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Bill· HRH.R. 5199 (102nd)referred
United States · United States Congress · 19 May 1992
Military Retiree and Veteran Health Care Act of 1992 - Entitles members and former members of the armed forces and their dependents who are eligible for medical or dental care in any military facility and who are also entitled to health insurance under title XVIII (Medicare) of the Social Security Act to receive medical or dental care in any military facility. Directs the facility providing such services to recover the costs of such care from Medicare Subvention funding. Provides for the deposit of funds received by a military medical treatment or Department of Veterans Affairs facility from Medicare Subvention funding for the provision of such care. Allows a covered beneficiary of a member or former member of the armed forces who is also entitled to hospital insurance benefits under Medicare to receive care in a military treatment facility and to have the Medicare hospital insurance benefits paid to such military treatment facility for the care so provided. Provides that, in the case of health care services incurred on behalf of covered beneficiaries, collection may be made from any third party payer, including the appropriate program under Medicare or title XIX (Medicaid) of the Social Security Act. (Currently, collection from a plan administered by Medicare or Medicaid is prohibited.) Prohibits medical or dental care from being provided to an otherwise eligible person at a military treatment facility only if the senior or commanding officer of such facility determines that such facility cannot provide the particular care required because of lack of space or facilities or because such type of care is not provided at such facility. Requires the administering Secretary to be advised immediately when a determination to deny treatment is made, with a verifiable date as to when the restriction will be removed. Amends Medicare provisions to make Department of Defense and Department of Veterans Affairs treatment facilities eligible for Medicare payments as long as they meet requirements applicable to hospitals and skilled nursing facilities under title XVIII.
Bill· HJRESH.J.Res. 486 (102nd)open
United States · United States Congress · 19 May 1992
Designates September 10, 1992, as National DARE (Drug Abuse Resistance Education) Day.
Law· HRH.R. 5194 (102nd)enacted
United States · United States Congress · 18 May 1992
Juvenile Justice and Delinquency Prevention Amendments of 1992 - Title I: Amendments to the Juvenile Justice and Delinquency Prevention Act of 1974 - Amends the Juvenile Justice and Delinquency Prevention Act of 1974 (JJDPA) to include within the policy enunciated under such Act to: (1) encourage parental involvement in treatment and alternative disposition programs; and (2) provide for coordination of services between State, local, and community-based agencies, and promote interagency cooperation in providing such services. Revises the definition of "valid court order" to mean a court order given by a juvenile court judge to a juvenile: (1) who was brought before the court and made subject to such order (as under current law); (2) who received, before the issuance of such order, the full due process rights guaranteed to such juvenile by the Constitution; and (3) with respect to whom an appropriate public agency (other than a court or law enforcement agency), before the issuance of such order, reviewed the behavior of the juvenile and circumstances under which the juvenile was brought before the court and made subject to such order, determined the reasons for such behavior, determined that all dispositions (including treatment), other than placement in a secure detention or correctional facility had been exhausted or were clearly inappropriate, and submitted to the court a written report stating the results of the review and the determinations made. Specifies that there shall be a direct reporting relationship between the Administrator of the Office of Juvenile Justice and Delinquency Prevention and the Attorney General, that the Administrator shall be directly responsible to the Attorney General, and that the Attorney General may not delegate specified powers, duties, or functions. (Under current law, the Administrator reports to the Attorney General through the Assistant Attorney General who heads the Office of Justice Programs under the Omnibus Crime Control and Safe Streets Act of 1968.) Directs the Administrator to develop objectives, priorities, and a long-term plan, and implement overall policy and a strategy to carry out such plan (currently, to implement overall policy and develop objectives and priorities). Specifies that such plan shall: (1) contain specific goals and criteria for making grants and contracts, conducting research, and carrying out other activities under such Act; and (2) provide for coordinating the administration of programs and activities under such Act with the administration of all other Federal juvenile delinquency programs and activities. Requires the Administrator to review such plan annually, revise it as appropriate, and publish it in the Federal Register. Repeals certain provisions with respect to: (1) the transfer of funds to other agencies; and (2) grants and contracts to other agencies, institutions, and individuals. Revises provisions with respect to the composition, functions, and administration of the Coordinating Council on Juvenile Justice and Delinquency Prevention. Provides for the appointment of specified numbers of members appointed from among individuals who are practitioners in the field of juvenile justice who are not officers or employees of the United States, from members selected by the Congress, and from members appointed by the President. Directs the Council to examine how the separate programs can be coordinated among Federal, State, and local governments to better serve at-risk children and juveniles. Specifies that, in addition to performing their functions as members of the Council, members shall collectively: (1) make recommendations regarding the development of the objectives, priorities, and long-term plan, and the implementation of overall policy and strategy to carry out such plan; and (2) submit recommendations to the Administrator and the chairmen of specified congressional committees. Requires the Administrator's annual report to include a summary and analysis of: (1) the types of facilities used to hold juveniles treated as adults for purposes of prosecution; and (2) the educational status of juveniles. Makes a portion of any State allotment under such Act available to pay for one full-time staff position. Revises State plan requirements to provide for: (1) representation by recreation departments on the advisory group appointed by the chief executive of the State; (2) an assessment of educational needs as part of the analysis of juvenile justice and delinquency prevention needs; (3) coordination and maximum utilization of existing juvenile-related recreation programs within the State; (4) home-based alternative services; (5) community-based programs and services designed to work with juveniles during their incarceration, and with their families, to ensure the safe return of such juveniles to their homes and to strengthen the family unit; (6) enhanced coordination with the local schools such juveniles would otherwise attend to ensure that the instruction such juveniles receive outside, is closely aligned with the instruction provided in, such schools, and that information regarding any learning problems identified in such alternative learning situations are communicated to such schools; (7) juvenile initiated programs and outreach programs to assist juveniles with limited English-speaking ability; (8) special emphasis on involving parents with limited English-speaking ability; (9) programs relating to juveniles who have educational problems; (10) programs (including referral to literacy and social service programs) to assist families with limited English-speaking ability that include delinquent juveniles to overcome language and cultural barriers that may prevent the complete treatment of such juveniles and the preservation of the family unit; (11) programs designed to prevent and reduce hate crimes committed by juveniles; (12) a prohibition on detention or confinement in institutions in which juveniles alleged or found to be delinquent have contact (currently, regular contact) with adult convicts or with adults awaiting trial on criminal charges, or with the security staff or direct-care staff of a jail or lockup for adults; (13) elimination of an exception to the requirement that no juvenile be detained or confined in any jail or lockup for adults; (14) family counseling during the incarceration of juvenile family members and coordination of family services when appropriate and feasible; and (15) an assurance that any specified excess funds received by the State shall be expended through or for programs that are part of a comprehensive and coordinated community system of services. Directs that such State plans contain an analysis of services available, and a plan for providing needed services, with respect to: (1) gender-specific services for the prevention and treatment of juvenile delinquency; (2) services for the prevention and treatment of juvenile delinquency in rural areas; and (3) mental health services available to juveniles in the juvenile justice system (including an assessment of the appropriateness of the particular placements of juveniles in order to receive such services) and of barriers to access to such services. Revises provisions with respect to the approval of State plans and the lack of a State plan. Provides for a reduction or termination of funds for noncompliance, subject to specified limitations. Specifies that the National Institute for Juvenile Justice and Delinquency Prevention (the Institute) shall serve as a clearinghouse for information regarding juvenile delinquency, including State and local juvenile delinquency prevention and treatment programs (as under current law), and including drug and alcohol programs and gender-specific programs. Authorizes the Administrator to: (1) support research related to achieving a better understanding of the commission, and designed to identify educational programs best suited to prevent and reduce the incidence, of hate crimes by juveniles; and (2) develop, conduct, and provide training programs for persons working with juveniles and their families (as under current law), including juveniles who commit hate crimes. Requires the Administrator to include within the Institute's training program methods and techniques specifically designed to prevent and reduce such incidence. Directs the Administrator to conduct a study of the incidence of violence committed by or against juveniles in urban areas of the United States. Sets forth study objectives, including: (1) identifying characteristics and patterns of behavior of juveniles who are at risk of becoming violent or victims of homicide, factors particularly indigenous to such areas that contribute to violence committed by or against juveniles, and existing and new diversion, prevention, and control programs to ameliorate conditions causing any increase in such violence; (2) determining the accessibility and use of firearms, and the conditions that cause any increase in violence committed, by or against juveniles; (3) using data available from Federal and State law enforcement agencies to make specified assessments with respect to hate crimes; (4) improving current systems to prevent and control violence by or against juveniles; and (5) developing a plan to assist State and local governments to establish viable ways to reduce homicide committed by or against juveniles. Sets forth reporting requirements. Directs the Administrator, in making grants and contracts under Special Emphasis Prevention and Treatment Programs, to include: (1) home-based treatment programs in establishing or maintaining community-based alternatives to traditional forms of institutionalization of juvenile offenders; (2) self-help programs for parents in developing or supporting model programs to strengthen and maintain the family unit; (3) programs that work with families during the incarceration of juvenile family members and which take into consideration the special needs of families with limited English-speaking ability; (4) targeting juveniles who have had, or are likely to have, contact with the juvenile justice system in disseminating information regarding model, innovative, law-related education programs; and (5) establishing or supporting programs designed to prevent and reduce the incidence of hate crimes committed by juveniles, including model educational programs (designed to reduce such incidence by means such as addressing the specific prejudicial attitude of each offender, developing an awareness in such offender of the effect of the hate crime on the victim, and educating such offender about the importance of tolerance in our society) and sentencing programs (designed specifically for juveniles who commit hate crimes and that provide alternatives to incarceration). Authorizes the Administrator, in making such grants and contracts, to assist in identifying learning disabilities in developing and implementing model programs and methods to keep students in elementary and secondary schools, and in encouraging new approaches with respect to prevention of school violence and vandalism. Bars the Administrator from making any such grant or contract to the Department of Justice (DOJ) or to any administrative unit or other entity that is part of DOJ. Modifies provisions regarding the competitive process (and related reporting requirements) in approving applications for such grants or contracts. Specifies that such process shall not apply to programs to be carried out in areas with respect to which the President declares (under the Robert T. Stafford Disaster Relief and Emergency Assistance Act) that a major disaster or emergency exists. Revises provisions with respect to prevention and treatment programs relating to juvenile gangs and drug abuse and trafficking. Directs the Administrator to make grants to or enter into contracts with public agencies (including local educational agencies) and private nonprofit agencies, organizations, and institutions to establish and support programs and activities that involve families and communities that are designed to carry out specified purposes, including to: (1) prevent and reduce the participation of juveniles in the activities of gangs that commit crimes (which may include individual, peer, family, and group counseling, education and social services designed to address the social and developmental needs of juveniles, the organization of neighborhood and community groups, and training and assistance to adults who have significant relationships with juveniles who are or may become members of gangs, in providing constructive alternatives to participating in gang activities); (2) promote and support the development of policies and activities in public elementary and secondary schools which will assist such schools in maintaining a safe environment conducive to learning; (3) assist juveniles who are or may become gang members to obtain appropriate educational instruction, in or outside a regular school program, including the provision of counseling and other services; (4) expand the availability of prevention and treatment services relating to the illegal use of controlled substances and controlled substance analogues by juveniles; (5) provide services to prevent juveniles from coming into contact with the juvenile justice system again as a result of gang-related activity; and (6) support activities to inform juveniles of the availability of treatment and services for which financial assistance is available. Authorizes the Administrator to make grants and enter into contracts with public agencies and private nonprofit agencies, organizations, and institutions to: (1) conduct research on issues related to juvenile gangs; (2) evaluate the effectiveness of programs and activities funded under these provisions; and (3) increase the knowledge of the public by disseminating information on research and on effective programs and activities. Sets forth application requirements, including that applications: (1) provide an assurance that the proposed program or activity will supplement, not supplant, similar programs and activities already available in the community; (2) describe how such program or activity is coordinated with other specified programs, activities, and services available locally; and (3) certify that the applicant has requested the State planning agency (currently, any designated local agency) to review and comment on such application, and summarize the responses of such State planning agency to the request). Directs the Administrator, in reviewing applications, to give priority to specified applications, including those: (1) submitted by, or substantially involving, local educational agencies; and (2) for assistance for programs and activities that are broadly supported by public and private nonprofit agencies, organizations, and institutions in the geographical area in which the applicants propose to carry out the programs and activities, and that will substantially involve the families of juvenile gang members in carrying out such programs or activities. Sets forth new provisions with respect to community-based gang intervention. Directs the Administrator to make grants to, or enter into contracts with, public and private nonprofit agencies, organizations, and institutions to carry out programs and activities to: (1) reduce the participation of juveniles in illegal gang activities; (2) develop regional task forces involving State, local, and community-based organizations to coordinate enforcement, intervention, and treatment efforts for juvenile gang members and to curtail interstate gang activities; and (3) facilitate coordination and cooperation among local education, juvenile justice, employment, and social service agencies, and community-based programs with a proven record of effectively providing intervention services to juvenile gang members for the purpose of reducing the participation of juveniles in illegal gang activities. Authorizes appropriations. Title II: Amendments to the Runaway and Homeless Youth Act - Amends the Runaway and Homeless Youth Act (RHYA) to direct the Secretary of Health and Human Services to make grants to provide services to deal with the immediate needs of homeless youth and their families (as under current law) in a manner which is outside the law enforcement, child welfare, mental health, and juvenile justice systems (current law specifies outside the law enforcement structure and juvenile justice system). Increases the allotment of grant funds. Amends the JJDPA to: (1) delete a provision authorizing the Secretary to provide on-the-job training to local runaway and homeless youth center personnel and coordinated networks of local law enforcement, social service, and welfare personnel to assist such personnel in recognizing and providing for learning disabled and other handicapped juveniles; and (2) authorize the Secretary, subject to specified appropriations-related limitations, to make grants to establish and operate street-based service projects for runaway, homeless, and street youth, and home-based service projects for families that are separated (or at risk of separation) as a result of the physical absence of a runaway youth or youth at risk of family separation. Amends the RHYA to provide that, to be eligible for assistance under the Runaway and Homeless Youth Grant Program, an applicant shall propose to establish, strengthen, or fund specified centers and services and a locally controlled facility providing temporary shelter (as under current law), including a family host home. Specifies that, to qualify for such assistance, the applicant shall submit a plan to the Secretary including assurances that such applicant shall: (1) use such assistance with respect to a facility that has a maximum capacity of not more than 25 youths (currently, not more than 25 children); (2) develop an adequate plan for assuring proper relations with law enforcement, social service, school system, and welfare personnel (as under current law), and health care personnel, as well as coordination with personnel of the schools to which runaway and homeless youth will return, to assist such youth to stay current with the curricula of such schools; (3) develop an adequate plan for providing counseling and aftercare services to such youth, and for encouraging the involvement of their parents or legal guardians in counseling (current law specifies aftercare counseling involving such youth and their families within the State in which the runaway and homeless youth center is located); (4) keep adequate statistical records profiling the children and parents which it serves, except that records maintained on individual youth shall not be disclosed without consent of the individual youth and family members (as under current law) whom it serves, including youth who are not referred to out-of-home shelter services; and (5) develop an adequate plan for establishing outreach programs designed to attract individuals (including minorities and those with limited English-speaking ability) who are eligible to receive services for which a grant may be expended. Amends the JJDPA to provide that, to be eligible for street-based services assistance, an applicant shall propose to establish, strengthen, or fund a street-based service project for runaway and homeless youth and street youth, and shall submit to the Secretary a plan in which such applicant agrees, as part of such project: (1) to provide qualified supervision of staff, backup personnel for on-street staff, informational and health educational material to runaway and homeless youth and street youth in need of services, and initial and periodic training of staff who provide services under such project; (2) to carry out outreach activities for, and collect statistical information on, such youth; (3) to develop referral relationships with agencies and organizations that provide services or assistance to such youth; (4) to submit to the Secretary an annual report, an annual budget, and such other information as the Secretary may reasonably require; (5) to implement such accounting procedures and fiscal control devices as the Secretary may require; (6) to keep adequate statistical records that profile such youth whom it serves and not disclose their identity in reports or other documents based on such records; and (7) not to disclose records maintained on individual youth without their consent to anyone other than an agency compiling statistical records. Requires an applicant, to be eligible for home-based services assistance, to propose to establish, strengthen, or fund a home-based service project for runaway youth or youth at risk of family separation and submit to the Secretary a plan in which the applicant agrees, as part of such project: (1) to provide counseling and information services needed by runaway youth, youth at risk of family separation, and the family (including unrelated individuals in the family household) of such youth, 24-hour service to respond to family crises (including immediate access to temporary shelter for such youth affected by family crises), informational and health educational material to such youth in need of services, and initial and periodic training of staff who provide services under such project; (2) to establish in partnership with the families of such youth objectives and measures of success to be achieved as a result of participating in such project; (3) to carry out outreach activities for, and collect statistical information on, such youth; (4) to ensure that caseloads remain sufficiently low to allow for intensive involvement with each family participating in, and that qualified supervision will be provided to staff who provide services under, such project; (5) to submit to the Secretary an annual report, an annual budget, and such other information as the Secretary may reasonably require; (6) to implement such accounting procedures and fiscal control devices as the Secretary may require; (7) to keep adequate statistical records that profile such youth whom it serves and not disclose the identity of such youth in reports or other documents based on such records; and (8) not to disclose records maintained on individual youth without their consent to anyone other than an agency compiling statistical records. Makes conforming amendments with respect to grants to private entities and approval by the Secretary of specified grant funds. Gives priority to grants smaller than $200,000 (currently, $150,000). Provides that, to be eligible for assistance under the Transitional Living Grant Program, an applicant must agree not to disclose records maintained on individual homeless youth without the consent of such individual (current law also requires consent of a parent or legal guardian) to anyone other than an agency compiling statistical records or a government agency involved in the disposition of criminal charges against youth. Directs the Secretary to include in its annual report to the Congress a summary of the results of Federal evaluation of the programs, projects, and activities carried out under the RHYA, and a description of the training provided to the individuals who carry out such evaluation. Specifies that, as part of such evaluation, the Secretary shall require such individuals to visit each grantee on-site not less frequently than at three-year intervals. Authorizes appropriations for the Runaway and Homeless Youth Grant Program and the Transitional Living Grant Program. Directs the Secretary to: (1) give priority to grant applicants (with respect to grants, as provided for under current law, for a national communication system to assist runaway and homeless youth in communicating with their families and with service providers) that have experience in providing telephone services to such youth; (2) coordinate the activities of agencies of the Department of Health and Human Services with those of other Federal and eligible non-Federal entities (currently, with respect to matters relating to communicable diseases); and (3) make grants to statewide and regional nonprofit organizations to provide technical assistance and training to eligible public and private entities (as under current law) for the purpose of carrying out the programs, projects, or activities for which such grants are made pursuant to this Act. Sets forth additional criteria for the Secretary to use in selecting applicants with respect to grants (provided for under current law) to States, localities, and private entities to carry out research, demonstration, and service projects designed to increase knowledge concerning, and to improve services for, runaway and homeless youth. Title III: Amendment to the Missing Children's Assistance Act - Amends the Missing Children's Assistance Act to authorize appropriations. Title IV: General Provisions - Sets forth effective dates of this Act.
Law· HRH.R. 5193 (102nd)enacted
United States · United States Congress · 18 May 1992
Authorizes the Secretary of Veterans Affairs to enter into an agreement with the Secretary of Defense to expand the availability of health-care sharing arrangements with the Department of Defense (DOD) during the period before October 1, 1996. Specifies that under such agreement: (1) the head of a Department of Veterans Affairs medical facility (the facility) may enter into agreements with the head of a DOD medical facility, with any other DOD official responsible for the provision of care to persons who are covered beneficiaries in the region of the facility, or with a DOD contractor responsible for the provision of care to persons who are covered beneficiaries in the region of the facility; and (2) the term "primary beneficiary" shall be treated as including persons described under statutory provisions concerning medical care for survivors and dependents of certain veterans and medical and dental care of members of the armed forces. Bars a proposed agreement authorized under this Act that is entered into by the head of a facility from taking effect unless the Chief Medical Director certifies to the Secretary that implementation of the agreement will: (1) result in the improvement of services to eligible veterans at that facility; and (2) not result in the denial of, or a delay in providing, access to care for any veteran at that facility. Specifies that, under such an agreement, statutory guidelines for the sharing of health-care resources may be modified to provide that any person who is a covered beneficiary and who is furnished care or services by a facility, or who meets other specified criteria, and who is furnished care or services by a DOD medical facility, may be authorized to receive such care or services: (1) without regard to any otherwise applicable requirement for the payment of a copayment or deductible; or (2) subject to a requirement to pay only part of any such otherwise applicable copayment or deductible, as specified in the guidelines. Sets forth reporting requirements.
Bill· HRH.R. 5196 (102nd)referred
United States · United States Congress · 18 May 1992
Influenza Immunization Awareness Act of 1992 - Amends the Omnibus Budget Reconciliation Act of 1987 to extend the influenza vaccination demonstration project currently conducted under the Medicare program (title XVIII of the Social Security Act). Amends the Public Health Service Act to mandate establishment of a program to award grants for hospital-based influenza vaccine delivery programs. Authorizes appropriations. Directs the Secretary of Health and Human Services to establish a National Clearinghouse on Vaccine Information through which health care providers may submit and obtain information on the availability of vaccines. Requires the Director of the Centers for Disease Control to study the feasibility and desirability of bulk purchases of vaccines by the Federal Government as a method of preventing shortages of vaccines.
Bill· SS. 2734 (102nd)open
United States · United States Congress · 15 May 1992
Water Resources Development Act of 1992 - Title I: Project Authorization - Authorizes the Secretary of the Army (the Secretary) to carry out public works projects in the following locations for improvements to navigation, flood control, and ecosystem restoration: (1) Southeast Alaska Harbors of Refuge, Alaska; (2) Whiteman's Creek, Arkansas; (3) American River Watershed, California; (4) Morro Bay Harbor, California; (5) Sacramento Metro Area, California; (6) Rio Grande Alamosa, Colorado; (7) Delaware River Mainstem and Channel Deepening, Delaware, New Jersey, and Pennsylvania; (8) Canaveral Harbor, Florida; (9) Kissimee River, Florida; (10) Port Everglades Harbor, Florida; (11) Savannah Harbor, Georgia and South Carolina; (12) Kentucky Lock Addition, Kentucky; (13) Amite River and Tributaries, Louisiana; (14) Saugus River and Tributaries, Massachusetts; (15) Las Vegas Wash and Tributaries, Nevada; (16) Morehead City Harbor, North Carolina; (17) West Onslow and New River Inlet, North Carolina; (18) Lackawanna River at Scranton, Pennsylvania; (19) Locks and Dams 2, 3, and 4 Monongahela River, Pennsylvania; (20) Rio Grande De Loiza, Puerto Rico; (21) Sargent Beach, Texas; and (22) Shoal Creek, Austin, Texas. Modifies projects at the following locations with respect to coastal storm protection, storm water collection, flood control beach erosion control and hurricane protection, navigation, and water quality improvement: (1) Virginia Beach, Virginia; (2) South Fork of the Zumbro River, Rochester, Minnesota; (3) Moorefield and Petersburg, West Virginia; (4) Buena Vista, Virginia; (5) Westhampton Beach, New York; (6) Jones inlet, New York; (7) Buffomville Lake, Massachusetts; (8) French River, Connecticut and Massachusetts; and (9) Clear Creek, Texas. Reauthorizes the project for flood control at: (1) Perry Creek, Sioux City, Iowa; and (2) Green Bay Levee District, Iowa. Title II: Project Related Provisions - Authorizes the Secretary to develop and implement a plan for modifying the channel bypass element of the Levisa Fork, Kentucky, project for water quality improvement in and restoration of Pikeville Lake, Kentucky. Authorizes appropriations. Bars the Secretary from proceeding with the divestiture of locks and dams five through 14 on the Kentucky River, Kentucky, until the Secretary has complied with the terms of a specified Memorandum of Understanding. Authorizes and directs the Secretary to: (1) develop a comprehensive five-year and 20-year sediment management strategy for the Toledo River (and authorizes the Secretary to conduct the engineering and construction activities necessary to implement the five-year strategy); and (2) establish the William B. Hoyt II Visitor Center at Mount Morris Dam, Mount Morris, New York. Authorizes appropriations. Directs the Secretary to proceed with the project for the Richmond, Virginia, Filtration Plant. Authorizes the Secretary to: (1) maintain navigation access to, and berthing areas at, all currently operating public and private commercial dock facilities associated with or having access to the Federal navigation project on the Columbia, Snake, and Clearwater Rivers from Bonneville Dam to and including Lewiston, Idaho, at a depth commensurate with the Federal navigation project; (2) complete the shore protection measures on Cliff Walk, Newport, Rhode Island; and (3) reconstruct the Allendale Dam in North Providence, Rhode Island. Amends the Water Resources Development Act of 1990 to make specified modifications with respect to the effective date of the local cooperation agreement with the City of Virginia Beach, Virginia and reimbursement for the Federal share of beach nourishment at the Virginia Beach periodic nourishment project. Authorizes and directs the Secretary to correct the design deficiency associated with the project for flood control at Ellenville, New York. Authorizes the Secretary to: (1) undertake an environmental restoration project along the banks of the White River in Indianapolis, Indiana; and (2) design and construct projects for combined sewer overflow (CSO) prevention for specified areas across the country. Sets forth provisions regarding project design and costs for the latter. Authorizes appropriations. Authorizes the Secretary to maintain the authorized Federal navigation channel at Port Orford, Oregon. Title III: General Provisions - Amends the Water Resources Development Act of: (1) 1986 to authorize appropriations for dam safety; and (2) 1974 to provide that up to half the non-Federal contribution for the cost-sharing program may be made by the provision of in-kind services, and to define "State" to include Indian tribes. Authorizes the Secretary to: (1) develop and implement a program to share the cost of managing recreation facilities and natural resources at water resource development projects under the Secretary's jurisdiction; (2) enter into cooperative agreements with non-Federal public and private entities to provide for operation and management of recreation facilities and natural resources at civil works projects under the Secretary's jurisdiction where such facilities and resources are being maintained at complete Federal expense; and (3) accept contributions of funds, materials, and services from such entities for purposes of this provision. Amends the Flood Control Act of 1968 to authorize the Secretary to charge fees (to be deposited into the special Treasury account for the Corps of Engineers) for the use of developed recreation sites and facilities, but not for the use or provision of drinking water, way side exhibits, general purpose roads, overlook sites, toilet facilities, or general visitor information. Amends the Land and Water Conservation Fund Act of 1965 to repeal a provision barring a Federal agency, at each lake or reservoir under the jurisdiction of the Corps of Engineers where camping is permitted, from charging a user fee for providing at least one primitive campground containing designated campsites, sanitary facilities, and vehicular access. Authorizes the Secretary to carry out projects for the protection, restoration, and creation of aquatic and ecologically-related habitats, including wetlands, in connection with dredging for construction, operation, or maintenance of an authorized navigation project. Specifies that such projects shall be undertaken, subject to appropriations and Federal cost-sharing limitations, in any case where the Secretary finds that: (1) the environmental, economic, and social benefits of the project justify the cost; and (2) such project will not result in any further environmental degradation. Specifies that any such project shall be initiated only after non-Federal interests have entered into a cooperative agreement, according to specified provisions of the Flood Control Act of 1970, under which such interests agree to: (1) provide 25 percent of the cost associated with the project, including provision of all lands, easements, rights-of-way, and necessary relocations; and (2) pay 100 percent of the cost of operation, maintenance, replacement, and rehabilitation costs associated with the project. Authorizes appropriations. Sets limits on the Federal share of the cost of each project. Amends the Water Resources Development Act of 1976 to revise provisions with respect to cost-sharing for disposal of dredged sand on beaches. Requires the Secretary to give consideration to the schedule of the State or political subdivision in providing its share of funds for the placing of such sand on the beaches of such State or subdivision and, to the maximum extent practicable, to accommodate such schedule. Makes the political subdivision responsible for providing payments required under such Act in lieu of the State. Specifies that amounts recovered under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 for any response action taken by the Secretary in support of the Army Civil Works Program shall be credited to the principal appropriation from which the costs of such action has been paid or will be charged. Authorizes the Secretary, in accomplishing the maintenance, rehabilitation, and modernization of hydroelectric power generating facilities at water resources projects under the jurisdiction of the Department of the Army, to increase the efficiency of energy production or the capacity of these facilities if, after consulting with other appropriate Federal agencies, the Secretary determines that such uprating: (1) is economically justified and financially feasible; (2) will not result in significant adverse environmental impacts or effects on the purposes for which the project is authorized; and (3) will not involve major structural or operational changes in the project. Authorizes the Secretary, at a water resources project where the non-Federal interest is responsible for performing the operation, maintenance, replacement, and rehabilitation of the project and the Government is responsible for paying a portion of such costs, to: (1) provide a payment of the estimated total Federal share of such costs (based on a specified formula) to the non-Federal interest after completion of project construction; and (2) make a payment only if the non-Federal interest has entered into a binding agreement with the Secretary to perform the operation, maintenance, replacement, and rehabilitation of the project, subject to specified requirements. Authorizes the Secretary to accept contributions of cash, funds, materials, and services from nonprofit private and non-Federal public entities for environmental protection and restoration. Extends the jurisdiction of the Mississippi River Commission to include Terrebonne Parish, Louisiana. Authorizes the Secretary to remove a sunken barge from waters off the shore of the Narragansett Town Beach in Narragansett, Rhode Island, subject to specified requirements. Authorizes the Director of the U.S. Fish and Wildlife Service to provide financial assistance to: (1) pay the costs of construction and equipment for an Upper Mississippi River Environmental Education Center to be located in Winona, Minnesota; and (2) share the costs of planning, engineering design, construction, and equipment for the North American Wildlife and Prairie Wetlands Interpretive Center to be constructed near Medina, North Dakota. Sets forth additional requirements. Authorizes appropriations. Authorizes the use of flood emergency funds to repair and restore protective beaches damaged or destroyed by wind, wave, or water action other than of an ordinary nature when such repair and restoration is necessary to provide a level of protection equivalent to that provided prior to such damage or destruction and when requested by the Governor. Amends the Water Resources Development Act of 1986 to require that credits for project lands, easements, relocations, and rights-of-way include full value of foregone royalties on subsurface minerals, such as sand, where State royalty schedules have been established on the commercial mining of such resources. Limits design and construction costs assigned to projects under such Act for purposes of cost-sharing by non-Federal interests to the direct costs of such projects (and excludes any departmental overhead or general and administrative overhead costs). Makes this provision applicable to projects authorized in this or subsequent Acts and to cost-sharing agreements for projects not specifically authorized by the Congress entered into after the date of enactment of this Act. Directs the Secretary and the Assistant Administrator for Research and Development at the Environmental Protection Agency (EPA) to coordinate an annual review of the environmental research activities conducted at their respective research facilities. Extends the time of transfer of lands and management responsibilities with respect to specified portions of the Cross Florida Barge Canal project. Authorizes and directs the Secretary to investigate and carry out saltmarsh restoration projects along the coastline of the State of Connecticut, subject to specified cost-sharing requirements. Directs the Secretary, for purposes of formulating, evaluating, and displaying the benefits and costs of any water resources project that involves beach renourishment, or that involves inlet dredging or other navigation improvements that are likely to affect erosion patterns on beaches adjacent to such project, to address: (1) economic costs to the State of not placing beach-quality sand on eroded or eroding beaches; and (2) cost savings, if any, that may be achieved by restoring or renourishing eroded or eroding beaches during a dredging or other navigation project as compared to performing such restoration or renourishment at a later date as a separate project. Specifies that the Secretary shall consider the protection of coastal resources through placement of beach quality sand on beaches as being in the public interest whenever such sand would otherwise be disposed of offshore. Requires the Secretary to establish by regulation a process for development of long-range plans for financing and execution of projects for beach nourishment and inlet management within each affected State. Sets forth minimum requirements with respect to such process and the amendment or termination of such plans. Authorizes appropriations. Title IV: Infrastructure Technology, Research and Development - Authorizes the Secretary to: (1) engage in research, development, and technology transfer activities with respect to water and related land resources and water transportation, and test, develop, or assist non-Federal entities in development of new technology; (2) engage in activities to inform the U.S. Maritime Industry and Port Authorities of technological innovations abroad that could significantly improve waterborne transportation in the United States, both inland and deep draft; and (3) coordinate water resources-related research efforts with those national centers and institutes focused on the development of new technology and solutions to the problems associated with the nation's infrastructure. Directs the Secretary to: (1) establish a cooperative agreement with the National Center for Infrastructure Studies, Columbia University, New York City, and its consortium of universities, to accelerate the development of new technology in infrastructure; and (2) contract with the National Center for implementation of such a cooperative agreement. Specifies that: (1) such cooperation between the National Center, the Army Corps of Engineers, and its research facilities shall focus on the development of solutions to national water and waterway related infrastructure problems, including the disposal of dredged material; and (2) cooperative activities shall include an assessment of high-speed commercial water transportation, vessels, and infrastructure needs, and that in addition to general cargo carriers, high-speed water passenger transport at and in the vicinity of congested coastal urban areas shall be included. Authorizes appropriations. Authorizes the Secretary to conduct such studies as necessary to provide a report to the Congress on the state of the National Ports and Harbors system of the United States. Authorizes appropriations. Directs the Administrator of the EPA and the Secretary: (1) based upon a review of specified decontamination technologies, to jointly select removal, pre- and post-treatment and decontamination technologies for contaminated marine sediments for a decontamination project in the New York/New Jersey Harbor; and (2) upon selection, to jointly implement a four-year program of selected technologies to assess their effectiveness in rendering sediments acceptable for unrestricted ocean disposal, beneficial reuse, or both. Provides for continuous review and evaluation of selected technologies, the joint development of an outyear management program, and reevaluation and updating of the program each year in light of the findings of the Administrator and Secretary and the comments of an advisory panel (established pursuant to this Act). Requires the Administrator and the Secretary to jointly recommend three additional sites and select appropriate technologies for marine sediment decontamination projects to be implemented on the Gulf of Mexico, the Great Lakes, and the West Coasts during FY 1995 through 1997. Provides for the establishment of an advisory panel (comprised of academic and agency scientists) for each decontamination project to advise the Administrator and the Secretary on technology review, technology selection, and decontamination program implementation. Sets forth reporting requirements. Authorizes appropriations. Title V: Environmental Infrastructure Facilities for Economically Distressed Areas - Environmental Infrastructure Assistance Act - Directs the Secretary to establish an Office of Community Environmental Infrastructure Assistance (the Office) within the Directorate of Civil Works of the Office of the Chief of Engineers, Department of the Army, to: (1) manage projects pursuant to this title; and (2) provide information and guidance to communities in economically distressed areas with respect to financial analysis and planning, assessment of feasibility of eligible projects under this title, and such economic and organizational issues as regionalization of environmental infrastructure facilities, reform of existing rate structures, and operation of special management districts (and, in cooperation with the Administrator, provide information and guidance to communities on issues related to construction, operation, maintenance, and rehabilitation of environmental infrastructure facilities). Directs the Secretary to: (1) establish an environmental infrastructure assistance program administered through the Office; (2) use funds under this title for the construction of wastewater treatment works, public water systems, and solid waste management facilities; and (3) use funds under this title for an eligible project only if the project is publicly owned. Specifies that funds provided for the implementation of this title shall be available only for environmental infrastructure projects located in an economically distressed area serving a population of less than 25,000. Authorizes the Governor of any State to submit to the Secretary a State priority project plan, which shall include a list of: (1) economically distressed areas in the State, other than a Federal Indian reservation, including such information qualifying such areas as the Secretary deems necessary and appropriate; (2) specific projects eligible for financial assistance and information concerning the nature, benefits, costs, and expected long-term operations of the projects; and (3) eligible projects ranked in priority order for the fiscal year with respect to which assistance is sought. Requires: (1) the Administrator to submit to the Secretary a priority project plan for eligible projects on Federal Indian reservations; and (2) the Secretary to establish by regulation such additional requirements for a State priority project plan as appropriate. Directs the Secretary to develop and submit to the Congress a national economically distressed area environmental infrastructure assistance plan, which shall include: (1) for any plan that is not an initial plan, a description of the efforts of the Secretary to implement the provisions of this title in the preceding year; (2) a list of all State environmental infrastructure priority projects; (3) such list, ranked in an order which, in the judgment of the Secretary, gives highest priority to projects with the greatest public health and environmental benefits, serving communities facing the greatest financial hardships associated with the project, and ranked highest by the Governor; and (4) a status report of any projects in progress or under construction. Bars the Secretary from listing such a project if, in the judgment of the Secretary, the project does not meet the eligibility requirements of this title. Requires the Secretary, subject to the availability of funds, to enter into local cooperation agreements with appropriate local governments for the planning, design, and construction of such environmental infrastructure projects. Sets forth requirements with respect to such agreements, project priorities, project management, and consistency with planning requirements. Directs the Administrator to publish guidelines for the design of wastewater treatment works, public water systems, and solid waste disposal facilities which: (1) describe the basic design standards to be applied in the planning of environmental infrastructure facilities; (2) identify appropriate engineering specifications for construction of environmental infrastructure facilities based on an expected operational life of 20 years; (3) establish such minimum standards of planning, engineering, design, and construction as are considered appropriate by the Administrator; and (4) assure that any facility constructed will comply with all applicable Federal and State environmental laws. Requires the Administrator to periodically review and revise the guidelines. Authorizes appropriations. Title VI: Contaminated Sediment and Ocean Dumping - National Contaminated Sediment Assessment and Management Act - Establishes a National Contaminated Sediment Task Force. Directs the Administrator to conduct: (1) a comprehensive national survey of data regarding aquatic sediment quality in the United States, including compilation of all existing information on the quantity, chemical and physical composition, and geographic location of pollutants in aquatic sediment; and (2) a comprehensive and continuing program to assess aquatic sediment quality. Sets forth reporting requirements. Amends the Marine Protection, Research, and Sanctuaries Act (MPRSA) to: (1) include a declaration by the Congress that it is the goal of the United States to eliminate the dumping of dredged materials containing contaminants in excess of marine water or sediment standards under the Federal Water Pollution Control Act (FWPCA) into ocean waters; and (2) specify that no permit or dumping authorization shall be issued for a dumping of material that, in the case of a dump site located in the territorial sea, will violate water quality standards or contains contaminants in quantities in excess of sediment quality standards adopted pursuant to the FWPCA, or, in the case of any other dump site, will violate water quality criteria or contains contaminants in quantities in excess of sediment quality criteria published pursuant to the FWPCA. (Current law states that no permit shall be issued for a dumping of material which will violate applicable water quality standards.) Specifies that: (1) in any case in which the Administrator disagrees with the Secretary's determination as to compliance with the criteria or restrictions (currently, criteria) established pursuant to the MPRSA relating to the effects of the dumping or specified restrictions relating to critical areas and site management plans (currently, critical areas), the determination of the Administrator shall prevail; and (2) if the Secretary finds that, in the disposition of dredged material, there is no economically feasible method or site available other than a dumping site the utilization of which would result in noncompliance with such criteria or restrictions (currently, criteria), he shall so certify and request a special permit from the Administrator (currently, a waiver of the specific requirements involved). Requires the Administrator: (1) within 90 (currently, 30) days of the receipt of the special permit (currently, waiver) request, to grant such permit (currently, waiver), subject to specified conditions; and (2) in reviewing a request for such a permit, to provide for public notice and comment. Authorizes States to adopt only such criteria, standards, rules, or regulations (to be transmitted to the Administrator and Secretary, who shall assure compliance) relating to the dumping of materials into ocean waters within the jurisdiction of the State which are more stringent and protective of such waters and sediment than those adopted under the MPRSA. (Under current law, no State shall adopt or enforce any rule or regulation relating to such activity, but may propose to the Administrator criteria related to ocean dumping, which the Administrator may adopt if not inconsistent with such Act, subject to specified requirements.) Directs the Administrator: (1) to designate sites or time periods for dumping that will mitigate the adverse impact on the environment to the greatest extent practicable (current law authorizes the Secretary to designate recommended sites or times); and (2) in any case where the Administrator determines that, with respect to certain materials, it is necessary to prohibit dumping at a site or during a time period, to prohibit the dumping during such time period (under current law, when necessary to protect critical areas, sites or times within which certain materials may not be dumped). Specifies that this prohibition shall apply to any dumping at the site or during such time period. Requires the Administrator to develop and implement a site management plan for each site designated, including: (1) baseline assessment of environmental conditions at the site and in adjacent areas that may be affected by the dumping activity as if dumping had never occurred; (2) special management conditions or practices to be implemented at each site that are necessary for the protection of the environment; (3) a program of monitoring for each site; (4) the anticipated use and management of the site over the 20-year period following the date of preparation of the plan; (5) a schedule of review and revision of the plan; and (6) such other requirements and conditions as the Administrator considers necessary. Specifies that: (1) after January 1, 1993, no site shall receive a final designation unless a management plan has been developed pursuant to the MPRSA; and (2) beginning on January 1, 1995, no permit or authorization for dumping shall be issued for a site designated pursuant to such Act unless a site management plan has been adopted for such site. Directs the Administrator to: (1) develop a site management plan for any site designated prior to January 1, 1993, as expeditiously as practicable, giving consideration to development plans for designated sites that are considered to have the greatest impact on the environment; and (2) provide for public review and comment on site designation actions, and hold a public hearing on any proposed designation or management plan development, revision, or redesignation in the region in which the site that is the subject of the management plan is located. Requires that permits issued with respect to the dumping permit program for dredged material: (1) designate and include such requirements, limitations, or conditions as necessary to assure consistency with any site management plan approved pursuant to the MPRSA (currently, the length of time for which the permits are valid and their expiration date), and special provisions that the Administrator or the Secretary determines to be reasonable and necessary to control and prevent pollution of waters and sediment in the area of the dredging project from on-shore and related facilities subject to the control of the entity seeking a permit; and (2) be issued for a period of up to three years. Specifies that any person who: (1) knowingly violates any provision of, or regulation promulgated or permit issued under, this title shall be fined under the Federal criminal code, imprisoned for not more than five years, or both (currently, fined up to $50,000, imprisoned for up to one year, or both); and (2) is convicted of such a violation shall forfeit to the United States any property constituting or derived from any proceeds that the person obtained as a result of such violation, and any of the property of the person which was used, or intended to be used, to commit or facilitate the commission of the violation. Provides that any vessel used to commit an act for which such a penalty is imposed under the MPRSA shall be subject to seizure and forfeiture to the United States under procedures established for seizure and forfeiture of conveyances under the Controlled Substances Act, with exceptions. Authorizes appropriations. Title VII: Studies - Authorizes and directs the Secretary to review the report of the Chief of Engineers on the Ohio River and Tributaries and other pertinent reports to determine whether modifications of the recommendations contained therein are advisable at the present time, with particular reference to improvements for water and related land resource needs. Authorizes appropriations. Directs the Secretary to conduct a study of the economic benefits of Federal and significant non-Federal shore protection activities in the Mid-Atlantic region from New York to Virginia, assessing: (1) the public investment in such activities; (2) damage incurred by such shore protection activities by the coastal storms of October 1991 and January 1992; (3) the prevention of damage by such storms to coastal and upland resources as a result of such shore protection activities; and (4) the extent to which the prevention of damage to coastal and upland resources is considered in benefit-cost ratios for shore protection activities. Sets forth reporting requirements. Authorizes the Secretary to enter into a memorandum of understanding with the Secretary of Agriculture to study problems associated with flooding in Harrison County, Mississippi. Specifies that such Secretaries shall jointly conduct a reconnaissance study of such county and specified bodies of water and associated watersheds. Sets forth reporting requirements. Authorizes the Secretary to study the need for navigation improvements in Reynolds Channel and the connecting State Boat Channel between Captree Island and Oak Beach. Sets forth reporting requirements. Authorizes the Secretary to review the reports of the Chief of Engineers and other pertinent documents pertaining to Orchard Beach, Bronx, New York, and to make recommendations concerning storm damage prevention, recreation, environmental restoration, and other purposes. Authorizes appropriations. Authorizes the Secretary to study the need for erosion protection along the East River, New York, in the vicinity of Brooklyn, Queens, and Manhattan, with a view toward mitigating the deleterious effects of drift removal on protecting the adjacent shoreline from erosion. Authorizes appropriations. Authorizes the Secretary to conduct a reconnaissance and feasibility study of remediation of contaminated sediments in Lake Champlain and the Narrows of Lake Champlain. Specifies that: (1) such activities shall be coordinated with the State of Vermont and the Water Resources Research Center at the University of Vermont; and (2) funds previously expended by such State and the Water Resources Research Institute in investigating sediment contamination shall be considered toward any joint funding requirements. Authorizes the Secretary to conduct a reconnaissance and feasibility study of providing additional: (1) boat access points on Lake Champlain; and (2) flood protection for Montpelier, Vermont. Directs the Board of Engineers to conduct an evaluation of long-term coastal dredged material disposal needs along the Maine and New Hampshire coasts. Specifies that, beginning in 1995, any dredged material resulting from a project proposed as a result of this study shall be disposed of at a site permanently designated by the EPA pursuant to the MPRSA. Authorizes funds to conduct this study. Authorizes and directs the Secretary, in studying the feasibility of Federal improvements to the St. John's River Channel, to: (1) examine the commercial and military uses of the Channel in those areas traversed by both military and commercial vessels; and (2) coordinate their efforts with the Department of the Navy to utilize available studies and resources which project future military dredging needs in the Channel. Requests the Chief of Engineers to review his report on central and southern Florida and other pertinent reports, with a view to determining whether modifications to the existing project are advisable at the present time due to significantly changed physical, biological, demographic, or economic conditions.
Bill· SS. 2730 (102nd)referred
United States · United States Congress · 14 May 1992
Military Personnel Transitional Health Benefits Improvements Act of 1992 - Authorizes a person who is involuntarily separated (except for gross misconduct) from active duty between October 1, 1990, and October 1, 1995, and whose eligibility for transitional health care benefits has expired to enroll for not to exceed 18 months of continued coverage under any Federal employee health benefit plan (FEHBP) available to separated civilian employees of the military department of that armed force. Prohibits a person from purchasing a conversion health policy on or after the implementation of this Act. Authorizes a person covered by such a policy to cancel and enroll in a FEHBP under this Act. Prohibits a person from being covered concurrently by a conversion health policy and FEHBP.
Bill· SS. 2732 (102nd)referred
United States · United States Congress · 14 May 1992
Health Insurance Market Reform Act of 1992 - Amends the Social Security Act (SSA) to add a new title XXI, Requirements Concerning Health Insurance. States under part A of new SSA title XXI that the purposes of such title are to increase the availability, portability, and affordability of health insurance, particularly to small employers and their employees and dependents, by seeking to ensure, among other things, that: (1) affordable health insurance is available to individuals and groups, and premiums do not vary substantially, regardless of health status or claims experience; (2) States regulating health insurance do not place an undue burden on small employers; and (3) insurers, providers, purchasers, and consumers are encouraged to contain costs of health care and health insurance. Applies the provisions of new SSA title XXI to health insurance plans offered in any State and to insurers offering such plans. Provides for the establishment of Federal and State regulatory programs implementing the requirements of parts B and C of new SSA title XXI. Requires the Secretary of Health and Human Services to: (1) request the National Association of Insurance Commissioners (NAIC) to recommend model standards for compliance with such requirements; and (2) using such model standards, with revisions as necessary, publish implementing regulations. Requires the Secretary to determine whether each State has established a regulatory program adequate to ensure compliance with such requirements. Allows State programs to establish standards more stringent than those required under new title XXI, if the Secretary finds them consistent with its purposes. Provides that an approved State program shall take effect, in lieu of the above mentioned implementing regulations, as of a specified date: (1) with respect to all insurers and health insurance plans subject to part B of new SSA title XXI; and (2) with respect to all insurers and health insurance plans subject to part C, except for employee welfare benefit plans which are not multiple employer welfare arrangements (MEWAs). Requires the Secretary to implement a program: (1) under part C in all States with respect to those insurers and health insurance plans not subject to State regulation; and (2) under both parts B and C with respect to all insurers and health insurance plans in each State without an approved program. Authorizes the Secretary to waive, with respect to one or all States, any provision of new SSA title XXI, or of Medicare or Medicaid (SSA titles XVIII and XIX, respectively), to the extent and for the period he or she finds likely to promote the purposes of facilitate the administration of new title XXI. Provides for Federal oversight over State programs. Makes the requirements of parts A, B, and C of new SSA title XXI generally effective with respect to health insurance plans offered, issued, or renewed in a State on or after January 1, 1994 (or certain later dates necessary to allow for enactment of State legislation). Provides that certain provisions concerning variations in premiums among and within blocks of business, and the rate of premium increases shall not apply, until two years after the general effective date, to a renewal of a health insurance plan that was in effect before the effective date. Provides that under part B of new SSA title XXI each insurer must register with the Secretary and the appropriate official for each State in which it issues or offers any health insurance plan to a small employer. Requires, subject to specified exceptions, any insurer offering a health insurance plan to any small employer in a State (or to any small employer in a local service area within the State, in the case of an insurer offering health insurance only within such an area) to: (1) make such plan available to every small employer in the State or local service area; (2) make available to every small employer any basic insurance plan a State may require; and (3) not cancel or refuse to renew any small employer health insurance plan. Requires an insurer providing small employer health insurance to notify the employer, at least 60 days before expiration, of the terms for renewal, and the extent to which any premium increase is based on actual or expected claims experience of covered individuals. Requires, subject to specified exceptions, that each health insurance plan offered to a small employer accept for enrollment, on the same terms as any other enrollee, every eligible employee and (in the case of a family plan) the employee's spouse and any dependent child under age 19 or, if older, under age 25 and a full-time student. Prohibits a small employer that made health insurance available to employees from using criteria related to health status or claims experience to determine eligibility for, benefits under, or terms of such health insurance for individual employees. Permits a State to define a basic benefit plan and to require that it be offered to small employers in the State by insurers (other than health insurance networks (HINs) or MEWAs) offering heatlh insurance plans to small employers in the State. Subjects the plan to review and approval by the Secretary to ensure that it is affordable by small employers. Requires that the regulatory program established with respect to a State require all insurers offering health insurance plans to small employers, during a specified period, to: (1) participate in an interim risk pooling mechanism; and (2) comply with requirements designed to limit variations among and increases in premium rates for such health insurance plans. Permits the interim risk pooling mechanism to be either a reinsurance program or an assigned risk program. Provides for funding such a mechanism. States that no Federal entity shall be at risk, as a guarantor of the solvency of a reinsurance fund or otherwise, for all or any part of the cost of health insurance plans subject to interim risk pooling. Provides that, for any rating period, no base premium rate for any small employer block of business may exceed the equivalent base premium rate for any other block of the insurer by more than 20 percent. Provides that the highest premium rate for a specific health insurance plan that an insurer can charge any small employer in a block of business for a rating period shall not exceed the corresponding base premium rate by more than: (1) 50 percent for a period ending before January 1, 1997; and (2) 35 percent for a period thereafter. Limits annual percentage increases in the premium rate charged to a small employer. Sets forth requirements concerning rate-setting methodology, including requirements for full disclosure of rating practices and actuarial certification. Establishes requirements for the permanent health risk pool system in a State. Provides continued health insurance coverage for certain college students. Provides under part C of new SSA title XXI that, except to the extent permitted under an assigned risk program, an insurer may not refuse to offer, refuse to renew, cancel, or condition the coverage under any employment-based health insurance plan on the basis of the health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability, of one or more individuals. Sets limits on exclusions under employment-based health insurance plans for pre-existing conditions. Preempts certain State laws relating to health insurance. Sets forth requirements an entity must meet in order to be entitled to certification as a health insurance network (HIN). Permits the Secretary to fund health risk pooling demonstrations in as many as four States. Authorizes the Secretary to develop model health risk pooling systems. Requires the Secretary to develop methods for measuring the health risk differential of individuals. Authorizes appropriations. Amends the Internal Revenue Code to impose an excise tax of $1000 per covered employee on insurers for noncompliance with the requirements of part B or C of SSA new title XXI.
Bill· SS. 2727 (102nd)referred
United States · United States Congress · 14 May 1992
Small Business Revitalization and Job Growth Act of 1992 - Title I: Amendments to Securities Acts - Amends the Securities Act of 1933 to increase from $5,000,000 to $10,000,000 the aggregate amount of an issue of securities that may be exempted by the Securities and Exchange Commission (SEC) from the regulatory requirements of such Act. Amends the Investment Company Act of 1940 (the ICA) to exempt from the definition of an investment company any securities issuer whose outstanding securities are owned exclusively by persons who, at the time of acquisition, are qualified purchasers, except that such issuer shall be deemed an investment company for purposes of limitations governing the purchase by such issuer of any security issued by a registered investment company and the sale of any security issued by a registered open-end investment company to such issuer. Defines as a "qualified purchaser" under the ICA any person whom the SEC has determined does not need the protections of the ICA, taking into consideration financial sophistication, net worth, and certain other financial knowledge and experience. Revises the definition of the beneficial ownership of securities for purposes of the ICA. Provides an additional exemption from the definition of an investment company under the ICA in the case of any company that is not engaged in the business of issuing redeemable securities and the operations of which are subject to regulation by the State in which it is organized under statutes governing entities that provide financial or managerial assistance to enterprises doing or proposing to do business primarily in such State if: (1) the purpose of such company is limited to the provision of such assistance; (2) at least 80 percent of the securities being offered for sale by such company represent persons who reside or have a substantial business presence in such State; (3) the securities are sold to accredited investors or other persons that the SEC may permit to purchase such securities; and (4) the company does not purchase any security issued by an investment company, or by a company that would be an investment company except for the exclusions from the definition of an investment company, other than investment-grade securities or securities required by its investment policies to invest in investment-grade or comparable securities. Requires any company proposing to meet such exemption to file with the SEC a notification of intent to do so, subject to SEC approval. Amends the ICA to: (1) increase from $100,000 to $10,000,000 the aggregate sums received by a closed-end investment company for the sale of its securities plus the value of remaining securities allowed to be held while still being exempted from provisions regulating investment companies; (2) include within the definition of "eligible portfolio company" any issuer that has total assets of not more than $4,000,000, and capital and surplus in excess of $2,000,000, allowing the SEC to adjust such figures to reflect changes in generally accepted indices for small businesses; (3) provide that a business development company, in order to be so considered, need not make available significant managerial assistance with respect to eligible portfolio companies or to any other company that meets such criteria as the SEC may permit; (4) allow acquisition by business development companies of the securities of eligible portfolio companies; (5) allow business development companies to issue without condition more than one class of senior securities representing indebtedness; (6) allow such companies to issue warrants, options, or other rights to convert securities to voting securities either alone or accompanied by securities; and (7) prohibit such warrants, options, or other rights of business development companies from being separately transferable unless no class of such rights and the securities (currently, senior securities) representing them has been publicly distributed. Title II: Credit Relief - Amends the Small Business Act to provide that the amount of deferred participation loans authorized under such Act shall: (1) mean the net amount of the loan principal guaranteed by the Small Business Administration (SBA) and does not include any amount not guaranteed; and (2) be available for a national program, except that the SBA may use up to ten percent of the amount authorized each year for special or pilot programs directed to identified sectors of the small business community or to specific U.S. geographic regions. Increases the amount the SBA is authorized to make in deferred participation loans and other financings to small businesses, and, from such authorized sums, the amount authorized to make general business loans for specified purposes under the Small Business Act and the Small Business Investment Act of 1958. Directs the Secretary of the Treasury, the Director of the Congressional Budget Office, and the Chairman of the SEC, in consultation with the SBA Administrator, to conduct a study of the potential benefits of, and legal, regulatory, and market-based barriers to, developing a secondary market for commercial real estate mortgage loans and loans to small businesses. Outlines study consideration requirements. Requires a report. Directs the chief executive officer of the Resolution Trust Corporation (RTC) to conduct a study and report to the Congress on the impact of its commercial real estate loan securitization program and the impact of the RTC's programs on the commercial real estate mortgage loan and small business loan secondary market. Directs the SBA Administrator to simplify the application process for a small business concern to receive a loan guarantee under the Small Business Act, including loan applications in connection with an additional loan guarantee application that is filed not later than two years after the initial application is filed. Title III: Capital Formation - Enterprise Capital Formation Act of 1992 - Amends the Internal Revenue Code to allow a deduction for gain on investments in new small business stock (seed capital) held for at least five years. Establishes special rules for such investments. Provides for determining the maximum capital gains rate for small business net capital gain or seed capital gain. Treats capital gains on the sale of such stock as a preference item for purposes of the minimum tax. Title IV: Health Care Provisions - Subtitle A: Small Business Purchasing Groups - Defines a "qualified small employer purchasing group," for purposes of this subtitle, as an entity that the Secretary of Health and Human Services determines: (1) is administered solely under authority and control of its member employers; (2) has as its membership solely small employers; (3) with respect to each State in which its members are located, consists of no fewer than 100 employers; (4) has member employers whose health care insurance plans are in compliance with applicable State law and model benefits plans and are not self-insured plans; (5) will be a nonprofit entity; and (6) has a board of directors with full authority to act on the part of the group. Directs the board of directors of the small employer purchasing group to: (1) establish geographic areas within which participating carriers may offer health care insurance coverage to eligible employees and dependents; and (2) enter into contracts with qualified carriers for providing health insurance coverage to eligible employees and dependents, and to pay such carriers on at least a monthly basis at the contracted rates. Outlines provisions relating to: (1) general qualifications of carriers, including financial solvency; (2) program standards, including review of the quality and appropriateness of care covered; (3) uniformity of benefits; (4) the collection of insurance premiums from small employers; (5) notification from the board to employers of the availability of sponsored health insurance coverage from the program; and (6) conditions of participation in the program, including a requirement that an entity is a valid small employer and not formed solely to secure health insurance coverage. Finds that qualified small employer purchasing groups organized to obtain health insurance for its employer members affect interstate commerce, and that no State law shall preempt provisions of the model benefit health insurance plan as outlined above. Amends the Internal Revenue Code to define the amount of the employer health insurance credit for a taxable year for Federal income tax purposes. Prohibits the taking of both a credit and a deduction for health insurance premiums paid under the model plan. Subtitle B: Deductible Health Insurance Costs for Self-Employed Individuals - Amends the Internal Revenue Code to increase from 25 to 100 percent the allowable deduction of health insurance costs for self-employed individuals and their spouses and dependents. Makes such increased deduction permanent (currently ends December 31, 1992). Subtitle C: Improvements in Health Insurance for Small Employers - Adds a new Title XXI to the Social Security Act entitled "Standards for Small Employer Health Insurance and Certification of Managed Care Plans." Treats as meeting the requirements of title XXI an insurer offering a health insurance plan to a small employer in a State on or after January 1, 1994, if: (1) the Secretary of Health and Human Services determines that the State has established a regulatory program that provides for the application and enforcement of appropriate requirements under this title; and (2) the State has not established such a program or if the program has been decertified by the Secretary, the health plan has been certified by the Secretary as meeting the requirements of part B of title XXI. Provides an extension of the date by which a regulatory program must be adopted by a State for States requiring legislation to be passed and which has a legislature which does not meet in 1993 in a legislative session. States that requirements under title XXI shall not apply to pre-existing health insurance plans. Requires each State to report to the Secretary on the implementation and enforcement of standards with respect to health insurance plans offered to small employers. Allows State standards more stringent than the requirements of title XXI. Directs the Secretary to require the National Association of Insurance Commissioners (NAIC) to: (1) develop specific standards for small employer health insurance plans; and (2) report to the Secretary on implementation. Directs the Secretary to develop appropriate standards if the NAIC fails to do so. Requires such standards to provide alternative standards for guaranteeing the availability of health insurance plans for all small employers in a State. Directs the Secretary to periodically review State regulatory programs, allow a State to adopt a plan of correction if necessary, and to decertify a State program and assume program responsibility, if necessary. Directs the Comptroller General to periodically audit sample State regulatory programs. Defines a "small employer" for purposes of title XXI as an employer who employs more than one but less than 51 employees on a typical business day. Requires each health insurer to register with the applicable regulatory authority for each State in which it issues or offers a health insurance plan to small employers. Prohibits such insurer from excluding any eligible employee, or their spouse or dependent, under a plan, with the exception of waiting periods required generally under health insurance coverage. Requires insurers offering a health insurance plan to small employers in a State to meet the standards for such insurance adopted by such State. Outlines provisions concerning: (1) State standards on the guaranteed availability of small employer health insurance; (2) the State adoption of a regulatory program for such standards; (3) standards for guaranteed insurance availability for States not adopting such standards; (4) appropriate grounds for refusal by an insurer to renew, and for termination of, a health insurance plan (including nonpayment of premiums, fraud or misrepresentation, or failure to maintain minimum participation rates); (5) authority of an insurer to require minimum participation rates; (6) guaranteed renewability of such insurance unless reasons enumerated in (4), above, occur; (7) nonrenewability of health insurance by an insurer who elects to terminate all of the health insurance plans issued to small employers in a State; and (8) a prohibition against an insurer denying, limiting, or conditioning health insurance coverage based on health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability of an individual. Allows a plan offered to a small employer under this title to exclude coverage with respect to a preexisting condition, but limits the period of such exclusion to six months. Reduces such authorized preexisting condition exclusionary period by one month for each month in which an individual was already in a plan of continuous coverage with respect to particular services on the date of initial coverage of the new plan. Prohibits the base premium rate charged by an insurer for any block of business (all of the small employers within a health insurance plan issued by the insurer) from exceeding by more than 20 percent the base premium rate charged for any other block of business, with exceptions. Limits similarly the variation of rates charged during a rating period to small employers within the same block of business of an insurer when such employers have similar demographic characteristics. Provides that, in establishing premium rates for health insurance plans offered to small employers: (1) an insurer making adjustments with respect to age, sex, or geography must apply such adjustments consistently across all small employers; and (2) no insurer may use a geographic area smaller than a county or a certain zip code area. Places limitations on the transfer by an insurer of employers among blocks of business, requiring employer consent. Limits to five percent over the base premium rate the percentage increase in the premium rate authorized to be charged to a small employer for a new rating period. Requires an insurer, at the time of offering a health insurance plan to a small employer, to fully disclose specified information relating to the insurer's rating practices with respect to small employers under a plan, and the insurer's right to change premium rates. Requires at least 60 days' prior notice of the renewal terms of a plan about to expire. Requires each participating insurer to file with the applicable regulatory authority a written actuarial certification of insurer compliance with standards and requirements of this title. Outlines the basic medical benefits which must be included in a benefits package offered by an insurer to small employers in a State as part of the health insurance plan. Requires such insurer to offer a managed care plan to such small employers if the insurer offers a managed care plan in such State to employers that are not small employers. Provides for cost sharing (premiums, deductibles, copayments) and out-of-pocket limits for health insurance plans containing basic benefit packages. Preempts State-mandated benefit packages in favor of the benefits package described in the small employer health insurance plan. Amends the Internal Revenue Code relating to taxes on group health plans to impose upon any person issuing a health insurance plan to a small employer a tax on the failure to meet at any time the applicable requirements of title XXI of the Social Security Act (as added by this Act). Directs the Secretary of Health and Human Services to determine whether a person meets such requirements. States that such tax shall be 25 percent of the gross premiums on health insurance plans issued to a small employer during a taxable year. Treats corporations which are members of the same controlled group of corporations as one person for purposes of such tax, as well as partnerships and proprietorships under common control. Waives the application of such tax where the failure to meet such requirements: (1) could not have reasonably been discovered; and (2) is corrected within 30 days of discovery. Allows the Secretary to waive all or part of such tax in the case of a failure due to reasonable cause and not to willful neglect. Makes nondeductible for income tax purposes any tax so imposed. Direct the Comptroller General to study and report to the Congress on the standards for rating practices and the requirements for benefit packages established under the new title XXI of the Social Security Act, as well as on certain other aspects of insurance offered to small employers under this Act. Requires the Comptroller General to include as part of such report any recommendations for adjusting rating standards under title XXI to eliminate variation in premiums. Subtitle D: Improvements in Portability of Private Health Insurance - Amends the Internal Revenue Code to impose an excise tax on any person or group health plan that fails to satisfy the preexisting condition requirements of group health insurance plans as enumerated under title XXI of the Social Security Act. Makes such tax $100 for each day of noncompliance. Outlines actions to be taken in order for a failed requirement to be considered corrected. Waives the application of such excise tax where the failure to meet such requirements: (1) could not have reasonably been discovered; and (2) is corrected within 30 days of discovery. Allows the Secretary to waive all or part of such tax in the case of a failure due to reasonable cause and not to willful neglect. States that group health plans: (1) may not deny, limit, or condition coverage based on health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability of an individual; and (2) may exclude coverage with respect to the treatment of a preexisting condition, limiting the period of exclusion to six months. Reduces such authorized preexisting condition exclusionary period by one month for each month in which an individual was already in a plan of continuous coverage with respect to particular services on the date of initial coverage in the group health plan. Requires any person who had provided previous coverage during a period of continuous coverage with respect to a covered individual to disclose to the group health plan the coverage and benefits provided to such individual. Subtitle E: Health Care Cost Containment - Amends title XXI of the Social Security Act to add a new Part entitled "Federal Certification of Managed Care Plans." Directs the Secretary of Health and Human Services to establish a process for certification of managed care plans and utilization review programs meeting the requirements of this Part. Defines a "utilization review program" as a system of reviewing the medical necessity, appropriateness, or quality of health care services and supplies provided under a health insurance plan or a managed care plan using specified guidelines. Defines a "managed care plan" as a plan operated by a managed care entity that provides for the financing and delivery of health care services to persons enrolled in such plan through: (1) arrangements with selected providers; (2) explicit standards for the selection of participating providers; (3) organizational arrangements for ongoing quality assurance and utilization review programs; and (4) financial incentives for persons enrolled in the plan to use the participating providers and procedures provided for by the plan. Defines related terms. Directs the Secretary to: (1) establish procedures for the periodic review and recertification of qualified managed care plans and qualified utilization review programs; and (2) terminate such certification when such plan or program no longer meets the applicable requirements for certification. Permits certification through the recognition of a State licensure program or national accreditation body that establishes requirements at least equivalent to the requirements under this part. Directs the Secretary, in consultation with the Health Care Cost Commission, to establish Federal standards for the certification of qualified managed care plans and qualified utilization review programs. Requires such standards to first be established within two years after enactment of this Subtitle. Directs the Secretary to periodically review and update such standards, as appropriate. Prohibits the imposition by State law or regulation of specified limitations and restrictions on qualified managed care plans and qualified utilization review programs, with exceptions. Extends to January 1, 1992, the date by which the Administrator of Health Care Policy and Research must develop an initial set of guidelines and standards with respect to treatments and conditions that constitute a significant portion of national health expenditures. Directs the Administrator, in consultation with the National Institute of Mental Health and mental health providers, to develop outcomes research and practice parameters for mental health services, including diagnosis and treatment of childhood attention deficit syndrome disorders and manic depression. Amends the Social Security Act with respect to research on outcomes of health care services to change from 70 to 50 percent of authorized FY 1993 and 1994 funds for such research the amount to be obtained from the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund. Increases the general authorization of FY 1992 through 1994 funds under such Act for such purpose. Subtitle F: Medical Liability Reform - Chapter 1: Definitions and Findings - Finds that the health care and insurance industries are industries affecting interstate commerce, and that the medical malpractice litigation system throughout the United States affects interstate commerce by contributing to the high cost of health care and premiums for malpractice insurance purchased by health care providers. Chapter 2: Expedited Medical Malpractice Settlements - Allows any claimant to bring a civil action for damages for harm caused during the provision of medical care pursuant to applicable State law, except to the extent that such law is superseded by this Chapter. Allows any claimant to file with the claim for damages a settlement offer for a specific amount. Directs the defendant, within 60 days or the time permitted by State law to respond to pleadings, whichever is longer, to make a settlement offer of a specific amount, except that if such pleadings include a motion to dismiss under applicable State law, the defendant may tender such relief to the claimant within ten days after the determination of the court regarding such motion. Provides for time extensions in certain cases. Outlines procedures for the rejection of settlement offers by the claimant and defendant in such cases. Provides for the calculation of attorney's fees in such cases by an hourly rate. Chapter 3: Alternative Dispute Resolution Procedures - Directs the Secretary of Health and Human Services to establish an Alternative Dispute Resolution Board of Advisors to make recommendations to the Secretary concerning the establishment of a model voluntary alternative dispute resolution program (dispute program). Directs the Secretary to approve a model dispute program submitted by the Board, with any modifications that the Secretary deems appropriate. Directs the Secretary to develop and implement a program to encourage States to develop and implement voluntary alternative dispute resolution procedures that meet the requirements of this Subtitle. Requires each State to adopt its own dispute program or the Federal program submitted by the Board to the Secretary within two years after enactment of this Act. Provides that, with respect to a State that has a dispute program in effect, in lieu of or in addition to making a settlement offer a claimant or defendant may offer to proceed pursuant to the dispute program and its procedures. Creates a rebuttable presumption that a refusal by an offeree to proceed under a dispute program was unreasonable or not in good faith if the verdict is rendered in favor of the offeror. Chapter 4: Uniform Standards for Medical Malpractice Cases - Applies provisions of this chapter to any medical malpractice case brought in Federal or State court and any such case resolved through a dispute program. Provides that in either such action, no person may be required to pay more than $100,000 in a single payment for future losses, but such person shall be permitted to make such payments on a periodic basis. Limits in a civil medical malpractice action the total amount of damages that may be awarded for noneconomic losses resulting from an injury to $250,000, regardless of the number of health care professionals and providers against whom the claim is brought. Reduces the total amount of damages received under such limits by any other payment that has been made to the injured individual (i.e., other insurance). Places specified limits on attorney's fees authorized to be collected under Chapter 4 actions. Provides that in either such action, the liability of each defendant for noneconomic damages shall be several only and not joint (requiring each such defendant to be liable only for their specific percentage of responsibility for the damages). Provides a statute of limitations with respect to such cases. Provides special medical malpractice liability provisions with respect to services provided during the delivery of a baby. Chapter 5: Uniform Disciplinary Reforms - Requires a State to comply with requirements of this chapter within two years after enactment of this Act. Directs each State to: (1) allocate the total amount of fees paid to the State in each year for the licensing or certification of each type of health care practitioner, or State funds equal to such amount, to the agencies responsible for the conduct of licensing and disciplinary actions with respect to such practitioners; and (2) permit the general public to be represented on State health care practitioner disciplinary boards. Provides immunity from liability for any member, consultant, witness, or other individual serving or having served on such a disciplinary board for either the board's operation or duties performed in good faith. Requires each State to have in effect within two years after enactment of this Act a Statewide risk management program to reduce the incidence of medical malpractice which meets any promulgated regulations. Directs each State to establish a health care disciplinary trust fund to provide resources to disciplinary boards for their functions and to provide additional resources for State consumer protection activities. Chapter 6: Medical Products - Provides that punitive damages otherwise permitted by law shall not be awarded in an action against a health care producer of a drug or device that caused the harm complained of if the drug or device: (1) was subject to approval or premarket approval under applicable Federal regulations with respect to the safety of the formulation or performance of the drug or device, or the adequacy of the packaging or labeling of the drug or device; and (2) was approved by the Food and Drug Administration (FDA); or (3) is generally recognized as safe and effective pursuant to conditions established by the FDA. States that such provision shall not apply when the defendant: (1) withheld from, or misrepresented to, the FDA or other Federal agency official material and relevant information as to the performance of the drug or device; or (2) made an illegal payment to an FDA official to secure approval of the drug or device. Outlines provisions with respect to evidence, punitive damages, and positive defense to strict liability against the health care producers of the drug or device. Subtitle G: Uniform Claims Criteria - Directs the Secretary of Health and Human Services, after consultation with group health plan entities and health care providers, to develop uniform claims criteria for use by beneficiaries and health care providers in submitting claims under this Act and under title XXI of the Social Security Act. Provides a claims criteria deadline. Title V: Miscellaneous Provisions - Amends the Congressional Budget Act of 1974 to require the Director of the Congressional Budget Office to prepare an estimate, for that fiscal year and the succeeding four fiscal years, of the cost which would be incurred by small business in carrying out or complying with any bill or resolution which is likely to result in an average annual cost to a small business of $1,000 or more. Amends the Internal Revenue Code to provide that Federal provisions with respect to general notice requirements of proposed rule making shall apply to all rules and regulations prescribed by the Secretary under the Code. Directs the SBA Administrator to establish a panel to provide recommendations to the Congress for a uniform statutory definition of the terms "small business" and "small business concern." Directs the Administrator to report to the Congress on the panel's findings and recommendations. Expresses the sense of the Congress that each Federal agency that issues rules, regulations, or orders which affect small business concerns or otherwise has some relationship with or affects small business should appoint one individual to serve as a small business ombudsman for that agency. Requires such ombudsman to represent the issues of small business to such agency, assist in the arbitration of disputes between agencies and small business concerns, and make certain reports to the Congress and the SBA Administrator. Expresses the sense of the Congress that the Chief Counsel for Advocacy of the SBA should be permitted to appear as amicus curiae (friend of the court) in any action or case brought in a U.S. court for the purpose of reviewing a rule.
Bill· HRH.R. 5174 (102nd)referred
United States · United States Congress · 14 May 1992
BasiCare Health Access and Cost Control Act - Title I: Immediate Reforms - Subtitle A: Small Employer Health Insurance Market Reform - Regulates accident and health insurance issued to small employers (defined as having fewer than 51 employees) regarding: (1) price; (2) sales practices; (3) guaranteed issue; (4) core benefits (requiring the same benefits as title XVIII (Medicare) of the Social Security Act); (5) deductibles, out-of-pocket expenses, and copayments; and (6) preventive benefits for children under 23. Preempts inconsistent State and local laws. Regulates: (1) guaranteed eligibility; (2) limited exclusion of preexisting conditions; (3) guaranteed renewability; (4) waiting periods; and (5) rating requirements. Allows the Secretary of Health and Human Services to agree with a State to apply the standards set by that State's laws instead of these requirements, provided the core benefits and sales practices requirements are met. Amends the Internal Revenue Code (IRC) to prohibit tax deductions for the tax imposed by title II, subtitle E, of this Act on insurers offering plans that do not qualify as BasiCare plans. Subtitle B: Community Health Services Expansion - Amends the Public Health Service Act (PHSA) to establish a program of allotments to States for grants for community-based primary health services to low-income or medically underserved populations regarding infant mortality and referrals for the health management of infants and pregnant women. Links the amount of the allotment to population and need. Describes the services to be included. Earmarks for the allotments specified percentages of appropriations under certain provisions added by this Act. Mandates grants to federally qualified health centers (FQHCs) and other entities for providing access to services, as described in specified provisions of title XIX (Medicaid) of the Social Security Act, for medically underserved populations or in high impact areas not currently being served by a FQHC. Authorizes appropriations. Subtitle C: Expansion of Tax Incentives for Self-Employed Individuals - Amends the IRC to increase to 100 percent (currently 25 percent) the portion of health insurance costs self-employed individuals may deduct. Removes provisions ending the deduction on a specified date. Subtitle D: Expanding the Supply of Health Professionals in Rural Areas - Amends the PHSA to authorize appropriations to carry out provisions relating to the National Health Service Corps scholarship and loan repayment program. Earmarks certain portions to carry out provisions of this Act relating to FQHCs. Amends the IRC to allow a tax credit for service by a physician, physician assistant, or nurse practitioner who: (1) provides primary health services to individuals in a rural health professional shortage area; and (2) is not receiving a National Health Service Corps scholarship or loan repayment and not fulfilling service obligations under such programs. Excludes National Health Service Corps loan repayments from gross income. Allows, with regard to elections to expense depreciable business assets, a higher aggregate cost to be taken into account for rural health care property in a rural health professional shortage area. Allows a deduction for a limited amount of the interest paid on medical education loans by an individual performing services under an agreement with an applicable rural community to perform professional services in the community. Authorizes use of the deduction in computing adjusted gross income. Subtitle E: Malpractice Reform - Part I: Definitions - Sets forth definitions for purposes of this subtitle. Part II: Tort Reform of Health Care Liability Actions - Declares that this part applies to any health care liability action brought in any Federal or State court. Limits the dollar amount of: (1) recovery by an individual and the individual's family members in a health care liability action, regardless of the number of providers or the number of actions; and (2) single payments which may be required. Requires offset for damages paid by a collateral source. Prohibits punitive damages from exceeding the sum of economic and non-economic damages. Regulates the award of attorney's fees and joint and several liability. Sets forth time limits on initiation of actions. Preempts State laws in certain circumstances. Subtitle F: Joint Ventures - Amends provisions of the National Cooperative Research Act of 1984 allowing, notwithstanding antitrust laws, certain cooperative research agreements to add references to joint health care provider ventures, defined as a group of activities by two or more hospitals for the provision or delivery of health care services. Title II: Long-Term Reforms - Subtitle A: Establishment of Commission and Advisory Board - Establishes the Commission on National Health Care Access and Reform and the National Advisory Board. Authorizes appropriations. Subtitle B: Reform and Standardization of Private Insurance - Requires the Commission to submit to the Congress a legislative proposal with specified elements, including: (1) a uniform national health benefits package (BasiCare); (2) a national health care insurance reform plan applicable to all carriers of health insurance in the United States; (3) self-insured plan requirements; and (4) a program to assist low-income individuals in the transfer from coverage under title XIX (Medicaid) of the Social Security Act to BasiCare coverage and financial assistance in obtaining BasiCare coverage. Sets forth the continuing duties and responsibilities of the Commission, including: (1) submission of a new legislative proposal annually for the next two years if the Congress does not approve the Commission's recommendation; (2) annual review and revision, subject to congressional recision, of benefits and premiums; (3) oversight of provider participation and billing; (4) oversight of the supplemental health insurance market; (5) submission to the Congress of plans for the long-term disposition of Medicaid benefits not covered or subsumed by BasiCare and assimilation of Medicare (title XVIII of the Social Security Act), the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), and the Federal employees' health benefits program into the BasiCare system; and (6) submission to the Congress of a legislative proposal for affordable and easy access to prescription drugs. Includes in BasiCare coverage basic hospitalization, basic outpatient services, prescription drugs, protection against catastrophic out-of-pocket costs, coverage against extraordinary long-term care costs, and coverage for preventive care. Requires each carrier to offer BasiCare. Preempts inconsistent State and local laws. Prohibits duplication, in whole or part, of BasiCare benefits. Prohibits discrimination based on health status, including preexisting conditions. Requires guaranteed issue, a minimum plan period, guaranteed renewability, and community-wide ratings. Applies these standards to reinsurance policies. Regulates premiums. Prohibits employment-related BasiCare plans from imposing waiting periods. Requires: (1) such plans to apply equally to employees of all income levels; and (2) total contributions for an employer for low-income employees to equal or exceed the total for other employees. Regulates self-insured plans. Mandates development of recommended managed care plan standards regarding benefits, coverage, and delivery systems. Establishes the Managed Care Advisory Committee. Preempts certain State laws regarding managed care plans. Subtitle C: Low-Income Assistance - Requires the Commission to provide for the termination of Medicaid program coverage which duplicates BasiCare. Terminates, after five years, any remaining Medicaid benefits. Mandates financial assistance, through a voucher system, to low-income individuals for BasiCare premiums, deductibles, and other cost-sharing. Subtitle D: Congressional Consideration of Commission Recommendation - Declares that these provisions are enacted as an exercise of the rulemaking power of the House of Representatives and the Senate with recognition of the right of either House to change the rules as any other rule of that House. Provides for the introduction and consideration of a joint resolution approving of the Commission's legislative proposal under subtitle B of this title. Subtitle E: Enforcement Provisions - Amends the Internal Revenue Code to remove provisions relating to a tax on any employer or employee organization that contributes to a group health plan or large group health plan that does not comply with certain Medicare provisions. Imposes a tax on: (1) insurers offering plans that do not qualify as BasiCare plans; (2) the failure of any service provider under a BasiCare plan to comply with specified provisions of this Act; and (3) the failure of any person to comply with provisions of this Act relating to employer responsibilities and self-insured plan requirements under this Act. Disallows personal exemptions unless the individual's BasiCare policy number is included in the individual's tax return. Subtitle F: Financial Provisions - Creates the BasiCare Trust Fund and transfers to the Fund: (1) a specified percentage of wages and self-employment income; (2) all of the taxes imposed by this Act; (3) additional revenues received as the result of amendments made by this Act; (4) the State's Medicaid share; and (5) all unobligated amounts in the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund. Appropriates to the Fund: (1) the Federal Medicaid share; and (2) amounts equal to appropriations for CHAMPUS and the Federal employees' health benefits program. Authorizes appropriations for additional sums as required to make expenditures under specified provisions of this act. Amends title II (Old-Age, Survivors, and Disability Insurance) of the Social Security Act to exclude amounts under certain provisions of this Act from appropriation to the Federal Old-Age and Survivors Insurance Trust Fund. Amends the Internal Revenue Code to: (1) exclude from gross income employer-provided coverage under a BasiCare plan (currently, under an accident or health plan); (2) prohibit deductions for employer expenses for a group health plan unless the plan qualifies as a BasiCare plan; and (3) include amounts paid for a BasiCare plan (currently, for insurance) in the definition of "medical care" for provisions relating to medical and dental expenses. Subtitle G: Definitions - Defines various terms as used in this Act.
Bill· HRH.R. 5179 (102nd)referred
United States · United States Congress · 14 May 1992
Nutrition Screening Research Act - Directs the Secretary of Health and Human Services to conduct a three-year nutrition screening and intervention activities study on the efficacy and cost-effectiveness of currently conducted nutrition screening and intervention activities and of a program that would institutionalize such screening and intervention activities. Directs the Secretary, in evaluating such a program, to determine: (1) if health or quality of life is measurably improved for older individuals who receive routine nutritional screening and treatment: (2) if federally subsidized home or institutional care is reduced because of increased independence of older individuals resulting from improved nutritional status; (3) if a multidisciplinary approach to nutritional care is effective in addressing the nutritional needs of older individuals; and (4) if reimbursement for nutrition screening and intervention activities is a cost-effective approach to improving the health status of older individuals. Specifies the populations of older individuals in which the study will be conducted. Directs the Secretary to conduct and report to the Congress on a three-year study to determine the extent of malnutrition in older individuals in hospitals and long-term care facilities and in older individuals who are living independently, including a determination regarding whether a program to institutionalize nutrition screening and intervention activities should be adopted and rationale for the determination. Directs the Secretary to establish an advisory panel to oversee the design, implementation, and evaluation of both studies. Authorizes appropriations.
Law· HJRESH.J.Res. 484 (102nd)enacted
United States · United States Congress · 14 May 1992
Designates the week beginning February 14, 1993, as National Visiting Nurse Associations Week.
Bill· SS. 2710 (102nd)referred
United States · United States Congress · 13 May 1992
Military Health Care Reform Act of 1992 - Expresses the sense of the Congress that: (1) members and former members of the uniformed services and their dependents should have access to health care under the uniformed services regardless of age or health care status; (2) such system should include a comprehensive managed care plan; (3) such plan should involve medical personnel of the uniformed services, civilian health care professionals of the executive agency of such services, medical treatment facilities of such services, contract health care personnel, and the Medicare system; (4) the Secretaries of Defense, Health and Human Services, and Transportation (appropriate Secretaries) should provide active duty personnel with free care in medical treatment facilities of the uniformed services and provide other personnel referred to in (1) with health care at minimal cost; and (5) the Secretaries should offer additional health care options to such personnel, including specified options for persons eligible for Medicare. Directs the Secretary of Defense to establish a joint services working group on the provision of military health care to persons who rely on health care facilities at military installations being closed or realigned. Requires such groups, after meeting with persons entitled to military health care, to submit recommendations to the Congress and the Secretary regarding the alternative means for continuing to provide accessible health care to such persons. Requires the administering Secretaries to: (1) provide a system for such persons to obtain prescription pharmaceuticals from mail-order suppliers; and (2) enter into contracts for the supply of such pharmaceuticals. Directs the Secretaries to pay 80 percent of the cost of generic pharmaceuticals for a person (also authorizes payment for pharmaceuticals for which no generic exists) if the person: (1) is under 65 years of age; or (2) is 65 or older and obtained prescription pharmaceuticals at a military health facility within 18 months before closure of such facility. Directs the administering Secretaries to conduct annual surveys of persons receiving military health care to determine their level of satisfaction with the health care system. Lowers the maximum annual amount to be paid by members or former members or covered individuals or family groups for health care under Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) health benefit contract plans. Permits CHAMPUS coverage for end-stage renal disease. Prohibits the administering Secretaries from recouping the cost of any health care furnished to a person who was erroneously determined to be eligible for such care. Directs the Secretaries of Defense and Health and Human Services to conduct a four-year demonstration project that provides for the Secretary of Health and Human Services to reimburse the Department of Defense (DOD) for health care services furnished to Medicare-eligible persons at a DOD health facility. Limits such reimbursement to 85 percent of the amount that would be paid to a provider of services under Medicare. Directs such Secretaries to conduct a five-year demonstration project under which the Secretary of Defense enters into risk-sharing contracts with eligible organizations described in the Social Security Act (health maintenance organizations or other specified health care providers) to furnish health care to members or former members (or their dependents) who are eligible for retired pay. Applies Medicare provisions concerning risk-sharing contracts to contracts under the project. Directs the Secretary of Health and Human Services, under such contracts, to pay eligible organizations for services furnished to such persons in an amount not to exceed the per capita rate of payment that the Secretary pays for a relevant class of persons receiving health care under a risk-sharing contract under Medicare. Requires payments for such projects to be made out of the Federal Hospital Insurance Trust Fund. Amends the National Defense Authorization Act for Fiscal Years 1992 and 1993 to require the Secretary of Defense, in a study of the military medical care system, to include a review of: (1) the Federal employees health benefits program to determine whether a similar program would be effective for persons eligible for military medical care; and (2) the DOD system for processing health care claims. Requires the Secretary of Defense to test a broad array of reform options for furnishing health care and to conduct a study of the tested options during FY 1994. Requires the study to compare the cost effectiveness of such options and the extent to which the persons are satisfied with the health care. Prohibits the Secretary from limiting the eligibility of any member, former member, or dependent or survivor to receive health care on the basis of an election by the individual not to participate in the DOD Coordinated Care Management Initiative. Sets forth location requirements for the Initiative. Establishes as goals of the Initiative reductions in the administrative paperwork associated with health care and in the average period that dependents must wait for such care. Requires the Secretary to ensure that a replacement contract for the CHAMPUS Reform Initiative contract applicable to California and Hawaii is awarded in sufficient time for the contractor to provide health care in such states no later than August 1, 1993. Provides for an evaluation of such contract. Prohibits the provision of health care services under CHAMPUS Reform Initiative contract number MDA903-R-0047 unless: (1) the prime contractor is the contractor that was the prime contractor under such contract on January 1, 1992; and (2) the subcontractors include each of the subcontractors under the subcontract on that date. Excludes certain incapacitated dependent children from CHAMPUS coverage. Authorizes appropriations.
Law· SJRESS.J.Res. 303 (102nd)enacted
United States · United States Congress · 13 May 1992
Designates October 1992 as National Breast Cancer Awareness Month.
Bill· HRH.R. 5162 (102nd)referred
United States · United States Congress · 13 May 1992
Earth Summit Leadership Act of 1992 - Title I: Foundation for Sustainable Development - Establishes the Foundation for Sustainable Development to: (1) encourage the growth of development institutions indigenous to developing countries which respond to the needs of the poor and promote environmental protection and conservation of natural resources; (2) support efforts to increase the productivity of the poor; (3) support self-help activities at the local level to enlarge opportunities for community development; (4) support efforts at community-based, environmentally sustainable management of natural resources; (5) stimulate and assist the process of people participating in the processes that affect their lives; (6) replicate successful projects promoting sustainable and equitable development funded by specified foundations; and (7) disseminate insights gained in the Foundation's work to the American public and citizens in developing countries. Authorizes the Foundation to provide grant assistance to indigenous organizations in developing countries or entities working in partnership with such organizations to carry out it purposes. Limits the total amount of assistance for a single project. Authorizes appropriations. Title II: Regional Development Foundations - Amends the Foreign Assistance Act of 1969 to increase the authorization amount for the Inter-American Foundation for FY 1993 and to authorize appropriations for FY 1994. Amends the African Development Foundation Act to authorize appropriations for the African Development Foundation for FY 1993 and 1994. Makes available an additional amount of economic support fund assistance under the Foreign Assistance Act of 1961 for Appropriate Technology International to enable it to emphasize large-scale replication of successful projects and partnerships with major development and financial institutions. Title III: Reduction in International Security Assistance - Places a ceiling on the total amount of international security assistance provided by the United States for FY 1993 and 1994. Expresses the sense of the Congress that international security assistance for FY 1995 and 1996 should be further reduced to promote global demilitarization and make available additional resources for sustainable development programs. Title IV: Multilateral Organizations - Requires the Secretary of the Treasury to instruct the U.S. executive directors of specified multilateral development banks to promote the following actions: (1) to make available to the public information on physical, institutional, and economic details and the environmental, public health, and sociocultural impacts of proposed bank operations; (2) to ensure that poverty reduction becomes a higher priority, including increases for lending for health care and basic education to at least five percent of the bank's lending; (3) to ensure that all structural adjustment loans after July 1993 are presented with documentation on how such loans will affect incomes of the poor, the diversification of industrial and agricultural production, the delivery to low-income people of essential social and technical services, and the integrity of the natural resource base; (4) to ensure the development of sustainable energy systems by ensuring that all energy sector loans are based on end-use efficiency and renewable energy applications; (5) to establish a comprehensive water resource policy that will require a least-cost approach to planning for and investing in water resource development projects; and (6) to purchase commercial debt obligations of developing countries on the secondary market and forgive those debts in return for adoption of sustainable development policies. Expresses the sense of the Congress that the President should follow up U.S. participation in the United Nations Conference on Environment and Development (UNCED) by taking an active role during the General Assembly session to ensure full implementation of UNCED recommendations on institutional reform issues. Title V: Domestic Environmental Policies - Expresses the sense of the Congress that: (1) all budgetary subsidies and tax advantages for unsustainable exploitation of natural resources should be eliminated as long as adequate provision is made to retrain displaced individuals and to assist poor people who are least able to bear the cost implied by such eliminations; (2) the director of the Office of Management and Budget should identify all current budgetary subsidies and tax advantages for the exploitation of nonrenewable energy, forest, and water resources and should estimate their cost to taxpayers as the basis for future congressional action to eliminate them; and (3) each Federal agency should conduct a survey of cost-effective renewable energy technologies which it could adopt for the conduct of its work and should begin conversion to those technologies as soon as possible. Directs the President to: (1) design a plan for reducing, by 2005, U.S. emissions of carbon dioxide to a level no greater than 80 percent of the 1990 level; and (2) formulate a national strategy for sustainable development.
Bill· HRH.R. 5156 (102nd)referred
United States · United States Congress · 13 May 1992
National Breast Cancer Strategy Act of 1992 - Title I: Establishment of Office of Breast Cancer and National Breast Cancer Commission - Amends the Public Health Service Act to establish: (1) the Office of Breast Cancer in the Office of the Assistant Secretary for Health; and (2) the National Breast Cancer Commission to study public and private breast cancer prevention, early detection, treatment, education, and research. Title II: Duties of Director of the National Cancer Institute Relating to Breast Cancer - Authorizes appropriations for conducting and supporting breast cancer research. Adds biomedical and behavioral research, training, and dissemination of information regarding breast cancer to the duties of the National Cancer Institute Director. Establishes the Rose Kushner Scholarship Program of scholarships in exchange for completing post-graduate clinical oncology training and serving as National Institutes of Health (NIH) employees carrying out breast cancer programs. Establishes a program of educational loan repayments in exchange for breast cancer activities as NIH employees. Authorizes appropriations for at least ten programs for research on breast, lung, and prostate cancer under designated Specialized Programs of Research Excellence.
Bill· SS. 2698 (102nd)referred
United States · United States Congress · 12 May 1992
Medicare Beneficiary Protection Act of 1992 - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to require the Secretary of Health and Human Services to: (1) provide that an individual enrolled under such part shall not be liable for physicians' charges in excess of authorized amounts; (2) provide pre-payment screening of nonparticipating physician claims; (3) require nonparticipating physicians to refund excess charges; (4) refer for sanctions any physicians who fail to make refunds; (5) send information on limiting charges and limited liability for excess charges to individuals enrolled under Medicare part B; (6) report annually to the Congress on charges in excess of authorized amounts; (7) provide for payment to Medicare beneficiaries, out of civil monetary penalties, of amounts charged in excess of limiting charges; and (8) establish a Medicare Beneficiary Advisory Council.
Bill· SS. 2690 (102nd)referred
United States · United States Congress · 12 May 1992
Defense Workers' Benefits Protection Act of 1992 - Amends the Internal Revenue Code, the Employee Retirement Income Security Act of 1974, and the Public Health Service Act to mandate health plan continuation coverage when there is a termination or reduction in hours as a result of the termination or curtailment of a defense contract. Regulates premiums for the continuation coverage. Terminates continuation coverage when coverage exists through a spouse. Allows the employee to elect lower cost benefit coverage if such coverage is offered by the employer to its other employees. Requires that related subsidies under the Acts be paid out of amounts appropriated under the Defense Economic Adjustment, Diversification, Conversion, and Stabilization Act of 1990.
Bill· SS. 2686 (102nd)referred
United States · United States Congress · 12 May 1992
Senior Home Care Choice Fairness and Improvement Act of 1992 - Amends title XIX (Medicaid) of the Social Security Act (SSA) to: (1) provide for the application of Medicaid spousal impoverishment rules to spouses of individuals receiving home- or community-based services; (2) increase the number of individuals allowed to receive such services; and (3) require hospitals to inform Medicaid patients of the availability of home care services and, in a State operating under a waiver program, to inform them of the availability of home- and community-based services. Mirrors such requirement with respect to Medicare (SSA title XVIII) patients. Requires the Secretary of Health and Human Services to study and report to the Congress on the costs of home health care.
Bill· SS. 2696 (102nd)referred
United States · United States Congress · 12 May 1992
Equitable Health Care for Severe Mental Illnesses Act of 1992 - Declares that it is the policy of the United States that: (1) persons with severe mental illnesses must not be discriminated against in health care; and (2) health care coverage, provided through any financing, must provide for the treatment of severe mental illnesses in a way that is equitable and commensurate with that provided for other major illnesses. Designates as consistent with that policy any plan which incorporates specified elements.
Bill· HRH.R. 5142 (102nd)referred
United States · United States Congress · 12 May 1992
Physician Self-Referral Amendments of 1992 - Amends title XVIII (Medicare) of the Social Security Act to extend the ban on physician self-referrals to all payors and to physical therapy services, radiology and diagnostic imaging services, radiation therapy services, and the furnishing of durable medical equipment. Makes changes in the exceptions to ownership and compensation arrangement prohibitions with respect to prepaid plans.
Bill· HRH.R. 5138 (102nd)referred
United States · United States Congress · 12 May 1992
Amends title XIX (Medicaid) of the Social Security Act to permit certain proprietary organizations to conduct functional assessments and to develop individual community care plans in order to provide home and community care for functionally disabled individuals.
Bill· HRH.R. 5131 (102nd)referred
United States · United States Congress · 11 May 1992
Amends the Solid Waste Disposal Act to prohibit the placement in mixed municipal solid waste of a battery containing added mercury, silver, lead, nickel, cadmium, or zinc. Requires users to return all batteries subject to such prohibition to the supplier that provided the battery or to a collection facility designated by the battery manufacturer. Requires manufacturers of such batteries to: (1) ensure that a system for the proper collection, transportation, segregation by type, and processing of waste batteries exists for purchasers; and (2) clearly inform each purchaser of the prohibition on disposal of waste batteries and of the availability of such system. Directs manufacturers, to ensure that such a system exists, to identify a collection chain through which batteries should be returned to the manufacturer or to designated collection sites. Requires manufacturers of button cell batteries that are to be sold at retail in interstate commerce to ensure that such batteries are clearly identifiable as to the type of electrode used in such batteries. Prohibits the retail sale or distribution for sale of alkaline manganese batteries containing more than .30 percent of mercury by weight and after January 1, 1994, .025 percent mercury by weight. Bars the sale of batteries containing any added mercury effective January 1, 1996. Authorizes the Administrator of the Environmental Protection Agency to exempt specific types of batteries from such prohibitions if there are no substitutes available. Prohibits, after January 1, 1994: (1) the retail sale or distribution for sale of button cell alkaline manganese batteries that contain more than 25 milligrams of mercury; and (2) the retail sale of button batteries containing added mercury unless they contain fewer than 25 milligrams of mercury. Prohibits the retail sale or distribution for sale in any State of a rechargeable battery consumer product unless: (1) the battery can be easily removed by the consumer or is contained in a battery pack that is separate from the product and can be easily removed; and (2) the product, the battery, and the package are labeled in a manner that is clearly visible, indicate that the battery must be recycled or disposed of properly, and are marked with specified recycling symbols. Authorizes exemptions from such prohibition if: (1) the product cannot be reasonably designed to comply with such requirements; (2) the redesign of the product would result in danger to public health or safety; or (3) the battery poses no unreasonable hazard when placed in and processed or disposed of as part of mixed municipal solid waste. Limits exemptions to two-year periods and permits only one renewal. Prohibits the knowing disposal, after July 1, 1993, of any lead-acid, nickel-cadmium, or other rechargeable battery in landfills, incinerators, or municipal solid waste composting facilities. Authorizes the Administrator to suspend such prohibition, as it applies to the operator of a solid waste management facility, upon finding that insufficient markets exist and alternate uses are not available.
Bill· SS. 2681 (102nd)passed
United States · United States Congress · 7 May 1992
Native Hawaiian Health Care Improvement Act - Amends the Native Hawaiian Health Care Act of 1988 to set forth the Native Hawaiian Health Care Improvement Act. Sets forth specified health objectives for Native Hawaiians to be met by the year 2000. Authorizes appropriations for implementing and updating the Native Hawaiian health care master plan. Makes Papa Ola Lokahi responsible for the: (1) implementation and updating of such plan; (2) training for specified health care practitioners, community outreach workers, counselors, and cultural educators; (3) identification of and research into the diseases that are most prevalent among Native Hawaiians; and (4) development of an action plan outlining the contributions that each member organization of Papa Ola Lokahi will make in carrying out this Act. Permits Papa Ola Lokahi to receive special project funds that may be appropriated for the purpose of research on the health status of Native Hawaiians or for addressing the health care needs of Native Hawaiians. Requires Papa Ola Lokahi to serve as a clearinghouse for: (1) the collection and maintenance of data associated with the health status of Native Hawaiians; (2) the identification and research into diseases affecting Native Hawaiians; (3) the availability of Native Hawaiian project funds, research projects, and publications; (4) the collaboration of research in the area of Native Hawaiian health; and (5) the dissemination of information pertinent to the Native Hawaiian health care system. Directs Papa Ola Lokahi to: (1) coordinate and assist the health care programs and services provided to Native Hawaiians; and (2) act as a statewide infrastructure to provide technical support and coordination of training and technical assistance to Native Hawaiian health care systems. Makes eligible for grants or contracts for providing health services to Native Hawaiians Native Hawaiian health care systems (currently, Native Hawaiian health centers or organizations or public or nonprofit private health providers). Limits to five (currently, nine) the number of grant or contract recipients. Revises matching fund requirements for such grants or contracts. Prohibits the awarding of grant or contract funds unless the recipient agrees that the funds will not be expended: (1) for purposes not listed under this Act; (2) to provide inpatient services; (3) to make cash payments to intended recipients of health services; or (4) to purchase or improve real property or to purchase major medical equipment. Extends the authorization of appropriations for such grants and contracts and for an administrative grant for Papa Ola Lokahi through 2001. Authorizes appropriations for the planning of Native Hawaiian health care systems. Directs the Secretary to provide funds through a direct grant or cooperative agreement to Kamehameha School/Bishop Estate for providing scholarship assistance for health profession training to Native Hawaiian students who meet certain requirements under the Public Health Service Act. Authorizes appropriations.
Bill· SS. 2678 (102nd)referred
United States · United States Congress · 7 May 1992
Amends the Omnibus Crime Control and Safe Streets Act of 1968 to authorize the Director of the Bureau of Justice Assistance to award grants to communities to pay the operating expenses associated with the costs and salaries incurred in the assignment of individuals within such communities as drug abuse resistance officers. Sets forth provisions regarding: (1) application requirements; (2) the allocation and distribution of grants; and (3) matching requirements (that the community provide one dollar for each three dollars of Federal funds provided). Authorizes appropriations. Amends the Drug-Free Schools and Communities Act of 1986 to provide that specified funds shall be used for grants to local educational agencies to provide drug abuse resistance education to students in grades kindergarten through 12 and to parent training programs. (Current law makes such funds available with respect to students in grades kindergarten through six.)
Bill· SS. 2680 (102nd)referred
United States · United States Congress · 7 May 1992
Medicare Geographic Data Accuracy Act of 1992 - Amends title XVIII (Medicare) of the Social Security Act to require the Secretary of Health and Human Services to consult with State medical societies in revising the geographic adjustment factors used to determine reimbursements for physician services under part B (Supplementary Medical Insurance) of Medicare. Requires the Secretary to base geographic-cost-of-practice indices under Medicare upon the most recent available data.
Bill· SS. 2683 (102nd)referred
United States · United States Congress · 7 May 1992
Amends title XVIII (Medicare) of the Social Security Act to: (1) require the first triennial review and revision of the geographic adjustment factor for Medicare physicians' services to apply to services furnished on or after January 1, 1994; and (2) authorize the Secretary of Health and Human Services to make a special adjustment to the geographical indices to correct for unique local circumstances. Requires a Health and Human Services study and report to the Congress with respect to the triennial review and revision of such indices. Requires the Physician Payment Review Commission to study and report to the Congress with respect to providing a special adjustment for physicians in isolated areas.
Bill· SS. 2675 (102nd)open
United States · United States Congress · 7 May 1992
Health Insurance Purchasing Cooperatives Act - Mandates grants to States for the administrative costs of planning and implementing coordinated buying programs through which small employers may purchase employee health insurance. Requires that the programs be the sole mechanism for small employers to purchase such insurance. Requires that a State program provide each small employer in the State access to health insurance for its employees and their dependents through one or more Health Insurance Purchasing Cooperatives, each covering a defined geographic district. Sets forth Cooperative duties, including issuing contracts and administering all aspects of coverage for all small employers within the district. Waives Federal and State antitrust laws. Authorizes appropriations. Establishes the National Health Board. Requires the Board to establish Coordinated Buying Program Precepts setting forth certain criteria, including regarding a uniform data system, collection of outcomes data, and determining minimum benefit requirements. Authorizes appropriations. Requires the Board to establish minimum benefit requirements for plans offered through Cooperatives, including inpatient and outpatient hospital care and physician services, diagnostic tests, prenatal and well-baby care, preventive and early intervention services, and certain inpatient and outpatient mental disorder services. Allows managed care and different levels of payments for different providers. Requires the Board to establish minimum benefit requirements for two additional health benefit plans providing more extensive or more innovative benefits. Amends provisions of the Public Health Service Act relating to health maintenance organizations (HMOs) to exempt from those provisions HMOs that provide services meeting the requirements under this Act. Establishes the National Health Insurance Data System, consisting of: (1) a National Data Base for Health Insurance and Health Outcomes Information; (2) no more than five Regional Health Insurance Data Centers; and (3) an electronic health insurance and outcomes data processing mechanism. Requires the Board to: (1) establish uniform billing and claims forms and mandatory reporting requirements; and (2) require carriers to issue to each participant an electronic processing card containing certain information on financial, administrative, and health outcomes matters. Authorizes appropriations.
Bill· HRH.R. 5120 (102nd)referred
United States · United States Congress · 7 May 1992
Intergovernmental Health Care Fraud and Abuse Commission Act of 1992 - Establishes the Intergovernmental Commission on Health Care Fraud and Abuse to investigate the nature, magnitude, and cost of health care fraud and abuse and develop methods for its prevention.
Bill· HRH.R. 5121 (102nd)referred
United States · United States Congress · 7 May 1992
Federal Facilities Community Oversight for Public Health Act of 1992 - Amends the Solid Waste Disposal Act to establish a citizens advisory board for each Department of Energy (DOE) nuclear weapons facility, whose duties shall be to: (1) evaluate DOE performance of environmental restoration, waste management, and health activities at the facility; (2) evaluate the exercise of regulatory authority by certain Federal and State agencies; (3) submit annually to certain Federal and State agencies an independent policy and technical evaluation of significant decisions made by them with respect to environmental restoration, waste management, and health activities at such facilities; (4) forward community views regarding such activities to the Secretary of Energy, the Administrator of the Environmental Protection Agency (EPA), and the Governor of the State in which the facility is located; and (5) submit an annual status report to the Congress and the Governor of the State in which the facility is located. Establishes the National Citizens' Advisory Board for DOE Nuclear Weapons Facilities to: (1) annually submit to DOE, EPA, and the National Governors' Association national policy and technical recommendations on environmental restoration, waste management, and health activities occurring at those facilities; and (2) submit an annual status report to the Congress. Directs the Administrator of the Agency for Toxic Substances and Disease Registry (ATSDR) to perform public health actions in accordance with the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 for each DOE nuclear weapons facility included in certain DOE programmatic environmental impact statements. Permits any person to petition the ATSDR Administrator for public health assessments. Directs the ATSDR Administrator to: (1) establish and maintain an integrated data base (with specified contents) that is specific to DOE nuclear weapons facilities that are the subject of a health assessment under this Act; (2) report annually to the Congress on how the data base will be used to conduct health assessments and protect human health and the environment; and (3) establish and maintain a registry of persons exposed to hazardous substances as a result of a release from a DOE nuclear weapons facility where the inclusion of such persons would be valuable for specific scientific studies. Directs the Secretary of Energy to submit a priority list to the ATSDR Administrator of hazardous substances most commonly found at DOE nuclear weapons facilities. Directs the ATSDR Administrator to ensure the timely completion of a toxicological profile of such substances. Requires the ATSDR Administrator to submit a comprehensive plan to the Congress for implementing this Act and for ensuring the substantive involvement of affected States, Indian tribes, communities, and the public in the conduct of ATSDR activities. Requires the Secretary of Energy to provide information to the ATSDR Administrator that may be helpful to implement this Act. Requires such Secretary and Administrator to enter into a memorandum of understanding regarding implementation of this Act. Authorizes appropriations.
Bill· HRH.R. 5106 (102nd)referred
United States · United States Congress · 7 May 1992
Amends title XVIII (Medicare) of the Social Security Act to disregard months during which a retiree is a former employee and covered under a group health plan of an employer for purposes of calculating the penalty for late enrollment under Medicare part B (Supplementary Medical Insurance).
Bill· HRH.R. 5115 (102nd)referred
United States · United States Congress · 7 May 1992
Medicare Beneficiary Financial Protection Act of 1992 - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to provide that Medicare beneficiaries are not liable for nonparticipating physicians' charges in excess of authorized amounts. Requires physicians to refund excess charges to beneficiaries within 30 days. Authorizes sanctions against physicians who knowingly and repeatedly overcharge beneficiaries, or who fail to make timely refunds. Provides for the notification of individuals receiving nonparticipating physician services of the limitations on charges and the availability of refunds. Requires Medicare carriers: (1) to conduct prepayment screening of services furnished by nonparticipating physicians; and (2) to notify physicians of the requirement to refund excessive charges.
Bill· HRH.R. 5129 (102nd)referred
United States · United States Congress · 7 May 1992
Considers the service of a named individual as a member of the National Health Service Corps as active commissioned military service in the Public Health Service for purposes of determining the grade and rank within grade, and computing the amount of pay and allowances, of such individual. Directs the Secretary of the Treasury to pay such individual a specified lump-sum payment based on such consideration.
Bill· HRH.R. 5110 (102nd)open
United States · United States Congress · 7 May 1992
Public Health Pesticides Protection Act of 1992 - Amends the Federal Insecticide, Fungicide, and Rodenticide Act to direct the Administrator of the Environmental Protection Agency to consider the risks and benefits of public health pesticides separate from the risks and benefits of other pesticides. Requires the Administrator, in weighing any regulatory action concerning a public health pesticide, to weigh any risks of the pesticide against the health risks to be controlled by the pesticide. Defines: (1) a "public health pesticide" as a minor use pesticide registered for use and used predominantly in public health programs for vector control or other health protection uses; and (2) "vector" as any animal capable of transmitting the causative agent of human disease or of producing human discomfort or injury. Exempts from reregistration fees public health pesticides of which more than 50 percent of usage (or at least 50 percent in the case of certain end use products) is devoted to the promotion of public health. Provides for expedited processing and review of pesticide applications that propose the initial or amended registration of an end use pesticide that, if registered as proposed, would be used solely for agricultural minor uses or as a public health pesticide. Provides for review by the Secretary of Health and Human Services of registrations of public health pesticides proposed for cancellation. Directs the Administrator to identify pests of significant public health importance and to implement programs to improve and facilitate the safe use of methods to combat and control such pests. Requires the Administrator to report annually to the Congress on the uses of public health pesticides to promote human health protection in the United States.
Bill· HJRESH.J.Res. 480 (102nd)failed
United States · United States Congress · 7 May 1992
Disapproves the Health Care Benefits Expansion Act of 1992, an Act passed by the District of Columbia Council and signed by the Mayor.
Bill· HJRESH.J.Res. 481 (102nd)referred
United States · United States Congress · 7 May 1992
Designates May 1992 as Older Americans Month.
Bill· SS. 2667 (102nd)referred
United States · United States Congress · 6 May 1992
Amends the Federal Food, Drug, and Cosmetic Act to allow, on order of a veterinarian: (1) a new animal drug approved for one use to be used for a different purpose; and (2) a new drug approved for human use to be used in non-food producing animals.
Bill· HRH.R. 5092 (102nd)referred
United States · United States Congress · 6 May 1992
Directs the Secretary of Defense to enter into an agreement with the Governor of Tennessee to carry out a pilot program during FY 1993 under which medical personnel of the Tennessee National Guard are used to provide health care to medically underserved individuals in Tennessee. Directs the Secretary to provide the funds for the pay, allowances, travel, and all necessary expenses of such National Guard personnel and for all medical supplies and equipment used in the pilot program. Provides an FY 1993 expenditure limit for such program. Counts such service by the Tennessee National Guard toward the annual training requirement imposed upon all members of the National Guard.
Bill· SS. 2654 (102nd)referred
United States · United States Congress · 5 May 1992
Land and Water Conservation Fund Amendments of 1992 - Amends the Land and Water Conservation Fund Act of 1965 to require the submission with the annual budget of the United States of a comprehensive statement of the estimated requirements during the ensuing fiscal year for appropriation from the Land and Water Conservation Fund for land acquisition by eligible Federal agencies and by States and local governments. Sets forth requirements with respect to: (1) allocations from the Fund, including funds for Indian tribes and Alaska Native Village Corporations; and (2) multipurpose acquisition by States. Authorizes the Secretary of the Interior to provide financial assistance to States for outdoor recreation maintenance and security. Repeals a restriction on assistance available under the Act to enclose or shelter facilities normally used for outdoor recreation activities. Permits the use of such funds, subject to specified limitations, for: (1) maintenance of facilities acquired and developed with financial assistance provided pursuant to the Act; (2) costs of law enforcement and security personnel and other security measures; and (3) development of sheltered facilities for public health or safety in connection with projects otherwise eligible for assistance under the Act. Authorizes the transfer of funds by grant recipients to private nonprofit organizations, subject to specified requirements, to be used for projects approved in writing by the grantor of the funds in connection with the acquisition of lands (or interests in lands) and the development of recreation facilities, but not for administrative expenses. Sets forth requirements regarding maintenance of expenditures by State and Federal grant recipients.
Bill· SS. 2657 (102nd)referred
United States · United States Congress · 5 May 1992
Spending Control and Programs Evaluation Act of 1992 - Title I: Reauthorizations of Government Programs - Requires each Government program to be reauthorized at least once during each sunset reauthorization cycle. (Sunset reauthorization cycle means the period of five Congresses beginning with the 103d Congress and with each sixth Congress following the 103d Congress.) Sets forth the procedure in the House of Representatives and the Senate for the consideration of any legislation which authorizes new budget authority. Exempts from the requirements of this Act specified items, such as interest on Federal debts, health care services, general retirement and disability payments, litigation activities which have as their objectives the protection and implementation of civil rights guaranteed by the Constitution, and specified social security and retirement pay and benefits. Expresses the sense of the Congress that all programs should be considered and reauthorized in program categories which constitute major areas of lelgislative policy for sufficient periods of time to enhance oversight and the review and evaluation of Government programs. Title II: Program Inventory - Directs the Comptroller General and the Director of the Congressional Budget Office, in cooperation with the Director of the Congressional Research Service, to prepare an inventory of Federal programs. Declares that the purpose of such program inventory is to advise and assist the Congress in carrying out reauthorization and reexamination requirements and to link such reauthorization and review process with the budget process. Requires the Comptroller General to submit such program inventory to each House of Congress no later than January 1, 1993. Directs the congressional committees, the Congressional Budget Office, and the Congressional Research Service to review the program inventory and to suggest revisions. Requires that the program inventory be revised at the end of each session of the Congress and that such revisions be reported to each House. Title III: Program Reexamination - Requires each committee of the Senate and the House of Representatives to reexamine selected programs or groups of programs over which it has jurisdiction. Sets forth procedures for such review and criteria for selection of program areas for evaluation. Title IV: Miscellaneous - Sets forth miscellaneous provisions to carry out the purposes of this Act. Directs the President, with the cooperation of the head of each appropriate agency, to submit to the Congress a regulatory duplication and conflicts report for all programs scheduled for reauthorization in the next Congress. Requires appropriate congressional committees to introduce a sunset reauthorization bill not later than 15 days after the beginning of the second regular session of the Congress. Sets forth discharge procedures to apply to motions to discharge such bills. Requires specified congressional committees to report on a review of the procedures established under this Act by December 31, 1998, and every five years thereafter. Authorizes appropriations for fiscal years ending before October 1, 2003.
Bill· SS. 2652 (102nd)referred
United States · United States Congress · 5 May 1992
Health Care Fraud Prosecution Act of 1992 - Amends the Federal criminal code to provide penalties for fraud by health care providers in connection with the provision of, or payments or reimbursement for, health care services or supplies, when: (1) the loss caused by the fraudulent conduct exceeds $10,000; or (2) the offender has previously been convicted of fraud in Federal or State court. Limits such penalties to ten years' imprisonment, unless the offense caused serious physical injury to, or endangered the life of, a patient (up to 20 years' imprisonment) or caused the death of a patient (up to life imprisonment). Specifies that the sentencing court: (1) shall order the offender to pay restitution to the patient and to the United States as payor for losses sustained as a result of the offender's fraudulent activity; and (2) may order the offender to pay restitution to others who sustained losses as a result of such activity. Provides for civil and criminal forfeiture of the proceeds of health care fraud. Authorizes the Attorney General to make payments of up to $10,000 to persons who furnish information unknown to the Government relating to a possible prosecution for health care fraud, with exceptions. Authorizes appropriations for the Federal Bureau of Investigation, U.S. Attorneys, and the Office of Inspector General of the Department of Health and Human Services to hire, equip, and train personnel in connection with the investigation and prosecution of health-care fraud cases. Includes within the scope of the mail fraud statute cases involving matter to be sent or delivered by any private or commercial interstate carrier.
Bill· SS. 2643 (102nd)referred
United States · United States Congress · 30 April 1992
Amends title XVIII (Medicare) of the Social Security Act to preserve until 1997 the current methodology (based on units of actual time) for determining the amount of time that may be billed for anesthesia services. Requires the General Accounting Office to study and report to the Congress and the Physician Payment Review Commission on any changes over a specified period in billing patterns for anesthesia services. Provides for evaluation of such report by the Commission.
Law· SJRESS.J.Res. 295 (102nd)enacted
United States · United States Congress · 30 April 1992
Designates September 10, 1992, as National DARE (Drug Abuse Resistance Education) Day.
Bill· SJRESS.J.Res. 296 (102nd)referred
United States · United States Congress · 30 April 1992
Designates the week of May 17 through 23, 1992, as National Senior Nutrition Week.
Bill· HRH.R. 5046 (102nd)referred
United States · United States Congress · 30 April 1992
Universal Coordinated Care Act of 1992 - Amends the Internal Revenue Code to allow an individual a tax credit for amounts paid by or on behalf of such individual to a health services account for the payment of qualified health expenses. Limits such credit to $1,500. Limits contributions to such accounts to $3,000. Defines qualified health expenses as: (1) care of the distributee at a skilled nursing facility; (2) care of the distributee at an intermediate care facility; (3) care at any other long-term facility, licensed by the State, which provides nursing or custodial care; (4) home health care of the distributee; or (5) health services supplemental policies for the distributee (established by this Act). Provides for the certification of a health services supplemental policy as a health insurance policy or other health benefit plan offered by a private entity to an individual which provided reimbursement for expenses incurred, or services for catastrophic and long-term care. Requires any amount distributed out of a health services account to be included in the taxable income of the distributee. Imposes a penalty on distributions not used to pay qualified health expenses. Declares such accounts exempt from tax, unless the distributee engages in prohibited transactions or the account is pledged as security for a loan. Terminates such accounts on the death of the distributee. Subjects such accounts to: (1) the excise tax on excess contributions to individual retirement accounts; (2) the excise tax on prohibited transactions; and (3) the penalty for failure to provided certain reports. Requires a Health and Human Services (HHS) report to the Congress on minimum standards for health services supplemental policies. Amends title XVIII (Medicare) of the Social Security Act to provide coverage of home care services for qualified patients. Describes the services and supplies constituting home care services. Requires a home health agency to provide such services and supplies to an individual in the individual's place of residence under a written plan of care established and periodically reviewed by a physician. Amends the Social Act to add a new title XXI, Home Care Services. Sets forth the conditions a home health agency must meet in order to receive Federal funding for the provision of home care services. Requires the Secretary of HHS to issue regulations that establish procedures for surveying home health agency compliance with title XXI requirements for quality of care. Authorizes sanctions against a home health agency which no longer meets such requirements. Requires the HHS Secretary to: (1) develop incentives to encourage home health agencies to provide high quality care; and (2) encourage States to develop policies and procedures for the licensing of home health agencies. Authorizes appropriations. Amends the Social Security Act to add a new title XXII, National Care Vouchers. Establishes the national care voucher program under which U.S. citizens, resident aliens, and certain officers and employees of international organizations or foreign governments, are eligible for benefit coverage through the purchase of insurance through a national care voucher. Requires such benefit coverage to consist of an entitlement to have payment made on the individual's behalf for medical and other specified health services, including preventive services. Requires a full cash payment to be made by the United States to each individual eligible to participate in the national care voucher program to purchase certified health care insurance. Requires the United States to establish an account meeting specified requirements for each such individual to be used for the purchase of certified health care insurance. Sets forth guidelines governing annual deposits to employee voucher accounts by employers and the United States. Exempts certain small employers from the requirements of new title XXII, including those participating in a small employer health plan. Requires the Secretary to establish: (1) minimum standards and requirements for the certification of health care insurance policies eligible to be purchased under this new title; and (2) a procedure for certifying such policies. Prescribes certification requirements. Sets forth procedures for health insurance enrollment under the national care voucher program. Requires each carrier of small employer health insurance to register with the Secretary. Requires such a carrier to offer the same health plan to any small employer located in the same community. Allows a carrier to refuse to issue or renew or terminate a plan only for nonpayment of premiums and fraud or misrepresentation. Prohibits a carrier from offering or issuing a small employer plan with a term of less than 12 months. Provides that, except with respect to rates and administrative changes, the terms of renewal (including benefits) shall be the same as the terms of issuance. Allows a carrier to change the terms of such renewal, but the premium rates charged with respect to such renewal shall be the same as that for a new issue. States that the period of renewal of each small employer health plan shall be for a period of not less than 12 months. Amends the Internal Revenue Code to allow a trade or business expense deduction for expenses paid or incurred by a small employer for a certified health care insurance policy. Amends the Trade Act of 1974 to require the Trade Representative to identify a foreign country as a high cost priority foreign country if the trade deficit between the United States and such country exceeds 15 percent of the total U.S. trade deficit and such country has entered into a free trade agreement with the United States. Requires an annual review of the list of such foreign countries for changes in the trade deficit. Imposes an equity tax of one percent of the value of the merchandise entered by high cost priority foreign countries. Establishes in the Treasury an Equity Health Insurance Trust Fund. Transfers to such Fund the equity taxes. Makes amounts in such fund available to provide payments to national voucher accounts.
Bill· HRH.R. 5050 (102nd)referred
United States · United States Congress · 30 April 1992
Universal Medical Care Act of 1992 - UniMed Act of 1992 - Creates the UniMed program with three components: MediWorkers, MediKids, and MediWrap. Title I: MediWorkers Component of UniMed Program - Subtitle A: Employer-Sponsored Group Health Plans - Amends the Employee Retirement Income Security Act of 1974 to require each employer to provide coverage to each eligible full-time employee or spouse. Provides for consumer protection by: (1) regulating claims procedures; (2) requiring certain disclosures; and (3) prohibiting financial arrangements between group health plans and physicians having the effect of reducing or limiting services. Sets forth procedures and requirements for group health plan certification by the Health Benefits Board (Board) established under this Act. Requires: (1) the Board to establish minimum quality standards; and (2) each plan to issue a health plan card to each covered individual. Mandates coverage of certain core services, including: (1) inpatient and outpatient hospital services; (2) physician and community health clinic services and certain other health professional services; (3) certain inpatient and outpatient mental health services; (4) certain alcohol and drug abuse treatment services; (5) pregnancy-related services; (6) specified preventive services; (7) diagnostic and laboratory services; and (8) case management. Allows the Board to include additional preventive services and, in order to conduct demonstrations, additional services as core benefits. Establishes related advisory committees. Prohibits a plan which is not a network plan (defining a network plan as a plan which limits coverage to services provided by participating providers or which permits higher deductibles and coinsurance applicable to the use of non-participating providers) from limiting coverage of core services to specified providers. Regulates deductibles, coinsurance, and cost-sharing. Requires the Board to: (1) annually establish reference payment rates, based on the payment methodology used under title XVIII (Medicare) of the Social Security Act, for all core services; or (2) substitute rates established by a State, unless that would increase expenditures or shift costs among UniMed's three components. Limits charges for: (1) institutional services to the reference rates; and (2) professional services to the same proportion above the reference rates as the limiting charge established under specified Medicare provisions. Requires adequate core services payment rates and use of Medicare payment methodologies. Mandates prospective reductions in reference payment rates for: (1) hospitals with excessive rates of increase of capital expenditures which were not pre-approved by the Board; and (2) medical residency programs inconsistent with number and specialty distribution standards. Limits employee-paid premiums according to a specified formula which includes consideration of the employee's wages. Prohibits excluding pre-existing conditions or exclusions for core services that are more restrictive than the exclusions under the MediWrap component. Sets forth consumer protections, including: (1) prohibiting a plan which is not a network plan from restricting the covered individual's choice of provider; (2) requiring notice of the low-income assistance available under this Act; and (3) insolvency and escrow reserves protection. Mandates issuance of health plan identification cards and use of standard claims forms and processes. Requires: (1) coordination of coverage and termination of coverage among plans and between plans and the MediKids and MediWrap components; (2) coordination of deductibles and cost-sharing among plans; (3) notice of beginning and terminating coverage of an individual; (4) ongoing accounting, for each covered individual, regarding deductibles and cost-sharing to promote portability; and (5) that the MediWrap component cover each MediWrap eligible individual whose coverage under a plan or under Medicare part A is terminated. Provides for certification of open (defined as not limited to a particular employer or industry or organized on behalf of a particular group) group health polices. Considers a plan as meeting certain certification requirements if it provides benefits through a contract with a carrier for an open certified policy. Prohibits a State from imposing any requirement on an open basic policy inconsistent with these requirements. Requires a certified group health policy to meet requirements of this Act relating to claims procedures, financial arrangements between group health plans and physicians having the effect of reducing or limiting services, issuance of UniMed cards, core services, deductibles, coinsurance, cost-sharing, payment rates, pre-existing conditions, choice of provider, solvency, standardization of cards and claims processing, and coordination and portability of coverage. Requires the carrier of a certified policy to assume responsibility under this Act for equalization of premiums. Requires a carrier which offers a certified policy to offer it without regard to the size of the employer. Allows health maintenance organizations to have certain geographic and size limits. Prohibits open basic certified policies from being terminated, except for premium nonpayment, fraud or misrepresentation, or at the end of a year. Allows employers to change to another policy without penalty at the end of each calendar year. Requires each open basic certified policy to provide coverage to eligible employees, if ordered by the Board because of employer failure to provide coverage. Provides a process for the equalization of premiums according to specified formulas, considerations, and factors. Mandates establishment of related advisory committees. Entitles certain small (fewer than 25 employees) employers to a premium subsidy beginning at a specified percentage of the employer premium and phasing out over four years. Establishes in the Health Benefits Administration the Federal Health Benefits Equalization Corporation to carry out provisions of this Act relating to equalization. Exempts the Corporation from Federal and, subject to exception, State and local taxes. Provides for the treatment of the Corporation and the Federal Health Benefits Equalization Fund (established under this Act) regarding the Federal budget and the Balanced Budget and Emergency Deficit Control Act of 1985. Establishes in the Treasury the Federal Health Benefits Equalization Fund to carry out the functions of the Corporation under these provisions, crediting to the Fund equalization payments and other amounts. Appropriates to the Fund: (1) a specified portion of taxes received under certain provisions; (2) amounts equal to the small employer subsidies; and (3) amounts equal to the low income assistance provided under title V of this Act. Sets forth reporting and disclosure requirements for all group health plans, including regarding a summary plan description, annual financial and other reports, the furnishing of certain information to covered individuals, and the publication of specified information. Regulates the retention of certain records. Requires that charges of violation of this Act be filed with the Special Counsel of the Board. Provides for the appointment of the Counsel. Requires the Counsel to investigate charges, issue complaints, and prosecute all complaints before administrative law judges of the Group Health Plan Review Board (Review Board) and the Health Benefits Board (Board). Establishes the Review Board. Provides for: (1) procedures for hearings before the administrative law judges; and (2) review of their decisions. Establishes an Early Resolution Program to facilitate discussions, clarify issues, identify additional information, encourage settlement, and present an assessment of the likely outcome of litigation. Establishes in the Health Benefits Administration the Claims Resolution Board (Claims Board) to take certain actions, including administering the Program. Sets forth Program eligibility criteria and initiation procedures. Prohibits formal rules of evidence, oaths, and transcripts. Provides for enforcement, with regard to matters which are not eligible to be brought before the Special Counsel, through a civil action brought by the Board, the Corporation, or any aggrieved party. Imposes civil penalties for failure to comply with reporting and disclosure rules. Prohibits interference with protected rights. Imposes criminal penalties for coercive interference. Preempts State laws: (1) different from this Act; (2) specifying the individuals to be covered under a certified plan or the duration of coverage; or (3) requiring a conversion right from a certified group plan to an individual plan. Prohibits State laws from prohibiting or unreasonably restricting network plans from taking specified actions. Defines a "network plan" as a plan which limits coverage of core services to those provided by participating providers or which permits higher deductibles and coinsurance applicable to the use of nonparticipating providers. Sets forth other requirements for network plans. Mandates establishment of standards for utilization review programs. Preempts inconsistent State laws. Subtitle B: Miscellaneous Provisions - Sets forth which provisions of title I (Protection of Employee Benefit Rights) of the Employee Retirement Income Security Act of 1974 (ERISA) apply and which provisions do not apply to group health plans. Title II: MediKids Component of UniMed Program - Subtitle A: Eligibility and Coverage - Entitles to benefits under this title each child who is: (1) under 22 years old; (2) a U.S. citizen or national, a lawful permanent resident alien, or an alien residing permanently in the United States; and (3) a U.S. resident (MediKids eligible children). Declares that failure to pay a premium tax under specified provisions of the Internal Revenue Code shall not terminate benefits under this title. Mandates issuance of identifying UniMed cards. Declares that MediKids eligible children are entitled to benefits whether or not a UniMed card has been issued with respect to them. Subtitle B: Benefits - Includes in core services those core services described in title I of this Act, as modified with regard to inpatient and outpatient mental health services, preventive services, prescription drugs, and developmental services. Establishes an advisory committee to advise the Board on medically necessary and reasonable core services. Allows the Board, in order to conduct demonstrations, to include additional services as core benefits. Mandates a study and report to the Congress on the appropriateness of providing coverage for long-term care under the MediKids component. Regulates (in some cases prohibits) coinsurance, copayment, and cost-sharing. Requires payment of benefits under this title to be made without regard to whether a MediKids eligible child is also entitled to benefits under titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act. Requires that Medicare benefits be coordinated with, and supplement, benefits under this title. Subtitle C: Payments; Premium Computation - Requires: (1) MediKids payments to be made on the same basis as MediWorkers payment rates, adjusting for the different populations and services; and (2) the Board to establish similar rates and methodologies for MediKids benefits that are not core services. Applies Medicare provisions (relating to withholding of payments for certain Medicaid providers and to offset of payments to individuals to collect past-due obligations arising from breach of scholarship and loan contracts) to this title. Prohibits providers from charging in excess of the applicable payment amount or charging for a service which is not medically necessary or reasonable. Provides for computation of the MediKids monthly premium amount. Subtitle D: Miscellaneous - Authorizes the Board to: (1) require providers to enter into participation agreements with the Board in order to be eligible for payments; or (2) permit such agreements. Authorizes the Board to provide for the administration of this title through a contract or agreement with one or more fiscal agents. Mandates application of the MediWorkers early resolution program and the claims review procedures to MediKids disputes and claims. Authorizes the Board to enter into a contract with health maintenance organizations and other prepaid capitation organizations for MediKids services and a monthly, prospectively determined capitated amount. Requires the Board to establish an optional primary care capitation payment methodology for pediatric practices involving a fixed, periodic payment. Authorizes agreements for utilization and quality control activities. Title III: MediWrap Component of UniMed Program - Subtitle A: Eligibility and Coverage - Entitles to MediWrap benefits each individual who is: (1) between 21 and 60 years old; (2) a U.S. citizen or national, a lawful permanent resident alien, or an alien otherwise permanently residing in the United States; and (3) a U.S. resident. Exempts from the entitlement persons entitled to benefits under Medicare part A or under MediWorkers provisions of this Act. Declares that failure to pay a premium tax under specified provisions of the Internal Revenue Code shall not terminate benefits. Mandates issuance of identifying UniMed cards. Declares that MediWrap eligible individuals are entitled to benefits whether or not a UniMed card has been issued with respect to them. Subtitle B: Benefits - Requires that MediWrap benefits be the same as MediWorkers core benefits. Allows the Board, in order to conduct demonstrations, to include additional benefits. Mandates establishment of an advisory committee to advise the Board on medical necessity and reasonableness. Regulates deductibles, coinsurance, and cost-sharing. Requires MediWrap payments to be made without regard to whether a MediWrap eligible individual is also entitled to benefits under title XIX (Medicaid) of the Social Security Act. Subtitle C: Payments; Premium Computation - Requires MediWrap payments to be made on the same basis as MediWorkers payment rates. Applies Medicare provisions (relating to withholding of payments for certain Medicaid providers and to offset of payments to individuals to collect past-due obligations arising from breach of scholarship and loan contracts) to this title. Prohibits providers from charging in excess of the applicable payment amount or charging for a service which is not medically necessary or reasonable. Provides for computation of the MediWrap monthly premium amount. Subtitle D: Miscellaneous - Authorizes the Board to: (1) require providers to enter into participation agreements with the Board in order to be eligible for payments; or (2) permit such agreements. Authorizes the Board to provide for the administration of this title through a contract or agreement with one or more fiscal agents. Mandates application of the MediWorkers early resolution program and the claims review procedures to MediWrap disputes and claims. Authorizes the Board to enter into a contract with health maintenance organizations and other prepaid capitation organizations for MediWrap services and a monthly, prospectively determined capitated amount. Authorizes agreements for utilization and quality control activities. Title IV: Cost Containment and Quality Control - Subtitle A: Cost Containment Provisions Contained Within UniMed Components - Sets forth references to other provisions of this Act. Subtitle B: Encouraging Use of "Managed" or "Coordinated" Care - Sets forth references to other provisions of this Act. Amends provisions of the Social Security Act relating to research on outcomes of health care services and procedures to mandate reflection of UniMed component needs in treatment- or condition-specific practice guidelines. Mandates inclusion of information UniMed impact in an annual report to the Congress. Authorizes appropriations to carry out the provisions. Modifies specifications regarding the source of appropriations under the provisions. Subtitle C: Quality Control - Amends the Employee Retirement Income Security Act of 1974 to require the Health Benefits Board to establish a locally-based, consumer-oriented process for providing information to employers, MediWorkers eligible individuals, and organizations representing the individuals on the quality and appropriateness of care provided under certified plans. Establishes the National Quality Advisory Committee. Requires the Board to establish a process for the recognition in each locality of a local health care quality review monitoring organization. Subtitle D: Improvements in Administrative Efficiency - Requires the Board to establish standards for: (1) UniMed cards, including electronic coding on the cards; and (2) forms to be used and electronic data to be submitted regarding claims. Subtitle E: Medical Malpractice Reform - Requires the Board to report to the Congress detailing specific reforms of medical malpractice. Allows the Board to provide for the implementation under the MediKids and MediWrap components of the early resolution program. Title V: Low Income Assistance - Mandates a sliding scale of subsidies to low income individuals for UniMed component deductibles and coinsurance. Requires, for those receiving advance assistance, subsequent filing of income statements and related payment adjustments. Disqualifies from assistance under this title all members of a family for which the statements are not filed by a specified deadline. Requires the Secretary of the Treasury to transmit income information to the Board as necessary for verification. Considers a family eligible under this title, without filing an application or an income statement, if the family that has been determined to be eligible for aid under parts A or E of title IV (Aid to Families with Dependent Children) or title XVI (Supplemental Security Income) of the Social Security Act. Title VI: Financing - Subtitle A: Amendments to Internal Revenue Code of 1986 - Amends the Internal Revenue Code to impose taxes on employers (including railroads), certain employees, railroad employee representatives, and self-employed individuals. Reduces the employer tax for small employers (under 25 employees), phasing out the reduction over four years. Imposes a tax on individuals who: (1) are covered by MediWrap; (2) are covered by MediKids, if their custodial parent is not covered by MediWrap and neither parent is covered by MediWorkers. Imposes a tax on a percentage of the excess (if any) of UniMed income (adjusted gross income determined without regard to specified provisions, plus interest income) over the income taxed by certain other provisions, plus an amount determined according to a specified formula. Modifies: (1) the percentage of health insurance costs of self-employed individuals which is deductible; and (2) requirements regarding the hospital insurance applicable contribution base. Excludes from gross income employer contributions to UniMed premiums. Phases out the exclusion for highly compensated employees. Subtitle B: Maintenance of Effort - Requires each State to pay to the UniMed Trust Fund amounts, determined according to specified formulas, relating to: (1) for the MediKids amount, the number of Medicaid-eligible children in the State, the average per child expenditures to be made under the MediKids component, and the Federal medical assistance percentage under Medicaid; and (2) for the MediWrap amount, the amount of MediWrap expenditures under the State Medicaid plan and the Federal medical assistance percentage under Medicaid. Appropriates equivalent amounts to the Fund. Subtitle C: UniMed Trust Fund - Establishes the UniMed Trust Fund with separate MediKids, MediWrap, and low income assistance accounts. Excludes Fund receipts and disbursements from the Federal budget and the Balanced Budget and Emergency Deficit Control Act of 1985. Makes the United States not liable for any obligation or liability of the Fund. Authorizes appropriations equal to the amount by which MediKids and MediWrap expenditures exceed Fund deposits. Transfers certain tax receipts and State and Federal payments to the various accounts of the Fund. Makes amounts in the Fund also available for payments under the provisions of the Social Security Act relating to outcomes of health care services and procedures. Title VII: Administration of UniMed Program - Establishes, as an independent agency in the executive branch, the Health Benefits Administration, governed by the Health Benefits Board, to administer the components of the UniMed program. Authorizes the Board to investigate and, where appropriate, refer civil and criminal violations regarding this Act, the Employee Retirement Income Security Act of 1974, or other Federal laws. Authorizes the Board to collect, analyze, and publish information relating to the UniMed program. Mandates studies regarding: (1) the effects of the program on the provisions and costs of group health plans; (2) the role of the program in meeting national health needs; (3) the operation of group health plans; (4) methods of encouraging the growth of the group health plan systems; and (5) the appropriateness of providing coverage for long-term care under the MediWorkers and MediWrap components. Title VIII: Medicare Program - Amends provisions of title II (Old-Age, Survivors, and Disability Insurance (OASDI)) of the Social Security Act relating to entitlement to hospital insurance benefits to replace references to age 65 with references to age 60 and to otherwise modify eligibility requirements for Medicare parts A (Hospital Insurance) and B (Supplementary Medical Insurance). Repeals Medicare provisions relating to: (1) hospital insurance for uninsured individuals not otherwise eligible; and (2) hospital insurance benefits for disabled individuals who have exhausted other entitlements. Amends specified Medicare provisions to replace references to age 65 with references to age 60. Makes Medicare a secondary payer after payment under MediKids. Appropriates to the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund, both established under the Social Security Act, the taxes received under specified provisions of the Internal Revenue Code with respect to the wages of individuals 60 years old or older or who are otherwise entitled to benefits under Medicare part A, less the decrease in income taxes resulting from such taxes. Title IX: Miscellaneous Provisions - Repeals provisions of: (1) the Internal Revenue Code relating to failure to satisfy continuation coverage requirements of group health plans; (2) the Employee Retirement Income Security Act of 1974 relating to continuation coverage under group health plans; and (3) the Public Health Service Act relating to requirements for certain group health plans for certain State and local employees. Amends the Internal Revenue Code to allow returns and return information to be furnished to the Health Benefits Administration and the Federal Health Benefits Equalization Corporation for the purposes of, and to the extent necessary in the administration of, this Act. Amends the Public Health Service Act to mandate grants to provide access to services for medically underserved populations or in high impact areas not currently being serviced by a Federally-qualified health center. Allows grant funds to be used for: (1) recruiting, training, and compensating staff; (2) facilities construction, acquisition, expansion, and modernization; (3) purchasing equipment; (4) principal and interest on related loans; (5) all services of a Federally-qualified health center; (6) any other services such a center may provide and be reimbursed under Medicaid; and (7) unreimbursed costs as described under provisions relating to community health centers. Authorizes appropriations. Mandates a study on the relationship and interaction between community health centers and hospitals in providing services to underserved areas. Authorizes appropriations. Prohibits a State, as a condition for receiving Medicaid payments, from reducing the eligibility for, or the amount of, benefits for children under 22 years old below those in effect before enactment of this Act. Amends Medicaid provisions to prohibit Medicaid payments for items and services for which payment is made under UniMed. Adds a requirement that a State Medicaid plan take all reasonable measures to ascertain the legal liability of third parties, including certified plans under MediWorkers, to pay for services under the plan. Title X: Glossary of Terms - Sets forth references to where terms are defined in this Act.
Bill· HRH.R. 5052 (102nd)referred
United States · United States Congress · 30 April 1992
Tuberculosis Prevention and Control Amendments of 1992 - Amends the Public Health Service Act to authorize appropriations for grants for the prevention, control, and elimination of tuberculosis. Requires the Director of the National Institute of Allergy and Infectious Diseases to conduct or support research and research training regarding tuberculosis. Authorizes appropriations. Authorizes grants for the prevention, control, and elimination of tuberculosis for: (1) construction or modernization of outpatient medical facilities serving medically underserved populations; (2) conversion of existing facilities into outpatient or long-term care facilities for such populations; and (3) renovation of inpatient facilities. Authorizes appropriations. Amends title XIX (Medicaid) of the Social Security Act to mandate provision to eligible persons with tuberculosis of certain drugs and services under Medicaid. Allows a State to limit the provision of case management services to such persons. Adds such persons to provisions defining "medical assistance."
Bill· HRH.R. 5051 (102nd)referred
United States · United States Congress · 30 April 1992
Prescription Accountability and Patient Care Improvement Act of 1992 - Title I: Assisting in Implementation of Controlled Substance Accountability Prescription Systems - Directs the Secretary of Health and Human Services to make funds available to at least ten States: (1) for electronic prescription accountability and patient care improvement programs under this Act; (2) to supplement State electronic claims management systems under title XIX (Medicaid) of the Social Security Act; (3) for the operations of existing triplicate systems under this Act; and (4) to supplement the implementation of guidelines developed by the Agency for Health Care Policy and Research and accepted drug utilization review principles to improve patient care and physician prescribing practices. Authorizes appropriations, to be derived solely from fees imposed under the Controlled Substances Act, as amended by this Act. Amends the Controlled Substances Act to authorize fees for registration to manufacture controlled substances in certain schedules and relating to the administration of programs to prevent and detect illegal and inappropriate drug distribution by allowing information on prescriptions of drugs that are controlled in Schedules II, III, and IV to be electronically transmitted to State health agencies. Describes a controlled substances electronic accountable prescription system, including requirements that it electronically report the dispensing of certain drugs. Requires the State health agency to: (1) pay transmittal costs; and (2) make all necessary transmittal equipment available to dispensers without charge. Requires each State system to provide for the maintenance of information in a central repository meeting certain requirements. Requires each State to designate a State agency to administer the collection of system information, control information access, and produce reports of aggregated data that indicate that a substance has been dispensed for a period outside the expected standards. Provides for confidentiality and disclosure of information. Requires the Director of a State agency to appoint a Prescription Accountability and Patient Care Improvement Board. Mandates disclosure to: (1) the State narcotics control agency and medical boards or licensing agencies only when there is reasonable cause for further inquiry into the illegal diversion or illegal prescribing of controlled substances; and (2) State medical boards and licensing agencies, and State medical societies only when there is reasonable cause for further inquiry of a medically inappropriate prescribing of controlled substances, for developing rules and procedures to improve physician prescribing practices and patient care. Requires the State health agency to: (1) appoint a Practice Parameter Advisory Panel; and (2) develop procedures to address the needs of individuals in need of substance abuse treatment counseling for controlled substances. Title II: Reports and Studies - Establishes a nationwide patient care improvement telephone hotline to respond to questions from patients, physicians, pharmacists, and any other health care practitioner involved in the dispensing or regulation of drugs. Requires that the hotline collect fees through "1-900" technologies to cover all hotline costs. Establishes the National Commission on Special Medical Needs to: (1) develop new initiatives regarding the appropriate prescribing of medically necessary drugs, including addressing both underprescribing and overprescribing; and (2) establish a system for identifying physicians needing further education on the needs of severely ill patients. Mandates regular consultation between certain officials of the Department of Health and Human Services and the Drug Enforcement Administration (DEA) regarding the annual quota for legal manufacture of schedule II controlled substances. Directs the Secretary to regularly advise the DEA of: (1) continuing medical developments in the therapeutically-effective prescribing of schedule II controlled substances; and (2) any developing shortages of schedule II controlled substances for pain or narcolepsy patients. Requires ongoing studies and reports to the Congress of the costs and benefits of existing electronic data transfer and multiple-copy prescription programs relating to controlled substances, including programs implemented under title I of this Act. Mandates ongoing efforts to identify prescription drugs which are not schedule II-IV controlled substances but which are subject to illegal diversion or needless addiction. Requires development and distribution of a brief information brochure regarding proper prescribing of controlled substances for specialty treatment. Mandates development of printed patient inserts regarding controlled substance use, including listing the hotline number. Requires the Inspector General of the Department of Health and Human Services to develop computer software to administer this Act, taking all steps to ensure compatibility with the Medicaid Audit Data Accounting Systems (MADAS).
Bill· HRH.R. 5039 (102nd)referred
United States · United States Congress · 30 April 1992
Directs the Secretary of Energy (the Secretary) to develop and implement a plan for the restructuring of the employee work force of the Department of Energy (DOE) defense nuclear facilities. Outlines plan contents designed to minimize the economic impact of the restructuring upon affected employees and communities. Requires the Secretary to issue annual plan updates to specified congressional committees. Sets forth requirements relating to contracts for environmental restoration and waste management at DOE defense nuclear facilities. Requires the Secretary to establish and implement a program to monitor current and former DOE employees subject to significant health risks as a result of their exposure to hazardous or radioactive substances during the course of their employment. Delineates plan contents. Directs the Secretary to: (1) notify employees exposed to certain hazardous and radioactive substances of the results of their medical examinations regarding such exposure; (2) collect information regarding such tests and examinations; (3) enter into an agreement with the Secretary of Health and Human Services to implement their respective activities under this Act; and (4) implement a health insurance program to cover the reasonable expenses of health care services incurred by such employees.
Bill· HRH.R. 5049 (102nd)referred
United States · United States Congress · 30 April 1992
Improved Access to Affordable Health Care Act of 1992 - Title I: Improvements in Health Insurance for Small Employers - Amends the Social Security Act to add a new title, Title XXI: Standards for Small Employer Health Insurance and Certification of Managed Care Plans. Directs the Secretary of Health and Human Services to request that the National Association of Insurance Commissioner (NAIC) develop standards concerning requirements for health insurance plans for small employers. Requires the Secretary to develop such standards if NAIC fails to do so. Requires such plans to provide for: (1) guaranteed eligibility; (2) guaranteed availability; and (3) guaranteed renewability. Prohibits: (1) an insurer from refusing to renew or terminate a plan, except for nonpayment of premiums, fraud, or failure to maintain minimum participation rates; and (2) for certain services, discrimination based on health status. Sets limits controlling the variation of premium charges permitted among all small employers insured by an insurer. Requires the full disclosure of an insurer's rating practices. Requires a health insurance plan for small employers to offer: (1) both a standard and basic benefit package; and (2) a managed care option, under certain conditions. Provides, under both the standard and basic package, for coverage of: (1) inpatient and outpatient hospital care; (2) inpatient and outpatient physician services; (3) diagnostic tests; and (4) preventive services. Provides, in addition, under the standard plan: (1) for the coverage of certain mental health care; (2) that, except as specified, there will be no limits on the amount, scope, or duration of benefits; and (3) for specified limits on deductibles, copayment, coinsurance, and out-of-pocket expenses. Provides under the basic plan that: (1) premiums, deductibles, copayments, or other cost-sharing may be imposed; and (2) there shall be an out-of-pocket limit. Sets forth study and reporting requirements. Title II: Improvements in Portability of Private Health Insurance - Amends title XXI of the Social Security Act to prohibit group health plans from denying, limiting, or conditioning plan coverage based on the individual's health status and other factors, subject to stated exceptions for preexisting conditions. Title III: Health Care Cost Containment - Establishes a Health Care Cost Commission which shall report annually to the President and the Congress on national health care costs. Authorizes appropriations. Requires the Secretary, under title XXI of the Social Security Act, to establish a process for the certification of managed care plans and of utilization review programs. Sets forth requirements for certification. Amends the Public Health Service Act to authorize additional funding for outcomes research. Title IV: Grants To States for Small Employer Health Insurance Purchasing Programs - Directs the Secretary to make grants to States for small employer health insurance purchasing programs. Authorizes appropriations. Sets forth reporting requirements. Directs the Secretary to study and report to the Congress on the feasibility and desirability of establishing payment rates, based upon Medicare payment rules, for optional use by private health insurers.