Healthcare

Fairness in Tobacco and Nicotine Regulation Act of 1993

United States · United States Congress · 18 May 1993

Fairness in Tobacco and Nicotine Regulation Act of 1993 - Amends the Federal Food, Drug, and Cosmetic Act (FFDCA) to require the Secretary of Health and Human Services to promulgate regulations governing the manufacture, distribution, sale, labeling, and advertising and promotion (manufacture) of tobacco products which are consistent with regulations governing other products which are ingested, but bars the Secretary from outlawing the sale and distribution of a tobacco product solely because tobacco causes disease. Sets minimum requirements pursuant to such regulations, including a prohibition on the sale or distribution of tobacco products to minors. Establishes in the Food and Drug Administration (FDA) the Tobacco and Nicotine Products Advisory Committee which shall review: (1) the available scientific evidence on the effects of tobacco products on human health, including the effects of environmental tobacco smoke on nonsmokers; (2) the manufacturing process of tobacco products; (3) the role of nicotine as part of the smoking habit; (4) the marketing and promotional techniques used by tobacco manufacturers; and (5) current Federal, State, and local laws governing the manufacture of tobacco products. Requires each tobacco product manufacturer to: (1) register with the Secretary; and (2) pay an annual fee determined by the Secretary based upon the total market share for each brand of tobacco product. Credits fees collected for a fiscal year to the appropriation account for salaries and expenses of the FDA. Amends: (1) the Federal Cigarette Labeling and Advertising Act (FCLAA) and the Comprehensive Smokeless Tobacco Health Education Act of 1986 (CSTHEA) to modify warning labels to emphasize the addictive nature of smoking; and (2) the FFDCA to include tobacco products within recordkeeping requirements applicable to the interstate shipment and factory inspection of food, drugs, devices, and cosmetics. Authorizes the Secretary to: (1) modify the warning labels required by the FCLAA and CSTHEA if the modification in the content of the label does not weaken the health message and is in the best interests of the public health; and (2) increase the size and placement of such required labels.

Medicare and Medicaid Budget Reconciliation Act of 1993

United States · United States Congress · 17 May 1993

TABLE OF CONTENTS: Title I: Short Title Title II: Table of Contents Title III: References to Omnibus Budget Reconciliation Act of 1993 Title IV: Other References in Act Title V: Reconciliation Provisions Relating to Medicare, Medicaid, and Other Health Programs Subtitle A: Medicare Program Subtitle B: Medicaid Program and Other Care Provisions Title I: Short Title - Medicare and Medicaid Budget Reconciliation Act of 1993. Title II: Table of Contents - (Sec. 201) Sets forth the table of contents of this Act. Title III: References to Omnibus Budget Reconciliation Act of 1993 - (Sec. 301) Declares that any references to the Omnibus Budget Reconciliation Act of 1993 shall be references to this Act. Title IV: Other References in Act - (Sec. 401) Declares that, except as otherwise specifically provided, whenever in this Act an amendment is expressed in terms of an amendment to or repeal of a section or other provision, it shall be considered a reference to the Social Security Act (SSA). States that, in this Act, the terms "OBRA-1986," "OBRA-1987," "OBRA-1989", and "OBRA-1990" refer to the Omnibus Budget Reconciliation Act of 1986 (Public Law 99-509), the Omnibus Budget Reconciliation Act of 1987 (Public Law 100-203), the Omnibus Budget Reconciliation Act of 1989 (Public Law 101-239), and the Omnibus Budget Reconciliation Act of 1990 (Public Law 101-508), respectively. Title V: Reconciliation Provisions Relating to Medicare, Medicaid, and Other Health Programs - Subtitle A: Medicare Program - Chapter 1: Provisions Relating to Part B - Subchapter A: Physicians' Services - (Sec. 5001) Amends part B (Supplementary Medical Insurance) of SSA Title XVIII (Medicare) to reduce the default update for physicians' services (except primary care services) in 1994. (Sec. 5002) Revises certain formulae to increase: (1) the Medicare Volume Performance Standards (MVPS) performance standard factor; and (2) the maximum reduction permitted in the annual default update to the Medicare Fee Schedule. (Sec. 5003) Classifies primary care services as a separate category of services for purposes of setting volume performance standards and annual updates. (Sec. 5004) Provides for a phased-in reduction in practice cost relative value units for certain services. (Sec. 5005) Provides for phased-in limitations on payment for anesthesia services where concurrent services are provided under the supervision of an anesthesiologist. (Sec. 5006) Requires that payments for anesthesia services be based on actual time. (Sec. 5007) Requires separate payment for the interpretation of electrocardiograms. (Sec. 5008) Repeals the requirement that payments for new physicians and practitioners be reduced during their first four years of practice. (Sec. 5009) Requires: (1) consultation with representatives of physicians in the review of geographic adjustment factors for medicare physicians' services; and (2) use of the most recent data in determining such adjustment. (Sec. 5010) Revises extra-billing limits with respect to Medicare beneficiaries overcharged by nonparticipating physicians or suppliers that do not accept payment on an assignment-related basis. (Sec. 5011) Directs the Secretary of Health and Human Services (HHS) to develop relative values for use in payment of pediatric services. (Sec. 5012) Revises the coverage of antigens under the Medicare Fee Schedule. (Sec. 5013) Prohibits fee charges for certain claims administration functions. Revises requirements for permissible substitute billing arrangements. Subchapter B: Outpatient Hospital Services and Ambulatory Surgical Services - (Secs. 5021 and 5022) Extends: (1) the ten percent reduction in payments for capital-related costs of outpatient hospital services; and (2) the current 5.8 percent reduction in payments for other costs of outpatient hospital services. (Sec. 5023) Provides for a one-year freeze in ambulatory surgery rates. (Sec. 5024) Revises the definition of eye or eye and ear hospitals. (Sec. 5025) Extends the cap on payments for intraocular lenses. Subchapter C: Durable Medical Equipment - (Sec. 5031) Revises the payment rules for durable medical equipment (DME), including prosthetic and orthotic items, by substituting the national median for the national weighted average. (Sec. 5032) Provides for a one-year freeze on payments for parenteral and enteral nutrients, supplies, and equipment. (Sec. 5033) Revises the categorization of nebulizers and aspirators under the DME fee schedules. (Sec. 5034) Establishes a certification program for DME suppliers. Prohibits DME suppliers for distributing, for commercial purposes, completed or partially completed certificates of medical necessity to physicians or individuals entitled to benefits. (Sec. 5035) Requires DME suppliers to use the part B carrier for the area in which the Medicare beneficiary lives. Prohibits carrier shopping. (Sec. 5036) Prohibits unsolicited telephone contacts from DME suppliers to Medicare beneficiaries. (Sec. 5037) Prohibits kickback arrangements between DME suppliers and entities that refer patients for covered items. (Sec. 5038) Revises the treatment of beneficiary liability for noncovered DME services. (Sec. 5039) Authorizes the Secretary of HHS to adjust DME payments in accordance with a policy of inherent reasonableness. (Sec. 5040) Sets forth a formula for lump-sum payments for surgical dressings. (Sec. 5041) Provides for a reduction in payments for TENS devices. Subchapter D: Part B Premium - (Sec. 5051) Extends the authority for the determination of the part B premium. Subchapter E: Other Provisions - (Sec. 5061) Reduces to the 76th percentile the national limitation of fee schedules for clinical diagnostic laboratory tests. Limits the annual update to fees to two percent. (Sec. 5062) Includes inpatient hospital services and diagnostic and therapeutic X-ray services among those covered by rural health clinics and federally qualified health centers. (Sec. 5063) Applies specified mammography certification requirements to Medicare standards for screening mammography facilities. (Sec. 5064 and 5066) Extends the Alzheimer's disease demonstration program and certain municipal health service demonstration projects. (Sec. 5065) Provides Medicare coverage for certain oral cancer drugs. (Sec. 5067) Provides for treatment of certain Indian health programs and facilities as Federally-qualified health centers. (Sec. 5068) Revises the ceilings for payment of "clean claims" under Medicare and the circumstances under which interest payments may be made on delayed claims. (Sec. 5069) Provides for Medicare coverage of certified nurse-midwife services performed outside the maternity cycle. (Sec. 5069A) Increases the annual cap on the amount of Medicare payments for outpatient physical therapy and occupational therapy services. Requires the Physician Payment Review Commission (PPRC) to study and report to specified congressional committees on the appropriateness of continuing an annual limitation on the amount of such payments. Chapter 2: Provisions Relating to Parts A and B - (Sec. 5071) Repeals the requirement for a special overhead add-on for the overhead of hospital-based home health agencies. (Sec. 5072) Directs the Secretary of HHS to study the methodology used to determine payments to hospitals under the Medicare program for the costs of medical residency training, including analysis of the causes of variation among such programs in the per-resident costs of direct graduate medical education, especially the support for them from non-hospital sources. (Sec. 5073) Revises specified aspects of the Medicare-as-secondary-payer program. (Sec. 5074) Extends the ban on physician self-referrals to additional designated health services, including home infusion therapy services. Revises specified exceptions to such ban. (Sec. 5075) Reduces Medicare payments for erythropoietin. (Sec. 5076) Requires any hospital with organ donors to make an agreement only with the designated organ procurement organization for the geographic area in which the hospital is located. (Sec. 5077) Amends OBRA-1986 to extend the health maintenance organization (HMO) waiver for the Watts Health Foundation. (Sec. 5078) Directs the Secretary of HHS to undertake certain outreach activities to increase participation in the Qualified Medicare Beneficiary program. (Sec. 5079) Amends OBRA-1987 to extend and expand the social health maintenance organization demonstration program. (Sec. 5080) Amends SSA to repeal the Peer Review Organization (PRO) precertification (second opinion) requirement for certain surgical procedures. (Sec. 5081) Grants home health agency beneficiaries the right to be informed about Medicare hospice benefits. (Sec. 5082) Provides, with respect to health maintenance organizations, for: (1) adjustments in Medicare capitation payments to account for regional variations in the application of secondary payor requirements; and (2) revision of the payment methodology for risk contractors. Chapter 3: Provisions Relating to Medicare Supplemental Insurance Policies - (Sec. 5091) Revises OBRA-1990 with respect to standards for Medicare supplemental insurance policies. Subtitle B: Medicaid Program and Other Health Care Provisions - Chapter 1: Medicaid Program - Subchapter A: Program Savings Provisions - Part I: Repeal of Mandate - (Sec. 5101) Amends SSA Title XIX (Medicaid) to: (1) repeal the mandate for inclusion of certain personal care services among home health care services in State medical assistance programs; and (2) allow States to provide an optional benefit for personal care services furnished outside the home. Part II: Outpatient Prescription Drugs - (Sec. 5106) Authorizes States to establish formularies limiting the coverage of prescription drugs under their Medicaid programs. (Sec. 5107) Repeals the prohibition on the imposition of prior authorization controls on new drugs for the first six months after Food and Drug Administration (FDA) approval. Part III: Restrictions on Divestiture of Assets and Estate Recovery - (Sec. 5111) Revises the restrictions on the transfer of assets by an individual subsequently applying for Medicaid benefits as an institutionalized individual. Extends the look-back period and repeals the limit on the period of ineligibility because of prohibited transfers, providing for cumulative periods for multiple transfers. Provides for a waiver of eligibility penalties because of undue hardship, and exempts certain trusts for the benefit of disabled individuals from the transfer rules. (Sec. 5112) Requires States to establish a program for identifying and recovering Medicaid benefits from estates of deceased beneficiaries who have received nursing home or other long-term care services. (Sec. 5113) Prohibits a State plan from disregarding any assets: (1) to the extent that payments are made under a long-term care insurance policy; or (2) because an individual has received (or is entitled to receive) benefits for a specified period of time under such a policy. Part IV: Improvement in Identification and Collection of Third Party Payments - (Sec. 5116) Requires States to prohibit insurers, HMOs, and self-funded plans (under the Employee Retirement Income Security Act of 1974 (ERISA) from denying payment for health services to insured individuals who are also Medicaid beneficiaries. (Sec. 5117) Directs the Secretary of HHS to establish a Health Coverage Clearinghouse to identify insurers, HMOs, ERISA plans, and other third parties which may be liable for payment for services to Medicaid or Medicare beneficiaries. Requires employers to include group health coverage information on employees' W-2 forms. (Sec. 5118) Requires States to have in effect certain medical child support laws, including a requirement that an insurer (including an HMO or ERISA plan) enroll under family health coverage any child whose parent (otherwise eligible for such coverage) is required by court or administrative order to provide the child with medical support. Part V: Assuring Proper Payments to Disproportionate Share Hospitals - (Sec. 5121) Prohibits States from designating a hospital as a Medicaid disproportionate share hospital unless at least one percent of its inpatient days were attributable to Medicaid patients. Limits payment adjustments to State or locally-owned or operated hospitals to the costs incurred in providing services to Medicaid-eligible patients and uninsured (indigent without health care coverage) patients, less certain payments received. Subchapter B: Miscellaneous Provisions- Part I: Anti-fraud and Abuse Provisions - (Sec. 5131) Revises the Medicare rules limiting certain physician referrals for clinical laboratory services. (Sec. 5132) Provides for intermediate sanctions for kickback violations. (Sec. 5133) Requires States to expend a certain minimum amount of funds annually for Medicaid fraud control units. Part II: Managed Care Provisions - (Sec. 5135) Sets forth with respect to Medicaid managed care organizations: (1) prohibitions against affiliations with individuals debarred by Federal agencies; (2) requirements for State conflict-of-interest safeguards in Medicaid risk contracting; (3) financial information disclosure requirements; (4) marketing fraud prohibitions; (5) adequate equity requirements for for-profit entities; (6) requirements for adequate provision against risk of insolvency; and (7) net earnings and additional benefits reporting requirements. Requires the Secretary of HHS to report to the Congress on the earnings of organizations with contracts to receive Medicaid payments on a prepaid capitation or any other risk basis. (Sec. 5136) Revises the treatment of HMO enrollees in computing the Medicaid inpatient utilization rate in qualifying hospitals as disproportionate share hospitals. (Secs. 5137 and 5138) Extends: (1) the period of applicability of the enrollment mix requirement to certain HMOs providing services under the Dayton Area Health Plan; and (2) the Medicaid waiver for the Tennessee Primary Care Network. (Sec. 5139) Waives application of the Medicaid enrollment mix requirement to the District of Columbia Chartered Health Plan, Inc. (Sec. 5140) Extends the Minnesota Prepaid Medicaid Demonstration Project. Part III: Emergency Services to Undocumented Aliens - (Sec. 5141 and 5142) Increases the Federal financial participation for emergency medical assistance to undocumented aliens. (Sec. 5142) Limits Federal Medicaid matching payments to bona fide emergency services for undocumented aliens. Part IV: Miscellaneous Provisions - (Sec. 5144) Increases the limit on Federal Medicaid matching payments to Puerto Rico and other territories. (Sec. 5145) Sets forth criteria for Departmental Appeals Board determinations of whether disallowances of Federal Medicaid matching payments to States should be reduced. (Sec. 5146) Renews the unfunded demonstration project for low-income pregnant women and children. (Sec. 5147) Provides for optional Medicaid coverage of TB-related services for certain TB-infected individuals. (Sec. 5148) Specifies the application of mammography certification requirements under the Medicaid program. (Sec. 5149) Repeals the termination date on the extension of eligibility for working families. (Sec. 5150) Extends the moratorium on the treatment of certain facilities as institutions for mental diseases. (Sec. 5150A) Deems as a federally-qualified health center any entity treated as a comprehensive federally funded health center as of January 1, 1990. (Sec. 5150B) Revises specified nursing facility requirements. Subchapter C: Miscellaneous and Technical Corrections Relating to OBRA-1990 - (Secs. 5151-5174) Makes technical and conforming amendments to specified sections of OBRA-1990. Chapter 2: Universal Access to Childhood Immunizations - (Sec. 5181) Amends the Public Health Service Act to establish entitlement and monitoring programs with respect to childhood immunizations. Directs the Secretary of HHS, acting through the Director of the Centers for Disease Control and Prevention (CDC), to provide for the purchase and delivery on behalf of any applicant State of sufficient quantities of pediatric vaccines to immunize each eligible child in the State who is a Medicaid beneficiary or is uninsured. Entitles: (1) each State to receive from the Secretary sufficient free vaccine to provide to all eligible children in the State; (2) each health care provider to receive from the State sufficient free vaccine to provide to all eligible children in his or her practice; and (3) each eligible child to receive free vaccine from any willing provider licensed to administer immunizations in the State. Requires participant States to agree to such entitlements. Authorizes eligible children to enforce the rights of the provider if the State fails to carry out its obligation. Requires States to make health care provider participation voluntary only. Prohibits providers from charging for free vaccine. Allows charges for immunization itself. Directs the Secretary to publish in the Federal Register criteria for the delivery on behalf of the States of federally-supplied pediatric vaccines to program-registered providers in the State. Sets forth general State compliance requirements. Allows States to purchase pediatric vaccine for the immunization of additional categories of otherwise ineligible children. Requires the Secretary to negotiate with manufacturers of pediatric vaccines for a reasonable purchase price, which would also be available to States that wished to purchase vaccine for otherwise ineligible children. Requires the Secretary to enter into multi-source contracts with multiple manufacturers of vaccine. Allows such contracts to be for more than one year. Requires the Secretary to establish: (1) a list of pediatric vaccines recommended for administration to all children for immunization (subject to any established contraindications); and (2) a schedule of nonbinding recommendations for administration of such immunizations. Establishes the National Childhood Immunization Trust Fund for the immunization program. Directs the Secretary, acting through the CDC Director, to make formula grants to States annually to establish and maintain a national system, composed of State registries, for monitoring the immunization status of children. Prescribes kinds of data to be collected. Authorizes appropriations. Authorizes the Secretary, acting through the CDC Director, to make grants to States for carrying out specified activities with respect to achieving certain objectives established by the Secretary for the year 2000 for the immunization status of children in the United States. Authorizes appropriations. (Sec. 5182) Amends OBRA-1989 and the Public Health Service Act with respect to the National Vaccine Injury Compensation Program. (Sec. 5183) Amends SSA title XIX (Medicaid) to provide for: (1) immunization outreach through the early and periodic screening, diagnostic, and treatment (EPSDT) services program; (2) coordination with the maternal and child health block grant programs and WIC (Women, Infants, and Children) programs; (3) coverage of public housing health centers as federally-qualified health centers; (4) adequate payment rates for vaccine administration to children; (5) denial of Federal financial participation for administration of single-antigen vaccines if combined-antigen vaccines are medically appropriate; and (6) Medicaid managed care plan compliance with immunization and other EPSDT requirements. (Sec. 5184) Authorizes a State plan to pay a vaccine manufacturer directly under a volunteer replacement program following certain guidelines. (Sec. 5185) Amends the Public Health Service Act to authorize the Secretary to make operating grants for up to 21 demonstration projects to provide specified Healthy Start for Infants services in order to meet year 2000 health status objectives for the U.S. population. Prescribes project requirements. Authorizes appropriations. (Sec. 5186) Increases the authorization of appropriations for the Maternal and Child Health Services Block Grant Program.

Recreational Camp Safety Act

United States · United States Congress · 17 May 1993

TABLE OF CONTENTS: Title I: Recreational Camp Reporting Requirements and Data Base Title II: President's Advisory Council on Recreational Camps Recreational Camp Safety Act - Title I: Recreational Camp Reporting Requirements and Data Base - Requires a recreational camp in a State to report to the Secretary of Health and Human Services on: (1) each medical incident that occurs at the camp; and (2) each incident of sexual abuse that is alleged to have occurred at the camp involving a camper or staff member as a victim and that has previously been reported to another governmental agency. Directs the Secretary to: (1) collect such information in a central data system in a manner that will enable compilation of separate statistics concerning incidents that involve campers, staff members, recreational camp operators and directors; and (2) report to the President, the Congress, the National Association of Governors, and the National Association of State Legislatures on a comprehensive analysis of the information. Authorizes the Secretary to issue advisories to assist States in the prevention of deaths, injuries, and illnesses at recreational camps. Requires a recreational camp to record information in a medical log concerning an incident that is required to be reported and such other illnesses and injuries that occur at the camp as the Secretary may prescribe. Requires the Secretary to advise each State agency that has legal responsibility for public health and each State agency that issues a license to a recreational camp of any failure by a camp to comply with any requirements of this Act. Title II: President's Advisory Council on Recreational Camps - Establishes the President's Advisory Council on Recreational Camps to develop model safety guidelines for recreational camps.

A resolution to express the sense of the Senate that comprehensive and equitable mental health and substance abuse benefits should be included in any comprehensive health care bill passed by Congress.

United States · United States Congress · 12 May 1993

Declares that model mental health and substance abuse services related to prevention, diagnosis, treatment, rehabilitation of mental illnesses and substance abuse disorders, and the promotion of mental health should be considered in determining mental health and substance abuse services to be included as part of any benefits package contained in any comprehensive health care or health insurance reform bill passed by the Congress. Requires the Secretary of Health and Human Services to establish a Commission, under the auspices of the Substance Abuse and Mental Health Services Administration, to study and report to appropriate congressional committees on further recommendations.

Health Insurance Purchasing Cooperatives Act

United States · United States Congress · 12 May 1993

Health Insurance Purchasing Cooperatives Act - Mandates grants to States for the administrative costs of planning and implementing coordinated buying programs through which small employers may purchase employee health insurance. Requires that the programs be the sole mechanism for small employers to purchase such insurance. Requires that a State program provide each small employer in the State access to health insurance for its employees and their dependents through one or more Health Insurance Purchasing Cooperatives. Waives Federal and State antitrust laws. Authorizes appropriations. Establishes the National Health Board. Requires the Board to establish Coordinated Buying Program Precepts setting forth certain criteria, including regarding a uniform data system, collection of outcomes data, and determining minimum benefit requirements. Authorizes appropriations. Requires the Board to establish minimum benefit requirements for plans offered through Cooperatives. Amends provisions of the Public Health Service Act relating to health maintenance organizations (HMOs) to exempt from those provisions HMOs that provide services meeting the requirements under this Act. Establishes the National Health Insurance Data System, consisting of: (1) a National Data Base for Health Insurance and Health Outcomes Information; (2) no more than five Regional Health Insurance Data Centers; and (3) an electronic health insurance and outcomes data processing mechanism. Requires the Board to: (1) establish uniform billing and claims forms and mandatory reporting requirements; and (2) require carriers to issue to each participant an electronic processing card containing certain information on financial, administrative, and health outcomes matters. Authorizes appropriations. Amends the Internal Revenue Code to allow a deduction to self-employed individuals of 100 percent of the amount paid for health insurance purchased through a Cooperative. Retains current provisions allowing a deduction of 25 percent of the amount paid for health insurance not purchased through a Cooperative. Removes provisions ending, on a specified date, deductibility of health insurance payments by self-employed individuals.

To amend title 10, United States Code, to include chiropractic care as an authorized health care benefit under the Civilian Health and Medical Program of the Uniformed Services.

United States · United States Congress · 12 May 1993

Includes chiropractic care as an authorized health care benefit provided under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS). Directs the Secretaries of Defense and Health and Human Services to establish a chiropractic review board to provide assistance to such Secretaries in the administration of the chiropractic care program under CHAMPUS.

Tuberculosis Prevention and Control Amendments of 1993

United States · United States Congress · 12 May 1993

Tuberculosis Prevention and Control Amendments of 1993 - Amends the Public Health Service Act to authorize appropriations for grants for the prevention, control, and elimination of tuberculosis. Requires the Director of the National Institute of Allergy and Infectious Diseases to conduct or support research and research training regarding tuberculosis. Authorizes appropriations. Amends title XIX (Medicaid) of the Social Security Act to mandate provision to eligible persons with tuberculosis of certain drugs and services under Medicaid.

A bill to amend title XVIII of the Social Security Act to permit Medicare select policies in all States and to modify the requirements with respect to such policies.

United States · United States Congress · 11 May 1993

Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) make permanent the Medicare select policy program; and (2) allow access to Medicare select policies in all States. Amends title XVIII (Medicare) of the Social Security Act to revise the Medicare select policy program and provide for a civil penalty for misrepresentations made in connection with a Medicare select policy.

A bill to amend title XVIII of the Social Security Act to eliminate the annual cap on the amount of payment for outpatient physical therapy and occupational therapy services under part B of the Medicare Program, and for other purposes.

United States · United States Congress · 11 May 1993

Amends title XVIII (Medicare) of the Social Security Act to eliminate the annual cap on the amount of payment for outpatient physical therapy and occupational therapy services under Medicare part B (Supplementary Medical Insurance). Revises the limitation on beneficiary liability for payment of any amounts billed in excess of the applicable limiting charge for physician services. Applies such limitation to nonparticipating suppliers and other persons, as well as nonparticipating physicians. Includes in the Secretary of Health and Human Services' annual explanation of Medicare benefits information on refunds of such amounts. Makes carriers responsible for determining, prior to making payment, whether the amount billed for services is in excess of the applicable limiting charge and, if so, notifying the physician or other providers as appropriate. Requires the reports to the Congress on changes in excess charges for physician services to reflect additional information on the services involved.

A bill to amend title XVIII of the Social Security Act to exempt mental health services furnished to an individual who is a resident of a nursing facility from the limitation on the amount of incurred expenses for mental health services that may be taken into account in determining the amount of payment for such services under part B of the Medicare Program.

United States · United States Congress · 11 May 1993

Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to remove the payment limitation with respect to mental health services furnished to skilled nursing facility residents.

Prescription Drug Purchasing Assistance for Older Americans Act

United States · United States Congress · 11 May 1993

Prescription Drug Purchasing Assistance for Older Americans Act - Amends title XIX (Medicaid) of the Social Security Act to give States the option of extending their Medicaid prescription drug program to certain low-income Medicare beneficiaries. Permits States which elect to make such an extension to charge a limited premium or co-payment for such prescription benefit to certain low-income Medicare beneficiaries.

Joint Resolution to designate the month of October 1993 as "National Down Syndrome Awareness Month".

United States · United States Congress · 11 May 1993

Designates October 1993 and October 1994 as National Down Syndrome Awareness Month.

United States Health Service Act

United States · United States Congress · 11 May 1993

TABLE OF CONTENTS: Title I: Establishment and Operation of the United States Health Service Title II: Delivery of Health Care and Supplemental Services Title III: Health Labor Force Title IV: Other Functions of Health Boards Title V: Financing of the Service Title VI: Miscellaneous Provisions United States Health Service Act - Title I: Establishment and Operation of the United States Health Service - Part A: Initial Organization - Establishes, as an independent entity within the executive branch, the United States Health Service (Service). Vests authority of the Service in the appropriate National Health Board and area health boards. Grants the Service the power of eminent domain. Directs the President to appoint individuals to serve as members of the Interim National Health Board of the Service. Declares that the members of the Interim National Board shall serve until the National Health Board holds its initial meeting in accordance with certain provisions of this Act. Sets forth the duties of the Interim National Board. Authorizes appropriations. Part B: Organization of Area Health Boards - Requires the Interim National Board to establish health care delivery regions throughout the United States which meet specified requirements. Sets forth procedures regarding election and appointment of members and certain officers of: (1) interim national, interim regional, and interim district health boards; and (2) initial and subsequent national, regional, district, and community health boards. Part C: General Provisions Regarding Health Boards - Sets forth the membership and terms of office of health boards. Provides for recall of board members for specified reasons and for filling vacancies on health boards. Sets forth procedures for the establishment by the National Board of guidelines and standards required by or in furtherance of the objectives of this Act. Requires each regional board to provide orientation, education, and technical assistance to district and community boards. Requires the appropriate national board to provide such assistance to regional boards. Title II: Delivery of Health Care and Supplemental Services - Part A: Patients' Rights in Health Care Delivery - Requires the Service to ensure that every user is given the right to receive high quality care and supplemental services without charge and without discrimination. Sets forth a list of other basic health rights. Amends the Fair Labor Standards Act of 1973 to entitle certain employees to health leave compensation, subject to specified exceptions which exist in current law as exceptions to minimum wage and maximum hours provisions. Part B: Eligibility for, Nature of, and Scope of Services Provided by the Service - Declares all individuals, while within the United States, to be eligible to receive health care and supplemental services under this Act. Excludes personal comfort or cosmetic services unless they are necessary for health-related reasons. Requires the Service to provide in the United States specified services in or through facilities established by the Service. Prohibits the Service from providing such services in a region, district, or community other than under the auspices of a regional, district, or community board established in accordance with this Act. Requires the Service to provide specified supplemental services in or through health care facilities established by the Service. Provides for reimbursement by the Service of the cost of emergency health care services under certain circumstances. Part C: Health Care Facilities and Delivery of Health Care Services - Requires each community board to establish and maintain such health care facilities as are necessary for efficient and effective delivery of comprehensive primary health care services, specialized health care services, special services, and community-oriented health measures which are provided, as much as possible, through a single comprehensive health center. Requires each district board to establish and maintain in its district a general hospital, such other health care facilities as are necessary, and such health care services of a specialized nature as may be provided most effectively and efficiently at the district level. Requires each regional board to establish and maintain: (1) a regional medical facility for highly specialized health care services; (2) health care and supplemental services for individuals whose needs cannot be met by community or district boards; and (3) such other facilities as are necessary. Requires each area health board to: (1) hire health workers; (2) purchase or lease necessary premises; and (3) seek to minimize fragmentation and duplication in delivery of health care. Requires each regional board to provide for affiliation and coordination within its region and with adjacent regions. Requires the National Board to establish guidelines for distribution and coordination of the delivery of health care services and plan and transition to the new facilities for affected workers. Requires regional boards, if a community or district board fails to provide health services, to provide the services. Requires each health board to establish policies and organizational plans consistent with provisions of this Act. Requires such boards, in establishing, implementing, and modifying such policies and plans, to seek participation of affected workers and users. Provides for a health board, if it determines that it cannot itself effectively manage the operation of all facilities, to establish a health care facility board or boards. Specifies elements to be provided for in the policies and organizational plans established by health boards. Prohibits a health board, on and after three years after the effective date of health services, from permitting its health care facilities to be used for the private delivery of health services. Prohibits individuals employed by a health board from engaging in the private delivery of health services. Requires each health board to ensure that health facilities it operates which provide outpatient services are open during hours which permit all users to make use of such services. Sets forth requirements for facilities providing inpatient services for 30 continuous days or longer. Requires each health board to provide that, at least once each year, the inpatients of facilities providing inpatient services for 30 continuous days or longer shall elect, from among themselves and representatives of certain user associations, a review committee of not less than three members. Provides for recall and proxies with respect to such committees. Requires various health boards to conduct regular inspections of specified facilities. Requires area health boards to provide: (1) contraception information and materials; (2) evaluation and treatment for venereal diseases and diseases of the reproductive organs; (3) information and counseling regarding pregnancy, child bearing, and possible genetically induced anomalies; (4) pregnancy testing; (5) prenatal services; (6) abortion services; and (7) counseling by women for specified services and counseling by men for specified services. Requires all such services to be delivered without coercion or harassment, with confidentiality, and without prior approval of individuals other than the individual receiving the services. Requires that individuals be permitted to be accompanied by a person of their choice during the provision of such services, subject to exception. Sets forth restrictions and requirements for informed consent regarding: (1) treatments or procedures which could affect an individual's reproductive capacity; and (2) mastectomy or other breast cancer treatment. Requires that women giving birth have the right to choose from a complete range of childbirth options. Title III: Health Labor Force - Part A: Job Categories and Certification - Declares that, notwithstanding State laws to the contrary, the Service shall be the sole judge of the qualifications of its employees. Requires each area health board to insure that work is performed by certified health workers. Requires the National Board to establish guidelines for classification, certification, and employment of health workers. Requires that such guidelines: (1) permit alternative approaches to healing, when such approaches have not been shown to be injurious to health; (2) have both flexibility and uniformity to meet stated objectives; and (3) require that each health worker employed by a community board work part of the time in a facility operated by a district or regional board and each health worker employed by a district or regional board work part of the time in a health care facility operated by a community board. States that each regional board, for job categories requiring advanced specialty training, shall establish certification standards. Part B: Education of Health Workers - Requires each regional board, in consultation with community and district boards, to establish a health team school (school) to provide initial and continuing basic education in health care delivery and initial and continuing advanced education in health care specialties and health science specialty fields. Requires that the schools be funded exclusively by the Service, prohibits them from charging or accepting tuition or fees, and requires them to provide each student with an allowance for living expenses, educational supplies, and any child care. Requires each regional board to establish and implement for the school: (1) admissions policies with certain required elements; (2) curriculum policies with stated elements; (3) faculty hiring procedures which will create a faculty which approximates the population of the region by race, sex, and language; and (4) a governance plan for the management of its school which gives significant decision making powers to staff and students. Prohibits enrolling any individual unless the individual agrees to perform health care services as an employee of the Service, in a job category for which training is being provided, for a period of time equal to the period of enrollment, but not less than two years, and subject to other terms and conditions. Entitles the Service, if an individual fails to start or fails to complete such service, to recover damages. Mandates that each area board periodically assess the ratio of the health workers employed by the board in each job category to the number of residents in the area. Gives priority in hiring individuals obligated to perform service to health worker shortage areas and, as a second level of priority, to the regional, district, or community board for the region, district, or community in which the program was completed. States that the National Board shall establish a program to match the preferences graduates have for locations with the needs and preferences of various boards. Requires the National Board to make payments of principal and interest on certain loans incurred by individuals for an educational program in health care delivery, health care specialties, or health science fields which is outstanding on the day that individual begins to work for the Service. Establishes a schedule for such payments. Part C: Employment and Labor-Management Relations Within the Service - Requires health boards to employ, classify, and fix the salaries and benefits of all employees of the Service. States that health boards shall give hiring preference to individuals employed as health workers before enactment of this Act. Requires the National Board to ensure that all such individuals desiring employment in the Service find appropriate employment in the Service. Places restrictions on hiring relating to the: (1) ratio of health workers to residents; and (2) existence of a health worker shortage area in the same region. Declares that employees of the Service are covered by specified Federal laws. Requires compensation, benefits, and other terms and conditions of employment to be the same on the effective date of health services as for Federal Government employees until changed by the Service. Prohibits changes in fringe benefits which result in a program which is less favorable to employees of the Service than fringe benefits for employees of the Federal Government on the effective date of health services. Declares that the provisions of the National Labor Relations Act shall apply to the Service and its employees, subject to specified exceptions. Declares that provisions of Federal law relating to participation in a strike shall not apply to employees of the Service. Amends the Labor-Management Reporting and Disclosure Act of 1959 to include the Service in the definition of the term "employer" under that Act. Provides that the remedies provided by stated Federal laws regarding jurisdiction and tort claims shall be exclusive of any other civil action or proceeding. Declares that assault or battery arising out of negligence in various health care functions is not an exception under specified Federal law to tort claims and jurisdiction provisions of Federal law. Authorizes the National Board to hold harmless or provide liability insurance for any employee of the Service under certain circumstances. Title IV: Other Functions of Health Boards - Part A: Advocacy, Grievance Procedures, and Trusteeships - Requires each area health board to establish a program of health advocacy with specified elements. Requires the National Board to establish a health rights legal services program, for users and health workers, providing specified elements. Requires each appropriate regional board to provide that any user, health worker, user association, or specified health board may commence grievance proceedings before specified health boards with respect to alleged violations of this Act. Provides for review of adverse decisions. Authorizes, in certain circumstances, the entity before which a grievance proceeding is commenced or reviewed to: (1) set aside an election of a community board and require a new election; and (2) if not involving a community board, require that a new election be conducted or a new appointment be made. Requires such entity to transfer such functions as necessary to the appropriate higher health board until a new election is conducted or a new appointment is made. Authorizes a health board which receives functions under such a transfer to appoint a trustee or trustee committee to carry out transferred functions. Part B: Occupational Safety and Health Programs - Requires the National Board to oversee occupational safety and health programs conducted at the regional level and to participate in the establishment and administration of occupational safety and health standards under the Occupational Safety and Health Act of 1970, with the advice and comments of regional occupational safety and health action councils established under this Act. Amends the Occupational Safety and Health Act of 1970 to substitute references to the National Health Board for references to the Secretary of Health and Human Services throughout such Act, with one specified exception. Adds references to the National Health Board to existing provisions in such Act regarding promulgation, modification, and revocation of safety and health standards. Requires the National Board to establish guidelines for: (1) its participation in the establishment and administration of safety and health standards; (2) the election of community occupational safety and health action councils; (3) the establishment of regional occupational safety and health programs; (4) the establishment and operation of work place health facilities; and (5) the provision of assistance by various health boards to various safety and health councils, and to work place safety and health committees. Requires each community board to provide for the operation of a community occupational safety and health action council (COSHAC). Gives a formula for election of the members of COSHACs. Specifies the duties of each COSHAC. Requires each regional board to establish an occupational health and safety program for its region with specified elements, including staffing and supporting the operation of the regional occupational safety and health action council (ROSHAC). Specifies the responsibilities of each ROSHAC. Requires the employer in each work place to establish and maintain a health facility in or near the work place to meet occupational and emergency health care needs of employees, to be operated either by the community board or by the employer, and the cost, in either case, to be borne by the employer. Grants employees in each work place having 25 or more employees the right to establish work place occupational safety and health committees. Grants the members of such committees rights to engage in certain activities relating to inspections without loss of pay or other job rights. Authorizes employees to monitor conditions and to remove themselves from the site of any hazard without loss of pay or other job rights. Requires employers to minimize hazards and furnish employees with or reimburse employees for needed equipment or clothing. Specifies rights of employees regarding: (1) inspection of medical records maintained by their employers; (2) provision to employees of copies of all reports, studies, and data concerning health and safety in that work place; and (3) the seeking, through collective bargaining, of standards more restrictive than those established under the Occupational Safety and Health Act of 1970. Part C: Health and Health Care Delivery Research - Requires the Service to conduct a program of research concerning health and health care delivery. Transfers the National Institutes of Health from the Department of Health and Human Services to the National Health Board. States that the National Board shall establish five new national institutes: Epidemiology, Evaluative Clinical Research, Health Care Services, Pharmacy and Medical Supply, and Sociology of Health and Health Care. Specifies the duties of each such institute. Part D: Health Planning, Distribution of Drugs and Other Medical Supplies, and Miscellaneous Functions - Requires each area board to collect data on supply and demand regarding health workers and health care delivery. Requires each regional board to coordinate the planning and administration of health care delivery, health worker education, and health research in its region. Requires the National Board to formulate one-year and five-year national plans and budgets. Requires the National Board, after consultation with regional boards, to publish, and regularly update, a National Pharmacy and Medical Supply Formulary. Specifies the contents of the Formulary. Requires each regional board to establish a program for the purchase and distribution of drugs and other medical supplies. Authorizes the National Board to establish and operate drug and medical supply manufacturing facilities in certain circumstances. Title V: Financing of the Service - Part A: Health Service Taxes - Amends the Internal Revenue Code to add a new part imposing on individuals and corporations an additional tax of specified percentages of the normal tax and surtax imposed by a specified section of such code. Ends the income tax exclusion from gross income of amounts paid by third parties for medical care. Excludes from gross income employer contributions to accident or health plans to the extent that such contributions do not provide for health care available to such employees under the Health Service Act. Prohibits income tax deductions for: (1) health care expenses as a trade or business expense; and (2) contributions to certain medical and hospital facilities. Repeals provisions of the Internal Revenue Code relating to: (1) medical and dental expenses; (2) hospital insurance tax imposed on employment and self-employment income; and (3) receipts for railroad employees. Declares that no contractual or other nonstatutory obligation of any employer to pay or provide for health care for present or former employees and their dependents and survivors shall apply on or after the effective date of health services under this Act to the extent such individuals are eligible to receive such services under this Act. Prohibits Federal, State, or private workers' compensation programs from paying for or providing any health care on or after the effective date of health services under this Act to the extent such care is available under this Act. Part B: Health Service Trust Fund - Creates in the Treasury the Health Service Trust Fund (Trust Fund). Appropriates to the Trust Fund amounts equal to 100 percent of the expected net receipts from specified provisions of the Internal Revenue Code. Appropriates to the Trust Fund a Government contribution equal to 40 percent of the amount appropriated under such 100 percent provision. Transfers to the Trust Fund all assets and liabilities of the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund. Creates the Board of Trustees of the Trust Fund. Requires the investment of specified portions of the Trust Fund. Extends the purposes for which obligations of the United States may be issued under the Second Liberty Bond Act, to authorize the issuance at par of public debt obligations for purchase by the Trust Fund. Part C: Preparation of Plans and Budgets - Requires the National Board to annually fix the maximum amount of funds which may be expended from the Trust Fund during the fiscal year. Specifies criteria to be considered in determining such amount's maximum value. Authorizes the National Board to refix such maximum amount in certain circumstances. Authorizes the National Board to exceed such maximum amount as necessary because of epidemic, disaster, or other occurrence which was not and could not have been planned for. Authorizes the National Board to allocate, in addition to such maximum amount, funds borrowed under specified provisions of this Act. Requires each community, district, and regional board to annually submit fiscal year and five-year plans and budgets to the next higher level health board. Part D: Allocation and Distribution of Funds - Requires the National Board to annually transmit to regional boards a national health budget dividing the total funds available into funds for ordinary operating expenses, preventive health measures, capital expenses, research expenses, and special operating expenses. Requires funds for ordinary operating expenses, preventive health measures, and research expenses to be allocated to the regional boards on the basis of population. Requires funds for capital expenses to be allocated according to stated criteria. Declares the budget submitted to the regional boards by the National Board to be adopted upon the approval by a majority of the regional boards. Sets forth requirements, similar to those for the national health budget, for preparation and adoption of regional and district budgets. Defines "special operating expenses" to mean operating expenses associated with: (1) care and treatment for users 65 years of age and older; (2) care and treatment of persons confined to full-time residential institutions, including nursing homes and facilities for the treatment of mental illness; (3) the special health care needs of low-income users; (4) the special health care needs of rural users; (5) special health care needs arising from environmental or occupational health conditions; (6) special health care needs arising from unexpected occurrences, including epidemics and natural disasters; and (7) the conduct of environmental health inspection and monitoring services. Sets forth rules for allocation of special operating expenses. Requires funds allocated under the national health budget to be distributed by the National Board from the Trust Fund. Prohibits health boards from requesting or receiving funds from any other source. Mandates annual financial statements by area health boards. Part E: General Provisions - Authorizes the National Board to borrow money and to issue and sell obligations as necessary for this Act, but only in amounts specified in appropriations Acts. Limits the aggregate amount of such obligations outstanding at any one time. Authorizes the National Board to pledge the assets of the Trust Fund and pledge its revenues and receipts for various purposes related to such obligations. Authorizes the National Board to enter into a variety of covenants as necessary or desirable to enhance the marketability of such obligations. Declares that such obligations: (1) shall be negotiable or nonnegotiable, bearer or registered; (2) shall contain a recital that they are issued under a specified provision of this Act; (3) shall be lawful investments; (4) shall be exempt from State taxes; and (5) shall not, subject to exception, be obligations of the U.S. Government. Requires the National Board to advise the Secretary of the Treasury of the proposed sale of obligations. Authorizes such Secretary to elect to purchase the obligations. Authorizes the National Board, if the Secretary elects not to buy such obligations, to issue and sell them to a party or parties other than the Secretary, upon notice to the Secretary and consultation regarding various terms and conditions. Empowers the National Board to require the Secretary of the Treasury to purchase obligations of the Service. Prohibits any required purchase which would result in a holding by the Secretary in excess of a specified amount. Makes obligations issued by the Service obligations of the U.S. Government under certain circumstances. Authorizes the Secretary of the Treasury, for the purpose of any purchase of the obligations of the Service, to use as a public debt transaction the proceeds from the sale of any securities issued under the Second Liberty Bond Act. Extends the purposes of such Act to include any purchases of the obligations of the Service under this part. Title VI: Miscellaneous Provisions - Repeals, on the effective date of health services, the Public Health Service Act, except for specified provisions relating to: (1) its short title and definitions; (2) licensing, quarantine, and inspections authority; and (3) safety of public water systems. Delays, until four years after the effective date of health services, repeal of portions of the Public Health Service Act regarding provision of assistance to educational institutions and their students, in areas which have not established health team schools under part A of title III of this Act. Repeals specified provisions of the Social Security Act relating to maternal and child health, Medicare, Medicaid, professional standards review, entitlement to hospital insurance benefits, uniform health reporting systems, limitation on Federal participation for capital expenditures, the program for determining qualification for certain health care personnel, disclosure of ownership and related information, disclosure of certain convictions, and payments to States for health care and supplemental services. Repeals specified provisions of Federal law relating to health insurance for Federal employees, medical benefits and programs relating to veterans, and the civilian health and medical program of the uniformed services. Repeals the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970, the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act Amendments of 1974, and a specified provision of the Comprehensive Drug Abuse Prevention and Control Act of 1970 relating to medical treatment of narcotic addiction. Repeals Federal law relating to hospitals, community hospitals, and other health facilities for Indians. Repeals the District of Columbia Medical Facilities Construction Act of 1968 and the District of Columbia Medical and Dental Manpower Act of 1970. Repeals specified provisions of the National Housing Act relating to mortgage insurance for nursing homes, hospitals, and group practice facilities. Repeals the Mental Retardation Facilities and Community Mental Health Centers Construction Act of 1963, the Family Planning Services and Population Research Act of 1970, the National Arthritis Act of 1974, and the National Diabetes Mellitus Research and Education Act. Repeals specified provisions of the Lead-Based Paint Poisoning Prevention Act relating to grant, demonstration, and research programs for lead-based paint poisoning prevention. Repeals the Act of March 2, 1897, relating to tea importation. Repeals specified provisions of the Occupational Safety and Health Act of 1970 relating to the National Institute for Occupational Safety and Health. Requires the President to prepare and submit to the Congress legislation to repeal or amend provisions of laws which are inconsistent with this Act, including the transfers of authority of the Secretary of Health and Human Services, under specified provisions of Federal law, to the Service. Sets forth various requirements regarding review and reporting to the President and the Congress concerning how the Service is carrying out the purposes of the various programs authorized to be conducted by provisions repealed by this Act. Transfers to the Health Service Trust Fund amounts appropriated to carry out the purposes of any law repealed by this Act. Provides transition rules regarding contracts entered into or rights or obligations arising before the effective date of such repeals. Amends the Budget and Accounting Act, 1921 to require that each budget submitted by the President set forth items relating to the Health Service Trust Fund separately from other operations of the Government. Declares that, if any provisions of this Act are declared invalid, the remainder of the Act shall not be affected.

Myelogram-Related Arachnoiditis Amendments of 1993

United States · United States Congress · 11 May 1993

Myelogram-Related Arachnoiditis Amendments of 1993 - Amends the Federal Food, Drug, and Cosmetic Act to prohibit a myelogram involving the use of Pantopaque, Amipaque, Omipacque, or Isovue. Amends the Public Health Service Act to require a study and research with respect to individuals who have undergone amyelogram and who have subsequently developed arachnoiditis.

Health Education Lending Program Act

United States · United States Congress · 11 May 1993

Health Education Lending Program Act - Amends the Public Health Service Act to establish a program of insured loans to students for attendance at any school of medicine, osteopathic medicine, dentistry, podiatry, or optometry from the Trust Fund established by this Act. Limits lifetime payments. Amends the Internal Revenue Code to impose an additional tax on any individual who received such payments. Imposes a higher tax rate where such payments exceed a certain amount. Establishes the Health Professions Education Trust Fund, appropriating to it the taxes imposed by this Act. Authorizes appropriations to the Trust Fund, as repayable advances, as necessary to make the payments.

Income-Dependent Education Assistance Act of 1993

United States · United States Congress · 11 May 1993

Income-Dependent Education Assistance Act of 1993 - Establishes the income-dependent education assistance (IDEA) program of supplemental direct higher education student loans in which a borrower's annual repayment obligation is dependent upon both postschool income level and borrowing history. Title I: System for Making Income-Dependent Education Assistance Loans - Directs the Secretary of the Treasury to: (1) make IDEA loans to eligible students; (2) establish an account for each IDEA loan borrower; and (3) collect repayments on such loans using the income tax collection system added by title II of this Act. Provides for interest charges on such loans, based on an interest rate equal to the lesser of: (1) ten percent; or (2) the sum of the average bond equivalent rates of 91-day Treasury bills auctioned for the previous year, plus two percentage points. Provides for conversion and consolidation of certain other types of student loans as IDEA loans (Stafford loans under the Higher Education Act of 1965 and HEAL loans under the Public Health Service Act). Requires conversion of certain defaulted student loans to IDEA loans. Terminates the authority to make additional loans under the Higher Education Act of 1965 (HEA) programs of supplemental loans for students (SLS) and direct loans to students in institutions of higher education. Title II: Collection of Income-Dependent Education Assistance Loans - Amends the Internal Revenue Code to provide for the collection of IDEA loans. Directs the Secretary of the Treasury to notify each IDEA loan borrower of his or her yearly repayment obligation. Sets forth formulas for computation of the annual IDEA loan repayment amount. Directs the Secretary of the Treasury to assess and collect any unpaid amount in the same manner as for any delay in the payment of income tax. Provides for discharge, by the Secretary of Education, of the IDEA loan liability of any borrower who dies or becomes permanently and totally disabled. Provides that, in general, an IDEA loan shall not be dischargeable in bankruptcy, but authorizes the Secretary of the Treasury to postpone certain portions of the loan liability in such cases.

Comprehensive Fetal Alcohol Syndrome Prevention Act

United States · United States Congress · 7 May 1993

Comprehensive Fetal Alcohol Syndrome Prevention Act - Amends the Public Health Service Act to establish: (1) a comprehensive program to prevent Fetal Alcohol Syndrome and Fetal Alcohol Effects and coordinate related Federal efforts; and (2) an Inter-Agency Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effects. Provides for related research, technical assistance, grants, cooperative agreements, and contracts, surveillance and prevention programs, professional and public education, and diagnostic criteria. Authorizes appropriations.

Birth Defects Prevention Act of 1993

United States · United States Congress · 6 May 1993

Birth Defects Prevention Act of 1993 - Amends the Public Health Service Act to establish birth defects prevention and research programs. Authorizes the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control (CDC), to provide for collection, analysis, and reporting of birth defects statistics from birth certificates, infant death certificates, hospital records, or other sources and to collect and disaggregate such statistics by gender and racial and ethnic group. Directs the Secretary to establish at least five regional birth defects monitoring and research programs to collect and analyze information on the number, incidence, correlation, and causes of birth defects. Authorizes the Secretary, acting through the Director of CDC, to award grants or enter into cooperative agreements with specified entities to serve as Centers of Excellence for Birth Defects Prevention Research. Requires one of the Centers to focus on birth defects among ethnic minorities. Requires the CDC to establish a clearinghouse for the collection and storage of data generated from birth defects monitoring programs developed under this Act. Directs the Secretary, acting through the Director of the CDC, to provide for the evaluation, and implementation of prevention strategies designed to reduce the incidence and effects of birth defects. Directs the Secretary to establish an Advisory Committee for Birth Defects Prevention. Requires the Secretary to report biennially to the House Committee on Energy and Commerce and the Senate Committee on Labor and Human Resources regarding birth defects. Authorizes appropriations.

An Act to authorize major medical facilitiy projects and leases for the Department of Veterans' Affairs, to revise and extend the authority of the Secretary of Veterans' Affairs to enter into enhanced-use leases, to revise certain authorities relating to Pershing Hall, France, and for other purposes.

United States · United States Congress · 6 May 1993

TABLE OF CONTENTS: Title I: Health Care Planning and Programs Title II: Medical Facilities Acquisition Title III: Administration Title IV: State Home Program Title V: Miscellaneous Veterans' Health Programs Amendments of 1993 - Title I: Health Care Planning and Programs - Directs the Secretary of Veterans Affairs to prescribe a specific, detailed statement of the mission of, and the clinical programs to be operated at, each health care facility of the Department of Veterans Affairs. Extends through September 30, 1997, the period during which the Secretary may conduct a pilot program for the furnishing of health-related services to certain eligible veterans as a noninstitutional alternative to nursing home care. Provides program funding. Extends certain reporting deadlines required under the Department of Veterans Affairs Nurse Pay Act of 1990. Title II: Medical Facilities Acquisition - Authorizes the Secretary to carry out the major medical facility leases and construction projects for which funds are requested in the FY 1994 budget. Prohibits the authorization of the construction of a nursing home facility in Baltimore, Maryland. Authorizes the Secretary to carry out the design of specified future major medical facility construction projects, with an accompanying authorization of appropriations for such construction. Directs the Secretary to conduct and report on: (1) a review of the methodology used by the Department for establishing the relative priority for major construction projects under consideration; and (2) an assessment of the need for nursing home beds in the Chesapeake network area. Title III: Administration - Authorizes the Secretary to undertake an administrative reorganization at a Department medical facility if necessary to respond to an emergency situation. Title IV: State Home Program - Directs the Secretary to pay each State a per diem amount for each veteran receiving adult day health care in a State nursing home. Authorizes the Secretary to enter into agreements with State veterans facilities for the sharing of health-care resources. Title V: Miscellaneous - Declares that specified veterans research advisory committees have functions integrally related to the successful completion by the Department of its statutory duties. Prohibits the Secretary from terminating any such committee unless the Secretary finds that it is no longer needed. Provides limitations on veteran payments or copayments for: (1) hospital and nursing home care; (2) outpatient medical services; and (3) medications. Authorizes and provides the conditions under which the Secretary may provide for the operation of child care centers at Department facilities.

Public Health and Safety Act of 1993

United States · United States Congress · 5 May 1993

Public Health and Safety Act of 1993 - Amends the Federal criminal code to prohibit the manufacture, import, export, sale, purchase, transfer, receipt, ownership, possession, transport, or use (manufacture) of a handgun or handgun ammunition. Makes exceptions with respect to the military, law enforcement agencies, registered security guard services, and licensed handgun clubs and members of such clubs. Authorizes the Secretary of the Treasury to approve such manufacture by licensed manufacturers, importers, and dealers as necessary to meet the lawful requirements of such persons and entities covered by the exceptions. Specifies handgun club licensing requirements. Requires: (1) the Secretary to revoke the license of any such club that does not continue to meet such requirements; and (2) such club to pay to the Secretary an annual license fee of $25. Specifies security guard service registration requirements. Requires: (1) the Secretary to revoke such registration if the service does not continue to meet such requirements; and (2) such service to pay to the Secretary an annual registration fee of $50. Sets forth provisions with respect to: (1) recordkeeping (by licensed manufacturers, importers, dealers, handgun clubs or their members and by registered security guard services that transfer handguns or handgun ammunition); (2) reports of loss or theft; and (3) transfers to handgun clubs. Authorizes the voluntary delivery to any designated Federal, State, or local law enforcement agency of a handgun owned or possessed by a person. Directs the Secretary to: (1) arrange with each such agency to receive handguns for the transfer, destruction, or other disposition of such handguns; and (2) pay to such person $25 or the fair market value of the gun. Authorizes appropriations. Sets penalties for violations of this Act. Specifies that a person who voluntarily delivers a handgun under this Act after 180 days after enactment shall not be subject to criminal prosecution for possession of the handgun, but shall pay to the Secretary a civil penalty in an amount not to exceed $500. Establishes penalties for: (1) failure to report the loss or theft of a handgun; (2) negligent and intentional deliveries to an unauthorized place; (3) false statements or representations; and (4) failure to keep, or permit inspection of, records. Provides for the forfeiture of any handgun or handgun ammunition involved or used in a violation of this Act or of any other criminal law of the United States.

Comprehensive Health and Rural Equality Act of 1993

United States · United States Congress · 5 May 1993

TABLE OF CONTENTS: Title I: Guaranteed Access to Affordable Health Care Coverage Title II: Small Employer Insurance Reform Title III: Health Care Cost Containment Subtitle A: Denial of Certain Tax Deductions and Exclusion for Excess Benefits Subtitle B: Medical Malpractice Reform Subtitle C: Administrative Cost Savings Subtitle C (sic): Estimates of Expenses Prior to Treatment Subtitle D: Antitrust Exemptions Title IV: Long-Term Care Subtitle A: Treatment of Long-Term Care Insurance Plans Subtitle B: Treatment of Accelerated Death Benefits Title V: Incentives for Provision of Services in Rural Areas Comprehensive Health and Rural Equality Act of 1993 - Title I: Guaranteed Access to Affordable Health Care Coverage - Requires all citizens and lawful aliens residing in the United States who are not covered under a health insurance program to register with the Secretary of Health and Human Services and be enrolled under a MedEquality plan. Provides: (1) for the issuance of a credit certificate which can only be used to purchase a MedEquality plan to each eligible individual; and (2) that the certificate's value shall be at the maximum level for individuals and families below the poverty line and that such certificate shall have no value for individuals and families with incomes of more than 150 percent of the poverty level. Provides for payments to States with agreements to carry out this title. Requires each licensed insurance carrier in a State, to make a MedEquality plan available to residents residing in the State. Title II: Small Employer Insurance Reform - Provides for the establishment of general standards for MedEquality plans. Requires each small employer carrier in a State to make available to each small employer a MedEquality plan. Sets forth the requirements for such a plan, including that it be designed to provide only basic hospital, medical, surgical, preventive, and diagnostic benefits so as to make it affordable to small employers. Prohibits the limitation of benefits based on a preexisting condition if: (1) the condition did not exist within six months before coverage; or (2) the limitation extends more than 12 months after coverage. Provides for the establishment of reinsurance mechanisms for high risk individuals. Preempts from insurance mandates qualified small employer purchasing groups. Amends the Internal Revenue Code to permanently make 100 percent of the health insurance costs for self-employed individuals deductible by 1997. Preempts the following provisions of State law: (1) restrictions on reimbursement rates or selective contracting; (2) restrictions on differential financial incentives; and (3) restrictions on utilization review. Title III: Health Care Cost Containment - Subtitle A: Denial of Certain Tax Deductions and Exclusion for Excess Benefits - Denies an employer a deduction for any expenses incurred for employee health care that are not within the basic benefits of a MedEquality plan. Denies the exclusion to an employee from gross income of employer-provided health care coverage to the extent coverage is provided for benefits not included in a MedEquality plan. Subtitle B: Medical Malpractice Reform - Prohibits a medical malpractice claim following the two year period beginning the date after which the injury should have been discovered, but in no event may it be brought more than four years following the injury. Provides an exception for children under six years of age. Requires the initial resolution of a medical malpractice claim under an alternative dispute resolution (ADR) system before any such claim may be brought in a State court. Requires the use of ADR in malpractice claims brought before a Federal agency. Requires a pretrial settlement conference before beginning a medical malpractice trial. Limits the award of noneconomic and punitive damages in medical malpractice cases. Limits attorney's fees in such cases. Prohibits joint liability. Requires a defendant's actions to have been not reasonable before being found negligent in such cases. Provides a complete defense to a defendant who followed the appropriate practice guideline. Sets forth requirements for a State's ADR system. Permits State professional societies to participate in licensing and disciplinary activities. Subtitle C: Administrative Cost Savings - Requires the adoption of: (1) data elements for use in paper and electronic claims processing; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements. Requires the promulgation of standards for hospitals concerning electronic medical data. Provides for the establishment of an advisory commission concerning medical data standards. Provides for Medicare and Medicaid magnetized identification cards. Authorizes appropriations. Requires each health benefit plan to use the social security number of each beneficiary as that beneficiary's personal identifier. Provides for the coordination of benefits when benefits are payable under two or more health plans, if the Secretary determines there is a need for such coordination. Subtitle C (sic): Estimate of Expenses Prior to Treatment - Requires every health care provider to provide an estimate of expenses before providing any item or service. Subtitle D: Antitrust Exemptions - Permits cooperative agreements among hospitals entered into solely with respect to sharing expensive capital-intensive technology or other highly resource-intensive services. Title IV: Long-Term Care - Subtitle A: Treatment of Long-Term Care Insurance Plans - Provides, under the Internal Revenue Code, for the treatment of qualified long-term care insurance as accident or health insurance. Excludes from gross income any benefit received through qualified long-term care insurance. Excludes from gross income amounts withdrawn from individual retirement plans or 401(K) plans for qualified long-term care insurance. Permits the exchange of a life insurance policy for a qualified long-term care policy without recognition of gain or loss. Subtitle B: Treatment of Accelerated Death Benefits - Excludes from gross income any amount paid under a life insurance contract on the life of a terminally ill individual or one who is permanently confined to a nursing home. Treats any reference to a life insurance contract as including a reference to a qualified accelerated death benefit rider on such contract. Title V: Incentives for Provision of Services in Rural Areas - Permits the deduction of the medical school loan interest incurred by doctors serving in medically underserved areas. Requires a State with a medically underserved area to develop a comprehensive health care plan for any such area.

Medical Injury Compensation Fairness Act of 1993

United States · United States Congress · 5 May 1993

Medical Injury Compensation Fairness Act of 1993 - Deems each individual or entity receiving health care services for which payment may be made in whole or in part with funds provided under a Federal program to have entered into an agreement to resolve any medical malpractice liability claim through a certified State or Federal dispute resolution system. Requires any such entity to bring any medical malpractice liability action that arises from a claim resolved through such system only in accordance with specified procedures. Denies a tax deduction for health insurance expenses to any employer not having in effect such an agreement with respect to the resolution of medical malpractice claims.

Environmental Research, Development, and Demonstration Authorization Act of 1993

United States · United States Congress · 5 May 1993

Environmental Research, Development, and Demonstration Authorization Act of 1993 - Authorizes appropriations to the Administrator of the Environmental Protection Agency (EPA) for FY 1994 for environmental research, development, and demonstration activities and for program management and support of the Office of Research and Development. Prohibits the Administrator from using any funds appropriated in this Act for office closings or reductions in force unless a congressional notice and wait procedure has been complied with by the Administrator. Requires the Administrator to establish separately identified core research programs consisting of fundamental ecological, health, and risk reduction research to support efforts to assess and mitigate serious environmental risks. Requires the Science Advisory Board to review and make recommendations on core research program activities. Directs the Administrator to establish an Environmental Monitoring and Assessment Program to conduct comprehensive, long-term environmental monitoring, data collection, and data analysis to assess and respond to the current and long-term status and trends of the ecological resources of the United States. Requires the Administrator to make available to the public and the Congress statistical data summaries and interpretive reports on ecological status and trends. Directs the Administrator to: (1) establish a modernization program to identify, acquire, and maintain modern buildings, facilities, supplies, and equipment needed to conduct high quality research; and (2) conduct studies and make assessments of the adequacy of the equipment and facilities to meet the needs of EPA and to attract well-qualified scientists, engineers, and other appropriate personnel. Repeals a required annual report from the Administrator of a five-year plan for environmental research, development, and demonstration. Directs the Administrator to: (1) carry out a program of environmental technology transfer and exchange of scientific information to make full use of EPA's research, development, and demonstration efforts; and (2) establish a separately identified research program to improve EPA's capability to identify and assess risks to public health and ecosystems resulting from environmental contamination.

Family Caregiver Support Act of 1993

United States · United States Congress · 5 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 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.

To amend title XIX of the Social Security Act to clarify the availability of medicaid payment for childhood vaccine replacement programs.

United States · United States Congress · 5 May 1993

Amends title XIX (Medicaid) with respect to the availability of Medicaid payment for childhood vaccine replacement programs.

Firearm Victims Prevention Act

United States · United States Congress · 4 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.

National Immunization Improvement Act of 1993

United States · United States Congress · 4 May 1993

National Immunization Improvement Act of 1993 - Amends the Public Health Service Act to require the Secretary of Health and Human Services to establish a program to award grants to States for the development and operation of computerized State registries to collect, track, and monitor immunization data with respect to children. Authorizes appropriations. Requires the Secretary to conduct specified activities to improve Federal, State, and local vaccine delivery systems and immunization outreach and education efforts. Authorizes appropriations.

National Immunization Act

United States · United States Congress · 4 May 1993

National Immunization Act - Amends the Social Security Act (SSA) to: (1) give States, in order to be eligible for enhanced Federal payments, the option of covering under their Medicaid (SSA title XIX) plans childhood immunization services for children of families with incomes up to 185 percent of the poverty line; (2) require States which exercise such option to implement simplified application and billing procedures for such services; (3) allow States with approved Medicaid plans to contract with manufacturers to supply vaccines for administration to children of Medicaid-eligible families at Federal discounted prices; and (4) give States the option of reducing AFDC (Aid to Families with Dependent Children) payments under SSA title IV part A to families with children who have not received appropriate immunizations. Amends the Internal Revenue Code to reinstate and continue indefinitely the imposition of taxes on certain vaccines under the National Vaccine Injury Compensation Program. Amends the Omnibus Budget Reconciliation Act of 1989 to reauthorize and extend such Program. Requires a study and report to the Congress by the Secretary of the Treasury on Program funding and payments and whether additional vaccines should be included in the Program. Requires the Secretary of Health and Human Services to develop and disseminate to all hospitals that provide maternity services informational materials on immunization and well-baby care. Requires providers of such services to disseminate such materials to new parents served by them in order to be eligible for funds under SSA titles XVIII (Medicare) or XIX.

Violence Reduction Training Act

United States · United States Congress · 4 May 1993

Violence Reduction Training Act - Amends the Public Health Service Act to authorize the Secretary of Health and Human Services to award grants to entities for demonstration projects in which health care providers are trained to: (1) interview and identify victims of domestic violence or sexual assault; and (2) refer such victims to entities providing treatment services. Directs the Secretary to carry out a program to educate health care providers and the public concerning domestic violence and assault. Provides for the conduct of epidemiological research on domestic violence and assault.

National Health Care Anti-Fraud and Abuse Act of 1993

United States · United States Congress · 4 May 1993

TABLE OF CONTENTS: Title I: All-Payer Fraud and Abuse Control Program Title II: Revisions to Current Sanctions for Fraud and Abuse Title III: Administrative and Miscellaneous Provisions National Health Care Anti-Fraud and Abuse Act of 1993 - Title I: All-Payer Fraud and Abuse Program - Requires the Secretary of Health and Human Services to establish a national program to control health care fraud and abuse and facilitate Federal, State, and local enforcement of Medicare and Medicaid (titles XVIII and XIX of the Social Security Act (SSA)) fraud and abuse programs. Creates in the Treasury the Anti-Fraud and Abuse Trust Fund. Authorizes appropriations. Amends SSA title XI to provide for the application of sanctions under the Medicare and Medicaid fraud and abuse programs for specified violations to similar violations by any health benefit plan. Requires the Secretary to establish a program through which Medicare beneficiaries may report allegations of fraud by providers under Medicare. Title II: Revisions to Current Sanctions for Fraud and Abuse - Makes revisions in specified current sanctions for fraud and abuse under Medicare and Medicaid and transfers certain of them for application under the new national program created above. Title III: Administrative and Miscellaneous Provisions - Requires providers to submit claims in a uniform format according to standards prescribed by the Secretary. Amends SSA title XI part A to direct the Secretary to publish in the Federal Register a listing of all final adverse actions taken during during the quarter. Requires the Secretary to establish a national health care fraud and abuse data collection program for the reporting of final adverse actions against health care providers, suppliers, and practitioners.

Respiratory Care Practitioner Cost Savings and Fairness Act of 1993

United States · United States Congress · 4 May 1993

Respiratory Care Practitioner Cost Savings and Fairness Act of 1993 - Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to treat certain respiratory therapists as licensed health professionals in applying nursing home reform requirements relating to the training of nurse aides.

Universal Coordinated Care Act of 1992

United States · United States Congress · 4 May 1993

Universal Coordinated Care Act of 1992 - Amends the Internal Revenue Code to allow an individual a tax credit for certain amounts paid by or on behalf of such individual to a health services account for the payment of qualified health expenses. Provides for the certification of a health services supplemental policy as a health insurance policy or other health benefit plan offered by a private entity to an individual which provided reimbursement for expenses incurred, or services for catastrophic and long-term care. Requires any amount distributed out of a health services account to be included in the taxable income of the distributee. Imposes a penalty on distributions not used to pay qualified health expenses. Declares such accounts exempt from tax, unless the distributee engages in prohibited transactions or the account is pledged as security for a loan. Terminates such accounts on the death of the distributee. Requires a Health and Human Services report to the Congress on minimum standards for health services supplemental policies. Amends title XVIII (Medicare) of the Social Security Act to provide coverage of home care services for qualified patients. Amends the Social Security Act to set forth the conditions a home health agency must meet in order to receive Federal funding for the provision of home care services. Authorizes appropriations. Amends the Social Security Act to establish the national care voucher program under which U.S. citizens, resident aliens, and certain officers and employees of international organizations or foreign governments, are eligible for benefit coverage through the purchase of insurance through a national care voucher. Sets forth guidelines governing annual deposits to employee voucher accounts by employers and the United States. Exempts certain small employers from the requirements of new title XXII, including those participating in a small employer health plan. Requires the Secretary to establish: (1) minimum standards and requirements for the certification of health care insurance policies eligible to be purchased under this new title; and (2) a procedure for certifying such policies. Sets forth procedures for health insurance enrollment under the national care voucher program. Requires each carrier of small employer health insurance to register with the Secretary. Requires such a carrier to offer the same health plan to any small employer located in the same community. Amends the Internal Revenue Code to allow a trade or business expense deduction for expenses paid or incurred by a small employer for a certified health care insurance policy. Amends the Trade Act of 1974 to require the Trade Representative to identify a foreign country as a high cost priority foreign country if the trade deficit between the United States and such country exceeds 15 percent of the total U.S. trade deficit and such country has entered into a free trade agreement with the United States. Imposes an equity tax of one percent of the value of the merchandise entered by high cost priority foreign countries. Establishes an Equity Health Insurance Trust Fund. Transfers to such Fund the equity taxes. Makes amounts in such fund available to provide payments to national voucher accounts.

A bill to amend title 38, United States Code, to provide for the payment to States of per diem for veterans who receive adult day health care through State homes, and to authorize the provision of assistance to States for the construction of adult day health care facilities at State homes.

United States · United States Congress · 29 April 1993

Authorizes the Secretary of Veterans Affairs to pay each State a per diem rate for each veteran receiving adult day health care in a State home. Includes the construction of adult day health care facilities in the authorized use of funds under a program authorizing the Secretary to provide grants to States for the construction of State veterans' nursing home or hospital care facilities.

Fairness for Adopted Children Act

United States · United States Congress · 29 April 1993

Fairness for Adopted Children Act - Establishes the National Advisory Council on Adoption (the Council), to be appointed by the Secretary of Health and Human Services (HHS). Authorizes appropriations for FY 1993 through 1995. Terminates such Council after three years. Directs the Secretary of HHS to: (1) report to the Congress, within 30 days, on the status of the implementation of the adoption data collection system required under specified provisions of the Social Security Act; (2) report monthly to the Congress on the progress made in implementing such system; and (3) consult with the Council in developing regulations to carry out such reporting requirements. Amends the Public Health Service Act to require the Secretary to award grants to States to enable them to establish programs to provide maternal health certificates to eligible pregnant women who are residents of a maternity home, or on a waiting list or receiving out-patient services from a maternity home. Limits such women's income to 175 percent of the State poverty level, not including support received from parents, guardians, or the father of the child. Sets forth eligibility requirements for the maternity home, including that it have the capability to serve at least four pregnant women concurrently. Requires the use of certificates to pay the reasonable costs associated with residence in, or services of, the maternity home. Allows the use of certificates to cover expenses incurred during a period that ends not later than one month after the birth of the child. Authorizes appropriations for FY 1993 through 1995. Amends the Higher Education Act of 1965 (HEA) to establish a program of fellowships for graduate study in social work, in innovative programs concerning the effects of adoption on the adopted children, their adoptive families, and their biological parents who make an adoption plan. Authorizes of appropriations for FY 1993 through 1995. Directs the Secretary of Education, within one year after enactment of this Act, to make grants to States to carry out adoption education programs. Authorizes appropriations for FY 1993 through 1995. Amends the Employee Retirement Income Security Act of 1974 to prohibit discrimination by insurance companies in the writing or executing of insurance policies on the basis of whether a child is adopted. Makes it an unlawful employment practice for an employer to discriminate against an employee with respect to a term or condition of any leave benefit on the basis of the fact that a child of an employee is not a biological child. Amends the Social Security Act to provide payments to States for expenses incurred in placing a child with special needs in adoptive homes if the child is placed within three months of becoming available for adoption. Expresses the sense of the Congress that each State should adopt and enforce specified types of adoption laws, rules, or regulations.

National Narcotics Leadership Act Amendments Act of 1993

United States · United States Congress · 29 April 1993

National Narcotics Leadership Act Amendments Act of 1993 - Amends the National Narcotics Leadership Act of 1988 to extend the termination date and authorization of appropriations for the Office of National Drug Control Policy until September 30, 1998.

Family and Economic Recovery Act

United States · United States Congress · 29 April 1993

TABLE OF CONTENTS: Title I: Tax Relief for Families Title II: Family Savings Incentives Subtitle A: Increase in Income Limitations for Deductible IRA Contributions; Increase in IRA Contribution Limits; Penalty-Free Withdrawals for Home Ownership, Education, and Medical Expenses Subtitle B: Exclusion for Employer-Provided Educational Assistance to Include Educational Assistance for Spouse and Dependents of Employee Title III: Medical Care Savings Accounts; Health Care Cost Controls; Deduction for Health Insurance Costs of Self-Employed Individuals Title IV: Educational Choice Programs Title V: Grants to Encourage Employers to Adopt Flexible Work and Family Policies Title VI: Reducing the Cost of Capital by Reducing Capital Gains Tax Rates, Indexing the Basis of Certain Assets, and Excluding Gain from Sales of Principal Residences Title VII: Enterprise Zones Subtitle A: Designation of Enterprise Zones Subtitle B: Federal Income Tax Incentives Subtitle C: Regulatory Flexibility Subtitle D: Establishment of Foreign-Trade Zones in Enterprise Zones Family and Economic Recovery Act - Title I: Tax Relief for Families - Amends the Internal Revenue Code to allow taxpayers a credit for each child who has not attained the age of 19. Allows a credit for qualified adoption expenses. Disallows the use of such credits together with other credits or deductions. Title II: Family Savings Incentives - Subtitle A: Increase in Income Limitations for Deductible IRA Contributions; Increase in IRA Contribution Limits; Penalty-Free Withdrawals for Home Ownership, Education, and Medical Expenses - Increases the income limitations on retirement savings deductions and provides a cost-of-living adjustment after 1994 for such limitations. Provides a cost-of-living adjustment for deductible retirement amounts after 1993. Allows distributions from certain retirement plans without penalty to purchase first homes, pay higher education expenses and financially devastating medical expenses, and assist certain unemployed individuals. Treats certain disaster victims as first-time homebuyers. Subtitle B: Exclusion for Employer-Provided Educational Assistance to Include Educational Assistance for Spouse and Dependents of Employee - Excludes from gross income employer-provided educational assistance to spouses and dependents of employees. Makes such exclusion permanent. Title III: Medical Care Savings Accounts; Health Care Cost Controls; Deduction for Health Insurance Costs of Self-Employed Individuals - Excludes from gross income medical care savings benefits. Describes such benefits as a health plan which provides that all or part of the premium differential realized by instituting a qualified higher deductible health plan is credited to participating employees to pay for medical care for a plan year. Requires amounts remaining at the end of such plan year to be deposited into a tax exempt medical care savings account (subject to rules similar to those for retirement plans) for use by the participant for medical expenses. Increases the deduction for health insurance costs of self-employed individuals to 100 percent (50 percent for 1995 and 1996) and makes such deduction permanent. Preempts State laws: (1) requiring the offering of health plans providing certain services; and (2) prohibiting employer groups from purchasing health insurance. Title IV: Educational Choice Programs - Educational Choice Programs Act - Authorizes appropriations for FY 1993 through 2000 for grants and scholarship awards to parents of elementary or secondary school children that may be redeemed at a variety of public and private schools, including religious schools. Sets forth administrative details for such program. Title V: Grants to Encourage Employers to Adopt Flexible Work and Family Policies - Authorizes appropriations for FY 1993 to provide start-up grants to businesses to explore, initiate, or expand flexible work policies in an effort to ease work and family demands on employees. Includes as examples flexitime, part-time, job sharing, telecommuting, flexiplace, or compressed work weeks. Title VI: Reducing the Cost of Capital by Reducing Capital Gains Tax Rates, Indexing the Basis of Certain Assets, and Excluding Gain from Sales of Principal Residences - Reduces the individual and corporate capital gains rate from 34 percent to 15 percent. Reduces such tax to 7.5 percent for low- and middle-income taxpayers. Provides for the phaseout of personal exemptions and the overall limitation on itemized deductions to take into account adjusted gross income which has been reduced by net capital gain. Requires indexing, based on the gross national product deflator, of the adjusted basis of certain assets (corporate stock and tangible property that is a capital asset of property used in a trade or business) that have been held for more than one year at the time of sale or other transfer, solely for the purpose of determining gain or loss. Provides for indexing the limitation of capital losses of noncorporate taxpayers. Excludes from gross income the sale or exchange of property that has been owned and used by the taxpayer as the taxpayer's principal residence. Terminates provisions relating to the rollover of gain on the sale of a principal residence. Title VII: Enterprise Zones - Subtitle A: Designation of Enterprise Zones - Authorizes the Secretary of Housing and Urban Development to designate enterprise zones for purposes of providing tax and regulatory relief and improving local services. Limits choices to areas nominated by States and local governments. Limits the total number of areas that may be designated, and the time period of the designation. Authorizes the Secretary to designate a zone only if the area meets certain locational, demographic, unemployment, and poverty criteria. Requires nominating local governments, as a condition of the Secretary's designation, to agree in writing to follow a course of action that may include reducing tax rates, improving local services, simplifying or streamlining regulation of business, and providing job training to area residents. Describes areas to which the Secretary must give preference in selecting areas for designation. Requires the Secretary to report to the Congress every two years on the effects of such enterprise zones' designation in accomplishing the purposes of this Act. Subtitle B: Federal Income Tax Incentives - Allows a nonrefundable income tax credit to enterprise zone employees for five percent of any qualified wages earned as do not exceed a specified amount. Phases out such credit as total wages increase over $20,000. Provides for the nonrecognition of capital gain on the sale of enterprise zone property. Allows a taxpayer a deduction on the aggregate amount paid for the purchase of enterprise stock on its original issue by a qualified issuer. Requires any gain from the disposition of the stock to be treated as ordinary income. Excludes enterprise zone capital gains from income computation of alternative minimum taxes. Subtitle C: Regulatory Flexibility - Amends Federal law to revise the definition of "small entity" for purposes of the analysis of regulatory functions to include qualified business, government, and nonprofit enterprises operating within enterprise zones. Authorizes Federal agencies, upon request by a designating government, to waive or modify rules and regulations pertaining to the implementation of projects or activities within an enterprise zone. Requires agencies to approve the request if the resulting benefits of job creation, community development, or economical revitalization outweigh the public interest in retaining the rule unchanged. Disallows waiver or modification of a rule that would directly violate a statutory requirement or present a danger to the public health and safety. Subtitle D: Establishment of Foreign-Trade Zones in Enterprise Zones - Requires the Foreign-Trade Zone Board to consider on a priority basis, and to expedite the processing of, applications for the establishment of foreign-trade zones within enterprise zones. Requires the Secretary of the Treasury to give priority to, and expedite applications for, the establishment of ports of entry necessary to establish such zones.

Physician Assistant Incentive Act of 1993

United States · United States Congress · 28 April 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. Removes restrictions on the employment relationship required for reimbursement of physician assistants and nurse practitioners to allow for independent contractor relationships.

Primary Care Health Practitioner Incentive Act of 1991

United States · United States Congress · 28 April 1993

Primary Care Health Practitioner Incentive Act of 1991 (sic) - 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.

Homeless Children's Immunization Assistance Act

United States · United States Congress · 28 April 1993

Homeless Children's Immunization Assistance Act - Amends the Stewart B. McKinney Homeless Assistance Act to require operators of specified emergency shelters and transitional housing to determine the immunization status of children under the age of six years old occupying such housing.

To provide a Federal response to fraud in connection with the provision of or receipt of payment for health care services, and for other purposes.

United States · United States Congress · 28 April 1993

TABLE OF CONTENTS: Title I: Health Care Fraud Prosecution Act of 1993 Title II: Health Care Fraud and Abuse Commission Act of 1993 Title I: Health Care Fraud Prosecution Act of 1993 - Health Care Fraud Prosecution Act of 1993 - Amends the Federal criminal code to provide penalties for fraud by health care providers in connection with the provision of, or payments or reimbursement for, health care services or supplies, when: (1) the loss caused by the fraudulent conduct exceeds $10,000; or (2) the offender has previously been convicted of fraud in Federal or State court. Limits such penalties to ten years' imprisonment, unless the offense caused serious physical injury to, or endangered the life of, a patient (up to 20 years' imprisonment) or caused the death of a patient (up to life imprisonment). Specifies that the sentencing court shall order a person convicted of an offense under this title to pay restitution to the patient and any payor for losses sustained as a result of the offense. Provides for criminal forfeiture of the proceeds of health care fraud. Authorizes the Attorney General to make payments of up to $10,000 to persons who furnish information unknown to the Government relating to a possible prosecution for health care fraud, with exceptions. Authorizes appropriations for the Federal Bureau of Investigation, U.S. Attorneys, and the Office of Inspector General of the Department of Health and Human Services to hire, equip, and train personnel in connection with the investigation and prosecution of health care fraud cases. Includes within the scope of the mail fraud statute cases involving matter to be sent or delivered by any private or commercial interstate carrier. Title II: Health Care Fraud and Abuse Commission Act of 1993 - Health Care Fraud and Abuse Commission Act of 1993 - Establishes the Health Care Fraud and Abuse Commission to investigate the nature, magnitude, and cost of health care fraud and abuse and develop methods for its prevention, detection, and prosecution or litigation. Authorizes appropriations.

Bruce C. Vladeck, of New York, to be Administrator of the Health Care Financing Administration, vice Gail Roggin Wilensky.

United States · United States Senate · 27 April 1993

National Wildlife Refuge System Management and Policy Act of 1994

United States · United States Congress · 27 April 1993

National Wildlife Refuge System Management and Policy Act of 1993 - Amends the National Wildlife Refuge System Administration Act of 1966 to prohibit the Secretary of the Interior (Secretary) from initiating or permitting a new use of a refuge or expanding or extending an existing use unless it is compatible with the purposes of the System and the refuge. Allows existing uses of such refuge system lands that have been determined to be compatible under this Act or the Refuge Recreation Act to continue under specified conditions. Ceases such use and requires revocation of any permits for it within five years after the enactment of this Act unless the Secretary determines that such use is compatible. Directs the Secretary, acting through the Director of the U.S. Fish and Wildlife Service, to establish and maintain a formal process for determinations of compatibility. Directs the Secretary to prepare and periodically revise: (1) a comprehensive plan for the System; and (2) a comprehensive conservation plan for each refuge or ecologically related complex of refuges in the System, except those in Alaska. Grants the Secretary emergency power to suspend any activity in any refuge in the National Wildlife Refuge System if such activity constitutes an imminent danger to the health and safety of any wildlife population, refuge, or to public health and safety. Authorizes appropriations

A joint resolution designating the week beginning May 2, 1993, as "National Mental Health Counselors Week".

United States · United States Congress · 27 April 1993

Designates the week beginning May 2, 1993, as National Mental Health Counselors Week.

Public Health Pesticides Protection Act of 1993

United States · United States Congress · 27 April 1993

Public Health Pesticides Protection Act of 1993 - Amends the Federal Insecticide, Fungicide, and Rodenticide Act to direct the Administrator of the Environmental Protection Agency to consider the risks and benefits of public health pesticides separately from the risks and benefits of other pesticides. Requires the Administrator, in weighing any regulatory action concerning a public health pesticide, to weigh any risks of the pesticide against the health risks to be controlled by the pesticide. Defines: (1) a "public health pesticide" as a minor use pesticide registered for use and used predominantly in public health programs for vector control or other health protection uses; and (2) "vector" as any animal capable of transmitting the causative agent of human disease or of producing human discomfort or injury. Exempts from reregistration fees public health pesticides of which more than 50 percent of usage (or at least 50 percent in the case of certain end use products) is devoted to the promotion of public health. Provides for expedited processing and review of pesticide applications that propose the initial or amended registration of an end use pesticide that, if registered as proposed, would be used as a public health pesticide. Provides for review by the Secretary of Health and Human Services of registrations of public health pesticides proposed for cancellation. Directs the Administrator to identify pests of significant public health importance and to implement programs to improve and facilitate the safe use of methods to combat such pests.

Designating September 1993 as "Childhood Cancer Month".

United States · United States Congress · 26 April 1993

Designates September 1993 as Childhood Cancer Month.

Medicare Cancer Coverage Improvement Act of 1993

United States · United States Congress · 22 April 1993

Medicare Cancer Coverage Improvement Act of 1993 - Amends title XVIII (Medicare) of the Social Security Act to cover: (1) any use of a drug approved by the Food and Drug Administration in an anticancer chemotherapeutic regimen if such use has been published in select peer-review medical literature or included in one or more of three specified medical compendia; and (2) an oral form of a drug prescribed for anticancer use for a given indication if the drug contains the same active ingredients and indication as a drug that would be covered if administered as incident to a physician's service if the drug could not be self-administered. Requires a study and report to specified congressional committees by the Secretary of Health and Human Services on Medicare coverage of patient care costs associated with clinical trials of new cancer therapies.

Federal Resource Efficient Building Materials Act of 1993

United States · United States Congress · 22 April 1993

Federal Resource Efficient Building Materials Act of 1993 - Requires the Administrator of General Services to establish a three-year pilot program to demonstrate the acquisition and use of resource efficient building materials in Federal facilities and buildings. Directs the Administrator, in the selection of such materials, to use the criteria of: (1) maximizing the conservation and preservation of natural resources; (2) ensuring that such materials are similar in quality and durability and are cost competitive to comparable, more conventional materials; (3) meeting appropriate environmental, public health, and safety standards; and (4) meeting appropriate energy efficiency standards. Establishes the Resource Efficient Building Material Advisory Board to advise and make recommendations to the Administrator concerning developments and uses of resource efficient building materials in Federal construction and the minimization of solid waste generation in such construction. Authorizes appropriations.

Child Immunization Incentive Act of 1993

United States · United States Congress · 22 April 1993

Child Immunization Incentive Act of 1993 - Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act to: (1) deny AFDC for children under six who have not received periodic examinations by a physician or immunizations; and (2) require State outreach activities with respect to preventive health care and immunizations for pre-school children. Amends the Child Care and Development Block Grant Act to require providers assisted under such Act to require each child receiving their services to receive immunizations in accordance with the recommendations issued by the Surgeon General pursuant to this Act.

Osteoporosis and Related Bone Disorders Research, Education, and Health Services Act of 1993

United States · United States Congress · 22 April 1993

Osteoporosis and Related Bone Disorders Research, Education, and Health Services Act of 1993 - Amends the Public Health Service Act to require the Director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMSD), the Director of the National Institute on Aging (NIA), and the Director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD) to expand and intensify research on osteoporosis and related bone disorders. Requires, with respect to osteoporosis and related bone disorders: (1) the NIAMSD Director to increase the number of Specialized Centers of Research; (2) the NIA Director to increase the number of program project grants devoted to creating centers of excellence; and (3) the NIDDKD Director to increase the number of grants in osteoporosis. Authorizes appropriations. Establishes in the Department of Health and Human Services the Interagency Council on Osteoporosis and Related Disorders and the Advisory Panel on Osteoporosis and Related Disorders. Authorizes appropriations for the Advisory Panel. Requires the NIAMSD Director to make grants or enter into contracts to establish a Resource Center on Osteoporosis and Related Disorders to: (1) disseminate information about research results, services, and educational materials to health professionals, patients, and the public; and (2) coordinate leadership training for the development of health professional resource networks. Requires grant and contract recipients to establish: (1) a central computerized information system to, among other matters, translate scientific and technical information into information readily understandable by the general public; and (2) a national toll-free telephone information line. Requires the grant or contract recipient to charge fees for providing information, but allows exceptions for individuals and organizations unable to pay. Authorizes appropriations.

Access to Obstetric Care Act of 1993

United States · United States Congress · 22 April 1993

Access to Obstetric Care Act of 1993 - Directs the Secretary of Health and Human Services to: (1) provide for demonstration projects to improve access to obstetric services in underserved urban and rural areas for eligible pregnant women under title XIX (Medicaid) of the Social Security Act; (2) develop and make public each year a compendium of State initiatives to address the obstetric access crisis; and (3) provide a grant for the study of obstetrical malpractice claims.