expenses incurred in determining the qualifications of educational institutions under the veterans' educational assistance program. Eliminates the requirement of a quarterly report by such agencies relating to such expenses. Eliminates the requirement that the Secretary supervise the provision of course approval services by such agencies. (Sec. 608) Extends through December 31, 2003, the Veterans' Advisory Committee on Education. (Sec. 609) Increases from $5 to $6 million the annual fiscal year funding for VA contracting for veterans' educational and vocational counseling services. (Sec. 610) Amends the Service Members Occupational Conversion and Training Act of 1992 to: (1) eliminate the current 18-month limit on training for former military personnel for employment in stable and permanent positions; (2) revise the amount of payments made to employers under the program; and (3) allow entry into a job training program with the employer on the day that notice is transmitted to the implementing official. Title VII: Employment Programs - Designates within the Department of Labor a Deputy Assistant Secretary of Labor for Veterans' Employment and Training, to perform duties as prescribed by the Assistant Secretary of Labor for Veterans' Employment and Training. Requires disabled veterans' outreach program specialists to be paid at rates comparable to those paid other professionals performing essentially similar duties. Adds certain veterans to a list of those to be subjects of a biennial study concerning unemployment among categories of veterans. Requires a report to the Congress on the study's results. (Sec. 702) Allows contractors of contracts of $10,000 or more for the procurement of personal property and non-personal services to exclude certain positions from a requirement that such contractors first offer positions under such contract to disabled and Vietnam veterans. Excludes any amounts received under the All-Volunteer Force educational assistance program from the needs or qualification requirements of the veterans' employment and training programs. (Sec. 703) Makes certain conforming and clarifying amendments to the Employee Retirement Income Security Act of 1974 as necessitated by the Uniformed Services Employment and Reemployment Rights Act of 1994. Title VIII: Cemeteries and Memorial Affairs - Provides eligibility for burial in national cemeteries for: (1) spouses who predecease veterans; and (2) unremarried surviving spouses who had a subsequent remarriage which was terminated by death or divorce. (Sec. 803) Extends through FY 1999 the authorization of appropriations for grants to States for establishing, expanding, or improving veterans' cemeteries. (Sec. 804) Authorizes the Secretary to provide for flat grave markers at the Willamette National Cemetery, Oregon. Title IX: Housing Programs - Makes eligible under the veterans' home loan program: (1) former members of the Selected Reserve who were discharged or released before completing six years of service because of a service-connected disability; and (2) surviving spouses of reserve personnel who died while on active duty. Revises provisions regarding the determination of the aggregate home loan guaranty amount. (Sec. 903) Prohibits the use of veterans' home loan funds for the purchase or construction of new residential housing that is not served by a public or community water and sewage system. (Sec. 904) Authorizes the use of veterans' guaranteed home loan funds to refinance existing guaranteed loans to make home energy efficiency improvements and to refinance adjustable rate mortgages as fixed rate mortgages. (Sec. 906) Provides that, with regard to the veterans' home loan program, any manufactured housing unit properly displaying a certification of conformity with Federal home construction and safety standards pursuant to the National Manufactured Housing Construction and Safety Standards Act of 1974 shall be deemed to meet standards required by the VA. Authorizes the Secretary to deny guaranteed or direct loan financing in the case of other types of manufactured homes. Repeals a provision requiring housing inspection results to be reported annually to the Congress. (Sec. 907) Permits the VA to acquire property from the lender at the price provided for under applicable State law, whether or not the lender's bid at foreclosure exceeds such price. (Sec. 908) Includes, as an exception to the minimum two-year active duty service requirement for entitlement to certain veterans' benefits, military personnel discharged before such period due to a reduction in force. Title X: Homeless Veterans Programs - Directs the Secretary to report annually to the veterans' committees on VA activities during the preceding year to assist homeless veterans. (Sec. 1002) Amends the Veterans' Medical Programs Amendments of 1992 to: (1) require updates during FY 1995 through 1997 of assessments of VA programs for assisting the homeless; and (2) require the Secretary to report to the veterans' committees with regard to such assessments as well as progress made in developing a homeless veterans assistance plan. (Sec. 1003) Amends the Homeless Veterans Comprehensive Service Programs Act of 1992 to: (1) raise from four to eight the authorized number of demonstration centers for the provision of comprehensive services to homeless veterans; and (2) repeal a prohibition on the use of funds to carry out certain provisions of such Act unless expressly provided for in an appropriations Act. (Sec. 1005) Expresses the sense of the Congress calling for a more proportionate share of Federal homeless assistance funds to be appropriated to the Secretary to assist homeless veterans. Requests the Secretary to encourage Federal agencies that provide assistance to the homeless to be aware of and make referrals to the VA for homeless assistance benefits. Title XI: Reductions in Department of Veterans Affairs Personnel - Requires a minimum number of 224, 377 full-time equivalent positions in the VA during a fiscal year from the date of enactment of this Act until September 30, 1999. Excludes certain full-time personnel from those to be considered full-time for purposes of the Federal Workforce Restructuring Act of 1994, including personnel paid with funds other than appropriated funds. Prohibits the Secretary from reducing the number of full-time VA personnel unless: (1) necessary due to a reduction in available funds; or (2) required under a law enacted after enactment of this provision which specifically refers to this provision. Requires a report from the Secretary to the veterans' committees annually through 2000 on any such reductions. (Sec. 1103) Precludes from application during FY 1995 through 1999 certain Federal provisions prohibiting the VA from contracting to have VA direct patient care or activities incident to such care from being converted to activities performed by non-VA providers. Requires that, whenever any activity at a VA health-care facility is so converted, the Secretary must: (1) require in the contract an employment priority for VA employees displaced due to the contract; and (2) provide to such former employees all possible assistance in obtaining other Federal employment or job training or retraining. Directs the Secretary to report annually to the Congress on all contracting-out authority exercised. (Sec. 1104) Directs the Secretary to enter into an agreement with a non-federal entity under which such entity carries out a study of the feasibility and advisability of alternative organizational structures for the provision of health care services to veterans. Requires the Secretary to submit such report to the veterans' committees. Authorizes appropriations. Title XII: Technical and Clerical Amendments - Makes technical and clerical amendments to Federal veterans' benefits provisions.

Social Security Act Amendments of 1994

United States · United States Congress · 7 October 1994

TABLE OF CONTENTS: Title I: Medicare Provisions Subtitle A: Provisions Relating to Part A Subtitle B: Provisions Relating to Part B Subtitle C: Provisions Relating to Parts A and B Subtitle D: Provisions Relating to Medicare Supplemental Insurance Policies Title II: Maternal and Child Health Services Block Grant Program Subtitle A: Child Welfare, Foster Care, Adoption Subtitle B: Child Support Enforcement Subtitle C: Supplemental Security Income Subtitle D: Aid to Families With Dependent Children Subtitle E: JOBS Program Subtitle F: Other Provisions Social Security Act Amendments of 1994 - Title I: Medicare Provisions - Subtitle A: Provisions Relating to Part A - Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) authorize the Secretary of Health and Human Services to take occupational mix into account in developing Medicare Geographic Classification Review Board (MGCRB) guidelines for determining the area wage index; (2) provide that if labor markets are no longer based on Metropolitan Statistical Areas, the method of calculating the wage index for reclassification would not apply and the MGCRB guidelines may be revised; and (3) require the Secretary to set the labor and non-labor portion of each standardized amount equal to the national average beginning in FY 1995. (Sec. 102) Revises the essential access community hospital (EACH) program, with changes: (1) increasing the number of participating States; (2) providing for treatment of inpatient hospital services provided in rural primary care hospitals; (3) extending the authorization of appropriations for grants to States and hospitals; and (4) addressing adjoining State hospital designation, rural primary care hospital skilled nursing services, payment for inpatient and outpatient hospital services, and physician staffing. (Sec. 103) Amends the Omnibus Budget Reconciliation Act of 1987 (OMBRA '87) to: (1) authorize appropriations for the rural health transition grant program; and (2) make rural primary care hospitals eligible for program grants. (Sec. 104) Revises requirements with regard to hospital psychology services, Medicare-dependent, small rural and sole community hospitals, notification of hospice services availability, qualifications for service on the Prospective Payment Assessment Commission, budget neutral adjustments for changes in payment amounts for transfer cases, and DRG payment window expansion. (Sec. 106) Requires the Secretary to begin collecting the data necessary to compute a wage index based on wages specific to skilled nursing facilities. Subtitle B: Provisions Relating to Part B - Part I: Physicians' Services - Requires the Secretary to develop and report to the Congress on a methodology for implementing a resource-based system for determining practice expense relative value units for each physicians' service. Repeals the existing payment methodology when the new payment methodology takes effect for services provided in years beginning with 1997. (Sec. 122) Requires the Secretary to: (1) review and revise the geographic practice cost indices; (2) use the most recent available data on practice and malpractice expenses and physician work effort in establishing such indices; and (3) study and report to the Congress on index construction, data used for indices revision, and other related specified matters. (Sec. 123) Revises rules for billing Medicare part B (Supplementary Medical Insurance) beneficiaries for physician services in excess of the applicable limiting charge involved (extra-billing limits). Imposes new obligations on carriers before making payment. Provides for refunds of excess amounts billed. (Sec. 124) Requires the Secretary to: (1) fully develop and refine the relative values for the full range of pediatric physicians' services; and (2) study and report to the Congress on such values to determine whether there are significant variations in the resources used for similar services to different populations. (Sec. 125) Prohibits the Secretary or a carrier from imposing fees for filing claims for physicians' services, claims errors or denials, administrative appeals, obtaining unique identifiers, or responding to inquiries concerning physicians' services. Permits the Secretary to recognize substitute billing arrangements between two physicians under specified conditions. Part II: Durable Medical Equipment - Requires suppliers of medical equipment and supplies to have a certified supplier number, except with regard to medical equipment and supplies furnished as incident to a physician's service, in order to be reimbursed under Medicare. Prohibits a supplier from having a number without meeting prescribed standards. Prohibits the issuance of more than one supplier number, except in certain circumstances. (Sec. 131) Requires the Secretary to develop one or more standardized certificates of medical necessity for medical equipment and supplies. Allows suppliers to distribute to physicians or beneficiaries a certificate of medical necessity containing certain limited information. Requires that any supplier distributing a certificate with such information must also list the fee schedule amount and charge involved before distributing it to the physician for completion. Requires the Secretary to: (1) develop and establish uniform national coverage and utilization review criteria for select items of medical equipment and supplies; (2) review annually and determine whether to subject to such criteria any items not already subject; (3) study and report to the Congress on the effects of the methodology for determining payments for items of durable medical equipment (DME) on the ability of persons entitled to disability benefits to obtain such items; and (4) report to the Congress on prosthetic devices or orthotics and prosthetics that do not require individualized or custom fitting and adjustment. (Sec. 132) Places restrictions on certain telephone marketing and sales activities by DME suppliers. (Sec. 133) Specifies the circumstances under which Medicare beneficiaries are not financially liable for covered items furnished by a supplier. (Sec. 134) Requires the Secretary to: (1) determine whether the payment amounts for decubitus care equipment, transcutaneous electrical nerve stimulators, and any other items considered appropriate are inherently reasonable; and (2) adjust payments for such items if the amounts are not inherently reasonable. (Sec. 135) Requires the Administrator of the Health Care Financing Administration (HCFA) to collect and report to the Congress on data on DME supplier costs and analyze them to determine costs attributable to service and product components and the extent to which they vary by type of equipment and geographic region. Part III: Other Items and Services - Addresses payment adjustments for ambulatory surgical center services and new technology intraocular lenses. (Sec. 142) Requires the Secretary to study and report to the Congress on: (1) patient care costs for Medicare beneficiaries enrolled in clinical trials of new cancer therapies; and (2) continuation of the annual limitation on the payment amount for outpatient services of independently practicing physical and occupational therapists. (Sec. 144) Authorizes the Secretary to enter into agreements with the States for allowing them to pay the penalties applicable to individuals for late enrollment premium payments under Medicare part B. (Sec. 145) Requires mammography facilities providing covered screening or diagnostic mammograms to Medicare beneficiaries to hold a certificate (or provisional certificate) issued under the Public Health Service Act. (Sec. 146) Changes the terms "speech therapy" and "speech pathology services" to "speech-language pathology services." (Sec. 147) Makes miscellaneous and technical amendments, among other things, to: (1) apply outpatient payment limits to diagnostic services; (2) exclude the services of nurse practitioners and clinical nurse specialists from the definition of inpatient hospital services; and (3) allow individuals who have employer group health coverage to enroll in part B at any time they are enrolled in the group health plan, rather than after they leave the plan. Subtitle C: Provisions Relating to Parts A and B - Makes various specified changes with regard to Medicare as secondary payer. (Sec. 152) Modifies reporting requirements under physician ownership and self-referral prohibitions to require physicians to report investment and compensation arrangements (in addition to ownership) with respect to designated health services provided. Includes magnetic resonance imaging, computerized axial tomography scans, and ultrasound services among those subject to such prohibitions. (Sec. 153) Allows the Secretary to recognize any successor exam to the Foreign Medical Graduate Examination in the Medical Sciences for payment of direct graduate medical education. (Sec. 154) Requires the Secretary to establish and implement a method for obtaining information from newly eligible Medicare beneficiaries that may be used to determine eligibility for Medicaid payment of their out-of-pocket Medicare expenses. (Sec. 155) Amends SSA title XI to require hospitals and rural primary care hospitals to enter into an agreement with the organ procurement agency designated by the Secretary for the service area in which the facility is located, unless it has obtained a waiver, in order to participate in Medicare or Medicaid. Requires an Office of Technology Assessment study and report to the Congress with respect to such hospital agreements and organ procurement and distribution. (Sec. 156) Amends SSA title XI to: (1) repeal the requirement that peer review organizations (PROs) precertify selected surgical procedures; and (2) revise provisions on the notification of State licensing boards by PROs. (Sec. 157) Requires the Secretary to: (1) treat as a separate class Medicare beneficiaries with respect to whom there is a primary group health plan in defining classes to be used in determining the annual per capita rate of payment to an eligible health maintenance organization with a risk-sharing contract; and (2) submit a proposal to the Congress providing for revisions to the payment method. Requires the Comptroller General to report to the Congress on the proposed revisions. (Sec. 158) Requires use of the most recent hospital wage data in constructing the home health wage index for cost reporting periods beginning July 1, 1996. Extends the limits on liability under the Consolidated Omnibus Budget Reconciliation Act of 1985 for claims disallowed by a lack of medical necessity. (Sec. 159) Makes permanent the authority provided under the Deficit Reduction Act of 1984 for the Secretary to enter into agreements with fiscal intermediaries and carriers on other than a cost basis. (Sec. 160) Provides that user fees imposed under the Clinical Laboratories Improvement Act of 1967 are not subject to Medicare's general ban on user fees. Modifies the phase-in schedule under the Omnibus Budget Reconciliation Act of 1993 (OMBRA '93) for Medicare beneficiaries who receive immunosuppressive drugs following an organ transplant. Subtitle D: Provisions Relating to Medicare Supplemental Insurance Policies - Makes various technical corrections to provisions relating to Medicare supplemental policies. (Sec. 172) Provides for a six month extension of THE period for issuance of such policies. Title II: Maternal and Child Health Services Block Grant Program - Subtitle A: Child Welfare, Foster Care, Adoption - Amends SSA title IV part B (Child-Welfare Services): (1) to increase the authorization of appropriations for the maternal and child health services block grant program; and (2) to repeal provisions requiring foster care protection for additional Federal payments and require instead that the State part B plan provide for such protections. Requires: (1) State review of its policies and administrative and judicial procedures in effect for children abandoned at or shortly after birth; and (2) implementation of those policies and procedures determined necessary to enable permanent decisions to be made expeditiously regarding the placement of such children. (Sec. 202) Prohibits reallotment among other States of any funds withheld or recovered from a State due to its failure to provide the above protections. (Sec. 203) Amends SSA title XI part A to require the Secretary to promulgate regulations to determine whether programs under SSA title IV parts B and E are in substantial conformity with State plan requirements, implementing regulations, and the relevant approved State plans. (Sec. 204) Requires a State part B plan to describe specific measures taken by the State to comply with the Indian Child Welfare Act. (Sec. 205) Specifies the assurances that grant applications for child welfare traineeships must provide in order to win approval. (Sec. 206) Amends SSA title IV part E (Foster Care and Adoption Assistance) to: (1) require each foster child's case plan to be designed not only to achieve placement in the least restrictive (most family-like) setting available, but in the most appropriate setting available as well; (2) require subsequent dispositional hearings to take place not less frequently than every 12 months after the first one, rather than periodically; (3) eliminate foster care ceiling and fund transfer provisions; (4) provide for accountability in cases of children placed in foster care a substantial distance from the home of their parents, or outside the State; and (5) codify the regulations for the treatment of State claims for foster care and adoption assistance. (Sec. 208) Amends SSA title XI part A to: (1) authorize the Secretary to permit up to ten States to conduct demonstration projects which the Secretary finds likely to promote the objectives of SSA title IV parts B or E; and (2) overturn certain limitations in Suter v. Artist M. on private enforceability of State plan requirements. Subtitle B: Child Support Enforcement - Amends SSA title IV part D (Child Support and Establishment of Paternity) to require State child support enforcement agencies to report periodically the names of obligors who are at least two months delinquent in support payments as well as the amount of the delinquency to consumer reporting agencies choosing to receive such information. Repeals provisions on payment of fees by consumer reporting agencies. (Sec. 214) Requires the Secretary to enter into an agreement with the Attorney General under which the services of the Parent Locator Service shall be made available to the Office of Juvenile Justice and Delinquency Prevention, upon request, for the purpose of locating any parent or child. Subtitle C: Supplemental Security Income - Amends SSA title XVI (Supplemental Security Income) (SSI) to extend the SSI childhood definition of disability to any person under 18. Subtitle D: Aid to Families with Dependent Children - Amends SSA title XI to allow any adult member of a family or household to sign a declaration, under penalty of perjury, on behalf of other adults in the household for purposes of receiving welfare payments. Provides that in the case of a newborn child, an adult member of the family or household may sign a declaration on behalf of the child no later than the next redetermination of the eligibility of the family or household. (Sec. 232) Welfare Indicators Act of 1994 - Declares certain policies of the United States, among them: (1) reducing the rate at and the degree to which families depend on welfare and its duration; (2) strengthening families; (3) improving the education and job skills of welfare recipients and individuals at risk of welfare receipt; and (4) providing the public with generally accepted measures of welfare receipt so that it can track it over time and determine whether progress is being made in reducing family dependency on welfare. Requires the Secretary to develop indicators and predictors of welfare receipt for a report to the Congress. Creates an Advisory Board on Welfare Indicators to provide advice and recommendations to the Secretary on the development of indicators, and on the development and presentation of annual reports on welfare receipt by the Secretary. (Sec. 233) Requires the Secretary to provide for a demonstration project for a qualified program in Milwaukee, Wisconsin, operated by The New Hope Project, Inc., a private not-for-profit corporation offering low-income Milwaukee residents employment, wage supplements, health and child care, and counseling and training for job retention or advancement. (Sec. 234) Amends the Family Support Act of 1988 to delay the requirement for implementation of the Unemployed Parent program in Puerto Rico, Guam, the Virgin Islands, and American Samoa until repeal of the limitations on Federal matching payments to these jurisdictions for making Aid to Families with Dependent Children (AFDC) and other maintenance payments. (Sec. 235) Gives States the option to decide, with respect to categories of families, whether or not to use monthly reporting, retrospective budgeting, or a combination of the two. Subtitle E: Jobs Program - Amends SSA title IV part F (Job Opportunities and Basic Skills Training Program) (JOBS) to count all Indians who live on a reservation, regardless of whether they are members of the tribe, in determining the tribe's allocation of JOBS funds. (Sec. 242) Delays the submission date for the Secretary's recommendations to the Congress with regard to JOBS performance standards. Requires the Secretary to develop criteria for the performance standards, rather than the standards themselves. Subtitle F: Other Provisions - Amends the Family Support Act of 1988 to reauthorize and extend certain demonstration projects to create employment opportunities for low-income individuals. (Sec. 262) Authorizes appropriations for early childhood development projects. (Sec. 263) Reallocates to the States certain funds received by an empowerment zone or enterprise community but not used, for use under SSA title XX (Block Grants to States for Social Services).

Small Business Occupational Safety and Health Compliance Incentive Act

United States · United States Congress · 7 October 1994

Small Business Occupational Safety and Health Compliance Incentive Act - Amends the Occupational Safety and Health Act of 1970 (OSHA) to revise provisions relating to small businesses' compliance with such Act. Increases the Federal share of a grant for administration and enforcement for States that demonstrate their meeting State plan requirements. Requires the State to use such additional amount to carry out a consultation program to: (1) enable employers to consult with the State or the Secretary of Labor respecting their responsibilities under OSHA; and (2) provide education and training to employers respecting such responsibilities, including methods of hazard identification and mitigation. Directs the Secretary to provide technical and other assistance to States to establish and operate such consultation programs. Exempts any employer with less than 100 employees from being subject under OSHA to: (1) any fee, if the employer solicits such consultation services and has not been found in violation of OSHA within the previous 12 months; (2) certain inspections, if the employer requests a consultation visit and the consultant entity later determines that its recommendations have been implemented; or (3) a civil penalty of more than $1,000, if the employer abates a non-willful hazard in what the consultant entity deems a reasonable period of time and if a subsequent inspection finds that any such hazard no longer exists. Bases the amount of such penalty on the employer's cooperation and due diligence in abating the hazard.

To prohibit use of education funds to make condoms available in an elementary school.

United States · United States Congress · 7 October 1994

Prohibits use of any funds made available under the Elementary and Secondary Education Act of 1965 to make condoms available in an elementary school.

To amend the National Voter Registration Act of 1993 to increase the number of college students who register and vote.

United States · United States Congress · 7 October 1994

Amends the National Voter Registration Act of 1993 to provide for voter registration and polling places at State-funded institutions of higher education.

Amending the Rules of the House of Representatives to apply certain laws to the House of Representatives, and for other purposes.

United States · United States Congress · 7 October 1994

Amends the Rules of the House of Representatives to add rule LII to establish an Office of Compliance to apply the following laws to the House of Representatives: (1) the Fair Labor Standards Act of 1938; (2) Title VII of the Civil Rights Act of 1964; (3) the Americans with Disabilities Act of 1990; (4) the Age Discrimination in Employment Act of 1967; (5) Titles I and V of the Family and Medical Leave Act of 1993; (6) the Occupational Safety and Health Act of 1970; (7) specified provisions of Federal law relating to Federal labor-management relations; (8) the Employee Polygraph Protection Act of 1988 (except with respect to the Capitol Police); (9) the Worker Adjustment and Retraining Notification Act; and (10) the Rehabilitation Act of 1973. Applies any provision of Federal law that relates to the terms and conditions of employment of employees to the House. Prohibits lobbyists, Members of Congress, and congressional employees from being on the Office Board of Directors. Requires the Board of Directors to study and report to the House on how the laws under rule LII should apply. Directs the Office to: (1) carry out a program of education for House Members and other House employing authorities respecting such laws and a program to inform individuals of their rights; (2) compile specified statistics, including those on the use of the Office by House employees, reasons for contact, and complaints filed; and (3) develop a system for the collection of demographic data respecting the composition of House employees and for collection of information on employment practices. Sets forth procedures for consideration of alleged violations of such laws consisting of the following steps: (1) counseling; (2) mediation; and (3) formal complaint and hearing by a hearing board. Declares that any intimidation of, or reprisal against, any House employee because of the exercise of a right under this Act constitutes an unlawful employment practice that may be remedied in the same manner under this Act as a violation of a law made applicable under rule LII. Directs the Office to study and report to the House on the application to the House of the Freedom of Information Act and the Privacy Act of 1974. Requires the House General Counsel to study further changes in House rules to provide House employees the ability to bring civil actions in Federal district court for alleged violations that relate to terms and conditions of employment until the statutory provisions contained in H.R. 4822, as passed by the House, are enacted.

Economic Equity Act

United States · United States Congress · 6 October 1994

TABLE OF CONTENTS: Title I: Workplace Fairness Subtitle A: Equal Remedies Act Subtitle B: Federal Employees Fairness Act Subtitle C: Congressional Employees Fairness Act Subtitle D: Sexual Harassment Subtitle E: Part-Time and Temporary Workers Protection Act Subtitle F: Unemployment Insurance Reform Subtitle G: Federal Temporary Workers Protection Act Subtitle H: Legislative Pay Equity Study Title II: Economic Opportunity Subtitle A: Women's Business Procurement Assistance Act Subtitle B: Microenterprise Opportunity Expansion Act Subtitle C: Equal Surety Bond Opportunity Act Subtitle D: Women and Minorities in Science and Engineering Work Force Act Subtitle E: Job Training Self-Sufficiency Act Title III: Work and Family Subtitle A: Child Care Public-Private Partnership Act Subtitle B: After-School Child Care Subtitle C: Dependent Care Tax Credit Refundability Subtitle D: Tax Incentives for Family-Friendly Workplaces Subtitle E: Federal Parental Leave for Education Activities Title IV: Economic Self-Sufficiency Subtitle A: Child Support Subtitle B: Pension Reform Subtitle C: Social Security Reform Subtitle D: Former Military Spouses Protection Subtitle E: Unremunerated Work Act Economic Equity Act - Title I: Workplace Fairness - Subtitle A: Equal Remedies Act - Equal Remedies Act - Amends the Civil Rights Act of 1991 to remove limitations on the amount of compensatory and punitive damages that may be awarded in cases of intentional discrimination in employment. Subtitle B: Federal Employees Fairness Act - Federal Employee Fairness Act - Amends the Civil Rights Act of 1964 to permit a Federal employee filing a discrimination complaint to file it with the Equal Employment Opportunity Commission (EEOC). Makes it an unlawful employment practice if the employee demonstrates that the filing of a complaint contributed to an adverse personnel action against such employee. Requires that any such complaint filed with an agency other than the EEOC be transmitted to the EEOC. Sets forth procedures for filing and processing such complaints. Permits a Federal employee to file a complaint up to 180 days following an alleged discrimination. (Sec. 113) Amends the Age Discrimination in Employment Act of 1967 to permit the filing of a complaint with the EEOC in accordance with the amendments made to the Civil Rights Act of 1964 by this Act. Amends the Rehabilitation Act of 1973 to apply its remedies and attorney fee provisions to complaints by individuals with disabilities with respect to employment in the Library of Congress. (Sec. 114) Amends title V of the United States Code, concerning government organization and employees, to permit an employee, under a negotiated grievance procedure, to raise matters dealing with actions involving discrimination. Subtitle C: Congressional Employees Fairness Act - Congressional Employees Fairness Act - Makes applicable to the Congress: (1) the Fair Labor Standards Act of 1938; (2) Title VII of the Civil Rights Act of 1964; (3) specified provisions of the Americans With Disabilities Act of 1990 and the Age Discrimination in Employment Act of 1967; and (4) the Family and Medical Leave Act of 1993. (Sec. 122) Makes applicable to the Congress any provision of Federal law to the extent that it relates to: (1) the terms and conditions of employment (including hiring, promotion, or demotion, salary and wages, overtime compensation, benefits, work assignments or reassignments, and termination) of employees; (2) protection from discrimination in personnel actions; (3) the health and safety of employees; (4) the availability of information to the public; or (5) other areas deemed appropriate by the Independent Office of Compliance (Office). (Sec. 123) Establishes the Office in the legislative branch to study and report to the Congress on the application of such laws. (Sec. 124) Sets forth provisions relating to congressional procedures for approval of the Board of Directors' recommendations relating to the application of future Federal laws to the Congress. Directs the Office to carry out an education program for Members of Congress and other employing authorities of the Congress respecting the laws applicable to them and a program to inform individuals of their rights under laws applicable to the Congress and under this Act. (Sec. 125) Requires the procedure for consideration of alleged violations of such laws to consist of the following steps: (1) counseling; (2) mediation; (3) formal complaint and hearing by a hearing board; and (4) judicial review of a hearing board's decision. (Sec. 129A) Authorizes a congressional employee or any Member of the Congress to petition the Personnel Appeals Board of the General Accounting Office to review a final decision if it is held to be unconstitutional. (Sec. 129D) Declares that any intimidation of, or reprisal against, any employee because of the exercise of a right under this Act constitutes an unlawful employment practice that may be remedied in the same manner under this Act as is a violation of a law made applicable to the Congress. (Sec. 129E) Requires the records and decisions of hearing boards to be made public if required for judicial review. (Sec. 129H) Limits a congressional employee to the judicial proceeding provided by this Act to redress prohibited practices. Subtitle D: Sexual Harassment - Sexual Harassment Prevention Act - Directs employers (including Federal and congressional agencies) to keep posted in conspicuous places a notice prepared or approved by the Equal Employment Opportunity Commission that sets forth: (1) the definition of sexual harassment found in the Code of Federal Regulations; (2) the fact that sexual harassment is a violation of the Civil Rights Act of 1964; (3) information describing how to file a complaint with the Commission alleging such harassment; (4) an address and toll-free number to be used to contact the Commission; and (5) other information required by the Commission. (Sec. 133) Provides for annual notices by employers to individual employees which provide such information and a description of the procedures used by the employers to resolve allegations of sexual harassment. Requires employers to provide to each supervisory employee information specifying the responsibility of, and the methods to be used by, such employee to ensure that immediate and corrective action is taken to address allegations of sexual harassment. (Sec. 134) Directs the Commission to make model notices and voluntary guidelines for procedures dealing with allegations of sexual harassment available to employers at no cost as well as a toll-free number for information regarding this Act. (Sec. 135) Prescribes civil penalties for willful violations of this Act. Subtitle E: Part-time and Temporary Workers Protection Act - Part-Time and Temporary Workers Protection Act - Amends the Internal Revenue Code to provide for the eligibility for unemployment compensation of certain individuals seeking part-time employment. (Sec. 143) Directs the Secretary of Labor, acting through the Commissioner of the Bureau of Labor Statistics, to conduct an annual survey relating to temporary workers. (Sec. 144) Amends the Employee Retirement Income Security Act of 1974 (ERISA) to set forth special participation, vesting, and accrual rules applicable to part-time and temporary employees. Allows limited reductions in employer-provided group health plan premiums for part-time employees. Modifies, with respect to employee benefit rights, the definition of "employee" to include persons who have performed at least 500 hours of service per year. Subtitle F: Unemployment Insurance Reform - Amends the Internal Revenue Code to provide for unemployment compensation eligibility for certain individuals who leave work or fail to return to work for certain qualified family-related reasons (for which they would be entitled to unpaid leave under the Family and Medical Leave Act of 1993, or would be so entitled if the employer were subject to such Act). Subtitle G: Federal Temporary Workers Protection Act - Amends Federal civil service law to extend Federal Employees Health Benefits Program coverage to temporary employees with the equivalent of one year of service within the preceding two years. Subtitle H: Legislative Pay Equity Study - Establishes the Commission on Employment Discrimination in the Legislative Branch to: (1) employ a nongovernmental consultant with expertise in job evaluation to study and compare the compensation paid within and between job classifications in the Library of Congress and to analyze its personnel policies and practices; (2) evaluate the Library's personnel policies and practices for compliance with title VII of the Civil Rights Act of 1964 and to make specific recommendations (other than any that would result in a pay reduction for any position) to the Congress for action necessary to achieve compliance; (3) develop a comprehensive plan for application of title VII principles throughout the legislative branch; and (4) make specific recommendations (other than any recommendation that, if implemented, would result in a reduction in the rate of pay payable for any position) to the Congress for improvement of personnel policies and practices in the legislative branch necessary to eliminate all forms of discrimination that adversely affect pay or working conditions of any employee. Title II: Economic Opportunity - Subtitle A: Women's Business Procurement Assistance Act - Women's Business Procurement Assistance Act - Amends the Small Business Act to require the President and the head of each Federal agency to include small business concerns owned and controlled by women within the Federal procurement contract process. (Sec. 205) Requires the Director of the Small and Disadvantaged Business Utilization section in each Federal agency to designate a "women-in-business" specialist responsible for the execution of programs designed to assist small business concerns owned and controlled by women. (Sec. 207) Establishes in the Small Business Administration the Office of Women's Business Ownership. (Sec. 208) Directs the Comptroller General to report to the Congress on the number of small businesses owned and controlled by women procuring Federal contracts. Expresses the sense of the Congress that if the number of such businesses procuring such contracts does not rise significantly, then further legislative steps should be taken. Subtitle B: Microenterprise Opportunity Expansion Act - Microenterprise Opportunity Expansion Act - Amends the Social Security Act to exclude certain small enterprise (microenterprise) business assets from accounting for public assistance purposes. (Sec. 213) Amends the Internal Revenue Code to authorize unemployment compensation for individuals starting microenterprises. (Sec. 214) Amends the Community Reinvestment Act of 1977 to treat microenterprise loans and grants as investments in a financial institution's community. (Sec. 215) Amends the Home Owners' Loan Act to treat microenterprise loans made by savings associations as qualified thrift investments. (Sec. 216) Amends the Housing and Community Development Act of 1974 to permit the use of assistance provided under the Act for the administrative and operating costs of entities assisting microenterprises. (Sec. 217) Requires each Federal banking agency to establish a Microenterprise Technical and Operations Office to offer technical assistance, training, and support for microenterprise start-ups, or institutions providing microenterprise financial services. (Sec. 218) Directs the Financial Institutions Examination Council to study and report to the Congress on the best means to make credit available for small businesses unable to obtain microenterprise loans and in need of credit in smaller amounts than is generally available from financial institutions or the Small Business Administration. Subtitle C: Equal Surety Bond Opportunity Act - Equal Surety Bond Opportunity Act - Cites activities constituting illegal discrimination with respect to surety bond issuance transactions. Mandates that a surety bond applicant be notified in writing of the reasons for denial of a surety bond. Subjects a surety to civil liability to the aggrieved applicant for violations of this Act. (Sec. 224) Proscribes Federal approval of a surety company that is not in compliance with this Act. Subtitle D: Women and Minorities in Science and Engineering Work Force Act - Women and Minorities in Science and Engineering Work Force Act - Establishes the Commission on the Advancement of Women in the Science and Engineering Work Forces. Terminates the Commission one year following submission of its required report. Authorizes appropriations. Subtitle E: Job Training Self-Sufficiency Act - Self-Sufficiency Standard Act - Amends the Job Training Partnership Act (JTPA) to establish economic self-sufficiency standards for disadvantaged adult training programs, according to a formula to be developed by the Secretary of Labor and local economic self-sufficiency tables to be developed by service delivery areas. (Sec. 245) Prohibits incentive grants to service delivery areas that do not have in effect, after two years, an approved local economic self-sufficiency standards table. (Sec. 246) Requires inclusion of such a table and related reports in the job training plan and in the Governor's coordination and special services plan. (Sec. 248) Directs the Secretary to make up to six grants in each of three fiscal years to States for demonstration and exemplary programs to increase the number of participants in disadvantaged adult training programs who are trained and placed in jobs that yield long-term economic self-sufficiency in accordance with the local economic self-sufficiency tables. Title III: Work and Family - Subtitle A: Child Care Public-Private Partnership Act - Child Care Public-Private Partnership Act - Directs the Secretary of Health and Human Services to establish a business-incentive grant program to provide child care through public-private partnerships. (Sec. 302) Provides program grants for: (1) businesses or consortia (including nonprofit private organizations) to start up, or provide additional, employee child care services; and (2) nonprofit business organizations to provide technical information and assistance to enable businesses to provide employee child care services. (Sec. 305) Gives priority in grant selection to businesses with fewer than 100 full-time employees and to business and consortia applications. Requires equitable geographic distribution. (Sec. 307) Authorizes appropriations. Subtitle B: After-School Child Care Act - After-School Child Care Act - Authorizes the Secretary of Education to make grants to State and local educational agencies for programs to provide affordable and quality after school care for students enrolled in kindergarten through grade six. Limits participation to public elementary school students who are: (1) children of a single working parent or guardian, or two working parents or guardians, or of those who work in the after-school program, or of those who attend school or job training for career development; or (2) recommended by the school on the basis of educational need, subject to available resources. Limits the Federal share to 75 percent. Authorizes appropriations. Subtitle C: Dependent Care Tax Credit Refundability - Repeals the Internal Revenue Code's nonrefundable income tax credit for employment-related dependent care expenses, replacing it with a corresponding refundable 50 percent credit, reduced (but not below 20 percent) as the taxpayer's adjusted gross income exceeds $15,000 (adjusted for inflation). Includes within the scope of the new credit up to $1,200 ($2,400 in the case of more than one qualifying individual) of respite care expenses incurred in the care of: (1) a dependent of the taxpayer who is at least 13 years old; or (2) a spouse or other dependent who is physically or mentally incapable of self-care. Subtitle D: Tax Incentives for Family-Friendly Workplaces - Tax Incentives for Family-Friendly Workplaces Act - Allows eligible small businesses a small business family and medical leave credit equal to 50 percent (up to $2,000) of family and medical leave costs paid or incurred in connection with complying with the Family and Medical Leave Act of 1993. (Sec. 333) Allows a business credit for wages paid to an employee who is permitted to shift hours of employment or work at home in order to reduce dependent care needs. Subtitle E: Federal Parental Leave for Education Activities - Amends Federal law relating to Federal employees to provide for parental leave for certain educational activities. Title IV: Economic Self-Sufficiency - Subtitle A: Child Support - Child Support Economic Security Act - Part A: Child Support Enforcement Amendments - Amends part D (Child Support and Establishment of Paternity) of title IV of the Social Security Act (SSA) to require the organizational unit for administering a State plan for child and spousal support to reside at the State level and administer such plan under rules that apply uniformly throughout the State. (Secs. 412 through 415, and 418) Requires: (1) State procedures to ensure that the administering agency has on-line access to all data base information maintained by the State or local government; (2) child support payments to continue until certain events occur; (3) all income (as well as lottery winnings, insurance payments, and cash settlements) to be subject to withholding to meet child support obligations; (4) property transaction recordings to be conditioned upon the party's payment of any overdue child support; (5) occupational and professional licenses to be denied to parents with overdue child support obligations in excess of $1,000; and (6) social security numbers to appear on marriage licenses and child support orders. (Sec. 416) Revises procedures for the reporting of overdue child support obligations to consumer credit reporting agencies. (Secs. 417 and 419) Requires State procedures providing for separate treatment of cases alleging nonsupport and cases alleging denial of visitation rights. Eliminates statutes of limitations in child support cases. (Sec. 420) Provides for timely response to interstate locate requests. (Sec. 421) Requires the Secretary to issue regulations establishing standards and procedures governing the processing of interstate child support cases. (Sec. 422) Amends SSA title IV part A (Aid to Families with Dependent Children) (AFDC) to subject child support enforcement funds instead of AFDC funds to reduction in cases of substantial noncompliance with part D requirements. Amends SSA title IV part D to increase payments to States for the operation of their part D plans. Repeals incentive payments to States under part D. (Sec. 423) Requires States to adopt a specified form of the Uniform Interstate Family Support Act in order to have their part D plans approved. (Sec. 424) Establishes the Commission on Child Support Guidelines to make recommendations to the Congress for national guidelines for child support award amounts. Part B: Interstate Child Support Act of 1993 - Declares the necessity of establishing national standards for child support orders and determinations of percentage and the effect each State shall give to those of other States' courts. Part C: Bankruptcy Amendments Relating to Child Support, Alimony, and Property Settlement Agreements - Amends Federal bankruptcy law to declare that the filing of a petition in bankruptcy does not operate as an automatic stay of actions for establishment of paternity or concerning certain debts for child and spousal support and maintenance. Includes among priority claims and expenses those for certain child and spousal support and maintenance. (Sec. 445) Precludes a trustee in bankruptcy from avoiding a transfer if it was a bona fide payment of a debt for child or spousal support, maintenance, or alimony. (Sec. 446) Amends the guidelines for what constitutes the property of the bankrupt estate of either a family farmer or an individual with regular annual income. Conditions the confirmation of a plan, for such debtors, upon payment of all allowable claims arising after the order for relief for debts for child and spousal support, maintenance, or alimony. (Sec. 448) Permits representatives of child support creditors to appear in court without charge and without meeting any special local court rule requirement for attorney appearances in any judicial bankruptcy proceeding if such representatives file information detailing the child support debt, status, and other characteristics. Part D: Locate and Case Tracking - Amends SSA title IV part D to allow use of the Federal Parent Locator Service (FPLS) along with appropriate safeguards for parentage establishment and child support and visitation enforcement. Expresses the sense of the Congress that: (1) denial of visitation rights under a child support order should be treated as irrelevant in any action to enforce its support provisions; and (2) failure to pay child support pursuant to such an order should be treated likewise in any action to enforce visitation rights. (Sec. 452) Requires the Secretary of the Treasury to enter into an agreement to provide the Secretary (Secretary) of Health and Human Services (HHS) with access to quarterly estimated Federal income tax returns filed with the Internal Revenue Service (IRS). Requires that: (1) State agencies charged with child support enforcement maintain child support order registries and be allowed access to medical, financial, employment, and other specified data base information on absent parents; and (2) registry information from each State be sent to the Office of Child Support Enforcement (OCSE) within HHS for a national registry of all State child support orders. Expresses the sense of the Congress that the Secretary should investigate accessing certain Federal data banks not linked with FPLS. (Sec. 453) Requires the Secretary to expand FPLS to provide State agencies and courts with a national locate and case tracking network. Expresses the sense of the Congress that the network should be used to access State records only through the agency administering the State's part D plan. (Sec. 454) Requires that private attorneys and pro se obligees be given access, in accordance with appropriate safeguards, to State locate resources and enforcement techniques with respect to child support, visitation, and parentage orders. (Sec. 455) Amends the Internal Revenue Code (IRC) to require employers to withhold from employee wages amounts owed for child support. Requires the Secretary of the Treasury to modify the W-4 form completed by new employees in order to enable employers to obtain employee child support and other information for the appropriate State employment security agency. (Sec. 456) Requires the heads of national and regional individual tracking systems to allow child support enforcement agencies access to their information for paternity or child support purposes. (Sec. 457 and 459) Requires that States: (1) broadcast warrants issued in child support proceedings over their crime information systems; (2) remit, in a criminal case, to any individual owed child support any security posted by or on behalf of the individual owing the support and then forfeited, to the extent of any arrearage in support owed; and (3) establish procedures to obtain access to financial records for purposes of child support establishment and enforcement. Part E: Establishment - Amends the Federal judicial code to establish the jurisdictional basis for State court recognition, enforcement, and modification of parentage and child support orders of other States. (Sec. 462) Amends SSA title IV part D to provide for service of process on Federal employees and members of the armed forces in connection with parentage and child support proceedings. (Sec. 463) Requires that: (1) parents' identification and locate information be filed with the appropriate adjudicating entity in parentage and child support actions; (2) there be appropriate safeguards on such information where a court has ordered that the custodial parent or child receive physical protection against the noncustodial parent; (3) appropriate administrative agencies make reasonable attempts to timely notify any individual owed child support of any proceeding to establish, modify, or enforce the support obligation; (4) States allow parties seeking both parentage and child support establishment in a judicial proceeding to bring a joint action in a single cause of action; (5) States provide for continuation of parental child support obligations until they terminate as described; (6) States allow parties to participate in interstate parentage and child support proceedings by telephonic means; (7) marriage licenses, birth certificates, and divorce and parentage decrees contain social security numbers; and (8) appropriate State agencies be allowed subpoena power in connection with child support hearings. (Sec. 464) Requires certain notices to custodial parents. (Sec. 465) Sets forth guidelines for uniform State procedures regarding jurisdiction and venue in parentage and child support cases. (Sec. 466) Amends the Consumer Credit Protection Act (CCPA) to allow appropriate State agencies to obtain from credit reporting agencies information for establishing and modifying child support awards. (Sec. 467) Creates a National Child Support Guidelines Commission to study and report to the President and the Congress on national child support guidelines, and to develop such guidelines for congressional consideration should it be advisable. (Sec. 468) Amends SSA title IV part D to specify certain principles to be used in accordance with the application of State child support guidelines. (Sec. 469) Expresses the sense of the Congress that, if children receive child support while obtaining postsecondary education, they will attain higher levels of education affording them a greater chance to break the welfare cycle. (Sec. 470) Requires the new OCSE Assistant Secretary to develop: (1) a national subpoena duces tecum for distribution to child support agencies and others to use to reach income information; and (2) a uniform abstract of a child support order for State court use. (Sec. 475) Requires the Legal Services Corporation to ensure the use of a specified amount of funding for child support cases. (Sec. 476) Expresses the sense of the Congress with respect to Indian child support and support orders outreach and demonstrations. Amends the Indian Child Welfare Act of 1978 to require Indian tribes to give full faith and credit to child support orders of other Indian tribes, to the extent such entities already give full faith and credit to the acts, records, and proceedings of the other entity. (Sec. 477) Amends SSA title IV part D to set forth specific measures designed to secure child support services in underserved areas and combat domestic violence. Part F: Parentage - Amends SSA title IV part D to: (1) require States to provide for hospital-based paternity outreach programs and adopt various specified procedures for voluntary paternity acknowledgment; and (2) provide for 90 percent Federal matching for such programs. Expresses the sense of the Congress that, in a proceeding to establish paternity, once paternity is alleged, the burden of proof should shift to the alleged father. Part G: Enforcement - Amends SSA title IV part D to: (1) require States to mandate that any individual or entity engaged in commerce, as a condition of doing business in the State, comply with wage withholding orders issued by any State court or administrative agency, and keep records of wages withheld for child support; (2) specify the priority for applying amounts withheld from income for child support and child health insurance; (3) subject to withholding for child support any income from workers' compensation and other specified Federal sources; (4) prohibit State court application of the election of remedies doctrine to prevent collection of child support; (5) deny State occupational, professional, and business licenses, and driver's licenses and vehicle registrations to delinquent noncustodial parents; (6) authorize liens on vehicle titles, seizure of bank accounts, and holds on lottery winnings, settlements, payouts, bequests, and proceeds from the sale of forefeited property to satisfy child support arrearages; (7) require States to make a rebuttable presumption that any transfer of property by an individual who owes a child support arrearage is made with the intent to avoid payment of the arrearage; (8) revise the mechanism for collection of past-due child support from Federal tax refunds to cover interests without a separate court order to satisfy child support arrearages; (9) mandate reporting monthly child support obligations to credit bureaus; (10) permit enforcement of any child support order until the child is at least 30; (11) require interest on all child support judgments; (12) require States to adopt the Uniform Interstate Family Support Act adopted by the National Conference of Commissioners on Uniform Laws in August 1992; (13) allow State courts to order the assignment of life insurance benefits and interests in jointly held property to satisfy child support arrearages; and (14) require States to treat international child support cases in the same manner as interstate child support cases. (Sec. 494) Amends CCPA with respect to State laws and garnishments for securing child support. Gives Federal debts a lower priority than child support debts when the obligor's disposable income cannot satisfy both debts through withholding. Prohibits employers from discharging any employee whose earnings are subject to garnishment for additional indebtedness arising from a child support order. (Sec. 496) Denies Federal occupational, professional, and business licenses of delinquent individuals until the license hold is released. (Sec. 499C) Expresses the sense of the Congress that the IRS Commissioner should instruct IRS field officers to give a high priority to requests for the use of full collection in delinquent child support cases. Requires the Secretary of the Treasury to simplify the full collection process and reduce the amount of child support arrearage needed before an individual may apply for full collections. (Sec. 499I) Amends the Federal bankruptcy code to: (1) allow parentage and child support case establishment, modification, and enforcement to proceed uninterrupted after a bankruptcy petition is filed; (2) treat as outside chapter 11, 12, or 13 plans any debt owed to child support creditors, except as specified; and (3) allow a claim for payment of a debt for child support to be asserted in court. (Sec. 499J) Sets forth requirements pertaining to parentage establishment and child support payments in the armed forces. (Sec. 499L) Directs the Comptroller General and Secretary of the Treasury to study an annual reconciliation process for paying child support arrearages as part of the Federal income tax process. (Sec. 499M) Authorizes the Secretary of State to refuse, revoke, or restrict passports in cases where the applicant or holder is a noncustodial parent subject to a State arrest warrant for nonpayment of a substantial child support arrearage. (Sec. 499N) Prohibits Federal benefits, loans, guarantees, and employment for individuals owing certain child support arrearages. (Sec. 499Q) Expresses the sense of the Congress that the United States should ratify the United Nations Convention of 1956. Part H: Collection and Distribution - (Sec. 499R) Amends SSA title IV part D to: (1) set priorities for State distribution of child support collections; (2) require States to limit claims against noncustodial parents for reimbursement of a child's portion of AFDC to the amount in the child support order; (3) revise part D plan provisions concerning fees; and (4) require States to provide for collection and disbursement points for child support cases. Part I: Federal Role - Requires Comptroller General studies and pilot projects with respect to requiring State systems to pay the child support collected under a State plan to the individuals to whom the support is owed before making any payment to reimburse any State for AFDC provided with respect to the child in question. Amends IRC to revise the Federal income tax refund offset mechanism. (Sec. 499V) Expresses the sense of the Congress that States should encourage parents to use the State child support agency to process and distribute child support payments. (Sec. 499W) Amends SSA title IV part D to: (1) designate the separate organizational unit currently charged with various parentage and child support responsibilities as the OCSE; (2) change OCSE's organizational structure. (Sec. 499X and Y) Requires: (1) the new OCSE Assistant Secretary to provide training assistance to the States; (2) States to provide training of child support personnel; and (3) the Secretary to study staffing at State child support enforcement programs and reduce payments to States that have not implemented recommended staffing levels. (Sec. 499Z) Requires the Secretary to: (1) authorize demonstration projects to test alternative approaches to incentive funding for State child support programs; and (2) reduce payments to States which have not reinvested incentive payments in their child support programs. Includes as "support" under SSA title IV part D with respect to incentive payments to States any premiums paid for health insurance coverage pursuant to a support order. Expresses the sense of the Congress that States should not use amounts paid to them pursuant to SSA title IV part D, which are reinvested in child support activities, to supplant State funding of such activities. (Sec. 499BB) Requires the Secretary to: (1) contract for a study of OCSE's audit process to develop criteria and methodology for auditing activities of State child support enforcement agencies; and (2) provide for State demonstration projects for the purpose of ensuring that custodial parents owned child support have a consistent source of income for the support of their children. (Sec. 499CC) Expresses the sense of the Congress that: (1) children should have a consistent source of income to meet their education and medical needs; (2) the provision of public assistance to a custodial parent for the support of a child with respect to whom the noncustodial parent owes child support does not absolve the latter of the obligation to provide such support; (3) the States must continue to vigorously pursue efforts to establish parentage and establish and enforce child support obligations; and (4) OCSE should develop a mechanism to publicize the best State practices in child support. Directs the Secretary to: (1) consider applications from eligible States to conduct child support assurance demonstration projects; and (2) submit an evaluation report on such projects to the Congress. (Sec. 499DD) Amends the IRC to establish in the Treasury a Children's Trust Fund to hold the contributions designated by individuals on their tax returns for funding child support programs. (Sec. 499EE, FF, GG, and HH) Requires: (1) the Comptroller General to study and report to the Congress on delinquent child support payments and the effectiveness of administrative versus judicial adjudication of parentage and child support cases; and (2) OCSE to produce and update a certain compendium of State child support laws published by the National Conference of State Legislatures, and establish a permanent child support advisory committee. Part J: State Role - Amends Amends SSA title IV D to require States to: (1) promote the greatest economic security possible for children, within the obligor's ability to pay; (2) provide custodial parents with certain information on child support cases and the services available under their part D plans; and (3) require any changes in child support payees to be made only through administrative procedures. (Sec. 499KK, MM, and NN) Expresses the sense of the Congress that States should: (1) work closely with parents to improve the quality of child support services; (2) have offices in areas accessible to public transportation with convenient hours that allow parents to meet privately with attorneys and caseworkers; and (3) establish administrative procedures to process child support cases and a child support council to recommend improvements in State paternity and child support programs. Part K: Jobs for Unemployed Noncustodial Parents - Expresses the sense of the Congress that any Federal program to provide jobs for noncustodial parents should be administered so as not to adversely affect any Federal program for custodial parents. Requires the Secretary to transmit evaluations of certain projects under the JOBS program under SSA title IV part F (Job Opportunities and Basic Skills Training Program) to the Secretary of Labor for study and possible action, including authorizing States to provide services of greater scope and duration to unemployed noncustodial parents under such program. Part L: Effective Date - Sets forth an effective date. Part M: Child Support Enforcement Improvements Act of 1993 - Child Support Enforcement Improvements Act - Absolves of liability under State or Federal law any person who discloses any financial record of an individual to a State child support enforcement agency attempting to establish, modify, or enforce a child support obligation of that individual. Requires such an agency to disclose such records only for child support purposes. Authorizes civil damages for unauthorized disclosures. (Sec. 499SS) Amends the Fair Credit Reporting Act with respect to access to and use of consumer reports by State child support enforcement agencies in child support cases. (Sec. 499TT through WW) Amends SSA title IV part D with regard to: (1) health care support; (2) reporting of State compliance with time limits for providing certain child support assistance; (3) employer wage withholding for child support obligations; and (4) the national parents locator network. Directs the Secretary to study and report to the Congress on incentives to encourage States to enforce health care support obligations of noncustodial parents. Part N: Reporting Delinquent Parents to Consumer Credit Agencies - Amends SSA to require provision to consumer reporting agencies of information on overdue child support obligations. Subtitle B: Pension Reform - Pension Reform Act - Amends ERISA and the IRC with respect to pension integration, participation, and vesting requirements. (Sec. 502) Extends applicability of new integration rules under the Tax Reform Act of 1986 to all existing accrued benefits. Amends the IRC to disallow integration for simplified employee pensions, by repealing provisions relating to permitted disparity under rules limiting discrimination under simplified employee pensions. Repeals for plan years beginning on or after January 1, 2002, IRC provisions relating to: (1) pension integration exceptions under nondiscrimination requirements for qualification; and (2) nondiscriminatory coordination of defined contribution plans with Old Age, Survivors and Disability Insurance. (Sec. 503) Revises IRC minimum coverage requirements with respect to separate lines of business. Sets forth a special rule where the employer operates a single line of business. Limits a line of business exception. (Sec. 504) Eliminates a special vesting rule for multiemployer plans under IRC and ERISA. (Sec. 505) Provides for division of pension benefits upon divorce unless otherwise provided in qualified domestic relations orders. (Sec. 507 and 508) Provides for studies and reports by the Comptroller General relating to cost-of-living adjustments and pension portability. (Sec. 509) Provides for the continued availability of remedies relating to rights of spouses to accrued benefits under pension plans under divorce case domestic relations orders entered before 1985. Subtitle C: Social Security Reform - Social Security Caregiver Act - Amends SSA title II (Old Age, Survivors and Disability Insurance) to: (1) provide for an increase of up to five in the number of years of either zero or low earnings disregarded in determining average annual earnings on which benefits are based provided such year were used to provide care to a child under the age of 12 or to a chronically dependent spouse or relative; (2) repeal the seven-year restriction on eligibility for widow's and widower's insurance benefits based on disability; and (3) provide full widow's or widower's insurance benefits to disabled widows or widowers without regard to age and without certain reductions. Subtitle D: Former Military Spouses Protection - Amends the National Defense Authorization Act for Fiscal Year 1991 to make certain amendments regarding military retired pay to former spouses applicable to divorces, dissolutions of marriage, annulments, and legal separations that became effective before such Act's enactment. (Currently, such amendments apply only to those events that become effective 90 days after such Act's enactment). Permits any change in payments of military retired or retainer pay due to such amendment to apply only to payments for months beginning 90 days after this Act's enactment. Subtitle E: Unremunerated Work Act - Unremunerated Work Act - Directs the Commissioner of the Bureau of Labor Statistics to: (1) conduct time use surveys of unremunerated work performed in the United States (including household, agricultural, and volunteer work and work related to child care and other care services, food production, and family businesses); and (2) calculate the monetary value of such unremunerated work, separately for men and women, and include such value in statistics used to determine the gross national product.

Job Training Consolidation and Reform Act

United States · United States Congress · 6 October 1994

TABLE OF CONTENTS: Title I: Federal Responsibilities Title II: State Responsibilities Title III: Local Responsibilities Title IV: Consolidation Title V: Integrated Labor Market Information System Job Training Consolidation and Reform Act - Consolidates and revises Federal job training programs to create a workforce development system. (Sec. 3) Authorizes appropriations. Title I: Federal Responsibilities - Establishes the National Workforce Development Board (the Board). (Sec. 101) Amends the Job Training Partnership Act (JTPA) to repeal the establishment of the National Commission for Employment Policy. Replaces references to such Commission with references to the Board. Requires the Board to issue a biennial National Workforce Strategic Plan (Federal Blueprint). Directs the Board also to: (1) provide congressional testimony; (2) make recommendations on measures (including tax code changes) to encourage employers and workers to invest in training and skills upgrading and employers to hire and train hard-to-serve individuals; (3) review implementation and incentive grant proposals; (4) coordinate with the National Skill Standards Board; and (5) make final recommendations in the form of a joint resolution to the President and the Congress. (Sec. 102) Requires the Board to prepare an annual report to be known as the Nation's Workforce Development Report Card (National Report Card) which shall assess the U.S. workforce development system performance and evaluate all workforce development programs that receive Federal funding. (Sec. 103) Authorizes the Secretary of Labor to make grants to applicant States to: (1) develop strategic plans for development of comprehensive statewide integrated workforce development systems; and (2) if they are leading edge States, implement such systems. Directs the Secretary to use specified information clearinghouses and other entities to: (1) collect and disseminate information to help States and localities to streamline and reform their job training systems; and (2) facilitate exchange of information and ideas among States and localities carrying out job training reform initiatives. Requires the Board to determine whether any proposed Federal job training legislation complies with data reporting, common definitions, and common funding cycles provisions under this Act. Makes it out of order for the Senate or House of Representatives to consider any bill or resolution concerning workforce development that would not comply with the national workforce development system, as determined by the Board. Requires a three-fifths affirmative vote to waive or suspend such requirement in the Senate or House. (Sec. 104) Directs the President to establish an expedited process to consider and act on requests by States for waivers of laws and regulations for specified programs for: (1) two years to facilitate provision of assistance for workforce development, for States not receiving implementation grants; or (2) the duration of the implementation grant, for States receiving such grants. (Sec. 105) Establishes a quality assurance system. Directs the Secretaries of Labor, of Education, and of Health and Human Services to jointly develop common terms and definitions and a placement accountability system and adjust existing program performance standards. Directs the Board to recommend a system of performance standards in its joint resolution to the Congress that includes standard outcome measures relating to employment, job retention, earnings, and nonemployment outcome measures (such as learning and competency gains). Requires each workforce development program that receives Federal funds to collect, and report to the Governor and State Council, specified information relating to each participant's: (1) quarterly employment status and earnings for one year after no longer receiving program assistance; (2) economic and demographic characteristics; (3) services received and spending for them; (4) program outcomes; and (5) other data that may be added as the Board develops other standard definitions. Requires that program monitoring under these provisions supplant existing monitoring and reporting requirements for program participants. Directs each Federal department and agency with responsibility for a workforce development program to report to the Board on its progress in adopting common terms and definitions for program participants, service activities, and outcomes by program operators and grant recipients. Requires each workforce development program receiving Federal funds to use the common terms and definitions. Directs the Board to make recommendations to: (1) the Secretaries and heads of other agencies operating workforce development programs, on common definitions for other terms; and (2) the Congress, on legislative action if any of the proposed common definitions require amendment to existing laws. Establishes a placement accountability system for all federally funded workforce development programs. Requires each such program to: (1) monitor its own performance by measuring quarterly employment status and earnings of each participant for one year after he or she no longer receives program assistance; and (2) provide required information on participants, to be matched by information from the State agency for labor market information which shall be reimbursed by the requesting program with Federal funds. Directs the State agency to submit the results of the matching to the State Council. Requires the Governor to ensure submission of matched data to the State Council, the Board, the Secretary (of Labor), and other Federal entities. Requires that such program quality assurance information be made available to the State Council, local workforce development boards in the State, and consumers of labor market information. Requires all federally funded workforce development programs to be funded on a consistent funding cycle basis. Directs the Board to make recommendations to the Congress on the appropriate funding cycle. Title II: State Responsibilities - Requires each State desiring to participate in development of an integrated and accountable workforce development system to: (1) establish a State Workforce Development Council (State Council); or (2) have an existing entity similar to a State Council that includes representatives of employers and workers. Directs each State Council to: (1) serve as principal advisory board to the Governor for all programs in the State's integrated workforce development system; and (2) assume the functions and responsibilities of councils and commissions required under Federal law that are part of such system. (Sec. 204) Directs the State Council to assist the Governor in: (1) preparing a biennial State Workforce Development Policy Blueprint and an annual State Workforce Development Report Card; and (2) certifying each local workforce development board, as well as recommending criteria to judge such local boards' effectiveness. (Sec. 205) Requires the State Council to develop a quality assurance system to complement and expand upon the one established under title I, in order to provide customers of job training services with consumer reprts on the supply, demand, price, and quality of job training services in each unified service delivery area in the State. Directs each State to select tools and measures appropriate to its needs, including: (1) collecting and organizing service provider performance data; and (2) conducting surveys to ascertain customer satisfaction. Directs the State Council, with the local workforce development boards, to establish mechanisms for collecting and disseminating the quality assurance information to individuals seeking employment, employers, Federal, State, and local policymakers, and training and education providers. Requires each public and private education, training, and career development service provider receiving Federal funds under a program in a State integrated system to collect and provide the quality assurance information. (Sec. 206) Sets forth State Council authorities, including funding and operating special projects for research or improvement of system performance. (Sec. 207) Directs State Councils to make recommendations to Governors for establishment of unified service delivery areas (SDAs). Requires States receiving implementation grants to establish unified SDAs to provide community-wide workforce development assistance in one-stop career centers. Requires consideration of existing labor market areas, local governments, and SDAs under JTPA, as well as distance traveled by individuals to receive services. Allows merger of existing SDAs. Prohibits approval of a total number of such unified SDAs greater than that of the existing SDAs in the State. (Sec. 208) Requires each State to use a portion of its development grant to design a unified financial and management information system. Directs each State receiving an implementation grant to require all programs in the integrated system to use such unified financial and management information system. Sets forth requirements for such systems. (Sec. 209) Requires each State, from its development or implementation grant, to develop a strategy to enhance capacity of institutions, organizations, and staff involved in State and local workforce development activities by providing certain types of services. (Sec. 210) Provides that the Governor of each State implementing an integrated workforce development system: (1) may adjust existing performance standards for programs in such system, using criteria including specified factors; and (2) shall, within parameters established by the Board, prescribe adjustments to such performance criteria for unified SDAs based on specified factors. Requires such developed performance criteria to be used in lieu of similar criteria for programs receiving Federal funding included in the State's integrated system, to the extent determined by the State Council subject to Board approval. Title III: Local Responsibilities - Requires the local elected officials of each unified SDA, in each State receiving an implementation grant (except any with a single unified SDA with contiguous borders), to establish a workforce development board (local board) to administer the workforce development provided by all programs in the integrated workforce development system in such area. (Sec. 302) Requires each local board to report to the State Council a biennial workforce development board policy blueprint. (Sec. 303) Requires each local board to submit to the State Council an annual unified SDA report card. (Sec. 304) Requires each local board receiving funds under an implementation grant to develop and implement a network of one-stop career centers in its unified SDA to provide jobseekers, workers, and businesses universal access to a comprehensive array of quality employment, education, and training services. Requires selection of a method for such establishment consistent with specified criteria. Makes eligible for selection as a one-stop career center each entity within the unified SDA that performs specified brokerage services for individuals and employers. Prohibits any entity that performs one-stop career center functions from making an education and training referral to itself, but allows waivers of this prohibition under certain conditions. Allows each one-stop career center to charge fees for certain brokerage services to employers, subject to local board approval. Requires each such center to: (1) adopt core data elements and common definitions; and (2) enter into an operating agreement with the local board. (Sec. 305) Directs each local board to submit annual progress reports to the State Council. (Sec. 306) Requires each local board to identify capacity building actions to be taken for the workforce development system in its unified SDA. Directs the State Council to make funds available to each local board for capacity building building activities from implementation grant funds and other funds within the State's integrated workforce development budget. Lists types of capacity building activities. (Sec. 307) Establishes a program of incentive grants for incumbent worker training, consisting of competitive matching grants to local boards to respond to the training needs of front-line workers in their communities. Sets forth provisions for applications, selection of grantees by the Secretary according to certain criteria, authorized uses of funds, and Federal and local matching shares of funding. Title IV: Consolidation - Provides for consolidation of the system of federally funded employment training services available to jobseekers, workers, and businesses. (Sec. 401) Expresses the sense of the Congress that: (1) any budget savings realized through elimination or consolidation or sunsetting of such programs should be reinvested in the national job training (or workforce development) system; and (2) elimination or merging of programs should be done without reducing the Federal commitment or level of effort to improve education, employment, and earnings of all workers, particularly hard-to-serve individuals, including those with limited-English proficiency and others with special needs. (Sec. 402) Directs the Board to study and report to the President and the Congress on how best to integrate specified programs for in-school-and out-of-school youth under various Federal laws with those under the School-to-Work Opportunities Act of 1994. (Sec. 403) Directs the board to advise on consolidation of workforce development progrms through: (1) recommendations to the President and the Congress for the elimination of Federal workforce development programs, or programs whose functions should be subsumed under other Federal programs; (2) a report and recommendations for proposed reforms to specified congressional committees based on its analysis of the experience of leading edge States and the progress toward establishing an integrated workforce development system; and (3) a draft of a joint resolution to the Congress with provisions to develop a streamlined, integrated, federally supported workforce development system, from listed programs and any other appropriate Federal program (including recommendations for standard program measures and a description of how the new system will maintain services to hard-to-serve populations). (Sec. 404) Requires any State receiving an implementation grant to include specified programs under various Federal laws (mandatory integrated programs) in its reformed delivery system. Allows any such State to include specified additional programs (optional integrated programs) under various Federal laws in its reformed delivery system. (Sec. 405) Repeals the provisons of various Federal laws for the listed mandatory integrated programs. Title V: Integrated Labor Market Information System - Directs the Secretary to oversee and ensure development, maintenance, and continued improvement of: (1) a nationwide integrated system of labor market information that will serve specified functions, include certain information, use common standards, and make certain data and information available to the Board and to consumers in automated delivery systems; and (2) certain mechanisms and programs for dissemination, technical assistance, and research. (Sec. 502) Directs the Board to plan, review, and evaluate the national integrated labor market information system. (Sec. 503) Requires the Secretary to: (1) manage the investment in an integrated labor market information on system in a specified manner; and (2) submit an annual plan for improving such system to the Board for review and recommendations, and to the President and the Congress. (Sec. 504) Directs each Governor and State Council to designate one State agency to be responsible for: (1) managing and overseeing a statewide integrated labor market information system; and (2) developing an annual State unified labor market information budget. Conditions Federal financial assistance under this title on the Governor or State Council carrying out other specified functions with respect to labor market information. Provides that the State agency is not limited by this Act from conducting additional data collection, analysis, and dissemination activities with funds derived from sources other than this Act.

Bipartisan Health Care Reform Act of 1994

United States · United States Congress · 6 October 1994

TABLE OF CONTENTS: Title I: Assuring Availability and Continuity of Health Coverage Subtitle A: Insurance Reforms Subtitle B: Benefits Subtitle C: Employer Responsibilities Subtitle D: Standards and Certification; Enforcement; Preemption Subtitle E: Multiple Employer Health Benefits Protection and Related Provisions Subtitle F: Definitions; General Provisions Title II: Removal of Financial Barriers to Access Subtitle A: Tax Deductibility for Individuals and Self- Employed Subtitle B: Premiums and Cost-Sharing Subsidy Program for Low-Income Individuals Title III: Medicaid Reforms Subtitle A: Treatment of Acute Care Benefits for AFDC and Non-cash Beneficiaries Subtitle B: Flexibility in Expenditures for Supplemental Benefits for AFDC and Non-cash Beneficiaries Subtitle C: Increased State Flexibility in Contracting for Coordinated Care Subtitle D: Additional Medicaid Reforms Title IV: Access Improvements Subtitle A: Expanding Access in Underserved Areas Subtitle B: Improved Access in Rural Areas Subtitle C: Academic Health Centers Subtitle D: United States-Mexico Border Health Commission Title V: Health Care Quality Enhancement Subtitle A: Quality Assurance Subtitle B: Primary Care Provider Education Title VI: Market Incentives to Containing Costs Subtitle A: Facilitating Establishment of Health Plan Purchasing Organization (HPPOs) Subtitle B: Preemption of State Benefit Mandates and Anti-Managed Care Laws Subtitle C: Malpractice Reform Subtitle D: Administrative Simplification Subtitle E: Fair Health Information Practices Subtitle F: Antitrust Subtitle G: Fraud and Abuse Subtitle H: Billing for Laboratory Services Title VII: Medicare Subtitle A: Increased Beneficiary Choice; Improved Program Efficiency Subtitle B: Savings Title VIII: Incentives to Purchase Long-Term Care Insurance Subtitle A: Establishment of Federal Standards for Long-term Care Insurance Subtitle B: Tax Treatment of Long-term Care Insurance Title IX: Department of Veterans Affairs Title X: Miscellaneous Savings Provisions Subtitle A: Automobile Insurance Coordination Subtitle B: Prefunding Government Health Benefits Contributions Bipartisan Health Care Reform Act of 1994 - Title I: Assuring Availability and Continuity of Health Coverage - Subtitle A: Insurance Reform - Part 1: Guaranteed Access to Health Coverage - Requires carriers that offer health insurance coverage in the individual-small group market in a fair rating area to make available qualified standard coverage and high-deductible coverage to qualifying individuals or small employers. (Sec. 1001) Exempts federally qualified health maintenance organizations (HMOs) and HMOs or managed care organizations recognized by State laws from the requirement to provide high-deductible coverage. Prohibits the offer of high-deductible coverage unless the carrier also makes standard coverage available with identical benefits and the individual or employee demonstrates that they have available assets equal to at least the deductible amount under the high-deductible coverage. Requires carriers to provide for coverage of benefits for items and services furnished throughout the fair rating area. Prohibits carriers from limiting coverage to portions of interstate metropolitan statistical areas (MSAs), requiring them to provide coverage throughout the entire MSA. Requires coverage offers to include a family coverage option. Prohibits carriers from requiring employers under group health plans to impose waiting periods for health coverage or require conditions on health coverage based on an individual's: (1) health status; (2) claims experience; (3) receipt of health care; (4) medical history; (5) receipt of public subsidies; or (6) lack of evidence of insurability. (Sec. 1002) Requires carriers to accept every small employer and qualifying individual that applies for enrollment during the required enrollment period. Provides that in the case of coverage offered by carriers or under group health plans that provide benefits through a managed care arrangement, the carriers or plans: (1) need not establish health care facilities throughout the fair rating area if the facilities are located in a manner that does not discriminate on the basis of health status of individuals residing in proximity to such facilities; and (2) may deny coverage under certain conditions. Permits carriers to deny coverage if they do not have the necessary financial reserves. (Sec. 1003) Prohibits carriers from denying, cancelling, or refusing to renew health coverage except on the basis of nonpayment of premiums or fraud or because they are not providing a particular coverage option in the market. Sets limitations on market exit and re-entry by carriers. Establishes similar conditions for cancellation or denial by multiemployer plans and multiple employer health plans. (Sec. 1004) Prohibits carriers or group health plans from excluding coverage with respect to services provided for preexisting conditions, except as provided by this Act. Provides for exclusion periods of up to six months subject to certain conditions. Makes exclusions inapplicable to pregnancy, newborns, adopted children, and certain individuals enrolled or enrolling during an open enrollment period. (Sec. 1005) Sets forth provisions regarding enrollment periods. Part 2: Provision of Benefits - Establishes: (1) standards for managed care arrangements and requirements and utilization review programs; and (2) requirements for arrangements with essential community providers. (Sec. 1014) Provides for the establishment of medical savings accounts. Makes the account beneficiary the owner of the account and includes distributions not used for qualified medical expenses in the beneficiary's gross income. Sets forth uses and limitations for such accounts. Excludes: (1) employer contributions to any medical savings account of an eligible employee from gross income (to the extent such contributions do not exceed the excess of premiums for standard coverage over the premiums for high-deductible coverage); and (2) health benefit payments made by employers from employment taxes. Part 3: Fair Rating Practices - Provides that the premium rate established by carriers for health insurance coverage in the individual-small group market may not vary except by the following: (1) age; (2) geographic area; (3) family class; (4) benefit design of coverage and by type of coverage option; and (5) permitted expense category. (Sec. 1022) Directs carriers and group health plans to accept and apply premium certificates issued under State premium assistance programs under title XXI of the Social Security Act (as established by this Act). (Sec. 1023) Requires the Secretary of Health and Human Services to request the National Association of Insurance Commissioners (NAIC) to develop a model risk adjustment system under which premiums applicable to coverage in the individual-small group market and coverage under small employer pooling arrangements and multiple employer welfare arrangements that are fully insured would be adjusted to take into account factors to predict the future need and efficient use of services by covered individuals in the market. Incorporates such model into a rule that specifies risk adjustment mechanisms. Requires each State to develop systems that conform with the Federal model. Part 4: Consumer Protections - Requires carriers and group health plans to provide information relating to their performance in providing coverage to specified individuals, including prospective enrollees. (Sec. 1032) Prohibits carriers from varying the commission or other remuneration to a person based on the claims experience or health status of individuals enrolled by or through such person. Subtitle B: Benefits - Sets forth provisions regarding standard coverage, preventive benefits to be covered without any deductible or cost-sharing, and high-deductible coverage. (Sec. 1105) Sets forth conditions under which supplemental benefits may be provided. (Sec. 1106) Requires carriers and group health plans to provide for an option under which children under 26 (without regard to whether they are students or disabled) will be treated as family members. Authorizes additional premiums for such option. (Sec. 1107) Includes coverage provided by Christian Science practitioners or in a Christian Science sanitorium within benefits under standard coverage. Subtitle C: Employer Responsibilities - Requires employers to make available to qualifying employees coverage under a group health plan that meets specified requirements, including: (1) an annual offering of coverage; (2) a choice of coverage and family coverage options; (3) an annual enrollment period; and (4) payroll withholding of premiums. (Sec. 1201) Provides that an employer is not required, subject to provisions regarding an equal contribution rule, to make any contribution to the cost of health coverage. Makes requirements regarding choice of coverage inapplicable if a group health plan is in effect as of July 1, 1994, and the employer makes contributions on behalf of employees under a collective bargaining agreement or similar contract. Excludes from this subtitle's requirements certain new and small employers. (Sec. 1202) Imposes an excise tax for failures of employers to comply with this subtitle. Subtitle D: Standards and Certification; Enforcement; Preemption; General Provisions - Directs the Secretary to request the NAIC to develop model regulations that specify standards with respect to this subtitle for carriers and health insurance coverage. (Sec. 1304) Imposes a tax on carriers that fail to comply with Parts 1 through 4 of Subtitle A and Subtitle B of this title unless a State has in effect a regulatory mechanism that provides sanctions. (Sec. 1305) Prohibits a single employer plan from offering health coverage other than through a carrier unless the plan has at least 100 eligible employees. Subtitle E: Multiple Employer Health Benefits Protections and Related Provisions - Part 1: Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to establish certification standards under title I (Protection of Employee Benefit Rights) for multiple employer welfare arrangements (MEWAs) providing health benefits. (Sec. 1401) Treats as employee welfare benefits plans, and exempts from certain restrictions on preemption, a MEWA which provides benefits consisting solely of specified medical care, which is not fully insured, and which applies for and receives a specified certification. Requires certain disclosures to participating employers. Requires certified MEWAs which are not fully insured to maintain excess-stop loss coverage and specified types of reserves. Sets forth corrective actions which such MEWAs' operating committees must take: (1) to avoid depletion of reserves; or (2) in connection with termination of the MEWA. Provides for review of actions by the Secretary of Labor with respect to denials of applications for, or suspensions or revocations of, such certifications. Requires, in cases where coverage is provided under a multiple employer health plan and more than ten percent of the participating employers are small employers, that the arrangement is maintained in the form of a small employer pooling arrangement. Sets forth requirements for such arrangements. (Sec. 1402) Revises ERISA with respect to: (1) a specified exemption from preemption; (2) treatment of single employer arrangements; and (3) treatment of certain collectively bargained arrangements. (Sec. 1405) Sets forth ERISA requirements relating to employee leasing health care arrangements (ELHAs). Provides for treatment of ELHAs as MEWAs, with certain exceptions. Sets forth special rules under which an ELHA may receive a MEWA certification. (Sec. 1408) Allows delegation to a State of some or all of the Secretary's enforcement authority with respect to MEWAs with certifications. Directs the Secretary to provide enforcement and technical assistance to the States with respect to MEWAs. Part 2: Simplifying Filing of Reports for Employers Covered under Multiple Employer Welfare Arrangements Providing Fully Insured Coverage Consisting of Medical Care - Directs the Secretary to prescribe an alternative method for the filing of a single annual report for all participating employers under MEWAs under which all coverage consists of medical care and is fully insured. Subtitle F: Definitions; General Provisions - Part 1: Definitions - Sets forth specified definitions. (Sec. 1905) Makes this title effective for plan years beginning on or after 1997 with respect to group health plans and as of January 1, 1997, with respect to carriers (for coverage other than under a group health plan). Part 2: Report and Recommendations on Health Coverage and Access - Provides that it is an objective of this Act to assure by 2002 that: (1) all eligible individuals in the United States have access to health coverage; and (2) at least 95 percent of such individuals have such coverage. (Sec. 1912) Requires the Secretary of Health and Human Services to report to the Congress on the extent to which eligible individuals have, or have access to, health care coverage. Title II: Removal Of Financial Barriers To Access - Subtitle A: Tax Deductibility for Individuals and Self-Employed - Amends the Internal Revenue Code to: (1) increase on a graduated basis the tax deduction for health insurance costs of self-employed individuals; (2) make the deduction permanent; (3) allow a tax deduction, regardless of whether the taxpayer itemizes other deductions, for health insurance costs of non-self-employed individuals not eligible to participate in any subsidized employer health plan; and (4) subject to taxation certain health benefits provided through cafeteria plans and flexible spending arrangements. Subtitle B: Premium and Cost-Sharing Subsidy Program for Low-Income Individuals - States that the amendments made by this subtitle and title III below provide for a transition from the current Medicaid system to a new system of acute care low-income assistance. (Sec. 2101) Amends the Social Security Act (SSA) to add a new title XXI providing for the establishment of new State programs under which, as a requirement for State participation in Medicaid, certain low-income eligible individuals who are not Medicare beneficiaries, SSI recipients, prison inmates, or unlawful aliens will be eligible for premium and cost-sharing assistance for use in obtaining qualifying coverage of the standard and preventive health benefits discussed above under title I of this Act. Sets forth specific requirements for such programs, allowing waivers in the case of any demonstration project which in the judgment of the Secretary of Health and Human Services is likely to assist in promoting the objectives of new SSA title XXI. Creates in the Treasury the Health Care Assurance Trust Fund to contain the savings resulting from this Act and other specified amounts for use in paying States operating subsidy and supplemental acute care benefits programs. Establishes a mechanism for financing such programs that is designed to be deficit neutral. Prohibits the use of funds appropriated to carry out new SSA title XXI to provide premium or cost-sharing assistance or supplemental acute care benefits under part B added below in connection with any abortion, except in cases where an abortion is necessary to save the life of the mother or where the pregnancy results from rape or incest. Title III: Medicaid Reforms - Subtitle A: Treatment of Acute Care Benefits for AFDC and Non-Cash Beneficiaries - Amends SSA title XIX (Medicaid) to: (1) establish Medicaid rules for benefits for acute medical services for AFDC recipients and non-cash Medicaid beneficiaries; (2) provide for the division of acute medical service benefits into core benefits and supplemental acute care benefits; (3) limit the amount of Federal financial participation for benefits for acute medical services for AFDC recipient and non-cash Medicaid beneficiaries; (4) condition Federal financial participation on State maintenance-of-effort; and (5) provide for the continuation of State Medicaid eligibility categories. Subtitle B: Flexibility in Expenditures for Supplemental Benefits for AFDC and Non-Cash Beneficiaries - Amends new SSA title XXI to require each State to establish a State supplemental acute care benefits program. Subtitle C: Increased State Flexibility in Contracting for Coordinated Care - Amends SSA title XIX to modify Federal requirements to allow States more flexibility in contracting for coordinated care services. Subtitle D: Additional Medicaid Reforms - Amends SSA title XIX to make various specified changes providing for: (1) a reduction in the amount of payment adjustments for disproportionate share hospitals; (2) elimination of the medically needy program for individuals not in an institution; and (3) elimination of the Medicaid pediatric immunization program, and establishment of alternative delivery programs. Title IV: Access Improvements - Subtitle A: Expanding Access in Underserved Areas - Amends SSA title XI to provide for community health authorities demonstration projects for providing access to cost-effective preventive and primary care and related services for various areas and populations, including low-income residents of medically underserved areas or for medically underserved populations. Amends the Public Health Service Act to authorize the Secretary to make grants to migrant and community health centers for the development of health service networks for serving high impact areas, medically underserved areas, or medically underserved populations within the area they serve. Subtitle B: Improved Access in Rural Areas - Part 1: Grants to Encourage Community Rural Health Networks - Directs the Secretary of Health and Human Services to make grants to an eligible State for the development of plans to increase access to health care services for residents of areas in the State designated as chronically underserved areas. Provides for technical assistance for entities establishing or enhancing a community rural health network in an underserved rural area. Provides financial assistance to entities to provide for the development and implementation of community rural health networks. Authorizes appropriations. Part 2: Incentives for Health Professionals to Practice in Rural Areas - Subpart A: National Health Service Corps Program - Amends the Internal Revenue Code to exclude National Health Service Corps Loan Repayments from gross income. (Sec. 4113) Increases the authorization of appropriations for the National Health Service Corps Scholarship and Loan Repayment Programs. Subpart B: Incentives Under Other Programs - Amends title XVIII (Medicare) of the Social Security Act to provide incentives under such Act to physicians in former shortage areas. Directs the Secretary to develop and publish a model law for adoption by States to increase the access of individuals residing in underserved rural areas to health care services by expanding the services which non-physician health care professionals may provide in such areas. Part 3: Assistance for Institutional Providers - Subpart A: Community and Migrant Health Centers - Extends and increases the authorizations of appropriations for migrant health centers and community health centers. Subpart B: Emergency Medical Systems - Revises title XII (Trauma Care) of the Public Health Service Act. Renames such title Emergency Medical and Trauma Care Services. Directs the Secretary to establish the Office of Emergency Medical and Trauma Care Services. Requires the Secretary to: (1) conduct and support research and demonstration projects; (2) foster development of appropriate modern systems of services; (3) assist States; and (4) coordinate and sponsor related activities. Requires that activities meet the unique needs of underserved inner-city and rural areas. (Sec. 4141) Authorizes grants to States to improve the availability and quality of emergency medical services through the operation of State offices of emergency medical services. Authorizes appropriations for emergency medical services. (Sec. 4142) Directs the Secretary to make grants to assist States in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments for injuries resulting from such emergencies. Authorizes appropriations. Subpart C: Assistance to Rural Providers Under Medicare - Amends title XVIII (Medicare) of the Social Security Act to: (1) increase by two the number of States eligible to participate in the essential access community hospital program; and (2) make other revisions concerning such program, including permitting the participation of hospitals in urban areas and the participation of hospitals in States adjoining participating States. Extends, by three years, the deadline for the development of prospective payment systems for both inpatient and outpatient rural primary care hospital services. (Sec. 4152) Defines a rural emergency access care hospital and rural emergency access care hospital services for purposes of title XVIII. Provides for the coverage of such services under part B (Supplementary Medical Insurance) of title XVIII. Subpart D: Demonstration Projects to Encourage Primary Care and Rural-Based Graduate Medical Education - Directs the Secretary to establish and conduct a demonstration project to increase the number and percentage of medical students entering primary care practice. Authorizes appropriations. Part 4: Hospital Affiliated Primary Care Center - Requires the Secretary to make grants and provide technical assistance to community hospitals for the development and operation of primary care services in medically underserved areas. Provides for a plan to allow primary care centers to retain income earned from operation under certain conditions. Authorizes appropriations. Subtitle C: Academic Health Centers - Directs the Secretary to study and report to the Congress on: (1) the feasibility and desirability of making payments to facilities that are not hospitals for the costs of graduate medical education attributable to residents trained at such facilities; and (2) determining the funding needs of health professions schools. Subtitle D: United States-Mexico Border Health Commission - Authorizes the President to conclude an agreement with Mexico to establish a binational commission to be known as the United States-Mexico Border Health Commission. (Sec. 4302) Declares that it should be the duty of the Commission to: (1) conduct a needs assessment in the U.S.-Mexican border area to identify and resolve health problems that affect the general population of the area; and (2) formulate recommendations for a fair method by which the government of one country could reimburse a public or private entity in the other country for the cost of a health care service furnished to a citizen of the first country who is unable to pay for the service. States that the Commission should establish at least two regional border offices in selected locations. Title V: Health Care Quality Enhancement - Subtitle A: Quality Assurance - Directs the Secretary to establish a Health Quality Advisory Council to develop an initial set of quality measures to be used to assess the quality of carriers, group health plans, and multiple employer welfare arrangements. Provides for auditing of such entities to determine compliance with certain quality measure and reporting requirements. Subtitle B: Primary Care Provider Education - Amends the Public Health Service Act to extend through FY 1999 authorized funding for training for certain health service providers. Title VI: Market Incentives to Containing Costs - Subtitle A: Facilitating Establishment of Health Plan Purchasing Organization (HPPOs) - Part 1: Health Plan Purchasing Organizations - Authorizes the establishment of health plan purchasing organizations (HPPOs) in accordance with this part. (Sec. 6002) Requires HPPOs to enter into agreements with carriers that desire to make health coverage available through HPPOs. (Sec. 6004) Requires HPPOs to offer enrollment for coverage for carriers. Authorizes HPPOs to impose administrative fees for enrollment. (Sec. 6006) Requires States to: (1) review the access of residents who are not employees of large employers or Medicare beneficiaries to obtain standard health insurance coverage through an HPPO; and (2) take actions to ensure that public or private entities provide access to residents who are unable to obtain such coverage. Part 2: Encouragement of Multiple Employer Arrangements Providing Basic Health Benefits - Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax exempt trust status for certified multiple employer health plans, fully-insured multiple employer welfare arrangements, and other specified plans described by ERISA. Part 3: Tax Exemption for High Risk Pools - Provides tax-exempt status to corporations or similar legal entities created by States or political subdivisions to establish risk pools to provide health insurance coverage to persons unable to obtain such insurance because of health conditions. Subtitle B: Preemption of State Benefit Mandates and Anti-Managed Care Laws - Preempts State laws that: (1) mandate health insurance benefits; (2) restrict managed care arrangements and utilization review programs; and (3) prohibit two or more employers from obtaining coverage that is fully-insured under multiple employer health plans. (Sec. 6105) Prohibits States from enforcing standards for health insurance coverage that differ from those established under title I of this Act. (Sec. 6106) Directs the Comptroller General to study and report to the Congress on the benefits and cost effectiveness of the use of managed care in the delivery of health care services. Subtitle C: Malpractice Reform - Part 1: Uniform Standards for Malpractice Claims - Makes this part applicable to any medical malpractice liability action brought in a Federal or State court and to any medical malpractice claim subject to an alternative dispute resolution (ADR) system that is initiated on or after January 1, 1996. (Sec. 6202) Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified ADR system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States. Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 6203) Authorizes States to develop specialty clinical practice guidelines to be certified by the Secretary. (Sec. 6204) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action. (Sec. 6206) Sets forth provisions regarding: (1) limits on attorney fees and other costs; and (2) statutes of limitations. (Sec. 6208) Specifies that in the case of a medical malpractice claim relating to services provided during labor or the delivery of a baby, if the health care professional or provider did not previously treat the claimant for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. (Sec. 6210) Provides that this part preempts State law, except for State law that imposes greater restrictions than those provided in this part. Part 2: Requirements for State Alternative Dispute Resolution Systems (ADR) - Lists requirements for State ADR systems, including that such a system: (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 6222) Directs the Secretary to certify State ADR systems that meet such requirements on an annual basis. Requires the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 6223) Directs the Secretary to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system. Part 3: Definitions - Sets forth definitions for this subtitle. Subtitle D: Administrative Simplification - Part 1: Standards for Data Elements and Transactions - Directs the Secretary to adopt standards for: (1) the electronic transmission of health information data; and (2) information transactions. Part 2: Requirements with Respect to Certain Transactions and Information - Lists transactions to be considered as standard transactions with respect to plan sponsors and HPPOs. (Sec. 6322) Requires certified health information security organizations to make available to Federal or State agencies, pursuant to a cost-type contract, any non-identifiable health information that is held by the service, consists of data elements that are subject to a standard under part 1, and is requested by such an agency to fulfill a requirement under this Act. (Sec. 6323) Directs the Secretary to establish a procedure under which a plan sponsor or health provider that does not have the ability to transmit standard data elements and does not have access to a certified health information network may comply with this part. Part 3: Miscellaneous Provisions - Requires the Secretary to establish standards and a certification procedure for health information network services. (Sec. 6333) Provides that this subtitle supersedes State law. Prohibits the enforcement of any State law that requires medical or health plan records to be maintained or transmitted in written rather than electronic form, except as provided by the Secretary. (Sec. 6334) Authorizes the Secretary to make grants for demonstration projects to promote the development and use of electronically integrated community-based clinical information systems and computerized patient medical records. Part 4: Assistance to the Secretary - Establishes the Health Care Information Advisory Committee to: (1) provide assistance to the Secretary in complying with the requirements imposed on the Secretary under this subtitle and subtitle E; (2) be responsible for advising the Secretary and the Congress on the status of the health information network; and (3) make recommendations to correct any problems that may occur in the network's implementation and operations and to refine and improve the network. Subtitle E: Fair Health Information Practices - Part 1: Duties of Health Information Trustees - Sets forth rights of individuals with respect to inspection of protected health information maintained by a health information trustee (specified entities, including health care providers, health benefit plan sponsors, and public health authorities). Makes exceptions to inspection rights if: (1) the information relates to mental health treatment notes or persons other than the protected individual; (2) the inspection could be expected to threaten an individual's life or personal safety; (3) the information could lead to the identification of a confidential source; (4) the information is used solely for administrative purposes or is duplicative; or (5) the information is compiled principally in anticipation of a legal proceeding. (Sec. 6402) Sets forth conditions under which a trustee must correct or amend information at the request of a protected individual. (Sec. 6404) Provides for: (1) recordkeeping with respect to health information disclosures; and (2) safeguards to ensure confidentiality and protection of information. Part 2: Use and Disclosure of Protected Health Information - Permits a health information trustee to use protected health information only for a purpose that is compatible with and related to the purpose for which the information was collected or received or for which the trustee is authorized to disclose under this subtitle. (Sec. 6411) Limits the use or disclosure of protected health information by a health information trustee to the minimum amount of information necessary. (Sec. 6412) Authorizes a health information trustee to disclose protected health information pursuant to an authorization executed by the individual who is the subject of the information if specified requirements are met. (Sec. 6413) Authorizes the disclosure of protected health information, subject to specified restrictions: (1) in connection with treatment and payment; or (2) for use in an action against or investigation of an individual relating to receipt of or payment for health care. (Sec. 6414) Sets forth provisions regarding the disclosure of protected health information to next of kin and others. (Sec. 6415) Establishes requirements with respect to the reporting of protected health information: (1) to a public health authority; (2) for a health research project; (3) in emergency circumstances; (4) for judicial and administrative purposes; (5) to a law enforcement agency; (6) pursuant to subpoena or warrant; and (7) to a health information service organization. Part 3: Access Procedures and Challenge Rights - Sets forth access procedures and challenge rights with respect to attempts to obtain protected health information. Part 4: Miscellaneous Provisions - Provides that if a protected individual pays a health information trustee for health care by presenting a debit, credit, or other payment card or by other electronic means, the trustee may only disclose protected health information as is necessary for the processing of the payment transaction. (Sec. 6442) Sets forth conditions under which protected health information may be released to persons outside the United States. (Sec. 6443) Directs the Secretary to establish standards with respect to the creation, transmission, receipt, and maintenance, in electronic and magnetic form, of documents required or authorized under this subtitle. (Sec. 6444) Sets forth duties of affiliated persons to whom health information trustees are authorized to provide protected health information. (Sec. 6445) Sets forth the rights of persons acting as agents or attorneys of protected individuals or on behalf of minors. Part 5: Enforcement - Authorizes persons whose rights under this subtitle have been knowingly or negligently violated to maintain civil actions. Sets forth penalty provisions. (Sec. 6453) Directs the Secretary to develop alternative dispute resolution methods for use by individuals, health information trustees, and others in resolving claims made in civil actions. (Sec. 6454) Amends the Federal criminal code to provide penalties for offenses related to protected health information. Part 6: Amendments to Title 5, United States Code - Requires Federal agencies that are health information trustees to promulgate rules to exempt systems of records within such agencies, to the extent that such systems contain protected health information, from certain provisions regarding access and other requirements with respect to an individual's records. Part 7: Regulations, Research, and Education; Effective Dates; Applicability; and Relationship to Other Laws - Directs the Secretary to prescribe regulations to carry out this subtitle. (Sec. 6471) Authorizes the Secretary to sponsor: (1) research relating to the privacy and security of protected health information; (2) the development of consent forms governing the disclosure of such information; and (3) the development of technology to implement standards regarding such information. Directs the Secretary to establish education and awareness programs to: (1) foster security practices by health information trustees; (2) train personnel of health information trustees respecting their duties with respect to such information; and (3) inform individuals and employers who purchase health care respecting their rights with respect to such information. (Sec. 6474) Prohibits States from enforcing any law that is inconsistent with certain requirements of this subtitle or imposes additional requirements with respect to health information trustees. Subtitle F: Antitrust - Directs the Attorney General to: (1) provide for the development of guidelines on the application of antitrust laws to the activities of health plans; and (2) establish a review process under which a health plan may request the Department of Justice's opinion on the plan's conformity with the Federal antitrust laws. (Sec. 6502) Requires the Attorney General to issue a certificate of public advantage to each eligible health care collaborative activity that complies with this section's requirements. Provides that such activity shall not be liable under the antitrust laws for conduct described in the certificate if such conduct occurs while the certificate is in effect. Directs the Attorney General to issue such a certificate if: (1) the benefits that are likely to result from the activity outweigh the reduction in competition that is likely to result; and (2) such reduction is necessary to obtain such benefits. Sets forth activity eligibility requirements. (Sec. 6503) Directs the Attorney General to report annually to the Congress as part of the annual budget oversight proceedings concerning the Antitrust Division of the Department of Justice. Requires the report to enable the Congress to determine how enforcement of antitrust laws is affecting the formation of efficient, cost-saving joint ventures and if the certificate of public advantage procedure has resulted in undesirable reduction in competition in the health care marketplace. Subtitle G: Fraud and Abuse - Directs the Attorney General to establish a program to: (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to the delivery of and payment for health care in the United States; (2) conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for health care in the United States; and (3) facilitate the enforcement of certain SSA title XI mandatory exclusion and other provisions applicable to health care fraud and abuse. Requires the Attorney General in carrying out such program to provide for coordination with law enforcement agencies, State Medicaid Fraud Control Units, State licensing agencies, as well as with third party insurers. (Sec. 6602) Authorizes additional appropriations for the Attorney General to investigate allegations of health care fraud and otherwise carry out the program established above. (Sec. 6603) Creates in the Treasury the Anti-Fraud and Abuse Trust Fund consisting of Federal health anti-fraud and abuse penalties for use in: (1) carrying out the program above; (2) supporting educational activities to prevent the occurrence of violations of anti-fraud and abuse laws; and (3) repaying beneficiaries for cost- sharing. (Sec. 6611) Amends SSA title XI to revise current sanctions for health care fraud and abuse, among other changes, providing for: (1) mandatory exclusion from participation in Medicare and State health care programs of any individuals convicted of a felony relating to fraud or the unlawful manufacture, distribution, prescription, or dispensing of a controlled substance; and (2) establishment of a minimum period of exclusion for certain individuals and entities subject to permissive exclusion from Medicare and State health care programs. (Sec. 6615) Amends SSA title XVIII to modify the limitations on physician self-referral. (Sec. 6616) Directs the Comptroller General to study and report to the Congress on the costs incurred by eligible organizations with risk-sharing contracts of complying with the requirement of entering into a written agreement with an entity providing peer review services with respect to services provided by the organization. (Sec. 6621) Amends the Federal criminal code to provide for: (1) penalties for health care fraud, including making it a felony; (2) rewards for information leading to prosecution relating to health care fraud; and (3) broadened application of mail fraud statute provisions. (Sec. 6631) Amends SSA titles XI and XVIII to authorize the issuance of advisory opinions by the Secretary according to specified guidelines. (Sec. 6641) Requires each State to establish and maintain a State agency to act as a Health Care Fraud and Abuse Control Unit for: (1) investigating and prosecuting violations under any Federally-funded or mandated health care program relating to fraud under State laws; (2) reviewing complaints of abuse or neglect involving patients of facilities receiving Federal payments and, where appropriate, investigate and prosecute such complaints; and (3) providing for the collection, or referral for collection, of overpayments made under any such program and found by the Unit. Subtitle H: Billing for Laboratory Services - Amends the Public Health Service Act to make it unlawful for any person who furnishes ancillary health services to present a bill or demand for payment to any person other than the patient receiving such services, with specified exceptions. Exempts ancillary health services for which payment may be made under Medicare. (Sec. 6701) Defines "ancillary health services" as clinical laboratory services, diagnostic x-rays and other diagnostic tests, durable medical equipment, and physical therapy services. Sets forth conditions under which a person who furnishes ancillary health services may present a bill or demand for payment to specified entities other than the patient. Imposes civil penalties for repeated and knowing demands for payment in violation of this subtitle. Provides for other sanctions for such violations, including the suspension of laboratory certifications and exclusion from participation in Medicare programs. Title VII: Medicare - Subtitle A: Increased Beneficiary Choice; Improved Program Efficiency - Amends SSA title XVIII to revise provisions for payments to health maintenance organizations (HMOs) to: (1) provide for the use of metropolitan statistical areas to determine adjusted average per capita cost; (2) require the Secretary to develop additional specified model packages of health benefits providing coverage for catastrophic illness, prescription drugs, and preventive services which an HMO may provide at its option; and (3) make various specified changes in HMO membership requirements, including changes in associated waiver provisions, and enrollment periods. (Sec. 7002) Amends the Omnibus Budget Reconciliation Act of 1990 to permit Medicare supplemental policies in all States. Modifies Medicare supplemental policy provisions. (Sec. 7003) Includes notice of available HMOs and carriers offering Medicare supplemental policies in the annual notice of Medicare benefits mailed to Medicare beneficiaries. (Sec. 7004) Directs the Secretary to: (1) develop and submit to the Congress a proposal for legislation which provides for the voluntary enrollment of Medicare beneficiaries in private health insurance plans; (2) provide for a monthly payment to a qualified private health insurance plan on behalf of enrolled Medicare beneficiaries who choose to enroll in such a plan (with the enrollee paying any difference between the monthly premium charged under the plan and the amount paid for under Medicare for the enrollee's class, while maintaining budget-neutrality); and (3) take such steps as may be necessary to consolidate the administration of Medicare parts A (Hospital Insurance) and B (Supplementary Medical Insurance). (Sec. 7003) Includes notice of an individual's rights under State law with regard to the formulation of advance directives in the annual notice of Medicare benefits mailed to Medicare beneficiaries. Subtitle B: Savings - Amends Medicare provisions relating to Medicare part A to provide for reductions in: (1) the update for payments for inpatient hospital services; and (2) payments for capital-related costs for inpatient hospital services. (Sec. 7111) Amends Medicare part B provisions on payment for physicians' services to provide for: (1) use of cumulative performance standards; (2) treatment of default update; (3) use of real GDP to adjust for volume and intensity; (4) repeal of restriction on maximum reduction under conversion factor update adjustment provisions; and (5) reduction in the conversion factor for the physician fee schedule for 1995. (Sec. 7112) Provides for the imposition of coinsurance on laboratory services. (Sec. 7113) Amends the Internal Revenue Code to provide for an increase in the Medicare part B premiums for high-income individuals. (Sec. 7114) Amends Medicare to provide for: (1) the extension of the 25 percent part B premium; (2) a reduction in hospital outpatient services and home health services through the establishment of a prospective payment system; and (3) various specified changes with regard to Medicare as secondary payer. Title VIII: Incentives to Purchase Long-Term Care Insurance - Subtitle A: Establishment of Federal Standards for Long-Term Care Insurance - Amends SSA to provide for model standards incorporating specified requirements for sales practices, benefits, and other matters that long-term care insurance policies must meet. Establishes civil monetary penalties for violations. Requires the National Association of Insurance Commissioners to issue guidelines for endorsements of long-term care insurance policies, or that permit such policies to be offered for sale through the organization or association. Subtitle B: Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of long-term care insurance contracts as accident or health insurance contracts generally, with qualified long-term services treated as medical care, among other changes with regard to long-term care insurance. Subtitle C: Studies - Requires the Comptroller General to conduct a study on the feasibility of: (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their homes with a tax credit. (Sec. 8203) Directs the Secretary to conduct a study and report to the Congress on: (1) case management of current long-term care benefits; and (2) subacute care. Title IX: Department of Veterans Affairs - Authorizes each veteran residing in the United States, certain surviving spouses and children of such veterans (also living in the United States) who are not otherwise eligible for medical care under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), and family members thereof to be enrolled with a Department of Veterans Affairs (VA) health care plan. Requires the payment of appropriate premiums, deductibles, copayments, or coinsurance with respect to such family members. Continues the eligibility of family members after the death of the veteran originally enrolled. Directs the Secretary of Veterans Affairs (Secretary, for purposes of this title) to establish enrollment ceilings to limit the number of eligible individuals enrolling for such coverage. Requires conformity of such plans with health plan requirements set forth in this Act and inclusion of all the items and services in the standard coverage under this Act. Directs the Secretary to continue to provide to veterans authorized VA care and services which are not included in the standard coverage provided under this Act. Provides for the continuation in the VA of specialized disabled veteran treatment and rehabilitative needs and facilities and requires a report on such continuation from the Secretary to specified congressional committees. Allows such plans to offer supplemental health benefits and cost-sharing policies consistent with this Act. Provides a limitation with regard to veterans who elect not to enroll to obtain such coverage. Prohibits the imposition of a cost-share charge of any kind upon a veteran for the treatment of a service-connected disability that requires specialized treatment by the VA. Prohibits funds appropriated to carry out this title from being used to provide abortions except when necessary to save the life of the mother or when the pregnancy is the result of rape or incest. Prohibits the imposition of cost-sharing charges of any kind upon veterans who are disabled to a degree of ten percent or more, veterans released from service due to a service-connected disability, veterans receiving disability compensation from the VA, former prisoners of war, veterans of the Mexican border period or World War I, and veterans unable to defray the costs of such care. Directs the Secretary to establish rates for premiums and other applicable charges with respect to all other enrollees. Empowers the Secretary to recover from third parties the cost of providing such care and services if such care and services would have been required to be provided by such third party. Establishes in the Treasury the Department of Veterans Affairs Health Coverage Fund to be used for VA health plan payments and services. Preserves existing health care benefits for facilities not offering qualified health coverage under this Act. Authorizes the Secretary to organize VA health plans and facilities as plans and facilities offering qualified health coverage under this Act. Requires any health insurance program provided for Federal employees to include as an option enrollment to obtain VA coverage. Requires the Secretary to take appropriate steps to ensure the financial solvency and stability of the VA coverage and of the contractors and subcontractors providing services as part of such coverage. Preempts certain State action with respect to standards and requirements of such coverage. Requires VA health care facilities to serve as providers to individuals residing in a State that operates as a single payer system, with appropriate reimbursement. Authorizes the head official offering VA health coverage or the director of a VA health care facility to enter into agreements with health care plans, insurers, health care providers, and other entities to furnish or obtain any health-care resource. Provides certain other administrative and personnel flexibility to the Secretary in providing or obtaining such services. Directs the Secretary of the Treasury to: (1) credit to a special fund specified amounts for FY 1995 and 1996 to be used for providing VA health coverage under this Act; and (2) report to the Congress on the operation of the VA health care system with respect to national health care reform as set forth under this Act. Authorizes the Secretary to apply for and accept grants and other forms of assistance to meet the needs of special populations. (Sec. 9003) Makes veterans enrolled with a VA plan under this title eligible for nursing home care, outpatient care, and care provided to obviate the need for hospital admission. (Sec. 9004) Makes any herbicide-exposed veteran eligible for hospital and nursing home care for any disease for which the National Academy of Sciences has determined: (1) that there is a positive association between disease occurrence and herbicide exposure; (2) that there is evidence suggesting such an association, though the evidence is limited; or (3) that available studies are insufficient to permit a conclusion about the presence or absence of such an association. Limits the authorized length of such care for eligible veterans. (Sec. 9005) Extends the authority to provide priority outpatient health care to veterans for exposure to environmental hazards until October 1, 1998, for any disability which becomes manifest before October 1, 1996. (Sec. 9006) Directs the Secretary to report to the Congress on the desirability and feasibility of waiving any requirement for cost-sharing under a VA health plan in the case of medical care provided to a family member of a Persian Gulf War veteran for any disease or disability which may be related to such service. (Sec. 9007) Directs the Secretary, during FY 1995 through 1997, to carry out and report to specified congressional committees on a study of the effect of telemedicine on the delivery of VA health care services. (Sec. 9008) Directs the Secretary of Health and Human Services to develop and submit to the Congress a proposal for legislation which provides for obtaining VA health coverage for Medicare beneficiaries who are veterans. (Sec. 9009) Directs the Secretary to carry out a pilot program to reduce waiting times for patients seeking health-care services in VA outpatient clinics and the traveling distance to such clinics by providing for operation of approximately 20 new outpatient clinics around two VA medical centers. Authorizes appropriations for FY 1998 through 2004. Title X: Miscellaneous Savings Provisions - Subtitle A: Automobile Insurance Coordination - Requires individuals enrolled in a health plan to receive automobile insurance medical services exclusively through the health plan. Makes such services subject to all quality, cost containment, and anti-fraud and abuse provisions that apply generally to medical services provided by or through health plans. (Sec. 10002) Permits an individual and an automobile insurance carrier to agree that treatment for bodily injury sustained in an automobile accident shall be provided by other than the health plan through which such individual is enrolled. Authorizes States to require such carriers to make direct payment to health care providers for automobile insurance medical services that are covered by Medicare or Medicaid and an automobile insurance contract that provides for direct payment of medical services regardless of fault. (Sec. 10003) Requires carriers liable for payment for automobile insurance medical services to make payment to health plans to the extent of obligations under the contract. Grants federally funded health care plans first priority to receive payment pursuant to any obligation under an automobile insurance policy covering such medical services. (Sec. 10004) Directs States to establish systems for prompt payment for automobile insurance medical services by such carriers to health plans, including mechanisms for resolution of disputes. Requires sanctions to be prescribed for failures to comply with this subtitle's requirements. (Sec. 10005) Requires the Secretary of Health and Human Services to provide for allotments to States for administrative expenses in carrying out this subtitle. Subtitle B: Prefunding Government Health Benefits Contributions - Directs each Federal agency within the executive branch whose receipts and disbursements are not generally included in the totals of the Government budget submitted by the President, effective FY 1994 (or February 1, 1995, in the case of the agency with the greatest number of employees), to prepay the Government contributions which will be required in connection with providing health-benefits coverage for annuitants of such agency.

To provide for the acceptance by the Secretary of Education of applications submitted by the local educational agency serving the Window Rock Unified School District, Window Rock, Arizona, under section 3 of the Act of September 30, 1950 (Public Law 874, 81st Congress ) for fiscal years 1994 and 1995.

United States · United States Congress · 6 October 1994

Directs the Secretary of Education to accept from the local educational agency serving the Window Rock Unified School District, Window Rock, Arizona, applications for funding for FY 1994 and 1995 under specified provisions of Federal law for impact aid, as if such applications were timely received in accordance with certain regulations.

To provide for the management of portions of the Presidio under the jurisdiction of the Secretary of the Interior.

United States · United States Congress · 6 October 1994

Authorizes the Secretary of the Interior to utilize the resources of the Presidio in California to provide for and support programs and activities that foster research, education, or demonstration projects and that relate to the environment, energy, transportation, international affairs, arts and cultural understanding, health, and science. Grants the Secretary authority to: (1) negotiate and enter into specified interagency agreements and leases for the use of property within the Presidio; and (2) retain the proceeds from leases under this Act and from concession and other use authorizations and services provided by the Golden Gate National Recreation Area for five years or until the leased property is transferred to the Presidio Trust (established by this Act). Establishes within the Department of the Interior the Presidio Trust to manage the leasing, maintenance, rehabilitation, repair, and improvement of property within the Presidio which is transferred to the Trust by the Secretary. Directs the Secretary to transfer to the Trust, subject to specified requirements, a leasehold in the Letterman-LAIR complex, Fort Scott, Main Post, Cavalry Stables, Presidio Hill, Wherry Housing, East Housing, the structures at Crissy Field, and such other properties within the Presidio as the Secretary and the Trust deem appropriate. Requires the Trust to obtain such competition as is practicable in the circumstances, maintain liaison with the Golden Gate National Recreation Area Advisory Commission, and meet with the Commission at least annually. Authorizes appropriations. Prohibits an entity from expending funds appropriated pursuant to this Act unless it complies with the Buy American Act. Expresses the sense of the Congress that only American-made equipment and products should be purchased by entities receiving financial assistance under this Act. Requires the head of each Federal agency to notify each such recipient of this congressional statement. Provides that if a court or Federal agency determines that any person intentionally affixed a "Made in America" label to any product sold or shipped to the United States that is not made in the United States, such person shall be ineligible to receive any contract or subcontract made with funds provided under this Act.

Proposing an amendment to the Constitution of the United States relating to voluntary school prayer.

United States · United States Congress · 6 October 1994

Constitutional Amendment - Declares that nothing in the Constitution shall be construed to prohibit individual or group prayer in public schools or other public institutions. States that no person shall be required by the United States or any State to participate in prayer. Provides that neither the United States nor any State shall compose prayers to be said in public schools.

Amending the Rules of the House of Representatives to apply certain laws to the House of Representatives, and for other purposes.

United States · United States Congress · 6 October 1994

Amends the Rules of the House of Representatives to add rule LII to establish an Office of Compliance to apply the following laws to the House of Representatives: (1) the Fair Labor Standards Act of 1938; (2) Title VII of the Civil Rights Act of 1964; (3) the Americans with Disabilities Act of 1990; (4) the Age Discrimination in Employment Act of 1967; (5) Titles I and V of the Family and Medical Leave Act of 1993; (6) the Occupational Safety and Health Act of 1970; (7) specified provisions of Federal law relating to Federal labor-management relations; (8) the Employee Polygraph Protection Act of 1988 (except with respect to the Capitol Police); (9) the Worker Adjustment and Retraining Notification Act; and (10) the Rehabilitation Act of 1973. Applies any provision of Federal law that relates to the terms and conditions of employment of employees to the House. Prohibits lobbyists, Members of Congress, and congressional employees from being on the Office Board of Directors. Requires the Board of Directors to study and report to the House on how the laws under rule LII should apply. Directs the Office to: (1) carry out a program of education for House Members and other House employing authorities respecting such laws and a program to inform individuals of their rights; (2) compile specified statistics, including those on the use of the Office by House employees, reasons for contact, and complaints filed; and (3) develop a system for the collection of demographic data respecting the composition of House employees and for collection of information on employment practices. Sets forth procedures for consideration of alleged violations of such laws consisting of the following steps: (1) counseling; (2) mediation; and (3) formal complaint and hearing by a hearing board. Declares that any intimidation of, or reprisal against, any House employee because of the exercise of a right under this Act constitutes an unlawful employment practice that may be remedied in the same manner under this Act as a violation of a law made applicable under rule LII. Directs the Office to study and report to the House on the application to the House of the Freedom of Information Act and the Privacy Act of 1974. Amends rule XLV of the Rules of the House to permit travel awards that accrue by reason of official travel of a House Member, officer, or employee to be used only with respect to official travel.

Federal Prohibition of Female Genital Mutilation Act of 1994

United States · United States Congress · 5 October 1994

Federal Prohibition of Female Genital Mutilation Act of 1994 - Amends the Federal criminal code to prohibit and set penalties for knowingly circumcising, excising, or infibulating any part of the labia majora, labia minora, or clitoris of a female (female circumcision) under age 18, except where: (1) necessary to the health of the person when performed by a licensed medical practitioner; or (2) performed on a person in labor or who has just given birth for connected medical purposes by a licensed medical practitioner, midwife, or person in training. Sets penalties for knowingly denying medical care or services or otherwise discriminating in the provision of medical care or services to, any person because that person has: (1) undergone female circumcision; or (2) requested that female circumcision be performed on any person. Directs the Secretary of Health and Human Services to ensure that the Deputy Assistant Secretary for Women's Health and the Deputy Assistant Secretary for Minority Health collaborate in: (1) compiling data on the number of females living in the United States, including, specifically, the number of girls under age 18, who have been subjected to female genital mutilation (mutilation); (2) identifying communities in the United States that practice mutilation; (3) designing and carrying out outreach activities to educate individuals in the communities on the physical and psychological health effects of such practice; and (4) developing recommendations for dissemination to students of medical and osteopathic schools regarding mutilation and its complications.

Sheep Promotion, Research, and Information Act of 1994

United States · United States Congress · 5 October 1994

Sheep Promotion, Research, and Information Act of 1994 - Directs the Secretary of Agriculture to issue a sheep and wool promotion, research, education, and information order. Includes in such order: (1) establishment of a National Sheep Promotion, Research, and Information Board; and (2) assessment of fees. Provides for approval referenda among producers, feeders, and importers. Authorizes appropriations.

A bill to award a Congressional gold medal to Rabbi Menachem Mendal Schneerson.

United States · United States Congress · 4 October 1994

Authorizes the President to present, on behalf of the Congress, to the Lubavitcher rebbe, Rabbi Menachem Mendel Schneerson, a gold medal in recognition of his outstanding and enduring contributions toward world education, morality, and acts of charity. States that no appropriations are authorized to implement this Act. Declares that the medals struck pursuant to this Act are national medals.

Sheep Promotion, Research, and Information Act of 1994

United States · United States Congress · 4 October 1994

Sheep Promotion, Research, and Information Act of 1994 - Directs the Secretary of Agriculture to issue a sheep and wool promotion, research, education, and information order. Includes in such order: (1) establishment of a National Sheep Promotion, Research, and Information Board; and (2) assessment of fees. Provides for approval referenda among producers, feeders, and importers. Authorizes appropriations.

Reemployment Act of 1994

United States · United States Congress · 4 October 1994

TABLE OF CONTENTS: Title I: Comprehensive Program for Worker Reemployment Subtitle A: State and Substate Delivery System Subtitle B: Federal Service Delivery System Subtitle C: Performance Standards and Quality Assurance Systems Subtitle D: Program Requirements Subtitle E: Fiscal Administrative Provisions Subtitle F: Consolidation Provisions Title II: One-Stop Career System for Employment and Training Subtitle A: Basic System Components Subtitle B: Grants to States Subtitle C: Federal Grants to One-Stop Service Areas Subtitle D: Administrative Requirements Subtitle E: Waiver of Statutory and Regulatory Requirements Subtitle F: National Programs Title III: National Labor Market Information Program for Title IV: Technical Provisions Reemployment Act of 1994 - Establishes: (1) a comprehensive program for worker reemployment; (2) a one-stop career system for employment and training; and (3) a national labor market information program for States and localities. (Sec. 3) Authorizes appropriations for titles I, II and III, of this Act. Title I: Comprehensive Program for Worker Reemployment - Allots funds among States for the program under this title. Allows reservation of funds for State activities and reserves certain funds for national activities. Provides for allocation to substate areas, and recapture and reallotment of unexpended funds, (Sec. 103) Makes certain permanently laid-off workers and long-term unemployed individuals (as well as workers facing imminent plant shutdowns and self-employed individuals unemployed because of community economic conditions or natural disasters) eligible for services under this title. Makes dislocated homemakers and involuntarily retired workers eligible if the substate grantee deems this appropriate and certain conditions are met. Subtitle A: State and Substate Delivery System - Makes States responsible for administrative and management systems under this title. (Sec. 112) Requires the Governor to designate or establish a dislocated worker unit at the State level, with specified rapid response, information, program support and coordination functions. Directs such unit to coordinate with substate grantees and to promote worker-management transition assistance committees. Provides for rapid response coverage of certain layoffs, prohibition of State transfer of State transfer of rapid response response functions, and Federal oversight of such functions. (Sec. 113) Requires the Governor to identify, or establish and maintain a comprehensive labor market information system in the State that meets certain requirements relating to the national system of effective labor market information. (Sec. 114) Requires the Governor to coordinate programs under this title with the worker profiling system under the Social Security Act and the retraining income support program under another Act introduced in the 103d Congress. (Sec. 115) Authorizes the Governor to award supplementary grants to eligible entities to improve delivery and provide authorized services to eligible individuals in areas of the State experiencing substantial increases in numbers of such individuals due to plant closures, base closures, and mass layoffs, as well as to other underserved unemployed individuals with barriers to employment. Allows such grant funds to be used to establish on-site transition centers. (Sec. 116) Requires establishment of substate area administrative procedure. (Sec. 117) Authorizes the use of substate area funds for the following services for eligible individuals: (1) basic reemployment services; (2) intensive reemployment services; (3) education and training services; (4) retraining income support; and (5) supportive services. (Sec. 118) Requires a substate grantee to issue a certificate of continuing eligibility for services to eligible individuals who are accepting employment at a significantly lower wage than their previous one or in an occupation significantly different from their previous one. Subtitle B: Federal Service Delivery System - Directs the the Secretary of Labor to designate or establish an identifiable worker reemployment unit to coordinate the Secretary's functions under this title. (Sec. 122) Authorizes the Secretary to make national discretionary grants to eligible entities for programs to: (1) address large-scale economic dislocations resulting from plant closures, base closures, or mass layoffs; (2) self-employment opportunity, public works employment, dislocated farmers, and job creation; (3) establish on-site transition centers; (4) address small-scale layoffs likely to harm State or local economies; and (5) additional financial assistance for programs and activities operated by States and substate grantees under this title. (Sec. 123) Directs the Secretary to make funds available for disaster relief employment assistance to States for substate allocation. (Sec. 124) Directs the Secretary to provide for: (1) evaluation of programs under this title; (2) research on addressing economic dislocation, facilitating the transition of permanently laid-off workers to reemployment, and upgrading skills of employed workers; and (3) demonstration projects to develop and improve methods of addressing economic dislocation and promoting worker adjustment. (Sec. 125) Directs the Secretary to provide staff training and technical assistance to various entities to enhance their capacity to develop and deliver adjustment assistance services to workers, and to avert plant closings or substantial layoffs. Requires integration of such activities with those of the Capacity Building and Information and Dissemination Network. (Sec. 126) Directs the Secretary to provide for delivery of programs, activities, and services under this title in any State that chooses not to participate. Subtitle C: Performance Standards and Quality Assurance Systems - Directs the Secretary to prescribe performance standards relating separately to the substate grantees and the career centers. Directs Governors to: (1) prescribe adjustments to such standards; (2) provided technical assistance to grantees that fail to meet such standards; (3) terminate grantees that so fail for to two consecutive years; and (4) award incentive grants to grantees and centers exceeding such standards. (Sec. 132) Requires each substate grantee to establish methods for obtaining customer feedback from eligible individuals and employers who have received services under this title. (Sec. 133) Makes providers of education and training services eligible to receive funds under this title if they are eligible to participate under student aid provisions of the Higher Education Act of 1965 or are determined eligible under alternative procedures established by Governors, and if they provide performance-based information. Exempts on-the-job training providers from such requirements. Part D: Program Requirements - Sets forth general requirements for programs under this title, including provisions for benefits, labor standards, and grievance procedures. Subtitle E: Fiscal Administrative Provisions - Sets forth various administrative provisions, including ones for program year, prompt allocation of funds, monitoring, fiscal controls and sanctions, reports, recordkeeping, and investigations, administrative adjudication, nondiscrimination, judicial review, and obligational authority. Part F: Consoidation Provisions - Repeals the following provisions of the Job Training Partnership Act (JTPA); (1) all of title III, Employment and Training Assistance for Dislocated Workers; (2) a requirement for maintenance of data on permanent layoffs and plant closings; and (3) all part of J of title IV, Disaster Relief Employment Assistance. (Sec. 172) Makes conforming amendments to JTPA and other Federal laws. (Sec. 173) Authorizes the Secretary to provide for orderly transition from the repealed programs under JTPA to the program under this title. Title II: One-Stop Career System for Employment and Training - Subtitle A: Basic System Components - Requires one-stop career system, to include: (1) integration of employment and training programs; (2) customer choice of information, services, and providers; (3) univeral access to services by customers, including individuals and employers; and (4) accountability of providers. (Sec. 212) Sets forth requirements for the integration of employment and training programs component. (Sec. 213) Sets forth requirements for the customer choice component. (Sec. 214) Sets forth requirements for the universal access component. (Sec. 215) Sets forth requirements for the accoutability component. Subtitle B: Grants to States - Authorizes the Secretary to provide grants to States for implementation of comprehensive statewide networks of one-stop career systems in all areas of such States. Provides for such grants to Native American tribal entities. Requires notification to the interagency task force before provision of any such grant. (Sec. 223) Sets forth application requirements, including review and comment by certain individuals and State plans. (Sec. 224) Provides for review of applications, including priority considerations and approval criteria. (Sec. 226) Requires State reports. Subtitle C: Federal Grants to One-Stop Service Areas - Authorizes the Secretary to provide grants directly to one-stop service areas to implement one-stop career systems. Provides for establishment of one-stop service areas and local consortia. Requires grant notification to the interagency task force. (Sec. 233) Sets forth application requirements, including a time limit for State review and comment. (Sec. 234) Provides for review of applications, including priority considerations and approval criteria. (Sec. 235) Requires integration of one-stop service area systems with statewide networks. (Sec. 236) Requires area reports. Subtitle D: Administrative Requirements - Requires State Governors to consider specified factors in establishing one-stop service areas and (with local officials) local consortia, and designating administrative entities for such areas. (Sec. 242) Lists participating programs for such one-stop career systems, including those under specified Federal and State laws as well as other Federal employment and training laws determined appropriate by the interagency task force. (Sec. 243) Requires each one-stop service provider to make available to individual participants in the one-stop career system certain services, includidng specified: (1) basic services; (2) additional basic services; and (3) State unemployment compensation initial claims' filing. Authorizes such providers to also provide certain intensive services and specialized employer services. (Sec. 244) Requires the administrative entity, in agreement with the local consortium, to establish a process for selecting one-stop service providers which are public agencies or private nonprofit organizations, including specified types of entities. (Sec. 245) Sets forth requirements for operating agreements. (Sec. 246) Makes each State implementing such a system responsible for administration, management, monitoring, and technical assistance. (Sec. 247) Requires each State to establish a State human resource investment council that meets specified JTPA requirements and carries out certain additional functions including advising on development and implementation of the statewide network of one-stop career systems. (Sec. 248) Provides for pooling of administrative resources. (Sec. 249) Sets forth applicable labor standards for activities under one-stop career systems. Subtitle E: Waiver of Statutory and Regulatory Requirements - Allows a State, local consortium, or Native American tribal entity to request from the Secretary concerned a waiver of one or more statutory or regulatory provisions. Sets forth waiver criteria. (Sec. 252) Subjects to such waiver authority specified participating programs of the systems. Subtitle F: National Programs - Authorizes the Secretary to monitor compliance of all aid recipients under this title. (Sec. 262) Sets forth requirements for performance standards and evaluation. (Sec. 263) Makes the Secretary responsible for reserving certain funds for providing, staff training and technical assistance (integrated with the Capacity Building and Information Dissemination Network under JTPA). (Sec. 264) Directs the Secretary (of Labor) and the Secretaries of Education and of Health and Human Services to establish an interagency task force to identify provisions of law and regulations that impede the ability of States and one-stop service areas to carry out this title and designate these as subject to expedited waiver authority. Requires a task force report to the Congress. Title III: National Labor Market Information Program for States and Localities - Directs the Secretary to develop, in coordination with Governors and appropriate Federal, State, regional, and local officials and entities, a strategy to establish a program to develop a nationwide system of State, regional, and local labor market information. Establishes the Office of Labor Market Information in the Department of Labor to have overall policy, coordination, and funding responsibilitiers for such system. (Sec. 303) Directs the Secretary, in cooperation with such other entities and public-private partnerships, to develop such system to make available specified types of information. Requires certain technical standards, consumer reports, and evaluation. (Sec. 304) Directs the Secretary to provide for coordination and integration of such system and appropriate dissemination of information. Title IV: Technical Provisions - Sets forth the effective date of this Act. (Sec. 402) Sets forth a sunset provision terminating the authority provided by titles II and III on October 1, 2003.

Concerning United States support for the new South Africa.

United States · United States Congress · 3 October 1994

Expresses the sense of the House of Representatives that: (1) President Nelson Mandela of South Africa deserves the congratulations and support of the United States; (2) the United States shall remain engaged in the political and economic development of South Africa; (3) assistance to South Africa should continue to focus on such issues as job creation, housing, enterprise, development, education, democracy, and health; and (4) steps should be taken to increase trade, investment, and development in South Africa.

Business Development Opportunity Act of 1994

United States · United States Congress · 29 September 1994

TABLE OF CONTENTS: Title I: Amendments to the Minority Small Business and Capital Ownership Development Title II: Contracting Program for Certain Small Business Concerns Title III: Expanding Subcontracting Opportunities Title IV: Repeals and Technical Amendments Title V: Definitions Title VI: Regulatory Implementation and Effective Dates Business Development Opportunity Act of 1994 - Title I: Amendments to the Minority Small Business and Capital Ownership Development Program - Part A: Program Organization and Participation Standards - Amends the Small Business Act to replace certain provisions regarding the minority small business and capital ownership development program with those establishing a Minority Enterprise Development Program. (Sec. 101) Requires the Program to consist of a Business Creation Phase, a Business Development Phase, and a Business Development (Preferential Contracting) Phase. Provides that only firms participating in the last phase shall be eligible for awards of Federal contracts and refers to such firms as Program participants. Permits firms to participate in the preferential contracting phase for up to nine years. (Sec. 103) Expands the definition of "socially and economically disadvantaged business concern" to include all Indian tribes and Native Hawaiian organizations for purposes of such Program. (Currently, such definition only includes economically disadvantaged Indian tribes and Native Hawaiian organizations.) (Sec. 104) Prohibits an applicant from being denied admission into the Program based solely on a determination that the participant has not been in operation for a period of time specified by the Small Business Administration (SBA) if the firm meets specified requirements, including demonstrations of business management and technical expertise, adequate capital, and ability to meet contract requirements. (Sec. 106) Directs the SBA Administrator to develop an action plan for improving participation in the Program by firms across the nation. Part B: Business Development Assistance - Removes conditions on the use of working capital provided under loan assistance programs for Program participants. (Sec. 113) Revises conditions regarding exemptions from surety bond requirements for Program participants. Authorizes Federal agencies with contracting authority to grant such an exemption if: (1) the Program participant provides certification that the firm was unable to obtain the requisite bonding from corporate surety bonding firms even with an SBA-issued guarantee; (2) the participant has provided for the protection of persons furnishing materials or labor under the contract pursuant to specified conditions; and (3) the award value of the contract for which the exemption is sought does not exceed $1 million (currently, $3 million). Terminates such authority after FY 1997. (Sec. 115) Authorizes financial assistance for business executive education programs conducted by institutions of graduate business education for owners or managers of small business concerns owned by socially and economically disadvantaged individuals. (Sec. 116) Establishes a Developmental Teaming Program within the Program to encourage the formation of teaming arrangements and long-term strategic business alliances between firms participating in the Program and Program graduates. Part C: Improving Access to Equity for Program Graduates - Provides that Program participants shall remain eligible for participating in the Program after a transfer of an ownership interest in the firm if ownership and control is: (1) retained by the socially and economically disadvantaged individuals upon whom Program eligibility is based; or (2) acquired by a small business owned and controlled by such individuals who have graduated from the Program or exited the Program through a means other than a termination proceeding. Permits Program participants that are tribally owned corporations to remain eligible for participation with other than a Native American as the firm's chief executive officer if the tribe certifies that it was unable to hire a qualified Native American after conducting national recruitment. Part D: Contract Award and Eligibility Matters - Removes existing provisions regarding contracts and subcontracts to disadvantaged small businesses. (Sec. 131) Directs the SBA to ensure that contracts sufficient to satisfy the contract support levels identified by Program participants are designated by Federal agencies for award. Requires the award of contracts to be made on a noncompetitive basis and at fair market prices. (Sec. 132) Revises contract eligibility provisions with respect to Program participants. (Sec. 133) Authorizes the Associate Administrator for Minority Enterprise Development to permit the noncompetitive award of contracts to Program participants to exceed certain amounts subject to certain conditions. (Sec. 135) Provides that the forecasts of overall business activity contained in the business plans of Program participants or estimates contained in contract support levels shall not be used by the SBA to determined that a firm is ineligible for a contract. (Sec. 137) Requires the SBA to promulgate regulations to eliminate regulatory limitations on self-marketing by Program participants. Part E: Tribally Owned Corporations - Authorizes contracts to be awarded to joint ventures owned and controlled by Program participants, notwithstanding the size status of such a joint venture, if the participant: (1) is owned and controlled by an Indian tribe; (2) owns at least 51 percent of the joint venture; (3) is located and performs most of its activities on the Indian reservation; and (4) employs members of such tribe for at least 50 percent of the work force of the joint venture. Prohibits such contracts if the tribe owns and controls one or more participants who are currently joint venturers on more than five of such contracts. Part F: Contract Administration Matters - Directs Federal agencies awarding contracts to disadvantaged small businesses to make reasonable efforts to respond to requests by contracting officers with respect to contract administration matters. Requires such agency, upon the request of a Program participant, to make alternative dispute resolution available. Part G: Program Administration - Requires Program participants to report specified information annually (currently, semiannually) to a Business Opportunity Specialist. Title II: Contracting Program for Certain Small Business Concerns - Part A: Civilian Agencies Program - Authorizes executive agencies, for purposes of attaining goals for the participating of disadvantaged small businesses, to enter into contracts using: (1) less than full and open competition by restricting competition for awards to such businesses; and (2) a price evaluation preference, of up to ten percent, when evaluating an offer received from a small business as the result of an unrestricted solicitation. (Sec. 202) Requires the Federal Acquisition Regulation (FAR) to be amended to provide uniform implementation of such procedures by such agencies. Includes within the FAR: (1) conditions for the use of advance payments; (2) provisions for accelerated payment for contract work and full payment for work performed; (3) guidance on how contracting officers may provide a reasonable advantage to disadvantaged small businesses without eliminating any participation of other small businesses; (4) procedures for a person to request a Federal agency to determine whether the use of competitions restricted to disadvantaged small businesses at a contracting activity has caused a particular industry category to bear a disproportionate share of the contracts awarded to attain the goal established for such activity; and (5) guidance for limiting the use of restricted competitions in cases where such an industry is caused to bear a disproportionate share of the contracts. Part B: Eligibility Determinations Regarding Status - Authorizes protests to be brought regarding a self-certification by a business regarding its status as a disadvantaged small business in cases where such certification is believed to be false. (Sec. 211) Requires the Office of Hearings and Appeals to hear appeals regarding such status. Imposes penalties against firms engaged in a pattern of misrepresentation. Title III: Expanding Subcontracting Opportunities - Sets forth provisions regarding subcontracting by small and disadvantaged small businesses. (Sec. 302) Requires disadvantaged small businesses to negotiate a subcontracting plan for the use of emerging disadvantaged small businesses under certain circumstances. (Sec. 304) Authorizes the publication of notices of subcontracting opportunities in the Commerce Business Daily. Title IV: Repeals and Technical Amendments - Part A: Repeals - Repeals specified expired and superseded provisions of the Small Business Act and the Business Opportunity Development Reform Act of 1988. Part B: Technical Amendments - Revises goals for the percentage of procurement contracts to be awarded to small and disadvantaged small businesses. Title V: Definitions - Revises specified definitions and defines "emerging small business concern." Title VI: Regulatory Implementation and Effective Dates - Part A: Assuring Timely Regulatory Implementation - Sets forth deadlines for the issuance of specified amendments to the FAR or SBA regulations. Part B: Effective Dates - Provides that this Act shall take effect upon enactment, except with respect to provisions requiring the issuance of regulations.

African Conflict Resolution Act

United States · United States Congress · 29 September 1994

African Conflict Resolution Act - Authorizes the President to provide assistance to: (1) strengthen the conflict resolution capabilities of the Organization of African Unity and subregional organizations established by countries in Subsaharan Africa; (2) nongovernmental organizations engaged in mediation and reconciliation efforts in Africa; and (3) provide for demobilizations of armed forces in Subsaharan African countries and for the reintegration of demobilized military personnel into civilian society. Earmarks funds for such purposes from foreign assistance funds allocated for Subsaharan Africa. Permits the President to establish a program to provide education and training in conflict resolution and peacekeeping for civilian and military personnel of countries in Subsaharan Africa. Earmarks funding for such program. Declares that the President should develop an integrated, long-term plan to provide support for the enhancement of conflict resolution capabilities and demobilization activities in Subsaharan Africa.

Individual Retirement Account Equity and Enhancement Act of 1994

United States · United States Congress · 29 September 1994

Individual Retirement Account Equity and Enhancement Act of 1994 - Amends the Internal Revenue Code to allow certain spouses a deduction for contributions to an individual retirement account. Allows distribution from certain retirement plans without penalty to purchase first homes, pay higher education expenses and qualified long-term care expenses, and assist certain unemployed individuals.

Elementary and Secondary Education Amendments of 1994

United States · United States Congress · 29 September 1994

TABLE OF CONTENTS: Title I: Elementary and Secondary Education Program Authorized Title II: Amendments to Other Educational Programs Elementary and Secondary Education Amendments of 1994 - Title I: Elementary and Secondary Education Program Authorized - Amends the Elementary and Secondary Education Act of 1965 (ESEA) to extend the period of authorization of payments to State educational agencies for grants entitlements for basic programs operated by local educational agencies under title I chapter 1 provisions for financial assistance to meet special educational needs of disadvantaged children. Extends the authorization of appropriations for the following ESEA programs: (1) participation of children enrolled in private schools in chapter 1 programs; (2) Even Start programs; (3) secondary school programs for basic skills improvement and dropout prevention and reentry; (4) funds for the implementation of school improvement programs; (5) certain Federal evaluation, coordination and technical assistance, and research activities; (6) rural educational opportunities; (7) studies; (8) Federal, State, and local partnership for educational improvement (as well as extending the duration of such payments); (9) Eisenhower mathematics and science education State grants, national programs, and regional mathematics and science education consortia; (10) foreign language assistance; (11) magnet schools assistance; (12) women's educational equity; (13) Ellender fellowship program; (14) immigrant education; (15) general assistance to the Virgin Islands and territorial training assistance; (16) programs under the Secretary's Fund for Innovation in Education (including instruction on the history and principles of democracy in the United States); (17) the Ready-to-Learn program of educational television and instructional video programming for preschool and elementary school children and their parents; (18) assistance to address school dropout problems; (19) assistance to provide basic skills improvement; and (20) bilingual education programs (including State data collection and dissemination). Title II: Amendments to Other Educational Programs - Extends the authorization of appropriations for the following educational programs: (1) adult education for the homeless and education for homeless children and youth under the Stewart B. McKinney Act; (2) Follow Through programs under the Follow Through Act; (3) impact aid programs under specified Federal laws; (4) Indian education programs involving financial assistance to local educational agencies, improvement of educational programs involving financial assistance to local educational agencies, improvement of educational opportunities, special educational training for teachers, fellowships for Indian students, gifted and talented education, adult education, and program administration, under the Indian Education Act of 1988; (5) refugee and immigrant education under the Refugee Education Assistance Act of 1980; (6) Native Hawaiian education programs involving model curriculum implementation, family-based education centers, higher education, gifted and talented education, and special education, under specified Federal law; (7) partnerships in education for mathematics, science, and engineering under the Education for Economic Security Act; (8) the National Center for Education Statistics under the General Education Provisions Act; (9) programs under the Fund for the Improvement of Schools and Teaching Act; and (10) the National Writing Project under the Education Council Act of 1991.

Waiving points of order against the conference report to accompany the bill (H.R. 6) to extend for six years the authorizations of appropriations for the programs under the Elementary and Secondary Education Act of 1965, and for certain other purposes.

United States · United States Congress · 29 September 1994

Waives points of order against the consideration of the conference report to accompany H.R. 6 (authorization of appropriations for programs under the Elementary and Secondary Education Act of 1965).

Health Innovation Partnership Act of 1994

United States · United States Congress · 28 September 1994

TABLE OF CONTENTS: Title I: Health Insurance Reform Title II: State Innovation Subtitle A: State Waiver Authority Subtitle B: Existing State Laws Title III: Public Health and Rural and Underserved Access Improvement Title IV: Medical Research Title V: Revenue Provisions Subtitle A: Financing Provisions Subtitle B: Health Care Reform Trust Fund Health Innovation Partnership Act of 1994 - Title I: Health Insurance Reform - Directs the Secretary of Health and Human Services to request the National Association of Insurance Commissioners (NAIC) to develop standards for health insurance plans with respect to: (1) the renewability and portability of coverage; (2) guaranteed issue with respect to all health insurance coverage products; (3) the establishment of an adjusted community rating system with adjustment factors limited to age; (4) solvency; (5) stop-loss standards for self-funded health insurance plans and multi-employer welfare arrangements and association plans; (6) the identification of minimum employer size for self- funding and the interrelationship between self-funding and the community-rated pool of enrollees; and (7) other appropriate areas. (Sec. 1001) Requires the Secretary to develop such standards if the NAIC fails to do so. (Sec. 1002) Revises provisions regarding Medicare supplemental policies. Title II: State Innovation - Subtitle A: State Waiver Authority - Includes within the objectives of the waiver programs approved under this title: (1) achieving the goals of increased health coverage and access; (2) containing the annual rate of growth in health care expenditures; (3) ensuring that patients receive high-quality, appropriate health care; and (4) testing alternative reforms. (Sec. 2001) Authorizes States to apply to the Secretary for alternative State health program waivers or limited State health care waivers. Directs the Secretary to establish a State Health Reform Advisory Board to monitor the status and progress achieved under waivers and to promote information exchange between States and the Federal Government. Requires the Board to make recommendations to the Secretary with respect to minimizing the negative effect of State waivers on national employer groups, provider organizations, and insurers because of differing State requirements under waivers. Permits the Secretary to revoke any waiver of Federal law granted under this subtitle and to terminate any alternative State health program for good cause. Authorizes grants to States for carrying out alternative State health programs. Grants priority to programs that have the greatest opportunity to succeed in providing expanded coverage and in providing children and youth with access to health care. Earmarks funds for such grants from the Health Care Reform Trust Fund. Subtitle B: Existing State Laws - Continues certain existing waivers to Federal law for States and grants specified waivers from requirements of the Employee Retirement Income Security Act of 1974 with respect to health care laws of Hawaii and Oregon. Title III: Public Health and Rural and Underserved Access Improvement - Public Health and Rural and Underserved Access Improvement Act of 1994 - Amends the Public Health Service Act to authorize appropriations for grants to States for core functions of public health programs. Includes within such core functions: (1) data collection and analytical activities related to population-based status and outcomes monitoring; (2) activities to reduce environmental risk and to assure the safety of housing, schools, workplaces, day-care centers, and food and water; (3) investigation, control, and public- awareness activities regarding adverse health conditions; (4) public information and education programs to reduce health risks; (5) public health laboratory services that screen for diseases and conditions; (6) training and education in the field of public health; and (7) leadership, policy development, and administration activities. (Sec. 3002) Authorizes appropriations for grants to States for evaluating the extent to which clinical preventive services, health promotion and unintentional injury prevention activities, and interpersonal and community violence prevention activities achieve health care cost reductions and health status improvement. Directs the Secretary to issue practice guidelines that are based on the results of such evaluations. Authorizes appropriations for: (1) scholarships and loan repayment programs for individuals attending schools of public health; (2) grants to expand the capacity of certain educational institutions with public health programs; (3) grants to expand public health training programs in States lacking adequate programs; (4) area health education centers and health education training centers; (5) activities regarding centers for the prevention and treatment of poisoning and control of poisons; (6) certain school-related health services; (7) scholarships and loan repayment programs for school nurses; (8) grants to migrant and community health centers; (9) the National Health Service Corps; (10) satellite clinics to provide primary health care; and (11) community health advisor programs. Title IV: Medical Research - Establishes a National Fund for Health Research in the Treasury. (Sec. 4002) Amends the Internal Revenue Code to designate overpayments of tax or cash contributions to be paid over to the National Fund for Health Research. Title V: Revenue Provisions - Subtitle A: Financing Provisions - Increases the excise tax on the following tobacco and tobacco-related products: (1) cigarettes; (2) cigars; (3) cigarette papers and tubes; and (4) smokeless and pipe tobacco. (Sec. 5001) Imposes a tax on tobacco products and cigarette papers and tubes manufactured or imported into Puerto Rico. Provides a floor stocks tax on tobacco products and cigarette papers and tubes manufactured in or imported into the United States or Puerto Rico which are removed before any tax-increase date and held on such date for sale. Bars a tax on cigarettes held for retail sale on any tax-increase date by any vending machine. Provides a tax credit against floor stocks taxes. Establishes conditions under which articles in foreign trade zones shall be subject to such taxes. (Sec. 5003) Imposes a tax on roll-your-own tobacco manufactured in or imported into the United States. Subtitle B: Health Care Reform Trust Fund - Establishes the Health Care Reform Trust Fund in the Treasury and provides for the deposit into such Fund of amounts received from taxes on tobacco products.

Advisory Committee Termination Act of 1994

United States · United States Congress · 27 September 1994

Advisory Committee Termination Act of 1994 - Amends specified Federal law to repeal authority for specified advisory committees in the Departments of: (1) Agriculture; (2) Defense; (3) Education; (4) Energy; (5) Health and Human Services; (6) the Interior; (7) Justice; and (8) Transportation.

A joint resolution designating November 1, 1994, as "National Family Literacy Day".

United States · United States Congress · 27 September 1994

Designates November 1, 1994, as National Family Literacy Day.

A resolution to amend Senate Resolution 75, 103d Congress, relating to the Jacob Javits Senate Fellowship Program.

United States · United States Congress · 27 September 1994

Amends Senate Resolution 75 (103d Congress, 1st session) to require the Jacob K. Javits Foundation, Inc., to: (1) broadly publicize the availability of the Jacob K. Javits Senate Fellowship Program; (2) develop and administer an application process for Senate fellowships; (3) conduct a screening of applicants for the Program; and (4) select participants without regard to race, color, religion, sex, national origin, age, or disability. Requires the Secretary of the Senate to assist in the placement of fellowship participants in positions supportive of their academic programs, if practicable. Considers Fellows as employees of the office or committee in which they are placed. Requires the Secretary to submit to the Majority and Minority Leaders of the Senate an evaluation report and recommendations concerning the Program's extension and continued funding level three months before the Program expires.

Health Innovation Partnership Act of 1994

United States · United States Congress · 22 September 1994

TABLE OF CONTENTS: Title I: Health Insurance Reform Title II: State Innovation Subtitle A: State Waiver Authority Subtitle B: Existing State Laws Title III: Public Health and Rural and Underserved Access Improvement Title IV: Medical Research Title V: Revenue Provisions Subtitle A: Financing Provisions Subtitle B: Health Care Reform Trust Fund Health Innovation Partnership Act of 1994 - Title I: Health Insurance Reform - Directs the Secretary of Health and Human Services to request the National Association of Insurance Commissioners (NAIC) to develop standards for health insurance plans with respect to: (1) the renewability and portability of coverage; (2) guaranteed issue with respect to all health insurance coverage products; (3) the establishment of an adjusted community rating system with adjustment factors limited to age; (4) solvency; (5) stop-loss standards for self-funded health insurance plans and multi-employer welfare arrangements and association plans; (6) the identification of minimum employer size for self-funding and the interrelationship between self-funding and the community-rated pool of enrollees; and (7) other appropriate areas. (Sec. 1001) Requires the Secretary to develop such standards if the NAIC fails to do so. (Sec. 1002) Revises provisions regarding Medicare supplemental policies. Title II: State Innovation - Subtitle A: State Waiver Authority - Includes within the objectives of the waiver programs approved under this title: (1) achieving the goals of increased health coverage and access; (2) containing the annual rate of growth in health care expenditures; (3) ensuring that patients receive high-quality, appropriate health care; and (4) testing alternative reforms. (Sec. 2001) Authorizes States to apply to the Secretary for alternative State health program waivers or limited State health care waivers. Directs the Secretary to establish a State Health Reform Advisory Board to monitor the status and progress achieved under waivers and to promote information exchange between States and the Federal Government. Requires the Board to make recommendations to the Secretary with respect to minimizing the negative effect of State waivers on national employer groups, provider organizations, and insurers because of differing State requirements under waivers. Permits the Secretary to revoke any waiver of Federal law granted under this subtitle and to terminate any alternative State health program for good cause. Authorizes grants to States for carrying out alternative State health programs. Grants priority to programs that have the greatest opportunity to succeed in providing expanded coverage and in providing children and youth with access to health care. Earmarks funds for such grants from the Health Care Reform Trust Fund. Subtitle B: Existing State Laws - Continues certain existing waivers to Federal law for States and grants specified waivers from requirements of the Employee Retirement Income Security Act of 1974 with respect to health care laws of Hawaii, Oregon, Minnesota, Washington, and Connecticut. Title III: Public Health and Rural and Underserved Access Improvement - Public Health and Rural and Underserved Access Improvement Act of 1994 - Amends the Public Health Service Act to authorize appropriations for grants to States for core functions of public health programs. Includes within such core functions: (1) data collection and analytical activities related to population-based status and outcomes monitoring; (2) activities to reduce environmental risk and to assure the safety of housing, schools, workplaces, day-care centers, and food and water; (3) investigation, control, and public-awareness activities regarding adverse health conditions; (4) public information and education programs to reduce health risks; (5) public health laboratory services that screen for diseases and conditions; (6) training and education in the field of public health; and (7) leadership, policy development, and administration activities. (Sec. 3002) Authorizes appropriations for grants to States for evaluating the extent to which clinical preventive services, health promotion and unintentional injury prevention activities, and interpersonal and community violence prevention activities achieve health care cost reductions and health status improvement. Directs the Secretary to issue practice guidelines that are based on the results of such evaluations. Authorizes appropriations for: (1) scholarships and loan repayment programs for individuals attending schools of public health; (2) grants to expand the capacity of certain educational institutions with public health programs; (3) grants to expand public health training programs in States lacking adequate programs; (4) area health education centers and health education training centers; (5) activities regarding centers for the prevention and treatment of poisoning and control of poisons; (6) certain school-related health services; (7) grants to migrant and community health centers; (8) the National Health Service Corps; (9) satellite clinics to provide primary health care; and (10) community health advisor programs. Title IV: Medical Research - Establishes a National Fund for Health Research in the Treasury. (Sec. 4002) Amends the Internal Revenue Code to designate overpayments of tax or cash contributions to be paid over to the National Fund for Health Research. Title V: Revenue Provisions - Subtitle A: Financing Provisions - Increases the excise tax on the following tobacco and tobacco-related products: (1) cigarettes; (2) cigars; (3) cigarette papers and tubes; and (4) smokeless and pipe tobacco. (Sec. 5001) Imposes a tax on tobacco products and cigarette papers and tubes manufactured or imported into Puerto Rico. Provides a floor stocks tax on tobacco products and cigarette papers and tubes manufactured in or imported into the United States or Puerto Rico which are removed before any tax-increase date and held on such date for sale. Bars a tax on cigarettes held for retail sale on any tax-increase date by any vending machine. Provides a tax credit against floor stocks taxes. Establishes conditions under which articles in foreign trade zones shall be subject to such taxes. (Sec. 5003) Imposes a tax on roll-your-own tobacco manufactured in or imported into the United States. Subtitle B: Health Care Reform Trust Fund - Establishes the Health Care Reform Trust Fund in the Treasury and provides for the deposit into such Fund of amounts received from taxes on tobacco products.

Women's Health Regional Centers Act

United States · United States Congress · 22 September 1994

Women's Health Regional Centers Act - Amends the Public Health Service Act to require the Director of the National Institutes of Health to make grants to, or enter into contracts with, public or nonprofit private entities for the development and operation of centers to carry out specified activities regarding women's health conditions. Requires the Director to provide for the development of five centers and to ensure that such a center is developed in each of the principal geographic regions of the United States. Directs each center to: (1) conduct basic, clinical, and applied research and training programs for health professionals and scientists; (2) devleop curricula and model continuing education programs for training health professionals and scientists and model programs for the delivery of health services to women; (3) disseminate information to health professionals, scientists, and the public; and (4) develop, in the case of women who are in the medical profession, model programs for training such women in the skills necessary for achieving positions of leadership in such schools and in academic health centers. Sets forth provisions regarding: (1) coordination of information; (2) structure of centers; (3) duration of support; and (4) limits on support. Authorizes appropriations.