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451 records in US in 1993
United States · United States Congress · 31 March 1993
Electoral Rights Enforcement Act of 1995 - Authorizes each State or the people thereof to prescribe the maximum number of terms to which a person may be elected or appointed to the Senate or the House of Representatives.
United States · United States Congress · 31 March 1993
TABLE OF CONTENTS: Title I: Grants to States for Alternative Dispute Resolution Systems Title II: Uniform Standards for Malpractice Claims Medical Care Injury Compensation Reform Act of 1993 - Title I: Grants to States for Alternative Dispute Resolution Systems - Directs the Secretary of Health and Human Services to make grants to States for the implementation and evaluation of alternative dispute resolution (ADR) systems. Requires the Secretary to: (1) designate each State receiving such a grant as a model ADR State (making such State eligible for a two-year extension); and (2) disseminate information on the ADR systems implemented by such States to other States, health care professionals and providers, and other interested parties. Directs the Secretary to: (1) develop and promulgate standards and regulations necessary to carry out the grant program, including qualification standards that States must meet to receive grants and regulations establishing State data gathering requirements; (2) take into account, in developing qualification standards, specified factors such as the effectiveness of such systems in supporting access to health care, encouraging improvements in the quality of care, resolving claims promptly, and providing predictable outcomes; (3) provide States with technical assistance; and (4) report to the Congress, within four years of the first grant, describing and evaluating the ADR systems implemented. Title II: Uniform Standards for Malpractice Claims - Specifies that, with respect to any health care liability action brought in a Federal or State court and any medical malpractice or medical product liability claim subject to an ADR system: (1) no person may be required to pay more than $100,000 in a single payment in damages for expenses to be incurred in the future, but shall be permitted to make periodic payments; (2) the total amount of damages that may be awarded to an individual and the family members of such individual for non-economic losses may not exceed $250,000; (3) the total amount of damages received by an individual shall be reduced by any other payment that has been or will be made to the individual to compensate such individual for the injury; (4) a claimant's attorney's fees may not exceed 25 percent of the first $150,000 of any award or settlement, or 15 percent of any additional amounts, paid to the claimant; (5) the total amount of punitive damages that may be assessed may not exceed twice the total amount of the damages awarded to compensate the claimant for losses resulting from the injury; and (6) the liability of each defendant for non-economic losses shall be several only and not joint, with each defendant liable only for non-economic losses allocated to the defendant in direct proportion to the defendant's percentage of responsibility. Establishes a two-year statute of limitations for medical malpractice and product liability claims, with an exception for minors under age six. Specifies that, in the case of a medical malpractice or product liability claim relating to services provided during labor or the delivery of a baby, if the defendant health care professional did not previously treat the plaintiff for the pregnancy, the trier of fact may not find that the defendant committed malpractice and assess damages against the defendant unless the malpractice is proven by clear and convincing evidence. Bars a defendant from being found to have committed malpractice unless the defendant's conduct at the time of providing the health care services was not reasonable, except where the claimant asserts that the defendant is liable under a strict liability theory. Bars the award of punitive damages with respect to any medical product liability claim alleged against a medical product producer if the drug or device that is the subject of the claim: (1) was subject to approval or premarket approval under the Federal Food, Drug, and Cosmetic Act by the Food and Drug Administration (FDA) with respect to the safety or performance of the drug or device or the adequacy of the packaging or labeling; (2) was approved by FDA; or (3) is generally recognized as safe and effective pursuant to conditions established by FDA and applicable regulations. Makes an exception in the case of withheld information, misrepresentation, or illegal payment to an FDA official for purposes of securing approval of the drug or device.
United States · United States Congress · 31 March 1993
Equitable Health Care for Severe Mental Illnesses Act of 1993 - Declares that it is the policy of the United States that: (1) persons with severe mental illnesses must not be discriminated against in health care; and (2) health care coverage, provided through any financing, must provide for the treatment of severe mental illnesses in a way that is equitable and commensurate with that provided for other major illnesses. Requires health care coverage, in order to be considered nondiscriminatory and equitable under this Act, to cover services that are essential to the effective treatment of severe mental illnesses in a manner that: (1) is not more restrictive than coverage provided for other major physical illnesses; (2) provides adequate financial protection to the person requiring the medical treatment for a severe mental illness; and (3) is consistent with effective and common methods of controlling health care costs for other major physical illnesses.
United States · United States Congress · 30 March 1993
Sensible Advertising and Family Education Act - Declares it to be an unlawful or deceptive act under the Federal Trade Commission Act to advertise through magazines, newspapers, brochures, and promotional displays any alcoholic beverage, unless the advertising includes one of specified health warnings. Requires the Secretary of Health and Human Services to maintain toll-free numbers referred to in some of the warnings.
United States · United States Congress · 30 March 1993
Equitable Health Care for Severe Mental Illnesses Act of 1993 - Declares that it is the policy of the United States that: (1) persons with severe mental illnesses must not be discriminated against in health care; and (2) health care coverage, provided through any financing, must provide for the treatment of severe mental illnesses in a way that is equitable and commensurate with that provided for other major illnesses. Requires health care coverage, in order to be considered nondiscriminatory and equitable under this Act, to cover services that are essential to the effective treatment of severe mental illnesses in a manner that: (1) is not more restrictive than coverage provided for other major physical illnesses; (2) provides adequate financial protection to the person requiring the medical treatment for a severe mental illness; and (3) is consistent with effective and common methods of controlling health care costs for other major physical illnesses.
United States · United States Congress · 30 March 1993
Rural Community Environmental Assistance Act of 1993 - Amends the Federal Water Pollution Control Act to extend the authorization of appropriations for State water pollution control revolving funds through FY 2000. Requires each State to establish a rural community environmental assistance account in such fund to be used only for the construction of wastewater treatment works and public water systems in economically distressed rural communities, subject to certain loan and grant conditions. Requires States to establish grant eligibility criteria. Permits assistance to be provided only if: (1) the wastewater treatment works is consistent with planning requirements under the Federal Water Pollution Control Act; and (2) the public water system is approved by the State agency with primary enforcement authority under the Safe Drinking Water Act. Requires States, in providing such assistance, to give priority to an economically distressed rural community in which: (1) there is a need for collector sewers and interceptors to improve access to wastewater treatment facilities; (2) residents rely on inadequate wastewater treatment facilities or drinking water systems that are determined by public health officials to be a hazard; or (3) residents rely on public water systems which do not meet requirements of the Safe Drinking Water Act. Requires States to submit plans for the intended uses of amounts in rural community environmental assistance accounts to the Administrator of the Environmental Protection Agency for approval. Permits the submission of a plan only if it has been approved by a State Rural Environmental Infrastructure Advisory Panel. Withholds payments from States that fail to comply with requirements for rural community environmental assistance accounts. Directs the Administrator to: (1) make grants to regional, State, and local agencies and not-for-profit organizations to assist economically distressed rural communities by providing technical assistance for the financing, operation, and maintenance of wastewater treatment works and public water systems; and (2) set aside appropriations for such grants.
United States · United States Congress · 30 March 1993
Comprehensive HIV Prevention Act of 1993 - Amends the Public Health Service Act to replace the title relating to the prevention of acquired immune deficiency syndrome (AIDS) with a new title on the prevention of human immunodeficiency virus (HIV) infection. Requires: (1) coordination of the HIV infection prevention activities of the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the National Institutes of Health (NIH), and the Substance Abuse and Mental Health Services Administration (designated agencies); (2) establishment of the Secretary's Advisory Council on HIV Prevention; (3) a comprehensive plan for each designated agency's activities; (4) submission directly to the President, for review and transmittal to the Congress, of a budget for carrying out each plan; and (5) establishment, within each designated agency other than NIH, of an office to prepare the plan and carry out related activities. Authorizes the conduct or support of: (1) activities to obtain epidemiological data; (2) community-based activities; (3) counseling and testing regarding HIV infection (and resulting conditions), referrals, and partner notification; (4) activities to provide information to the public and to special populations; (5) prevention activities regarding adolescents, including through school-based programs; and (6) prevention programs in addition to those specified in this Act. Authorizes appropriations. Authorizes technical assistance.
United States · United States Congress · 30 March 1993
Senior Home Care Choice Fairness and Improvement Act of 1993 - Amends title XIX (Medicaid) of the Social Security Act (SSA) to: (1) provide for the application of Medicaid spousal impoverishment rules to spouses of individuals receiving home- or community-based services; (2) increase the number of individuals allowed to receive such services; and (3) require hospitals to inform Medicaid patients of the availability of home care services and, in a State operating under a waiver program, to inform them of the availability of home- and community-based services. Mirrors such requirement with respect to Medicare (SSA title XVIII) patients.
United States · United States Congress · 30 March 1993
Health Insurance Fairness Act of 1993 - Amends the Social Security Act (SSA) to add a new title XXI, Health Plan Standards. Prohibits an individual health plan, and any person which issues such a plan, from denying, limiting, or conditioning coverage of benefits for an individual, or varying premiums charged, based on the individual's health status or claims experience, except that plans may, for a limited period, exclude coverage of services related to treatment of a preexisting condition. Sets forth similar prohibitions with respect to group health plans. Outlines general requirements for health plans issued to small employers, as well as requirements related to restrictions on rating practices. Requires individual and group plans to be certified by the Secretary of Health and Human Services or approved by a State regulatory program before such plans may be issued. Requires the Secretary to establish specific standards that incorporate the requirements of this Act for individual and group health plans. Provides for establishment of a toll-free telephone information system to: (1) handle the receipt and disposition of consumer complaints regarding plan compliance with applicable standards; and (2) provide information to small employers about insurers that offer health plans meeting such standards. Amends the Internal Revenue Code to impose an excise tax on issuers of plans that do not meet applicable standards established under this Act. Sets forth a formula for determining the amount of such tax. Requires the General Accounting Office to study and report to the Congress on the impact of the standards for rating practices for small group health insurance on the availability and price of insurance offered to small employers.
United States · United States Congress · 26 March 1993
Designates July 5 through 12, 1993, as National Awareness Week for Life-Saving Techniques.
United States · United States Congress · 25 March 1993
Makes technical corrections with respect to Federal provisions concerning the price of drugs purchased by the Department of Veterans Affairs and other Federal agencies. Provides for the determination of price of a drug of a manufacturer that was not available for inclusion under the original drug purchase contract at the time such contract went into effect. Amends the Social Security Act to establish the Medicaid (title XIX of such Act) prescription drug rebate limit for the last calendar quarter of 1992 as 50 percent of the average manufacturer price.
United States · United States Congress · 25 March 1993
Postreproductive Health Care Act - Amends the Public Health Service Act to mandate grants for: (1) prevention and outpatient treatment of, and counseling for, health conditions unique to, more serious, or more prevalent for women of menopausal age or older, or for which the medical risk or types of medical intervention are different; and (2) related education and training of health professionals. Authorizes appropriations.
United States · United States Congress · 25 March 1993
Prescription Drug Records Privacy Protection Act of 1993 - Amends the Federal criminal code to make any retailer of pharmaceutical products or services, physician, or administrator of a health benefit plan who knowingly discloses personally identifiable information contained in a prescription drug record of an individual liable to such individual. Makes exceptions with respect to any such disclosures: (1) to the individual; (2) with the informed, written consent of the individual; (3) to a law enforcement agency (LEA) pursuant to a warrant, a grand jury subpoena, or a court order; (4) to an LEA or health care agency for the purpose of addressing illegal drug diversion or improving prescribing practices; (5) pursuant to a court order in a civil proceeding upon a showing of compelling need for the information that cannot be accommodated by any other means, subject to specified conditions; and (6) to any person involved in the administration and review of health care services provided to the individual. Sets forth provisions regarding safeguards against unauthorized disclosure where court orders are granted. Permits persons aggrieved by any act of an individual in violation of this Act to bring a civil action in a U.S. district court for actual and punitive damages, costs, and other preliminary and equitable relief, subject to specified limitations.
United States · United States Congress · 24 March 1993
TABLE OF CONTENTS: Title I: Improving Enrollment Title II: Application of Other Medicaid Eligibility Rules Title III: Report Medicare Enrollment Improvement and Protection Act of 1993 - Title I: Improving Enrollment - Amends title XVIII (Medicare) of the Social Security Act (SSA) to require the Secretary of Health and Human Services' annual notice to Medicare beneficiaries to inform certain low-income Medicare beneficiaries of the requirements to qualify for Medicaid (SSA title XIX) payment of their Medicare out-of-pocket expenses and how to apply for such cost-sharing benefit. Requires such notice to be suitable for posting and distributed to physicians, medical facilities, and others receiving grants to provide services to older individuals. Mandates direct enrollment of Medicare part A (Hospital Insurance) eligibles by the Secretary. Requires the Secretary to establish a toll-free telephone number for information about such cost-sharing benefit. Amends the Medicaid program to: (1) require the Secretary to develop a simplified form for applying for such cost-sharing benefit for processing at social security offices; and (2) provide for a period of presumptive eligibility for medical assistance for individuals who qualify for such cost-sharing benefit without regard to whether a final determination of eligibility for such assistance has been made. Directs the Secretary to make grants to State agencies and organizations for the provision of outreach assistance to older individuals who may be eligible for such cost-sharing benefit. Authorizes appropriations. Title II: Application of Other Medicaid Eligibility Rules - Amends the Medicaid program to permit retroactive payments of medical costs incurred by certain low-income Medicare beneficiaries in or after the third month before the month in which such an individual applied for such cost-sharing benefit. Title III: Report - Directs the Secretary to report to the Congress on Department activities to ensure enrollment in and full implementation of such cost-sharing program.
United States · United States Congress · 24 March 1993
Veterans Health-Care Reform Act of 1993 - Directs the Secretary of Veterans Affairs to provide medical care as needed for any disability of a veteran who meets any of the following conditions: (1) the veteran has a service-connected disability; (2) the annual attributable income of the veteran does not exceed a specified amount; (3) the discharge or release from duty was for a disability incurred or aggravated in the line of duty; or (4) the veteran is in receipt of, or would be entitled to, disability compensation. Outlines provisions concerning the computation of the annual income and corpus of the estate of the veteran for purposes of determining annual attributable income. Outlines the various types of health care, services, and other benefits to which such qualifying veterans are entitled. Directs the Secretary to contract for needed care for such veterans when Department of Veterans Affairs facilities are geographically inaccessible, lack sufficient capacity, or are otherwise incapable of furnishing such care. Outlines requirements for such alternative care. Authorizes the Secretary to: (1) repair or replace any prosthetic device, hearing aid, spectacles, or related devices reasonably necessary to a veteran when damaged or destroyed by a fall or other accident; (2) furnish hearing assistance devices to veterans profoundly deaf and entitled to compensation on account of hearing impairment; and (3) contract for nursing home care for any veteran who has been furnished hospital care in the Philippines and who requires protracted nursing home care. Repeals a provision prohibiting the Secretary from furnishing care and treatment and rehabilitative services to veterans for alcohol and drug dependence and abuse after December 31, 1994, and requiring specific appropriation for such program. Repeals a provision limiting the payment of certain beneficiary travel expenses to and from Department medical facilities. Authorizes the Secretary (currently the United States) to recover the cost of certain care and services provided by the Department if such veteran would have received payment for receiving such care or services from a third party.
United States · United States Congress · 24 March 1993
Designates July 5 through 12, 1993, as National Awareness Week for Life-Saving Techniques.
United States · United States Congress · 23 March 1993
Freedom of Access to Clinic Entrances Act of 1993 - Amends the Public Health Service Act to subject to criminal penalties and a civil remedy persons who intentionally: (1) by force, threat of force, or physical obstruction injure, intimidate, or interfere with any person because that person is or has been obtaining abortion services or lawfully aiding another to obtain such services; or (2) damage or destroy the property of a medical facility because such facility provides abortion services. Directs the Secretary of Health and Human Services to conduct a study concerning the effect of such prohibited conduct on the delivery of reproductive health services for women and on the health and welfare of women throughout the United States. Requires the Secretary to conduct an investigation to determine whether any person has violated or is violating this Act. Permits the Secretary to obtain the assistance of the Attorney General or a State or local government agency in conducting such investigations. Directs the Secretary to immediately refer a violation to the Attorney General for appropriate action. Sets forth provisions regarding: (1) civil remedies (including compensatory and punitive damages, injunctive relief, and costs); and (2) action by the Attorney General (who may commence a civil action in any appropriate U.S. district court).
United States · United States Congress · 23 March 1993
TABLE OF CONTENTS: Title I: Managed Competition in Health Care Plans Subtitle A: Health Plan Purchasing Cooperatives Subtitle B: Accountable Health Plans (AHPs) Subtitle C: Federal Health Board Title II: Primary and Preventive Care Services Title III: Tax Incentives to Increase Health Care Access Title IV: Disclosure of Certain Information to Beneficiaries Under the Medicare and Medicaid Programs Title V: Cooperative Agreements Between Hospitals Title VI: Patient's Right to Decline Medical Treatment Title VII: Insurance Administration Simplification Title VIII: Child Health Care Title IX: Improving Access to Health Care for Rural and Underserved Areas Subtitle A: Revenue Incentives for Practice in Rural Areas Subtitle B: Public Health Service Act Provisions Title X: Primary and Preventive Care Providers Title XI: Malpractice Reform Title XII: Medicare Preferred Provider Demonstration Projects Title XIII: Treatment and Outcomes Research Title XIV: Long-Term Care Subtitle A: Tax Treatment of Qualified Long-Term Care Insurance Policies Subtitle B: Tax Incentives for Purchase of Qualified Long-Term Care Insurance Subtitle C: Medicaid Amendments Title XV: Financing Title XVI: Responsibilities Under Uniform Set of Effective Benefits Title XVII: Enforcement Provisions Comprehensive Access and Affordability Health Care Act of 1993 - Title I: Managed Competition in Health Care Plans - (Sec. 100) Mandates grants to States for the costs under this title. Authorizes appropriations. (Sec. 101) Requires States to establish Health Plan Purchasing Cooperatives (HPPCs) to: (1) make agreements with Accountable Health Plans (AHPs); (2) make agreements with small employers; (3) enroll individuals in AHPs; (4) receive premiums and forward the premiums to AHPs; and (5) coordinate with other HPPCs. (Sec. 104) Requires HPPCs to: (1) distribute comparative AHP information; and (2) add a percentage to premiums to cover the HPPCs' budgets. (Sec. 111) Requires that an AHP: (1) offer the uniform set of effective benefits specified by the Federal Health Board; (2) not discriminate on the basis of health status, claims, or lack of evidence of insurability (regulates preexisting condition exclusions); (3) establish standard premiums; (4) meet solvency protection requirements; and (5) have a grievance procedure for enrollees, restrict physician incentive plans, and meet requirements regarding advance directives. (Sec. 118) Sets forth additional requirements for open AHPs: (1) an agreement with a HPPC; (2) open enrollment; and (3) for "eligible organizations" under title XVIII (Medicare) of the Social Security Act, having a Medicare risk sharing contract for offering benefits to Medicare beneficiaries. Amends the Omnibus Budget Reconciliation Act of 1990 to make existing provisions relating to Medicare select policies effective after a specified date. (Currently, the provisions apply only in 15 States and only during a specified period.) Requires open AHPs to participate in the Federal Employees Health Benefits Program (FEHBP). Prohibits enrollment in a plan under FEHBP unless it is an AHP. Regulates the Federal FEHBP contribution. (Sec. 119) Requires an AHP that does not meet specified requirements of this title to pay the Board amounts as required to put the AHP in the same financial position as the AHP would have been in if it had meet the requirement. (Sec. 120) Preempts State laws or regulations regarding AHPs. (Sec. 121) Limits State restrictions on network plans (plans that: (1) limit coverage to benefits provided by participating providers; or (2) allow the use of non-participating providers, imposing higher cost sharing). (Sec. 122) Preempts State laws or regulations prohibiting or regulating activities under a utilization review program. (Sec. 131) Establishes the Federal Health Board, to be appointed by the President with the advice and consent of the Senate. (Sec. 132) Requires that the uniform set of effective benefits specified by the Board include the full range of: (1) treatment for any condition if the treatment reasonably improves or significantly ameliorates the condition; and (2) preventive services, including counseling. Mandates guidelines concerning nondiscrimination towards individuals with, and coverage for treatment of, severe mental illnesses. Requires uniform deductibles and cost-sharing. (Sec. 133) Requires the Board to establish as nonprofit corporations the Health Benefits and Data Standards Board and the Health Plan Standards Board to make recommendations to the Board. Provides funding through annual AHP registration fees. (Sec. 135) Provides for waivers to permit a State to use funds under title XIX (Medicaid) of the Social Security Act to enroll individuals in an AHP. (Sec. 136) Mandates: (1) rules for risk adjustment of premiums among AHPs by HPPCs; and (2) standards for information reporting by AHPs. (Sec. 138) Requires analysis, rating, and publication regarding the quality of care provided by specialized centers of care. (Sec. 139) Mandates a report on: (1) the extent that AHP enrollees have greater health service needs than the population of those eligible to enroll; (2) methods for reducing adverse impacts resulting from such adverse selection; and (3) the impact of requiring all eligible individuals to enroll. Title II: Primary and Preventive Care Services - (Sec. 201) Authorizes grants: (1) to States for coordinated, multidisciplinary, and comprehensive primary health care and social services for pregnant women and infants; and (2) for the development of model health and nutrition curricula for children in primary and secondary education. Authorizes appropriations. (Sec. 202) Amends the Public Health Service Act to authorize appropriations for: (1) immunization programs; (2) tuberculosis and sexually transmitted disease prevention programs; (3) migrant and community health centers; (4) health services for the homeless; (5) family planning services; (6) breast and cervical cancer prevention; (7) preventive health and health services block grants; and (8) early intervention services regarding human immunodeficiency virus (HIV) disease. Amends title V (Maternal and Child Health Services Block Grant) of the Social Security Act to authorize appropriations to improve the health of all mothers and children. (Sec. 203) Amends the Elementary and Secondary Education Act of 1965 to replace provisions relating to school health education with provisions mandating grants to States for local programs of comprehensive health education and prevention, early health intervention, and health education in elementary and secondary schools. Establishes the Office of Comprehensive School Health Education. Authorizes appropriations. (Sec. 204) Mandates grants to Head Start training agencies for training and technical assistance regarding health education to Head Start teachers and other child care providers. Reserves funds for the development of innovative model health education programs or curricula. Authorizes appropriations. (Sec. 205) Considers, for purposes of Internal Revenue Code provisions relating to medical care deductions, qualified expenditures for disease prevention and health promotion programs to be amounts paid for medical care. (Sec. 206) Mandates grants to States for assistance to businesses with not over 100 employees for the establishment and operation of work site employee wellness programs. Authorizes appropriations. Title III: Tax Incentives to Increase Health Care Access - (Sec. 301) Amends the Internal Revenue Code to allow a credit for a percentage of accountable health plan costs (amounts paid by individuals for insurance which constitutes Medicare) limited to the reference premium amount applicable in a HPPC area. Allows employers to make advance payments of such costs for employees with eligibility certificates. Coordinates such credit with other health insurance credits and deductions. Terminates the health insurance credit under earned income provisions. (Sec. 302) Disallows a deduction for the excess health plan expenses of any employer. (Sec. 303) Increases and makes permanent the deduction for health insurance costs of self-employed individuals from 25 percent to 100 percent. Limits such deduction to accountable health plan costs. (Sec. 304) Sets forth special rules for the deduction for health plan premium expenses. (Sec. 305) Excludes from the gross income of an employee employer-provided basic coverage under an accountable health plan. Title IV: Disclosure of Certain Information to Beneficiaries under the Medicare and Medicaid Programs - (Sec. 401) Amends title II (Old Age, Survivors, and Disability Insurance) (OASDI) of the Social Security Act to mandate regulations requiring each provider receiving payment under titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to: (1) make available to service recipients an annual report regarding rates of mortality and nosocomial infection, frequently-performed tests, and malpractice claims; (2) make certain information available before an invasive procedure or treatment is performed; and (3) inform individuals of their right to refuse information and treatment, to refuse provider attendance, and to leave the premises. (Sec. 402) Authorizes grants for outreach activities to inform Medicare beneficiaries of the information. Authorizes appropriations. Mandates a Medicaid outreach program. Title V: Cooperative Agreements Between Hospitals - (Sec. 502) Amends the Public Health Service Act to authorize the Attorney General to waive antitrust laws to permit hospitals to enter into cooperative agreements to share medical or high technology equipment or services, including drugs, devices, medical and surgical procedures, and organizational and support systems. Title VI: Patient's Right to Decline Medical Treatment - (Sec. 601) Prohibits State restrictions, except to protect a third party, on the right of: (1) a competent person to consent to or decline medical treatment; or (2) an incompetent person to consent to or decline medical treatment through mandated national forms containing advance directives and durable powers of attorney. Requires all health care providers to honor the forms. Shields providers who act in good faith from criminal or civil liability or professional discipline. Denies Medicare and Medicaid payment for services contrary to advance directives. (Sec. 603) Declares that this title does not permit, condone, authorize, or approve suicide or mercy killing or any affirmative act to end a human life. (Sec. 605) Requires conforming changes to policies relating to Medicare and Medicaid advance directives provisions. (Sec. 606) Requires that information on an individual's right to consent to or decline treatment be provided periodically to beneficiaries under titles II (Old Age, Survivors, and Disability Insurance) (OASDI), XVI (Grants to States for Aid to the Aged, Blind, or Disabled), XVIII (Medicare), and XIX (Medicaid) of the Social Security Act. (Sec. 607) Mandates recommendations to the Congress concerning the medical, legal, ethical, social, and educational issues related to this title. Title VII: Insurance Administration Simplification - (Sec. 701) Amends the Social Security Act to create a new title on health insurance. Establishes the Health Insurance Standards Commission, requiring it to: (1) make recommendations regarding implementation of the title; and (2) develop a long-term plan for computerized billing and eligibility and uniform standards for electronic data interchange. Requires that the resulting system: (1) not be mandatory for a provider in a whole-county nonmetropolitan Health Professional Shortage Area; and (2) apply to participants under titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act. Title VIII: Children's Health Care - (Sec. 801) Establishes a program under which local educational agencies receiving Federal assistance are required to offer basic health insurance coverage to eligible students in schools. Sets forth student eligibility requirements, including: (1) being uninsured for at least six months; and (2) not being covered by title XIX (Medicaid) of the Social Security Act. Authorizes withholding from a noncomplying local educational agency a specified percentage of Federal educational assistance. (Sec. 802) Amends the Internal Revenue Code to allow a tax credit for qualified amounts paid for policies under this Act. Phases out the credit as income goes from 100 percent to 200 percent of the poverty line. (Sec. 803) Requires development of a single model uniform application form and process for benefits under the Special Supplemental Food Program (WIC Program) of the Child Nutrition Act of 1966, the Maternal and Child Health Service Block Grant Program (title V) of the Social Security Act, and Medicaid (the Programs). (Sec. 804) Mandates grants to not more than five States for demonstration projects to encourage women to obtain prenatal and well-baby care under the Programs. (Sec. 805) Authorizes appropriations to carry out this title. Title IX: Improved Access to Health Care for Rural and Underserved Areas - (Sec. 901) Amends the Internal Revenue Code to allow a tax credit for service by a physician, physician assistant, or nurse practitioner who: (1) provides primary health services to individuals in a rural health professional shortage area; and (2) is not receiving a National Health Service Corps scholarship or loan repayment and is not fulfilling service obligations under those programs. Excludes National Health Service Corps loan repayments from gross income. Allows, with regard to elections to expense depreciable business assets, a higher aggregate cost to be taken into account for rural health care property in a rural health professional shortage area. Allows a deduction for interest paid on medical education loans by an individual performing services under an agreement to perform professional services in a rural community. Allows use of the deduction in computing adjusted gross income. (Sec. 911) Amends the Public Health Service Act to authorize appropriations to carry out provisions relating to the National Health Service Corps scholarship and loan repayment program. Earmarks certain portions to carry out provisions of this Act relating to federally qualified health centers (FQHCs). (Sec. 912) Mandates: (1) allotments to States for community based primary health care entities providing services to pregnant women and children to age three; and (2) grants to FQHCs and other entities for providing services for medically underserved populations or in high impact areas not currently served by an FQHC. Authorizes appropriations. Requires a study of the relationship and interaction between community health centers and hospitals in medically underserved areas. Authorizes appropriations. (Sec. 914) Authorizes grants for development and implementation of a plan for rural mental health outreach. Authorizes appropriations. (Sec. 915) Requires giving priority, in making grants under provisions of the Public Health Service Act relating to health professions education or to nurse education, to factors relating to medically underserved areas. Mandates grants to: (1) health professions institutions to expand training for individuals desiring to practice in or serve medically underserved communities; and (2) regional consortia to enhance and expand coordination among health professions programs, particularly in medically underserved rural areas. Authorizes appropriations. (Sec. 916) Authorizes grants for the development of networks among rural and urban health care providers to preserve and share resources and enhance the quality and availability of rural health care. Authorizes appropriations. (Sec. 917) Authorizes grants to develop and administer rural cooperatives to establish a case management and reimbursement system supporting the economic viability of essential public or private health services, facilities, health care systems, and resources. Requires the cooperative to: (1) facilitate negotiations among member providers and third party payers concerning reimbursement rates; (2) identify and implement a malpractice insurance program and pay a portion of the premiums of provider members; and (3) establish joint case management and patient care practice standards programs that members must meet in order to participate in the negotiations. Allows employers to join the cooperative in order to provide, through a third party payer, health insurance to their employees. Authorizes appropriations. Title X: Primary and Preventive Care Providers - (Sec. 1001) Amends Medicare provisions to modify or establish payment requirements regarding certified nurse midwives, nurse practitioners, clinical nurse specialists, and physician assistants. Mandates bonus payments for such individuals and for certified registered nurse anesthetists for service in health professional shortage areas. (Sec. 1002) Includes physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists in the Medicaid definition of "medical assistance" for which payment will be made. (Sec. 1003) Amends the Public Health Service Act to establish grants programs to: (1) provide medical (including osteopathic medical) students for programs to interest high school or college students in careers in general medical practice; and (2) develop strategies for recruiting and placing medical students interested in practicing general medicine. Authorizes appropriations. (Sec. 1004) Amends Medicare provisions to allow entities with approved medical residency training programs (as well as hospitals) to receive payments for direct medical education costs. Mandates payments for indirect costs of medical education. Modifies requirements regarding payments to hospitals for such indirect costs. Title XI: Malpractice Reform - Amends the Public Health Service Act to establish a program of grants to assist States in establishing prelitigation panels that identify claims of professional negligence that merit compensation, encourage resolution of meritorious claims prior to suit, and encourage withdrawal or dismissal of nonmeritorious claims. Authorizes appropriations. Title XII: Medicare Preferred Provider Demonstration Projects - (Sec. 1201) Provides for up to ten demonstration projects to test the effectiveness of providing payment under Medicare for primary and specialty procedures and services furnished by preferred provider organizations. Allows waiver of Medicare requirements as necessary. Title XIII: Treatment and Outcomes Research - (Sec. 1301) Authorizes establishment of a program for the conduct of clinical trials regarding promising new drugs and disease treatments. Authorizes appropriations. (Sec. 1302) Authorizes appropriations for the Agency for Health Care Policy and Research. Amends the Internal Revenue Code to impose a tax on health insurance premiums. Establishes the Trust Fund for Medical Treatment Outcomes Research and deposits the revenue from the tax in the Fund, making those amounts available for outcomes research. (Sec. 1303) Amends the Public Health Service Act to prohibit use of guidelines established by the Office of the Forum for Quality and Effectiveness in Health Care in any Federal or State action arising from health care services, except by a provider who is a party to the action. Requires, if introduced, that the guidelines establish a rebuttable presumption that the service prescribed by the guidelines is the appropriate standard of medical care. Title XIV: Long-Term Care - Subtitle A: Tax Treatment of Qualified Long-Term Care Insurance Policies - (Sec. 1403) Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation. (Sec. 1404) Provides for the exclusion as a death benefit of any amount paid to an individual under a life insurance contract because such individual is terminally ill, has a dread disease, or has been permanently confined to a nursing home. Subtitle B: Tax Incentives for Purchase of Qualified Long-Term Care Insurance - (Sec. 1411) Allows a tax credit for a percentage of qualified long-term care premiums. (Sec. 1412) Allows a deduction for expenses relating to long-term care and an exclusion from gross income of benefits received from long-term care insurance. (Sec. 1414) Allows a deduction for employers of contributions made for long-term care insurance if any refund or premium is applied to reduce the future costs of the plan or increase its benefits. (Sec. 1415) Allows the inclusion of such insurance in cafeteria plans. (Sec. 1416) Excludes from gross income amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangements to pay long-term care premiums and expenses. Increases the amounts of deductible contributions to individual retirement plans. (Sec. 1417) Excludes from gross income amounts received from the surrender, cancellation, or exchange of any life insurance contract if such amounts are used to pay premiums for long-term care insurance. (Sec. 1418) Authorizes the tax-free use of the gain from the sale of a principal residence for the purchase of long-term health care insurance. Subtitle C: Medicaid Amendments - (Sec. 1421) Amends title XIX of the Social Security Act (Medicaid) to set forth eligibility requirements for long-term care benefits and to require coverage of home and community-based long-term care. Title XV: Financing - (Sec. 1501) Repeals the dollar limitation on the amount of wages subject to hospital insurance tax. Title XVI: Responsibilities Under Uniform Set of Effective Benefits - (Sec. 1601) Requires that employment-related health plans not: (1) deny or condition coverage based on health, claims, or lack of evidence of insurability of an individual; (2) discourage coverage of preexisting conditions; (3) impose waiting periods; and (4) apply differently to employees of different income levels. Requires employer contributions to be the same or higher for employees of a specified low income as for higher-income employees. (Sec. 1602) Requires that, to be eligible for Federal benefits, an individual possess health insurance meeting the standards of this title, except for enrollment under title XVIII (Medicare) of the Social Security Act, the veterans' health care program, the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), the Indian health service program, and the Federal employees program. (Sec. 1603) Specifies the matters a self-insured health benefit plan must demonstrate in order to obtain certification as a health plan. (Sec. 1604) Requires providers, as a condition of participation in the health plan, to accept any payment specified by the Federal Health Board as full payment for the service performed. Title XVII: Enforcement Provisions - (Sec. 1701) Amends the Internal Revenue Code to set forth enforcement provisions for health plan carriers, providers, employers, and employees.
United States · United States Congress · 23 March 1993
Amends title V (Maternal and Child Health Services) of the Social Security Act to provide for an increase in funding for maternal and child health services block grants. Allows the use of such funding for programs to: (1) enhance and expand school health services; and (2) provide and promote integrated services for children.
United States · United States Congress · 23 March 1993
Prescription Drug Consumer Protection Act of 1993 - Establishes in the executive branch the Prescription Drug Price Review Board which shall review the prices of prescription drugs. Permits the Board, after notice and a hearing, to take such actions as may be necessary to revoke a drug patent, if the drug's manufacturer does not reduce the price of a drug found to have an excessive price.
United States · United States Congress · 23 March 1993
Sets forth the rule for the consideration of H.R. 670 (public health services for pregnant women).
United States · United States Congress · 23 March 1993
Expresses the sense of the Congress that any legislation enacted to reform the health care delivery system of the United States should: (1) ensure that the unique needs of rural residents are addressed and solved, that people who live in rural areas receive the same quality health care as others, and that rural health care services are coordinated effectively with existing systems and programs of medical, income, residential, and social support at the Federal, State, and local levels; (2) increase funding for programs that train health care professionals for rural practice and provide incentives for them to practice in rural areas, increase coordination among transportation programs, and increase funding to rural transit programs and to emergency medical services; and (3) encourage telecommunications consortia and other measures to ensure rural access to emerging medical technologies.
United States · United States Congress · 19 March 1993
Applies certain protections and remedies under the Whistleblower Protection Act of 1989 to current and former health care employees of the Department of Veterans Affairs.
United States · United States Congress · 19 March 1993
Declares that it is a shared interest of the public and private sectors at the Federal, State, and local levels to provide access to high quality, affordable health care coverage and services for every man, woman, and child in the United States, and that collectively we commit outselves to take the necessary steps towards that goal.
United States · United States Congress · 18 March 1993
TABLE OF CONTENTS: Title I: Requiring Employers to Provide Health Insurance Coverage for Employees and Dependents Title II: Provision of Health Insurance Through a Public Health Plan Title III: Cost Containment Subtitle A: Health Care Spending Amounts Subtitle B: Administrative Simplification Subtitle C: Malpractice Reform Title IV: Group Health Insurance Reform Title V: Changes in Medicare Program Title VI: Financing Provisions Subtitle A: General Provisions Subtitle B: Deductibility of Certain Health Insurance Costs Subtitle C: State Maintenance of Effort Title VII: Medicaid Provisions Flexible Medical Access and Cost Containment Act of 1993 - Title I: Requiring Employers to Provide Health Insurance Coverage for Employees and Dependents - (Sec. 101) Amends the Internal Revenue Code (IRC) to impose an excise tax on employers who fail to cover employees and their dependents under a qualified employer health plan. (Sec. 102) Amends the Social Security Act (SSA) to require employers to enroll their employees and dependents in a qualified employer health plan with a basic benefit package that at least mirrors the benefits provided under the public health plan created below or else pay such tax. Provides that a small employer may meet such requirements by purchasing coverage under the public plan. Allows a qualified employer health plan to be either a private or a self-insured plan, depending upon the employer's size. Allows employers to charge employees towards the cost of the premium for such basic coverage. Outlines additional requirements for qualified employer health plan premiums and cost-sharing and for low-income assistance for plan deductibles. Sets forth standards to certify qualified employer health plans. Requires the Secretary of Health and Human Services to: (1) establish procedures for periodic review and recertification of qualified employer health plans; and (2) terminate certification when the plan no longer meets such standards. Preempts certain State and Federal requirements concerning benefit and coverage rules. Applies this title to residents of the 50 States and the District of Columbia, but not Puerto Rico and U.S. territories. (Sec. 103) Amends IRC, the Employee Retirement Income Security Act of 1974, and the Public Health Service Act (PHSA) to repeal certain health insurance continuation requirements. Title II: Provision of Health Insurance Through a Public Health Plan - (Sec. 201) Amends SSA to create a public health plan similar to Medicare (SSA title XVIII) under which those U.S. citizens and resident aliens who are not Medicare beneficiaries or enrolled under a qualified employer health plan above, or under a Federal health plan, are eligible to enroll for basic health insurance benefits. Provides that, in order to meet the requirements of title I of this Act, a small or medium-size employer may provide for the enrollment of full-time employees and their dependents in the public health plan, but only under certain conditions. Makes individuals with income below the Federal poverty level who enroll in the plan on a non-employment basis eligible for assistance to limit or eliminate their cost-sharing oligations under the plan. Provides that the benefits under the public health plan shall generally be the same as those currently covered under Medicare, with certain exceptions. Requires payments for services under the public health plan to be based on rates established by the Secretary in accordance with specified standards and approved by the Federal Health Care Cost Containment Commission. Directs the Secretary to establish a global fee schedule for payment of obstetrical services with a disincentive for cesarean sections. Creates in the Treasury the Public Health Trust Fund to receive the funds generated from the excise taxes imposed under this Act as well as from other revenues dedicated to the support of the plan. Directs the Secretary to provide for the: (1) submission of claims under the new plans established by this Act using uniform forms; and (2) reporting to the Commission of information on required health services provided under this title. Requires the Secretary to establish a toll-free telephone number for information on the public health plan. Authorizes the Secretary to conduct demonstration projects to: (1) improve the delivery and quality of health care services under title I of this Act; and (2) increase the efficiency and effectiveness of the methods for paying for such services. Authorizes reciprocal coverage of foreign nationals whose home countries provide health benefits to U.S. citizens who reside there. Applies this title only to residents of the 50 States and the District of Columbia. Title III: Cost Containment - (Sec. 301) Sets national annual limits on the health expenditures of the public health plan and qualified employer health plans for services covered, adjusted each year as specified. (Sec. 302) Establishes the Federal Health Care Cost Containment Commission (Commission) to: (1) apportion overall health care spending among the States; (2) monitor State compliance with such apportionment; (3) approve payment rates in certain States; and (4) establish an appeals process for payment rates. (Secs. 303 and 304) Requires each State to establish a State Health Commission to: (1) allocate its health care spending apportionment among the health services furnished by different classes of providers; and (2) establish, and revise at the direction of the Commission, payment rates for such services which meet specified standards for approval by the Commission. (Sec. 305) Provides that payment rates approved under this title shall apply under Medicare and the public health plan. (Sec. 321) Details requirements for uniform health claims cards, systems to verify entitlement to plan benefits, uniform claims submission, electronic medical data reporting, uniform hospital cost reporting, and a study by the Physician Payment Review Commission on malpractice reform. Title IV: Group Health Insurance Reforms - (Secs. 401 and 402) Amends SSA and IRC, respectively, to: (1) require the Secretary to develop standards for employment-related group health insurance plans; and (2) impose an excise tax on group plan issuers failing to meet such standards, with specified exceptions. Directs the Secretary to provide for a toll-free telephone information and complaint system for the receipt and disposition of consumer complaints or inquiries about health plan compliance with this title and information to small employers about carriers that offer small employer health plans. Provides that under such standards, no group plans may discriminate on the basis of an individual's health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability. Provides for the same treatment of pre-existing condition exclusions under such group plans as provided under qualified employer health plans. Requires the Secretary to publish the names of issuers of insured employment-related small employer health plans that comply with this title. Requires any health insurance carrier offering small employer health plans to register with the Secretary. Requires such carriers to offer the same plan to all small employers within their community on a continuous, year-round basis. Allows a carrier to terminate or refuse to issue or renew, a plan only for nonpayment of premiums and fraud or misrepresentation. Prohibits a carrier from offering to, or issuing with respect to, a small employer a small employer health plan with a term of less than 12 months. Requires a plan to provide for benefits for all required health services. Prohibits a plan, however, from imposing cost-sharing with respect to basic benefits in excess of the deductibles and co-payments permitted. Requires premiums to be community-rated for a given geographic area. Prohibits a small employer carrier from varying the remuneration paid to a broker for the sale or renewal of any small employer health plan based on the claims experience associated with the group to which the plan was sold. Sets forth requirements relating to health maintenance organization enrollment of small employer employees. Title V: Changes in Medicare Program - (Secs. 501 through 504) Amends Medicare to add as Medicare benefits annual screenings for colorectal cancer for individuals over age 50 and for breast cancer for women over 64, vaccinations for influenza and tetanus-diphtheria, and well-child care services. (Sec. 505) Directs the Secretary to provide for demonstration projects providing for Medicare coverage of other specified preventive services to determine whether to cover such services under Medicare part B (Supplementary Medical Insurance). Authorizes appropriations. (Sec. 506) Directs the Director of the Office of Technology Assessment (OTA) to conduct a study to develop a process to review Medicare coverage of preventive services. Title VI: Financing Provisions - (Sec. 601) Amends IRC to remove limitations on the contribution base for the hospital insurance tax. (Secs. 611 and 612) Allows self-employed individuals to deduct the full amount paid for health insurance costs (currently, such deduction is limited to 25 percent of such costs). Repeals the termination date for such deduction, extending it indefinitely. Applies special rules for such individuals and personal corporations before employer health plan requirements take effect. (Sec. 613) Allows small employers (those employing fewer than 100 employees) a deduction of 20 percent of the insurance premiums paid for qualified employee coverage. Title VII: Medicaid Provisions - (Sec. 701) Amends SSA title XIX (Medicaid) to: (1) limit Federal financial participation for covered public health plan services; and (2) provide for continuation of Medicaid benefits not covered under the public health plan and nonduplication of benefits with such plan.
United States · United States Congress · 18 March 1993
Alcohol Ingredient Labeling Act of 1993 - Amends the Federal Food, Drug, and Cosmetic Act to deem a malt beverage, wine, or distilled spirit mislabeled unless it bears a label disclosing: (1) the alcoholic content; (2) the number of drinks (defining "drink" as .6 ounces of alcohol); (3) its ingredients and calories; (4) the common name of each ingredient, including additives; and (5) a toll-free number for help with a drinking problem. Authorizes appropriations for the toll-free number.
United States · United States Congress · 18 March 1993
Animal Medicinal Drug Use Clarification Act of 1993 - Amends the Federal Food, Drug, and Cosmetic Act to permit the extra-label use of drugs in animals if such use is upon the order of licensed veterinarian, is in compliance with appropriate regulations, and is in the context of a veterinarian-client-patient relationship. Prohibits such use if it results in unacceptable residues of a drug in food.
United States · United States Congress · 18 March 1993
Designates November 1993 and 1994 as National Hospice Month.
United States · United States Congress · 17 March 1993
Medicare Diabetes Outpatient Self-Management Training Act of 1993 - Amends title XVIII (Medicare) of the Social Security Act to provide for Medicare coverage of diabetes outpatient self-management training services.
United States · United States Congress · 16 March 1993
Designates the weeks beginning April 18, 1993, and April 17, 1994, as National Organ and Tissue Donor Awareness Week.
United States · United States Congress · 16 March 1993
Creates the Congressional Office of Inspector General (Office), independent of the executive departments and under the control and direction of the Speaker and minority leader of the House of Representatives. Sets forth the functions of the Office. Makes an Inspector General (Inspector), to be appointed by the Speaker and minority leader, head of the Office for a seven-year term, unless removed by the Speaker and minority leader for cause. Makes the Inspector ineligible for reappointment. Requires the Inspector to appoint: (1) an Assistant Inspector General for Auditing to supervise the auditing of the office procedures and operations of each Member or committee of the House and any other House office whose employees are paid by the Clerk; and (2) an Assistant Inspector General for Investigations to supervise investigations of such office procedures and operations. Sets forth the duties and responsibilities of the Inspector. Requires each Inspector General to report annually to the Speaker and minority leader of the House. Authorizes the Inspector to receive and investigate complaints or information from a House employee concerning the possible existence of a violation of law or the Rules of the House, mismanagement, gross waste of funds, abuse or authority, or a substantial and specific danger to the public health and safety. Prohibits the Inspector, upon receiving the complaint or information, from disclosing the complainant's identity without the employee's consent, unless such disclosure is unavoidable during the course of the investigation. Prohibits any employee who has authority to take, directs others to take, or recommends or approves any personnel action from taking action against an employee as reprisal for making a complaint or disclosing information to an Inspector, unless the complaint was false and the complainant knew this or willfully disregarded truth or falsity. Repeals a provision of the Rules of the House which establishes and outlines the duties of an Inspector General.
United States · United States Congress · 12 March 1993
Establishes the budget for FY 1994 and sets forth appropriate budgetary levels for FY 1995 through 1998. Sets forth recommended budgetary levels of Federal revenues, new budget authority, budget outlays, deficits, public debt, and credit activity. Sets forth the increase in the public debt subject to limitation. Displays Federal retirement trust fund balances. Sets forth Social Security trust fund revenues and outlays for Senate enforcement purposes. Sets forth funding levels for each major functional category. Requires the House and Senate Budget Committees to report a reconciliation bill or resolution or both to their respective Houses carrying out all recommendations of House committees concerning changes in laws to provide direct spending sufficient to reduce outlays. Expresses the sense of the Congress that: (1) the Government should sell assets from time to time; and (2) the amounts realized from such sales will not recur on an annual basis and do not reduce the demand for credit. Allows budget authority and outlay allocations for legislation that increases funding for certain purposes when legislation has been reported that will not, if enacted, increase the deficit for FY 1994 through 1998. Describes such purposes as funding: (1) to improve the health and nutrition of children and to provide for services to protect children and strengthen families; (2) for economic growth initiatives for unemployment compensation and related programs; (3) to make continuing improvements in ongoing health care programs and comprehensive health care reform; (4) to improve educational opportunities for individuals at the early childhood, elementary, secondary, or higher education levels, or to invest in America's children; (5) to preserve and rebuild the United States maritime industry; (6) to reform the financing of Federal elections; and (7) to implement trade-related legislation. Limits the levels of social security outlays and revenues for this resolution to the current services levels. Establishes Senate enforcement procedures to extend the system of discretionary spending limits to budget resolutions for FY 1996 through 1998 and enforce pay-as-you-go spending. Expresses the sense of the Senate with respect to debt limit reconciliation.
United States · United States Congress · 11 March 1993
TABLE OF CONTENTS: Title I: Safety and Health Programs Title II: Safety and Health Committees and Employee Safety and Health Representatives Title III: Coverage Title IV: Occupational Safety and Health Standards Title V: Enforcement Title VI: Protection of Employees from Discrimination Title VII: OSHA Training and Education Title VIII: Recordkeeping and Reporting Title IX: NIOSH Title X: State Plans Title XI: Victims' Rights Title XII: Construction Safety Title XIII: Administration Title XIV: Effective Date Comprehensive Occupational Safety and Health Reform Act - Amends the Occupational Safety and Health Act of 1970 (OSHA) with respect to occupational safety and health programs, committees, employee representatives, coverage, standards, enforcement, antidiscrimination, training and education, hazard and illness evaluation, State plans, and victims' rights. Title I: Safety and Health Programs - (Sec. 101) Amends OSHA to establish requirements for each employer to set up and carry out a written occupational safety and health program that includes specified methods and procedures. Title II: Safety and Health Committees and Employee Safety and Health Representatives - (Sec. 201) Amends OSHA to require each employer of 11 or more employees (each for 20 or more hours per week) to provide for: (1) health committees; and (2) employee safety and health representatives. Authorizes the Secretary of Labor (the Secretary), upon the employer's application, to approve establishment of an alternative method of employee participation in worksite health and safety activities in a manner at least as effective as committee participation, if such alternative mechanism meets specified conditions. (Sec. 202) Provides for employee participation in the Secretary's inspections of workplaces. Title III: Coverage - (Sec. 301) Revises the OSHA definition of employer to extend OSHA coverage to States and local government employees. (Sec. 302) Directs the Committee on House Administration of the House of Representatives to establish a comprehensive occupational safety and health program meeting specified OSHA and other requirements. (Sec. 303) Applies OSHA to employment performed in Federal nuclear facilities under the control or jurisdiction of the Department of Energy. (Sec. 304) Extends an employer's duties under OSHA to all employees working at the place of employment (even if they are not the employer's employees). Title IV: Occupational Safety and Health Standards - (Sec. 401) Specifies timeframes and procedures for setting OSHA standards. (Sec. 403) Requires each OSHA standard to prescribe requirements for recording or reporting work-related adverse medical conditions determined as a result of medical examinations or test. (Sec. 404) Requires public disclosure of all communications on OSHA standards with parties outside the Department of Labor, including those with executive branch officials (except the President). (Sec. 405) Directs the Secretary, in cooperation with the Secretary of Health and Human Services (HHS) acting through the National Institute for Occupational Safety and Health (NIOSH) to modify and establish exposure limits for toxic materials and harmful physical agents on a regular basis in a specified manner. (Secs. 406 and 407) Directs the Secretary to promulgate final standards: (1) on exposure monitoring and medical surveillance programs; and (2) on ergonomic hazards to protect employees from work-related musculoskeletal disorders. (Sec. 408) Requires that emergency temporary standards: (1) be issued based on the best available evidence; and (2) remain in effect for no more than 18 months (currently six months). (Sec. 409) Directs the Secretary to issue, within 60 days, an interim final regulation reducing permissible exposure limits to toxic substances, including a specified final rule on air contaminants and a proposed rule on air contaminants for construction, agriculture, and maritime. Title V: Enforcement - (Sec. 501) Provides that time spent by an employee in accompanying the Secretary's representative on an OSHA inspection shall be deemed hours worked, with no loss of wages, benefits, or other terms and conditions of employent. (Sec. 502) Requires the Secretary to notify employees or their representatives, within 30 days after receipt of their request for inspection, of the Secretary's determination that there no reasonable grounds to believe a violation or danger exists. (Sec. 503) Requires the Secretary to make a special inspection upon notification by any Federal or State agency of reasonable grounds to believe that a violation of OSHA or specified safety and health standards exists that threatens physical harm. (Sec. 504) Directs the Secretary to carry out a special emphasis inspection program for conducting inspections of industries or operations where existing hazards or newly recognized or new hazards introduced into work sites warrant more intensive than normal inspections. (Sec. 505) Requires the Secretary to investigate any work-related death or serious incident resulting in hospitalization of two or more employees. Requires the employer to: (1) notify the Secretary of any death or serious incident occurring in a place of employment covered by OSHA; and (2) prevent the destruction or alteration of evidence that would assist in an investigation. (Sec. 506) Revises provisions for abatement of serious hazards during employer contests to a citation. (Sec. 507) Grants employees the right to contest a citation's designation of the character of a violation or any proposed penalties as inadequate. (Sec. 508) Grants employee representatives the right to participate in other proceedings (as well as hearings) conducted under specified OSHA enforcement procedures. (Sec. 509) Requires the Occupational Safety and Health Review Commission's rules of procedure to provide for prompt notice to affected employees or their representatives if the Secretary intends to withdraw or modify a citation as a result of any agreement with the employer. Grants employees or their representative, regardless of whether they have previously elected to participate in the proceedings, the right to object to modifications or withdrawals of citations. (Sec. 510) Revises OSHA provisions for restraining imminent dangers. Grants employees the right to refuse to perform a duty identified as the source of an imminent danger, and prohibits discrimination against them for such refusal. Specifies a civil penalty against an employer for each day during which an employee continues to be exposed. (Sec. 511) Authorizes the Secretary to issue citations and assess penalties for violations of specified OSHA provisions relating to: (1) inspections, investigations, and recordkeeping; (2) safety and health programs; (3) safety and health committees; and (4) construction plans and programs. (Sec. 512) Revises OSHA criminal penalties to subject to them not only the employer but also certain officers, management officials, and supervisiors. Increases the maximum amount of fines and length of prison terms for specified violations. Establishes criminal penalties for a willful violation that causes serious bodily injury (currently, death only). Prohibits a penalty or fine imposed on a director, officer, or agent of an employer from being paid out of the employer's assets. Provides that nothing in OSHA shall preclude State and local law enforcement agencies from conducting criminal prosecutions. (Sec. 514) Directs the Secretary to establish an effective system for targeting inspections of worksites, with priority given to those with a high potential for death, serious injury, or exposures to toxic materials or harmful physical agents. (Sec. 515) Provides for the vacating of specified citations for violations if the employer demonstrates that certain conditions involving adequate employee training and work rule enforcement have been met. Title VI: Protection of Employees from Discrimination - (Sec. 601) Extends OSHA antidiscrimination coverage to employees: (1) reporting any injury, illness, or unsafe condition to the employer, employer's agent, safety and health committee, or employee safety and health representative; and (2) refusing to perform duties when reasonably apprehensive that doing so would result in serious injury to themselves or other employees, after having sought and been unable to obtain from the employer corrections of the circumstances causing such refusal. Revises procedures for consideration of discrimination complaints. Revises remedies. (Sec. 602) Requires the Secretary's regulations to include provisions requiring employers to post employee rights protections under such OSHA antidiscrimination provisions. Title VII: OSHA Training and Assistance - (Sec. 701) Requires the Secretary to develop and disseminate curricula, model programs, and other information and materials to assist employers in complying with OSHA standards and requirements for safety and health programs, employee training and education, and safety and health committees. Directs the Secretary to establish a program to provide technical assistance and consultative services concerning worksite safety and health to employers and employees. Requires targeting of such assistance and consultation at small employers, high hazard worksites, and high hazard industries. Directs the Secretary to award: (1) grants for regional or State safety resource councils or centers; and (2) excellence awards to employees and other organizations. (Sec. 702) Establishes in the Treasury a revolving fund, the OSHA Assistance Fund, to pay for such programs. Directs the Secretary to impose fees to offset program costs. Title VIII: Recordkeeping and Reporting - (Sec. 801) Requires the Secretary to collect information and conduct analyses identifying: (1) industries, employers, processes, operations, and occupations, with a high rate of injury or illness; (2) factors that cause or contribute to injuries and illnesses; (3) workers' compensation costs associated with injuries and illnesses; and (4) employee exposure to toxic substances and harmful physical agents. Directs the Secretary to require each employer covered by OSHA to report: (1) each work-related death of an employee immediately upon knowledge; and (2) each serious incident resulting in hospitalization of two or more employees within 24 hours of the incident. (Sec. 802) Revises OSHA requirements for employer records and reports to include work-related illnesses reported by an employee or an employee's physician, unless the employer makes a reasonable determination that the illness is not work-related. (Sec. 803) Requires all such employer records and reports to be made available to the Secretary, the Secretary of HHS, employees, and employee representatives. Title IX: NIOSH - (Sec. 901) Requires NIOSH hazard to evaluation reports to evaluate whether any potentially hazardous condition or harmful physical agent found in the place of employment poses a risk to exposed employees. (Sec. 902) Directs the Secretary of HHS to identify major factors contributing to occupational injuries and deaths through accident investigations and epidemiological research. (Sec. 903) Extends the authority of the Secretary of HHS, and of NIOSH, to inspect records to the Secretary's designees and contractors. (Sec. 904) Directs the Secretary of HHS to establish a national surveillance program to identify cases of occupational illnesses, deaths, and serious injuries. (Sec. 905) Establishes NIOSH as a separate agency within the U.S. Public Health Service in the Department of HHS. (Sec. 906) Includes education programs for employees and members of safety and health committees under NIOSH training provisions. Title X: State Plans - (Secs. 1001 and 1002) Revises OSHA requirements for State plans to provide for: (1) development of safety and health programs and safety and health committees and training programs that are at least as effective as those under the new OSHA requirements; and (2) reporting requirements, protection of employee rights, and access to information that are at least as effective as those under OSHA or other Federal laws governing access to information related to OSHA. (Sec. 1003) Requires a State to enforce a Federal OSHA standard until a State standard at least as effective is in effect, if a State fails to adopt or promulgate such a standard within six months after the Federal standard is promulgated. (Secs. 1004 and 1005) Sets forth requirements and procedures for the Secretary of Labor to: (1) investigate complaints against a State's compliance with and enforcement of the State plan; and (2) take corrective action against such State noncompliance. (Sec. 1006) Requires States operating State safety and health plans to conform them to this Act. Title XI: Victims' Rights - (Sec. 1101) Provides for victims' rights under OSHA, including family members as well as the injured employee. Title XII: Construction Safety - Construction Safety, Health, and Education Improvement Act of 1993 - (Sec. 1203) Amends OSHA to establish in the Occupational Safety and Health Administration (the Administration) an Office of Construction Safety, Health, and Education (the Office). Directs the Secretary of Labor (the Secretary) to: (1) identify construction employers with high rates of fatalities or lost workday injuries or illnesses or with patterns of noncompliance with health and safety requirements; (2) develop a system for notifying such employers; (3) establish courses and curricula for training OSHA inspectors an other OSHA employees with construction safety and health duties; (4) establish model compliance programs and assist employers, employees, and their representative organizations in setting up their training programs; and (5) establish a toll-free line on which reports, complaints, and notifications required under OSHA may be made. Establishes within the Administration the position of Deputy Assistant Secretary of Labor for Construction. (Sec. 1203) Establishes requirements for construction safety and health plans and programs, involving construction employers and designated project constructors and coordinators. (Sec. 1204) Directs the Secretary to establish an effective targeting system for general schedule construction inspections. Directs the Secretary to require constructors to report promptly any incident involving construction work that results in a fatality, an injury or illness causing two or more hospitalizations, or a structural failure or fire or explosion which caused or could have caused serious bodily injury to employees. (Sec. 1206) Expands the advisory jurisdiction of the Advisory Committee on Construction Safety and Health (the Committee). (Sec. 1207) Requires any State construction safety and health plan to contain requirements at least as effective as those imposed by the Act and the Contract Work Hours and Safety Standards Act. (Sec. 1208) Establishes in OSHA a Construction Safety and Health Academy to train OSHA employees who conduct construction worksite inspections, and others the Secretary considers appropriate. (Sec. 1209) Considers a project constructor an employer for specified OSHA enforcement purposes. (Sec. 1210) Directs the Secretary to report to the President and the Congress annually on the construction industry and after three years on whether the office should be continued or a Construction Industry Safety and Health Administration should be established in the Department of Labor. (Sec. 1211) Directs the Secretary to recommend to specified congressional committees any legislative changes required to make safety records (including records of compliance with Federal safety and health laws and regulations) one criterion considered in the awarding of Federal construction contracts. Title XIII: Administration - (Sec. 1301) Establishes an Occupational Safety and Health Administration in the Department of Labor, to be headed by an Assistant Secretary of Labor for Occupational Safety and Health. Title XIV: Effective Date - (Sec. 1401) Sets forth the effective date of this Act.
United States · United States Congress · 11 March 1993
Local Exchange Infrastructure Modernization Act of 1993 - Amends the Communications Act of 1934 to require the Federal Communications Commission (FCC) to exercise its authority to: (1) preserve and enhance universal telephone service at reasonable rates; (2) achieve universal availability of advanced network capabilities and information services; (3) assure a seamless nationwide distribution network through joint network planning, coordination, and service arrangements between and among local exchange carriers (LECs); (4) maintain high standards of quality for advanced network services; and (5) assure adequate communication for the public health, safety, defense, education, national security, and emergency preparedness. Defines "local exchange carrier" for purposes of such Act. Requires the FCC to prescribe regulations that require: (1) joint coordinated network planning, design, and cooperative implementation among all LECs in the provision of public switched network infrastructure and services; (2) development of standards for interconnection between the LEC public switched network and others by appropriate standard-setting bodies; and (3) a LEC to share public switched network infrastructure and functionality with requesting LECs which serve a geographic area for which they lack economies of scale or scope for the particular required network functionality.
United States · United States Congress · 11 March 1993
Local Exchange Infrastructure Modernization Act of 1993 - Amends the Communications Act of 1934 to require the Federal Communications Commission (FCC) to exercise its authority to: (1) preserve and enhance universal telephone service at reasonable rates; (2) achieve universal availability of advanced network capabilities and information services; (3) assure a seamless nationwide distribution network through joint network planning, coordination, and service arrangements between and among local exchange carriers (LECs); (4) maintain high standards of quality for advanced network services; and (5) assure adequate communication for the public health, safety, defense, education, national security, and emergency preparedness. Defines "local exchange carrier" as a carrier that: (1) is required to provide upon request, under tariff or subject to other government oversight (by the FCC or a State commission), interstate and intrastate access services and telephone exchange service; (2) is, or was, a participant in one or more interstate pools established by the FCC, or would have been required to participate in one or more such pools had the carrier been engaged in interstate and intrastate access and telephone exchange service while such participation was mandatory; (3) is subject to the requirements imposed by the FCC or a State commission related to the provision of equal access; and (4) conforms with the provisions of the North American Numbering Plan applicable to the assignment of numbering resources for telephone exchange service, as defined by the Plan's Administrator. Requires the FCC to prescribe regulations that require: (1) joint coordinated network planning, design, and cooperative implementation among all LECs in the provision of public switched network infrastructure and services; (2) development of standards for interconnection between the LEC public switched network and others by appropriate standard-setting bodies; and (3) a LEC to share public switched network infrastructure and functionality with requesting LECs which serve a geographic area for which they lack economies of scale or scope for the particular required network functionality.
United States · United States Congress · 11 March 1993
Federal Research Product Commercialization Act - Amends the Public Health Service Act to require that a biomedical research project relating to the development of a drug, device, or other tangible product may not be supported by the National Institutes of Health (NIH) unless there is in effect an agreement ensuring that any commercial parties involved in the project make the product available to the public at a reasonable price and that the commercial parties pay NIH royalties reasonably related to the amounts NIH spent with respect to the product.
United States · United States Congress · 11 March 1993
Chemical Control Amendments Act of 1993 - Amends the Comprehensive Drug Abuse Prevention and Control Act of 1970 to: (1) replace references to "listed precursor chemicals" with "list I chemicals" and "listed essential chemicals" with "list II chemicals"; and (2) revise the definitions of "regulated person" (to include individuals who act as brokers or traders for international transactions involving a listed chemical, tableting machine, or encapsulating machine) and "regulated transaction" (to include international transactions involving shipment of a threshold amount of a listed chemical and to exclude specified transactions). Removes the exemption for products in which ephedrine is the only active medicinal ingredient in therapeutic amounts. Permits the Attorney General to remove the exemption for other drugs containing listed chemicals if it is determined that they are being diverted for use in the illicit production of a controlled substance, with exceptions. Provides registration requirements for list I chemicals, including the authority to revoke or deny based on public interest grounds, immediate suspension in cases of imminent danger to the public health or safety, and criminal penalties for distribution, importation, or exportation without the required registration. Authorizes the Attorney General to reduce controls on the importation of specified chemicals by modifying or eliminating the advance notice requirement. Adds specific criminal penalties for: (1) attempting to evade reporting requirements by falsely claiming that a shipment is destined for a country for which a waiver has been established; and (2) smuggling of listed chemicals. Makes it a felony for a person who possesses a listed chemical with intent that it be used in the illegal manufacture of a controlled substance to manage the listed chemical or waste from the manufacture of a controlled substance other than as required under the Solid Waste Disposal Act. Specifies that a person who violates such prohibition shall be assessed costs of the initial cleanup and disposal of the listed chemical and contaminated property, as well as the cost of restoring property damaged by exposure to such chemical. Subjects listed chemicals to the same forfeiture provisions which apply to controlled substances. Amends the Health Care Quality Improvement Act of 1986 to require the Secretary of Health and Human Services to make available to the Attorney General information in the national practitioner data bank.
United States · United States Congress · 11 March 1993
Amends title XVIII (Medicare) of the Social Security Act to prohibit the use of claim sampling to deny claims or recover overpayments under Medicare except when fraud has been determined, in which case claim sampling may be used for the purpose of assessing civil monetary penalties.
United States · United States Congress · 11 March 1993
Urges the President to reach agreement with Mexico and Canada on the establishment of a North American Commission on the Environment (NACE) to address environmental concerns and promote the protection of the environment and the public health in the North American Free Trade Agreement (NAFTA) region. Urges NACE to create a Border Environmental Fund to address cleanup of existing environmental problems and construction of facilities to help prevent future environmental and related public health problems in the U.S.-Mexico border region. Urges NACE to participate as an equal partner with the Free Trade Commission established under NAFTA on environmental issues related to NAFTA. Requires NACE to establish and oversee a Secretariat comprising national sections.
United States · United States Congress · 10 March 1993
Amends title XIX (Medicaid) of the Social Security Act to allow the participation in home- and community-based care programs of functionally disabled elderly individuals with: (1) incomes of up to three times the maximum amount allowed under the Supplemental Security Income program, at the State's option; and (2) two of five (currently, two of three) impaired activities of daily living. Exempts small community care settings which are not providers of home- and community-based care from survey and certification requirements. Requires case managers who have been properly trained to review such small settings for compliance with applicable requirements. Revises program funding provisions to: (1) guarantee States with a certain amount of funding over one year's election period; and (2) allow remaining funds to be carried over to the next fiscal year. Requires: (1) a State to notify the Secretary of Health and Human Services of its intention to provide home- and community-based care in order to receive Federal funding for it; and (2) the Secretary to notify each State which has submitted such a notice of the Federal funding amount available to it for the fiscal year. Requires the Secretary to evaluate and report annually to specified congressional committees on the provision of home-and community-based care by States. Revises the definition of developmentally disabled individual with respect to eligibility for community supported living arrangements program services. Allows program funds remaining at the end of a fiscal year to be carried over to the next fiscal year. Requires the Secretary to evaluate and report annually to specified congressional committees on the provision of community supported living arrangement services by States. Amends the Omnibus Budget Reconciliation Act of 1986 to reauthorize Alzheimer's disease demonstration projects.
United States · United States Congress · 10 March 1993
Amends title XIX (Medicaid) of the Social Security Act with respect to the home- and community-based care program to: (1) revise income and disability eligibility requirements; (2) limit the number of States which may participate in such program; (3) permit States to limit the number of individuals who may receive program services; and (4) revise application of Medicaid spousal impoverishment rules to spouses of individuals receiving program services.
United States · United States Congress · 10 March 1993
Designates the week of October 3 through 9, 1993, as Mental Illness Awareness Week.
United States · United States Congress · 10 March 1993
Declares that it is the sense of the Congress that any legislation enacted to reform the health care system must: (1) ensure that every person has access to coverage for medically and psychologically necessary treatments for mental disorders that is equitable to the coverage provided for treatments of physical illnesses; and (2) meet specified requirements concerning coverage, consumer choice, financial protection, financing policies, and coordination across Federal, State, and local programs.
United States · United States Congress · 10 March 1993
TABLE OF CONTENTS: Title I: Safety and Health Programs Title II: Safety and Health Committees and Employee Safety and Health Representatives Title III: Coverage Title IV: Occupational Safety and Health Standards Title V: Enforcement Title VI: Protection of Employees from Discrimination Title VII: Technical Assistance and Training Title VIII: Recordkeeping and Reporting Title IX: NIOSH Title X: State Plans Title XI: Victim's Rights Title XII: Construction Safety Title XIII: Worker's Compensation Study Title XIV: Administration Title XV: Effective Date Comprehensive Occupational Safety and Health Reform Act - Amends the Occupational Safety and Health Act of 1970 (OSHA) with respect to occupational safety and health programs, committees, employee representatives, coverage, standards, enforcement, antidiscrimination, training and education, hazard and illness evaluation, State plans, and victims' rights. Title I: Safety and Health Programs - (Sec. 101) Amends requirements for each employer to set up and carry out a written occupational safety and health program that includes specified methods and procedures. Title II: Safety and Health Committees and Employee Safety and Health Representatives - (Sec. 201) Amends OSHA to require each employer of 11 or more employees (each for 20 or more hours per week) to provide for: (1) health committees; and (2) employee safety and health representatives. Authorizes the Secretary of Labor (the Secretary), upon the employer's application, to approve establishment of an alternative method of employee participation in worksite health and safety activities in a manner at least as effective as committee participation, if such alternative mechanism meets specified conditions. Provides for employee participation in the Secretary's inspections of workplaces. Title III: Coverage - (Sec. 301) Revises the OSHA definition of employer to extend OSHA coverage to States and local government employees. (Sec. 302) Directs the Committee on House Administration of the House of Representatives to establish a comprehensive occupational safety and health program meeting specified OSHA and other requirements. (Sec. 303) Applies OSHA to employment performed in Federal nuclear facilities under the control or jurisdiction of the Department of Energy. (Sec. 304) Extends an employer's duties under OSHA to all employees working at the place of employment (even if they are not the employer's employees). Title IV: Occupational Safety and Health Standards - (Sec. 401) Specifies timeframes and procedures for setting OSHA standards. (Sec. 403) Requires each OSHA standard to prescribe requirements for recording or reporting work-related adverse medical conditions determined as a result of medical examinations or test. (Sec. 404) Requires public disclosure of all communications on OSHA standards with parties outside the Department of Labor, including those with executive branch officials (except the President). (Sec. 405) Directs the Secretary, in cooperation with the Secretary of Health and Human Services (HHS) acting through the National Institute for Occupational Safety and Health (NIOSH) to modify and establish exposure limits for toxic materials and harmful physical agents on a regular basis in a specified manner. (Sec. 406 and 407) Directs the Secretary to promulgate final standards: (1) on exposure monitoring and medical surveillance programs; and (2) on ergonomic hazards to protect employees from work-related musculoskeletal disorders. (Sec. 408) Requires that emergency temporary standards: (1) be issued based on the best available evidence; and (2) remain in effect for no more than 18 months (currently six months). (Sec. 409) Directs the Secretary to issue, within 60 days, an interim final regulation reducing permissible exposure limits to toxic substances, including a specified final rule on air contaminants and a proposed rule on air contaminants for construction, agriculture, and maritime. Title V: Enforcement - (Sec. 501) Provides that time spent by an employee in accompanying the Secretary's representative on an OSHA inspection shall be deemed hours worked, with no loss of wages, benefits, or other terms and conditions of employent. (Sec. 502) Requires the Secretary to notify employees or their representatives, within 30 days after receipt of their request for inspection, of the Secretary's determination that there are no reasonable grounds to believe a violation or danger exists. (Sec. 503) Requires the Secretary to make a special inspection upon notification by any Federal or State agency of reasonable grounds to believe that a violation of OSHA or specified safety and health standards exists that threatens physical harm. (Sec. 504) Directs the Secretary to carry out a special emphasis inspection program for conducting inspections of industries or operations where existing hazards or newly recognized or new hazards introduced into work sites warrant more intensive than normal inspections. (Sec. 505) Requires the Secretary to investigate any work-related death or serious incident resulting in hospitalization of two or more employees. Requires the employer to: (1) notify the Secretary of any death or serious incident occurring in a place of employment covered by OSHA; and (2) prevent the destruction or alteration of evidence that would assist in an investigation. (Sec. 506) Revises provisions for abatement of serious hazards during employer contests to a citation. (Sec. 507) Grants employees the right to contest a citation's designation of the character of a violation or any proposed penalties as inadequate. (Sec. 508) Grants employee representatives the right to participate in other proceedings (as well as hearings) conducted under specified OSHA enforcement procedures. (Sec. 509) Requires the Occupational Safety and Health Review Commission's rules of procedure to provide for prompt notice to affected employees or their representatives if the Secretary intends to withdraw or modify a citation as a result of any agreement with the employer. Grants employees or their representative, regardless of whether they have previously elected to participate in the proceedings, the right to object to modifications or withdrawals of citations. (Sec. 510) Revises OSHA provisions for restraining imminent dangers. Grants employees the right to refuse to perform a duty identified as the source of an imminent danger, and prohibits discrimination against them for such refusal. Specifies a civil penalty against an employer for each day during which an employee continues to be exposed. (Sec. 511) Authorizes the Secretary to issue citations and assess penalties for violations of specified OSHA provisions relating to: (1) inspections, investigations, and recordkeeping; (2) safety and health programs; (3) safety and health committees; and (4) construction plans and programs. (Sec. 512) Revises OSHA criminal penalties to subject to them not only the employer but also certain officers, management officials, and supervisiors. Increases the maximum amount of fines and length of prison terms for specified violations. Establishes criminal penalties for a willful violation that causes serious bodily injury (currently, death only). Prohibits a penalty or fine imposed on a director, officer, or agent of an employer from being paid out of the employer's assets. Provides that nothing in OSHA shall preclude State and local law enforcement agencies from conducting criminal prosecutions. (Sec. 514) Directs the Secretary to establish an effective system for targeting inspections of worksites, with priority given to those with a high potential for death, serious injury, or exposures to toxic materials or harmful physical agents. (Sec. 515) Provides for the vacating of specified citations for violations if the employer demonstrates that certain conditions involving adequate employee training and work rule enforcement have been met. (Sec. 516) Increases the minimum penalty for specified types of serious offenses. Title VI: Protection of Employees from Discrimination - (Sec. 601) Extends OSHA antidiscrimination coverage to employees: (1) reporting any injury, illness, or unsafe condition to the employer, employer's agent, safety and health committee, or employee safety and health representative; and (2) refusing to perform duties when reasonably apprehensive that doing so would result in serious injury to themselves or other employees, after having sought and been unable to obtain from the employer corrections of the circumstances causing such refusal. Revises procedures for consideration of discrimination complaints. Revises remedies. (Sec. 602) Requires the Secretary's regulations to include provisions requiring employers to post employee rights protections under such OSHA antidiscrimination provisions. Title VII: Technical Assistance and Training - (Section 701) Requires the Secretary to develop and disseminate curricula, model programs, and other information and materials to assist employers in complying with OSHA standards and requirements for safety and health programs, employee training and education, and safety and health committees. Directs the Secrtary to establish a program to provide technical assistance and consultative services concerning worksite safety and health to employers and employees. Requires targeting of such assistance and consultation at small employers, high hazard worksites, and high hazard industries. Establishes in the Treasury a revolving fund, the OSHA Assistance Fund, to pay for such programs. Directs the Secretary to impose fees to offset program costs. Title VIII: Recordkeeping and Reporting - (Sec. 801) Requires the Secretary to collect information and conduct analyses identifying: (1) industries, employers, processes, operations, and occupations, with a high rate of injury or illness; (2) factors that cause or contribute to injuries and illnesses; (3) workers' compensation costs associated with injuries and illnesses; and (4) employee exposure to toxic substances and harmful physical agents. Directs the Secretary to require each employer covered by OSHA to report: (1) each work-related death of an employee immediately upon knowledge; and (2) each serious incident resulting in hospitalization of two or more employees within 24 hours of the incident. (Sec. 802) Revises OSHA requirements for employer records and reports to include work-related illnesses reported by an employee or an employee's physician, unless the employer determines the illness is not work-related. (Sec. 803) Requires all such employer records and reports to be made available to the Secretary, the Secretary of HHS, employees, and employee representatives. Title IX: NIOSH - (Sec. 901) Requires NIOSH hazard to evaluation reports to evaluate whether any potentially hazardous condition or harmful physical agent found in the place of employment poses a risk to exposed employees. (Sec. 902) Directs the Secretary of HHS to identify major factors contributing to occupational injuries and deaths through accident investigations and epidemiological research. (Sec. 903) Extends the authority of the Secretary of HHS, and of NIOSH, to inspect records to the Secretary's designees and contractors. (Sec. 904) Directs the Secretary of HHS, to establish a national surveillance program to identify cases of occupational illnesses, deaths, and serious injuries. (Sec. 905) Establishes NIOSH as a separate agency within the U.S. Public Health Service in the Department of HHS. (Sec. 907) Includes education programs for employees and members of safety and health committees under NIOSH training provisions. Title X: State Plans - (Sec. 1001 and Sec. 1002) Revises OSHA requirements for State plans to provide for: (1) development of safety and health programs and safety and health committees and training programs that are at least as effective as those under the new OSHA requirements; and (2) reporting requirements, protection of employee rights, and access to information that are at least as effective as those under OSHA or other Federal laws governing access to information related to OSHA. (Sec. 1003) Requires a State to enforce a Federal OSHA standard until a State standard at least as effective is in effect, if a State fails to adopt or promulgate such a standard within six months after the Federal standard is promulgated. (Sec. 1004 and Sec. 1005) Sets forth requirements and procedures for the Secretary of Labor to: (1) investigate complaints against a State's compliance with and enforcement of the State plan; and (2) take corrective action against such State noncompliance. (Sec. 1006) Requires States operating State safety and health plans to conform them to this Act. Title XI: Victim's Rights - (Sec. 1101) Provides for victims' rights under OSHA, including family members as well as the injured employee. Title XII: Construction Safety - (Sec. 1202) Amends OSHA to establish in the Occupational Safety and Health Administration (the Administration) an Office of Construction Safety, Health, and Education (the Office). Directs the Secretary of Labor (the Secretary) to: (1) identify construction employers with high rates of fatalities or lost workday injuries or illnesses or with patterns of noncompliance with health and safety requirements; (2) develop a system for notifying such employers; (3) establish courses and curricula for training OSHA inspectors an other OSHA employees with construction safety and health duties; (4) establish model compliance programs and assist employers, employees, and their representative organizations in setting up their training programs; and (5) establish a toll-free line on which reports, complaints, and notifications required under OSHA may be made. Establishes within the Administration the position of Deputy Assistant Secretary of Labor for Construction. (Sec. 1203) Establishes requirements for construction safety and health plans and programs, involving construction employers and designated project constructors and coordinators. (Sec. 1204) Directs the Secretary to establish an effective targeting system for general schedule construction inspections. Directs the Secretary to require constructors to report promptly any incident involving construction work that results in a fatality, an injury or illness causing two or more hospitalizations, or a structural failure or fire or explosion which caused or could have caused serious bodily injury to employees. (Sec. 1205) Expands the advisory jurisdiction of the Advisory Committee on Construction Safety and Health (the Committee). (Sec. 1206) Requires any State construction safety and health plan to contain requirements at least as effective as those imposed by the Act and the Contract Work Hours and Safety Standards Act. (Sec. 1207) Establishes in OSHA a Construction Safety and Health Academy to train OSHA employees who conduct construction worksite inspections and others the Secretary considers appropriate. (Sec. 1208) Considers a project constructor an employer for specified OSHA enforcement purposes. (Sec. 1209) Directs the Secretary to report to the President and the Congress annually on the construction industry and after three years on whether the office should be continued or a Construction Industry Safety and Health Administration should be established in the Department of Labor. (Sec. 1210) Directs the Secretary to recommend to specified congressional committees any legislative changes required to make safety records (including records of compliance with Federal safety and health laws and regulations) one criterion considered in the awarding of Federal construction contracts. Title XIII: Worker's Compensation Study - (Sec. 1301) Establishes the Federal Workers' Compensation Commission. Directs the Commission to study and report on workers' compensation laws and system with respect to specified issues. Title XIV: Administration - Establishes an Occupational Safety and Health Administration in the Department of Labor, to be headed by an Assistant Secretary for Occupational Safety and Health. Title XV: Effective Date - (Sec. 1501) Sets forth the effective date of this Act.
United States · United States Congress · 10 March 1993
Amends the Internal Revenue Code to impose an excise tax through 1999 on taxable first sales of syringes and intravenous systems to health care providers which do not meet antineedlestick prevention standards. Directs the Commissioner of the Food and Drug Administration to prescribe safety standards for syringes, and appropriate components of intravenous systems, to prevent accidental needlestick injuries to health care providers.
United States · United States Congress · 10 March 1993
Multiple Employer Health Benefits Protection Act of 1993 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to establish certification standards under title I (Protection of Employee Benefit Rights) for multiple employer welfare arrangements (MEWAs) providing health benefits. Treats as employee welfare benefits plans, and exempts from certain restrictions on preemption, a MEWA which provides benefits consisting solely of specified medical care, which is not fully insured, and which applies for and receives a specified exemption. Sets forth exemption procedures, as well as additional requirements applicable to exempted arrangements. Requires certain disclosures to participating employees. Requires exempted MEWAs which are not fully insured to maintain specified types of reserves. Sets forth corrective actions which such MEWAs' operating committees must take: (1) to avoid depletion of reserves; or (2) in connection with termination of the MEWA. Provides for review of actions by the Secretary of Labor with respect to denials of applications for, or suspensions or revocations of, such exemptions. Revises ERISA with respect to: (1) a specified exemption from preemption; (2) treatment of single employer arrangements; and (3) treatment of certain collectively bargained arrangements. Sets forth ERISA requirements relating to employee leasing health care arrangements (ELHAs). Provides for treatment of ELHAs as MEWAs, with certain exceptions. Sets forth special rules under which an ELHA may receive a MEWA exemption. Includes under such exemption requirements: (1) a minimum three-year lessor tenure; (2) solicitation restrictions; (3) creation of an employment relationship, involving disclosure statements, informed consent, and informed recruitment of the lessee's employees; and (4) a requisite employer-employee relationship under the ELHA. Allows delegation to a State of some or all of the Secretary's enforcement authority with respect to MEWAs with exemptions. Directs the Secretary to provide enforcement and technical assistance to the States with respect to MEWAs.
United States · United States Congress · 10 March 1993
Birth Defects Prevention Act of 1993 - Amends the Public Health Service Act to establish birth defects prevention and research programs. Authorizes the Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control (CDC), to provide for collection, analysis, and reporting of birth defects statistics from birth certificates, infant death certificates, hospital records, or other sources and to collect and disaggregate such statistics by gender and racial and ethnic group. Directs the Secretary to establish at least five regional birth defects monitoring and research programs to collect and analyze information on the number, incidence, correlation, and causes of birth defects. Authorizes the Secretary, acting through the Director of CDC, to award grants or enter into cooperative agreements with specified entities to serve as Centers of Excellence for Birth Defects Prevention Research. Requires one of the Centers to focus on birth defects among ethnic minorities. Requires the CDC to establish a clearinghouse for the collection and storage of data generated from birth defects monitoring programs developed under this Act. Directs the Secretary, acting through the Director of the CDC, to provide for the evaluation, and implementation of prevention strategies designed to reduce the incidence and effects of birth defects. Directs the Secretary to establish an Advisory Committee for Birth Defects Prevention. Requires the Secretary to report biennially to the House Committee on Energy and Commerce and the Senate Committee on Labor and Human Resources regarding birth defects. Authorizes appropriations.
United States · United States Congress · 10 March 1993
Community Ambulance Support Act of 1993 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of paramedic intercept services under Medicare part B (Supplementary Medical Insurance).
United States · United States Congress · 10 March 1993
Designates October 3 through 9, 1993, as Mental Illness Awareness Week.
United States · United States Congress · 9 March 1993
Long-Term Care Insurance Consumer Protection Act of 1993 - Amends title XIX (Medicaid) of the Social Security Act to afford Federal consumer protection to purchasers of long-term care insurance policies by requiring that before such policies may be issued or sold they must have been either certified by the Secretary of Health and Human Services as meeting the minimum Federal standards and requirements established by this Act or approved under a State regulatory program. Requires the Secretary to promulgate such standards incorporating the requirements of this Act, unless the National Association of Insurance Commissioners (NAIC) does so first. Outlines requirements for State regulatory programs. Provides for regulation of the marketing of long-term care insurance policies by establishing prohibitions on certain sales practices, such as high pressure tactics, and on sales to Medicaid beneficiaries and sales of duplicate service benefit policies. Outlines general requirements for long-term care insurance policies. Imposes requirements on issuers of long-term care insurance policies with respect to: (1) policy mailing after approval; (2) information for policyholders and the Secretary and appropriate State officials on denied claims; and (3) medical assessments for elderly applicants with policies whose issue is not guaranteed. Sets forth civil penalties for violations involving unapproved or uncertified policies and prohibited sales practices. Requires reports by the Secretary to the Congress on functional ability assessment tools and solvency protections for issuers. Requires a study by the Secretary to develop a standard measure of value for long-term care insurance policies. Amends the Omnibus Budget Reconciliation Act of 1990 to increase funding for long-term care insurance information, counseling, and assistance.