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Bill· HRH.R. 3434 (103rd)open
United States · United States Congress · 3 November 1993
Smoke-Free Environment Act of 1993 - Amends the Public Health Service Act to add a new title on smoke free environments. Requires the responsible entity for each public facility to adopt, implement, and post a policy prohibiting smoking in the facility and on facility property in the immediate vicinity of the facility's entrance. Allows designated smoking areas if: (1) the area is ventilated to exhaust directly to the outside; and (2) nonsmoking individuals do not have to enter the area for any purpose. Allows enforcement actions by any aggrieved person, any State or local government agency, or the Administrator of the Environmental Protection Agency. Provides for civil monetary penalties.
Bill· HRH.R. 3439 (103rd)referred
United States · United States Congress · 3 November 1993
Amends title XIX (Medicaid) of the Social Security Act to give States the option of covering room and board furnished by a relative under home- and community-based waivers under the Medicaid program only if such coverage does not result in greater expenditures under the State's Medicaid plan.
Bill· SS. 1600 (103rd)referred
United States · United States Congress · 28 October 1993
TABLE OF CONTENTS: Title I: Long-Term Care Provisions Title II: Long-Term Care Tax Provisions Secure Choice Act of 1993 - Title I: Long-Term Care Provisions - Amends the Social Security Act (SSA) to establish a new Federal program to provide grants to States for furnishing long-term care assistance, which includes nursing facility as well as home and community based services, to eligible low-income functionally impaired individuals (including children) and their spouses under an approved State plan which provides for nominal cost-sharing, nondenial of care, and general freedom of provider choice. (Sec. 101) Allows the use of grants to enable each State to establish a Secure Choice Insurance Program that ensures access of residents to qualified long-term care insurance policies at special premiums which provide certain minimum benefits subsidized by Federal and State funding. Provides for: (1) maximum lifetime benefits after which policyholders may become eligible for assistance under the State plan above; and (2) portability in the case of qualified policies which are group policies. Authorizes appropriations. (Sec. 102) Directs the Secretary of Health and Human Services to: (1) provide that individuals eligible for services under SSA title XIX (Medicaid) which, effective upon the enactment of this Act, are provided under the new Federal program above shall continue to be eligible to receive such services in the same manner as previously provided; (2) establish, in collaboration with the National Association of Insurance Commissioners (NAIC), and report to the Congress on, a system for collecting data on public and private long-term care services for making certain service-related predictions; (3) establish a new organizational unit to administer the new Federal program established above; and (4) submit to appropriate congressional committees a legislative proposal for such amendments as are required by this Act. (Sec. 103) Amends Medicaid to repeal provisions concerning home and community care for functionally disabled elderly individuals. (Sec. 104) Directs the Comptroller General to study and report to the Congress on the appropriateness and adequacy of using the Federal medical assistance percentage used under Medicaid for payment of services provided under such new program. Title II: Long-Term Care Tax Provisions - Amends the Internal Revenue Code to: (1) allow an individual an itemized deduction for qualified long-term care services; (2) provide for the treatment of long-term care insurance or plans; (3) set forth specified consumer protection provisions to be satisfied by qualified long-term care insurance contracts, including the NAIC model Act; and (4) impose an excise tax on persons for failing to meet specified requirements for long-term care insurance policies, including certain requirements of the model Act and regulation and those involving disclosure. (Sec. 214) Requires NAIC to promulgate standards for the use of uniform language and definitions in such policies, with certain variations permitted.
Bill· HRH.R. 3400 (103rd)open
United States · United States Congress · 28 October 1993
TABLE OF CONTENTS: Title I: Department of Agriculture Title II: Department of Commerce Title III: Department of Defense Title IV: Department of Energy Title V: Department of Health and Human Services Title VI: Department of Housing and Urban Development Title VII: Department of the Interior Title VIII: Miscellaneous Provisions Title IX: Department of Labor Title X: Department of State and United States Information Agency Title XI: Department of Transportation Title XII: Department of Veterans Affairs Title XIII: Human Resource Management Title XIV: Reinventing Support Services Title XV: Streamlining Management Control Title XVI: Financial Management Title XVII: Year-End Spending Government Reform and Savings Act of 1993 - Title I: Department of Agriculture - Subtitle A: Department of Agriculture Reorganization - Directs the Secretary of Agriculture to reduce and reorganize the Department of Agriculture, including specified levels of personnel reduction. Subtitle B: Eliminate Federal Support for Wool and Mohair - Repeals the National Wool Act as of December 31, 1995. Reduces 1994 and 1995 wool and mohair support levels. Subtitle C: Eliminate Federal Support for Honey - Amends the Agricultural Act of 1949 to eliminate the honey price support program as of December 31, 1995. Reduces 1994 and 1995 support levels. (Sec. 1203) Reduces honey loan forfeiture limitations. Title II: Department of Commerce - Directs the Departments of Commerce and of Defense and the National Aeronautics and Space Administration to propose a single operational polar environmental and weather satellite system which meets national needs. Requires the Director of the Office of Science and Technology Policy to submit to the Congress by a certain date an implementation plan designed to result in specified savings in budget authority and outlays between FY 1994 and 1999. Title III: Department of Defense - Subtitle A: Create Incentives for the Department of Defense to Generate Revenues - Allows the commander of a military installation, at his discretion, to credit proceeds from the sale of recyclable materials to the nonappropriated morale and welfare account of such installation for use for morale and welfare activities. Subtitle B: Closure of the Uniformed Services University of the Health Sciences - Repeals Federal provisions establishing the Uniformed Services University of the Health Sciences. Phases out such University beginning in FY 1995, with closure no later than September 30, 1998. Subtitle C: Streamline and Reorganize the U.S. Army Corps of Engineers - Directs the Secretary of the Army to reorganize the U.S. Army Corps of Engineers through the reorganization and reduction of offices and the restructuring of functions in order to increase efficiency and reduce costs, with a goal of achieving $50 million in net annual savings by FY 1998. Title IV: Department of Energy - Subtitle A: Alaska Power Administration Sale Authorization Act - Alaska Power Administration Sale Authorization Act - Authorizes the Secretary of Energy, in accordance with specified purchase agreements, to sell: (1) the Snettisham Hydroelectric Project to the State of Alaska Industrial Development and Export Authority; and (2) the Eklutna Hydroelectric Project to the Anchorage Municipal Light and Power, the Chugach Electric Association, Inc., and the Matanuska Electric Association Inc. Directs the Secretary to: (1) close out the Alaska Power Administration; and (2) assess alternative options for maximizing the return to the Treasury from the sale of the Alaska Power Marketing Administration before taking any of the sales action authorized by this Title. Subtitle B: Federal-Private Cogeneration of Electricity - Amends the National Energy Conservation Policy Act to modify the definition of "energy savings" to include increased efficiency from cogeneration processes for other than federally owned buildings or other federally owned facilities. Subtitle C: Power Marketing Administration Debt Buyout - Part 1: Bonneville Power Administration Debt Buyout - Bonneville Power Administration Repayment Bonds Act - Authorizes the Administrator of the Bonneville Power Administration to sell bonds according to prescribed procedures. (Sec. 4203) Amends the Federal Columbia River Transmission System Act to authorize the Administrator to make expenditures from the Bonneville Power Administration fund to pay the financing and debt service costs of such bonds. (Sec. 4204) Amends the Pacific Northwest Electric Power Planning and Conservation Act to authorize the Administrator to base power and transmission rates upon a single, combined generation and transmission repayment study which demonstrates that all indebtedness is repaid by its due date. Part 2: Other Power Marketing Administrations Debt Buyout - Power Marketing Administrations Financing Act - Sets forth procedural guidelines for the Administrators of the Southeastern, Southwestern and Western Area Power Administrations to repay the discounted present value of existing indebtedness to the United States. (Sec. 4209) Establishes a Power Marketing Administration Sinking Fund. (Sec. 4210) Authorizes each Administrator to issue revenue bonds and other instruments of indebtedness to refinance existing indebtedness. Title V: Department of Health and Human Services - Subtitle A: Increased Flexibility in Contracting for Medicare Claims Processing - Amends title XVIII (Medicare) of the Social Security Act (SSA) to make various changes with respect to the contractor system under Medicare, including eliminating the authority of the Railroad Retirement Board to contract for processing the Medicare claims of railroad retirees. Subtitle B: Workers' Compensation Data Exchange Pilot Projects - Authorizes the Secretary of Health and Human Services to conduct pilot projects with up to three States for studying the ways of obtaining workers' compensation data for the Secretary. Reimburses participating States out of the social security trust funds for the costs of participation. Subtitle C: Federal Clearinghouse on Death Information - Amends SSA title II (Old Age, Survivors and Disability Insurance) to restructure the current program for the exchange of death information to, for example, use a Federal Clearinghouse on Death Information as the vehicle for all such exchanges and, in the case of individuals with respect to whom federally funded benefits are provided by (or through) a Federal or State agency other than under SSA, require such agency to pay a set fee to cover all costs connected with the provision of such information for them. Requires any contract requiring a State to furnish death information to the Secretary of Health and Human Services to authorize the Secretary to use such information and redisclose it to any Federal, State, or local agency in accordance with certain SSA information sharing requirements. Subtitle D: Continuing Disability Reviews - Amends SSA title II to earmark specified levels of administrative funding for continuing disability reviews of disabled beneficiaries for FY 1994 through 1999. Title VI: Department of Housing and Urban Development - Subtitle A: Multifamily Property Disposition - Amends the Housing and Community Development Amendments of 1978 to revise provisions regarding the management and disposition of Department of Housing and Urban Development (HUD) - held multifamily properties and mortgages. Subtitle B: Merger of the Certificate and Voucher Programs - Amends the United States Housing Act of 1937 to merge the public housing certificate and voucher programs. Subtitle C: Streamline HUD - Directs the Secretary of Housing and Urban Development to carry out HUD reorganization and reduction activities. Subtitle D: Refinance Section 235 Mortgages - Amends the National Housing Act to cover mortgage refinancing costs under the lower-income family homeownership assistance program. Subtitle E: Section 8 Rents for New Construction and Rehabilitation Projects - Prohibits temporarily the adjustment of maximum monthly public housing (section 8) rents for new construction and rehabilitation projects. Title VII: Department of the Interior - Subtitle A: Improve the Federal Helium Program - Amends the Helium Act Amendments of 1960 to authorize the Secretary of the Interior (the Secretary) to: (1) reduce costs and increase operational efficiencies; and (2) establish and adjust fees charged private industry for storage, transmission, and withdrawal of privately-owned helium from government storage facilities to compensate fully for all costs incurred. Directs the Secretary to: (1) avoid disruptions of the helium market when making helium sales; (2) sell helium at prices comparable to those of private industry; and (3) develop a long-term, comprehensive plan to cancel the outstanding debt owed to the Treasury by the Department of the Interior related to the Federal helium program, and improve Federal helium program operations. Subtitle B: Improve Minerals Management Service Royalty Collection - Directs the Secretary of the Interior to require the Minerals Management Service, Royalty Management Program, to develop and implement: (1) an automated business information system to provide its auditors with a lease history according to prescribed guidelines; (2) the optimum methods to identify and resolve anomalies and verify that royalties are paid correctly; (3) a more efficient and cost-effective royalty collection process; and (4) any other actions necessary to reduce royalty underpayment and increase revenue by a certain amount. Amends the Federal Oil and Gas Royalty Management Act of 1982 to prescribe penalty assessment guidelines for substantial underreporting of lease royalties. Subtitle C: Phase Out the Mineral Institute Program - Directs the Secretary to phase out the Mining and Mineral Resources Research Institute Act of 1984. Authorizes appropriations. Prohibits appropriations after September 30, 1998. Title VIII: Department of Justice - Amends the Federal criminal code to authorize the Attorney General to: (1) assess a nominal fee against a Federal prison inmate's trust fund account for any health services provided the inmate; and (2) waive or refund all or part of such fees for good cause at any time. Declares that no inmate shall be denied health services treatment because of inability to pay a health services fee. Title IX: Department of Labor - Subtitle A: Deterrence of Fraud and Abuse in the FECA Program - Amends the Federal Employees Compensation Act (FECA) to add provisions to deter fraud and abuse in the FECA program. Subtitle B: Enhancement of Reemployment Programs for Federal Employees Disabled in the Performance of Duty - Amends FECA to authorize the Secretary of Labor, as part of the vocational rehabilitation effort, to assist permanently disabled individuals in seeking and/or obtaining employment. Authorizes the Secretary to reimburse an employer (including a Federal employer), who was not the employer at the time of injury and who agrees to employ a disabled beneficiary, for portions of the salary, through payments from the Employees' Compensation Fund. (Sec. 9101) Authorizes the Secretary to expand the FECA Periodic Roll Management Project to all offices of the Office of Workers' Compensation Program of the Department of Labor. Subtitle C: Wage Determinations: McNamara-O'Hara Service Contract Act and Davis-Bacon Act - Amends the McNamara-O'Hara Service Contract Act and the Davis-Bacon Act to authorize the Secretary of Labor to develop and implement electronic data interchange systems to request and obtain wage determinations required under such Acts. Subtitle D: Elimination of Filing Requirement for Plan Descriptions, Summary Plan Descriptions, and Descriptions of Material Modifications to a Plan - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to eliminate certain filing requirements for routine disclosure to employee benefit plan participants and beneficiaries of plan descriptions, summary plan descriptions, and descriptions of material modifications to a plan. Provides for such disclosures by plan administrators through written requests to the Secretary of Labor. Title X: Department of State/United States Information Agency - Directs the Secretary of State to reduce costs of providing marine guard and other security at diplomatic missions overseas by a specified amount by the end of FY 1999. (Sec. 10002) Requires the Director of the United States Information Agency (USIA) to improve the efficiency of USIA's public diplomacy activities and save a specified amount by the end of FY 1999. Title XI: Department of Transportation - Subtitle A: Authority to Charge Tuition for Attendance at the U.S. Merchant Marine Academy - Amends the Merchant Marine Act, 1936 to require the Secretary of Transportation (Secretary) to impose a system of tuition and fees on individuals attending the Academy equal to an amount that is up to one-half the total operating costs of the Academy during the preceding fiscal year. Authorizes the Secretary to impose reasonable fees on cadets at the Academy for all required uniforms and textbooks. (Currently, the Academy is required to provide for such items.) Subtitle B: Reform of the Essential Air Service Program - Amends the Federal Aviation Act of 1958 to provide that in order for a point to be eligible for basic essential air service it must not require a rate of subsidy per passenger in excess of $200, and may not be located fewer than 70 highway miles from the nearest hub airport or small hub airport. Decreases the amount of funds from the Airway Trust Fund for the essential air service program for FY 1994 through 1998. Authorizes amounts from such Fund for FY 1999. Subtitle C: Repeal of Authorizations for the Airway Science Program, Collegiate Training Initiative, and Air Carrier Maintenance Technician Training Facility Grant Program - Repeals all authority for: (1) the Airway Science Program; (2) the Collegiate Training Initiative; and (3) the Air Carrier Maintenance Technician Training Facility Grant Program. Title XII: Department of Veterans Affairs - Subtitle A: Remove Certain Limitations and Restrictions Contained in Veterans Law - Eliminates: (1) Department of Veterans Affairs (Department) hospital and nursing home bed capacity requirements; (2) a required increase in the number of full-time personnel in the Office of the Inspector General of the Department; (3) required reports to the Congress concerning Department administrative reorganizations; (4) the requirement of certain services and offices within the Veterans Health Administration of the Department; and (5) the requirement of a Deputy, Associate Deputy, and various assistant medical directors within the Office of the Chief Medical Director of the Department. Subtitle B: Closure of Supply Depots and Transfer of Revolving Supply Fund Money - Directs the Secretary of Veterans Affairs to: (1) phase out and close Department supply depots in Somerville, New Jersey, Hines, Illinois, and Bell, California; and (2) transfer to the General Fund of the Treasury in FY 1994 and 1995 specified amounts from the Department Revolving Supply Fund. Subtitle C: Provision of Information from the Medicare and Medicaid Coverage Data Bank to the Department of Veterans Affairs - Provides as an additional purpose of the Medicare and Medicaid Coverage Data Bank the provision of information to the Secretary of Veterans Affairs concerning the collection of payments from third parties for health care items and services furnished to veterans. Subtitle D: Veterans' Appeals Improvement Act of 1993 - Veterans' Appeals Improvement Act of 1993 - Provides for the appointment by the Chairman of the Board of Veterans Appeals of any necessary number of Deputy Vice Chairmen. Removes current limitations on the authorized period of service for acting Board members. Requires the Chairman to include in an annual report information with respect to activities of acting Board members during the previous year. (Sec. 12303) Authorizes the Chairman to decide alone, or to assign to another Board member, any matter or motion before the Board. (Current law requires a minimum three-member Board determination of such matters.) Prohibits judicial review of any such assignments. (Sec. 12304) Authorizes the Board to: (1) dismiss appeals which allege no specific error of fact or law or in which the determination being appealed has become moot; (2) remand cases for which additional developments require appropriate disposition; and (3) render a written final Board decision on issues not dismissed or remanded. Revises provisions concerning situations under which the Chairman shall exclude himself from the reconsideration of an appeal. Provides for the reconsideration of a case based on a difference of opinion as to how the evidence should be evaluated rather than on a specific error in the prior decision. (Sec. 12307) Authorizes Board member to: (1) collect medical opinions from Board employees, Department employees, or employees of other Federal departments and agencies, as long as such employees are licensed to practice medicine in any State; and (2) secure advisory medical opinions from independent medical experts when the case warrants such opinions. Requires opinions to be in writing and to be made part of the record, with an opportunity for the appellant to respond. Revises provisions concerning appellant hearing procedures. Title XIII: Human Resource Management - Subtitle A: Federal Workforce Restructuring Act of 1993 - Federal Workforce Restructuring Act of 1993 - Amends Federal civil service law to eliminate various restrictions on employee training and authorize certain Federal agencies to establish temporary programs to offer a lump sum financial incentive (the lesser of $25,000 or the amount of an employee's severance pay) to selected groups of employees in order to encourage them to voluntarily separate from an agency, whether by retirement or resignation, in order to assist agency heads in restructuring their workforce. Provides for repayment of separation incentives if any employee rejoins the Federal Government within two years. Requires Federal agencies to pay a specified contribution to the Civil Service Retirement and Disability Fund based on the final rate of basic pay of each agency employee who retires early. (Sec. 13003) Expresses the sense of the Congress that: (1) employment in the Executive Branch should be reduced by not less than one full-time equivalent position for each two employees who are paid voluntary separation incentives under this Act; and (2) each agency should adjust its employment levels to achieve this result. Subtitle B: SES Annual Leave Accumulation - Repeals the authorization for unlimited accumulation of annual leave by members of the Senior Executive Service. Title XIV: Reinventing Support Services - Government Information Dissemination and Printing Improvement Act of 1993 - Directs the President to establish policy for the acquisition of printing by executive agencies and promulgate appropriate Government-wide regulations. Requires such policy to ensure that the Government Printing Office (GPO) has the opportunity to compete on an equal basis for executive agency printing acquisitions. (Sec. 14005) Requires GPO to remain the mandatory source for certain executive agency printing for two years after the enactment of this Act, except that during such period executive agencies may obtain printing services costing under $2500 from other sources. (Sec. 14006) Requires the Director of the Office of Management and Budget to develop policies and practices for agency dissemination of public information to ensure, among other things, that agencies: (1) avoid establishing, or permitting others to establish, exclusive, restricted, or other distribution arrangements that interfere with the availability of information dissemination products on a timely and equitable basis; and (2) set user charges for information dissemination products no higher than sufficient to recover the cost of dissemination, except where required by statute or specifically authorized by the Director. (Sec. 14007) Specifies Federal agency responsibilities for information dissemination. (Sec. 14008) Requires the Director of OMB to propose amendments to Federal law to ensure the distribution of government information dissemination products to depository libraries. (Sec. 14009) Requires the Director to: (1) maintain a publicly accessible comprehensive inventory of all approved Federal agency information collection requests in order to assist agencies and the public in reducing the burden of agency information and collection requests by minimizing duplication; (2) cause to be established and maintained an agency-based electronic Government Information Locator Service in order to assist agencies and the public in locating information; (3) require each agency having significant information dissemination products to establish and maintain a comprehensive inventory of such products; and (4) establish an interagency committee to develop technical standards for agency inventory systems. Abolishes the old Federal Information Locator System. Title XV: Streamlining Management Control - Authorizes the Director of OMB to publish annually in the President's Budget any recommendations for the consolidation, elimination, or adjustments in frequency and due dates of statutorily required periodic reports to the Congress or its committees. Title XVI: Financial Management - Federal Financial Management Act of 1993 - Subtitle A: Electronic Payments - Amends Federal law to require direct deposit of Federal wage, salary, and retirement payments by electronic funds transfer for recipients who begin such payments on or after January 1, 1995. Subtitle B: Franchise Funds and Innovation Funds - Authorizes the establishment of a franchise fund in an executive agency for expenses and equipment necessary for the maintenance and operations of administrative services that may be performed more advantageously on a centralized basis. Authorizes the establishment of an innovation fund in an executive agency to provide a self-sustaining source of financing to invest in projects designed to produce measurable improvements in agency efficiency and significant taxpayer savings. Requires such funds to be made available without further appropriation action by the Congress. Subtitle C: Simplifying the Management Reporting Process - Authorizes the Director of the Office of Management and Budget (OMB) to publish annually in the President's budget recommendations for consolidation, elimination, or adjustments in frequency and due dates of statutorily required periodic reports of agencies to the OMB or the President and of agencies or the OMB to the Congress under any laws for which the OMB has general management or financial management responsibility. Subtitle D: Annual Financial Reports - Requires the annual financial statements of executive agencies to be audited prior to submission to OMB. Subtitle E: Strengthening Debt Collection Programs - Authorizes appropriations from debt collection payments to improve debt collection activities. (Sec. 16502) Makes provisions governing contracts for collection services inapplicable to certain claims or debts under the Social Security Act or the Internal Revenue Code. Subtitle F: Improving Department of Justice Debt Collection - Establishes a Debt Collection Fund to reimburse executive agency expenses incurred in conducting or providing support to debt collection litigation, enforcing judgments, and related activities. Subtitle G: Adjusting Civil Monetary Penalties for Inflation - Amends the Federal Civil Penalties Inflation Adjustment Act of 1990 to require adjustment to the civil monetary penalties for inflation every four years (currently, every five years). Title XVII: Year-End Spending - Limits the amount of appropriations for salaries and expenses that can remain available for successive fiscal years. Limits the amount of such carried-over funds for employee cash awards and training programs.
Bill· HRH.R. 3413 (103rd)referred
United States · United States Congress · 28 October 1993
TABLE OF CONTENTS: Title I: Medical Savings Accounts Title II: Development and Distribution of Comparative Value Information Health Care Savings Plan Act of 1993 - Title I: Medical Savings Account - 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. Excludes employer contributions to such accounts from employment taxes. 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. Allows the full deduction for medical and dental expenses for amounts paid for qualified catastrophic coverage health plans. Title II: Development and Distribution of Comparative Value Information - Requires each State to develop and implement information programs regarding comparative health values for purchasers of health care. Makes grants available for the development of such programs. Requires Federal implementation of a program for any State that does not develop or continue to implement such a program. Requires the dissemination of comparative value information relative to Federal programs of health insurance and health care services. Requires the development of model systems to facilitate the gathering and analyzing of data on health care cost, quality, and outcome with respect to health insurance plans and hospitals. Authorizes appropriations.
Bill· SS. 1597 (103rd)open
United States · United States Congress · 27 October 1993
Organ Transplant Program Reauthorization Act of 1993 - Amends the Public Health Service Act to authorize the grant program for organ procurement organizations and other public or nonprofit institutions to increase organ donation through public education programs, training individuals to request organ donations, and providing technical assistance to organ-procuring organizations and hospitals. Requires priority to be given to grant requests designed to alleviate organ shortages for minority and other populations where there is a greater degree of organ shortages relative to the general population. Revises requirements of organ procurement organizations to increase the rate of donations, including: (1) evaluation of their effectiveness in acquiring organs, especially among minority populations; (2) assessment of the variations in procurement among hospitals within their region; and (3) development of plans to increase procurement for minorities and other populations experiencing organ shortages. Requires the Office of Technology Assessment to report to specified congressional committees on a study of organ procurement organizations. Requires participation by transplant recipients and their families on the boards of organ procurement organizations and on the board of the Organ Procurement and Transplantation Network. Sets forth provisions for a more equitable allocation of organ donations. Directs the Comptroller General to report to specified congressional committees on the prevalence and distribution of organ transplants to foreign nationals and nonresident aliens, the equitable allocation systems for organs, and the composition of board membership of organ procurement organizations and the Network. Extends the authorization of appropriations for the grant program for organ procurement organizations until FY 1996.
Bill· SS. 1595 (103rd)referred
United States · United States Congress · 27 October 1993
Bone Marrow Donor Program Reauthorization Act of 1993 - Amends the Public Health Service Act to provide for the terms of office for members of the board of the National Bone Marrow Donor Registry. Modifies Registry functions. Mandates establishment, through grant or contract, of an office of patient advocacy and case management. (Current law requires the Registry to establish a system for patient advocacy.) Authorizes grants and contracts to increase bone marrow donation, including through public education, training individuals in requesting donations, and testing and enrolling marrow donors. Authorizes appropriations.
Bill· SJRESS.J.Res. 147 (103rd)open
United States · United States Congress · 27 October 1993
Designates October 23 through 30, 1993, as National Red Ribbon Week for a Drug-Free America.
Bill· SJRESS.J.Res. 149 (103rd)referred
United States · United States Congress · 27 October 1993
Designates the week beginning October 31, 1993, as National Health Information Management Week.
Bill· HRH.R. 3392 (103rd)open
United States · United States Congress · 27 October 1993
Safe Drinking Water Act Amendments of 1993 - Amends the Safe Drinking Water Act to require the Administrator of the Environmental Protection Agency, in the case of specified contaminants listed in the Federal Register for which national primary drinking water regulations have not been promulgated, to: (1) publish maximum contaminant level goals and promulgate such regulations for those contaminants that occur in drinking water and are of public health concern; and (2) eliminate monitoring, compliance, and enforcement requirements for those contaminants that do not occur in drinking water at levels of public health concern. (Current law requires the promulgation of such goals and regulations for specified numbers of such contaminants by certain dates.) Directs the Administrator to promulgate such goals and regulations for new contaminants every five years. Requires the Administrator to establish in each national primary drinking water regulation best technology treatment techniques for public water systems serving fewer than 1,000, between 1,000 and 10,000, and more than 10,000 people, respectively. Directs the Administrator to promulgate national primary drinking water regulations for radionuclides, disinfection and corrosion byproducts, and sulfate. Revises provisions concerning variances from national drinking water regulations to permit the issuance of a variance by a State only if the water system cannot afford to install the best available technology to meet the maximum contaminant level and it is not feasible for the system to connect with another source of water that will meet the standards. Requires variances to be reviewed by the State at least every three years. Repeals provisions that authorize States to exempt public water systems from requirements respecting maximum contaminant levels or treatment techniques. Prohibits treated drinking water from being removed from a public water system or routed through any device or pipes outside the system and returned to the system. Includes such action in the definition of "tampering," a violation for which criminal penalties are imposed. Makes such prohibition inapplicable to pipes and devices totally within the control of one or more public water systems or to connections between water mains. Requires (currently, authorizes) the Administrator to conduct research relating to diseases and other impairments resulting from contaminants in drinking water or to the provision of a safe supply of drinking water. Authorizes appropriations. Extends the authorization of appropriations for grants for State public water system supervision programs. Requires the Administrator to promulgate revised regulations every five years that list up to 30 unregulated contaminants to be monitored by public water systems. Directs the Administrator to assemble a national drinking water occurrence data base to include information on the occurrence of regulated and unregulated contaminants.
Bill· HRH.R. 3395 (103rd)referred
United States · United States Congress · 27 October 1993
Directs the Administrator of the Environmental Protection Agency, in promulgating any final regulation relating to the public health and safety or the environment, to publish the following in the Federal Register: (1) an estimate of the risk to health and safety of the public addressed by the regulation, the regulation's effect on health or the environment, and the costs associated with the regulation; (2) a comparative analysis of the risk addressed by the regulation relative to other risks to which the public is exposed; and (3) a certification that the estimate and analysis are based on a scientific evaluation of the risk and are supported by the best available data and that the regulation will advance public health or safety and environmental protection against the specified risk and will produce benefits to public health and safety or the environment that will justify its cost.
Bill· SS. 1581 (103rd)referred
United States · United States Congress · 25 October 1993
TABLE OF CONTENTS: Title I: Increase in the Number of Trained Law Enforcement Personnel Subtitle A: Rapid Deployment Strike Force Subtitle B: Federal-State Anti-Drug and Anti-Violence Task Forces Subtitle C: Police Corps Program Subtitle D: Law Enforcement Scholarship and Employment Program Subtitle E: Job Training and Placement for Separated Members of the Armed Forces Title II: Studies Subtitle A: Commission on Crime and Violence Subtitle B: Use of Antiloitering Laws to Fight Crime Title III: Violent and Habitual Offenders Subtitle A: Serious Habitual Offender Comprehensive Action Program Subtitle B: Federal Law Enforcement Assistance Grants Title IV: Prisons Subtitle A: Prison for Violent Drug Offenders Subtitle B: Task Force on Prison Construction Standardization and Techniques Title V: Violent Crime and Drug Emergency Areas Violent Crime Reduction Act of 1993 - Title I: Increase in the Number of Trained Law Enforcement Personnel - Subtitle A: Rapid Deployment Strike Force - Directs the Attorney General to establish in the Federal Bureau of Investigation (FBI) a Rapid Deployment Force (RDF), which shall be made available to assist units of local government in combatting crime. Requires the RDF to be headed by a Deputy Assistant Director of the FBI and comprised of approximately 2,500 Federal law enforcement officers with training and experience in the investigation of violent and drug-related crime, criminal gangs, and juvenile delinquency and in community action to prevent crime. (Sec. 102) Authorizes the Deputy Assistant Director, upon application of the Governor of a State and the chief executive officer of the affected local government and upon finding that criminal activity in a particular jurisdiction is being exacerbated by the interstate flow of drugs, guns, and criminals, to deploy on a temporary basis an RDF unit to assist State and local law enforcement agencies in the investigation of criminal activity. Sets forth provisions regarding application requirements, conditions of deployment, and deputization of RDF members. (Sec. 104) Authorizes appropriations. Subtitle B: Federal-State Anti-Drug and Anti-Violence Task Forces - Authorizes appropriations for the support and expansion of Federal-State anti-drug and anti-violence task forces participated in by the FBI, the Drug Enforcement Administration, the Bureau of Alcohol, Tobacco, and Firearms, and U.S. Attorneys Offices with State and local law enforcement agencies and prosecutors for the purposes of: (1) enhancing interagency coordination of activities in the provision of intelligence information; (2) facilitating multijurisdictional investigations; and (3) aiding in the investigation, arrest, and prosecution of drug traffickers and violent criminals. Subtitle C: Police Corps Program - Requires a State that desires to participate in the Police Corps program (established pursuant to this Act) to designate a lead agency and submit a State plan containing assurances with respect to: (1) lead agency cooperation with other State and local agencies; (2) the State advertising of the assistance available; (3) State screening and selection of law enforcement personnel for participation in the program; and (4) compliance with other specified requirements. (Sec. 124) Establishes within the Department of Justice (DOJ) an Office of the Police Corps to be headed by a Director. (Sec. 125) Authorizes the Director to award scholarships to participants who agree to work for four years in a State or local police force after completion of a baccalaureate program and police corps training. Sets forth provisions regarding: (1) scholarship assistance for dependent children of law enforcement officers; (2) the selection of participants; (3) minority recruitment; and (4) leaves of absence. (Sec. 127) Requires the Director to establish up to three training centers to provide basic law enforcement training to State Police Corps program participants. Requires participants to attend two eight-week training sessions at such centers and to meet certain performance standards in order to remain in the program. Requires the Director to pay participants a weekly stipend during training. (Sec. 129) Requires a State, in order to participate in the Police Corps program, to submit a plan for implementing such program to the Director for approval. Requires such plan to: (1) include assurances that participants will receive additional State or local training after completing Federal training which shall count toward the four-year service obligation; and (2) provide that program participants shall be assigned to community and preventive patrol in geographic areas with the greatest need for additional law enforcement personnel. (Sec. 129A) Sets forth provisions regarding: (1) assistance to States and localities employing Police Corps officers; (2) the swearing in of participants and members of the police force to which they are assigned after completing Federal training and meeting the requirements of that police force; and (3) layoffs. (Sec. 129C) Authorizes appropriations. Subtitle D: Law Enforcement Scholarship and Employment Program - Sets forth requirements regarding designation of a lead agency and submission of a State plan which are analogous to those under the Police Corps program. (Sec. 135) Directs each State to pay from funds under this Act the Federal share (not more than 60 percent) of the costs of: (1) awarding scholarships to in-service law enforcement personnel for further education; and (2) providing full-time employment in the summer or part-time employment for a period not to exceed one year. (Sec. 138) Sets forth State and individual application requirements. Grants priority in awarding scholarships to persons who are members of underrepresented groups, are pursuing an undergraduate degree, and are not receiving financial assistance under the Higher Education Act of 1965. (Sec. 139A) Requires each scholarship recipient to work in a law enforcement position in the State for a period of one month for each credit hour for which funds are received under the scholarship (with a six-month minimum and two-year maximum). (Sec. 139C) Authorizes appropriations. Subtitle E: Job Training and Placement for Separated Members of the Armed Forces - Amends the Job Training Partnership Act (JTPA) to require the Secretary of Veterans Affairs to enter into an interagency agreement with the Directors of the FBI and the National Institute of Justice (NIJ) under which the FBI and NIJ will develop and operate, on a reimbursable basis, a training program to assist eligible separated members of the armed forces in obtaining the training necessary to become law enforcement personnel. Sets forth provisions regarding the selection and number of participants, the content of the training program, and job placement assistance. Authorizes appropriations. (Sec. 142) Amends the JTPA to require the Secretary to offer to enter into a cooperative agreement with the National Center for Housing Management under which the Center will develop and operate a training program to assist eligible separated members of the armed forces in obtaining the training necessary to become managers and employees in public housing agencies and organizations that manage housing projects for such agencies. Sets forth provisions regarding the selection and number of participants, the content of the training program, the use of experts, evaluations, and job placement assistance. Authorizes appropriations. Title II: Studies - Subtitle A: Commission on Crime and Violence - Establishes the National Commission on Crime and Violence in America to: (1) review all segments of the criminal justice system and the effectiveness of traditional criminal justice approaches in preventing and controlling crime and violence; (2) examine the impact that changes to Federal and State law during the past 25 years have had in controlling crime and violence; (3) convene hearings in various parts of the country to receive testimony from a cross-section of criminal justice professionals, victims of crime, and others; (4) bring to public attention successful models and programs in crime prevention, control, and antiviolence; and (5) develop a comprehensive and effective crime control and antiviolence strategy and recommend how to implement such a strategy in a coordinated fashion by Federal, State, and local authorities. Subtitle B: Use of Antiloitering Laws to Fight Crime - Directs the Attorney General to: (1) study ways in which antiloitering laws can be used, without violating the constitutional rights of citizens, to eradicate open-air drug markets and other blatant criminal activity; (2) prepare a model antiloitering statute and guidelines for enforcing it to prevent, deter, and punish illegal drug and other criminal activity; and (3) make the results of the study and the model statute and guidelines available to Federal, State, and local law enforcement authorities. Title III: Violent and Habitual Offenders - Subtitle A: Serious Habitual Offender Comprehensive Action Program - Directs the Attorney General, using specified funds appropriated under the Juvenile Justice and Delinquency Prevention Act of 1974, to continue the funding of new demonstration projects in the Serious Habitual Offenders Comprehensive Action Program during FY 1995 through 1997. Subtitle B: Federal Law Enforcement Assistance Grants - Amends the Omnibus Crime Control and Safe Streets Act of 1968 to: (1) require States to impose a mandatory sentence of 20 years' imprisonment without possibility of probation, parole, or any other form of early release for a firearm offense committed by a career criminal (i.e., a person with three or more convictions under Federal or State law for crimes of violence) in order to avoid a 50 percent reduction of drug control and system improvement grant funds (to be reallocated equally among States in compliance); and (2) permit the use of such grants for programs designed to keep victims informed concerning the status of cases against offenders and to provide victims advance notification of the release of alleged offenders prior to conviction and of convicted offenders at the conclusion of their terms of imprisonment or on probation, parole, or any other form of release. Title IV: Prisons - Subtitle A: Prison for Violent Drug Offenders - Directs the Attorney General to construct and operate ten regional prisons in which eligible prisoners shall participate in a drug treatment program under conditions established by the Director of National Drug Control Policy. Requires the Director to choose former military facilities as locations for such prisons. Sets forth provisions regarding: (1) goals in prisoner selection; (2) postrelease treatment; (3) payment of costs; and (4) prisoner eligibility (including return of prisoners not in compliance with the conditions for participation in a drug treatment program). Authorizes appropriations. Subtitle B: Task Force on Prison Construction Standardization and Techniques - Requires the Director of the Bureau of Prisons to establish a task force composed of experts in prison design and construction to: (1) establish and recommend standardized construction plans and techniques for prison construction and to evaluate and recommend new construction technologies, techniques, and materials to reduce prison construction costs and make such construction more efficient; (2) disseminate such information to State and local officials involved in prison construction; and (3) work to promote the implementation of, evaluate and advise on the results and effectiveness of, and certify the effectiveness of, cost-saving efforts at the Federal, State, and local levels. Title V: Violent Crime and Drug Emergency Areas - Authorizes the President to declare a State or part of a State to be a violent crime or drug emergency area and to provide emergency Federal assistance to protect property, public health, and safety. Specifies that requests for declaration of an emergency must be made in writing by the chief executive officer of a State or local government and that the President must act on the request within 30 days. Authorizes the President to direct any Federal agency to utilize its resources in support of State and local assistance efforts and to provide technical and advisory assistance to meet any such emergency. Limits assistance under this title.
Bill· SS. 1579 (103rd)open
United States · United States Congress · 21 October 1993
TABLE OF CONTENTS: Title I: Managed Competition in Employer-Based Health Plans: Incentives to Control Costs Subtitle A: Use of Tax Incentives to Purchase Cost-Effective Plans Subtitle B: Health Plan Purchasing Cooperatives (HPPCs) Subtitle C: Accountable Health Plans (AHPs) Subtitle D: National Health Board Subtitle E: Managed Competition in Rural and Urban Underserved Areas Subtitle F: Treatment of Chronically Underserved Areas Subtitle G: Repeal of COBRA Continuation Requirements Subtitle H: Definitions Title II: Low-Income Assistance for Health Coverage Subtitle A: Low-Income Assistance Subtitle B: Long-Term Care Phase-Down Assistance to States Subtitle C: Financing Subtitle D: Repeal of Medicaid Program Title III: Training and Education of Health Care Professionals Subtitle A: Reform of Federal Funding for Medical Residency Training Subtitle B: Other Medical Education Grants and Programs Title IV: Preventive Health and Individual Responsibility Subtitle A: Expansion of Public Health Programs Subtitle B: Medicare Title V: Malpractice Reform Subtitle A: Findings; Purpose; Definitions Subtitle B: Grants to States for Alternative Dispute Resolution Systems Subtitle C: Uniform Standards for Malpractice Claims Subtitle D: Grants to States for Development of Practice Guidelines Title VI: Paperwork Reduction and Administrative Simplification Managed Competition Act of 1993 - 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 a tax on the excess health plan expenses of any employer which are health plan expenses exceeding specific limits under an accountable health plan for a defined geographical area. (Sec. 1002) Increases to 100 percent and makes permanent the deduction for health plan premium expenses of self-employed individuals. (Sec. 1003) Permits the deduction for medical, dental, etc. expenses without regard to the limitation on such deduction with respect to amounts paid for premiums under an accountable health plan. (Sec. 1004) Provides for the exclusion from gross income of contributions by a partnership or S corporation to a health plan covering partners or shareholders. Subtitle B: Health Plan Purchasing Cooperatives (HPPCs) - Provides for the establishment of Health Plan Purchasing Cooperatives (HPPCs). Considers each State to be a HPPC, except that a State may subdivide into HPPC areas, and that there may be interstate HPPCs, as specified. Requires HPPCs to enter into agreements with accountable health plans and small employers, offer enrollment in accountable health plans, and charge premiums. Subtitle C: Accountable Health Plans (AHPs) - Directs the National Health Board to provide a process whereby a health plan may be registered with the Board by its sponsor as an accountable health plan. Sets forth requirements for a plan to be registered, including: (1) coverage for a specified uniform set of benefits, including cost-sharing for low-income individuals; (2) standard premiums for the uniform benefits; (3) grievance procedures; (4) collecting and providing specified information; (5) prohibiting discrimination in enrollment or benefits; and (6) financial solvency. (Sec. 1208) Sets forth additional requirements for open AHPs, which is any plan which is not closed. Defines a closed plan as one limited by structure or law to one or more large employers. (Sec. 1211) Requires each AHP to provide for payment of one percent of gross premium receipts to the National Medical Education Fund. (Sec. 1221) Sets forth provisions concerning the preemption of State laws for AHPs. (Sec. 1231) Directs the President to provide for the development and publication of guidelines on the application of Federal antitrust laws to AHPs. Subtitle D: National Health Board - Establishes, as an independent agency in the Executive Branch, a National Health Board (the Board). Requires the Board to transmit annually to the Congress recommendations for the uniform set of effective benefits. States that such recommendations shall apply unless the Congress passes a joint resolution of disapproval. (Sec. 1303) Directs the Board to provide for the initial organization, as a nonprofit corporation in the District of Columbia, of the Benefits, Evaluations, and Data Standards Board in order to make recommendations to the Board concerning the uniform set of effective benefits and matters related to the evaluation of health care services. (Sec. 1304) Directs the Board to provide for the initial organization, as a nonprofit organization, of the Health Plan Standards Board in order to make recommendations to the Board concerning the standards for AHPs and concerning its assessment of risk-adjustment factors. (Sec. 1305) Sets forth provisions concerning the registration of AHPs. (Sec. 1306) Directs the Board to establish rules for the process of risk-adjustment of premiums among AHPs by HPPCs. (Sec. 1307) Directs the Board to establish standards for the periodic provision by AHPs of standardized information. (Sec. 1309) Establishes, within the Department of Health and Human Services, the Agency for Clinical Evaluations which shall assume the responsibilities of the Director of the Office of Medical Applications of Research at the National Institutes of Health, the Director of the Office of Research and Demonstrations of the Health Care Financing Administration (insofar as such responsibilities relate to clinical evaluations), the Administrator for Health Care Policy and Research under title IX of the Public Health Service Act and specified provisions of the Social Security Act, and the Director of the National Center for Health Statistics, as well as other specified responsibilities. Authorizes appropriations. (Sec. 1312) Authorizes appropriations for the Board through FY 2000. Terminates the Board on December 31, 1999. Subtitle E: Managed Competition in Rural and Urban Underserved Areas - Authorizes the Governor of any State to designate rural and urban areas of a State as underserved areas. Permits a HPPC serving such an area to require AHPs offered by the HPPC and with a service area adjoining such area to include the area as part of their service area. (Sec. 1411) Authorizes appropriations for: (1) technical assistance for entities seeking to establish a network plan in an underserved area; (2) financial assistance to eligible entities in order to provide for the development and implementation of AHPs in rural areas; and (3) under the Public Health Service Act, migrant health centers and community health centers. (Sec. 1422) Provides coverage under part B of title XVIII (Medicare) of the Social Security Act for rural emergency access care hospital services. (Sec. 1431) Directs the Secretary of Health and Human Services to make payments for transitional assistance to eligible hospitals. Requires any hospital accepting such assistance to provide a significant volume of services to persons unable to pay for services. Authorizes appropriations. Subtitle F: Treatment of Chronically Underserved Areas - Directs the National Health Board to develop standards for the identification of chronically underserved areas. Makes provisions for addressing health care delivery in such areas. Subtitle G: Repeal of COBRA Continuation Requirements - Repeals the COBRA continuation requirements for group health plans and title XXII of the Public Health Service Act. Subtitle H: Definitions - Sets forth definitions for this title and title II. Title II: Low-Income Assistance for Health Coverage - Subtitle A: Low-Income Assistance - Provides premium assistance for very-low income individuals and moderately low-income individuals. Provides for nominal cost-sharing for such individuals and special assistance for certain items and services. Subtitle B: Long-Term Care Phase-Down Assistance to States - Provides for long-term care phase-down assistance to eligible States for each calendar quarter in 1995 through 1998. Subtitle C: Financing - Amends title XVIII (Medicare) of the Social Security Act to achieve savings under such program by: (1) reducing the update for inpatient hospital services; (2) reducing the conversion factor for the physician fee schedule for non-primary care services; and (3) reducing hospital outpatient services through establishing a prospective payment system. (Sec. 2204) Amends the Internal Revenue Code to impose a Medicare part B premium tax on higher-income individuals. (Sec. 2205) Achieves additional Medicare savings through the: (1) phased-in elimination of Medicare disproportionate share adjustment payments; (2) reduction of routine cost limits for home health services; (3) reduction in routine cost limits for extended care services; and (4) reductions in payments for hospice services. Subtitle D: Repeal of Medicaid Program - Repeals title XIX (Medicaid) of the Social Security Act. Title III: Training and Education of Health Care Professionals - Subtitle A: Reform of Federal Funding for Medical Residency Training - Directs the National Health Board to approve a resident training position in a medical residency program for purposes of funding approved medical residency training programs under this title. Provides funding, in addition, for physician retraining. Sets forth provisions concerning: (1) the allocation of entry positions among programs; and (2) the general distribution of positions among specialties. (Sec. 3004) Requires payment by AHPs of one percent of gross premium receipts to the National Medical Education Fund. Requires payments from the Medicare trust funds to the National Medical Education Fund. (Sec. 3005) Establishes the National Medical Education Fund. Subtitle B: Other Medical Education Grants and Programs - Authorizes appropriations under the Public Health Service Act for medical education programs, including: (1) the scholarship and loan repayment programs of the National Health Service Corps; (2) area education centers; (3) public health and preventive medicine; (4) family medicine; (5) general internal medicine and pediatrics; (6) physician assistants; (7) allied health projects grants and contracts; and (8) nurse practitioner and nurse midwife programs. Title IV: Preventive Health and Individual Responsibility - Subtitle A: Expansion of Public Health Programs - Authorizes appropriations under the Public Health Service Act for the following public health programs: (1) immunizations against vaccine-preventable diseases; (2) prevention, control, and elimination of tuberculosis; (3) lead poisoning prevention; (4) preventive health measures with respect to breast and cervical cancers; (5) the Office of Disease Prevention and Health Promotion; (6) the Office of Minority Health; (7) preventive health and health services block grant; (8) categorical grants for early intervention regarding acquired immune deficiency syndrome; and (9) programs of the Centers for Disease Control regarding the smoking of tobacco products. Directs the Office of Disease Prevention and Health Promotion to promote individual responsibility in personal health care and in the use of valuable health care resources. Subtitle B: Medicare - Provides Medicare coverage for: (1) screening fecal-occult blood tests and screening flexible sigmoidoscopies for the purpose of the early detection of cancer; (2) tetanus-diphtheria boosters; (3) well-child services; and (4) an annual screening mammography for women over age 64. Title V: Malpractice Reform - Subtitle A: Findings; Purpose; Definitions - Sets forth the findings, purpose, and definitions for this title. Subtitle B: Grants to States for Alternative Dispute Resolution Systems - Provides for grants for a two year period to States for the implementation and evaluation of alternative dispute resolution systems. Subtitle C: Uniform Standards for Malpractice Claims - Makes the provisions of this subtitle applicable to any medical malpractice liability action brought in a Federal or State court, and to any malpractice claim subject to alternative dispute resolution. (Sec. 5202) Establishes the United States Commission on Malpractice Awards which shall promulgate guidelines relating to limits on noneconomic and punitive damages. (Sec. 5205) Makes special provision for obstetric services. (Sec. 5206) Permits a finding of malpractice only if the defendant's conduct was unreasonable. Subtitle D: Grants to States for Development of Practice Guidelines - Directs the Secretary to make grants to States for the development of medical practice guidelines for health care professionals that may be applied to resolve medical malpractice liability claims. Title VI: Paperwork Reduction and Administrative Simplification - Preempts State quill pen laws. Ensures the confidential treatment of electronic health care information. Sets forth provisions which provide for: (1) the standardization of electronic health information; (2) uniform claims forms; (3) the liability of insurers when benefits are payable under two or more plans; and (4) the uniformity of the availability of information among health plans when benefits are payable under two or more plans. (Sec. 6007) Amends the Internal Revenue Code to impose a tax on a health plan not in compliance with specified requirements of this title.
Bill· HRH.R. 3333 (103rd)referred
United States · United States Congress · 21 October 1993
Medisave Patient Empowerment Act of 1993 - Amends the Internal Revenue Code to allow to individuals a tax deduction for contributions made to a Medisave account established for the benefit of an eligible individual. Limits the amount of allowable contributions. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to such accounts.
Bill· HRH.R. 3324 (103rd)referred
United States · United States Congress · 20 October 1993
Eating Disorders Information and Education Act of 1993 - Amends the Public Health Service Act to mandate a program of public information and education on the prevention and treatment of eating disorders, including toll free telephone communications to provide information and referrals. Authorizes appropriations.
Bill· SS. 1569 (103rd)open
United States · United States Congress · 19 October 1993
TABLE OF CONTENTS: Title I: Health Policy Title II: Health Services Title III: Health Professions Title IV: Research and Data Collection Title V: Miscellaneous Title VI: General Provisions Preventive Health Services and Health Professions Amendments Act of 1993 - Title I: Health Policy - Amends the Public Health Service Act to establish the Advisory Committee on Minority Health to advise the Secretary of Health and Human Services on the development of the goals of the Office of Minority Health for each racial and ethnic group. Authorizes appropriations for FY 1994 through 1998. Requires a specific amount of such funds to be used to improve access to health care services for individuals with limited English proficiency. (Sec. 102) Provides for the establishment of an Office of Minority Health at the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Substance Abuse and Mental Health Administration, and the Agency for Health Care Policy and Research. Requires such Offices to develop and implement health programs that target racial and ethnic minority populations. (Sec. 103) Authorizes the Secretary to make grants to States for the purpose of improving the health status in minority communities, through the operation of State offices of minority health established to monitor and facilitate the achievement of the Health Objectives for the Year 2000 as they affect minority populations. Authorizes appropriations for FY 1995 through 1997. (Sec. 104) Establishes in the Department of Health and Human Services an Assistant Secretary for Civil Rights, who shall be appointed by the President, by and with the advice and consent of the Senate. Title II: Health Services - Extends authorized appropriations for grants to States for the community scholarship program until FY 1996. Revises the eligibility requirements for such program. Modifies the definition of primary health care to include dentistry and mental health provided by physicians and other health professionals (currently, provided by physicians, certified nurse practitioners, certified nurse midwives, or physician assistants). (Sec. 202) Extends the authorized appropriations for the grant program for health services for residents of public housing to FY 1996. (Sec. 203) Requires the Secretary to issue regulations to reduce the extent to which having limited English proficiency constitutes a significant impediment to individuals for eligibility in health programs under the Public Health Service Act. (Sec. 204) Amends the Disadvantaged Minority Health Improvement Act of 1990 to allow substance abuse services under the grant program for health services for Pacific Islanders. Extends authorized appropriations for such program through FY 1996. Requires a report to the Congress on the effectiveness of projects funded under such program. Title III: Health Professions - Extends authorized appropriations until FY 1996 for: (1) loans for disadvantaged students; (2) the Cesar Chavez Scholarship Program (currently known as the Exceptional Financial Need Program); (3) the Thurgood Marshall Scholarship Program (currently known as the Scholarship for Disadvantaged Students program); (4) loan repayments and fellowships regarding faculty positions at health professions schools; (5) Centers of Excellence; and (6) educational assistance regarding undergraduates. (Sec. 305) Requires Centers of Excellence (health professions schools) to carry out community-based training programs to prepare students in secondary schools and institutions of higher education for attendance at such schools. Requires such schools to provide training to students to enable them to provide health service to minorities at community-based health facilities. Allows such schools to establish consortia. Allows schools of pharmacy and clinical psychology to be Centers of Excellence. Title IV: Research and Data Collection - Establishes an Advisory Committee on Research on Minority Health to advise the Director of the Office on Minority Health on appropriate research activities. (Sec. 402) Extends authorized appropriations through FY 1997 for the National Center for Health Statistics. (Sec. 403) Requires that research, demonstration projects, and evaluations be carried out on the health status of, and the delivery of health care to, populations of medically underserved urban and rural areas and low-income, minority groups, and the elderly. Title V: Miscellaneous - Extends authorized appropriations for the program for State offices of rural health through FY 1996 and revises the matching fund requirement. (Sec. 504) Extends the demonstration project for grants to States for Alzheimer's disease through FY 1998. Requires improved access for individuals with Alzheimer's disease, particularly racial and ethnic minorities and individuals living in isolated rural areas, to services that are home-based or community-based. (Sec. 505) Directs the Secretary to study and report to the Congress on the need to combine the designations of medically underserved area and health professional shortage area. (Sec. 506) Requires the Secretary to establish programs regarding birth defects. Title VI: General Provisions - Declares that this Act is effective October 1, 1993, or upon enactment, whichever occurs later.
Law· HRH.R. 3313 (103rd)enacted
United States · United States Congress · 19 October 1993
TABLE OF CONTENTS: Title I: Women Veterans Health Improvements Title II: Care for Veterans Exposed to Toxic Substances Title III: Readjustment Services Title IV: Services for Mentally Ill Veterans Veterans Health Improvements Act of 1993 - Title I: Women Veterans Health Improvements - Women Veterans Health Improvements Act of 1993 - Directs the Secretary of Veterans Affairs to ensure that each Department of Veterans Affairs health care facility is able to provide in a timely and appropriate manner all authorized health care services to women veterans. Requires the provision of direct Department care (rather than by contract or other agreement) for women veterans in an area in which the number of such veterans makes it cost effective to do so. Extends the requirement for, and adds to the information required in, an annual report concerning women veterans health care and research. Prohibits mammograms from being performed at a Department facility unless it is accredited by a private nonprofit organization designated by the Secretary. Directs the Secretary to prescribe mammogram quality assurance and control standards and to perform periodic inspections of Department mammogram equipment and facilities. Requires application of such standards to non-Department facilities or providers under contract with the Department. Requires the Secretary, in conducting or supporting clinical research, to ensure that women and minority veterans are included as subjects in such research. Extends through 1998 the authority for the provision of sexual trauma counseling to women veterans. Requires with respect to such counseling: (1) the availability of a toll-free telephone number; (2) appropriate training to Department personnel who provide counseling assistance; and (3) a report to the Congress on the operation of the telephone assistance service. Amends the Veterans Health Care Act of 1992 to require each coordinator of women's services to serve on a full-time basis. Requires such coordinators to be fully able to carry out their responsibilities and to provide women veterans with equal access to Department facilities. Directs the Secretary to: (1) conduct a survey to identify deficiencies relating to women patient privacy in Department medical centers; (2) correct any such deficiencies; and (3) report to the Congress. Title II: Care for Veterans Exposed to Toxic Substances - Extends eligibility for hospital, nursing home, or outpatient medical care through the Department of Veterans Affairs to: (1) a veteran who may have been exposed to a herbicide agent while serving on active duty in Vietnam during the Vietnam era if the National Academy of Sciences has, in a report issued under the Agent Orange Act of 1991, made specified determinations regarding an association between exposure to a herbicide agent and occurrence of the veteran's disease; and (2) a radiation-exposed veteran if the Secretary of Veterans Affairs, based on advice of the Advisory Committee on Environmental Hazards, determines that there is credible evidence of a positive association between exposure to ionizing radiation and the veteran's disease. Terminates eligibility for herbicide-exposed veterans under this Act after September 30, 1996. Title III: Readjustment Services - Authorizes the Secretary to furnish counseling in a vet center to assist any veteran who served in combat during World War II or the Korean conflict in overcoming the effects of such combat experience. Requires a report. Establishes in the Department the Advisory Committee on Veterans Readjustment Counseling to perform advisory services with respect to veterans' readjustment, taking into special account Vietnam era veterans. Requires reports. Directs the Secretary to report to specified congressional committees a plan for the expansion of the Vietnam Veteran Resource Centers program. Title IV: Services for Mentally Ill Veterans - Authorizes the Secretary to establish at any Veterans Health Administration facility a nonprofit corporation to: (1) arrange for therapeutic work for patients of such facility or other Department facilities; and (2) provide a funding mechanism to achieve such purposes. Outlines provisions concerning: (1) the establishment of a board of directors for each such corporation; (2) the deposit of excess corporation funds; (3) annual reports by the corporation and the Secretary; (4) a prohibition against the establishment of such corporations after FY 1999; and (5) required recognition of such corporation within four years as a tax-exempt organization under Internal Revenue Service rules. Extends through FY 1998 (currently 1994) the Department compensated work therapy and therapeutic transitional housing demonstration program. Removes the 50-residence limit under the housing program, increasing such amount for each of FY 1994 through 1998. Directs the Secretary to establish a Special Committee on Care of Severely Chronically Mentally Ill Veterans to carry out a continual assessment of the Department's ability to meet the treatment and rehabilitation needs of severely, chronically mentally ill veterans and to provide appropriate advice and recommendations after such assessment. Requires annual reports.
Bill· HRH.R. 3310 (103rd)referred
United States · United States Congress · 19 October 1993
Barbara McClintock AIDS Cure Act - Directs the Secretary of Health and Human Services to establish a project to develop a cure for acquired immune deficiency syndrome (AIDS). Prohibits the program from being administered by any officer or employee of the National Institutes of Health. Requires the Secretary to ensure that the project: (1) pursues all basic science investigations, based on diverse theories and schools of thought which elucidate the pathogenesis of AIDS; and (2) identifies, based on this work, all promising curatives and oversees their timely and adequate testing. Establishes a governing council to set policy and oversee research priorities, ethical standards, conflict of interest rules, and hiring of researchers. Establishes a coordinating committee to facilitate communication among the different scientists working on the project, evaluate the progress of its work, and convene the entire staff on some regular schedule (or when necessary) to evaluate the progress of the project as a whole, reevaluate its direction, and consider newly developed theories emanating from both within and outside the project. Grants the Secretary extraordinary powers in carrying out such project.
Bill· HRH.R. 3314 (103rd)referred
United States · United States Congress · 19 October 1993
Federal Risk Assessment in Women's Health Act of 1993 - Directs the Office of Science and Technology Policy to conduct a review of all Federal programs that assess or mitigate the risks to women's health from environmental exposures, including programs setting standards for exposure to various pollutants, toxic substances, pesticide use, and pesticide residues. Requires the National Institute of Environmental Health Sciences to enter into a contract with the National Research Council of the National Academy of Sciences to study the status of the science base and needs of the Federal Government for research relating to the risks to women's health from environmental exposures, for the purpose of assessing and mitigating such risks. Requires results of such review and study to be reported to the Congress.
Resolution· HCONRESH.Con.Res. 167 (103rd)referred
United States · United States Congress · 19 October 1993
Expresses the sense of the Congress that any national comprehensive benefit package that results from health care reform legislation (and the Medicare program, but only with respect to items or services that are provided to women who are at least 65 years of age) should cover all preventive and treatment services relating to breast and cervical cancers, sexually transmitted diseases, and general gynecological health.
Bill· SS. 1563 (103rd)referred
United States · United States Congress · 18 October 1993
American Jobs Protection Act - Requires employers to provide specified notice and employee benefits (including severance pay, continuation of health care benefits, reimbursement for retraining, training incentive payments, and accelerated eligibility for early retirement) to employees who are subject to a plant closing or mass layoff because their work is transferred to (or similar products are imported from) another country which has specified levels of lower wages or less effective employment standards for overtime compensation, child labor, and employee safety. Prohibits employers who do not provide such notice and benefits, except in cases of national security, from entering into a contract with the United States for provision of products or services involved in the work transfer or substantially similar products or services. Provides for enforcement of this Act by: (1) investigative and administrative actions and actions for injunctions by the Secretary of Labor; and (2) civil actions by employees, local governments, States, and the Secretary. Requires employers to post notice concerning this Act and the filing of a charge. Authorizes civil fines for violations.
Bill· HRH.R. 3294 (103rd)referred
United States · United States Congress · 15 October 1993
Frontline Medical Education Act - Amends title XVIII (Medicare) of the Social Security Act with respect to: (1) services of interns and residents at federally-qualified health centers and Medicare payments for graduate medical education; (2) Medicare payment for direct graduate medical education costs of such centers; and (3) waiver of the application of productivity screens for such centers receiving medical education payments.
Bill· HJRESH.J.Res. 278 (103rd)referred
United States · United States Congress · 15 October 1993
Designates March 21 through 27, 1994, as National Long-Term Care Administrators Week.
Bill· SS. 1545 (103rd)open
United States · United States Congress · 14 October 1993
Environmental Research, Development, and Demonstration Authorization Act of 1993 - Authorizes appropriations for FY 1994 through 1996 for environmental research, development, and demonstration activities and program management support of the Office of Research and Development of the Environmental Protection Agency (EPA). Prohibits the EPA Administrator from closing any field station, regional office, laboratory, or other research center, permitting any reduction-in-force, or finalizing any closing or reduction unless specified congressional committees are provided with pertinent information prior to the notice of closing or reduction. Directs the Administrator to establish separately identified ecological, health, and risk reduction research programs for purposes of assessing and mitigating serious environmental risks. Requires the Administrator to carry out an Experimental Program to Stimulate Competitive Research to: (1) enhance the competitiveness within the peer-review system of investigators from academic institutions in eligible States; and (2) increase the probability of long-term growth of competitive funding to such investigators. Provides for assistance to eligible States under certain conditions and earmarks funding for such assistance. Directs the Administrator to establish a National Human Exposure Assessment Survey to monitor and assess the extent and characteristics of human exposure to harmful chemical substances. Authorizes the Administrator to: (1) conduct research on the nature and impacts of international environmental problems and ways to respond to such problems; and (2) provide assistance to foreign countries and international bodies to improve the quality of the environment. Directs the Administrator to conduct specified pesticide monitoring and research. National Arid Climate Ground Water Research Center Act - Requires the Administrator to establish the National Arid Climate Ground Water Research Center in the State of Nevada. Authorizes appropriations. Requires the Administrator to establish an Environmental Monitoring and Assessment Program and a Modernization Program to acquire and maintain buildings, supplies, and equipment needed to conduct high quality research. Directs the Science Advisory Board to report annually to the Congress and the Administrator on the views of the Board concerning proposed research programs described in the President's annual budget. Requires the Administrator to: (1) carry out a program of environmental technology transfer and exchange of scientific and technical information; (2) establish a separately identified research program to assess risks to public health and ecosystems from environmental contamination; (3) establish a lead research program; and (4) carry out a research program to reduce the scientific uncertainties with respect to the assessment of certain environmental risks. Authorizes appropriations for the lead research program. Directs the Administrator to report to the Congress on opportunities for the technology transfer of defense-related research for environmental applications. Requires the Administrator to conduct research on disinfection and disinfection byproducts as part of the negotiated rulemaking procedures for national primary drinking water regulations for Phase VIA contaminants. Authorizes appropriations. Expresses the sense of the Congress that any recipient of a grant under this Act should, when they are available and cost-effective, purchase equipment and products manufactured in the United States.
Bill· SS. 1544 (103rd)open
United States · United States Congress · 14 October 1993
World Summit for Children Implementation Act of 1993 - Expresses the sense of the Congress that specified amounts should be appropriated for FY 1994 and 1995 to achieve full participation in the special supplemental food program for women, infants, and children under the Child Nutrition Act (WIC program) and the Head Start program. Amends the Foreign Assistance Act of 1961 to authorize appropriations for FY 1994 and 1995 for contributions to the United Nation's Children's Fund and for the Child Survival Fund. Expresses the sense of the Congress that authority should be granted to the President to exercise specified debt forgiveness for least developed countries that are pursuing economic policy reforms to promote long-term development. Earmarks development assistance funds for FY 1994 and 1995 for the Vitamin A Deficiency Program. Authorizes additional appropriations for FY 1994 and 1995 for: (1) iodine and iron fortification programs; and (2) prevention, care, and control programs related to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in developing countries. Earmarks development and economic assistance funds for FY 1994 and 1995 for programs in support of basic education. Authorizes additional appropriations for FY 1994 and 1995 for population assistance activities. Expresses the sense of the Congress that specified amounts should be appropriated for FY 1994 and 1995 for migration and refugee assistance. Directs the Secretary of the Treasury to instruct the U.S. Executive Director of the World Bank to: (1) ensure that poverty reduction and support of basic human needs become a higher priority within the Bank; (2) ensure that the majority of water and sanitation projects fall within targeted interventions against poverty; and (3) increase the proportion of total Bank lending which supports primary health care and basic education, with a minimum of five percent of total lending devoted to each area. Requires the President to call upon other governments to provide their share of resources required to achieve the World Summit for Children goals by the year 2000.
Bill· SS. 1547 (103rd)open
United States · United States Congress · 14 October 1993
Safe Drinking Water Act Amendments of 1993 - Amends the Safe Drinking Water Act to require the Administrator of the Environmental Protection Agency to make capitalization grants to States to establish State drinking water treatment revolving loan funds. Requires the Administrator to reserve one percent of funds for such grants for financial assistance to Indian tribes for the improvement of public water systems and to respond to public health emergencies, respectively. Authorizes the Administrator to make grants for the improvement of public water systems to the District of Columbia and specified U.S. terrorities. Directs States to prepare intended use plans prior to receiving grants. Requires priority for the use of funds to be given to public water systems that are in violation of a national primary drinking water regulation and in which residential water system rates are the highest percentage of median household income. Authorizes appropriations. Authorizes (currently, requires) the Administrator to publish a maximum contaminant level goal (MCLG) and promulgate a national primary drinking water regulation for any contaminant that may have adverse health effects and is anticipated to occur in public water systems in a concentration that indicates a public health concern. Requires the Administrator to publish a list and assessment of at least 15 unregulated contaminants that present the greatest public health concern, with additional lists and assessments of at least seven contaminants every three years. Directs the Administrator to publish health assessments for listed contaminants. Requires the Administrator to establish a publicly-available data base on the occurrence of unregulated contaminants in public water systems. Authorizes a minimum of seven State Governors to petition the Administrator to publish an MCLG and a national primary drinking water regulation for a contaminant. Requires drinking water regulations to be reviewed at least once every six (currently, three) years. Authorizes the Administrator to modify a drinking water regulation to remove monitoring requirements for public water systems that have not detected the contaminant that is the subject of the regulation if the systems have conducted at least two rounds of monitoring and the contaminant has only been detected at specified minimum levels. Permits the Administrator to modify monitoring requirements with respect to cancer-causing contaminants to waive such requirement for public water systems serving populations of fewer than 10,000 individuals if monitoring for any one quarter after this Act's enactment fails to detect the presence of the contaminant. Revises provisions concerning variances to drinking water regulations to require States with primary enforcement responsibility to submit triennially to the Administrator a State drinking water supply plan for the management of public water systems that serve fewer than 3,300 individuals. Provides for one of the following management approaches for systems that are in violation of a maximum contaminant level (MCL): (1) compliance with an MCL if the system has the financial and management capacity to comply; or (2) an individualized compliance program that implements consolidation, alternative water supply, alternative small system technology, or other system restructuring. Requires the Administrator, at the same time a drinking water regulation for a contaminant is published, to publish guidance describing treatment technologies associated with the contaminant that is appropriate for systems serving fewer than 3,300 individuals. Sets forth enforcement authorities. Requires the Administrator to issue regulations to establish a health-effects based performance standard that establishes minimal leaching levels of lead from new plumbing pipes, fittings, and fixtures that convey drinking water. Imposes restrictions on the importation, manufacturing, processing, or distribution in commerce of fixtures that contain more than a specified percentage of lead by dry weight if such regulations are not established. Directs the Administrator to promulgate national primary drinking water regulations and an MCL for radon. Permits alternative contaminant levels if a system is: (1) implementing an approved alternative compliance program; or (2) located in a State that is implementing a program to reduce radon in indoor air and is receiving specified grant assistance for the program. Lists requirements for alternative compliance programs. Amends the Toxic Substances Control Act to prohibit Federal agencies from providing financial assistance relating to the financing of a residence located in a high-risk radon area unless the sale of the residence is conducted in compliance with regulations requiring testing for radon in indoor air at the time of such sale. Requires potential purchasers to be provided with results of any radon test and background information on radon health threats prior to the date of purchase of a residence in such an area. Requires the Administrator to establish a program to: (1) determine the effectiveness of water treatment devices designed to remove contaminants installed at a residence at the point of water use; and (2) ensure that consumers are provided with appropriate information about the devices at the time of sale. Replaces provisions concerning the sole source aquifer demonstration program and State programs to establish wellhead protection areas with programs to protect water supply areas. Amends the Federal Water Pollution Control Act to make funds under such Act available for water supply protection programs. Authorizes appropriations for drinking water research, investigations, and demonstrations. Requires the Chief Operator of a public water system and additional personnel, as designated by the Administrator, to be certified for proficiency. Extends the authorization of appropriations for technical assistance to small water systems. Authorizes appropriations for public water system supervision programs and grants to States for groundwater protection. Replaces provisions concerning special project grants to require the Administrator to establish a program for the collection of fees from public water systems to support the costs of administration of public water system supervision programs in States without primary enforcement responsibility for the programs. Establishes the Public Drinking Water System Supervision Fund. Extends the authorization of appropriations for recordkeeping and inspection requirements. Waives the sovereign immunity of the United States with respect to any requirement, administrative authority, process, or sanction imposed concerning the provision of safe drinking water. Directs the Administrator to study and report to the Congress on the seriousness of contamination of private sources of drinking water that are not regulated by this Act.
Bill· HRH.R. 3267 (103rd)referred
United States · United States Congress · 13 October 1993
TABLE OF CONTENTS: Title I: Supplemental Appropriations for Full Employment Economy Title II: Work Hours Title III: Wages Title IV: Tax Incentives for Full Employment Title V: Entitlement Programs Full Employment Act for Fiscal Year 1994 - Title I: Supplemental Appropriations for Full Employment Economy - Makes supplemental appropriations for FY 1994 to: (1) the Department of Agriculture for watershed and flood prevention operations, rural water and waste disposal grants, the special supplemental food program, and the National Forest System; (2) the Small Business Administration for the business loans program account; (3) the Department of the Interior for the National Park System; (4) the Department of Energy for energy conservation activities; (5) the Department of Labor for training and employment services and community service employment for older Americans; (6) the Department of Health and Human Services for health resources and services, the Office of the Assistant Secretary for Health, and children and families services programs; (7) the Department of Education for compensatory education for the disadvantaged and student financial assistance; (8) the Department of Transportation for grants-in-aid for airports, Federal-aid highways, grants to the National Railroad Passenger Corporation, and formula grants; (9) the Department of the Treasury for Internal Revenue Service information systems; (10) the Department of Housing and Urban Development for homeless assistance and community development grants; and (11) the Environmental Protection Agency for construction grants. Title II: Work Hours - Amends the Fair Labor Standards Act of 1938 to require overtime to be paid at two times the regular hourly rate (currently, one- and one-half times). Reduces the regular 40-hour workweek to a 30-hour workweek. Title III: Wages - Establishes the minimum wage at $7 an hour. Title IV: Tax Incentives for Full Employment - Expresses the sense of the Congress that appropriate tax incentives should be provided to businesses that hire new employees, create new jobs, provide ongoing education and training for their employees, provide child care arrangements for their employees, establish health care plans for their employees, and undertake research and development. Title V: Entitlement Programs - Expresses the sense of the Congress that individuals who receive assistance under any Federal entitlement program should seek to obtain employment providing livable wages and, where appropriate, affordable child care arrangements.
Bill· HRH.R. 3262 (103rd)referred
United States · United States Congress · 12 October 1993
Imposes an additional duty of four percent ad valorem on imported goods. Establishes within the Treasury the National Health Care Trust Fund consisting of the duties imposed under this Act.
Bill· HRH.R. 3257 (103rd)referred
United States · United States Congress · 12 October 1993
Equity in Health Professions Education Act - Directs the Secretary of Health and Human Services to conduct a study to determine the extent to which health professions schools provide adequate education to students on women's health conditions. Requires priority in the study to be given to schools of medicine and osteopathic medicine. Requires a report to specified congressional committees by April 1, 1995.
Bill· SS. 1533 (103rd)open
United States · United States Congress · 7 October 1993
TABLE OF CONTENTS: Title I: Improved Access to Affordable Health Care Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families Subtitle B: Reform of Health Insurance Marketplace for Small Business Subtitle C: Preemption Subtitle D: Health Deduction Fairness Subtitle E: Improved Access to Community Health Services Subtitle F: Improved Access to Rural Health Services Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program Subtitle H: Medicaid Program Flexibility Title II: Health Care Cost Containment and Quality Enhancement Subtitle A: Medical Malpractice Liability Reform Subtitle B: Administrative Cost Savings Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Accounts Subtitle D: Anti-Fraud Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals Subtitle F: Removing Anti-Trust Impediments Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities Subtitle H: Prefunding Government Health Benefits for Certain Annuitants Subtitle I: Miscellaneous Provisions Title III: Long-Term Care Subtitle A: Tax Treatment of Long-Term Care Insurance Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance Subtitle C: Studies Subtitle D: Volunteer Service Credit Demonstration Projects Affordable Health Care Now Act of 1993 - Title I: Improved Access to Affordable Health Care - Subtitle A: Increased Availability and Continuity of Health Coverage for Employees and Their Families - Part 1: Required Coverage Options for Eligible Employees, Spouses, and Dependents - Requires each employer to make available to each eligible employee a group health plan under which: (1) coverage of each eligible individual with respect to such employee may be elected on an annual basis; (2) coverage is provided for at least the required coverage specified; and (3) employees may elect to have premiums collected through payroll deduction. Does not require employer contributions to the cost of coverage under such a plan. Provides for the exclusion of: (1) employers who have been employers for less than two years or who have no more than two eligible employees or no more than two eligible employees not covered under any group health plan; and (2) family members under specified circumstances. Specifies that a group health plan shall not be treated as failing to meet the requirements of this Act solely because a period of service by an eligible employee of not more than 60 days is required for coverage. Specifies that the required coverage is standard coverage, except that in the case of a small employer that has not contributed during the previous plan year to the cost of coverage for any eligible employee under any group health plan, the required coverage for the plan year is coverage under a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan. Provides for a five-year transition for existing group health plans. (Sec. 1002) Sets forth provisions regarding: (1) compliance with applicable requirements through multiple employer health arrangements; and (2) coverage options under a State medical health allowance program. Part 2: Preexisting Conditions and Continuity of Coverage; Renewability - Prohibits a group health plan from imposing (and an insurer from requiring an employer from imposing through a waiting period for coverage under a plan or similar requirement) a limitation or exclusion of benefits relating to treatment of a preexisting condition if: (1) the condition relates to a condition that was not diagnosed or treated within three months before the date of coverage under the plan; or (2) the limitation or exclusion extends over more than six month after the date of coverage, applies to an individual who, as of the date of birth, was covered under the plan, or relates to pregnancy. Specifies that, in the case of an individual who is eligible for coverage under a plan but for a waiting period imposed by the employer, the individual shall be treated as having been covered under the plan as of the earliest date of the beginning of the waiting period. (Sec. 1012) Requires each group health plan to waive any period applicable to a preexisting condition for similar benefits with respect to an individual to the extent that the individual, prior to enrollment in such plan, was covered for the condition under any other health plan. (Sec. 1013) Prohibits: (1) a multiemployer plan and an exempted multiple employer health plan from canceling or denying renewal of coverage under such a plan for an employer other than for nonpayment of contributions, fraud or other misrepresentation, noncompliance with plan provisions, or misuse of a provider network provision, or because the plan is ceasing to provide any coverage in a geographic area; (2) an insurer from canceling a health insurance plan or denying renewal of coverage other than as prescribed above; and (3) an insurer who terminates the offering of health insurance plans in an area from offering such a plan to any employer in the area until five years after the date of the termination. Part 3: Enforcement; Effective Dates; Definitions - Makes provisions of the Employee Retirement Income Security Act of 1974 applicable with respect to enforcement of this Act (by the Department of Labor). Amends the Internal Revenue Code (Code) to impose a tax ($100 per day for each individual involved, subject to specified limitations) on the failure of an insurer to comply with the requirements under part 2 unless the Secretary of Health and Human Services (Secretary) determines that the State has in effect a regulatory enforcement mechanism that provides adequate sanctions. Subtitle B: Reform of Health Insurance Marketplace for Small Business - Requires each insurer that makes available a health insurance plan to a small employer in a State to make available to each small employer in the State a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan, with exceptions for health maintenance organizations (HMOs) and if a State provides for guaranteed availability (rather than guaranteed issue). Requires each insurer that offers a MedAccess plan to a small employer in a State to accept: (1) every small employer in the State that applies for coverage; and (2) every eligible individual who applies for enrollment on a timely basis. Sets forth provision regarding: (1) special rules for HMOs; (2) timely enrollment requirements; and (3) enrollment of spouses and dependents. Makes such requirements inapplicable in a State that has provided (in accordance with specified standards) a mechanism under which each insurer offering a health insurance plan to a small employer in the State must participate in a program for assigning high-risk small employer groups (or individuals within such a group) among some or all such insurers, if the insurers comply. (Sec. 1102) Defines "MedAccess plan" as a health insurance plan that: (1) is designed to provide standard coverage with substantial cost-sharing, only catastrophic coverage, or medisave coverage; (2) includes only essential and medically necessary services; (3) meets applicable requirements relating to guaranteed issue; and (4) meets specifies consumer protection standards. Defines "MedAccess standard plan," "MedAccess catastrophic plan," and "MedAccess medisave plan" to mean a MedAccess plan that provides for at least standard coverage, for only catastrophic coverage, or medisave coverage, respectively. Requests the National Association of Insurance Commissioners (NAIC) to submit to the Secretary a set of rules which NAIC determines is sufficient for determining, in the case of any health insurance plan and for purposes of this subtitle, the actuarial value of the coverage offered by the plan. Directs the Secretary to certify such set of rules for use under this subtitle if they meet such requirements or establish such a set of rules. Specifies that a health insurance plan is considered to provide: (1) standard coverage if the benefits are determined, in accordance with certified rules of actuarial equivalence, to have a value that is within five percentage points of an established target actuarial value for standard coverage; (2) catastrophic coverage if benefits are available under the plan for a year only to the extent that expenses for covered services in a year exceed a deductible amount that is consistent with a specified requirement for a catastrophic health plan under the Code, and are determined, in accordance with certified actuarial equivalence rules, to have a value that is within five percentage points of an established target actuarial value for catastrophic coverage; and (3) medisave coverage if such plan consists of a catastrophic health plan within the meaning of the Code and a medical savings account. Requests NAIC to submit to the Secretary target actuarial values for standard and catastrophic coverage. Permits NAIC to submit periodic revisions of, and permits the Secretary to revise, the set of rules of actuarial equivalence and target actuarial values where necessary to take into account changes in the relevant types of health benefits provisions, in deductible levels for catastrophic coverage, or in relevant demographic conditions. (Sec. 1103) Directs the Secretary to request NAIC to develop model regulations that specify standards with respect to requirements: (1) that insurers make available MedAccess plans; (2) of guaranteed availability of MedAccess plans to small employers; (3) relating to limits on premiums and certain consumer protections; and (4) relating to limitation of annual premium increases. Requires the Secretary to review such standards and, if NAIC fails to specify standards meeting such requirements, to promulgate standards. Sets forth provisions regarding: (1) the application of MedAccess standards and consumer protection standards by the States; and (2) the Federal role. (Sec. 1104) Sets forth provisions: (1) regarding limits on premiums and annual premium increases; and (2) requiring an insurer, at the time of offering a health insurance plan to a small employer, to fully disclose rating practices for health insurance plans, including rating practices for different populations and benefit designs. (Sec. 1106) Directs the Secretary to: (1) request NAIC to develop models for reinsurance or allocation of risk mechanisms for health insurance plans made available to small employers for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models or specify models. Sets forth provisions regarding implementation of reinsurance or allocation of risk mechanisms by the States and the Federal role. Amends the Code to provide for the imposition of a tax on any health insurance plan which covers any employee in a Federal reinsurance State. (Sec. 1108) Directs the Secretary to establish an Office of Private Health Care Coverage. Requires the Office Director to submit to the Congress annual reports evaluating health care coverage reform. (Sec. 1109) Authorizes the Director to conduct: (1) research on the impact of this subtitle on the availability of affordable health coverage for employees and dependents in the small employers group health care coverage market and other specified topics; and (2) demonstration projects relating to such topics. Requires the Director to develop: (1) methods for measuring the relative health risks of eligible individuals in terms of the expected costs of providing benefits under health insurance plans and, in particular, MedAccess plans; and (2) a model for equitably distributing health risks among insurers in the small employer health care coverage market. Authorizes appropriations. Subtitle C: Preemption - Part 1: Scope of State Regulation - Prohibits: (1) State benefit mandates for group health plans; and (2) State or local law prohibitions against two or more employers obtaining coverage under an insured multiple employer health plan. (Sec. 1203) Preempts State restrictions concerning: (1) reimbursement rates or selective contracting; (2) differential financial incentives; and (3) utilization review methods. Directs the Comptroller General to conduct a study of the benefits and cost effectiveness of the use of managed care in the delivery of health services. Part 2: Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to allow a limited exemption under preemption rules for multiple employer plans providing health benefits subject to certain Federal standards. (Sec. 1212) Relieves exempted multiple employer plans providing medical care benefits of certain restrictions on preemption of State law. Treats such plans as employee welfare benefit plans. Allows commencement of new arrangements only if such exemption is in effect or an application is pending and the Secretary of Labor determines that provisional protection is appropriate. Sets forth exemption procedures, eligibility requirements, and additional requirements applicable to exempted arrangements. Requires certain disclosures to participating employers, maintenance of reserves, and corrective actions. Provides for expiration, suspension, and revocation of exemptions, and for review of actions by the Secretary. (Sec. 1213) Revises provisions relating to scope of preemption rules, and to treatment of single employer arrangements and of certain collectively bargained arrangements. (Sec. 1215) Establishes special rules for employee leasing healthcare arrangements. Treats such arrangements as multiple employer welfare arrangements except when they are multiple employer health plans. (Sec. 1216) Sets forth enforcement provisions relating to multiple employer welfare arrangements and employee leasing health care arrangements. (Sec. 1217) Sets forth filing requirements for multiple employer welfare arrangements. (Sec. 1218) Provides for cooperation between Federal and State authorities in enforcing ERISA requirements for multiple employer welfare arrangements with the limited exemption. Part 3: Encouragement of Multiple Employer Arrangements Providing Basic Health Benefits - Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax exempt trust status for multiple employer health plans and insured multiple employer health plans if they meet certain requirements under ERISA and this Act. Part 4: Simplifying Filing of Reports for Employers Covered under Insured Multiple Employer Health Plans - Amends ERISA to direct the Secretary of Labor to prescribe an alternative method providing for a single annual report with respect to all employers who are covered under the same insured multiple employer health plan. Part 5: Compliance with Coverage Option Requirements - Provides for compliance with applicable coverage requirements through multiemployer plans and other multiple employer health arrangements. Subtitle D: Health Deduction Fairness - Amends the Internal Revenue Code to provide: (1) for a permanent extension and increase in the health insurance tax deduction for self-employed individuals; and (2) that the deduction for certain health insurance costs be determined without regard to an adjusted gross income threshold. Disallows the deduction to individuals eligible for employer-subsidized coverage. Allows the deduction whether or not the individual itemizes other deductions. Subtitle E: Improved Access to Community Health Services - Part 1: Increased Authorization for Community and Migrant Health Centers - Directs the Secretary to provide for grants to migrant and community health centers to promote primary health care services for underserved individuals. Allows grants to be used to promote the provision of off-site services, to improve birth outcomes in areas with high infant mortality and morbidity, to establish primary care clinics in areas in need, and for recruitment and training costs of necessary providers and operating costs for unreimbursed services. Authorizes appropriations. Directs the Secretary to conduct a study of the impact of such grants on access to health care, birth outcomes, and the use of emergency room services. Part 2: Grants for Projects for Coordinating Delivery of Services - Amends the Public Health Service Act to authorize the Secretary to make grants to public and nonprofit private entities: (1) to carry out demonstration projects to increase access to outpatient primary health services in specified geographic areas (i.e., areas that are rational areas for the delivery of health services, have a population of not more than 500,000 individuals, and have been designated by the Secretary as areas with a shortage of personal health services or that have a significant number of individuals with low incomes or insufficient health care insurance through coordinating the delivery of such services under Federal, State, local, and private programs; and (2) for developing plans to carry out such projects. Authorizes appropriations. Subtitle F: Improved Access to Rural Health Services - Part 1: Establishment of Rural Emergency Access Care Hospitals Under Medicare - Amends title XVIII (Medicare) of the Social Security Act (SSA) to provide for: (1) establishment of rural emergency access care hospitals under Medicare; and (2) coverage of and payment for rural emergency access care hospital services under Medicare part B (Supplementary Medical Insurance). Part 2: Rural Medical Emergencies Air Transport - Amends the Public Health Service Act to direct the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments. Sets forth provisions regarding: (1) application and State plan requirements; (2) considerations in awarding grants; (3) State administration and use of grants; (4) the number of grants; and (5) reporting requirements. Authorizes appropriations. Part 3: Emergency Medical Services Amendments - Amends the Public Health Service Act to direct the Secretary to: (1) establish an Office of Emergency Medical Services, headed by a Director; (2) engage in specified emergency medical services activities, including disseminating information obtained in carrying out specified activities to public and private entities, providing technical assistance to State and local agencies, coordinating Department of Health and Human Services (DHHS) activities with those of other Federal agencies; and (3) ensure that such activities are carried out consistent with certain requirements regarding maintaining an adequate number of health professionals with expertise in the provision of services, developing, periodically reviewing, and revising as appropriate guidelines for the provision of such services, appropriately using available technologies, and serving the unique needs of underserved inner-city and rural areas. (Sec. 1522) Authorizes the Secretary to make grants to States for the purpose of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services, subject to specified matching fund, budgetary, and other requirements. (Sec. 1523) Provides for demonstration projects to establish telecommunications between rural medical facilities and medical facilities with expertise or equipment. Directs the Secretary to ensure that the telecommunications technologies demonstrated include interactive video telecommunications, static video imaging transmitted through the telephone system, and facsimiles transmitted through such system. (Sec. 1524) Authorizes appropriations for: (1) emergency medical services (including for State offices of Emergency Medical Services and for telecommunications demonstrations); and (2) trauma care and certain other activities. Subtitle G: State Flexibility in the Medicaid Program: The Medical Health Allowance Program - Amends SSA title XIX (Medicaid) to provide for the establishment of State health allowance programs under which the State makes payments to a group health plan which provides coverage to an eligible individual as an allowance towards the costs of providing the individual with benefits under the plan. Subtitle H: Medicaid Program Flexibility - Amends SSA title XIX Medicaid) to modify: (1) Federal requirements to allow States more flexibility in contracting for coordinated care services under Medicaid; and (2) provisions regarding the extension of certain waivers. Title II: Health Care Cost Containment and Quality Enhancement - Subtitle A: Medical Malpractice Liability Reform - Part 1: General Provisions - Makes this subtitle applicable with respect to any medical malpractice liability claim and to any medical malpractice liability action brought in State or Federal court, except a claim or action for damages arising from a vaccine-related injury or death to the extent that title XXI of the Public Health Service Act applies. Sets forth provisions regarding: (1) preemption of State law; (2) effect on sovereign immunity and choice of law or venue; (3) jurisdiction; and (4) effective dates. Part 2: Medical Malpractice and Product Liability Reform - Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified alternative dispute resolution (ADR) system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States under chapter 171 of the Federal judicial code (U.S. Court of Federal Claims). Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 2012) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action. Sets limits on punitive damages and on periodic payments for future losses. (Sec. 2013) Set forth provisions regarding: (1) limits on attorney fees and other costs; (2) joint and several liability (generally, liability may be found only for those damages directly attributable to the person's proportionate share of fault or responsibility for the injury); (3) a statute of limitations of seven years; and (4) a uniform standard for determining negligence (the defendant's conduct at the time of providing the health care services was not reasonable). (Sec. 2017) Specifies that in the case of a medical malpractice liability claim relating to services provided during labor or the delivery of a baby, if the health care professional did not previously treat the injured individual for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. Part 3: Requirements for State Alternative Dispute Resolution Systems - Lists requirements for State ADR systems, including that such a system: (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 2032) Directs the Secretary, by October 1 of each year, to certify State ADR systems that meet such requirements. Directs the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 2033) Directs the Secretary, within five years, to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system, including: (1) information on the effect of the ADR systems on health care costs, access to health care, and quality of care provided within the State; and (2) to the extent that such report does not provide information on no-fault systems operated by States as ADR systems, an analysis of the feasibility and desirability of establishing a system for resolving medical malpractice liability claims on a no-fault basis. Part 4: Other Provisions Relating to Medical Malpractice Liability - Authorizes a State agency responsible for disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies to permit their participation in the licensing of such practitioner and to review any health care malpractice action, claims, or allegation, or other information concerning the practice patterns of any such practitioner. Sets forth agreement requirements. (Sec. 2042) Directs the Secretary to study incentives adopted by State and local governments, insurers, medical societies, and other entities to encourage physicians to volunteer to provide health care services in medically underserved areas. (Sec. 2043) Directs each State to require: (1) each health care professional and health care provider to participate in a risk management program to prevent, and provide early warning of, practices which may result in injuries to patients or endanger patient safety; and (2) each provider of health care professional and provider liability insurance in the State to establish risk management programs or sanction programs of risk management for health care professionals and providers provided by other entities, and require each such professional or provider, as a condition of maintaining insurance, to participate in one such program at least once in each three-year period. (Sec. 2044) Directs the Secretary to make grants: (1) for basic research in the prevention of, and compensation for, injuries resulting from health care professional or provider malpractice and for research of the outcomes of health care procedures; (2) to the States to assist in improving their ability to license and discipline health care professionals; and (3) to States and local governments, private nonprofit organizations, and health professional schools for educating the general public about the appropriate use of health care, realistic expectations of medical intervention, and the resources and role of health care professional licensing and disciplinary boards in investigating claims of incompetence or health care malpractice, and for developing programs of faculty training and curricula for educating health care professionals in quality assurance, risk management, and medical injury prevention. Authorizes appropriations. Subtitle B: Administrative Cost Savings - Part 1: Standardization of Claims Processing - Directs the Secretary to adopt standards relating to: (1) data elements for use in paper and electronic claims processing under health benefit plans and in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. (Sec. 2102) Authorizes the Secretary, two years after standards are adopted for classes of services upon determining that a significant number of claims for benefits for such services under health benefit plans are not being submitted in accordance with such standards, to require that all providers of such services submit claims to health benefit plans in accordance with such standards. (Sec. 2103) Directs the Secretary to: (1) provide for the ongoing receipt and review of comments and suggestions for changes in the standards adopted and promulgated; (2) establish a schedule for the periodic review of such standards; and (3) revise such standards. Part 2: Electronic Medical Data Standards - Directs the Secretary to promulgate standards for hospitals concerning electronic medical data, including standards for transmission of such data and confidentiality of patient-specific information. Authorizes the Secretary to periodically revise such standards. (Sec. 2112) Sets forth requirements with respect to: (1) the sharing of hospital information under Medicare; (2) waiver of such requirements; and (3) application of such requirements to hospitals of the Department of Veterans Affairs. (Sec. 2113) Authorizes the head of a Federal agency to require a provider to present and transmit a required data element electronically in accordance with applicable presentation or transmission standard. (Sec. 2114) Sets forth limitations on data requirements where standards with respect to data elements are in effect. (Sec. 2115) Directs the Secretary to establish an advisory commission on the standards established under this part and operational concerns about the implementation of such standards. Authorizes appropriations. Part 3: Development and Distribution of Comparative Value Information - Directs the Secretary to determine whether each State is developing and implementing a health care value information program that meets specified criteria and a specified schedule. Authorizes the Secretary to: (1) make grants to enable each State to plan development and initiate implementation of its health care value information program; and (2) recover the amount of such a grant by offset against any other amount payable to the State under the Social Security Act under specified circumstances. Authorizes appropriations. (Sec. 2122) Directs the Secretary to take actions necessary to implement a comparable program in a State that fails to develop or implement a health care value information program in accordance with such criteria and schedule. Authorizes the Secretary to charge fees for the information materials provided pursuant to such a program. (Sec. 2123) Directs the head of each Federal agency with responsibility for the provision of health insurance or health care services to individuals to develop health care value information relating to each program that such head administers and covering the same types of data that a State program meeting such criteria would provide. (Sec. 2124) Directs the Secretary to: (1) develop model systems to facilitate the gathering of data on health care cost, quality, and outcome and the analysis of such data in a manner that will permit the valid comparison of such data among providers and among health plans; (2) support experimentation with different approaches to achieve such objectives in the most cost effective manner; and (3) evaluate the various methods to determine their relative success. Authorizes the Secretary to establish standards for the collective and reporting of data on health care cost, quality, and outcomes. Authorizes appropriations. Part 4: Additional Standards and Requirements; Research and Demonstrations - Directs the Secretary to: (1) adopt standards relating to the design and use of magnetized Medicare identification cards to assist health care providers in determining whether individuals are eligible for benefits for provided services under the Medicare program and in billing the Medicare program for covered services; (2) take steps to encourage and assist States in the design and use of magnetized Medicaid identification cards under their Medicaid plans; and (3) establish a Medicare and Medicaid information system to provide information on group health and other health benefit plans that are primary payors to the Medicare and Medicaid programs. Authorizes appropriations. (Sec. 2132) Specifies that, effective January 1, 1994, no effect shall be given to any provision of State law that requires medical or health insurance records (including billing information) to be maintained in written, rather than electronic, form. (Sec. 2133) Requires, effective January 1, 1995, each health benefit plan: (1) to use a beneficiary's social security number as the personal identifier for claims processing and related purposes (authorizes the Secretary to impose a civil money penalty on any plan that fails to do so); and (2) to use the unique identifier under title XVIII of the Social Security Act (Medicare) for a provider that furnishes health care items or services to a beneficiary under the plan as the identifier of that provider for claims processing and related purposes. (Sec. 2134) Directs the Secretary to: (1) determine, where benefits are payable under two or more health benefit plans, whether problems relating to the rules for determining the liability of plans or the availability of information among plans causes significant administrative costs; and (2) promulgate standards, if the implementation of standards would significantly reduce such administrative costs. Authorizes the Secretary to impose a civil money penalty on plans that fail to comply with such standards. (Sec. 2135) Directs the Secretary to provide grants to qualified entities for research on the application of comprehensive information systems in continuously monitoring and improving patient care. Authorizes the Secretary to make grants to: (1) two to five community organizations or coalitions of health care providers, health benefit plans, and purchasers to establish and document the efficacy of communication links between the information systems of health benefit plans and of health care providers; (2) two to five public or private nonprofit entities for the development of regional or community-based clinical information systems; and (3) public or private nonprofit entities to develop and test the definition of a comprehensive set of data elements and the specification and manner of presentation of the individual data elements of the set, for electronic medical data generated by physicians and other entities (other than hospitals) that provide health care services. Authorizes appropriations. Subtitle C: Deduction for Cost of Catastrophic Health Plan; Medical Savings Account - Amends the Internal Revenue Code to include under the medical expense deduction the portion of such expense attributable to coverage under a catastrophic health plan. (Sec. 2202) Allows individuals a tax deduction for percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to medical care savings accounts. Subtitle D: Anti-Fraud - Part 1: Criminal Prosecution of Health Care Fraud - Amends the Federal criminal code to: (1) set penalties for health care providers who knowingly engage in any scheme or artifice to defraud any person in connection with the provision of health care; and (2) make activity which, if engaged in by the U.S. Postal Service, would be a violation of mail fraud provisions punishable to the same extent with respect to private or commercial interstate carriers. (Sec. 2303) Authorizes appropriations to hire, equip, and train no fewer than: (1) 225 special agents of the Federal Bureau of Investigation and support staff to investigate health care fraud cases; (2) 50 assistant United States Attorneys and support staff to prosecute such cases; and (3) 25 investigators in the Office of Inspector General, DHHS, to be devoted exclusively to health care fraud cases. (Sec. 2304) Amends the Federal criminal code to authorize the Attorney General to make payments of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution of health care fraud, subject to specified requirements and exceptions. Part 2: Coordination of Health Care Anti-Fraud and Abuse Activities - Directs the Secretary to establish in the Office of the Inspector General of DHHS a program (all-payer fraud and abuse control program) to: (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to the delivery of, and payment for, health care in the United States; (2) conduct investigations, audits, evaluations, and inspections relating to such delivery and payment; and (3) facilitate the enforcement of provisions of the Social Security Act and other statutes applicable to health care fraud and abuse. Directs the Secretary to establish standards to carry out such program, including standards relating to the furnishing of information by health insurers, providers, and other to enable the Secretary to carry out the program and procedures to assure that such information is provided and utilized in a manner that protects the confidentiality of the information and the privacy of individuals receiving health care services. Sets forth provisions regarding: (1) qualified immunity for providing information; (2) ensuring access to documentation; and (3) failure to comply as grounds for exclusion from the Medicare and Medicaid programs. (Sec. 2312) Authorizes additional appropriations to enable the Secretary to conduct investigations of allegations of health care fraud and to carry out the all-payor fraud and abuse control program. (Sec. 2313) Establishes in the Treasury an Anti-Fraud and Abuse Trust Fund to be used to assist the Inspector General of DHHS in carrying out the all-payor fraud and abuse control program in the fiscal year involved. Sets forth provisions regarding: (1) the deposit into the Fund of Federal health anti-fraud and abuse penalties; and (2) the use of such penalties to repay beneficiaries for cost-sharing. (Sec. 2314) Amends SSA title XI to provide for the application of Federal health anti-fraud and abuse sanctions to all fraud and abuse against private health benefit plans. Subtitle E: Medicare Payment Changes; Part B Premium Tax for High-Income Individuals: Part 1 - Medicare Payment Changes - Amends SSA title XVIII to: (1) eliminate the membership limitation for Medicare health maintenance organizations; and (2) revise the Medicare select policy program and provide for a civil money penalty for misrepresentations made in connection with a Medicare select policy. (Sec. 2402) Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) make permanent the Medicare select policy program; and (2) allow access to Medicare select policies in all States. (Sec. 2403) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate the administration of Medicare parts A and B. Part 2: Part B Premium Tax for High-Income Individuals - (Sec. 2411) Amends the Internal Revenue Code to impose a tax on the Medicare part B premiums of high income individuals. Subtitle F: Removing Anti-Trust Impediments - Directs the Attorney General to promulgate guidelines under which a health care joint venture may submit an application requesting that the Attorney General provide the entities participating in the venture with an exemption under which: (1) monetary recovery on an antitrust claim brought against the entity shall be limited to actual damages if specified conditions are met; and (2) the conduct of the entity in making or performing a contract to carry out the venture shall not be deemed illegal per se. Requires the Attorney General to approve or disapprove the application within a specified time frame and to provide a statement explaining the reasons for any disapproval. Directs the Attorney General to approve the application if an entity participating in the venture submits to the Attorney General an application that contains the identities of the parties to the venture; the nature, objectives, and planned activities of the venture; and specified assurances and information. Sets forth provisions regarding: (1) revocation and renewal of exemptions and withdrawal of an application; (2) requirements relating to notice and publication of exemptions; and (3) issuance of health care certificates of public advantage to each eligible health care joint venture that complies with specified requirements. Establishes the Interagency Advisory Committee on Competition, Antitrust Policy, and Health Care to: (1) discuss and evaluate competition and antitrust policy and their implications regarding the performance of health care markets; (2) analyze the effectiveness of health care joint ventures receiving exemptions in reducing costs and expanding access; and (3) make recommendations to the Congress. Subtitle G: Encouraging Enforcement Activities of Medical Self-Regulatory Entities - Part 1: Application of the Clayton Act to Medical Self-Regulatory Entities - Provides that no damages, cost of suit, or attorney fee may be recovered under section 4, 4A, or 4C of the Clayton Act, or under any similar State law, except by a State or the United States, from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities that are: (1) designed to promote the quality of health care provided to patients; and (2) not conducted for purposes of financial gain. Directs the court to award the cost of such a suit, including a reasonable attorney fee, to a substantially prevailing defendant. Part 2: Consultation by Federal Agencies - Requires any Federal agency engaged in the establishment of medical profession standards to consult with appropriate medical societies or associations, specialty boards, or recognized accrediting agencies, if available, in carrying out medical professional standard setting and guidelines or standards relating to the practice of medicine. Subtitle H: Prefunding Government Health Benefit for Certain Annuitants - Requires that certain agencies prefund Government health benefits contributions for their annuitants. Subtitle I: Miscellaneous Provisions - Amends Civil Service and Federal Employees' Retirement Systems law to increase the minimum age required to be eligible for an immediate retirement annuity. Provides for the conformance of other Federal retirement systems with the minimum age increase made above. Title III: Long-Term Care - Subtitle A: Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation. (Sec. 3002) Excludes from gross income benefits provided under a long-term care insurance contract. Includes in gross income employer-provided coverage for long-term care services. (Sec. 3003) Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions. Includes any parent or grandparent as a dependent for purposes of such expenses. (Sec. 3004) Provides for the nonrecognition of gain or loss on the exchange of any life insurance contract or an endowment or annuity contract for a long-term care insurance contract. (Sec. 3005) Excludes from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangement to pay long-term care premiums. (Sec. 3006) Allows insurance companies to issue accelerated death benefit riders on life insurance contracts. Subtitle B: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance - Amends SSA title XIX to require State Medicaid plans to disregard some or all of the individual's assets attributable to coverage under a qualified long-term care insurance contract in determining the individual's eligibility for long-term care services. Subtitle C: Studies - Requires the Comptroller General to study the feasibility of: (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their home with an income tax credit. (Sec. 3203) Requires the Secretary of Health and Human Services to study and report to the Congress on the feasibility of encouraging or requiring the use of a single designate public or nonprofit agency to coordinate, through case management, the provision of long-term care benefits under current Federal, State, and local programs in a geographic area. Subtitle D: Volunteer Service Credit Demonstration Projects - (Sec. 3301) Amends the Older Americans Act of 1965 to require the Commissioner of the Administration on Aging to establish and operate a volunteer service credit demonstration project in each State.
Bill· HRH.R. 3249 (103rd)referred
United States · United States Congress · 7 October 1993
Rural Telemedicine Development Act of 1993 - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to award grants: (1) to hospitals, hospital networks, and other health care providers to encourage the initial development of rural telemedicine networks to use telecommunications technology in providing health services to rural areas; and (2) for linking such networks together using advanced telemedicine systems and for linking such networks to existing fiber optic telecommunications systems. Sets forth provisions regarding: (1) application requirements; (2) preferences in awarding grants; and (3) use of funds for initial development and advanced telemedicine grant programs. Authorizes appropriations.
Bill· SS. 1523 (103rd)open
United States · United States Congress · 6 October 1993
Stewart B. McKinney Homeless Assistance Reauthorization Act of 1993 - Amends the Public Health Service Act to extend the authorization of appropriations for primary health services for homeless children. Amends the Stewart B. McKinney Homeless Assistance Act to extend homeless program authorizations of appropriations for: (1) community demonstration projects for the mentally ill; (2) adult education; (3) education for homeless children and youth; (4) job training; (5) emergency community services; and (6) family support centers.
Bill· HRH.R. 3222 (103rd)open
United States · United States Congress · 6 October 1993
TABLE OF CONTENTS: Title I: Managed Competition in Employer-Based Health Plans: Incentives to Control Costs Subtitle A: Use of Tax Incentives to Purchase Cost-Effective Plans Subtitle B: Health Plan Purchasing Cooperatives (HPPCs) Subtitle C: Accountable Health Plans (AHPs) Subtitle D: Health Care Standards Commission Subtitle E: Managed Competition in Rural and Urban Underserved Areas Subtitle F: Treatment of Chronically Underserved Areas Subtitle G: Repeal of COBRA Continuation Requirements Subtitle H: Definitions Title II: Low-Income Assistance for Health Coverage Subtitle A: Low-Income Assistance Subtitle B: Long-Term Care Phase-Down Assistance to States Subtitle C: Financing Subtitle D: Repeal of Medicaid Program Title III: Training and Education of Health Care Professionals Subtitle A: Reform of Federal Funding for Medical Residency Training Subtitle B: Other Medical Education Grants and Programs Title IV: Preventive Health and Individual Responsibility Subtitle A: Expansion of Public Health Programs Subtitle B: Medicare Title V: Malpractice Reform Subtitle A: Findings; Purpose; Definitions Subtitle B: Uniform Standards for Malpractice Claims Subtitle C: Requirements for State Alternative Dispute Resolution Systems (ADR) Subtitle D: Grants to States for Development of Practice Guidelines Title VI: Paperwork Reduction and Administrative Simplification Title VII: Additional Benefits On a Pay-As-You-Go Basis Managed Competition Act of 1993 - 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 a tax on the excess health plan expenses of any employer which are health plan expenses exceeding specific limits under an accountable health plan for a defined geographical area. (Sec. 1002) Increases to 100 percent and makes permanent the deduction for health plan premium expenses of self-employed individuals. (Sec. 1003) Permits the deduction for medical, dental, etc. expenses without regard to the limitation on such deduction with respect to amounts paid for premiums under an accountable health plan. (Sec. 1004) Provides for the exclusion from gross income of contributions by a partnership or S corporation to a health plan covering partners or shareholders. (Sec. 1006) Eliminates the commonality of interest and geographic location requirements with respect to group purchasing by large tax-exempt organizations. Subtitle B: Health Plan Purchasing Cooperatives (HPPCs) - Provides for the establishment of Health Plan Purchasing Cooperatives (HPPCs). Considers each State to be a HPPC, except that a State may subdivide into HPPC areas, and that there may be interstate HPPCs, as specified. Requires HPPCs to enter into agreements with accountable health plans and small employers, offer enrollment in accountable health plans, and charge premiums. Subtitle C: Accountable Health Plans (AHPs) - Directs the Health Care Standards Commission to provide a process whereby a health plan may be registered with the Commission by its sponsor as an accountable health plan. Sets forth requirements for a plan to be registered, including: (1) coverage for a specified uniform set of benefits, including cost-sharing for low-income individuals; (2) standard premiums for the uniform benefits; (3) grievance procedures; (4) collecting and providing specified information; (5) prohibiting discrimination in enrollment or benefits; and (6) financial solvency. (Sec. 1208) Sets forth additional requirements for open AHPs, which is any plan which is not closed. Defines a closed plan as one limited by structure or law to one or more large employers. (Sec. 1211) Requires each AHP to provide for payment of one percent of gross premium receipts to the National Medical Education Fund. (Sec. 1221) Sets forth provisions concerning the preemption of State laws for AHPs. (Sec. 1231) Directs the President to provide for the development and publication of guidelines on the application of Federal antitrust laws to AHPs. (Sec. 1232) Provides for the issuance of certificates of public advantage by the Attorney General to eligible health care joint ventures which, if followed, exempt such ventures from antitrust liability. Subtitle D: Health Care Standards Commission - Establishes, as an independent agency in the Executive Branch, a Health Care Standards Commission. Requires the Commission to transmit annually to the Congress recommendations for the uniform set of effective benefits. States that such recommendations shall apply unless the Congress passes a joint resolution of disapproval. (Sec. 1303) Directs the Commission to provide for the initial organization, as a nonprofit corporation, of the Benefits, Evaluations, and Data Standards Board in order to make recommendations to the Commission concerning the uniform set of effective benefits and matters related to the evaluation of health care services. (Sec. 1304) Directs the Commission to provide for the initial organization, as a nonprofit organization of the Health Plan Standards Board in order to make recommendations to the Commission concerning the standards for AHPs and concerning its assessment of risk-adjustment factors. (Sec. 1305) Sets forth provisions concerning the registration of AHPs. (Sec. 1306) Directs the Commission to establish rules for the process of risk-adjustment of premiums among AHPs by HPPCs. (Sec. 1307) Directs the Commission to publish information concerning procedures, their prices, and their quality. (Sec. 1309) Establishes, within the Department of Health and Human Services, the Agency for Clinical Evaluations which shall assume the responsibilities of the Director of the Office of Medical Applications of Research at the National Institutes of Health, the Director of the Office of Research and Demonstrations of the Health Care Financing Administration (insofar as such responsibilities relate to clinical evaluations), the Administrator for Health Care Policy and Research under title IX of the Public Health Service Act, as well as other specified responsibilities. Authorizes appropriations. (Sec. 1311) Prohibits the Commission from establishing or enforcing any controls on health care spending. (Sec. 1313) Authorizes appropriations for the Commission through FY 2000. Terminates the Commission on December 31, 1999. Subtitle E: Managed Competition in Rural and Urban Underserved Areas - Authorizes the Governor of any State to designate rural and urban areas of a State as underserved areas. Permits a HPPC serving such an area to require AHPs offered by the HPPC and with a service area adjoining such area to include the area as part of their service area. (Sec. 1411) Authorizes appropriations for: (1) technical assistance for entities seeking to establish a network plan in an underserved area; (2) financial assistance to eligible entities in order to provide for the development and implementation of AHPs in rural areas; and (3) under the Public Health Service Act, migrant health centers and community health centers. (Sec. 1422) Provides coverage under part B of title XVIII (Medicare) of the Social Security Act for rural emergency access care hospital services. (Sec. 1431) Directs the Secretary of Health and Human Services to make payments for transitional assistance to eligible hospitals. Requires any hospital accepting such assistance to provide a significant volume of services to persons unable to pay for services. Authorizes appropriations. Subtitle F: Treatment of Chronically Underserved Areas - Directs the Health Care Standards Commission to develop standards for the identification of chronically underserved areas. Makes provisions for addressing health care delivery in such areas. Subtitle G: Repeal of COBRA Continuation Requirements - Repeals the COBRA continuation requirements for group health plans and title XXII of the Public Health Service Act. Subtitle H: Definitions - Sets forth definitions for this title and title II. Title II: Low-Income Assistance for Health Coverage - Subtitle A: Low-Income Assistance - Provides premium assistance for very-low income individuals and moderately low-income individuals. Provides for nominal cost-sharing for such individuals and special assistance for certain items and services. Subtitle B: Long-Term Care Phase-Down Assistance to States - Provides for long-term care phase-down assistance to eligible States for each calendar quarter in 1995 through 1998. Subtitle C: Financing - Amends title XVIII (Medicare) of the Social Security Act to achieve savings under such program by: (1) reducing the update for inpatient hospital services; (2) reducing the conversion factor for the physician fee schedule for non-primary care services; and (3) reducing hospital outpatient services through establishing a prospective payment system. (Sec. 2204) Amends the Internal Revenue Code to impose a Medicare part B premium tax on higher-income individuals. (Sec. 2205) Achieves additional Medicare savings through the: (1) phased-in elimination of Medicare disproportionate share adjustment payments; (2) reduction of routine cost limits for home health services; (3) reduction in routine cost limits for extended care services; and (4) reductions in payments for hospice services. Subtitle D: Repeal of Medicaid Program - Repeals title XIX (Medicaid) of the Social Security Act. Title III: Training and Education of Health Care Professionals - Subtitle A: Reform of Federal Funding for Medical Residency Training - Directs the Health Care Standards Commission to approve a resident training position in medical residency program for purposes of funding approved medical residency training programs under this title. Provides funding, in addition, for physician retraining. Sets forth provisions concerning: (1) the allocation of entry positions among programs; and (2) the general distribution of positions among specialties. (Sec. 3004) Requires payment by AHPs of one percent of gross premium receipts to the National Medical Education Fund. Requires payments from the Medicare trust funds to the National Medical Education Fund. (Sec. 3005) Establishes the National Medical Education Fund. Subtitle B: Other Medical Education Grants and Programs - Authorizes appropriations under the Public Health Service Act for medical education programs, including: (1) the scholarship and loan repayment programs of the National Health Service Corps; (2) area education centers; (3) public health and preventive medicine; (4) family medicine; (5) general internal medicine and pediatrics; (6) physician assistants; (7) allied health projects grants and contracts; and (8) nurse practitioner and nurse midwife programs. Title IV: Preventive Health and Individual Responsibility - Subtitle A: Expansion of Public Health Programs - Authorizes appropriations under the Public Health Service Act for the following public health programs: (1) immunizations against vaccine-preventable diseases; (2) prevention, control, and elimination of tuberculosis; (3) lead poisoning prevention; (4) preventive health measures with respect to breast and cervical cancers; (5) the Office of Disease Prevention and Health Promotion; (6) the Office of Minority Health; (7) preventive health and health services block grant; (8) categorical grants for early intervention regarding acquired immune deficiency syndrome; and (9) programs of the Centers for Disease Control regarding the smoking of tobacco products. Directs the Office of Disease Prevention and Health Promotion to promote individual responsibility in personal health care and in the use of valuable health care resources. Subtitle B: Medicare - Provides Medicare coverage for: (1) screening fecal-occult blood tests and screening flexible sigmoidoscopies for the purpose of the early detection of cancer; (2) tetanus-diphtheria boosters; (3) well-child services; and (4) an annual screening mammography for women over age 64. Title V: Malpractice Reform - Subtitle A: Findings; Purpose; Definitions - Sets forth the findings, purpose, and definitions for this title. Subtitle B: Uniform Standards for Malpractice Claims - Prohibits bringing a medical malpractice liability action in a State court unless there has been an initial resolution under an alternative dispute resolution system. Limits the total noneconomic damages in such actions to $250,000. Sets limits on attorney's fees. Makes special provision for obstetric services. Subtitle C: Requirements for State Alternative Dispute Resolution Systems (ADR) - Establishes requirements for State alternative dispute resolution systems. Provides for grants to States to assist in implementation of such systems. Subtitle D: Grants to States for Development of Practice Guidelines - Directs the Secretary to make grants to States for the development of medical practice guidelines for health care professionals that may be applied to resolve medical malpractice liability claims. Title VI: Paperwork Reduction and Administrative Simplification - Preempts State quill pen laws. Ensures the confidential treatment of electronic health care information. Sets forth provisions which provide for: (1) the standardization of electronic health information; (2) uniform claims forms; (3) the liability of insurers when benefits are payable under two or more plans; and (4) the uniformity of the availability of information among health plans when benefits are payable under two or more plans. (Sec. 6007) Amends the Internal Revenue Code to impose a tax on a health plan not in compliance with specified requirements of this title. Title VII: Additional Benefits On a Pay-As-You-Go Basis - Expresses the sense of the Congress that additional benefits should be provided by the Federal Government to the extent that additional financing is made available on a pay-as-you-go basis.
Bill· HRH.R. 3226 (103rd)referred
United States · United States Congress · 6 October 1993
Anti-Discrimination in Health Care Act - Prohibits a service provider under Federal health programs from refusing to provide services to an individual on the grounds that such individual has been a plaintiff in a medical malpractice liability action. Excludes violators from participation in Federal health programs.
Bill· HRH.R. 3230 (103rd)referred
United States · United States Congress · 6 October 1993
Minority Health Opportunity Enhancement Act of 1993 - Amends the Public Health Service Act to direct the Office of Minority Health to establish a center to carry out programs to improve access to health care services for individuals lacking proficiency in speaking English. Establishes an Office of Minority Health in specified agencies of the Public Health Service. Provides for equitable allocation of appropriations for certain health programs. Revises the factors to be considered in designating medically underserved populations and health professional shortage areas to include the percentage of members of racial or ethnic minority groups and the extent of cultural and language barriers. Authorizes appropriations for grants to migrant health centers and community health centers for programs to reduce the extent to which a lack of proficiency in English or other cultural factors constitutes a significant barrier to obtaining health services. Provides funding for the Centers of Excellence, activities of the Agency for Health Care Policy and Research, and certain activities of the National Center for Health Statistics. Requires such entities to spend a portion of such funding on ethnic and racial minorities. Authorizes appropriations for a demonstration project relating to Hispanics, African Americans, and other populations that are at significant risk of contracting diabetes mellitus.
Bill· HJRESH.J.Res. 274 (103rd)referred
United States · United States Congress · 6 October 1993
Designates October 1993 as National Spina Bifida Prevention Month.
Resolution· HRESH.Res. 270 (103rd)referred
United States · United States Congress · 6 October 1993
Provides that any comprehensive health care reform legislation should be considered on the floor of the House of Representatives under an open rule that authorizes any Representative to offer one or more amendments.
Bill· HRH.R. 3220 (103rd)open
United States · United States Congress · 5 October 1993
Health Professions Education Availability Act of 1993 - Amends the Public Health Service Act to authorize grants under the program for health care for rural areas to health professions schools that emphasize training and encourage study in primary health care. Requires such schools to admit applicants who are not citizens or permanent residents only if no qualified citizens seek admission.
Law· HRH.R. 3216 (103rd)enacted
United States · United States Congress · 5 October 1993
Domestic Chemical Diversion Control Act of 1993 - Amends the Controlled Substances Act to remove ephedrine products from the legal drug exemption of the Chemical Diversion and Trafficking Act (which currently precludes the application of any of the regulatory control measures of such Act to a listed chemical which is contained in a drug product approved under the Federal Food, Drug, and Cosmetic Act). Directs the Attorney General to remove from exemption any other drug products which are being diverted to use in the illicit production of controlled substances. Establishes a registration system for distributors, importers, and exporters of listed chemicals which are diverted within the United States. Directs the Attorney General to register an applicant to distribute, and to import or export, a list I (currently, listed precursor) chemical unless the Attorney General determines that registration of the applicant is inconsistent with the public interest, based on specified criteria. Amends the Controlled Substances Import and Export Act to set penalties for knowingly or intentionally importing or exporting a listed chemical in violation of such registration requirements. Makes provisions of the Controlled Substances Act regarding administrative inspections and authority, forfeiture, and threshold amounts of substances applicable to listed chemicals, as well as to controlled substances. (Currently only the latter are covered by such provisions.)
Bill· SS. 1506 (103rd)referred
United States · United States Congress · 30 September 1993
Domestic Violence Identification and Referral Act of 1993 - Amends the Public Health Service Act to require certain health professions entities to train students in the identification and referral of victims of domestic violence. Decreases funding to entities that fail to provide such training.
Bill· HRH.R. 3207 (103rd)referred
United States · United States Congress · 30 September 1993
Domestic Violence Identification and Referral Act of 1993 - Amends the Public Health Service Act to require certain health professions entities to train students in the identification and referral of victims of domestic violence. Decreases funding to entities that fail to provide such training.
Bill· HRH.R. 3203 (103rd)referred
United States · United States Congress · 30 September 1993
Women's Health Services Act of 1993 - Amends title XVIII (Medicare) of the Social Security Act to: (1) provide for coverage under Medicare part B (Supplementary Medical Insurance) of bone mass measurements and annual screening mammography for women over age 64; and (2) make permanent the coverage of certain osteoporosis drugs under such part.
Bill· HRH.R. 3170 (103rd)referred
United States · United States Congress · 29 September 1993
Amends title XVIII (Medicare) of the Social Security Act to require the Secretary of Health and Human Services to consult with appropriate representatives of physicians in reviewing the geographic adjustment factors used to determine reimbursements for physician services under Medicare part B (Supplementary Medical Insurance). Requires the Secretary to: (1) base such factors on the most recent available data; (2) first review and revise such factors by January 1, 1995; and (3) study and report to specified congressional committees on the construction of the geographic cost of practice index and the review and revision of the geographic indices under Medicare. Directs the Physician Payment Review Commission to study and report to the Congress on criteria to refine fee schedule areas in applying geographic adjustment factors for computing payment amounts under Medicare for physicians' services.
Bill· HJRESH.J.Res. 270 (103rd)referred
United States · United States Congress · 29 September 1993
Declares that: (1) all Members of Congress should enroll in the lowest price health plan in the Alliance area from which they are elected; and (2) a Member of Congress shall pay an annual excise tax equal to three times the annual difference between the health premium which the Member pays and the premium paid by enrollees in the lowest cost health plan in the Alliance area from which the Member is elected.
Bill· HJRESH.J.Res. 269 (103rd)referred
United States · United States Congress · 28 September 1993
Designates October 23 through 31, 1993, as National Red Ribbon Week for a Drug-Free America.
Resolution· HCONRESH.Con.Res. 156 (103rd)referred
United States · United States Congress · 28 September 1993
Provides that any health care reform legislation approved by the Congress should provide health care plans of comparable high quality and that Members of Congress should participate on an equal basis with all other Americans in the health care system that results from such legislation.
Bill· HRH.R. 3137 (103rd)open
United States · United States Congress · 27 September 1993
Health Care Information Modernization and Security Act of 1993 - Amends the Social Security Act to establish the Health Care Data Panel to: (1) develop and submit to the Office of Management and Budget for implementation proposed regulations for an integrated electronic health care data interchange system; (2) select and establish data and transaction standards, conventions, and requirements for the data interchange system; and (3) provide for appointment of a National Health Informatics Commission to advise the Panel on its activities. Authorizes appropriations.
Resolution· HCONRESH.Con.Res. 155 (103rd)referred
United States · United States Congress · 27 September 1993
Declares that it is the sense of the Congress that the Federal Government should develop and implement a comprehensive program to deal with the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS), including routine testing between the ages of 14 and 55, contact tracing, Government-assisted medical and psychological treatment, expanded medical research, civil rights protections for HIV-infected individuals, public education campaigns on HIV effects and transmission, and penalties for knowingly spreading HIV.
Bill· SS. 1494 (103rd)open
United States · United States Congress · 24 September 1993
Health Care Information Modernization and Security Act of 1993 - Amends the Social Security Act to establish the Health Care Data Panel to: (1) develop and submit to the Office of Management and Budget for implementation proposed regulations for an integrated electronic health care data interchange system; (2) select and establish data and transaction standards, conventions, and requirements for the data interchange system; and (3) provide for appointment of a National Health Informatics Commission to advise the Panel on its activities. Authorizes appropriations.
Bill· HRH.R. 3131 (103rd)open
United States · United States Congress · 23 September 1993
TABLE OF CONTENTS: Title I: Public Safety and Policing Title II: Death Penalty Title III: Habeas Corpus Reform Title IV: Coerced Confessions Title V: Firearms Subtitle A: Brady Handgun Violence Prevention Act Subtitle B: Gun Crime Penalties Title VI: Youth Violence Subtitle A: General Subtitle B: Criminal Street Gangs Subtitle C: Certainty of Punishment for Young Offenders Subtitle D: Juvenile Drug Trafficking and Gang Prevention Grants Title VII: Terrorism Subtitle A: Maritime Navigation and Fixed Platforms Subtitle B: General Provisions Title VIII: Sexual Violence and Child Abuse Subtitle A: Sexual Abuse Subtitle B: Child Protection Subtitle C: Crimes Against Children Title IX: Crime Victims Title X: State and Local Law Enforcement Subtitle A: Safer Streets and Neighborhoods Subtitle B: DNA Identification Subtitle C: Department of Justice Community Substances Abuse Prevention Subtitle D: Drug Testing of Arrested Individuals Subtitle E: Racial and Ethnic Bias Study Grants Title XI: Provisions Relating to Police Officers Subtitle A: Law Enforcement Relating to Police Officers Subtitle B: Police Pattern or Practice Subtitle C: Police Corps and Law Enforcement Officers Subtitle D: Study Rights of Police Officers Title XII: Grant Program for State Prisons Title XIII: Federal Prisons Subtitle A: General Subtitle B: Drug Testing Subtitle C: Enhanced Penalties for Drugs in Federal Prisons Subtitle D: Drug Treatment in Federal Prisons Subtitle E: Studies Title XIV: Rural Crime Subtitle A: Fighting Drug Trafficking in Rural Areas Subtitle B: Drug Free Truck Stops and Safety Rest Areas Title XV: Drug Control Subtitle A: Drug Emergency Areas Subtitle B: Precursor Chemicals Subtitle C: General Provisions Title XVI: Drunk Driving Provisions Title XVII: Commissions Subtitle A: Commission on Crime and Violence Subtitle B: National Commission to Study the Causes of the Demand for Drugs in the United States Subtitle C: National Commission to Support Law Enforcement Title XVIII: Motor Vehicle Theft Prevention Title XIX: Protections for the Elderly Title XX: Consumer Protection Title XXI: Sentencing Provisions Title XXII: Computer Cime Title XXIII: International Parental Kidnapping Title XXIV: Safe Schools Title XXV: Financial Institutions Fraud Prosecutions Title XXVI: White Collar Crime Amendments Title XXVII: Gambling Title XXVIII: Bail Posting Reporting Title XXIX: General Increased Penalty Provisions Title XXX: Miscellaneous Title XXXI: Technical Corrections Violent Crime Control and Law Enforcement Act of 1993 - Title I: Public Safety and Policing - Amends the Omnibus Crime Control and Safe Streets Act of 1968 (Omnibus Act) to authorize the Attorney General to make grants and provide technical assistance to units of State and local government, and to other public and private entities, to increase police presence (including the rehiring of law enforcement officers laid off as a result of State and local budget reductions, as well as the hiring of new, additional career law enforcement officers, for deployment in community-oriented policing), expand and improve cooperative efforts between law enforcement agencies (LEAs) and members of the community, and otherwise enhance public safety. Sets forth matching fund, application, and related requirements. Authorizes appropriations. Title II: Death Penalty - Amends the Federal criminal code to provide for imposition of the death penalty for various offenses, including: (1) murder by a Federal prisoner; (2) civil rights murders; (3) drive-by shootings and carjackings resulting in death; (4) foreign murder of U.S. nationals; (5) rape and child molestation murders; (6) gun murders during Federal crimes of violence and drug trafficking crimes; and (7) murder of Federal witnesses. (Sec. 201) Sets forth procedures for the imposition, implementation, and review of such sentence. Limits mitigating factors (such as impaired capacity, duress, minor participation, and victim's consent) and aggravating factors (such as previous conviction of a violent felony involving a firearm, previous conviction of other serious offenses, vulnerability of victim, and continuing criminal enterprise involving drug sales to minors, and previous conviction of sexual assault or child molestation). Requires a special hearing to determine whether a death sentence is justified. Directs the court to instruct the jury not to consider the race, color, religious beliefs, national origin, or sex of the defendant or of any victim. Prohibits the execution of a woman while she is pregnant and of a person who is mentally retarded. Title III: Habeas Corpus Reform - Amends the Federal judicial code to impose a 180-day limitations period for the filing of Federal habeas corpus petitions, applicable in both capital and non-capital cases in which the State has offered the petitioner counsel for State post-conviction review, which begins from the time the petitioner's conviction becomes final on State direct review. Tolls such period while the petitioner pursues State post-conviction remedies, unless the petitioner fails to initiate post-conviction review within 270 days in capital cases or 180 days in non-capital cases. Provides for a one-time 60-day extension of the period upon a showing of good cause. (Sec. 302) Provides an automatic stay of execution in capital cases through the consideration of the first Federal habeas corpus petition. Permits a stay of execution to be granted thereafter only if the petition on its face satisfies the requirements for successive petitions. (Sec. 303) Prohibits a Federal court from announcing or applying a new rule to grant relief to a habeas corpus petitioner, except where the new rule places a class of individual conduct beyond the power of the criminal lawmaking authority to proscribe or prohibits the imposition of a certain type of punishment for a class of persons because of their status or offense, or constitutes a watershed rule of criminal procedure implicating the fundamental fairness and accuracy of the criminal proceeding. Codifies case law providing for an independent Federal habeas corpus review of claims under Federal law, except for fourth amendment exclusionary rule claims. Specifies that the State bears the burden of proving harmless error in Federal habeas corpus review of State criminal convictions. (Sec. 304) Allows a prisoner to bring a second or subsequent petition only upon a showing of cause for not having brought the claim before and prejudice if the claim is not heard. (Sec. 306) Sets standards and procedures for the provision of counsel for indigent defendants. Requires each State in which a sentence of death may be imposed to establish a State counsel certification authority, comprised of members of the State's criminal defense bar, to recruit, train, monitor, and support attorneys involved at all stages of capital litigation. (Sec. 307) Amends the Omnibus Act to require the Director of the Bureau of Justice Assistance (BJA) to make grants to States to help fund the provision of defense counsel. Authorizes: (1) Federal grants of up to 75 percent of the additional costs imposed by the new counsel requirements during the first three years following enactment of this title and 50 percent thereafter; and (2) grants for the prosecution of Federal habeas corpus cases in an amount equal to that allocated to capital resource centers. Title IV: Coerced Confessions - Specifies that the admission into evidence of a coerced confession (i.e., one elicited in violation of the fifth or fourteenth amendments to the Constitution) shall not be considered harmless error. Title V: Firearms - Subtitle A: Brady Handgun Violence Prevention Act - Amends the Federal criminal code to provide for a five (business) day waiting period for the purchase of a handgun. Sets forth: (1) interim procedures (pending the establishment of a national instant criminal background check system) for checking with the chief law enforcement officer of the place of residence of the purchaser as to whether the purchaser has a criminal record or whether there is any other legal impediment to such individual's receiving a handgun; and (2) permanent procedures for conducting criminal background checks. Sets penalties for violations. (Sec. 502) Directs the Attorney General to establish a national instant criminal background check system that any licensee may contact for information on whether receipt of a firearm by a prospective purchaser would violate specified legal provisions. Provides for the correction of erroneous information in the system. (Sec. 503) Permits the use of formula grants under the Omnibus Act for improvements in State criminal records. Authorizes appropriations. Sets forth provisions with respect to the withholding of State and Department of Justice (DOJ) funds for failure to meet set deadlines. Subtitle B: Gun Crime Penalties - Directs the U.S. Sentencing Commission to amend its sentencing guidelines to enhance the penalty for: (1) use of a semiautomatic firearm during a crime of violence or a drug trafficking crime; (2) a second offense of using an explosive to commit a Federal felony; (3) use of a firearm in the commission of counterfeiting or forgery; and (4) firearms possession by violent felons and serious drug offenders. (Sec. 506) Prohibits and sets penalties for: (1) smuggling firearms in aid of drug trafficking; (2) theft of firearms and explosives; (3) the transfer of firearms to a nonresident of a State, except for lawful sporting purposes; (4) conspiracies to commit firearms and explosives crimes; and (5) the distribution of explosives to a person who is legally disqualified from having the explosives. (Sec. 508) Increases the penalty for: (1) knowingly making a false, material statement in connection with the acquisition of a firearm from a licensed dealer; and (2) interstate gun trafficking. Title VI: Youth Violence - Subtitle A: General - Amends the Controlled Substances Act (CSA) to increase the penalty for employing, using, inducing, or coercing individuals under age 18 to violate provisions of such Act, or to assist in avoiding detection or apprehension for certain offenses under such Act by Federal, State, or local law enforcement officials. (Sec. 602) Amends the Federal criminal code to prohibit a juvenile from being transferred to adult prosecution or a hearing from being held under section 5037 (disposition after a finding of juvenile delinquency) until any prior juvenile records have been received by the court or other specified conditions are met. (Sec. 603) Amends the Omnibus Act to authorize grants for bindover systems for the prosecution of 16- and 17-year-olds as adults for certain violent crimes (first- and second-degree murder, attempted murder, armed robbery with a firearm, aggravated battery or assault with a firearm, criminal sexual penetration when armed with a firearm, and drive-by shooting). Subtitle B: Criminal Street Gangs - Amends the Federal criminal code to provide for imprisonment of up to ten years for a gang member or person acting on behalf of a criminal street gang who commits a Federal drug or violent crime offense and who has had a prior drug or violent crime conviction, with the penalty to run consecutively to any other sentence imposed Subtitle C: Certainty of Punishment for Young Offenders - Amends the Omnibus Act to authorize the Director of the BJA to make grants to States for the purpose of developing alternative methods of punishment for young offenders to traditional forms of incarceration and probation. Authorizes appropriations. Subtitle D: Juvenile Drug Trafficking and Gang Prevention Grants - Amends the Omnibus Act to authorize the Director of the BJA to make grants for programs to reduce the formation or continuation of juvenile gangs and the use and sale of illegal drugs by juveniles. Authorizes appropriations. Title VII: Terrorism - Subtitle A: Maritime Navigation and Fixed Platforms - Amends the Federal criminal code to prohibit and set penalties for the seizure of a ship or fixed platform by force, an act of violence against a person aboard, damage or destruction, or the injuring or killing of a person in connection with such activities. Provides the death penalty where death results. Subtitle B: General Provisions - Provides the death penalty where death results from the use of a weapon of mass destruction. (Sec. 705) Extends: (1) special maritime and territorial jurisdiction to offenses committed by or against a U.S. national during a voyage on a foreign vessel scheduled to depart from or arrive in the United States; and (2) the statute of limitations to ten years for certain terrorist offenses. (Sec. 706) Provides: (1) the death penalty for the commission of torture outside the United States and for the killing of a U.S. national outside the country; (2) the Federal Bureau of Investigation (FBI) with access to telephone subscriber information if the Director or Deputy Assistant Director certifies that such information is relevant to a foreign counterintelligence investigation and that it pertains to an agent of a foreign power; and (3) criminal penalties for willful violations of airport or airline security regulations. (Sec. 709) Prohibits: (1) acts of terrorism at U.S. international airports (and provides the death penalty where death results); and (2) counterfeiting U.S. currency abroad. Enhances penalties for any felony that involves or is intended to promote international terrorism. (Sec. 713) Amends the Immigration and Nationality Act to authorize the Attorney General to grant a nonimmigrant visa to an alien who possesses critical information about a criminal organization and whose presence in the United States is essential to an investigation or prosecution of such organization; and (2) the Federal criminal code to set penalties for those who provide material support to terrorists. Title VIII: Sexual Violence and Child Abuse - Subtitle A: Sexual Abuse - Amends the Federal criminal code to include within the definition of "sexual act" the intentional touching, not through the clothing, of the genitalia of another person who has not attained age 16 with intent to abuse, humiliate, harass, degrade, or arouse or gratify the sexual desire of any person. Subtitle B: Child Protection - Provides for the establishment of a national background check system whereby child care organizations can determine whether prospective employees have histories of child abuse or other serious crimes. Requires State to have at least 80 percent currency of crime cases in their systems within three years. Directs the Administrator of the Office of Juvenile Justice and Delinquency Prevention to begin a study of child abusers' criminal records. (Sec. 806) Amends the Omnibus Act to provide for the use of drug control and system improvement grants for the improvement of State record systems and the sharing of records of child abuse crime information to implement this subtitle. Subtitle C: Crimes Against Children Registration - Directs the Attorney General to establish guidelines for State programs requiring any person convicted of a criminal offense against a victim who is a minor to register a current address with a designated State LEA for ten yeas after release from prison, or being placed on parole or supervised release. Subjects to criminal penalties a person required to register under a State program who knowingly fails to register and keep such registration current. (Sec. 808) Specifies that the allocation of BJA grant funds (under the Omnibus Act) received by a State not complying with provisions of this Act three years after its enactment shall be reduced by ten percent, with the unallocated funds to be reallocated to the States in compliance with this Act. Title IX: Crime Victims - Amends the Victims of Crime Act of 1984 to: (1) specify the amounts available for grants under certain sections of the Act; and (2) provide that if the compensation paid by an eligible crime victim compensation program would cover costs that a Federal, or federally financed State or local, program would otherwise pay, such victim compensation program shall not pay such compensation and the other program shall make its payments without regard to the existence of the crime victim compensation program. (Sec. 903) Amends Rule 32 of the Federal Rules of Criminal Procedure to give victims of violent crimes and sexual abuse the right to address the court concerning the sentence to be imposed on convicted offenders. Permits such right to be exercised by a parent or guardian if the victim is under 18, or by one or more family members if the victim is deceased or incapacitated. (Sec. 904) Directs the Attorney General and the Secretary of Health and Human Services to report to specified congressional committees on the medical and psychological basis of "battered women's syndrome" and the extent to which evidence of the syndrome has been admitted as evidence of guilt or as a defense in criminal trials. Title X: State and Local Law Enforcement - Subtitle A: Safer Streets and Neighborhoods - Continues the current Federal-State funding formula for grants under title I of the Omnibus Act. (Sec. 1002) Amends such Act to authorize the Director of the BJA to make grants to, or enter into contracts with, non-Federal public or private agencies, institutions, or organizations to carry out specified purposes of the Act (current law does not specify "non-Federal"), effective October 1, 1994. Subtitle B: DNA Identification - Amends the Omnibus Act to authorize the use of drug control and system improvement grants to develop or improve in a forensic laboratory a capability to analyze deoxyribonucleic acid (DNA) for identification purposes. Authorizes appropriations. (Sec. 1004) Requires the Director of the FBI to appoint an advisory board on DNA quality assurance methods and issue standards for quality assurance. Authorizes the Director to establish an index of DNA identification records of persons convicted of crimes, and of analyses of DNA samples recovered from crime scenes and from unidentified human remains. (Sec. 1006) Sets forth proficiency testing and privacy protection requirements, and penalties for violations. (Sec. 1007) Authorizes appropriations. Subtitle C: Department of Justice Community Substances Abuse Prevention - Amends the Omnibus Act to authorize the Attorney General to make grants to eligible coalitions to develop and implement substance abuse prevention programs, with the efforts of such coalitions involving substantial community participation. Grants priority to communities providing evidence of significant abuse. Authorizes appropriations. Subtitle D: Drug Testing of Arrested Individuals - Amends the Omnibus Act to authorize the Director of the BJA to make grants to States for the purpose of developing, implementing, or continuing a drug testing project when individuals are arrested and during the pretrial period. Authorizes appropriations. Subtitle E: Racial and Ethnic Bias Study Grants - Authorizes the Attorney General to make grants to States that have established, by State law or the court of last resort, plans for analyzing the role of race in their criminal justice systems. Requires State plans to include recommendations designed to correct any findings of racial and ethnic bias. Authorizes appropriations. Title XI: Provisions Relating to Police Officers - Subtitle A: Law Enforcement Family Support - Amends the Omnibus Act to: (1) require the Director of the BJA to establish guidelines and oversee the implementation of family-friendly policies in law enforcement divisions of DOJ, identify model programs that provide support to law enforcement families, and provide technical assistance for stress reduction and family support efforts by State and local LEAs; and (2) authorize the Director to make grants to States and local LEAs and organizations representing State or local law enforcement personnel to provide family support services to law enforcement personnel. Authorizes appropriations. Subtitle B: Police Pattern or Practice - Prohibits any governmental authority, or any agent or person acting on behalf of such authority, from engaging in a pattern or practice of conduct by law enforcement officers that deprives persons of their constitutional or Federal rights. Authorizes the Attorney General to bring a civil action against such officers to eliminate such practices. (Sec. 1104) Directs the Attorney General to acquire data about the use of excessive force by law enforcement officers. Subtitle C: Police Corps and Law Enforcement Officers Scholarship Programs - Chapter 1: Community Police Corps Initiatives - Authorizes the Attorney General to make grants for up to ten Community Police Corps Programs in which participants can receive scholarships of not more than $5,000 annually times the number of years in the educational institution's regular program in exchange for a commensurate period of work with a State or local police force upon graduation. Authorizes appropriations. Permits up to ten percent of grant funds to be awarded to law enforcement officers currently employed by the jurisdiction, and who are assigned to community-oriented policing or who exercise supervisory or training roles in relation to such officers, for college or post-graduate work. Chapter 2: Law Enforcement Scholarship Program - Requires the Director of the BJA to provide scholarships for in-service law enforcement personnel who seek further education, allotting 80 percent of funds based on the relative number of law enforcement officers per State and 20 percent based on the relative shortage of officers. Provides grants for summer jobs or part-time jobs during the year for high school students interested in law enforcement careers. Authorizes appropriations. Subtitle D: Study Rights of Police Officers - Directs the Attorney General to conduct a study of the procedures followed in internal, noncriminal investigations of State and local law enforcement officers to determine if such investigations are conducted fairly and effectively. Title XII: Grant Programs for State Prisons - Amends the Omnibus Act to authorize the Director of the BJA to make grants to States for residential substance abuse treatment programs in State correctional facilities, as well as those in which inmates are incarcerated for a time sufficient to permit substance abuse treatment. Authorizes appropriations. Title XIII: Federal Prisons - Subtitle A: General - Amends the Federal criminal code to: (1) prohibit the Bureau of Prisons from considering the social or economic status of a prisoner in designating such prisoner's place of imprisonment; and (2) require that any submission of legislation by the judicial or executive branch that might affect prison populations be accompanied by an impact statement (and requires the Attorney General to prepare and transmit to the Congress annual prison impact assessments). (Sec. 1303) Requires notice to State and local law enforcement authorities concerning the release or relocation to their areas of Federal offenders under post-release supervision at least five days prior to such release or relocation, with respect to prisoners convicted of drug trafficking and violent crimes. (Sec. 1304) Deems references to supervised release, in the case of prisoners convicted of offenses committed prior to November 1, 1987, to be references to probation or parole. Subtitle B: Drug Testing - Requires the Director of the Administrative Office of the U.S. Courts to establish a program of drug testing of Federal offenders on post-conviction release. Subtitle C: Enhanced Penalties for Drugs in Federal Prisons - Provides for enhanced penalties for drug trafficking and illegal drug use in Federal prisons. Subtitle D: Drug Treatment in Federal Prisons - Establishes a schedule for the Bureau of Prisons to place all eligible prisoners into residential substance abuse treatment programs for between nine and 12 months, in facilities separate from the general prison population. Specifies that prisoners who successfully complete such programs could be released up to a year early. Authorizes appropriations. Subtitle E: Studies - Requires the National Institute of Justice to study: (1) the feasibility of establishing an information clearinghouse to facilitate the interstate transfer of prisoners to facilities near their families; (2) the recidivism rates of persons who were under the influence of alcohol at the time they committed their crimes, comparing recividism rates of those who participated in a residential treatment program while in custody with those who did not; and (3) the use of alcohol, alone or in combination with other drugs, as a factor in criminal activity. Title XIV: Rural Crime - Subtitle A: Fighting Drug Trafficking in Rural Areas - Amends the Omnibus Act to authorize appropriations, and increase the base allocation, for rural drug enforcement assistance. (Sec. 1402) Directs the Attorney General to establish a Rural Drug Enforcement Task Force in each of the Federal judicial districts which encompass significant rural lands. (Sec. 1403) Authorizes the Attorney General to cross-designate up to 100 Federal officers with jurisdiction to enforce CSA provisions on non-Federal lands to the extent necessary to effect the purposes of this title. (Sec. 1404) Requires the Director of the Federal Law Enforcement Training Center to develop a specialized course of instruction devoted to training law enforcement officers from rural agencies in the investigation of drug trafficking and related crimes. Authorizes appropriations. Subtitle B: Drug Free Truck Stops and Safety Rest Areas - Amends the CSA to enhance penalties for drug distribution at or near truck stops and safety rest areas. Title XV: Drug Control - Subtitle A: Drug Emergency Areas - Amends the National Narcotics Leadership Act of 1988 to authorize the President to declare a State, or part thereof, a drug emergency area, to take all necessary actions to save lives and protect property, public health, and safety, and to make grants aggregating $25 million for any single major drug-related emergency. Requires grant money to be divided equally between drug supply and demand reduction efforts, unless State or local conditions dictate otherwise. Permits the President to direct any Federal agency to utilize its resources to assist State anti-drug efforts. Authorizes appropriations. Subtitle B: Precursor Chemicals - Amends the CSA to impose registration requirements for precursor chemicals. (Sec. 1504) Requires manufacturers to submit annual reports concerning listed chemicals manufactured during the year. (Sec. 1505) Amends the Controlled Substances Import and Export Act to: (1) subject brokers and traders to the same recordkeeping and reporting requirements for international transactions, and the same criminal penalties, as exporters; and (2) authorize the Attorney General to require that the 15-day advance notice requirement with respect to the importation and exportation of listed chemicals apply to all exports of specific listed chemicals to specified countries, regardless of the status of certain customers in such countries as regular customers, if necessary to support effective diversion control programs or as required by treaty; and (3) establish criminal penalties for attempting to evade reporting requirements and for smuggling listed drugs. (Sec. 1509) Grants the Attorney General the same inspection authority for listed chemicals as presently exists with respect to controlled substances. (Sec. 1511) Makes it a felony to violate the Solid Waste Disposal Act in the handling of chemicals used to illegally manufacture a controlled substance. Requires that violators be assessed costs of the initial cleanup and disposal of the listed chemical and contaminated property and the costs of restoring property damaged by exposure to such chemical. Subtitle C: General Provisions - Prohibits and sets penalties for: (1) drug dealing in or near public housing authority facilities; (2) a physical trainer or adviser who tries to persuade an individual to use anabolic steroids; and (3) advertising which aims to illegally solicit or sell drugs. (Sec. 1518) Enhances penalties for drug dealing in "drug-free zones." (Sec. 1519) Includes among the long-term goals of the National Drug Control Strategy making drug treatment available to all who need it. Title XVI: Drunk Driving Provisions - Amends the Federal criminal code to provide supplementary prison terms and fine authorizations in cases where drunk driving endangers or injures a person under age 18. (Sec. 1602) Expresses the sense of the Congress that in determining child custody and visitation rights the courts should consider the history of drunk driving of anyone involved in the determination. Title XVII: Commissions - Subtitle A: Commission on Crime and Violence - Establishes the National Commission on Crime and Violence in America to develop a comprehensive crime control plan for the 1990's. Subtitle B: National Commission to Study the Causes of the Demand for Drugs in the United States - Establishes a National Commission to Study the Causes of the Demand for Drugs in the United States. Subtitle C: National Commission to Support Law Enforcement - Establishes a National Commission to Support Law Enforcement. Title XVIII: Motor Vehicle Theft Prevention - Directs the Attorney General to develop a national voluntary motor vehicle theft prevention program which would involve placing identifiable decals on the vehicles of consenting owners, whereby such vehicles could then be stopped by law enforcement officers upon a reasonable suspicion that the vehicles were not being operated by or with the consent of their owners. (Sec. 1802) Prohibits and sets penalties for tampering with the decals, with exceptions. Title XIX: Protections for the Elderly - Directs the Attorney General to make grants in support of programs to protect and locate missing patients with Alzheimer's disease and related dementias. Authorizes appropriations. (Sec. 1902) Directs the Sentencing Commission to ensure that the sentences for those convicted of crimes of violence against elderly victims be sufficiently stringent to deter such crimes, protect the public from additional crimes of such a defendant, and provide enhanced penalties under specified criteria. Title XX: Consumer Protection - Amends the Federal criminal code to set penalties for insurance industry crimes, including embezzling from insurance companies, making false entries in insurance company books with intent to deceive, and corruptly influencing or obstructing proceedings before State insurance regulatory agencies or insurance examiners. Prohibits persons convicted of criminal felonies involving dishonesty or breach of trust from engaging in the insurance business without the written consent of an insurance regulatory official authorized to regulate the insurer. (Sec. 2002) Consumer Protection Against Credit Card Fraud Act of 1993 - Prohibits the sale of credit cards without credit card company authorization, fraudulent receipt of payments via credit card for goods never received or inferior to those promised, and laundering to credit card receipts. (Sec. 2003) Extends the mail fraud statute to include mail sent by private interstate carriers. Title XXI: Sentencing Provisions - Amends the Federal criminal code to allow the court, in determining the sentence to be imposed in the case of a violation of probation or supervised release, to consider guidelines or policy statements issued by the Sentencing Commission. (Sec. 2103) Sets forth provisions regarding mandatory revocation of probation and of supervised release after imprisonment for possession of a controlled substance or firearm, or for refusal to comply with drug testing. (Sec. 2105) Permits concurrent sentencing of a defendant to imprisonment and probation for petty offenses. Title XXII: Computer Crime - Amends the Computer Fraud and Abuse Act to make it a felony to knowingly transmit an unauthorized program or code that alters the information stored in a computer with the intent to damage the system or information contained within the affected computer or system, or to withhold or deny the use of such system or information, if the transmission: (1) occurred without the authorization of the person responsible for the computer system receiving the program; and (2) causes damage exceeding $1,000 in any one-year period or modifies or impairs the medical care of any individual. Makes it a misdemeanor to recklessly transmit a destructive computer program or code. Creates a civil cause of action for persons suffering damage or loss by virtue of a violation of this title. Modifies the prohibition against accessing a Government computer where such conduct affects the use of the Government's operation of such computer to cover only actions that "adversely" affect such use. Title XXIII: International Parental Kidnapping - Amends the Federal criminal code to establish penalties for removing a child from, or retaining a child outside, the United States with intent to obstruct the lawful exercise of parental rights. (Sec. 2302) Authorizes appropriations to carry out under the State Justice Institute Act of 1984 national, regional, and in-State training and educational programs dealing with criminal and civil aspects of interstate and international parental child abduction. Title XXIV: Safe Schools - Amends the Omnibus Act to: (1) authorize the Director of the BJA to make grants to local educational agencies for the purpose of providing assistance to such agencies most directly affected by crime and violence; and (2) require the Director to develop a written safe schools model in English and in Spanish and make such model available to any such agency that requests it. Authorizes appropriations. Title XXV: Financial Institutions Fraud Prosecutions - Amends the Federal Deposit Insurance Act and the Federal Credit Union Act to disqualify certain persons with criminal records from participating in the affairs of insured depository institutions and credit unions. Title XXVI: White Collar Crime Amendments - Establishes penalties for knowingly receiving the proceeds of: (1) extortion; (2) a kidnapping; and (3) a postal robbery. (Sec. 2603) Extends the prohibition against obstructing civil investigative demands to include obstruction in racketeering and false claims investigations. Title XXVII: Gambling - Sets forth provisions regarding the scope of the prohibition on gambling on ships in international waters. Grants a State gaming enforcement office located within a State Attorney General's office access to FBI criminal history record information for licensing purposes. Title XXVIII: Bail Posting Reporting - Illegal Drug Profits Act of 1991 (sic) - Requires State and Federal criminal court clerks to report to the Internal Revenue Service and prosecutors the name and taxpayer identification number of anyone accused of a drug, money laundering, or racketeering crime who posts cash bail exceeding $10,000. Title XXIX: General Increased Penalty Provision - Increases penalties for assault: (1) of Federal officers, foreign officials, and official guests and internationally protected persons; (2) within a maritime and territorial jurisdiction; and (3) of the President, presidential staff, congressional leaders, cabinet officials, and Supreme Court justices. (Sec. 2902) Increases the maximum penalties for voluntary and involuntary manslaughter. (Sec. 2903) Increases penalties for: (1) conspiracy to commit murder for hire; (2) trafficking in counterfeit goods and services; and (3) Travel Act violations. (Sec. 2906) Broadens the scope and increases the penalties for conspiracies to deprive persons of their civil rights. Title XXX: Miscellaneous - Extends the protection of the criminal civil rights statute to any person in a State. (Currently, the statute only covers a State "inhabitants.") (Sec. 3003) Directs the Attorney General to: (1) require State and local LEAs to annually audit and detail the uses and expenses to which forfeiture funds were dedicated and the amount used for each use or expense; and (2) report to the Congress on the administrative and contracting expense paid from the DOJ Assets Forfeiture Fund. (Sec. 3005) Creates an optional venue in the District of Columbia for espionage and related offenses regarding the gathering, transmitting, losing, or delivering of defense information. (Sec. 3007) Prohibits: (1) the disclosure of information obtained through wiretapping or electronic surveillance with the intent to obstruct a criminal investigation; (2) the theft of major art works from museums; (3) misuse of the words "Drug Enforcement Administration" or the initials "DEA"; and (4) attempted robbery, kidnapping, smuggling, and property damage offenses. (Sec. 3010) Permits trials by a magistrate judge in petty offense cases involving juveniles. Title XXXI: Technical Corrections - Makes technical corrections to various criminal law provisions.