Healthcare

Organ Transplant Program Reauthorization Act of 1994

United States · United States Congress · 15 July 1993

Organ and Bone Marrow Transplantation Amendments of 1993 - Amends the Public Health Service Act to authorize the Secretary of Health and Human Services to make grants to qualified organ procurement organizations for programs of information, education, and training with respect to organ donations, with priority consideration given to minority populations in the award of such grants. Requires the board of directors of such organizations and the Organ Procurement and Transplantation Network to include individuals who have received a transplant and individuals who are related to a donor. Requires such organizations and the Network to maintain for each type of organ a single list of patients referred for transplants and who are citizens or permanent resident aliens. Transfers the National Bone Marrow Donor Registry program to the Administrator of the Health Resources and Services Administration. Revises the system of patient advocacy for bone marrow transplant patients to include case management services. Requires a study by the General Accounting Office of the bone marrow donor program. Authorizes appropriations for FY 1994 through 1996. Requires a study by the Secretary on the feasibility, fairness, and enforceability of allocating organs to patients based solely on the clinical need of the patient involved and viability of the organ involved.

Nutrition and Health Information Act

United States · United States Congress · 15 July 1993

Nutrition and Health Information Act - Amends the Public Health Service Act to require the Surgeon General to report biennially on the relationship between nutrition and health. Authorizes appropriations.

Readjustment Counseling Service Amendments of 1994

United States · United States Congress · 14 July 1993

Readjustment Counseling Service Amendments of 1993 - Includes a Readjustment Counseling Service (RCS) as part of the Veterans Health Administration of the Department of Veterans Affairs. Prohibits the Secretary of Veterans Affairs from altering or revising the organizational structure of RCS until the Secretary has notified specified congressional committees and 60 days have elapsed since such notification. Requires RCS budget information to be included annually in the President's budget submitted to the Congress. Outlines eligibility requirements for one of the Assistant Under Secretaries for Health in the Department, including at least three years of clinical experience and two years of administrative experience in RCS or other comparable mental health care counseling service. Makes such a qualified person the director of RCS. Directs the Secretary, upon the request of any veteran (currently, only veterans discharged or released from active duty but not otherwise eligible for such counseling) to furnish counseling in readjusting to civilian life. Allows the provision of counseling to survivors of members of the armed forces who die while serving on active duty or from a condition incurred or aggravated by military service. Provides for the confidentiality of the records of any patient of RCS, permitting disclosure only in specific limited circumstances. Establishes in the Department the Advisory Committee on Veteran Readjustment Counseling to perform advisory services with respect to veterans' readjustment, taking into special account Vietnam era veterans. Requires specified reports from the Advisory Committee and the Secretary. Directs the Secretary to report to specified congressional committees a plan for the expansion of the Vietnam Veteran Resource Center program as established under prior law. Directs the Secretary to carry out and report to the Congress on a pilot program for the provision of health-related services to eligible veterans at readjustment counseling centers.

United States-Mexico Border Health Commission Act

United States · United States Congress · 14 July 1993

United States-Mexico Border Health Commission Act - Authorizes the President to conclude an agreement with Mexico to establish a binational commission to be known as the United States-Mexico Border Health Commission. Declares that it should be the duty of the Commission to: (1) conduct a needs assessment in the U.S.-Mexican border area to identify and resolve health problems that affect the general population of the area; (2) develop a plan to coordinate public and private efforts to educate the population about, and resolve, such health problems and develop programs to meet needs that are not being met; and (3) formulate recommendations for a fair method by which the government of one country would reimburse a public or private person in the other country for the cost of a health care service furnished to a citizen or resident alien of the first country who is unable to pay for the service. Authorizes appropriations.

Health Care Cooperative Antitrust Protection Act of 1993

United States · United States Congress · 14 July 1993

Health Care Cooperative Antitrust Protection Act of 1993 - Directs the Secretary of Health and Human Services to promulgate guidelines under which a health care joint venture may submit an application requesting that the Secretary provide the entities participating in the venture with an exemption under which: (1) monetary recovery on an antitrust claim brought against the entity shall be limited to actual damages if specified conditions are met and the conduct of the entity in making or performing a contract to carry out the venture shall not be deemed illegal per se; or (2) the antitrust laws shall not apply to conduct within the scope of the venture for a five-year period. Requires the Secretary to approve or disapprove the application within a specified time frame and, with respect to a disapproval, to provide a statement explaining the reasons for such disapproval. Directs the Secretary and the Attorney General to approve the application if: (1) in the case of a venture seeking the five-year exemption, the Secretary finds that such venture meets specified criteria, such as promoting enhancement of the quality of health care services to individuals residing in the geographic area served by the participating entities, preserving meaningful competition among health care providers, reducing costs or increasing efficiency, improving utilization of services, and eliminating costly and unnecessary duplication in the delivery of health care services in such area; and (2) an entity participating in the venture submits to the Secretary, the Attorney General, and the Interagency Advisory Committee on Competition, Antitrust Policy, and Health Care (created by this Act) an application that contains the identities of the parties to the venture; the nature, objectives, and planned activities of the venture; and specified assurances and information. Sets forth provisions regarding: (1) revocation and renewal of exemptions, and withdrawal of an application; and (2) requirements relating to notice and publication of exemptions. Establishes the Advisory Committee to: (1) discuss and evaluate competition and antitrust policy and their implications regarding the performance of health care markets; (2) analyze the effectiveness of health care joint ventures receiving exemptions in reducing costs and expanding access; and (3) make recommendations to the Congress.

Telecommunications Infrastructure and Facilities Assistance Act of 1993

United States · United States Congress · 14 July 1993

TABLE OF CONTENTS: Title I: General Provisions Title II: Assistance for Telecommunications and Information Infrastructure Development Title III: Assistance for Planning and Construction of Public Broadcasting Facilities Title IV: National Telecommunications and Information Administration Title V: National Endowment for Children's Educational Television Telecommunications and Information Infrastructure and Public Broadcasting Facilities Assistance Act of 1993 - Title I: General Provisions - Amends the Communications Act of 1934 (the Act) to define the term "telecommunications and information infrastructure" (TII) as the hardware and software necessary to transmit, receive, store, or distribute signals for voice, data, or video, with the exclusion of public broadcasting facilities. Title II: Assistance for Telecommunications and Information Infrastructure Development - Amends the Act to authorize the Secretary of Commerce to provide grants to eligible entities for the development of a national TII using the most efficient and and economical means. Requires TII to promote the enhancement of TII for health care providers, educational institutions, research facilities, libraries, museums, State and local governments, and other social service and public information providers, including a focus on the interconnection and interoperability of such systems between such social service providers. Authorizes the Secretary to fund appropriate training and planning to carry out this title. Requires special consideration to be given to minorities, disabled individuals, women, and other underserved populations with respect to such TII development. Authorizes FY 1994 through 1998 appropriations. Sets forth recordkeeping and monitoring requirements. Title III: Assistance for Planning and Construction of Public Broadcasting Facilities - Authorizes appropriations for FY 1994 through 1998 to assist in the planning and construction of public broadcasting facilities which: (1) extend delivery of public broadcasting services to as many U.S. citizens as possible; (2) increase such services and facilities available to, and operated or owned by, minorities and women; and (3) strengthen the capability of existing public broadcasting entities to provide their services to the public. Requires special consideration to be given to applications which would increase participation in public broadcasting by minorities, women, and traditionally underserved populations. Provides recordkeeping requirements. Directs the Secretary to establish criteria for making construction and planning grants which are consistent with the purposes enumerated under this Act. Title IV: National Telecommunications and Information Administration - Authorizes appropriations for FY 1994 through 1998 for the administration of the National Telecommunications and Information Administration. Title V: National Endowment for Children's Educational Television - Authorizes FY 1994 through 1998 appropriations for the National Endowment for Children's Educational Television.

Commissions on Regulatory Reform Act of 1993

United States · United States Congress · 14 July 1993

Commissions on Regulatory Reform Act of 1993 - Requires the Director of the Office of Management and Budget to establish five commissions to review the regulations issued by the: (1) Environmental Protection Agency; (2) the Occupational Health and Safety Administration; (3) the Health Care Financing Administration; and (4) two Federal agencies selected by the Director. Establishes standards for such review.

Primary Medical Care Act of 1993

United States · United States Congress · 13 July 1993

TABLE OF CONTENTS: Title I: Increasing the Number of Primary Care Providers Title II: Community Health Services Expansion Title III: Expanding the Supply of Health Professionals in Rural Areas Title IV: Miscellaneous Provisions Primary Medical Act of 1993 - Title I: Increasing the Number of Primary Care Providers - Amends title XVIII (Medicare) of the Social Security Act to revise Medicare medical education payments with the goal of achieving an increase in the number of primary care physicians by: (1) providing that payments for primary care residency programs relative to nonprimary care residency programs shall be 50 percent higher; and (2) requiring hospitals and health care training consortia receiving Medicare assistance for their residency programs to pay primary care residents at least 20 percent more than the amount paid to nonprimary care residents. Defines health care training consortium as an association that includes at least one school of medicine, teaching hospital, and ambulatory site that is organized in such a manner that at least 50 percent of the involved medical school's or schools' graduates become primary care providers. Amends the Public Health Service Act to direct the Secretary of Health and Human Services, for the purposes of payments made pursuant the provisions of this paragraph, to: (1) establish criteria to be used to determine which residencies in pediatrics, internal medicine, and obstetrics and gynecology shall be approved as primary care training programs; (2) approve such programs, using such criteria; and (3) approve health care training consortium. Authorizes appropriations for grants and contracts for the training of: (1) physician assistants; and (2) nurse practitioners and nurse midwives. Directs the Secretary to award grants to States or nonprofit entities for at least ten demonstration projects which will evaluate increasing and enhancing the delivery of primary care services. Amends the Health Education Extension Amendments of 1992 to authorize appropriations for data bases concerning postgraduate training programs for primary care providers. Title II: Community Health Services Expansion - Directs the Secretary, under the Public Health Service Act, to establish and administer a program to provide allotments to States to enable such States to provide grants for the creation or enhancement of community-based primary care entities that provide services to low-income or medically underserved populations. Directs the Secretary to fund such program with 50 percent of the funds appropriated for grants to federally qualified health centers (FQHCs) for the purpose of providing access to services for medically underserved populations or in high impact areas not currently being served by a FQHC. Authorizes appropriations. Title III: Expanding the Supply of Health Professionals in Rural Areas - Authorizes appropriations for the scholarship program and loan repayment program of the National Health Service Corps. Amends the Internal Revenue Code to set forth specified tax incentives for primary health services providers practicing in rural areas. Title IV: Miscellaneous Provisions - Sets forth effective date provisions.

Comprehensive Health Care and Cost Containment Act of 1993

United States · United States Congress · 13 July 1993

TABLE OF CONTENTS: Title I: Federal and State Administration Subtitle A: Federal Administration Subtitle B: State Administration Title II: Health Care Services Subtitle A: National Health Insurance Program Subtitle B: Payment Amounts for Health Care Practitioner Services and for Covered District Health Care Services Title III: Malpractice Insurance Reform Title IV: Provisions Relating to ERISA and Federal and State Antitrust Laws Title V: Health Care Education Trust Fund Title VI: Tax Treatment of Health Insurance Premiums Title VII: Private Options Title VIII: Prescription Drug Review Board Title IX: Termination of Programs Comprehensive Health Care and Cost Containment Act of 1993 - Title I: Federal and State Administration - Subtitle A: Federal Administration - Subtitle A: Federal Administration - Establishes within the Department of Health and Human Services a Federal Health Board. Requires the Board to: (1) determine national per capita spending rates for covered district health care services and for health care practitioner services; (2) establish a single national insurance premium for enrollment catgories; (3) make Federal payments to States and insurers; (4) certify State compliance with this Act; (5) enter into reciprocity agreements with foreign countries; and (6) report to the Congress on duplicative Federal health care programs. Requires an annual report to the Congress on the status of the health care system in the United States. Establishes within the Department of Education a Federal Health Education Commission to manage the Federal grant program to States for consumer education programs and for primary care practitioners. Subtitle B: State Administration - Requires each State to provide for a State Health Board to establish health districts to appoint district health care boards, set global budgets for each health care district, establish fee schedules for practitioner groups, and develop long-range plans for future health care infrastructure. Requires each State Health Board to establish a State Health Care Education Commission to be responsible for specified activities. Title II: Health Care Services - Subtitle A: National Health Insurance Program - Sets forth national standards for health insurance for district health care services or health care practitioner services, including enrollment requirements. Authorizes reduced premiums for low-income individuals. Subtitle B: Payment Amounts for Health Care Practitioner Services and for Covered District Health Care Services - Requires each State to provide for the chartering of practitioner associations with respect to fee schedules and medical malpractice insurance. Provides for the establishment of annual per capita rates for district health care costs and the development of State and district budgets for health care services. Requires the Board to disseminate Federal payments to States for such services. Title III: Malpractice Insurance Reform - Sets forth requirements for States with respect to physician medical malpractice liability in order to be eligible for Federal payments. Title IV: Provisions Relating to ERISA and Federal and State Antitrust Laws - Declares that provisions of the Employee Retirement Income Security Act are superseded to the extent inconsistent with the requirements of this Act. Provides that the antitrust laws do not apply to health service entities covered under this Act. Title V: Health Care Education Trust Fund - Establishes the Health Care Education Trust Fund to be administered by the Federal Health Care Commission in making grants for health care consumer education. Authorizes appropriations. Amends the Internal Revenue Code to increase the tax on cigarettes and distilled spirits. Title VI: Tax Treatment of Health Insurance Premiums - Allows a tax deduction for health insurance expenses, whether or not the taxpayer itemizes deductions. Title VII: Private Options - States that individuals are not precluded from obtaining insurance for services that are covered health care services. Title VIII: Prescription Drug Review Board - Establishes in the executive branch the Prescription Drug Price Review Board to develop guidelines for determining excessive prescription drug prices. Permits the Board, after following specified procedures, to determine: (1) if such a price is excessive; and (2) to revoke the patent of a drug determined to have an excessive price. Title IX: Termination of Programs - Amends the Social Security Act to repeal the Medicare and Medicaid programs. Repeals specified CHAMPUS provisions. Repeals the Federal Employees Health Benefits Program.

M. Joycelyn Elders, of Arkansas, to be Medical Director in the Regular Corps of the Public Health Service, subject to qualifications therefor as provided by law and regulations, and to be Surgeon General of the Public Health Service, for a term of four years, vice Antonia Coello Novello.

United States · United States Senate · 1 July 1993

Office for Rare Disease Research Act of 1994

United States · United States Congress · 1 July 1993

Center for Rare Disease Research Act of 1993 - Amends the Public Health Service Act to establish in the Office of the Director of the National Institutes of Health a Center for Rare Disease Research in order to promote and coordinate the conduct of research on rare diseases and to establish and maintain a rare disease clinical data base. Authorizes appropriations.

A joint resolution to designate the first Monday in October of each year as "Child Health Day".

United States · United States Congress · 1 July 1993

Designates the first Monday in October of each year as Child Health Day.

Mediplan Health Care Act of 1993

United States · United States Congress · 1 July 1993

TABLE OF CONTENTS: Title I: Health Care Eligibility and Benefits Title II: Cost Containment Title III: Financing Provisions Mediplan Health Care Act of 1993 - Title I: Health Care Eligibility and Benefits - Adds a new title XXI to the Social Security Act (SSA) entitled "Mediplan Health Benefits." Makes all U.S. residents eligible for Mediplan benefits, which include prescription drugs and biologicals. Requires the development of a Mediplan enrollment mechanism that includes automatic enrollment at birth and the issuance of Mediplan cards for identification and claims processing purposes. Provides the same benefits under the Mediplan program as are provided under title XVIII (Medicare) of the Social Security Act to individuals who are entitled to benefits under part A (Hospital Insurance) and enrolled under part B (Supplementary Medical Insurance) of the Medicare program. Provides additional Mediplan coverage to children under age 23, pregnant women, and low-income individuals. Establishes the Mediplan Trust Fund which shall consist of revenues raised by this Act's financing mechanism. Requires the modification of Medicaid (SSA title XIX) and other Federal health programs to avoid their duplication of Mediplan coverage. Requires group health plans which provide their current beneficiaries with benefits in addition to Mediplan benefits to continue to do so, though they need not provide such additional benefits to individuals not entitled to them before this Act's enactment. Provides for the regulation of Mediplan supplemental policies. Allows States to elect to have health care benefits made available instead under an alternative program meeting specified requirements. Amends the Internal Revenue Code (IRC) to impose an excise tax with respect to Mediplan supplemental policies which fail to meet certain requirements. Title II: Cost Containment - (Sec. 201) Establishes a national budget for Mediplan expenditures. Details formulae for determining such expenditures and subsequent adjustments to them. (Secs. 202 and 203) Provides for the establishment of separate classes of health care services and the allocation of the national Mediplan expenditure budget by class of service. (Sec. 204) Requires the Secretary of Health and Human Services to establish a national health expenditures reporting system for purposes related to the national Mediplan expenditure budget. (Secs. 205 and 206) Provides for the adjustment of Medicare payment rates for purposes related to Mediplan health expenditure allocations and graduate medical education. Title III: Financing Provisions - (Sec. 301) Amends IRC to impose an additional income tax on individuals and health service providers in order to finance Mediplan health care premiums.

Traumatic Brain Injury Act of 1993

United States · United States Congress · 1 July 1993

Traumatic Brain Injury Act of 1993 - Amends the Public Health Service Act to direct the Secretary of Health and Human Services, acting through the Administrator of the Agency for Health Care Policy and Research, to conduct a study concerning traumatic brain injury. Requires the study to seek to: (1) identify common therapeutic interventions which are used for the rehabilitation of individuals with traumatic brain injuries; and (2) develop practice guidelines for the rehabilitation of traumatic brain injury. Authorizes appropriations. Directs the Secretary, acting through the Director of the Centers for Disease Control and Prevention, to conduct studies concerning traumatic brain injury and establish a uniform reporting system. Authorizes appropriations. Directs the Secretary to cooperate with, and provide assistance to, public and private nonprofit entities to reduce the incidence of traumatic brain injury through the establishment and effectuation of prevention projects. Authorizes the Secretary to award grants to State and local entities, and to public or nonprofit 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 services coordination. Authorizes appropriations. 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. Authorizes appropriations. Directs the Secretary to award grants to States for the establishment of programs related to traumatic brain injury. Authorizes appropriations. Designates October 1993 as National Head Injury Month.

Federal Acupuncture Coverage Act of 1993

United States · United States Congress · 1 July 1993

Federal Acupuncture Coverage Act of 1993 - Provides for coverage of acupuncturist services under the Federal Employees Health Benefits Program and part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act.

Presidential Commission on TV Violence and Children Act

United States · United States Congress · 1 July 1993

Presidential Commission on TV Violence and Children Act - Establishes a Presidential Commission on TV Violence and Children. Directs the Commission to: (1) review and report on findings linking television (TV) violence and violence in children and society; (2) solicit opinions from children and their parents on their views concerning TV violence and their suggestions for lessening its negative effects; (3) solicit opinions from public health, crime, and education experts, and the broadcast, cable, film, and advertising industries of TV violence and their recommendations for lessening its negative effects; and (4) present a final report and recommendations for comprehensive strategies and solutions to alleviate harmful effects of TV violence that continue to preserve our tradition of free expression. Authorizes appropriations.

Federal Facilities Community Oversight for Public Health Act of 1993

United States · United States Congress · 30 June 1993

Federal Facilities Community Oversight for Public Health Act of 1993 - Amends the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) to establish a citizens advisory board at each Department of Energy (DOE) defense nuclear facility to evaluate: (1) DOE environmental restoration and waste management activities at each facility; (2) the exercise of regulatory authority over such facilities by the Environmental Protection Agency (EPA) and State environmental agencies; and (3) Federal regulatory decisions on environmental restoration and waste managment activities. Sets forth the board's oversight functions for environmental and waste management activities. Prescribes guidelines under which Federal and State agencies shall provide the board with specified information regarding environmental restoration and waste management activities at the facilities. Directs the Administrator of the Agency for Toxic Substances and Disease Registry (ATSDR) to perform: (1) public health actions for each facility included in certain DOE programmatic environmental impact statements; and (2) an off-site preliminary exposure assessment for each facility in order to identify potential human exposure to contaminants released from hazardous substances at the facility. Permits any person to petition the ATSDR Administrator for public health assessments. Directs the Secretary of Energy and the ATSDR Administrator to develop a long-range strategy for ensuring the substantive involvement of affected States, Indian tribes, communities, and the public in implementing this Act. Authorizes appropriations.

To designate the month of August as "National Scleroderma Awareness Month", and for other purposes.

United States · United States Congress · 29 June 1993

Designates August 1993 and August 1994 as National Scleroderma Awareness Month.

To amend title 38, United States Code, to provide additional authority for the Secretary of Veterans Affairs to provide health care for veterans of the Persian Gulf War.

United States · United States Congress · 28 June 1993

Directs the Secretary of Veterans Affairs to provide hospital care, and authorizes the Secretary to provide nursing home care, to a veteran exposed to an environmental hazard. Makes a veteran who the Secretary finds may have been exposed to a toxic substance or an environmental hazard during the Persian Gulf War eligible for hospital and nursing home care for any disability which becomes manifest before October 1, 1996, notwithstanding whether it is medically evident that such disability is associated with such exposure. Extends through FY 1998 the provision of such care. Makes such veterans eligible for outpatient care for any disability through such period, if the disability becomes manifest before October 1, 1996.

Omnibus Nuclear Power Safety and Security Enhancement Act of 1993

United States · United States Congress · 25 June 1993

Omnibus Nuclear Power Safety and Security Enhancement Act of 1993 - Amends the Energy Reorganization Act of 1974 to require certain persons (including owners and operators) with information about a defect or safety violation at nuclear facilities regulated by the Nuclear Regulatory Commission (NRC), including those leased by the United States Enrichment Corporation, to notify the NRC immediately if such defect or violation could create a substantial safety hazard. Authorizes the NRC to issue regulations requiring such persons to devise and implement notification compliance procedures. Mandates that the notification requirements be preeminently posted on the business premises of persons subject to this Act. Provides a civil penalty for non-compliance. Grants the NRC enforcement powers. Amends the Atomic Energy Act of 1954 to establish civil penalties for violations of its licensing or certification strictures. Declares that each day of a continuing violation constitutes a separate violation for purposes of computing the civil penalty. Repeals the requirement that the Advisory Committee on Reactor Safeguards submit an annual status report to the Congress on reactor safety research. Authorizes the NRC to: (1) permit its licensees to carry firearms while in the discharge of their official duties; and (2) issue regulations regarding the introduction of dangerous weapons or instrumentalities upon property within its licensing purview. Includes within the penalty guidelines for the sabotage of nuclear facilities those facilities subject to NRC licensing during their construction where the damage could affect public health and safety during the operation of the facility. Sets forth guidelines for the NRC to conduct warrantless searches, and to enter certain premises with a judicially approved administrative search warrant.

Rural Health Innovation Demonstration Act of 1993

United States · United States Congress · 24 June 1993

Rural Health Innovation Demonstration Act of 1993 - Amends the Public Health Service Act to authorize competitive grants for the development of networks among rural and urban health care providers to preserve and share health care resources and enhance the quality and availability of health care in rural areas. Allows the networks to be statewide or regional. Specifies the services for which grant amounts must be used. Authorizes appropriations. Authorizes competitive grants to develop and administer cooperatives in rural areas that will establish an effective case management and reimbursement system designed to support the economic viability of essential public or private health services, facilities, health care systems, and health care resources. Involves the cooperative in matters such as third party reimbursement, employee health insurance, malpractice insurance, and managed care and practice standards. Authorizes appropriations. Authorizes competitive grants to develop and implement a plan for mental health outreach programs in rural areas. Authorizes appropriations. Authorizes grants to enable rural communities to provide stipends to physicians, nurses, or other health professional trainees to encourage such individuals to continue to provide health care services in such communities. Authorizes appropriations to carry out provisions relating to area health education centers.

Rural Health Innovation Demonstration Act of 1993

United States · United States Congress · 24 June 1993

Rural Health Innovation Demonstration Act of 1993 - Amends the Public Health Service Act to authorize competitive grants for the development of networks among rural and urban health care providers to preserve and share health care resources and enhance the quality and availability of health care in rural areas. Allows the networks to be statewide or regional. Specifies the services for which grant amounts must be used. Authorizes appropriations. Authorizes competitive grants to develop and administer cooperatives in rural areas that will establish an effective case management and reimbursement system designed to support the economic viability of essential public or private health services, facilities, health care systems, and health care resources. Involves the cooperative in matters such as third party reimbursement, employee health insurance, malpractice insurance, and managed care and practice standards. Authorizes appropriations. Authorizes competitive grants to develop and implement a plan for mental health outreach programs in rural areas. Authorizes appropriations. Authorizes grants to enable rural communities to provide stipends to physicians, nurses, physician assistants, and other health professional trainees to: (1) encourage such individuals to provide health care services in such communities; and (2) encourage such individuals who are already practicing in such communities to stay in such areas. Authorizes appropriations to carry out provisions relating to area health education centers.

A bill to enhance the authorities and responsibilities of the Office of National Drug Control Policy, and for other purposes.

United States · United States Congress · 23 June 1993

Amends the National Narcotics Leadership Act of 1988 to require the Director of National Drug Control Policy to request the head of a department or agency to include in its budget submission to the Office of Management and Budget funding requests for specific initiatives. Directs each agency to comply with such request. Authorizes the Director to: (1) request an agency head to place personnel engaged in drug control activities on temporary detail to another agency in order to implement the National Drug Control Strategy and directs the agency head to comply; and (2) transfer funds appropriated to a National Drug Control Program agency account to a different such account and to issue to the head of a Program agency a funds control notice. Prohibits an officer or employee of a Program agency from making or authorizing an expenditure or obligation contrary to such a notice. Provides for disciplinary action for violations. Limits the number of political appointees to the Office of Drug Control Policy. Prohibits Federal officers in the Office from using official authority or influence for partisan political purposes. Amends the Asset Forfeiture Amendments Act of 1988 to provide for transfers to the Special Forfeiture Fund according to specified guidelines of funds from the Department of Justice Assets Forfeiture Fund and the Department of the Treasury Forfeiture Fund. Makes certain surplus amounts within the Fund available to the Director for Federal, State, or local drug control activities. Requires each Federal program manager or department head with responsibilities under the Strategy to provide such information for drug control purposes as the Director may request. Authorizes the Director to: (1) designate certain data collection systems as being essential for drug control purposes; and (2) require that such systems be modified to ensure appropriate scope and coverage. Prohibits an officer or employee of a Program agency from taking any action to implement a change in drug control policy unless such change has been certified in advance by the Director. Terminates the Office on September 30, 1998. Requires the Director to be a member of the President's cabinet. Extends the authorization of appropriations for the office.

Making appropriations for the government of the District of Columbia and other activities chargeable in whole or in part against the revenues of said District for the fiscal year ending September 30, 1994, and for other purposes.

United States · United States Congress · 23 June 1993

TABLE OF CONTENTS: Title I: Fiscal Year 1994 Appropriations Title II: Fiscal Year 1993 Supplemental Federal Funds Title I: Fiscal Year 1994 Appropriations - District of Columbia Appropriations Act, 1994 - Appropriates funds to the District of Columbia for FY 1994 for: (1) the Federal payment to the District of Columbia; (2) the Federal contribution to retirement funds; and (3) the Federal contribution for crime and youth initiatives. Appropriates specified sums out of the District of Columbia general fund for the current fiscal year for: (1) governmental direction and support; (2) economic development and regulation; (3) public safety and justice; (4) public education; (5) human support services; (6) public works; (7) the Washington Convention Center Fund; (8) repayments of specified loans and interest; (9) repayment of the general fund deficit; (10) employees' optical and dental benefits; (11) employees' pay adjustments; (12) capital outlay; (13) the Water and Sewer Enterprise Fund and water construction projects; (14) the Lottery and Charitable Games Enterprise Fund; (15) the Cable Television Enterprise Fund; and (16) the Starplex Fund. Requires the District of Columbia Mayor to reduce appropriations and expenditures for personal and nonpersonal services by a specified amount. Sets forth certain uses of and restrictions on the expenditure of appropriations made by this Act. Requires that the annual budget for the District of Columbia government for FY 1995 be transmitted to the Congress by April 15, 1994. Directs the Mayor to submit to the D.C. Council, within 30 days after the end of the first quarter of FY 1994, the FY 1994 revenue estimates. Prohibits the number of FTEs (Full Time Equivalents) at the end of FY 1994 from exceeding such number approved in the FY 1994 budget less a one percent attrition rate and the actual corresponding dollar savings. Requires the Mayor to: (1) establish a program to offer incentives for employees to accept early-out retirement; and (2) report to the D.C. Council for approval of such program by mid-FY 1994 with an actuarial study to show the District's liability for the program. Title II: Fiscal Year 1993 Supplemental Federal Funds - District of Columbia Supplemental Appropriations and Rescissions Act, 1993 - Makes supplemental appropriations (including rescissions) to the District of Columbia for FY 1993 for: (1) governmental direction and support; (2) economic development and regulation; (3) public safety and justice; (4) public education; (5) human support services; (6) repayment of loans and interests; (7) resizing costs of the Temporary Appeals Panel; (8) severance pay; (9) employee pay adjustments; (10) capital outlay; (11) the Water and Sewer Enterprise Fund; and (12) the Cable Television Enterprise Fund. Rescinds specified FY 1993 funds earmarked for public works, repayment of the general fund deficit, and the Lottery and Charitable Games Enterprise Fund. Repeals provisions of the District of Columbia Appropriations Act, 1993 relating to prohibiting the use of funds to: (1) enforce or implement any registration system for unmarried, cohabitating couples that are homosexual, lesbian, or heterosexual, including registration for the extension of employment, health, or governmental benefits to such couples on the same basis as that extended to legally married couples, or the District Domestic Partner Act (also called the District of Columbia Health Care Benefits Expansion Act of 1992); (2) perform abortions except where the life of the mother would be endangered if the fetus were carried to term; or (3) provide for the salaries, expenses, or other costs associated with the offices of U.S. Senator or Representative under the District of Columbia Statehood Constitutional Convention Initiative of 1979. Repeals provisions appropriating funds for the rental and leasing of facilities for governmental purposes. Requires each agency, office, and instrumentality of the District, except the District of Columbia courts, to furlough each of its employees for one day in each month of FY 1993. Prohibits any District employee from receiving within-grade salary increases during FY 1993 or accruing time toward the waiting period for advancement to the following within-grade rate. Requires the resulting savings to be distributed within other appropriations. Lowers the amount by which the Mayor must reduce expenditures for personal and nonpersonal services. Requires the amount of reductions previously mandated to be distributed within other appropriations. Amends the Act to: (1) authorize the D.C. Council to accept and use gifts without prior approval by the Mayor; and (2) transfer a specified sum out of funds appropriated for the Starplex Fund to the University of the District of Columbia.

Essential Health Facilities Investment Act of 1993

United States · United States Congress · 23 June 1993

TABLE OF CONTENTS: Title I: Essential Access Community Hospital Program Title II: Capital Financing Assistance for Safety Net Providers Subtitle A: Amendments of Internal Revenue Code of 1986 Subtitle B: Capital Financing Assistance for Safety Net Providers Title III: Capital Allocation Plans Essential Health Facilities Investment Act of 1993 - Title I: Essential Access Community Hospital Program - (Secs. 101 and 102) Amends part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act (SSA) to: (1) revise the Essential Access Community Hospital Program (EACH), extending EACH to all States and authorizing increased appropriations for EACH grants; and (2) establish a program of assistance (PA) for activities related to the formation of community health networks by State and local governments. (Sec. 103) Requires the Secretary of Health and Human Services to study and report to the Congress on the effectiveness of EACH and PA in increasing medically underserved population access to health care. Title II: Capital Financing Assistance for Safety Net Providers - Subtitle A: Amendments of Internal Revenue Code of 1986 - (Sec. 201) Amends the Internal Revenue Code (IRC) to impose a tax on the hospital gross receipts of any person for the taxable year. Subtitle B: Capital Financing Assistance for Safety Net Providers - (Sec. 211) Amends SSA to establish a program to provide capital financing assistance in the form of loan guarantees, interest rate subsidies, matching loans, and direct grants to eligible hospitals and facilities with approved applications. Creates in the Treasury the Capital Financing Trust Fund (Fund) to hold the revenues generated from the taxes above in order to finance expenditures for carrying out such program and the plans described below. (Sec. 212) Provides for adjustment of Medicare payments to hospitals to take into account any capital financing assistance received by the hospital. (Sec. 213) Amends IRC to grant tax exempt status to State and local bonds guaranteed by the Fund. Title III: Capital Allocation Plans - (Sec. 301) Amends SSA title XVIII to mandate that each State establish a plan for Federal approval of capital expenditures for certain non-rural health care services in the State in order to receive Medicare reimbursement for capital-related expenses.

World Summit for Children Implementation Act of 1993

United States · United States Congress · 23 June 1993

World Summit for Children Implementation Act of 1993 - Expresses the sense of the Congress that specified amounts should be appropriated for FY 1994 and 1995 to achieve full participation in the special supplemental food program for women, infants, and children under the Child Nutrition Act (WIC program) and the Head Start program. Amends the Foreign Assistance Act of 1961 to authorize appropriations for FY 1994 and 1995 for contributions to the United Nation's Children's Fund and for the Child Survival Fund. Expresses the sense of the Congress that authority should be granted to the President to exercise specified debt forgiveness for least developed countries that are pursuing economic policy reforms to promote long-term development. Earmarks development assistance funds for FY 1994 and 1995 for the Vitamin A Deficiency Program. Authorizes additional appropriations for FY 1994 and 1995 for: (1) iodine and iron fortification programs; and (2) prevention, care, and control programs related to human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in developing countries. Earmarks development and economic assistance funds for FY 1994 and 1995 for programs in support of basic education. Authorizes additional appropriations for FY 1994 and 1995 for population assistance activities. Expresses the sense of the Congress that specified amounts should be appropriated for FY 1994 and 1995 for migration and refugee assistance. Directs the Secretary of the Treasury to instruct the U.S. Executive Director of the World Bank to: (1) ensure that poverty reduction and support of basic human needs become a higher priority within the Bank; (2) ensure that the majority of water and sanitation projects fall within targeted interventions against poverty; and (3) increase the proportion of total Bank lending which supports primary health care and basic education, with a minimum of five percent of total lending devoted to each area. Requires the President to call upon other governments to provide their share of resources required to achieve the World Summit for Children goals by the year 2000.

Rural Health Improvement Act of 1993

United States · United States Congress · 22 June 1993

Rural Health Improvement Act of 1993 - Amends title VII (Administration) of the Social Security Act (SSA) to create within the Department of Health and Human Services (HHS) an Assistant Secretary for Rural Health to: (1) head an independent Office of Rural Health Policy; (2) report directly to the HHS Secretary on the implications of national health care reforms for rural areas; and (3) establish a program to provide grants to rural health care networks to enhance the delivery of health care in rural areas through the use of interactive telecommunications systems. Authorizes appropriations. Amends parts A (Hospital Insurance) and B (Supplementary Medical Insurance) of SSA title XVIII (Medicare) to provide for coverage of, and payment for, medical assistance facility services. Provides for: (1) adjustments in Medicare graduate medical education payments for certain publicly funded family practice residency programs; and (2) preventive care services as part of the initial residency period under Medicare.

Omnibus Budget Reconciliation Act of 1993

United States · United States Congress · 22 June 1993

TABLE OF CONTENTS: Title I: Committee on Agriculture, Nutrition, and Forestry Subtitle A: Commodity Programs Subtitle B: Restructuring of Loan Programs Subtitle C: Food Stamp Program Subtitle D: Agricultural Trade Subtitle E: Miscellaneous Title II: Committee on Armed Services Title III: Committee on Banking, Housing, and Urban Affairs Title IV: Communications and Transportation Title V: Committee on Energy and Natural Resources Subtitle A: Recreation and Commercial Use Fees Subtitle B: Hardrock Mining Claim Maintenance Fee Subtitle C: Commonwealth of Northern Mariana Islands Agreement Subtitle D: Mineral Receipts Title VI: Committee on Environment and Public Works Title VII: Finance Committee Reconciliation Provisions Relating to Medicare, Medicaid, and Other Programs Subtitle A: Medicare Subtitle B: Medicaid Program Subtitle C: Income Security Programs Subtitle D: Miscellaneous Provisions Title VIII: Finance Committee Revenue Provisions Subtitle A: Training and Investment Incentives Subtitle B: Revenue Increases Title IX: Committee on Foreign Relations Title X: Committee on Governmental Affairs Subtitle A: Civil Service Subtitle B: Postal Service Title XI: Judiciary Title XII: Committee on Labor and Human Resources Subtitle A: Student Loan Provisions Subtitle B: Public Health Service Act Provisions Subtitle C: Improved Immunization Delivery and Monitoring Subtitle D: ERISA Amendments Title XIII: Veterans' Programs Omnibus Budget Reconciliation Act of 1993 - Title I: Committee on Agriculture, Nutrition, and Forestry - Agricultural Reconciliation Act of 1993 - Subtitle A: Commodity Programs - Amends the Agricultural Act of 1949 to reduce, with specified exceptions, the acreage eligible for deficiency payments from 92 percent to 85 percent for wheat, feed grains, upland cotton, and rice. (Sec. 1105) Extends the dairy support program. Sets forth purchase price ceilings for butter and nonfat dry milk. Reduces milk prices by ten cents per hundredweight for 1996. Prohibits the sale of bovine growth hormone during a specified time period. (Sec. 1106) Amends the Agricultural Adjustment Act of 1938 to require domestic cigarette manufacturers to certify the amount of U.S.-produced tobacco in their products. Establishes a domestic marketing assessment. Requires domestic cigarette manufacturers to purchase specified amounts of Burley and Flue-cured tobacco from producer-owned cooperatives. Amends the Agricultural Act of 1949 to require importers of foreign tobacco to pay: (1) specified marketing assessments; and (2) specified assessments to the No Net Cost Tobacco Fund. Amends the Tobacco Adjustment Act of 1983 to subject imported tobacco to inspection fees on the same basis as domestic tobacco. Amends the Agricultural Adjustment Act of 1938 to extend quota reduction floor authority (with waiver authority to avoid excess inventories) for Burley and Flue-cured tobacco. (Sec. 1107) Increases 1995 and 1996 sugarcane and sugarbeet marketing assessment rates. (Sec. 1108) Reduces 1994 and 1995 loan levels for soybeans and oilseeds. Revises loan maturation provisions. Eliminates loan origination fees for post-1993 crop years. (Sec. 1109) Increases 1994 and 1995 peanut marketing assessment and first purchaser-producer assessment rates. (Sec. 1110) Reduces 1994 through 1997 honey price support levels and individual payment ceilings. (Sec. 1111) Amends the National Wool Act of 1954 to reduce 1995 through 1997 wool and mohair individual payment ceilings. Maintains the 1993 support price for shorn wool through 1997. Eliminates specified marketing assessments. Subtitle B: Restructuring of Loan Programs - Amends the Rural Electrification Act of 1936 to restructure Rural Electrification Administration electric and telephone loan programs, including the establishment of: (1) electric hardship loans and cost-of-money loans; and (2) telephone hardship loans and cost-of-money loans. Revises the definition of "rural area" for purposes of rural electrification and telephone service. Amends the Consolidated Farm and Rural Development Act to permit electric and telephone borrowers to qualify for: (1) water and waste disposal loans; and (2) rural economic development assistance. Subtitle C: Food Stamp Program - Amends the Food Stamp Act of 1977 to reduce to 50 percent Federal cost-sharing expenses for: (1) food stamp investigations and prosecutions; and (2) immigration status verifications under the Social Security Act. Includes automated data processing and information retrieval systems among eligible cost-sharing activities. Subtitle D: Agricultural Trade - Amends the Agricultural Trade Act of 1978 to eliminate required FY 1994 and 1995 additional funding levels for the market promotion program and obligate certain sums for specified categories of exporters. (Sec. 1402) Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) remove specified acreage reduction requirements for grain sorghum and barley; and (2) eliminate certain support level adjustment provisions. (Sec. 1403) Amends the Agricultural Trade Act of 1978 to prohibit the entry into or the withdrawal from a warehouse of any imported wheat or barley that it is not covered by an end-use certificate. (Sec. 1404) Expresses the sense of the Congress that the Secretary of Agriculture should aggressively promote the export of vegetable oil. Subtitle E: Miscellaneous - Amends the Federal Crop Insurance Act to direct the Federal Crop Insurance Corporation to take specified actions to improve the actuarial soundness of Federal crop insurance coverage. (Sec. 1502) Amends the Food Security Act of 1985 with regard to the conservation reserve program to: (1) make the current discretionary enrollment provision mandatory; and (2) reduce acreage requirements. Extends the wetlands reserve program and revises acreage enrollment provisions. (Sec. 1503) Authorizes the Secretary of Agriculture to charge admission, entrance, and recreation fees at appropriate sites, and public or recreation areas. (Sec. 1504) Expresses the sense of the Senate that: (1) farmers should pay no more than their fair share of any budget reduction necessary to achieve deficit reduction; and (2) the level of budget reduction should take into account taxes, interest rates, and user fees. Title II: Committee on Armed Services - Directs the Secretary of Defense to provide a limited increase in the military retired pay of former military personnel who became members of the armed forces before August 1, 1986. Specifies the month for which such increases becoming effective on December 1 of FY 1994 through 1998 shall be payable as part of retired pay. Title III: Committee on Banking, Housing, and Urban Affairs - Amends the Federal Deposit Insurance Act (FDICA) to prescribe an order of priority for the distribution of amounts realized from the resolution of any insured depository institution. (Sec. 3002) Amends the Federal Reserve Act to mandate for FY 1997 and FY 1998 the transfer into the Treasury of specified percentages of the surplus fund of any Federal reserve bank. Prohibits a Federal reserve bank from replenishing its surplus fund by the amount of such transfer. (Sec. 3003) Amends the Stewart B. McKinney Homeless Assistance Amendments Act of 1988 to: (1) include certain Indian housing programs within the parameters of the Department of Housing and Urban Development program; (2) require submission of certain income disclosure consent forms to verify applicant eligibility for benefits; and (3) revise applicant, participant, and public housing agency protections. Amends the United States Housing Act of 1937 to declare that adjustments to a public housing agency's operating subsidy shall reflect actual changes in rental income collections resulting from application of the Stewart B. McKinney Homeless Assistance Amendments Act of 1988. (Sec. 3004) Amends the National Housing Act to direct the Government National Mortgage Association (GNMA) to: (1) charge fees in connection with its multiclass securities guarantee program (the program); (2) take steps to assure that a certain portion of the benefit resulting from the program accrues to mortgagors who execute eligible mortgages; (3) summarize program activities in its annual report; and (4) report to certain congressional committees on specified risk minimization aspects of the program. (Sec. 3005) Directs the Secretary of Housing and Urban Development to increase the rate at which the Secretary earns the single premium payment collected at the time of insurance of a mortgage that is an obligation of the Mutual Mortgage Insurance Fund. Title IV: Communications and Transportation - Subtitle A: Spectrum Allocation and Auction - Emerging Telecommunications Technologies Act of 1993 - Directs the Assistant Secretary of Commerce for Communications and Information and the Chairman of the Federal Communications Commission (FCC) to meet at least biannually to conduct joint spectrum planning with respect to: (1) future spectrum requirements for public and private uses and the allocation actions to accommodate those uses; and (2) actions to promote the efficient use of the spectrum. Directs the Assistant Secretary and the Chairman to report jointly to specialized congressional committees on their recommendations. Requires the FCC to develop procedures to ensure that minority-owned businesses and small businesses are given the opportunity to provide spectrum-based services. Directs the FCC to report to the Congress a study of current and future spectrum needs of State and local government public safety agencies through the year 2010. (Sec. 404) Directs the Secretary of Commerce to identify radio band frequencies that are allocated on a primary basis for Federal use, are not currently required for Federal needs, can easily be made available for other uses, and have the greatest potential for productive uses and public benefits. Directs the Secretary to recommend to the President and the Congress the immediate reallocation of no less than 30 megahertz of such frequencies. Requires a preliminary and final report on other reallocable frequencies, with an opportunity for public comment. (Sec. 405) Directs the President, after receipt of the Secretary's recommendation, to: (1) withdraw the assignment of appropriate frequencies no longer needed by the Government; (2) assign other frequencies to Federal stations; (3) reallocate for public or mixed use appropriate frequencies; and (4) provide notice of his actions to the FCC and the Congress. Authorizes appropriations. (Sec. 406) Directs the FCC to issue rules for the allocation of all frequencies made available for immediate reallocation under this Act. Authorizes the President to reclaim reassigned frequencies for reassignment to Federal stations. (Sec. 408) Amends the Communications Act of 1934 to direct the FCC, during FY 1994 through 1998, to use competitive bidding procedures to grant all radio spectrum licenses for which two or more mutually exclusive applications have been filed. Requires a report on such procedures. Provides rural program license procedures. Provides for the State and local tax treatment of radio licenses and permits. (Sec. 409) Revises the FCC's regulatory authority in the management of mobile communications services. Considers a person engaged in the provision of commercial mobile services to be a common carrier and, therefore, required to establish physical connections with such service as required under the Communications Act. Prohibits a person engaged in private land mobile service from being considered to be a common carrier for such purposes. Prohibits any State or local government from imposing any rate or entry regulation upon any commercial or private land mobile service, but allows a State to regulate other terms and conditions of commercial mobile service, under certain conditions. Provides certain FCC deadlines with respect to rules, licenses, and permits for personal communications services. Subtitle B: Vessel Tonnage Duties - Amends Federal law relating to shipping to extend the years during which certain tonnage duties are imposed. Title V: Committee on Energy and Natural Resources - Subtitle A: Recreation and Commercial Use Fees - Amends the Land and Water Conservation Fund Act of 1965 to: (1) authorize the charging of admission fees for FY 1994 through 1998 at Bureau of Land Management (BLM) national monuments and scenic areas and areas of concentrated public use; (2) strike a provision prohibiting a recreation fee for the use of visitors' centers, picnic tables, or boat ramps; (3) authorize the Secretaries of Agriculture and the Interior to withhold from a special account made up of user fees an amount determined to be equal to the additional fee collection costs for each fiscal year; (4) direct the Secretary of the Interior, for FY 1994 through 1998, to establish and collect fees on commercial tour vehicles entering units of the National Park System in which fees are authorized; and (5) authorize the Secretaries to allow businesses and other organizations to sell and collect fees for the Golden Eagle Passport (an admission passport valid for an entire year). (Sec. 5003) Directs the Secretaries to assess and collect charges for utilization of radio and television communication sites located on Federal lands administered by the Forest Service or BLM. Requires such users to provide the Forest Service or BLM with a list identifying all additional site users and all revenues received from such users. Requires the Secretaries to establish a broad based advisory group to determine the market value for radio and television communication site users. Requires a report to specified congressional committees. Subtitle B: Hardrock Mining Claim Maintenance Fee - Mandates payment for maintenance fees of $100 per claim by each claimant of an unpatented mining claim, mill or tunnel site on federally-owned lands in order to hold such claims for the assessment year. Declares that such fee is in lieu of assessment work and related filing requirements contained in certain Federal laws. Waives such fees under certain conditions. (Sec. 5102) Mandates the payment of a location fee for every unpatented mining claim, mill or tunnel site located after the date of enactment of this Act and before September 30, 1998. Replaces certain assessment requirements and expenditures with the annual maintenance fee. Subtitle C: Commonwealth of Northern Mariana Islands Agreement - Limits the payments to the Northern Mariana Islands for FY 1994 through 1998 to the amounts and for the purposes set forth in the Agreement of the Special Representatives on Future Financial Assistance of the Northern Mariana Islands of December 1992. Continues funding after 1998 at a specified annual amount. Subtitle D: Mineral Receipts - Amends the Mineral Leasing Act to provide that in calculating the amount to be paid to States of revenues derived from Federal onshore mineral and geothermal steam leasing receipts, 50 percent of the portion of the appropriation allocable for administration and enforcement shall be deducted from those receipts in approximately equal amounts each month before their division and distribution between the States and the United States. Title VI: Committee on Environment and Public Works - Amends the Omnibus Budget Reconcilitation Act of 1990 to extend from 1995 to 1998 the authority of the Nuclear Regulatory Commission to assess and collect annual charges. (Sec. 6002) Amends the Flood Control Act of 1968 to authorize the Secretary of the Army to charge fees for the use of developed recreation sites and facilities with specified exceptions. Mandates deposit of such fees into a certain account established for the Army Corps of Engineers. Title VII: Finance Committee Reconciliation Provisions Relating to Medicare, Medicaid, and Other Programs - Subtitle A: Medicare - Part I: Provisions Relating to Part A - Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) provide for a reduction in payment updates for inpatient hospital services; (2) provide for a reduction in payment for the indirect costs of medical education; (3) extend payments for Medicare-dependent, small rural hospitals; (4) repeal the requirement for a return on equity for proprietary skilled nursing facilities; (5) extend the ten percent reduction in payments for capital-related costs of inpatient hospital services; (6) lower the per diem limits with respect to payments for routine service costs of extended care services; and (7) change the update formula for hospice care payment starting in 1994. (Sec. 7103) Provides for continuation of the other urban payment rate through 1994. Requires the Secretary of Health and Human Services to: (1) permit hospitals that fail to qualify as rural referral centers due to their urban reclassification to decline their reclassification and retain their former status; and (2) make lump-sum retroactive payments to such hospitals. Part II: Provisions Relating to Part B: Subpart A - Physician Services - Amends SSA title XVIII to: (1) reduce the default update for the conversion factor otherwise applicable to surgical and non-surgical services (except primary care services) in 1994; (2) increase the performance standard factor starting in 1994; (3) double the maximum reduction in the default update allowed for 1994 starting in 1995; (4) provide for classification of primary care services as a separate category of services for purposes related to the application of volume performance standards and updates in conversion factors for physicians' services; (5) directs the Secretary to phase-in reductions to the practice expense relative value units for certain services; (6) revise the payment policy for anesthesia care teams; (7) repeal the prohibition on separate billing for the interpretation of electrocardiograms (EKGs); (8) repeal payment reductions for new physicians and practitioners; (9) require adjustments in the relative value units for services provided by physicians and other practitioners in order to ensure budget neutrality; (10) revise the application of the limiting charge policy with respect to claims submitted on a nonassignment basis; (11) add payment and billing rules for services furnished by certain practitioners; (12) set forth requirements for Medicare carriers to provide limiting charge information on the explanation of benefits form furnished to Medicare beneficiaries and screen unassigned claims by service providers before making payment to determine whether the amount billed exceeds the applicable limiting charge; and (13) require the Secretary's report to the Congress on changes in expenditures for physician services to reflect information on charges in excess of the applicable limiting charge. Subpart B: Outpatient Hospital Services and Ambulatory Surgical Services - Amends SSA title XVIII to: (1) extend the ten percent reduction in payments for capital-related costs of outpatient hospital services; (2) extend the reduction in payments for other costs of outpatient hospital services; and (3) make changes to payment formulae for outpatient hospital services. (Sec. 7224) Amends the Omnibus Budget Reconciliation Act of 1990 (OMBRA '90) to reduce payments for intraocular lenses. Subpart C: Durable Medical Equipment - Amends SSA title XVIII to: (1) revise the payment rules for durable medical equipment (DME); (2) provide for the treatment of nebulizers and aspirators and payment for accessories relating to such items; (3) provide a method for determining payment for surgical dressings; and (4) reduce payments for TENS devices. Subpart D: Part B Premium - Amends SSA title XVIII to revise current law establishing the monthly part B premium for Medicare beneficiaries. Subpart E: Other Provisions - Amends SSA title XVIII to: (1) provide for a freeze, then reduction, in updates for certain items and services covered under Medicare part B (Supplementary Medical Insurance), including DME and ambulatory surgical center services; and (2) lower the cap on payments for clinical diagnostic laboratory tests performed after December 31, 1993. Part III: Provisions Relating to Parts A and B - Amends SSA title XVIII to: (1) revise weighting factors and other criteria used in determining payments for direct graduate medical education costs; (2) include preventive care services as part of the initial residency period; (3) include successor exams in the definition of an FMGEMS examination; (4) modify home health agency cost limits; (5) extend the ban on certain referrals by physicians to cover additional specified health services and include new exceptions as well as modified ones related to its application; and (6) reduce payments for erythropoietin. (Sec. 7303) Amends SSA title XVIII and the Internal Revenue Code (IRC) to make numerous changes with respect to Medicare as secondary payer. Subtitle B: Medicaid Program - Part I: Program Savings Provisions - Subpart A: Repeal of Mandate - Amends SSA title XIX to: (1) repeal the mandate that States cover personal care services under their Medicaid programs for all individuals entitled to nursing facility benefits; and (2) give States the option of covering personal care services furnished in a home or other location. Subpart B: Outpatient Prescription Drugs - Amends SSA title XIX to: (1) allow States, under certain conditions, to establish formularies limiting coverage of prescription drugs under their Medicaid programs; (2) eliminate the prohibition on a State's subjecting covered outpatient drugs to prior authorization during the first six months after the drug is approved by the Food and Drug Administration; and (3) make modifications to the Medicaid prescription drug program. Subpart C: Restrictions on Divestiture of Assets and Estate Recovery - Amends SSA title XIX to: (1) revise provisions regarding adjustments and recoveries and transfers of assets; and (2) set forth rules for the treatment of trusts for purposes of determining an individual's eligibility for, and amount of, benefits under a State's Medicaid plan. Subpart D: Improvement in Identification and Collection of Third Party Payments - Amends SSA title XIX to: (1) address the liability of third parties to pay for care and services under Medicaid; and (2) require States to have in effect certain specified laws relating to medical child support. (Sec. 7433) Amends IRC and SSA title XIX to provide for collection of payment obligations relating to medical assistance from State and Federal tax refunds. Subpart E: Assuring Proper Payments to Disproportionate Share Hospitals - Amends SSA title XIX to make changes with regard to payments for disproportionate share hospitals. Subpart F: Anti-Fraud and Abuse Provisions - Amends SSA title XIX to prohibit payment with respect to any amount expended for an item or service for which payment would be denied under the Medicare ban on certain physician referrals if the item or service were furnished to an individual entitled to benefits under Medicare. Part II: Other Medicaid Provisions - Amends OMBRA '90 to revise : (1) the limits on expenditures and funding for demonstration projects to study the effect of allowing States to extend Medicaid coverage to certain low-income families not otherwise qualified to receive Medicaid benefits; and (2) project reporting requirements. Subtitle C: Income Security Programs - Amends SSA title IV part A (Aid to Families with Dependent Children) (AFDC) to make changes with regard to Federal matching of State AFDC administrative expenditures. Amends SSA titles I (Old Age Assistance), X (Aid to the Blind), XIV (Aid to the Permanently and Totally Disabled), and XVI (Supplemental Security Income) to revise the formula for determining Federal payments to the States for expenses incurred in administering their State plans under such SSA titles. Amends SSA title XI to change the requirements for attesting to citizenship status. (Sec. 7602) Amends SSA title IV part D (Child Support and Establishment of Paternity) to: (1) modify performance standards for State paternity establishment programs; and (2) modify existing, and require certain additional, procedures under State law with respect to child support enforcement. (Sec. 7603) Amends SSA title XVI (SSI) and other Federal law to: (1) require the Social Security Administration to charge States fees for the Federal cost of administering State supplemental SSI payments; and (2) require the Secretary to charge fees for additional services requested by the State that are beyond the level customarily provided in administering a State's supplemental SSI payments. Subtitle D: Miscellaneous Provisions - Part I: Trade Provisions - Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to extend authority for levying customs user fees. (Sec. 7702) Amends the Trade Act of 1974 to provide for an extension of, and authorization of appropriations for, the trade adjustment assistance program. Part II: Improved Access to Childhood Immunizations - Amends SSA title XIX to direct the Secretary to promulgate a list of vaccines that provide immunization against naturally occurring infectious diseases and are recommended for universal use in children. Provides for immunization outreach through the EPSDT (Early and Periodic Screening, Diagnostic, and Treatment Services) Program. Requires Medicaid managed care plans to comply with specified requirements relating to EPSDT. Allows State plans to make payments directly to the manufacturer of the vaccine under a voluntary replacement program. Requires the Secretary to provide for demonstration projects designed to improve the rate and timeliness of immunization against childhood diseases in the case of any Medicaid-eligible child up to age two who is part of a family eligible for AFDC. (Sec. 7803) Amends SSA to add a new title XXI entitled "Central Bulk Purchasing Program For Pediatric Vaccines" under which the Secretary shall provide for the purchase and delivery on behalf of the applicant State of such quantities of pediatric vaccines as may be necessary for the immunization of each eligible child in the State. Part III: Disclosure Provisions - Amends the Internal Revenue Code to extend the authority to disclose return information for the administration of certain veterans programs. (Sec. 7902) Authorizes the disclosure of such information: (1) in the administration of repayments of certain student loans; and (2) for income verification under certain housing assistance programs. (Sec. 7904) Amends title XI of the Social Security Act to provide for the establishment of a Third Party Liability Clearinghouse to identify third parties responsible for payment for health care items and services furnished to beneficiaries of Medicare and Medicaid. Authorizes the disclosure of certain taxpayer return information for purposes of identifying health insurance coverage of certain individuals and spouses. Requires employers to report whether a group health plan is available to an employee on wage statements. Part IV: Other Provisions - Expands the 45-day interest-free period for refunding tax overpayments to all returns, as well as to amended returns and claims for refunds. Provides that if interest is not refunded within 45 days after the taxpayer files an amended return or claim for refund, interest will be paid only for periods after the date on which the return or claim is filed. (Sec. 7951) Requires the establishment of a program requiring the payment of user fees for the processing of applications for certificates of alcohol label approval and exemption, formula reviews, and statements of process (including laboratory tests and analyses). (Sec. 7952) Removes authority to use the Harbor Maintenance Trust Fund for administrative expenses of certain customs fee collections. (Sec. 7953) Increases the amount that individuals may designate to the Presidential Election Campaign Fund on their tax returns. (Sec. 7954) Increases the public debt limit and repeals the temporary limit on such increases. Title VIII: Revenue Provisions - Revenue Reconciliation Act of 1993 - Subtitle A: Training and Investment Incentives - Extends until June 30, 1994, the tax exclusion for employer-provided educational assistance and the targeted jobs credit. (Sec. 8111) Suspends the credit for increasing research activities from July 1, 1992, through June 30, 1993, and any period after June 30, 1994. Modifies the fixed base percentage of such credit for startup companies for taxable years after 1993. (Sec. 8115) Eliminates the depreciation adjustment for computing adjusted current earnings for such property placed in service after December 31, 1993. (Sec. 8119) Increases the dollar limitation on the election to expense certain depreciable small business assets. (Sec. 8121) Extends until June 30, 1994, the authority to issue qualified small issue bonds to finance manufacturing facilities and farm property. (Sec. 8131) Repeals certain interaction rules of the earned income credit with respect to the medical expense deduction, the deduction for health insurance, and the dependent care credit. Revises credit and phaseout percentages for 1994. (Sec. 8141) Extends the authority to issue qualified mortgage bonds and qualified mortgage credit certificates until June 30, 1994. Makes permanent the low-income housing credit. (Sec. 8143) Provides for the treatment of rental real estate activities under the limitations on losses from passive activities. (Sec. 8144) Modifies exceptions to the exclusion of real property acquired by a qualified organization from the meaning of acquisition indebtedness. Makes certain exceptions inapplicable to sales out of foreclosure by a financial institution. (Sec. 8145) Repeals the special rule for publicly traded partnerships with respect to the treatment of unrelated business taxable income. (Sec. 8146) Permits a tax-exempt title-holding company to receive unrelated business taxable income if the unrelated income is incidentally derived from the holding of real property. (Sec. 8147) Excludes from unrelated business taxable income: (1) gains from the sale, exchange or other disposition of real property acquired from financial institutions that are in conservatorship or receivership; and (2) loan commitment fees and certain option premiums. Provides for the tax treatment of pension fund investments in real estate investment trusts. (Sec. 8151) Increases the depreciation recovery period for nonresidential real property. (Sec. 8161) Repeals the luxury excise tax on boats, aircraft, jewelry, and furs. Modifies the luxury excise tax on automobiles to index the threshold for inflation occurring after 1990 and make such tax applicable to the first retail sale. (Sec. 8162) Exempts from the luxury excise tax parts or accessories installed for use of passenger vehicles by disabled individuals. (Sec. 8163) Extends the current diesel fuel excise tax to diesel fuel used by noncommercial motorboats. Retains such taxes in the General Fund of the Treasury. (Sec. 8171) Repeals the tax preference for the appreciated property charitable deduction. Disallows an adjustment related to the earnings and profits effects of any charitable contribution from being made in computing adjusted current earnings. (Sec. 8172) Establishes substantiation requirements for charitable contributions of $250 or more. (Sec. 8173) Sets forth disclosure requirements for an organization that receives a quid pro quo contribution (payment made partly as a contribution and partly in consideration for goods or services provided to the payor by the donee organization). Imposes a penalty for failure to make such disclosure. (Sec. 8174) Amends the Railroad Retirement Solvency Act of 1983 to make permanent the treatment of certain railroad retirement benefits as received under employer plans. (Sec. 8175) Provides for the temporary extension of the deduction of health insurance costs of self-employed individuals. Subtitle B: Revenue Increases - Lowers the tax rates for certain taxpayers and increases the tax rate for certain higher incomes. Imposes a surtax on certain higher incomes. (Sec. 8203) Increases the tentative minimum tax for taxpayers other than corporations. (Sec. 8204) Makes permanent the overall limitation on itemized deductions and the phaseout of personal exemptions for high-income taxpayers. (Sec. 8206) Sets forth provisions to prevent the conversion of ordinary income to capital gain in certain financial transactions. Repeals certain exceptions to market discount rules. Provides for the treatment of purchases of stripped preferred stock after April 30, 1993. Revises the methods of : (1) computing the limitation on the deductibility of investment interest; and (2) determining substantial appreciation of partnership inventory items. (Sec. 8207) Repeals the limitation on the amount of wages subject to the health insurance employment tax. (Sec. 8208) Increases and makes permanent the highest estate and gift tax rate. (Sec. 8209) Reduces the deduction for business meals and entertainment expenses. (Sec. 8210) Disallows a tax deduction for social membership dues, except for employee recreational expenses. (Sec. 8211) Disallows a deduction as a trade or business expense for remuneration to certain employees in excess of $1 million. (Sec. 8212) Reduces the compensation taken into account in determining contributions and benefits under qualified retirement plans. (Sec. 8213) Removes qualified residence sales, purchases, or leases and meals from the deduction for moving expenses. Places a dollar limitation on the deduction for moving expenses. (Sec. 8214) Revises the limitation on using the preceding year's tax to calculate an individual's estimated tax payments. (Sec. 8215) Increases the amount of social security and tier 1 railroad retirement benefits to be included in the gross income of certain taxpayers. (Sec. 8221) Increases the tax rate for corporate income in excess of $10 million and the tax rate on personal service corporations. (Sec. 8222) Denies a tax deduction for lobbying expenses. Subjects lobbying organizations to special reporting requirements. (Sec. 8223) Requires any security which is inventory in the hands of the dealer to be included in inventory at its fair market value. Requires any dealer in securities that holds any security which is not in inventory at the close of any taxable year to: (1) recognize gain or loss as if the security were sold on the last business day of the taxable year; and (2) take into account any such gain or loss for such year (the mark-to-market requirement). (Sec. 8224) Requires taking into account: (1) certain Federal Savings and Loan Insurance Corporation (FSLIC) assistance as compensation for loss; and (2) any FSLIC assistance for any debt for determining whether such debt is worthless and in determining the amount of any addition to a reserve for bad debts arising from such worthlessness or partial worthlessness. (Sec. 8225) Increases the required annual payment for corporations that fail to pay estimated income tax. Modifies the periods for applying such annualization. (Sec. 8226) Repeals the stock for debt exception in determining income from discharge of indebtedness. (Sec. 8227) Limits the Puerto Rico and possession tax credit to 40 percent of the possession corporation's qualified possession wages by 1998 and thereafter. (Sec. 8228) Modifies the limitation on corporate deductions for interest paid to related persons to take into account disqualified guarantees of indebtedness and the imposition of a gross basis tax. (Sec. 8231) Requires U.S. shareholders of controlled foreign corporations to include in gross income a pro rata share of the corporations' excess passive assets. Sets forth rules for determining such amounts. Modifies the rule on taxation of investment in United States property and takes into account excessive passive assets. (Sec. 8233) Excepts from foreign personal holding income dividends attributable to earnings and profits of the distributing corporation accumulated during any period during which the person receiving such dividend did not hold such stock. Requires the establishment of an excess limitation account by taxpayers who receive foreign tax credits in a year they receive previously taxed earnings and profits. (Sec. 8234) Reduces the amount allowed as allocation and apportionment of research and experimental expenditures from sources within the United States. (Sec. 8235) Excludes passive dividends or interest income from foreign oil and gas income. (Sec. 8236) Modifies accuracy-related penalties for tax underpayments. (Sec. 8237) Denies the inclusion of certain contingent interest in the exemption for portfolio interest for nonresident aliens. (Sec. 8238) Authorizes the Secretary of the Treasury to prescribe regulations recharacterizing any multiple-party financing transaction as a transaction directly among any two or more such parties where appropriate to prevent any tax avoidance. (Sec. 8239) Provides that export property eligible for certain tax incentives does not include any unprocessed softwood timber for purposes of: (1) taxation of foreign sales corporations (FSCs); and (2) taxation of domestic international sales corporations (DISCs). Requires any income from the sale of such unprocessed timber which was cut from an area in the United States to be sourced in the United States. Repeals the deferral for income of the controlled foreign corporation from sales or milling (outside the United States) of unprocessed softwood timber to the extent that any controlled foreign corporation is owned by ten percent or more U.S. shareholders. (Sec. 8241) Increases the excise tax on gasoline, diesel fuel, aviation fuel, and other transportation fuels. (Sec. 8242) Imposes an excise tax on fuel (separate from the gasoline tax and the tax on aviation). Exempts from such tax diesel fuel: (1) used by trains and intercity, local, or school buses; and (2) which is dyed or marked in accordance within regulations prescribed by the Secretary of the Treasury. Provides that the Airport and Airway Trust Fund financing rate does not apply to aviation fuel sold by a producer or importer for use by the purchaser in a nontaxable use. Imposes a civil penalty on persons who use reduced-rate fuel for a taxable use. (Sec. 8243) Imposes a floor stocks tax on any person holding diesel fuel on April 1, 1994. (Sec. 8224) Increases the tax on gasoline and diesel fuels for purposes of the Highway Trust Fund financing rate. Increases the amount to be transferred to the Mass Transit Account from such Fund. (Sec. 8251) Requires information reporting on payments to corporations for services. (Sec. 8252) Modifies provisions concerning substantial understatement and return-preparer penalties to allow reasonable cause exceptions. (Sec. 8253) Requires certain financial entities (including the Federal Deposit Insurance Corporation, the Resolution Trust Corporation, and the National Credit Union Administration, and their successors or subunits) to file information returns regarding discharges of indebtedness of $600 or more. (Sec. 8261) Allows an amortization deduction with respect to certain intangible property, including goodwill, that is acquired and held by a taxpayer in connection with the conduct of a trade or business or an activity engaged in for the production of income. (Sec. 8271) Denies the business travel expense deduction for spouses, dependents, or others. (Sec. 8272) Increases the withholding rate for supplemental wage payments. (Sec. 8273) Makes permanent the excise tax on certain vaccines. Title IX: Committee on Foreign Relations - Delays cost-of-living adjustments in Foreign Service retirement benefits during FY 1994 through 1996. (Sec. 9002) Eliminates the lump sum retirement option for certain Foreign Service employees. Title X: Committee on Governmental Affairs - Subtitle A: Civil Service - Delays cost-of-living adjustments in Federal employee retirement benefits during FY 1994 through 1996. (Sec. 1002) Eliminates permanently the lump sum retirement option for certain Federal employees. (Sec. 1003) Amends Federal law to make changes regarding District of Columbia government contributions for specified periods for certain employee and annuitant health benefits. Subtitle B: Postal Service - Directs the United States Postal Service to make a specified additional payment into the Civil Service Retirement and Disability Fund and the Employee Health Benefits Fund to cover increases due to retirement cost-of-living adjustments and increases in health benefits costs. Subtitle C: Miscellaneous - Makes changes under the Civil Service and Federal Employees Retirement Systems regarding survivor annuities. Title XI: Judiciary - Amends the Omnibus Budget Reconciliation Act of 1990 to extend through FY 1998 the surcharge fees for Patent and Trademark Office users. Title XII: Committee on Labor and Human Resources - Subtitle A: Student Loan Provisions - Student Loan Reform Act of 1993 - Amends the Higher Education Act of 1965 (HEA) to replace the Federal Family Education Loan Program, under which loans made by private lenders are guaranteed by the Government, with a Federal Direct Student Loan Program, over a four-year transition period. Chapter 1: Federal Direct Student Loan Program - Amends HEA to change the Federal Direct Loan Demonstration Program to the Federal Direct Student Loan Program (FDSL). (Sec. 12011) Sets forth program authority for making necessary sums available to make FDSL loans to all eligible students (and parents) at participating higher education institutions selected by the Secretary of Education (Secretary), for the period beginning July 1, 1994. Requires such loans to be made by participating institutions that also have agreements with the Secretary to originate loans, or by alternative originators designated by the Secretary. Directs the Secretary to provide funds for such student and parent loans either directly to a participating institution that also has an origination agreement or to a designated alternative originator, on the basis of need and eligibility of students and parents at each participating institution. Requires the Secretary to pay fees to assist in meeting costs of loan origination to participating institutions or alternative originators. Declares that no institution shall have a right to participate in FDSL programs. Provides for phase-in of the program, and application of the requirements of the Cash Management Improvement Act of 1990 on a transition schedule. Sets forth selection criteria for an institution's participation in the FDSL program and in origination agreements. Allows consortia of eligible participating institutions to apply to originate FDSL loans as consortia. Sets forth FDSL program participation and origination agreement requirements for institutions. Sets forth terms and conditions for FDSL loans, including certain parallels with Stafford, supplemental, parent, and unsubsidized Stafford loans under the FFEL program. Sets interest rates according to different formulas for loans made before rather than on or after July 1, 1997. Sets minimum and maximum loan fees to be charged to borrowers. Provides for standard, extended, graduated, and income contingent repayment plan options. Sets forth deferment and forbearance possibilities (including national service). Sets forth provisions for consolidation, borrower defenses, optically imaged records, and nondischargeability in bankruptcy. Authorizes the Secretary to award contracts under the FDSL program for: (1) alternative origination of loans; (2) servicing and collection of loans; (3) data systems for records maintenance; and (4) services to assist in orderly transition from FFEL to FDSL programs. Authorizes the Secretary to use funds for research on, or demonstration or evaluation of, any FDSL program aspects, including flexible repayment plans. Provides funds for specified administrative expenses of the FDSL program and the transition from the FFEL program, including certain transition expenses of guaranty agencies. Establishes a bipartisan National Student Loan Reform Commission to study the advisability of replacing the FFEL program with direct lending. Authorizes appropriations. Chapter 2: Student Loan Savings - (Sec. 12022) Revises interest rates for new student loans after July 1, 1994. (Sec. 12023) Reduces student loan origination fees paid by students. Requires lenders to pay fees. (Sec. 12024) Requires the Student Loan Marketing Association (Sallie Mae) to pay an offset fee to the Secretary. (Sec. 12025) Reduces the amount of the tax exemption granted to holders of certain student loans. (Sec. 12026) Reduces the interest rate for consolidation loans. Requires holders of consolidation loans to pay a rebate fee to the Secretary. (Sec. 12027) Reduces certain maximum interest premiums and eliminates certain reinsurance fees. (Sec. 12028) Requires the transferee to pay the Secretary a loan transfer fee. (Sec. 12030) Establishes a $10,000 annual limit on PLUS loans, still subject to the limitation based on need. Requires multiple disbursement. Chapter 3: Conforming Amendments - Subchapter A: Conforming Amendments to the Higher Education Act of 1965 - Amends HEA to provide for access to FFEL program student and parent loans during the transition to the FDSL program. Provides for advances to guaranty agencies for lender-of-last-resort services. Requires Sallie Mae or its designated agent to begin making FFEL loans as lender-of-last-resort, subject to certain limitations, upon the Secretary's request, and to cease such lending when the triggering conditions have ceased. (Sec. 12043) Modifies terms of loans under the FFEL program. Authorizes requiring a defaulted borrower to make income contingent repayments. Subchapter B: Amendments to Other Laws - Amends the Internal Revenue Code to add or revise provisions relating to disclosure of tax return information with respect to income contingent repayment of student loans, individuals who owe on overpayment of Federal Pell Grants, and collection of payments on Federal Direct Student Loans. Chapter 4: Cost Sharing by States - Amends HEA to require any State in which there are higher education institutions with cohort default rates exceeding 20 percent to pay the Secretary specified portions of costs related to such loan defaults. Allows States to charge institutions fees based on their cohort default rate and the State's risk of loss. Chapter 5: General Effective Date - Sets forth the effective dates of subtitle A. Subtitle B: Public Health Service Act Provisons - Amends the Public Health Service Act (PHSA) to create a new title establishing the Health Coverage Clearinghouse to identify third parties which may be liable for payment for health care items and services furnished by a covered health program (defined as certain entities under the PHSA, a non-Federal entity under the Indian Self-Determination Act, or any other federally funded program providing payments for medical services that may be covered under a private health insurance policy). Requires: (1) the Secretary of the Treasury to furnish tax information to the Clearinghouse on the identity and employer of the spouse or parents; and (2) employers to furnish information on group health plan coverage of the individual, spouse, or parents. Requires the Clearinghouse to maintain a data bank containing such information. Authorizes disclosure of any information in the data bank to: (1) the Secretary, administrators of covered health programs (CHPs), employers, insurers; and (2) Federal and State law enforcement officials in connection with proceedings relating to a CHP. Mandates service fees to cover Clearinghouse costs. Amends the Employee Retirement Income Security Act of 1974 (ERISA) to require the administrator of each employee benefit plan to comply with the amendments made by these provisions. (Sec. 12102) Mandates a study on referral of a patient by a health care provider to an entity in which the provider has a financial interest or from which the provider receives a financial benefit for the referral. (Sec. 12103) Delays, during specified fiscal years, cost-of-living increases for National Health Service Corps retiree annuitants. (Sec. 12104) Allows a members of the Corps who is covered by provisions of Federal law relating to retirement or the Federal Employees' Retirement System and has a critical medical condition to elect annuity benefits under specified provisions. (Sec. 12105) Amends the PHSA to allow malpractice coverage, in certain circumstances, for officers, employees, and contractors of entities that are migrant or community health centers or that provide health services for the homeless or for residents of public housing when they provide services to individuals who are not patients of the entities. Subtitle C: Improved Immunization Delivery and Monitoring - Comprehensive Child Immunization Act of 1993 - Amends the Public Health Service Act to mandate establishment of a list of the vaccines that the Secretary of Health and Human Services recommends for administration to all children and a recommended administration schedule. Requires that the list and schedule be subordinate to State law. Mandates allotments to States. Provides for the establishment of State registries to monitor the immunization status of all children. Requires States to monitor and enforce compliance with these provisions by health care providers. Authorizes appropriations. Establishes a national immunization surveillance program to assess the effects of these provisions, provide technical assistance to States, and receive aggregate epidemiologic data collected by States. Authorizes appropriations. Directs the Secretary of Health and Human Services to provide for the distribution, without charge, of pediatric vaccines purchased by the Secretary to health care providers who are: (1) members of a uniformed service; (2) U.S. officers or employees; (3) federally qualified health centers; (4) migrant or community health centers; (5) entities providing health services for the homeless or for residents of public housing; or (6) public or nonprofit entities receiving funds under provisions of the Social Security Act relating to special projects of regional and national significance. Prohibits a provider receiving the vaccine from imposing a charge for the vaccine but allows a charge for the actual costs of the administration of the vaccine. Mandates activities to improve Federal, State, and local vaccine delivery systems and immunization outreach and education efforts, including a National Immunization Public Awareness Campaign and incorporation of immunization status assessment and referral in the application process for various types of Federal assistance. Authorizes grants to States to develop, revise, and implement immunization improvement plans. Requires States to establish child immunization rate goals. Authorizes appropriations. Mandates: (1) a biennial report on the costs, efficiency, and effectiveness of procedures established to deliver vaccine to health care providers; and (2) a report by the National Academy of Sciences on the role of the National Vaccine Program established under this title in achieving progress toward the established immunization goals for the year 2000. (Sec. 12203) Requires that the Vaccine Injury Table of the National Vaccine Injury Compensation Program include any vaccine on the list established under this subtitle. Allows a special master to award reasonable attorney's fees whether or not an election has been made to file a civil action regarding a vaccine injury compensation petition. Requires that compensation under the Program be used as determined by the special master to be in the best interests of the petitioner. (Current law requires that the compensation be used, with the consent of the petitioner, as determined by the special master to be in the best interests of the petitioner.) Sets time limits regarding applications for attorney's fees and costs. Authorizes appropriations for payment of compensation under the Program regarding vaccines administered before the effective date of the Program. Revises requirements regarding: (1) time limits on actions when the Table is revised; and (2) extensions of time limits for decisions. Mandates an annual report on amounts collected under provisions regarding subrogation of petitioners' rights. Requires the Advisory Commission on Childhood Vaccines to monitor the balance of the Vaccine Injury Trust Fund and recommend changes in the tax per dose. Revises requirements regarding vaccine information materials. Authorizes appropriations from the Trust Fund for administering the National Vaccine Program. (Sec. 12204) Removes provisions authorizing grants for research on the prevention and control of diseases through vaccination and related demonstration projects, public information programs, and health professionals training and clinical skills improvement. Subtitle D: ERISA Amendments - Chapter 1: Group Health Amendments - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to modify requirements regarding supersedure of State laws in connection with title XIX (Medicaid) of the Social Security Act requirements. (Sec. 12302) Prohibits a group health plan from reducing its coverage of pediatric vaccine costs below the coverage it provided on a specified date. Chapter 2: Liabilities and Penalties - Mandates joint and several liability for any person who participates in an act or omission of a fiduciary, knowing that the act or omission was a breach of fiduciary responsibility. (Sec. 12312) Changes requirements regarding civil enforcement actions brought by a participant, beneficiary, or fiduciary or by the Secretary of Labor and requires amounts recovered to be subject to a civil penalty. Limits awards of punitive damages and monetary relief. Modifies civil penalty requirements. Allows waiving or reducing penalties if the person will not be able to restore all losses to the plan, participants, or beneficiaries (currently, to the plan) without severe financial hardship. Requires reduction of penalties by the amount of any penalty or tax imposed by provisions of the Internal Revenue Code relating to minimum funding standards and prohibited transactions. Chapter 3: Public Health Service Act - Amends the Public Health Service Act to prohibit any health insurance policy in effect before a specified date from reducing coverage for pediatric vaccine costs below the coverage on the date of enactment of this provision. Mandates civil money penalties for violations. Title XIII: Veterans' Programs - Extends permanently (currently, ends September 30, 1997) the $90 monthly pension limitation for veterans having neither spouse nor child and being furnished domiciliary care by the Department of Veterans Affairs. (Sec. 13002) States that the FY 1994 cost of living increases in veterans' disability compensation and dependency and indemnity compensation shall be no more than the percentage increases under title II (Old Age, Survivors and Disability Insurance) of the Social Security Act. (Sec. 13003) Requires an increased reduction in the monthly basic pay of active duty and reserve personnel entering into service after FY 1993 for participation in the Montgomery GI Bill educational assistance program. Provides similar increases for those enrolled in such program before either voluntary or involuntary separation from the armed forces. (Sec. 13004) Extends permanently (currently terminated as of December 31, 1992) certain procedures applicable to liquidation sales on defaulted home loans to veterans which were guaranteed by the Department. Increases the home loan fees charged to such veterans for such guarantee loans. (Sec. 13006) Extends permanently: (1) the authority of the United States to recover from third party insurers the cost of certain care and services provided to veterans through the Department; (2) a required minimum copayment for medication received by certain veterans on an outpatient basis; and (3) the authority of the Secretary of Veterans Affairs to obtain, and the Secretary of the Treasury to provide, certain financial information of veterans for income verification purposes.

Pollution Prevention and Incineration Alternatives Act of 1993

United States · United States Congress · 22 June 1993

Pollution Prevention and Incineration Alternatives Act of 1993 - Amends the Solid Waste Disposal Act to prohibit the issuance of permits for construction or expansion of municipal solid waste incinerators until 1997. Prohibits Federal agencies, State or local governments, or other waste management jurisdictions from issuing permits to such incinerators after December 31, 1996, unless the applicant demonstrates that: (1) an annual waste composition analysis of the solid waste generated within the area to be served by the facility is conducted; (2) specified percentages of certain waste categories are diverted to waste management methods other than incineration; (3) the facility will not interfere with diversion rates; (4) it is not feasible to manage the remaining solid waste through source reduction, reuse, or recycling; (5) the facility will not adversely affect the environment, human health, or the local economy and is not situated in a nonattainment area identified under the Clean Air Act; (6) the full cost of the facility over its entire life will be less costly than reducing, recycling, or composting waste; (7) the waste management jurisdiction conducts a public participation process; (8) the proposed construction or expansion is approved by the affected unit of local government; (9) firms operating the facility are in compliance with environmental and public health statutes, have paid outstanding fines for violations of such statutes, and make disclosure statements available; (10) an approved environmental impact statement is completed; (11) the facility is not located within one and a half miles of specified sites, including schools or churches, or of a drinking water source; (12) certain incinerator capacity studies have been completed; and (13) the facility will not have a disproportionate impact on minority or low-income communities. Requires ash from municipal solid waste incinerators to be managed in a monofill that contains only such ash and meets specified design requirements. Prohibits the use of such ash for any purpose. Prohibits the incineration of household hazardous waste, batteries, chlorinated plastics, consumer electronics, and yard waste in such incinerators. Prohibits the issuance of permits or prior approval for the construction or expansion of hazardous waste incinerators unless requirements similar to those for municipal solid waste incinerators have been met. Directs hazardous waste management permit applicants to demonstrate that the State in which the incinerator is located, and each State in which generators of hazardous waste to be incinerated at the facility are located, are implementing toxics use reduction programs. Applies this Act to any facility that burns hazardous waste.

Information Dissemination and Research Accountability Act

United States · United States Congress · 18 June 1993

Information Dissemination and Research Accountability Act - Establishes in the National Library of Medicine a National Center for Research Accountability to assist in eliminating duplication of effort in Federal research proposals involving live animals. Requires referral of all such proposals to the Center for approval prior to funding. Provides for the modernization of biomedical information storage and dissemination by the National Library of Medicine.

School-Based Childhood Immunizations Program Amendments Act

United States · United States Congress · 18 June 1993

School-Based Childhood Immunizations Program Amendments Act - Amends the Public Health Service Act to authorize grants for immunizations for children. Authorizes the grants only to local educational agencies with elementary schools in communities with substantial cases of vaccine-preventable diseases and substantial numbers of unimmunized children. Mandates community education. Specifies permissible uses of grant funds, including recruiting and retaining a school nurse. Authorizes appropriations.

A bill to extend the method of computing the average subscription charges under section 8906(a) of title 5, United States Code, relating to Federal employee health benefits programs.

United States · United States Congress · 17 June 1993

Extends the method for computing average subscription charges for Federal employee health benefits programs through contract year 1998. Expresses the sense of the Congress that nothing in this Act should be considered to reflect any view on any aspect of the comprehensive health care reform legislation.

Department of Veterans Affairs Health Professionals Education Debt Reduction Act

United States · United States Congress · 17 June 1993

Department of Veterans Affairs Health Professionals Education Debt Reduction Act - Authorizes the Secretary of Veterans Affairs to carry out the Department of Veterans Affairs Education Debt Reduction Program to assist Department health-care personnel serving in the Veterans Health Administration in reducing the amount of debt incurred in completing educational programs that qualify such personnel for such service. Makes eligible for such Program any individual other than a physician or dentist serving in a Department health care position and having an outstanding health education loan from a qualified educational institution. Provides certain assistance preferences. Limits the assistance to $4,000 for each full year served in a Department health-care position, up to a $12,000 maximum. Authorizes appropriations for the Program for FY 1994 through 1998.

A bill to amend the Public Health Service Act to provide for the establishment of a residential support service program for special high-risk populations of pregnant women and their children, and for other purposes.

United States · United States Congress · 17 June 1993

Amends the Public Health Service Act to direct the Secretary of Health and Human Services to make grants to establish residential programs for special populations of high-risk and disadvantaged pregnant women and their children. Sets forth provisions regarding eligibility of entities to receive such grants and application requirements. Requires such programs to provide specified services in the language and cultural context appropriate for the mother and her family, such as: (1) medical services (including assessment and screening, referrals, and psychological services); and (2) parenting, job counseling, and other services. Sets forth provisions regarding: (1) eligibility of women to receive services under such programs; (2) housing facilities; and (3) peer review. Authorizes appropriations.

International Population Stabilization and Reproductive Health Act

United States · United States Congress · 17 June 1993

International Population Stabilization and Reproductive Health Act - Amends the Foreign Assistance Act of 1961 to set forth population assistance authorities and requirements. Makes such assistance available to a country that: (1) accounts for a significant portion of the world's annual population increment; (2) has significant unmet needs for methods of contraception, prevention and treatment of sexually transmitted diseases, and obstetric and gynecological care and requires foreign assistance to sustain quality reproductive health services; or (3) demonstrates a strong commitment to population stabilization and reproductive health strategies. Prohibits nongovernmental and multilateral organizations from being subjected to requirements which are more restrictive than those applicable to foreign governments for such assistance. Makes funds available for: (1) the United Nations Population Fund if it agrees to prohibit the use of funds for coerced abortion or involuntary sterilization; and (2) the Special Programme of Research, Development and Research Training to further international cooperation in the development of contraceptive technology. Authorizes appropriations. Makes development assistance available on a priority basis for countries which have agreed to address specific education, literacy, and health issues. Authorizes the President to establish a grant program, to be known as the Safe Motherhood Initiative, to improve the access of girls and women to reproductive health care services. Earmarks amounts of development and economic assistance for programs in support of equalizing male and female levels of primary and secondary school enrollment. Authorizes appropriations for the Child Survival Fund, the Safe Motherhood Initiative, and for research on, and treatment and control of, acquired immune deficiency syndrome (AIDS) in developing countries. Requires the U.S. executive directors of specified international financial institutions to report anually to the Congress on allocations to population activities and, if such allocations total less than $1 million, to set forth actions to encourage increased allocations. Establishes the Commission on World Population Stabilization and Reproductive Health to coordinate U.S. participation in the 1994 International Conference on Population and Development. Authorizes appropriations. Provides for certain actions to support the United Nations Forward Looking Strategies for the Advancement of Women and the United Nations Convention on the Elimination of All Forms of Discrimination Against Women.

A joint resolution to designate the month of August as "National Scleroderma Awareness Month", and for other purposes.

United States · United States Congress · 16 June 1993

Designates August 1993 and August 1994 as National Scleroderma Awareness Month.

Responsible Parent Immunization Plan Act of 1993

United States · United States Congress · 16 June 1993

TABLE OF CONTENTS: Title I: Immunization of Children Receiving AFDC Title II: Immunization of Children Receiving Food Stamps Benefits Title III: Current Program Regarding Immunizations Title IV: Immunizations for Uninsured Children Title V: Monitoring System with Respect to Immunization of Certain Children Title VI: Parental Behavior with Respect to Childhood Immunizations Title VII: Use of Medicaid Funds for Monitoring Medicaid Beneficiaries Responsible Parent Immunization Plan Act of 1993 - Title I: Immunization of Children Receiving AFDC - Amends part A (Aid to Families with Dependent Children) of title IV of the Social Security Act to require a State's AFDC plan to require any parent applying for or receiving aid to ensure that each of his or her children have received specified immunizations. Title II: Immunization of Children Receiving Food Stamps Benefits - Amends the Food Stamp Act of 1977 to: (1) provide for a benefit reduction if all children in a household have not received specified immunizations; or (2) provide for a benefit increase if all such children have received such immunizations. Title III: Current Program Regarding Immunizations - Amends the Public Health Service Act to authorize appropriations for grants to States for immunizations. Title IV: Immunizations for Uninsured Children - Provides, under the Public Health Service Act, for grants to States to provide pediatric immunizations to uninsured children without charge for the cost of the vaccine. Authorizes appropriations. Title V: Monitoring System with Respect to Immunization of Certain Children - Provides, under the Public Health Service Act, for grants to States for the purpose of establishing a monitoring system which encourages the parents of uninsured children or children who are members of families receiving food stamps or other forms of assistance to have their children receive immunizations. Authorizes appropriations. Title VI: Parental Behavior with Respect to Childhood Immunizations - Provides, under the Public Health Service Act, for grants for demonstration projects to develop innovative methods to encourage parents to ensure that their children receive scheduled immunizations. Authorizes appropriations. Title VII: Use of Medicaid Funds for Monitoring Medicaid Beneficiaries - Amends title XIX (Medicaid) of the Social Security Act to provide for the use of Medicaid funds to monitor Medicaid beneficiaries under the monitoring system established by title V of this Act.

To amend title XVIII of the Social Security Act to include services provided by interns and residents under any medical residency training program approved by the Accreditation Council for Graduate Medical Education in determining the amount of payment to hospitals under part A of the medicare program for the indirect costs of medical education.

United States · United States Congress · 16 June 1993

Amends title XVIII (Medicare) of the Social Security Act to count services provided by interns and residents under certain off-site medical residency training programs approved by the Accreditation Council for Graduate Medical Education in determining the amount of payment to hospitals under Medicare part A (Hospital Insurance) for the indirect costs of medical education.

Medical Injury Compensation Reform Act of 1993

United States · United States Congress · 16 June 1993

Medical Injury Compensation Reform Act of 1993 - Makes this Act applicable, with exceptions, to: (1) any medical malpractice liability claim and action brought in State or Federal court; and (2) claims accruing or actions brought after three years after enactment of this Act. Specifies that nothing in this Act shall be construed to establish jurisdiction in U.S. district courts over medical malpractice liability actions on Federal question grounds. Prohibits a medical malpractice liability claim from being brought more than two years after the date the alleged injury should reasonably have been discovered, but in no event after four years after the alleged injury occurred, with an exception for minors. Sets forth provisions regarding: (1) attorney's fees (including limitations on contingency fees); (2) calculation and payment of damages (including limitations on noneconomic damages, periodic payments for future losses, and mandatory offsets for damages paid by a collateral source); (3) notice requirements; (4) injunctive relief; and (5) preemption. Permits State professional societies to participate in disciplinary activities.

Rural Development Investment Zone Act of 1993

United States · United States Congress · 15 June 1993

TABLE OF CONTENTS: Title I: Designation of Rural Development Investment Zones Title II: Federal Income Tax Incentives Subtitle A: Credits for Employers Subtitle B: Credits for Investment in Tangible Property in Rural Development Investment Zones Subtitle C: Rural Development Investment Zone Bonds Title III: Establishment of Foreign-Trade Zones in Rural Development Investment Zones Title IV: Responsibilities of Federal Agencies in Rural Development Investment Zones; Regulatory Flexibility Rural Development Investment Zone Act of 1993 - Title I: Designation of Rural Development Investment Zones - Amends the Internal Revenue Code to authorize the Secretary of the Treasury to designate rural development investment zones for purposes of providing tax and regulatory relief and improving local services. Limits choices to areas nominated by States and local governments. Limits the total number of areas that may be designated, and the time period of the designation. Authorizes the Secretary to designate an investment zone only if the area meets certain locational, demographic, unemployment, and poverty criteria. Requires nominating local governments, as a condition of the Secretary's designation, to agree in writing to follow a course of action that may include reducing tax rates, improving local services, simplifying or streamlining regulation of business, and providing job training to area residents. Describes areas to which the Secretary must give preference in selecting areas for designation. Requires the Secretary to report to the Congress every four years on the effects of such investment zones' designation in accomplishing the purposes of this Act. Title II: Federal Income Tax Incentives - Subtitle A: Credits for Employers - Allows employers located in investment zones a nonrefundable income tax credit for qualified increased employment expenditures. Subtitle B: Credits for Investment in Tangible Property in Rural Development Investment Zones - Allows businesses an additional investment tax credit for investments made in certain investment zone construction property. Limits the credit to ten percent for new property, including rental property. Requires the recapture of credit amounts upon the early disposition of the property. Subtitle C: Rural Development Investment Zone Bonds - Provides for the issuance of rural development investment zone bonds as qualified small issue bonds. Title III: Establishment of Foreign-Trade Zones in Rural Development Investment Zones - Requires the Foreign-Trade Zone Board to consider on a priority basis and to expedite the processing of applications for the establishment of foreign-trade zones within investment zones. Requires the Secretary to give priority to, and expedite applications for, the establishment of ports of entry necessary to establish such zones. Title IV: Responsibilities of Federal Agencies in Rural Development Investment Zones; Regulatory Flexibility - Requires Federal agencies to seek to provide special assistance to designated rural development investment zones. Amends Federal law to revise "small entity" with regard to the analysis of regulatory functions to include qualified business, government, and nonprofit enterprises operating with investment zones. Authorizes Federal agencies, upon request by a designating government, to waive or modify rules and regulations pertaining to the implementation of projects or activities within an investment zone. Requires agencies to approve a request if the resulting benefits of job creation, community development, or economic revitalization outweigh the public interest in maintaining the rule unchanged. Disallows waiver or modification of a rule that would directly violate a statutory requirement or present a danger to the public health and safety.

Trauma Care Amendments Act of 1993

United States · United States Congress · 15 June 1993

Trauma Care Amendments Act of 1993 - Amends the Public Health Service Act to: (1) increase (from 12 to 13) the number of members of the Advisory Council on Trauma Care Systems; (2) include on the Council an individual who has been a trauma patient at a designated trauma center, to be appointed for a four-year term; and (3) require that at least four (currently, 25 percent) of the members be knowledgeable concerning rural areas. Requires the Council to meet not less than once and, if the Chair determines necessary, up to four times each year (currently, at the call of the Chair and not less than once each three months). Includes among requirements for State plans (in order to receive allotments) coordination and cooperation among bordering States with respect to areas in which logical geographic groupings across State borders would be appropriate (currently, among States that share any standard metropolitan statistical area). Authorizes appropriations. Directs the General Accounting Office to study and report to the appropriate congressional committees on the duplication of Federal emergency medical services and trauma activities.

A bill to amend certain provisions of title XVIII of the Social Security Act relating to end stage renal disease, and for other purposes.

United States · United States Congress · 15 June 1993

Amends title XVIII (Medicare) of the Social Security Act to: (1) increase the period during which group health plans are the primary payers for dialysis treatment furnished to individuals with end stage renal disease (ESRD) who are newly eligible for Medicare part A (Hospital Insurance); and (2) extend to three years (starting after 1996), on a phased in, graduated basis, the current one-year period following a transplant procedure during which Medicare covers immunosuppresive drug therapy for Medicare beneficiaries who have received organ transplants. Amends the Omnibus Budget Reconciliation Act of 1986 to increase payments for dialysis treatments for ESRD patients.

Brain Injury Rehabilitation Quality Act of 1993

United States · United States Congress · 15 June 1993

Brain Injury Rehabilitation Quality Act of 1993 - Amends title XIX (Medicaid) of the Social Security Act to provide for optional Medicaid coverage of case-management services to Medicaid-eligible individuals who sustain traumatic brain injuries, reside in a State with a case-management program meeting specified requirements, and meet other specified criteria. Requires States electing to provide such coverage to appoint a State coordinator to establish policies and standards for providing services, make necessary reports, supervise and coordinate services for eligible persons, and perform other specified duties. Requires the Secretary of Health and Human Services to establish standards for reporting data on traumatic brain injuries and operation of registries of traumatic brain injuries for use by State coordinators. Authorizes appropriations. Requires the Administrator of the Agency for Health Care Policy and Research to study and report to the Congress on the effectiveness of traumatic brain injury interventions. Authorizes appropriations.

A bill to amend title 38, United States Code, to authorize the inclusion in the Office of the Under Secretary for Health of the Department of Veterans' Affairs of health care personnel appointed to positions in the Veterans' Health Administration.

United States · United States Congress · 15 June 1993

Provides for the inclusion of health care personnel appointed to positions in the Veterans Health Administration within the Office of the Under Secretary for Health of the Department of Veterans Affairs.

Lupus Research Amendments of 1993

United States · United States Congress · 15 June 1993

Lupus Research Amendments of 1993 - Amends the Public Health Service Act to require the Director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases to expand and intensify research and related activities of the Institute with respect to lupus. Requires the Director to: (1) coordinate such activities with similar activities conducted by other national research institutes and agencies of the National Institutes of Health; and (2) conduct or support research to expand the understanding of the causes of, and to find a cure for, lupus, including research to determine the reasons underlying the elevated prevalence of the disease among African-American and other women. Authorizes appropriations.

To amend title 38, United States Code, to provide priority health care to veterans of the Persian Gulf War who were exposed to environmental hazards.

United States · United States Congress · 15 June 1993

Amends Federal veterans' benefits provisions to: (1) require the Secretary of Veterans Affairs to provide hospital care, and authorize such Secretary to provide nursing home care, to veterans exposed to environmental hazards during their military service; (2) make eligible for hospital and nursing home care for any disability of a Persian Gulf War veteran who was exposed to environmental hazards; (3) extend the authority for all such care through FY 2003; and (4) provide priority outpatient care for any disability of a Persian Gulf War veteran exposed during such service to environmental hazards.

Medicaid Brain Injury Rehabilitation Act of 1993

United States · United States Congress · 15 June 1993

Medicaid Brain Injury Rehabilitation Act of 1993 - Amends title XIX (Medicaid) of the Social Security Act to provide for optional Medicaid coverage of case-management services to Medicaid-eligible individuals who sustain traumatic brain injuries, reside in a State with a case-management program meeting specified requirements, and meet other specified criteria. Requires States electing to provide such coverage to appoint a State coordinator to establish policies and standards for providing services, make necessary reports, supervise and coordinate services for eligible persons, and perform other specified duties. Requires the Secretary of Health and Human Services to establish standards for reporting data on traumatic brain injuries and operation of registries of traumatic brain injuries for use by State coordinators. Authorizes appropriations. Requires the Administrator of the Agency for Health Care Policy and Research to study and report to the Congress on the effectiveness of traumatic brain injury interventions. Authorizes appropriations.

To amend title 38, United States Code, to provide additional authority for the Secretary of Veterans Affairs to provide health care for veterans of the Persian Gulf War.

United States · United States Congress · 15 June 1993

Directs the Secretary of Veterans Affairs to provide hospital care, and authorizes the Secretary to provide nursing home care, to a veteran exposed to an environmental hazard. Makes a veteran exposed to a toxic substance or an environmental hazard during the Persian Gulf War eligible for hospital and nursing home care for any disability for which a need for treatment is determined by the Secretary before October 1, 1994, notwithstanding whether it is medically evident that such disability is associated with such exposure. Extends the provision of such care through FY 1996. Makes such veterans eligible through such period for outpatient care for any disability for which a need for treatment is determined before October 1, 1994.

Designating September 9, 1993, and April 21, 1994, each as "National D.A.R.E. Day".

United States · United States Congress · 15 June 1993

Designates September 9, 1993, and April 21, 1994, as National DARE (Drug Abuse Resistance Education) Day.

National Defense Authorization Act for Fiscal Year 1994

United States · United States Congress · 14 June 1993

TABLE OF CONTENTS: Title I: Procurement Subtitle A: Authorization of Appropriations Subtitle B: Other Matters Title II: Research, Development, Test, and Evaluation Title III: Operation and Maintenance Subtitle A: Authorization Appropriations Subtitle B: Other Matters Title IV: Military Personnel Authorizations Subtitle A: Active Forces Subtitle B: Reserve Forces Subtitle C: Military Training Student Loads Title V: Military Personnel Policy Subtitle A: Officer Personnel Policy Subtitle B: Reserve Component Matters Subtitle C: Service Academies Subtitle D: Education and Training Subtitle E: Other Matters Title VI: Compensation and Other Peronnel Benefits Subtitle A: Pay and Allowances Subtitle B: Retired Pay and Survivor Benefits Subtitle C: Other Matters Title VII: Health Care Provisions Subtitle A: Health Care Management Subtitle B: Other Matters Title VIII: Department of Defense Organization and Management Subtitle A: Office of the Secretary of Defense Subtitle B: Professional Military Education Subtitle C: Other Matters Title IX: General Provisions Title X: Matters Relating to Allies and Other Nations National Defense Authorization Act for Fiscal Year 1994 - Title I: Procurement - Subtitle A: Authorization of Appropriations - Authorizes appropriations to the Army, Navy and Marine Corps, and Air Force for FY 1994 for aircraft, missiles, weapons and tracked combat vehicles, ammunition, shipbuilding and conversion, and for other procurement. Authorizes appropriations for FY 1994 for: (1) defense-wide procurement; (2) the Defense Inspector General; (3) the Defense Health Program; and (4) the chemical demilitarization program. Repeals a separate budget account requirement for the chemical demilitarization program. Subtitle B: Other Matters - Repeals the current requirement for a separate budget request for the procurement of reserve equipment. Title II: Research, Development, Test, and Evaluation - Authorizes appropriations for FY 1994 for the armed forces for research, development, test, and evaluation (R&D). Title III: Operation and Maintenance - Subtitle A: Authorization of Appropriations - Authorizes appropriations for FY 1994 for the armed forces and specified activities and agencies of the Department of Defense (DOD) for operation and maintenance. Authorizes appropriations for FY 1994 for DOD working capital and revolving funds. Amends the National Defense Authorization Act for Fiscal Years 1992 and 1993 to include within the funding provided by the Defense Business Operations Fund the activities of the Defense Contract Audit Agency and the Defense Contract Management Command. Authorizes the obligation during FY 1994 of a specified amount from the National Security Education Trust Fund. Subtitle B: Other Matters - Repeals a current limitation on the number of military and civilian employees assigned or detailed to headquarters and non-management headquarters and headquarters support activities. Limits the authorized FY 1994 sale of stockpiled materials in the National Defense Stockpile (NDS). Authorizes the Secretary of Defense to impose a moratorium on new material acquisition in order to reduce existing excess NDS materials. Authorizes the Commandant of the Marine Corps to provide minor maintenance and repairs to Pacific battle monuments with specified operation and maintenance funds. Title IV: Military Personnel Authorizations - Subtitle A: Active Forces - Provides for the authorized end strengths for active-duty forces as of FY 1994. Subtitle B: Reserve Forces - Provides the authorized end strengths for reserve personnel as of FY 1994 and for certain reserves on active duty in support of the reserves. Subtitle C: Military Training Student Loads - Provides the authorized FY 1994 military training student loads. Title V: Military Personnel Policy - Subtitle A: Officer Personnel Policy - Authorizes the Secretary of the military department concerned to delete from certain reports and promotion lists the names of officers erroneously considered for promotion by promotion selection boards. Provides for the involuntary separation of certain regular warrant officers. Subtitle B: Reserve Component Matters - Provides certain reserve personnel call-up authority for the Secretary and the Secretary of Transportation when the Coast Guard is not under the jurisdiction of the Navy. Repeals the current requirement for physical examinations in the Army and Air National Guard. Requires each member of the Ready Reserve to be examined every five years (currently four). Subtitle C: Service Academies - Revises provisions concerning the procedure for nominating candidates for admission to the service academies. Subtitle D: Education and Training - Revises the eligibility requirements for advanced training in the Reserve Officer Training Corps (ROTC) program. Subtitle E: Other Matters - Repeals the statutory restriction on the assignment of women in the Navy and Marine Corps. Title VI: Compensation and Other Personnel Benefits - Subtitle A: Pay and Allowances - Authorizes the Secretary concerned, in times of war, hostilities, or national emergency, to limit the direct pay to military personnel serving in prescribed areas. Makes permanent the authority for certain bonuses and special pay for nurse officer candidates, registered nurses, and nurse anesthetists serving in the armed forces. Extends specified expiring authorities for certain other special pay and bonus programs within the regular and reserve armed forces. Subtitle B: Retired Pay and Survivor Benefits - Provides disability coverage for certain officer candidates granted excess leave. Subtitle C: Other Matters - Provides permanent authority for former prisoners of war to claim payments because of violation of the Geneva Conventions (inhumane treatment). Title VII: Health Care Provisions - Subtitle A: Health Care Management - Amends the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to: (1) revise, and extend until October 1, 1995, the authority to provide nonemergency inpatient hospital care to certain spouses and dependents of military personnel who reside outside of a 40-mile radius of a military medical facility; (2) revise and codify changes to the CHAMPUS physician payment program; (3) award constructive service credit for certain advanced health degrees obtained by defense health personnel; and (4) authorize the Secretary to obtain additional distinguished pathologists and scientists (currently limited to six) if determined to be in the best interests of DOD. Subtitle B: Other Matters - Repeals the statutory restriction on the use of DOD funds for abortions. Title VIII: Department of Defense Organization and Management - Subtitle A: Office of the Secretary of Defense - Authorizes certain organizational and administrative changes within the Office of the Secretary of Defense, including establishing the position of Under Secretary of Defense for Personnel and Readiness and renaming the Under Secretary of Defense for Acquisition as the Under Secretary of Defense for Acquisition and Technology. Subtitle B: Professional Military Education - Authorizes the President of the National Defense University to confer master of science degrees in national security strategy and national resource strategy. Subtitle C: Other Matters - Authorizes payment of escort and flag expenses incident to the death of a civilian employee who dies while serving with an armed force in a contingency operation. Title IX: General Provisions - Authorizes the award of gold star lapel buttons to survivors of service members killed by terrorist acts. Authorizes the Secretary of the Air Force to establish and maintain an Aviation Leadership Program to provide undergraduate pilot and related training to selected air force personnel of friendly, less-developed foreign countries. Title X: Matters Relating to Allies and Other Nations - Authorizes the Secretary of Defense to exchange U.S. military and civilian defense personnel with the defense departments or ministries of allied and friendly foreign governments. Authorizes the Secretary to transfer to the Republic of Korea certain excess or obsolete defense articles. Authorizes the Secretary to accept cash or other contributions from Japan, Kuwait, and the Republic of Korea as defense burdensharing payments.