Healthcare

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751 records in US in 1999

Records

Bill· HRH.R. 476 (106th)open

To prescribe alternative payment mechanisms for the payment of annual enrollment fees for the TRICARE program of the military health care system.

United States · United States Congress · 2 February 1999

Directs the Secretary of Defense to permit persons who enroll in the TRICARE program (a managed health care program of the armed forces) to pay their annual enrollment fees on a monthly basis and to establish mechanisms to provide for payment of such fees through: (1) a deduction from military retired or retainer pay; (2) a deduction from monthly social security benefits; and (3) an electronic funds transfer from a checking or savings account. Requires the Secretary to enter into an agreement with the Commissioner of Social Security and the Secretary of the Treasury to conduct the Social Security deduction mechanism in the same manner as provided for the monthly deduction of Medicare premiums.

Bill· HRH.R. 450 (106th)referred

United States Agricultural Products Market Access Act of 1999

United States · United States Congress · 2 February 1999

United States Agricultural Products Market Access Act of 1999 - Amends the Trade Act of 1974 to direct the United States Trade Representative (USTR) to identify those foreign countries that: (1) deny fair and equitable market access to U.S. agricultural products or apply standards for the importation of U.S. agricultural products that are not related to public health concerns or cannot be substantiated by reliable analytical methods; and (2) are determined by the USTR to be priority foreign countries. Limits the identification of priority foreign countries to those that engage in the most onerous or egregious acts which have the greatest adverse impact on the relevant U.S. products. Provides that if available information indicates that such action is appropriate, the USTR may at any time: (1) revoke the identification of any foreign country as a priority foreign country; or (2) identify any foreign country as a priority foreign country. Subjects priority foreign countries to investigation by means other than a petition. Authorizes the USTR, with respect to an investigation of a country identified as denying fair and equitable market access to U.S. agricultural products, to request the Secretary of Agriculture to direct the Food Safety and Inspection Service of the Department of Agriculture to review certifications for the facilities of such country that export meat and other agricultural products to the United States.

Bill· SS. 331 (106th)passed

Work Incentives Improvement Act of 1999

United States · United States Congress · 28 January 1999

TABLE OF CONTENTS: Title I: Expanded Availability of Health Care Services Title II: Ticket to Work and Self-Sufficiency and Related Provisions Subtitle A: Ticket to Work and Self-Sufficiency Subtitle B: Elimination of Work Disincentives Subtitle C: Work Incentives Planning, Assistance, and Outreach Title III: Demonstration Projects and Studies Title IV: Technical Amendments Work Incentives Improvement Act of 1999 - Title I: Expanded Availability of Health Care Services - Amends title XIX (Medicaid) of the Social Security Act (SSA) to provide for expanding State options under Medicaid for workers with disabilities, namely by creating State options to eliminate income, assets, and resource limitations for workers with disabilities who buy into Medicaid and to expand opportunities for such workers to make such a buy. Provides that Federal funds paid to a State for medical assistance provided to certain working disabled individuals must be used to supplement but not supplant the level of State funds expended as of FY 1999 for programs to enable working disabled individuals to work. (Sec. 102) Provides for certain continuation of Medicare coverage for working individuals with disabilities. (Sec. 103) Directs the Secretary of Health and Human Services to: (1) award grants to eligible States to support establishment of State infrastructures to support the working disabled as well as to enable State outreach campaigns on infrastructure existence; and (2) submit a recommendation to specified congressional committees on whether such grant program should be continued after FY 2010. Authorizes appropriations. (Sec. 104) Authorizes State demonstration projects for certain Medicaid coverage of up to a specified maximum number of workers with a potentially severe disability, coverage equal to that afforded under the State option provided for above for eliminating income, assets, and resource limitations for disabled workers buying into Medicaid. Authorizes appropriations. Title II: Ticket to Work and Self-Sufficiency and Related Provisions - Subtitle A: Ticket to Work and Self-Sufficiency - Amends part A (General Provisions) of SSA title XI to direct the Commissioner to establish a Ticket to Work and Self-Sufficiency Program (TWSSP) under which a disabled beneficiary may use a TWSSP ticket issued by the Commissioner under a described system, designed to ensure quality assurance, to obtain employment, vocational rehabilitation services, or other support services, pursuant to an appropriate individual beneficiary work plan that meets specified requirements, at the Commission's expense, from a participating employment network, public or private, which: (1) meets specified qualifications and is under an agreement with the Commissioner who must select a program manager to assist in administering TWSSP; (2) is chosen by the beneficiary, and (3) is willing to accept assignment of the beneficiary's TWSSP ticket. Allows State agencies administering or supervising the administration of the State plan under title I of the Rehabilitation Act of 1973 to elect to participate as an employment network. Sets forth special requirements applicable to cross-referral to certain State agencies and requirements relating to provision of services. Describes employment network payment systems. Provides that during any period for which an individual is using a TWSSP ticket, the Commissioner and any applicable State agency may not initiate a continuing disability or similar review with regards to whether the individual is or is not disabled. Requires payments to employment networks to be made out of the social security trust funds in the case of ticketed SSA title II (Old Age, Survivors and Disability Insurance) (OASDI) disability beneficiaries who return to work, or from the appropriation made available for making Supplemental Security Income (SSI) payments under SSA title XVI, in the case of SSI disability beneficiaries who return to work. Provides for allocation of other costs. (Sec. 202) Establishes within the Social Security Administration the Work Incentives Advisory Panel to advise the Commissioner with respect to TWSSP, and other Federal officials on related issues. Provides that the costs for carrying out this paragraph shall be paid from amounts available for the administration of SSA titles II and XVI, and shall be allocated among those amounts as appropriate. Subtitle B: Elimination of Work Disincentives - Amends SSA title II to set forth a number of measures designed to eliminate work disincentives, namely prohibiting work activity as a basis for review of an individual's disability status and providing for expedited eligibility determinations for applications for disability benefits of former certain long-term disability beneficiaries that engaged in substantial gainful activity during a certain extended period following the end of a rehabilitation services trial work period. Subtitle C: Work Incentives Planning, Assistance, and Outreach - Amends SSA title XI part A (General Provisions) to direct the Commissioner to establish a community-based work incentives outreach program for disabled beneficiaries that includes the provision of technical assistance to organizations and entities that are designed to encourage disabled beneficiaries to return to work. Provides that the costs of carrying out this subtitle shall be paid from amounts made available for administration of SSA titles II and XVI, and shall be allocated among such amounts as appropriate. (Sec. 222) Amends SSA title XI to authorize the Commissioner to make certain minimum payments in each State to the protection and advocacy system established under the Developmental Disabilities Assistance and Bill of Rights Act for the purpose of providing services to disabled beneficiaries, services which may include advocacy or other services that such a beneficiary may need to secure or regain gainful employment. Provides for funding similar to that in he paragraph above. Title III: Demonstration Projects and Studies - Amends the Social Security Disability Amendments of 1980 to provide for an extension of disability insurance program demonstration project authority to include any group of applicants for benefits under such program with impairments that may reasonably be presumed to be disabling for purposes of such demonstration project. (Sec. 302) Directs the Commissioner to conduct certain demonstration projects designed to provide for specified reductions in disability insurance benefits based on earnings. Requires expenditures for such demonstration projects to come out of the social security and Medicare trust funds to the extent provided in advance in appropriation acts. (Sec. 303) Expresses the sense of the Congress that the Commissioner of Social Security and the Secretary of Health and Human Services should establish additional demonstration projects to assist individuals with disabilities to engage in work. (Sec. 304) Directs the Comptroller General to conduct and report to the Congress on various described studies concerning existing disability-related employment incentives and coordination of the OASDI disability insurance program and the SSI program as they relate to individuals entering or leaving concurrent entitlement under such programs, as well as on a study concerning the impact of the substantial gainful activity limit on return to work. Title IV: Technical Amendments - Amends the Contract with America Advancement Act of 1996 with respect to: (1) final adjudication of denied claims by drug addicts and alcoholics for SSA title II disability benefits; and (2) the effective dates of certain requirements concerning representative payees and treatment referrals for such individuals. (Sec. 402) Amends SSA title II to: (1) provide for payments to State and local prisons for monthly reports on the identities of inmates whose OASDI benefits are determined by the Commissioner not to be payable as a result of such reports; (2) provide for a 50 percent reduction in such payments under SSA titles II and XVI in cases involving a comparable payment under the other title with respect to the same prisoner; (3) exempt from the Privacy Act of 1974 any agreements with State and local prisons to supply such information; (4) transfer from the OASDI trust funds any sums necessary to enable the Commissioner to make such payments; (5) eliminate the requirement that confinement stem only from a crime punishable by imprisonment for more than one year (thus denying OASDI benefits to individuals confined for any criminal offense); and (6) provide for continued denial of benefits to sex offenders remaining confined to public institutions upon completion of prison term. (Sec. 403) Provides for a two-year open season for members of the clergy who wish to revoke their exemption from social security coverage. (Sec. 404) Amends SSA title XI to make a miscellaneous technical amendment relating to cooperative research or development projects under SSA titles II and XVI. (Sec. 405) Amends SSA title XI to make miscellaneous technical amendments to provisions concerning the requirements of State income and eligibility verification systems, among other changes allowing a State to permit certain employers that make returns with respect to domestic service employment taxes on a calendar year basis to instead make such reports on an annual basis.

Bill· SS. 326 (106th)open

Patients' Bill of Rights Act

United States · United States Congress · 28 January 1999

TABLE OF CONTENTS: Title I: Patients' Bill of Rights Subtitle A: Right to Advice and Care Subtitle B: Right to Information about Plans and Providers Subtitle C: Right to Hold Health Plans Accountable Title II: Individual Rights with Respect to Personal Medical Information Subtitle A: Access to Medical Records Subtitle B: Establishment of Safeguards Subtitle C: Enforcement; Definitions Title III: Genetic Information and Services Title IV: Healthcare Research and Quality Patients' Bill of Rights Act - Title I: Patients' Bill of Rights - Subtitle A: Right to Advice and Care - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to define "fully insured group health plan" as one under which benefits are provided pursuant to the terms of an arrangement between a group health plan and a health insurance issuer and are guaranteed by the issuer under a contract or policy of insurance. Requires a group health plan (for purposes of benefits and protections discussed in this subtitle, one other than a fully insured group health plan) covering emergency medical care to provide coverage, without requiring preauthorization, for appropriate emergency medical screening examinations to the extent that a prudent layperson, possessing an average knowledge of health and medicine, would determine such examinations to be necessary to determine whether emergency medical care is necessary. (Sec. 101) Requires a plan to cover additional emergency medical services following such an examination to the extent that a prudent emergency medical professional would determine such services to be necessary to avoid specified serious consequences. Requires a plan (other than a small employer's fully insured group health plan) providing benefit coverage only through a defined set of participating health care professionals to offer the option of point-of-service coverage (of the same benefits provided by a nonparticipating health care professional), unless the plan offers multiple issuer or coverage options. Requires any plan offering gynecological, obstetric, or pediatric care not to require prior authorization from a participant's primary care provider if such provider is not a gynecologist, obstetrician, or pediatrician. Requires a plan to permit a participant or beneficiary undergoing a course of treatment to continue such treatment for a period of time even though the contract between the plan and a health care provider is terminated, or the schedule of benefits or coverage is terminated by a change in the terms of the provider's participation in the plan. Specifies a 90-day continuation of coverage generally, and other transitional periods for institutionalization (until discharge), pregnancy (through post-partum care), and terminal illness. Declares that a plan shall not prohibit or otherwise restrict a health care professional from advising a patient about the patient's health status, medical care, or treatment for the patient's condition or disease, regardless of whether coverage for such care or treatment is provided under the contract, if the professional is acting within the lawful scope of the practice. Subtitle B: Right to Information about Plans and Providers - Requires plans and group health insurance issuers to disclose specified plan information to enrollees and (upon request) potential enrollees. (Sec. 112) Directs the Secretary of Health and Human Services (HHS) to contract with the Institute of Medicine for a study and report to the appropriate congressional committees on: (1) health care professionals information currently available to patients, consumers, States, and professional societies, nationally and on a State-by-State basis; (2) the legal and other barriers to the sharing of information about health care professionals; and (3) recommendations for disclosure of such information on health care professionals, including their competencies and professional qualifications, to better facilitate patient choice, quality improvement, and market competition. Subtitle C: Right to Hold Health Plans Accountable - Revises requirements for plan provision of a procedure for appealing denied claims. (Sec. 121) Requires a plan or health insurance issuer conducting utilization review to have: (1) specified procedures in place for coverage determinations, including expedited determinations; (2) written procedures for addressing grievances between a plan and enrollees; (3) an internal procedure for coverage determination appeals; and (4) an external review procedure for enrollee appeals, involving specified entities and independent medical experts, whose determination shall be binding. Prescribes external review standards. Directs the General Accounting Office to study and report to the appropriate congressional committees on a statistically appropriate sample of completed external reviews. Title II: Individual Rights with Respect to Personal Medical Information - Personal Medical Information Access Act - Subtitle A: Access to Medical Records - Requires any health care provider, health plan, employer, health or life insurer, school, or university, except in specified circumstances, to: (1) permit an individual who is the subject of protected health information (or the individual's designee) to inspect and copy protected health information concerning the individual; (2) amend such information upon the individual's request; and (3) make reasonable efforts to inform any person to whom the unamended portion of the information was previously disclosed of any nontechnical amendment that has been made. (Sec. 212) Prescribes procedures for: (1) an entity's denial of a request to amend such information; and (2) an individual's filing of a statement of disagreement with such denial, which shall accompany any subsequent disclosure of the disputed portion of the information. (Sec. 213) Requires any health care provider, health plan, employer, health or life insurer, school, or university to post notice of the entity's confidentiality practices, including specified information. Requires the Secretary to develop and disseminate model notices of confidentiality practices. Subtitle B: Establishment of Safeguards - Requires any health care provider, health plan, employer, health or life insurer, school, or university to establish and maintain appropriate administrative, technical, and physical safeguards to protect the confidentiality, security, accuracy, and integrity of protected health information the entity creates, receives, obtains, maintains, uses, transmits, or disposes of. Subtitle C: Enforcement; Definitions - Prescribes civil money penalties for substantial and material failure to comply with this Act. (Sec. 232) Sets forth definitions. Title III: Genetic Information and Services - Genetic Information Nondiscrimination in Health Insurance Act of 1999 - Amends ERISA, the Public Health Service Act (PHSA), and the Internal Revenue Code to prohibit a health care plan or health insurance issuer from restricting enrollment or adjusting premium or contribution amounts for a group on the basis of predictive genetic information concerning an individual in the group or a family member of the individual (including information about a request for or receipt of genetic services). (Sec. 302) Prohibits a plan or issuer from requesting or requiring predictive genetic information concerning an individual or a family member of the individual (including information about a request for or receipt of genetic services). Permits a plan or issuer to request, but not require, such information for diagnosis, treatment, or payment purposes only. Title IV: Healthcare Research and Quality - Healthcare Research and Quality Act of 1999 - Amends the PHSA to establish within the Public Health Service (PHS) an Agency for Healthcare Research and Quality to replace the current Agency for Health Care Policy and Research. (Sec. 402) Directs the Agency to identify and disseminate methods or systems used to assess health care research results, particularly to rate the strength of the scientific evidence behind health care practice, recommendations in research literature, and technology assessments. Requires the Agency to employ research strategies and mechanisms that will link research directly with clinical practice in geographically diverse locations throughout the United States, including: (1) Healthcare Improvement Research Centers that combine demonstrated multidisciplinary expertise in outcomes or quality improvement research with linkages to relevant sites of care; (2) Provider-based Research Networks, including plan, facility, or delivery system sites of care (especially primary care), that can evaluate and promote quality improvement; and (3) other innovative mechanisms or strategies. Authorizes the Agency to provide specified scientific and technical support for private and public efforts to improve health care quality, including activities of accrediting organizations. Directs the Secretary, acting through the Agency Director, to establish a demonstration program of grants for one or more centers to conduct: (1) state-of-the-art clinical research on drugs, biological products, and devices; (2) research on the comparative effectiveness, cost-effectiveness, and safety of drugs, biological products, and devices; and (3) other appropriate activities (excluding the review of new drugs). Requires the Agency Director to: (1) collect certain data on the cost and quality of health care; (2) support research on and initiatives to advance the use of information systems for the study of health care quality; and (3) provide ongoing administrative, research, and technical support for the Preventive Services Task Force, which shall review scientific evidence on the effectiveness, appropriateness, and cost-effectiveness of clinical preventive services regarding their usefulness in daily clinical practice. Establishes within the Agency a Center for Primary Care Research to serve as the principal funding source for HHS primary care research and demonstrations with respect to the first contact when illness or health concerns arise, the diagnosis, treatment or referral to specialty care, preventive care, and the relationship between the clinician and the patient in the context of the family and community. Requires the Agency Director by specified activities to promote innovation in evidence-based clinical practice and health care technologies. Requires the Secretary, acting through the Director, to coordinate all research, evaluations, and demonstrations related to health services research and quality measurement and improvement activities undertaken and supported by the Federal Government. Requires the Secretary to contract with the Institute of Medicine to: (1) describe and evaluate current quality improvement research and monitoring processes; and (2) recommend options to improve the efficiency and effectiveness of such processes. Establishes an Advisory Council for Healthcare Research and Quality to replace the current Advisory Council for Health Care Policy, Research, and Evaluation. Requires the Agency Director to establish technical and scientific peer review groups to review each application for a grant, cooperative agreement, or contract under this title. Repeals the mandates for: (1) a demonstration program regarding centers for education and research on therapeutics; and (2) the Office of the Forum for Quality and Effectiveness in Health Care. Authorizes appropriations. (Sec. 404) Requires the Secretary, within 30 days after enactment of any Act providing for a qualifying health care benefit, to evaluate scientifically and report to the appropriate congressional committees on: (1) the safety, efficacy, cost, benefits and value of such benefit; (2) alternative approaches in improving care compared with such benefit; and (3) the benefit's overall impact on health care as measured through research. Title V: Miscellaneous Provisions - Expresses the sense of the Senate Committee on Health, Education, Labor, and Pensions that Congress should take measures to further the purposes of this Act, including necessary changes to the Internal Revenue Code or other Acts to: (1) promote equity and prohibit discrimination based on genetic information with respect to the availability of health benefits; (2) allow the full deduction of health insurance costs for the self-employed; (3) provide for the full availability of medical savings accounts; (4) provide for the carryover of unused benefits from cafeteria plans and other flexible arrangements; and (5) permit contributions to medical savings accounts through the Federal employees health benefits program.

Bill· SS. 324 (106th)referred

Drug Addiction Treatment Act of 1999

United States · United States Congress · 28 January 1999

Drug Addiction Treatment Act of 1999 - Amends the Controlled Substances Act to waive the requirement that practitioners who dispense narcotic drugs to individuals for maintenance or detoxification treatment annually obtain a separate registration for that purpose, and that the Attorney General register an applicant to dispense narcotic drugs to individuals for such treatment, in the case of the dispensing by a practitioner of narcotic drugs in schedule IV or V or combinations of such drugs (schedule IV-V drugs) if the practitioner and the drugs meet specified conditions. Requires that: (1) the practitioner, before dispensing schedule IV-V drugs to patients for maintenance or detoxification treatment, submit to the Secretary of Health and Human Services a notification of intent to begin dispensing such drugs for that purpose, including certifications that the practitioner is licensed under State law and has the ability to treat and manage opiate-dependent patients, has the capacity to refer the patients for appropriate counseling and other appropriate ancillary services, and meets other specified requirements; and (2) the schedule IV-V drugs have been approved for use in maintenance or detoxification treatment and have not been the subject of an "adverse determination" (i.e., requires additional standards regarding the qualifications of practitioners to provide such treatment, or requires standards regarding the quantities of the drugs that may be provided for unsupervised use). Sets forth specified procedural requirements to make the waiver effective. Requires the Secretary and the Attorney General, during the three-year period beginning on the date of this Act's enactment, to make determinations regarding whether: (1) treatments provided under such waivers have been effective forms of maintenance and detoxification treatment in clinical settings; (2) such waivers have significantly increased the availability of such treatment; and (3) such waivers have adverse public health consequences. Authorizes the Secretary to collect data from the practitioners for whom waivers are in effect. Sets forth further requirements with respect to the Secretary and the Attorney General, and further procedural requirements. Prohibits a State, during the three-year period, from precluding a practitioner from dispensing schedule IV-V drugs to patients for maintenance or detoxification treatment in accordance with this Act unless, before the expiration of such period, the State enacts a law prohibiting a practitioner from dispensing such drugs.

Bill· SS. 307 (106th)referred

Medicare+Choice Payment Equity Act of 1999

United States · United States Congress · 26 January 1999

Medicare+Choice Payment Equity Act of 1999 - Amends title XVIII (Medicare) of the Social Security Act to eliminate the budget neutrality adjustment factor used in calculating the blended capitation rate for Medicare+Choice organizations under Medicare part C (Medicare+Choice). Directs the Secretary of Health and Human Services to submit to the Congress a legislative proposal that provides for aggregate decreases in Federal expenditures under the Medicare program as are equal to the aggregate increases in such expenditures under such program resulting from such elimination.

Bill· SS. 300 (106th)referred

Patients' Bill of Rights Act

United States · United States Congress · 22 January 1999

Patients' Bill of Rights Act - Title I: Patients' Bill of Rights - Subtitle A: Right to Advice and Care - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to require a group health plan covering emergency medical care to provide coverage, without requiring preauthorization, for appropriate emergency medical screening examinations to the extent that a prudent layperson, possessing an average knowledge of health and medicine, would determine such examinations to be necessary to determine whether emergency medical care is necessary. (Sec. 101) Requires a plan to cover additional emergency medical services to stabilize an emergency medical condition following such an examination to the extent that a prudent emergency medical professional would determine such services to be necessary to avoid specified serious consequences. Requires a plan (other than a fully insured group health plan) providing benefit coverage only through a defined set of participating health care professionals to offer the option of point-of-service coverage (of the same benefits provided by a nonparticipating health care professional), unless the plan offers multiple issuer or coverage options. Exempts from this requirement any group health plan (other than a fully insured plan) of a small employer. Requires any plan offering gynecological, obstetric, or pediatric care not to require prior authorization from a participant's primary care provider if such provider is not a gynecologist, obstetrician, or pediatrician. Requires a plan to permit a participant or beneficiary undergoing a course of treatment to continue such treatment for a period of time even though the contract between the plan (other than a fully insured plan) and a health care provider is terminated, or the schedule of benefits or coverage is terminated by a change in the terms of the provider's participation in the plan. Specifies a 90-day continuation of coverage generally, and other transitional periods for institutionalization (until discharge), pregnancy (through post-partum care), and terminal illness (remainder of life). Declares that a plan shall not prohibit a health care professional from advising a patient about the patient's health status, medical care, or treatment for the patient's condition or disease, regardless of whether coverage for such care or treatment is provided under the contract, if the professional is acting within the lawful scope of the practice. Defines "fully insured group health plan" as a plan where benefits are provided pursuant to the terms of an arrangement between a group health plan and a health insurance issuer and are guaranteed by the health insurance issuer under a contract or policy of insurance. Subtitle B: Right to Information about Plans and Providers - Amends ERISA, as amended by the Omnibus Consolidated and Emergency Supplemental Appropriations Act, 1999, to require plans and group health insurance issuers to disclose specified plan information to enrollees and (upon request) potential enrollees. (Sec. 112) Directs the Secretary of Health and Human Services (HHS) to contract with the Institute of Medicine for a study and report to the appropriate congressional committees on: (1) health care professionals information currently available to patients, consumers, States, and professional societies, nationally and on a State-by-State basis; (2) the legal and other barriers to the sharing of information about health care professionals; and (3) recommendations for disclosure of such information on health care professionals, including their competencies and professional qualifications, to better facilitate patient choice, quality improvement, and market competition. Subtitle C: Right to Hold Health Plans Accountable - Revises requirements for plan provision of a procedure for appealing denied claims. (Sec. 121) Requires a plan or health insurance issuer conducting utilization review to have: (1) specified procedures in place for coverage determinations, including expedited determinations; (2) written procedures for addressing grievances between a plan and enrollees; (3) an internal procedure for coverage determination appeals; and (4) an external review procedure for enrollee appeals, involving specified entities and independent medical experts, whose determination shall be binding. Prescribes external review standards. Directs the General Accounting Office to study and report to the appropriate congressional committees on a statistically appropriate sample of completed external reviews. Subtitle D: Miscellaneous Provisions - Amends the Internal Revenue Code to deem the requirements of subtitle B of this Act to be incorporated into the Code. Title II: Individual Rights with Respect to Personal Medical Information - Personal Medical Information Access Act - Subtitle A: Access to Medical Records - Requires any health care provider, health plan, employer, health or life insurer, school, or university, except in specified circumstances, to: (1) permit an individual who is the subject of protected health information (or the individual's designee) to inspect and copy protected health information concerning the individual; (2) amend such information upon the individual's request; and (3) make reasonable efforts to inform any person to whom the unamended portion of the information was previously disclosed of any nontechnical amendment that has been made. (Sec. 212) Prescribes procedures for: (1) an entity's denial of a request to amend such information; and (2) an individual's filing of a statement of disagreement with such denial, which shall accompany any subsequent disclosure of the disputed portion of the information. (Sec. 213) Requires any health care provider, health plan, employer, health or life insurer, school, or university to post notice of the entity's confidentiality practices, including specified information. Requires the Secretary to develop and disseminate model notices of confidentiality practices. Subtitle B: Establishment of Safeguards - Requires any health care provider, health plan, employer, health or life insurer, school, or university to establish and maintain appropriate administrative, technical, and physical safeguards to protect the confidentiality, security, accuracy, and integrity of protected health information the entity creates, receives, obtains, maintains, uses, transmits, or disposes of. Subtitle C: Enforcement; Definitions - Prescribes civil money penalties for substantial and material failure to comply with this Act. (Sec. 232) Sets forth definitions. Title III: Genetic Information and Services - Genetic Information Nondiscrimination in Health Insurance Act of 1999 - Amends ERISA, the Public Health Service Act (PHSA) (as amended by the Omnibus Consolidated and Emergency Supplemental Appropriations Act, 1999), and the Internal Revenue Code to prohibit a health care plan or health insurance issuer from restricting enrollment or adjusting premium or contribution amounts for a group on the basis of predictive genetic information concerning an individual in the group or a family member of the individual (including information about a request for or receipt of genetic services). (Sec. 302) Prohibits a plan or issuer from requesting or requiring predictive genetic information concerning an individual or a family member of the individual (including information about a request for or receipt of genetic services). Permits a plan or issuer to request, but not require, such information for diagnosis, treatment, or payment purposes only. Title IV: Healthcare Research and Quality - Healthcare Research and Quality Act of 1999 - Amends PHSA to establish within the Public Health Service (PHS) an Agency for Healthcare Quality Research to replace the current Agency for Health Care Policy and Research. (Sec. 402) Directs the Agency to identify and disseminate methods or systems used to assess healthcare research results, particularly to rate the strength of the scientific evidence behind healthcare practice and technology recommendations in the research. Requires the Agency to employ research strategies and mechanisms that will link research directly with clinical practice in geographically diverse locations throughout the United States, including: (1) Healthcare Improvement Research Centers that combine demonstrated multidisciplinary expertise in outcomes or quality improvement research with linkages to relevant sites of care; (2) Provider-based Research Networks, including plan, facility, or delivery system sites of care (especially primary care), that can evaluate and promote quality improvement; and (3) other innovative mechanisms or strategies. Directs the Agency to: (1) award grants to enable eligible entities at geographically diverse locations throughout the United States to carry out research training programs dedicated to health services research training at the doctoral, post-doctoral, and junior faculty levels; and (2) provide specified scientific and technical support for private and public efforts to improve healthcare quality, including accrediting organizations. Directs the Secretary, acting through the Agency Director, to establish a program of grants for one or more centers to conduct: (1) state-of-the-art clinical research on drugs, biological products, and devices; (2) research on the comparative effectiveness, cost-effectiveness, and safety of drugs, biological products, and devices; and (3) other appropriate activities (excluding the review of new drugs). Requires the Agency Director to: (1) collect certain data on the cost and quality of healthcare; (2) support research on and initiatives to advance the use of information systems for the study of healthcare quality; and (3) provide ongoing administrative, research, and technical support for the Preventive Services Task Force, which shall review scientific evidence on the effectiveness, appropriateness, and cost-effectiveness of clinical preventive services regarding their usefulness in daily clinical practice. Establishes within the Agency a Center for Primary Care Delivery Research to serve as the principal funding source for HHS primary care delivery research and demonstrations with respect to the first contact when illness or health concerns arise, the diagnosis, treatment or referral to specialty care, preventive care, and the relationship between the clinician and the patient in the context of the family and community. Requires the Agency Director by specified activities to promote innovation in evidence-based clinical practice and healthcare technologies. Requires the Secretary, acting through the Director, to coordinate all research, evaluations, and demonstrations related to health services research and quality measurement and improvement activities undertaken and supported by the Federal Government. Requires the Secretary to contract with the Institute of Medicine to: (1) describe and evaluate current quality improvement research and monitoring processes; and (2) recommend options to improve the efficiency and effectiveness of such processes, and optimize public-private sector accreditation bodies. Establishes an Advisory Council for Healthcare Quality Research to replace the current Advisory Council for Health Care Policy, Research, and Evaluation. Requires the Agency Director to establish technical and scientific peer review groups to review each application for a grant, cooperative agreement, or contract under this title. Repeals the mandates for: (1) a demonstration program regarding centers for education and research on therapeutics; and (2) the Office of the Forum for Quality and Effectiveness in Health Care. Authorizes appropriations. (Sec. 404) Requires the Secretary, within 30 days after enactment of any Act providing for a qualifying health care benefit, to evaluate scientifically and report to the appropriate congressional committees on: (1) the safety, efficacy, cost, benefits and value of such benefit; (2) alternative approaches in improving care compared with such benefit; and (3) the benefit's overall impact on health care as measured through research. Title V: Enhanced Access to Health Insurance Coverage - Amends the Internal Revenue Code to allow a full deduction from gross income of the health insurance costs of self-employed individuals. (Sec. 502) Repeals the limitation of the availability of medical savings accounts (MSAs) to employees of small employers and the self-employed. Reduces from $1,500 to $1,000 (self-only coverage) and from $3,000 to $2,000 (family coverage) the minimum annual deductible of a high deductible health plan. Revises the formula for the monthly limitation on the allowable deduction for MSAs to increase the contribution limit to 100 percent of the annual deductible under a high deductible health plan. Waives the additional tax on MSA distributions not used for qualified medical expenses to the extent any payment or distribution does not reduce the fair market value of the MSA assets to an amount less than the annual deductible for the account holder's high deductible health plan. (Sec. 503) Allows the annual carryover of up to $500 of unused benefits from cafeteria plans, flexible spending arrangements, and health flexible spending accounts. (Sec. 504) Authorizes the Office of Personnel Management to contract for or approve catastrophic FEHBP plans, whose covered expenses exceed $500. Amends Federal civil service law, with respect to Government contributions under the Federal Employees Health Benefits Program (FEHBP), to require an additional Government contribution, according to a certain formula, to an individual's MSA with respect to a catastrophic plan. Deems subscription charges for MSAs to be the amount of Government contributions.

Bill· SS. 289 (106th)referred

Faith-Based Drug Treatment Enhancement Act

United States · United States Congress · 21 January 1999

Faith-Based Drug Treatment Enhancement Act - Amends the Public Health Service Act to declare that the amendments made by this Act apply to each program that makes awards of Federal financial assistance to prevent or treat substance abuse. Allows, notwithstanding any other provision of law, a religious organization to be an award recipient, make subawards, provide services through vouchers, or accept vouchers for providing services. Makes religious organizations eligible on the same basis as any other nonprofit private organization. Prohibits Federal or State: (1) discrimination against an organization on the basis that the organization has a religious character; and (2) requirements that a religious organization, in order to be a program participant, remove religious art, icons, scripture, or other symbols. Requires a religious organization to arrange for services through an alternative entity if an individual objects to the religious organization. Allows a religious organization to require a beneficiary who has elected to receive services from the organization to actively participate in religious practice, worship, and instruction. Prohibits using funds for sectarian worship or instruction, unless the beneficiary may choose where the assistance is redeemed or allocated. Declares that assistance to or on behalf of a beneficiary is aid to the beneficiary and not to the organization. Requires, if a State law or constitution would prevent the expenditure of State or local funds by religious organizations, that the Federal funds shall be segregated from State or other public funds. Requires, for personnel working in religious organization drug treatment programs, giving credit for religious education and training equivalent to credit given for secular course work. Mandates waiver of educational requirements if the religious organization has a record of successful drug treatment and the State or local government fails to demonstrate empirically that the educational qualifications are necessary.

Bill· SS. 255 (106th)referred

Home Health Integrity Preservation Act of 1999

United States · United States Congress · 20 January 1999

Home Health Integrity Preservation Act of 1999 - Amends title XVIII (Medicare) of the Social Security Act (SSA) with regard to home health agencies. (Sec. 2) Revises a home health agency's conditions of participation to require that it have: (1) sufficient knowledge of reimbursement requirements, coverage criteria and claims procedures, and the civil and criminal penalties for noncompliance; (2) managing employees with sufficient prior education or work experience in health care delivery; (3) a fraud and abuse compliance program; and (4) a practice of making the most recent compliance survey available to beneficiaries or their representatives. Requires a home health agency to notify its fiscal intermediary and the State licensing or certifying entity that the agency: (1) is providing a category of skilled service that it was not providing at the time of its most recent standard survey; (2) is operating a new branch office that was not in operation at the time of its most recent survey; and (3) is involved in a new joint venture with other health care providers or other business entities. (Sec. 3) Requires the Secretary of Health and Human Services (HHS) to provide for the comprehensive training of State and Federal surveyors in matters relating to requirements for reimbursement and coverage of services. (Sec. 4) Requires home visits conducted as part of a home health agency's standard survey to evaluate whether individuals are homebound for purposes of qualifying for home health benefits. Requires a standard survey to include: (1) an assessment of whether the agency is in compliance with all conditions of participation and other specified requirements; (2) an assessment that the agency's managing employees have attested in writing to having sufficient knowledge of the requirements for reimbursement, coverage criteria and claims procedures, and the civil and criminal penalties for noncompliance; and (3) a review of the services provided by agency subcontractors to ensure that they are being provided in a manner consistent with requirements. Requires a survey, after the first two annual surveys, at any time the agency notifies the Secretary of a new category of skilled service it is providing, or of a new branch office. Requires occasional surveys of randomly selected agencies. Requires any agreement with a fiscal intermediary to require that it review the overall business structure of a home health agency submitting a reimbursement claim, including any related organizations of the agency. (Sec. 5) Prohibits the Secretary from entering into an agreement for the first time with a home health agency unless the agency has: (1) been in operation for at least 60 calendar days; and (2) had at least ten patients during that period of prior operation. (Sec. 6) Directs the Secretary to establish: (1) various specified standards and procedures to improve the quality of home health services; and (2) within HHS' Office of Inspector General a home health integrity task force charged with investigating fraud in home health service provision. (Sec. 9) Amends SSA title XI to provide that certain Medicare actions against debtors shall not be subject to a stay of bankruptcy proceedings. Makes certain Medicare debt nondischargeable in bankruptcy. Declares that the repayment of certain Medicare debts shall be considered final and not avoidable transfers under the Federal bankruptcy code. Amends SSA title XVIII to make Medicare rules applicable to bankruptcy proceedings of a Medicare service provider. (Sec. 10) Directs the Secretary to study and report to the Congress on all matters relating to the appropriate home health services to be provided under the Medicare program to individuals with chronic conditions.

Bill· SS. 265 (106th)referred

Hospital Length of Stay Act of 1999

United States · United States Congress · 20 January 1999

Hospital Length of Stay Act of 1999 - Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to require that group and individual health insurance coverage, as well as Medicare supplemental insurance policies and managed care plans under Medicare and Medicaid, provide coverage for hospital lengths of stay as determined by the attending health care provider in consultation with the patient. Applies these requirements also to care provided under: (1) the Federal Employees Health Benefits Program; (2) programs of medical care for members and certain former members of the uniformed services and their dependents; (3) veterans' hospital care provisions; (4) the State Children's Health Insurance Program under title XXI of the Social Security Act; (5) Indian Health Service and tribal organization programs; and (6) provisions for health care of Peace Corps volunteers.

Bill· SS. 264 (106th)referred

A bill to increase the Federal medical assistance percentage for Hawaii to 59.8 percent.

United States · United States Congress · 20 January 1999

Increases to 59.8 the Federal medical assistance percentage for the State of Hawaii for purposes of the Medicaid program and the Children's Health Insurance program under, respectively, titles XIX and XXI of the Social Security Act.

Bill· SS. 256 (106th)referred

Medicare Universal Product Number Act of 1999

United States · United States Congress · 20 January 1999

Medicare Universal Product Number Act of 1999 - Sets a deadline for all claims forms used for reimbursement under the Medicare program (title XVIII of the Social Security Act (SSA)) to accommodate the use of universal product numbers (UPNs) for a UPN covered item. Amends SSA title XVIII to require any claim for reimbursement for any UPN covered item under Medicare to contain the UPN of the covered item in order for the claim to be paid. Directs the Secretary of Health and Human Services to study and report periodically to the Congress on the implementation of this Act. Authorizes appropriations.

Bill· SS. 235 (106th)referred