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Bill· HRH.R. 4260 (103rd)referred
United States · United States Congress · 20 April 1994
Health Research Act of 1994 - Establishes in the Treasury the National Fund for Health Research. Requires regional and corporate health alliances formed under a comprehensive health care reform program to set aside and transfer specified amounts each calendar year into the Fund. Amends the Internal Revenue Code to authorize individuals (other than nonresident aliens) to designate for payment into the Fund at least $1 of a cash contribution or of any tax overpayment made. Requires the Secretary of Health and Human Services to distribute specified amounts from the Fund for various health research activities of the National Institutes of Health and the National Center for Research Resources. Excludes Fund amounts from any budget enforcement procedures under the Congressional Budget Act of 1974 or the Balanced Budget Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act).
Bill· HJRESH.J.Res. 358 (103rd)referred
United States · United States Congress · 20 April 1994
Designates September 18 through 24, 1994, as Iron Overload Diseases Awareness Week.
Bill· HJRESH.J.Res. 359 (103rd)referred
United States · United States Congress · 20 April 1994
Designates the week beginning June 13 as National Parkinson's Disease Awareness Week.
Bill· HRH.R. 4241 (103rd)open
United States · United States Congress · 18 April 1994
Insurance Form Simplification Act - Amends Federal law to require standardized claim forms under the Federal employees' health benefits program and the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS).
Bill· SS. 2019 (103rd)open
United States · United States Congress · 14 April 1994
Safe Drinking Water Act Amendments of 1994 - Amends the Safe Drinking Water Act to require the Administrator of the Environmental Protection Agency to make capitalization grants to States to establish State drinking water treatment revolving loan funds. (Sec. 3) Authorizes State Governors to transfer amounts between such funds and water pollution control revolving funds established under the Clean Water Act. Requires the Administrator to reserve one and a half percent of drinking water funds for capitalization grants to Indian tribes for the improvement of public water systems. Authorizes the Administrator to make such grants to the District of Columbia and specified U.S. territories. Authorizes States to reserve a certain amount of such grants for technical assistance for small public water systems. Requires the Administrator, beginning in FY 1998, to withhold 50 percent of each capitalization grant made to a State if the Administrator has not approved a State viability program. Directs States to prepare annual intended use plans for funds. Requires priority for the use of funds to be given to projects that address the most serious risk to human health and that assist systems most in need on a household basis according to State affordability criteria. Authorizes appropriations. (Sec. 4) Requires the Administrator, no later than May 31, 1994, to propose maximum contaminant level goals (MCLGs) or maximum residual disinfectant level goals and a national primary drinking water regulation for disinfectants and disinfectant byproducts. Directs the Administrator to propose an interim enhanced surface water treatment rule for systems serving a population of over 10,000 that includes an MCLG for cryptosporidium. Requires publication of such goals, regulation, and rule (for microbial contaminants including cryptosporidium) by December 31, 1996. Directs the Administrator to: (1) promulgate an information collection rule to obtain information that will facilitate further revisions to the national primary drinking water regulation for disinfectants and disinfection byproducts by July 29, 1994; (2) promulgate a final long-term enhanced surface water treatment rule for all public water systems serving over 10,000 by December 31, 1998; and (3) promulgate a revised national primary drinking water regulation for disinfectants and disinfection byproducts incorporating collected information by June 30, 2000. Requires the Administrator to propose a regulation that describes treatment techniques that meet requirements for filtration and are feasible for community water systems serving 3,300 people or fewer and noncommunity water systems. Directs the Administrator to publish an MCLG and promulgate a national primary drinking water regulation for any contaminant that may have adverse health effects and is known or anticipated to occur in public water systems with a frequency and at levels of public health concern. (Current law requires MCLGs and regulations for those that may have adverse health effects and are known or anticipated to occur in such systems.) Requires the Administrator to publish a list of at least 15 contaminants that present the greatest public health concern, with additional lists of at least seven contaminants every five years. Establishes deadlines for the promulgation of regulations and MCLGs for such contaminants. Directs the Administrator to assemble a national drinking water occurrence data base to include information on the occurrence of regulated and unregulated contaminants. Prohibits the Administrator, for any contaminant that is regulated on the basis of its carcinogenic effects, from establishing a maximum contaminant level (MCL) that is more stringent than the level necessary to ensure that lifetime cancer risks resulting from concentrations of the contaminant in drinking water will not exceed one in 1,000,000 considering sensitive subpopulations that can be identified and characterized. Authorizes the Administrator to establish an MCL for such a contaminant that is less stringent than is feasible if such level will: (1) result in compliance costs that are substantially less than costs that would be experienced by public water systems to comply with the more stringent level; and (2) ensure that lifetime cancer risks resulting from concentrations of the contaminant in drinking water are essentially equivalent to the risks that would occur at the feasible level. Permits the Administrator to establish an MCL for a contaminant at a level that is less stringent than is feasible if the feasible level would result in an increase in the overall health risk from drinking water by: (1) increasing the concentration of other contaminants; or (2) interfering with the efficacy of treatment techniques that are used to comply with other national primary drinking water regulations. Requires such MCL to minimize the overall health risks. Makes this authority inapplicable with respect to regulations promulgated for disinfectants and disinfection byproducts. Revises provisions concerning the monitoring of unregulated contaminants. Requires the Administrator to establish criteria for a monitoring program for such contaminants. Directs the Administrator, within three years of this Act's enactment and every five years thereafter, to issue a list of up to 30 unregulated contaminants to be monitored by public water systems. Requires systems that serve over 10,000 people to monitor for all listed contaminants. Directs each State to develop a representative monitoring plan to assess the occurrence of such contaminants in systems that serve fewer than 10,000. Provides that such plans shall require monitoring for systems representative of different sizes, types, and geographic locations within a State. Authorizes the Administrator to waive monitoring requirements if a State demonstrates that the criteria for listing a contaminant do not apply in the State. Authorizes appropriations. Requires drinking water regulations to be reviewed at least once every six (currently, three) years. Makes national primary drinking water regulations effective three years after the date of promulgation (currently, 18 months) unless the Administrator determines that an earlier date is practicable. Permits up to two additional years to comply with an MCL or treatment technique if additional time is necessary for capital improvements. Authorizes exemptions from MCL or treatment technique requirements to allow a public water system to develop an alternative source of water supply or to restructure or consolidate the system. Permits the renewal of an exemption for one additional two-year period (currently, one or more two-year periods) for a system that serves no more than 3,300 people (currently, that serves no more than 500 service connections) and needs financial assistance for necessary improvements. Prohibits exemptions for small systems that receive variances under this Act. Requires the Administrator to review monitoring requirements for at least 12 contaminants and propose any necessary modifications. Authorizes States to submit alternative monitoring requirements for any national primary drinking water regulation to the Administrator for approval. Permits the Administrator or a State with primary enforcement responsibility (primacy), with respect to monitoring requirements for contaminants regulated on the basis of carcinogenic effects, to exempt public water systems serving fewer than 10,000 people from conducting additional quarterly monitoring during any three-year period if monitoring conducted at the beginning of the period fails to detect the presence of the contaminant and it is unlikely to be detected by further monitoring. (Sec. 5) Authorizes the Administrator or a State with primacy to grant variances for compliance with an MCL or treatment techniques to public water systems serving fewer than 10,000 people. Permits such variances if a system installs and operates treatment technology that is feasible for small systems as determined by the Administrator and: (1) the State cannot afford to comply with a national primary drinking water regulation; and (2) the variance ensures adequate health protection. Establishes application deadlines for variances. Requires variances to be granted or denied within one year of the deadline. Establishes a moratorium on penalties for violations of MCLs or treatment techniques for systems that submit timely applications. Makes variances unavailable for: (1) an MCL or treatment technique for contaminants with respect to which a national primary drinking water regulation was promulgated prior to January 1, 1986; or (2) a regulation for a microbial contaminant or an indicator or treatment technique for such contaminant. Requires the Administrator to issue guidance or regulations describing treatment techniques for public water systems serving fewer than 3,300 people. Directs States with primacy to implement State Drinking Water System Viability Programs that ensure the capability of systems to comply with requirements. Provides that a public water system in violation of a requirement specifying an MCL or treatment technique that seeks assistance from a State for restructuring shall not be subject to a penalty for three years if the system is meeting the conditions of a State restructuring order. Makes such extensions unavailable for systems that apply for assistance four years after this Act's enactment. Directs the Administrator to make grants to institutions of higher education to establish at least five small public water system technology assistance centers in the United States. (Sec. 6) Revises enforcement authorities. Exempts systems that submit approved consolidation plans from enforcement actions for a certain time period. Requires States to report annually to the Administrator on public water system compliance. Directs the Administrator to summarize such reports for the Congress and make recommendations on resources needed to ensure compliance. (Sec. 7) Makes it unlawful for any person to: (1) introduce into commerce any pipe or pipe or plumbing fitting or fixture that is not lead free; (2) sell solder or flux that is not lead free while engaged in the business of selling plumbing supplies; or (3) introduce into commerce any solder or flux that is not lead free unless it bears a label stating that it is illegal to use such solder or flux in the installation or repair of any plumbing providing water for human consumption. Requires the Administrator to: (1) provide technical information and assistance to qualified third-party certifiers in the development of voluntary standards and testing protocols for the leaching of lead from new plumbing fittings and fixtures that are intended to dispense water for human ingestion; and (2) promulgate regulations setting a health-effects-based performance standard establishing maximum leaching levels from such fittings and fixtures if a voluntary standard is not established within one year of this Act's enactment. Prohibits, if such standards are not promulgated within five years of this Act's enactment, the importation, manufacturing, processing, or distribution in commerce of fittings or fixtures that contain more than four percent lead by dry weight. Prohibits any person from removing water from a public water system through a pipe or device outside such system and returning water to the system unless the pipe or device is totally within the control of one or more systems. (Sec. 8) Directs the Administrator to promulgate national primary drinking water regulations and an MCL for radon. Permits alternative contaminant levels if a system is: (1) located in a State that is implementing a program to reduce radon in indoor air or is receiving State grant assistance for the program; or (2) implementing an approved service area alternative compliance program. (Sec. 9) Requires State Governors to submit source water protection programs to the Administrator for approval. Authorizes community water systems, State or local government agencies, or planning entities, after such programs are approved, to submit source water protection, sole source aquifer, or wellhead protection plans to a State for approval. Withholds 50 percent of each capitalization grant to a State, beginning in FY 1998, if the Administrator has not approved a State source water protection program. Makes projects under approved programs eligible for assistance under the Clean Water Act. Extends the authorization of appropriations for sole source aquifer protection and wellhead protection programs. (Sec. 11) Authorizes appropriations for drinking water research, investigations, and demonstrations. Requires the principal operator of a public water system and additional personnel, as designated by the Administrator, to be certified for proficiency. Extends the authorization of appropriations for technical assistance to small water systems. Establishes additional research authorities, including requirements for studies of risk assessment and the occurrences of chemicals in drinking water. Sets priorities for research. Directs the Administrator to develop an integrated risk characterization strategy for drinking water quality. Adds to the list of requirements that a State must meet to retain primacy for drinking water programs that the State has adopted requirements for the certification of operators of public water systems and laboratories conducting tests. (Sec. 12) Authorizes appropriations for public water system supervision programs and grants to States for groundwater protection. (Sec. 14) Waives the sovereign immunity of the United States with respect to any requirement, administrative authority, process, or sanction imposed concerning the provision of safe drinking water. (Sec. 15) Directs the Administrator to: (1) rank sources of pollution with respect to the relative degree of risk of adverse effects on human health, the environment, and public welfare; (2) evaluate costs and benefits associated with compliance with regulations and Federal actions with health and environmental impacts; and (3) identify reasonable opportunities to achieve significant risk reduction through modifications in environmental regulations and programs and other Federal programs with health and environmental impacts. (Sec. 16) Requires the Administrator to study and report to the Congress on the seriousness of contamination of private sources of drinking water that are not regulated by this Act. Authorizes the Chief of Engineers of the Army Corps of Engineers to borrow from the Federal Financing Bank to finance capital improvements at the Washington Aqueduct.
Bill· HRH.R. 4216 (103rd)referred
United States · United States Congress · 14 April 1994
Medicare Beneficiary Coinsurance Protection Act - Amends title XVIII (Medicare) of the Social Security Act concerning hospital insurance benefits for the aged and disabled to limit a beneficiary's financial liability for outpatient hospital services to 20 percent of the reasonable cost of the item or service. (Currently such liability is 20 percent of hospital charges.) Modifies the formula for calculating the beneficiary's financial liability for ambulatory surgical center, radiology, and diagnostic procedures to subtract the beneficiary's out-of-pocket payment after total payment has been calculated.
Bill· HRH.R. 4202 (103rd)open
United States · United States Congress · 13 April 1994
TABLE OF CONTENTS: Title I: Insurance Reform Subtitle A: Insurance Provisions Subtitle B: Promoting Development of Voluntary Health Plan Purchasing Cooperatives Subtitle C: Federal Preemption Subtitle D: Rules of Construction Regarding Abortion Services; Inseverability Title II: Amendments of Internal Revenue Code of 1986 Subtitle A: Limitations on Employer Deduction for Health Care Coverage for Employees and on Employee Exclusion for Employer-Provided Health Care Coverage Subtitle B: Credits for Contributions to Medical Savings Accounts, for Purchase of High Deductible Umbrella Insurance, and for Routine Preventive Care Subtitle C: Repeal of Medical Expense Deduction Subtitle D: Veterans Medical Benefits and Services Unaffected Title III: Savings In Medicare and Medicaid Programs Subtitle A: Medicare Program Subtitle B: Medicaid Program Title IV: Containing Health Care Costs Subtitle A: Medical Malpractice Liability Reform Subtitle B: Treatment of Certain Activities Under the Antitrust Laws Title V: Special Assistance for Frontier, Rural, and Urban Underserved Areas Subtitle A: Frontier, Rural, and Urban Underserved Areas Subtitle B: Primary Care Provider Education Subtitle C: Programs Relating to Primary and Preventive Care Services Subtitle D: Limitation on Funding for Abortions Title VI: Administrative Cost Savings Subtitle A: Standardization of Claims Processing Subtitle B: Electronic Medical Data Standards Subtitle C: Development and Distribution of Comparative Value Information Subtitle D: Preemption of State Quill Pen Laws Title VII: Anti-Fraud and Anti-Rationing Subtitle A: Criminal Prosecution of Health Care Fraud Subtitle B: Coordination of Health Care Anti-Fraud and Abuse Activities Subtitle C: Protection Against Rationing of Treatment Health Savings and Security Act of 1994 - Title I: Insurance Reform - Subtitle A: Insurance Provisions - Part 1: Requirements for Tax-Favored Health Plans - Authorizes a State to establish or operate a managed health care plan. (Sec. 102) Requires such a plan to provide for all medically necessary acute medical care (including physician services; inpatient, outpatient, and emergency hospital services and appropriate alternatives to hospitalization; and inpatient and outpatient prescription drugs), to not exclude coverage for selected illnesses or selected treatments if consistent with medically accepted practices, and to meet applicable cost-sharing requirements of this Act. Requires that such plan, in the case of a high deductible umbrella insurance plan, provide a deductible amount for benefits provided in any plan year which is at least $1,500 (but not to exceed $3,000) for items and services furnished to a family (composed of one or more individuals) enrolled under the plan in a year. Specifies that a health insurance plan may not require the payment of any copayment or coinsurance for an item or service for which coverage is required after an individual or a family has incurred out-of-pocket expenses equal to a specified limit for a plan year. (Sec. 103) Requires that such a plan provide: (1) for a variation in premium rates only on the basis of age, sex, geography, and family enrollment, individual and group coverage, and in the case of group coverage, on the basis of the number of individuals covered within the group; (2) for a charge of the same premium rates to new applicants and existing policyholders with the same age, sex, geographic characteristics, and family enrollment; and (3) that the highest premium for the plan for a particular class of family enrollment and geographic characteristics may not exceed four times the lowest premium for such plan for the same enrollment and geographic characteristics. Permits incentive discounts of not more than ten percent for participating in an approved program to promote healthy behavior, prevent or delay the onset of illness, or provide for screening or early detection of illness. (Sec. 104) Requires that such plan: (1) provide guaranteed issue at standard rates to all applicants; and (2) not exclude from coverage, or limit coverage for, any preexisting condition, with exceptions. (Sec. 105) Requires that such plan provide the policyholder with a contractual right to renew the coverage which stipulates that the insurer cannot cancel or refuse to renew the coverage except for cases of nonpayment of premiums, or fraud or misrepresentation, by the policyholder. (Sec. 106) Sets forth restrictions on agent compensation and broker activities. Part 2: Certification of High Deductible Umbrella Insurance Plans and Managed Care Health Plans - Requires each State to submit to the Secretary of Health and Human Services a report on steps the State is taking to implement and enforce a regulatory program with respect to high deductible umbrella insurance plans and managed care health plans by a specified deadline. Directs the Secretary, upon determining that a State has failed to submit a report by the deadline or that the State has not implemented and provided adequate enforcement of the regulatory program, to give the State 60 days to submit such report or implement and enforce such program. Sets forth procedures for Federal enforcement if such failure has not been corrected. (Sec. 112) Directs the Secretary to develop State regulatory program standards, in the form of model Acts and model regulations, which include: (1) procedures for certifying that the requirements of part 1 of this subtitle have been met by a health insurance plan applying for certification as a high deductible umbrella insurance plan or a managed care health plan; (2) specified requirements regarding marketing practices and reinsurance or allocation of risk mechanisms with respect to such a plan; (3) requirements regarding solvency standards and guaranty funds for carriers of such plans; and (4) reporting requirements under which carriers report to the Internal Revenue Service regarding the acquisition and termination by individuals of coverage under such plans. Directs the Secretary to: (1) request the National Association of Insurance Commissioners to develop models for reinsurance or allocation of risk mechanisms for high deductible umbrella insurance plans and managed care health plans made available to individuals for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models to determine if they provide for an effective reinsurance or allocation of risk mechanism. Requires each State to establish one or more reinsurance or allocation of risk mechanisms consistent with such a model. Permits a State to establish and maintain such a mechanism jointly with other States. Directs the Secretary to establish and maintain a reinsurance or allocation of risk mechanism if a State has failed to establish or maintain such a mechanism. Amends the Internal Revenue Code to impose a tax on the providing of any high deductible umbrella insurance plan or managed care health plan which covers any individual in a Federal reinsurance State. Directs that the tax imposed equal the applicable percentage of the amount received by the insurer for providing such plan in such Federal reinsurance State. Makes the insurer liable for payment of the tax. Subtitle B: Promoting Development of Voluntary Health Plan Purchasing Cooperatives - Directs the Secretary to establish standards relating to the establishment of health plan purchasing cooperatives (HPPCs), qualifications for qualified health carriers, and the roles of States under this subtitle. Sets forth provisions regarding deadlines, revision of standards, application of standards through States, the Federal role, and implementation of the standards. (Sec. 122) Requires each State to establish boundaries for HPPC areas in the State. (Sec. 123) Authorizes the establishment of one or more State-chartered, nonprofit private corporations to serve as an HPPC for each HPPC area for the benefit of small employers and eligible individuals in the area. Specifies that a carrier may not form, underwrite, or possess a majority vote of an HPPC, but may administer an HPPC. Sets forth provisions regarding: (1) the establishment by each HPPC of bylaws; (2) the election of members of its board of directors; (3) limitation of liability for good faith actions taken by any member of the board, its employees, or agent in the performance of duties of HPPCs; (4) appointment of officers and an executive director; (5) reporting, recordkeeping, and audit requirements; and (6) general authorities and limits on the authority of HPPCs. (Sec. 124) Requires each HPPC to: (1) enter into contracts and hold policies with qualified health carriers which elect to offer HPPC plans to members; (2) provide for the enrollment of eligible employees of small employers and eligible individuals in HPPC plans of qualified health carriers offered by the HPPC; (3) provide to its members and eligible employees of small employer members comparison sheets with clear standardized information on each qualified health carrier and each HPPC plan offered by a qualified health carrier; (4) establish requirements for participation of small employers and eligible individuals as HPPC members consistent with any standards established by the Secretary and to maintain eligibility records; and (5) establish dispute resolution procedures to resolve disputes between the HPPC and its members or qualified health carriers. Sets forth requirements concerning: (1) contracts with members; (2) contracts with plans; (3) overhead allowance; (4) uniform administrative and accounting procedures; and (5) contracts for administrative services. (Sec. 125) Requires each State to establish a process whereby a carrier that demonstrates to the satisfaction of the State insurance commissioner that it has the capability to fulfill specified requirements (with regard to licensure, administrative capacity, access, grievance procedures, utilization management procedures, quality, information, and data elements) is designated as a qualified health carrier. Sets forth the functions of qualified health carriers. Requires that coverage under an HPPC plan offered by a qualified health carrier be available to any member of the HPPC at the anniversary date of each member's coverage under an HPPC plan, with exceptions and subject to specified conditions. (Sec. 126) Requires each: (1) HPPC to use efficient and standardized means to notify small employers of the availability of plans through the HPPC and to notify the State insurance commissioner of any marketing practices or materials that it finds contrary to the fair marketing of qualified health carriers and HPPC plans; and (2) State insurance commissioner to monitor compliance with marketing requirements. (Sec. 127) Requires: (1) each HPPC to submit specified data to the State on a quarterly basis; and (2) the Secretary to establish uniform standards for data that an HPPC collects from qualified health carriers and providers and disseminates. (Sec. 128) Requires each State to: (1) assure compliance of HPPCs, small employers, and eligible employees and individuals with the requirements of this subtitle and to conduct reviews at least annually on the performance of each HPPC in assuring access to health coverage to small employers and eligible individuals in the HPPC area; (2) receive, review, and act on appeals of unresolved disputes between an HPPC and a member; (3) analyze information collected from qualified health carriers and other sources and report findings that assist consumers, HPPCs, qualified health carriers, or health care providers in improving the delivery or purchase of cost-effective health care; (4) prepare and make available to HPPCs and employers located in the State (and to eligible individuals upon request) information, in comparative form, concerning the HPPC plans in the State and HPPCs operating in the State; (5) report to the Secretary annually on the impact of the reform under this subtitle in expanding the availability and affordability of health coverage to eligible employees and individuals; and (6) supervise HPPCs to ensure that actions that affect market competition accomplish the objectives of this title, so as to provide State and Federal protection to HPPCs and HPPC boards of directors against Federal and State antitrust laws. Subtitle C: Federal Preemption - Bars applicability of any provision of State or local law that: (1) in the case of a group health plan, requires the coverage of one or more specific benefits, services, or categories of health care, or services of any class or type of provider of health care; and (2) prohibits two or more employers from obtaining coverage under an insured multiple employer health plan. (Sec. 143) Preempts and makes unenforceable specified State law restrictions with respect to reimbursement rates or selective contracting, differential financial incentives, and utilization review methods. Directs the Comptroller General to conduct a study of the benefits and cost effectiveness of the use of managed care in the delivery of health services. (Sec. 144) Specifies that nothing in this subtitle shall be construed to invalidate any State law that has the effect of preventing the denial of lifesaving medical treatment pending transfer to another health care provider. Subtitle D: Rules of Construction Regarding Abortion Services; Inseverability - Specifies that: (1) nothing in this title or title II may be construed to require any health plan to include any abortion services or to condition tax deductibility on the inclusion of such services; and (2) if such provision is judicially determined to be invalid all the provisions of this title and title II shall be deemed to be invalid. Title II: Amendments of Internal Revenue Code of 1986 - Subtitle A: Limitations on Employer Deduction for Health Care Coverage for Employees and on Employee Exclusion for Employer-Provided Health Care Coverage - Amends the Internal Revenue Code to allow an employer a deduction: (1) for health care coverage for employees under a high deductible umbrella insurance plan or a managed health care plan; (2) for contribution to a medical savings account for an employee; or (3) for payment of permitted coverage. Prohibits such deduction from exceeding the health care tax benefit limitation imposed on individuals receiving coverage under a tax-qualified health care plan. (Sec. 202) Excludes from the gross income of an employee only coverage under a tax-qualified health care plan, contributions to a medical savings account, or permitted coverage payments. (Sec. 203) Prohibits the provision of health benefits under cafeteria plans. Subtitle B: Credits for Contributions to Medical Savings Accounts, for Purchase of High Deduction Umbrella Insurance, and for Routine Preventive Care - Allows individuals a tax credit (with limitation) for a percentage of contributions to a medical savings account. Makes such account tax-exempt and excludes other employer payments from the individual's tax base. (Sec. 212) Allows individuals a tax credit for a percentage of the amount paid for coverage under a tax-qualified health care plan. Requires the establishment of a program to provide health insurance certificates for low-income individuals eligible for such credit. (Sec. 213) Allows certain individuals a tax credit for a percentage of the amount paid for routine preventive care for the taxpayer, spouse, and dependents. Subtitle C: Repeal of Medical Expense Deduction - Repeals the deduction for medical, dental, etc., expenses. Subtitle D: Veterans Medical Benefits and Services Unaffected - Declares that nothing in this title affects veterans' medical benefits and services. Title III: Savings in Medicare and Medicaid Programs - Subtitle A: Medicare Program - Amends the Internal Revenue Code to impose an annual tax on the Medicare part B (Supplementary Medical Insurance) premiums of high-income and certain other individuals covered by such part. (Sec. 302) Amends title XVIII (Medicare) of the Social Security Act (SSA) to: (1) impose a co-payment for clinical diagnostic laboratory tests; (2) eliminate mandatory assignment for test payment and billing; and (3) provide for annual indexing of the part B deductible. Subtitle B: Medicaid Program - Amends SSA title XIX (Medicaid) to: (1) cap Federal payments for acute medical services; (2) discontinue reimbursement standards for inpatient hospital services; (3) provide for optional enrollment of low-income individuals under high deductible umbrella insurance plans and managed care plans (with reduced payment adjustments for States providing such enrollment); (4) allow States more flexibility in contracting for coordinated care services; and (5) prohibit Medicaid funding of abortions not necessary to prevent the death of the mother. Title IV: Containing Health Care Costs - Subtitle A: Medical Malpractice Liablity Reform - Part 1: General Provisions - Makes this subtitle applicable with respect to any medical malpractice liability claim and action brought in any State or Federal court, with exceptions (such as a claim or action for damages arising from a vaccine-related injury or death). Sets forth provisions regarding preemption, effect on sovereign immunity and choice of law or venue, and Federal court jurisdiction. Part 2: Medical Malpractice and Product Liability Reform - Prohibits a medical malpractice liability action from being brought in any: (1) State court during a calendar year unless the medical malpractice liability claim that is the subject of the action has been initially resolved under a State's alternative dispute resolution (ADR) system certified for the year by the Secretary or under the alternative Federal system established by this Act; and (2) Federal court during a calendar year unless such claim that is the subject of the action has been initially resolved under such ADR system in the State whose law applies. Directs the Attorney General to establish an ADR process for the resolution of medical malpractice liability claims brought against the United States, which shall occur after the completion of the administrative claim process. Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under the ADR process established by the Attorney General. Sets forth provisions regarding: (1) procedures for filing actions; and (2) the legal effect of uncontested ADR decisions. (Sec. 412) Sets a $250,000 limit on noneconomic damages that may be awarded to a claimant and the members of the claimant's family for losses resulting from the injury which is the subject of a medical malpractice liability action. Prohibits the award of punitive or exemplary damages in such an action: (1) unless the claimant establishes by clear and convincing evidence that the injury suffered was the direct result of conduct manifesting a malicious, wanton, willful, or excessively reckless disregard of the safety of others; and (2) against the manufacturer of a medical product. Requires that: (1) any punitive or exemplary damages awarded in a medical malpractice liability action be paid to the State in which the action is brought or, in a case brought in Federal court, in the State in which the health care services that caused the injury that is the subject of the action were provided; and (2) such State use such amounts to carry out activities to assure the safety and quality of health care services provided in the State. Prohibits a defendant, in any medical malpractice liability action in which the damages awarded for future economic loss exceed $100,000, from being required to pay such damages in a single, lump-sum payment, but permits periodic payments based on when the damages are found likely to occur, as determined by the court. Authorizes a court to waive the application of such provision if it is not in the best interests of the plaintiff to receive periodic payments. (Sec. 413) Directs the court in a medical malpractice liability action to require the party that contested an ADR ruling with respect to the medical malpractice liability claim that is the subject of the action to: (1) pay attorney fees and other costs, with exceptions; and (2) post a performance bond, subject to waiver by the court upon determining that the posting of such a bond is not necessary to ensure that the party pay the costs incurred by the opposing party under the action. Sets forth provisions regarding: (1) limits on attorney's fees paid; and (2) recordkeeping requirements. (Sec. 414) Allows a defendant to be held severally but not jointly liable in a medical malpractice action for noneconomic damages, and only for those damages directly attributable to the person's proportionate share of fault or responsibility for the injury. (Sec. 415) Establishes a seven-year statute of limitations for medical malpractice liability claims beginning on the date the alleged injury occurred. (Sec. 416) Prohibits a defendant in a medical malpractice liability action from being found to have acted negligently unless the defendant's conduct at the time of providing the health care services was not reasonable. (Sec. 417) Prohibits the trier of fact, in the case of a medical malpractice liability claim relating to services provided during labor or the delivery of a baby where the health care professional against whom the claim is brought did not previously treat the individual alleged to have been injured for the pregnancy, from finding that the defendant committed malpractice and assessing damages unless the malpractice is proven by clear and convincing evidence. Specifies that a health care professional shall be considered to have previously treated an individual for a pregnancy if the professional is a member of a group practice whose members previously treated the individual for the pregnancy or is providing services to the individual during labor or the delivery pursuant to an agreement with another health care professional. Part 3: Requirements for State Alternative Dispute Resolution Systems - Sets requirements for a State's ADR system, including that the system: (1) apply to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) require that a written opinion resolving the dispute be issued within six months of receipt of notice of the claim by each party against whom the claim is filed; (3) require that individuals who hear and resolve claims under the system meet specified qualifications; (4) be approved by the State or local governments; (5) with respect to a State system consisting of multiple dispute resolution procedures, permit the parties to a dispute to select the procedure to be used (and, if they do not agree, assign a particular procedure); (6) transmit to the State agency responsible for monitoring or disciplining health care professionals and providers any findings that such professional or provider committed malpractice, with exceptions; and (7) transmit to the Administrator for Health Care Policy and Research information on disputes resolved in a manner that assures that the identity of the parties to a dispute shall not be revealed. Makes the provisions of part 2 (malpractice liability standards) applicable with respect to claims brought under a State or alternative Federal ADR system in the same manner as such provisions apply to medical malpractice liability actions brought in the State. (Sec. 422) Directs the Secretary to: (1) determine, by October 1 of each year (beginning with 1995), whether a State's ADR system meets the requirements of this part for the following calendar year, and certify such system if it does; and (2) establish an alternative Federal ADR system for the resolution of medical malpractice liability claims during a calendar year in States that do not have in effect an alternative ADR system certified for the year. Sets forth provisions regarding: (1) requirements for the alternative Federal ADR system; and (2) the treatment of States with the alternative system in effect. (Sec. 423) Directs the Secretary to submit to the Congress a report describing and evaluating State ADR systems operated pursuant to this part and the alternative Federal system. Part 4: Other Provisions Relating to Medical Malpractice Liability - Permits a State agency responsible for the conduct of disciplinary actions for a type of health care practitioner to enter into agreements to permit State or county professional societies to participate in the licensing of such practitioner and to review any health care malpractice action, claim, allegation, or other information concerning the practice patterns of any such practitioner. (Sec. 432) Requires the Secretary to conduct a study analyzing the existence and effectiveness of incentives adopted by State and local governments, insurers, medical societies, and other entities to encourage physicians (whether practicing or retired) to volunteer to provide health care services in medically underserved areas. (Sec. 433) Directs each State to require each: (1) health care professional and provider in the State to participate in a risk management program to prevent, and provide early warning of, practices which may injure or otherwise endanger a patient; and (2) entity which provides health care professional or provider liability insurance in the State to establish risk management programs based on available data or sanction such programs provided by other entities and to require each such professional or provider, as a condition of maintaining insurance, to participate in at least one such program every three years. (Sec. 434) Requires the Secretary to make grants: (1) for basic research in the prevention of, and compensation for, injuries resulting from health care professional or provider malpractice and for research of the outcomes of health care procedures; (2) to assist States in improving their ability to license and discipline health care professionals; and (3) to States and local governments, private nonprofit organizations, and health professional schools for educating the public about the appropriate use of health care and realistic expectations of medical intervention and about the resources and role of health care professional licensing and disciplinary boards in investigating claims of incompetence or malpractice, and for developing programs of faculty training and curricula for educating health are professionals in quality assurance, risk management, and medical injury prevention. Authorizes appropriations. Subtitle B: Treatment of Certain Activities Under the Antitrust Laws - Exempts from the antitrust laws specified "safe harbor" activities listed in, or designated by the Attorney General pursuant to, this subtitle. Sets forth provisions regarding the award of attorney's fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt. (Sec. 452) Lists as safe harbors specified: (1) activities relating to health care services of combinations of health care providers with market share below a specified threshold; (2) activities of medical self-regulatory entities relating to standard setting or enforcement activities not conducted for purposes of financial gain; (3) participation of a health care provider in a written survey of the prices of services, reimbursement levels, or the compensation and benefits of employees and personnel; (4) activities relating to health care joint ventures for high technology and costly equipment and services; (5) activities relating to hospital mergers; (6) joint purchasing arrangements; and (7) negotiations. (Sec. 453) Directs the Attorney General to publish a notice in the Federal Register soliciting proposals for additional safe harbors and to review and report on proposed safe harbors. Sets forth criteria in establishing safe harbors, including: (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. (Sec. 454) Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates. Sets forth procedures regarding applications for, revocation of, and review of determinations regarding, such certificates. Limits the disclosure of information. (Sec. 455) Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. (Sec. 456) Directs the Attorney General to periodically review the safe harbors and certificates of review. (Sec. 458) Establishes within the Department of Health and Human Services an Office of Health Care Competition Policy. Title V: Special Assistance for Frontier, Rural, and Urban Underserved Areas - Subtitle A: Frontier, Rural, and Urban Underserved Areas - Amends the Public Health Service Act to direct the Secretary to establish and administer a program to provide allotments to enable States to provide grants for the creation or enhancement of community-based primary health care entities that provide services to low-income or medically underserved populations. Directs the Secretary to award grants to Federally Qualified Health Centers (FQHCs) and other entities and organizations for the purpose of providing access to services for medically underserved populations or in high impact areas not currently being served by an FQHC. Authorizes appropriations. Directs the Secretary to provide for a study to examine the relationship and interaction between community health centers and hospitals in providing services to individuals residing in medically underserved areas, ensuring that the National Rural Research Centers participate in such study. (Sec. 502) Amends the Internal Revenue Code to allow a qualified primary health services provider (physician, physician assistant, or nurse practitioner who provides full time primary health services in a health professional shortage area, subject to specified requirements) a credit against tax for a period of 60 consecutive calendar months from the time the taxpayer becomes a qualified provider. Sets forth rules regarding the recapture of credit and the expensing of medical equipment. Excludes National Health Service Corps loan repayments from gross income. Provides a deduction for student loan payments by medical professionals practicing in rural areas. (Sec. 503) Amends the SSA to include rural emergency access care hospital services among the benefits provided under the Supplementary Medical Insurance Program for the Aged and Disabled. (Sec. 504) Amends the Public Health Service Act to direct the Secretary to make grants to assist States in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments. (Sec. 505) Authorizes the Secretary to: (1) conduct a demonstration project under which public and private entities may apply for waivers of provisions of the SSA in order to operate rural health networks which improve the access of Medicare and Medicaid beneficiaries to, and the quality and outcomes of, health care services; and (2) grant waivers to operate rural health networks under the demonstration project to a number of public and private entities. Directs the Secretary to award grants to public and private entities which have received a waiver for planning, developing, and operation of rural health networks. Authorizes appropriations. Subtitle B: Primary Care Provider Education - Amends the Public Health Service Act to direct the Secretary to provide for the establishment of demonstration projects: (1) in up to seven States for the purpose of testing and evaluating mechanisms to increase the number and percentage of medical students entering primary care practice through the use of funds otherwise available for direct graduate medical education costs under the SSA; and (2) for up to seven health care training consortia for such purpose. Directs the Secretary to award grants to such consortia for developing and evaluating such projects. Authorizes appropriations. (Sec. 512) Amends the SSA to count residency training time in nonhospital-owned facilities in determining full-time equivalent residents for direct graduate medical education payments, and for certain indirect medical education payments, under Medicare. (Sec. 513) Amends the Public Health Service Act to increase: (1) National Health Service Corps funding; and (2) health professions funding for primary care physicians, nurse practitioners, and physician assistants. Authorizes the Secretary to award grants to enable public and nonprofit private entities to meet the cost of providing traineeships for individuals in baccalaureate and advanced-degree programs to educate such individuals to serve in and prepare for practice as physician assistants. Authorizes appropriations. (Sec. 516) Directs the Secretary to award grants to States or nonprofit entities to fund not less than ten demonstration projects to enable such States or entities to evaluate: (1) State mechanisms, including changes in the scope of practice laws, to enhance the delivery of primary care by nurse practitioners or physician assistants; (2) the feasibility of and most effective means of training subspecialists to deliver primary care as primary care providers; and (3) State mechanisms to increase the supply or improve the distribution of primary care providers. Authorizes appropriations. Subtitle C: Programs Relating to Primary and Preventive Care Services - Authorizes the Secretary to award grants to enable States to plan and implement coordinated, multidisciplinary, and comprehensive primary health care and social service programs targeted to pregnant women and infants. Authorizes appropriations. (Sec. 522) Authorizes frontier States (including Alaska, Wyoming, and Montana) to: (1) implement proposals to offer preventive services, including mobile preventive health centers, which may be located on aircraft, watercraft, or other forms of transportation; and (2) participate in demonstration projects to improve recruitment, retention, and training of rural providers, including nurse partitioners and physician assistants. Subtitle D: Limitation on Funding for Abortions - Specifies that: (1) nothing in this title shall be construed to authorize funding for any abortion, except to prevent the death of the mother; and (2) the provision of abortion services by a State or other entity shall not be regarded as a condition for participation in any grant or benefit authorized in this title. Title VI: Administrative Cost Savings - Subtitle A: Standardization of Claims Processing - Directs the Secretary to adopt standards relating to: (1) data elements for use in paper and electronic claims processing under health insurance plans, as well as for use in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. Directs the Secretary, in adopting such standards, to take into account the recommendations of current task forces, consult with the National Association of Insurance Commissioners, and seek to make the standards consistent with any uniform clinical data sets which have been adopted and are widely recognized. Sets forth provisions regarding: (1) deadlines for promulgation; and (2) application of the standards. (Sec. 603) Directs the Secretary to provide for the periodic review and revision of such standards. Subtitle B: Electronic Medical Data Standards - Directs the Secretary to promulgate standards for hospitals concerning electronic medical data, including confidentiality standards. Authorizes the Secretary to periodically revise the standards and to promulgate (and periodically revise) standards for providers that are not hospitals. (Sec. 612) Requires each hospital, as of January 1, 1996 to: (1) maintain clinical data included in the set of comprehensive data elements in electronic form on all inpatients; (2) upon request of the Secretary or a utilization and quality control peer review organization, transmit electronically the data set; and (3) upon request of the Secretary or a fiscal intermediary or carrier, transmit electronically any data with respect to a claim from such data set in accordance with specified standards. Grants the Secretary waiver authority under specified circumstances. Directs the Secretary of Veterans Affairs to provide that each hospital of the Department of Veterans Affairs shall comply with requirements of this subtitle as if it were participating in the Medicare program. Grants such Secretary waiver authority under specified circumstances. (Sec. 613) Authorizes, effective January 1, 2000, a Federal agency to require a provider to transmit required data elements electronically in accordance with applicable presentation or transmission standards. (Sec. 614) Prohibits a health insurance plan, if standards for data elements are promulgated with respect to a class of provider, from requiring for the purpose of utilization review or as a condition of providing benefits under the plan that a provider in the class: (1) provide any data element not in the set of comprehensive data elements specified under such standards; or (2) transmit or present any such data element in a manner inconsistent with the applicable transmission or presentation standards. Authorizes the Secretary to impose a civil monetary penalty on any health insurance plan (with exceptions) that fails to comply with such provision. (Sec. 615) Directs the Secretary to establish an advisory commission in collection and use of data and operation of data systems to monitor and advise the Secretary concerning the standards established under this subtitle and operational concerns about the implementation of such standards. Authorizes appropriations. Subtitle C: Development and Distribution of Comparative Value Information - Directs the Secretary to determine whether each State is developing and implementing a health care value information program (to assure the availability of comparative value information to purchasers of health care in each State) that meets specified criteria. Authorizes the Secretary to make grants to enable each State to plan the development of, and initiate the implementation of its health care value information program. Authorizes appropriations. (Sec. 622) Directs the Secretary, if a State has failed to develop or implement such program, to implement a comparable program in the State. (Sec. 623) Requires the head of each Federal agency with responsibility for the provision of health insurance or health care services to promptly develop and make available to States and to providers and consumers of health care services relevant to health care value information. Subtitle D: Preemption of State Quill Pen Laws - Provides that, effective January 1, 1996, no effect shall be given to any State law provision that requires medical or health insurance records (including billing information) to be maintained in written rather than electronic form. Title VII: Anti-Fraud and Anti-Rationing - Subtitle A: Criminal Prosecution of Health Care Fraud - Amends the Federal criminal code to set penalties for health care fraud. (Sec. 702) Authorizes the Attorney General, in special circumstances, to make payments of up to $10,000 to a person who furnishes information unknown to the Government relating to a possible prosecution for health care fraud, subject to specified limitations. Subtitle B: Coordination of Health Care Anti-Fraud and Abuse Activities - Amends the SSA to apply Federal health anti-fraud and abuse sanctions to all fraud and abuse against any health insurance plan. Directs the Secretary to: (1) identify opportunities for the satisfaction of community service obligations that a court may impose upon the conviction of a criminal ofense involving Medicare or State health care programs; and (2) make information concerning such opportunities available to Federal and State law enforcement officers and State and local health care officials. Subtitle C: Protection Against Rationing of Treatment - Prohibits a health care provider or health insurance plan from denying medical treatment or insurance coverage that a patient is otherwise qualified to receive against the wishes of a patient (or if the patient is incompetent, against the wishes of the patient's guardian) on the basis of the patient's present or predicted age, disability, degree of medical need, or quality of life. (Sec. 722) Makes specified remedies and procedures under the Civil Rights Act of 1964 applicable to any person who is denied medical treatment or insurance coverage, or who has reasonable grounds for believing that such person is about to be subjected to such denial, in violation of this subtitle. Permits an individual subjected to such denial (or a person who would be entitled to bring a cause of action for the individual's wrongful death) to obtain damages.
Bill· HRH.R. 4167 (103rd)referred
United States · United States Congress · 12 April 1994
Colon Cancer Screening and Prevention Act - Amends title XVIII (Medicare) of the Social Security Act to prescribe frequency and payment limits under Medicare part B for screening fecal-occult blood tests, flexible sigmoidoscopies, and colonoscopy.
Bill· SS. 2009 (103rd)referred
United States · United States Congress · 11 April 1994
TABLE OF CONTENTS: Title I: Family Investment Program and Other Welfare Reform Title II: Improvements in the Collection of Child Support Welfare to Self-Sufficiency Act of 1994 - Title I: Family Investment Program and Other Welfare Reform - Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act (SSA) to require State AFDC plans in States without a waiver from the Secretary of Health and Human Services (Secretary) to provide for a program in which the State agency negotiates an agreement with each family on AFDC outlining the steps non-exempt family members must take. Includes among such steps participation in education or job training programs, or in substance abuse treatment or parenting programs, in order to obtain self-sufficiency within a certain period. Requires supplemental services, such as transportation and child care, when necessary for achieving such goal, as well as support and case management when adapting such agreement for changing family circumstances. Requires the State agency to offer such families enrollment in a limited benefit plan under which benefits are suspended after six months, and in which families failing to comply with the agreement are automatically enrolled. (Sec. 101) Requires the Secretaries of Health and Human Services, of Labor, and of Education to ensure appropriate coordination in the planning, development, and operation of the family investment program above and other specified programs, including the JOBS program under SSA title IV part F (Job Opportunities and Basic Skills Training Program) in order to improve departmental services and reduce program overlap and administrative costs. (Sec. 102) Makes numerous miscellaneous amendments to SSA title IV part A. Provides States with various specified options for moving AFDC recipients towards self-sufficiency, including options for: (1) increasing asset limits and disregards for work expenses, earned income, and automobiles; (2) disregarding interest income and certain earned income of new employees and dependent children as well as certain income and resources related to microenterprise and other employment and self-sufficiency initiatives; and (3) requiring certain unemployed parents to participate in job search and training activities. Eliminates the earned income disregard time limitation and various work-related requirements with regard to unemployed parent households. Provides for the inclusion of microenterprise training and activities in the JOBS program, and makes various specified changes with regard to program job searches, work assignments, and grievance procedures. (Sec. 106) Requires pregnant AFDC recipients to participate in the JOBS program. Changes payment formulae for the JOBS program and child care. Increases the JOBS program's authorization. (Sec. 109) Extends transitional child care benefits and the disregards for earned income and child care to non-recipient stepparents. Provides for timely preventive health care for children of AFDC recipients. (Sec. 110) Directs the Secretary to establish wage supplementation demonstration projects for certain AFDC-eligible individuals to provide an incentive to work. (Sec. 111) Amends the Public Health Service Act to increase the authorization for family planning services. Title II: Improvements in the Collection of Child Support - Amends SSA title IV part D (Child Support and Establishment of Paternity) and the Internal Revenue Code to provide for the establishment of a system under which the Internal Revenue Service (IRS) would collect child support via wage withholding and estimated tax payments and disperse it as appropriate. Requires the entire amount of child support owed to be paid to the IRS by the end of the applicable tax year along with the individual's tax return. Subjects delinquent individuals to generally the same penalties applicable to back taxes. (Sec. 203) Gives States the option of periodically making available for publication the identity of individuals at least three months behind in child support payments.
Law· SJRESS.J.Res. 179 (103rd)enacted
United States · United States Congress · 26 March 1994
Designates June 12 through 19, 1994, as National Men's Health Week.
Bill· SS. 1994 (103rd)referred
United States · United States Congress · 25 March 1994
TABLE OF CONTENTS: Title I: Liability Title II: State Implementation Title III: Remedy Selection Title IV: Funding Comprehensive Superfund Improvement Act - Title I: Liability - Amends the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) to limit liability under such Act to actions involving hazardous substance releases occurring after December 11, 1980 (thus, eliminating retroactive liability), subject to the conditions of this Act. Makes such limit inapplicable to actions occurring before such date which were contrary to law. Provides for reimbursement from the Retroactive Liability Fund as provided by this Act. (Sec. 102) Sets forth retroactive liability provisions for actions which occurred before December 11, 1980. Bars reimbursement from the Retroactive Liability Fund to potentially responsible parties (PRPs) for construction costs if construction of the response action has been completed by January 1, 1994. Requires the President, if a PRP is conducting operation and maintenance (O&M) related to the action as of January 1, 1994, to assume the future costs of O&M and reimburse the party for costs incurred. Provides for reimbursement of construction costs for response actions not completed by such date, but only after the construction is completed. Directs the President to use the Retroactive Liability Fund to pay for all response action costs for sites discovered after such date. Establishes provisions for actions for which liability occurred before and after December 11, 1980. Permits PRPs conducting O&M related to the response action as of January 1, 1994, to petition the President for an allocation of O&M costs. Provides for reimbursement from the Retroactive Liability Fund of O&M costs attributable to actions occurring before December 11, 1980. Permits PRPs to petition for allocations of construction and O&M costs where actions have not been completed by January 1, 1994. Provides for reimbursement of O&M and construction costs attributable to actions occurring before December 11, 1980. Directs the President to use the Retroactive Liability Fund to pay for all costs attributable to actions occurring before December 11, 1980, for sites discovered after January 1, 1994. (Sec. 103) Provides that persons considered to be qualified organizations under provisions of the Internal Revenue Code governing charitable contributions who are grantees of conservation easements with respect to real property on which a facility is located shall not be considered as owners or operators, for purposes of determining liability for removal and response costs, unless they have caused or contributed to the release of hazardous substances. Establishes a rebuttable presumption that a defendant who has acquired real property has made all appropriate inquiry into previous ownership and uses of the property if he establishes that, immediately prior to or at the time of acquisition, he obtained an environmental assessment of the property to determine the presence of hazardous substances, including a review of specified records of the previous ownership and use of such property. (Sec. 104) Absolves persons who have resolved liability to the United States or a State in an approved settlement proceeding of liability for cost recovery regarding matters addressed in the settlement. (Sec. 105) Provides that persons who own or operate real property that is contiguous to or otherwise situated with respect to real property on which there has been a release of a hazardous substance and that may be contaminated shall not be considered to be an owner or operator for purposes of determining liability. Authorizes the President to issue assurances of no enforcement action to such persons and grant protection against cost recovery and contribution actions. (Sec. 106) Requires the President to issue regulations to define certain terms as they apply to liability of lenders and financial service providers. Excludes from the definition of "owner or operator" (thus, protecting from individual liability) fiduciaries who hold legal title to, are the mortgagees or secured parties with respect to, control, or manage, any facility or vessel at which a release occurred for purposes of administering an estate or trust of which such vessel or facility is a part. (Sec. 108) Makes liable parties who accept or successfully appeal the results of the allocation of responsibility under title V of this Act to be liable only for, with respect to National Priority List (NPL) sites, their assigned share of the costs of: (1) removal or remedial action incurred by the United States, a State, or an Indian tribe; (2) response incurred by any other person; and (3) any health assessment or health effects study. Requires the orphan share of an NPL site to be paid out of the Hazardous Substance Superfund (Fund) or the Retroactive Liability Fund. (Sec. 109) Makes PRPs or liable parties who fail to perform response actions at NPL sites subject to specified civil action. Requires reimbursement by Superfund of PRPs who perform and pay for response actions at NPL sites. Authorizes liable parties who perform and pay for such actions to recover costs as creditor parties as provided under title V of this Act. (Sec. 110) Directs the Administrator of the Environmental Protection Agency (EPA) to appoint panels of administrative law judges to perform expedited administrative proceedings, to be known as "binding allocations of responsibility (BARs)," for purposes of determining the liability of PRPs at NPL sites. Provides that BARs shall not address or affect liability concerning damages to natural resources. Provides for the initiation of a BAR by the filing of a petition with the EPA Office of Administrative Law Judges by the Administrator or a State where the site is located. Exempts de micromis parties (parties that a panel determines contributed only 100 pounds or liters of material containing hazardous substances at the facility or such amount as determined by the Administrator) from liability to the United States or to any other person for response actions or for past, present, or future costs incurred at the site. Requires final BARs to be issued within 18 months of the publication of a notice of petition (or 24 months for cases of exceptional complexity). Bases the assigned share of liability on specified allocation factors, including the ability to pay. Requires the Administrator to make firm offers of settlement to all de minimis parties (parties that contributed only one percent or less of the total quantity of hazardous substances present at the site). Makes a BAR decision binding as to all past, present, and future liability for response costs and for contributions in civil proceedings. Permits judicial review of final BAR decisions. Sets forth procedures for recovery by creditor parties. Provides for stays of certain pending enforcement actions and private party litigation until a BAR is issued. Authorizes any group of PRPs to submit a private allocation for the NPL site, to be known as a "voluntary binding allocation of responsibility," to the allocation panel. Provides that a BAR shall constitute a permanent determination of the assigned share of a liable party and of the orphan share and, except for specified additions to the orphan share and judicially mandated changes, shall not be subject to any change for at least five years after the date of final decision. Permits a new BAR only if the request demonstrates that due to new information not reasonably available during the first BAR, a 35 percent or greater increase in total waste-in volume has been discovered. (Sec. 111) Exempts qualified redevelopers from liability for costs or damages with respect to hazardous substance releases. (Sec. 112) Extends a current exemption from liability for response action contractors under Federal law to State and local law and expands the activities considered to be response actions. Excludes such contractors from the definition of "owner or operator" for purposes of limiting liability. Provides a limitation on actions against response action contractors. Title II: State Implementation - Authorizes States to apply to the Administrator to carry out response actions and enforcement activities at all facilities listed or proposed for listing on the NPL. Grants a State such authority if it possesses the legal authority, technical capability, and resources necessary to conduct response actions in a manner consistent with this Act. Makes such States eligible for response action financing from the Fund and the Retroactive Liability Fund. Requires States to pay ten percent of the costs of all response actions for which the State receives funds from the Fund. Makes such cost-sharing requirement inapplicable to States that receive funds from the Retroactive Liability Fund. (Sec. 201) Authorizes a State to select a response action that achieves a level of cleanup that is more stringent than required if it agrees to pay for the incremental increase in response cost attributable to achieving the more stringent level. (Sec. 203) Directs the President to: (1) maintain records of the costs incurred in connection with any oversight contract or arrangement for remedial investigations or feasibility studies; and (2) establish an administrative procedure under which a party that conducts a response action may contest the costs incurred in such oversight. Requires oversight costs exceeding 50 percent of the response costs incurred by the responsible party to be paid by the Fund. Title III: Remedy Selection - Authorizes the President or an authorized State to take immediate risk reduction measures whenever a release poses an imminent and substantial danger to public health. Prohibits the President or a State from instituting long-term remediation measures. Authorizes the use of the Fund for such measures, but permits the President to recover costs from liable parties as well. (Sec. 302) Applies the hazard ranking system to a site or facility only after the site or facility has undergone immediate risk reduction measures. Applies such requirement to sites and facilities to be newly listed on the NPL and to any sites already listed for which remedial investigation and feasibility studies have not been conducted. (Sec. 303) Directs the President or a State, as appropriate, to prepare a long-term response plan for an affected facility. Authorizes PRPs to prepare and carry out certain elements of such plan. Requires such plans to address: (1) site characterization; (2) risk assessment; (3) recommendations made by community advisory councils; and (4) response option identification. Requires plans for: (1) facilities to be newly listed on the NPL after this Act's enactment date; (2) facilities or sites listed on the NPL for which remedial investigations and feasibility studies have not been conducted; and (3) facilities or sites on the NPL for which such investigations and studies have been conducted but for which contracts have not been executed for remedial design and action. Directs persons carrying out remedial investigations to assess risks to human health and the environment, separately evaluating current and likely future risks. Directs the Administrator to create a Community Advisory Council for each facility listed on the NPL to provide information to PRPs, the Administrator, and the State regarding the future use of the facility and affected off-site areas and resources. Requires response option identifications under long-term remediation plans to provide for cost-benefit analyses on containment, remediation, monitoring, delisting, and institutional controls. Directs the President to promulgate and include in the national contingency plan guidelines for conducting cost/benefit analyses of response actions conducted under CERCLA. (Sec. 304) Revises provisions regarding selection of remedial actions to require the President or a State, after completion of a long-term response plan, to select the response that best achieves an acceptable level of residual risk reduction at the facility or site. Sets forth factors to be considered in selecting such actions, including site-specific impacts, economic impacts on PRPs, and costs and benefits of options. Provides preferences for actions that significantly reduce the volume, toxicity, or mobility of the hazardous substances or the exposure to such substances. Extends site or facility boundaries to include areas subject to easements or other institutional controls with respect to response actions. Makes selections subject to judicial review. Requires implementation of an action within 60 days after the selection has been made and: (1) an appeal has been filed and a court has acted on the appeal; or (2) the time for filing an appeal has expired and no appeal has been filed. Repeals certain cleanup standards. (Sec. 305) Requires the review of selected response actions at least once every five years to assure that human health and the environment are being protected. (Currently, such review is required for actions that result in hazardous substances remaining at the site.) (Sec. 306) Provides for delisting of sites or facilities from the NPL after an action achieves the cleanup goal. Title IV: Funding - Amends the Internal Revenue Code to extend environmental tax and certain Superfund provisions for a period of five years. Increases the aggregate tax which may be collected and credited to the Fund. Extends the deadline for repayment of advances made to the Fund from December 31, 1995, to December 31, 2000. Extends the authorization of appropriations for the Fund through FY 2000. (Sec. 402) Increases the environmental income tax. Provides that only 50 percent of such taxes received in the Treasury shall be deposited into the Fund in tax years between December 31, 1994, and January 1, 2000. (Sec. 404) Establishes the Retroactive Liability Fund. Appropriates 50 percent of revenues from the environmental tax to such fund in addition to certain environmental fees and assessments on insurance companies.
Bill· SS. 1995 (103rd)reported
United States · United States Congress · 25 March 1994
Health Centers Reauthorization Act of 1994 - Amends the Public Health Service Act to reauthorize migrant, community, and homeless health center programs, and health services programs for residents of public housing.
Bill· SS. 1996 (103rd)open
United States · United States Congress · 25 March 1994
Medicare Choice Act of 1994 - Amends title XVIII (Medicare) of the Social Security Act (SSA) to replace current provisions for payments to health maintenance organizations and competitive medical plans with provisions generally allowing Medicare beneficiaries enrolled under part B (Supplementary Medical Insurance) an annual choice of enrolling under certain conditions in: (1) any of the various competing Medicare health plans certified as meeting specified requirements and under contract with the Secretary of Health and Human Services in the Medicare market area established where they reside; (2) an employer-sponsored health plan; or (3) the Medicare fee-for-service coverage otherwise provided under SSA title XVIII. Allows such individuals to choose supplementary benefits offered either by a Medicare supplemental policy or any of the plans above. Requires the Secretary and the Physician Payment Review Commission to report biennially to the Congress on the method for determining the maximum per capita rate and the experience of each Medicare market area with the formula. Directs the Secretary to: (1) determine annual fee-for-service spending limits for each Medicare market area pursuant to a specified formula; and (2) take specified actions providing for Medicare administrative simplification, including ensuring streamlined electronic processing of fee-for-service claims. Provides for enforcement of such limits, exempting low-cost areas.
Bill· SS. 1974 (103rd)open
United States · United States Congress · 24 March 1994
VA State Health Care Reform Pilot Program Act - Authorizes the Secretary of Veterans Affairs to carry out pilot programs on the participation of the Department of Veterans Affairs health care system in the health care systems of States that have adopted comprehensive health benefit plans. Allows up to five States to be used for such pilot programs. Requires the Secretary to provide benefits to persons through the Department health care system in such a State as if such system were a provider of benefits under the State plan. Prohibits a State from refusing Department participation in a State health benefit plan unless the chief executive officer of such State certifies that the Department plan or its facilities are inadequate to meet the State health benefit plan. Requires the Secretary to designate a health system director for each State in which a pilot program is carried out. Authorizes the Secretary to carry out any necessary administrative reorganization of Department health care systems or facilities in a program State. Allows the Secretary to exclude Department facilities from participation in a pilot program. Authorizes a health system director to enter into contracts and agreements for the provision of health care services and related services in connection with the pilot program. Excludes such contracts and agreements from certain Federal law. Requires review by the Central Office of the Department of contracts and agreements of $250,000 or more. Outlines provisions concerning: (1) the use of Department personnel in a pilot program; (2) eligible persons; and (3) copayments and other charges (and their waiver with respect to certain veterans). Establishes in the Treasury the Department of Veterans Affairs Health Care Reform Fund to be used for pilot program purposes, with a separate account established for each program. Requires the Secretary to collect, and report to specified congressional committees concerning, information with respect to the provision of health care benefits under each pilot program.
Bill· SS. 1978 (103rd)referred
United States · United States Congress · 24 March 1994
TABLE OF CONTENTS: Title I: Small Business Participation in Federal Employees Health Benefits Plans Title II: Better Access to Affordable Health Care Subtitle A: Improvements in Health Insurance Affordability for Small Employers Subtitle B: Improvements in Health Insurance for Small Employers Subtitle C: Improvements in Portability of Private Health Insurance Subtitle D: Health Care Cost Containment Title III: Health Insurance Costs for Self-Employed Federal Health Care Expansion Act of 1994 - Title I: Small Business Participation in Federal Employees Health Benefits Plans - Amends Federal civil service law to require the Office of Personnel Management (OPM) to promulgate regulations applying the Federal Employees Health Benefits Program (FEHBP) to self-employed individuals and businesses employing 100 or fewer employees, allowing required enrollee and Government contributions to be made by the State or small businesses involved or subsidized by the Secretary of Health and Human Services in any amount, or else be made in full by the self-employed or small business enrollee. (Sec. 102) Extends continued coverage under FEHBP. (Sec. 103) Requires carriers under FEHBP and the small business health insurance program above to submit periodic reports to OPM comparing costs between the programs. (Sec. 104) Requires OPM to study and report to the Congress on risk adjustment in the administration of such programs. (Sec. 105) Directs the Secretary to phase-out Medicare and Medicaid disproportionate share hospital payments to finance: (1) the grants to States for small employer health insurance group purchasing programs under title II of this Act; (2) the increase in the self-employed tax deduction for health insurance costs under title III of this Act; and (3) the premium subsidy under the small business health insurance program for low-income workers. (Sec. 106) Directs the Secretary to study and report to the Congress on nonworker and noncovered employee buy-ins for FEHBP coverage. Title II: Better Access to Affordable Health Care - Subtitle A: Improvements in Health Insurance Affordability for Small Employers - Directs the Secretary to make grants to States for small employer health insurance group purchasing programs. Authorizes appropriations. Subtitle B: Improvements in Health Insurance for Small Employers - Amends the Social Security Act to direct the Secretary to request the National Association of Insurance Commissioners (NAIC), or in their absence the Secretary, to develop specific standards to incorporate specified requirements for health insurance plans for small employers relating to: (1) guaranteed eligibility, availability, and renewability; (2) coverage based on an individual's health status or medical history; (3) restrictions on rating practices; and (4) benefit package offerings. (Sec. 221) Amends the Internal Revenue Code to impose an excise tax of 25 percent of gross premiums on the issuer of any health insurance plan to a small employer if the plan does not meet such requirements. (Sec. 231) Directs the Comptroller General to study and report to the Congress on rating requirements and benefit packages for small group health insurance. Subtitle C: Improvements in Portability of Private Health Insurance - Imposes an excise tax of $100 per day, with respect to a covered individual, on a group health plan for its failure to provide coverage for a preexisting condition, subject to stated exceptions. Subtitle D: Health Care Cost Containment - Requires the Secretary to establish a process for certifying managed care plans and utilization review programs. Sets forth certification requirements. Title III: Health Insurance Costs for Self-Employed - Amends the Internal Revenue Code to: (1) allow self-employed individuals to fully deduct their health insurance premiums; and (2) make such deduction permanent.
Bill· SS. 1981 (103rd)open
United States · United States Congress · 24 March 1994
Orphan Drug Act Amendments of 1994 - Amends the Federal Food, Drug, and Cosmetic Act to change from seven to four years the period of market exclusivity guaranteed to any approved orphan drug. Specifies that orphan drugs of "limited commercial potential," as defined by regulations to be issued by the Department of Health and Human Services, would qualify for an additional three years of exclusive marketing rights. Permits more than one company to put a particular orphan drug on the market in instances where both companies were working on the drug in roughly the same time frame. Provides for the withdrawal of exclusive marketing rights if the patient population for the approved treatment exceeds 200,000. Extends the authorization of the research grant program. Replaces the existing Orphan Products Board with an Office for Orphan Diseases and Conditions.
Bill· SS. 1967 (103rd)referred
United States · United States Congress · 24 March 1994
Sarah Weber Home Infusion Consumer Protection Act of 1994 - Prohibits any: (1) person from providing home infusion therapy services in a State unless the person is licensed by the State to provide such services; and (2) State from licensing such a person unless the person meets licensing standards to be established by the Secretary of Health and Human Services. Specifies that a licensed person shall only provide services to an individual who is under the care of, and under a plan established and periodically reviewed by, a physician. Sets forth licensing requirements, including having been determined capable of providing services, maintaining clinical records, adhering to written protocols and policies, making services available seven days a week on a 24-hour basis, coordinating services with the patient's physician, conducting a quality assessment and assurance program, assuring that only trained personnel provide infusion products, assuming responsibility for the quality of services provided by others under arrangements with such person, and establishing appropriate protocols and explaining such protocols clearly to patients before the initiation of treatment. Sets forth requirements regarding: (1) cancellation of services; (2) limits on fees; and (3) enforcement of Act requirements. Prohibits a physician (or an immediate family member) who has a financial relationship with a specified entity under the Medicare program from making a referral to such entity for the furnishing of such services. Makes Medicare physician ownership and referral provisions applicable to this Act. Specifies that: (1) the payment of reasonable compensation to a physician for patient management and coordination of care shall not be considered to be a compensation arrangement; and (2) the prescription of a drug to be administered through home infusion shall constitute a referral by a physician.
Bill· SJRESS.J.Res. 177 (103rd)referred
United States · United States Congress · 24 March 1994
Designates October 2 through 8, 1994, as Mental Illness Awareness Week.
Resolution· SCONRESS.Con.Res. 65 (103rd)referred
United States · United States Congress · 24 March 1994
A Child is Waiting Resolution - Expresses the sense of the Congress that: (1) any health care reform legislation include guaranteed full funding for the special supplemental food program for women, infants, and children (WIC); and (2) specified amounts should be made available to move toward such full funding goal.
Bill· HRH.R. 4160 (103rd)open
United States · United States Congress · 24 March 1994
Orphan Drug Act Amendments of 1994 - Amends the Federal Food, Drug, and Cosmetic Act to change from seven to four years the period of market exclusivity guaranteed to any approved orphan drug. Specifies that orphan drugs of "limited commercial potential," as defined by regulations to be issued by the Department of Health and Human Services, would qualify for an additional three years of exclusive marketing rights. Permits more than one company to put a particular orphan drug on the market in instances where both companies were working on the drug in roughly the same time frame. Provides for the withdrawal of exclusive marketing rights if the patient population for the approved treatment exceeds 200,000. Extends the authorization of the research grant program. Replaces the existing Orphan Products Board with an Office for Orphan Diseases and Conditions.
Bill· HRH.R. 4128 (103rd)referred
United States · United States Congress · 24 March 1994
Sarah Weber Home Infusion Consumer Protection Act of 1994 - Prohibits any: (1) person from providing home infusion therapy services in a State unless the person is licensed by the State to provide such services; and (2) State from licensing such a person unless the person meets licensing standards to be established by the Secretary of Health and Human Services. Specifies that a licensed person shall only provide services to an individual who is under the care of, and under a plan established and periodically reviewed by, a physician. Sets forth licensing requirements, including having been determined capable of providing services, maintaining clinical records, adhering to written protocols and policies, making services available seven days a week on a 24-hour basis, coordinating services with the patient's physician, conducting a quality assessment and assurance program, assuring that only trained personnel provide infusion products, assuming responsibility for the quality of services provided by others under arrangements with such person, and establishing appropriate protocols and explaining such protocols clearly to patients before the initiation of treatment. Sets forth requirements regarding: (1) cancellation of services; (2) limits on fees; and (3) enforcement of Act requirements. Prohibits a physician (or an immediate family member) who has a financial relationship with a specified entity under the Medicare program from making a referral to such entity for the furnishing of such services. Makes Medicare physician ownership and referral provisions applicable to this Act. Specifies that the prescription of a drug to be administered through home infusion shall constitute a referral by a physician.
Bill· HRH.R. 4161 (103rd)referred
United States · United States Congress · 24 March 1994
TABLE OF CONTENTS: Title I: Liability Title II: State Implementation Title III: Remedy Selection Title IV: Funding Comprehensive Superfund Improvement Act - Title I: Liability - Amends the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) to limit liability under such Act to actions involving hazardous substance releases occurring after December 11, 1980 (thus, eliminating retroactive liability), subject to the conditions of this Act. Makes such limit inapplicable to actions occurring before such date which were contrary to law. Provides for reimbursement from the Retroactive Liability Fund as provided by this Act. (Sec. 102) Sets forth retroactive liability provisions for actions which occurred before December 11, 1980. Bars reimbursement from the Retroactive Liability Fund to potentially responsible parties (PRPs) for construction costs if construction of the response action has been completed by January 1, 1994. Requires the President, if a PRP is conducting operation and maintenance (O&M) related to the action as of January 1, 1994, to assume the future costs of O&M and reimburse the party for costs incurred. Provides for reimbursement of construction costs for response actions not completed by such date, but only after the construction is completed. Directs the President to use the Retroactive Liability Fund to pay for all response action costs for sites discovered after such date. Establishes provisions for actions for which liability occurred before and after December 11, 1980. Permits PRPs conducting O&M related to the response action as of January 1, 1994, to petition the President for an allocation of O&M costs. Provides for reimbursement from the Retroactive Liability Fund of O&M costs attributable to actions occurring before December 11, 1980. Permits PRPs to petition for allocations of construction and O&M costs where actions have not been completed by January 1, 1994. Provides for reimbursement of O&M and construction costs attributable to actions occurring before December 11, 1980. Directs the President to use the Retroactive Liability Fund to pay for all costs attributable to actions occurring before December 11, 1980, for sites discovered after January 1, 1994. (Sec. 103) Provides that persons considered to be qualified organizations under provisions of the Internal Revenue Code governing charitable contributions who are grantees of conservation easements with respect to real property on which a facility is located shall not be considered as owners or operators, for purposes of determining liability for removal and response costs, unless they have caused or contributed to the release of hazardous substances. Establishes a rebuttable presumption that a defendant who has acquired real property has made all appropriate inquiry into previous ownership and uses of the property if he establishes that, immediately prior to or at the time of acquisition, he obtained an environmental assessment of the property to determine the presence of hazardous substances, including a review of specified records of the previous ownership and use of such property. (Sec. 104) Absolves persons who have resolved liability to the United States or a State in an approved settlement proceeding of liability for cost recovery regarding matters addressed in the settlement. (Sec. 105) Provides that persons who own or operate real property that is contiguous to or otherwise situated with respect to real property on which there has been a release of a hazardous substance and that may be contaminated shall not be considered to be an owner or operator for purposes of determining liability. Authorizes the President to issue assurances of no enforcement action to such persons and grant protection against cost recovery and contribution actions. (Sec. 106) Requires the President to issue regulations to define certain terms as they apply to liability of lenders and financial service providers. Excludes from the definition of "owner or operator" (thus, protecting from individual liability) fiduciaries who hold legal title to, are the mortgagees or secured parties with respect to, control, or manage, any facility or vessel at which a release occurred for purposes of administering an estate or trust of which such vessel or facility is a part. (Sec. 108) Makes liable parties who accept or successfully appeal the results of the allocation of responsibility under title V of this Act to be liable only for, with respect to National Priority List (NPL) sites, their assigned share of the costs of: (1) removal or remedial action incurred by the United States, a State, or an Indian tribe; (2) response incurred by any other person; and (3) any health assessment or health effects study. Requires the orphan share of an NPL site to be paid out of the Hazardous Substance Superfund (Fund) or the Retroactive Liability Fund. (Sec. 109) Makes PRPs or liable parties who fail to perform response actions at NPL sites subject to specified civil action. Requires reimbursement by Superfund of PRPs who perform and pay for response actions at NPL sites. Authorizes liable parties who perform and pay for such actions to recover costs as creditor parties as provided under title V of this Act. (Sec. 110) Directs the Administrator of the Environmental Protection Agency (EPA) to appoint panels of administrative law judges to perform expedited administrative proceedings, to be known as "binding allocations of responsibility (BARs)," for purposes of determining the liability of PRPs at NPL sites. Provides that BARs shall not address or affect liability concerning damages to natural resources. Provides for the initiation of a BAR by the filing of a petition with the EPA Office of Administrative Law Judges by the Administrator or a State where the site is located. Exempts de micromis parties (parties that a panel determines contributed only 100 pounds or liters of material containing hazardous substances at the facility or such amount as determined by the Administrator) from liability to the United States or to any other person for response actions or for past, present, or future costs incurred at the site. Requires final BARs to be issued within 18 months of the publication of a notice of petition (or 24 months for cases of exceptional complexity). Bases the assigned share of liability on specified allocation factors, including the ability to pay. Requires the Administrator to make firm offers of settlement to all de minimis parties (parties that contributed only one percent or less of the total quantity of hazardous substances present at the site). Makes a BAR decision binding as to all past, present, and future liability for response costs and for contributions in civil proceedings. Permits judicial review of final BAR decisions. Sets forth procedures for recovery by creditor parties. Provides for stays of certain pending enforcement actions and private party litigation until a BAR is issued. Authorizes any group of PRPs to submit a private allocation for the NPL site, to be known as a "voluntary binding allocation of responsibility," to the allocation panel. Provides that a BAR shall constitute a permanent determination of the assigned share of a liable party and of the orphan share and, except for specified additions to the orphan share and judicially mandated changes, shall not be subject to any change for at least five years after the date of final decision. Permits a new BAR only if the request demonstrates that due to new information not reasonably available during the first BAR, a 35 percent or greater increase in total waste-in volume has been discovered. (Sec. 111) Exempts qualified redevelopers from liability for costs or damages with respect to hazardous substance releases. (Sec. 112) Extends a current exemption from liability for response action contractors under Federal law to State and local law and expands the activities considered to be response actions. Excludes such contractors from the definition of "owner or operator" for purposes of limiting liability. Provides a limitation on actions against response action contractors. Title II: State Implementation - Authorizes States to apply to the Administrator to carry out response actions and enforcement activities at all facilities listed or proposed for listing on the NPL. Grants a State such authority if it possesses the legal authority, technical capability, and resources necessary to conduct response actions in a manner consistent with this Act. Makes such States eligible for response action financing from the Fund and the Retroactive Liability Fund. Requires States to pay ten percent of the costs of all response actions for which the State receives funds from the Fund. Makes such cost-sharing requirement inapplicable to States that receive funds from the Retroactive Liability Fund. (Sec. 201) Authorizes a State to select a response action that achieves a level of cleanup that is more stringent than required if it agrees to pay for the incremental increase in response cost attributable to achieving the more stringent level. (Sec. 203) Directs the President to: (1) maintain records of the costs incurred in connection with any oversight contract or arrangement for remedial investigations or feasibility studies; and (2) establish an administrative procedure under which a party that conducts a response action may contest the costs incurred in such oversight. Requires oversight costs exceeding 50 percent of the response costs incurred by the responsible party to be paid by the Fund. Title III: Remedy Selection - Authorizes the President or an authorized State to take immediate risk reduction measures whenever a release poses an imminent and substantial danger to public health. Prohibits the President or a State from instituting long-term remediation measures. Authorizes the use of the Fund for such measures, but permits the President to recover costs from liable parties as well. (Sec. 302) Applies the hazard ranking system to a site or facility only after the site or facility has undergone immediate risk reduction measures. Applies such requirement to sites and facilities to be newly listed on the NPL and to any sites already listed for which remedial investigation and feasibility studies have not been conducted. (Sec. 303) Directs the President or a State, as appropriate, to prepare a long-term response plan for an affected facility. Authorizes PRPs to prepare and carry out certain elements of such plan. Requires such plans to address: (1) site characterization; (2) risk assessment; (3) recommendations made by community advisory councils; and (4) response option identification. Requires plans for: (1) facilities to be newly listed on the NPL after this Act's enactment date; (2) facilities or sites listed on the NPL for which remedial investigations and feasibility studies have not been conducted; and (3) facilities or sites on the NPL for which such investigations and studies have been conducted but for which contracts have not been executed for remedial design and action. Directs persons carrying out remedial investigations to assess risks to human health and the environment, separately evaluating current and likely future risks. Directs the Administrator to create a Community Advisory Council for each facility listed on the NPL to provide information to PRPs, the Administrator, and the State regarding the future use of the facility and affected off-site areas and resources. Requires response option identifications under long-term remediation plans to provide for cost-benefit analyses on containment, remediation, monitoring, delisting, and institutional controls. Directs the President to promulgate and include in the national contingency plan guidelines for conducting cost/benefit analyses of response actions conducted under CERCLA. (Sec. 304) Revises provisions regarding selection of remedial actions to require the President or a State, after completion of a long-term response plan, to select the response that best achieves an acceptable level of residual risk reduction at the facility or site. Sets forth factors to be considered in selecting such actions, including site-specific impacts, economic impacts on PRPs, and costs and benefits of options. Provides preferences for actions that significantly reduce the volume, toxicity, or mobility of the hazardous substances or the exposure to such substances. Extends site or facility boundaries to include areas subject to easements or other institutional controls with respect to response actions. Makes selections subject to judicial review. Requires implementation of an action within 60 days after the selection has been made and: (1) an appeal has been filed and a court has acted on the appeal; or (2) the time for filing an appeal has expired and no appeal has been filed. Repeals certain cleanup standards. (Sec. 305) Requires the review of selected response actions at least once every five years to assure that human health and the environment are being protected. (Currently, such review is required for actions that result in hazardous substances remaining at the site.) (Sec. 306) Provides for delisting of sites or facilities from the NPL after an action achieves the cleanup goal. Title IV: Funding - Amends the Internal Revenue Code to extend environmental tax and certain Superfund provisions for a period of five years. Increases the aggregate tax which may be collected and credited to the Fund. Extends the deadline for repayment of advances made to the Fund from December 31, 1995, to December 31, 2000. Extends the authorization of appropriations for the Fund through FY 2000. (Sec. 402) Increases the environmental income tax. Provides that only 50 percent of such taxes received in the Treasury shall be deposited into the Fund in tax years between December 31, 1994, and January 1, 2000. (Sec. 404) Establishes the Retroactive Liability Fund. Appropriates 50 percent of revenues from the environmental tax to such fund in addition to certain environmental fees and assessments on insurance companies.
Bill· HRH.R. 4126 (103rd)referred
United States · United States Congress · 24 March 1994
TABLE OF CONTENTS: Title I: State Welfare Reform Option Title II: Incentives for State Participation in Welfare Reform Title III: Policy Changes to Reward Work Title IV: Child Support Enforcement Work-First Welfare Reform Act of 1994 - Title I: State Welfare Reform Option - Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act (SSA) to give States the option of developing a welfare reform plan containing a welfare-job development integration plan meeting specified requirements (including those requiring welfare recipient participation along with the State in one of two specified types of Empowerment Compacts with specific goals and timetables for each individual participant's attainment of self-sufficiency) for reorienting their welfare programs towards such overall goal for all welfare recipients who are capable of working. (Sec. 101) Provides for approval, implementation, and evaluation of welfare reform plans. Title II: Incentives for State Participation in Welfare Reform - Amends SSA title IV part A to provide for: (1) increased Federal payments to welfare reform States meeting specified requirements for the costs of operating programs under part F (Job Opportunities and Basic Skills Training Program) (JOBS); and (2) modification of the amount payable to individual welfare reform plan participants expecting a decrease in income over a certain period in States which have elected to adjust individual AFDC benefits quarterly. (Sec. 203) Authorizes the Secretary to make grants to States for purposes of developing welfare reform plans. Sets limits on the amount the Secretary may expend on such grants in any fiscal year through FY 2000. Title III: Policy Changes to Reward Work - Amends SSA title IV part A and the Internal Revenue Code to make various specified changes designed to reward work, by, for example: (1) giving States the authority to establish enhanced earnings disregards for AFDC recipients and define unemployment for purposes of the AFDC-UP program; and (2) making the tax credit for dependent care expenses refundable, and requiring employers to make advance payments of such credit to their employees. (Sec. 304) Requires the Secretaries of Agriculture, of Health and Human Services, and of Labor to submit to the Congress an annual report on any State or Federal laws which may inhibit implementation of welfare reform plans. (Sec. 305) Directs the Secretary of Health and Human Services to establish the requirements to be followed by each State in developing and applying outcome measures and targets for assessing the effectiveness of the State's JOBS program. Amends SSA title IV part A to provide for a reduction in State JOBS funding for States which have not submitted for approval a plan for meeting such requirements. (Sec. 306) Directs the Comptroller General to submit to the Congress a methodology for determining the use of transitional child care and extended medical assistance under Medicaid. Makes various specified amendments to SSA title IV part A, including with regard to matters concerning transitional child care and certain student earnings and income. Title IV: Child Support Enforcement - Directs the Secretary to establish a Federal registry of child support orders issued or modified in a State for comparing information reported on an employee's W-4 form with information in the registry, and for notifying the appropriate State child support order registry established by this Act of the accuracy of the amount specified on the form as the empoyee's monthly child support obligation. (Sec. 402) Makes various specified amendments to SSA title IV part D (Child Support and Establishment of Paternity), including with regard to matters concerning: (1) expansion of the Federal Parent Locator Service; (2) development of a uniform child support withholding order; (3) State agency access to various data bases containing information with respect to absent parents; and (4) private access to State locate resources and enforcement services for purposes of establishing, modifying, and enforcing child support and parentage orders. (Sec. 403) Directs the Secretary of the Treasury to: (1) establish a national system for reporting copies of every employee's W-4 form to the appropriate State and Federal child support order registries; and (2) modify the W-4 form to enable the employee to indicate on it certain information related to child support and health care insurance for any dependent children. (Sec. 404) Amends the Internal Revenue Code to: (1) provide for the reconciliation of child support obligations and payments on income tax returns, with the full amount due by the end of the applicable tax year and subject to the same collection process and penalties applicable to back taxes; (2) provide for a tax credit for withholdings and payments in excess of applicable obligations; (3) require the Secretary to pay amounts collected to the appropriate State registry; and (4) require employers to include withheld obligations on the employee's W-2 form. (Sec. 407) Amends the Consumer Credit Protection Act to: (1) give debts relating to child support higher priority in a garnishment than other Federal debts when an individual's disposable earnings are not sufficient to pay both debts; and (2) prohibit employers from discharging employees with more than one indebtedness, if all but one of the debts arise from one or more orders for the support of a child. (Sec. 408) Amends SSA title IV part D to require States to enact the version of the Uniform Interstate Family Support Act adopted by the National Conference of Commissioners on Uniform State Laws in August 1992.
Bill· HRH.R. 4151 (103rd)referred
United States · United States Congress · 24 March 1994
Essential Pharmaceuticals Act of 1994 - Directs the Secretary of Health and Human Services to notify the Commissioner of Patents and Trademarks if the Secretary determines that the owner of a patent which claims a product or a method of using or manufacturing a product and which may be extended has not taken all reasonable steps toward the commercial marketing or use of that product whose availability to the public is of vital importance to the public health or welfare. Requires the Commissioner to provide for the compulsory licensing of all patents relating to that product. Allows an individual aggrieved by a decision of: (1) the Commissioner under this Act to appeal that decision to the Board of Patent Appeals and Interferences, after paying the fee for such appeal; and (2) the Board to appeal that decision to the United States Court of Appeals for the Federal Circuit.
Bill· HRH.R. 4124 (103rd)referred
United States · United States Congress · 24 March 1994
Allows each veteran who is an eligible individual within the meaning of the Health Security Act (the Act) to enroll with a Department of Veterans Affairs health plan (VA health plan). Allows certain surviving spouses and children of such veterans who are not otherwise eligible for medical care under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to enroll with a VA health plan. Directs the Secretary of Veterans Affairs to authorize a VA health plan to enroll family members of an enrollee, subject to all requirements of the Act concerning premiums, deductibles, copayments, and coinsurance. Continues such eligibility after the death of the veteran enrolled. Directs the Secretary to ensure that each VA health plan provides to each enrollee the items and services provided in the comprehensive benefit package under the Act. Provides continued coverage of care and services offered under veterans' medical care and benefits provisions that are not offered under the comprehensive plan. Allows a VA health plan to offer supplemental health benefits policies for health care services not provided through the Department and cost sharing policies consistent with the requirements of the Act. Provides coverage limitations with respect to veterans enrolled with health plans outside the Department (such as those in a regional alliance area). Prohibits the Secretary from imposing a cost-share charge of any kind for veteran enrollees who are service-disabled, discharged for a disability incurred in the line of duty, former prisoners of war, veterans of the Mexican border period or World War I, or unable to defray the expenses of necessary care. Requires the payment of premiums, copayments, deductibles, and coinsurance for all other veterans. Provides that, for purposes of any Medicare program, a Department facility shall be deemed to be a Medicare provider and a VA health plan shall be deemed to be a Medicare HMO. Provides for the recovery from third party insurers of the cost of certain covered care and services provided through the Department. Establishes in the Treasury the Department of Veterans Affairs Health Plan Fund, to be used to fund VA health plans under this Act. Provides for the preservation of existing benefits for facilities not operating as VA health plans. Directs the Secretary to organize health plans and operate Department facilities as or within health plans under the Act and in conformity with requirements prescribed under the Act. Allows VA health plans or the director of a Department health care facility to enter into agreements with health care plans, insurers, and health care providers to furnish or obtain any health-care resource. Allows the Secretary to carry out any necessary Department administrative reorganizations in order to participate in the national health care plan of the Act. Directs the Secretary of the Treasury to credit to a special fund for each of FY 1995 through 1997 specified amounts for VA health plans authorized under this Act. Directs the Secretary of Veterans Affairs to report to the Congress on the operation of the VA health plans. Authorizes the Secretary to apply for and accept grants to meet the needs of special populations with respect to such plans. Makes eligible for nursing home care, outpatient care, and care to obviate the need for inpatient care the same veterans enrolled in a VA health plan under this Act from whom no cost-share charge is permitted.
Bill· HJRESH.J.Res. 349 (103rd)referred
United States · United States Congress · 24 March 1994
Designates October 2 through 8, 1994, as Mental Illness Awareness Week.
Resolution· HCONRESH.Con.Res. 234 (103rd)open
United States · United States Congress · 24 March 1994
Calls for the United States, at the International Conference on Population and Development, to: (1) place the highest priority on the success of the Conference by actively participating, particularly through the President's personal participation; (2) propose or support an initiative concerning the financing of global cooperation on efforts to slow rapid population growth that takes into account the costs of slowing growth and the basic development goals of developing countries and that increases accountability for the use of funds provided for family planning purposes; (3) seek to initiate a process of regular high-level intergovernmental consultations on the issues under consideration at the Conference and establish improved organizational and procedural means to implement its objectives; (4) support the effective implementation of a global action plan to raise the economic, educational, and leadership status of women and programs that provide maternal and child health care, education, and training for women and voluntary family planning; and (5) promote public participation, especially by women, at all levels of formulation and implementation of family planning and sustainable development policy and programs.
Resolution· HCONRESH.Con.Res. 233 (103rd)referred
United States · United States Congress · 24 March 1994
A Child is Waiting Resolution - Expresses the sense of the Congress that: (1) any health care reform legislation include guaranteed full funding for the special supplemental food program for women, infants, and children (WIC); and (2) specified amounts should be made available to move toward such full funding goal.
Bill· SJRESS.J.Res. 175 (103rd)referred
United States · United States Congress · 23 March 1994
Designates the week beginning June 13 as National Parkinson's Disease Awareness Week.
Bill· HRH.R. 4113 (103rd)referred
United States · United States Congress · 23 March 1994
Mental Health Care Providers Bounty Prevention Act of 1994 - Amends the Federal criminal code to prohibit, and set penalties with respect to, the intentional solicitation, receipt, or payment of remuneration for patient referrals to, or for purchasing, leasing, ordering, or arranging for any good, facility, or service from, mental health care providers.
Bill· HRH.R. 4118 (103rd)referred
United States · United States Congress · 23 March 1994
Civilian Ex-Prisoner of War Health and Disability Benefits Act of 1994 - Entitles a former civilian prisoner of war (POW) to receive necessary medical care and disability benefits for any injury or disability resulting from the period of internment or hiding. Requires any presumptive medical and dental condition related to a period of internment provided for former military POWs to be extended to former civilian POWs and requires that it be considered to have been incurred in or aggravated by the period of internment or hiding regardless of the absence of any record of the injury. Establishes the Former Civilian Prisoner of War Committee. Authorizes appropriations for FY 1995 through 2000.
Bill· SS. 1961 (103rd)referred
United States · United States Congress · 22 March 1994
Civilian Ex-Prisoner of War Health and Disability Benefits Act of 1994 - Entitles a former civilian prisoner of war (POW) to receive necessary medical care and disability benefits for any injury or disability resulting from the period of internment or hiding. Requires any presumptive medical and dental condition related to a period of internment provided for former military POWs to be extended to former civilian POWs and requires that it be considered to have been incurred in or aggravated by the period of internment or hiding regardless of the absence of any record of the injury. Establishes the Former Civilian Prisoner of War Committee. Authorizes appropriations for FY 1995 through 2000.
Resolution· HCONRESH.Con.Res. 229 (103rd)referred
United States · United States Congress · 22 March 1994
Expresses the sense of the Congress that: (1) all women should have the opportunity to make decisions about their own reproductive health; (2) any national comprehensive health benefit package should cover the full range of reproductive health services; (3) every woman should be able to decide whether or not to have an abortion; and (4) any health care practitioner should be able to exempt himself or herself from participating in an abortion based on a religious or moral belief.
Bill· HRH.R. 4095 (103rd)referred
United States · United States Congress · 21 March 1994
Abolishes the Medicare and Medicaid Coverage Data Bank established under the Omnibus Budget Reconciliation Act of 1993. Directs the Secretary of Health and Human Services to study and report to the Congress on how to achieve the former objectives of such entity in the most cost-effective manner.
Resolution· SCONRESS.Con.Res. 63 (103rd)open
United States · United States Congress · 18 March 1994
TABLE OF CONTENTS: Title I: Levels and Amounts Title II: Budgetary Procedures Title III: Sense of Congress Provisions Title I: Levels and Amounts - Establishes the budget for FY 1995 and sets forth appropriate budgetary levels for FY 1996 through 1999. (Sec. 2) Sets forth recommended budgetary levels of Federal revenues, new budget authority, budget outlays, deficits, public debt, and credit activity. (Sec. 3) Sets forth the increase in the public debt subject to limitation. Displays Federal retirement trust fund balances. Sets forth Social Security trust fund revenues and outlays for Senate enforcement purposes. (Sec. 6) Sets forth funding levels for each major functional category. Title II: Budgetary Procedures - Expresses the sense of the Congress that: (1) the Government should sell assets from time to time; and (2) the amounts realized from such sales will not recur on an annual basis and do not reduce the demand for credit. (Sec. 22) Limits the levels of social security outlays and revenues for this resolution to the current services levels. (Sec 23) Establishes Senate enforcement procedures to continue pay-as-you-go enforcement procedures through FY 2003. (Sec. 24) Allows budget authority and outlay allocations for legislation that increases funding for certain purposes when legislation has been reported that will not, if enacted, increase the deficit for FY 1995 through 1999. Describes such purposes as funding: (1) to improve the well-being of families through welfare or other reforms, to provide for services to support or protect children, or to improve the health, nutrition or care of children; (2) to provide comprehensive training or job search assistance or to reform unemployment compensation; (3) to make continuing improvements in ongoing health care programs and comprehensive health care reform; (4) to preserve and rebuild the United States maritime industry; (5) to reform the financing of Federal elections; (6) to implement trade-related legislation; (7) for reforms relating to the Pension Benefit Guaranty Corporation; (8) to provide for simplified collection of employment taxes on domestic services; (9) to reform the Comprehensive Environmental Response, Compensation, and Liability Act of 1980; (10) to consolidate the supervision of depository institutions insured under the Federal Deposit Insurance Act; and (11) to preserve United States energy security. (Sec. 25) Establishes Senate enforcement procedures to extend the system of discretionary spending limits to budget resolutions for FY 1996 through 1998 and enforce pay-as-you-go spending. Title III: Sense of Congress Provisions - Expresses the sense of the Senate with respect to budgetary accounting of health care reform, reimbursing State and local governments for illegal immigration costs, using Blue Chip projections for economic assumptions, and the cost to State and local governments of unfunded Federal mandates.
Bill· SS. 1944 (103rd)open
United States · United States Congress · 17 March 1994
Health Care Fraud and Abuse Act of 1994 - Amends title XI of the Social Security Act to: (1) increase civil monetary penalties; (2) expand criminal penalties to include treble damages; (3) provide for the application of such sanctions to fraud and abuse involving any health benefit plan; and (4) include civil monetary penalties in anti-kickback sanctions. Requires the Secretary of Health and Human Services (HHS) to publish regulations establishing a program of voluntary disclosure of wrongdoing providing for less substantial sanctions than those otherwise imposed for health care fraud and abuse. Authorizes appropriations for hiring additional personnel for HHS's Office of Inspector General to sustain and expand the investigation of health care fraud.
Bill· SS. 1947 (103rd)referred
United States · United States Congress · 17 March 1994
Health Care Anti-Fraud Act of 1994 - Amends the Federal criminal code to prohibit and set penalties for knowingly: (1) executing a scheme or artifice to defraud to obtain a health care payment; or (2) presenting a statement containing false or misleading information as part of, or in support of, a claim for a health care payment. Increases such penalties if the offender knowingly or recklessly causes serious bodily injury or death or endangers the life of an individual. Directs the Attorney General to: (1) identify opportunities for the satisfaction of community service obligations that a court may impose upon the conviction of a health care fraud offense or under criminal penalties for acts involving Medicare or State health care programs; and (2) make information concerning such opportunities available to Federal and State law enforcement officers and State and local health care officials.
Bill· HRH.R. 4077 (103rd)open
United States · United States Congress · 17 March 1994
TABLE OF CONTENTS: Title I: Fair Information Practices for Protected Health Information Title II: Amendments to Title 5, United States Code Title III: Regulations; Effective Dates; Applicability; and Relationship to Other Laws Fair Health Information Practices Act of 1994 - Title I: Fair Information Practices for Protected Health Information - Sets forth: (1) the rights of an individual with respect to health information about the individual that is created or maintained as part of the health treatment and payment process; (2) the rights and responsibilities of any individual who creates or maintains such information; and (3) enforcement mechanisms. Title II: Amendments to Title 5, United States Code - Amends provisions of title 5 (Government Organization and Employees) of the United States Code relating to agency records to provide that the provisions of this Act shall preempt the title V provisions regarding protected health information, except as specified. Title III: Regulations; Effective Dates; Applicability; and Relationship to Other Laws - Directs the Secretary of Health and Human Services to prescribe regulations to carry out this Act. Sets forth provisions concerning effective dates, applicability, and relationship to other laws.
Bill· HRH.R. 4078 (103rd)open
United States · United States Congress · 17 March 1994
TABLE OF CONTENTS: Title I: Golden Gate National Area Title II: Presidio Public Benefit Corporation Title I: Golden Gate National Recreation Area - Includes certain areas in Mateo County, California, within the Golden Gate National Recreation Area. Authorizes the Secretary of the Interior to: (1) utilize the resources of the Presidio unit of the Golden Gate National Recreation Area, California, to provide for and support programs and activities that foster research, education, and demonstration projects concerning the environment, international affairs, cultural understanding, health, and science; (2) negotiate and enter into leases, as appropriate, with any private or government entity for the use of any property within the Presidio, except such properties which the Secretary of Defense determines are essential for the continued use of the Presidio by the sixth Army in accordance with the Area's General Management Plan or the Act establishing the Area; (3) negotiate and enter into leases or other appropriate agreements with any Federal agency or organization to house that agency's or organization's employees who are engaged in activities or programs at the Presidio; and (4) enter into interagency permitting agreements or other appropriate agreements with the Secretary of Defense and the Administrator of the Federal Emergency Management Agency and leases with the Red Cross to house their activities and employees at the Presidio. Requires the Secretary to establish competitive bidding procedures to be used for the issuance of such leases. Authorizes the Secretary to enter into cooperative agreements and permits for purposes of such Area. Title II: Presido Public Benefit Corporation - Authorizes the President to establish the Presidio Public Corporation only after San Francisco makes specified zoning decisions. Requires the Secretary to transfer all lands, facilities, and interest in certain Presidio properties to the Corporation. Transfers the Public Health Service Hospital and surrounding 36 acres to the administrative jurisdiciton of the Corporation. Directs the Corporation to sell: (1) the Public Health Service Hospital and adjacent golf course and allows it to use the proceeds of the sale for any function authorized by this Act; and (2) at fair market value, the Letterman Army Institute of Research, Letterman Army Medical Center, and such other buildings and lands in the Letterman complex necessary to conduct scientific research or education programs pertaining to human health to the University of California and authorizes it to use the proceeds from the sale for the same purposes. Allows the Secretary or other Cabinet officers to provide Federal personnel, facilities, and services to the Corporation on a reimbursement basis. Declares that the Corporation is devoted to an essential public and governmental function and purpose. Exempts it from all Federal taxes and special assessments. Applies all general penal statutes relating to the larceny, embezzlement, or conversion of public moneys or U.S. property to the moneys and property of the Corporation. Subjects the Corporation to provisions of Federal laws relating to administrative procedures and freedom of information.
Bill· HRH.R. 4047 (103rd)referred
United States · United States Congress · 16 March 1994
Fairness in Medicaid Funding Act of 1994 - Amends title XIX (Medicaid) of the Social Security Act to change the Federal medical assistance percentage used under the Medicaid program. Bases payments to the States for administration costs on the Federal medical assistance percentage.
Resolution· HCONRESH.Con.Res. 223 (103rd)open
United States · United States Congress · 16 March 1994
Expresses the sense of the Congress that any national health care reform legislation should cover syringes for those individuals with diabetes who require the administration of insulin by syringe.
Bill· SS. 1932 (103rd)open
United States · United States Congress · 15 March 1994
TABLE OF CONTENTS: Title I: Initiatives to Move Welfare Recipients into the Work Force Title II: Initiatives to Strengthen Families and Break the Cycle of Welfare Dependency Title III: Initiatives to Diversify and Improve the Performance of Welfare Services Title IV: Offsetting Expenditure Reductions Welfare Reform Through State Innovation Act - States that the purpose of this Act is to implement the demonstration projects established below as part of a comprehensive national program to: (1) terminate part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act (SSA) after two years; and (2) make employment available to such families where necessary. (Sec. 4) Provides for demonstration project approval, evaluation, duration, and implementation when effective in breaking the cycle of welfare dependency, unemployment, and poverty. (Sec. 5) Authorizes appropriations. Title I: Initiatives to Move Welfare Recipients into the Work Force - Directs the Secretary of Health and Human Services (NHS) to provide for demonstration projects in States with approved applications which: (1) condition AFDC benefits on school attendance or job training for single parents under age 20 with at least one dependent child but no children under six months; (2) limit the time period for the receipt of such benefits; and (3) generally require the parent to live in an adult-supervised home and receive such benefits through a parent or legal guardian. (Sec. 101) Requires participating States to make child care available and pay all education and job training costs in order to conduct such a demonstration project. (Sec. 102) Amends the Job Training Partnership Act to authorize the Secretary to establish a pilot JOB CORPS program targeting young, disadvantaged mothers on AFDC with below school-age children. Requires such program to include a parents as teachers program designed to educate parents in child development. (Sec. 103) Directs the Secretary to provide for State demonstration projects which generally require a parent or other relative of a dependent child to undergo as part of the application process, 30 days of assisted job search or substance abuse treatment before the family may receive AFDC. (Sec. 104) Amends SSA title IV part A to permit States to allow families on AFDC to save up to $10,000 in a qualified education and employment account and still be eligible for AFDC. (Sec. 105) Amends SSA title IV part A and the Internal Revenue Code to allow various offsets against income for self-employment program participants owning small businesses with regard to purchasing capital equipment, repaying business loans, and retaining cash from the business for future business uses for purposes of determining earned income under the AFDC program. Directs the Secretary to provide for demonstration projects in States which: (1) establish public-private partnerships for technical assistance to self-employed AFDC recipients; (2) train AFDC recipients as self-employed providers of child care services; and (3) promote ownership of extended family-owned businesses by AFDC recipients. (Sec. 106) Amends SSA title IV part F (Job Opportunities and Basic Skills Training Program) (JOBS) to emphasize moving people into the work force, then providing post-employment education and training. (Sec. 107) Directs the Secretary to provide for additional demonstration projects in States which move AFDC recipients into the work force. Title II: Initiatives to Strengthen Families and Break the Cycle of Welfare Dependency - Directs the Secretary to provide for State demonstration projects which: (1) establish child centered programs through conversion of certain AFDC and JOBS payments into block grants; (2) provide no additional benefits with respect to children born while a family is on AFDC and allow increases in the earned income disregard; (3) provide incentives to marry; (4) reduce AFDC benefits if school attendance is irregular or preventive health care for dependent children is not obtained; (5) increase child support collection; (6) develop community-based programs for teenage pregnancy prevention and family planning; and (7) strengthen families and break the cycle of welfare dependency. Title III: Initiatives to Diversify and Improve the Performance of Welfare Services - Directs the Secretary to provide for State demonstration projects which: (1) provide placement of AFDC recipients in private sector jobs; and (2) establish performance-based incentives for State public welfare providers. Title IV: Offsetting Expenditure Reductions - Amends the Food Security Act of 1985 to make certain changes, including elimination of the "three-entity rule," to provide offsetting expenditure reductions.
Bill· SS. 1933 (103rd)referred
United States · United States Congress · 15 March 1994
Abolishes the Medicare and Medicaid Coverage Data Bank established under the Omnibus Budget Reconciliation Act of 1993. Directs the Secretary of Health and Human Services to study and report to the Congress on how to achieve the former objectives of such entity in the most cost-effective manner.
Bill· HRH.R. 4013 (103rd)open
United States · United States Congress · 11 March 1994
TABLE OF CONTENTS: Title I: Veterans Health Administration Staffing Levels Title II: Pilot Programs Title III: Health Care Resource Agreements Veterans Health Programs Improvement Act of 1994 - Title I: Veterans Health Administration Staffing Levels - Prohibits any reduction, during the five-year period beginning October 1, 1994, in the number of full-time equivalent employees in the Veterans Health Administration (VHA) of the Department of Veterans Affairs other than as specifically required by law or by the availability of funds. States that during such period no law imposing hiring restrictions on executive agencies to achieve workforce reductions shall apply to the VHA. Directs the Secretary of Veterans Affairs to report to the veterans' committees on VHA streamlining activities. Title II: Pilot Programs - Veterans Health-Care Pilot Program Act of 1994 - Authorizes the Secretary to establish and operate a pilot program in up to five States which have established a health care reform plan. Authorizes the Secretary to: (1) provide health-care services to veterans and their dependents on the same or a similar basis as the State reform plan; (2) comply with State law in establishing and operating a veterans' health plan in such State; (3) conduct the pilot program in some or all Department health-care facilities in the State; and (4) establish appropriate catchment areas in the State for enrollment in the pilot programs. Outlines conditions for participation in the pilot programs, including a finding that the workload in one or more Department health care facilities in a State would otherwise decline to a level which would impair the ability to meet assigned missions. Allows a pilot program to be implemented only after the plan has been submitted to the Congress and 30 days have elapsed. Exempts certain high-priority veterans (e.g., those with severe disabilities) from the payment of premiums or copayments in connection with care received under a pilot program. Establishes in the Treasury a revolving fund for conducting the pilot programs. Authorizes appropriations to the fund for FY 1995 through 2000. Provides for: (1) authorized transfers from other accounts to such fund; (2) authorized fund receipts and disbursements; and (3) transfer to the Treasury of excess funds. Requires annual reports. Terminates the pilot programs on September 30, 2000. Title III: Health Care Resource Agreements - Authorizes the director of a Department health care facility serving veterans who reside in a State with a State health reform plan to enter into agreements with health plans and other health care providers to furnish or obtain any health care resource. Requires to provide for reimbursement to the Department based on a methodology that provides appropriate flexibility to establish an appropriate reimbursement rate.
Bill· HRH.R. 4028 (103rd)referred
United States · United States Congress · 11 March 1994
Health Care Fraud and Abuse Advisory Opinion Act of 1994 - Amends title XI of the Social Security Act (SSA) to give the Secretary of Health and Human Services the authority to issue binding advisory opinions addressing certain matters, such as what constitutes prohibited remuneration or an inducement to reduce or limit Medicare or Medicaid services, and whether an arrangement or activity, actual or proposed, violates any other SSA provisions. Amends SSA title XVIII (Medicare) to give the Secretary the authority to issue binding advisory opinions on whether an arrangement or proposed arrangement will result in a prohibited physician referral. Requires the Secretary to issue regulations establishing systems for the issuance of the advisory opinions above.
Bill· HRH.R. 4024 (103rd)referred
United States · United States Congress · 11 March 1994
National Community Health Advisor Act - Directs the Secretary of Health and Human Services, for each State or State-designated entity that submits an appropriate application, to award financial assistance for the development and operation of community health advisor (CHA) programs. Requires such States to: (1) operate a clearinghouse to maintain and disseminate information on CHA programs; (2) provide technical assistance for training CHAs; and (3) coordinate all CHA activities carried out by the State under the award. Limits administrative costs to 15 percent of the total award. Provides CHA program objectives and goals. Requires funding agreements for such awards to give priority to developing and operating CHA programs for medically underserved communities (poor rural and inner city areas). Requires a State to provide matching funds of 25 percent of award amounts toward such programs. Requires a CHA program in a State to be carried out in at least one urban area and one rural area. Requires ongoing supervision of CHAs involved in the program. Allows for expenditures under the award for training and continuing education programs. Requires reports from State applicants to the Secretary assessing the effectiveness of CHA programs. Provides for the determination of the amount allotted to each chosen applicant, taking into account the population and poverty level of the area involved. Directs the Secretary to establish guidelines for quality assurance and cost-effectiveness of the CHA programs, requiring evaluations of each such program. Prohibits this Act from being construed to require the Secretary to modify or terminate the Community Health Representative Program of the Indian Health Service.
Bill· SS. 1920 (103rd)referred
United States · United States Congress · 10 March 1994
Safe Drinking Water Act Amendments of 1994 - Amends the Safe Drinking Water Act to require the Administrator of the Environmental Protection Agency, in the case of specified contaminants listed in the Federal Register for which national primary drinking water regulations have not been issued, to: (1) publish maximum contaminant level (MCL) goals and issue such regulations for those contaminants that occur in drinking water at a level of public health concern; and (2) eliminate monitoring, compliance, and enforcement requirements for those contaminants that do not occur in drinking water at levels of public health concern. (Current law requires the promulgation of such goals and regulations for specified numbers of such contaminants by certain dates.) (Sec. 4) Directs the Administrator to promulgate such goals and regulations for new contaminants every five years. Requires the Administrator to identify best technology treatment techniques that may be used to meet MCLs for public water systems serving fewer than 1,000, between 1,000 and 10,000, and more than 10,000 people. Directs the Administrator to promulgate national primary drinking water regulations for radionuclides, disinfection and corrosion byproducts, and sulfate. (Sec. 7) Revises provisions concerning variances from such regulations to permit the issuance of a variance by a State only if the water system cannot afford to install the best available technology to meet the MCL and it is not feasible for the system to connect with another source of water that will meet the standards. Requires variances to be reviewed by the State at least every three years. (Sec. 8) Repeals provisions that authorize States to exempt public water systems from requirements respecting MCLs or treatment techniques. (Sec. 9) Prohibits treated drinking water from being removed from a public water system or routed through any device or pipes outside the system and returned to the system. Includes such action in the definition of "tampering," a violation for which criminal penalties are imposed. Makes such prohibition inapplicable to pipes and devices totally within the control of one or more public water systems or to connections between water mains. (Sec. 11) Requires (currently, authorizes) the Administrator to conduct research relating to diseases and other impairments resulting from contaminants in drinking water or to the provision of a safe supply of drinking water. Authorizes appropriations. (Sec. 12) Extends the authorization of appropriations for grants for State public water system supervision programs. (Sec. 13) Requires the Administrator to promulgate revised regulations every five years that list up to 30 unregulated contaminants to be monitored by public water systems. Directs the Administrator to assemble a national drinking water occurrence data base to include information on the occurrence of regulated and unregulated contaminants. (Sec. 16) Requires the Administrator to make capitalization grants to States to establish State drinking water treatment revolving loan funds. Reserves the following amounts from such grants: (1) one percent for financial assistance to Indian tribes for the improvement of public water systems; and (2) .5 percent to respond to public health emergencies. Sets aside specified dollar amounts for rural small drinking water systems technical assistance programs and drinking water health effects research. Authorizes the Administrator to make grants for public water system improvement to the District of Columbia and specified U.S. territories. Requires 15 percent of amounts in a State loan fund to be available solely for assistance to public water systems that serve fewer than 10,000 individuals. Directs States to prepare intended use plans prior to receiving grants. Requires priority for the use of funds to be given to systems that are in violation of a national primary drinking water regulation. Requires the Administrator to submit quadrennially to the Congress a survey of the needs of facilities eligible for State loan fund assistance. Authorizes appropriations. (Sec. 17) Permits the Administrator to provide financial assistance to minority communities with economic hardship for eligible wastewater treatment projects. (Sec. 18) Authorizes the Administrator to transfer funds to another Federal agency or award grants to any appropriate entity or border State (Arizona, California, New Mexico, or Texas) to provide assistance to low-income communities (colonias) in such areas that lack basic sanitation facilities for: (1) the conservation, development, use, and control of water; and (2) the construction or improvement of sewers, wastewater treatment works, and essential community facilities. Requires such funds to be used in communities subject to a significant health risk attributable to lack of access to a water supply system or wastewater treatment works. Authorizes appropriations.
Bill· HJRESH.J.Res. 334 (103rd)referred
United States · United States Congress · 10 March 1994
Designates May 29 through June 4, 1994, as Pediatric and Adolescent AIDS Awareness Week.
Resolution· HCONRESH.Con.Res. 220 (103rd)referred
United States · United States Congress · 9 March 1994
Expresses the sense of the Congress concerning: (1) the need for adequate breast cancer screenings for women between the ages of 40 through 49; and (2) the National Cancer Institute's recent statement regarding such screenings.
Bill· SS. 1907 (103rd)reported
United States · United States Congress · 8 March 1994
Directs the Secretary of Veterans Affairs to: (1) determine whether the injury of any veteran as a result of medical treatment was caused by medical malpractice by the Department of Veterans Affairs; and (2) if so, provide appropriate compensation.