Records whose title is actually about this topic. Use a country filter if the list is still too broad.
Records
Bill· HRH.R. 6045 (102nd)referred
United States · United States Congress · 25 September 1992
Amends the Internal Revenue Code to allow medical doctors an itemized deduction for the value of medical services provided: (1) without charge to an individual who is not covered by a health plan; and (2) without compensation pursuant to participation in a qualified health care organization. Provides that such deduction is not subject to the two-percent floor on miscellaneous itemized deductions.
Bill· HRH.R. 6027 (102nd)referred
United States · United States Congress · 24 September 1992
Comprehensive Health Care and Cost Containment Act of 1992 - Title I: Federal and State Administration - Subtitle A: Federal Administration - Subtitle A: Federal Administration - Establishes within the Department of Health and Human Services a Federal Health Board. Requires the Board to: (1) determine national per capita spending rates for covered district health care services and for health care practitioner services; (2) establish a single national insurance premium for enrollment catgories; (3) make Federal payments to States and insurers; (4) certify State compliance with this Act; (5) enter into reciprocity agreements with foreign countries; and (6) report to the Congress on duplicative Federal health care programs. Requires an annual report to the Congress on the status of the health care system in the United States. Establishes within the Department of Education a Federal Health Education Commission to manage the Federal grant program to States for consumer education programs and for primary care practitioners. Subtitle B: State Administration - Requires each State to provide for a State Health Board to establish health districts to appoint district health care boards, set global budgets for each health care district, establish fee schedules for practitioner groups, and develop long-range plans for future health care infrastructure. Requires each State Health Board to establish a State Health Care Education Commission to be responsible for specified activities. Title II: Health Care Services - Subtitle A: National Health Insurance Program - Sets forth national standards for health insurance for district health care services or health care practitioner services, including enrollment requirements. Authorizes reduced premiums for low-income individuals. Subtitle B: Payment Amounts for Health Care Practitioner Services and for Covered District Health Care Services - Requires each State to provide for the chartering of practitioner associations with respect to fee schedules and medical malpractice insurance. Provides for the establishment of annual per capita rates for district health care costs and the development of State and district budgets for health care services. Requires the Board to disseminate Federal payments to States for such services. Title III: Malpractice Insurance Reform - Sets forth requirements for States with respect to physician medical malpractice liability in order to be eligible for Federal payments. Title IV: Provisions Relating to ERISA and Federal and State Antitrust Laws - Declares that provisions of the Employee Retirement Income Security Act are superseded to the extent inconsistent with the requirements of this Act. Provides that the antitrust laws do not apply to health service entities covered under this Act. Title V: Health Care Education Trust Fund - Establishes the Health Care Education Trust Fund to be administered by the Federal Health Care Commission in making grants for health care consumer education. Authorizes appropriations. Amends the Internal Revenue Code to increase the tax on cigarettes and distilled spirits. Title VI: Tax Treatment of Health Insurance Premiums - Allows a tax deduction for health insurance expenses, whether or not the taxpayer itemizes deductions. Title VII: Private Options - States that individuals are not precluded from obtaining insurance for services that are covered health care services. Title VIII: Pharmaceuticals and Other Health Care Devices - Limits manufacturers and marketers of pharmaceuticals and other health devices to prices charged in Canada by the Patented Medicine Review Board. Title IX: Termination of Programs - Amends the Social Security Act to repeal certain Federal health care programs.
Bill· HRH.R. 6023 (102nd)referred
United States · United States Congress · 24 September 1992
Medicare Respite Care Coverage Act of 1992 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of respite care services for a chronically dependent individual under Medicare part B (Supplementary Medical Insurance).
Resolution· HCONRESH.Con.Res. 362 (102nd)referred
United States · United States Congress · 24 September 1992
Declares that the leadership of the House of Representatives and of the Senate should work together in a bipartisan manner to pass health care reform initiatives prior to the adjournment of the 102d Congress.
Bill· HRH.R. 5993 (102nd)referred
United States · United States Congress · 22 September 1992
National American Youth Service Act - Title I: Imposition and Term of Mandatory National Service Obligation - Imposes an obligation to perform at least 1,000 hours of national service on each individual who: (1) is a U.S. citizen or permanent resident; and (2) attains age 18 on or after October 1, 1995. Allows commencement of such service upon the individual's attaining age 18, but requires completion before the individual attains age 26. Provides that prior service shall not be counted if performed before October 1, 1995, or before registration as a participant under this Act. Provides for prorated amounts of service for new citizens and permanent residents after age 18 and before age 26. Requires registration with the local national service board within 90 days after the participant attains age 18 (or after naturalization or attainment of permanent resident status). Allows advanced registration at any time after age 16. Sets forth the types of national service to satisfy the obligation, including: (1) service as a (tax free) one dollar-per hour volunteer with an accredited sponsor organization or a Federal volunteer program established by a Federal agency pursuant to task force or identification; (2) service with the existing programs of the Peace Corps, the National Volunteer Antipoverty Program (VISTA, student community service programs, and special volunteer programs), the Urban Elementary School Literacy Corps, the American Conservation and Youth Corps and other programs of the Commission on National and Community Service, and the National Health Service Corps; (3) employment as a law enforcement officer or firefighter for at least two years before attaining age 26; (4) service in the armed forces (unless the member is separated under adverse conditions before attaining age 26); and (5) participation in the Job Corps or a job training program for the economically disadvantaged under the Job Training Partnership Act or a comparable State job training program (such participation counting toward the service obligation only if the participant successfully completes training). Makes individuals who fail to register or complete the national service obligation ineligible for: (1) appointment to a position in a Federal agency; (2) the Medicare program; (3) Federal old-age, survivors, and disability insurance benefits; (4) any student grant, loan, or work assistance under the Higher Education Act of 1965; (5) student assistance under the Public Health Service Act; and (6) job training and employment assistance under the Job Training Partnership Act. Requires inclusion of an appeals process under rules to implement such eligibility requirements and to verify individual compliance with registration and service obligations. Provides for exemptions and deferments on the basis of unfitness to serve. Provides for temporary hardship deferments. Title II: Administration of National Service - Establishes in the executive branch and Office of National Service (ONS) to regulate and oversee registration and performance of national service participants. Requires ONS to be supervised by a Director appointed by the President, by and with Senate advice and consent. Requires ONS to be fully operational by October 1, 1995. Establishes a task force on national service (the task force), which shall consist of the Director and a representative of each Executive department. Requires the task force to: (1) identify existing opportunities in the Federal Government for volunteer services performance; (2) consider methods to expand opportunities for national service participants to satisfy their obligations through federally-operated programs; and (3) report to the President and the Congress within nine months after enactment of this Act. Requires the Director to: (1) establish a system to track and record national service performance by participants; (2) consider the feasibility of using Selective Service System personnel and facilities and certain Internal Revenue Code statement and records for such purpose; (3) notify each participant upon completion of the service obligation; and (4) carry out other duties relating to information services, promotion, and consultation. Requires the Director to establish a network, consisting of a State national service office for each State and a local national service board for each congressional district, to: (1) register participants; (2) assist participants to find and perform national service in satisfaction of their obligation; and (3) approve sponsor organizations. Authorizes the Director, with the cooperation of the Director of Selective Service, to use State headquarters and local boards of the Selective Service System as part of the network. Requires each State office and local board in the network to: (1) disseminate information on registration and national service obligations; (2) provide information and counseling to participants on service opportunities; and (3) investigate complaints between participants and sponsor organizations. Sets forth application procedures for nonprofit organizations to serve as sponsor organizations for national service participants in a State. Sets forth accreditation agreement requirements for such organizations. Requires the State office to establish and maintain a directory of accredited sponsor organizations. Requires that the actual selection of a participant to perform service with a sponsor organization be left to that organization's discretion. Authorizes appropriations for titles I and II. Title III: Miscellaneous National Service Programs - Amends the National and Community Service Act of 1990 to authorize appropriations to the Commission on National and Community Service for grants under the American Conservation and Youth Service Corps program. Amends the Domestic Volunteer Service Act of 1973 to extend the authorization of appropriations for the Volunteers in Service to America (VISTA) program. Increases the minimum number of years of VISTA volunteer service (including training and other support) for which funds must be made available first from appropriations for National Volunteer Antipoverty Programs for specified fiscal years. Amends the Peace Corps Act to authorize appropriations to carry out the Peace Corps program. Requires the President to endeavor to maintain a minimum Peace Corps enrollment of at least specified numbers of volunteers for specified fiscal years. Amends the Elementary and Secondary Education Act of 1965 to direct the Secretary of Education (the Secretary) to establish the Urban Elementary School Literacy Corps (UESLC) to recruit, select, train, and assign volunteers to provide individual attention and instruction in reading and writing to first and second grade students in urban elementary schools. Sets forth UESLC program requirements for qualifying schools and volunteers, volunteer assignment and placement, terms and conditions of service, stipends, allowances and support services, notice and acceptance of terms and conditions, grievance procedures, and legal expenses. Sets forth requirements for UESLC preservice training, including support and allowances, and direct administrative authority or grants and contracts to various entities to carry out such training. Sets forth special limitations relating to UESLC volunteer activities, support costs, government assistance, and nondiscrimination. Makes Federal law relating to Federal employees inapplicable to UESLC volunteers, except as specifically provided in this Act for purposes of specific Federal laws, for credit in connection with subsequent employment in the Federal Government, and for eligibility for appointment to the competitive service in the same manner as Peace Corps volunteers. Authorizes appropriations for UESLC program. Requires the Secretary to establish the UESLC program within two years after enactment of this Act. Amends specified Federal law relating to Federal employees compensation for work injuries and civil service retirement to include provisions for UESLC volunteers. Amends the Higher Education Act of 1965 to provide for cancellation of certain student loans because of service as a UESLC volunteer. Amends the Foreign Service Act of 1980 to credit towards Foreign Service retirement any service as a UESLC volunteer. Amends the Public Health Service Act to allow a deferment of repayment of certain health education assistance while a borrower is in service as a UESLC volunteer.
Bill· HRH.R. 5989 (102nd)referred
United States · United States Congress · 22 September 1992
Family Choice and Universal Coverage Health Insurance Reform Act of 1992 - Title I: New Tax Credit for Health Expenses - Amends the Internal Revenue Code to provide a limited tax credit for coverage of the taxpayer, spouse, and dependents under a qualified health plan. Adjusts such amount for inflation. Phases out the exclusion from gross income for employer-provided health coverage. Makes such exclusion applicable only to individuals covered before the date of enactment of this Act. Terminates the medical expense deduction, the deduction for health insurance costs of the self-employed, and the health insurance earned income credit. Title II: Standards for Qualified Health Plans - Subtitle A: General Standards Relating to Benefits and Cost-Sharing, Underwriting, and Premiums for Federally-Qualified Health Plans - Specifies the required coverages of federally-qualified health plans for inpatient and outpatient hospital services, physicians' services, prenatal and well-baby and well-child care, diagnostic tests, inpatient prescription drugs, and emergency services. Allows such plans to impose cost-sharing for covered services with limitations. Prohibits the issuer of such plans from canceling or refusing to renew a policy except in the case of willful fraud, failure to pay premiums, or nonavailability. Prohibits premiums on plan renewals from taking into account claims experience or changes in health status. Subtitle B: Requirements for Current Employer Health Benefit Plans - Sets forth requirements with respect to conversion offers. Title III: Requirements on Employers - Sets forth requirements for employers with respect to withholding and remitting premiums and employee notification of contribution amounts. Requires the addition to employee wages of employer health plan contributions. Title IV: Requirements for States; Preemption of Certain State Laws; Changes in Medicaid and Medicare Programs - Requires each State, as a condition of receiving Federal funds for health care programs, to: (1) establish a health insurance program; (2) enroll each uninsured individual residing in the State; and (3) establish an office of State government to carryout such program. Sets forth requirements and administrative responsibilities of such program. Preempts State laws regarding: (1) mandated insurance benefits; (2) anti-managed care plans; and (3) certificate of need. Waives Medicaid requirements for States with an alternative health care coverage plan. Sets forth requirements for such plans. Amends the Social Security Act to eliminate Federal Medicaid payments to States for uncompensated care. Repeals the Medicare disproportionate share of hospital payment provisions. Title V: Medical Malpractice Reform - Subtitle A: Grants to States for Alternative Dispute Resolution Systems - Directs the Secretary of Health and Human Services to make grants to States for the implementation and evaluation of alternative dispute resolution (ADR) systems. Sets forth eligibility requirements for States seeking such grants. Directs the Secretary to award not less than ten such grants each fiscal year, with exceptions. Requires the Secretary to: (1) designate each State receiving such a grant as a model ADR State (making such State eligible for a two-year extension); and (2) disseminate information on the ADR systems implemented by such States to other States, health care professionals and providers, and other interested parties. Directs the Secretary to: (1) develop and promulgate standards and regulations necessary to carry out the grant program, including qualification standards that States must meet to receive grants and regulations establishing State data gathering requirements; (2) take into account, in developing qualfication standards, specified factors such as the effectiveness of such systems in supporting access to health care, encouraging improvements in the quality of care, resolving claims promptly, and providing predictable outcomes; (3) provide States with technical assistance; and (4) report to the Congress, within four years of the first grant, describing and evaluating the ADR systems implemented. Subtitle B: Uniform Standards for Malpractice Claims - Specifies that, with respect to any health care liability action brought in a Federal or State court and any medical malpractice claim or medical product liability claim subject to an ADR system: (1) no person may be required to pay more than $100,000 in a single payment in damages (whether for economic or non-economic losses) for expenses to be incurred in the future, but shall be permitted to make periodic payments (as determined by the court); (2) the total amount of damages that may be awarded to an individual for non-economic losses may not exceed $250,000; (3) the total amount of damages received by an individual shall be reduced by any other payment that has been or will be made to the individual to compensate such individual for the injury that was the subject of the action or claim; (4) a claimant's attorney's fees may not exceed 25 percent of the first $150,000 of any award or settlement, or 15 percent of any additional amounts, paid to the claimant; (5) the total amount of punitive damages that may be assessed may not exceed twice the total amount of the damages awarded to compensate the claimant for losses resulting from the injury; and (6) the liability of each defendant for non-economic losses shall be several only and not joint, and each defendant shall be liable only for the amount of non-economic losses allocated to the defendant in direct proportion to the defendant's percentage of responsibility. Establishes a two-year statute of limitations for medical malpractice and product liability claims, beginning on the earlier of the date on which the injury that is the subject of the action was discovered or the date it should reasonably have been discovered. Specifies that, in the case of a medical malpractice or product liability claim relating to services provided during labor or the delivery of a baby, if the claimant was not previously treated for the pregnancy by the defendant health care professional or provider a court may not find that the defendant committed malpractice and assess damages against the defendant unless the malpractice is proven by clear and convincing evidence. Bars a defendant from being found to have committed malpractice unless the defendant's conduct at the time of providing the health care services was not reasonable, except where the claimant asserts that the defendant is liable under a strict liability theory. Bars the award of punitive damages with respect to any medical product liability claim alleged against a medical product producer if the drug or device that is the subject of the claim: (1) was subject to approval or premarket approval under the Federal Food, Drug, and Cosmetic Act by the Food and Drug Administration (FDA) with respect to the safety or performance of the drug or device or the adequacy of the packaging or labeling; (2) was approved by FDA; or (3) is generally recognized as safe and effective pursuant to conditions established by FDA and applicable regulations. Makes an exception in the case of withheld information, misrepresentation, or illegal payment to an FDA official for purposes of securing approval of the drug or device. Provides for a separate proceeding to determine punitive damages. Sets forth provisions with respect to: (1) the admissibility of evidence; and (2) criteria for determining the amount of punitive damages. Provides that the U.S. district courts shall not have jurisdiction over health care liability actions based on Federal questions or based on specified provisions concerning commerce and antitrust regulations. Specifies that this title preempts State law only to the extent that State law: (1) permits the recovery by a claimant or the assessment against a defendant of a greater amount of damages; (2) permits the awarding of a greater amount of attorneys' fees; (3) establishes a longer period during which medical malpractice or product liability claims may be initiated; or (4) establishes a less strict standard of proof for determining whether a defendant has committed malpractice.
Bill· HRH.R. 5985 (102nd)referred
United States · United States Congress · 22 September 1992
Community Ambulance Support Act of 1992 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of paramedic intercept services under part B (Supplementary Medical Insurance) of Medicare.
Bill· SS. 3256 (102nd)referred
United States · United States Congress · 21 September 1992
Minority Biomedical Research Construction Act - Amends the Public Health Service Act to authorize grants to eligible institutions, including historically Black colleges and universities, for the acquisition, construction, remodeling, expansion, or equipping of graduate biomedical research facilities. Defines as eligible an institution that has at least one-half of its students from disadvantaged backgrounds and that awards doctoral degrees in the health professions or biomedical sciences. Authorizes approprations.
Bill· SJRESS.J.Res. 340 (102nd)referred
United States · United States Congress · 21 September 1992
Designates the week of February 14 through 20, 1993, as National Visiting Nurse Associations Week.
Bill· SS. 3243 (102nd)referred
United States · United States Congress · 17 September 1992
Family Investment Act of 1992 - Title I: Family and Medical Leave - Subtitle A: Short Title; Findings and Purposes - Family and Medical Leave Act of 1992 - Sets forth the short title of this title I, along with findings and purposes. Subtitle B: General Requirements for Leave - Establishes certain requirements for family and medical leave for permanent employees. Makes employees eligible for such leave if they have been employed, by the employer from whom leave is sought, for at least: (1) a total of 12 months; and (2) 1,250 hours of service during the previous 12-month period. (Excludes from such coverage: (1) employees at worksites at which the employer employs less than 50 persons, if the total number of employees of that employer within 75 miles of that worksite is less than 50; and (2) Federal officers and employees covered under subtitle C of this title.) Entitles employees to 12 workweeks of leave during any 12-month period because of: (1) the birth and care of their child; (2) the placement of a child for their adoption or foster care; (3) their care of a child, spouse, or parent who has a serious health condition; or (4) their own serious health condition which makes them unable to perform the functions of their position. Conditions such leave for the birth or placement of a child as follows: (1) the entitlement ends 12 months after the birth or placement; and (2) such leave may not be taken intermittently unless employee and employer agree otherwise. Allows intermittent leave for necessary medical treatment of an employee or family member. Allows the employer to require a temporary transfer to an equivalent alternative position that better accommodates such intermittent leave. Allows all leave to which an employee is entitled under this subtitle: (1) to be taken on a reduced leave schedule, upon agreement with the employer; and (2) to consist of unpaid leave, except under specified conditions when substitution of certain types of paid leave may be elected or required. Declares that nothing in this Act shall require an employer to provide paid sick or medical leave in any situation in which the employer would not normally provide any such paid leave. Requires employees to: (1) give at least 30 days' notice of the need for leave to which they are entitled under this Act, when foreseeable; and (2) make a reasonable effort to schedule medical treatment or supervision so as not to disrupt unduly the employer's operations, subject to approval of the health care provider. Allows limitation of the dual aggregate leave entitlement to 12 weeks in any 12-month period, in the case of spouses employed by the same employer, if such leave is for the birth or placement of a child or for the care of a sick parent. Sets forth conditions of certification for leave entitlements under this title, including provisions relating to: (1) sufficient certification; (2) explanation of inability to perform job functions; (3) dates and duration of planned medical treatment in the case of intermittent leave; (4) second opinion; (5) resolution of conflicting opinions; and (6) subsequent recertification. Sets forth employment and benefits protections relating to leave entitlements under this title. Requires restoration of the employee to his or her position or an equivalent position upon return from such leave. Allows an employer to deny such restoration to certain highly compensated employees (i.e. those among the highest paid ten percent of the employer's employees within 75 miles of the facility at which the employee works), under specified conditions, if necessary to prevent substantial and grievous economic injury to the employer's operations. Requires maintenance of employee health benefits during such leave. Allows the employer to recover premiums paid for such coverage if the employee fails to return to work after the leave period has expired for reasons other than a certified serious health condition or other circumstances beyond the employee's control. Prohibits employers or other persons from: (1) interfering with employee rights under this title; or (2) from discriminating against any individual because of participation in proceedings or inquiries under this subtitle, or because the individual opposes any practice made unlawful by this subtitle. Sets forth the investigative authority of the Secretary of Labor (the Secretary) under this subtitle. Provides for enforcement of this title. Provides for administrative action by the Secretary to resolve complaints of violations under this subtitle in the same manner as under specified provisions of the Fair Labor Standards Act of 1938. Provides for civil actions by employees, and by the Secretary on their behalf. Makes an employer who violates this subtitle's prohibitions against interfering with employee exercise of rights or discriminating against employees liable for damages in the amount of: (1) any wages, salary, employment benefits, or other compensation denied or lost to the employee by reason of the violation; (2) (in any case where such compensation has not been denied or lost) any actual monetary losses sustained by the employee as a direct result of the violation, such as the cost of providing care, up to the amount of 12 weeks' wages or salary; (3) interest on such losses; and (4) an additional amount of liquidated damages equal to the sum of such losses and the interest (except that the court may reduce or eliminate such additional liquidated damages in cases where the employer can show good faith and reasonable grounds for believing that the act or omission was not a violation). Makes such employers also liable for appropriate equitable relief, including, without limitation, employment, reinstatement, and promotion. Requires the court to allow attorney's fees and other costs of the action to be paid by the defendant in addition to any judgment awarded to the plaintiff. Sets forth provisions for limitations of such civil actions. Sets forth provisions for action for injunction by the Secretary. Sets forth special rules concerning employees of local educational agencies and of private elementary and secondary schools, including provisions relating to intermittent leave for instructional employees, periods near the completion of an academic term, and reduction of liability. Requires employers to post notice of the pertinent provisions of this subtitle. Requires fines for willful violations of such requirement. Directs the Secretary of Labor to prescribe regulations to carry out this subtitle. Subtitle C: Leave for Civil Service Employees - Amends specified Federal law to entitle civil service employees to family and temporary medical leave for specified periods. Makes such employees eligible for such leave if they have been employed by an employing agency for at least 12 months on other than a temporary or intermittent basis. Allows such employees up to 12 administrative workweeks in any 12-month period for: (1) family leave (i.e., leave because of the birth or placement of a child or care of a sick spouse, child, or parent), but such leave may not be used at a time more than 12 months after such birth or placement; or (2) temporary medical leave for a serious health condition that makes the employee unable to perform the functions of their position. Provides that such leave shall be without pay. Allows employees to substitute other types of paid leave for any part of such leave. Sets forth requirements for employees to give prior notice of the need for such leave, when foreseeable, and to schedule medical treatments, if possible, so as to not unduly disrupt the employing agency's operations. Sets forth certification provisions. Provides for protection for job position and health insurance benefits of employees using such leave. Sets forth prohibitions against coercion. Requires the Office of Personnel Management to prescribe regulations for administration of this title which are consistent with the regulations prescribed by the Secretary of Labor under subtitle B of this title. Subtitle D: Commission on Leave - Establishes the Commission on Leave. Requires the Commission to conduct a comprehensive study of: (1) existing and proposed policies relating to leave; (2) the potential costs, benefits, and impact on productivity of such policies on employers; and (3) alternative and equivalent State enforcement of this title with respect to employees of local educational agencies and private schools. Requires the Commission to report on such study to the Congress within two years after the Commission first meets. Terminates the Commission within 30 days after its report to the Congress. Subtitle E: Miscellaneous Provisions - Sets forth the effect of this title on other laws and existing employment benefits. Provides that nothing in this title shall be construed to discourage employers from adopting more generous leave policies. Directs the Secretary of Labor to prescribe regulations to carry out this subtitle within 60 days. Subtitle F: Coverage of Congressional Employees - Applies the rights and protections established under specified provisions of subtitle B of this title to Senate employees and any employing office of the Senate. Makes specified provisions of the Government Employee Rights Act of 1991 applicable, with certain exceptions including limitations on the period for requests for counseling. Provides that allegations shall be considered by the Office of Senate Fair Employment Practices or another entity designated by the Senate. Requires such Office to ensure that Senate employees are informed of their rights under this title. Applies the rights and protections under subtitle B of this title to employees of the House of Representatives, except for the exemption concerning highly compensated employees. Requires that the remedies and procedures under the Fair Employment Practices Resolution be applied in administering such coverage. Title II: Head Start, Child Immunization, and Other Assistance for Children - Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to treat as emergency funding requirements not subject to discretionary spending limits the costs of carrying out Head Start programs under the Head Start Act, child immunizations under the Public Health Service Act, and the special supplemental food program (WIC) under the Child Nutrition Act of 1966. Title III: Family Involvement in Education - Parents as Teachers: The Family Involvement in Education Act of 1992 - Amends the Elementary and Secondary Education Act of 1965 to establish a Parents as Teachers program. Authorizes the Secretary of Education (the Secretary) to make grants to States for parents as teachers programs, with special consideration for hard-to-serve populations. Makes eligible for such a grant any State which operates a parents as teachers program associated with the Parents as Teachers National Center in Missouri. Sets forth program requirements, limiting services to families during the period from the last three months of a mother's pregnancy to the child's attaining age three. Directs the Secretary to: (1) establish a Parents as Teachers National Center for information dissemination and technical and training assistance for States with such programs; and (2) evaluate such programs within four years. Provides for a declining Federal share in such program from 100 percent in the first year to 25 percent in the fifth year. Authorizes appropriations. Title IV: Child Welfare - Subtitle A: Foster Care, Adoption, and Child Welfare Services - Amends part B (Child-Welfare Services) of title IV of the Social Security Act (SSA) to create a permanent capped entitlement program for innovative child and family services designed to preserve and strengthen families and prevent the need for unnecessary placement in foster care. Authorizes appropriations. Directs the Secretary of Health and Human Services (HHS) to authorize up to 15 States to conduct demonstration projects to improve the coordination of services and benefits provided by child and family services programs with others such as the women, infants, and children (WIC), the job opportunities and basic skills (JOBS) and Medicaid (SSA title XIX) programs which provide such services. Directs the Secretaries of HHS, of Agriculture, of Education, and the Attorney General to: (1) review department policies and regulations to determine whether changes can be made without statutory changes to improve the funding and delivery of such services; and (2) issue a report to the Congress that includes recommendations for both legislative and nonlegislative changes to improve the coordination of the funding and delivery of such services. Amends SSA title IV part E (Foster Care and Adoption Assistance) to require that a court or administrative body conducting a periodic case review of a child who is legally eligible for adoption determine and document: (1) for the child the specific measures taken by the State child welfare agency to find an adoptive family; or (2) that adoption placement would be inappropriate for the child. Gives State part E plans the option of continuing foster care maintenance and adoption assistance payments to children whose adoptions have set aside by a court. Amends the Internal Revenue Code to provide for a tax deduction of up to $3,000 for families who adopt a child with special needs. Directs the HHS Secretary to establish an Advisory Committee on Foster Care Placement to study and report to the Secretary and the Congress with respect to reasonable efforts requirements under State part E plan provisions. Revises the definition of case review system. Directs the HHS Secretary to provide for demonstration projects to test whether family reunification can be facilitated by allowing a family to receive assistance under SSA title IV part A (Aid to Families with Dependent Children) (AFDC) for the month prior to the child's return home from a foster care placement. Provides for Federal payment of specified percentages of State costs in developing, installing, and operating statewide mechanized data collection and information retrieval systems which: (1) the Secretary determines are likely to enhance the administration of programs under parts B and E; and (2) meet other specified requirements. Modifies the independent living program to permit States to allow foster children making the transition from foster care to independent living to accumulate assets for the purpose of establishing a household while preserving such child's eligibility for Medicaid. Makes such program permanent. Directs the HHS Secretary to provide for: (1) child welfare traineeships under part B for the education and training of students in child welfare services programs; and (2) guidelines for States to use Federal funds for training State and local child welfare agency employees in order to improve agency capacity to administer programs under parts B and E and to provide services accordingly. Provides for an extension of the increase in reimbursement for foster and adoptive parent training made under the Omnibus Budget Reconciliation Act of 1989. Adds to the list of information comprising the health and education records of foster children: (1) the telephone numbers of the child's health and educational providers; and (2) a record that the foster care provider was advised of the child's eligibility for Medicaid services. Permits the HHS Secretary to authorize up to ten States to conduct and evaluate specified types of child welfare demonstration projects. Allows the State of New York, after its application has been approved by the HHS Secretary as meeting specified requirements, to conduct a demonstration project for the purpose of testing how to enhance the practices and procedures that will expedite the discharge of children from foster care or the adoption of children by suitable parents. Amends the Omnibus Budget Reconciliation Act of 1989 to modify the prohibition against penalizing States before FY 1991 for noncompliance with foster care protections. Directs the HHS Secretary to submit to specified congressional committees recommendations for legislation to establish a system for the review of State child welfare programs and the provision of technical assistance to any such program. Requires the HHS Secretary to pay a State claim for foster care and adoption assistance within 90 days of its receipt unless the Secretary issues a deferral or a disallowance of such claim prior to the expiration of such 90 day period. Directs the HHS Secretary to appoint a Commission on the Evaluation of Disability in Children to study and report to the Congress on the effects of the definition of "disability" under the Supplemental Security Income program (SSA title XVI) as it applies to determining whether a child under age 18 is eligible to receive benefits under such program. Subtitle B: Provisions Relating to Comprehensive Substance Abuse Programs for Pregnant Women and Caretaker Parents with Children - Amends SSA title IV part B to authorize appropriations to enable States to establish comprehensive programs of substance abuse treatment for certain low-income pregnant women, caretaker parents, and their children. Title V: Safe Children and Communities - Safe Children and Communities Act of 1992 - Authorizes the Secretary to make grants for projects to improve the safety of families with children in low-income, violent communities. Authorizes appropriations.
Bill· HRH.R. 5970 (102nd)referred
United States · United States Congress · 17 September 1992
American Health Care Access Improvements Act of 1992 - Title I: Health Care Access Improvements - Subtitle A: Health Insurance Deduction Fairness - Amends the Internal Revenue Code to make permanent and increase from 25 to 100 percent the health insurance tax deduction for the self-employed. Subtitle B: Extension of Special Treatment Rules for Medicare-Dependent, Small Rural Hospitals - Amends title XVIII (Medicare) of the Social Security Act to extend for one year special treatment rules for Medicare-dependent small rural hospitals. Subtitle C: Benefits and Services Requirements for Exemption From Tax for Hospitals - Amends the Internal Revenue Code to set forth requirements for hospitals to maintain tax-exempt status, including: (1) the provision of certain emergency medical care; (2) the acceptance of Medicaid and Medicare patients; and (3) the provision of community health centers and clinics in medically underserved areas. Title II: Insurance Availability - Requires eligible uninsured individuals to register with the Secretary of Health and Human Services for enrollment in a qualified Federal health plan. Provides for the collection of premiums through the income tax system. Authorizes appropriations. Title III: Health Care Cost Containment - Subtitle A: Paperwork and Administrative Expense Reduction - Requires the Director of the Office of Management and Budget to: (1) identify, inventory, and assess the Federal paperwork burden associated with health care services; and (2) establish a goal for reducing such burden in each of the fiscal years 1993 through 1998 by at least five percent of the preceding fiscal year's paperwork burden. Provides a bonus for providers who initiate the use of electronic claims under the Medicare program. Subtitle B: Medical Malpractice Liability Reform - Directs the Secretary of Health and Human Services to make grants to States for the implementation and evaluation of alternative dispute resolution (ADR) systems. Sets forth eligibility requirements for States seeking such grants. Directs the Secretary to award not less than ten such grants each fiscal year, with exceptions. Requires the Secretary to: (1) designate each State receiving such a grant as a model ADR State (making such State eligible for a two-year extension); and (2) disseminate information on the ADR systems implemented by such States to other States, health care professionals and providers, and other interested parties. Directs the Secretary to: (1) develop and promulgate standards and regulations necessary to carry out the grant program, including qualification standards that States must meet to receive grants and regulations establishing State data gathering requirements; (2) take into account, in developing qualification standards, specified factors such as the effectiveness of such systems in supporting access to health care, encouraging improvements in the quality of care, resolving claims promptly, and providing predictable outcomes; (3) provide States with technical assistance; and (4) report to the Congress, within four years of the first grant, describing and evaluating the ADR systems implemented. Specifies that, with respect to any health care liability action brought in a Federal or State court and any medical malpractice claim or medical product liability claim subject to an ADR system: (1) no person may be required to pay more than $100,000 in a single payment in damages (whether for economic or non-economic losses) for expenses to be incurred in the future, but shall be permitted to make periodic payments (as determined by the court); (2) the total amount of damages that may be awarded to an individual and the family members of such individual for non-economic losses may not exceed $250,000; (3) the total amount of damages received by an individual shall be reduced by any other payment that has been or will be made to the individual to compensate such individual for the injury that was the subject of the action or claim; (4) a claimant's attorney's fees may not exceed 25 percent of the first $150,000 of any award or settlement, or 15 percent of any additional amounts, paid to the claimant; (5) the total amount of punitive damages that may be assessed may not exceed twice the total amount of the damages awarded to compensate the claimant for losses resulting from the injury; and (6) the liability of each defendant for non-economic losses shall be several only and not joint, and each defendant shall be liable only for the amount of non-economic losses allocated to the defendant in direct proportion to the defendant's percentage of responsibility. Establishes a two-year statute of limitations for medical malpractice and product liability claims, beginning on the earlier of the date on which the injury that is the subject of the action was discovered or the date it should reasonably have been discovered. Specifies that, in the case of a medical malpractice or product liability claim relating to services provided during labor or the delivery of a baby, if the claimant was not previously treated for the pregnancy by the defendant health care professional or provider a court may not find that the defendant committed malpractice and assess damages against the defendant unless the malpractice is proven by clear and convincing evidence. Bars a defendant from being found to have committed malpractice unless the defendant's conduct at the time of providing the health care services was not reasonable, except where the claimant asserts that the defendant is liable under a strict liability theory. Bars the award of punitive damages with respect to any medical product liability claim alleged against a medical product producer if the drug or device that is the subject of the claim: (1) was subject to approval or premarket approval under the Federal Food, Drug, and Cosmetic Act by the Food and Drug Administration (FDA) with respect to the safety or performance of the drug or device or the adequacy of the packaging or labeling; (2) was approved by FDA; or (3) is generally recognized as safe and effective pursuant to conditions established by FDA and applicable regulations. Makes an exception in the case of withheld information, misrepresentation, or illegal payment to an FDA official for purposes of securing approval of the drug or device. Provides for a separate proceeding to determine punitive damages. Sets forth provisions with respect to: (1) the admissibility of evidence; and (2) criteria for determining the amount of punitive damages. Provides that the U.S. district courts shall not have jurisdiction over health care liability actions based on Federal questions or based on specified provisions concerning commerce and antitrust regulations. Specifies that this title preempts State law only to the extent that State law: (1) permits the recovery by a claimant or the assessment against a defendant of a greater amount of damages; (2) permits the awarding of a greater amount of attorney's fees; (3) establishes a longer period during which medical malpractice or product liability claims may be initiated; or (4) establishes a less strict standard of proof for determining whether a defendant has committed malpractice. Amends the Public Health Service Act to direct the Secretary to encourage the establishment of a nationwide risk retention group (RRG) for community and migrant health centers receiving assistance under such Act. Defines an RRG for purposes of this title as an entity defined in the Liability Risk Retention Act of 1986 that: (1) provides professional liability insurance and other types of profitable insurance approved for issuance by the Secretary to community and migrant health centers; (2) provides insurance that applies to all claims filed against a community or migrant health center after the entity initiates insurance coverage and to claims arising from acts that occurred prior to the initiation of coverage if the claims are not covered by other insurance; and (3) meets such other requirements as the Secretary may establish. Subtitle C: Medical Savings Accounts - Amends the Internal Revenue Code to allow individuals a tax deduction for contributions made to a medical care savings account established for the benefit of an eligible individual. Defines an eligible individual as: (1) one who is not covered by an employer-provided group health plan; or (2) one who is covered by such a plan which is a qualified catastrophic coverage health plan and is not covered by any other health plan. Allows penalty-free withdrawals from such accounts to the extent that amounts in such accounts exceed $15,000. Allows such deduction in arriving at adjusted gross income. Establishes an excise tax for excess contributions to medical care savings accounts and makes such accounts subject to the tax on prohibited transactions. Allows the transfer of unused amounts in flexible spending accounts of cafeteria plans to medical savings accounts. Subtitle D: Estimates of Expenses Prior to Treatment - Requires providers of health care items or services to disclose to individuals prior to their treatment the price to be charged for such items or services, except in cases of emergencies. Subtitle E: Limitation on Exclusion for Employer Provided Health Coverage - Limits the amount excludable from the gross income of an employee for employer-provided health care coverage. Subjects such amount to an inflation adjustment.
Bill· HRH.R. 5973 (102nd)referred
United States · United States Congress · 17 September 1992
Family Investment Act of 1992 - Title I: Family and Medical Leave - Subtitle A: Short Title; Findings and Purposes - Family and Medical Leave Act of 1992 - Sets forth the short title of this title I, along with findings and purposes. Subtitle B: General Requirements for Leave - Establishes certain requirements for family and medical leave for permanent employees. Makes employees eligible for such leave if they have been employed, by the employer from whom leave is sought, for at least: (1) a total of 12 months; and (2) 1,250 hours of service during the previous 12-month period. (Excludes from such coverage: (1) employees at worksites at which the employer employs less than 50 persons, if the total number of employees of that employer within 75 miles of that worksite is less than 50; and (2) Federal officers and employees covered under subtitle C of this title.) Entitles employees to 12 workweeks of leave during any 12-month period because of: (1) the birth and care of their child; (2) the placement of a child for their adoption or foster care; (3) their care of a child, spouse, or parent who has a serious health condition; or (4) their own serious health condition which makes them unable to perform the functions of their position. Conditions such leave for the birth or placement of a child as follows: (1) the entitlement ends 12 months after the birth or placement; (2) such leave may not be taken intermittently unless employee and employer agree otherwise. Allows intermittent leave for necessary medical treatment of an employee or family member. Allows the employer to require a temporary transfer to an equivalent alternative position that better accommodates such intermittent leave. Allows all leave to which an employee is entitled under this subtitle: (1) to be taken on a reduced leave schedule, upon agreement with the employer; and (2) to consist of unpaid leave, except under specified conditions when substitution of certain types of paid leave may be elected or required. Declares that nothing in this Act shall require an employer to provide paid sick or medical leave in any situation in which the employer would not normally provide any such paid leave. Requires employees to: (1) give at least 30 days' notice of the need for leave to which they are entitled under this Act, when foreseeable; and (2) make a reasonable effort to schedule medical treatment or supervision so as not to disrupt unduly the employer's operations, subject to approval of the health care provider. Allows limitation of the dual aggregate leave entitlement to 12 weeks in any 12-month period, in the case of spouses employed by the same employer, if such leave is for the birth or placement of a child or for the care of a sick parent. Sets forth conditions of certification for leave entitlements under this title, including provisions relating to: (1) sufficient certification; (2) explanation of inability to perform job functions; (3) dates and duration of planned medical treatment in the case of intermittent leave; (4) second opinion; (5) resolution of conflicting opinions; and (6) subsequent recertification. Sets forth employment and benefits protections relating to leave entitlements under this title. Requires restoration of the employee to his or her position or an equivalent position upon return from such leave. Allows an employer to deny such restoration to certain highly compensated employees (i.e. those among the highest paid ten percent of the employer's employees within 75 miles of the facility at which the employee works), under specified conditions, if necessary to prevent substantial and grievous economic injury to the employer's operations. Requires maintenance of employee health benefits during such leave. Allows the employer to recover premiums paid for such coverage if the employee fails to return to work after the leave period has expired for reasons other than a certified serious health condition or other circumstances beyond the employee's control. Prohibits employers or other persons from: (1) interfering with employee rights under this title; or (2) from discriminating against any individual because of participation in proceedings or inquiries under this subtitle, or because the individual opposes any practice made unlawful by this subtitle. Sets forth the investigative authority of the Secretary of Labor (the Secretary) under this subtitle. Provides for enforcement of this title. Provides for administrative action by the Secretary to resolve complaints of violations under this subtitle in the same manner as under specified provisions of the Fair Labor Standards Act of 1938. Provides for civil actions by employees, and by the Secretary on their behalf. Makes an employer who violates this subtitle's prohibitions against interfering with employee exercise of rights or discriminating against employees liable for damages in the amount of: (1) any wages, salary, employment benefits, or other compensation denied or lost to the employee by reason of the violation; (2) (in any case where such compensation has not been denied or lost) any actual monetary losses sustained by the employee as a direct result of the violation, such as the cost of providing care, up to the amount of 12 weeks' wages or salary; (3) interest on such losses; and (4) an additional amount of liquidated damages equal to the sum of such losses and the interest (except that the court may reduce or eliminate such additional liquidated damages in cases where the employer can show good faith and reasonable grounds for believing that the act or omission was not a violation). Makes such employers also liable for appropriate equitable relief, including, without limitation, employment, reinstatement, and promotion. Requires the court to allow attorney's fees and other costs of the action to be paid by the defendant in addition to any judgment awarded to the plaintiff. Sets forth provisions for limitations of such civil actions. Sets forth provisions for action for injunction by the Secretary. Sets forth special rules concerning employees of local educational agencies and of private elementary and secondary schools, including provisions relating to intermittent leave for instructional employees, periods near the completion of an academic term, and reduction of liability. Requires employers to post notice of the pertinent provisions of this subtitle. Requires fines for willful violations of such requirement. Directs the Secretary of Labor to prescribe regulations to carry out this subtitle. Subtitle C: Leave for Civil Service Employees - Amends specified Federal law to entitle civil service employees to family and temporary medical leave for specified periods. Makes such employees eligible for such leave if they have been employed by an employing agency for at least 12 months on other than a temporary or intermittent basis. Allows such employees up to 12 administrative workweeks in any 12-month period for: (1) family leave (i.e., leave because of the birth or placement of a child or care of a sick spouse, child, or parent), but such leave may not be used at a time more than 12 months after such birth or placement; or (2) temporary medical leave for a serious health condition that makes the employee unable to perform the functions of their position. Provides that such leave shall be without pay. Allows employees to substitute other types of paid leave for any part of such leave. Sets forth requirements for employees to give prior notice of the need for such leave, when foreseeable, and to schedule medical treatments, if possible, so as to not unduly disrupt the employing agency's operations. Sets forth certification provisions. Provides for protection for job position and health insurance benefits of employees using such leave. Sets forth prohibitions against coercion. Requires the Office of Personnel Management to prescribe regulations for administration of this title which are consistent with the regulations prescribed by the Secretary of Labor under subtitle B of this title. Subtitle D: Commission on Leave - Establishes the Commission on Leave. Requires the Commission to conduct a comprehensive study of: (1) existing and proposed policies relating to leave; (2) the potential costs, benefits, and impact on productivity of such policies on employers; and (3) alternative and equivalent State enforcement of this title with respect to employees of local educational agencies and private schools. Requires the Commission to report on such study to the Congress within two years after the Commission first meets. Terminates the Commission within 30 days after its report to the Congress. Subtitle E: Miscellaneous Provisions - Sets forth the effect of this title on other laws and existing employment benefits. Provides that nothing in this title shall be construed to discourage employers from adopting more generous leave policies. Directs the Secretary of Labor to prescribe regulations to carry out this subtitle within 60 days. Subtitle F: Coverage of Congressional Employees - Applies the rights and protections established under specified provisions of subtitle B of this title to Senate employees and any employing office of the Senate. Makes specified provisions of the Government Employee Rights Act of 1991 applicable, with certain exceptions including limitations on the period for requests for counseling. Provides that allegations shall be considered by the Office of Senate Fair Employment Practices or another entity designated by the Senate. Requires such Office to ensure that Senate employees are informed of their rights under this title. Applies the rights and protections under subtitle B of this title to employees of the House of Representatives, except for the exemption concerning highly compensated employees. Requires that the remedies and procedures under the Fair Employment Practices Resolution be applied in administering such coverage. Title II: Head Start, Child Immunization, and WIC Programs as Emergency Funding for Budget Purposes - Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to treat as emergency funding requirements not subject to discretionary spending limits the costs of carrying out Head Start programs under the Head Start Act, child immunizations under the Public Health Service Act, and the special supplemental food program (WIC) under the Child Nutrition Act of 1966. Title III: Parents as Teachers - Parents as Teachers: the Family Involvement in Education Act of 1992 - Amends the Elementary and Secondary Education Act of 1965 to establish a Parents as Teachers program. Authorizes the Secretary of Education (the Secretary) to make grants to States for parents as teachers programs, with special consideration for hard-to-serve populations. Makes eligible for such a grant any State which operates a parents as teachers program associated with the Parents as Teachers National Center in Missouri. Sets forth program requirements, limiting services to families during the period from the last three months of a mother's pregnancy to the child's attaining age three. Directs the Secretary to: (1) establish a Parents as Teachers National Center for information dissemination and technical and training assistance for States with such programs; and (2) evaluate such programs within four years. Provides for a declining Federal share in such program from 100 percent in the first year to 25 percent in the fifth year. Authorizes appropriations. Title IV: Family Preservation - Subtitle A: References to Social Security Act - States that, except as otherwise expressly provided, all amendments in this title are to the Social Security Act. Subtitle B: Child Welfare Services - Amends part B (Child Welfare Services) of title IV of the Social Security Act (SSA) to create an entitlement program for specialized child welfare services designed to keep together or reunify families in crises due to substance abuse, and prevent the need for placement in foster care. Repeals provisions for incentive payments to States which maintain a foster care inventory, information system, and case review system; but requires States to provide such protections and other services designed to keep families together or reunify them, or to place children for adoption, with a legal guardian, or in some other planned, permanent living arrangement. Requires States to submit the following types of reports on child welfare services and expenditures: (1) pre-expenditure reports; (2) post-expenditure reports; and (3) comparative financial contributions reports. Requires the Secretary of Health and Human Services to transmit annually to specified congressional committees a summary of the information in such contributions reports. Reserves funds for entitlement grants to State court systems to assess and improve procedures in child welfare cases, in carrying out SSA title IV parts B and E (Foster Care and Adoption Assistance). Sets forth application requirements and formulas for determining the amount of such grants for FY 1994 through 1998. Directs the Secretary to submit interim and final reports to the Congress on the information obtained from assessments conducted with such grants and the impact of such grant program on State court procedures and functions. Requires each State to compile biennially a detailed directory of programs designed to keep families together or reunify them or place children permanenty, identifying which of such programs provides specialized child welfare services to families in crisis due to substance abuse. Requires State part B plans to contain a description of the measures taken by the State to comply with the Indian Child Welfare Act. Subtitle C: Foster Care and Adoption Assistance - Amends SSA title IV to add a new part C, Comprehensive Service Projects to grant States the flexibility and resources to develop comprehensive and coordinated services designed to: (1) preserve and strengthen families with children at risk of placement outside their homes; (2) reunite children with their families expeditiously if an out-of-home placement is found to be necessary; and (3) place children in adoptive homes or other permanent arrangements in a timely fashion if reunification with their families is not appropriate. Permits any State to apply to the Secretary for permission to: (1) conduct a comprehensive service project in a selected area or areas; and (2) suspend certain child welfare services and foster care and adoption assistance requirements with respect to State activities in such area or areas during the project. Sets forth: (1) application requirements and administrative provisions for such projects; (2) requirements with which such a project must comply; (3) provisions for determining project grant amounts; and (4) requirements for notification to States of such amounts, and for grant payments in equal quarterly installments. Places restrictions on the manner in which a State may carry out such projects. Requires States to report annually on funds expended under such projects to the Secretary and the Advisory Commission on Children and Families. Provides for project termination. Permits foster care and adoption assistance payments to be made in certain cases involving abandoned children and children whose adoption has been set aside by a court. Makes technical changes in the foster care maintenance and adoption assistance programs with respect to the removal from home requirement. Gives States the option of providing for respite care for foster parents with children who have special needs. Expands the definition of children with special needs for purposes of the adoption assistance program. Requires each States to submit to the Secretary the factors and conditions it uses to identify children with special needs, for purpsoes of such program, and any modifications to such factors and conditions. Directs the Secretary to establish an Advisory Committee on Foster Care Placement to study and report to the Secretary and the Congress on reasonable efforts requirements under State part E plan provisions. Covers specified percentages of State costs in developing, installing, and operating statewide mechanized data collection and information retrieval systems which: (1) the Secretary determines are likely to enhance the administrations of programs under parts B and E; and (2) meet other specified requirements. Requires State part E plans to provide for: (1) a triennial review of the amounts paid as foster care maintenance payments and adoption assistance to assure their continuing appropriateness; and (2) a report to the Secretary on the results. Requires that the dispositional hearing to determine the final status of a foster child occur within 12 months of his or her original placement, rather than the current 18 months. Revises: (1) the definition of "case review system"; and (2) the time frame for judicial determinations on voluntary placements. Sets forth case plan requirements for placement of children in out-of-State foster care. Requires annual review of the status of children in out-of-State foster care placements with the child present, except under certain circumstances. Requires States to collect data on the numbers of children in out-of-State foster care placements. Requires a State, in order to receive payments for expenditures after FY 1994 for foster care maintenance payments with respect to children placed in foster care outside the State, to conduct and submit to the Secretary a study identifying the number and common characteristics of such children and the reason why they were not placed in foster care in the State. Permits States to allow foster children making the transition from foster care to independent living to accumulate assets for the purpose of establishing a household. Eliminates: (1) the ceilings on Federal foster care payments to States; and (2) the States' authority to transfer unused foster care funds to the Child Welfare Services program. Directs the Secretary to: (1) establish an advisory committee; and (2) after consultation with it, issue final regulations for training of staff of agencies responsible for administering foster care and adoption assistance programs and for training of foster and adoptive parents. Directs the Secretary to publish annually information, on a State-by-State basis, on expenditures for, and the operations of, the Child Welfare Services program, the Foster Care and Adoption Assistance program, and Comprehensive Service Projects. Amends SSA title IV to add a new part G, Child Welfare Review System, under which the Secretary is required to: (1) establish a new system for reviewing State child welfare program compliance with SSA requirements; and (2) take certain actions in cases of noncompliance, which include imposing financial penalties. Subtitle D: Social Services Block Grant - Amends SSA title XX (Block Grants to States for Social Services) to authorize increased appropriations under such grant program. Provides for the allocation of funds to Indian tribes and tribal organizations. Subtitle E: Research, Demonstration, and Evaluation Activities - Amends part A (General Provisions) of SSA title XI to require the Director of the Office of Technology Assessment (OTA) to establish an Advisory Commission on Children and Families. Requires the Commission to collect and assess specified types of information in order to identify cost-effective approaches to protect and enhance the physical, mental, emotional, and financial well-being of children and their families. Directs OTA to report annually to the Congress on the Commission and its assessment. Requires the Commission to conduct, directly or through contracts with independent research organizations, the following research and evaluation projects: (1) an evaluation of child welfare service programs, including intensive family preservation programs; (2) foster care evaluations; (3) longitudinal child welfare data bases, and studies of child welfare population dynamics; and (4) comprehensive service projects evaluations. Requires the Commission to study child separation guidelines. Directs the Secretary to contract with independent organizations to conduct the following research and evaluations: (1) a study to assess the prevalence and nature of risks to the safety of employees of child welfare systems; and (2) a three-year study to examine methodologies for measuring the workloads of providers of child welfare services and community mental health services. Directs the Secretary to authorize the following types of child welfare demonstration projects: (1) expeditious permanent placement of children; (2) child welfare worker training to deliver culturally sensitive and special needs services in U.S. areas that border on Mexico; (3) child welfare worker recruitment and retention strategies; and (4) joint training of child welfare workers and staff of mental health and juvenile justice agencies. Permits the Secretary to authorize foster care and adoption assistance demonstration projects to test the feasibility of eliminating certain SSA income and resources requirements, and allowing States to receive reimbursement for foster care and adoption assistance payments made with respect to children without regard to such income and resources. Directs the Secretary to provide technical assistance to States for: (1) implementing child welfare services, comprehensive service projects, and foster care and adoption assistance programs; (2) disseminating information on innovative child welfare agencies; (3) correcting problems identified through Federal audits and reviews and carrying out corrective action plans under foster care and adoption assistance programs; (4) implementing the foster care and adoption data collection system; and (5) addressing other matters identified by the Secretary. Subtitle F: Miscellaneous Human Resources Amendments - Amend SSA title IV part A (Aid to Families with Dependent Chidren) (AFDC) to: (1) give States the option to use retrospective budgeting without monthly reporting under the AFDC program; and (2) increase the stepparent income disregarded under the AFDC program. Amends the Family Support Act of 1988 to provide for an extension of the period for demonstration projects for evaluating model procedures for reviewing child support awards. Title V: Safe Children and Communities - Safe Children and Communities Act of 1992 - Authorizes the Secretary to make grants for projects to improve the safety of families with children in low-income, violent communities. Authorizes appropriations.
Bill· SS. 3238 (102nd)referred
United States · United States Congress · 16 September 1992
Privacy for Consumers and Workers Act - Requires employers who engage in electronic monitoring of their employees to comply with various restrictions and requirements under this Act. Directs the Secretary of Labor (the Secretary) to prepare and distribute to employers a printed general notice to be posted in conspicuous places on the employer's premises to inform employees of their rights and protections under this Act. Requires such notice to state that the employer engages in or may engage in electronic monitoring of employees, specifying the circumstances under which an employee is or is not entitled to additional specific notice. Requires employers to provide each employee who will be electronically monitored with prior written notice describing specified aspects of such electronic monitoring. Requires such specific notice also to describe certain periodic and random monitoring, including circumstances for authorized monitoring without notice. Requires employers to notify prospective employees at their first personal interviews of existing forms of electronic monitoring which may affect them and, upon request, provide them with the specific written notice provided to employees. Requires employers who engage in telephone service observation to prominently place a statement that they are engaging in such observation in each of their written advertisements and each of their customer bills. Requires an employer who engages in electronic monitoring of members of the public who are not the employer's customers to notify such individuals of the monitoring. Allows such notice to take a form reasonably calculated to reach members of the public who may be affected. Allows employers to engage in electronic monitoring of employees on a periodic or random basis if the employee is new, with a cumulative total period of such employment of not more than 60 days. Prohibits such monitoring of an employee with a cumulative employment period of at least five years. Permits such monitoring of an employee with a cumulative employment period of at least five years. Permits such monitoring of a work group, if the prior written specific notice to each employee is provided between 24 and 72 hours before monitoring begins. Provides a special exception to all such notice requirements, and to certain privacy protections, if an employer has a reasonable suspicion that any employee is engaged in conduct which violates criminal or civil law and adversely affects the interests of the employer or the other employees. Requires the employer, before engaging in special exception worksite monitoring of such an employee or the relevant area, to execute a signed statement setting forth with particularity the conduct to be monitored and the monitoring's basis and identifying the specific economic loss or injury to the business or injury to the other employees resulting from the conduct to be monitored. Requires such statement to be retained for three years after the beginning of monitoring or until judgment is rendered in a private civil action brought by an affected employee which is later. Prohibits employers from periodic or random review of data obtained by continuous electronic monitoring of employees, but not from review of: (1) electronic data obtained from an electronic card system; and (2) data continuously monitored by an employer and appearing simultaneously on multiple television screens or sequentially on a single screen. Allows an employer to review data obtained by continuous electronic monitoring of employees after the monitoring is completed, only if review is limited to specific data which the employer has reason to believe contains information relevant to the employee's work. Requires employers to provide employees or the authorized agents with an opportunity to review all personal data obtained by electronic monitoring of the employee. Requires, in the case of special exception monitoring, opportunity for such review promptly after the investigation has been completed or disciplinary action has been taken against the employee. Prohibits employers from using personal data obtained by electronic monitoring as the basis for any action against an employee unless the employer has complied with requirements of this Act with respect to the monitoring of such employee. Prohibits employers from using quantitative data obtained by electronic monitoring as the sole basis for: (1) individual employee performance evaluation; or (2) setting production quotas or work performance expectations. Allows an exception from such prohibiton if an employee is not working at a facility of an employer and transmits work electronically to the employer, if such quantitative data are the only basis available to the employer for such evaluations, quotas, or expectations. Prohibits employers from intentionally using or disseminating personal data obtained by electronic monitoring when an employee is exercising First Amendment rights, but does not prohibit incidental collection of such data. Prohibits employers from intentionally collecting personal data on an employee which is not confined to the employee's work performance, but does not prohibit incidental collection of such data. Prohibits employers from disclosing personal data obtained by electronic monitoring to any person or business except to the individual employee to whom that data pertains or without the employee's prior written consent, unless disclosure would be: (1) to the employer's officers and employees who need it to perform their duties; (2) to a law enforcement agency for a criminal investigation or prosecution; or (3) pursuant to a proper court order. Allows an employer to disclose to the public personal data obtained by electronic monitoring of an employee if the data contain evidence of illegal conduct by a public official or have a direct and substantial effect on public health or safety. Prohibits employers from engaging in electronic monitoring in bathrooms, locker rooms, or dressing rooms, except under the special monitoring exception. Prohibits employers from: (1) violating any requirement of this Act; (2) engaging in video monitoring with a video camera not visible to the subject, except in cases under the special monitoring exception, or for law enforcement, or off-worksite (which is not covered by this Act); (3) interfering with or denying exercise or attempted exercise of employee rights with regard to use of data collected; or (4) discriminating in any way against an employee for instituting or testifying at a proceeding or disclosing information about a violation under this Act. Sets forth the following enforcement provisions: (1) civil penalties; (2) injunctive actions by the Secretary of Labor; and (3) private civil actions. Prohibits waiver of rights and procedures provided by this Act, unless such waiver is part of a written settlement by the parties to a pending action or complaint. Makes this Act inapplicable to: (1) otherwise permissible electronic monitoring by law enforcement agencies in criminal investigations; (2) electronic monitoring of employees off the worksite of the employer; and (3) required monitoring under various Federal or State laws. Prohibits third party monitoring and use of data unless the requirements of this Act are complied with. Directs the Secretary of Labor to issue rules and regulations to carry out this Act within six months. Declares that this Act shall not be construed to restrict, limit, or eliminate more stringent requirements of States, localities, or collective bargaining agreements. Provides for coverage of employees of the House of Representatives and the Senate under this Act.
Law· HRH.R. 5954 (102nd)enacted
United States · United States Congress · 16 September 1992
Amends the Rural Electrification Act of 1936 with regard to Rural Telephone Bank accounting policies. Provides for the calculation of interest rates on loans made by the Bank.
Bill· HRH.R. 5952 (102nd)open
United States · United States Congress · 16 September 1992
Prescription Drug User Fee Act of 1992 - Amends the Federal Food, Drug, and Cosmetic Act to provide authority for the Secretary of Health and Human Services to assess and collect fees from manufacturers of prescription drugs beginning in FY 1993. Establishes a schedule for prescription drug application and supplement fees, prescription drug establishment fees, and prescription drug product fees. Provides for the annual adjustment of such fees to reflect increases in the Consumer Price Index for urban consumers or increases in Federal pay. Authorizes the Secretary to waive or reduce fees. Prohibits the assessment of fees for a fiscal year after FY 1993 unless appropriations for salaries and expenses of the Food and Drug Administration (FDA) are equal or greater than such appropriations for FY 1992. Credits such fees to the appropriation account for salaries and expenses of the FDA. Authorizes appropriations for FY 1993 through 1997. Provides a mechanism for collecting unpaid fees. Requires the FDA to make annual reports to the Congress on this Act.
Bill· HJRESH.J.Res. 551 (102nd)referred
United States · United States Congress · 16 September 1992
Designates October 4 through 10, 1992, as National Bone Marrow Donor Awareness Week.
Bill· SS. 3232 (102nd)referred
United States · United States Congress · 15 September 1992
Medicare Communication Disorders and Services Amendments Act of 1992 - Amends title XVIII (Medicare) of the Social Security Act to provide expanded coverage of speech-language pathology and audiology services under the Medicare program. Excludes from program coverage procedures performed for selecting or fitting hearing aids.
Bill· HRH.R. 5938 (102nd)referred
United States · United States Congress · 15 September 1992
Mammography Quality Standards Act of 1992 - Amends the Public Health Service Act to require certification (or provisional certification) in order for a facility to perform or interpret mammograms, inspect equipment, or provide for the processing of mammography film. Authorizes the Secretary of Health and Human Services to issue and renew certificates for a specified period of time. Allows the Secretary to approve a private nonprofit organization or State agency to be an accreditation body if it meets certain standards. Mandates standards to assure the safety and accuracy of mammograms, including regarding: (1) quality assurance and control programs; (2) equipment used; (3) licensing, certification, and training of personnel; and (4) recordkeeping and retention. Directs the Secretary to conduct annual inspections of certified facilities. Requires, subject to waiver, 48 hours notice of inspections. Provides for: (1) directed plans of correction, on site monitoring costs payment, and civil money penalties; (2) suspension, revocation, and limitation of certificates; and (3) injunctions. Limits State inspection fees to the costs of conducting the inspections. Requires annual publication of a list of facilities convicted of fraud and abuse, false billings, or kickbacks, facilities that have had certificates revoked, suspended, or limited, and facilities that have been the subject of a sanction or other similar matters. Establishes the National Mammography Quality Assurance Advisory Committee. Mandates grants to establish surveillance systems to evaluate breast cancer screening programs. Authorizes appropriations to carry out this Act.
Bill· HRH.R. 5936 (102nd)referred
United States · United States Congress · 15 September 1992
Managed Competition Act of 1992 - Title I: Managed Competition in Employer-Based Health Plans: Incentives to Control Costs - Subtitle A: Use of Tax Incentives to Purchase Cost Effective Plans - Amends the Internal Revenue Code to impose an excise tax on the excess health plan expenses of employers. Allows a full and permanent deduction for the health plan premium expenses of self-employed individuals, except with respect to excess health plan expenses. Excludes from gross income contributions by a partnership or S corporation to an accident or health plan covering its partners or shareholders. Subtitle B: Health Plan Purchasing Cooperatives (HPPCs) - Provides for the establishment of health plan purchasing cooperatives as not-for-profit corporations in or among States to: (1) enter into agreements with accountable health plans; (2) enter into agreements with small employers; (3) enroll individuals in accountable health plans; (4) receive and forward adjusted premiums, including the reconciliation of low-income assistance among such plans; and (5) coordinate and carryout other functions as required by this title. Subtitle C: Accountable Health Plans (AHPs) - Sets forth requirements for accountable health plans with respect to: registration and qualifications, uniform benefits, cost-sharing for low-income individuals, standardized information, prohibition of discrimination based on health status, standard premiums, financial solvency, grievance mechanisms, and coordinating benefits. Preempts State laws for accountable health plans. Subtitle D: National Health Board - Establishes a National Health Board to: (1) specify a uniform set of effective benefits by October 1, 1993; (2) provide for an advisory Health Benefits and Data Standards Board and a Health Plan Standards Board; (3) register accountable health plans; (4) establish rules for the process of risk-adjustment premiums; (5) establish standards for a national health data system; (6) measure the quality of care in specialized centers; and (7) make specified reports to the Congress. Subtitle E: Treatment of Areas of Ineffective Competition - Authorizes States to develop plans for controlling growth in premiums of accountable health plans where there is ineffective price competition. Subtitle F: Repeal of COBRA Continuation Requirements - Repeals provisions of the Internal Revenue Code, the Employee Retirement Income Security Act of 1974, and the Public Health Service Act with respect to continuation coverage requirements of group health plans. Subtitle G: Definitions - Provides definitions for terms under this title. Title II: Low-Income Assistance for Health Coverage - Subtitle A: Low-Income Assistance - Provides assistance to low-income individuals enrolled under accountable health plans who are not eligible for Medicare through adjustments of premiums, cost-sharing assistance, and payments for certain items and services. Subtitle B: Long-Term Care Phase-Down Assistance to States - Phases down assistance to States for long-term care from 1994 through 1997. Subtitle C: Financing - Repeals the dollar limitation on the amount of wages subject to the hospital insurance tax. Subtitle D: Repeal of Medicaid Program - Repeals title XIX (Medicaid) of the Social Security Act. Requires the National Health Board to report to the Congress on changes in the laws needed to conform to such repeal. Title III: Improved Access in Rural and Underserved Areas - Amends the Public Health Service Act to extend authorizations of appropriations for migrant health centers, community health centers, scholarship and loan repayment programs of the National Health Service Corps, and area health education centers. Title IV: Preventive Health and Personal Responsibility Subtitle A: Expansion of Public Health Programs - Extends authorized appropriations for: immunizations against vaccine preventable diseases, lead poisoning prevention, preventive health measures with respect to breast and cervical cancers, health information and health promotion, and preventive health and health services block grants. Provides for the use of appropriated funds for the prevention, control, and elimination of tuberculosis and for grants for early intervention regarding acquired immune deficiency syndrome (AIDS). Authorizes appropriations for programs regarding the smoking of tobacco products. Subtitle B: Expansion of Medicare Coverage of Preventive Services - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage for colorectal screening, certain immunizations, well-child care, annual mammography screenings, and certain additional benefits. Title V: Malpractice Reform - Subtitle A: Findings; Purpose; Definitions - Sets forth congressional findings with respect to the need for malpractice reforms. Subtitle B: Grants to States for Alternative Dispute Resolution Systems - Authorizes the Secretary of Health and Human Services to make grants to States for a two-year period for the implementation and evaluation of alternative dispute resolution systems. Sets forth eligibility requirements for States seeking such grants and standards and regulations for such program. Subtitle C: Uniform Standards for Malpractice Claims - Establishes uniform standards for health care liability actions brought in a Federal or State court and to medical malpractice claims subject to an alternative dispute resolution system, except in the case of an injury arising from the use of a medical product. Subtitle D: Liability Protections for Federally-Supported Health Centers - Provides liability protection for physicians or other licensed or certified health care practitioners deemed to be employees of the Public Health Service. Requires the Attorney General to report to the Congress on medical malpractice liability claims arising under this subtitle. Title VI: Paperwork Reduction and Administrative Simplification - Preempts State laws that require medical or health insurance records to be maintained in written, rather than electronic form. Requires the National Health Board to ensure the confidentiality of electronic health care information and establish standardization for the electronic receipt and transmission of health plan information. Requires the Board to establish goals and time frames for: (1) the use of uniform health claims forms and identification numbers; (2) achieving uniformity in determining the liability of insurers when benefits are payable under two or more health plans; and (3) achieving uniformity in the availability of information among health plans when benefits are payable under two or more health plans. Amends the Internal Revenue Code to impose a tax on the administrator of a health plan for failure to satisfy certain health plan requirments.
Bill· SS. 3226 (102nd)referred
United States · United States Congress · 10 September 1992
Child Immunization Access Act of 1992 - Amends title XIX (Medicaid) of the Social Security Act to require States to provide for the establishment and operation of a vaccine replacement system, unless such a system is not appropriate or cost-effective or a bulk vaccine purchasing program (universal vaccine distribution system) is already in operation. Defines vaccine replacement system as a State program which purchases vaccines at the lowest practicable prices and distributes them free of charge to medical providers for immunization of Medicaid-eligible children. Provides for payments to States for costs incurred with respect to establishing and operating a vaccine replacement system or a bulk vaccine purchasing program.
Bill· SS. 3223 (102nd)referred
United States · United States Congress · 10 September 1992
State Health Care Financing Equity Act of 1992 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to waive ERISA preemption requirements so as to allow States to: (1) provide for State universal health plans, State risk pools for the medically uninsurable, or prospective payment systems; and (2) impose State provider taxes.
Resolution· HRESH.Res. 562 (102nd)passed
United States · United States Congress · 10 September 1992
Sets forth the rule for the consideration of H.R. 3724 (Indian health care).
Bill· HRH.R. 5922 (102nd)referred
United States · United States Congress · 9 September 1992
Directs the Secretary of the Treasury (the Secretary) to design and strike a bronze medal in commemoration of organ donors and their families. Declares that any organ donor, or donor's family, is eligible for the medal. Requires the Secretary of Health and Human Services to arrange for medal presentation to eligible individuals through a qualified organ procurement organization. Declares the medals to be national medals. Authorizes the Secretary of the Treasury to enter into an agreement with the entity operating the Organ Procurement and Transplantation Network with respect to the solicitation of donations to offset expenditures relating to medal issuance.
Bill· HRH.R. 5919 (102nd)referred
United States · United States Congress · 9 September 1992
Comprehensive Health Reform Act of 1992 - Title I: Deduction of Health Insurance Costs of Self-Employed Individuals - Health Benefits for Self-Employed Individuals Act of 1992 - Amends the Internal Revenue Code with respect to the income tax deduction for the health insurance costs of self-employed individuals to: (1) make the deduction permanent; and (2) phase in an increase in it, reaching 100 percent of costs for taxable years beginning in 1996. Title II: Health Insurance Market Reform - Health Insurance Market Reform Act of 1992 - Amends the Social Security Act (SSA) to add a new title XXI, Requirements Concerning Health Insurance. States that the purposes of part A of new SSA title XXI are to increase the availability, portability, and affordability of health insurance, particularly to small employers and their employees and dependents, by seeking to ensure, among other things, that: (1) affordable health insurance is available to individuals and groups, and premiums do not vary substantially, regardless of health status or claims experience; (2) States regulating health insurance do not place an undue burden on small employers; and (3) insurers, providers, purchasers, and consumers are encouraged to contain costs of health care and health insurance. Applies the provisions of new SSA title XXI to health insurance plans offered in any State and to insurers offering such plans. Provides for the establishment of Federal and State regulatory programs implementing the requirements of parts B and C of new SSA title XXI. Requires the Secretary of Health and Human Services to: (1) request the National Assoication of Insurance Commissioners (NAIC) to recommend model standards for compliance with such requirements; and (2) using such model standards, with revisions as necessary, publish implementing regulations. Requires the Secretary to determine whether each State has established a regulatory program adequate to ensure compliance with such requirements. Allows State programs to establish standards more stringent than those required under new title XXI, if the Secretary finds them consistent with its purposes. Provides that an approved State program shall take effect, in lieu of the above mentioned implementing regulations, as of a specified date: (1) with respect to all insurers and health insurance plans subject to part B of new SSA title XXI; and (2) with respect to all insurers and health insurance plans subject to part C, except for employee welfare benefit plans which are not multiple employer welfare arrangements (MEWAs). Requires the Secretary to implement a program: (1) under part C in all States with respect to those insurers and health insurance plans not subject to State regulation; and (2) under both parts B and C with respect to all insurers and health insurance plans in each State without an approved program. Authorizes the Secretary to waive, with respect to one or all States, any provision of new SSA title XXI, or of Medicare or Medicaid (SSA titles XVIII and XIX, respectively), to the extent and for the period he or she finds likely to promote the purposes and facilitate the administration of new title XXI. Provides for Federal oversight over State programs. Makes the requirements of parts A, B, and C of new SSA title XXI generally effective with respect to health insurance plans offered, issued, or renewed in a State on or after January 1, 1994 (or certain later dates necessary to allow for enactment of State legislation). Provides that certain provisions concerning variations in premiums among and within blocks of business, and the rate of premium increases shall not apply, until two years after the general effective date, to a renewal of a health insurance plan that was in effect before the effective date. Provides that under part B of new SSA title XXI each insurer must register with the Secretary and the appropriate official for each State in which it issues or offers any health insurance plan to a small employer. Requires, subject to specified exceptions, any insurer offering a health insurance plan to any small employer in a State (or to any small employer in a local service area within the State, in the case of an insurer offering health insurance only within such an area) to: (1) make such plan available to every small employer in the State or local service area; (2) make available to every small employer any basic insurance plan a State may require; and (3) not cancel or refuse to renew any small employer health insurance plan. Requires an insurer providing small employer health insurance to notify the employer, at least 60 days before expiration, of the terms for renewal, and the extent to which any premium increase is based on actual or expected claims experience of covered individuals. Requires, subject to specified exceptions, that each health insurance plan offered to a small employer accept for enrollment, on the same terms as any other enrollee, every eligible employee and (in the case of a family plan) the employee's spouse and any dependent child under age 19 or, if older, under age 25 and a full-time student. Prohibits a small employer that made health insurance available to employees from using criteria related to health status or claims experience to determine eligibility for, benefits under, or terms of such health insurance for individual employees. Permits a State to define a basic benefit plan, and to require that it be offered to small employers in the State by insurers (other than health insurance networks (HINs) or MEWAs) offering heatlh insurance plans to small employers in the State. Subjects the plan to review and approval by the Secretary to ensure that it is affordable by small employers. Requires that the regulatory program established with respect to a State require all insurers offering health insurance plans to small employers, during a specified period, to: (1) participate in an interim risk pooling mechanism; and (2) comply with requirements designed to limit variations among and increases in premium rates for such health insurance plans. Permits the interim risk pooling mechanism to be either a reinsurance program or an assigned risk program. Provides for funding such a mechanism. States that no Federal entity shall be at risk as a guarantor of the solvency of a reinsurance fund or otherwise, for all or any part of the cost of health insurance plans subject to intermin risk pooling. Provides that, for any rating period, no base premium rate for any small employer block of business may exceed the equivalent base premium rate for any other block of the insurer by more than 20 percent. Provides that the highest premium rate for a specific health insurance plan that an insurer can charge any small employer in a block of business for a rating period shall not exceed the corresponding base premium rate by more than: (1) 50 percent, for a period ending before January 1, 1997; and (2) 35 percent, for a period thereafter. Limits annual percentage increases in the premium rate charged to a small employer. Sets forth requirements concerning rate-setting methodology, including requirements for full disclosure of rating practices and actuarial certification. Establishes requirements for the permanent health risk pool system in a State. Provides continued health insurance coverage for certain college students. Provides under part C of new SSA title XXI that, except to the extent permitted under an assigned risk program, an insurer may not refuse to offer, refuse to renew, cancel, or condition the coverage under any employment-based health insurance plan on the basis of the health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability, of one or more individuals. Sets limits on exclusions under employment-based health insurance plans for pre-existing conditions. Preempts certain State laws relating to health insurance. Sets forth requirements an entity must meet in order to be entitled to certification as an HIN. Permits the Secretary to fund health risk pooling demonstrations in as many as four States. Authorizes the Secretary to develop model health risk pooling systems. Requires the Secretary to develop methods for measuring the health risk differential of individuals. Authorizes appropriations. Amends the Internal Revenue Code to impose an excise tax of $1000 per covered employee on insurers for noncompliance with the requirements of part B or C of SSA new title XXI. Title III: Medical And Health Insurance Information Reform - Medical and Health Insurance Information Reform Act of 1992 - Adds a new SSA title XXII, Medical and Health Insurance Information Reform. Requires the Secretary, in order to assure the availability of comparative value information to health care purchasers, to determine whether each State is developing and implementing a health care value information program. Enumerates the criteria for State programs. Provides that if the Secretary finds that a State has not developed or implemented a health care value information program that comports with such criteria, the Secretary must take necessary actions to implement a comparable program in the State. Allows fees to be charged for the informational materials provided pursuant to such program. Directs the head of any Federal agency with responsibility for the provision of health insurance or health care services to develop and make comparative value information available to States, health care providers, and consumers. Directs the Secretary to promulgate requirements for health insurers to furnish periodically to the Secretary, on a sample basis, health care data relevant to health care services research. Requires the Secretary to make available, under the Freedom of Information Act, all Medicare claims records, without regard to the consent of the physician or other individual who furnished the item or service in question. Maintains in force Privacy Act protections against the release of information that identifies Medicare beneficiaries. Applies this new requirement for release of records only to information received after the enactment of this Act. Directs the Secretary, directly or through grant or contract, to develop model systems: (1) for gathering health care cost, quality, and outcomes data; and (2) for analyzing such data in a manner that would allow valid comparisons among providers and among health plans. Requires the Secretary to support and evaluate experiments with different approaches to achieve the most cost-effective method. Provides that, when appropriate, the Secretary may establish standards for data gathering in order to facilitate analysis and comparisons across the nation. Authorizes appropriations. Authorizes the Secretary to make grants to States to enable them to plan and initiate implementation of their health care information programs. Authorizes appropriations. Nullifies any State law which requires medical or health insurance records (including billing information) to be kept in written, rather than electronic, form. Directs the Secretary, after taking into consideration the Insurance Information and Privacy Protection Model Act of NAIC to promulgate requirements concerning health insurance information privacy and confidentiality. Includes among such requirements that information identifying individuals shall not be redisclosed (with such limited exceptions as the Secretary may provide) except to the extent necessary to carry out the purpose for which the information was collected. Requires the Secretary to take into consideration specified principles concerning information that identifies individuals when promulgating such requirements. Directs the Secretary to determine whether problems relating to standards for the electronic receipt and transmission of health insurance information cause significant administrative costs. Requires the Secretary, if such costs are generated, to promulgate standards for the electronic receipt and transmission of claims, payment, eligibility, and enrollment information (including privacy and confidentiality protection requirements). Directs the Secretary to determine whether problems relating to the receipt and transmission of health insurance eligibility verification cause significant administrative costs. Requires the Secretary, if such costs are generated, to promulgate requirements for the receipt and transmission of health insurance eligibility verification. Directs the Secretary to determine whether the proportion of health insurance claims and payment information received and transmitted by paper will continue to cause significant administrative costs. Directs the Secretary, if such costs are generated, to require a specified proportion of (or all of) such information to be received and transmitted electronically (with such exceptions as the Secretary might specify). Directs the Secretary to promulgate requirements for the format and content of basic claim forms under health insurance plans. Directs the Secretary to determine whether the variety of information requested by health insurers (in addition to information requested in basic claims forms) causes administrative costs disproportionate to the benefits derived. Requires the Secretary, if such costs are generated, to publish recommendations concerning what additional information should be allowed to be requested and in what format. Directs the Secretary, after consulting with NAIC, to promulgate rules for determining the relative liability of insurers and the priority of payment when several health insurance policies cover the same individual. Directs the Secretary to determine whether problems relating to the transfer of information among health insurers that cover the same individual cause significant mistaken payments or administrative costs. Requires the Secretary, if such payments or costs are generated, to promulgate requirements concerning the transfer among insurers (and annual updating) of information (which may include requirements for the use of unique identifiers, and for the listing of all individuals covered under a health insurance plan). Directs the Secretary to determine, for each State, whether there were in effect State requirements substantially the same as those enumerated below and whether the State effectively enforced them. Applies the requirements enumerated below to administrators of self-insured employee plans. Provides for Federal backup authority to be effective in a State (with respect to a section) only if the Secretary makes a negative finding with respect to certain requirements or if the State does not provide sufficient information to enable the Secretary to make the determination. Requires health insurers (in States that do not have an equivalent program) to: (1) meet the Federal requirements concerning the protection of privacy and confidentiality; (2) use social security numbers for their beneficiaries and Medicare unique identifiers for each provider that furnishes items and services; (3) meet the standards and requirements (if any) concerning the receipt and transmission of health insurance information; (4) meet the requirements concerning the form and content of health insurance claim forms; (5) follow the rules determining the priority of payment when several health insurance policies cover the same individual; and (6) meet the requirements (if any) concerning the furnishing of information among insurers. Requires the Secretary, after consulting with the American National Standards Institute (ANSI) and others, to promulgate requirements for hospitals concerning electronic medical data. Specifies the data sets to be included in such requirements. Permits the Secretary, after consulting with ANSI and others, to promulgate requirements for health care entities other than hospitals concerning electronic medical data. Requires hospitals that participate in the Medicare program to maintain an electronic patient care information system that meets certain data set requirements promulgated by the Secretary for hospitals, and to transmit data electronically to the Secretary, peer review organizations, carriers, and intermediaries, from the appropriate data sets. Permits waivers of such requirements for hospitals in the process of developing an electronic patient care information system, for small rural hospitals, and for certain hospitals that agree to subject their data transfer processes to specified quality assurance procedures. Permits Federal agencies to require electronic transmission of data elements utilized for certain agency health care or research programs. Amends the Internal Revenue Code to subject insurers to an excise tax for any failure to comply with requirements under SSA new title XXII respecting health insurance. Specifies the amount of such tax for administrators of self-insured employee welfare benefit plans and other insurers. Provides that the excise tax generally shall not apply if the violation could not have been discovered through the exercise of reasonable diligence, or if the violation was corrected within 30 days after it had been discovered. Gives the Secretary authority to waive the tax if the violations were due to reasonable cause and not willful neglect, to the extent payment of the tax would be excessive relative to the failure involved. Authorizes the Secretary to make grants to: (1) community organizations or coalitions of health care providers, insurers, and purchasers to establish, and document the efficacy of, communication links between the information systems of health insurers and of health care providers; and (2) public and private non-profit entities for the development of regional- and community-based clinical information systems, and for the development and testing of certain ambulatory care data sets. Authorizes appropriations. Title IV: MEWA Enforcement Improvements - Multiple Employer Welfare Arrangements Enforcement Improvements Act of 1992 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to revise provisions relating to MEWAs and other employee welfare benefit plans. Revises the definition of employee welfare benefit plan to: (1) allow up to five percent of the aggregate number of covered individuals to be individuals who are not employees or former employees of the employer, or members or former members of the employee organization which established or maintains the plan; and (2) include a plan, fund, or program established or maintained by a franchise network or by two or more trades or businesses that are within the same control group or were within it at any time during the preceding one-year period. Amends the definition of MEWA to: (1) limit the exclusion of collective bargaining agreements, under specified conditions; (2) exclude franchise networks; (3) exclude insurers, or health maintenance organizations licensed to do business in a State; (4) exclude trades and businesses within the same control group at any time during the preceding one-year period (as well as those currently in the same group), by deeming them a single employer; and (5) provide that single employer plans shall not be deemed MEWAs solely because they cover individuals who are not employees or former employees, or their beneficiaries, if the number of such individuals never exceeds five percent of the aggregate covered during the plan year. Makes ERISA title I (Protection of Employee Benefit Rights) applicable to any MEWA engaged in commerce or in any industry or activity affecting commerce, with specified exceptions. Requires MEWAs which provide medical care benefits to file annual registration statements with the Secretary of Labor (the Secretary), including: (1) certain information on persons involved in its operation and States where it conducts business; (2) certification that copies of the registration have been filed with the appropriate State insurance commissioners; and (3) indication of whether the MEWA has obtained, applied for, or intends to apply for a certain exemption from State regulation. Authorizes the Secretary, to assess a civil penalty for a trustee's or other responsible person's failure or refusal to file such registration statement. Authorizes district courts, upon the Secretary's showing that a MEWA is neither licensed under State insurance laws nor operating in accordance with the terms of a certain Federal exemption fron State regulation, to order the MEWA to cease activities and to grant additional equitable or remedial relief, unless the MEWA can show that it is fully insured, meets the specified State or Federal requirements, and operates in accordance with applicable State insurance laws that are not superseded under ERISA. Sets forth an exemption procedure under which the Secretary is authorized to exempt from State regulation, for up to three years, individually, or by class, MEWAs which are not fully insured and which provide medical care benefits. Allows such exemption to be renewed upon application. Prohibits such an exemption unless the Secretary finds that it is: (1) administratively feasible; (2) not adverse to the interests of participants and beneficiaries; and (3) protective of participant and beneficiary rights and benefits. Requires published and adequate notification and opportunity for a hearing for interested persons before any such exemption is granted. Postpones, until 18 months after enactment of this Act, the required applicability of State insurance laws to MEWAs that provide medical care benefits if such MEWAs: (1) file for the exemption within 180 days after such enactment; and (2) the Secretary does not find such application to be materially deficient. Terminates such exclusion from State requirements for any such MEWA at any time when the Secretary determines it would be detrimental to the interests of participants or beneficiaries. Places any determination relating to such exclusion in the Secretary's sole discretion. Provides that States may require disclosure of information from any employee welfare benefit plan (in connection with an investigation to determine if violations of the State insurance law have or are about to occur) as to whether such plan is a MEWA or is in compliance with the MEWA exemption or 18-month exclusion. Title V: Health Care Liability Reform And Quality of Care Improvement - Health Care Liability Reform and Quality of Care Improvement Act of 1992 - Requires, in order to receive a notification of compliance with this title, that States have in effect the health care liability reforms set forth below. Requires, in any health care liability action, the liability of each defendant for noneconomic damages to be several and not joint, with each defendant liable only for the proportion of that defendant's fault and a separate judgment against that defendant in that amount. Prohibits awarding noneconomic damages over $250,000 in any health care liability action, subject to waiver. Reduces the total damages received by a plaintiff by the amount of any collateral source benefits. Allows: (1) future economic damage awards to be paid periodically based on when the damages are likely to occur or at the time the damages accrue; and (2) in certain circumstances, the court to require the health care provider to purchase an annuity or fund a reversionary trust to make such periodic payments. Prohibits reopening a judgment awarding periodic payments to contest, amend, or modify the schedule or amount in the absence of fraud or any ground permitting relief after entry of a final judgment. Declares it U.S. policy to encourage alternative dispute resolution (ADR). Requires a State to establish at least one ADR mechanism. Requires each State to: (1) cooperate with Federal research efforts regarding patient outcomes, clinical effectiveness, and clinical practice guidelines; (2) collect, analyze, and supply the Secretary of Health and Human Services with information regarding State medical board performance; and (3) impose continuing education requirements on disciplined physicians. Allows alternatives to these requirements regarding medical board performance and continuing education if the Secretary finds such alternatives at least as effective in reducing the incidence of negligence as compliance with the requirements. Allows States three years from the adoption of this Act to enact, adopt, or otherwise comply with the requirements of this title. Requires withholding of State payments for noncompliance. Allows waiver of the requirements of this title for any experimental, pilot, or demonstration project which is likely to assist in promoting this title's objectives for health care liability reform. Sets forth the framework for establishing a system of mandatory nonbinding arbitration in each State for the resolution of health care liability claims. Amends Federal law to prohibit, in a health care liability action, finding the United States jointly and severally liable for noneconomic damages. Allows liability only for those noneconomic damages directly attributable to its pro rata share of fault. Reduces damages paid by the United States by the amount of any collateral source benefits. Prohibits awarding noneconomic damages, in an action against the United States, over $250,000. Requires, at the request of the United States when future economic damages are awarded in excess of $100,000, an order that such damages be paid by periodic payments based on when the damages are likely to occur. Allows the United States, in such cases, to pay the judgment periodically, purchase an annuity, or fund a reversionary trust. Prohibits reopening the judgment to contest, amend, or modify the schedule or amount in the absence of fraud or any ground permitting relief after entry of a final judgment.
Bill· HRH.R. 5911 (102nd)referred
United States · United States Congress · 9 September 1992
Dire Emergency Supplemental Appropriations Act, 1992, for Disaster Assistance to Meet the Present Emergencies Arising from the Consequences of Hurricane Andrew and other Natural Disasters - Makes supplemental appropriations for FY 1992 for emergencies arising from natural disasters such as Hurricane Andrew and Typhoon Omar. Designates such amounts as emergency requirements for all purposes of the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act). Title I: Department of Agriculture, Rural Development, Food and Drug Administration, and Related Agencies - Makes additional appropriations available to the Department of Agriculture for: (1) the Agricultural Research Service for buildings and facilities; (2) the Commodity Credit Corporation for crop losses and the tree assistance program; (3) the Soil Conservation Service for watershed and flood prevention operations; (4) the Agricultural Stabilization and Conservation Service for the emergency conservation program; (5) the Farmers Home Administration for the agricultural credit insurance fund program account, the rural housing insurance fund program account, the rural development insurance fund program account, the rural development loan fund program account, rural water and waste disposal grants, very-low-income housing repair grants, rural housing for domestic farm labor, emergency community water assistance grants, and salaries and expenses; and (6) the Food and Nutrition Service for the food stamp program. Declares that funds provided by this title are available only to the extent funds are not provided by the Federal Emergency Management Agency. Title II: Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies - Makes additional funds available to: (1) the Department of Commerce for the Economic Development Administration, the Minority Business Development Agency, and the National Oceanic and Atmospheric Administration; (2) the Department of Justice for general administration, legal activities, the Federal Prison System, and the Office of Justice Programs; (3) the Department of State for the administration of foreign affairs; (4) the Judiciary for Courts of Appeals, District Courts, and other judicial services; and (5) the Small Business Administration for the disaster loans program account. Title III: Department of Defense - Military - Makes additional amounts available for incremental costs of military, reserve, and national guard personnel and for operation and maintenance of military forces. Title IV: Energy and Water Development Department of Defense - Civil - Makes additional funds available to the Army Corps of Engineers-Civil for general construction, flood control and coastal emergencies, operation and maintenance, and flood control for the Mississippi River and tributaries, Arkansas, Illinois, Kentucky, Louisiana, Mississippi, Missouri, and Tennessee. Title V: Department of the Interior and Related Agencies - Makes additional appropriations available to the Department of the Interior for: (1) the United States Fish and Wildlife Service; (2) the National Park Service; (3) the United States Geological Survey; and (4) the Bureau of Indian Affairs. Title VI: Departments of Laobr, Health and Human Services, Education, and Related Agencies - Makes additional funds available to: (1) the Department of Health and Human Services for the Public Health Emergency Fund; (2) the Department of Education for educational excellence, impact aid, student financial assistance, and departmental management. Title VII: Department of Defense - Military - Makes supplemental amounts available to cover incremental costs at Homestead Air Force Base, Florida, for military construction and family housing. Title VIII: Department of Transportation and Related Agencies - Makes additional funds available to the Department of Transportation for: (1) the Coast Guard; (2) the Federal Aviation Administration; (3) the Federal Transit Administration; and (4) the Research and Special Programs Administration. Title IX: Treasury Department, U.S. Postal Service, the Executive Office of the President, and Certain Independent Agencies - Makes supplemental funds available to: (1) the Department of the Treasury for the U.S. Customs Service and the Internal Revenue Service; and (2) the General Services Administration (GSA) for the Federal Buildings Fund and the Federal Supply Service. Authorizes the Secretary of the Treasury and the Administrator of GSA to hire temporary employees as necessary for government operations in areas affected by Hurricane Andrew and Typhoon Omar. Amends the Treasury, Postal Service and General Government Appropriations Act, 1992 to repeal restrictions on travel expenses on employees subject to such Act. Authorizes heads of Federal agencies to establish emergency administrative leave as necessary for employees affected by the Hurricane and the Typhoon. Title X: Departments of Veterans Affairs and Housing and Urban Development, and Independent Agencies - Makes additional amounts available to: (1) Department of Veterans Affairs for the Veterans Health Administration and departmental administration; (2) the Department of Housing and Urban Development for housing programs, housing counseling assistance, guaranteed housing loans, and management administration; and (3) the Federal Emergency Management Agency for disaster relief, the disaster assistance direct loan program account, the community disaster loan program account, and salaries and expenses.
Bill· SS. 3183 (102nd)referred
United States · United States Congress · 12 August 1992
Comprehensive Fetal Alcohol Syndrome Prevention Act - Amends the Public Health Service Act to establish: (1) a comprehensive program to prevent Fetal Alcohol Syndrome and Fetal Alcohol Effects and coordinate related Federal efforts; and (2) an Inter-Agency Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effects. Provides for related research, technical assistance, grants, cooperative agreements, and contracts, surveillance and prevention programs, professional and public education, and diagnostic criteria. Authorizes appropriations.
Bill· SS. 3179 (102nd)open
United States · United States Congress · 12 August 1992
Agency for Health Care Policy and Research Reauthorization Act of 1992 - Amends the Public Health Service Act to add prevention of diseases and other health conditions to the purposes of the Agency for Health Care Policy and Research. Authorizes training grants in the field of health services research. Mandates: (1) the gathering, organizing, summarizing, and conveyance of technology assessment information to provide a single public source regarding assessment of health care technologies; (2) an annual report on technology assessments; and (3) conducting assessments of existing and new technologies, in part through an evaluation of health services provided through publicly and privately funded sources. Replaces provisions establishing at the National Library of Medicine (NLM) an information center on health care technologies and health care technology assessment with provisions mandating establishment and publication of a methodology for setting assessment priorities. Requires: (1) implementation of the methodology to produce, at least annually, a ranked list of assesements to be conducted or supported; and (2) annually conducting at least five of the high priority assessments. Requires the Office of Health Technology Assessment to publish a description of the process used to conduct its assessments. Establishes: (1) a program of grants, contracts, or cooperative agreements for public-private partnerships for conducting health care technology assessments of activities in the private sector; and (2) a task force to support interagency collaboration on health technology assessment, including the development of new and emerging technologies, the conduct of clinical trials, and consensus development. Requires, with regard to certain Agency guidelines, standards, performance measures, and review criteria: (1) inclusion of information on the risks, benefits, and costs of all alternative strategies; and (2) coverage, by a specified date, of at least three clinical treatments or conditions that account for a significant portion of national health expenditures, have significant variation in treatment, and are identified by a specified Advisory Council as likely to involve inappropriate use of health care resources. Establishes, as part of the single public health care technology assessment source established by this Act, a Resource Center for Clinical Practice Guidelines. Requires the NLM to establish a system to identify and collect practice guidelines and to provide information on guidelines in a convenient, electronic form. Requires the Agency to enter into an agreement with the NLM to implement this paragraph. Requires that the Agency's Administrator carry out provisions relating to the Forum for Quality and Effectiveness in Health Care through the Form's Director. Provides for the selection and composition of panels convened by the Director. Limits the percentage of members of grant and contract peer review groups who may be U.S. officers or employees. (Currently, U.S. officers and employees are excluded from the groups.) Revises other requirements regarding the groups. Allows the Agency to tabulate and analyze statistics and prepare studies for public or nonprofit private entities who pay the costs of such services. Modifies requirements for the agenda for development of guidelines, standards, performance measures, and review criteria, including covering at least three conditions that account for significant national health expenditures. Mandates production of an annual list of priority guideline topics. Modifies, with regard to guidelines, standards, performance measures, and review criteria, requirements concerning: (1) pilot testing; and (2) evaluations. Mandates studies of: (1) cost estimating methods for alternative treatments included in guidelines; and (2) the processes by which guidelines and standards are developed and disseminated. Requires the National Advisory Council for Health Care Policy, Research, and Evaluation to advise the Agency's Administrator on the selection of Guideline Panels and the Chairpersons of the Panels and to participate in the production of the annual list of priority guideline topics. Removes provisions establishing a subcouncil of the Council to carry out specified duties. Authorizes appropriations to carry out provisions relating to the Agency. Authorizes appropriations for demonstration projects on emergency medical services for children.
Bill· SS. 3180 (102nd)open
United States · United States Congress · 12 August 1992
State Care Act of 1992 - Amends the Social Security Act (SSA) to add a new title XXI, State Comprehensive Health Coverage And Cost Containment Demonstration Projects, establishing a program under which the State-Based Comprehensive Health Care Commission (established below) is required to select States to participate in health coverage and cost containment demonstration projects (State Care projects). Establishes the State-Based Comprehensive Health Care Commission (the Commission) to review, approve, and oversee State Care projects. Authorizes appropriations. Requires States desiring grants to develop State Care projects to establish a State Health Care Authority through which to develop such projects. Exempts from this requirement States that have enacted comprehensive health care plans (State Care plans) within 12 months of enactment of this Act. Establishes Federal standards for approval of applications for grants for demonstrations in up to ten States. Specifies State Care plan requirements, including those for standard and basic benefit packages, cost-control mechanisms, and quality control procedures. Details the various items and services which constitute each respective package. Sets limits on the amount, scope, and duration of certain benefits under the standard package. Details cost-sharing under the respective packages, and provides for limits on out-of-pocket package expenses. Authorizes the Commission to award grants to States receiving approval of a State Care project grant application for: (1) establishment of a data base infrastructure necessary to measure and evaluate State Care plan success in achieving cost containment and access goals; and (2) consolidation of health care budgeting, regulating, financing, and delivery responsibilities of the State. Authorizes appropriations. Prohibits payments under Medicaid (SSA title XIX) for State Care project services if payment for them may be made under the State Care plan. Directs the Secretary of Health and Human Services to pay to each State participating in a State Care project an amount equal to the amount of any payments that, as a result of such prohibition, were not made under Medicaid because payment was made under the State Care plan. Sets forth provisions governing the application of Medicare (SSA title XVIII) and ERISA (Employee Retirement Income Security Act of 1974) with respect to any approved State Care project. Requires periodic reports by the Commission to the Congress on the reforms undertaken in States participating in State Care projects, along with recommendations for increased Federal funding for reform initiatives and project grants. Requires additional Commission reports on continued financing of State Care plans and, if no national comprehensive health care system has been established, on establishing such a system that utilizes the experiences of State Care projects.
Bill· SS. 3185 (102nd)referred
United States · United States Congress · 12 August 1992
Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) make permanent the Medicare select policy program; (2) allow access to Medicare select policies in all States; and (3) make various technical corrections to provisions relating to Medicare supplemental policies. Amends title XVIII (Medicare) of the Social Security Act to revise the Medicare select policy program and provide for a civil penalty for misrepresentations made in connection with a Medicare select policy.
Bill· SS. 3186 (102nd)referred
United States · United States Congress · 12 August 1992
Ethics in Referrals and Billing Act of 1992 - Amends the Public Health Service Act to create a new title on physician referral and billing. Prohibits, subject to exceptions, referrals and related billing by physicians involving an entity in which the physician (or an immediate family member) has a financial relationship. Requires each entity providing health-related items or services to disclose certain information concerning the entity's ownership. Declares that no individual, entity, or third party payor shall be required to pay for items or services in connection with a prohibited referral. Makes any person collecting such payments liable to the payor. Requires insurance payors to report violation patterns. Provides for civil fines for persons repeatedly presenting bills, physicians repeatedly making referrals, and persons acting in concert in violation. Allows for violations: (1) suspension, revocation, or limitation of laboratory certificates; and (2) exclusion from any program under title XVIII (Medicare) of the Social Security Act. Makes it unlawful, subject to exception, for any: (1) person who furnishes ancillary health services to present a bill to any person other than the patient receiving the services; or (2) physician to present a bill to any ancillary service recipient unless the services where furnished personally or under the supervision of the referring physician or a member of that physician's group practice or by individuals employed by that physician or group practice. Makes any person collecting payments for such services liable to the payor. Provides for civil fines for persons repeatedly presenting bills in violation. Allows, for violations: (1) suspension, revocation, or limitation of laboratory certificates; and (2) exclusion from any pogram under Medicare.
Bill· SS. 3212 (102nd)referred
United States · United States Congress · 12 August 1992
Medicaid Eligibility Simplification Act - Amends title XIX (Medicaid) of the Social Security Act (SSA) to: (1) permit States to extend Medicaid coverage of prenatal care services to alien pregnant women who are neither officially nor under color of law permanent residents of the United States, but who are otherwise eligible for medical assistance under Medicaid; and (2) provide for simplification of the application process for enrollment in Medicaid. Amends SSA title XVI (Supplemental Security Income) (SSI) to preserve the Medicaid and SSI eligibility of individuals who would otherwise become ineligible for Medicaid benefits and SSI payments due to their receipt of weekly or biweekly income. Amends the Medicaid program: (1) to make optional currently mandatory reporting requirements under program provisions extending Medicaid coverage to eligible families making the transition from welfare to work; (2) with respect to program provisions concerning presumptive eligibility for pregnant women to include as a qualified provider any individual employed by the State and capable of making determinations of the type described under such provisions; (3) to revise the definition of qualified Medicare beneficiary; and (4) with respect to the income methodology used in determining the eligibility of certain individuals for Medicaid benefits.
Bill· SS. 3191 (102nd)referred
United States · United States Congress · 12 August 1992
Medicaid Coordinated Care Improvement Act of 1992 - Amends title XIX (Medicaid) of the Social Security Act to revise Medicaid requirements to provide States with more flexibility to use coordinated care programs. Adds new provisions to Medicaid respecting State use of coordinated care programs, including those that: (1) permit States to mandate enrollment of Medicaid-eligible individuals with program providers only if at least two risk contacting entities are available, or one such entity and a primary care case management entity, or two such case management entities; (2) mandate quality care reviews; and (3) provide for participation of federally qualified health centers and rural health clinics. Makes technical amendments to Medicaid respecting case management services and home- and community-based waivers. Provides that in the case of certain plan services prescribed under the Individuals with Disabilities Education Act for children who are eligible for medical assistance under such plan, the State or local agency administering such plan is not required to take measures to ascertain the legal liability of third parties under Medicaid for such services. Sets forth miscellaneous congressional reporting requirements respecting coordinated care programs and: (1) services for children with special needs; (2) public health services; (3) payments for hospital services; and (4) payments to risk contracting entities.
Bill· SS. 3187 (102nd)referred
United States · United States Congress · 12 August 1992
Amends title XIX (Medicaid) of the Social Security Act to allow the participation in home- and community-based care programs of functionally disabled elderly individuals with: (1) incomes of up to three times the maximum amount allowed under the Supplemental Security Income program, at the State's option; and (2) two of five (currently, two of three) impaired activities of daily living. Exempts small community care settings which are not providers of home- and community-based care from survey and certification requirements. Requires case managers who have been properly trained to review such small settings for compliance with applicable requirements. Revises program funding provisions to: (1) guarantee States with a certain amount of funding over one year's election period; and (2) allow remaining funds to be carried over to the next fiscal year. Requires the Secretary of Health and Human Services to: (1) evaluate the provision of home- and community-based care by States: and (2) submit to specified congressional committees an annual report on the effectiveness of such care. Makes technical revisions in the definition of developmentally disabled individual with respect to eligibility for community supported living arrangements program services. Allows program funds remaining at the end of a fiscal year to be carried over to the next fiscal year. Requires the Secretary to: (1) evaluate the provision of community supported living arrangement services by States; and (2) submit to specified congressional committees an annual report on their effectiveness. Amends the Omnibus Budget Reconciliation Act of 1986 to reauthorize Alzheimer's disease demonstration projects. Requires the Secretary to report to the Cognress any recommendations regarding: (1) a plan under which the Federal Government would provide, and finance the provision of, both long-term and home- and community-based care; and (2) the appropriate role of the States in such a plan.
Bill· SS. 3176 (102nd)referred
United States · United States Congress · 12 August 1992
Health Care Affordability and Quality Improvement Act of 1992 - Title I: Disclosure Of Certain Information To Beneficiaries Under The Medicare And Medicaid Programs - Amends part A (General Provisions) of title XI of the Social Security Act (SSA) to direct the Secretary of Health and Human Services to issue regulations requiring that each institutional health care provider receiving payment for services under SSA titles XVIII (Medicare) or XIX (Medicaid) make an annual report available to service recipients. Specifies the contents of such report, including information on mortality and infection rates and malpractice claims. Requires the Secretary to issue regulations requiring that each noninstitutional provider receiving payment for services under such titles make an annual report available to service recipients. Specifies the contents of such report, including information on provider qualifications and malpractice and other actions taken against the provider. Requires the Secretary to issue regulations requiring that each institutional and noninstitutional health care provider receiving payment for such services: (1) make available any forms required in connection with the receipt of such services which consist of any diagnostic, surgical, or other invasive procedure, before performance of such procedure; (2) disclose to any individual receiving any surgical, palliative, or other health care procedure or any drug therapy or other treatment, specified information before performance of such procedure or treatment; and (3) inform any individual receiving such services of that individual's right to refuse the information made available above and any procedure or treatment. Provides for penalties for failure to comply with the regulations issued above. Authorizes the Secretary to award grants to nonprofit private entities for outreach activities to inform Medicare beneficiaries of the information made available above. Authorizes appropriations. Amends Medicare to require the annual notice of Medicare benefits to contain a description of the information made available above. Amends Medicaid to require State plans to provide for an outreach program informing Medicaid beneficiaries of the information made available above. Title II: Advisory Committee On Patient Self-Determination - Directs the Secretary to establish an advisory committee or committees for the purpose of issuing recommendations about various issues related to patient self-determination. Lists specific issues to be addressed by such committee or committees. Title III: Maternal and Infant Care Coordination - Authorizes the Secretary to award grants to States to implement coordinated, multidisciplinary, and comprehensive primary health care and social service programs targeted to pregnant woman and infants. Specifies grant eligibility criteria. Authorizes appropriations. Authorizes the Secretary, in conjunction with the Secretaries of Education and Agriculture, to award grants for the development of model health and nutrition education curricula for children. Authorizes appropriations. Title IV: Improved Access To Nursing And Physician Assistant Services - Amends Medicare to provide for increased payments for nurse practitioners, clinical nurse specialists, certified nurse midwives, and physician assistants. Provides for bonus payments for such practitioners who provide services in health professional shortage areas. Amends Medicaid to include coverage of physician assistant, nurse practitioner, and clinical nurse specialist services under the Medicaid program. Title V: Medicare Preferred Provider Demonstration Projects - Requires the Secretary to provide for demonstration projects to test the effectiveness of providing payment under Medicare for primary and specialty procedures and services furnished by preferred provider organizations. Title VI: Cost Containment - Amends the Public Health Service Act to authorize the Director of the National Institutes of Health to establish a program for the conduct of clinical trials with respect to promising new drugs and disease treatments. Authorizes appropriations. Reauthorizes research under the Public Health Service Act on cost-effective methods of health care. Requires amounts appropriated in excess of those appropriated for FY 1992 to be used for developing and disseminating new practice guidelines related to cost-effective methods of health care. Amends the Internal Revenue Code to impose on health insurance carriers an excise tax of .001 cent per dollar on health insurance policy premiums. Creates in the Treasury the Trust Fund for Medical Treatment Outcomes Research to hold the revenues generated from such tax to pay for research activities related to medical treatment outcomes. Requires the Secretary, after considering the recommendations of the Health Care Cost Control Advisory Committee established by this Act, to report to appropriate congressional committees on the establishment of national spending targets for health care and health care services.
Bill· SJRESS.J.Res. 334 (102nd)referred
United States · United States Congress · 12 August 1992
Designates September 1992 as Childhood Cancer Month.
Bill· HRH.R. 5857 (102nd)referred
United States · United States Congress · 12 August 1992
Directs the Administrator of the Environmental Protection Agency to promulgate standards to protect public health, safety, and the environment from the hazards of radiologically contaminated sites. Authorizes appropriations.
Bill· HRH.R. 5887 (102nd)referred
United States · United States Congress · 12 August 1992
Defense Nuclear Workers' Health Insurance Act of 1992 - Mandates payment to certain former Department of Energy employees for health care services incurred (through insurance or out-of-pocket) above a specified dollar amount. Sets forth eligibility requirements, including that a former employee have had certain exposure to ionizing radiation or have worked in a facility in which radioactive materials were regularly stored, handled, or disposed of.
Bill· HRH.R. 5854 (102nd)referred
United States · United States Congress · 12 August 1992
Savings Through Health Protocols and Malpractice Reform Act of 1992 - Title I: Development and Implementation of Diagnostic and Treatment Protocols - Mandates grants or contracts for the operation of four to six centers to develop: (1) diagnostic and treatment protocols for various health conditions; and (2) model programs for training health care providers regarding the protocols. Requires establishment of an advisory council to make recommendations on carrying out this title. Title II: Medical Malpractice Liability Reform - Provides for certification of a State if it has enacted certain medical malpractice liability reforms, including: (1) several and not joint liability for non-economic damages, with determination of percentages of liability; (2) specified dollar limits on non-economic damages; (3) mandatory offsets for collateral source damages paid; and (4) at least one alternative dispute resolution mechanism. Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to mandate a reduction in uncertified States and an increase in certified States of: (1) Medicare payments to hospitals for inpatient services; and (2) certain Medicaid payments to States. Amends Federal law relating to tort claims procedures to mandate, with regard to health care liability actions against the United States: (1) several and not joint liability for non-economic damages, with determination of percentages of liability; (2) specified dollar limits on non-economic damages; and (3) mandatory offsets for collateral source damages paid.
Bill· HRH.R. 5837 (102nd)referred
United States · United States Congress · 12 August 1992
American Health Security Plan of 1992 - Title I: Eligibility and Enrollment - Entitles every U.S. resident citizen, national, and lawful resident alien to health care services and long-term care services under this Act. Requires each State program to provide for a mechanism for enrollment and issuance of an identification and processing card. Provides for portability, including mandating use of a uniform claims form. Title II: Benefits - Subtitle A: Health Care Services - Includes as covered services: (1) inpatient and outpatient hospital care; (2) diagnostic and screening tests; (3) services furnished by health care professionals, including medically necessary dental care; (4) preventive care; (5) prescription drugs, biologicals, and devices; (6) substance abuse services; (7) outpatient mental health services; (8) hospice care; (9) habilitation and rehabilitation; (10) home medical equipment and prosthetic devices; and (11) approved experimental treatment. Prohibits States from limiting the amount, duration, or scope of services except as provided in this Act. Excludes cosmetic surgery and certain inpatient amenities. Requires: (1) the Federal Health Board established by this Act to provide, subject to certain requirements, for copayments and out-of-pocket limits; and (2) the Federal Health Priorities Council established by this Act to study: (1) whether out-of-pocket limits should be modified to take into account family size and composition; (2) whether co-payments effectively contain costs and whether they are an administrative burden on providers; (3) the effects of the continuation of duplicative private insurance on the quality, access, and cost of the public insurance program; and (4) whether cost sharing should be different for individuals who engage in practices deemed to increase the likelihood of service use. Subtitle B: Long-Term Care Services - Requires that the Board set standards for eligibility, long-term care services coverage, income protection, and case management. Requires that long-term care include at least home- and community-based services, nursing home care, hospice care, home medical equipment, and services for individuals with developmental disabilities and mental illness. Requires the Board to establish an income-related cost sharing schedule. Requires reduction of cost sharing to ensure that the income and assets of the individual using long-term care services under this Act are sufficient to: (1) cover all items needed in addition to those provided by the long-term care facility; (2) maintain the individual's primary residence; and (3) maintain the individual's independence once the individual no longer needs long-term care services. Requires a reduction in cost sharing to ensure that the income of the spouse, dependent, parent, or guardian of the individual using long-term care services is not reduced below certain levels. Provides for the appointment of a Long-Term Care Services Assessment Commission to make recommendations annually regarding specified aspects of long-term care under this Act. Authorizes appropriations. Subtitle C: Modification of Services - Requires annual recommendations by the Priorities Council regarding changes in services under this Act. Authorizes the Board to promulgate regulations for implementing the Council's recommendations. Gives the regulations the force of law unless Congress disapproves. Title III: Federal and State Administration - Subtitle A: Federal Administration - Establishes the Federal Health Board to administer this Act and take other actions, including establishing national minimum quality standards, establishing uniform reporting requirements, developing a uniform claims form, and reviewing and approving interstate consortia minimizing fragmented care, and combating fraud and abuse. Requires the Board to appoint the Federal Health Advisory Council. Establishes the Federal Health Priorities Council to conduct hearings and studies and make recommendations on how health care dollars should be allocated in the context of a publicly funded national health insurance plan. Authorizes appropriations for the Board, the Advisory Council, and the Priorities Council. Subtitle B: State Administration - Provides for Board review and approval of State programs. Includes in requirements for State programs: (1) financing of services through a designated fund; (2) designation of a single nonprofit State agency to administer the program; (3) establishment of boards to negotiate with hospitals and practitioners; and (4) freedom of individuals to choose providers. Allows States to contract with fiscal intermediaries, in a process of competitive bidding, to administer the State program. Provides for waivers for States to: (1) implement alternative and innovative provider reimbursement, cost sharing, and administration; and (2) provide services through a capitation method. Allows any group of States to establish a regional consortium in lieu of State programs. Provides for congressional disapproval of the consortium agreement. Mandates grants to and cooperative agreements with States for programs, research, and treatment relating to environmental health and health promotion and disease prevention. Mandates grants to States or regional consortia for the establishment and initial operation of the State or regional plan. Authorizes appropriations. Title IV: Financing - Subtitle A: Health Budgets - Requires the Board to establish an annual or biennial budget for Federal and State expenditures under this Act. Requires computation of national average per capita costs, adjustments for risk groups, and adjustments for specified factors in each State. Provides for determination by the Board of the Federal and State shares of expenditures, subject to congressional disapproval. Entitles each State with an approved State program to a Federal contribution of the Federal share plus that State's total projected expenditures for services under this Act. Prohibits a State, either by intention or as an unstated consequence of budget allocations, from restricting timely access to medically necessary and appropriate services under this Act or permitting queues to form that have the potential to be life threatening. Subtitle B: Payments to Providers - Provides for State payments to hospitals and other health care and long-term care institutions for the areas of operating, capital, and health training expenses. Sets forth principles for guiding State reimbursement negotiation boards in each such area. Requires the State practitioner reimbursement negotiation board to negotiate with the State organizations representing each of the practitioner disciplines to derive a relative value scale fee schedule fulfilling specified principles. Sets forth principles for negotiating reimbursement rates for nonphysician providers. Declares payment by a State program to be payment in full. Subtitle C: Revenues - Requires the Board to develop a mechanism for determining and collecting a premium from individuals and employers. Requires the Board, subject to congressional disapproval, to collect premiums from individuals and employers according to certain requirements, including that the premiums from: (1) individuals be income-based and progressive; and (2) employers be based on each employer's ability to pay. Amends the Internal Revenue Code to define "accident or health insurance," for purposes of provisions relating to exclusions from gross income, to mean an approved State program under this Act. Removes provisions relating to amounts paid to highly compensated individuals under a discriminatory self-insured medical expense reimbursement plan. Prohibits trade or business expense deductions for employer group health plan expenses unless the plan is an approved State plan under this Act. Removes provisions: (1) limiting deductions for health insurance costs of self-employed individuals to 25 percent of those costs; and (2) terminating, on a specified date, the allowance of any deductions for such costs for self-employed individuals. Modifies definitions under provisions allowing individual medical expense deductions, including defining "medical care" to mean premiums and cost-sharing under this Act. Terminates, after 1998, the child health insurance credit. Establishes in the Treasury the Federal Health Care Trust Fund. Appropriates to the Fund premiums under this Act and additional revenues received as a result of amendments made by this subtitle. Transfers to the Fund all remaining amounts in the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund. Authorizes and appropriates: (1) amounts equal to appropriations under title XIX (Medicaid) of the Social Security Act and under provisions of Federal law relating to the Civilian Health and Medical Plan of the Uniformed Services (CHAMPUS) and relating to health insurance for Federal officials and employees; (2) additional sums as required to cover administrative expenses and grants; (3) payments to each State for the Federal share of expenditures under this Act; and (4) sums as determined by the Board to be necessary to cover contingencies. Declares that the receipts and disbursements of the Fund shall not be included in the totals of the U.S. budget and exempts them from any general budget limitation. Makes each State responsible for establishing a financing program for the implementation of the State program. Title V: Congressional Consideration - Sets forth rules, changeable as any other rule of the House of Representatives or the Senate, regarding congressional disapproval resolutions under this Act. Title VI: Private Options - Declares that this Act does not prohibit private insurance coverage supplementing the services covered under this Act. Allows private insurance coverage for services covered under this Act, subject to limitations, including: (1) prohibiting private coverage for the cost-sharing requirements for health care services and other non-long-term care services covered under this Act; (2) requiring issuers of private insurance to inform purchasers of any duplication in coverage; and (3) requiring the Comptroller General to review private insurance industry practices and make recommendations to the Congress regarding prevention of fraud and abuse in the sale of duplicative or supplemental private insurance. Declares that the purchase of any private insurance does not relieve the purchaser of the payment of premiums under this Act. Title VII: Expansion of Outcomes Research and Delivery of Services in Underserved Areas - Amends provisions of the Social Security Act relating to health care outcomes research to authorize appropriations. Authorizes appropriations to carry out provisions of the Public Health Service Act relating to the National Health Service Corps. Amends the Public Health Service Act to authorize grants to local communities for programs to finance the health-related education of residents of such communities, provided such residents agree to practice in a health-related field in that community for at least four years after graduation. Authorizes appropriations. Mandates grants to expand the availability of comprehensive primary health services in medically underserved areas. Allows community and migrant health centers in existence at enactment of this Act to use any increase in revenue resulting from the increase in the number of insured patients treated for the expansion of the amounts and types of services furnished, to serve additional patients or areas, or to promote the recruitment, training, or retention of personnel. Authorizes appropriations. Title VIII: Malpractice Reform - Requires the Board to make grants to States for the development and implementation of medical malpractice reforms meeting specified criteria. Authorizes appropriations. Title IX: Effective Dates; Terminations; Transition; Relation to ERISA - Repeals: (1) titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act; (2) provisions of the Internal Revenue Code relating to hospital insurance; (3) certain provisions of Federal law relating to the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); and (4) specified provisions of Federal law relating to health benefits for Federal officials and employees. Requires the Board to recommend to the Congress amendment or repeal of any other Federal program inconsistent with or duplicative of the principles of this Act. Supersedes, to the extent they are inconsistent with this Act, the provisions of the Employee Retirement Income Security Act.
Bill· HRH.R. 5833 (102nd)referred
United States · United States Congress · 12 August 1992
Rural Health Care Access Improvement Act of 1992 - Title I: Provisions Relating to Physicians' Services - Subtitle A: Incentives Under Medicare - Amends title XVIII (Medicare) of the Social Security Act to modify requirements regarding payments to new physicians and other new health care practitioners for services in a rural area. Prohibits failure to make Medicare payments based on the failure of an individual to complete a questionnaire concerning the existence of a primary plan. Declares that any such payment remains conditional. Regulates the use, by carriers used for the administration of Medicare benefits, of extrapolation. Prohibits fees (by carriers or the Secretary of Health and Human Services) for filing a claim concerning physicians' services, related errors or appeals, applications for unique identifiers, responding to inquiries respecting physicians' services, or providing information with respect to medical review of such services. Requires consideration, in applying standards and criteria for contracts with carriers, of evaluations submitted by medical societies representing physicians served by the carrier. Provides for appeals of carrier actions. Requires carriers to provide for review (of denial of payments for physicians' services) by a physician in the same medical specialty. Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to modify the circumstances in which payments may be made to a physician for services provided by a second physician. Amends the Social Security Act to exclude surgical procedures performed in a rural area from requirements of utilization and quality control review. Subtitle B: Increasing Number of Physicians Practicing in Rural Areas - Amends the Internal Revenue Code to allow a personal interest deduction for qualified medical education loan interest which accrues while the physician is providing primary care to residents of a medically underserved rural area. Amends the Higher Education Act of 1965 to declare that two-year time limits do not apply to a borrower serving an internship or residency program in preparation for primary care practice with regard to paying interest subsidies on certain educational loans, insuring certain student loans, and repaying the principal and interest on certain educational loans. Amends the Public Health Service Act to add the ratio of medically underserved individuals in a health professional shortage area to the aggregate population of all such areas to the list of exclusive factors to be considered in determining the greatest shortages in the assignment of National Health Service Corps members. Subtitle C: Reduction in Medical Malpractice Liability for Community Health Centers - Amends the Public Health Service Act to include entities receiving Federal funds under provisions relating to migrant health centers, community health centers, or health services for the homeless, or health services for residents of public housing, and officers, employees, or certain contractors of such entities who are licensed or certified health practitioners, in the coverage of provisions regulating civil actions for injury resulting from medical or related functions against commissioned officers or employees of the Public Health Service. Subrogates to the United States any insurance claim such an entity or person has. Terminates the inclusion after a specified date. Prohibits grants under provisions relating to migrant or community health centers, health services for the homeless, or health services for residents of public housing unless the applicant has: (1) implemented policies and procedures to assure against malpractice and the risk of lawsuits; (2) reviewed the professional credentials, claims history, and other information regarding its licensed health care practitioners; (3) no history of claims against it (or its officers, employees, or contractor) under such provisions relating to officers and employees of the Public Health Service, or has cooperated with the Attorney General in defending against such claims and has taken corrective action; and (4) has cooperated with the Attorney General in providing information relating to an estimate of expected claims. Empowers the Attorney General, if certain conditions are met, to determine that an individual physician or other practitioner not be deemed a Public Health Service employee for purposes of these provisions. Prohibits hospitals from denying admitting privileges to an otherwise qualified health care provider who is an officer, employee, or contractor of such an entity. Mandates an annual estimate of the amount of expected claims and withholding that amount from the appropriation for each involved grant program. Subtitle D: Expansion of Exceptions to Limitations on Physician Self-Referrals - Amends provisions of title XVIII (Medicare) of the Social Security Act prohibiting physician referrals to an entity with which the physician has a financial relationship to provide for exceptions relating to health maintenance organizations, managed care plans, shared facility services, and certain community services for which it is found that community individuals will be deprived of adequate health services without such an exception. Mandates a study of the changes in aggregate costs, under Medicare and other health plans, which will result from the amendments made by this subtitle. Title II: Provisions Relating to Hospitals - Amends Medicare provisions to require rural hospital prospective payment system amounts for capital-related costs of inpatient services to be based on reasonable costs or on the methodology used to determine the payment for other hospitals, as elected by the hospital. Amends the Omnibus Budget Reconciliation Act of 1989 to extend the termination date of provisions requiring referral centers. Removes Medicare provisions relating to exceptions and adjustments in certain payments for regional and national referral centers. Provides that the disproportionate share adjustment percentage be determined, in certain circumstances, as though such provisions had not been removed. Shields from certain antitrust laws specified actions of hospitals meeting described requirements, including being outside of a city or in a city with fewer than a specified number of inhabitants. Title III: Miscellaneous Provisions - Subtitle A: Administrative Simplification - Requires any public or private health benefit plan to: (1) issue health claims cards; (2) provide information to the assigned health claims clearinghouse on eligibility and benefits for an individual; and (3) accept the determinations of clean claims made by the clearinghouse. Requires each health service provider to submit claims only to the assigned clearinghouse and only consistent with standards under this Act. Imposes civil penalties. Establishes a sunset date for the penalties. Requires each hospital, as a Medicare participation agreement requirement, to report information in a uniform manner consistent with specified provisions of the Omnibus Budget Reconciliation Act of 1987. Requires: (1) designation of clearinghouse areas having about five million residents each; and (2) a separate contract in each area with a public or private organization to perform the clearinghouse functions. Allows a clearinghouse to impose user charges. Sets forth clearinghouse functions, including eligibility and benefit verification and claims processing. Provides for inter-clearinghouse verification and the use of electronic and other communication forms. Allows the clearinghouse contract to provide for claim payment by the clearinghouse, including regarding Medicare payments. Mandates standards for: (1) uniform health claims cards with certain information electronically encoded; and (2) the type and form of information required for claims acceptance and payment. Requires the Secretary of Health and Human Services to develop and make available to providers such computer software as will enable providers to make inquiries, receive responses, and submit claims electronically and, in the case of hospitals, to submit uniform reports. Amends the Internal Revenue Code to impose a tax on the failure of any group health plan to meet certain requirements of this title, specifying sunset dates for the tax. Sets the amount of the tax at 25 percent of the gross premiums received during the year from all group health plans issued by the person on whom the tax is imposed. Requires that Medicare and Medicaid identification cards be modified to meet the requirements of this Act. Subtitle B: Other Provisions - Amends the Public Health Service Act to require that demonstration projects involving telecommunications to improve trauma care in rural areas include specified elements. Authorizes the use of a specified amount from funds appropriated to carry out provisions relating to health personnel student assistance for grants to nursing schools for the establishment of clinics to provide primary care services in medically underserved rural areas or within a certain distance of Indian country and to provide for related clinical training development, faculty enhancement, and student scholarships. Amends Federal law relating to the independent collection of information by an agency to require: (1) a study of the burden of federally conducted or sponsored health care services information collection requests; and (2) setting a goal of reducing that burden by specified percentages.
Bill· HRH.R. 5893 (102nd)referred
United States · United States Congress · 12 August 1992
National AIDS Vaccine Development and Compensation Act of 1992 - Title I: Vaccines - Amends the Public Health Service Act to establish in the Department of Health and Human Services a National Program to achieve optimal prevention of the acquired immune deficiency syndrome (AIDS) through immunization. Includes in Program responsibilities AIDS vaccine research, development, safety and efficacy testing, licensing, production and procurement, distribution and use, and evaluation of need, effectiveness, and adverse effects. Establishes the AIDS Vaccine Review Advisory Committee. Authorizes appropriations. Establishes the National Vaccine Injury Compensation Program under which compensation may be paid for a human immunodeficiency virus (HIV) vaccine-related injury or death. Makes it an ethical obligation of any attorney to inform individuals consulting about such an injury or death that compensation may be available under the program. Sets forth compensation procedures. Establishes in the U.S. Claims Court an office of not more than eight special masters. Requires the special masters to issue decisions on compensation petitions. Requires proof by a preponderance of the evidence. Mandates establishment of a vaccine injury table including potential HIV vaccines and the conditions and deaths resulting from the administration of the vaccine. Requires compensation to include: (1) certain actual unreimbursable expenses; (2) in the event of death, a specified dollar amount; (3) actual or anticipated loss of earnings; (4) to a specified dollar maximum, actual and projected pain and suffering. Prohibits punitive or exemplary damages and compensation for other than the health, education, or welfare of the person who suffered the injury. Requires awarding attorney's fees and other costs. Makes the Program liable after other sources such as insurance or other Federal or State health benefits programs (other than title XIX (Medicaid) of the Social Security Act). Authorizes appropriations for payment of compensation. Sets forth time limits on actions. Subrogates the trust fund established to provide compensation under the Program to the rights of the petitioner. Establishes the Advisory Commission on AIDS Vaccines. Provides for additional remedies, including allowing a civil action for damages and allowing the petitioner, in certain circumstances, to chose to continue or withdraw the petition. Sets forth standards of responsibility, including providing that a manufacturer is not liable for: (1) unavoidable adverse side effects, if the vaccine is properly prepared and accompanied by proper directions and warnings; or (2) damages due to the manufacturer's failure to provide direct warnings to the injured party. Prohibits a State from establishing or enforcing a law prohibiting a civil action not barred by provisions of this Act. Requires a civil action trial for an HIV vaccine-related injury or death to be held in three stages: liability, general damages, and punitive damages. Sets forth recordkeeping and reporting requirements for health care providers administering an AIDS vaccine. Mandates development and dissemination of vaccine information materials. Requires the establishment of a task force on safer HIV vaccines. Sets forth recordkeeping and reporting requirements for AIDS vaccine manufacturers. Provides for fines and imprisonment for violations. Allows any person to commence a civil action against the Secretary of Health and Human Services where there is an alleged failure of the Secretary to perform any act under the provisions established by this Act. Allows awarding litigation costs, including attorney's fees, to a plaintiff in certain circumstances. Mandates: (1) a study of AIDS vaccine risks; (2) guidelines for vaccine administration; and (3) review of the warnings, use instructions, and precautionary information issued by vaccine manufacturers. Title II: Amendments of the Internal Revenue Code of 1986 - Amends the Internal Revenue Code to establish in the Treasury the AIDS Vaccine Injury Compensation Trust Fund. Appropriates to the Fund excise taxes on HIV vaccines and the amounts recovered through subrogation. Makes amounts in the Fund available, as provided in appropriation Acts, only for the AIDS vaccine development and compensation program. Authorizes appropriations to the Fund, as repayable advances, of sums as necessary to carry out the purposes of the Fund. Allows claims to be paid only out of the Fund. Provides for the order in which unpaid claims are to be paid. Appropriates a specified amount to the Fund as a repayable advance. Title III: Revenue Sources for AIDS Vaccine Injury Compensation Trust Fund - Mandates a study on the appropriate amount of tax to be imposed on any HIV vaccine manufacturer, producer, or importer to be deposited in the Fund. Title IV: Miscellaneous - Declares that: (1) provisions of Federal law relating to coordination of Federal information policy do not apply to information required for carrying out this Act; and (2) if any provision of this Act is declared unconstitutional, the entire Act shall be considered invalid.
Bill· HRH.R. 5907 (102nd)referred
United States · United States Congress · 12 August 1992
Traumatic Brain Injury Act of 1992 - Amends the Public Health Service Act to direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control, to conduct a study concerning traumatic brain injury. Requires the study to seek to: (1) determine the major causes of traumatic brain injury; (2) identify common therapeutic interventions which are used for the rehabilitation of individuals with traumatic brain injuries; (3) determine the preventive efforts that are being used by States and non-profit agencies to reduce the occurrence of such injuries; (4) identify effective treatment and long-term rehabilitation services needed to meet the needs of individuals with traumatic brain injuries; (5) develop practice guidelines for the treatment of traumatic brain injury; and (6) determine whether there is a need for national standards for helmets used by bicyclists and others. Requires the results of such study to be reported to the Congress not later than three years after enactment of this Act. Requires the Secretary to biennially prepare a report containing recommendations for the prevention of traumatic brain injuries, including identifying States that have mandated helmet laws for bicyclists and others. Requires such report to be disseminated to State health officers. Makes the Director responsible for gathering data concerning the number of individuals surviving traumatic brain injury and regarding the cost of such injuries. Requires the Director to establish a uniform reporting system under which hospitals and State and local health-related agencies will report on matters including: (1) the occurrence of traumatic brain injuries; (2) the amount of traumatic brain injury research, training and services; (3) the identification of States and localities that have approved mandated helmet use laws; and (4) the health insurance status of individuals with such injuries. Requires the reporting system to permit the Director to make an accurate assessment of resource needs, provide a basis for the allocation of resources, and track survivors of traumatic brain injury from the provision of initial health care through long-term rehabilitation. Directs the Director to determine which Federal, State, local or other entities collect data on traumatic brain injury and the means by which such entities collect the data. Authorizes the Director to enter into cooperative agreements with other agencies, and to provide assistance to other entities with responsibility for data collection, to establish traumatic brain injury as a specific reportable condition in existing and future reporting systems. Authorizes the Secretary to award grants to State and local entities, and to public or non-profit private entities, to support: (1) special prevention and public awareness initiative projects; (2) model traumatic brain injury prevention, research and support programs; (3) projects that study the service needs of individuals with traumatic brain injury; and (4) projects involving grants for service coordination. Authorizes the Secretary to provide assistance to public and private nonprofit entities to reduce the incidence of traumatic brain injury through the establishment and effectuation of prevention projects. Sets forth eligibility requirements. Authorizes the Secretary, acting through the Director of the National Institutes of Health, to provide assistance to public and private nonprofit entities to support the conduct of basic and applied research concerning traumatic brain injury, especially with respect to the biomechanics of brain injury, the molecular and cellular characteristics of primary and secondary injury to the brain and the development of improved experimental brain injury models. Specifies the research to be conducted. Directs the Secretary to award grants to States for the establishment of Statewide protection and advocacy demonstration projects for individuals affected by traumatic brain injury. Sets forth eligibility requirements. Requires each State that receives assistance under this Act to establish a consumer-controlled advisory board within the Department of Health or Human Services of the State or within another department as designated by the chief executive officer of the State. Directs an advisory board to coordinate communications with and between Federal, State and local agencies, citizen's groups, private industry and labor and nonprofit organizations and to encourage citizen participation through public hearings and other types of community outreach programs. Requires each State to establish a services coordination program to identify the services required to prevent the institutionalization or to minimize the need for residential rehabilitation in the case of traumatic brain injuries. Sets forth the requirements for such program. Authorizes appropriations to carry out provisions of this Act for FY 1993 through 1995. Designates October 1992 as National Head Injury Month.
Bill· HRH.R. 5867 (102nd)referred
United States · United States Congress · 12 August 1992
Consumer Hospital Price Awareness Act of 1992 - Amends title XVIII (Medicare) of the Social Security Act to require as a condition of participation in the Medicare program that hospitals disclose to patients upon their request an estimate of the costs to be incurred or a statement of the costs already incurred by the hospital in providing services to the patient.
Bill· HRH.R. 5860 (102nd)referred
United States · United States Congress · 12 August 1992
Emergency Public Health and Drinking Water Protection Act - Authorizes the Secretary of the Army to make a grant to the city of Pawtucket, Rhode Island, for replacement and repair of the city's water transmission system.
Bill· HRH.R. 5885 (102nd)referred
United States · United States Congress · 12 August 1992
Women Veterans Health Programs Act of 1992 - Title I: Sexual Trauma Services - Requires that a veteran who is diagnosed by a Department of Veterans Affairs (DVA) health professional designated by the Chief Medical Director (following an examination of the veteran by such professional) to be in need of counseling or treatment for sexual trauma resulting from events that occurred during the period of the veteran's service on active duty be furnished such care and services, even though such trauma has not been determined to be service-connected. Authorizes the Secretary of the DVA to enter into contracts with appropriate non-DVA facilities to furnish veterans with such care and services. Sets forth reporting requirements. Directs the Secretary to provide information and referrals concerning care and services related to sexual trauma that are available to veterans in the communities in which such veterans reside, including care and services available under programs of the DVA and from non-DVA agencies or organizations, by means of a telephone information system using a toll-free number. Requires the Secretary to ensure that such system: (1) is operated by DVA personnel who are trained in the provision of information and referrals to persons who have experienced sexual trauma; (2) is operated in a manner that protects the confidentiality of persons who place telephone calls to the system; (3) operates at all times; and (4) is visibly posted in DVA medical facilities and advertised through public service announcements, pamphlets, and other means. Directs the Secretary to commence a study of the needs of veterans for counseling, medical care, and other services for sexual trauma, including: (1) the extent to which women service members have experienced rape, sexual assault, sexual harassment, or other acts of sexual violence while on active military, naval, or air service; (2) the extent of any under-reporting of incidents of sexual violence among women members of the armed forces and the extent to which the rate of such under-reporting differs from the rate of under-reporting of such incidents among the general population of women in the United States; (3) the extent to which women members of the armed forces and women veterans who have experienced sexual trauma have used counseling, medical care, and other services furnished by the Department of Defense and the DVA in order to respond to such experiences; and (4) the same types of information with respect to men who are members of the armed forces and men who are veterans. Sets forth reporting requirements with respect to such study and the care and services furnished by DVA to veterans who have experienced sexual trauma. Directs the Secretary and the Secretary of Defense to jointly carry out a program to ensure that persons who are being separated from active military, naval, or air service are provided information on: (1) the counseling, medical care, and other services and assistance relating to sexual trauma that are available to veterans under programs carried out by the DVA; and (2) the requirements of eligibility for or entitlement to, and the procedures for applying for, such counseling, medical care, and other services and assistance. Requires the Secretaries to ensure that such information is provided in both a written and oral form through an in-person interview conducted by trained personnel with each person being separated. Requires the Secretary to submit to the Senate and House Committees on Veterans' Affairs a report relating to determinations of service connection for sexual trauma. Title II: Health Care for Women Veterans - Includes the term "well-women care services" within the definition of medical services for purposes of Federal veterans' provisions. Defines such term to mean health care services provided to women, including counseling and services relating to: (1) papanicolaou tests (pap smear); (2) breast examinations and mammography; (3) general reproductive health care and contraceptives; (4) the management of infertility and sexually transmitted diseases; (5) menopause; and (6) physical or psychological conditions arising out of acts of sexual violence. Authorizes contracts for hospital care and medical services with non-DVA facilities to furnish well-women care services for veterans on an ambulatory or outpatient basis, but only under contracts that expire not later than December 31, 1994. Directs the Secretary to: (1) submit to the Congress a report on the provision of health care services to women veterans; and (2) foster and encourage the initiation and expansion of research into matters relating to women's health. Requires the Comptroller General to carry out a study to determine: (1) the percentage of all admissions of women veterans to DVA facilities that are based on a diagnosis of psychotic illness; (2) the percentage of all admissions of men veterans to such facilities that are based on such diagnosis; and (3) an explanation of the difference, if any, in such percentages. Authorizes appropriations. Requires the Secretary, to the extent that the quantity and nature of information available to DVA personnel with respect to issues relating to health care for women veterans permit such personnel to carry out research relevant to the health care needs of women veterans, to take actions to ensure that medical research carried out by the Secretary gives consideration to issues relating to the health of the general population of adult women in the United States. Directs the Secretary to conduct an ongoing study to determine the needs of women veterans for health-care services. Sets forth reporting requirements. Authorizes appropriations. Requires the Secretary to submit to the Senate and House Committees on Veterans' Affairs a report on research relating to women veterans. Directs the Secretary to take appropriate actions to ensure that: (1) sufficient funding is provided to each DVA facility to permit the women veterans coordinator to carry out the functions of the coordinator at the facility; (2) sufficient clerical and communications support is provided to each such coordinator for that purpose; and (3) each such coordinator has direct access to the Director or Chief of Staff of the facility to which the coordinator is assigned. Directs the Secretary to appoint a full-time regional women veterans coordinator to serve in each regional office of the Veterans Health Administration. Sets forth responsibilities of such coordinators. Requires the Secretary to provide funds to be used for the members of the Advisory Committee on Women Veterans for: (1) travel in connection with a reasonable number of visits to DVA facilities to permit such members to carry out the responsibilities of the Advisory Committee; and (2) the conduct of meetings of the Advisory Committee.
Bill· HRH.R. 5832 (102nd)referred
United States · United States Congress · 12 August 1992
Persian Gulf War Health Registry Act - Requires the Secretary of Veterans Affairs (Secretary) to maintain a Persian Gulf War Health Registry for purposes of compiling information on Persian Gulf War veterans to assist in identifying possible disabilities which may result from service in the U.S. armed forces in southwest Asia during such war. Sets forth provisions regarding: (1) information to be included in the Registry, including a description of activities in which the veteran participated during the war that may have long-term health effects, locations in which the veteran served, and any investigation drugs administered to such veterans by the Department of Defense (DOD); and (2) steps that the Secretary may (and Secretary of Defense, upon request, shall) take, including a comprehensive mental and physical examination and follow-up consultation, to determine the current health status of such veterans. Directs the Secretary and Secretary of Defense to: (1) inform Gulf War veterans who are no longer members of the armed forces of the provisions of this Act and encourage such veterans to participate in the Registry; and (2) annually furnish to such veterans updated information on health risks of service in southwest Asia during the war. Requires DOD to reimburse the Department of Veterans Affairs each fiscal year, from funds appropriated for health care, for the cost of administering the Registry for Gulf War veterans who are members of the armed forces. Specifies that: (1) nothing in this Act shall be construed as authorizing the Secretary to provide Gulf War veterans in the Registry with hospital care, nursing home care, or outpatient medical services for the treatment of diseases or disabilities identified in an examination authorized pursuant to this Act; and (2) application for an examination shall not be construed as an application for any other benefit. Directs the Secretary to conduct a longitudinal study, over a 50-year period, to assess the short- and long-term health consequences of service in southwest Asia during the Gulf War, including an ongoing examination of the health consequences of petrochemical exposure, investigation drugs administered during the Gulf War, the fumes of burning trash, and diseases indigenous to the Middle East. Requires the Secretary and Secretary of Defense to submit to the Congress a joint annual report on the Registry. Directs the Secretary to: (1) establish the Registry (and have access to the registry established by the Secretary of Defense); and (2) submit to the Congress a research protocol for the 50-year study.
Bill· SS. 3168 (102nd)referred
United States · United States Congress · 11 August 1992
Acid Mine Drainage Abatement Act of 1992 - Amends the Surface Mining Control and Reclamation Act of 1977 to authorize the States to set aside: (1) up to ten percent of their annual grants for a special trust fund to redress public health and safety problems beyond 1995; and (2) up to 30 percent for an acid mine drainage abatement and treatment trust fund. Permits States that receive funds for acid mine drainage treatment to apply to the Secretary of the Interior for grants for such projects which do not exceed 50 percent of project costs.
Bill· SS. 3165 (102nd)referred
United States · United States Congress · 11 August 1992
Health Insurance Purchasing Cooperatives Act - Mandates grants to States for the administrative costs of planning and implementing coordinated buying programs through which small employers may purchase employee health insurance. Requires that the programs be the sole mechanism for small employers to purchase such insurance. Allow exceptions for insurance purchased from certain associations that offer health insurance as a service to members. Requires that a State program provide each small employer in the State access to health insurance for its employees and their dependents through one or more Health Insurance Purchasing Cooperatives, each covering a defined geographic district. Regulates Cooperative governance. Sets forth Cooperative duties, including issuing contracts and administering all aspects of coverage for all small employers within the district. Waives Federal and State antitrust laws. Mandates that the State program require any small employer that chooses to provide a health benefit plan to do so by purchasing insurance through the Cooperative, nothwithstanding specified provisions of the Employee Retirement Income Security Act of of 1974. Authorizes appropriations. Establishes the National Health Care Board. Requires the Board to establish Coordinated Buying Program Precepts setting forth certain criteria, including regarding a uniform data system, collection of outcomes data, and determining minimum benefit requirements. Authorizes appropriations. Requires the Board to establish minimum benefit requirements for plans offered through Cooperatives, including inpatient and outpatient hospital care and physician services, diagnostic tests, prenatal and well-baby care, preventive and early intervention services, and certain inpatient and outpatient mental disorder services. Declares that nothing in State law or this Act: (1) prohibits managed care or different levels of payments for different providers; or (2) requires payment to any provider excluded from participation in any Federal health care program. Requires the Board to establish minimum benefit requirements for two additional health benefit plans providing more extensive or more innovative benefits. Amends provisions of the Public Health Service Act relating to health maintenance organizations (HMOs) to exempt from those provisions HMOs that provide services meeting the requirements under this Act. Establishes the National Health Insurance Data System, consisting of: (1) a National Data Base for Health Insurance and Health Outcomes Information; (2) no more than five Regional Health Insurance Data Centers; and (3) an electronic health insurance and outcomes data processing mechanism. Requires the Board to: (1) establish uniform billing and claims forms and mandatory reporting requirements; and (2) require carriers to issue to each participant an electronic processing card. Authorizes appropriations.
Bill· HRH.R. 5825 (102nd)referred
United States · United States Congress · 11 August 1992
Amends title XVIII (Medicare) of the Social Security Act to change the definition of certified nurse-midwife services (and thus allow certified nurse-midwives to receive payment under Medicare for all services which such practitioners are legally authorized to perform under State law or regulations).
Bill· HRH.R. 5812 (102nd)referred
United States · United States Congress · 11 August 1992
Health Insurance Purchasing Cooperatives Act - Mandates grants to States for the administrative costs of planning and implementing coordinated buying programs through which small employers may purchase employee health insurance. Requires that the programs be the sole mechanism for small employers to purchase such insurance. Requires that a State program provide each small employer in the State access to health insurance for its employees and their dependents through one or more Health Insurance Purchasing Cooperatives, each covering a defined geographic district. Sets forth Cooperative duties, including issuing contracts and administering all aspects of coverage for all small employers within the district. Waives Federal and State antitrust laws. Authorizes appropriations. Establishes the National Health Board. Requires the Board to establish Coordinated Buying Program Precepts setting forth certain criteria, including regarding a uniform data system, collection of outcomes data, and determining minimum benefit requirements. Authorizes appropriations. Requires the Board to establish minimum benefit requirements for plans offered through Cooperatives, including inpatient and outpatient hospital care and physician services, diagnostic tests, prenatal and well-baby care, preventive and early intervention services, and certain inpatient and outpatient mental disorder services. Allows managed care and different levels of payments for different providers. Requires the Board to establish minimum benefit requirements for two additional health benefit plans providing more extensive or more innovative benefits. Amends provisions of the Public Health Service Act relating to health maintenance organizations (HMOs) to exempt from those provisions HMOs that provide services meeting the requirements under this Act. Establishes the National Health Insurance Data System, consisting of: (1) a National Data Base for Health Insurance and Health Outcomes Information; (2) no more than five Regional Health Insurance Data Centers; and (3) an electronic health insurance and outcomes data processing mechanism. Requires the Board to: (1) establish uniform billing and claims forms and mandatory reporting requirements; and (2) require carriers to issue to each participant an electronic processing card containing certain information on financial, administrative, and health outcomes matters. Authorizes appropriations. Amends the Internal Revenue Code to allow a deduction to self-employed individuals of 100 percent of the amount paid for health insurance purchased through a Cooperative. Retains current provisions allowing a deduction of 25 percent of the amount paid for health insurance not purchased through a Cooperative. Removes provisions ending, on a specified date, deductibility of health insurance payments by self-employed individuals.