Healthcare

State Medicaid Savings Incentive Act of 1995

United States · United States Congress · 28 March 1995

State Medicaid Savings Incentive Act of 1995 - Amends title XIX (Medicaid) of the Social Security Act to authorize incentive payments to States that achieve a rate of growth for Medicaid expenditures for a fiscal year which is less than a baseline rate for such year determined by the Secretary of Health and Human Services. Makes an incentive payment equal to the amount that is 20 percent of the difference between the amount that the Federal Government would have paid if State expenditures had increased by the baseline rate and the amount paid using the actual growth rate.

Comprehensive Wetlands Conservation and Management Act of 1995

United States · United States Congress · 28 March 1995

Comprehensive Wetlands Conservation and Management Act of 1995 - Amends the Federal Water Pollution Control Act to prohibit, unless such activity is undertaken pursuant to a permit issued by the Secretary of the Army: (1) the discharge of dredged or fill material into U.S. waters, including wetlands at a specific disposal site; or (2) the draining, channelization, or excavation of wetlands. Requires the Secretary, upon receiving permit applications, to: (1) classify as Type A wetlands that are of critical significance to the long-term conservation of the aquatic environment and meet other specified requirements; (2) classify as Type B wetlands wetlands that provide habitat for a significant population of wildlife or provide other significant wetlands functions; and (3) classify as Type C wetlands wetlands that serve marginal functions but exist in such abundance that regulation of activities is not necessary to conserve wetlands functions or are lands that do not serve significant wetlands functions. Authorizes persons with ownership interests in property to request the Secretary to make determinations as to whether the property contains U.S. waters or is a wetland. Subjects such determinations to judicial review. Directs the Federal Government to compensate a property owner whose use of the property has been limited by an agency action under this Act that diminishes the fair market value of the property by at least 20 percent. Requires the compensation to equal the diminution in value resulting from such action. Directs the Federal Government, at the owner's option, to buy the portion of property for fair market value if the diminution in value is greater than 50 percent. Prohibits compensation with respect to agency actions: (1) the primary purpose of which is to prevent a public health or safety hazard or damage to specific property other than the property whose use is limited; or (2) pursuant to the Federal navigation servitude except as such servitude applies to wetlands. Sets forth procedures for owners seeking compensation and notice requirements for agencies taking actions to limit the use of private property. Applies compensation provisions only to surface interests or water rights, with specified exceptions for oil, gas, or mineral interests beneath or adjacent to Type A or B wetlands. Requires the Secretary to determine whether to issue a permit for an activity in Type A wetlands based on a sequential analysis that seeks to avoid or minimize adverse actions on wetlands and compensate for losses of functions that cannot be avoided or minimized. Authorizes mitigation requirements when appropriate to prevent loss or degradation of Type A wetlands. Permits the Secretary to issue a permit for activities in Type B wetlands if the issuance of the permit is in the public interest, balancing the foreseeable benefits and detriments resulting from the permit. Imposes requirements for mitigation when such activities result in permanent wetland loss or degradation. Directs the Secretary to issue regulations for the establishment and oversight of mitigation banks for wetlands. Requires the Secretary, at the option of the permit applicant, to issue permits authorizing activities in Type A and B wetlands in States with substantial conserved wetlands areas subject to the following requirements. Permits the Secretary to include conditions for minimization of adverse impacts when economically practicable. Prohibits any requirements for mitigation to compensate for adverse impacts in such permits. Directs the Secretary, upon application by owners of economic base lands in a State with substantial conserved wetlands, to issue individual and general permits for activities in waters or wetlands. Reduces requirements to allow such lands to be beneficially used to sustain economic activity and to reflect the social and economic needs of Alaska Natives to utilize such lands. Exempts specified activities from this Act's requirements. Prohibits more than 20 percent of any county, parish, or borough from being classified as Type A wetlands. Requires wetlands located on agricultural lands and associated non-agricultural lands to be delineated by the Secretary of Agriculture in accordance with the Food Security Act of 1985. Exempts from the requirements of this Act agricultural lands that are exempt from the requirements of the Food Security Act of 1985. Requires the Secretary and the Secretary of Agriculture to undertake a project to identify and classify U.S. wetlands. Directs the Secretary to establish procedures pursuant to which: (1) landowners may appeal determinations of regulatory jurisdiction over a parcel of property, wetlands classifications with respect to property, or determinations that an activity does not qualify under a general permit; (2) any person may appeal a determination that a proposed activity is not exempt (non-exempt activities require permits); (3) permit applicants may appeal determinations to deny issuance of a permit or to impose a requirement under the permit; and (4) landowners or others required to restore or alter property may appeal an order to do so. Provides that persons who have filed appeals shall not be required to pay penalties or perform mitigation or restoration until the appeal has been decided. Authorizes civil actions and prescribes penalties for permit violations. Authorizes States to administer permit programs for activities covered by this Act, subject to the Secretary's approval. Deems specified activities associated with cranberry production operations to be in compliance with provisions regarding effluent limitations, subject to certain conditions. Directs the Secretary, in implementing responsibilities under the regulatory program, to balance the objective of conserving functioning wetlands with the objectives of ensuring continued economic growth, providing essential infrastructure, maintaining strong State and local tax bases, and protecting against the diminishment and value of private property. Requires the Secretary and the heads of Federal agencies to seek to minimize the effects of the regulatory program on the use and value of private property. Directs the Secretary to develop procedures for facilitating actions necessary to respond to emergency conditions under this Act which may involve loss of life or property damage. Provides that no U.S. waters or wetlands shall be subject to this Act based solely on the fact that migratory birds use or could use the waters or wetlands. Provides for reevaluation of determinations of regulatory jurisdiction or permit conditions imposed before this Act's enactment upon the request of a permit holder. Authorizes modification or suspension of permits, as appropriate. Bars compensation to persons as a result of such reevaluation and continues activities in Type A wetlands without permit modification.

Tax Fairness and Deficit Reduction Act of 1995

United States · United States Congress · 28 March 1995

TABLE OF CONTENTS: Title I: Discretionary Savings Title II: Extension of Authority of Federal Communications Commission to Use Competitive Bidding Title III: Privatization of the United States Enrichment Corporation Title IV: Retirement Title V: Medicare Savings Extensions Subtitle A: Provisions Relating to Part A of the Medicare Program Subtitle B: Provisions Relating to Part B of the Medicare Program Subtitle C: Provisions Relating to Parts A and B of the Medicare Program Title VI: Contract With America Tax Relief Act of 1995 Subtitle A: American Dream Restoration Subtitle B: Senior Citizens' Equity Subtitle C: Job Creation and Wage Enhancement Subtitle D: Family Reinforcement Subtitle E: Social Security Earnings Test Subtitle F: Technical Corrections Tax Fairness and Deficit Reduction Act of 1995 - Title I: Discretionary Savings - Discretionary Spending Reduction and Control Act of 1995 - Amends the Congressional Budget Act of 1974 to establish discretionary spending limits for FY 1996 through 2000. Extends congressional committee allocation and enforcement provisions and the applicability of certain points of order through FY 2000. Extends the requirement for five-year concurrent resolutions on the budget through FY 2000. Amends the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act) to establish amounts for FY 1996 through 2000 to eliminate budgetary excess from the Violent Crime Reduction Trust Fund. (Sec. 1003) Revises the general statement of budget enforcement to apply to discretionary spending limits and pay-as-you-go requirements rather than expired maximum deficit amounts. (Sec. 1004) Extends enforcement of discretionary spending limits, pay-as-you-go requirements, and reporting requirements through FY 2000. (Sec. 1009) Provides a special rule on the interrelationship between changes in discretionary spending limits and pay-as-you-go requirements for enforcement purposes. Prohibits changes in direct spending and receipts resulting from this Act from being reflected in pay-as-you-go estimates. Revises the final sequestration report to be made by the Office of Management and Budget for FY 1996. Title II: Extension of Authority of Federal Communications Commission to Use Competitive Bidding - Amends the Communications Act of 1934 to extend through FY 2000 the authority of the Federal Communications Commission to use competitive bidding in granting licenses and permits. Title III: Privatization of the United States Enrichment Corporation - USEC Privatization Act - Provides for the transfer by the United States Enrichment Corporation of some or all of its assets and obligations regarding uranium- and uranium enrichment-related activities to a private corporation. Title IV: Retirement - Congressional and Federal Employee Retirement Equalization Act - Increases, incrementally through 1997, percentages of basic pay which may be deposited by a Federal employee or Member of Congress in the Civil Service Retirement and Disability Fund for service for which retirement deductions or deposits have not been made. Adjusts employing agency deductions and withholding according to this schedule. Provides that Government contributions shall be determined, with respect to service after 1995, according to the 1995 applicable percentage plus three percent. Conforms military basic pay and volunteers' readjustment allowance or stipend percentages to the percentages for employee service. Revises Federal Employees' Retirement System (FERS) deductions and withholding so that the rates applicable to Federal and congressional employees and Members, increased incrementally through 1997, are made uniform. Provides higher rates for law enforcement officers, fire fighters, and air traffic controllers. Conforms military basic pay and volunteers' compensation percentages to the FERS percentages for employee service. Exempts postal employees from the applicability of these Civil Service Retirement System (CSRS) and FERS contribution changes. (Sec. 4004) Revises rules relating to average pay, for purposes of computing employee annuities or survivor annuities for employees separating after 1995, to increase the number of consecutive years of service considered. Revises accrual rates, with respect to annuities of congressional employees and Members with at least five years of service, to compute annuities on the basis of service before 1996. Applies, in the case of immediate retirement, the 1.1 percent accrual rate in the computation of the basic annuity of a Member or congressional employee who separates after January 1, 1996. (Sec. 4006) Eliminates the option of Members not to participate in FERS. Title V: Medicare Savings Extensions - Medicare Presidential Budget Savings Extension Act of 1995 - Subtitle A: Provisions Relating to Part A of the Medicare Program - Amends title XVIII (Medicare) of the Social Security Act (SSA) to prohibit the Secretary of Health and Human Services (Secretary), with respect to per diem limits on routine costs of services of skilled nursing facilities or prospective payments to such facilities, from considering changes in the costs of services occurring during cost periods which began in FY 1994 or 1995. Subtitle B: Provisions Relating to Part B of the Medicare Program - Sets the monthly part B premium (for supplementary medical insurance) at 50 percent of the monthly actuarial rate for enrollees age 65 and over. Subtitle C: Provisions Relating to Parts A and B of the Medicare Program - Amends title XVIII secondary payer provisions to extend permanently requirements for employer responses to fiscal intermediaries or carriers inquiring as to coverage of an employee under a group health plan. Amends the Internal Revenue Code to extend permanently requirements of the Secretary of the Treasury and the Commissioner of Social Security to provide taxpayer identity information for verification of Medicare beneficiary employment status. Extends permanently the prohibition on large group health plans from taking into account that a disabled active individual under age 65 is entitled to Medicare benefits under title II (Old Age, Survivors and Disability Insurance) of the SSA. Extends the period during which a group health plan may not take into account that an individual with end stage renal disease is entitled to Medicare benefits solely by reason of title II provisions. Prohibits the Secretary, in determining limits on reasonable costs of home health care agency services, from taking into account changes in the costs of services furnished with respect to cost reporting periods which began on or after July 1, 1994, and before July 1, 1996. Title VI: Contract With America Tax Relief Act of 1995 - Contract With America Tax Relief Act of 1995 - Subtitle A: American Dream Restoration - Amends the Internal Revenue Code to allow individuals a tax credit of $500 multiplied by the number of qualifying children who have not attained age 18. Places limitations on such credit for taxpayer adjusted gross incomes over $200,000. Provides an inflation adjustment for such credit and the taxpayer adjusted gross income amount. (Sec. 6102) Allows a marriage penalty reduction credit for qualified married couples to be determined under tables prescribed by the Secretary of the Treasury. (Sec. 6103) Establishes individual retirement plans (IRAs) which can be designated as American Dream Savings Accounts. Disallows a tax deduction for amounts contributed to such accounts. Limits contributions to such accounts to the lesser of $2,000, or compensation includible in an individual's gross income for a taxable year ($4,000 in the case of certain married individuals). Provides an inflation adjustment of such amounts. Permits contributions to be made after age 70.5. Excludes distributions from such accounts from gross income and makes the penalty on early distributions inapplicable. Designates qualified distributions as those: (1) made after the individual attains age 59.5; (2) made to a beneficiary on or after the death of the individual; (3) attributable to the individual being disabled; and (4) qualified as special purpose distributions. Prohibits qualified distributions from being made within the five-year period since the account began. Describes special purpose distributions as those for: (1) qualified first-time homebuyers; (2) qualified higher education expenses; and (3) qualified medical expenses, including long-term care insurance. Terminates the authority to make nondeductible contributions to IRAs. (Sec. 6104) Provides for computing a spousal IRA on the basis of compensation of both spouses. Subtitle B: Senior Citizens' Equity - Amends the Internal Revenue Code to decrease the tax on social security benefits from 1996 through 1999. Terminates such tax after December 31, 1999. (Sec. 6211) Provides for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation. Prohibits long-term care insurance under cafeteria plans. Includes in the gross income of an employee employer-provided coverage for qualified long-term care services provided through flexible spending arrangements. Provides that the continuation coverage excise tax does not apply to a group health plan solely by reason of failing to provide long-term care insurance. Declares that payments to relatives (unlicensed with respect to long-term medical care services) shall be treated as not paid for medical care. (Sec. 6212) Includes amounts paid for qualified long-term care services as medical expenses deductible from gross income. (Sec. 6213) Provides for the nonrecognition of gain or loss on the exchange of any life insurance contract or an endowment or annuity contract for a long-term care insurance contract. (Sec. 6214) Excludes from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangements to pay long-term care premiums. (Sec. 6221) Provides for the exclusion as a death benefit of any amount paid or advanced to an individual under a life insurance contract because such individual is terminally ill or chronically ill and confined to a qualified facility. (Sec. 6222) Allows insurance companies to issue accelerated death benefit riders on life insurance contracts. (Sec. 6231) Includes in gross income excess long-term care benefits, except for terminally ill individuals. (Sec. 6232) Establishes reporting requirements for persons who pay long-term care benefits. Subtitle C: Job Creation and Wage Enhancement - Amends the Internal Revenue Code to allow a 50 percent income tax deduction for the net capital gain of noncorporate taxpayers. Allows such deduction in computing gross income. (Sec. 6302) 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 or property used in a trade or business) that have been held for more than three years at the time of sale or other transfer, solely for the purpose of determining gain or loss. Allows a taxpayer, other than a corporation that holds any readily tradable stock on January 1, 1995, to treat such stock as having been sold on the last business day before such date for an amount equal to its closing market price on such last business day (and as having been reacquired on such last business day for an amount equal to such closing market price). (Sec. 6311) Reduces the alternative capital gains tax on corporations from 35 percent to 25 percent. (Sec. 6316) Allows an itemized deduction for losses arising from the sale or exchange of a principal residence. (Sec. 6321) Allows the depreciation deduction to be computed based on a neutral recovery basis for property placed in service after December 31, 1994. (Sec. 6322) Provides for the treatment of lessor improvements which are abandoned at the termination of a lease. (Sec. 6331) Phases out the alternative minimum tax for corporations to zero after December 31, 2000. Provides for earlier termination of certain tax adjustments. (Sec. 6341) Establishes in the Treasury a Public Debt Reduction Trust Fund for the deposit of portions of tax liability designated by individuals. Makes amounts in such Trust Fund available only to pay at maturity, or to redeem or buy before maturity, any obligation of the Federal Government included in the public debt. Prohibits the reissuance of any obligation which is paid, redeemed, or bought with amounts from the Trust Fund. Amends the Balanced Budget and Emergency Deficit Control Act of 1985 to require a sequestration (reduction) of Federal spending equivalent to the aggregate amounts designated for payment to such Fund. Sets forth congressional reporting requirements. (Sec. 6351) Increases the unified credit against the estate tax and the unified credit against the gift tax and provides a cost-of- living adjustment for such credits. Provides an inflation adjustment for the alternate valuation of certain farm and business property, the gift tax exclusion, the generation-skipping tax exemption, and the estate tax on closely held businesses. (Sec. 6352) Increases the dollar limitation on the election to expense certain depreciable business assets. (Sec. 6353) Includes as a principal place of business, for purposes of qualifying a home office for the deductibility of expenses, a place of business used by the taxpayer for administrative or management activities of a trade or business if there is no other fixed location where the taxpayer conducts such activities. (Sec. 6354) Treats the storage of product samples as inventory for deduction purposes. Subtitle D: Family Reinforcement - Allows an income tax credit for up to $5,000 of qualified adoption expenses paid or incurred by the taxpayer during the taxable year. Sets forth a formula for reduction of such credit for taxpayers whose adjusted gross income exceeds $60,000. Denies such a credit for any expense for which a deduction or credit is allowable under another Code provision. Defines "qualified adoption expenses" as reasonable and necessary adoption fees, court costs, attorney's fees, and other lawful expenses directly related to legal adoption of a child, but not any expenses paid from any funds received under a Federal, State, or local program. Disqualifies for such a credit any expenses in connection with the adoption of a child of the taxpayer's spouse. (Sec. 6402) Allows a tax credit for an individual who maintains a household which includes one or more qualified persons requiring custodial care equal to $500 for each such person. Subtitle E: Social Security Earnings Test - Amends title II (Old Age, Survivors and Disability Insurance) of the Social Security Act to increase the monthly exempt amount for individuals who have attained retirement age. Subtitle F: Technical Corrections - Makes technical amendments to the Revenue Reconciliation Act of 1990 and the Revenue Reconciliation Act of 1993. Provides for the application of amendments made by title XII of the Omnibus Budget Reconciliation Act of 1990. Includes among such amendments clarification of U.S. shareholder interests in controlled foreign corporations with respect to dividends, modification of the election to include a child's unearned income on a parent's return, and certain investments in annuity contracts.

Second Supplemental Appropriations and Rescissions Act, 1995

United States · United States Congress · 24 March 1995

TABLE OF CONTENTS: Title I: Supplementals and Rescissions Title II: General Provisions Second Supplemental Appropriations and Rescissions Act, 1995 - Title I: Supplementals and Rescissions - Makes FY 1995 additional supplemental appropriations to the Department of Agriculture for the Agricultural Research Service, the Food Safety and Inspection Service, the Commodity Credit Corporation, and the Food and Nutrition Service. Rescinds appropriations made to the Department of Agriculture for the Office of the Secretary, Agricultural Research Service, the Cooperative State Research Service, the Animal and Plant Health Inspection Service, the Rural Development Administration and Farmers Home Administration, the Alcohol Fuels Credit Guarantee Program Account, the Rural Electrification Administration, the Food and Nutrition Service, and the Foreign Agricultural Service. Makes FY 1995 additional supplemental appropriations to the National Bankruptcy Review Commission and the United States Information Agency. Rescinds appropriations made to: (1) the Department of Justice for the Immigration and Naturalization Service and Office of Justice Programs; (2) the Department of Commerce for the National Institute of Standards and Technology, the National Oceanic and Atmospheric Administration, the Under Secretary for Technology-Office of Technology Policy, the National Technical Information Service, and the Economic Development Administration; (3) the Judiciary for the United States Court of International Trade and for defender services; (4) the Small Business Administration; (5) the Department of State; (6) the Arms Control and Disarmament Agency; (7) the Board for International Broadcasting; and (8) the United States Information Agency. Rescinds appropriations made to: (1) the Corps of Engineers-Civil; (2) the Bureau of Reclamation of the Department of the Interior; (3) the Department of Energy; (4) the Appalachian Regional Commission; and (5) the Tennessee Valley Authority. Rescinds funds appropriated to the President for foreign operations, export financing, and related programs. Rescinds appropriations made to: (1) the Department of the Interior for the Bureau of Land Management, the United States Fish and Wildlife Service, the National Park Service, the Bureau of Indian Affairs, and territorial and international affairs; (2) the Department of Agriculture for the Forest Service; (3) the Department of Energy for fossil energy research and development, naval petroleum and oil shale reserves, and energy conservation; (4) the Department of Education for the Office of Elementary and Secondary Education. Rescinds appropriations made to the Smithsonian Institution, the National Gallery of Art, the John F. Kennedy Center for the Performing Arts, the Woodrow Wilson International Center for Scholars, and the National Foundation on the Arts and the Humanities. Rescinds appropriations made to the Department of Labor for the Employment and Training Administration and the Bureau of Labor Statistics. Rescinds appropriations made to the Department of Health and Human Services for the Health Resources and Services Administration, the Centers for Disease Control and Prevention, the National Institutes of Health, the Assistant Secretary for Health, the Agency for Health Care Policy and Research, the Health Care Financing Administration, the Social Security Administration, the Administration for Children and Families, the Administration on Aging, and the Office of the Secretary. Rescinds appropriations made to specified Department of Education programs, the Corporation for Public Broadcasting, and the Railroad Retirement Board. Amends the Higher Education Act of 1965 to decrease the appropriated funds for FY 1995 for the Federal Direct Student Loan Program. Rescinds funds made available to the Legislative Branch for: (1) the payments to widows and heirs of deceased Members of Congress; (2) Joint Economic Committee and the Joint Committee on Printing; (3) the Office of Technology Assessment for salaries and expenses; (4) the Congressional Budget Office for salaries and expenses; (5) the Architect of the Capitol for capitol buildings and grounds; (6) the Government Printing Office for congressional printing and binding and salaries and expenses; (7) the Botanic Garden for salaries and expenses; (8)the Library of Congress for salaries and expenses; and (9) the General Accounting Office for salaries and expenses. Rescinds funds made available to the Department of Defense for: (1) military construction; (2) the North Atlantic Treaty Organization; and (3) Base Realignment and Closure Account, Parts II and III. Rescinds funds made available to the Department of Transportation (DOT) for: (1) the Office of the Secretary; (2) the Coast Guard; (3) the Federal Aviation Administration; (4) the Federal Highway Administration; (5) the National Highway Traffic Safety Administration; (6) the Federal Railroad Administration; and (7) the Federal Transit Administration. Reduces certain obligation limitations for DOT. (Sec. 901) Rescinds funds from the DOT working capital fund. (Sec. 902) Cancels a specified amount for DOT civilian and military compensation and benefits permanently. Makes FY 1995 additional supplemental appropriations to the General Services Administration and the Office of Personnel Management. Rescinds funds made available to the Department of the Treasury for departmental offices, the Financial Management Service, the United States Mint, the Bureau of the Public Debt, and the Internal Revenue Service. Rescinds funds made available to the Executive Office of the President for the White House Office and Federal drug control programs. Rescinds funds made available to the General Services Administration for the Federal Buildings Fund and the Office of Personnel Management for salaries and expenses. Makes FY 1995 additional supplemental appropriations to the Federal Emergency Management Agency for disaster relief and the National Flood Insurance Fund. Rescinds funds made available to: (1) the Department of Veterans Affairs for medical care and major projects construction; and (2) the Department of Housing and Urban Development for housing programs. Amends the United States Housing Act of 1937 to: (1) permit a public housing agency to use modernization assistance for any eligible activity, including demolition, replacement housing, and temporary relocation assistance, authorized by this or other applicable appropriations Acts; (2) permit replacement units to be built on the site of the original demolished public housing unit only if the number of replacement units is significantly less than the number of units demolished; (3) repeal provisions prohibiting public housing projects from transferring title unless there is Federal funding assistance providing for a unit for unit replacement for each transfer; and (4) permit the reuse of any budget authority that is recaptured on account of termination of a housing assistance payments contract only for one or more the following, tenant-based assistance or project-based assistance. Rescinds funds made available to the: (1) Chemical Safety and Hazard Investigation Board; (2) Community Development Financial Institutions Fund; (3) Corporation for National and Community Service; (4) Environmental Protection Agency; (5) National Aeronautics and Space Administration; (6) National Science Foundation; and (7) Federal Deposit Insurance Corporation. Title II: General Provisions - Directs the Secretary concerned to: (1) prepare, offer, and award contracts for salvage timber sales from Federal lands; and (2) perform the appropriate revegetation and tree planting operations in the salvage area. Subjects such sales to judicial review only in the United States district court for the district in which the affected Federal lands are located. Permits such an action only if made within 15 days after the initial advertisement of the challenged timber sale. (Sec. 2002) Amends the Treasury, Postal Service and General Government Appropriations Act, 1995 and other Federal law provisions concerning overtime for criminal investigators. (Sec. 2006) Prohibits the use of funds available in FY 1995 appropriations being used for specified purposes by the Environmental Protection Agency.

VA State Health Care Reform Pilot Program Act

United States · United States Congress · 24 March 1995

VA State Health Care Reform Pilot Program Act - Authorizes the Secretary of Veterans Affairs to carry out pilot programs on the participation of the Department of Veterans Affairs health care system in the health care systems of States that have adopted comprehensive health benefit plans. Allows up to five States to be used for such pilot programs. Requires the Secretary to provide benefits to persons through the Department health care system in such a State as if such system were a provider of benefits under the State plan. Prohibits a State from refusing Department participation in a State health benefit plan unless the chief executive officer of such State certifies that the Department plan or its facilities are inadequate to meet the State health benefit plan. Requires the Secretary to designate a health system director for each State in which a pilot program is carried out. Authorizes the Secretary to carry out any necessary administrative reorganization of Department health care systems or facilities in a program State. Allows the Secretary to exclude Department facilities from participation in a pilot program. Authorizes a health system director to enter into contracts and agreements for the provision of health care and related services in connection with the pilot program. Excludes such contracts and agreements from certain Federal law. Requires review by the Central Office of the Department of contracts and agreements of $250,000 or more. Outlines provisions concerning: (1) the use of Department personnel in a pilot program; (2) eligible persons; and (3) copayments and other charges (and their waiver with respect to certain veterans). Establishes in the Treasury the Department of Veterans Affairs Health Care Reform Fund to be used for pilot program purposes, with a separate account established for each program. Requires the Secretary to collect, and report to specified congressional committees concerning, information with respect to the provision of health care benefits under each pilot program.

Health Care Quality and Fairness Act of 1995

United States · United States Congress · 23 March 1995

TABLE OF CONTENTS: Title I: Protection of Consumer Choice Title II: Office for Consumer Information, Counseling and Assistance Title III: Utilization Management Title IV: Health Plan Standards Title V: Health Insurance Market Reform Title VI: Miscellaneous Provisions Health Care Quality and Fairness Act of 1995 - Title I: Protection of Consumer Choice - Requires each employer, including self-insured employers, who provides a health plan to provide each employee a choice of at least one managed care, one point-of-service, and one fee-for-service plan. Provides for enrollment periods. Title II: Office for Consumer Information, Counseling and Assistance - Mandates grants to States for establishment and operation of an Office for Consumer Information, Counseling and Assistance in each State to be concerned with consumer health insurance rights. Authorizes appropriations. Title III: Utilization Management - Requires a health plan to have a utilization review program meeting the requirements of this title and certified by the State. (Sec. 303) Requires Federal standards for the establishment, operation, certification, and recertification of review programs. Allows States to certify a plan as meeting Federal standards if the plan meets standards for accreditation as applied by a nationally recognized, independent, non-profit accreditation entity. Sets forth review program requirements and related plan requirements. Requires plans to provide emergency services coverage without regard to whether the health professional or provider furnishing the services has an arrangement with the plan. Prohibits preauthorization requirements if an enrollee arrived at the emergency department with symptoms reasonably suggesting an emergency. Title IV: Health Plan Standards - Mandates Federal standards for health plan certification and recertification. Requires a State to provide for plan certification if the State-designated certifying authority finds the plan meets this Act's requirements. Allows a plan sponsor to offer a plan only if the plan is State-certified. (Sec. 402) Requires plan minimum solvency standards. (Sec. 403) Mandates disclosure to prospective covered individuals of certain plan terms and conditions in an easily understandable, truthful, linguistically appropriate, and objective manner. (Sec. 404) Requires plans to demonstrate a sufficient number, distribution, and variety of providers to insure that services will be available and accessible in a timely manner, including access to specialized treatment. Prohibits care coordination and cost control processes from imposing an undue enrollee burden. Requires meeting these requirements in all areas, including rural areas, allowing a plan to provide access by providing out-of-network services. (Sec. 405) Requires plans to credential the health professionals furnishing services under the plan. Requires credentialing decisions to be made on objective standards with input from health professionals credentialed under the plan. (Sec. 406) Mandates a timely and organized system for resolving complaints and formal grievances filed by covered individuals. Mandates disclosure of credentialing information to the professional involved and provides for submission of corrections. Declares that a professional is not entitled to be selected or retained by a plan whether or not the professional meets credentialing standards. Regulates the use of economic considerations in the selection process. Provides for procedures relating to the suspension, termination, and review of the plan contract with a professional. (Sec. 407) Mandates confidentiality of specified enrollee patient information and records. (Sec. 408) Prohibits plan discrimination: (1) on the basis of race and other factors, including socio-economic status, disability, health status, or anticipated need for health services; (2) in the selection of provider members on the basis of race or other factors, including the anticipated need for health services of the provider's patients; and (3) in participation, reimbursement, or indemnification against a health professional who is acting within the scope of the professional's license or certification solely on the basis of the professional's license or certification. (Sec. 409) Prohibits plan marketing or other practices intended to discourage or limit the plan on the basis of risk factors. Title V: Health Insurance Market Reform - Requires guaranteed issue and renewability. (Sec. 502) Prohibits limits on coverage or establishment of premiums based on health status or similar factors, including genetic predisposition to medical conditions. Prohibits waiting periods before coverage begins. Regulates the treatment of preexisting conditions. (Sec. 503) Mandates Federal specification of uniform age, geography, and family size categories and maximum rating increments for adjustment factors. (Sec. 504) Requires plans to participate in a risk adjustment program developed by the State under Federal standards. (Sec. 505) Prohibits lifetime benefit limits. (Sec. 506) Declares that a plan shall be considered to be an eligible organization under title XVIII (Medicare) of the Social Security Act for applying rules under provisions relating to the right to accept or refuse treatment and relating to advance directives. (Sec. 507) Preempts State law only if in direct conflict. Declares that additional consumer protections under State law are not in direct conflict. (Sec. 508) Requires health plans offered to small employers and individuals through associations or other intermediaries to meet the requirements of this title. Title VI: Miscellaneous Provisions - Requires States to prohibit the offering or issuance of any health plan if it does not meet certain requirements of this Act and any other requirements determined appropriate by the Secretary of Health and Human Services. Directs the Secretary of Labor to develop health plan standards consistent with this Act and applicable to self-insured plans. Authorizes the Secretary of Labor to terminate or disqualify a self-insured plan not meeting those standards.

Federal Risk Assessment in Women's Health Act of 1995

United States · United States Congress · 23 March 1995

Federal Risk Assessment in Women's Health Act of 1995 - Directs the Office of Science and Technology Policy to conduct a review of all Federal programs that assess or mitigate the risks to women's health from environmental exposures, including programs setting standards for exposure to various pollutants, toxic substances, pesticide use, and pesticide residues. Requires the National Institute of Environmental Health Sciences to enter into a contract with the National Research Council of the National Academy of Sciences to study the status of the science base and needs of the Federal Government for research relating to the risks to women's health from environmental exposures, for the purpose of assessing and mitigating such risks. Requires results of such review and study to be reported to the Congress.

Retired Worker Health Security Act of 1995

United States · United States Congress · 23 March 1995

Retired Worker Health Security Act of 1995 - Requires employers to notify workers at least 60 days before their health care benefits or retirement benefits are terminated. Defines employer as any business enterprise which has 100 or more employees or 500 or more employees who have retired and receive or will receive health and pension benefits from such enterprise.

American Samoa Economic Development Act of 1995

United States · United States Congress · 23 March 1995

American Samoa Economic Development Act of 1995 - Authorizes appropriations to the Secretary of the Interior for the Government of American Samoa for FY 1996 through 2005 to be used for: (1) construction, maintenance, and repair of American Samoa's capital assets; (2) operations of the Government of American Samoa; and (3) reduction of unbudgeted debt incurred by the Government of American Samoa in fiscal years prior to 1996. Requires amounts appropriated to be placed in a trust administered by a nongovernmental entity. Prohibits the release of funds for the construction of capital assets for FY 1997 and following years until: (1) the Government of American Samoa submits to the trustee a master plan of capital needs that ranks projects in order of priority for at least five years; and (2) such Government submits to the trustee a maintenance plan covering the anticipated life of the project and the project is initially funded. Approves the release of funds only for construction projects for specified public purposes. Prohibits the release of such funds, beginning in FY 1997, in the areas of communications, electrical power, public health, transportation, water, and wastewater until semiautonomous government agencies of the Government of American Samoa are established by local law. Requires funding provided to reduce the unbudgeted debt and for maintenance or repair of capital assets to be matched by non-Federal sources. Prohibits funds appropriated pursuant to this Act from being transferred to other accounts, loaned to other accounts or agencies, or used as collateral for loans made by the local government. Sets forth conditions on the release of trust funds to be used for construction of capital assets, debt reduction, and maintenance or repair. Requires the Government of American Samoa to obtain and submit an annual audit of its financial position to specified congressional committees. Withholds funds for government operations until a qualifying audit is received and reported. Authorizes the Comptroller General and the Inspector General to conduct audits of all funds of branches and semiautonomous authorities of the Government of American Samoa.

FDA Export Reform and Enhancement Act of 1995

United States · United States Congress · 22 March 1995

FDA Export Reform and Enhancement Act of 1995 - Amends the Federal Food, Drug, and Cosmetic Act (FDCA) to modify the circumstances in which a drug, device, or biological product (including a partially processed biological product) may be exported.

Medicare/Medicaid Solvency Act

United States · United States Congress · 22 March 1995

Medicare/Medicaid Solvency Act - Amends the Internal Revenue Code to establish in the Treasury the Tobacco Product Health Care Cost Reimbursement Trust Fund. Directs the Secretary of the Treasury to: (1) distribute amounts in the Fund to each Secretary responsible for the expenditure of Federal funds for that fiscal year (beginning with FY 1997) under titles XXVIII (Medicare) and XIX (Medicaid) of the Social Security Act or any other Federal program for the payment of health care costs for individuals with diseases attributable to the use of tobacco products; and (2) pay administrative expenses of the Fund. Requires each manufacturer of tobacco products to pay to the Fund an annual contribution based on the total amount of tobacco-related Federal health care costs in proportion to that manufacturer's share of the tobacco market.

FDA Export Reform and Enhancement Act of 1995

United States · United States Congress · 22 March 1995

FDA Export Reform and Enhancement Act of 1995 - Amends the Federal Food, Drug, and Cosmetic Act (FDCA) to modify the circumstances in which a drug, device, or biological product (including a partially processed biological product) may be exported.

Medical Device Exportation Act of 1995

United States · United States Congress · 16 March 1995

Medical Device Exportation Act of 1995 - Requires the Secretary of Health and Human Services, in administering a specified provision of the Federal Food, Drug, and Cosmetic Act, to determine that the exportation of a medical device (which has not been banned by the Secretary) is not contrary to public health and safety, and has the approval of the importing country, if the Secretary has received notice of approval of the device for marketing or investigational use in the European Community or by the Ministry of Health and Welfare of Japan.

Expressing the sense of the House of Representatives with respect to restricting medical professionals from providing to women full and accurate medical information on reproductive health options.

United States · United States Congress · 16 March 1995

Declares that it is the sense of the House of Representatives that the Government should not establish any policy restricting medical professionals from providing women full and accurate medical information on their reproductive health options, including the provision of nondirective abortion counseling.

Health Professions Education Consolidation and Reauthorization Act of 1996

United States · United States Congress · 14 March 1995

TABLE OF CONTENTS: Title I: Health Professions Education and Financial Assistance Programs Subtitle A: Health Professions Education Programs Subtitle B: Nursing Education Subtitle C: Financial Assistance Title II: Office of Minority Health Title III: Selected Initiatives Title IV: Miscellaneous Provisions Health Professions Education Consolidation and Reauthorization Act of 1995 - Title I: Health Professions Education and Financial Assistance Programs - Subtitle A: Health Professions Education Programs - Amends the Public Health Service Act (PHSA) to replace provisions relating to students from disadvantaged backgrounds with provisions mandating grants or contracts to increase the number and quality of disadvantaged health professionals. Authorizes appropriations. Repeals provisions relating to the terms of obligated service under various PHSA health professional education provisions. (Sec. 102) Repeals provisions relating to: (1) area health education center programs; (2) training in general internal medicine, general pediatrics, general dentistry, physician assistants, and podiatric medicine; and (3) related general provisions. Modifies provisions relating to training in family medicine by adding: (1) references to internal medicine and pediatrics; and (2) provisions regarding the training of physician assistants and training in preventive medicine. Authorizes appropriations. (Sec. 103) Replaces provisions relating to training in certain health professions with provisions relating to area health education centers. Authorizes grants and contracts for projects meeting specified criteria. Authorizes grants and contracts for the establishment of geriatric education centers. Authorizes appropriations. (Sec. 104) Removes provisions relating to geriatrics and relating to rural areas. Authorizes grants and contracts to strengthen capacity for health professions education and practice. Authorizes appropriations. Requires (currently, authorizes) expansion of a uniform health professions data reporting system. Extends the termination date of the Council on Graduate Medical Education. Allows use of amounts otherwise appropriated under title VII (Health Professions Education) of the PHSA to be used for the Council's medical education activities. (Sec. 105) Repeals provisions relating to miscellaneous programs, statistics, a biennial report, and certain general provisions. Sets forth general provisions for such title VII. (Sec. 106) Grants funding preference to programs that have graduated less than three classes and meet specified criteria. (Sec. 107) Adds State or local health departments with a severe shortage of public health personnel to the definition of "medically underserved community" for purposes of such title VII. Subtitle B: Nursing Education - Nursing Education Consolidation and Reauthorization Act of 1995 - Replaces title VIII (Nurse Education) of the PHSA (except for provisions relating to student loans (but does remove the authorization of appropriations for student loan funds), the loan repayment program, discrimination on the basis of sex, and certain generally applicable provisions) with provisions relating to application requirements, uses of funds (including maintenance of effort), matching requirements, preference, and generally applicable provisions (including peer review). Establishes the National Advisory Council on Nurse Education and Practice. Allows amounts appropriated under title VIII to be used to support activities of the Council and to provide technical assistance. Provides for recovery for construction assistance if the facility is used or ceases to be used according to requirements. Authorizes grants and contracts for: (1) supporting advanced practice nursing education and practice and traineeships for advanced practice nursing; (2) special projects to increase nursing education opportunities for individuals from disadvantaged racial and ethnic backgrounds underrepresented among registered nurses; and (3) projects to strengthen capacity for basic nurse education and practice. Authorizes appropriations. (Sec. 125) Grants funding preference to programs that have graduated less than three classes and meet specified criteria. Subtitle C: Financial Assistance - Adds references to training in, schools of, and activities related to public health, disease prevention, and health promotion numerous places in provisions authorizing and regulating the National Health Service Corps Loan Repayment Program. Adds references to degrees or graduate training programs in public health to provisions relating to the period of obligated service under the National Health Service Corps Scholarship Program and the Loan Program. Authorizes appropriations to carry out the Scholarship Program and the Loan Program. Allows: (1) grants to States for loan repayment programs to be used for public health disease prevention and health promotion in health professional shortage areas; and (2) a State, in carrying out a State loan repayment program, to accept service in a private clinical practice in a health professional shortage area. Removes provisions authorizing appropriations for grants to States for demonstration programs to increase the availability of primary health care in health professional shortage areas. (Sec. 132) Removes nursing loan repayment program provisions relating to breach of agreements for obligated service and authorizations of appropriations. (Sec. 133) Adds to the definition of "health professional shortage area" State or local health departments with a severe shortage of public health personnel. (Sec. 135) Requires that schools participating in a student loan fund under specified provisions have certain percentages of their graduates over the preceding four (currently, three) years in primary care residency or practice. Requires student loan recipients to practice in primary care for five years after their residency is completed (currently, to practice in primary care until the loan is repaid). (Sec. 136) Authorizes appropriations for Federal capital contributions to student loan funds for individuals from disadvantaged backgrounds. Repeals the authorization provisions on a specified date. (Sec. 137) Allows nursing student loan recipients who failed to make consecutive payments but who have made consecutive payments for the last year to have the repayment period extended a specified period. Provides for breach of agreement to provide services in consideration of receiving Federal funds for nursing education. Modifies requirements regarding the distribution of assets from nursing student loan funds. (Sec. 141) Defers repayment of graduate insured health education assistance loans while the borrower is providing health care services to Indians through an Indian health program. Modifies loan limits. (Sec. 151) Authorizes grants and contracts for scholarships for individuals from disadvantaged backgrounds. Authorizes appropriations. Title II: Office of Minority Health - Revises the duties of the Office of Minority Health and establishes the Advisory Committee on Minority Health. Modifies provisions regulating grants, cooperative agreements, and contracts to carry out the Office's duties. Authorizes appropriations. Title III: Selected Initiatives - Mandates programs on birth defects, including operating regional centers for conducting epidemiological birth defect prevention research. Requires establishment of a National Information Clearinghouse on Birth Defects. Authorizes grants and contracts. (Sec. 302) Authorizes the program for trauma research under specified provisions to make grants or contracts for basic and applied research on traumatic brain injury. Authorizes grants to States for demonstration projects to improve the availability of services regarding traumatic brain injury. Requires matching funds. Authorizes appropriations. Mandates a study on traumatic brain injury and a national consensus conference on managing traumatic brain injury and related rehabilitation concerns. (Sec. 303) Removes a requirement that State contributions of nonfederal matching funds (for the operation of State rural health offices) be in cash. Authorizes appropriations. Increases the aggregate grant amount after which no more grants may be made and repeals, on a specified date, the provisions authorizing the grants. (Sec. 304) Modifies the permitted uses of grants and contracts for serving the health needs of Pacific Islanders. Authorizes appropriations. (Sec. 305) Removes the limits on the number of grants that must be made to States for demonstration projects on Alzheimer's disease or related disorders. Revises project requirements. Removes grant time limits. Authorizes appropriations. Title IV: Miscellaneous Provisions - Authorizes appropriations for carrying out (currently, for making grants under) provisions mandating, directly or through grants, specified activities regarding tuberculosis. (Sec. 402) Authorizes establishment of technical and scientific peer review groups and scientific advisory committees as needed for the Centers for Disease Control and Prevention. Mandates establishment of fellowship and training programs in disease detection and prevention methods. (Sec. 403) Amends the National Institutes of Health Revitalization Act of 1993 to remove provisions prohibiting an entity from spending funds under the Act unless the entity agrees to comply with the Buy American Act. (Sec. 404) Includes in the definition (for purposes of title VII (Health Professions Education) of the PHSA) of "medically underserved community" ambulatory practice sites designated by State Governors and practices or facilities in which not less than 50 percent of the patients are eligible to receive aid under title XIX (Medicaid) of the Social Security Act or are uninsured. Provides for recovery of funds paid in connection with construction of a facility if the facility ceases, during a prescribed period, to be owned or used as required. (Sec. 405) Adds counseling to the list of disciplines in provisions relating to obligatory service in return for traineeships. (Sec. 406) Reduces the amount required to be reserved for grants and contracts for regional centers for research on primates.

Women Veterans' Mammography Quality Standards Act

United States · United States Congress · 14 March 1995

Women Veterans' Mammography Quality Standards Act - Prohibits mammograms from being performed at a Department of Veterans Affairs facility unless such facility is accredited for such purpose by a private nonprofit organization designated by the Secretary of Veterans Affairs. Requires any such organization to meet the standards for accrediting bodies established under the Public Health Service Act (the Act). Directs the Secretary to prescribe quality assurance and control standards relating to the performance and interpretation of mammograms and the use of Department mammogram equipment and facilities consistent with requirements of the Act. Requires the Secretary to inspect such equipment and facilities annually. Requires any Department mammograms contracted to a non-Department provider to conform to the standards of the Act. Requires a report on the quality standards prescribed.

Long-Term Care Insurance Consumer Protection Act of 1995

United States · United States Congress · 14 March 1995

Long-Term Care Insurance Consumer Protection Act of 1995 - Amends the Public Health Service Act to prohibit the sale of long-term care insurance unless this Act is complied with. Imposes civil money penalties. Requires application of standards meeting the requirements of this Act, allowing State standards providing greater policyholder protection. Imposes a duty of good faith and fair dealing. Prohibits: (1) twisting, high pressure tactics, and cold lead advertising; (2) knowingly selling a policy to an individual eligible for assistance under title XIX (Medicaid) of the Social Security Act; (3) selling a service-benefit policy duplicating existing coverage; and (4) selling a policy to an organization's member without disclosing a financial arrangement between the seller and the organization. Imposes civil money penalties and applies Social Security Act provisions regarding civil money penalties. Requires issuers to return premiums if a policy is denied or returned, explain denials, and use pre-issuance medical assessments of applicants 75 years old or older, and limit agent sales compensation. Imposes civil money penalties and applies Social Security Act provisions regarding civil money penalties. Prohibits cancellation or nonrenewal except for nonpayment of premium or material misrepresentation. Regulates continuation and conversion rights. Requires policies to use uniform language and format and contain certain disclosures. Prohibits conditioning or limiting benefits in specified ways or placing certain limits or requirements on home health care services, if covered. Mandates a minimum coverage period. Prohibits treating benefits differently for individuals with certain dementias or mental illness differently from individuals with other conditions. Restricts preexisting condition limits. Requires policies to determine benefits based on a functional assessment. Requires policies to provide for annual increases in payment levels and the maximum payment limit and limits on annual premium increases. Requires policies to provide that, if a policy lapses after being in effect for a minimum period, the policy will provide certain benefits without additional premiums. Prohibits policy cancellation or claim denial based on issuance fraud or misrepresentation unless notice is provided within six months of issuance. Allows applicants to return a policy within 30 days and have the premium refunded. (Sec. 3) Amends Medicaid provisions to require each State Medicaid plan to establish a regulatory program to enforce the standards issued under this Act. Prohibits Medicaid payments to a State for nursing facility services if the State fails to establish a regulatory program. (Sec. 5) Authorizes appropriations for information, counseling, and assistance regarding the procurement of adequate and appropriate long-term care insurance.

Basic Health Care Reform Act of 1995

United States · United States Congress · 14 March 1995

TABLE OF CONTENTS: Title I: Assuring Availability and Continuity of Health Coverage Subtitle A: Insurance Reform Subtitle B: Facilitating Establishment of Health Plan Choice Organization (HPCOs) Subtitle C: Preemption of State Benefit Mandates and Anti-Managed Care Laws Subtitle D: Definitions; General Provisions Title II: Administrative Simplification Subtitle A: Standards for Data Elements and Transactions Subtitle B: Requirements With Respect to Certain Transactions and Information Subtitle C: Miscellaneous Provisions Title III: Fraud and Abuse Reform: Advisory Opinions Title IV: Malpractice Reform and Antitrust Subtitle A: Malpractice Reform Subtitle B: Antitrust Basic Health Care Reform Act of 1995 - Title I: Assuring Availability and Continuity of Health Coverage - Subtitle A: Insurance Reform - Requires carriers that offer health insurance coverage in the individual-small group market in a fair rating area to make available qualified standard coverage and high-deductible coverage to small employers. Exempts federally qualified health maintenance organizations (HMOs) and HMOs or managed care organizations recognized by State laws from the requirement to provide high-deductible coverage. Prohibits the offer of high-deductible coverage unless the carrier also makes standard coverage available with identical benefits and the employee demonstrates that they have available assets equal to at least the deductible amount under the high-deductible coverage. Requires carriers to provide for coverage of benefits for items and services furnished throughout the fair rating area. Prohibits carriers from limiting coverage to portions of interstate metropolitan statistical areas (MSAs), requiring them to provide coverage throughout the entire MSA. Requires coverage offers to include a family coverage option. Prohibits carriers from requiring employers under group health plans to impose waiting periods for health coverage or require conditions on health coverage based on an individual's: (1) health status; (2) claims experience; (3) receipt of health care; (4) medical history; or (5) receipt of public subsidies. (Sec. 1002) Requires carriers to accept every small employer and qualifying individual that applies for enrollment during the required enrollment period. Provides that in the case of coverage offered by carriers or under group health plans that provide benefits through a managed care arrangement, the carriers or plans: (1) need not establish health care facilities throughout the fair rating area if the facilities are located in a manner that does not discriminate on the basis of health status of individuals residing in proximity to such facilities; and (2) may deny coverage under certain conditions. Permits carriers to deny coverage if they do not have the necessary financial reserves. (Sec. 1003) Prohibits carriers from denying, cancelling, or refusing to renew health coverage except on the basis of nonpayment of premiums or fraud or because they are not providing a particular coverage option in the market. Sets limitations on market exit and re-entry by carriers. Establishes similar conditions for cancellation or denial by multiemployer plans. (Sec. 1004) Prohibits carriers or group health plans from excluding coverage with respect to services provided for preexisting conditions, except as provided by this Act. Provides for exclusion periods of up to 12 months subject to certain conditions. Makes exclusions inapplicable to pregnancy, newborns, adopted children, and certain individuals enrolled or enrolling during an open enrollment period. (Sec. 1005) Sets forth provisions regarding enrollment periods. (Sec. 1011) Establishes standards for general coverage requirements, managed care arrangements and requirements, and utilization review programs. (Sec. 1014) Amends the Internal Revenue Code to provide for the establishment of medical savings accounts. Makes the account beneficiary the owner of the account and includes distributions not used for qualified medical expenses in the beneficiary's gross income. Sets forth uses and limitations for such accounts. Excludes: (1) employer contributions to any medical savings account of an eligible employee from gross income (to the extent such contributions do not exceed the excess of premiums for standard coverage over the premiums for high-deductible coverage); and (2) health benefit payments made by employers from employment taxes. (Sec. 1021) Provides that the premium rate established by carriers for health insurance coverage in the small group market may not vary except by the following: (1) age; (2) geographic area; (3) family class; (4) benefit design of coverage and by type of coverage option; and (5) permitted expense category. (Sec. 1022) Requires the Secretary of Health and Human Services to request the National Association of Insurance Commissioners (NAIC) to develop a model risk adjustment system under which premiums applicable to coverage in the small group market would be adjusted to take into account factors to predict the future need and efficient use of services by covered individuals in the market. Incorporates such model into a rule that specifies risk adjustment mechanisms. Requires each State to develop systems that conform with the Federal model. (Sec. 1031) Requires carriers and group health plans to provide information relating to their performance in providing coverage to specified individuals, including prospective enrollees. (Sec. 1032) Prohibits carriers from varying the commission or other remuneration to a person based on the claims experience or health status of individuals enrolled by or through such person. (Sec. 1041) Directs the Secretary to request the NAIC to develop model regulations that specify standards with respect to this subtitle for carriers and health insurance coverage. (Sec. 1044) Imposes a tax on carriers or group health plans that fail to comply with provisions of this subtitle through Sec. 1033 unless a State has in effect a regulatory mechanism that provides sanctions. (Sec. 1045) Prohibits a plan from offering health coverage other than through a carrier unless the plan has at least 50 eligible employees, except where the plan is a multiple employer welfare arrangement which covers at least 1,000 qualifying employees and meets State established solvency standards. (Sec. 1051) Applies the provisions of this subtitle to carriers offering health insurance coverage to qualifying individuals in the individual market in the same manner as such provisions apply to carriers offering health insurance coverage to employers. Provides for an exception relating to risk adjustment systems. Subtitle B: Facilitating Establishment of Health Plan Choice Organization (HPCOs) - Authorizes the establishment of health plan choice organizations (HPCOs). (Sec. 1102) Requires HPCOs to enter into agreements with carriers that desire to make health coverage available in the small group market through HPCOs. (Sec. 1104) Requires HPCOs to offer enrollment for coverage, on behalf of carriers, to individuals in the market through which the organization offers coverage in the area served by the choice organization. Authorizes HPCOs to impose administrative fees for enrollment. Subtitle C: Preemption of State Benefit Mandates and Anti-Managed Care Laws - Preempts State laws that: (1) mandate health insurance benefits; (2) restrict managed care arrangements and utilization review programs; and (3) establish standards for health insurance coverage that differ from those established under this title. Subtitle D: Definitions; General Provisions - Sets forth definitions and effective date provisions. Title II: Administrative Simplification - Subtitle A: Standards for Data Elements and Transactions - Directs the Secretary to adopt standards for: (1) the electronic transmission of health information data; (2) information transactions; and (3) health information network privacy standards. Subtitle B: Requirements with Respect to Certain Transactions and Information - Lists transactions to be considered as standard transactions with respect to plan sponsors and HPCOs. (Sec. 2202) Requires certified health information security organizations to make available to Federal or State agencies, pursuant to a cost-type contract, any non-identifiable health information that is held by the service, consists of data elements that are subject to a standard under Subtitle A, and is requested by such an agency to fulfill a requirement under this Act. (Sec. 2203) Directs the Secretary to establish a procedure under which a plan sponsor or health provider that does not have the ability to transmit standard data elements and does not have access to a certified health information network may comply with this part. Subtitle C: Miscellaneous Provisions - Requires the Secretary to establish standards and a certification procedure for health information network services. (Sec. 2303) Provides that this subtitle supersedes State law. Prohibits the enforcement of any State law that requires medical or health plan records to be maintained or transmitted in written rather than electronic form, except as provided by the Secretary. Title III: Fraud and Abuse Reform: Advisory Opinions - Amends Social Security Act titles XI and XVIII to mandate the issuance of advisory opinions by the Secretary according to specified guidelines. Title IV: Malpractice Reform and Antitrust - Subtitle A: Malpractice Reform - Makes provisions of this subtitle through Sec. 4010 applicable to any medical malpractice liability action brought in a Federal or State court and to any medical malpractice claim subject to an alternative dispute resolution (ADR) system that is initiated on or after January 1, 1996. (Sec. 4002) Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified ADR system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States. Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 4003) Authorizes States to develop specialty clinical practice guidelines to be certified by the Secretary. (Sec. 4004) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action. (Sec. 4006) Sets forth provisions regarding: (1) limits on attorney's fees and other costs; and (2) statutes of limitations. (Sec. 4008) Specifies that in the case of a medical malpractice claim relating to services provided during labor or the delivery of a baby, if the health care professional or provider did not previously treat the claimant for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. (Sec. 4010) Provides that this part preempts State law, except for State law that imposes greater restrictions than those provided in this part. (Sec. 4021) Lists requirements for State ADR systems, including that such a system: (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 4022) Directs the Secretary to certify State ADR systems that meet such requirements on an annual basis. Requires the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 4023) Directs the Secretary to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system. (Sec. 4031) Sets forth definitions for this subtitle. Subtitle B: Antitrust - Directs the Attorney General to: (1) provide for the development of guidelines on the application of antitrust laws to the activities of health plans; and (2) establish a review process under which a health plan may request the Department of Justice's opinion on the plan's conformity with the Federal antitrust laws. (Sec. 4102) Requires the Attorney General to issue a certificate of public advantage to each eligible health care collaborative activity that complies with this section's requirements. Provides that such activity shall not be liable under the antitrust laws for conduct described in the certificate if such conduct occurs while the certificate is in effect. Directs the Attorney General to issue such a certificate if: (1) the benefits that are likely to result from the activity outweigh the reduction in competition that is likely to result; and (2) such reduction is necessary to obtain such benefits. Sets forth activity eligibility requirements.

Medicare Parts B and C Administration Budget Savings Extension Act of 1995

United States · United States Congress · 13 March 1995

TABLE OF CONTENTS: Title I: Provisions Relating to Part B of the Medicare Program Title II: Provisions Relating to Parts A and B of the Medicare Program Medicare Parts B and C Administration Budget Savings Extension Act of 1995 - Title I: Provisions Relating to Part B of the Medicare Program - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to permanently set the monthly premium under the supplementary medical insurance program at 50 percent of the monthly actuarial rate for enrollees age 65 and over. Title II: Provisions Relating to Parts A and B of the Medicare Program - Makes permanent specified Medicare secondary payer provisions currently scheduled to expire in FY 1998, including those with respect to disabled individuals in large group health plans and individuals with end-stage renal disease. Prohibits the Secretary, in establishing cost limits on home health services, from taking into account any changes in the costs of home health agency services with respect to cost reporting periods which began between July 1, 1994, and July 1, 1996.

Insurance Protection for Victims of Domestic Violence Act

United States · United States Congress · 10 March 1995

Insurance Protection for Victims of Domestic Violence Act - Amends the Public Health Service Act to create a new title prohibiting health insurers from discriminating against an individual or group because the individual or a family member is the subject of abuse. Mandates development of model standards. Requires each State to report on its implementation actions and, where States fail to act, provides for Federal enforcement involving civil fines against insurers and a Federal private right of action. Provides for application of this Act to specified provisions of the Employee Retirement Income Security Act of 1974.

Victims of Abuse Access to Health Insurance Act

United States · United States Congress · 9 March 1995

Victims of Abuse Access to Health Insurance Act - Prohibits health insurers from discriminating against an individual or group because the individual is or may be a victim of domestic violence. Prohibits considering a condition or injury resulting from domestic violence as a pre-existing condition. Mandates civil and criminal penalties and provides for injunctive relief and compensatory and punitive damages. Declares that, for the purposes of the McCarran-Ferguson Act, this Act specifically relates to the business of insurance.

American Health Security Act of 1995

United States · United States Congress · 9 March 1995

TABLE OF CONTENTS: Title I: Establishment of a State-Based American Health Security Program; Universal Entitlement; Enrollment Title II: Comprehensive Benefits, Including Preventive Benefits and Benefits for Long Term Care Title III: Provider Participation Title IV: Administration Subtitle A: General Administrative Provisions Subtitle B: Control Over Fraud and Abuse Title V: Quality Assessment Title VI: National Health Security Budget; Payments; Cost Containment Measures Subtitle A: Budgeting and Payments to States Subtitle B: Payments by States to Providers Subtitle C: Mandatory Assignment and Administrative Provisions Title VII: Promotion of Primary Health Care; Development of Health Service Capacity; Programs to Assist the Medically Underserved Subtitle A: Promotion and Expansion of Primary Care Professional Training Subtitle B: Direct Health Care Delivery Subtitle C: Primary Care and Outcomes Research Subtitle D: School-Related Health Services Title VIII: Financing Provisions; American Health Security Trust Fund Subtitle A: American Health Security Trust Fund Subtitle B: Taxes Based on Income and Wages Subtitle C: Increase in Excise Taxes on Tobacco Products Title IX: Conforming Amendments to the Employee Retirement Income Security Act of 1974 American Health Security Act of 1995 - Title I: Establishment of a State-Based American Health Security Program; Universal Entitlement; Enrollment - Establishes in the United States an American Health Security Program (AHSP) to be administered by the States (including the District of Columbia and, if they so choose, U.S. territories) in accordance with Federal standards established under this Act. Requires a State to establish a State health security program (program) in accordance with this Act to receive Federal health care funding. (Sec. 102) Entitles every individual who is a resident of the United States and is a U.S. citizen or national or a lawful resident alien to benefits for health care services under this Act under the appropriate State program. Sets forth provisions regarding the treatment of nonimmigrants and other individuals. (Sec. 103) Requires each State program to: (1) provide a mechanism for the enrollment of individuals entitled or eligible for benefits (which includes a process for the automatic enrollment of individuals at the time of birth, immigration, or other acquisition of lawful resident status in the United States and provides for the enrollment of all individuals who are eligible to be enrolled as of January 1, 1995); and (2) issue a health security card to enrolled individuals. (Sec. 104) Makes benefits portable when enrollees move or travel between States. Prohibits imposition of a minimum residence or waiting period in excess of three months for program benefit eligibility. Allows reciprocal arrangements between programs in adjacent States for coverage for enrollees residing in the border region. (Sec. 105) Makes benefits available under this Act for items and services furnished on or after January 1, 1996. (Sec. 106) Supersedes Medicare, Medicaid, the Federal Employee Health Benefits Program, and CHAMPUS, which must pay for completion of services they covered before January 1, 1996. Specifies that nothing in this Act affects the eligibility of veterans for Veterans Administration health benefits and services, or of Indians for benefits and services of the Indian Health Service. Title II: Comprehensive Benefits, Including Preventive Benefits and Benefits for Long Term Care - Entitles all eligible individuals to have payment made (if medically necessary and appropriate for the maintenance of health or for the diagnosis, treatment, or rehabilitation of a health condition) for inpatient and outpatient hospital services, professional services of State-authorized practitioners, community-based primary health services, preventive services, long-term, acute, and chronic care services, prescription drugs, biologicals, insulin, and medical foods, dental services, mental health services and substance abuse treatment services, diagnostic tests, and other specified items and services, including outpatient therapy, durable medical equipment, home dialysis, ambulance, prosthetic devices, and other items and services specified by the American Health Security Standards Board (Board) (established by title IV of this Act). Specifies that: (1) no deductibles, coinsurance, or copayments may be charged for acute care benefits, except for specified cost-sharing for long-term care services; (2) no provider may charge a patient for covered services; (3) no private insurance may duplicate program benefits; and (4) States and employers may provide additional benefits at their own expense. (Sec. 203) Covers home and community-based long-term care services for persons unable to perform at least two of five listed activities of daily living without assistance. Limits the cost of such services to 65 percent (or an alternative percentage determined by the Board) of the cost of nursing home care for an individual in the same area in which the services were provided. (Sec. 204) Sets forth special delivery requirements for mental health and substance abuse treatment services provided to at-risk children. Directs the Board to make national determinations on coverage of experimental services, with professional and public input. Specifies that where the Board has recognized practice guidelines, coverage is limited to services provided according to the guidelines or any established exception process. Allows the Board to limit quantities of eyeglasses, contact lenses, hearing aids, and durable medical equipment that will be covered. Excludes from coverage cosmetic procedures, personal comfort items, and services furnished in non-participating facilities. (Sec. 205) Specifies that: (1) States may require providers to certify that covered services were provided according to program requirements; (2) quality review programs must meet Federal standards; and (3) States may require plans of care for coverage of certain services. Title III: Provider Participation - Requires providers, to receive payment, to agree: (1) not to discriminate based on race, national origin, income, religion, age, sex or sexual orientation, disability, handicapping condition, or (subject to the professional qualifications of the provider) illness; (2) not to charge patients for covered services; (3) to furnish necessary information to the Board or program; (4) not to employ other providers whose participation has been terminated for cause; and (5) to submit bills within a specified time frame. (Sec. 302) Considers a health care provider to be qualified if it is licensed or certified and meets State law requirements, applicable Federal requirements, and additional standards that the Board may specify. Requires: (1) the Board to establish, evaluate, and update national minimum standards to assure the quality of services provided and to monitor efforts by programs to assure such quality; (2) a reasonable transition period for any new standards; and (3) the Board to provide for an exchange of information among programs with respect to quality assurance and cost containment. (Sec. 303) Defines a "comprehensive health service organization" (CHSO) as a public or private organization which, in return for a capitated payment amount, furnishes or arranges a full range of health services and out-of-area coverage in the case of urgently needed services to an identified population in a specified service area which enrolls voluntarily in the organization. Sets forth various CHSO requirements regarding enrollment, withdrawal for cause, accessibility of services, continuity of care, consumer and provider representation on the board of directors, a patient grievance program, medical standards committees, premiums, utilization and bonus information, provision of services to enrollees at institutions operating under global budgets, marketing of services, and provision of emergency services to nonenrollees. (Sec. 304) Extends current Medicare prohibitions on physician self-referrals to other services and applies such prohibitions to AHSP. Title IV: Administration - Subtitle A: General Administrative Provisions - Establishes the American Health Security Standards Board to develop policies and procedures for enrollment, benefits, provider participation, national and State funding levels, assisting programs with planning for capital expenditures and service delivery, and other functions and to establish uniform reporting standards for health services and programs. Authorizes the Board to make statistical and other studies, test alternative payment methods, and develop and test information and budget systems. Provides for the appointment of an Executive Director of the Board and an Inspector General. (Sec. 402) Directs the Board to provide for an American Health Security Advisory Council to advise the Board on matters of general policy, in the formulation of regulations, and in the performance of the Board's duties and to study the operation of, and utilization of health services under, this Act. (Sec. 403) Directs the Board and the Secretary to consult with private entities. (Sec. 404) Requires: (1) each State to submit to the Board a plan for a program for providing health care services to residents of the State (but allows neighboring States to join in regional plans); (2) the Board to provide incentives for States to develop regional planning mechanisms to promote the rational distribution of, adequate access to, and efficient use of, tertiary care facilities, equipment, and services; (3) State programs to meet Federal standards, including single-agency administration, a State health security budget, provider payment and quality review methodologies consistent with Federal standards, freedom to choose providers, a consumer ombudsman, an annual report, and a fraud and abuse prevention and control unit; and (4) the Governor of each State to provide for appointment of a State Health Security Advisory Council to advise and make recommendations to the Governor and State regarding program implementation. Allows: (1) programs not meeting Federal requirements, after notice, to be placed in receivership under the Board's jurisdiction; and (2) States to use fiscal agents, after competitive bidding, to process claims. (Sec. 405) Requires the Secretary of Health and Human Services (Secretary) to direct all activities of the Department of Health and Human Services toward contributions to health of the people in a manner complementary to this Act. Subtitle B: Control Over Fraud and Abuse - Authorizes the Board to exclude providers from participation, impose civil monetary penalties, and seek criminal prosecution for fraud or abuse, based on current Medicaid standards. Requires providers to disclose relevant information about their ownership interest in health facilities and services, based on current Medicaid standards. (Sec. 412) Requires the Board: (1) through the Inspector General, to establish a national health care fraud and abuse data base, including the identity of any provider who has been convicted, had a license revoked, has been excluded or suspended from participation, or has been subjected to a civil penalty with respect to a State program, Medicare, Medicaid, or any other federally funded health program; and (2) to establish rules to protect the confidentiality of information in the data base. Requires States to provide relevant information for this purpose and to periodically inquire of the data base to determine provider qualifications to participate in programs. Sets penalties for submitting false information. (Sec. 413) Requires each program to establish and maintain a health care fraud and abuse unit. (Sec. 414) Directs the Board to provide for the assignment of a unique identifier to each participating provider and to each individual eligible for services, which shall be used for claims and payment. Title V: Quality Assessment - Establishes the American Health Security Quality Council in order to: (1) review and evaluate each practice guideline developed under specified provisions of the Public Health Service Act; (2) review and evaluate each standard of quality, performance measure, and medical review criterion developed under specified provisions of the Public Health Service Act; (3) develop criteria for entities conducting quality reviews; (4) report to the Board annually; and (5) perform the functions of the Council described in sections 502 and 505. (Sec. 502) Directs the Council to: (1) adopt methods for profiling the patterns of practice of health care professionals and for identifying outliers; (2) develop guidelines for certain medical procedures to be performed only at tertiary centers; (3) develop standards for education and sanctions with respect to outliers; and (4) disseminate such methods, guidelines, and standards to the States. (Sec. 503) Requires each participating State to establish an entity to conduct quality reviews of persons providing covered services under its program which meet Federal standards for the adoption of practice guidelines, identification of outliers, development of remedial programs and monitoring for outliers, and the application of sanctions. Allows the State to adopt alternative methodologies to those adopted by the Quality Council provided that the State can demonstrate that the efficacy of such review and education programs meets Federal standards. Requires the quality review entity to meet the criteria for competence for such entities developed by the Council. (Sec. 504) Expresses the intent to replace random utilization controls with a systematic review of patterns of practice that compromise the quality of care by January 1, 1998. Supersedes all existing Federal utilization review programs, including random case-by-case reviews and programs requiring pre-certification of medical procedures on a case-by-case basis, with exceptions. Specifies that nothing in this section shall preclude case management of catastrophic, mental health, or substance abuse cases where necessary to achieve appropriate, cost-effective, and beneficial comprehensive medical care. (Sec. 505) Requires: (1) each State program to develop and use a uniform electronic data base in order to perform systematic quality review and support comparative outcomes research and analysis; (2) the Council to establish a set of clinical data derived from patient medical records to be transmitted to State electronic data bases to be used by State health security programs; (3) the Board to designate standards for software in order to assure compatibility; and (4) the Council to establish standards, as specified, for the use and disclosure by a State health security program of such data. Title VI: Health Security Budget; Payments; Cost Containment Measures - Subtitle A: Budgeting and Payments to States - Directs the Board to establish a national health security budget which specifies the total expenditures to be made by the Federal Government and the States for covered health care services, and allocates those expenditures among the States. Prohibits such budget from exceeding the budget for the preceding year increased by the percentage increase in gross domestic product. Divides the budget into quality assessment, professional education, administrative, and operating components. (Sec. 602) Provides for the allocation of funds in the budget by the Board to the States, based on the national average per capita costs of covered services adjusted for differences among the States in costs and the health status of populations. Permits the use of statistical models to estimate State capitation amounts. Sets forth State adjustment factors to reflect differences in relative needs for funds and directs that such factors be applied in a budget-neutral manner resulting in no change in total Federal expenditures from the national per capita average. (Sec. 603) Requires each program to submit to the Board a proposed and final annual budget broken into quality assessment, professional training, administrative, and operating components, with the operating component broken into facility-based services, individual practitioner payments, payments to CHSOs, and payments for other items and services. Sets forth provisions regarding proposed and final budget deadlines, adjustments in allocations, and expenditure limits. Permits programs to provide for a process for the approval of capital expenditures based on information derived from regional planning agencies. (Sec. 604) Provides for programs to receive Federal funds equal to a weighted average of 86 percent of their population-based share of the budget, which the Board may adjust between 81 and 91 percent based on State economic conditions. (Sec. 605) Requires each program to establish a separate budget account for health professional education expenditures and to distribute funds consistent with the achievement of specified national and program goals, including the receipt by the Board of reports to monitor compliance, and taking into account the potentially higher costs of placing health professional students in clinical education programs in health professional shortage areas. Subtitle B: Payments by States to Providers - Directs that: (1) payment for operating expenses for institutional and facility- based care under State programs be made directly to each institution or facility under an annual prospective global budget approved under the program; (2) such budgets take into account discharges by diagnosis-related group, prior expenditures, the extent to which debt service for capital expenditures has been included in the proposed operating budget, the extent to which capital expenditures are financed directly or indirectly through reductions in direct care to patients, change in the consumer price index and other price indices, compensation, occupancy levels, past financial and clinical performance, training, technological changes, and incentives to maintain costs without reducing care; and (3) facility budgets be adjusted to reflect payments made by CHSOs. Allows programs to permit institutions and facilities to raise funds from private sources to pay for newly constructed facilities, major renovations, and equipment. (Sec. 612) Requires: (1) State programs to pay individual practitioners on a fee-for-service basis, as negotiated between States and practitioner representatives; (2) the Board to establish models for such payment and for global fee payment methodologies to encourage payment for combinations of services; and (3) practitioners to bill State programs within 30 days of providing services. Permits States to require electronic billing. (Sec. 613) Authorizes programs to pay CHSOs based on annual budgets or risk-adjusted capitation payments, reduced by the costs of covered services not provided by the CHSO. (Sec. 614) Directs that programs pay for community-based primary health services based on global budgets, basic primary care capitation amounts for enrollees, or fee-for-service, taking into account costs of serving non-covered patients, providing case management, transportation, and translation, and providing health professional education programs. (Sec. 615) Requires: (1) the Board to establish a list of approved prescription drugs and to determine maximum prices; and (2) each program to pay for such drugs based on such maximum prices and to pay separate dispensing fees to pharmacies. (Sec. 616) Directs the Board to establish a list of approved durable medical equipment and therapeutic devices and equipment and programs to pay for such items based on maximum prices determined by the Board. (Sec. 617) Requires State programs to pay for other items and services based on methodologies to be adopted by the Board, consistent with the State health security budget. (Sec. 618) Directs the Board to establish model payment methodologies and other incentives to promote the provision of services in medically underserved areas. Permits programs to adjust payments amounts within their budgets to encourage provision of appropriate services in underserved areas. (Sec. 619) Authorizes programs to utilize alternative payment methodologies, provided that such methodologies do not affect the entitlement of individuals to coverage, the weighting of fee schedules to encourage an increase in the number of primary care providers, the ability of individuals to choose among qualified providers, the benefits covered under the Program, or compliance with the State health security budget. Requires States to report on the operation and effectiveness of alternative methodologies to enable the Board to evaluate the appropriateness of applying such methodologies to other States. Subtitle C: Mandatory Assignment and Administrative Provisions - Specifies that participating providers: (1) must accept payment from a program as full payment for covered services; and (2) may not impose additional charges on patients. Permits the Board to exclude from participation and subject to civil penalties violators of such provision. (Sec. 632) Requires programs to establish: (1) procedures for reimbursing providers within 60 days of bill submission; and (2) an appeals process to handle grievances pertaining to provider payments. Title VII: Promotion of Primary Health Care; Development of Health Service Capacity; Programs to Assist the Medically Underserved - Subtitle A: Promotion and Expansion of Primary Care Professional Training - Makes the Board responsible for: (1) coordinating health professional education policies and goals to achieve national goals; (2) overseeing program health professional education expenditures; (3) developing and maintaining a system to monitor the number and specialties of individuals through their health professional education, any postgraduate training, and professional practice; and (4) developing, coordinating, and promoting other policies that expand the number of primary care practitioners. Sets as national goals that: (1) at least 50 percent of graduate medical residencies be in primary care within five years of this Act's enactment; and (2) there be a certain number, specified by the Board, of midlevel primary care practitioners employed in the health care system as of January 1, 2001. Directs the Board to: (1) establish a method of applying such goals to program goals for each medical residency program or consortium of programs and reducing payments for residency programs failing to meet their goals; (2) advise the Public Health Service on allocations of funding under specified programs to increase the supply of midlevel primary care practitioners; and (3) commission a study of the potential benefits and disadvantages of expanding the scope of practice authorized under State laws for any class of midlevel primary care practitioners. (Sec. 702) Requires the Board to establish an Advisory Committee on Health Professional Education to advise the Board concerning graduate medical education policies under this title. (Sec. 703) Directs the Board to transfer specified revenues from the American Health Security Trust Fund (Trust Fund) for specified existing programs supporting health professional education and nursing education and for the National Health Service Corps. Subtitle B: Direct Health Care Delivery - Requires the Board to transfer specified Trust Fund revenues to the Public Health Service for: (1) maternal and child health block grants, prevention and treatment of tuberculosis, prevention and treatment of sexually transmitted diseases, preventive health block grants, grants to States for community mental health services and prevention and treatment of substance abuse, grants for HIV health care services, and public health formula grants; and (2) primary care service expansion grants. (Sec. 713) Directs the Board to make primary service expansion grants to primary care centers (i.e., nonprofit community health centers, migrant health centers, and other federally qualified health centers) to serve medically underserved populations in urban and rural areas. Specifies that grant funds may be used to plan, develop, and deliver primary care in such areas. Subtitle C: Primary Care and Outcomes Research - Requires the Board to transfer specified Trust Fund revenues to the Agency for Health Care Policy and Research for health outcomes research. (Sec. 722) Amends the Public Health Service Act to establish within the Office of the Director of the National Institutes of Health (NIH) an Office of Primary Care and Prevention Research to be headed by a Director who shall identify and coordinate research activities relating to primary care and prevention, including care provided by multidisciplinary teams. Requires the Director of NIH to establish a national data system and clearinghouse on primary care and prevention research. Authorizes appropriations. Subtitle D: School-Related Health Services - Authorizes appropriations through FY 2002 for this subtitle. (Sec. 734) Directs the Secretary to make grants to State health agencies or to local community partnerships to develop and operate school health service sites. Requires preference in making grants to be given to those communities showing the most substantial level of need. Title VIII: Financing Provisions; American Health Security Trust Fund - Subtitle A: American Health Security Trust Fund - Amends the Internal Revenue Code to create the American Health Security Trust Fund. Appropriates to the trust fund the increase in tax liabilities attributable to the application of amendments made by this title and receipts from the following programs: Medicare, Medicaid, Federal employees' health benefits program, and the CHAMPUS program, Maternal and Child Health program (under title V of the Social Security Act), vocational rehabilitation programs, drug abuse and mental health services programs under the Public Health Service Act, programs providing general hospital or medical assistance, and certain other Federal programs. Transfers to such trust fund amounts in the Federal Hospital Insurance Trust Fund and the Federal Supplementary Medical Insurance Trust Fund. Subtitle B: Taxes Based on Income and Wages - Creates a health care excise tax on every employer with respect to each employee equal to 8.7 percent of wages paid. Imposes the tax on the self-employed, railroad employers, and railroad employee representatives. Imposes an individual health care income tax equal to 2.2 percent of taxable income. Prohibits credits against the tax and any effect on the minimum tax in relation to the individual health care income tax. Subtitle C: Increase in Excise Taxes on Tobacco Products - Increases the excise taxes on tobacco products. Title IX: Conforming Amendments to the Employee Retirement Income Security Act of 1974 - Makes ERISA inapplicable to health coverage arrangements under State health security programs. Exempts State health security programs from ERISA preemption. Prohibits employee benefits duplicating State health security program benefits and requires that a liable workers' compensation carrier reimburse the State health security plan. Repeals continuation coverage requirements under ERISA.

Victims of Abuse Access to Health Insurance Act

United States · United States Congress · 9 March 1995

Victims of Abuse Access to Health Insurance Act - Prohibits health insurers from discriminating against an individual or group because the individual is or may be a victim of domestic violence. Prohibits considering a condition or injury resulting from domestic violence as a pre-existing condition. Mandates civil and criminal penalties and provides for injunctive relief and compensatory and punitive damages. Declares that, for the purposes of the McCarran-Ferguson Act, this Act specifically relates to the business of insurance.

Recreational Camp Safety Act

United States · United States Congress · 9 March 1995

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, and 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.

Health Care Liability Reform Act of 1995

United States · United States Congress · 9 March 1995

TABLE OF CONTENTS: Title I: General Provisions Title II: Health Care Liability Reform Subtitle A: Reform Described Subtitle B: Requirements for State Alternative Dispute Resolution Systems (ADR) Health Care Liability Reform Act of 1995 - Title I: General Provisions - Applies this Act to any health care liability claim or action in State or Federal court, except for vaccine or medical product injuries. Preempts State laws, subject to limitations. Title II: Health Care Liability Reform - Subtitle A: Reform Described - Requires initial resolution under an alternative dispute resolution system (ADR) of State or Federal health care liability actions and claims against the United States. Sets a time limit for commencement of actions. Limits contingent attorney's fees to percentages of the amount recovered (including any periodic payments projected to life expectancy). Requires payment by the contesting party of attorney's fees and costs if the award amount is not adjusted at least a specified percentage in favor of the contesting party. Limits noneconomic damages for an injury to a specified dollar amount regardless of the number of defendants or the number of actions. Requires, if requested by either party, that future expense payments over a certain amount be paid on a periodic basis. Mandates collateral source payment offsets. Regulates punitive damages with regard to the standard of proof, medical products subject to premarket approval, pleadings, separate proceedings, and amount. Permits several but not joint liability. Allows injunctions prohibiting violations of this title. Authorizes State agencies responsible for health care practitioner disciplinary actions to make agreements with professional societies to participate in health care practitioner licensing and to review malpractice actions and allegations. Subtitle B: Requirements for State Alternative Dispute Resolutions Systems (ADR) - Sets forth requirements for State ADRs, including requiring that State ADRs apply to all health care liability claims in that State's courts. Provides for annual Federal certification of State ADRs and mandates an alternative Federal ADR for claims in uncertified States. Requires uncertified States to reimburse the United States for costs and prohibits payments under the Public Health Service Act to those States, their local governments, or any entity in those States.

A resolution to express the sense of the Senate that obstetrician-gynecologists should be included in Federal laws relating to the provision of health care.

United States · United States Congress · 8 March 1995

Expresses the sense of the Senate that: (1) obstetrician-gynecologists should be included as primary care providers for women in Federal laws relating to the provision of health care; and (2) legislative proposals that define primary care should include primary care services performed by obstetrician-gynecologists in such definition.

Second Supplemental Appropriations and Rescissions Act, 1995

United States · United States Congress · 8 March 1995

TABLE OF CONTENTS: Title I: Emergency Supplemental Appropriations Title II: Rescissions Title III: General Provision Title I: Emergency Supplemental Appropriations - Makes FY 1995 emergency supplemental appropriations to the: (1) Federal Emergency Management Agency for disaster relief; and (2) the Coast Guard for certain operating expenses. Title II: Rescissions - Rescinds appropriations made to the Department of Agriculture for the Office of the Secretary, alternative agricultural research and commercialization, the Agricultural Research Service, the Cooperative State Research Service, the Rural Development Administration and Farmers Home Administration, the Rural Electrification and Administration, and the Food and Nutrition Service. Rescinds appropriations made to the Department of Justice for the Working Capital Fund, the Immigration and Naturalization Service, and the Office of Justice Programs. Rescinds appropriations made to the Department of Commerce for the National Institute of Standards and Technology, the National Oceanic and Atmospheric Administration, the Office of Technology Policy, the National Technical Information Service, the National Telecommunications and Information Administration, and the Economic Development Administration. Rescinds appropriations made to the: (1) Courts of Appeals, District Courts, and other judicial services for defender services; (2) the Small Business Administration; (3) the Legal Services Corporation; and (4) the Board for International Broadcasting. Rescinds appropriations made to the: (1) Corps of Engineers-Civil; (2) the Bureau of Reclamation of the Department of the Interior; (3) the Department of Energy; (4) the Appalachian Regional Commission; and (5) the Tennessee Valley Authority Fund. Rescinds funds appropriated to the President for multilateral economic assistance, bilateral economic assistance, military assistance, and export assistance. Rescinds appropriations made to the: (1) Department of the Interior for the Bureau of Land Management and the United States Fish and Wildlife Service; (2) the Department of Agriculture for the Forest Service; (3) the Department of Energy for fossil energy research and development, naval petroleum and oil shale reserves, and energy conservation; (4) the Department of Education for Indian education. Rescinds appropriations made to the Smithsonian Institution, the National Gallery of Art, the John F. Kennedy Center for the Performing Arts, the Woodrow Wilson International Center for Scholars, and the National Foundation on the Arts and the Humanities. Rescinds appropriations made to the Department of Labor for the Employment and Training Administrations, the Employment Standards Administration, and the Occupational Safety and Health Administration. Rescinds appropriations made to the Department of Health and Human Services for the Health Resources and Services Administration, the Centers for Disease Control and Prevention, the National Institutes of Health, the Assistant Secretary for Health, the Agency for Health Care Policy and Research, the Health Care Financing Administration, the Administration for Children and Families, and the Administration on Aging. Rescinds appropriations made to specified Department of Education programs, the Corporation for Public Broadcasting, and the Railroad Retirement Board. Amends the Higher Education Act of 1965 to decrease the amount of funds available for FY 1995 for the Federal Direct Student Loan Program. Rescinds funds made available to the Legislative Branch for: (1) the Joint Economic Committee and the Joint Committee on Printing; (2) the Office of Technology Assessment for salaries and expenses; (3) the Architect of the Capitol for capitol buildings and grounds; (4) the Government Printing Office for congressional printing and binding and salaries and expenses; (5) the Botanic Garden for salaries and expenses; (6) the Library of Congress; and (7) the General Accounting Office for salaries and expenses. Rescinds funds made available to the Department of Transportation (DOT) for: (1) the Office of the Secretary; (2) the Coast Guard; (3) the Federal Aviation Administration; (4) the Federal Highway Administration; (5) the Federal Railroad Administration; and (6) the Federal Transit Administration. Reduces certain obligation limitations for DOT. (Sec. 801) Rescinds funds from the DOT working capital fund. (Sec. 802) Cancels a specified amount for DOT civilian and military compensation and benefits permanently. Rescinds funds made available to the Department of the Treasury for departmental offices, the Federal Law Enforcement Training Center, the Financial Management Service, the Bureau of the Public Debt, and the Internal Revenue Service. Rescinds funds made available to the Executive Office of the President for the White House Office and Federal drug control programs. Rescinds funds made available to the General Services Administration, the Federal Election Commission, and the Office of Personnel Management. Rescinds funds made available to: (1) the Department of Veterans Affairs for medical care and major projects construction; and (2) the Department of Housing and Urban Development for housing programs. Rescinds funds made available to: (1) the Chemical Safety and Hazard Investigation board; (2) the Community Development Financial Institutions; (3) the Corporation for National and Community Service; (4) the Environmental Protection Agency; (5) the National Aeronautics and Space Administration; (6) the National Science Foundation; and (7) the Federal Deposit Insurance Corporation. Title III: General Provision - Prohibits the use of funds under this Act for any direct benefit or assistance to individuals not lawfully within the United States, other than that of an emergency nature or to reduce immediate threats to public health and safety.

A bill to amend title XVIII of the Social Security Act to provide for a 5-year extension of the medicare-dependent, small, rural hospital payment provisions, and for other purposes.

United States · United States Congress · 7 March 1995

Amends title XVIII (Medicare) of the Social Security Act to extend for five years payments to small, rural hospitals under the Medicare Dependent Hospital Program.

Coast Guard Authorization Act for Fiscal Years 1996 and 1997

United States · United States Congress · 7 March 1995

TABLE OF CONTENTS: Title I: Authorizations Title II: Personnel Management Amendments Title III: Navigation Safety and Waterway Services Management Title IV: Marine Safety and Environmental Protection Title V: Establishment of Alternate Convention Tonnage (ITC) Thresholds Title VI: Miscellaneous Amendments Title VII: State Recreational Boating Safety Funding Title VIII: Personnel Management Improvement Title IX: Navigation Safety and Waterway Services Management Title X: Marine Safety Management Improvements Title XI: Coast Guard Regulatory Reform Title XII: Law Enforcement Enhancement Title XIII: Coast Guard Auxiliary Amendments Coast Guard Authorization Act for Fiscal Years 1996 and 1997 - Title I: Authorizations - Authorizes appropriations for the Coast Guard for FY 1996 and 1997 for: (1) operation and maintenance; (2) acquisition, construction, renovation, and improvement of aids to navigation, shore and offshore facilities, vessels, and aircraft; (3) research, development, testing, and evaluation; (4) retired pay, payments under the Retired Serviceman's Family Protection and Survivor Benefit Plans, and payments for medical care of retired personnel and their dependents; (5) alteration or removal of bridges; and (6) environmental compliance and restoration at Coast Guard facilities. Amends Federal law to authorize the funding of highway bridges that are determined to be unreasonable obstructions to navigation under the Truman-Hobbs Act from amounts set aside from the discretionary bridge program. Limits the amounts available in specified fiscal years. (Sec. 102) Authorizes Coast Guard end-of-year strength and military training student loads. Title II: Personnel Management Amendments - Amends Federal law to authorize the Coast Guard Commandant to require that Coast Guard and Coast Guard Reserve personnel (including cadets and applicants) request that all information on the individual in the National Driver Register be made available to the Commandant. (Sec. 202) Amends Federal law relating to the Coast Guard to clarify that provisions mandating confidentiality of medical quality assurance records applies to activities before, on, and after the date the confidentiality requirements were enacted. Shields from civil liability an individual who in good faith provides information to a person (currently, to an individual) that reviews or creates quality assurance records. (Sec. 203) Authorizes the Commandant to enter into personal services and other contracts to provide health care to Coast Guard personnel and covered beneficiaries. (Sec. 204) Amends the National Defense Authorization Act for Fiscal Year 1995 to prohibit providing, by grant or contract, any Department of Transportation funds to any higher education institution that prevents campus military recruiting. Title III: Navigation Safety and Waterway Services Management - Amends the Inland Navigational Rules to modify specified rules. (Sec. 302) Amends Federal law to declare that: (1) provisions relating to recreational boating safety do not apply to an undocumented barge numbering system established under specified provisions; and (2) the system and the issuing authority for the system shall be determined by regulations promulgated by the head of the department in which the Coast Guard is operating. (Sec. 303) Amends the Inland Navigational Rules Act of 1980 to extend the termination date of the Navigation Safety Advisory Council. (Sec. 304) Amends Federal law to extend the termination date of the Commercial Fishing Industry Vessel Advisory Committee. Title IV: Marine Safety and Environmental Protection - Amends Federal law to declare that provisions relating to court sales of documented vessels do not apply to a documented vessel that has been operated only as a fishing vessel, a fish processing vessel, a fish tender vessel, or a documented vessel operated only for pleasure. (Sec. 402) Amends the Ports and Waterways Safety Act to prohibit general or public disclosure or inspection of information regarding security for passenger vessels or passenger terminals authorized under the Act. (Sec. 403) Amends Federal law to impose a civil penalty for failing to implement or conduct drug or alcohol testing prescribed by provisions relating to vessels and seamen or prescribed by the head of the department in which the Coast Guard is operating. (Sec. 404) Amends Federal law relating to transportation of hazardous material, the Ports and Waterways Safety Act, the Inland Navigational Rules Act, and Federal law relating to carriage of liquid bulk dangerous cargoes to mandate refusal or revocation of customs clearance to leave a port or a permit (under the Tariff Act of 1930) to depart if there is reasonable cause to believe that the owner, operator, or person in charge of a vessel may be subject to various penalties or fines under those Acts. (Sec. 405) Allows evaluation (notwithstanding specified provisions) of the service of an applicant for a license, certificate of registry, or merchant mariner's document by using the tonnage on which service was acquired. (Sec. 406) Amends Federal law to increase the penalties for failing to report a marine casualty or violating small vessel manning provisions. Title V: Establishment of Alternate Convention Tonnage (ITC) Thresholds - Amends Federal law relating to measurement of vessels to authorize the head of the department in which the Coast Guard is operating to prescribe, where a statute allows, an alternate tonnage. (Sec. 502) Allows alternate tonnage measurement by amending the Longshore and Harbor Workers Act, the Vessel Bridge-to-Bridge Radiotelephone Act, the Port and Tanker Safety Act, the Merchant Marine Act, 1920, the Maritime Education and Training Act of 1980, and numerous provisions of Federal law relating to vessels and seamen. Title VI: Miscellaneous Amendments - Amends the Magnuson Fishery Conservation and Management Act to define "vessel subject to the jurisdiction of the United States" as the term is defined in the Maritime Drug Law Enforcement Act. Makes it: (1) unlawful for any person on a vessel of the United States or subject to U.S. jurisdiction to engage in large-scale driftnet fishing beyond the Exclusive Economic Zone (EEZ) of any nation or within the U.S. EEZ; (2) a rebuttable presumption that any vessel in such areas with gear capable of use for that type of fishing is engaged in such fishing. (Sec. 602) Amends Federal law to allow the sale, by a modified negotiated sale, of recyclable Coast Guard materials when the estimated proceeds will not exceed a specified amount. (Sec. 603) Amends the Communications Act of 1934 to require ships of a certain tonnage to have a radio station complying with the International Convention for the Safety of Life at Sea. Ends certain exemptions from that requirement. Modifies the authority of the Federal Communications Commission (FCC) to exempt ships. Removes provisions allowing exemptions related to unforeseeable equipment failures and radio direction finding apparatus requirements. Specifies the FCC's authorities regarding ship radio installations for passenger and cargo vessels. Removes provisions relating to: (1) technical requirements of equipment on radiotelephone equipped ships; (2) survival craft; (3) approval of installations by the FCC; (4) safety information; and (5) master's control over operations. Title VII: State Recreational Boating Safety Funding - Amends Federal law (popularly known as the Federal Aid in Fish Restoration Act, the Fish Restoration and Management Projects Act, and the Dingell-Johnson Sport Fish Restoration Act) to mandate the distribution from the Sport Fish Restoration Account of certain amounts in specified fiscal years for grants under the Clean Vessel Act of 1992 and State recreational boating safety programs. Authorizes the head of the department in which the Coast Guard is operating to spend, under contracts with States, certain amounts for State recreational boating safety programs. Authorizes appropriations. Title VIII: Personnel Management Improvement - Amends Federal law to allow the Coast Guard to expend operating funds for recruiting. (Sec. 802) Authorizes the head of the department in which the Coast Guard is operating to make child development services available for members of the armed forces and Federal civilian employees. Authorizes expenditures. (Sec. 803) Declares that provisions of the National Defense Authorization Act for Fiscal Year 1993 relating to homeowners' assistance for individuals affected by hurricane Andrew apply to Coast Guard military personnel in the vicinity of Homestead Air Force Base, Florida. Requires that Coast Guard funds, limited in amount, be used. (Sec. 804) Amends Federal law relating to continuation of Coast Guard captains on active duty to remove provisions requiring dissemination to the service at large of the names of those selected for continuation. (Sec. 805) Prohibits counting, in computing authorized strength, Coast Guard Ready Reserve members ordered to active duty in an emergency. (Sec. 806) Requires lieutenants, selected for separation for failure of promotion and then selected (for the needs of the service) for continuation for two to four years, to further continue until they have completed 20 years of service if they have completed at least 18 years of service on the date specified for discharge. (Sec. 807) Authorizes the Coast Guard Commandant to: (1) obtain research on personnel resource and training needs; and (2) employ special programs for recruiting women and minorities, including using grants, cooperative agreements, and contracts. Terminates this authority on a specified date. Title IX: Navigation Safety and Waterway Services Management - Amends Federal law to remove provisions relating to fees for certain foreign vessel inspection. (Sec. 902) Amends Federal law relating to documentation of vessels to increase civil penalties for violations. Allows seizure and forfeiture of a documented vessel placed under the command of a non-U.S. citizen. (Sec. 903) Requires documented uninspected fishing vessels, fish processing vessels, and fish tender vessels to be operated by an individual licensed to operate that type of vessel. (Sec. 904) Amends the Outer Continental Shelf Lands Act to mandate a civil penalty for failure to comply with or violation of a regulation issued under the Act. (Sec. 905) Amends Federal law to authorize the head of the department in which the Coast Guard is operating to conduct informal investigations of marine casualties. Makes opinions, recommendations, deliberations, and conclusions in a report of a marine casualty investigation inadmissible as evidence and not subject to discovery in any civil, administrative, or State criminal proceeding arising from a marine casualty without the consent of the Secretary of Transportation. Title X: Marine Safety Management Improvements - Amends Federal law relating to uninspected commercial fishing industry vessels to add a requirement that vessels that operate beyond three miles from the coastline of the Great Lakes be equipped with alerting and locating equipment, including emergency position indicating radio beacons. (Sec. 1002) Declares that a person commits a class D felony if the person services or alters lifesaving, fire safety, or any other equipment subject to provisions relating to inspection and regulation of vessels so that the equipment is so defective as to be insufficient for its purpose. (Sec. 1003) Adds a requirement that, in order to be eligible for documentation, a vessel must be over a specified length. Title XI: Coast Guard Regulatory Reform - Coast Guard Regulatory Reform Act of 1995 - Authorizes the head of the department in which the Coast Guard is operating (the Secretary), in order to implement the International Management Code for the Safe Operation of Ships and for Pollution Prevention adopted by the International Maritime Organization and to establish voluntary alternative compliance programs, to prescribe regulations governing the U.S. merchant marine, merchant marine personnel, and shore-based management of vessels. (Sec. 1103) Authorizes the Secretary, in carrying out provisions relating to inspection and regulation of vessels, to use reports, documents, and certificates issued by persons the Secretary determines may be relied on regarding marine safety, security, and environmental protection. (Sec. 1104) Authorizes the Secretary to accept certain approvals of fire and life safety equipment and materials by foreign governments. (Sec. 1105) Modifies the required inspection frequency of specified types of vessels. (Sec. 1106) Eliminates the maximum time limit before an inspection certificate expires that the Secretary must be notified that inspection will be required or the vessel will not be operated so as to require inspection. (Sec. 1107) Allows the use of the American Bureau of Shipping or other classification society (currently, or a similar U.S. classification society) in connection with conducting and certifying vessel inspections. Title XII: Law Enforcement Enhancement - Amends Federal criminal law to make it unlawful to: (1) fail to land an aircraft or bring to a vessel of the United States or a vessel subject to U.S. jurisdiction on order of a Federal law enforcement officer; or (2) resist vessel boarding, arrest, or other law enforcement action authorized by Federal law. Allows a foreign nation to consent or waive objection to enforcement of U.S. law by radio, telephone, or similar oral or electronic means. Mandates imprisonment and fines for violation and authorizes aircraft and vessel seizure and forfeiture and liability in rem. (Sec. 1202) Amends Federal transportation law to require revocation of an aircraft's registration and the airman certificate of any person on failure to land. (Sec. 1203) Amends Federal law to authorize the Coast Guard to issue orders and make inquiries, searches, seizures, and arrests regarding U.S. law violations aboard any aircraft subject to U.S. jurisdiction. (Sec. 1204) Imposes a civil penalty upon a person, and in rem liability of a vessel or aircraft, for violations. (Sec. 1205) Amends provisions of the Tariff Act of 1930 relating to boarding vessels to define "authorized place" with respect to vehicles and aircraft. (Sec. 1206) Mandates a civil penalty for a person, makes an aircraft liable in rem, and provides for seizure, forfeiture, and sale of an aircraft for failure to comply with an order of a Federal law enforcement officer to land. Title XIII: Coast Guard Auxiliary Amendments - Amends Federal law to specify the Coast Guard Commandant's authorities regarding the Coast Guard Auxiliary. Deems the Auxiliary a U.S. instrumentality except when it acts outside its legislated purpose or forms a corporation under State law. (Sec. 1302) Declares that the Auxiliary's purpose is to assist the Coast Guard. (Sec. 1403 (sic)) Declares that Auxiliary members are not Federal employees except for certain situations. (Sec. 1304) Removes the word "specific" from provisions: (1) authorizing the use of Coast Guard appropriations for certain expenses of Auxiliary members assigned to authorized specific duties; and (2) relating to assignment of Auxiliary members to specific duties and related vesting in the Auxiliary members of the same power and authority as members of the regular Coast Guard assigned to similar duty. (Sec. 1305) Authorizes the Coast Guard to use Auxiliary members and facilities in assisting Federal agencies, States, Territories, possessions, or political subdivisions. (Sec. 1306) Deems motorboats, yachts, or aircraft, while assigned to Coast Guard duty, to be public vessels of the United States and vessels of the Coast Guard or Coast Guard aircraft. Deems (subject to specified provisions) Auxiliary pilots to be Coast Guard pilots. (Sec. 1308) Authorizes disposal of obsolete or unneeded Coast Guard material to the Auxiliary.

A bill to amend title XVI of the Social Security Act to deny SSI benefits for individuals whose disability is based on alcoholism or drug addiction, and for other purposes.

United States · United States Congress · 6 March 1995

Amends title XVI (Supplemental Security Income) (SSI) of the Social Security Act to deny SSI benefits for a disability if alcoholism or drug addiction would be a contributing factor material to the determination that the individual is disabled. Authorizes appropriations from the amount which would otherwise have been expended for FY 1997 through 2000 but for the amendments made by this Act for: (1) substance abuse treatment services grants through the Federal Capacity Expansion Program under the Public Health Service Act; and (2) the medication development project of the National Institute on Drug Abuse to improve drug abuse and drug treatment research.

Medicare Presidential Budget Savings Extension Act of 1995

United States · United States Congress · 6 March 1995

TABLE OF CONTENTS: Title I: Provisions Relating to Part A of the Medicare Program Title II: Provisions Relating to Part B of the Medicare Program Title III: Provisions Relating to Parts A and B of the Medicare Program Medicare Presidential Budget Savings Extension Act of 1995 - Title I: Provisions Relating to Part A of the Medicare Program - Amends part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act to prohibit updates on per diem cost limits on extended care services of skilled nursing facilities from taking into account any changes in routine service costs of such facilities occurring during cost reporting periods beginning during FY 1994 or 1995. Bars any change made by the Secretary of Health and Human Services in the amount of prospective payments to such facilities for cost reporting periods beginning on or after October 1, 1995, from taking into account changes in the costs of services occurring during cost reporting periods beginning in FY 1994 or 1995. Title II: Provisions Relating to Part B of the Medicare Program - Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to permanently set the monthly premium under the Supplementary Medical Insurance program at 50 percent of the monthly actuarial rate for enrollees age 65 and over. Title III: Provisions Relating to Parts A and B of the Medicare Program - Makes permanent specified Medicare secondary payer provisions currently scheduled to expire in FY 1998, including those with respect to disabled individuals in large group health plans and individuals with end-stage renal disease. Prohibits the Secretary, in establishing cost limits on home health services, from taking into account any changes in the costs of home health agency services with respect to cost reporting periods which began between July 1, 1994, and July 1, 1996.

Tuberculosis Prevention and Control Amendments of 1995

United States · United States Congress · 6 March 1995

Tuberculosis Prevention and Control Amendments of 1995 - Amends the Public Health Service Act to authorize appropriations for grants for the prevention, control, and elimination of tuberculosis. Includes services regarding incarceration in the purposes for which the grants may be expended. Increases the amount authorized to be reserved for emergency grants for geographic areas with high numbers or substantial increases in the number of cases. Authorizes appropriations for grants for bulk purchases of medications and other supplies regarding tuberculosis. Authorizes appropriations for expenditures (directly or through grants) for research, demonstration projects, public information and education, education of health professionals, support of centers, and collaboration with international organizations and foreign countries. Authorizes grants for the establishment and operation of not more than five centers to train health professionals regarding tuberculosis, including regarding screening and referral and provision of facilities and equipment. Mandates, directly or through contracts, evaluation of the centers. Authorizes appropriations. Authorizes appropriations for conducting or supporting research and research training on tuberculosis. Authorizes grants for: (1) construction or modernization of outpatient medical facilities located apart from hospitals and providing services for medically underserved populations; (2) conversion of existing facilities into outpatient medical facilities or long-term care facilities for such populations; (3) renovation of inpatient facilities; and (4) construction or renovation of facilities to provide services regarding incarceration. Authorizes appropriations.

To repeal statutory limitations on the transportation of chemical munitions.

United States · United States Congress · 3 March 1995

Repeals specified provisions of the Department of Defense Appropriations Act, 1995 and the National Defense Authorization Act for Fiscal Year 1995 which: (1) prohibit appropriated funds from being used to transport chemical munitions (munitions) to the Johnston Atoll for the purpose of storage or demilitarization; (2) prohibit the transportation of munitions across State lines; and (3) allow the transportation to the nearest storage facility of munitions which are not part of the chemical weapons stockpile only if considered necessary and able to be accomplished while protecting the public health and safety.

Medicare Diabetes Outpatient Self-Management Training Act of 1995

United States · United States Congress · 2 March 1995

Medicare Diabetes Outpatient Self-Management Training Act of 1995 - Amends title XVIII (Medicare) of the Social Security Act to provide for Medicare coverage of diabetes outpatient self-management training services.

To terminate the Office of the Surgeon General of the Public Health Service.

United States · United States Congress · 1 March 1995

Transfers all authorities, funds, and personnel of the Office of the Surgeon General of the Public Health Service to the Assistant Secretary for Health of the Department of Health and Human Services. Terminates the Office and the position of Surgeon General.

Henry W. Foster, Jr., of Tennessee, to be Medical Director in the Regular Corps of the Public Health Service, subject to qualifications therefor as provided by law and regulations, and to be Surgeon General of the Public Health Service, for a term of four years, vice M. Joycelyn Elders, resigned.

United States · United States Senate · 28 February 1995

To amend title XVIII of the Social Security Act to provide for uniform coverage under part B of the medicare program of blood-testing strips for individuals with diabetes.

United States · United States Congress · 28 February 1995

Amends part B (Supplemental Medical Insurance) of title XVIII (Medicare) of the Social Security Act to include within Medicare coverage the use of blood-testing strips for individuals with Type I or II diabetes. Requires such strips to be included within a payment methodology covering inexpensive and routinely purchased equipment.

To amend title XVIII of the Social Security Act to provide for coverage of diabetes outpatient self-management training services under part B of the medicare program.

United States · United States Congress · 28 February 1995

Amends title XVIII (Medicare) of the Social Security Act to provide for Medicare coverage of diabetes outpatient self-management training services.

Federal Employees Health Benefits Access Act

United States · United States Congress · 28 February 1995

Federal Employees Health Benefits Access Act - Prohibits a Government health services contract from being made or a plan approved unless the carrier agrees to offer to the general public the same benefits as would be offered under such contract or plan to Federal employees and annuitants and their family members. Requires premiums for coverage to be established in conformance with such requirements as the Office of Personnel Management (OPM) shall prescribe. Specifies that in no event shall this Act's enactment result in any: (1) increase in the level of individual or Government contributions required, including copayments or deductibles; (2) decrease in the types of benefits offered; or (3) other change that would adversely affect the coverage afforded to employees and annuitants and their family members. Permits a carrier to file an application with OPM setting forth reasons why it, or a plan provided by such carrier, should be excluded from the requirements of this Act. Allows OPM, in reviewing any such application, to consider such factors as: (1) any bona fide enrollment restrictions which would make the application of this Act inappropriate; (2) whether compliance would jeopardize the financial solvency of the plan or carrier or otherwise compromise its ability to offer health benefits; and (3) the anticipated duration of the requested exclusion and what efforts the plan or carrier proposes to take in order to be able to comply with this Act. Requires a claim for payment or reimbursement to be submitted on a standard form or in a standard manner as may be required by OPM in relation to health benefit plans. Directs OPM to: (1) prepare information relating to the use of advance directives regarding the type or intensity of care which an individual desires in the event that such individual becomes unable to communicate by reason of incapacity due to illness or injury; and (2) require, as a condition for contract approval, that appropriate provisions be included so that such information may be made available to enrollees of the plan involved. Requires OPM to conduct a demonstration project to assess the feasibility and desirability of offering the use of arbitration, instead of litigation, to resolve medical malpractice claims arising out of covered health care services. Sets forth provisions regarding project requirements and evaluation.

Multiple Sclerosis Home Treatment Act of 1995

United States · United States Congress · 28 February 1995

Multiple Sclerosis Home Treatment Act of 1995 - Amends title XVIII (Medicare) of the Social Security Act to provide coverage and payment for beta interferons approved by the Food and Drug Administration for self-administration by patients with multiple sclerosis.

Health Care and Housing for Women and Children Act of 1995

United States · United States Congress · 27 February 1995

TABLE OF CONTENTS: Title I: Maternal Health Certificates Program Title II: Rehabilitation Grants for Maternity Housing and Services Facilities Health Care and Housing for Women and Children Act of 1995 - Title I: Maternal Health Certificates Program - Directs the Secretary of Health and Human Services to establish a program to provide maternal health certificates for eligible pregnant women to cover expenses incurred at a maternity and housing services facility. Authorizes appropriations. Title II: Rehabilitation Grants for Maternity Housing and Services Facilities - Directs the Secretary of Housing and Urban Affairs to establish a program of rehabilitation grants for maternity housing and services facilities. Authorizes appropriations.

To amend title XVIII of the Social Security Act to require renal dialysis facilities to meet hemodialysis standards as a condition of receiving payment for renal hemodialysis services furnished under the medicare program.

United States · United States Congress · 27 February 1995

Amends title XVIII (Medicare) of the Social Security Act to require renal dialysis facilities to meet specified standards for adequate hemodialysis in order to receive payments for services under the Medicare program. Applies this Act to services furnished during cost reporting periods beginning on or after January 1, 1997.

To direct the Secretary of Health and Human Services to conduct a demonstration project under which payment shall be made under the medicare program for renal disease management services furnished to individuals at risk for end stage renal disease to accurately assess whether those management services can prevent the progression of renal disease to renal failure and thereby delay the onset of dialysis and cause savings for the medicare program.

United States · United States Congress · 27 February 1995

Requires the Secretary of Health and Human Services to conduct a three-year demonstration project at two sites under which payments shall be made under the Medicare program for renal disease management services furnished to eligible individuals in order to accurately assess whether those management services can prevent the progression of renal disease to renal failure and thereby delay the onset of dialysis and cause savings for the program. Describes eligible individuals and renal disease management services for purposes of this Act. Sets forth criteria for determining payment for renal disease management services covered, and not covered, under Medicare. Requires the Secretary to enter into a contract with an entity to monitor the project and to assess and make public the extent to which: (1) the implementation of renal disease management services produces increased job retention, preservation of meaningful and taxable income, or improvement in the quality of life; (2) such services affect the patient's functional outcome and or natural history of their kidney disease as compared to a control group; and (3) the implementation of such services has delayed the progression of renal disease and, therefore, the onset of dialysis.

Colorectal Cancer Screening Act of 1995

United States · United States Congress · 24 February 1995

Colorectal Cancer Screening Act of 1995 - Amends title XVIII (Medicare) of the Social Security Act to prescribe frequency and payment limits under Medicare part B (Supplementary Medical Insurance) for screening fecal-occult blood tests, flexible sigmoidoscopies, barium enemas, and colonoscopy.

Risk Assessment and Cost-Benefit Act of 1995

United States · United States Congress · 23 February 1995

TABLE OF CONTENTS: Title I: Risk Assessment and Communication Title II: Analysis of Risk Reduction Benefits and Costs Title III: Peer Review Title IV: Judicial Review Title V: Plan Title VI: Priorities Risk Assessment and Cost-Benefit Act of 1995 - Declares that this Act shall not apply to: (1) an emergency situation, in which case the agency head shall comply with this Act within as reasonable a time as is practical; (2) activities necessary to maintain military readiness; (3) any individual food, drug, or other product label, or any risk characterization appearing on any such label, if the individual product label is required by law to be approved by a Federal department or agency prior to use; and (4) Federal agency approval of State programs or plans. Title I: Risk Assessment and Communication - Risk Assessment and Communication Act of 1995 - Applies this title generally to all significant risk assessment and risk characterization documents, except: (1) screening analyses; (2) health, safety, or environmental inspections; or (3) the sale or lease of Federal resources or regulatory activities that directly result in collection of Federal receipts. (Sec. 104) Requires each covered Federal agency head to apply specified principles in order to assure that significant risk assessment documents and all of their components distinguish scientific findings from other considerations and are, to the extent feasible, scientifically objective, unbiased, and inclusive of all relevant data and rely, to the extent available and practicable, on scientific findings. (Sec. 105) Specifies the requirements that each significant risk characterization document is required to meet. (Sec. 106) Prohibits any covered Federal agency from automatically incorporating or adopting any recommendation or classification made by a non-United States-based entity concerning the health effects value of a substance without an opportunity for notice and comment. Requires compliance with this title by any risk assessment document or risk characterization document adopted by a covered Federal agency on the basis of such a recommendation or classification. (Sec. 107) Directs the President to: (1) issue guidelines for Federal agencies consistent with specified risk assessment and characterization principles; and (2) provide a format for summarizing risk assessment results. Requires such guidelines to include guidance on such subjects such as the evaluation of benign tumors and the use of different types of dose-response models. Requires the President to periodically review and revise such guidelines as appropriate. (Sec. 108) Directs each covered Federal agency head to do the following for periodic reports to the Congress: (1) regularly and systematically evaluate risk assessment research and training needs of the agency; and (2) develop a strategy and schedule for carrying out research and training to meet certain such needs. (Sec. 109) Requires the Director of the Office of Management and Budget (OMB) to provide for a study using comparative risk analysis to rank health, safety, and environmental risks and to provide a common basis for evaluating strategies for reducing or preventing those risks. Requires the Director to submit to the Congress a report of the National Research Council with recommendations regarding the use of comparative risk analysis and ways to improve the use of comparative risk analysis for decision-making in appropriate Federal agencies. (Sec. 110) Limits covered Federal agencies to: (1) the Environmental Protection Agency; (2) the Occupational Safety and Health Administration; (3) the Food and Drug Administration; (4) the Consumer Product Safety Commission; (5) the Department of Transportation; (6) the Department of Energy; (7) the Department of Agriculture; (8) the Department of the Interior; (9) the Nuclear Regulatory Commission; (10) the National Oceanic and Atmospheric Administration; (11) the U.S. Army Corps of Engineers; (12) the Mine Safety and Health Administration; and (13) other Federal agencies determined by the President, acting through the OMB Director. Title II: Analysis of Risk Reduction Benefits and Costs - Requires the President to require each Federal agency to prepare specified analyses for each new major rule within a program designed to protect human health, safety, or the environment. (Sec. 202) Requires that certain certifications be made in order for a final rule subject to this title to be promulgated. (Sec. 203) Directs OMB to issue guidance consistent with this title to: (1) assist the agencies, the public, and the regulated community in the implementation of this title, including any new requirements or procedures needed to supplement prior agency practice; and (2) govern the development and preparation of analyses of risk reduction benefits and costs. Title III: Peer Review - Requires each Federal agency head to develop a systematic program for independent and external peer review for regulatory programs designed to protect human health, safety, or the environment in connection with any risk assessment or cost analysis forming the basis of any rule likely to result in an annual increase in costs of $100 million or more. Exempts from such requirement any: (1) rule or other action taken by an agency to authorize or approve any individual substance or product; and (2) data or method which has been previously subjected to peer review or any component of any analysis or assessment previously subjected to peer review. Authorizes the OMB Director to order that peer review be provided for any major risk assessment or cost assessment likely to have a significant impact on public policy decisions. Directs the President to appoint National Peer Review Panels to review annually for a report to the Congress the risk and cost assessment practices of each Federal agency for programs designed to protect human health, safety, or the environment. Title IV: Judicial Review - Provides for judicial review under this Act. Title V: Plan - Requires each covered Federal agency to publish a plan to review and, where appropriate, revise significant risk assessment or characterization documents if the agency head determines that application of the appropriate specified principles for risk assessment and risk characterization and communication would be likely to alter significantly the results of the prior risk assessment or characterization. Provides for public participation and consultation in plan development. Title VI: Priorities - Directs the President, in order to assist in the public policy and regulation of risks to public health, to identify specified opportunities to reflect priorities within existing Federal regulatory programs designed to protect human health in a cost-effective and cost-reasonable manner. (Sec. 601) Requires the President to issue biennial reports to the Congress recommending priorities for modifications to, elimination of, or strategies for existing Federal regulatory programs designed to protect public health. Requires an agency to consider the priorities set forth in the report when preparing a budget or strategic plan for any such regulatory program.

Blood Products Advisory Committee Act of 1995

United States · United States Congress · 23 February 1995

Blood Products Advisory Committee Act of 1995 - Directs the Secretary of Health and Human Services to ensure that not fewer than one third of the voting members of the Blood Products Advisory Committee shall be: (1) individuals who have received blood products but not in connection with a professional or commercial activity; and (2) representatives of consumer organizations with expertise in blood products.

Birth Defects Prevention Act of 1995

United States · United States Congress · 22 February 1995

Birth Defects Prevention Act of 1995 - 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. Subjects the provisions of this Act to requirements of the Privacy Act. Applies all Federal laws relating to the privacy of information to data and information collected under this Act. Authorizes appropriations.

Family Health Care Coverage Act

United States · United States Congress · 22 February 1995

Family Health Care Coverage Act - Requires health plans that provide a family class of enrollment to offer and provide equal coverage to any child of an eligible individual who is less than 27 years of age, has never been married, has no dependents, and has a parent-child relationship with such individual.

Long-Term Care Insurance Standards and Consumer Protection Act of 1995

United States · United States Congress · 22 February 1995

Long-Term Care Insurance Standards and Consumer Protection Act of 1995 - Amends the Social Security Act to require the National Association of Insurance Commissioners (NAIC) or, if NAIC does not, the Secretary of Health and Human Services, to establish minimum Federal standards for long-term care insurance policies that incorporate specified requirements. Prohibits the offering of a long-term care insurance policy in a State unless the State has an approved regulatory program, or the policy has been certified by the State. Requires NAIC to: (1) issue guidelines governing endorsements for long-term care insurance policies; (2) establish requirements for long-term insurance agent training and certification; and (3) establish a Steering Committee on Long-Term Care Insurance Standards in order to make recommendations concerning such minimum Federal standards. Provides for enforcement of standards. Sets forth conditions for the approval of State regulatory programs by the Secretary. Authorizes appropriations. Directs the Secretary to study, develop, and report to the appropriate congressional committees on a standard measure of value for long-term care policies.

Birth Defects Prevention Act of 1995

United States · United States Congress · 22 February 1995

Birth Defects Prevention Act of 1995 - 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. Subjects the provisions of this Act to requirements of the Privacy Act. Authorizes appropriations.