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Bill· HRH.R. 2407 (103rd)referred
United States · United States Congress · 14 June 1993
Partnership for Long-Term Care Act of 1993 - Title I: Medicaid Program Improvements - Amends title XIX (Medicaid) of the Social Security Act (SSA) to require States to cover certain primary care for pregnant women and children, and nursing facility services for other individuals, whose incomes are below the Federal poverty level. Requires States to establish a subsidy program to assist individuals whose incomes are no less than the Federal poverty level and no more than twice such level in paying long-term care insurance premiums. Provides larger subsidies as individuals' incomes approach the Federal poverty level. Prohibits States from establishing a subsidy resource eligibility limit at less than twice the resource limit under (SSA) title XVI (Supplemental Security Income). Title II: Medicaid Amendments Relating to Treatment of Payments Under Qualified Long-Term Care Insurance Policies - Subtracts long-term care insurance payments from an individual's assets in determining his or her Medicaid eligibility. Title III: Tax Treatment of Long-Term Care Insurance - Requires that, for the purpose of determining the income tax liability of life insurance companies, qualified long-term care insurance be treated as accident or health insurance. Applies this provision to policies which provide coverage for at least 12 consecutive months of diagnostic, preventive, therapeutic, rehabilitative, maintenance, or personal care services provided in a setting other than the acute care unit of a hospital and for an individual's loss of functional capacity. Provides that for the purpose of determining whether a tax exclusion applies to employer contributions to, or an employee's receipt of benefits from, qualified long-term care insurance, such contributions and benefits shall be considered to be for coverage under an accident or health plan. Makes the penalty tax on early distributions from qualified retirement plans inapplicable when such distributions are used to pay for qualified long-term care insurance. Treats an individual's qualified long-term care expenses as deductible medical care expenditures. Provides for the deduction of employer contributions to a reserve fund providing employees with post-retirement qualified long-term care benefits. Permits inclusion of qualified long-term care insurance in cafeteria plans. Excludes it from a cafeteria plan participant's gross income.
Bill· SS. 1096 (103rd)open
United States · United States Congress · 10 June 1993
International Population Stabilization and Reproductive Health Act - Amends the Foreign Assistance Act of 1961 to set forth population assistance authorities and requirements. Makes such assistance available to a country that: (1) accounts for a significant portion of the world's annual population increment; (2) has significant unmet needs for fertility regulation and requires foreign assistance to sustain quality family planning services; or (3) demonstrates a strong policy commitment to population stabilization through the expansion of reproductive choice. Prohibits nongovernmental and multilateral organizations from being subjected to requirements which are more restrictive than those applicable to foreign governments for such assistance. Makes funds available for: (1) the United Nations Population Fund if it agrees to prohibit the use of funds for coerced abortion or involuntary sterilization; and (2) the Special Programme of Research, Development and Research Training to further international cooperation in the development of fertility regulation technology. Authorizes appropriations. Requires the U.S. executive directors of specified international financial institutions to report annually to the Congress on allocations to population activities and, if such allocations total less than $1 million to set forth actions to encourage increased allocations. Establishes the Commission on World Population Stabilization and Reproductive Health to coordinate U.S. participation in the 1994 International Conference on Population and Development. Authorizes appropriations. Makes development assistance available on a priority basis for countries which have agreed to address specific education, literacy, and health issues. Authorizes the President to establish a grant program, to be known as the Safe Motherhood Initiative, to improve the access of girls and women to reproductive health care services. Earmarks amounts of development and economic assistance for programs in support of equalizing male and female levels of primary and secondary school enrollment. Authorizes appropriations for the Child Survival Fund, the Safe Motherhood Initiative, and for research on, and treatment and control of, acquired immune deficiency syndrome (AIDS) in developing countries.
Bill· SS. 1088 (103rd)referred
United States · United States Congress · 10 June 1993
Rural Telemedicine Development Act of 1993 - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to award grants: (1) to hospitals, hospital networks, and other health care providers to encourage the initial development of rural telemedicine networks to use telecommunications technology in providing health services to rural areas; and (2) for linking such networks together using advanced telemedicine systems and for linking such networks to existing fiber optic telecommunications systems. Sets forth provisions regarding: (1) application requirements; (2) preferences in awarding grants; and (3) use of funds for initial development and advanced telemedicine grant programs. Authorizes appropriations.
Bill· SS. 1094 (103rd)open
United States · United States Congress · 10 June 1993
Extends through December 31, 2003, the authority of the Secretary of Veterans Affairs to provide priority health care to veterans who were exposed to Agent Orange or ionizing radiation during military service.
Bill· HRH.R. 2386 (103rd)referred
United States · United States Congress · 10 June 1993
Primary Care Health Practitioner Incentive Act of 1993 - Amends title XVIII (Medicare) of the Social Security Act to provide increased Medicare reimbursement for nurse practitioners, clinical nurse specialists, and certified nurse midwives (practitioners) for services performed without regard to location or practice setting. Provides for bonus payments for services provided by such practitioners in health professional shortage areas. Defines "clinical nurse specialist" as an individual who is a registered nurse, is licensed to practice nursing in the State in which the clinical nurse specialist services are performed, and holds a master's degree in a defined clinical area of nursing from an accredited educational institution.
Bill· HRH.R. 2394 (103rd)referred
United States · United States Congress · 10 June 1993
Women and AIDS Research Initiative Amendments of 1993 - Amends the Public Health Service Act to establish a program to conduct or support biomedical and behavioral research on cases of infection with the human immunodeficiency virus (HIV) in women. Regulates HIV clinical trials with women subjects. Mandates the conduct or support of: (1) clinical trials regarding the effectiveness of standard gynecological treatments in treating conditions arising from HIV infection; (2) clinical trials regarding whether the treatment protocols approved for men with HIV infection are effective for women with HIV infection; (3) research on barrier methods for the prevention of sexually transmitted diseases that women can use without their sexual partner's cooperation or knowledge; and (4) epidemiological research to determine HIV risk factors particular to women. Mandates support services for women in the clinical trials. Regulates the Women's Interagency HIV Study. Authorizes appropriations.
Bill· HRH.R. 2367 (103rd)open
United States · United States Congress · 10 June 1993
Health Care Accessibility Expansion Act of 1993 - Amends the Internal Revenue Code to: (1) increase the allowable deduction for health insurance costs of self-employed individuals from 25 percent to 100 percent; and (2) make the deduction permanent. Allows a tax credit for a medical practitioner who commences a medical practice in a rural area. Allows such credit for the year such commencement occurs and the four succeeding taxable years. Limits such credit to $5,000. Requires the taxpayer to practice medicine in the rural area for at least nine months in a taxable year. Allows a deduction on medical education loan interest of a physician which accrues while the physician is living in and providing medical care to residents of a rural area. Allows individuals a tax deduction for contributions made to a medical care savings account established for the benefit of an eligible individual. Defines an eligible individual as: (1) one who is not covered by an employer-provided group health plan; or (2) one who is covered by such a plan which is a qualified catastrophic coverage health plan and is not covered by any other health plan. Exempts such accounts from taxation. Allows such deduction in arriving at adjusted gross income. Establishes an excise tax for excess contributions to medical care savings accounts and makes such accounts subject to the tax on prohibited transactions. Allows the transfer of unused amounts in flexible spending accounts of cafeteria plans to medical savings accounts. Establishes a program under which eligible participants in medical savings accounts may obtain health insurance vouchers to make payments for qualified medical expenses. Allows a tax credit for the amount of such vouchers. Declares that it shall not be considered a violation of antitrust laws for hospitals to jointly undertake the purchasing, contracting for, or sharing of high technology equipment and services. Amends the Public Health Service Act to require demonstration projects to assist hospitals in acquiring and sharing such equipment and services. Authorizes appropriations for FY 1993 through 1996 for such projects.
Bill· HRH.R. 2375 (103rd)open
United States · United States Congress · 10 June 1993
Extends through December 31, 2003, the authority of the Secretary of Veterans Affairs to provide priority health care to veterans who were exposed to Agent Orange or ionizing radiation during military service.
Bill· HRH.R. 2396 (103rd)open
United States · United States Congress · 10 June 1993
Child Support Enforcement Improvements Act of 1993 - Makes depository institutions not liable under any Federal or State law to any person for disclosing any financial record of an individual to a State child support enforcement agency attempting to establish, modify, or enforce a child support obligation of such individual. Prohibits such an agency from disclosing such a record for any other purpose and provides for civil damages for unauthorized disclosures. Amends the Fair Credit Reporting Act to permit credit reporting agencies to grant access to certain consumer reports to a State child support enforcement agency that is seeking to establish, modify, or enforce a child support obligation against the consumer. Amends part D (Child Support and Establishment of Paternity) of title IV of the Social Security Act to: (1) require State laws to provide for the use of procedures requiring child support orders to provide for coverage of the health care costs of the child in accordance with State guidelines; (2) include under the incentive payments program any dependent medical insurance coverage which is provided due to the successful application of such procedures; (3) direct HHS' Office of Child Support Enforcement to report to the Congress annually on State compliance with specified standards establishing time limits for State response to certain child support assistance requests; (4) require States to assess a penalty against any employer who fails to make timely payment of withheld wages to pay child support obligations of an employee; and (5) direct the Office to develop a national parent locator network which would build on comprehensive statewide child support enforcement systems to allow States to carry out specified parent locator activities. Directs the Secretary of Health and Human Services (HHS) to study and report to specified congressional committees on how the successful efforts of States in enforcing obligations of absent parents to pay (and obtain medical insurance coverage with respect to) the health and dental expenses of their children should be rewarded through an incentive payments program.
Bill· HRH.R. 2395 (103rd)referred
United States · United States Congress · 10 June 1993
Women and HIV Outreach and Prevention Act - Amends the Public Health Service Act to authorize grants, with regard to women (and their partners) and acquired immune deficiency syndrome (AIDS), for preventive health services, referrals, follow-ups, outreach, and training on the effective provision of such services. Authorizes appropriations. Authorizes grants to educate women on the prevention of infection with, and the transmission of, the etiologic agent for AIDS. Authorizes appropriations. Authorizes grants, cooperative agreements, and contracts to provide: (1) substance abuse treatment to women; (2) counseling to women who engage in substance abuse on the prevention of infection with, and the transmission of, the etiologic agent for AIDS; and (3) such counseling to women who are the partners of individuals who abuse substances. Authorizes appropriations. Authorizes appropriations for grants under existing provisions to provide early intervention services for women and related technical assistance.
Bill· HRH.R. 2387 (103rd)referred
United States · United States Congress · 10 June 1993
Physician Assistant Incentive Act of 1993 - Amends title XVIII (Medicare) of the Social Security Act to provide increased Medicare reimbursement for physician assistants at 97 percent of the physician fee schedule amount for services performed, regardless of the location or practice setting. Provides for bonus payments for services provided by physician assistants in health professional shortage areas.
Bill· HRH.R. 2397 (103rd)referred
United States · United States Congress · 10 June 1993
Permits, notwithstanding limitations, a petition filed under the Public Health Service Act seeking compensation from the National Vaccine Injury Compensation Program for vaccine-related injuries suffered by a named individual.
Bill· SS. 1082 (103rd)referred
United States · United States Congress · 8 June 1993
State Offices of Rural Health Amendments of 1993 - Revises matching funds provisions of the program of grants to States for operation of offices of rural health (under the Public Health Service Act) to prohibit the Secretary of Health and Human Services: (1) from making grants under the program unless the State agrees to provide non-Federal contributions towards specified costs, in cash, in an amount not less than one dollar for each dollar of Federal funds provided in the grant; and (2) in determining the amount of non-Federal contributions in cash that a State has provided, from including any amounts provided to the State by the Federal Government. Authorizes appropriations. Increases grant amounts that may be made before termination of the program.
Law· SJRESS.J.Res. 99 (103rd)enacted
United States · United States Congress · 8 June 1993
Designates September 9, 1993, and April 21, 1994, as National DARE (Drug Abuse Resistance Education) Day.
Bill· HRH.R. 2345 (103rd)referred
United States · United States Congress · 8 June 1993
American Jobs Protection Act - Requires employers to provide specified notice and employee benefits (including severance pay, continuation of health care benefits, reimbursement for retraining, training incentive payments, and accelerated eligibility for early retirement) to employees who are subject to a plant closing or mass layoff because their work is transferred to (or similar products are imported from) another country which has specified levels of lower wages or less effective employment standards for overtime compensation, child labor, and employee safety. Prohibits employers who do not provide such notice and benefits from entering into a contract with the United States for provision of products or services involved in the work transfer or substantially similar to such products or services. Provides for enforcement of this Act by: (1) investigative and administrative actions and actions for injunctions by the Secretary of Labor; and (2) civil actions by employees, local governments, States, and the Secretary. Requires employers to post notice concerning this Act and the filing of a charge. Authorizes civil fines for violations.
Bill· HRH.R. 2344 (103rd)referred
United States · United States Congress · 8 June 1993
TABLE OF CONTENTS: Title I: Definitions Title II: Public Water Systems Title III: Protection of Underground Sources of Drinking Water Title IV: General Provisions Water Supply Protection Act of 1993 - Title I: Definitions - Amends the Safe Drinking Water Act to revise definitions. Title II: Public Water Systems - Directs the Administrator of the Environmental Protection Agency, if a contaminant occurs in drinking water at a level posing an unacceptable risk to public health or welfare, to promulgate national primary drinking water regulations that establish maximum contaminant levels or drinking water source protection or treatment requirements. Sets forth conditions under which a maximum contaminant level will be applied to a public water system. Authorizes each regulation that includes a standard for a chronic contaminant or requires treatment or source protection to include requirements for risk vulnerability assessments of such systems. Provides for treatment and source protection requirements if: (1) water treatment technology cannot reduce ambient levels of a contaminant to the maximum contaminant level that would otherwise be promulgated; or (2) commercially available water quality analytical methods are not capable of reliable quantification at the maximum level that would otherwise be promulgated. Continues the implementation of existing regulations for contaminants that meet criteria for regulation under this Act. Revises provisions that currently set forth requirements for national drinking water regulations to require the Administrator to establish a National Water Contaminant Health and Aesthetic Quality Advisory Program. Establishes a repository of information concerning contaminants in drinking water and protective exposure levels as part of the Program. Provides for the incorporation of data associated with existing national primary and secondary drinking water regulations into the repository and rescinds such regulations on inclusion of such data. Directs the Administrator to list triennially at least 15 contaminants for which there is insufficient scientific data that may have entered into drinking water. Provides for data collection on such contaminants. Directs the Administrator to establish a National Water Treatment Technology Advisory Program and a National Drinking Water Source Protection Management Practices Advisory Program. Provides for data repositories as part of such Programs. Requires the Administrator to: (1) develop model curricula for institutions of higher education concerning the design and packaging of small flow treatment trains and drinking water source management and protection; and (2) establish annual contests to demonstrate innovative solutions to water treatment and source protection problems. Removes certain conditions on State authority to grant variances or exemptions to national primary drinking water regulations. Provides that no notice or hearing shall be required if a representative of a public water system provides documentation that the system is eligible for a variance or exemption. Directs the Administrator to prescribe regulations to ensure the national certification of public water systems operators and analytical laboratories. Title III: Protection of Underground Sources of Drinking Water - Conditions Federal funding for State wellhead protection areas on a State filling a position for a groundwater protection source coordinator. Title IV: General Provisions - Directs the Administrator to establish a partnership to demonstrate low-cost small flow water treatment technologies that can be used by very small public water systems to meet primary drinking water standards and develop means to simplify State approvals of such technologies. Requires the Administrator to report to the Congress on: (1) steps taken to coordinate potable groundwater protection; and (2) recommendations on alternative Federal legislation to simplify the cost-effective consolidation of small public water systems. Authorizes the Administrator to establish, and award grants for, a technical assistance program for rural and small public water systems. Authorizes appropriations. Extends the authorization of appropriations for specified State public water supervision and protection programs. Authorizes appropriations for grants to States to adopt uniform data repository, collection, and reporting systems for a water supply supervision program. Directs the Administrator to suspend regulations requiring monitoring for unregulated contaminants until the regulations are modified to ensure that: (1) the annual household cost of monitoring is reasonable in light of other needs for public health protection; (2) the requirements reflect one-time sampling and the maximum use of pooled samples; (3) the use of certain analytical and screening methods are fully exploited; and (4) liberal exceptions are provided for in cases where the probability of contamination is low. Authorizes appropriations.
Bill· HJRESH.J.Res. 209 (103rd)referred
United States · United States Congress · 8 June 1993
Designates June 12 through 19, 1994, as National Men's Health Week.
Bill· SS. 1072 (103rd)referred
United States · United States Congress · 28 May 1993
Family Caregiver Support Act of 1993 - Amends the Social Security Act (SSA) to establish a program to enable States to furnish services to support informal caregivers of eligible individuals with functional disabilities. Outlines State plan requirements for such caregiver support services, including requirements that: (1) States support 50 percent of program administration costs; (2) program services may not supplant services otherwise available to eligible recipients under Medicare or Medicaid (SSA titles XVIII and XIX) or any other public or private health insurance plan; and (3) persons with incomes exceeding 200 percent of the Federal poverty level must make co-payments on a sliding scale basis established by the State. Caps total annual Federal expenditures per eligible recipient. Authorizes appropriations.
Bill· SS. 1067 (103rd)referred
United States · United States Congress · 28 May 1993
Authorizes the President to conclude an agreement with Mexico to establish a binational commission to be known as the United States-Mexico Border Health Commission. Declares that it should be the duty of the Commission to: (1) conduct a needs assessment in the U.S.-Mexican border area to identify and resolve health problems that affect the general population of the area; (2) coordinate public and private persons to educate the population about, and resolve, such health problems and develop programs to meet needs that are not being met by such persons; and (3) formulate recommendations for a fair method by which the government of one country would reimburse a public or private person in the other country for the cost of a health care service furnished to a citizen or resident alien of the first country who is unable to pay for the service.
Bill· SS. 1064 (103rd)referred
United States · United States Congress · 28 May 1993
Amends title XIX (Medicaid) of the Social Security Act to change the definition of certified nurse-midwife services (and thus allow certified nurse-midwives to receive payment under Medicaid for all services which such practitioners are legally authorized to perform under State law or regulations).
Bill· SS. 1041 (103rd)open
United States · United States Congress · 27 May 1993
Amends the Public Health Service Act to authorize States to identify unimmunized infants and children enrolled in a specified program and ensure that they are immunized. Requires States to determine the vaccinations that are appropriate for the age of an infant or child. Allows States to use amounts made available under specified Federal law to carry out this Act. Authorizes grants to States to assist in the vaccination of children enrolled in such program at local program offices where no health care providers are available. Authorizes appropriations.
Bill· SS. 1042 (103rd)referred
United States · United States Congress · 27 May 1993
Amends the Public Health Service Act to require additional review procedures prior to the approval of research applications. Requires the Secretary to establish a standing Ethical Advisory Board to: (1) advise, report on, and make recommendations to the Secretary and the Congress regarding ethical, legal, and social acceptability of supporting specific biomedical and behavioral research designs, applications, or proposals submitted to it by the Secretary or any Agency Head within the Department of Health and Human Services; and (2) prepare reports and make recommendations concerning ethical policies relating to biomedical and behavioral research referred to it by the Secretary, Agency Heads, or congressional committees. Authorizes the Board to develop reports and make recommendations concerning other matters that it considers of major importance to the general public.
Bill· SS. 1057 (103rd)referred
United States · United States Congress · 27 May 1993
TABLE OF CONTENTS: Title I: Eligibility and Enrollment Title II: Administration by Federal Medicore Board Title III: Core Services Title IV: Federal Medicore Guidelines Title V: Approval and Oversight of State Programs Title VI: Medicore Budget Title VII: Preparation and Submission of Medicore Budget to Congress Title VIII: Effective Date; Repeals; Transition; Relation to ERISA MediCORE Health Act of 1993 - Title I: Eligibility and Enrollment - Makes each legal resident of the United States eligible for CORE SERVICES through a MediCORE card under a State program. Title II: Administration by Federal MediCORE Board - Establishes within the Department of Health and Human Services a Federal MediCORE Board to be responsible for the overall administration of this Act and for the oversight of State compliance with this Act, as well as the development of CORE SERVICES and of specific State guidelines. Requires the Board to: (1) publish and make available to each State a Model MediCORE Administration Manual; and (2) establish and administer the operation of a National Data Bank System with health care data and information. Specifies various health care studies to be conducted by the Board. Requires an annual report to the appropriate congressional committees on the state of the Nation's health care services. Title III: CORE SERVICES - Requires the Board to provide for CORE SERVICES that include: medically necessary services, Medicare services, preventive health care services, long-term health, custodial or personal assistance, and catastrophic care. Amends the Child Nutrition Act to authorize appropriations for the special supplemental food program. Title IV: Federal MediCORE Guidelines - Establishes requirements for Federal MediCORE guidelines to be developed and implemented by the Board. Title V: Approval and Oversight of State Programs - Grants approval and oversight authority to the Board over State programs. Title VI: MediCORE Budget - Requires the Board to prepare an annual MediCORE Budget which provides each approved State program with health care revenue sharing payments. Established the MediCORE Trust Fund to make such payments. Provides funding for such Trust Fund through appropriations, the transfer of certain taxes, and the transfer of funds from social security trust funds. Amends the Internal Revenue Code to impose a tax on employees and employers to provide for health care revenue sharing. Imposes a MediCORE tax on individuals. Makes other tax changes to conform to provisions of this Act. Title VII: Preparation and Submission of MediCORE Budget to Congress - Requires the Board to annually submit a MediCORE budget report to the Congress. Title VIII: Effective Date; Repeals; Transition; Relation to ERISA - Establishes the effective date for the MediCORE program. Repeals certain Acts and laws to conform to such program. Authorizes appropriations. Supersedes provisions of the Employee Retirement Income Security Act to the extent inconsistent with this Act.
Bill· HRH.R. 2300 (103rd)referred
United States · United States Congress · 27 May 1993
TABLE OF CONTENTS: Title I: Assistance to Workers Subject to Plant Closings or Mass Layoffs Because their Work is Transferred to Low Wage Foreign Countries Title II: Amendments to the Worker Adjustment and Retraining Notification Act Title III: Effective Date American Jobs Protection Act - Title I: Assistance to Workers Subject to Plant Closings or Mass Layoffs Because Their Work Is Transferred to Low Wage Foreign Countries - Requires employers to provide specified notice and employee benefits (including severance pay, continuation of health care benefits, reimbursement for retraining, training incentive payments, and accelerated eligibility for early retirement) to employees who are subject to a plant closing or mass layoff because their work is transferred to (or similar products are imported from) another country which has specified levels of lower wages or less effective employment standards for overtime compensation, child labor, and employee safety. Prohibits employers who do not provide such notice and benefits from entering into a contract with the United States for provision of products or services involved in the work transfer or substantially similar to such products or services. Provides for enforcement of this title by: (1) investigative and administrative actions and actions for injunctions by the Secretary of Labor; and (2) civil actions by employees, local governments, States, and the Secretary. Requires employers to post notice concerning this title and the filing of a charge. Authorizes civil fines for violations. Title II: Amendments to the Worker Adjustment and Retraining Notification Act - Amends the Worker Adjustment and Retraining Notification Act to lower the number of employees an employer must have to be covered by such Act to 50 (currently 100) and the number involved to be considered a plant closing or mass layoff to 25 (currently 50 for a closing and various formulas for a layoff). Reduces the aggregate number of weekly hours of such employees by half to reflect such change. Increases the time period of notice required before plant closings and mass layoffs to 180 days. Adds to the damages for which an employer in violation of such Act is liable. Excludes liability for liquidated damages if the violation is a good faith act or omission. Adds required enforcement actions by the Secretary of Labor. Requires (currently allows) the prevailing party in a civil action against an employer under such Act to receive a reasonable attorney's fee as part of the costs. Requires employers to post notice concerning such Act and the filing of a charge. Authorizes civil fines for violations. Title III: Effective Date - Sets forth the effective date of this Act and the amendments it makes.
Bill· HRH.R. 2305 (103rd)reported
United States · United States Congress · 27 May 1993
Authorizes the President to conclude an agreement with Mexico to establish a binational commission to be known as the United States-Mexico Border Health Commission. Declares that it should be the duty of the Commission to: (1) conduct a needs assessment in the U.S.-Mexican border area to identify and resolve health problems that affect the general population of the area; (2) coordinate public and private persons to educate the population about, and resolve, such health problems and develop programs to meet needs that are not being met by such persons; and (3) formulate recommendations for a fair method by which the government of one country would reimburse a public or private person in the other country for the cost of a health care service furnished to a citizen or resident alien of the first country who is unable to pay for the service.
Bill· HRH.R. 2317 (103rd)referred
United States · United States Congress · 27 May 1993
TABLE OF CONTENTS: Title I: Tax Treatment of Long-Term Care Insurance Title II: Refundable Tax Credit for Certain Custodial Care Title III: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance Long-Term Care Insurance Incentive Act of 1993 - Title I: Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation. Excludes from gross income benefits provided under a long-term care insurance contract. Includes in gross income employer-provided coverage for long-term care services. Allows a tax credit for a percentage of qualified long-term care premiums. Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions. Includes any parent or grandparent as a dependent for purposes of such expenses. Provides for the nonrecognition of gain or loss on the exchange of any life insurance contract or an endowment or annuity contract for a long-term care insurance contract. Excludes from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangements to pay long-term care premiums. Provides for the exclusion as a death benefit of any amount paid or advanced to an individual under a life insurance contract because such individual is terminally ill, chronically ill, or has been permanently confined to a qualified facility. Allows insurance companies to issue accelerated death benefit riders on life insurance contracts. Title II: Refundable Tax Credit for Certain Custodial Care - Allows a $2,000 per qualified person tax credit for taxpayers who maintain a household which includes a chronically ill dependent. Title III: Protection of Assets Under Medicaid Through Use of Qualified Long-Term Care Insurance - Amends title XIX of the Social Security Act (Medicaid) to disregard assets which are attributable to coverage under a qualified long-term care insurance contract for purposes of eligibility.
Law· HJRESH.J.Res. 205 (103rd)enacted
United States · United States Congress · 27 May 1993
Designates the week beginning October 31, 1993, as National Health Information Management Week.
Bill· HJRESH.J.Res. 206 (103rd)open
United States · United States Congress · 27 May 1993
Designates October 1993 and October 1994 as National Down Syndrome Awareness Month.
Resolution· HCONRESH.Con.Res. 108 (103rd)referred
United States · United States Congress · 27 May 1993
Urges the States and the District of Columbia to enact comprehensive laws to prohibit any person under 21 years of age from purchasing or attempting to purchase alcohol, possessing or consuming it in public, and misrepresenting his or her age or using false identification to purchase alcohol.
Bill· SS. 1030 (103rd)referred
United States · United States Congress · 26 May 1993
Amends the Veterans Health Care Act of 1992 and Federal veterans' benefits provisions to: (1) extend through December 31, 1998, the authority of the Department of Veterans Affairs to provide sexual trauma counseling at Department facilities as well as through non-Department providers; (2) remove a requirement that veterans seek such counseling within a specified period after discharge; (3) remove the current one-year limit on the length of such counseling; (4) make the provision of such counseling equal in priority to the provision of Department outpatient services; (5) authorize the Department to provide such counseling to all veterans (currently, only women); and (6) require (current law authorizes) the provision of a 24-hour toll-free telephone number for the provision of sexual trauma crisis counseling. Directs the Secretary of Veterans Affairs to make certain reports with respect to: (1) the operation of the telephone hotline; and (2) the difficulties veterans encounter in obtaining from the Department determinations that disabilities relating to sexual trauma are service-connected. Modifies responsibilities of Department coordinators of women's services. Requires the Secretary to ensure that such coordinators are provided sufficient resources to carry out such responsibilities.
Bill· HRH.R. 2285 (103rd)open
United States · United States Congress · 26 May 1993
Amends the Veterans Health Care Act of 1992 and Federal veterans' benefits provisions to: (1) extend through December 31, 1998, the authority of the Department of Veterans Affairs to provide sexual trauma counseling at Department facilities as well as through non-Department providers; (2) remove a requirement that veterans seek such counseling within a specified period after discharge; (3) remove the current one-year limit on the length of such counseling; (4) make the provision of such counseling equal in priority to the provision of Department outpatient services; (5) authorize the Department to provide such counseling to all veterans (currently, only women); and (6) require (current law authorizes) the provision of a 24-hour toll-free telephone number for the provision of sexual trauma crisis counseling. Directs the Secretary of Veterans Affairs to make certain reports with respect to: (1) the operation of the telephone hotline; and (2) the difficulties veterans encounter in obtaining from the Department determinations that disabilities relating to sexual trauma are service-connected. Modifies responsibilities of Department coordinators of women's services. Requires the Secretary to ensure that such coordinators are provided sufficient resources to carry out such responsibilities.
Bill· HRH.R. 2293 (103rd)referred
United States · United States Congress · 26 May 1993
Breast and Cervical Cancer Information Act of 1993 - Amends the Public Health Service Act to require each recipient of a grant or contract for family planning services to: (1) provide information (in a culturally competent manner) concerning breast and cervical cancer, including information on the need and skills for breast self-examinations; and (2) refer clients for breast and cervical cancer screening, treatment, or other services.
Bill· HRH.R. 2275 (103rd)referred
United States · United States Congress · 26 May 1993
Amends title XVIII (Medicare) of the Social Security Act to treat ventilators, aspirators, and certain other items as miscellaneous items of durable medical equipment for purposes of determining payment for such items under Medicare part B (Supplementary Medical Insurance).
Bill· HRH.R. 2276 (103rd)referred
United States · United States Congress · 26 May 1993
Firearm Victims Prevention Act - Amends the Internal Revenue Code to increase the excise tax on manufacturers of certain handguns, assault weapons, and ammunition. Imposes a retail excise tax on the sale, transfer, or other disposition of such weapons and ammunition. Establishes the Health Care Trust Fund to make grants to facilities providing medical care to gunshot victims. Amends the Federal criminal code to increase the license application fees for dealers in firearms. Appropriates to the Trust Fund certain revenue from the excise taxes and the increased fees.
Law· HRH.R. 2264 (103rd)enacted
United States · United States Congress · 25 May 1993
TABLE OF CONTENTS: Title I: Committee on Agriculture Title II: Committee on Armed Services Title III: Committee on Banking, Finance and Urban Affairs Title IV: Education and Labor Title V: Committee on Energy and Commerce Title VI: Committee on Foreign Affairs Title VII: Committee on the Judiciary Title VIII: Committee on Merchant Marine and Fisheries Title IX: Committee on Natural Resources Title X: Committee on Post Office and Civil Service Title XI: Committee on Public Works and Transportation Title XII: Committee on Veterans Affairs Title XIII: Committee on Ways and Means-Savings Title XIV: Revenue Provisions Title I: Committee on Agriculture - Agricultural Reconciliation Act of 1993 - Subtitle A: Commodity Programs - Amends the Agricultural Act of 1949 to reduce payment acres for wheat, feed grains, upland cotton, and rice. (Sec. 1101) Extends specified loan, payment, and acreage reduction programs for wheat, feed grains, upland cotton, rice, milk and dairy products, tobacco, sugar, oilseeds, peanuts, honey, and wool and mohair. Sets forth maximum purchase prices for butter and nonfat dry milk. Increases marketing assessments for tobacco and sugar. Establishes an additional marketing assessment for peanuts. (Sec. 1109) Amends the Harmonized Tariff Schedule of the United States to provide temporary additional customs duties on peanut butter and peanut paste. Subjects peanut butter to import quotas. (Sec. 1110) Amends the Agricultural Act of 1949 to reduce the support rate and annual payments for honey. Eliminates marketing assessments. (Sec. 1111) Reduces annual payments for wool and mohair. Eliminates marketing assessments. Subtitle B: Restructuring of Loan Programs - Amends the Rural Electrification Act of 1936 to restructure current Rural Electrification Administration (REA) electric and telephone loan programs, including creation of categories of hardship loans and municipal (electric) loans. Authorizes appropriations. (Sec. 1202) Transfers REA authority to the Department of Agriculture's Rural Development Administration. Subtitle C: Food Stamp Program - Mickey Leland Childhood Hunger Relief Act - Chapter 1: Ensuring Adequate Food Assistance - Amends the Food Stamp Act of 1977 to increase the basic food stamp program (program) benefit to 104 percent of the thrifty food plan. (Sec. 1312) Increases the age for students whose income is excluded from consideration as program income. (Sec. 1313) Removes (with an interim increase) the excess shelter cap. (Sec. 1314) Eliminates food stamp reductions for certain reapplying households. (Sec. 1315) Excludes third party payments for transitional housing for the homeless from consideration as program income. (Sec. 1318) Increases funding for the nutrition assistance program in Puerto Rico. (Sec. 1316) Excludes general assistance vendor payments from consideration as program income. Chapter 2: Promoting Self Sufficiency - Excludes education assistance and certain child support from consideration as program income. (Sec. 1324) Increases dependent care deductions and participant and State agency reimbursements in connection with employment and training activities. (Sec. 1325) Increases annually the fair market value limits of vehicles that program recipients may own. (Sec. 1326) Excludes from financial resources the value of a household vehicle used to carry heating fuel or water for home use. (Sec. 1327) Authorizes resource accumulation demonstration projects. Chapter 3: Simplifying the Provision of Food Assistance - Permits related adults living in the same household to apply for separate program benefits. (Sec. 1332) Makes children living with parents who are partcipating in drug or alcohol treatment programs eligible for food stamps. (Sec. 1333) Permits a participating family made up of, or including, an elderly or disabled member to own $3,000 in allowable financial resources. (Sec. 1334) Repeals provisions authorizing benefit reductions due to funding. Chapter 4: Improving Program Integrity - Expands: (1) the permitted use and disclosure of information provided by retail and wholesale food concerns; and (2) claims collections alternatives. (Sec. 1343) Authorizes demonstration projects aimed at coupon trafficking. Chapter 5: Improving Food Stamp Program Management - Excludes from categorical eligibility any household disqualified from participation because of workfare noncompliance. (Sec. 1353) Disqualifies program participants for trading food stamp coupons for controlled substances or for firearms, ammunition, or explosives. (Sec. 1356) Modifies the program's quality control system. Requires an error measurement study. Chapter 6: Uniform Reimbursement Rates - Revises State reimbursement rates. Chapter 7: Implementation and Effective Dates - Sets forth implementation and effective dates. Subtitle D: Miscellaneous Provisions - Amends the Agricultural Trade Act of 1978 to extend and reduce expenditure levels for the market promotion program. (Sec. 1402) Authorizes the Secretary of Agriculture (Secretary) to improve admission and recreation fees at specified public use areas. (Sec. 1403) Requires reduction of Department of Agriculture expenditures through personnel and office consolidations. (Sec. 1404) Amends the Food Security Act of 1985 to: (1) reduce the conservation reserve program acreage requirement; and (2) revise and make mandatory wetlands reserve program acreage requirements. (Sec. 1405) Amends the Federal Crop Insurance Act to direct the Federal Crop Insurance Corporation to make available four levels of commodity insurance based upon percentage of loss in yield. Title II: Committee on Armed Services - Directs the Secretary of Defense to provide a limited increase in the military retired pay of any former military personnel who became a member of the armed forces before August 1, 1986. (Sec. 2002) Waives the automatic FY 1994 increase in the rates of basic pay, basic allowance for quarters, and basic subsistence allowance. Provides that if the General Schedule pay rates for Federal employees is increased during any of FY 1995 through 1998, then military pay rates shall be increased. Title III: Committee on Banking, Finance and Urban Affairs - Amends the Federal Deposit Insurance Act to prescribe an order of priority for the distribution of amounts realized from the resolution of any insured depository institution. Requires distributions in connection with certain claims to be accompanied by an accounting report. (Sec. 3002) Amends the Federal Reserve Act to mandate that for FY 1994 through FY 1998 specified percentages of the surplus fund of any Federal reserve bank be transferred to the Treasury. Prohibits a Federal reserve bank from replenishing its surplus fund by the amount of such transfer. (Sec. 3003) Amends the Stewart B. McKinney Homeless Assistance Amendments Act of 1988 to: (1) require that certain income disclosure consent forms be submitted for verification of eligibility for benefits; and (2) amend applicant, participant, and public housing agency protections. (Sec. 3004) Amends the National Housing Act to direct the Government National Mortgage Association (GNMA) to: (1) charge fees in connection with its multiclass securities guarantee program; (2) assure that a portion of program benefits accrue to mortgagors who execute eligible mortgages; and (3) summarize program activities to the Congress. (Sec. 3005) Directs the Secretary of Housing and Urban Development to increase the rate at which the Secretary earns the single premium payment collected at the time of insurance of a mortgage that is an obligation of the Mutual Mortgage Insurance Fund. Title IV: Education and Labor - Subtitle A: Federal Direct Loan Program - Student Loan Reform Act of 1993 - Amends the Higher Education Act of 1965 (HEA) to replace the Federal Family Education Loan Program, under which loans made by private lenders are guaranteed by the Government, with a Federal Direct Student Loan Program. Chapter 1: Amendments to Part D of Title IV of the Higher Education Act of 1965 - Amends HEA to change the Federal Direct Loan Demonstration Program to the Federal Direct Student Loan Program (FDSL). (Sec. 4002) Sets forth program authority for making sums available for FDSL loans to all eligible students (and parents). Directs the Secretary of Education to provide funds for such student and parent loans on the basis of need and eligibility of students and parents at each participating institution. Declares that no institution shall have a right to participate in FDSL programs. Provides for application of the requirements of the Cash Management Improvement Act of 1990 on a transition schedule. Sets forth selection criteria for an institution's participation in the FDSL program and in origination agreements. Allows consortia to apply to originate FDSL loans. Sets forth terms and conditions for FDSL loans, including certain parallels with Stafford, supplemental, parent, and unsubsidized Stafford loans under the FFEL program. Sets interest rates. Sets minimum and maximum loan fees. Provides for standard, extended, graduated, and income contingent (EXCEL account) repayment plan options. Sets forth deferment and forbearance possibilities (including national service). Authorizes the Secretary to award contracts under the FDSL program for: (1) alternative origination of loans; (2) servicing and collection of loans; (3) data systems for records maintenance; and (4) services to assist in orderly transition from FFEL to FDSL programs. Authorizes the use of funds for research on FDSL program aspects, including flexible repayment plans. Chapter 2: Conforming Amendments - Amends HEA with respect to FFEL program student and parent loans during the transition to the FDSL program. (Sec. 4021) Provides for advances to guaranty agencies for lender-of-last-resort services. Requires the Student Loan Marketing Association (Sallie Mae) to begin making FFEL loans as lender-of-last-resort and to cease such lending when the triggering conditions have ceased. (Sec. 4028) Requires a study of alternatives for Sallie Mae during and after the transition to FDSL, including its own transition from a Government-sponsored enterprise to a private corporation. (Sec. 4030) Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to provide that any reductions in the FDSL program required by a sequestration order shall be achieved only through a specified increase in the loan fee. Chapter 3: Effective Dates; Study - Sets forth effective dates for amendments made by this Act. (Sec. 4032) Directs the Secretary to report to the Congress on the feasibility of Internal Revenue Service (IRS) collection of student loan repayments. (Sec. 4033) Expresses the preference of the House Committee on Education and Labor for an IRS collection mechanism. Subtitle B: Cost Sharing by States - Amends HEA to require any State in which there are higher education institutions with cohort default rates exceeding 20 percent to pay portions of costs related to such loan defaults. Allows States to charge institutions fees based on their cohort default rate and the State's risk of loss. Subtitle C: ERISA Amendments Relating to Group Health Plans - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to coordinate ERISA preemption rules with Medicaid provisions for liability of third parties. (Sec. 4202) Prohibits a group health plan from reducing its coverage of the costs of pediatric vaccines below that provided as of May 1, 1993. (Sec. 4203) Sets forth rules whereby: (1) ERISA preemption of State laws shall be inapplicable to certain State laws (of Hawaii, Maryland, Minnesota, and New York); or (2) the Secretary of Labor can assist such States in effectuating the policies of certain provisions superseded by ERISA. Title V: Committee on Energy and Commerce - Subtitle A: Medicare Program - Chapter 1: Provisions Relating to Part B - Subchapter A: Physicians' Services - Amends title XVIII (Medicare) of the Social Security Act (SSA) to, among other things: (1) reduce the default update for the conversion factor otherwise applicable to surgical and non-surgical services (except primary care services) in 1994; (2) increase the performance standard factor; (3) provide for classification of primary care services as a separate category of services with respect to volume performance standards and updates in conversion factors for physicians' services; (4) phase-in reductions to the practice expense relative value units; (5) revise the payment policy for anesthesia care teams; (6) repeal the prohibition on separate billing for the interpretation of electrocardiograms (EKGs); (7) require adjustments in the relative value units for services in order to ensure budget neutrality; (8) require Medicare carriers to screen unassigned claims; (9) include antigens prepared by a physician on the physician fee schedule; and (10) specify the conditions under which the Secretary can recognize substitute billing arrangements between two physicians. (Sec. 5011) Requires the Secretary to develop relative values for pediatric physicians' services. Subchapter B: Outpatient Hospital Services and Ambulatory Surgical Services - Amends SSA title XVIII to: (1) extend the ten percent reduction in payments for capital-related costs of outpatient hospital services, as well as the 5.8 percent reduction in payments for other costs of such services; and (2) extend special payment rates for certain eye or eye and ear hospitals. (Sec. 5023) Directs the Secretary to suspend the annual update for ambulatory surgery payments for FY 1994. (Sec. 5025) Amends the Omnibus Budget Reconciliation Act of 1990 (OMBRA '90) to extend the cap on payments for intraocular lenses. Subchapter C: Durable Medical Equipment - Amends SSA title XVIII to: (1) revise payment rules for items of durable medical equipment (DME) and supplies; (2) remove aspirators and nebulizers from the category of DME items requiring frequent and substantial servicing, and specifically provide for payment of related accessories; (3) set forth requirements which suppliers of medical equipment and supplies must satisfy in order to qualify for Medicare reimbursement; (4) require development of standardized certificates of medical necessity forms; (5) require DME suppliers to submit claims to the carrier with jurisdiction over the geographic area including the patient's permanent residence; (6) place restrictions on certain DME supplier marketing and sales practices; (7) specify circumstances under which Medicare beneficiaries are not financially liable for covered items and services furnished by a supplier; (8) address adjustments made to unreasonable DME payment amounts; (9) determine payments for surgical dressings; and (10) reduce the DME fee schedule amount for transcutaneous electrical nerve stimulation devices. (Sec. 5032) Freezes payments during 1994 for parenteral and enteral nutrients, supplies, and equipment at 1993 levels. (Sec. 5034) Directs the Secretary to report to the Congress on: (1) the effect of the uniform criteria established pursuant to this Act for DME items; and (2) appropriate methodology for determining payment under Medicare for prosthetic devices and orthotics. (Sec. 5037) Amends SSA title XI to modify anti-kickback provisions. (Sec. 5042) Requires a report to the Congress on variations in DME supplier costs. Subchapter D: Part B Premium - Amends SSA title XVIII to extend current law with respect to the monthly Medicare part B premium for beneficiaries enrolled in Medicare. Subchapter E: Other Provisions - Revises provisions of SSA title XVIII, including: (1) to revise payments for clinical diagnostic laboratory tests; (2) to address the provision of x-ray services by rural health clinics and federally-qualified health centers; (3) to condition payment for mammograms on the certification status of the facility; and (4) to provide Medicare coverage of oral cancer drugs. (Sec. 5064) Amends the Omnibus Budget Reconciliation Act of 1986 (OMBRA '86) to extend the Alzheimer's Disease Demonstration. (Sec. 5066) Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 (COMBRA '85) to extend certain municipal health service demonstration projects. (Sec. 5069A) Requires a report to the Congress on annual payment limitations for outpatient physicial and occupational therapy services. Chapter 2: Provisions Relating to Parts A and B - Amends Medicare part C (Miscellaneous) provisions relating to Medicare parts A (Hospital Insurance) and B (Supplementary Medical Insurance) to: (1) eliminate requirements for special adjustments for administrative costs of hospital-based home health agencies; (2) make changes with regard to Medicare as secondary payor; (3) reduce payment for erythropoientin; (4) require nursing facilities and home health agencies to inform Medicare beneficiaries of the hospice benefit; and (5) require revision of the capitation payment methodology for health maintenance organizations (HMOs) to account for regional variations in application of Medicare secondary payor provisions. (Sec. 5073) Amends Medicare part B with regard to use of carriers to recover erroneous payments from primary payers. (Sec. 5072, 5074, and 5078) Requires: (1) a report on Medicare payments to hospitals for medical residency training program costs; (2) a report on the use of the new shared facility arrangement exception to ownership and compensation arrangements under the ban on certain referrals by physicians; and (3) establishment of a method of outreach to newly eligible Medicare beneficiaries qualifying for Medicaid payment of out-of-pocket expenses. (Sec. 5077) Amends OMBRA '86 to extend certain waivers under Medicare for the Watts Health Foundation. (Sec. 5079) Amends the Omnibus Budget Reconciliation Act of 1987 (OMBRA '87) to extend the waivers under Medicare for social health maintenance organization (SHMO) demonstration projects. Amends the Deficit Reduction Act of 1984 to require additional SHMO demonstration projects and permit one project to enroll Medicare end stage renal disease beneficiaries. (Sec. 5082) Amends the Omnibus Budget Reconciliation Act of 1990 (OMBRA '90) to revise the payment methodology for organizations under a risk-sharing contract with the Secretary. Chapter 3: Provisions Relating to Medicare Supplemental Insurance Policies - Amends OMBRA '90 and Medicare to make changes to Federal standards respecting the sale of Medicare supplemental insurance policies. Subtitle B: Medicaid Program and Other Health Care Provisions- Chapter 1: Medicaid Program - Subchapter A: Program Savings Provisions - Amends SSA title XIX to, among other things: (1) repeal the mandate that States cover personal care services under their Medicaid programs for all individuals entitled to nursing facility benefits; (2) allow States to establish formularies limiting coverage of prescription drugs under their Medicaid programs; (3) prohibit States from disregarding assets in cases where an individual has received payments under a long-term care policy; (4) address the liability of third parties to pay for care and services provided to Medicaid eligibles; (5) require States to have in effect certain laws relating to medical child support; and (6) make changes with regard to payments for disproportionate share hospitals. (Sec. 5117) Amends SSA to add a new title XXI requiring establishment of a Health Coverage Clearinghouse to identify third parties which may be liable for payment of health care items and services furnished to Medicare, Medicaid, Indian Health Service, and Maternal and Child Health Service beneficiaries. Subchapter B: Miscellaneous Provisions - Amends SSA title XIX to, among other things: (1) provide for the application under Medicaid of the physician self-referral prohibitions currently under Medicare; (2) require State maintenance of annual expenditures (adjusted) for State Medicaid fraud control units; (3) change treatment of HMO enrollees in determining the Medicaid inpatient utilization rate of a hospital seeking to qualify as a disproportionate share hospital; (4) raise, with respect to eligible States, Federal Medicaid matching payments for State expenses incurred in the provision of bona fide emergency medical services to undocumented aliens; (5) establish an option for States to make TB-infected individuals eligible for limited TB-related services; (6) require that mammographies paid for under Medicaid be conducted by a facility certified under the Mammography Quality Standards Act of 1992; and (7) make permanent the current law requirement for continued Medicaid coverage of families who lose eligibility for cash assistance under the Aid to Families with Dependent Chidren Program because they work. (Sec. 5132 and 5144) Amends SSA title XI to: (1) authorize an alternative intermediate remedy for redressing kickback offenses; (2) change procedures for initiation of a civil monetary penalty action; and (3) raise the ceiling on Federal Medicaid matching payments to Puerto Rico and other specified territories. (Sec. 5137) Extends the period during which the Secretary is required to waive application of the enrollment mix requirement under Medicaid for certain HMOs under the Dayton Area Health Plan, Inc. (Sec. 5138, 5146, and 5150) Amends the Omnibus Budget Reconciliation Act of 1989 with respect to the Tennessee Primary Care Network, certain demonstration projects for low-income pregnant women and children, and the Kent Community Hospital Complex and the Saginaw Community Hospital. (Sec. 5139) Directs the Secretary to waive application of the enrollment mix requirement under Medicaid with respect to the District of Columbia Chartered Health Plan, Inc.. (Sec. 5140) Amends the Family Support Act of 1988 to extend the period during which the Secretary is required to waive application of certain provisions of Medicaid law for the Minnesota Prepaid Demonstration Project. Subchapter C: Miscellaneous and Technical Corrections Relating to OMBRA '90 - Amends OMBRA '90 to make miscellaneous and technical corrections to various specified Medicaid-related provisions. Chapter 2: Universal Access to Childhood Immunizations - Amends the Public Health Service Act to entitle each State to the Federal purchase of enough pediatric vaccines to immunize each child in the State who is: (1) covered under title XIX (Medicaid) of the Social Security Act; (2) uninsured, or has insurance which does not cover vaccinations; or (3) an Indian. (Sec. 5181) Establishes the National Childhood Immunization Trust Fund. Exempts the vaccine program from reduction under the Balanced Budget and Emergency Deficit Control Act of 1985. Mandates State allotments for a registry of information on every child, including immunization data. Authorizes appropriations. Mandates grants to States to achieve objectives for immunizing U.S. children. Authorizes appropriations. (Sec. 5182) Amends the Omnibus Budget Reconcilation Act of 1989 to authorize appropriations from the Vaccine Injury Compensation Trust Funds to administer certain provisions of the National Vaccine Injury Compensation Program. Amends the Public Health Service Act to modify provisions regulating the effect on the statute of limitations of revisions to the Vaccine Injury Table. (Sec. 5183) Amends Medicaid provisions to require notifying all Medicaid-eligible persons under 21 of the need for immunizations. Adds grant entities under Public Health Service Act health provisions for residents of public housing to the list of entities within the definition of "Federally-qualified health center." (Sec. 5184) Allows Medicaid payments directly to vaccine manufacturers under certain programs. (Sec. 5185) Authorizes grants for demonstration projects providing comprehensive services to reduce the incidence of infant mortality and morbidity, fetal deaths, maternal mortality, fetal alcohol syndrome, and low birth weight. Authorizes appropriations. (Sec. 5186) Amends title V (Maternal and Child Health Services Block Grant) of the Social Security Act to authorize appropriations to carry out specified provisions. (Sec. 5187) Modifies compensation requirements regarding members of the National Advisory Council on the National Health Service Corps. Allows certain entities that are migrant, community, homeless, and public housing health services providers to elect certain treatment under the Public Health Service for purposes of malpractice actions. Removes provisions allowing waiver of rights to recover National Health Service Corps scholarship or loan repayment amounts after default. Subtitle C: Communications Licensing Improvement - Chapter 1: Competitive Bidding Authority - Licensing Improvement Act of 1993 - Amends the Communications Act of 1934 to empower the Federal Communications Commission (FCC) to use a system of competitive bidding in the granting of licenses involving the use of the electromagnetic spectrum (public airwaves). Outlines certain provisions, including: (1) uses to which such bidding may apply; (2) establishment by the FCC of a competitive bidding methodology; (3) alternative payment schedules for the use of airwaves; and (4) bidder and licensee qualifications. (Sec. 5205) Revises the FCC's regulatory authority in the mangagement of mobile communications services. Considers a person engaged in the provision of commercial mobile services to be a common carrier and, therefore, required to establish physical connections as required under the Communications Act. Prohibits State or local government imposition of any rate or entry regulation on commercial mobile service, but allows the FCC to grant a State petition to regulate rates under certain conditions. Chapter 2: Emerging Telecommunications Technologies - Emerging Telecommunications Technologies Act of 1993 - Amends the National Telecommunications and Information Administration Organization Act to require the Assistant Secretary of Commerce for Communications and Information and the FCC Chairman to conduct joint electromagnetic spectrum planning with respect to future spectrum requirements and promotion of efficient use of the spectrum. (Sec. 5222) Directs the Secretary to report to the President and the Congress identifying bands of frequencies that are allocated primarily for Government, are eligible for licensing, and are not required by the Government. Requires a report to the Congress on preliminary identification of reallocable bands of frequencies. Requires that an advisory committee be convened to assist in carrying out this Chapter. Directs certain actions after receipt of the advisory committee report on reallocation of band frequency assignments between Government and private uses. Authorizes the President to substitute alternative frequencies in the interest of national defense, governmental needs, public health or safety, or financial considerations. Directs the FCC to submit a plan for the distribution of reallocated frequency bands. Authorizes the President to reclaim reassigned frequencies. Chapter 3: Communications Technical Amendments - Sets forth corrections and technical amendments to communications provisions. Subtitle D: Energy Programs - Amends the Omnibus Budget Reconciliation Act of 1990 to extend from September 30, 1995, to September 30, 1998, the authority of the Nuclear Regulatory Commission to collect annual charges. Title VI: Committee on Foreign Affairs - States that the Committee on Foreign Affairs recommends changes in Federal law which would reduce direct spending under the Foreign Service Retirement and Disability Fund and the Foreign Service Pension System by requiring a three-month delay in cost-of-living adjustments for each year, FY 1994 through 1996. Title VII: Committee on the Judiciary - Amends the Omnibus Budget Reconciliation Act of 1990 to extend through FY 1998 the authorization for the collection of surcharges for use of the Patent and Trademark Office. Title VIII: Committee on Merchant Marine and Fisheries - Amends Federal shipping law to extend the years during which certain tonnage duties are imposed. (Sec. 8002) Declares the sense of the Congress that the inland waterways fuel tax should not be increased beyond those increases already mandated by law. Title IX: Committee on Natural Resources - Amends specified Federal law regarding the political union of the Commonwealth of the Northern Mariana Islands (Commonwealth) with the United States to repeal the direct grant asssitance for such Islands. Prescribes guidelines under which the United States commits its full faith and credit for specified payments to certain U.S. possessions and territories, including payments for capital improvements projects. Requires reports on the minimum wage and immigration policies of the Commonwealth. (Sec. 9002) Amends the Mineral Leasing Act to provide that, in calculating the amount to be paid to States of revenues derived from Federal onshore mineral and geothermal steam leasing receipts, 50 percent of the portion of the appropriation allocable for administration and enforcement shall be deducted from those receipts in approximately equal amounts each month prior to their division and distribution between the States and the United States. (Sec. 9003) Mandates the payment of a specified minimum flat claim maintenance fee and location fee by the holder of an unpatented mining claim, mill, or tunnel site in lieu of the assessment work and related filing requirements under certain Federal mining law. Exempts certain oil shale claims from the fee requirement. Waives fees under certain conditions. (Sec. 9004) Amends Federal reclamation laws to mandate that non-Federal recipients of water delivered by way of Federal facilities pay an operation and maintenance charge to the United States. Establishes the Natural Resources Restoration Fund for the benefit of fish and wildlife resources and habitat affected by Federal reclamation projects. (Sec. 9005) Amends the Land and Water Conservation Fund Act of 1965 to prohibit recreation user fees for campgrounds lacking specified amenities. Revises the terms of "Golden Age" passports in the National Park System. Establishes user fees for rights-of-way, tour vehicles or aircraft, and commercial telephone transmission facilities on Federal lands. (Sec. 9007) Directs the Secretaries of Energy and of the Interior adjust fees and other charges in order to recover the cost of Government services and establish a fee mechanism to recover Government costs of providing services which are currently free. (Sec. 9008) Directs the President to transmit in the annual budget an estimate of unfunded future Federal liabilities that are not accounted for in the budget itself. Title X: Committee on Post Office and Civil Service - Subtitle A: Civil Service - Delays the cost-of-living adjustments scheduled to take effect under certain Federal employee retirement systems during FY 1994 through 1996. (Sec. 1002) Amends the Civil Service and Federal Employees' Retirement Systems and the Foreign Service and Central Intelligence Agency systems to permanently eliminate the lump sum retirement option except for employees with a critical medical condition. (Sec. 1003) Eliminates the 1994 annual cost-of-living adjustment for Members of Congress and Federal employees. Amends the Ethics Reform Act of 1989 and other Federal law to modify the formulae for computing such adjustments for 1995 through 1997. (Sec. 1004) Amends Federal law to delay locality-based comparability payments until July of 1994. Limits the total amounts payable for locality payments between July 1, 1994, and September 30, 1998. Authorizes the President to specify locality payments less than the minimum amounts which would otherwise be required if necessary to comply with such limitations. Delays annual cost-of-living adjustments for Federal employees and Members of Congress until July of each year for the period between January 1, 1995, and December 31, 2003. Repeals provisions excluding senior executives from the limitation on the accumulation of annual leave. Prohibits cash awards during FY 1994 through 1998. Limits the average total number of civilian employees in the executive branch (except employees of the U.S. Postal Service and Postal Rate Commission) during FY 1994 through 1998. Requires the Director of the Administrative Office of United States Courts to apply the prohibitions and limitations of this Act with respect to annual cost-of-living adjustments and locality-based comparability payments to employees under the separate system of the Office. (Sec. 1005) Requires certain Federal Employees Health Benefits Program (FEHBP) plans to apply the Medicare part B limiting charges for physicians' services to enrolled retirees who are 65 or older and do not participate in Medicare part B. (Sec. 1006) Extends the proxy premium formula for determining Government contributions under FEHBP through contract year 1998 in the absence of a Government-wide indemnity benefit plan. Expresses the sense of the Congress that such extension should not be considered to reflect any view on the appropriateness, merits, or timing, or any other aspect of any comprehensive health care reform legislation. Subtitle B: Postal Service - Directs the U.S. Postal Service to make a specified additional payment into the Civil Service Retirement and Disability Fund and the Employee Health Benefits Fund to cover increases due to retirement cost-of-living adjustments and increases in health benefits costs. Subtitle C: Revenue Forgone Reform - Revenue Forgone Reform Act - Amends Federal postal service law to repeal the authorization of appropriations under the Overseas Citizens Voting Rights Act of 1975 and the Federal Voting Assistance Act of 1955 for mail sent at reduced postage rates. Revises provisions relating to the treatment of reduced-rate categories of mail. (Sec. 10203) Repeals certain Federal provisions authorizing appropriations to the Postal Service for certain accumulated operating indebtedness and directing the Postal Service to provide door or curbline delivery to certain permanent addresses. Authorizes appropriations for FY 1994 through 2035 to cover losses. (Sec. 10205) Prohibits reduced mailing rates for mail adverstising or offering products or services if: (1) the sale is not related to the purposes allowing mail at such rates; or (2) the mail matter involved is part of a cooperative mailing with a person not authorized to mail at reduced rates. Revises provisions with respect to the mailing rates of books. (Sec. 10207) Expresses the sense of the Congress that any legislation enacted after September 30, 1994, which would expand the class of mail eligible for reduced rates should provide for funding ensuring no losses to the Postal Service nor increases in rates for other classes of mail. Title XI: Committee on Public Works and Transportation - Amends the Federal Aviation Act of 1958 to revise fees charged for aircraft registration, designation as an aviation medical examiner, issuance of an airman's certificate to be a pilot and costs associated with processing forms for fuel system repairs. Requires fees be deposited in the Airport and Airway Trust Fund. (Sec. 11002) Amends the Flood Control Act of 1968 to authorize the Secretary of the Army to collect fees for the use of developed recreation facilities, including campsites, beaches, and boat launching ramps. Requires fees to be deposited into the Treasury account for the Corps of Engineers. Title XII: Committee on Veterans Affairs - Veterans Reconciliation Act of 1993 - Amends the Omnibus Reconciliation Act of 1990 to extend through September 30, 1998, the requirement that veterans with a certain minimum income level make copayments in exchange for receiving certain health care benefits through the Department of Veterans Affairs. Extends: (1) the requirement of a minimal copayment for medications received by veteran outpatients; (2) authority to recover the cost of veterans' services from third party insurers; (3) the authority of the Secretary of the Treasury to provide certain financial information for income verification purposes; (4) a monthly pension limitation for certain recipients of nursing home care covered under Medicaid; and (5) procedures applicable to liquidation sales on defaulted home loans to veterans. (Sec. 12006) Prohibits any FY 1994 cost-of-living adjustment in the rates of dependency and indemnity compensation paid to surviving spouses. (Sec. 12008) Increases the home loan fee charged to veterans for loans guaranteed by the Department, closed after September 30, 1993, and before October 1, 1998. (Sec. 12009) Reduces by one percentage point the FY 1994 cost-of-living adjustment for educational assistance benefits payable to active duty and reserve personnel under the Montgomery GI Bill educational assistance program. (Sec. 12010) Excludes a person who is not the natural or legally adopted child of the parent from eligibility for survivors' and dependents' educational assistance. Title XIII: Committee on Ways and Means: Savings - Subtitle A: Old-Age, Survivors and Disability Insurance Programs - Amends OMBRA '90 to require the Secretary to reestablish and maintain in service the same number of telephone lines to each local social security office that were in place as of September 30, 1989. (Sec. 13003) Makes amendments to SSA title II, including to: (1) permit States collecting social security numbers to use those numbers to eliminate duplicate names and names of convicted felons from jury source lists; (2) extend to all States the option to provide police officers and firefighters with social security coverage; (3) disregard the windfall elimination provision in computing any U.S. totalization benefit and the amount of a regular U.S. benefit of an individual who receives a foreign totalization benefit based in part on U.S. employment, and who does not receive any other pension based on noncovered employment; (4) provide that military pensions based wholly on service in the military reserves before 1988 shall not trigger application of the Government pension offset or windfall elimination provision to the individual's social security benefits; (5) permit the Department of Agriculture to share its list of names, social security numbers, and employer identification numbers of the owners of retail grocery stores which redeem food stamps with other Federal agencies for the purpose of investigating food stamp fraud and other crimes; and (6) prohibit a State from using social security numbers in the administration of any driver's license or motor vehicle registration law where the State has not contracted to provide death certificate and related information to the Secretary, or where use of death information is restricted. (Sec. 13005) Exempts from payment liability and penalties ministers who were American citizens and residents of Canada prior to the 1984 totalization agreement between the United States and Canada and failed to file a tax return or pay self-employment taxes. (Sec. 13010) Amends IRC to: (1) authorize the Secretary of the Treasury to disclose information from tax returns on individuals' mortality status to the Secretary for eipdemiological research purposes; (2) coordinate the collection of domestic service employment taxes with the collection of income taxes; and (3) change threshold requirements with respect to social security employment taxes on domestic services. (Sec. 13015) Requires the Secretary to study and report to the Congress on the rising costs of disability benefits. (Sec. 13016) Amends the Social Disability Amendments of 1980 to extend the Secretary's authority to conduct disability work incentive demonstration projects. Subtitle B: Human Resources Amendments - Chapter 1: Child Welfare Services, Foster Care, and Adoption Assistance - Amends SSA title IV part B (Child-Welfare Services) to, among other thing: (1) create a capped entitlement program to provide child welfare services designed to strengthen and preserve families; (2) repeal provisions linking the payment of title IV part B funds to the implementation of protections for children in foster care; (3) require State part B plans to contain a description of the specific measures taken by the State to comply with the Indian Child Welfare Act; and (4) provide for child welfare traineeships. (Sec. 13212) Directs the Secretary to provide grants for State courts to improve foster care placement and adoption proceedings. (Sec. 13216) Amends SSA title IV part E (Foster Care and Adoption Assistance) (FCAA) to change the reimbursement policy with respect to foster care maintenance payments made on behalf of certain children whose adoption has been set aside by a court or whose voluntary placement in foster care has been judicially determined to be in the best interests of the child. Requires States to review their foster care maintenance payment and adoption assistance levels. Requires the health and education records in each child's case plan include a record that the foster care provider was advised (where appropriate) of the child's eligibility for certain Medicaid services. Makes permanent the authorization for the independent living program. Sets forth case plan requirements for children placed in foster care a substantial distance from their homes or in a different State. (Sec. 13218) Directs the Secretary to study and report to the Congress on the ways in which States implement the reasonable efforts requirements for State part E plans. (Sec. 13225) Amends OMBRA '89 to extend permanently (and retroactively to October 1, 1992) the level of Federal reimbursement under part E for the training of personnel employed by the State or local child welfare agency, and for the training of foster and adoptive parents. (Sec. 13227) Amends SSA title XI part A to overturn certain limitations in Suter v. Artist M. on private enforceability of State plan requirements. (Sec. 13232) Prohibits the Secretary, until October 1, 1994, from reducing any payment to any State under parts B or E because of State noncompliance with part B foster care protections. (Sec. 13233) Requires the Secretary to make grants to eligible institutions to train individuals to deliver culturally sensitive and bilingual child welfare services in border areas with Mexico. Authorizes approprations. Chapter 2: Child Support Enforcement - Amends SSA title IV part D (Child Support and Establishment of Paternity) to set up new paternity establishment performance standards and procedures for State child support enforcement programs. Outlines State plan requirements. Requires State child support enforcement agencies to periodically report, at no charge, the names and amounts of obligors at least two months delinquent in child support payments to bona fide consumer reporting agencies. Chapter 3: Supplemental Security Income - Amends SSA title XVI (Supplemental Security Income) (SSI) and other Federal law to require the Social Security Administration to charge States fees for the Federal cost of administering supplemental SSI payments. (Sec. 13252) Amends OMBRA '90 to make permanent the exclusion of State and local relocation assistance from countable income under SSI. (Sec. 13253-13256) Amends SSA title XVI to: (1) deem to be living in a household a spouse or parent of family members on SSI who is absent because of active duty military assignment; (2) exclude hazardous duty pay from countable income; (3) continue SSI benefits to children who are U.S. citizens if they received SSI in the United States and then accompanied their parents on military assignment to a U.S. territory or possession; and (4) extend the SSI definition of disability for children under 18 to any person under age 18. (Sec. 13257) Exempts income of up to $2,000 per year received by individual Indians that is derived from leases on trust or restricted Indian lands in determining eligibility and benefit levels under AFDC (SSA title IV part A) and SSI. Chapter 4: Aid to Families with Dependent Children - Amends SSA title IV part A to: (1) reduce to 50 percent the enhanced Federal matching available for certain categories of State administrative expenses; (2) make optional a State's verification of an individual's immigration status with the Immigration and Naturalization Service through an immigration status verfication system; (3) delay Federal requirements regarding AFDC-UP participation rates; and (4) increase the amount of stepparent earnings disregarded in determining the eligibility and benefit amounts of AFDC recipients and applicants. (Sec. 13263) Amends part F (Job Opportunities and Basic Skills Training Program) (JOBS) to require development of criteria for performance standards in the JOBS program, rather than performance standards themselves. (Sec. 13264) States that the Congress declares: (1) it is the responsibility of the Federal Government to reduce family dependence on income from welfare programs, to assist them toward self-sufficiency, and to increase the living standards of low-income families; and (2) the Federal Government should help welfare recipients and individuals at risk of welfare participation to improve education and job skills, to obtain access to child care and support services, and to take other steps as may assist them to become financially independent. Directs the Secretary to develop welfare participation measures and predictors, and report annually on welfare participation to specified congressional committees. Establishes the Advisory Board on Welfare Participation. (Sec. 13265) Directs the Secretary to provide for a demonstration project offering low-income residents of Milwaukee, Wisconsin, employment, wage supplements, health and child care, and job counseling and training. (Sec. 13266 and 13270) Amends the Family Support Act of 1988 to: (1) delay the requirement for implementation of the Unemployed Parent program in Puerto Rico, Guam, the Virgin Islands, and American Samoa until the limitations on Federal matching payments with respect to AFDC and FCAA maintenance payments are repealed; and (2) extend the authorization for early childhood development projects. (Sec. 13269) Amends OMBRA '87 to extend New York State's Child Assistance Program demonstration. (Sec. 13267) Amends SSA title XI to provide that, with respect to AFDC, one adult member of a household may sign a declaration attesting to the citizenship or satisfactory immigration status of other household members. Chapter 5: Unemployment Insurance - Amends IRC and SSA title III (Unemployment Compensation) to provide for the treatment of short-time compensation programs under which individuals whose workweeks have been reduced by at least ten percent (especially as an alternative to a temporary layoff) are eligible for unemployment compensation, under certain conditions. (Sec. 13275) Amends the Federal-State Extended Unemployment Compensation Act of 1970 to increase the reimbursement rate and repeal special eligibility requirements under the extended unemployment program. (Sec. 13276 and 13277) Amends IRC to extend the current Federal unemployment tax rate and require disclosure of tax information to the Railroad Retirement Board for administration of the Railroad Retirement and Railroad Unemployment Insurance Acts. Chapter 6: Technical Provisions - Makes technical corrections related to the income security and human resources provisions of OMBRAs '89 and '90. (Sec. 13283) Amends SSA title XVI to repeal certain obsolete provisions relating to treatment of the earned income tax credit. Subtitle C: Medicare Program - Chapter 1: Provisions Relating to Part A -Subchapter A: Elimination of Inflation Update for Services Provided under Part A: - Amends SSA title XVIII (Medicare) to eliminate updates for inpatient hospital services and hospice care under Medicare part A in FY 1994 and 1995. (Sec. 13402) Prohibits the Secretary from applying an update factor to the cost limits for skilled nursing facility cost reporting periods beginning in FY 1994 and 1995. Subchapter B: Other Provisions Relating to Part A - Amends SSA title XVIII to, among other things: (1) provide that a change in classification of hospitals from one area to another cannot result in a reduction in the wage index for an urban area if the area has an age index below the rural wage index for the State or if the area is the only urban area in a State with no rural areas; (2) change certain standards for designating metropolitan statistical areas that are used in determining treatment of hospitals in rural counties adjacent to urban areas; (3) require the phase out of payments for day outlier cases starting in FY 1995; (4) authorize appropriations for the Essential Access Community Hospital (EACH) demonstration program; (5) provide for a prospective payment system for outpatient rural primary care hospital services; (6) continue special payments for Medicare-dependent, small rural hospitals for discharges occurring through FY 1994, with reduced payments for certain discharges; (7) allow to participate in Medicare hospitals where the care of patients receiving qualified psychologist services is under a clinical psychologist; (8) require skilled nursing facilities to inform beneficiaries of the hospice benefit under Medicare; (9) reduce the part A premium, on a phase-in basis, for individals with 30 or more quarters of social security coverage (and their spouses); (10) require periodic updating of salary equivalency guidelines for physical therapy and respiratory therapy services; and (11) provide that diagnosis-related group (DRG) window provisions will not apply to hospitals that are not paid on a DRG basis. (Sec. 13414) Amends OMBRA '87 to: (1) reauthorize and extend the rural health transition grant program; and (2) provide that all hospitals classified as regional referral centers on September 30, 1992, shall retain such status through FY 1994. (Sec. 13418) Amends OMBRA '90 to require the Secretary to continue limited-service rural hospital demonstration projects through calendar 1995. (Sec. 13419) Amends OMBRA' 89 to extend the hemophilia pass-through program. (Sec. 13420) Declares that, in the case of a State with a Medicare-approved payment system, no other provision of law shall be construed as preventing the system from providing that payment for covered services be made on the basis of rates provided for under such system. (Sec. 13423) Prohibits the Secretary from taking action to recover certain amounts paid by Medicare to uniformed services treatment facilities in Boston, Baltimore, and Seattle for services provided between October 1, 1986, and December 31, 1989, except to the extent that funds are made available for that purpose under the Department of Defense Appropriations Act, 1993. Requires a report to the Congress on establishment of joint medical facilities among the Department of Defense, the Department of Veterans' Affairs, and other entities. (Sec. 13424 and 13425) Requires the Secretary to: (1) review ]the DRGs assigned to discharges of patients with intractable epilepsy; (2) revise the assignment of discharges to such groups as the Secretary considers appropriate to account for the resource requirements of such patients; and (3) begin collecting data necessary to compute a skilled nursing facility wage index adjustment to the routine service cost limits required under Medicare. Requires the Prospective Payment Assessment Commission to report to the Congress on the impact of applying routine per diem cost limits for skilled nursing facilities on a regional basis. (Sec. 13429) Allows hospitals that have been reclassified from urban to rural as a result of revisions to metropolitan statistical area definitions issued by the Office of Management and Budget on December 28, 1992, to apply to the Medicare Geographic Classification Review Board for reclassification in FY 1994. Chapter 2: Provisions Relating to Part B: Subchapter A: Elimination of Inflation Update - Amends SSA title XVIII part B to eliminate the inflation update for physician and related professional services and other items and services. (Sec. 13432) Freezes payments for enteral and parenteral nutrients, supplies and equipment, rural health clinic, federally qualified health center, and comprehensive outpatient rehabilitation facility services, dialysis services, and other part B items and services. Subchapter B: Physicians' Services - Amends SSA title XVIII part B to, among other things: (1) repeal the OMBRA '90 prohibition on separate payments for EKG interpretations; (2) repeal the reductions in payments to new physicians and practitioners; (3) prohibit changing the methodology in effect as of January 1, 1992, for calculating anesthesia time in the fee schedules; (4) revise requirements with respect to geographic adjustment factors and beneficiary liability for amounts billed above the limiting charge; (5) require pre-payment screening by carriers of unassigned claims submitted by nonparticipating physicians; (6) require the Explanation of Benefits form to contain information on amounts billed in excess of the applicable limiting charge; (7) specify the practitioners who may only bill for services on an assignment-related basis; (8) include antigens prepared by a physician on the physician fee schedule; (9) prohibit the imposition of user fees in specified circumstances in the administration of claims relating to physicians' services; and (10) specify the conditions under which the Secretary can recognize substitute billing arrangements between two physicians. (Sec. 13444) Requires the Secretary to revise and report to specified congressional committees on the data necessary to revise geographic indices. Requires the Physician Payment Review Commission to develop criteria for use in redefining the localities used within States for adjusting physicians' fees. (Sec. 13446) Requires the Secretary to develop relative values for the full range of pediatric physicians' services and report to the Congress. Subchapter C: Ambulatory Surgical Center Services - Makes amendments identical to those made above to the Medicare program and OMBRA'90 under subchapter B of chapter 1 of title V of this Act with respect to eye and eye and ear hospitals and intraocular lenses. (Sec. 13452) Requires the Secretary to report to the Congress on the costs to providers of intraocular lenses provided to individuals enrolled under Medicare part B. Subchapter D: Durable Medical Equipment - Makes amendments similar to those made above to the Medicare program and SSA title XI under subchapter C of chapter 1 of title V of this Act with respect to durable medical equipment and kick-backs. (Sec. 13468) Subjects ostomy supplies, tracheostomy supplies, and urologicals to national payment limits. Subchapter E: Other Provisions - Makes amendments similar to those made above to the Medicare program, OMBRA '86, and COMBRA '85 under subchapter E of chapter 1 of title V of this Act with respect to oral cancer drugs and the treatment of certain Indian health programs and facilities as federally-qualified health centers, and the extension of Alzheimer's disease and municipal health service demonstration projects. (Sec. 13471) Amends SSA title XVIII to, among other things: (1) freeze at the 1992 level the conversion factor used to determine payments to medically directed certified registered nurse anesthetists; (2) cap the part B premium penalty for late enrollment for Federal employees who meet certain conditions; and (3) establish statutory definitions for speech language pathologist and audiologists. (Sec. 13473) Provides for uniform coverage of "off-label" drugs used in anti-cancer therapy. Requires a report to specified congressional committees on Medicare coverage of patient care costs associated with clinical trials of new cancer therapies. Subchapter F: Part B Premiums - Duplicates the amendment to the Medicare program made above under subchapter D of chapter 1 of subtitle A of title V of this Act with respect to the monthy Medicare part B premium. Chapter 3: Provisions Relating to Parts A and B -Subchapter A: Elimination of Updates - Amends SSA title XVIII to eliminate updates in payments to hospitals for the direct costs of graduate medical education for cost reporting periods beginning during FY 1994 and 1995. (Sec. 13502) Prohibits the Secretary from providing any update in the cost limits for home health services for cost reporting periods beginning during FY 1994 and 1995. Subchapter B: Medicare Secondary Payer Provisions - Makes amendments similar to those under chapter 2 of subtitle A of title V of this Act with respect to Medicare as secondary payer. Subchapter C: Physician Ownership and Referral - Amends SSA title XVIII to: (1) apply the ban on certain referrals by physicians to all payers, extending it to cover additional specified health services as well as new exceptions; (2) expand current standards used to define a group practice; and (3) provide that Federal law shall not preempt State laws that related to referrals not covered under the ban, or that relate to referrals covered under the ban but are even more restrictive. Subchapter D: Other Provisions - Sets forth measures similar to those under chapters 1 and 2 of subtitle A of title V of this Act with respect to: (1) interest payments on clean claims; (2) payments for erythropoietin; (3) qualified Medicare beneficiary outreach; (4) social health maintenance demonstrations; (5) the second surgical opinion program under SSA title XI; (6) hospice notification; and (7) Medicare capitation payments. (Sec. 13551) Requires the Secretary to redetermine the full-time-equivalent (FTE) resident amount to reflect the amount that would be allowed if the hospital had been liable to pay FICA taxes or make other specified retirement contributions for residents during the base year, but did not make such payments, yet now must do so as a result of OMBRA '90. Amends SSA title XVIII to: (1) provide for adjustments for certain publicly funded family residency programs; (2) extend on a graduated basis to three years (after 1997) the current one-year period following a transplant procedure during which Medicare covers immunosuppressive drug therapy for beneficiaries who have received organ transplants; and (3) provide that user fees imposed under the Clinical Laboratories Improvement Act of 1967 are not subject to the general ban on user fees for determining compliance with any requirement of Medicare. (Sec. 13560) Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to provide that to the extent that appropriations are enacted providing budget authority for Medicare administrative costs above a base level spending in FY 1992 of $1.526 billion, the appropriate discretionary spending limits shall be adjusted to accommodate additional budget authority in FY 1994 and 1995. Chapter 4: Medicare Supplemental Insurance Policies - Amends OMBRA '90 and Medicare to make specified changes to Federal standards respecting the sale and regulation of Medicare supplemental insurance policies. Chapter 5: Treatment of Certain State Health Care Programs - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide that: (1) the Hawaii Prepaid Health Care Act will not be preempted by ERISA unless the Secretary of Labor notifies the Governor of Hawaii that certain conditions exist; and (2) State tax laws relating to employee benefit plans will continue to be preempted. Subtitle D: Customs and Trade Provisions - Amends the Tariff Act of 1930 to authorize appropriations for FY 1994 and 1995 for the United States International Trade Commission (ITC). Prohibits use of funds for any special study, requested by the executive branch unless the ITC is reimbursed. (Sec. 13601) Amends the Customs Procedural Reform and Simplification Act of 1978 to authorize appropriations for FY 1994 and 1995 for the United States Customs Service for noncommercial and commercial operations, and the air and marine interdiction programs. Amends the Trade Act of 1974 to authorize appropriations for FY 1994 and 1995 for the Office of the United States Trade Representative. (Sec. 13602) Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) to extend the authority of the Secretary of the Treasury to collect customs user fees through September 30, 1998. (Sec. 13603) Amends the Trade Act of 1974 to remove the Union of Soviet Socialist Republics from the list of countries ineligible for designation as a beneficiary developing country under the Generalized System of Preferences (GSP). Extends duty-free treatment provided under the GSP through September 30, 1994. (Sec. 13604) Extends the worker trade adjustment assistance program (trade adjustment assistance benefits for workers adversely affected by import competition or the relocation of U.S. production facilities abroad), and authorization of appropriations, from FY 1993 through FY 1996. (Sec. 13605) Amends the Omnibus Trade and Competitiveness Act of 1988 to extend the authority of the President, for a specified period of time, to enter into trade agreements with foreign countries for the reduction or elimination of tariff or nontariff barriers if the Uruguay Round of multilateral trade negotiations under the General Agreement on Tariffs and Trade (GATT) has not resulted in such trade agreements by May 31, 1993. Provides that implementing bills involving tariff and nontariff trade agreements shall be effective only if, among other things, the President, at least 120 calendar days (currently, 90 days) before he enters into such an agreement, notifies the Congress of his intention and publishes such intention in the Federal Register. Extends congressional "fast track procedures" to such implementing bills through April 16, 1994. (Sec. 13606) Amends the Federal Trade Act of 1974 to eliminate the East-West Trade Statistics Monitoring System. Subtitle E: Customs Officer Pay Reform - Revises the pay system for United States Customs Service inspectors. (Sec. 13701) Amends the Tariff Act of 1930 to prohibit merchandise or passengers from foreign places, or merchandise being transported from one port to another, from being unladen from carrying vehicles during overtime hours (currently, at night). (Sec. 13702) Authorizes cash awards to customs officers for foreign language proficiency. (Sec. 13703) Amends COBRA to provide for reimbursement of appropriations from the Customs User Fee Account for agency retirement contributions. (Sec. 13704) Amends Federal law with regard to the treatment of certain pay of customs officers for retirement purposes. (Sec. 13705) Revises COBRA congressional reporting requirements respecting Account reimbursements. Requires additional General Accounting Office reports to the Congress on financing of overtime inspectional services through user fees. Title XIV: Revenue Provisions - Revenue Reconciliation Act of 1993 - Subtitle A: Training and Investment Incentives - Part I: Provisions Relating to Education and Training - Makes permanent after June 30, 1992: (1) the tax exclusion of employer-provided educational assistance; and (2) the targeted jobs credit. Allows the use of the targeted jobs credit, with limitations, for the hiring of a qualified participant in an approved school-to-work program. Part II: Investment Incentives - Subpart A: Research Credit - Makes permanent the credit for increasing research activities. Modifies the fixed base percentage of such credit for startup companies for taxable years after 1993. Subpart B: Capital Gain Provisions - Allows a taxpayer other than a corporation to exclude from gross income 50 percent of gain from the sale or exchange of qualified small business stock held for more than five years. Set forth rules and limitations for such exclusion. Treats one-half of such exclusion as an item of tax preference for minimum tax purposes. (Sec. 14114) Allows the rollover of gain from the sale of publicly traded securities into specialized small business investment companies. Subpart C: Modifications to Minimum Tax Depreciation Rules - Modifies the method of determining the depreciation deduction for certain personal property placed in service after 1993. Eliminates the depreciation adjustment for computing adjusted current earnings for such property. Subpart D: Increase in Expense Treatment for Small Business - Increases the dollar limitation on the election to expense certain depreciable small business assets. Part III: Tax-Exempt Bond Provisions - Provides a complete tax exemption (currently a 75 percent tax exemption) for bonds used to finance high-speed intercity rail facilities. (Sec. 14122) Permanently extends the authority to issue qualified small issue bonds to finance manufacturing facilities and farm property. Part IV: Expansion and Simplification of Earned Income Tax Credit - Repeals certain interaction rules with respect to the medical expense deduction, the deduction for health insurance, and the dependent care credit. Revises credit and phaseout percentages for 1994. Part V: Incentives for Investment in Real Estate - Subpart A: Extension of Qualified Mortgage Bonds and Low-Income Housing Credit - Makes permanent: (1) the authority to issue qualified mortgage bonds and qualified mortgage credit certificates; and (2) the low-income housing credit. (Sec. 14142) Provides that assistance under the HOME Investment Partnerships Act should not result in certain buildings being federally subsidized. Subpart B: Modification of Passive Loss Rules - Provides for the treatment of rental real estate activities under the limitations on losses from passive activities. Subpart C: Provisions Relating to Real Estate Investments by Pension Funds - Modifies exceptions to the exclusion of real property acquired by a qualified organization from the meaning of acquisition indebtedness. Makes certain exceptions inapplicable to sales out of foreclosure by a financial institution. (Sec. 14145) Repeals the special rule for publicly traded partnerships with respect to the treatment of unrelated business taxable income. (Sec. 14146) Permits a tax-exempt title-holding company to receive unrelated business taxable income if the unrelated income is incidentally derived from the holding of real property. (Sec. 14147) Excludes from unrelated business taxable income: (1) gains from the sale, exchange, or other disposition of real property acquired from financial institutions that are in conservatorship or receivership; and (2) loan commitment fees and certain option premiums. Provides for the tax treatment of pension fund investments in real estate investment trusts. Subpart D: Discharge of Indebtedness - Excludes from gross income the income from the discharge of qualified real property business indebtedness. Subpart E: Increase in Recovery Period for Nonresidential Real Property - Increases the depreciation recovery period for nonresidential real property. Part VI: Luxury Tax - Repeals the luxury excise tax on boats, aircraft, jewelry, and furs. (Sec. 14162) Modifies the luxury excise tax on automobiles to index the threshold for inflation occurring after 1990 and make such tax applicable to the first retail sale. Exempts from the luxury excise tax parts for accessories installed for use of passenger vehicles by disabled individuals. (Sec. 14163) Extends the current diesel fuel excise tax to diesel fuel used by noncommercial motorboats. Retains such taxes in the General Fund of the Treasury. Part VII: Other Changes - Repeals the tax preferences for the appreciated property charitable deduction. Disallows an adjustment related to the earnings and profits effects of any charitable contribution from being made in computing adjusted current earnings. (Sec. 14171) Requires Secretary of the Treasury to report to specified congressional committees on the development of a procedure for taxpayers to seek an agreement with the Secretary on the value of tangible personal property prior to the donation of such property to a qualifying charitable organization. (Sec. 14172) Amends the Railroad Retirement Solvency Act of 1983 to make permanent the treatment of certain railroad retirement benefits as received under employer plans. (Sec. 14173) Provides for the temporary extension of the deduction of health insurance costs of self-employed individuals. Subtitle B: Revenue Increases - Part I: Provisions Affecting Individuals- Subpart A: Rate Increases - Lowers the tax rates for certain taxpayers and increases the tax rate for certain higher incomes. Imposes a surtax on certain higher incomes. (Sec. 14203) Increases the tentative minimum tax for taxpayers other than corporations. (Sec. 14204) Makes permanent the overall limitation on itemized deductions and the phaseout of personal exemptions for high-income taxpayers. (Sec. 14206) Sets forth provisions to prevent the conversion of ordinary income to capital gain in certain financial transactions. Repeals certain exeptions to market discount rules. Provides for the treatment of purchases of stripped preferred stock after April 30, 1993. Revises methods of: (1) computing the limitation on the deductibility of investment interest; and (2) determining substantial appreciation of partnership inventory items. Subpart B: Other Provisions - Repeals the limitation on the amount of wages subject to the health insurance employment tax. (Sec. 14208) Increases and makes permanent the highest estate and gift tax rate. (Sec. 14209) Reduces the deduction for business meals and entertainment expenses. (Sec. 14210) Disallows a tax deduction for social club membership dues, except for employee recreational expenses. (Sec. 14211) Disallows a deduction as a trade or business expense remuneration to certain employees in excess of $1 million. (Sec. 14212) Reduces the compensation taken into account in determining contributions and benefits under qualified retirement plans. (Sec. 14213) Removes qualified residence sales, purchases, or leases and meals from the deduction for moving expenses. (Sec. 14214) Revises the limitation on using the preceding year's tax to calculate an individual's estimated tax payments. (Sec. 14215) Increases the amount of social security and tier 1 railroad retirement benefits to be included in the gross income of certain taxpayers. Part II: Provisions Affecting Business - Increases the tax rate for corporate income in excess of $10 million and the tax rate on personal service corporations. (Sec. 14222) Denies a tax deduction for lobbying expenses. Subjects lobbying organizations to special reporting requirements. (Sec. 14223) Requires any security which is inventory in the hands of the dealer to be included in inventory at its fair market value. Requires any dealer in securities that holds any security which is not in inventory at the close of any taxable year to: (1) recognize gain or loss as if the security were sold on the last business day of the taxable year; and (2) take into account any such gain or loss for such year (the mark-to-market requirement). (Sec. 14224) Requires taking into account: (1) certain Federal Savings and Loan Insurance Corporation (FSLIC) assistance as compensation for loss; and (2) FSLIC assistance for any debt for determining whether such debt is worthless and the amount of any addition to a reserve for bad debts. (Sec. 14225) Increases the required annual payment for corporations that fail to pay estimated income tax. Modifies the periods for applying such annualization. (Sec. 14226) Limits the Puerto Rico and possession tax credit to 60 percent of the possession corporation's qualified possession wages. (Sec. 14227) Modifies the limitation on corporate deductions for interest paid to related persons to take into account disqualified guarantees of indebtedness and the imposition of a gross basis tax. Part III: Foreign Tax Provisions - Subpart A: Current Taxation of Certain Earnings of Controlled Foreign Corporations - Requires U.S. shareholders of controlled foreign corporations to include in gross income a pro rata share of the corporation's excess passive assets. Modifies the rule on taxation of investment in U.S. property and takes into account excessive passive assets. Requires a report on investments by controlled foreign corporations in U.S property. (Sec. 14233) Excepts from foreign personal holding income dividends attributable to earnings and profits of the distributing corporation accumulated during any period which the person receiving such dividend did not hold such stock. Requires the establishment of an excess limitation account by taxpayers who receive foreign tax credits in a year they receive previously taxed earnings and profits. Subpart B: Allocation of Research and Experimental Expenditures - Reduces the amount allowed as allocation and apportionment of research and experimental expenditures from sources within the United States. Subpart C: Other Provisions - (Sec. 14235) Excludes passive dividends or interest income from foreign oil and gas income. (Sec. 14236) Modifies accuracy-related penalties for tax underpayments. (Sec. 14237) Denies the inclusion of certain contingent interest in the exemption for portfolio interest for nonresident aliens. (Sec. 14238) Authorizes the Secretary of the Treasury to prescribe regulations recharacterizing any multiple-party financing transaction as a transaction directly among any two or more of such parties when appropriate to prevent tax avoidance. Part IV: Energy Tax Provisions - Subpart A: Energy Tax Based on Btu Content - Imposes an excise tax on the following energy products: (1) taxable refined petroleum products removed from a U.S. refinery or terminal entered into the United States for consumption, use, or warehousing, and sold to a nonregistered person; (2) natural gas removed from any U.S. pipeline, entered into the United States for consumption, use, or warehousing, and entered into any nonregistered pipeline; (3) coal received at any facility for use as a fuel at such facility; and (4) the sale of electricity to ultimate users in the United States and the use of electricity which was not subject to such tax. Bases the rate of tax on such products on the applicable Btu factor and content. (Sec. 14241) Provides for refunding certain amounts to ultimate vendors of petroleum used for heating oil and international commercial transportation. Repays certain sums to persons who use petroleum to produce calcined coke. Provides excise tax exemptions for certain uses. Refunds the tax paid by certain users of methane recovered from biomass or coal mining. Imposes a tax on the use of any fossil fuel: (1) in the manufacture or production of a fuel other than at a U.S. refinery; or (2) as a fuel. Imposes a tax on floor stock of taxable fuels held on the date of the tax increase. Allows a credit against such tax. Provides for such tax increases to begin July 1, 1994. Imposes a Btu tax on certain imported products that contain significant levels of direct energy inputs that would be taxable if the products were manufactured in the United States. Imposes a penalty on persons who sell dyed fuel for taxable uses. Subpart B: Modifications to Tax on Diesel Fuel - Imposes an excise tax on diesel fuel. Exempts from such tax diesel fuel: (1) used by trains and intercity, local, or school buses; and (2) which is dyed or marked in accordance in regulations. (Sec. 14242) Provides that the Airport and Airway Trust Fund financing rate does not apply to aviation fuel sold by a producer or importer for use by the purchaser in a nontaxable use. Imposes a civil penalty on persons who use reduced-rate fuel for a taxable use. (Sec. 14243) Imposes a floor stocks tax on any person holding diesel fuel April 1, 1994. Subpart C: Extension of Motor Fuel Tax Rates; Increased Deposits Into Highway Trust Fund - Increases the tax on gasoline and diesel fuels for purposes of the Highway Trust Fund financing rate. Increases the amount to be transferred to the Mass Transit Account from such Fund. Part V: Compliance Provisions - Requires information reporting on payments to corporations for services. (Sec. 14252) Modifies provisions concerning substantial understatement and return-preparer penalties to allow reasonable cause exceptions. (Sec. 14253) Requires certain financial entities (including the Federal Deposit Insurance Corporation, the Resolution Trust Corporation, and the National Credit Union Administration, and their successors or subunits) to file information returns regarding discharges of indebtedness of $600 or more. Part VI: Treatment of Intangibles - Allows an amortization deduction with respect to certain intangible property, including goodwill, that is acquired and held by a taxpayer in connection with the conduct of a trade or business or an activity engaged in for the production of income. Part VII: Miscellaneous Provisions - Establishes substantiation requirements for charitable contributions of $750 or more. (Sec. 14272) Sets forth disclosure requirements for an organization that receives a quid pro quo contribution (payment made partly as a contribution and partly in consideration for goods or services provided to the payor by the donee organization). Imposes a penalty for failure to make such disclosure. (Sec. 14273) Expands the 45-day interest-free period for refunding tax overpayments to all returns, amended returns, and claims for refunds. Provides that if interest is not refunded within 45 days after the taxpayer files an amended return or claim for refund, interest will be paid only for periods after the date on which the return or claim is filed. (Sec. 14274) Denies the business travel expense deduction for spouses, dependents, or others. (Sec. 14275) Increases the withholding rate for supplemental wage payments. Subtitle C: Empowerment Zones and Enterprise Communities - Part I: Empowerment Zones and Enterprise Communities, Etc. - Provides for the designation of 100 tax enterprise communities and ten enpowerment zones between 1993 and 1996: (1) by the Secretary of Housing and Urban Development for urban areas; (2) by the Secretary of Agriculture for rural areas; and (3) by the Secretary of the Interior for Indian reservations. (Sec. 14301) Sets forth eligibility criteria. Makes certain buildings in such communities or zones eligible for the low-income housing credit applicable to buildings in high-cost areas. Provides for the issuance of enterprise zone facility bonds in enterprise communities and enpowerment zones in a manner similar to exempt facility bonds. Excludes enterprise zone facility bonds from the interest deduction limitations on financial institutions. Provides States an additional housing credit ceiling for each zone and community through 1996. Allows a limited empowerment zone employment credit to employers for a percentage of qualified zone wages paid during calendar years 1994 through 2004. Allows businesses a zone resident empowerment savings credit of 50 percent of the qualified savings contributions made by an employer to a defined contribution plan on behalf of a zone employee. Limits the credit amount based on the employee's compensation. Increases the limitation on expensing certain depreciable business assets. Increases the volume cap applicable to enterprise zone facility bonds if the business owners meet specified ownership requirements with regard to abiding in such zones. (Sec. 14302) Allows use of the targeted jobs credit for hiring empowerment zone residents. Part II: Credit for Contributions to Certain Community Development Corporations - Allows a general business tax credit for contributions to selected community development corporations for low-income individuals who are residents of the operational area of the community. Subtitle D: Other Provisions - Part I: Disclosure Provisions - Extends the authority to disclose tax return information to the Department of Veterans Affairs through September 30, 1998. (Sec. 14402) Authorizes the disclosure of certain tax return information to the Department of Education to implement the direct student loan program and to the Department of Housing for income verification. Part II: User Fee Provisions - Requires establishment of a program requiring the payment of user fees for the processing of applications for certificates of alcohol label approval and exemption, formula reviews, and statements of process (including laboratory tests). (Sec. 14412) Removes authority to use the Harbor Maintenance Trust Fund for administrative expenses of certain customs fee collections. (Sec. 14413) Increases the tax on fuel used on commercial transportation on inland waterways. Part III: Public Debt Limit - Increases the public debt limit and repeals the temporary limit on such increase. Part IV: Vaccine Provisions - Makes permanent: (1) the excise tax on certain vaccines; and (2) the authority to pay compensation from the Vaccine Trust Fund under the National Vaccine Injury Compensation Program for certain damages resulting from vaccines administered after September 30, 1988. Directs the Secretary of the Treasury to report to specified congressional committees on uses of such Fund. (Sec. 14431) Imposes a floor stocks tax on taxable vaccines. (Sec. 14432) Requires contribution coverage under group health plans of the costs of pediatric vaccines. (Sec. 14433) Establishes the Childhood Immunization Trust Fund for the entitlement program under the Public Health Service Act.
Bill· HRH.R. 2261 (103rd)referred
United States · United States Congress · 25 May 1993
TABLE OF CONTENTS: Title I: Standardization of Claims Processing Title II: Electronic Medical Data Standards Title III: Development and Distribution of Comparative Value Information Title IV: Additional Standards and Requirements; Research and Demonstrations Title I: Standardization of Claims Processing - Requires the Secretary of Health and Human Services to adopt standards relating to each of the following: (1) data elements for use in paper and electronic claims processing under health benefit plans, as well as for use in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. Title II: Electronic Medical Data Standards - Requires the Secretary to promulgate standards for hospitals concerning electronic medical data, including: (1) a definition of a standard set of data elements for use by utilization and quality control peer review organizations; (2) a definition of the set of comprehensive data elements; (3) standards for an electronic patient care information system; (4) standards concerning the transmission of electronic medical data; and (5) standards relating to confidentiality of patient-specific information. Establishes an advisory commission to advise the Secretary concerning the standards. Authorizes appropriations. Title III: Development and Distribution of Comparative Value Information - Provides for the development and implementation in each State of a comparative health care value information program that covers the prices of health care services and health insurance plans. Authorizes appropriations. Title IV: Additional Standards and Requirements; Research and Demonstrations - Provides for: (1) magnetized identification cards under both Medicare and Medicaid; and (2) a Medicare and Medicaid data bank that provides information on health plan payors under Medicare and Medicaid. Authorizes appropriations. Preempts State quill pen laws. Requires the use of standard identification numbers by health benefit plans. Provides for the coordination of benefits when two or more health benefit plans are liable, if the Secretary determines there is a need for such coordination.
Bill· SS. 1002 (103rd)open
United States · United States Congress · 20 May 1993
Breast and Cervical Cancer Information Act of 1993 - Amends the Public Health Service Act to require each recipient of a grant or contract for family planning services to: (1) provide information (in a culturally competent manner) concerning breast and cervical cancer, including information on the need and skills for breast self-examinations; and (2) refer clients for breast and cervical cancer screening, treatment, or other services.
Bill· SS. 997 (103rd)open
United States · United States Congress · 20 May 1993
Beaches Environmental Assessment, Closure, and Health Act of 1993 - Amends the Federal Water Pollution Control Act to direct the Administrator of the Environmental Protection Agency (EPA) to issue water quality criteria for pathogens in coastal recreation waters. Requires States to adopt consistent water quality standards. Requires the Administrator to publish regulations specifying methods to be used by States to monitor coastal recreation waters, during periods of use by the public, for compliance with standards. Requires notification of local governments and the public of water quality standards violations. Requires the Administrator to: (1) issue guidance on uniform assessment and monitoring procedures for floatable materials in coastal recreation waters; and (2) specify the conditions under which the presence of floatable materials constitutes a threat to public health and safety. Requires an ongoing study and report to the Congress on developing better indicators for detecting harmful bacteria and viruses in coastal recreation waters. Authorizes the Administrator to make grants to States to fulfill requirements under this Act. Authorizes appropriations.
Law· HRH.R. 2202 (103rd)enacted
United States · United States Congress · 20 May 1993
Breast and Cervical Cancer Amendments of 1993 - Amends Public Health Service Act provisions authorizing grants for breast and cervical cancer preventive health measures to allow States to make contracts with private entities, provided the amount paid does not exceed the amount that would be paid under title XVIII (Medicare) of the Social Security Act. Revises breast and cervical cancer screening quality assurance requirements. Allows the grants to be made to tribes and tribal organizations. Establishes a committee to coordinate Federal agency activities regarding established objectives for reductions in breast and cervical cancer in the United States by the Year 2000. Authorizes appropriations to carry out the breast and cervical cancer preventive health measures provisions.
Bill· HRH.R. 2205 (103rd)open
United States · United States Congress · 20 May 1993
Trauma Care Amendments Act of 1993 - Amends the Public Health Service Act to: (1) increase (from 12 to 13) the number of members of the Advisory Council on Trauma Care Systems; (2) include on the Council an individual who has been a trauma patient at a designated trauma center, to be appointed for a four-year term; and (3) require that at least four (currently, 25 percent) of the members be knowledgeable concerning rural areas. Requires the Council to meet not less than once and, if the Chair determines necessary, up to four times each year (currently, at the call of the Chair and not less than once each three months). Includes among requirements for State plans (in order to receive allotments) coordination and cooperation among bordering States with respect to areas in which logical geographic groupings across State borders would be appropriate (currently, among States that share any standard metropolitan statistical area). Authorizes appropriations. Directs the General Accounting Office to study and report to the appropriate congressional committees on the duplication of Federal emergency medical services and trauma activities.
Bill· HRH.R. 2203 (103rd)referred
United States · United States Congress · 20 May 1993
Sexually Transmitted Diseases Amendments of 1993 - Amends the Public Health Service Act to authorize appropriations through FY 1998 for programs for: (1) the prevention and control of sexually transmitted diseases; and (2) the prevention of infertility arising as a result of such diseases.
Bill· HRH.R. 2204 (103rd)referred
United States · United States Congress · 20 May 1993
Silvio O. Conte Disabilities Prevention Act - Amends the Public Health Service Act to authorize grants and contracts for the prevention of disabilities and the prevention of secondary conditions resulting from disabilities, including through demonstrations and interventions, surveillances and studies, public education, and training health professionals. Authorizes appropriations.
Bill· HRH.R. 2201 (103rd)referred
United States · United States Congress · 20 May 1993
Injury Prevention and Control Amendments of 1993 - Amends the Public Health Service Act to require the Secretary of Health and Human Services to carry out specified activities with respect to domestic violence and sexual assault, including: (1) collecting data relating to the incidence of such violence and assault; (2) making grants to public and nonprofit entities for the evaluation of programs whose purpose is to prevent such violence and assault; (3) providing to the public information and education on such violence and assault; (4) training health care providers to identify individuals whose medical condition or statements indicate that they are victims of such violence and assault and to refer them to entities that provide related services; and (5) making grants to public and nonprofit private entities for demonstration projects with respect to such violence and assault. Directs the Secretary to establish an advisory committee to advise the Secretary and the Director of the Centers for Disease Control and Prevention with respect to the prevention and control of injuries. Revises reporting requirements under the Act to include periodic reporting of activities carried out with respect to such violence and assault and with respect to rural areas. Authorizes the Secretary to work in cooperation with other Federal agencies and with public and nonprofit private entities to promote activities regarding the prevention and control of injuries (currently, limited to injury control). Directs the Secretary to disseminate information concerning the practical applications of research conducted or assisted to the public, including elementary and secondary schools. Authorizes appropriations.
Resolution· HRESH.Res. 179 (103rd)passed
United States · United States Congress · 20 May 1993
Waives points of order against the consideration of the conference report on S. 1 (amending the Public Health Service Act to revise and extend programs of the National Institutes of Health).
Bill· SS. 985 (103rd)open
United States · United States Congress · 19 May 1993
Minor Crop Pesticides Act of 1993 - Amends the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) to define "minor use" as the use of a pesticide on an animal or a commercial agricultural crop or site or for the protection of public health where: (1) the use does not provide sufficient economic incentive to support registration; and (2) the Administrator of the Environmental Protection Agency (EPA) has not determined that the use presents an unreasonable adverse environmental effect. Prohibits data that relates solely to a minor use, without the permission of the original data submitter, from being considered by the Administrator to support a minor use application by another person for ten years following the submission of the data. Requires the Administrator, on the request of a registrant, to extend the deadline for the production of residue chemistry data required solely to support a minor use pesticide up to two years subject to specified conditions. Applies the same extension conditions to data for reregistrations. Permits the Administrator, with respect to the registration of a pesticide for a minor use, to waive applicable data requirements if such use does not have an adverse environmental effect. Provides for expedited review (within 180 days of submission) of applications to support minor use pesticide registrations. Requires the Administrator to conditionally amend a registration to permit additional minor uses even if data is insufficient if the applicant has submitted satisfactory data pertaining to the proposed minor use and amending such registration would not increase environmental risks. Authorizes the Administrator to conditionally register or amend the registration of a pesticide for a minor use if: (1) the active ingredient has been listed for reregistration; (2) the minor use was a registered use of a product that has been canceled, proposed for cancellation, or deleted as a use after December 24, 1988; and (3) the use requires only residue chemistry data for reregistration. Outlines additional requirements for conditional registrations. Directs the Administrator to establish a minor use program within the Office of Pesticide Programs. Requires the Secretary of Agriculture to establish a minor use grant program to ensure the availability of a minor use crop protection chemical. Authorizes appropriations.
Law· SJRESS.J.Res. 95 (103rd)enacted
United States · United States Congress · 19 May 1993
Designates October 1993 as National Breast Cancer Awareness Month.
Bill· HRH.R. 2170 (103rd)referred
United States · United States Congress · 19 May 1993
Omnibus Nuclear Power Safety and Security Enhancement Act of 1993 - Amends the Energy Reorganization Act of 1974 to require certain persons (including owners and operators) with information about a defect or safety violation at nuclear facilities regulated by the Nuclear Regulatory Commission (NRC), including those leased by the United States Enrichment Corporation, to notify the NRC immediately if such defect or violation could create a substantial safety hazard. Authorizes the NRC to issue regulations requiring such persons to devise and implement notification compliance procedures. Mandates that the notification requirements be prominently posted on the business premises of persons subject to this Act. Provides a civil penalty for non-compliance. Grants the NRC enforcement powers. Amends the Atomic Energy Act of 1954 to establish civil penalties for violations of its licensing or certification strictures. Declares that each day of a continuing violation constitutes a separate violation for purposes of computing the civil penalty. Repeals the requirement that the Advisory Committee on Reactor Safeguards submit an annual status report to the Congress on reactor safety research. Authorizes the NRC to: (1) permit its licensees to carry firearms while in the discharge of their official duties; and (2) issue regulations regarding the introduction of dangerous weapons or instrumentalities upon property within its licensing purview. Includes within the penalty guidelines for the sabotage of nuclear facilities those facilities subject to NRC licensing during their construction where the damage could affect public health and safety during the operation of the facility. Sets forth guidelines for the NRC to conduct warrantless searches and to enter certain premises with a judicially approved administrative search warrant.
Bill· HRH.R. 2158 (103rd)referred
United States · United States Congress · 19 May 1993
Women's Preventive Health Amendments of 1993 - Amends the Public Health Service Act to authorize the Secretary of Health and Human Services to make grants for up to three demonstration projects providing women's preventive health services. Authorizes appropriations.
Bill· HRH.R. 2172 (103rd)referred
United States · United States Congress · 19 May 1993
TABLE OF CONTENTS: Title I: Requirement that President Submit and Budget Committees Report Budgets that Achieve a Balanced Budget by Fiscal Year 2000 Title II: Joint Budget Resolutions Title III: Categorical Sequestration and Pay-As-You-Go Title IV: The Budget Baseline Health Care Reform Budget Enforcement Act of 1993 - Title I: Requirement That President Submit and Budget Committees Report Budgets That Achieve a Balanced Budget by Fiscal Year 2000 - Amends Federal law to require any budget submitted by the President to the Congress for FY 1994 through 2000 be a budget for that fiscal year and the four ensuing fiscal years that provides for a balanced budget by FY 2000 and subsequent fiscal years. Requires that such budgets be within categorical targets. Amends the Congressional Budget Act of 1974 to require the reporting of balanced budgets by the congressional budget committees. Title II: Joint Budget Resolutions - Replaces the concurrent resolution on the budget with a joint resolution on the budget. Makes it out of order in the House and Senate to consider any appropriation or authorizing legislation for a fiscal year covered by a joint resolution on the budget before that joint resolution is enacted. Title III: Categorical Sequestration and Pay-As-You-Go - Establishes direct spending and discretionary spending targets (replaces maximum deficit amounts) for FY 1994 through 2000. Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to require adjustments to discretionary spending targets to include expiring housing contracts and emergencies. Establishes a reconciliation process for the congressional committees on Appropriations to avoid sequestration. Prohibits the House or Senate from considering legislation to reduce revenues unless such legislation reduces any combination of entitlement targets or discretionary spending targets in order to make such legislation deficit-neutral. Provides for permanent sequestration of direct spending, eliminating excess direct spending, and a reconciliation process to avoid sequestration. Designates benefits payable under the old-age, survivors and disability insurance program under title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act as the only program exempt from reduction from any sequestration order. Repeals other exceptions, limitations, and special rules. Title IV: The Budget Baseline - Amends Federal law to require both the President and the Congress to draft a budget based on estimates of current fiscal year spending, proposing increases or decreases based on this level (rather than on an estimated baseline). Amends the Congressional Budget Act of 1974 to require the Congressional Budget Office to use such a current fiscal year baseline in its report to the congressional budget committees, projecting growth for entitlement and discretionary spending based on current fiscal year spending.
Bill· HRH.R. 2141 (103rd)open
United States · United States Congress · 18 May 1993
TABLE OF CONTENTS: Title I: Short Title; References to Omnibus Budget Reconciliation Act of 1993 Titles II-XII: (Reserved) Title XIII: Committee on Ways and Means-Savings Subtitle A: Old-Age, Survivors, and Disability Insurance Program Subtitle D (sic): Customs and Trade Provisions Subtitle E: Customs Officer Pay Reform Subtitle B (sic): Human Resources Amendments Subtitle C: Medicare Program Title XIV: Revenue Provisions Subtitle A: Training and Investment Incentives Subtitle B: Revenue Increases Subtitle C: Empowerment Zones and Enterprise Communities, Etc. Subtitle D: Other Provisions Title I: Short Title; References to Omnibus Budget Reconciliation Act of 1993 - Ways and Means Budget Reconciliation Act of 1993 - Deems any reference in this Act to the Omnibus Budget Reconciliation Act of 1993 to be a reference to the Ways and Means Budget Reconciliation Act of 1993. Titles II-XII: (Reserved) Title XIII: Committee on Ways and Means: Savings - Subtitle A: Old-Age, Survivors and Disability Insurance Program - Amends the Omnibus Budget Reconciliation Act of 1990 (OMBRA '90) to require the Secretary of Health and Human Services (Secretary) to reestablish and maintain in service the same number of telephone lines to each local social security office that were in place on September 30, 1989. (Sec. 13002) Amends the Internal Revenue Code (IRC) and title II (Old Age, Survivors and Disability Insurance) of the Social Security Act (SSA) to raise the threshold at which election services become subject to social security employment taxes. (Sec. 13003) Amends SSA title II to: (1) permit States which already collect social security numbers under current law to use them to eliminate duplicate names and names of convicted felons from jury source lists; (2) extend to all States the option to provide police officers and firefighters participating in a public retirement system with social security coverage under voluntary agreements with the Secretary; (3) disregard the windfall elimination provision in computing any U.S. totalization benefit and the amount of a regular U.S. benefit of an individual who receives a foreign totalization benefit based in part on U.S. employment, and who does not receive any other pension which is based on noncovered employment; (4) provide that military pensions based wholly on service in the military reserves before 1988 shall not trigger application of the Government pension offset or windfall elimination provision to the individual's social security benefits; (5) repeal the facility-of-payment provision; (6) make the guaranteed primary insurance amount the basis for calculating the guaranteed maximum family benefit; (7) make unauthorized disclosure of information and fraudulent attempts to obtain personal information under SSA a felony, and increase penalties for such offenses; (8) increase the time for which an extension may be granted for filing an annual earnings report; (9) permit the Department of Agriculture to share its list of names, social security numbers, and employer identification numbers of the owners and officers of retail grocery stores which redeem food stamps with other Federal agencies for the purpose of investigating food stamp fraud and violations of other Federal laws; (10) prohibit the misuse of Department of the Treasury names, symbols, etc.; (11) prohibit a State from using an individual's social security number in the administration of any driver's license or motor vehicle registration law where the State has not entered into a contract to provide death certificate and related information to the Secretary, or where such a contract restricts the Secretary's use of death information; and (12) require the Secretary to study improvements in gathering and reporting of death information. (Sec. 13005) Exempts from payment liability and penalties any ministers who were American citizens and residents of Canada prior to the 1984 totalization agreement between the United States and Canada and failed to file a tax return or pay self-employment taxes. (Sec. 13010) Amends IRC to: (1) authorize the Secretary of the Treasury to disclose information from tax returns on individuals' mortality status to the Secretary for epidemiological research purposes; (2) provide for the coordination of the collection of domestic service employment taxes with the collection of income taxes; and (3) change threshold requirements with respect to social security employment taxes on domestic services. (Sec. 13015) Requires the Secretary to study the rising costs of disability benefits for a report to the Congress with recommendations for legislative changes. (Sec. 13016) Amends the Social Security Disability Amendments of 1980 to extend the Secretary's authority to conduct disability work incentive demonstration projects. Subtitle D (sic): Customs and Trade Provisions - Amends the Tariff Act of 1930 to authorize appropriations for the United States International Trade Commission (ITC). Prohibits use of such funds for any special study, investigation, or report requested by an agency of the executive branch unless such agency reimburses the ITC for its costs. (Sec. 13601) Amends the Customs Procedural Reform and Simplification Act of 1978 to authorize appropriations for the United States Customs Service for: (1) noncommercial and commercial operations; and (2) the air and marine interdiction programs. Amends the Trade Act of 1974 to authorize appropriations for the Office of the United States Trade Representative. (Sec. 13602) Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) to extend the authority of the Secretary of the Treasury to collect customs user fees. (Sec. 13603) Amends the Trade Act of 1974 to remove the Union of Soviet Socialist Republics from the list of countries ineligible for designation as a beneficiary developing country under the Generalized System of Preferences (GSP). Extends duty-free treatment provided under the GSP. (Sec. 13604) Extends the worker trade adjustment assistance program (trade adjustment assistance benefits for workers adversely affected by import competition or the relocation of U.S. production facilities abroad) as well as authorization of appropriations for it. (Sec. 13605) Amends the Omnibus Trade and Competitiveness Act of 1988 to extend the authority of the President, for a specified period of time, to enter into trade agreements with foreign countries for the reduction or elimination of tariff or nontariff barriers if the Uruguay Round of multilateral trade negotiations under the General Agreement on Tariffs and Trade (GATT) has not resulted in such trade agreements by May 31, 1993. Provides that implementing bills involving tariff and nontariff trade agreements shall be effective only if, among other things, the President, at least 120 calendar days (currently, 90 days) before he enters into such agreement, notifies the Congress of his intention to enter into it, and publishes such intention in the Federal Register. Extends congressional "fast track procedures" to such implementing bills through April 16, 1994. (Sec. 13606) Amends the Trade Act of 1974 to eliminate the East-West Trade Statistics Monitoring System. Subtitle E: Customs Officer Pay Reform - Amends Federal law to revise the pay system for United States Customs Service Inspectors (customs inspectors). (Sec. 13702) Authorizes cash awards to customs officers for foreign language proficiency. (Sec. 13703) Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) to provide for reimbursement of appropriations from the Customs User Fee Account (Account) for agency retirement contributions. (Sec. 13704) Amends Federal law with regard to the treatment of certain pay of customs officers for retirement purposes. (Sec. 13705) Revises COBRA congressional reporting requirements respecting Account reimbursements. Requires additional General Accounting Office reports to the Congress concerning the financing of overtime inspectional services through user fees. Subtitle B: (sic) Human Resources Amendments - Chapter 1: Child Welfare Services, Foster Care, and Adoption Assistance - Amends SSA title IV part B (Child-Welfare Services) to: (1) create a capped entitlement program to provide child welfare services designed to strengthen and preserve families; (2) repeal provisions linking the payment of certain SSA title IV part B funds to the implementation of certain protections for children in foster care; (3) require that the State part B plan provide for the foster care protections currently outlined in such provisions as well as for State review of its procedures in effect for children abandoned at or shortly after birth, as well as enactment of any procedures necessary to enable permanent child placement decisions to be made expeditiously; (4) provide that the funds withheld or recovered from a State owing to its failure to comply with such protections may not be reallotted among other States; (5) require State part B plans to contain a description of the specific measures taken by the State to comply with the Indian Child Welfare Act; and (6) provide for child welfare traineeships. (Sec. 13212) Directs the Secretary to provide grants for State courts to assess and improve proceedings relating to foster care placement and adoption. (Sec. 13216) Amends SSA title IV part E (Foster Care and Adoption Assistance) (FCAA) to: (1) change the reimbursement policy with respect to foster care maintenance payments made on behalf of certain children whose adoption has been set aside by a court or whose voluntary placement in foster care has been judicially determined to be in the best interests of the child; (2) provide for 90 (and later 50) percent matching of State expenditures for planning, design, development, or installation of statewide mechanized data collection and information retrieval systems, and 50 percent matching of State expenditures for operation of the systems; (3) require States to review periodically their foster care maintenance payment and adoption assistance levels to ensure their continuing appropriateness; (4) revise the case review system to provide that hearings after the initial dispositional hearing take place at least every 12 months, rather than periodically; (5) require the health and education records in each child's case plan to include a record that the foster care provider was advised (where appropriate) of the child's eligibility for early and periodic Medicaid screening, diagnostic, and treatment services; (6) provide for the treatment of assets of youths participating in the independent living program; (7) make permanent the authorization for the independent living program; (8) repeal authority to transfer unused foster care funds to the child welfare services program; (9) require the Secretary to promulgate regulations for on-site reviews and audits of State expenditures for foster care maintenance and adoption assistance payments; (10) set forth case plan requirements for children placed in foster care a substantial distance from their homes or in a different State; (11) require the dispositional hearing for a child placed in foster care in a different State to determine whether the out-of-State placement continues to be appropriate and in the child's best interests; (12) require the adoption and foster care data collection system to provide information on the number and characteristics of children placed in foster care outside the State; and (13) codify Federal regulations providing a timetable for the treatment of State claims for foster care and adoption assistance. (Sec. 13218) Directs the Secretary to study and report to the Congress on the ways in which States implement the reasonable efforts requirements for State SSA title IV part E plans. (Sec. 13225) Amends the Omnibus Budget Reconciliation Act of 1989 (OMBRA '89) to extend permanently (and retroactively to October 1, 1992) the level of Federal reimbursement under SSA title IV part E for the training of personnel employed or preparing for employment by the State or local child welfare agency, and for the training of foster and adoptive parents. (Sec. 13227) Amends SSA title XI part A to: (1) bar the Secretary from imposing financial penalties on States for the failure of State programs under SSA title IV parts B and E to comply with State plan requirements, except pursuant to final regulations meeting specified requirements; (2) provide for certain demonstration projects to promote the objectives of such parts; and (3) overturn certain limitations in Suter v. Artist M. on private enforceability of State plan requirements. (Sec. 13232) Prohibits the Secretary: (1) until October 1, 1994, from reducing any payment to, withholding any payments from, or seeking any repayments from any State under SSA title IV parts B or E by reason of a determination in connection with a review of State compliance with SSA title IV part B foster care protections; and (2) from reducing any payments to, withholding any payments from, or seeking any repayments from any State under SSA title IV part E by reason of a determination in connection with any on-site Federal financial review, or any audit conducted by the Inspector General using similar methodologies. (Sec. 13233) Requires the Secretary to make grants to eligible institutions to train individuals to deliver culturally sensitive and bilingual child welfare services in border areas with Mexico. Authorizes appropriations. Chapter 2: Child Support Enforcement - Amends SSA title IV part D (Child Support and Establishment of Paternity) to: (1) set up new paternity establishment performance standards and procedures for State child support enforcement programs; (2) outline State SSA title IV part D plan requirements applicable to health insurers, employers, and State Medicaid agencies with regard to health insurance coverage for children of parents subject to a support order; and (3) require State child support enforcement agencies to periodically report, at no charge, the names of obligors at least two months delinquent in child support payments to bona fide consumer reporting agencies capable of making accurate use of such information. Chapter 3: Supplemental Security Income - Amends SSA title XVI (Supplemental Security Income) (SSI) and other Federal law to: (1) require the Social Security Administration to charge States fees for the Federal cost of administering State supplemental SSI payments; and (2) require the Secretary to charge fees for additional services requested by the State that are beyond the level customarily provided in administering such payments. (Sec. 13252) Amends OMBRA '90 to make permanent the exclusion of State and local relocation assistance from countable income under SSI. (Sec. 13253) Amends SSA title XVI to: (1) deem to be living in a household a spouse or parent of family members on SSI who is absent from the household solely because of active duty military assignment; (2) exclude hazardous duty pay received while on active military duty from countable income; (3) continue SSI benefits to children who are U.S. citizens if they received SSI in the United States and then accompany their parents on military assignment to any U.S. territory or possession; and (4) extend the SSI definition of disability for children under 18 to any person under 18. (Sec. 13257) Amends Federal law to exempt income of up to $2,000 per year received by individual Indians that is derived from leases on individually-owned trust or restricted Indian lands in determining eligibility and benefit levels under AFDC (SSA title IV part A) and SSI. Chapter 4: Aid to Families with Dependent Children - (Sec. 13261) Amends SSA title IV part A to: (1) reduce to 50 percent the enhanced Federal matching available for certain categories of State administrative expenses; (2) make optional a State's verification of an individual's immigration status with the Immigration and Naturalization Service through an immigration status verification system; (3) delay Federal requirements regarding AFDC-UP participation rates; and (4) increase the amount of stepparent earnings disregarded in determining the eligibility and benefit amounts of AFDC recipients and applicants. (Sec. 13263) Amends SSA title IV part F (Job Opportunities and Basic Skills Training Program) (JOBS) to require the Secretary to develop criteria for performance standards in the JOBS program, rather than performance standards themselves, by a certain date. (Sec. 13264) States that the Congress hereby declares that: (1) it is the policy and responsibility of the Federal Government to reduce the rate and degree to which families depend on income from welfare programs, to assist them toward self-sufficiency, and to increase the living standards of low-income families; and (2) the Federal Government should help welfare recipients as well as individuals at risk of welfare participation to improve their education and job skills, to obtain access to high quality child care and other necessary support services, and to take such other steps as may assist them to meet their responsibilities to become financially independent. Directs the Secretary to develop welfare participation measures and predictors, and report annually on welfare participation to specified congressional committees. Establishes the Advisory Board on Welfare Participation to assist the Secretary in the development of such measures and predictors. (Sec. 13265) Directs the Secretary to provide for a demonstration project offering low-income residents of Milwaukee, Wisconsin, employment, wage supplements, health and child care, and counseling and training for job retention or advancement. (Sec. 13266) Amends the Family Support Act of 1988 to: (1) delay the requirement for implementation of the Unemployed Parent program in Puerto Rico, Guam, the Virgin Islands, and American Soma until the limitations on Federal matching payments to these jurisdictions with respect to AFDC and FCAA maintenance payments are repealed; and (2) extend the authorization for early childhood development projects. (Sec. 13269) Amends the Omnibus Budget Reconciliation Act of 1987 (OMBRA '87) to extend New York State's Child Assistance Program demonstration. (Sec. 13267) Amends SSA title XI to provide that, with respect to AFDC, one adult member of a family or household may sign, under penalty of perjury, a declaration attesting to the citizenship or satisfactory immigration status of other family or household members. Permits an adult to sign a declaration on behalf of a newly born child no later than the next eligibility redetermination date. Chapter 5: Unemployment Insurance - Amends IRC and SSA title III (Unemployment Compensation) to provide for the treatment of short-time compensation programs under which individuals whose workweeks have been reduced by at least ten percent (especially as an alternative to a temporary layoff) are eligible for unemployment compensation, under certain conditions. (Sec. 13275) Amends the Federal-State Extended Unemployment Compensation Act of 1970 to increase the reimbursement rate and repeal special eligibility requirements under the extended unemployment program. (Sec. 13276) Amends IRC to: (1) extend the current Federal unemployment tax rate; and (2) require disclosure of information about certain taxes to the Railroad Retirement Board for purposes of its administration of the Railroad Retirement and Railroad Unemployment Insurance Acts. Chapter 6: Technical Provisions - Makes technical corrections related to the income security and human resources provisions of OMBRAs '89 and '90. (Sec. 13283) Amends SSA title XVI to repeal certain obsolete provisions relating to treatment of the earned income tax credit. Subtitle C: Medicare Program - Chapter 1: Provisions Relating to Part A - Subchapter A: Elimination of Inflation Update for Services Provided under Part A: - Amends SSA title XVIII (Medicare) to eliminate updates for inpatient hospital services and hospice care under Medicare part A in FY 1994 and 1995. (Sec. 13402) Prohibits the Secretary from applying an update factor to the cost limits for skilled nursing facility cost reporting periods beginning in FY 1994 and 1995. Subchapter B: Other Provisions Relating to Part A - Amends SSA title XVIII to: (1) provide that a change in classification of hospitals from one area to another cannot result in a reduction in the wage index for an urban area if the area has a wage index below the rural wage index for the State or if the area is the only urban area in a State with no rural areas; (2) change certain requirements with respect to the standards for designating metropolitan statistical areas that are used in determining treatment of certain hospitals in rural counties adjacent to one or more urban areas; (3) require the Secretary to phase out payments for day outlier cases starting in FY 1995; (4) revise and authorize appropriations for the Essential Access Community Hospital (EACH) demonstration program; (5) provide for a prospective payment system for determining payments for outpatient rural primary care hospital services; (6) continue special payments for Medicare-dependent, small rural hospitals for discharges occurring through FY 1994, with reduced payments for certain discharges; (7) extend the regional floor provision with respect to certain hospital discharges the payment for which is set at 85 percent of the national amount and 15 percent of the regional amount; (8) allow to participate in Medicare hospitals where the care of patients receiving qualified psychologist services is under a clinical psychologist; (9) provide for additional medical education payments for interns and residents providing services at a community heath center under a hospital's ownership or control; (10) require skilled nursing facilities to inform beneficiaries of the hospice benefit under Medicare, except under certain conditions; (11) reduce the part A premium, on a phase-in basis, for individuals with 30 or more quarters of social security coverage (and their spouses); (12) require the Secretary to update periodically the salary equivalency guidelines for physical therapy and respiratory therapy services using the most recent available data; and (13) provide that diagnosis-related group (DRG) window provisions will not apply to hospitals that are not paid on a DRG basis. (Sec. 13414) Amends OMBRA '87 to: (1) reauthorize and extend the rural health transition grant program; and (2) provide that all hospitals classified as regional referral centers on September 30, 1992, shall retain such status through FY 1994. (Sec. 13415) Requires the Secretary to: (1) make a lump sum retroactive payment to any such hospital for payments lost as a result of the loss of its regional referral center status; and (2) provide any hospital which fails to qualify as a rural referral center as a result of its urban reclassification with the opportunity to decline such reclassification and retain rural referral center status. (Sec. 13418) Amends OMBRA '90 to require the Secretary to continue limited-service rural hospital demonstration projects through calendar 1995. (Sec. 13419) Amends OMBRA' 89 to extend the hemophilia pass-through program. (Sec. 13420) Declares that, in the case of a State with a Medicare-approved payment system, no other provision of law shall be construed as preventing the system from providing that payment for covered services be made on the basis of rates provided for under such system. (Sec. 13423) Prohibits the Secretary from taking action to recover certain amounts paid by Medicare to uniformed services treatment facilities in Boston, Baltimore, and Seattle for services that were provided between October 1, 1986, and December 31, 1989, except to the extent that funds are made available for that purpose under the Department of Defense Appropriations Act, 1993. Requires a study and report to the Congress by the Secretary on establishment of joint medical facilities among the Department of Defense, the Department of Veterans Affairs, and other public and private entities. (Sec. 13424) Requires the Secretary to: (1) review ]the DRGs assigned to discharges of patients with intractable epilepsy; (2) revise, for discharges occurring on or after October 1, 1994, the assignment of discharges to such groups as the Secretary considers appropriate to account for the resource requirements of such patients; and (3) begin collecting the data necessary to compute a skilled nursing facility wage index adjustment to the routine service cost limits required under Medicare. Requires the Prospective Payment Assessment Commission to study and report to the Congress on the impact of applying routine per diem cost limits for skilled nursing facilities on a regional basis. (Sec. 13429) Allows hospitals that have been reclassified from urban to rural as a result of revisions to metropolitan statistical area definitions issued by the Office of Management and Budget on December 28, 1992, to apply to the Medicare Geographic Classification Review Board for reclassification in FY 1994. Chapter 2: Provisions Relating to Part B: Subchapter A: Elimination of Inflation Update - Amends SSA title XVIII part B to eliminate the inflation update for physician and related professional services and other specified items and services. (Sec. 13432) Freezes payments for enteral and parenteral nutrients, supplies and equipment, rural health clinic, federally-qualified health center, and comprehensive outpatient rehabilitation facility services, dialysis services, and other part B items and services. Subchapter B: Physicians' Services - Amends SSA title XVIII part B to: (1) repeal the OMBRA '90 prohibition on separate payments for EKG interpretations; (2) repeal the reductions in payments to new physicians and practitioners; (3) prohibit the Secretary from changing the methodology in effect as of January 1, 1992, for calculating anesthesia time in the fee schedules for anesthesia services; (4) revise requirements with respect to geographic adjustment factors and beneficiary liability for amounts billed above the limiting charge; (5) require pre-payment screening by carriers of unassigned claims submitted by nonparticipating physicians; (6) require the Explanation of Benefits form to contain information on amounts billed in excess of the applicable limiting charge; (7) specify the practitioners who may only bill for services on an assignment-related basis; (8) include antigens prepared by a physician on the physician fee schedule; (9) prohibit the imposition of user fees in specified circumstances in the administration of claims relating to physicians' services; and (10) specify the conditions under which the Secretary can recognize substitute billing arrangements between two physicians. (Sec. 13444) Requires the Secretary to: (1) study and report to specified congressional committees on the data necessary to review and revise geographic indices; and (2) review and revise such indices and the geographic index values applied for all fee schedule areas by a certain date. Requires the Physician Payment Review Commission to conduct a study to develop criteria for use in redefining the localities used within States for adjusting physicians' fees. (Sec. 13446) Requires the Secretary to: (1) fully develop, by not later than July 1, 1994, relative values for the full range of pediatric physicians' services; and (2) study and report to the Congress on the relative values for pediatric and other services. Subchapter C: Ambulatory Surgical Center Services - Amends SSA title XVIII to extend special payment rates for certain eye or eye and ear hospitals to any hospital that otherwise meets current law criteria but, on October 1, 1987, operated as a physically separate or distinct eye or ear unit of a general acute care hospital which has since disposed of a substantial portion of its other acute care operations. (Sec. 13452) Amends OMBRA '90 to extend the cap on payments for intraocular lenses through 1994. Requires the Secretary to study and report to the Congress on the costs to providers of intraocular lenses provided to individuals enrolled under Medicare part B. Subchapter D: Durable Medical Equipment - Amends SSA title XVIII to: (1) remove aspirators and nebulizers from the category of durable medical equipment (DME) items requiring frequent and substantial servicing; (2) specifically provide for payment of accessories relating to aspirators and nebulizers; (3) set forth requirements which suppliers of medical equipment and supplies must satisfy in order to qualify for Medicare reimbursement; (4) require the Secretary to develop standardized certificates of medical necessity forms for use in documenting the medical necessity of DME items and supplies; (5) require DME suppliers to submit claims to the carrier having jurisdiction over the geographic area that includes the permanent residence of the patient to whom the item is furnished; (6) place restrictions on certain marketing and sales practices by DME suppliers; (7) specify the circumstances under which Medicare beneficiaries are not financially liable for covered items and services furnished by a supplier on an unassigned basis; (8) address adjustments made to final DME payment amounts for inherent reasonableness generally and require adjustments for certain items where the final payment amounts are found reasonable; and (9) subject ostomy supplies, tracheostomy supplies, and urologicals to national payment limits. Subchapter E: Other Provisions - Amends SSA title XVIII to: (1) freeze at the 1992 level the conversion factor used to determine payments to medically directed certified registered nurse anesthetists; (2) provide that in subsequent years such factor shall be the previous year's conversion factor increased by the update for physician anesthesia services for that year; (3) provide for Medicare coverage of oral cancer drugs, under certain conditions; (4) provide for uniform coverage of "off-label" anti-cancer drugs; (5) cap the part B premium penalty for late enrollment for Federal employees who meet certain conditions; (6) authorize the Secretary to enter into agreements with States to allow them to pay the late enrollment premium increases of eligible individuals; (7) establish statutory definitions for speech-language pathologists and audiologists consistent with current coverage guidelines; and (8) provide for the treatment of certain Indian health programs and facilities as federally-qualified health centers. (Sec. 13473) Requires a study and report to specified congressional committees by the Secretary on Medicare coverage of patient care costs associated with clinical trials of new cancer therapies. (Sec. 13476) Amends the Consolidated Omnibus Budget Reconciliation Act of 1985 to extend municipal health service demonstration projects. Subchapter F: Part B Premium - Amends SSA title XVIII to extend current law provisions for establishing the monthly Medicare part B premium for beneficiaries enrolled in Medicare. Chapter 3: Provisions Relating to Parts A and B - Subchapter A: Elimination of Updates - Amends SSA title XVIII to eliminate updates in payments to hospitals for the direct costs of graduate medical education for cost reporting periods beginning during FY 1994 and 1995. (Sec. 13502) Prohibits the Secretary from providing any update in the cost limits for home health services for cost reporting periods beginning during FY 1994 and 1995. Subchapter B: Medicare Secondary Payer Provisions - Specifies numerous changes with regard to Medicare as secondary payor. Subchapter C: Physician Ownership and Referral - Amends SSA title XVIII to: (1) apply the ban on certain referrals by physicians to all payers, extending it to cover additional specified health services as well as new exceptions; (2) expand current standards used to define a group practice; and (3) provide that Federal law shall not preempt State laws that relate to referrals not covered under the ban, or that relate to referrals covered under the ban but are even more restrictive. Subchapter D: Other Provisions - Requires the Secretary to: (1) redetermine the full-time-equivalent (FTE) resident amount to reflect the amount that would be allowed if the hospital had been liable to pay FICA taxes or make other specified retirement contributions for residents during the base year, but did not make such payments, yet now must do so as a result of OMBRA '90; and (2) establish outreach to Medicare beneficiaries who may qualify for Medicaid payment of their out-of-pocket Medicare expenses. (Sec. 13551) Amends SSA title XVIII to: (1) reduce payments for erythropoientin; (2) require home health agencies to inform Medicare beneficiaries of their entitlement to hospice care under Medicare; (3) provide for interest payments to be made on clean claims if payment is not made within 30 days of receipt; (4) provide for adjustment in Medicare capitation payments to account for regional variations in application of Medicare secondary payer provisions; (5) provide for adjustments for certain publicly- funded family practice residency programs; (6) extend on a graduated basis to three years (after 1997) the current one-year period following a transplant procedure during which Medicare covers immunosuppressive drug therapy for beneficiaries who have received organ transplants; and (7) provide that user fees imposed under the Clinical Laboratories Improvement Act of 1967 are not subject to the general ban on user fees for determining compliance with any requirement of Medicare. (Sec. 13555) Amends OMBRA '87 and the Deficit Reduction Act of 1984 to: (1) extend social health maintenance organization demonstration projects for an additional two years; and (2) permit one of the projects to enroll Medicare end-stage renal disease beneficiaries. Increases the limit on the number of individuals who pay participate in such projects. (Sec. 13558) Amends SSA title XI to repeal the requirement that peer review organizations precertify selected surgical procedures. (Sec. 13560) Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to provide that to the extent that appropriations are enacted providing budget authority for Medicare administrative costs above a base level of spending in FY 1992 of $1.526 billion, the appropriate discretionary spending limits shall be adjusted to accommodate additional budget authority in FY 1994 and 1995. Chapter 4: Medicare Supplemental Insurance Policies - Amends OMBRA '90 and Medicare to make specified changes to Federal standards respecting the sale and regulation of Medicare supplemental insurance policies. Chapter 5: Treatment of Certain State Health Care Programs - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide that: (1) the Hawaii Prepaid Health Care Act will not be preempted by ERISA unless the Secretary of Labor notifies the Governor of Hawaii that, as a result of any amendment to such Act, the proportion of the population covered would be less than the current proportion or the level of coverage would be less than the actuarial equivalent of the current level of coverage; and (2) State tax laws relating to employee benefit plans will continue to be preempted. Title XIV: Revenue Provisions - Revenue Reconciliation Act of 1993 - Subtitle A: Training and Investment Incentives - Part I: Provisions Relating to Education and Training - Makes permanent after June 30, 1992: (1) the tax exclusion of employer-provided educational assistance; and (2) the targeted jobs credit. Allows the use of the targeted jobs credit, with limitations, for the hiring of a qualified participant in an approved school-to-work program. Part II: Investment Incentives - Subpart A: Research Credit - Makes permanent the credit for increasing research activities. Modifies the fixed base percentage of such credit for startup companies for taxable years after 1993. Subpart B: Capital Gain Provisions - Allows a taxpayer other than a corporation to exclude from gross income 50 percent of gain from the sale or exchange of qualified small business stock held for more than five years. Set forth rules and limitations for such exclusion. Treats one-half of such exclusion as an item of tax preference for minimum tax purposes. (Sec. 14114) Allows the rollover of gain from the sale of publicly traded securities into specialized small business investment companies. Subpart C: Modifications to Minimum Tax Depreciation Rules - Modifies the method of determining the depreciation deduction for certain personal property placed in service after 1993. Eliminates the depreciation adjustment for computing adjusted current earnings for such property. Subpart D: Increase in Expense Treatment for Small Business - Increases the dollar limitation on the election to expense certain depreciable small business assets. Part III: Tax-Exempt Bond Provisions - Provides a complete tax exemption (currently a 75 percent tax exemption) for bonds used to finance high-speed intercity rail facilities. (Sec. 14122) Permanently extends the authority to issue qualified small issue bonds to finance manufacturing facilities and farm property. Part IV: Expansion and Simplification of Earned Income Tax Credit - Repeals certain interaction rules with respect to the medical expense deduction, the deduction for health insurance, and the dependent care credit. Revises credit and phaseout percentages for 1994. Part V: Incentives for Investment in Real Estate - Subpart A: Extension of Qualified Mortgage Bonds and Low-Income Housing Credit - Makes permanent: (1) the authority to issue qualified mortgage bonds and qualified mortgage credit certificates; and (2) the low-income housing credit. (Sec. 14142) Provides that assistance under the HOME Investment Partnerships Act should not result in certain buildings being federally subsidized. Subpart B: Modification of Passive Loss Rules - Provides for the treatment of rental real estate activities under the limitations on losses from passive activities. Subpart C: Provisions Relating to Real Estate Investments by Pension Funds - Modifies exceptions to the exclusion of real property acquired by a qualified organization from the meaning of acquisition indebtedness. Makes certain exceptions inapplicable to sales out of foreclosure by a financial institution. (Sec. 14145) Repeals the special rule for publicly traded partnerships with respect to the treatment of unrelated business taxable income. (Sec. 14146) Permits a tax-exempt title-holding company to receive unrelated business taxable income if the unrelated income is incidentally derived from the holding of real property. (Sec. 14147) Excludes from unrelated business taxable income: (1) gains from the sale, exchange or other disposition of real property acquired from financial institutions that are in conservatorship or receivership; and (2) loan commitment fees and certain option premiums. Provides for the tax treatment of pension fund investments in real estate investment trusts. Subpart D: Discharge of Indebtedness - Excludes from gross income the income from the discharge of qualified real property business indebtedness. Subpart E: Increase in Recovery Period for Nonresidential Real Property - Increases the depreciation recovery period for nonresidential real property. Part VI: Luxury Tax - Repeals the luxury excise tax on boats, aircraft, jewelry, and furs. (Sec. 14162) Modifies the luxury excise tax on automobiles to index the threshold for inflation occurring after 1990 and make such tax applicable to the first retail sale. Exempts from the luxury excise tax parts for accessories installed for use of passenger vehicles by disabled individuals. (Sec. 14163) Extends the current diesel fuel excise tax to diesel fuel used by noncommercial motorboats. Retains such taxes in the General Fund of the Treasury. Part VII: Other Changes - Repeals the tax preference for the appreciated property charitable deduction. Disallows an adjustment related to the earnings and profits effects of any charitable contribution from being made in computing adjusted current earnings. Requires the Secretary of the Treasury to report to specified congressional committees on the development of a procedure for taxpayers to seek an agreement with the Secretary on the value of tangible personal property prior to the donation of such property to a qualifying charitable organization. (Sec. 14172) Amends the Railroad Retirement Solvency Act of 1983 to make permanent the treatment of certain railroad retirement benefits as received under employer plans. (Sec. 14173) Provides for the temporary extension of the deduction of health insurance costs of self-employed individuals. Subtitle B: Revenue Increases - Part I: Provisions Affecting Individuals- Subpart A: Rate Increases - Lowers the tax rates for certain taxpayers and increases the tax rate for certain higher incomes. Imposes a surtax on certain higher incomes. (Sec. 14203) Increases the tentative minimum tax for taxpayers other than corporations. (Sec. 14204) Makes permanent the overall limitation on itemized deductions and the phaseout of personal exemptions for high-income taxpayers. (Sec. 14206) Sets forth provisions to prevent the conversion of ordinary income to capital gain in certain financial transactions. Repeals certain exceptions to market discount rules. Provides for the treatment of purchases of stripped preferred stock after April 30, 1993. Revises the methods of: (1) computing the limitation on the deductibility of investment interest; and (2) determining substantial appreciation of partnership inventory items. Subpart B: Other Provisions - Repeals the limitation on the amount of wages subject to the health insurance employment tax. (Sec. 14208) Increases and makes permanent the highest estate and gift tax rate. (Sec. 14209) Reduces the deduction for business meals and entertainment expenses. (Sec. 14210) Disallows a tax deduction for social club membership dues, except for employee recreational expenses. (Sec. 14211) Disallows a deduction as a trade or business expense remuneration to certain employees in excess of $1 million. (Sec. 14212) Reduces the compensation taken into account in determining contributions and benefits under qualified retirement plans. (Sec. 14213) Removes qualified residence sales, purchases, or leases and meals from the deduction for moving expenses. (Sec. 14214) Revises the limitation on using the preceding year's tax to calculate an individual's estimated tax payments. (Sec. 14215) Increases the amount of social security and tier 1 railroad retirement benefits to be included in the gross income of certain taxpayers. Part II: Provisions Affecting Business - Increases the tax rate for corporate income in excess of $10 million and the tax rate on personal service corporations. (Sec. 14222) Denies a tax deduction for lobbying expenses. Subjects lobbying organizations to special reporting requirements. (Sec. 14223) Requires any security which is inventory in the hands of the dealer to be included in inventory at its fair market value. Requires any dealer in securities that holds any security which is not in inventory at the close of any taxable year to: (1) recognize gain or loss as if the security were sold on the last business day of the taxable year; and (2) take into account any such gain or loss for such year (the mark-to-market requirement). (Sec. 14224) Requires taking into account: (1) certain Federal Savings and Loan Insurance Corporation (FSLIC) assistance as compensation for loss; and (2) any FSLIC assistance for any debt for determining whether such debt is worthless and in determining the amount of any addition to a reserve for bad debts arising from such worthlessness or partial worthlessness. (Sec. 14225) Increases the required annual payment for corporations that fail to pay estimated income tax. Modifies the periods for applying such annualization. (Sec. 14226) Limits the Puerto Rico and possession tax credit to 60 percent of the possession corporation's qualified possession wages. (Sec. 14227) Modifies the limitation on corporate deductions for interest paid to related persons to take into account disqualified guarantees of indebtedness and the imposition of a gross basis tax. Part III: Foreign Tax Provisions - Subpart A: Current Taxation of Certain Earnings of Controlled Foreign Corporations - Requires U.S. shareholders of controlled foreign corporations to include in gross income a pro rata share of the corporations excess passive assets. Sets forth rules for determining such amounts. Modifies the rule on taxation of investment in United States property and takes into account excessive passive assets. Requires a report to specified congressional committees on a study of investments by controlled foreign corporations in U.S property. (Sec. 14233) Excepts from foreign personal holding income any dividends attributable to earnings and profits of the distributing corporation accumulated during any period during which the person receiving such dividend did not hold such stock. Requires the establishment of an excess limitation account by taxpayers who receive foreign tax credits in a year they receive previously taxed earnings and profits. Subpart B: Allocation of Research and Experimental Expenditures - Reduces the amount allowed as allocation and apportionment of research and experimental expenditures from sources within the United States. Subpart C: Other Provisions - Excludes passive dividends or interest income from foreign oil and gas income. (Sec. 14236) Modifies accuracy-related penalties for tax underpayments. (Sec. 14237) Denies the inclusion of certain contingent interest in the exemption for portfolio interest for nonresident aliens. (Sec. 14238) Authorizes the Secretary of the Treasury to prescribe regulations recharacterizing any multiple-party financing transaction as a transaction directly among any two or more of such parties where appropriate to prevent any tax avoidance. Part IV: Energy Tax Provisions - Subpart A: Energy Tax Based on Btu Content - Imposes an excise tax on the following energy products: (1) taxable refined petroleum products removed from a U.S. refinery or terminal entered into the United States for consumption, use, or warehousing, and sold to a nonregistered person; (2) natural gas removed from any pipeline in the United States, entered into the United States for consumption, use, or warehousing, and entered into any nonregistered pipeline; (3) coal received at any facility for use as a fuel at such facility; and (4) the sale of electricity to ultimate users in the United States and the use of electricity which was not subject to such tax. Bases the rate of tax on such products on the applicable Btu factor and content. Provides for refunding certain amounts to ultimate vendors of petroleum used for heating oil and international commercial transportation. Repays certain sums to persons who use petroleum to produce calcined coke. Provides exemptions from such excise tax for certain uses. Refunds the tax paid by certain users of methane recovered from biomass or coal mining. Imposes a tax on the use of any fossil fuel: (1) in the manufacture or production of a fuel other than at a U.S. refinery; or (2) as a fuel. Specifies the application of such tax and exceptions. Imposes a tax on floor stock of taxable fuels held on the date of the tax increase. Allows a credit against such tax. Provides for such tax increases to begin July 1, 1994. Imposes an imported Btu tax on certain imported products that contain significant levels of direct energy inputs that would be taxable if the products were manufactured in the United States. Imposes a penalty on persons who sell dyed fuel for taxable uses. Subpart B: Modifications to Tax on Diesel Fuel - Imposes an excise tax on diesel fuel (separate from the gasoline tax and the tax on aviation). Exempts from such tax diesel fuel: (1) used by trains and intercity, local, or school buses; and (2) which is dyed or marked in accordance in regulations prescribed by the Secretary of the Treasury. Provides that the Airport and Airway Trust Fund financing rate does not apply to aviation fuel sold by a producer or importer for use by the purchaser in a nontaxable use. Imposes a civil penalty on persons who use reduced-rate fuel for a taxable use. (Sec. 14243) Imposes a floor stocks tax on any person holding diesel fuel April 1, 1994. Subpart C: Extension of Motor Fuel Tax Rates; Increased Deposits Into Highway Trust Fund - Increases the tax on gasoline and diesel fuels for purposes of the Highway Trust Fund financing rate. Increases the amount to be transferred to the Mass Transit Account from such Fund. Part V: Compliance Provisions - Requires information reporting on payments to corporations for services. (Sec. 14252) Modifies provisions concerning substantial understatement and return-preparer penalties to allow reasonable cause exceptions. (Sec. 14253) Requires certain financial entities (including the Federal Deposit Insurance Corporation, the Resolution Trust Corporation, and the National Credit Union Administration, and their successors or subunits) to file information returns regarding discharges of indebtedness of $600 or more. Part VI: Treatment of Intangibles - Allows an amortization deduction with respect to certain intangible property, including goodwill, that is acquired and held by a taxpayer in connection with the conduct of a trade or business or an activity engaged in for the production of income. Part VII: Miscellaneous Provisions - Establishes substantiation requirements for charitable contributions of $750 or more. (Sec. 14272) Sets forth disclosure requirements for an organization that receives a quid pro quo contribution (payment made partly as a contribution and partly in consideration for goods or services provided to the payor by the donee organization). Imposes a penalty for failure to make such disclosure. (Sec. 14273) Expands the 45-day interest-free period for refunding tax overpayments to all returns, as well as to amended returns and claims for refunds. Provides that if interest is not refunded within 45 days after the taxpayer files an amended return or claim for refund, interest will be paid only for periods after the date on which the return or claim is filed. (Sec. 14274) Denies the business travel expense deduction for spouses, dependents, or others. (Sec. 14275) Increases the withholding rate for supplemental wage payments. Subtitle C: Empowerment Zones and Enterprise Communities- Part I: Empowerment Zones and Enterprise Communities, Etc. - Provides for the designation of 100 tax enterprise communities and ten empowerment zones during calendar years after 1993 and before 1996: (1) by the Secretary of Housing and Urban Development, in the case of an urban area; (2) by the Secretary of Agriculture in the case of a rural area; and (3) the Secretary of the Interior for an Indian reservation. Sets forth eligibility criteria for such designations. Makes certain buildings in such communities or zones eligible for the low-income housing credit applicable to buildings in high-cost areas. Provides for the issuance of enterprise zone facility bonds in enterprise communities and empowerment zones in a manner similar to exempt facility bonds. Excludes enterprise zone facility bonds from the interest deduction limitations on financial institutions. Provides States an additional housing credit ceiling for each zone and community through 1996. Allows an empowerment zone employment credit to employers for a percentage of qualified zone wages paid during calendar years 1994 through 2004. Limits the amount of such credit. Allows businesses a zone resident empowerment savings credit of 50 percent of the qualified savings contributions made by an employer to a defined contribution plan on behalf of a zone employee. Limits the amount of such credit based on the employee's compensation. Increases the limitation on expensing certain depreciable business assets. Increases the volume cap applicable to enterprise zone facility bonds if the business owners meet specified ownership requirements with regard to abiding in such zones. (Sec. 14302) Allows the use of the targeted jobs credit for hiring empowerment zone residents. Part II: Credit for Contributions to Certain Community Development Corporations - Allows a general business tax credit for contributions to selected community development corporations to provide employment of, and business opportunities for low-income individuals who are residents of the operational area of the community. Subtitle D: Other Provisions - Part I: Disclosure Provisions - Extends the authority to disclose tax return information to the Department of Veterans Affairs through September 30, 1998. (Sec. 14402) Authorizes the disclosure of certain tax return information to: (1) the Department of Education to implement the direct student loan program; and (2) to the Department of Housing for income verification under certain housing programs. Part II: User Fee Provisions - Requires the establishment of a program requiring the payment of user fees for the processing of applications for certificates of alcohol label approval and exemption, formula reviews, and statements of process (including laboratory tests and analyses). (Sec. 14412) Removes authority to use the Harbor Maintenance Trust Fund for administrative expenses of certain customs fee collections. (Sec. 14413) Increases the tax on fuel used on commercial transportation on inland waterways. Part III: Public Debt Limit - Increases the public debt limit and repeals the temporary limit on such increase. Part IV: Vaccine Provisions - Makes permanent: (1) the excise tax on certain vaccines; and (2) the authority to pay compensation from the Vaccine Trust Fund under the National Vaccine Injury Compensation Program for certain damages resulting from vaccines administered after September 30, 1988. Directs the Secretary of the Treasury to report to specified congressional committees on various uses of such Fund. Imposes a floor stocks tax on taxable vaccines. (Sec. 14432) Requires continuation coverage under group health plans of the costs of pediatric vaccines. (Sec. 14433) Establishes the Childhood Immunization Trust Fund for the childhood immunization entitlement program under the Public Health Service Act.