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Bill· HRH.R. 5665 (102nd)referred
United States · United States Congress · 22 July 1992
State Health Care Reform Incentive Act of 1992 - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to permit States to seek waivers of program requirements in order to provide health care coverage under certain regular or alternative State programs. Establishes Federal requirements for such State programs. Sets forth payment provisions.
Bill· SS. 2990 (102nd)referred
United States · United States Congress · 21 July 1992
Tuberculosis Prevention and Control Centers Act of 1992 - Amends the Public Health Service Act to authorize grants for the establishment of tuberculosis prevention and control centers to engage in certain activities, including: (1) screening, detection, and treatment; and (2) education and training for patients, providers, and the public. Requires the grant recipient to: (1) submit a local tuberculosis control plan; and (2) establish a local tuberculosis advisory committee. Authorizes appropriations.
Law· HRH.R. 5623 (102nd)enacted
United States · United States Congress · 21 July 1992
Waives the period for congressional review for the following District of Columbia Acts and makes them effective upon the enactment of this Act: (1) National Public Radio Revenue Bond Act of 1992; (2) Howard University Revenue Bond Act of 1992; (3) National Learning Center Revenue Bond Act of 1992; (4) Children's Hospital Bond Act of 1992; (5) Medlantic Healthcare Group, Inc., Revenue Bond Act of 1992; (6) Catholic University of America Revenue Bond Act of 1992; and (7) Temporary Panel of the Office of Employee Appeals Temporary Extension Act of 1992.
Resolution· HCONRESH.Con.Res. 350 (102nd)referred
United States · United States Congress · 21 July 1992
Expresses the sense of the Congress that the Secretary of the Treasury should release to Leona Benten the dosage of the drug RU-486 that was seized from her on July 1, 1992, for her personal use under the supervision of a physician of her choice.
Bill· SS. 2988 (102nd)referred
United States · United States Congress · 20 July 1992
Tuberculosis Prevention and Control Amendments of 1992 - Amends the Public Health Service Act to authorize appropriations for grants for the prevention, control, and elimination of tuberculosis. Requires the Director of the National Institute of Allergy and Infectious Diseases to conduct or support research and research training regarding tuberculosis. Authorizes appropriations. Authorizes grants for the prevention, control, and elimination of tuberculosis for: (1) construction or modernization of outpatient medical facilities serving medically underserved populations; (2) conversion of existing facilities into outpatient or long-term care facilities for such populations; and (3) renovation of inpatient facilities. Authorizes appropriations. Amends title XIX (Medicaid) of the Social Security Act to mandate provision to eligible persons with tuberculosis of certain drugs and services under Medicaid. Allows a State to limit the provision of case management services to such persons. Adds such persons to provisions defining "medical assistance."
Bill· HRH.R. 5610 (102nd)referred
United States · United States Congress · 9 July 1992
Administrative Health Costs Reduction Act of 1992 - Directs the Secretary of Health and Human Services to adopt standards relating to uniform: (1) claims data elements; (2) claims forms; and (3) electronic transmission of billing information. Allows a health benefit plan to reject a nonelectronic claim not submitted on a form meeting the standards. Provides, a specified period after adoption of the standards, for direct electronic filing by providers of claims. Defines "health benefit plan" to include various employee benefit plans and the Medicare and Medicaid provisions (titles XVIII and XIX) of the Social Security Act.
Bill· HRH.R. 5614 (102nd)open
United States · United States Congress · 9 July 1992
Medicaid Prescription Drug Amendments Act of 1992 - Amends title XIX (Medicaid) of the Social Security Act to: (1) repeal the use of the best price mechanism used to determine rebates for prescription drugs; and (2) require manufacturers of such drugs to enter into discount pricing agreements with the Department of Veterans Affairs in order to receive payment for such drugs.
Bill· HRH.R. 5615 (102nd)referred
United States · United States Congress · 9 July 1992
Prescription Drug Records Privacy Protection Act of 1992 - Amends the Federal criminal code to make any pharmacist, physician, or administrator of a health benefit plan who knowingly discloses personally identifiable information contained in a prescription drug record of an individual liable to such individual. Makes exceptions with respect to any such disclosures: (1) to the individual; (2) with the informed, written consent of the individual; (3) to a law enforcement agency (LEA) pursuant to a warrant, a grand jury subpoena, or a court order; (4) to an LEA or health care agency for the purpose of addressing illegal drug diversion or improving prescribing practices; (5) pursuant to a court order in a civil proceeding upon a showing of compelling need for the information that cannot be accommodated by any other means, subject to specified conditions; and (6) to any person involved in the administration and review of health care services provided to the individual. Sets forth provisions regarding safeguards against unauthorized disclosure where court orders are granted. Permits persons aggrieved by any act of an individual in violation of this Act to bring a civil action in a U.S. district court for actual and punitive damages, costs, and other preliminary and equitable relief, subject to specified limitations.
Bill· HRH.R. 5613 (102nd)referred
United States · United States Congress · 9 July 1992
Amends the Federal Food, Drug, and Cosmetic Act to deem a malt beverage, wine, or distilled spirit mislabeled unless it bears a label disclosing: (1) the alcoholic content; (2) the number of drinks (defining "drink" as .6 ounces of alcohol); (3) its ingredients and calories; (4) the common name of each ingredient, including additives; and (5) a toll-free number for help with a drinking problem. Authorizes appropriations for the toll-free number.
Bill· HRH.R. 5609 (102nd)referred
United States · United States Congress · 9 July 1992
Superfund Equitable Liability and Improved Cleanup Act - Amends the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 to revise liability provisions to make the following persons liable for costs and damages under such Act: (1) owners or operators of a site or facility if such persons should have known that disposal was likely to result in the release of a hazardous substance that would endanger public health or welfare or the environment; and (2) any person if the person violated any applicable environmental statute, plan, or order in effect at the time of disposal and the violation contributed to such endangerment or the person's action contributed to such endangerment and the person should have known that the disposal would cause such endangerment or would result in liability under common law. Directs the Administrator of the Environmental Protection Agency to promulgate regulations establishing numerical standards for each hazardous substance, pollutant, and contaminant. Applies such standards to remedial actions at each site on the National Priorities List unless the Administrator: (1) determines that the standards are not sufficiently protective of human health or the environment; or (2) grants a waiver of the standards at the site in response to a petition from a party responsible for cleanup at the site. Requires the Administrator to promulgate regulations establishing deadlines for any person who is liable with respect to a site for the completion of remedial action investigation, design, and implementation. Prescribes civil penalties for violations of deadlines. Prohibits the President from selecting the capping of a site as a remedial action unless the President determines that compliance with the numerical cleanup standards is not technologically feasible. Amends the Internal Revenue Code to modify the amount of excess minimum taxable income upon which environmental tax is imposed (thereby making an increased amount of corporate income subject to the tax).
Bill· HRH.R. 5592 (102nd)referred
United States · United States Congress · 9 July 1992
Veterans' Health Care Financing Reform Demonstration Act of 1992 - Directs the Secretary of Veterans Affairs to conduct a demonstration program to test the feasibility and desirability of requiring that, whenever the Department of Veteran Affairs provides hospital care or medical services for a non-service-connected disability to an individual who is also entitled to such care or services from another Federal department or agency, such department or agency shall reimburse the Department for the provision of such care or services. Requires the demonstration project to be conducted at three Department medical centers selected by the Secretary. Outlines health care programs of the Department of Defense, Department of Health and Human Services, and Department of the Interior's Bureau of Indian Affairs as covered programs under which such reimbursement shall take place. Allows the Department to recover the cost of care or services provided to an individual for a non-service-connected disability, reduced by any appropriate unpaid deductible, to the extent that the individual would be eligible to receive such care or services from another department or agency. Directs the Secretary to establish a central electronic billing system for such amounts. Subrogates the Secretary to any right or claim that the veteran may have against another department or agency. Directs the Secretary to prescribe regulations to determine the amount to be recovered for such care or services, taking into account the geographic area involved. Directs the Secretary to establish mechanisms to evaluate the impact and cost-effectiveness of the demonstration project and the satisfaction of the patients served. Requires the Secretary to report to the Congress after one year of the project, describing the findings of the evaluation.
Bill· HRH.R. 5573 (102nd)referred
United States · United States Congress · 8 July 1992
Full-Service Schools Act - Establishes the Federal Interagency Work Group (the Group) to: (1) facilitate collaboration between agencies and mobilize Federal policy to achieve systemic reform to meet the comprehensive needs of at-risk children and their families for education, health, and social and human services; and (2) provide grants to States and local entities to develop similar programs at the State and local levels. Provides that the Group shall be composed of the Secretaries of Education, Health and Human Services, and Labor, and funded equally by their departments. Directs the Secretary of Education to act as the fiscal agent for the Group. Requires the Group to: (1) assist Federal, State, and local agencies to develop, implement, and evaluate service integration programs under this Act; (2) coordinate agency resources and funding to allow for consolidation of Federal categorical programs, when waiver requests are made; (3) establish and maintain a national data base that includes Federal, State, local, and private collaborative efforts to serve at-risk children; (4) make grants to States for interagency work groups and local efforts to integrate services for at-risk youth and their families; (5) determine grant amounts by considering the number of local project sites the State group can target with limited allocations to each site; and (6) waive certain Federal requirements that impede collaborative efforts, if such waivers will result in more efficient use of resources. Requires States, for grant elibility, to: (1) establish a State interagency work group (with at least the State public education and health and human services departments); (2) develop training to assist staff members to understand communities and the full array of available resources to help at-risk children and families; (3) require equal contributions by departments in the State group; (4) set as a goal the integration of existing funding sources from the departments represented; (5) designate a fiscal agent; and (6) assist local entities in developing local interagency agreements. Requires local entities, for grant eligibility, to: (1) develop a community planning process including specified parties; (2) develop mandatory services recommended by the planning group; (3) establish a local interagency work group (if located in a city of 10,000 or more); (4) require equal contributions of the local educational agency and represented entities; (5) assure a reasonable effort to initiate structural reform; and (6) designate a fiscal agent. Sets forth application requirements and grant limitations. Requires local programs to include activities to improve educational performance by: (1) reducing school dropout and teen pregnancy rates and the number of children in unsupervised settings; (2) increasing adult/family literacy and the number of students returning to school after dropping out; and (3) improving access to primary health care for families and their children. Allows local programs to develop a variety of programs to serve the comprehensive needs of students, including specified optional activities. Sets forth requirements for annual local reports, a State report after the second calendar year of funding, and a Federal report within three years after enactment of this Act. Authorizes appropriations.
Bill· HRH.R. 5576 (102nd)referred
United States · United States Congress · 8 July 1992
Medicaid Quality Control Reform Act of 1992 - Amends title XIX (Medicaid) of the Social Security Act to create a new Medicaid quality control system applicable to erroneous excess payments by States for medical assistance provided under the Medicaid program.
Bill· HRH.R. 5563 (102nd)referred
United States · United States Congress · 7 July 1992
Medicaid Management Improvement Act of 1992 - Establishes a State Medicaid Advisory Panel to review proposed regulations affecting the Medicaid program under title XIX of the Social Security Act and make recommendations to the Secretary of Health and Human Services for changes in such regulations appropriate to take into account the concerns of State and local governments in the operation and financing of the Medicaid program. Requires the Panel to review, and make recommendations to the Secretary about, State requests for waivers of requirements applicable to State plans approved under the Medicaid program. Gives States the option of delaying implementation of new program requirements until the Secretary promulgates final regulations. Expresses the sense of the Congress that if a State is required by future legislation to provide for additional services, eligible individuals, or otherwise incur additional costs under its Medicaid program, the Federal Government shall provide for full payment of any such additional costs for at least the first two years in which such requirement applies. Sets a deadline for actions on waiver applications. Changes the formula that determines the States' Medicaid matching ratio from the current system based on per capita personal income to a system based on the States' fiscal capacity. Revises State Medicaid plan provisions to enforce the use of: (1) parental health insurance coverage of children by absent parents; and (2) garnishment of the income of individuals who have been ordered to cover the medical costs of a Medicaid-eligible individual and have received payment for such costs from a third party but have not used them to make appropriate reimbursements.
Bill· SS. 2949 (102nd)open
United States · United States Congress · 2 July 1992
Traumatic Brain Injury Act of 1992 - Amends the Public Health Service Act to direct the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control, to conduct a study concerning traumatic brain injury. Requires the study to seek to: (1) determine the major causes of traumatic brain injury; (2) identify common therapeutic interventions which are used for the rehabilitation of individuals with traumatic brain injuries; (3) determine the preventive efforts that are being used by States and non-profit agencies to reduce the occurrence of such injuries; (4) identify effective treatment and long-term rehabilitation services needed to meet the needs of individuals with traumatic brain injuries; (5) develop practice guidelines for the treatment of traumatic brain injury; and (6) determine whether there is a need for national standards for helmets used by bicyclists and others. Requires the results of such study to be reported to the Congress not later than three years after enactment of this Act. Requires the Secretary to biennially prepare a report containing recommendations for the prevention of traumatic brain injuries, including identifying States that have mandated helmet laws for bicyclists and others. Requires such report to be disseminated to State health officers. Makes the Director responsible for gathering data concerning the number of individuals surviving traumatic brain injury and regarding the cost of such injuries. Requires the Director to establish a uniform reporting system under which hospitals and State and local health-related agencies will report on matters including: (1) the occurrence of traumatic brain injuries; (2) the amount of traumatic brain injury research, training, and services; (3) the identification of States and localities that have approved mandated helmet use laws; and (4) the health insurance status of individuals with such injuries. Requires the reporting system to permit the Director to make an accurate assessment of resource needs, provide a basis for the allocation of resources, and track survivors of traumatic brain injury from the provision of initial health care through long-term rehabilitation. Directs the Director to determine which Federal, State, local or other entities collect data on traumatic brain injury and the means by which such entities collect the data. Authorizes the Director to enter into cooperative agreements with other agencies, and to provide assistance to other entities with responsibility for data collection, to establish traumatic brain injury as a specific reportable condition in existing and future reporting systems. Authorizes the Secretary to award grants to State and local entities, and to public or non-profit private entities, to support: (1) special prevention and public awareness initiative projects; (2) model traumatic brain injury prevention, research and support programs; (3) projects that study the service needs of individuals with traumatic brain injury; and (4) projects involving grants for service coordination. Authorizes the Secretary to provide assistance to public and private nonprofit entities to reduce the incidence of traumatic brain injury through the establishment and effectuation of prevention projects. Sets forth eligibility requirements. Authorizes the Secretary, acting through the Director of the National Institutes of Health, to provide assistance to public and private nonprofit entities to support the conduct of basic and applied research concerning traumatic brain injury, especially with respect to the biomechanics of brain injury, the molecular and cellular characteristics of primary and secondary injury to the brain and the development of improved experimental brain injury models. Specifies the research to be conducted. Directs the Secretary to award grants to States for the establishment of Statewide protection and advocacy demonstration projects for individuals affected by traumatic brain injury. Sets forth eligibility requirements. Requires each State that receives assistance under this Act to establish a consumer-controlled advisory board within the Department of Health or Human Services of the State or within another department as designated by the chief executive officer of the State. Directs an advisory board to coordinate communications with and between Federal, State and local agencies, citizen's groups, private industry and labor and nonprofit organizations and to encourage citizen participation through public hearings and other types of community outreach programs. Requires each State to establish a services coordination program to identify the services required to prevent the institutionalization or to minimize the need for residential rehabilitation in the case of traumatic brain injuries. Sets forth the requirements for such program. Authorizes appropriations to carry out provisions of this Act for FY 1993 through 1995. Designates October 1992 as National Head Injury Month.
Bill· SS. 2950 (102nd)referred
United States · United States Congress · 2 July 1992
Amends title XIX (Medicaid) of the Social Security Act to repeal best price provisions and increase the discount used in determining rebates for prescription drugs purchased under Medicaid. Restores prescription drug discounts to various Federal programs.
Bill· HRH.R. 5556 (102nd)referred
United States · United States Congress · 2 July 1992
Patented Medicine Prices Review Board Act of 1992 - Establishes in the Food and Drug Administration the Patented Medicine Prices Review Board. Directs the Board to require each patentee of a prescription drug to provide information annually on: (1) the type of prescription drug sold by the patentee; (2) the price at which the drug is being sold in the United States; and (3) the costs of producing and marketing the drug in the United States. Requires the Board to decrease the length of a patent term for a prescription drug if the patentee of such drug charges an excessive price for its use. Allows the Board to increase the patent term for a prescription if the patentee has not charged an excessive price for such drug during a five-year period and provides assurances that it will not charge an excessive price during the extension of the term. Requires the Board to report annually to each Federal agency that dispenses or makes payments for the dispensing of prescription drugs on: (1) a list of prescription drugs sold at excessive prices; (2) recommendations against dispensing or making payments for such drugs; and (3) recommendations to substitute the drug with a similar prescription drug which is not sold at an excessive price. Requires the Board to report annually to the Congress describing its activities.
Bill· HRH.R. 5553 (102nd)referred
United States · United States Congress · 2 July 1992
Makes additional appropriations to the Secretary of Health and Human Services for peer review activities and activities to reduce waste and fraud under the Medicare program under title XVIII of the Social Security Act.
Bill· HRH.R. 5540 (102nd)reported
United States · United States Congress · 2 July 1992
Waives the period for congressional review for the following District of Columbia Acts and makes them effective upon the enactment of this Act: (1) National Public Radio Revenue Bond Act of 1992; (2) Howard University Revenue Bond Act of 1992; (3) National Learning Center Revenue Bond Act of 1992; (4) Children's Hospital Bond Act of 1992; (5) Medlantic Healthcare Group, Inc., Revenue Bond Act of 1992; (6) Catholic University of America Revenue Bond Act of 1992; and (7) Temporary Panel of the Office of Employee Appeals Temporary Extension Act of 1992.
Bill· HRH.R. 5558 (102nd)referred
United States · United States Congress · 2 July 1992
Amends title XVIII (Medicare) of the Social Security Act to prohibit reductions in payments to certain geographically reclassified hospitals for the operating costs of inpatient hospital services. Provides for application of a separate wage index with respect to certain hospitals in an urban area from which other hospitals have been reclassified. Makes changes with respect to criteria for geographic reclassification. Provides for the exclusion of certain payments in determining the eligibility of rural hospitals for urban reclassification. Amends the Omnibus Budget Reconciliation Act of 1989 to permit certain hospitals to be treated as regional referral centers under the Medicare program.
Bill· SS. 2937 (102nd)referred
United States · United States Congress · 1 July 1992
Information Infrastructure and Technology Act of 1992 - Amends the National Science and Technology Policy, Organization, and Priorities Act of 1976 to require the Director of the Office of Science and Technology Policy, through the Federal Coordinating Council for Science, Engineering, and Technology, to establish an Information Infrastructure Program and five-year implementation plan that shall provide a coordinated interagency effort to develop technologies needed to apply high-performance computing and high-speed networking in education, libraries, health care, manufacturing, and other appropriate fields. Requires the plan to take into consideration the activities of the Library of Congress. Directs the establishment of an advisory committee, consisting of qualified industry and academia representatives, on high-performance computing and high-speed networking communications to independently assess plan progress. Requires Federal agency plan participants to report annually on high-performance computing activities. Directs the National Science Foundation and other appropriate agencies to provide for the development of advanced technologies for use in education, including pilot projects connecting primary and secondary schools to the Internet and the National Research and Education Network. Directs the National Institute of Standards and Technology to establish an Advanced Manufacturing Systems and Networking Project to create a collaborative multiyear technology development program. Directs the National Institutes of Health to develop technologies for applications in the health care sector, including application of testbed networks linking medical facilities and schools for the sharing of medical data and imagery. Calls for the development of technologies for digital libraries of electronic information, including the development of advanced data storage systems. Directs the National Science Foundation, working with the supercomputer centers it supports, to develop prototype digital libraries of scientific data, and the National Aeronautics and Space Administration to develop databases of software and remote-sensing images. Authorizes appropriations.
Bill· SS. 2935 (102nd)referred
United States · United States Congress · 1 July 1992
Birth Defects Prevention Act of 1992 - Amends the Public Health Service Act to establish birth defects prevention and research programs. Authorizes the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control (CDC), to award grants to, enter into cooperative agreements with, or provide direct technical assistance in lieu of cash to, States, State health authorities, or health agencies of political subdivisions of a State for collection, analysis, and reporting of birth defects statistics from birth certificates, infant death certificates, hospital records, or other sources and to collect and disaggregate such statistics by gender and racial and ethnic group. Directs the Secretary to establish at least five regional birth defects monitoring and research programs to collect and analyze information on the number, incidence, correlation, and causes of birth defects, to include information regarding gender and different racial and ethnic groups, including Hispanics, non-Hispanic whites, African Americans, Native Americans, and Asian Americans. Authorizes the Secretary, acting through the Director of CDC, to award grants or enter into cooperative agreements with specified entities to serve as Centers of Excellence for Birth Defects Prevention Research. Requires one of the Centers to focus on birth defects among ethnic minorities. Requires the CDC to establish a clearinghouse for the collection and storage of data and generated from birth defects monitoring programs developed under this Act. Directs the Secretary, acting through the Director of the CDC, to award grants to or enter into cooperative agreements with State departments of health, universities, or other private, or nonprofit entities to develop, evaluate, and implement prevention strategies designed to reduce the incidence and effects or birth defects. Directs the Secretary to establish an Advisory Committee for Birth Defects Prevention to provide advice and recommendations on prevention and amelioration of birth defects to the Secretary and the Director of the CDC. Requires the Secretary to report biennially to the House Committee on Energy and Commerce and the Senate Committee on Labor and Human Resources regarding the incidence of birth defects, the contribution of birth defects to infant mortality, the outcome of implementation of prevention strategies, and identified needs for research and policy development to include information regarding the various racial and ethnic groups, including Hispanic, non-Hispanic whites, African Americans, Native Americans, and Asian Americans. Authorizes appropriations.
Bill· HRH.R. 5531 (102nd)referred
United States · United States Congress · 1 July 1992
Birth Defects Prevention Act of 1992 - Amends the Public Health Service Act to establish birth defects prevention and research programs. Authorizes the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control (CDC), to award grants to, enter into cooperative agreements with, or provide direct technical assistance in lieu of cash to, States, State health authorities, or health agencies of political subdivisions of a State for collection, analysis, and reporting of birth defects statistics from birth certificates, infant death certificates, hospital records, or other sources and to collect and disaggregate such statistics by gender and racial and ethnic group. Directs the Secretary to establish at least five regional birth defects monitoring and research programs to collect and analyze information on the number, incidence, correlation, and causes of birth defects, to include information regarding gender and different racial and ethnic groups, including Hispanics, non-Hispanic whites, African Americans, Native Americans, and Asian Americans. Authorizes the Secretary, acting through the Director of the CDC, to award grants or enter into cooperative agreements with specified entities to serve as Centers of Excellence for Birth Defects Prevention Research. Requires one of the Centers to focus on birth defects among ethnic minorities. Requires the CDC to establish a clearinghouse for the collection and storage of data and generated from birth defects monitoring programs developed under this Act. Directs the Secretary, acting through the Director of the CDC, to award grants to or enter into cooperative agreements with State departments of health, universities, or other private, or nonprofit entities to develop, evaluate, and implement prevention strategies designed to reduce the incidence and effects or (sic) birth defects. Directs the Secretary to establish an Advisory Committee for Birth Defects Prevention to provide advice and recommendations on prevention and amelioration of birth defects to the Secretary and the Director of the CDC. Requires the Secretary to report biennially to the House Committee on Energy and Commerce and the Senate Committee on Labor and Human Resources regarding the incidence of birth defects, the contribution of birth defects to infant mortality, the outcome of implementation of prevention strategies, and identified needs for research and policy development to include information regarding the various racial and ethnic groups, including Hispanic, non-Hispanic whites, African Americans, Native Americans, and Asian Americans. Authorizes appropriations.
Bill· HRH.R. 5532 (102nd)referred
United States · United States Congress · 1 July 1992
Authorizes appropriations to the Centers for Disease Control for epidemiological activities in Texas regarding the elevated rate of anencephaly (a birth defect) and for educating health care providers and the public regarding anencephaly.
Bill· SS. 2913 (102nd)referred
United States · United States Congress · 30 June 1992
Public Health and Safety Act of 1992 - Amends the Federal criminal code to prohibit the manufacture, import, export, sale, purchase, transfer, receipt, ownership, possession, transport, or use (manufacture) of a handgun or handgun ammunition. Makes exceptions with respect to: (1) the Army, Navy, Air Force, Marine Corps, Coast Guard, and National Guard; (2) Federal, State, or local government agencies charged with law enforcement duties that require officers to possess handguns; (3) registered security guard services; and (4) licensed handgun clubs and members of such clubs. Authorizes the Secretary of the Treasury to approve such manufacture by licensed manufacturers, importers, and dealers as necessary to meet the lawful requirements of such persons and entities covered by the exceptions. Specifies handgun club licensing requirements. Requires: (1) the Secretary to revoke the license of any such club that does not continue to meet such requirements; and (2) such club to pay to the Secretary an annual license fee of $25. Specifies security guard service registration requirements. Requires: (1) the Secretary to revoke such registration if the service does not continue to meet such requirements; and (2) such service to pay to the Secretary an annual registration fee of $50. Sets forth provisions with respect to: (1) recordkeeping (by licensed manufacturers, importers, dealers, handgun clubs or their members and by registered security guard services that transfer handguns or handgun ammunition); (2) reports of loss or theft; and (3) transfers to handgun clubs. Authorizes the voluntary delivery to any designated Federal, State, or local law enforcement agency of a handgun owned or possessed by a person. Directs the Secretary to: (1) arrange with each such agency to receive handguns for the transfer, destruction, or other disposition of such handguns; and (2) pay to such person $25 or the fair market value of the gun on May 31, 1992. Authorizes appropriations. Sets penalties for violations of this Act. Specifies that a person who voluntarily delivers a handgun under this Act after 180 days after enactment shall not be subject to criminal posecution for possession of the handgun under any Federal, State, or local law, but shall pay to the Secretary a civil penalty in an amount determined by the Secretary, not to exceed $500. Establishes penalties for: (1) failure to report the loss or theft of a handgun; (2) negligent and intentional deliveries to an unauthorized place; (3) false statements or representations; and (4) failure to keep, or permit inspection of, records. Provides for the forfeiture of any handgun or handgun ammunition involved or used in a violation of this Act or of any other criminal law of the United States.
Bill· SS. 2914 (102nd)referred
United States · United States Congress · 30 June 1992
Amends title XVIII (Medicare) of the Social Security Act to repeal the prohibition against separate billing for electrocardiogram interpretations. Directs the Secretary of Health and Human Services to make separate payment under the Medicare fee schedule for any such interpretations performed or ordered to be performed as part of or in conjunction with a visit to or a consultation with a physician. Provides for adjustment of medical visit and consultation relative values so as not to include relative value units for electrocardiogram interpretation in the relative value for medical visits and consultations. Sets forth guidelines for the adjustment of Medicare fee schedule amounts to reflect the separate payment for electrocardiogram interpretations.
Bill· HRH.R. 5514 (102nd)referred
United States · United States Congress · 30 June 1992
Health Choice Act of 1992 - Title I: Eligibility and Choice of Plan - Entitles each individual to benefits if they are: (1) a U.S. resident and either a citizen, national, or lawful resident alien; and (2) neither a beneficiary under title XVIII (Medicare) of the Social Security Act nor an active armed forces member. Phases in benefits over six years, phase one for prenatal and delivery services and services for children under six, phase two for individuals under 22 and individuals between 60 and 65, and phase three for all eligible individuals. Requires: (1) residents of a State to choose benefits under any arrangement provided by their State's plan; and (2) nonresidents to choose either an employment-based, managed care, or fee-for-service plan. Allows collective bargaining agreements to specify the plan in which the individual must enroll. Mandates distribution of materials and a toll-free telephone number regarding plan choice. Title II: Benefits - Subtitle A: Services - Includes in "basic health services:" (1) clinical preventive services; (2) physicians' services, rural health clinic services, and Federally qualified health center services; (3) hospital services; (4) post-hospital skilled nursing facility services; (5) part-time or intermittent home health services; (6) hospice care; (7) covered outpatient drugs; and (8) other medical and health services as defined by the National Health Board established by this Act. Considers services reasonable and necessary only if they would be so considered under Medicare and requires review of any national coverage determination to be made as under Medicare. Applies certain Medicare exclusions to this title. Subtitle B: Cost-Sharing - Part 1: General Requirements - Mandates certain deductibles for general services, inpatient services, and prescription drugs. Allows a Health Choice plan to require copayments and limited coinsurance. Prohibits deductibles or coinsurance for clinical preventive services. Mandates cost-sharing rules for capitated plans and special payment methodologies. Allows certain cost-sharing for restricted provider managed care plans. Prohibits premiums for basic health services. Part 2: Reduction in Cost-Sharing for Low-Income Individuals - Reduces deductibles for certain low income individuals. Provides for advance and retroactive cost-sharing assistance and for help in completing assistance applications. Mandates reconciliation of advance assistance with actual income. Considers an individual or family that has been determined eligible for aid under specified provisions of parts A (Aid to Families with Dependent Children) and E (Foster Care and Adoption Assistance) of title IV or Supplemental Security Income benefits of the Social Security Act to have an adjusted total income below the poverty line. Title III: Requirements for Health Choice Plans - Subtitle A: Qualified State Health Insurance Plans - Requires each qualified State health insurance plan to enroll each eligible State resident, except for an individual enrolled in a qualified multi-state employment-based health plan. Mandates health care fraud and abuse measures. Subtitle B: Qualified Employment-Based Health Plans - Requires that a qualified employment-based health plan (EBHP) specify its eligibility basis. Allows the plan to group individuals into classifications based on factors determined by the Board. Prohibits enrollment denial within a classification or on the basis of health status or use of health services. Declares that an EBHP is a multi-state plan if the percentage of individuals from one State does not exceed a level set by the Board. Subtitle C: Qualified Managed Care Plans - Specifies certain requirements for a restricted provider managed care plan, including a prohibition of expulsion on the basis of health status or use of health services, continuation of coverage if the plan terminates, and coverage of out-of-plan services. Subtitle D: Fee-for-Service Choice Plan - Requires the Board to operate a fee-for-service choice plan (Choice Plan) providing basic health services through any willing provider. Makes Medicare beneficiaries, notwithstanding other provisions of this Act, eligible for clinical preventive services under a Choice Plan. Applies certain provisions of the Social Security Act relating to: (1) withholding of payments for certain Medicaid providers to this subtitle; and (2) physician referrals to referrals for clinical laboratory services under the Choice Plan. Requires the determination of the amount, scope, and duration of Choice Plan benefits to be made by the Board. Subtitle E: Plan Requirements and Related Provisions - Part 1: Requirements Applicable to Health Choice Plans Generally - Requires each Health Choice plan to provide for at least all basic health services. Prohibits pre-existing condition exclusions. Requires that enrollment of an individual in a Health Choice include enrollment of that individual's family members. Provides for coordination and portability of coverage under qualified plans. Prohibits a Health Choice plan from paying for basic health services unless the provider is qualified to have payment made. Provides for the qualification of hospitals, physicians, other providers and suppliers, and Indian health service facilities, applying certain Medicare provisions. Requires risk management programs. Allows fee-for-service and capitated plans to restrict coverage through utilization review programs meeting standards set by the Board. Prohibits a Health Choice plan from operating a physician incentive plan (providing compensation or other financial arrangements that may reduce services) unless certain Medicare requirements are met. Protects individuals from liability to providers if a plan fails to make payments for basic health services. Requires each plan to coordinate benefits with low-income assistance under title II of this Act. Mandates quality assurance mechanisms, measures to control fraud and abuse, transmission of information regarding outcomes and expenditures, and the use of unique provider and individual identifiers and uniform plan cards. Applies certain Medicare provisions (relating to offset of payments to individuals to collect past-due obligations from a breach of scholarship and loan contracts) to this title. Requires, after complete phase-in of benefits, fee-for-service claims to be submitted electronically. Requires each plan to maintain written policies and procedures regarding advance directives, as defined in specified Medicare provisions. Part 2: Requirements and Other Applicable Provisions for Capitated Plans - Provides for the approval of State, employment-based, and managed care plans. Sets forth minimum enrollment levels for employment-related and managed care plans. Prohibits a capitated plan that has enrolled an individual from denying enrollment to the individual's family. Allows geographic limitations for State and managed care plans. Provides for the setting and calculation of payment amounts for capitated plans. Requires each capitated plan: (1) except for employment-based plans, to make certain disclosures, including regarding comparing benefits and cost-sharing to fee-for-service plans, describing pre-existing condition limitations, describing provider limits, and disclosing the availability of low-income assistance; (2) to provide grievance and appeals procedures; and (3) to establish insolvency protection. Provides for enforcement of capitated plan requirements through civil monetary penalties, suspension of enrollment, termination of approval, and intermediate sanctions. Requires capitated plans to disclose certain information to the Board. Part 3: Preemption of State Laws - Prohibits State laws and regulations: (1) requiring the offering, as part of a managed care plan or an employment-based plan, of any services; (2) specifying the individuals to be covered under such a plan or the duration of coverage; or (3) requiring a right of conversion from such a plan to an individual plan. Prohibits a State from prohibiting or regulating: (1) a managed care plan meeting the requirements of subtitle C from taking specified actions; or (2) utilization review programs meeting the requirements of specified provisions of this Act. Title IV: Cost Containment - Subtitle A: Basic Health Services - Part 1: Establishment of National Limits on Health Care Spending - Requires the Board to: (1) annually monitor nonmedicare and medicare expenditures and, if expenditures exceed allocations, reduce allocations for specified expenditures in the second succeeding year; (2) determine, according to a specified formula, overall nonmedicare and Medicare spending amounts; and (3) apportion nonmedicare spending among the States according to the number of eligible residents, adjusted to reflect certain risk factors, cost differences outside the control of providers, and other considerations the Board deems appropriate. Requires: (1) the Board to publish, for nonmedicare and Medicare spending, allocations among the classes of services; (2) the nonmedicare allocations to be reduced to account for individuals in capitated plans; and (3) a reduction in the allocation to that class for the second succeeding year after expenditures exceed the allocation. Allows the Congress, by enacting a law by a specified date in any year, to change the amounts, apportionments, allocations, or reductions set by the Board. Prohibits administrative or judicial review of: (1) the spending, apportionments, or allocations; (2) exceptions under specified provisions; or (3) payment amounts negotiated, payment methodologies used, or payment amounts established under parts 2 or 3. Part 2: Development of Negotiated Payment Amounts for Basic Health Services Under Fee-for-Service Choice Plan and the Medicare Program - Provides for negotiation of payment amounts, including Board approval of recommended negotiated amounts. Part 3: Establishment of Payment Amounts If Negotiated Amounts Not Approved - Provides, if there are no (or unsuccessful) negotiations, for establishment by the Board of the amounts. Specifies the basis for nonmedicare payment amounts. Part 4: Application of Payment Amounts - Makes the negotiated amounts (or the amounts established by the Board) in a State the payment amounts for the State under the fee-for-service plan. Makes the negotiated amounts, if approved by the Board, the basis for Medicare payments. Reduces Medicare payments, if the negotiated amounts are not approved by the Board, by a uniform factor as necessary to keep expenditures from exceeding allocations. Subtitle B: Promotion of Primary Care Services through Changes in Graduate Medical Education - Requires the Board to establish incentives for training needed personnel. Authorizes: (1) payment of additional amounts to particularly successful training programs; and (2) elimination or reduction of payments to hospitals and medical residency programs not meeting needs. Subtitle C: Administrative Savings - Mandates: (1) uniform claims forms; and (2) standards for electronic billing. Title V: Control Over Fraud and Abuse - Amends title XI (General Provisions and Professional Standards Review) of the Social Security Act to add references to Health Choice plans to specified provisions: (1) mandating or permitting exclusion of certain individuals from participation in Medicare; (2) mandating civil monetary penalties; and (3) mandating criminal penalties. Directs the Secretary of Health and Human Services, through the Inspector General, to establish a national data base containing information n health care fraud and abuse, including the identify of providers subjected to certain actions. Requires: (1) each Health Choice plan to report to and query the data base; and (2) coordination with a specified malpractice data base. Provides for confidentiality. Requires each State to maintain a health care fraud and abuse control unit. Allows a unit described in title XIX (Medicaid) of the Social Security Act to meet this requirement. Provides for the structure, functions, and resources of the unit. Requires cooperative agreements between the unit and similar units in other States, the Inspector General, and the U.S. Attorney General. Mandates the assignment and use of unique provider identifiers and unique patient identifiers. Title VI: Administration of Health Choice Program; Health Choice Trust Fund; Quality Assessment - Subtitle A: Administration - Establishes: (1) as an independent agency in the Government, the National Health Board; and (2) the National Advisory Council on Health Policy. Authorizes appropriations from the Health Choice Trust Fund for the Board and the Council. Subtitle B: Health Choice Trust Fund - Creates in the Treasury the Health Choice Trust Fund (Fund), consisting of: (1) taxes resulting from the value added tax and the health excise tax on employers imposed by this title; and (2) State contributions under this title. Requires the Fund to be managed by the Board. Authorizes the issuance of public debt obligations for purchase by the Fund. Excludes Board receipts and disbursements from U.S. budget totals. Provides for the treatment of the Board with regard to the Balanced Budget and Emergency Deficit Control Act of 1985. Transfers from the Fund to the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund (Trust Funds) amounts equal to the benefits and administrative costs payable from such Trust Funds as a result of specified provisions of this Act. Provides for the treatment of amounts owed to the Board or the Fund in bankruptcy and reorganization proceedings. Mandates transfers from the Fund to the Agency for Health Care Policy and Research to carry out provisions of the Public Health Service Act relating to that Agency. Requires that expenditures be made from the Fund for grants under title X of this Act relating to: (1) primary care centers and public health clinics serving medically underserved populations; and (2) specialized screening, diagnostic, and treatment services for children. Mandates expenditures from the Fund for demonstration projects under part 2 of subtitle D (relating to medical malpractice). Requires a set-asides of Fund expenditures to: (1) assure adequate support in the administration of the fee-for-service choice plan; and (2) expand the Inspector General's capacity to carry out title V (Control Over Fraud and Abuse). Subtitle C: Miscellaneous - Requires the Board to assess service quality under Health Choice plans, monitor the health status of individuals in the United States, and compile information regarding the appropriateness and quality of services under such plans to provide for a more informed choice in the selection among the plans. Amends provisions of the Social Security Act relating to outcomes research to require that the needs and priorities of the Health Choice program are reflected in the development and updating of treatment- or condition-specific practice guidelines in specified forms. Authorizes demonstration projects to improve service delivery and quality and to increase payment efficiency and effectiveness. Requires project funding to come from the Fund. Mandates reports on: (1) the impact of this Act in meeting goals in "Healthy People, 2000;" (2) consolidating Medicare and other Federal health benefit programs with the Health Choice program; and (3) the impact of this Act on facilities recognized as centers of medical excellence. Subtitle D: Resolution of Medical Malpractice Claims Relating to Health Choice Program - Part 1: Resolution of Claims - Applies this subtitle to any medical malpractice claim in any Federal or State court relating to Health Choice plan services except for a vaccine-related injury or death or to the extent that title XXI (Vaccines) of the Public Health Service Act applies. Preempts differing State laws. Mandates the development of practice guidelines for basic health services and requires that any such guideline serve as the standard of care for the resolution of medical malpractice claims. Requires regulations establishing: (1) factors commonly considered in calculating malpractice economic damages; and (2) a methodology for standardizing the costs or value associated with the factors. Makes the list and methodology admissible. Requires annual compilation of information on damage awards and categorization so as to assist triers of fact in calculating damages. Provides, when a damage award is over a specified amount, for periodic damage payments, imposes a limit on any single payment, and prohibits certain payments after the plaintiff's death. Reduces damages by the amount of collateral source payments, except for payments under title III or Medicare. Mandates development of a methodology for assisting parties in quantifying the dollar value of non-economic harm. Requires: (1) 50 percent of any punitive damages to be awarded to the State for activities to prevent medical injuries or to the State health professional licensing agency; and (2) a reduction in punitive damages by the amount of any plaintiff's attorney's fees owed. Limits the application of these requirements in States limiting malpractice award amounts. Limits attorney's fees. Part 2: Demonstration Projects, Studies, Etc. - Mandates grants for four-year demonstration projects for model administrative systems for the final resolution of all medical malpractice claims through a non-judicial process. Sets forth system requirements. Waives conflicting State laws. Requires designation of a list of medical procedures as generally preventable medical outcomes designated to be compensable in advance of the initiation of a medical malpractice claim (accelerated compensation events). Mandates research relating to the prevention of medical injuries. Requires each State to use all fees paid to the State for licensing, certification, or accreditation of health practitioners to conduct disciplinary and educational activities. Mandates a study on the impact of part 1 on specified matters. Requires an annual report on medical malpractice premiums, including geographic differences. Title VII: Medicare Benefit Improvement - Amends Medicare provisions to remove the limit on the number of inpatient hospital days covered. Revises requirements regarding inpatient hospital deductibles and eliminates references to inpatient hospital coinsurance. Modifies inpatient psychiatric hospital coverage and payments for emergency hospital services. Defines "covered outpatient drug" and specifies exclusions. Provides for determination of the payment amount for such drugs according to specified formulas. Declares that the deductible shall be the deductible under specified provisions of title II of this Act. Sets the coinsurance percentage, certain payment limits, and administrative allowances. Mandates a program to identify (and educate physicians and pharmacists concerning): (1) inappropriate prescribing and dispensing practices; (2) substandard care with respect to such drugs; and (3) potential adverse reactions. Requires related standards. Provides for the treatment of certain prepaid organizations with regard to prescription drugs, including with regard to drug buy-out plans. Requires development and annual updating and dissemination of an information guide for physicians comparing average wholesale prices of at least 500 of the most commonly prescribed covered outpatient drugs. Provides for participation agreements between pharmacies and the Secretary with specified minimum contents. Directs the Secretary to: (1) provide such electronic equipment and technical assistance as necessary for electronic claims submission by pharmacies; and (2) a point-of-sale electronic system for use by carriers and participating pharmacies in the submission of information on covered drugs dispensed to Medicare beneficiaries. Allows payment for such drugs to be made on the basis of an assignment only to a participating pharmacy. Imposes civil monetary penalties for violation of a participation agreement, excessive charges, or failure to provide certain information. Provides for limits on the length of time covered by a prescription. Amends provisions relating to the use of carriers for administration of benefits to set forth requirements applicable to carriers that make determinations or payments regarding covered outpatient drugs. Allows payment for the operation of the electronic claims system. Mandates interest on late payments by the system. Sets forth special rules for health maintenance organizations and competitive medical plans. Regulates the amount a provider may charge. Requires the Director of the Congressional Office of Technology Assessment to provide for the appointment of a Prescription Drug Payment Review Commission. Requires the Commission to report annually to the Congress on methods of determining payment for covered outpatient drugs under Medicare part B. Authorizes appropriations, payable from the Federal Supplementary Medical Insurance Trust Fund. Mandates studies on: (1) including experimental drugs and biological products as Medicare covered outpatient drugs; (2) use of mail pharmacies to reduce costs to Medicare and Medicare beneficiaries; (3) improving utilization review of covered outpatient drugs; (4) the use, studied on a longitudinal basis, of outpatient prescription drugs by Medicare beneficiaries regarding medical necessity, adverse interactions, cost, and patient stockpiling or wastage; (5) average wholesale prices as compared to actual pharmacy acquisition costs; (6) retail pharmacy overhead costs; and (7) discounts by pharmacies to other third-party insurers. Mandates a standard Medicare claims form. Adds tetanus-diphtheria boosters and their administration to the Medicare definition of "medical and other health services." Allows screening mammographies for women over 64 years old 11 (currently, 23) months after a previous screening. Modifies requirements regarding the frequency of screening pap smears. Eliminates certain Medicare cost-sharing requirements after out-of-pocket cost-sharing equals an amount specified under title II of this Act. Imposes other cost-sharing limits. Provides for the inpatient hospital deductible when phase two of this Act becomes effective. Removes provisions relating to: (1) the amount of premiums for individuals enrolled under Medicare part B (Supplementary Medical Insurance); and (2) payment of such premiums. Modifies requirements regarding: (1) the determination of the amount of monthly premiums for certain individuals; and (2) appropriations to cover Government contributions to the Federal Supplementary Medical Insurance Trust Fund and the associated contingency reserve. Amends title II (Old Age, Survivors, and Disability Insurance (OASDI)) provisions of the Social Security Act relating to entitlement to hospital insurance benefits to entitle every individual over age 64 to hospital insurance benefits under Medicare part A (Hospital Insurance). (Current law imposes certain conditions on such entitlement.) Removes provisions relating to the determination of certain monthly Medicare premiums to be paid by the State. Removes provisions allowing payment on the basis of an itemized bill. (Current law allows payment on the basis of an itemized bill or on the basis of an assignment.) Revises requirements regarding refunds of amounts billed on an unassigned basis. Subjects Medicare expenditures to reductions to assure that they do not exceed the allocation for the class of services involved under this Act. Allows a group health plan that is a qualified employment-based health plan under title III of this Act to take into account that an individual is eligible for Medicare benefits if the individual is: (1) a working aged individual, a disabled active individual in a large group health plan, or an individual with end stage renal disease; and (2) not an eligible individual under this Act. Appropriates to the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund from the Health Choice Trust Fund amounts equal to the benefits and administrative expenses that result from the amendments made by subtitle A of title VIII of this Act. Title VIII: Medicaid - Amends Medicaid provisions to prohibit payments to States (and declare that a State is not required to make payments) for basic health services for which payment is made under Medicare or this Act. Title IX: Financing - Subtitle A: Value Added Tax - Amends the Internal Revenue Code to impose a tax on each taxable transaction, defined as being, in connection with a business, the sale of property in the United States, the performance of services in the United States, and the importing of property into the United States. Includes in the imposition of the tax any sale or leasing of real property and any importing of property, whether or not in connection with a business. Declares that the taxable amount is the price charged for the property or service or, in the case of exchanges, the fair market value. Sets a zero tax rate for: (1) food, housing (as a primary residence), and medical care, applying the zero rating to all transactions after such items become clearly identifiable as items to which the zero rating will apply; (2) sales to governmental entities; and (3) the providing by a governmental entity of property and services in connection with education. Taxes sales by a governmental entity only if there is a separate charge or fee. Sets a zero rate for transactions engaged in by certain charitable (section 501(c)(3)) organizations unless the organization imposes a charge or fee for the service. Allows a tax credit for the aggregate tax which has been paid by sellers to the taxpayer of property and services which the taxpayer uses in the business to which the transaction relates. Provides for the treatment of excess credit as an overpayment of tax. Makes the seller liable for the tax. Requires the seller to give the purchaser a tax invoice. Allows a person whose aggregate taxable transactions (except for transactions involving real property or importing) are under $20,000 to elect to be treated as a nontaxable person. Allows a tax credit for low income individuals. Subtitle B: Employer Contribution - Imposes an excise tax on every employer on a percentage of wages paid, specifying a higher percentage for those employers contributing to any employee medical care plan. Imposes a tax on self-employment income. Imposes similar taxes through provisions relating to railroads. Subtitle C: State Medicaid Contribution - Requires each State, as a requirement for receiving its Federal Medicaid payment, to pay to the Health Choice Trust Fund any excess of Medicaid payment to the State that would have been made (if this Act had not been in effect) for basic health services under subtitle A of title II of this Act over the Medicaid payment actually made for such service. Title X: Expansion of Primary Care and Public Health Delivery Capacity in Meeting Health Objectives - Amends the Public Health Service Act to authorize appropriations for programs relating to: (1) vaccinations; (2) the prevention and control of tuberculosis, lead poisoning, or sexually transmitted diseases; (3) migrant and community health centers; (4) health services for the homeless and for residents of public housing; (5) family planning; and (6) early intervention services for individuals with HIV disease. Mandates grants (from Health Choice Trust Funds set aside under title VI of this Act) to plan and develop primary care centers and public health clinics for medically underserved populations, allowing grant funds to be used as under provisions of the Public Health Service Act relating to community health centers. Defines a primary care center to mean a migrant or community health center or an entity qualified to receive a grant under provisions relating to health services for the homeless, health services for residents of public housing, family planning services, or early intervention services for individuals with HIV disease. Defines a public health clinic to mean an entity qualified to receive a grant under provisions relating to vaccinations or the prevention and control of tuberculosis, lead poisoning, or sexually transmitted diseases. Mandates grants (from Health Choice Trust Funds set aside under title VI of this Act) for specialized screening, diagnostic, and treatment services to children under 22 years old. Title XI: Reform of Health Insurance Market - Declares that Medicare provisions relating to the revision of National Association of Insurance Commissioners standards regarding Medicare supplemental policies apply in the case of the changes in Medicare benefits made by title VIII. Requires the Board to promulgate standards relating to health insurance policies offered to supplement the Health Choice program. Prohibits the sale or issue of any nonconforming policy, prescribing civil monetary penalties. Repeals specified provisions of the Internal Revenue Code, the Employee Retirement Income Security Act of 1974, and the Public Health Service Act relating to continuation coverage.
Resolution· HCONRESH.Con.Res. 340 (102nd)referred
United States · United States Congress · 30 June 1992
Declares that the Congress: (1) recognizes the accomplishments of the National Eye Institute; (2) commends the Institute on its 25th anniversary; and (3) supports taxpayer education concerning the returns yielded by their investments in vision research.
Resolution· HCONRESH.Con.Res. 341 (102nd)referred
United States · United States Congress · 30 June 1992
Expresses the sense of the Congress that the Federal Government should: (1) reduce by 60 percent, within two years, expenditures for foreign assistance; (2) enforce U.S. trade laws to restore employment and open foreign markets; (3) intitiate incentives to restore U.S. international competitiveness; (4) reduce Department of Defense spending and redirect the defense industrial structure to domestic needs; (5) rebuild U.S. infrastructure and develop new forms of transportation; (6) require host nations to assume the total costs of U.S. military presence; (7) recover uncollected taxes; (8) implement tax parity between domestic and foreign enterprises operating within the United States; (9) require full elimination of waste, fraud, abuse, and unnecessary spending in all branches of government within two years; (10) implement a program to protect U.S. natural resources from foreign exploitation by restricting ownership and limiting exportation; (11) establish a goal, by 2000, of providing comprehensive health care for all U.S. citizens; and (12) implement incentives for States to initiate training and work-fare programs for the unemployed and welfare recipients.
Bill· SS. 2908 (102nd)open
United States · United States Congress · 29 June 1992
Human Tissue Transplantation Act of 1992 - Amends the Public Health Service Act to provide for the regulation of tissue banks and human tissue for transplantation. Prohibits human tissue intended for transplantation from being procured, processed, or distributed unless: (1) it is processed and distributed by one or more tissue banks licensed by the Secretary of Health and Human Services; and (2) it is subject to voluntary professional standards (established under this Act). Exempts from such requirements transplants in the same patient and non-frozen transplants within 72 hours of procurement. Requires the Secretary to enter into a contract with a nonprofit entity that is not engaged in any significant activity unrelated to human tissue banking to establish and operate a National Council on Tissue Transplantation. Sets forth reporting requirements and routine duties of the Council. Requires the Council to develop and disseminate voluntary professional standards for: (1) the procurement of human tissue from donors to provide reasonable assurances that such tissue does not transmit disease; (2) the processing and distribution of human tissue banks; (3) a type or types of human tissue (including the basis for such standard); and (4) human heart valves. Requires the Secretary to promulgate regulations for the annual registration of every tissue bank and every entity (other than a tissue bank) that procures human tissue within a State. Requires the Secretary to promulgate regulations for the licensing of tissue banks that process or distribute human tissue that is intended for transplantation. Specifies the process for obtaining such a license. Sets forth the standards for accrediting a tissue bank for purposes of licensure. Grants authority to the Secretary to make inspections of tissue banks subject to licensure requirements at reasonable times and in a reasonable manner. Requires the Secretary to publish voluntary professional standards for a type or types of human tissue and provide opportunity for public comment. Sets forth enforcement provisions for violations of this Act. Provides for judicial review in accordance with the Federal Food, Drug, and Cosmetic Act. Provides that State laws may continue in effect to the extent that they are not inconsistent with this Act. Authorizes the Secretary, after consultation with the Council, to prescribe regulations requiring that providers of services under Medicare or Medicaid establish and maintain records of transplantation of tissue in a manner that facilitates the identification of transplant patients, donors, and the distributor of such tissue. Prohibits the Secretary from enforcing existing regulations that treat human heart valves as medical devices subject to premarket approval. Rescinds the determination by the Secretary that human heart valves must undergo premarket approval. Provides for the expedited determination of whether a public standard applicable to human heart valves should be established.
Law· HRH.R. 5504 (102nd)enacted
United States · United States Congress · 29 June 1992
Department of Defense Appropriations Act, 1993 - Title I: Military Personnel - Appropriates funds for FY 1993 for military and reserve personnel in the Army, Navy, Marine Corps, and Air Force and for National Guard personnel in the Army and Air Force. Title II: Operation and Maintenance - Appropriates funds for FY 1993 for the operation and maintenance of the Army, Navy (including a transfer of funds), Marine Corps, Air Force, the defense agencies, the respective reserve components, and the Army and Air National Guards. Appropriates funds for the Army's National Board for the Promotion of Rifle Practice, the Court of Military Appeals, environmental restoration (including a transfer of funds), humanitarian assistance, support and services for the World University Games, the 1996 Summer Olympics, the 1994 World Cup USA, and for real property maintenance, defense. Title III: Procurement - Appropriates funds for FY 1993 for the procurement by the Army of aircraft, missiles, weapons, tracked combat vehicles, and ammunition and for other procurement. Appropriates funds to the Navy for the procurement of aircraft, weapons, and shipbuilding and conversion (including a transfer of funds) and for other procurement. Appropriates funds for Marine Corps procurement. Appropriates funds for procurement by the Air Force of aircraft and missiles and for other procurement. Appropriates funds for: (1) National Guard and Reserve equipment; (2) procurement by the defense agencies; and (3) Defense Production Act purchases. Title IV: Research, Development, Test, and Evaluation - Appropriates funds for FY 1993 for research, development, test, and evaluation by the Army, Navy, Air Force, and defense agencies. Appropriates funds for the Deputy Director of Defense Research and Engineering (Test and Evaluation) and the Director, Operational Test and Evaluation. Title V: Revolving and Management Funds - Appropriates funds for the Defense Business Operations Fund. Title VI: Other Department of Defense Programs - Appropriates funds for: (1) medical and health care programs of the Department of Defense (DOD); (2) the destruction of lethal chemical agents and munitions; (3) drug interdiction and counter-drug activities, defense (including a transfer of funds); and (4) expenses and activities of the Office of the Inspector General in carrying out the Inspector General Act of 1978. Title VII: Related Agencies - Appropriates funds for: (1) the Central Intelligence Agency Retirement and Disability System Fund; and (2) the Edward R. Roybal Foundation (including a transfer of funds). Title VIII: Defense Reinvestment for Economic Growth - Earmarks funds appropriated in this Act for defense reinvestment programs as authorized by the National Defense Authorization Act for Fiscal Year 1993. Title IX: General Provisions - Prohibits the use of appropriations for unauthorized publicity or propaganda. Exempts during FY 1992 DOD personnel from provisions of law prohibiting the employment of non-U.S. citizens. Provides that no part of any appropriation contained in this Act may remain available for obligation beyond the current fiscal year, unless expressly so provided. Prohibits the obligation of more than 20 percent of the funds appropriated by this Act during the last two months of the fiscal year, except as specified. Prohibits the use of appropriations for the procurement of any food, clothing, specified cloth (including cotton, silk, and wool) or synthetic fabrics, or specified metals not grown, produced, or processed within the United States, with specified exceptions. Authorizes the Secretary of Defense, in the national interest and with the approval of the Office of Management and Budget (OMB), to transfer and merge specified working capital funds. Directs the Secretary to notify the Congress of all such transfers. Limits the cash balances which may be maintained in such funds. Authorizes the Secretary of the Air Force to use any available funds to implement cost-effective agreements for required heating facility modernization in the Kaiserslautern Military Community in the Federal Republic of Germany, under certain conditions. Prohibits the use of appropriated funds for: (1) the initiation of a special access program without prior notification to the Senate and House Appropriations (appropriations) and Armed Services (defense) Committees; (2) the preparation of a request to the appropriations committees for a reprogramming of funds, except as specified; (3) certain claims for physician or provider reimbursement for medical services provided under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) in excess of those allowed for FY 1992; (4) programs of the Central Intelligence Agency (CIA) beyond FY 1992, with a specified exception; (5) initiating a multiyear contract that employs economic order quantity procurement in excess of specified amounts, unless proper congressional notification is given; (6) any intelligence or special activity different from an activity previously justified to the Congress unless the Secretary has notified the appropriations committees of the intent to make such funds available; (7) converting certain military technician positions to positions to be held by persons in active Guard or Reserve status if such conversion would reduce the number of military technicians below a specified amount; or (8) including civilian military technicians in any administratively-imposed freeze on civilian positions. Requires governments of Indian tribes to be treated as State and local governments for purposes of the disposition of real property recommended for closure. Eliminates during FY 1993 the requirement that the Congress must authorize by law the end-strengths for civilian personnel in DOD. Prohibits setting any end-strength limitations for such personnel during FY 1993. Prohibits the use of appropriated funds for: (1) congressional lobbying; (2) the pay of certain nonmilitary Army Reserve technicians; and (3) floating storage of petroleum or petroleum products in non-U.S. vessels. Permits the appropriation of funds for humanitarian and civic assistance costs incident to authorized operations of the armed forces. Authorizes the Secretaries of the Army and the Air Force to retain in active status until age 60 certain officers who need such status in order to maintain employment as a National Guard or Reserve technician. Permits the use of operation and maintenance funds provided under this Act for studies and demonstration projects relating to the delivery of military health and medical care. Prohibits the use of funds appropriated by this Act to make contributions to the Department of Defense Education Benefits Fund for educational assistance for a member of the armed forces who enlists for less than three years or receives an enlistment bonus. Prohibits the use of funds appropriated by this Act for the basic pay and allowances of a member of the Army participating as a full-time student and receiving benefits through the Secretary of Veterans Affairs when time spent as a full-time student is credited toward completion of a service commitment. Limits the availability of appropriations to specified percentages of postsecondary educational costs for off-duty training of military personnel. Prohibits the use of appropriated funds for conversion to contractor performance of an activity or function of DOD that is currently performed by more than ten civilian DOD employees until a cost-analysis on such performance is completed and certified to the appropriations committees. Prohibits funds available to DOD from being used to award a competitive procurement contract for any round of 120mm mortar ammunition unless such round has successfully passed certain testing and has a validated technical data package to support its procurement. Prohibits the obligation of funds appropriated in this Act to the Army for the procurement of such mortars or ammunition if manufactured outside the United States. Prohibits the use of appropriated funds for the payment of salaries of any persons who authorize the transfer of unobligated or deobligated funds into the Reserve for Contingencies of the CIA. Requires funds appropriated under this Act for CIA construction projects to remain available until expended. Authorizes the Secretary of the Navy to use specified funds to charter ships for use as auxiliary minesweepers, under specified conditions. Directs DOD to competitively award contracts for the geographical expansion of the CHAMPUS Reform Initiative in Florida, Washington, Oregon, and Alexandria, Louisiana, under specified conditions. Permits the use of appropriated funds to fully utilize the facilities at the U.S. Army Engineer's Waterways Experiment Station, with a specified exception. Prohibits this Act's funds from being used by a military department to modify an aircraft, weapon, ship, or other item of equipment if such item is to be retired or otherwise disposed of within five years after completion of the modification, with specified exceptions. Specifies the definition of "program, project, and activity" for appropriations contained in this Act for purposes of the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act). Earmarks specified funds appropriated to the Army under this Act for the Reserve Component Automation System (RCAS), with certain expenditure limitations. Prohibits the use of appropriated funds for fixed-price contracts exceeding $10,000,000 for the development of a major defense system or subsystem, unless the Under Secretary of Defense for Acquisition and the Secretary of Defense take certain action. Provides that monetary limitations on the purchase price of passenger motor vehicles shall not apply to vehicles purchased for certain intelligence activities. Earmarks specified funds for the construction of classified military projects within the continental United States. Prohibits the use of appropriated funds for the procurement of welded shipboard anchor and mooring chains manufactured outside the United States. Authorizes DOD to transfer prior-year unobligated balances to the operations and maintenance appropriations of the reserve components in order to provide military technician and DOD medical personnel pay and medical programs the same exemption from the Gramm-Rudman-Hollings Act as is currently granted to other military personnel accounts, with specified exceptions. Prohibits any funds available to the Department of the Navy from being used to enter into any contract for the overhaul, repair, or maintenance of any naval vessel on the west coast which includes interport differential charges as a factor for the award of such contract. Prohibits funds appropriated by this Act for CHAMPUS programs from being used to reimburse any health care provider for inpatient mental health services in excess of specified periods (depending on one's age), or for care received when a patient is referred to a provider of such care by a medical or health care professional having an economic interest in the facility to which the patient is referred, with specified exceptions. Requires the designs of specified military aircraft to incorporate certain standard avionics specifications by no later than 1998. Provides for the accounting treatment of expenses incurred by the United States in monitoring Soviet implementation of the INF Treaty. Provides funds from this Act for transportation to an annual meeting in the United States of the next-of-kin of individuals who have been prisoners of war or missing in action from the Vietnam era. Prohibits funds available to the Department of the Navy from being used to implement certain automated data processing or information technology facility consolidation plans or to make reductions or transfers of personnel in connection with such plans until a congressional notification requirement has been met by the Secretary. Prohibits funds from this Act from being obligated or expended to prepare, or to assist any defense contractor in preparing, any material with respect to economic or employment impact in a State of an acquisition program for which all research, development, testing and evaluation has not been completed. Prohibits funds appropriated by this Act from being available for a contract for studies, analyses, or consulting services entered into without competition on the basis of an unsolicited proposal unless the head of the activity responsible for the procurement makes certain determinations with respect to such contract. Prohibits the use of DOD funds under this Act to dispose of specified unserviceable M1 rifles and carbines. Prohibits this Act's funds from being used to pay more than 50 percent of a lump-sum reenlistment bonus. Prohibits this Act's funds from being used to assign a supervisor's title or grade when the number of people he or she supervises is considered as a basis for such determination. Prohibits Navy funds appropriated by this or any other Act from being used to carry out an electromagnetic pulse program in the Chesapeake Bay area in connection with the Electromagnetic Pulse Radiation Environment Simulator for Ships (EMPRESS) program until the Secretary has made certain certifications to the Congress concerning the importance of such program. Limits the funds available for a health care demonstration project regarding chiropractic care required by the Department of Defense Authorization Act, 1985. Prohibits this Act's funds from being used to pay health care providers under CHAMPUS for services determined to be not medically or psychologically necessary. Requires sums for FY 1993 pay raises for programs funded by this Act to be absorbed within the levels appropriated in this Act. Prohibits funds available in this Act from being used for: (1) payments under a DOD contract with the Louisiana State University Medical Center involving the use of cats for wound research; or (2) conducting bone trauma research at the Letterman Army Institute of Research until the Secretary of the Army makes certain certifications. Requires the Secretary to include in any base closure and realignment plan submitted to the Congress a complete review for FY 1992 through 1996 which includes specified information relating to force structures and cost savings after such closure or realignment. Limits the amount of funds to be used for any single relocation of an organization, unit, activity, or function of DOD into or within the National Capital Region. Provides for the waiver of such limitation in certain cases. Directs the Secretary to ensure that at least 50 percent of the Joint Service Missile Mission is in place at the Letterkenny Army Depot by the time that Systems Integration Management Activity and Depot Systems Command are scheduled to relocate to Rock Island Arsenal, Illinois. Prohibits this Act's funds from being used for producing more than two-thirds of the liquid gas requirements in-house at Andersen Air Force Base, Guam. Allows appropriated funds to be used for the pay, allowances, and benefits of Federal or District of Columbia employees who are members of the reserve or National Guard, who perform Federal or military service to enforce the law or provide assistance to civil authorities in the protection or saving of life or property, and who request and are granted leave. Prohibits funds appropriated by this Act from being used to: (1) initiate or continue any cost study pursuant to OMB Circular A-76; or (2) begin closing a military treatment facility unless the Secretary notifies the appropriations committees. Prohibits funds appropriated by this Act for the American Forces Information Service from being used for any national or international political or psychological activities. Prohibits any unobligated balances available during FY 1992 from the National Defense Stockpile Transaction Fund from being obligated or expended to finance any grant or contract to conduct R&D activities for the development or production of advanced materials, unless amounts are specifically appropriated in a subsequent appropriations Act. States as the policy of the United States the opposition to restrictive trades or boycotts fostered or imposed by foreign countries against other countries friendly to the United States or against any other U.S. person. Prohibits any DOD prime contract in excess of the small purchase threshold from being awarded to a foreign person, company, or entity unless such entity certifies to the Secretary that it does not comply with the secondary Arab boycott of Israel. Authorizes the Secretary to waive such certification requirement when necessary in the national security interest, but to notify the Congress quarterly of any contract in which a waiver was granted. Outlines exceptions to the prohibition. Requires all DOD software to be written in the programming language Ada in the absence of a special exemption. Authorizes the Secretary to adjust the wage rates of certain civilian employees hired for certain health care occupations as authorized by the Secretary of Veterans Affairs for the direct care of veterans in the Department of Veterans Affairs. Prohibits funds available to DOD from being used for the training or utilization of psychologists in the prescription of drugs, except upon the findings and recommendations of a specified Army Blue Ribbon Panel. Prohibits this Act's funds from being used to reduce the military or civilian medical and medical support personnel end strength at a base undergoing a partial closure or realignment, where more than one joint command is located, below the September 30, 1991, level. Earmarks funds made available in this Act for the Civil Air Patrol. Prohibits funds appropriated or made available in this Act from being used to reduce or disestablish the operation of the 815th Tactical Airlift Squadron of the Air Force Reserve if such action would reduce the WC-130 weather reconnaissance mission below the levels funded in this Act. Allows withdrawal credits to be made during FY 1992 by the Defense Business Operations Fund to the credit of current applicable appropriations of the DOD activity in connection with the acquisition of supplies that are repairable at a repair depot and that are capitalized into such Fund as the result of certain management changes. Requires, in the use of funds for the procurement of supplies or services appropriated by this Act, that qualified nonprofit agencies for the blind or other severely handicapped be afforded the maximum opportunity to participate as subcontractors and suppliers in the performance of DOD contracts. Provides that small business concerns participating in a subcontracting plan for the participation of small businesses with DOD under the Small Business Act shall be given credit toward meeting the subcontracting goal required under such Act for any purchases made from qualified nonprofit agencies for the blind or other severely handicapped. Establishes under the direction and control of the Attorney General the National Drug Intelligence Center, to coordinate and consolidate drug intelligence from all national security and law enforcement agencies, and produce information regarding the structure, membership, finances, communications, and activities of drug trafficking organizations. Provides funding for the Center from DOD drug interdiction and counter-drug activities appropriations. Authorizes the Navy, during FY 1992, to provide notice to exercise options under the LEASAT program for the next fiscal year. Earmarks specified Navy R&D funds for the V-22 aircraft program. Specifies the manner in which prior-year appropriations for the V-22 program shall be expended. Directs the Secretary to provide the Congress with the total funding plan and schedule to complete the Phase II V-22 full-scale engineering development program. Directs the Secretary to include sufficient funds to complete development, manufacture, and testing of six production representative aircraft under the development program and to produce sufficient V-22 aircraft to meet the operational requirements of the Marine Corps and other services in all DOD future year planning documents and budget estimates. Provides that, during FY 1992, third party payments for health care provided in a military medical facility shall be available for the use of such facility and shall be over and above the facility's direct budget amount. Prohibits funds appropriated in this Act from being used to: (1) procure a Multibeam Sonar Mapping System not manufactured in the United States; or (2) fill the commander's position at any military medical facility with a health care professional unless such candidate demonstrates professional administrative skills. Earmarks funds appropriated by this Act for the Defense Health Program to continue CHAMPUS benefits until age 65 for a former member of the armed forces who is entitled to retired or retainer pay (or a dependent of such member) and who becomes eligible for hospital insurance benefits under part A of title XVIII (Medicare) of the Social Security Act solely on the grounds of physical disability. Provides limitations on the coverage of such expenses. Authorizes the Secretary to accept, during FY 1992, burdensharing contributions in the form of money from Japan, Korea, and Kuwait for the costs of local national employees, supplies, and services of DOD, to be credited to operation and maintenance appropriations and available for the same purposes and time period. Requires the Secretary to report quarterly to the Congress on contributions accepted. Prohibits obligations in excess of 70 percent of sales from DOD stock funds from being incurred against such stock funds during FY 1992. Prohibits the use of funds appropriated or made available in this Act to reduce or disestablish the operation of the Navy Reserve P-3 squadrons below the levels funded in this Act. Directs the Secretary of the Navy to obligate funds appropriated for FY 1991 through 1993 for the modernization of such aircraft that such Secretary intends to keep in the fleet for more than five years. Earmarks specified prior-year appropriated funds for payment of claims to U.S. military and civilian personnel for damages incurred as a result of the volcanic eruption of Mount Pinatubo in the Philippines. Prohibits funds appropriated in this Act from being obligated or expended for any contract or grant with a university or other higher educational institution unless such grant or contract is audited under certain Federal Acquisition Regulation procedures. Requires any such institution to respond fully to any requests for financial information in connection with such grant or contract. Prohibits funds appropriated in this Act to finance activities of DOD federally-funded R&D centers from being obligated or expended for such center if a member of its board of directors or trustees simultaneously serves on the board or trustees of a profit-making company under contract to DOD unless such center has a DOD-approved conflict of interests policy for its members. Mandates that certain previously required reports be submitted to the appropriations committees before funds from this Act may be used for such centers. Prohibits funds appropriated in this Act from being used to: (1) comply with or implement any provision issued in compliance with a memorandum of the Deputy Secretary of Defense concerning debarment from defense contracts for felony criminal convictions; or (2) procure carbon, alloy or armor steel plate for use in any Government-owned facility or DOD property which was not melted and rolled in the United States or Canada (with a waiver allowed on a case-by-case basis). Prohibits more than 15 percent of the funds available to DOD for sealift from being used to acquire ships constructed in foreign shipyards. Authorizes the Secretary, during FY 1992, to acquire the modification, depot maintenance, and repair of aircraft, vehicles, and vessels as well as the production of components and other defense-related articles through competition between DOD depot maintenance activities and private firms. Requires the Secretary, if he finds after consultation with the U.S. Trade Representative that a foreign country has violated a reciprocal defense procurement agreement by discriminating against certain types of products produced in the United States, to rescind the Secretary's blanket waiver of the Buy American Act with respect to such types of products produced in that foreign country. Directs the Secretary to report to the Congress on the amount of DOD purchases from foreign entities in FY 1993. Prohibits any funds appropriated or made available in this or any DOD appropriations Act during FY 1992 from being obligated for the procurement of ball or roller bearings other than in accordance with a specified Defense Federal Acquisition regulation. Transfers specified FY 1991 Navy shipbuilding and conversion funds to Navy operations and maintenance for use in connection with the USS John F. Kennedy at the Philadelphia Naval Shipyard. Directs the Air Force to use FY 1992 R&D funds to execute the cleanup of uncontrolled hazardous waste contamination affecting a sale parcel of land at Hamilton Air Force Base, California. Outlines procedures to be followed in the event that the purchaser of such sale parcel exercises its option to withdraw from such sale. Directs the Air Force to be reimbursed from the sale proceeds for cleanup expenses in excess of a specified amount. Provides for the conveyance by DOD of certain buildings and easements with respect to such parcel. Authorizes the Secretary, when considered to be in the best interest of the United States, to cancel up to $2,500 of a debt owed to the United States by a member or former member of the armed forces if it was incurred in connection with Operation Desert Shield/Storm. Transfers a specified cash balance in the Defense Business Operations Fund to DOD appropriations available for energy conservation improvement projects under the Department of Defense Energy Conservation Improvement Program. Allows appropriations contained in this Act that remain available at the end of the current fiscal year as a result of energy cost savings realized by DOD to remain available for obligation to the facilities responsible for such savings. Authorizes the Secretary to provide optional summer school programs authorized under the Defense Dependents Education Act of 1978 and to charge a fee for participation in such programs. Makes available through FY 1993 unobligated balances of the funds appropriated in the FY 1992 Department of Defense Appropriations Act for the World University Games and the 1992 Summer Olympics. Authorizes the Secretary during FY 1992 to transfer available funds from the National Defense Stockpile Transaction Fund to the appropriation for environmental restoration, defense. Allows after December 31, 1992, voluntary separation incentives to be paid in such amounts as necessary from assets of the Voluntary Separation Incentive Fund. Requires amounts deposited during FY 1992 and 1993 to special accounts established for the transfer or disposal of DOD real property and the leasing of non-excess DOD property to be appropriated and available for facility maintenance and repair and for environmental restoration at the military installation in which the property was sold, transferred, or leased. Prohibits any funds available to DOD in this Act from being used to award a contract for the procurement of four-ton dolly jacks manufactured outside of the United States. Authorizes DOD to transfer up to a specified amount of the funds appropriated under this Act for certain purposes authorized in the Nuclear Threat Reduction Act of 1992. Authorizes the Secretary to transfer up to a certain amount of DOD funds to the appropriate accounts within DOD for the transportation of humanitarian assistance to the former Soviet Union in order to address emergency conditions. Prohibits funds appropriated or made available in this Act from being used for the procurement of high purity quartz yarn or fiber, or related products or materials, not produced in the United States. Provides for the waiver of such prohibition on a case-by-case basis. Directs the Secretary to ensure that such yarn or fiber produced by domestic sources is tested for qualification for use or incorporation in the production of weapon systems and in weapons development programs. Provides a purchase preference to certain domestic producers of high carbon ferrochromium and ferromanganese from chromite and manganese ore authorized for disposal from the National Defense Stockpile. Prohibits funds available to DOD from being used to implement a specified defense management report decision pertaining to conventional ammunition which has the objective of financing such ammunition out of any funds other than those specifically appropriated or made available for the procurement of ammunition. Prohibits funds made available to DOD from being used: (1) for an Abrams tank upgrade program that does not first modify specified tank configurations; (2) in connection with any action within DOD which would support or lead to the purchase or acquisition of LTV Aerospace and Defense Company by any foreign person; and (3) to procure or acquire handguns or handgun ammunition except the 9mm DOD standard handgun and ammunition. Directs the Secretary, if he determines that a person has been convicted of intentionally affixing a "Made in America" label to any product sold in or shipped to the United States that is not made in America, to debar such person from contracting with the Government for at least three and up to five years. Authorizes FY 1992 DOD appropriations to be used to reimburse a reserve member who is not otherwise entitled to travel and transportation allowances and who occupies transient government housing while performing active duty for training or inactive duty training. Allows such funds to also be used for the civilian pay, allowances, and benefits of a National Guard technician who serves on active duty for participation outside the United States in airlift or refueling operations and who requests and is granted leave. Provides other conditions for such payments. Directs the Secretary to negotiate with a military medical treatment facility to assume operation of the Silas B. Hays Army Community Hospital at Fort Ord, California, in a manner consistent with the managed-care delivery model required under the National Defense Authorization Act for Fiscal Year 1991. Prohibits funds appropriated by this Act or made available to DOD from being used to operate, maintain, and pay the salaries of the employees assigned or detailed to the Defense Printing Service Management Office. Earmarks specified funds appropriated by this Act for paying the Administrator of General Services charges established under the Federal Property Administrative Services Act of 1949 for space and services. States that, as of September 1, 1993, no funds appropriated by this Act or made available to DOD may be used for payment of compensation of members of the Senior Executive Service assigned to DOD in excess of 95 percent of such personnel assigned to or serving in DOD on September 30, 1992. Requires the issuance of specified amounts from the Defense Business Operations Fund for supplies, equipment, and material for the Army, Navy, Marine Corps, and Air Force. Prohibits funds from this Act from being used by DOD or the Navy to consolidate the Naval Biodynamics Laboratory until 90 days after the General Accounting Office has submitted a report to the appropriations committees on plans to consolidate R&D laboratories. Directs the Comptroller General to issue a report on the Navy's accounting practices at its nuclear shipyards. Requires the Director of the Air National Guard, during FY 1992, to establish a command, control, communications, and intelligence planning office manned by three full-time Air Guard officers of specified rank. States that as of September 1, 1993, no funds appropriated by this Act shall be available for the payment of compensation of personnel assigned to or serving in the National Foreign Intelligence Program in excess of 98 percent of such personnel assigned to or serving in such Program on September 30, 1992. Prohibits funds appropriated by this Act or made available to DOD from being deposited into the Pentagon Reservation Maintenance Revolving Fund for renovation, construction, or any purposes other than the actual and necessary day-to-day operation of the Reservation or the performance of engineering studies and designs for renovation of the existing structure. Prohibits funds appropriated or otherwise made available in this Act from being used to promulgate or enforce a certain DOD policy prohibiting non-funded abortions in military medical treatment facilities outside the continental United States or any other policies having the same substance.
Law· SS. 2901 (102nd)enacted
United States · United States Congress · 26 June 1992
Amends the Omnibus Budget Reconciliation Act of 1989 to direct the Secretary of Health and Human Services to extend the waiver of the enrollment mix requirement under title XIX (Medicaid) of the Social Security Act which was granted to the Tennessee Primary Care Network.
Bill· SS. 2900 (102nd)referred
United States · United States Congress · 26 June 1992
Prohibits the Administrator of the Environmental Protection Agency from implementing any national primary drinking water regulation under the Safe Drinking Water Act (the Act) or any similar regulation until this Act's requirements are met and legislation that extends the authorization of the Act is enacted. Requires the Administrator to study and report to the Congress on: (1) each final regulation that has been promulgated under the Act and regulatory alternatives that reflect a range of levels of safety or direct health benefits; (2) any health effect an alternative would prevent and the system-level incremental cost of each alternative; (3) the contaminants listed pursuant to the Act for purposes of considering revisions to the list, taking into account anticipated adverse health effects of the contaminant, the risk or safety factors associated with the maximum contaminant level, and whether the contaminant may occur in public water systems; (4) compliance deadlines; (5) whether a regulation should apply exclusively to small public water systems; and (6) recommended alternatives to ensure that States and political subdivisions meet funding needs to carry out the Act. Directs the Administrator, if a primary drinking water regulation is justifiable to protect human health, to implement or promulgate such regulation without regard to the requirements of this Act.
Bill· HRH.R. 5502 (102nd)referred
United States · United States Congress · 26 June 1992
Health Care Cost Containment and Reform Act of 1992 - Title I: Cost Containment - Subtitle A: National Health Budget - Establishes a national health expenditure budget for each calendar year beginning with 1994. Specifies the total amount of such budget for 1994 and a formula for subsequent year budgets. Sets forth guidelines for computing a budget baseline for 1993. Provides for establishment of classes of health care services and the annual allocation of the national health expenditure budget among such classes. Subtitle B: Maximum Payment Rates - Provides for the establishment and general application and enforcement of maximum payment rates. Sets forth exceptions to maximum payment rates, which include an exception for health maintenance organizations (HMOs). Provides for conforming payment rates under Medicare and Medicaid (Social Security Act (SSA) titles XVIII and XIX). Details various methodologies for determining maximum rates of payment for inpatient hospital services and class of physicians' services and other professional medical services. Provides for development of prospectively-determined payment rates for each class of services for which payment rates are not specified and are not determined on a prospective basis. Subtitle C: State Provider Payment Control Systems - Provides that, if the Secretary of Health and Human Services (HHS) approves a State provider payment control system under this Act, the payment rates provided under such system shall apply to services covered under the system and furnished in the State, instead of the maximum payment rates otherwise applicable to such services under subtitle B of this title. Details the process for approval of a State system. Specifies conditions for approval. Authorizes sanctions against a State with aggregate system expenditures in excess of specified limits. Lists such sanctions. Provides for termination of approval of State systems. Subtitle D: Incentives for Expansion of Qualified Health Maintenance Organizations - Repeals the termination date set under the Health Maintenance Organization Amendments of 1988 for dual choice requirements under the Public Health Service Act. Amends the Public Health Service Act to revise such requirements to provide for multiple options for HMO membership. Provides that health benefit plans shall make available, to each individual eligible to enroll with a qualified HMO under such an option, such marketing materials as the HMO provides to the plan. Preempts State law restrictions on the ability of an HMO to negotiate reimbursement rates with providers or to contract selectively with one provider or a limited number of providers. Amends the Medicare program to provide for adjustment in Medicare capitation payments to account for regional variations in application of secondary payor provisions. Requires a General Accounting Office (GAO) study and report to the Congress on additional measures that may be taken to encourage HMO development and expansion. Title II: Health Systems Reform - Subtitle A: Health Insurance Reform - Amends the Internal Revenue Code to impose an excise tax on any health benefit plan that is not certified under new SSA title XXI added by this Act, or is providing coverage in violation of certain title XXI requirements. Requires that the amount of such tax be equal to: (1) 50 percent of the gross premiums received by the issuer attributable to the period during which the plan is not certified or is providing coverage in violation of certain requirements, in the case of an insured health benefit plan; and (2) 50 percent of the expenditures under a self-insured health benefit plan during such a period, in the case of a self-insured health benefit plan. Provides that in the case of an insured health benefit plan, the issuer of the insurance or subscriber contract under which such plan is provided shall be liable for the tax imposed above. Provides generally that in the case of a self-insured plan, the employer maintaining such plan shall be liable for the tax imposed above. Amends SSA to add a new title XXI, Health Benefit Plan Standards. Provides that no health benefit plan may be issued unless it has been certified as meeting specific standards established by the Secretary. Requires such standards to implement specified requirements relating to: (1) health benefit plan coverage and health status; (2) premium charges within self-insured health benefit plans; (3) a prohibition against self-insured plans for small employers; (4) insured health benefit plan enrollment, issuance, and renewal; (5) use of community-rated premium rates for insured health plans; (6) minimum insured plan periods; (7) payment of commissions; and (8) insured plans that are multiple employer welfare arrangements. Prohibits States from establishing or enforcing any law or regulation that prevents the health benefit plan of a college or university from offering eligible individuals continuation of coverage under the plan. Subtitle B: Administrative Simplification - Requires each health benefit plan to issue to each U.S. resident entitled to benefits under it a uniform health claims card meeting specified requirements. Mandates uniform claims submission. Sets forth enforcement provisions. Provides for standards for uniform claims. Sets forth the administrative framework for eligibility and benefit verification and claims processing through health claims clearinghouses for residents and providers in areas within the United States designated as clearinghouse areas. Provides for the use of clearinghouses by health benefit plans. Requires that each hospital, for each cost reporting period under Medicare beginning during or after FY 1993, provide for the reporting of information to the Secretary with respect to any hospital care provided in a uniform manner consistent with standards established by the Secretary to carry out certain provisions of the Omnibus Budget Reconciliation Act of 1987. Subtitle C: Fraud and Abuse - Provides for the establishment in the HHS Office of the Inspector General of a program to coordinate programs to: (1) restrict fraud and abuse in health care programs; and (2) facilitate the enforcement of SSA title XI provisions concerning the exclusion of certain individuals and entities from participation in Medicare and State health care programs. Provides for coordination with law enforcement agencies in carrying out such program. Authorizes appropriations. Creates in the Treasury the Anti-Fraud and Abuse Trust Fund for purposes related to such program. Amends SSA title XI for the application of Federal anti-fraud and abuse sanctions to fraud and abuse involving any health benefit plan. Adds treble damages to the list of criminal penalties for acts involving Medicare, State health care programs, or health benefit plans. Makes any act subject to such SSA criminal penalties a "racketeering activity" as defined under the Federal criminal code. Subjects to SSA civil money penalties any offer of inducements to receive covered items or services to individuals enrolled under or employed by Medicare or other health programs or plans. Provides for intermediate sanctions for HMO violations under Medicare. Sets forth procedures for imposing such sanctions. Requires written agreements between HMOs and peer review organizations. Requires the Secretary to develop a model of the agreement that an HMO with a risk-sharing contract must enter into with a peer review organization with respect to HMO services. Requires a GAO study and report to the Congress on the costs incurred by HMOs with risk-sharing contracts of complying with the requirement to enter into a written agreement with a peer review organization with respect to HMO services, together with an analysis of how information generated by such organizations is used by the Secretary to assess the quality of HMO services. Modifies the self-referral ban on Medicare payment for clinical laboratory services provided in connection with improper physician referrals to extend such ban to payment by other payors for additional specified services. Makes changes in exceptions relating to compensation arrangements under Medicare. Subtitle D: Other Provisions - Requires the Physician Payment Review Commission to study and report to the Congress on: (1) the need for tort reforms with respect to medical malpractice liability claims; and (2) the impact of such reforms on expenditures for health care services and on access to such services, the quality of health care services, and access of injured patients to the medical malpractice system. Requires the Secretary to establish a national data base on patient outcomes to demonstrate the feasibility and benefits of the collection of information on the outcomes of treatment. Requires the Secretary to select a certain number of conditions, disorders, or diseases for which outcomes data shall be collected for the database. Sets forth guidelines for the collection of information for the database. Requires the Secretary to publish and distribute an annual report on patient outcomes, including information on individual providers, based on information from the data base and appropriate utilization information available from health claims clearinghouses. Requires the Secretary to develop a model questionnaire to measure patient satisfaction with health service providers. Authorizes a demonstration project concerned with the furnishing of durable medical equipment by a physician-owned oncology facility. Title III: Expansion of Health Benefits and Other Initiatives - Subtitle A: Medicaid Benefits Improvements - Sets a floor on Medicaid payment levels for inpatient hospital services and physicians' services. Provides for expanded Medicaid eligibility for certain low-income individuals. Provides for full Federal payment for new mandated expenditures under Medicaid, including expenditures for medical assistance attributable to such low-income individuals. Subtitle B: Expansion of Medicare Benefits - Amends the Medicare program to provide for coverage of: (1) annual screening mammography for women over age 65; (2) colorectal screening; (3) certain immunization; (4) well-child care; and (5) certain prescription drugs. Sets forth payment and administrative provisions applicable to such preventive benefits and prescription drugs. Authorizes demonstration projects for the coverage of other preventive services. Specifies the services to be covered under such projects. Authorizes appropriations. Requires the Director of the Office of Technology Assessment to provide for the appointment of a Prescription Drug Payment Review Commission. Requires the Commission to submit an annual report to the Congress concerning methods of determining payment for prescription drugs. Authorizes appropriations. Provides for coverage of prescription drugs for qualified Medicare beneficiaries and qualified disabled and working individuals. Makes adjustments to payments under Medicare for graduate medical education. Subtitle C: Health Insurance Deduction for the Self-Employed - Amends the Internal Revenue Code to make permanent and increase the deduction for health insurance costs of self-employed individuals. Subtitle D: Health Insurance Program for Children - Amends SSA to add a new title XXII, Health Insurance For Children. Provides that children who are U.S. citizens or permanent residents, and are under age 19, are eligible to enroll for benefits under such new title. Provides for periods of enrollment and coverage. Requires program benefits, except those for newborn and well-baby care, to consist generally of the same benefits that are available under Medicare to individuals entitled to benefits under Medicare part A (Hospital Insurance) and enrolled under Medicare part B (Supplementary Medical Insurance). Provides for newborn and well-baby care, waiver of cost-sharing for well-child services, and special rules for the deductible for covered outpatient drugs. Details payment provisions. Discusses premium rates to be charged under such program. Creates in the Treasury the Children's Health Insurance Trust Fund for purposes related to the health insurance program for children established above. Authorizes appropriations.
Bill· SS. 2899 (102nd)open
United States · United States Congress · 25 June 1992
National Institutes of Health Revitalization Amendments of 1992 - Title I: General Provisions Regarding title IV of Public Health Service Act - Subtitle A: Research Freedom - Part I: Review of Proposals for Biomedical and Behavioral Research - Amends the Public Health Service Act to prohibit the Secretary of Health and Human Services from approving certain research or financial assistance to conduct research unless specified review has taken place and the review entity has recommended approval. Prohibits the Secretary from withholding, on ethical grounds, funding for research that has received such review approval unless: (1) an ethics advisory board recommends the withholding; or (2) such a board recommends against withholding, but the Secretary finds that the recommendation is arbitrary and capricious. Part II: Research on Transplantation of Fetal Tissue - Permits the Secretary to conduct or support research on the transplantation of human fetal tissue for therapeutic purposes regardless of whether the tissue is obtained from a spontaneous or induced abortion or a stillbirth, in accordance with State and local law. Requires the researcher, if the tissue bank established under a specified executive order is in operation, to obtain the tissue from that bank, unless the bank does not provide requested tissue within a specified time of a request. Requires certain statements by the woman providing the tissue, the researcher, and the donee. Imposes criminal penalties for certain commercial transactions involving the transfer or directed donation of human fetal tissue. Prohibits: (1) any official of the executive branch from imposing a policy prohibiting the Department of Health and Human Services from conducting or supporting any research on the transplantation of human fetal tissue for therapeutic purposes; and (2) the Secretary from withholding funds for research which is in accordance with this Act. Deems a specified report of the Human Fetal Tissue Transplantation Research Panel to be a report issued by an ethics advisory board finding, on a basis that is neither arbitrary nor capricious, that there are no ethical grounds for withholding funds for such research. Part III: Miscellaneous Repeals - Removes certain provisions of the Public Health Service Act relating to: (1) biomedical ethics; (2) a study by the Biomedical Ethics Advisory Committee on waiver of a specified risk standard; and (3) the construction of title IV (National Research Institutes) of the Act. Subtitle B: Clinical Research Equity Regarding Women and Minorities - Part I: Women and Minorities as Subjects in Clinical Research - Requires that women and minorities be included as subjects in each clinical research project under such title IV. Requires projects to be designed and carried out so as to provide for an analysis of whether the variables being tested affect women or minorities differently than other subjects. Requires the establishment of inclusion guidelines. Requires that technical and scientific peer review conducted under existing provisions include an evaluation of the merit of the proposal regarding women and minorities. Part II: Office of Research on Women's Health - Establishes in the National Institutes of Health (NIH) the Office of Research on Women's Health. Requires the Director of the Office to establish: (1) the Coordinating Committee on Research on Women's Health; and (2) the Advisory Committee on Research on Women's Health. Mandates: (1) a determination of the extent to which women are represented among senior physicians and scientists of the national research institutes and among those conducting research supported by the institutes; and (2) as appropriate, activities to increase the extent of such representation. Requires establishment of: (1) a data system, available to the public, for the collection, analysis, and dissemination of information regarding research on women's health conducted or supported by the institutes; and (2) a program to provide information on research and prevention activities of the institutes relating to women's health research. Subtitle C: Scientific Integrity - Replaces provisions relating to protection against scientific fraud with provisions establishing as an independent entity in the Department of Health and Human Services the Office of Scientific Integrity. Requires: (1) applicants for a grant, contract, or cooperative agreement under the Act for biomedical or behavioral research to have an administrative process to review reports of scientific misconduct and agree to report any investigation of such reports; and (2) a response process for the Office. Establishes the Commission on Scientific Integrity. Provides for employee whistle blower protection. Mandates measures for identifying, responding to, and reporting the existence of a financial interest that will or may create a bias in favor of obtaining results, in a project to evaluate the safety or effectiveness of a drug, medical device, or treatment, that are consistent with the interest. Title II: Protection of Health Facilities - Prohibits stealing or otherwise converting personal property or damaging real property of a health facility assisted under the Public Health Service Act, or deterring, through physical restraint, any individual from entering or exiting the facility. Includes in the prohibitions various acts interfering with the use of animals for research. Provides for fines, imprisonment, restitution, and private civil actions. Title III: National Institutes of Health in General - Modifies the duties of the NIH's Associate Director for Prevention. Establishes a program to enhance the competitiveness of research entities in States which have historically had low success in obtaining funds from the national research institutes for biomedical and behavioral research. Mandates activities, consistent with the global Children's Vaccine Initiative, to develop affordable new and improved vaccines. Authorizes appropriations. Requires a plan regarding research methods that do not require the use of animals, reduce the number of animals used, and produce less distress in the animals. Establishes the Interagency Coordinating Committee on the Use of Animals in Research. Repeals similar provisions. Authorizes the Secretary of Health and Human Services to conduct and support research, research training, recruitment, and other activities to increase the number of women and individuals from disadvantaged backgrounds in biomedical and behavioral research. Requires that any survey of human sexual behavior conducted or supported through NIH: (1) undergo review in accordance with specified provisions; and (2) have been determined by the Secretary to assist in reducing the incidence of infectious disease or improve health conditions. Establishes a fund for use by the NIH Director to carry to carry out NIH activities. Authorizes appropriations. Modifies the term of office of members of advisory councils of the national research institutes. Requires that at least half of all new or revised health education and promotion materials developed or funded by NIH be in a form that does not exceed a level of functional literacy. Authorizes a program to provide day care service for NIH employees. Title IV: General Provisions Respecting National Research Institutes - Requires that the Secretary receive from the President and the Office of Management and Budget directly all funds appropriated by the Congress for obligation and expenditure by the Institute. Removes provisions authorizing the Director of the National Cancer Institute to directly receive such funds. Modifies the authority of the directors of the national research institutes to establish and appoint the members of technical and scientific peer review groups in addition to those appointed under specified provisions. Makes the Federal Advisory Committee Act inapplicable to such additional groups. Requires expansion and intensification of programs of research and related activities concerning osteoporosis, Paget's disease, and related bone disorders. Provides for the establishment, through a grant, cooperative agreement, or contract, of a clearinghouse to enhance knowledge and understanding of professionals, patients, and the public. Authorizes appropriations. Establishes: (1) a comprehensive program of conducting basic and clinical research on trauma, including diagnosis, treatment, rehabilitation, and general management of trauma; and (2) the Trauma Research Interagency Coordinating Committee. Title V: National Cancer Institute - Requires expanding, intensifying, and coordinating the activities of the National Cancer Institute (NCI) regarding breast and ovarian cancer, other cancers of the reproductive system of women, and prostate cancer. Requires inclusion of the conduct and support of research and demonstration centers. Authorizes appropriations. Removes provisions authorizing appropriations for NCI and the National Heart, Lung, and Blood Institute (NHLBI). Title VI: National Heart, Lung, and Blood Institute - Requires NHLBI to conduct intramural training and education. Authorizes development of three centers for basic and clinical research into, training in, and demonstration of, advanced diagnosis, prevention, and treatment for cardiovascular diseases in children. Authorizes appropriations for NHLBI. Title VII: National Institute on Diabetes and Digestive and Kidney Diseases - Establishes a program of conducting and supporting research, training, health information dissemination, and other activities regarding nutritional disorders, including obesity. Provides for the development or substantial expansion of centers for research and training. Title VIII: National Institute on Arthritis and Musculoskeletal and Skin Diseases - Removes provisions stating that the purpose of the National Institute on Arthritis and Musculoskeletal and Skin Diseases (NIAMSD) includes sports-related injuries. Requires NIAMSD to place emphasis on arthritis affecting children. Establishes a multipurpose arthritis and musculoskeletal disease center focusing on children. Modifies the composition of the National Arthritis Advisory Board and its annual report requirements. Title IX: National Institute on Aging - Transfers to the Public Health Service Act provisions of the Health Research Extension Act of 1985 authorizing a grant to develop a registry for epidemiological data on Alzheimer's disease and related data collection training. Removes the existing authorization of appropriations. Mandates research into the aging processes of women, with particular emphasis on menopause and into the diagnosis, disorders, and complications related to aging and loss of ovarian hormones. Authorizes appropriations for the National Institute on Aging. Title X: National Institute of Allergy and Infectious Diseases - Includes programs regarding tropical diseases in the purposes of the National Institute of Allergy and Infectious Diseases. Authorizes grants or contracts for centers to conduct basic and clinical research on chronic fatigue syndrome. Establishes an extramural study section for the syndrome. Title XI: National Institute of Child Health and Human Development - Subtitle A: Research Centers with Respect to Contraception and Research Centers with Respect to Infertility - Mandates grants or contracts for three centers to conduct activities to improve methods of contraception and two centers to conduct activities to improve methods of diagnosis and treatment of infertility. Authorizes appropriations. Establishes a program of agreements with health professionals, including graduate students, to conduct research on contraception or infertility in consideration of the Government repaying a limited amount of the educational loans of the professionals. Subtitle B: Program Regarding Obstetrics and Gynecology - Establishes in the National Institute of Child Health and Human Development (NICHHD) an intramural laboratory and clinical research program in obstetrics and gynecology. Subtitle C: Child Health Research Centers - Mandates development of and support for centers for conducting research on child health. Subtitle D: Study Regarding Adolescent Health - Mandates a longitudinal, large-scale study on the general health and well-being of adolescents in the United States. Allocates funding from amounts appropriated to NICHHD. Title XII: National Eye Institute - Authorizes not more than three grants for the establishment and support of centers for clinical research on eye care for individuals with diabetes. Allows grant funds to be used for equipment and for construction and modification of facilities. Title XIII: National Institute of Neurological Disorders and Stroke - Mandates the conduct and support of research on multiple sclerosis. Title XIV: National Institute of Environmental Health Sciences - Establishes the Applied Toxicological Research and Testing Program. Title XV: National Library of Medicine - Subtitle A: General Provisions - Directs the Secretary to promote the use of computers and telecommunications by health professionals. Increases the dollar limit on grants to medical libraries and related instrumentalities. Authorizes appropriations for the National Library of Medicine (NLM). Subtitle B: Financial Assistance - Mandates grants for research on, and development and demonstration of, new educational technologies. Requires recipient institutions to make grant projects available for: (1) training health professions students; and (2) enhancing the capabilities of health professionals regarding research and teaching. Authorizes appropriations to carry out provisions relating to medical libraries and related matters. Subtitle C: National Center for Biotechnology Information - Authorizes appropriations to carry out provisions relating to the National Center for Biotechnology Information. Subtitle D: National Information Center on Health Services Research and Health Care Technology - Establishes in NLM the National Information Center on Health Services Research and Health Care Technology to collect, analyze, and disseminate information on health services research and health care technology. Authorizes appropriations. Requires the Administrator of the existing information center on health care technologies and health care technology assessment and the NLM Director to enter into an agreement on the implementation of these provisions. Title XVI: Other Agencies of National Institutes of Health - Subtitle A: Division of Research Resources - Redesignates the Division of Research Resources as the National Center for Research Resources. Authorizes grants to alter existing or construct new research facilities. Establishes the Scientific and Technical Review Board on Biomedical and Behavioral Research Facilities to advise the Center director and the existing advisory council. Conditions grant approval on Board approval. Authorizes appropriations. Requires the NIH Director to reserve a specified sum from amounts appropriated under this authorization for grants and contracts to construct or improve regional centers for research on primates. Subtitle B: National Center for Nursing Research - Redesignates the National Center for Nursing Research as the National Institute for Nursing Research and adds the Institute to the list of NIH's national research institutes. Subtitle C: National Center for Human Genome Research - Adds the National Center for Human Genome Research to the list of NIH agencies. Declares the purpose of the Center to be to characterize the structure and function of the human genome, including the mapping and sequencing of individual genes. Title XVII: Awards and Training - Subtitle A: National Research Service Awards - Directs the Secretary to carry out provisions relating to National Research Service Awards in a manner that will recruit into biomedical or behavioral research, and provide research training to, women and individuals from disadvantaged backgrounds. Subtitle B: Acquired Immune Deficiency Syndrome - Modifies a program of agreements (under which certain health professionals conduct research regarding acquired immune deficiency syndrome (AIDS) as NIH employees in consideration of Government repayment of educational loans) to remove provisions requiring a minimum of three years as an NIH employee. Authorizes appropriations. Authorizes the Commissioner of Food and Drugs to carry out a similar program regarding the review of applications concerning AIDS. Subtitle C: Loan Repayment for Research Generally - Mandates a program of agreements with health professionals who have a substantial amount of educational loans relative to income and who meet other requirements to conduct research, as NIH employees, in consideration of Government repayment of a limited amount of the educational loans of the professionals. Authorizes appropriations. Subtitle D: Scholarship and Loan Repayment Programs Regarding Professional Skills Needed by Certain Agencies - Authorizes a program of contracts with individuals from disadvantaged backgrounds for scholarships for undergraduate programs for professions needed by NIH in consideration of service by the individuals as NIH employees. Authorizes a program of contracts with health professionals from disadvantaged backgrounds who have a substantial amount of educational loans relative to income to conduct clinical research as NIH employees in consideration of the Government repaying a limited amount of the educational loans of the professionals. Subtitle D: (SIC) Funding - Authorizes appropriations for making payments under National Research Service Awards and under grants for such Awards. Modifies set-aside amounts and requires a set-aside for provisions relating to residency programs in the general practice of dentistry. Title XVIII: National Foundation for Biomedical Research - Excludes from voting rights the ex officio members of the National Foundation for Biomedical Research. Authorizes appropriations. Title XIX: Research with Respect to Acquired Immune Deficiency Syndrome - Modifies the duties of the AIDS Clinical Research Review Committee, including requiring the Committee to: (1) give advice to other agencies of NIH as well as to the National Institute of Allergy and Infectious Diseases (NIAID); and (2) make recommendations on research projects regarding diagnosing immune deficiency and predicting, diagnosing, preventing, and treating opportunistic cancers and infectious diseases. States that the requirement that the clinical evaluation units at the National Cancer Institute and NIAID conduct evaluations of treatments for acquired immune deficiency syndrome (AIDS) includes evaluations of methods of: (1) diagnosing immune deficiency; and (2) predicting, diagnosing, preventing, and treating opportunistic cancers and infectious diseases. Modifies provisions relating to the support of international efforts to add to the purpose of grants, cooperative agreements, and contracts for such efforts provisions promoting and expediting: (1) international training; (2) research and training concerning the natural history and pathogenesis of the human immunodeficiency virus; and (3) the development and evaluation of vaccines and treatments for opportunistic infections. Authorizes appropriations for each fiscal year. Requires that model protocols (developed with grants under existing provisions) for the clinical care of individuals infected with the etiologic agent for AIDS include treatment and prevention of human immunodeficiency virus (HIV) infection and related conditions among women. Authorizes appropriations. Adds collection of data on the natural history of infection with the etiologic agent to the purposes of the epidemiological data base mandated by current provisions. Authorizes appropriations for each fiscal year. Requires the Director of NIH to develop and implement a comprehensive plan for the conduct and support of AIDS research by NIH agencies. Authorizes appropriations for each fiscal year for fellowship and training programs relating to AIDS under existing provisions. Title XX: Certain Authorities of Centers for Disease Control - Authorizes grants to States and local health departments for programs for specified activities relating to prostate cancer, including screening, public information, and improving professional training. Authorizes appropriations. Authorizes: (1) grants or contracts for population-based, statewide cancer registries; (2) grants for developing plans that meet the requirements of specified provisions; and (3) technical assistance to States, either directly or through grants and contracts. Mandates a study on the factors contributing to elevated breast cancer mortality rates in specified States. Authorizes appropriations. Requires a survey to determine which entities collect data on traumatic brain injuries and the nature of their data collection systems. Authorizes cooperation and assistance to establish traumatic brain injury as a specific reportable condition or disability. Authorizes appropriations. Title XXI: Studies - Mandates studies on: (1) the impact, with regard to acquired immune deficiency syndrome (AIDS), of parallel-track drug-release mechanisms on clinical research and on the activities of the Commissioner of Food and Drugs regarding drug approval; (2) third-party payor policies regarding payment of costs incident to the participation of individuals as subjects in AIDS drug clinical trials; and (3) whether AIDS advisory committees in NIH are being sufficiently coordinated. Requires a plan for the inclusion of HIV-infected women, infants, and children in HIV vaccine studies conducted by or through NIH. Authorizes appropriations. Mandates an annual report on the leading causes of death in the United States and related spending by the Department of Health and Human Services for research, prevention, and education. Requires three-year studies on: (1) nutrition screening and intervention regarding the elderly; and (2) the extent of malnutrition in hospitals, in long-term care facilities, and among those living independently. Establishes an advisory panel to oversee the studies. Mandates a report on the feasibility of developing a plan for the conduct of research at NIH on the prevention of traumatic injuries. Directs the Secretary to: (1) review existing data and research concerning whether there is a relationship between legal and illegal drug use; and (2) if necessary, conduct additional research. Mandates reports on: (1) research conducted or supported by NIH on chronic fatigue syndrome; (2) the appropriateness and impact of NIH assuming responsibility for the conduct of all Federal research, development, testing, and evaluation relating to medical countermeasures against biowarfare threat agents. Requires a study on the potential for, the prevalence of, and the issues related to the contamination of worker's homes with substances from their work places. Requires: (1) establishment of the Worker's Family Protection Task Force to take specified actions, including developing an investigative strategy for obtaining any needed additional data; and (2) each Federal department or agency to fulfill the role assigned by the strategy. Authorizes appropriations. Mandates studies: (1) of the retention, recruitment, vacancy and turnover rates of NIH support staff, including fire fighters, law enforcement, procurement officers, technicians, nurses, and clerical employees; and (2) to develop a streamlined procurement system for NIH. Title XXII: Miscellaneous Provisions - Redesignates the Senior Biomedical Research Service as the Silvio Conte Senior Biomedical Research Service and increases the limit on the number of its members. Renames the AIDS Clinical Research Review Committee as the AIDS Research Advisory Committee. Prohibits the Secretary from conducting or supporting the SHARP survey of adult sexual behavior. Requires that a report on carcinogens be submitted biennially (currently, annually). Mandates a report analyzing the report of the National Committee on Sleep Disorders Research and presenting a plan for the conduct and support of sleep disorders research at NIH. Mandates presentation to the Congress of a master plan to provide for the replacement or refurbishment of less than adequate buildings, utility equipment and distribution systems, roads, walkways, parking areas, and grounds of NIH laboratory and clinical facilities. Allows the plan to make recommendations for the undertaking of new projects consistent with the objectives of these provisions. Title XXIII: Effective Date - Sets forth the effective date of this Act.
Bill· HRH.R. 5500 (102nd)referred
United States · United States Congress · 25 June 1992
Health Care for Every American Act of 1992 - Title I: Establishment of A State-Based National Health Insurance Program; Universal Eligibility; Enrollment - Establishes the State-Based National Health Insurance Program. Entitles every U.S. resident who is a citizen, national, or lawful resident alien to services. Provides for the eligibility of certain nonimmigrants and other individuals. Requires each State program to provide for: (1) an enrollment mechanism, including a process for automatic enrollment at birth or immigration; and (2) issuance of a universal health insurance card to be used for identification and claims processing. Provides for portability of benefits. Ends, after a specified date, benefits and payments under: (1) titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act; (2) provisions of Federal law relating to Federal employees' health benefits; (3) provisions of Federal law relating to the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); and (4) certain veterans' medical benefits. Title II: Comprehensive Benefits, Including Preventive Benefits and Benefits for Long Term Care - Entitles enrolled individuals to payment, subject to certain limitations and requirements, for comprehensive acute, preventive, mental health, drug and alcohol abuse treatment, long term care, and plan of care services (major service categories). Prohibits: (1) deductibles, coinsurance, or copayments for comprehensive acute and preventive services; (2) imposing a charge, except as provided under this Act, for covered services; and (3) insurance which duplicates payment for covered items or services. Permits State programs and employers to provide additional benefits. Lists covered services in each major service category, specifying matters such as limits, cost-sharing requirements, and exclusions. Mandates a report to the Congress on the effects of the cost-sharing under specified provisions of this Act and the optional State charge for non-enrollment with comprehensive health service organizations required under title V of this Act. Title III: Provider Participation - Mandates a participation agreement between a State health insurance program and a provider addressing specified elements, including prohibitions on discrimination and charging for covered services other than as authorized under this Act. Specifies requirements in order to be considered a qualified provider, including for health care practitioners, institutional and facility-based providers, community-based primary services providers, independent pathology laboratories, independent radiology services, providers of outpatient drugs and devices, and providers of covered transportation (including ambulance) services, in most cases requiring that they be licensed, meet State law requirements, and meet the requirements of this Act. Requires national and authorizes State minimum standards to assure service quality. Defines a comprehensive health service organization (CHSO) as an organization that, in return for a capitated amount, furnishes, arranges for, or pays for a full range of health services to a population in a specified service area. Makes all eligible persons in that area eligible to enroll in the organization, subject to the organization's capacity. Sets forth CHSO requirements. Title IV: Administration - Establishes the National Health Insurance Standards Board to develop policies, procedures, guidelines, and requirements to carry out this Act. Authorizes the Board to waive provisions of this Act to accommodate demonstration projects. Mandates uniform reporting requirements and standards and certain studies. Requires the Board to recommend to the Congress one or more proposals for the treatment of Federal health care facilities. Mandates advisory committees on: (1) benefits; (2) payments and cost containment; (3) quality and utilization review; and (4) primary care and the medically underserved. Requires the Board to provide for a National Health Advisory Council. Mandates submission by each State (or, for neighboring States which so choose, by each region) of a plan for a State (or regional) health insurance program providing services under this Act. Sets forth plan requirements. Provides for sanctions for failure to meet the requirements, including placing the State program in receivership under the jurisdiction of the Board. Prohibits a State, by intention or as an unstated consequence of budget allocations, from restricting timely access to medically necessary services or permitting potentially life threatening queues. Mandates appointment in each State of: (1) a State Health Advisory Council; and (2) a quality control mechanism. Allows States to use fiscal agents. Requires each State program to establish district health advisory councils covering distinct geographic areas to: (1) advise the State; (2) receive and investigate complaints by eligible persons and by providers; and (3) carry out district management and planning. Requires each district health advisory council to provide assistance and technical support to community organizations and nonprofit agencies submitting funding applications under specified provisions of the Public Health Service Act. Requires all Department of Health and Human Services activities to be complementary to this Act. Title V: National Health Insurance Budget; Payments; Cost Containment Measures - Subtitle A: Budgeting and Payments to States - Requires the Board to annually establish a national health insurance budget specifying the total Federal and State expenditures for covered services, set as the sum of the capitation amounts under this title plus Federal administrative expenses. Sets a national health insurance spending ceiling according to a specified formula involving: (1) the increase in the gross national product; (2) the Board's estimate of the increase in health care expenditures due solely to changes in the age or other risk characteristics of the U.S. population; and (3) percentage points set, for the first four years, by this Act and thereafter set by the Board. Requires each State program to annually establish a State health insurance budget, with a separate account for graduate medical education expenses. Provides for the computation of individual and state capitation amounts. Entitles each State with an approved program to receive specified Federal payments involving the State capitation amount and the Federal contribution percentage. Requires the Board to establish a formula for the Federal percentage for each State, considering the State's per capita income and revenue capacity and other relevant economic indicators as appropriate. Requires each State program to provide for a process and standards regarding the approval of capital purchases or leases for new or renovated facilities and for equipment valued over an amount specified by this Act or by the Board. Allows a State program, where a CHSO is available, to impose a charge for individuals who are enrolled with the CHSO for the receipt of covered services under this Act. Requires that the charge be assessed relative to income and specifies miniumum and maximum charges. Subtitle B: Payments by States to Providers - Requires direct payment by a State program to institutions and facilities for operating expenses under an approved negotiated annual prospective global budget. Allows institutions and facilities to raise private funds for new facilities, major renovations, and equipment, declaring that the expenditure of the private funds does not obligate the State program to provide for continued support for the expenditures. Entitles every independent health care practitioner to payment for the provision of covered services either, at the practitioner's election, by a fee-for-service method or a capitation method. Allows a State program, through an agreement with an organization representative of independent practitioners or otherwise, to pay individual practitioners through an annual salary, hourly payments, or other method under which aggregate payments do not exceed the amounts that would otherwise be made. Requires the Board to establish models and encourage State programs to implement alternative methodologies incorporating global fees for related services or for a basic group of services furnished to an individual over a period of time. Requires the State program to establish, after negotiations, a prospective payment schedule based on a relative value scale and conversion factors established by each State and providing for the application of expenditure targets. Allows State Programs to have practitioner-specific adjustments reflecting practitioner use patterns and to publicly disclose the use patterns. Requires payment to: (1) CHSOs to be determined by the State based on a global budget or on the basic capitation amount determined by the State program on the basis of the average estimated expenditures for an enrollee with the same actuarial characteristics as the enrollee; (2) community based primary health services to be based on a global budget or be made on an individual patient basis; and (3) care managers to be made directly by each State program pursuant to payment schedules, based on negotiations, capitation, or other methods, under an annual prospective budgeting system. Requires the Board to establish a list of approved prescription drugs and biologicals the board determines necessary for health, employability, or self-management and eligible for coverage. Allows the Board to exclude ineffective, unsafe, or over-priced products where better alternatives are available. Requires the Board to determine product prices. Authorizes the Board to conduct price negotiations, on behalf of State health programs, with drug manufacturers and distributors. Requires each State program to provide for payment for a drug furnished by an independent pharmacy based on the drug's cost to the pharmacy plus a dispensing fee according to a schedule set by the State program. Requires the Board to establish a list of approved durable medical equipment and therapeutic devices and equipment (including eyeglasses, hearing aids, and prosthetic appliances) the Board determines necessary for health, employability, or self-management and eligible for coverage. Requires the Board to determine product prices. Authorizes the Board to conduct price negotiations, on behalf of State health programs, with equipment and device manufacturers and distributors. Allows the Board to exclude ineffective, unsafe, or over-priced products where better alternatives are available. Mandates determination by the State program of the amount of payment for other covered services in accordance with payment methodologies specified by the Board. Requires the Board to establish, in addition to payment otherwise provided in this title, model payment methodologies and other incentives that promote the provision of services in medically underserved areas. Authorizes the Board to waive required payment methodologies as necessary to allow alternative payment schemes or conduct experiments and demonstration projects. Subtitle C: Malpractice Reform - Authorizes the Board to award grants to State programs for the development and implementation of programs for medical malpractice reforms. Authorizes appropriations. Mandates a study of medical malpractice, including regarding: (1) ineffective or unnecessary medical testing and practices; (2) the occurrence of malpractice and malpractice awards; (3) the adequacy of existing licensing and discipling procedures in preventing malpractice; and (4) the reasonableness of malpractice insurance premiums and rate-setting practices. Authorizes appropriations. Subtitle D: Mandatory Assignment and Administrative Provisions - Declares that payments for benefits under this Act constitutes payment in full, requires the furnishing entity to accept the payment as such, and prohibits the entity from accepting any payment other than from the State program, except for authorizd cost-sharing. Provides for sanctions in the same manner as under specified provisions of title XVIII (Medicare) of the Social Security Act. Requires a State program to establish: (1) a timely and administratively simple procedure for reimbursement to all providers under this Act; and (2) an appeals process regarding provider payments. Title VI: Financing - Creates the National Health Insurance Trust Fund. Appropriates to the Fund all: (1) tax increases from this Act; and (2) amounts that would otherwise have been appropriated to carry out titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act, the Federal employees health benefit program, and the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). Transfers to the Fund any amounts remaining in the Federal Hospital Insurance Trust Fund or the Federal Supplementary Medical Insurance Trust Fund. Directs the Secretary of the Tresury to: (1) develop a formula for determining and collecting National Health Insurance premiums from individuals and employers to finance covered services; (2) determine the aggregate premiums for each taxable year; and (3) collect premiums from individuals using a formula with specified characteristics, including that it be income-based and progressive. Directs the Secretary of the Treasury to collect the premiums from employers by: (1) increasing the highest marginal corporate income tax rate; (2) increasing the employer and self-employment hospital insurance tax; and (3) imposing a surtax on regular and minimum taxes. Declares that such taxes shall be increased as specified by the Secretary. Mandates a method for employers to pay premiums otherwise payable by employees. Amends Internal Revenue Code provisions relating to exclusions from gross income to define "accident or health insurance" to mean an approved State program under this Act. Removes provisions relating to amounts paid to highly compensated individuals under a discriminatory self-insured medical expense reimbursement plan. Disallows deductions for employer expenses for health care services, whether or not covered under this Act. Declares that this does not disallow a deduction for National Health Care premiums. Allows health insurance costs (currently, 25 percent of health insurance costs) of self-employed individuals to be deducted. Removes provisions ending the deductibility on a specified date. Defines "medical care," for provisions relating to individual deductions for medical and dental expenses, to mean National Health Insurance premiums, cost-sharing, and other premiums for coverage under a State program. Ends, after a specified date, the health insurance credit for coverage which includes at least one child. Makes each State responsible for establishing a financing program for the implementation of the State program. Entitles each State with a State program approved by the Board to funding from the Board in the amounts provided under specified provisions of this Act. Title VII: Promotion of Primary Health Care; Development of Health Service Capacity; Programs to Assist the Medically Underserved - Subtitle A: Promotion and Expansion of Primary Care Practitioners - Makes the Board responsible for certain activities toward a national goal of having, ten years after enactment of this Act, 50 percent of the physicians in medical residency programs being trained as primary care physicians, including coordinating graduate medical education policies and overseeing State program residency expenditures. Requires the Board to establish a method of applying the national goal to program goals for each medical residency program. Provides for enforcement, against State programs that fail to meet the goal, through reducing: (1) medical residency payments; and (2) the indirect portion of extramural biomedical and behavioral research grants from the National Institutes of Health (NIH). Requires the Board to provide for an Advisory Committee on Graduate Medical Education. Amends the Public Health Service Act to establish in NIH the Office of Primary Care and Prevention Research. Establishes in that Office: (1) the Coordinating Committee on Research on Primary Care and Prevention Research; and (2) the Advisory Committee on Research on Primary Care and Prevention Research. Requires the NIH Director to: (1) establish a data system for the collection, storage, analysis, retrieval, and dissemination of information regarding primary care and prevention research conducted or supported by the national research institutes; and (2) establish and operate a program to provide information on research and prevention activities of the institutes relating to such research. Authorizes appropriations for the Office. Mandates priority, in providing financial assistance under certain provisions relating to health research and teaching facilities and training of professional health personnel, to applicants, a substantial percentage of whose graduates are (or are expected to be) providing primary care to a substantial number of medically underserved individuals. Places an additional requirement on residency programs that they provide significant experience in providing: (1) primary care to such individuals; or (2) such services in ambulatory health facilities. Subtitle B: Grants for Expansion of Availability of Primary Care Services through Health Centers - Part 1: Primary Care Service Expansion Grants - Amends the Public Health Service Act to mandate grants to expand the availability of comprehensive primary health services in medically underserved areas. Authorizes appropriations. Part 2: Reduction in Medical Malpractice Liability for Community Health Centers - Includes entities receiving Federal funds under provisions relating to migrant health centers, community health centers, health services for the homeless, or (as added by this Act) grants for expansion of the availability of primary care services (and officers, employees, or contractors of such entities who are licensed health care practitioners) in the coverage of provisions regulating civil actions for injury resulting from medical or related functions against commissioned officers or employees of the Public Health Service. Subrogates to the United States any insurance claim such an entity or person has. Prohibits grants under such provisions unless the applicant has: (1) implemented policies and procedures to assure against malpractice; and (2) reviewed the professional credentials, claims history, and other information regarding its licensed health care practitioners; and (3) no history of claims against it under such provisions relating to officers and employees of the Public Health Service, or has cooperated with the Attorney General in defending against such claims and has taken corrective action. Empowers the Attorney General, if certain conditions are met, to determine that an individual practitioner shall not be deemed a Public Health Service employee for purposes of these provisions. Prohibits hospitals from denying admitting privileges to an otherwise qualified health care provider who is an officer, employee, or contractor of such an entity. Mandates withholding from the amounts appropriated for such entities an annual estimate of the amount of all claims under provisions relating to such civil actions. Subtitle C: Expansions in the National Health Service Corps - Authorizes appropriations for: (1) the National Health Service Corps Loan Repayment Program for physician and midlevel practitioner placements at entities receiving grants for expansion of the availability of primary care services; and (2) a number of contracts (for such repayments and scholarships under the National Health Service Corps Scholarship Program) sufficient to ensure the placement of a specified number of additional primary care physicians and a specified percentage increase in midlevel practitioners in health professional shortage areas. Defines "midlevel practitioner" to include certified nurse midwives, certified nurse practitioners, physician assistants, and similar nonphysician health care practitioners.
Bill· HRH.R. 5496 (102nd)referred
United States · United States Congress · 25 June 1992
Health Insurance Fairness Act of 1992 - Amends the Social Security Act (SSA) to add a new title XXI, Health Plan Standards. Prohibits an individual health plan, and any person which issues such a plan, from denying, limiting, or conditioning coverage of benefits for an individual, or varying premiums charged, based on the individual's health status or claims experience, except that plans may, for a limited period, exclude coverage of services related to treatment of a preexisting condition. Sets forth similar prohibitions with respect to group health plans. Outlines general requirements for health plans issued to small employers, as well as requirements related to restrictions on rating practices. Requires individual and group plans to be certified by the Secretary of Health and Human Services or approved by a State regulatory program before such plans may be issued. Requires the Secretary to establish specific standards that incorporate the requirements of this Act for individual and group health plans. Provides for establishment of a toll-free telephone information system to: (1) handle the receipt and disposition of consumer complaints regarding plan compliance with applicable standards; and (2) provide information to small employers about insurers that offer health plans meeting such standards. Amends the Internal Revenue Code to impose an excise tax on issuers of plans that do not meet applicable standards established under this Act. Sets forth a formula for determining the amount of such tax. Requires the General Accounting Office to study and report to the Congress on the impact of the standards for rating practices for small group health insurance on the availability and price of insurance offered to small employers.
Bill· HRH.R. 5495 (102nd)referred
United States · United States Congress · 25 June 1992
National Institutes of Health Revitalization Amendments of 1992 - Title I: General Provisions Regarding title IV of Public Health Service Act - Subtitle A: Research Freedom - Part I: Review of Proposals for Biomedical and Behavioral Research - Amends the Public Health Service Act to prohibit the Secretary of Health and Human Services from approving certain research or financial assistance to conduct research unless specified review has taken place and the review entity has recommended approval. Prohibits the Secretary from withholding, on ethical grounds, funding for research that has received such review approval unless: (1) an ethics advisory board recommends the withholding; or (2) such a board recommends against withholding, but the Secretary finds that the recommendation is arbitrary and capricious. Part II: Research on Transplantation of Fetal Tissue - Permits the Secretary to conduct or support research on the transplantation of human fetal tissue for therapeutic purposes regardless of whether the tissue is obtained from a spontaneous or induced abortion or a stillbirth, in accordance with State and local law. Requires the researcher, if the tissue bank established under a specified executive order is in operation, to obtain the tissue from that bank, unless the bank does not provide requested tissue within a specified time of a request. Requires certain statements by the woman providing the tissue, the researcher, and the donee. Imposes criminal penalties for certain commercial transactions involving the transfer or directed donation of human fetal tissue. Prohibits: (1) any official of the executive branch from imposing a policy prohibiting the Department of Health and Human Services from conducting or supporting any research on the transplantation of human fetal tissue for therapeutic purposes; and (2) the Secretary from withholding funds for research which is in accordance with this Act. Deems a specified report of the Human Fetal Tissue Transplantation Research Panel to be a report issued by an ethics advisory board finding, on a basis that is neither arbitrary nor capricious, that there are no ethical grounds for withholding funds for such research. Part III: Miscellaneous Repeals - Removes certain provisions of the Public Health Service Act relating to: (1) biomedical ethics; (2) a study by the Biomedical Ethics Advisory Committee on waiver of a specified risk standard; and (3) the construction of title IV (National Research Institutes) of the Act. Subtitle B: Clinical Research Equity Regarding Women and Minorities - Part I: Women and Minorities as Subjects in Clinical Research - Requires that women and minorities be included as subjects in each clinical research project under such title IV. Requires projects to be designed and carried out so as to provide for an analysis of whether the variables being tested affect women or minorities differently than other subjects. Requires the establishment of inclusion guidelines. Requires that technical and scientific peer review conducted under existing provisions include an evaluation of the merit of the proposal regarding women and minorities. Part II: Office of Research on Women's Health - Establishes in the National Institutes of Health (NIH) the Office of Research on Women's Health. Requires the Director of the Office to establish: (1) the Coordinating Committee on Research on Women's Health; and (2) the Advisory Committee on Research on Women's Health. Mandates: (1) a determination of the extent to which women are represented among senior physicians and scientists of the national research institutes and among those conducting research supported by the institutes; and (2) as appropriate, activities to increase the extent of such representation. Requires establishment of: (1) a data system, available to the public, for the collection, analysis, and dissemination of information regarding research on women's health conducted or supported by the institutes; and (2) a program to provide information on research and prevention activities of the institutes relating to women's health research. Subtitle C: Scientific Integrity - Replaces provisions relating to protection against scientific fraud with provisions establishing as an independent entity in the Department of Health and Human Services the Office of Scientific Integrity. Requires: (1) applicants for a grant, contract, or cooperative agreement under the Act for biomedical or behavioral research to have an administrative process to review reports of scientific misconduct and agree to report any investigation of such reports; and (2) a response process for the Office. Establishes the Commission on Scientific Integrity. Provides for employee whistle blower protection. Mandates measures for identifying, responding to, and reporting the existence of a financial interest that will or may create a bias in favor of obtaining results, in a project to evaluate the safety or effectiveness of a drug, medical device, or treatment, that are consistent with the interest. Title II: Protection of Health Facilities - Prohibits stealing or otherwise converting personal property or damaging real property of a health facility assisted under the Public Health Service Act, or deterring, through physical restraint, any individual from entering or exiting the facility. Includes in the prohibitions various acts interfering with the use of animals for research. Provides for fines, imprisonment, restitution, and private civil actions. Title III: National Institutes of Health in General - Modifies the duties of the NIH's Associate Director for Prevention. Establishes a program to enhance the competitiveness of research entities in States which have historically had low success in obtaining funds from the national research institutes for biomedical and behavioral research. Mandates activities, consistent with the global Children's Vaccine Initiative, to develop affordable new and improved vaccines. Authorizes appropriations. Requires a plan regarding research methods that do not require the use of animals, reduce the number of animals used, and produce less distress in the animals. Establishes the Interagency Coordinating Committee on the Use of Animals in Research. Repeals similar provisions. Authorizes the Secretary of Health and Human Services to conduct and support research, research training, recruitment, and other activities to increase the number of women and individuals from disadvantaged backgrounds in biomedical and behavioral research. Requires that any survey of human sexual behavior conducted or supported through NIH: (1) undergo review in accordance with specified provisions; and (2) have been determined by the Secretary to assist in reducing the incidence of infectious disease or improve health conditions. Establishes a fund for use by the NIH Director to carry out NIH activities. Authorizes appropriations. Modifies the term of office of members of advisory councils of the national research institutes. Requires that at least half of all new or revised health education and promotion materials developed or funded by NIH be in a form that does not exceed a level of functional literacy. Authorizes a program to provide day care service for NIH employees. Title IV: General Provisions Respecting National Research Institutes - Requires that the Secretary receive from the President and the Office of Management and Budget directly all funds appropriated by the Congress for obligation and expenditure by the Institute. Removes provisions authorizing the Director of the National Cancer Institute to directly receive such funds. Modifies the authority of the directors of the national research institutes to establish and appoint the members of technical and scientific peer review groups in addition to those appointed under specified provisions. Makes the Federal Advisory Committee Act inapplicable to such additional groups. Requires expansion and intensification of programs of research and related activities concerning osteoporosis, Paget's disease, and related bone disorders. Provides for the establishment, through a grant, cooperative agreement, or contract, of a clearinghouse to enhance knowledge and understanding of professionals, patients, and the public. Authorizes appropriations. Establishes: (1) a comprehensive program of conducting basic and clinical research on trauma, including diagnosis, treatment, rehabilitation, and general management of trauma; and (2) the Trauma Research Interagency Coordinating Committee. Title V: National Cancer Institute - Requires expanding, intensifying, and coordinating the activities of the National Cancer Institute (NCI) regarding breast and ovarian cancer, other cancers of the reproductive system of women, and prostate cancer. Requires inclusion of the conduct and support of research and demonstration centers. Authorizes appropriations. Removes provisions authorizing appropriations for NCI and the National Heart, Lung, and Blood Institute (NHLBI). Title VI: National Heart, Lung, and Blood Institute - Requires NHLBI to conduct intramural training and education. Authorizes development of three centers for basic and clinical research into, training in, and demonstration of, advanced diagnosis, prevention, and treatment for cardiovascular diseases in children. Authorizes appropriations for NHLBI. Title VII: National Institute on Diabetes and Digestive and Kidney Diseases - Establishes a program of conducting and supporting research, training, health information dissemination, and other activities regarding nutritional disorders, including obesity. Provides for the development or substantial expansion of centers for research and training. Title VIII: National Institute on Arthritis and Musculoskeletal and Skin Diseases - Removes provisions stating that the purpose of the National Institute on Arthritis and Musculoskeletal and Skin Diseases (NIAMSD) includes sports-related injuries. Requires NIAMSD to place emphasis on arthritis affecting children. Establishes a multipurpose arthritis and musculoskeletal disease center focusing on children. Modifies the composition of the National Arthritis Advisory Board and its annual report requirements. Title IX: National Institute on Aging - Transfers to the Public Health Service Act provisions of the Health Research Extension Act of 1985 authorizing a grant to develop a registry for epidemiological data on Alzheimer's disease and related data collection training. Removes the existing authorization of appropriations. Mandates research into the aging processes of women, with particular emphasis on menopause and into the diagnosis, disorders, and complications related to aging and loss of ovarian hormones. Authorizes appropriations for the National Institute on Aging. Title X: National Institute of Allergy and Infectious Diseases - Includes programs regarding tropical diseases in the purposes of the National Institute of Allergy and Infectious Diseases. Authorizes grants or contracts for centers to conduct basic and clinical research on chronic fatigue syndrome. Establishes an extramural study section for the syndrome. Title XI: National Institute of Child Health and Human Development - Subtitle A: Research Centers with Respect to Contraception and Research Centers with Respect to Infertility - Mandates grants or contracts for three centers to conduct activities to improve methods of contraception and two centers to conduct activities to improve methods of diagnosis and treatment of infertility. Authorizes appropriations. Establishes a program of agreements with health professionals, including graduate students, to conduct research on contraception or infertility in consideration of the Government repaying a limited amount of the educational loans of the professionals. Subtitle B: Program Regarding Obstetrics and Gynecology - Establishes in the National Institute of Child Health and Human Development (NICHHD) an intramural laboratory and clinical research program in obstetrics and gynecology. Subtitle C: Child Health Research Centers - Mandates development of and support for centers for conducting research on child health. Subtitle D: Study Regarding Adolescent Health - Mandates a longitudinal, large-scale study on the general health and well-being of adolescents in the United States. Allocates funding from amounts appropriated to NICHHD. Title XII: National Eye Institute - Authorizes not more than three grants for the establishment and support of centers for clinical research on eye care for individuals with diabetes. Allows grant funds to be used for equipment and for construction and modification of facilities. Title XIII: National Institute of Neurological Disorders and Stroke - Mandates the conduct and support of research on multiple sclerosis. Title XIV: National Institute of Environmental Health Sciences - Establishes the Applied Toxicological Research and Testing Program. Title XV: National Library of Medicine - Subtitle A: General Provisions - Directs the Secretary to promote the use of computers and telecommunications by health professionals. Increases the dollar limit on grants to medical libraries and related instrumentalities. Authorizes appropriations for the National Library of Medicine (NLM). Subtitle B: Financial Assistance - Mandates grants for research on, and development and demonstration of, new educational technologies. Requires recipient institutions to make grant projects available for: (1) training health professions students; and (2) enhancing the capabilities of health professionals regarding research and teaching. Authorizes appropriations to carry out provisions relating to medical libraries and related matters. Subtitle C: National Center for Biotechnology Information - Authorizes appropriations to carry out provisions relating to the National Center for Biotechnology Information. Subtitle D: National Information Center on Health Services Research and Health Care Technology - Establishes in NLM the National Information Center on Health Services Research and Health Care Technology to collect, analyze, and disseminate information on health services research and health care technology. Authorizes appropriations. Requires the Administrator of the existing information center on health care technologies and health care technology assessment and the NLM Director to enter into an agreement on the implementation of these provisions. Title XVI: Other Agencies of National Institutes of Health - Subtitle A: Division of Research Resources - Redesignates the Division of Research Resources as the National Center for Research Resources. Authorizes grants to alter existing or construct new research facilities. Establishes the Scientific and Technical Review Board on Biomedical and Behavioral Research Facilities to advise the Center director and the existing advisory council. Conditions grant approval on Board approval. Authorizes appropriations. Requires the NIH Director to reserve a specified sum from amounts appropriated under this authorization for grants and contracts to construct or improve regional centers for research on primates. Subtitle B: National Center for Nursing Research - Redesignates the National Center for Nursing Research as the National Institute for Nursing Research and adds the Institute to the list of NIH's national research institutes. Subtitle C: National Center for Human Genome Research - Adds the National Center for Human Genome Research to the list of NIH agencies. Declares the purpose of the Center to be to characterize the structure and function of the human genome, including the mapping and sequencing of individual genes. Title XVII: Awards and Training - Subtitle A: National Research Service Awards - Directs the Secretary to carry out provisions relating to National Research Service Awards in a manner that will recruit into biomedical or behavioral research, and provide research training to, women and individuals from disadvantaged backgrounds. Subtitle B: Acquired Immune Deficiency Syndrome - Modifies a program of agreements (under which certain health professionals conduct research regarding acquired immune deficiency syndrome (AIDS) as NIH employees in consideration of Government repayment of educational loans) to remove provisions requiring a minimum of three years as an NIH employee. Authorizes appropriations. Authorizes the Commissioner of Food and Drugs to carry out a similar program regarding the review of applications concerning AIDS. Subtitle C: Loan Repayment for Research Generally - Mandates a program of agreements with health professionals who have a substantial amount of educational loans relative to income and who meet other requirements to conduct research, as NIH employees, in consideration of Government repayment of a limited amount of the educational loans of the professionals. Authorizes appropriations. Subtitle D: Scholarship and Loan Repayment Programs Regarding Professional Skills Needed by Certain Agencies - Authorizes a program of contracts with individuals from disadvantaged backgrounds for scholarships for undergraduate programs for professions needed by NIH in consideration of service by the individuals as NIH employees. Authorizes a program of contracts with health professionals from disadvantaged backgrounds who have a substantial amount of educational loans relative to income to conduct clinical research as NIH employees in consideration of the Government repaying a limited amount of the educational loans of the professionals. Subtitle D: (SIC) Funding - Authorizes appropriations for making payments under National Research Service Awards and under grants for such Awards. Modifies set-aside amounts and requires a set-aside for provisions relating to residency programs in the general practice of dentistry. Title XVIII: National Foundation for Biomedical Research - Excludes from voting rights the ex officio members of the National Foundation for Biomedical Research. Authorizes appropriations. Title XIX: Research with Respect to Acquired Immune Deficiency Syndrome - Modifies the duties of the AIDS Clinical Research Review Committee, including requiring the Committee to: (1) give advice to other agencies of NIH as well as to the National Institute of Allergy and Infectious Diseases (NIAID); and (2) make recommendations on research projects regarding diagnosing immune deficiency and predicting, diagnosing, preventing, and treating opportunistic cancers and infectious diseases. States that the requirement that the clinical evaluation units at the National Cancer Institute and NIAID conduct evaluations of treatments for acquired immune deficiency syndrome (AIDS) includes evaluations of methods of: (1) diagnosing immune deficiency; and (2) predicting, diagnosing, preventing, and treating opportunistic cancers and infectious diseases. Modifies provisions relating to the support of international efforts to add to the purpose of grants, cooperative agreements, and contracts for such efforts provisions promoting and expediting: (1) international training; (2) research and training concerning the natural history and pathogenesis of the human immunodeficiency virus; and (3) the development and evaluation of vaccines and treatments for opportunistic infections. Authorizes appropriations for each fiscal year. Requires that model protocols (developed with grants under existing provisions) for the clinical care of individuals infected with the etiologic agent for AIDS include treatment and prevention of human immunodeficiency virus (HIV) infection and related conditions among women. Authorizes appropriations. Adds collection of data on the natural history of infection with the etiologic agent to the purposes of the epidemiological data base mandated by current provisions. Authorizes appropriations for each fiscal year. Requires the Director of NIH to develop and implement a comprehensive plan for the conduct and support of AIDS research by NIH agencies. Authorizes appropriations for each fiscal year for fellowship and training programs relating to AIDS under existing provisions. Title XX: Certain Authorities of Centers for Disease Control - Authorizes grants to States and local health departments for programs for specified activities relating to prostate cancer, including screening, public information, and improving professional training. Authorizes appropriations. Authorizes: (1) grants or contracts for population-based, statewide cancer registries; (2) grants for developing plans that meet the requirements of specified provisions; and (3) technical assistance to States, either directly or through grants and contracts. Mandates a study on the factors contributing to elevated breast cancer mortality rates in specified States. Authorizes appropriations. Requires a survey to determine which entities collect data on traumatic brain injuries and the nature of their data collection systems. Authorizes cooperation and assistance to establish traumatic brain injury as a specific reportable condition or disability. Authorizes appropriations. Title XXI: Studies - Mandates studies on: (1) the impact, with regard to acquired immune deficiency syndrome (AIDS), of parallel-track drug-release mechanisms on clinical research and on the activities of the Commissioner of Food and Drugs regarding drug approval; (2) third-party payor policies regarding payment of costs incident to the participation of individuals as subjects in AIDS drug clinical trials; and (3) whether AIDS advisory committees in NIH are being sufficiently coordinated. Requires a plan for the inclusion of HIV-infected women, infants, and children in HIV vaccine studies conducted by or through NIH. Authorizes appropriations. Mandates an annual report on the leading causes of death in the United States and related spending by the Department of Health and Human Services for research, prevention, and education. Requires three-year studies on: (1) nutrition screening and intervention regarding the elderly; and (2) the extent of malnutrition in hospitals, in long-term care facilities, and among those living independently. Establishes an advisory panel to oversee the studies. Mandates a report on the feasibility of developing a plan for the conduct of research at NIH on the prevention of traumatic injuries. Directs the Secretary to: (1) review existing data and research concerning whether there is a relationship between legal and illegal drug use; and (2) if necessary, conduct additional research. Mandates reports on: (1) research conducted or supported by NIH on chronic fatigue syndrome; (2) the appropriateness and impact of NIH assuming responsibility for the conduct of all Federal research, development, testing, and evaluation relating to medical countermeasures against biowarfare threat agents. Requires a study on the potential for, the prevalence of, and the issues related to the contamination of worker's homes with substances from their work places. Requires: (1) establishment of the Worker's Family Protection Task Force to take specified actions, including developing an investigative strategy for obtaining any needed additional data; and (2) each Federal department or agency to fulfill the role assigned by the strategy. Authorizes appropriations. Mandates studies: (1) of the retention, recruitment, vacancy and turnover rates of NIH support staff, including fire fighters, law enforcement, procurement officers, technicians, nurses, and clerical employees; and (2) to develop a streamlined procurement system for NIH. Title XXII: Miscellaneous Provisions - Redesignates the Senior Biomedical Research Service as the Silvio Conte Senior Biomedical Research Service and increases the limit on the number of its members. Renames the AIDS Clinical Research Review Committee as the AIDS Research Advisory Committee. Prohibits the Secretary from conducting or supporting the SHARP survey of adult sexual behavior. Requires that a report on carcinogens be submitted biennially (currently, annually). Mandates a report analyzing the report of the National Committee on Sleep Disorders Research and presenting a plan for the conduct and support of sleep disorders research at NIH. Mandates presentation to the Congress of a master plan to provide for the replacement or refurbishment of less than adequate buildings, utility equipment and distribution systems, roads, walkways, parking areas, and grounds of NIH laboratory and clinical facilities. Allows the plan to make recommendations for the undertaking of new projects consistent with the objectives of these provisions. Title XXIII: Effective Date - Sets forth the effective date of this Act.
Bill· SS. 2888 (102nd)referred
United States · United States Congress · 24 June 1992
Amends title XVIII (Medicare) of the Social Security Act to eliminate the adjacency requirements for rural hospitals that apply for reclassification to another rural area, so long as the two areas are within 35 miles of one another.
Resolution· SCONRESS.Con.Res. 126 (102nd)referred
United States · United States Congress · 24 June 1992
Declares that it is the sense of the Congress that any legislation passed by the Congress to address American health care needs must include coverage for mental disorders.
Bill· SS. 2882 (102nd)referred
United States · United States Congress · 23 June 1992
National Telecommunications and Information Administration Authorization Act of 1992 - Authorizes appropriations for: (1) the National Telecommunications and Information Administration; (2) the acquisition of ATS-1 satellite space segment capacity and equipment; (3) the management of the operation of satellite communications services of the Pan-Pacific Educational and Cultural Experiments Satellite Program; (4) establishment of an advisory panel to develop recommendations for improvement of rural health care through improved information services; and (5) the National Endowment for Children's Educational Television. Requires the Secretary of Commerce to promote efficient and cost-effective use of the spectrum to the maximum extent feasible in awarding assignments for mobile radio services. Authorizes the Secretary to withhold or refuse to award an assignment for mobile radio service in order to make efficient and cost-effectiveness use of the spectrum. Requires the Secretary, by June 1, 1993, to adopt a plan for Federal agencies with existing mobile radio systems to use technologies that are at least as spectrum-efficient and cost-effective as readily available commercial mobile radio systems.
Bill· SS. 2878 (102nd)referred
United States · United States Congress · 23 June 1992
Medical and Health Insurance Information Reform Act of 1992 - Adds a new title XXII, Medical And Health Insurance Information Reform, to the Social Security Act (SSA). Requires the Secretary of Health and Human Services, in order to assure the availability of comparative value information to health care purchasers, to determine whether each State is developing and implementing a health care value information program. Enumerates the criteria for State programs. Provides that if the Secretary finds that a State has not developed or implemented a health care value information program that comports with such criteria, the Secretary must take necessary actions to implement a comparable program in the State. Allows fees to be charged for the informational materials provided pursuant to such program. Directs the head of any Federal agency with responsibility for the provision of health insurance or health care services to develop and make comparative value information available to States, health care providers, and consumers. Directs the Secretary to promulgate requirements for health insurers to furnish periodically to the Secretary, on a sample basis, health care data relevant to health care services research. Requires the Secretary to make available, under the Freedom of Information Act, all Medicare (SSA title XVIII) claims records, without regard to the consent of the physician or other individual who furnished the item or service in question. Maintains in force Privacy Act protections against the release of information that identifies Medicare beneficiaries. Applies this new requirement for release of records only to information received after the enactment of this Act. Directs the Secretary, directly or through grant or contract, to develop model systems: (1) for gathering health care cost, quality, and outcomes data; and (2) for analyzing such data in a manner that would allow valid comparisons among providers and among health plans. Requires the Secretary to support and evaluate experiments with different approaches to achieve the most cost-effective method. Provides that, when appropriate, the Secretary may establish standards for data gathering in order to facilitate analysis and comparisons across the nation. Authorizes appropriations. Authorizes the Secretary to make grants to States to enable them to plan and initiate implementation of their health care information programs. Authorizes appropriations. Nullifies any State law which requires medical or health insurance records (including billing information) to be kept in written, rather than electronic, form. Directs the Secretary, after taking into consideration the Insurance Information and Privacy Protection Model Act of the National Association of Insurance Commissioners (NAIC), to promulgate requirements concerning health insurance information privacy and confidentiality. Includes among such requirements that information identifying individuals shall not be redisclosed (with such limited exceptions as the Secretary may provide) except to the extent necessary to carry out the purpose for which the information was collected. Requires the Secretary to take into consideration specified principles concerning information that identifies individuals when promulgating such requirements. Directs the Secretary to determine whether problems relating to standards for the electronic receipt and transmission of health insurance information cause significant administrative costs. Requires the Secretary, if such costs are generated, to promulgate standards for the electronic receipt and transmission of claims, payment, eligibility, and enrollment information (including privacy and confidentiality protection requirements). Directs the Secretary to determine whether problems relating to the receipt and transmission of health insurance eligibility verification cause significant administrative costs. Requires the Secretary, if such costs are generated, to promulgate requirements for the receipt and transmission of health insurance eligibility verification. Directs the Secretary to determine whether the proportion of health insurance claims and payment information received and transmitted by paper will continue to cause significant administrative costs. Directs the Secretary, if such costs are generated, to require a specified proportion of (or all of) such information to be received and transmitted electronically (with such exceptions as the Secretary might specify). Directs the Secretary to promulgate requirements for the format and content of basic claim forms under health insurance plans. Directs the Secretary to determine whether the variety of information requested by health insurers (in addition to information requested in basic claims forms) causes administrative costs disproportionate to the benefits derived. Requires the Secretary, if such costs are generated, to publish recommendations concerning what additional information should be allowed to be requested and in what format. Directs the Secretary, after consulting with the NAIC, to promulgate rules for determining the relative liability of insurers and the priority of payment when several health insurance policies cover the same individual. Directs the Secretary to determine whether problems relating to the transfer of information among health insurers that cover the same individual cause significant mistaken payments or administrative costs. Requires the Secretary, if such payments or costs are generated, to promulgate requirements concerning the transfer among insurers (and annual updating) of information (which may include requirements for the use of unique identifiers, and for the listing of all individuals covered under a health insurance plan). Directs the Secretary to determine, for each State, whether there were in effect State requirements substantially the same as those enumerated below and whether the State effectively enforced them. Applies the requirements enumerated below to administrators of self-insured employee plans. Provides for Federal backup authority to be effective in a States (with respect to a section) only if the Secretary makes a negative finding with respect to certain requirements or if the State does not provide sufficient information to enable the Secretary to make the determination. Requires health insurers (in States that do not have an equivalent program) to: (1) meet the Federal requirements concerning the protection of privacy and confidentiality; (2) use social security numbers for their beneficiaries and Medicare unique identifiers for each providers that furnishes items and services; (3) meet the standards and requirements (if any) concerning the receipt and transmission of health insurance information; (4) meet the requirements concerning the form and content of health insurance claim forms; (5) follow the rules determining the priority of payment when several health insurance policies cover the same individual; and (6) meet the requirements (if any) concerning the furnishing of information among insurers. Requires the Secretary, after consulting with the American National Standards Institute (ANSI) and others, to promulgate requirements for hospitals concerning electronic medical data. Specifies the data sets to be included in such requirements. Permits the Secretary, after consulting with ANSI and others, to promulgate requirements for health care entities other than hospitals concerning electronic medical data. Requires hospitals that participate in the Medicare program to maintain an electronic patient care information system that meets certain data set requirements promulgated by the Secretary for hospitals, and to transmit data electronically to the Secretary, peer review organizations, carriers, and intermediaries, from the appropriate data sets. Permits waivers of such requirements for hospitals in the process of developing an electronic patient care information system, for small rural hospitals, and for certain hospitals that agree to subject their data transfer processes to specified quality assurance procedures. Permits Federal agencies to require electronic transmission of data elements utilized for certain agency health care or research programs. Amends the Internal Revenue Code to subject insurers to an excise tax for any failure to comply with requirements under SSA new title XXII respecting health insurance. Specifies the amount of such tax for administrator of self-insured employee welfare benefit plans and other insurers. Provides that the excise tax generally shall not apply if the violation could not have been discovered through the exercise of reasonable diligence, or if the violation was corrected within 30 days after it had been discovered. Gives the Secretary authority to waive the tax if the violations were due to reasonable cause and not willful neglect, to the extent payment of the tax would be excessive relative to the failure involved. Authorizes the Secretary to make grants to: (1) community organizations or coalitions of health care providers, insurers, and purchasers to establish, and document the efficacy of, communication links between the information systems of health insurers and of health care providers; and (2) public and private non-profit entities for the development of regional- and community- based clinical information systems, and for the development and testing of certain ambulatory care data sets. Authorizes appropriations.
Bill· SS. 2884 (102nd)referred
United States · United States Congress · 23 June 1992
Fish Safety Act of 1992 - Amends the Food Security Act of 1985 to create a new title setting forth a fish inspection program. Directs the Secretary of Agriculture (the Secretary) to exempt from specific provisions of the title: (1) fish processing by an individual for use in that individual's household; (2) custom processing for use in the household of the product owner; (3) processing of products not intended for nor capable of use as human food; (4) warehousing of up to 50 pounds or of product caught for other than commercial purposes in waters outside the United States; and (5) operations of types traditionally and usually conducted at retail stores or restaurants. Excludes from the application of the title recreational vessels, commercial fishing vessels, or fish tender vessels except where such vessels process fish. Authorizes the Secretary to cooperate with the appropriate agency in any State that has enacted a mandatory State fish product inspection law with requirements at least equal to those in the title. Prohibits State programs from permitting products to bear any official marks or certificates applicable to products in interstate commerce. Requires that fish products processed for intrastate commerce under a State program that are sold, transported, delivered, or offered for sale in interstate commerce be considered adulterated. Authorizes the Secretary to cooperate with State agencies concerning the State administration of the inspection and sampling components of the fish inspection program established under the title on behalf of the Secretary. Authorizes the Secretary to provide State agencies with advisory assistance, technical and laboratory assistance and training, and financial and other assistance for up to 50 percent of the cost of the cooperative program. Requires State program participants to submit operation plans to the Secretary annually. Directs the Secretary to establish standards for the efficient and effective administration of the sampling and inspection program by each approved State. Authorizes the Secretary to deputize specific State employees in approved States. Authorizes the Secretary to appoint advisory committees. Requires the appropriate State agency with which the Secretary may cooperate to be a single agency that is primarily responsible for the coordination of the State programs having objectives the same as the title. Directs the Secretary to develop and administer a comprehensive and efficient health-based inspection program for fish products designed to protect the consuming public from fish products that may be adulterated or misbranded. Sets forth program requirements. Directs the Commissioner of Food and Drugs to establish tolerances, except where tolerances are established by the Administrator of the Environmental Protection Agency, that shall be applicable to poisonous or deleterious substances that may adulterate fish products. Requires the tolerances to be: (1) established at levels so that fish products are not injurious to health; and (2) based on a scientific analysis of health risks. Directs the Commissioner to establish tolerances, except where tolerances are established by the Administrator under the Federal Food, Drug, and Cosmetic Act, for harmful chemicals, toxins, parasites, pathogenic microorganisms, viruses, bacteria, and other harmful agents that may render fish products adulterated. Allows the tolerances to include the use of indicators, including indicator organisms. Directs the Secretary of Commerce and appropriate State authorities, for waters under their jurisdiction, to establish a system for the identification and classification of growing and harvesting areas for fish in coastal areas and the Great Lakes. Directs the Secretary to sample and test fish products regarding any instance or trend that may pose a significant threat to consumers' health and safety. Authorizes the Secretary to provide financial and other assistance to States to prevent the entry of adulterated fish products into establishments, including annual grants to each State that is a member of the Interstate Shellfish Sanitation Conference. Authorizes the Secretary of Commerce, with regard to waters under the exclusive jurisdiction of that Secretary, to close waters or restrict harvesting of a species if fish of that species within the identified harvesting or growing areas are likely to be adulterated. Directs the Secretary of Commerce to: (1) periodically review the closure or restriction; and (2) establish procedures for review on petitions by affected persons. Requires reasonable public notice prior to closure or restriction, except in public health emergencies. Requires inspectors authorized by the Secretary to take actions as necessary to implement the title, including: (1) inspection of establishments, products, packages, equipment, procedures, and records; (2) sampling and testing of fish products; (3) detention and condemnation of adulterated or misbranded products; and (4) inspection, sampling, and testing of imports of fish products. Provides for: (1) segregation, seizure, condemnation, and destruction of adulterated or misbranded fish products; (2) processing of products to the extent necessary to prevent spoilage pending hearing and review; and (3) deferral of condemnation pending bringing of a product into compliance by relabeling or other action. Requires establishments to maintain premises, facilities, equipment, and operations in accordance with sanitation regulations set by the Secretary. Directs the Secretary to establish regulations for the storage or handling of fish products by any person in the business of buying, selling, freezing, storing, transporting, or importing fish products. Authorizes the Secretary to establish guidelines for training persons employed by establishments involved in fish product sanitation and quality control. Authorizes the Secretary to exempt products from inspection requirements until a specified date if appropriated funds are insufficient or if the exemption will aid in the effective transition to the programs implemented under the title. Directs the Secretary to establish procedures for the annual certification of establishments and persons engaged in importing of fish and fish products. Prohibits importers from processing or handling any fish product for commercial purposes unless the establishment is certified. Authorizes the Secretary to refuse to certify or to decertify establishments or importers unfit to engage in any business as a result of Federal or State convictions for: (1) acquiring, handling, or distributing adulterated, mislabeled, or deceptively packaged food, or fraud in food transactions; or (2) any felony involving a lack of the integrity needed for the conduct of operations affecting the public health. Requires all products processed at any certified establishment to bear on their shipping containers and immediate containers information as the Secretary requires. Authorizes the Secretary to permit such products to bear a seal stating that the product was processed in accordance with Federal standards or similar language. Authorizes the Secretary to prescribe: (1) labeling requirements to avoid false or misleading labeling; (2) definitions and standards of identity or composition and fill; and (3) procedures that permit statements on labels that indicate the State or location of the product's origin. Directs the Secretary to: (1) require that each package of fish product bears the appropriate identification, issued under the title, and an official mark; and (2) ensure that the official mark shall be available only on products processed in certified establishments. Prohibits articles from being sold or offered for sale under any name, marking, or labeling that is false or misleading, or in any container of a misleading form or size. Permits established trade names and other marking and labeling that are not false or misleading and that are approved by the Secretary. Authorizes the Secretary, if any marking, labeling, size, or form of any container is false or misleading, to require that use be withheld unless modified as prescribed by the Secretary so that it will not be false or misleading. Prohibits a fish product from being entered, or withdrawn from warehouses, for consumption in the United States, unless the product: (1) is not adulterated or misbranded; (2) complies with all requirements of the title; and (3) is marked and labeled as required for imports. Treats all such products as domestic fish products under the title, except that its labeling must identify the country of origin. Directs the Secretary to enforce these provisions through inspections, sampling, and any other necessary procedures. Requires products refused entry or entered, or withdrawn from warehouses, in violation of these provisions to be destroyed unless exported or brought into compliance. Requires storage, cartage, labor, and other costs from denial of entry or withdrawal from warehouse to be paid by the owner or consignee. Declares that nonpayment constitutes a lien against the product and any other fish product thereafter entered, or withdrawn from warehouse, for consumption in the United States by such owner or consignee. Directs the Secretary, on request of a country desiring to export fish products to the United States, to review the inspection program of products offered for importation to determine whether the requirements and tolerances for the products are at least equal to those under the title and, if so, and if the country will permit the enforcement measures the Secretary determines necessary, to issue a certificate stating that the country meets the requirements. Requires all fish products imported from an uncertified country to be inspected by the Secretary to ensure compliance with these provisions. Directs the Secretary to enforce these provisions through inspections, sampling, testing, or other actions in the foreign country, during importation, or otherwise as necessary. Declares that products intended for export shall not be considered adulterated or misbranded if they are consistent with the laws of the importing country and meet other requirements. Directs the Secretary to inspect products intended for export as necessary. Directs the Secretary, on request of the exporter, to provide a certificate for export stating the condition of fish products inspected under these provisions. Authorizes the Secretary to require any person who owns or operates an establishment or is in the business of importing fish products to recall any fish product that is adulterated or misbranded if it could cause serious health consequences. Directs the Secretary of Health and Human Services to establish, through the Centers for Disease Control, an active surveillance system, based on a representative portion of the U.S. population, to provide an estimate of the frequency of human disease in the United States associated with the consumption of food, including a comparison of each major food category. Sets forth a list of prohibited acts in connection with the processing, handling, selling, transporting, offering for sale or transportation, possessing, misbranding, or importation of fish products or in connection with inspections under the title. Provides civil monetary penalties and criminal penalties for violations. Prohibits a common or contract carrier, including carriers that are fish tender vessels, from being subject to penalties under the title unless the carrier: (1) had knowledge, or possessed facts that would cause a reasonable person to believe, that the products were adulterated or misbranded; or (2) refuses to furnish certain information and documents. Sets forth: (1) felony penalties for giving or receiving bribes; and (2) criminal penalties for forcibly assaulting, resisting, intimidating, or interfering with any inspector or other person while engaged in official duties under the title. Requires each establishment or import business subject to inspection under the title to be operated in accordance with such sanitary and other procedures and practices as the Secretary requires. Directs the Secretary to prescribe standards for marking fish or fish products handled or processed in accordance with the title, or their packages, with an official stamp. Directs the Secretary to establish priorities for fish and fish products safety research. Requires the appropriate Federal agencies to conduct research regarding the priorities. Directs the Secretary, through the Extension Service, to provide a specified sum each fiscal year out of funds appropriated for the title to award grants for demonstration projects by States with regard to providing food safety information and instruction regarding the proper handling, storage, and preparation of fish and fish products for human consumption. Directs the Secretary of Commerce to establish through grants and administer, for a five-year period, a shellfish indicator research program to develop a system of classification of shellfish harvesting areas. Directs the Secretary to establish an advisory panel to assist in the development and implementation of the research programs under these provisions. Prohibits: (1) copying of any official mark; and (2) processing fish products except in compliance with the title. Authorizes the Secretary to limit the entry of fish products and other materials into any establishment consistent with the purposes of the title. Provides for administrative detention of any fish product meeting certain requirements if there is reason to believe the product is adulterated or misbranded. Makes any fish product capable of use as human food and adulterated or misbranded, or which otherwise is or has been in violation of the title, liable to be proceeded against and seized and condemned at any time, on a libel of information. Provides for disposal of a condemned product and for the delivery of the product to the owner on delivery of bond. Applies specified provisions of Federal law to the administration and enforcement of the title. Exempts the inspection, sampling, regulation, handling, processing, storage, or transportation of fish products from the Federal Food, Drug, and Cosmetic Act to the extent such matters are covered by the title. Requires that the cost of inspections be borne by the United States, except for overtime or holiday work required in an establishment, which must be borne by the establishment. Authorizes appropriations to carry out the title, earmarking: (1) certain sums for the research programs under the title; (2) certain percentages for the Food and Drug Administration; and (3) other percentages for the Department of Commerce. Amends Federal law to add a reference to food safety to provisions specifying the matters to be included in cooperative agricultural extension work. Authorizes appropriations for programs administered by the Secretary of Agriculture through the Extension Service to disseminate food safety information and instruction to consumers, restaurant food handlers, schools, and other persons. Requires the Commissioner of Food and Drugs to: (1) develop and implement a program to carry out and administer the title; and (2) enter into contracts with the National Academy of Sciences to identify chemical and microbiological contaminants, parasites, toxins, and other harmful substances that are most likely to be found in fish and fish products and that are most likely to cause fish and fish products to be adulterated. Directs the Secretary of Commerce to develop and implement a program to carry out the requirements of the title.
Bill· SJRESS.J.Res. 321 (102nd)referred
United States · United States Congress · 23 June 1992
Designates the week beginning March 21, 1993, as National Endometriosis Awareness Week.
Bill· HRH.R. 5464 (102nd)referred
United States · United States Congress · 23 June 1992
Medical and Health Insurance Information Reform Act of 1992 - Adds a new title XXII, Medical And Health Insurance Information Reform, to the Social Security Act (SSA). Requires the Secretary of Health and Human Services, in order to assure the availability of comparative value information to health care purchasers, to determine whether each State is developing and implementing a health care value information program. Enumerates the criteria for State programs. Provides that if the Secretary finds that a State has not developed or implemented a health care value information program that comports with such criteria, the Secretary must take necessary actions to implement a comparable program in the State. Allows fees to be charged for the informational materials provided pursuant to such program. Directs the head of any Federal agency with responsibility for the provision of health insurance or health care services to develop and make comparative value information available to States, health care providers, and consumers. Directs the Secretary to promulgate requirements for health insurers to furnish periodically to the Secretary, on a sample basis, health care data relevant to health care services research. Requires the Secretary to make available, under the Freedom of Information Act, all Medicare (SSA title XVIII) claims records, without regard to the consent of the physician or other individual who furnished the item or service in question. Maintains in force Privacy Act protections against the release of information that identifies Medicare beneficiaries. Applies this new requirement for release of records only to information received after the enactment of this Act. Directs the Secretary, directly or through grant or contract, to develop model systems: (1) for gathering health care cost, quality, and outcomes data; and (2) for analyzing such data in a manner that would allow valid comparisons among providers and among health plans. Requires the Secretary to support and evaluate experiments with different approaches to achieve the most cost-effective method. Provides that, when appropriate, the Secretary may establish standards for data gathering in order to facilitate analysis and comparisons across the nation. Authorizes appropriations. Authorizes the Secretary to make grants to States to enable them to plan and initiate implementation of their health care information programs. Authorizes appropriations. Nullifies any State law which requires medical or health insurance records (including billing information) to be kept in written, rather than electronic, form. Directs the Secretary, after taking into consideration the Insurance Information and Privacy Protection Model Act of the National Association of Insurance Commissioners (NAIC), to promulgate requirements concerning health insurance information privacy and confidentiality. Includes among such requirements that information identifying individuals shall not be redisclosed (with such limited exceptions as the Secretary may provide) except to the extent necessary to carry out the purpose for which the information was collected. Requires the Secretary to take into consideration specified principles concerning information that identifies individuals when promulgating such requirements. Directs the Secretary to determine whether problems relating to standards for the electronic receipt and transmission of health insurance information cause significant administrative costs. Requires the Secretary, if such costs are generated, to promulgate standards for the electronic receipt and transmission of claims, payment, eligibility, and enrollment information (including privacy and confidentiality protection requirements). Directs the Secretary to determine whether problems relating to the receipt and transmission of health insurance eligibility verification cause significant administrative costs. Requires the Secretary, if such costs are generated, to promulgate requirements for the receipt and transmission of health insurance eligibility verification. Directs the Secretary to determine whether the proportion of health insurance claims and payment information received and transmitted by paper will continue to cause significant administrative costs. Directs the Secretary, if such costs are generated, to require a specified proportion of (or all of) such information to be received and transmitted electronically (with such exceptions as the Secretary might specify). Directs the Secretary to promulgate requirements for the format and content of basic claim forms under health insurance plans. Directs the Secretary to determine whether the variety of information requested by health insurers (in addition to information requested in basic claims forms) causes administrative costs disproportionate to the benefits derived. Requires the Secretary, if such costs are generated, to publish recommendations concerning what additional information should be allowed to be requested and in what format. Directs the Secretary, after consulting with the NAIC, to promulgate rules for determining the relative liability of insurers and the priority of payment when several health insurance policies cover the same individual. Directs the Secretary to determine whether problems relating to the transfer of information among health insurers that cover the same individual cause significant mistaken payments or administrative costs. Requires the Secretary, if such payments or costs are generated, to promulgate requirements concerning the transfer among insurers (and annual updating) of information (which may include requirements for the use of unique identifiers, and for the listing of all individuals covered under a health insurance plan). Directs the Secretary to determine, for each State, whether there were in effect State requirements substantially the same as those enumerated below and whether the State effectively enforced them. Applies the requirements enumerated below to administrators of self-insured employee plans. Provides for Federal backup authority to be effective in a State (with respect to a section) only if the Secretary makes a negative finding with respect to certain requirements or if the State does not provide sufficient information to enable the Secretary to make the determination. Requires health insurers (in States that do not have an equivalent program) to: (1) meet the Federal requirements concerning the protection of privacy and confidentiality; (2) use social security numbers for their beneficiaries and Medicare unique identifiers for each provider that furnishes items and services; (3) meet the standards and requirements (if any) concerning the receipt and transmission of health insurance information; (4) meet the requirements concerning the form and content of health insurance claim forms; (5) follow the rules determining the priority of payment when several health insurance policies cover the same individual; and (6) meet the requirements (if any) concerning the furnishing of information among insurers. Requires the Secretary, after consulting with the American National Standards Institute (ANSI) and others, to promulgate requirements for hospitals concerning electronic medical data. Specifies the data sets to be included in such requirements. Permits the Secretary, after consulting with ANSI and others, to promulgate requirements for health care entities other than hospitals concerning electronic medical data. Requires hospitals that participate in the Medicare program to maintain an electronic patient care information system that meets certain data set requirements promulgated by the Secretary for hospitals, and to transmit data electronically to the Secretary, peer review organizations, carriers, and intermediaries, from the appropriate data sets. Permits waivers of such requirements for hospitals in the process of developing an electronic patient care information system, for small rural hospitals, and for certain hospitals that agree to subject their data transfer processes to specified quality assurance procedures. Permits Federal agencies to require electronic transmission of data elements utilized for certain agency health care or research programs. Amends the Internal Revenue Code to subject insurers to an excise tax for any failure to comply with requirements under SSA new title XXII respecting health insurance. Specifies the amount of such tax for administrators of self-insured employee welfare benefit plans and other insurers. Provides that the excise tax generally shall not apply if the violation could not have been discovered through the exercise of reasonable diligence, or if the violation was corrected within 30 days after it had been discovered. Gives the Secretary authority to waive the tax if the violations were due to reasonable cause and not willful neglect, to the extent payment of the tax would be excessive relative to the failure involved. Authorizes the Secretary to make grants to: (1) community organizations or coalitions of health care providers, insurers, and purchasers to establish, and document the efficacy of, communication links between the information systems of health insurers and of health care providers; and (2) public and private non-profit entities for the development of regional- and community- based clinical information systems, and for the development and testing of certain ambulatory care data sets. Authorizes appropriations.
Bill· HRH.R. 5454 (102nd)referred
United States · United States Congress · 22 June 1992
Long-Term Health Care Program Act of 1992 - Amends title XVIII (Medicare) of the Social Security Act to add a new part C, Long-Term Care Program. Makes U.S. citizens and resident aliens with limited capacity to perform daily living activities or a mental impairment eligible for specified long-term care benefits. Specifies the scope and duration of such benefits. Directs the Secretary of Health and Human Services to contract with State or other entities to establish: (1) Long-Term Care Screening Agencies for determining the eligibility of individuals for part C benefits; and (2) Long-Term Care Case Management Agencies for providing case management services for eligible individuals, developing individual care plans, and assisting individuals in choosing qualified providers to carry out the care plan. Specifies the qualifications for home- and community-based service providers. Provides for payments to such providers as well as to Case Management Agencies and nursing facilities. Sets forth requirements for certification of service providers. Establishes the Home- and Community-Based Care Advisory Council to: (1) assist the Secretary in assuring the prompt and efficient implementation of new part C; (2) regularly review that implementation; and (3) recommend to the Secretary and the Congress any necessary modifications of the program. Sets forth requirements qualified providers must meet in order to receive funding for the provision of: (1) home- or community-based services; and (2) durable medical equipment services. Sets forth quality assurance requirements agencies must meet in order to receive funding for the provision of case management services under new part C. Directs the Secretary to develop and implement a standard and extended survey of home care agencies certified to receive payments for services under this Act. Directs the Secretary to promulgate a consumers' bill of rights recognizing specified rights of consumers of long-term care which may be asserted by the consumer or his or her representative or guardian. Requires utilization and quality control peer review organizations to establish and appoint members to a quality assurance board that will monitor the quality of care provided in the area served by the organization. Provides for low-income assistance for individuals entitled to part C benefits for room and board payments. Sets forth administrative provisions. Creates in the Treasury the Long-Term Care Trust Fund to hold the revenues generated under title II of this Act for financing the new long-term care program. Requires major efforts by peer review organizations on quality assurance activities with respect to long-term care. Sets forth additional provisions relating to quality assurance. Revises provisions respecting the hospital discharge planning process. Eliminates overlapping mandatory long-term care benefits under the Medicaid program under title XIX of the Social Security Act. Title II: Financing - Amends the Internal Revenue Code to: (1) eliminate the limit on wages and self-employment income subject to FICA and railroad retirement taxes; and (2) increase hospital insurance tax rates. Title III: Grants And Demonstration Projects - Directs the Secretary to make grants to schools of nursing, social work, allied health, and public health of accredited universities to develop and conduct programs to train individuals in the provision, supervision, planning, and analysis of home- and community-based care and nursing facility services for the elderly, disabled, and chronically ill children and in the administration of such programs. Authorizes appropriations. Provides for grants for home health aides, model consumer training programs, and centers for long-term care planning and technical assistance. Authorizes appropriations. Requires the Secretary to conduct demonstration projects to determine the relative effectiveness, cost, and impact on quality of long-term home care of using different models of providing and reimbursing long-term home care services for seriously mentally ill individuals and family caregivers. Authorizes appropriations. Amends the Medicare program to set forth special rules for frail elderly demonstration projects and similar projects.
Bill· HRH.R. 5449 (102nd)referred
United States · United States Congress · 22 June 1992
Health Care Fraud Prosecution Act of 1992 - Amends the Federal criminal code to provide penalties for fraud by health care providers in connection with the provision of, or payments or reimbursement for, health care services or suuplies, when: (1) the loss caused by the fraudulent conduct exceeds $10,000; or (2) the offender has previously been convicted of fraud in Federal or State court. Limits such penalties to ten years' imprisonment, unless the offense caused serious physical injury to, or endangered the life of, a patient (up to 20 years' imprisonment) or caused the death of a patient (up to life imprisonment). Specifies that the sentencing court: (1) shall order the offender to pay restitution to the patient and to the United States as payor for losses sustained as a result of the offender's fraudulent activity; and (2) may order the offender to pay restitution to others who sustained losses as a result of such activity. Provides for civil and criminal forfeiture of the proceeds of health care fraud. Authorizes the Attorney General to make payments of up to $10,000 to persons who furnish information unknown to the Government relating to a possible prosecution for health care fraud, with exceptions. Authorizes appropriations for the Federal Bureau of Investigation, U.S. Attorneys, and the Office of Inspector General of the Department of Health and Human Services to hire, equip, and train personnel in connection with the investigation and prosecution of health-care fraud cases. Includes within the scope of the mail fraud statute cases involving matter to be sent or delivered by any private or commercial interstate carrier.
Bill· HRH.R. 5451 (102nd)referred
United States · United States Congress · 22 June 1992
Nursing Facility Assistance Act of 1992 - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to revise standards for decertification of nurse aide training and competency evaluation programs (programs) operated by nursing facilities. Repeals requirements under Medicaid for preadmission screening and annual resident review by such facilties. Repeals requirements under Medicare and Medicaid respecting: (1) annual external reviews of the use of psychopharmacologic drugs; and (2) repayments to the Federal Government of payments continued pending remediation if corrective action is not taken. Provides for an increase in the minimum amount required under Medicare and Medicaid for the separate deposit of nursing facility residents' personal funds. Provides for reimbursement under Medicaid for amounts spent for programs which are attributable to activities relating to individuals who are not enrolled under a State Medicaid plan. Makes this Act effective as if included in the enactment of the Omnibus Reconciliation Act of 1987.
Bill· SS. 2867 (102nd)referred
United States · United States Congress · 18 June 1992
Senior Government Officer Benefit Limitation Act of 1992 - Prohibits the use of aircraft owned or leased by the Federal Government for: (1) any personal, political, or authorized special use travel; or (2) any official travel mixed with personal or political activities. Excepts the President, Vice President, and their families from this prohibition, if they reimburse the Federal Government the full costs of such travel. Requires executive agency reports on agency use of Government owned or leased aircraft. Prohibits the expenditure of Federal agency funds to equip, operate, or maintain any golf course owned or operated by an executive agency, unless it is located in a remote or isolated area. States that any such golf course shall be operated by concessionaire contract and open to the general public. Prohibits the expenditure of Federal agency funds to: (1) subsidize the costs to equip, operate, or maintain dining rooms or kitchen facilities for the exclusive use of senior Government officers or to purchase or prepare food for their consumption, except in certain circumstances; (2) acquire luxury vehicles for the purpose of transporting senior Government officers, except for cabinet officers and executive agency heads, among others; or (3) employ drivers for the exclusive use of transporting senior Government officers, except for the officers listed. Requires the General Services Administration to prescribe regulations and uniform guidelines for the purchase or lease of luxury vehicles for or by the Federal Government that ensure the least cost to the Government. States that all costs to equip, operate, and maintain physical fitness facilities for use by Federal employees shall be fully paid by the users of such facilities. Prohibits the expenditure of appropriated funds by any executive agency for the costs of membership or other fees for the use of physical fitness facilities, including exercise equipment and classes. Prohibits executive agencies from granting administrative leave to Federal employees for the purpose of physical fitness activities, unless such employees must meet physical fitness standards as a condition of employment. Directs the head of each executive agency to charge a nominal fee to any employee of such agency for access to medical services provided by the Public Health Service, the employing agency, any other Federal agency, or other medical service provider for which no charge is otherwise paid by such employee. Establishes a schedule for reductions in executive agency noncareer Senior Executive Service positions and Schedule C positions. Requires the Office of Management and Budget to report annually to the Congress on compliance with this Act.
Bill· HRH.R. 5435 (102nd)referred
United States · United States Congress · 18 June 1992
Puerto Rico Medicaid Improvement Act of 1992 - Amends title XI of the Social Security Act (SSA) to raise the limit on Federal matching funds available for the Medicaid program (SSA title XIX) in Puerto Rico. Amends SSA title XV (Medicare), the Omnibus Budget Reconciliation Act of 1986, and the Omnibus Budget Reconciliation Act of 1989 to make changes with respect to the furnishing of and payment for parenteral and enteral nutrition equipment and related supplies furnished to Medicare beneficiaries.