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Bill· SS. 291 (104th)open
United States · United States Congress · 27 January 1995
TABLE OF CONTENTS: Title I: Regulatory Analysis and Review Title II: Risk-Based Priorities Title III: Regulatory Accounting Title IV: Market Incentives and Economically Efficient Regulation Regulatory Reform Act of 1995 - Title I: Regulatory Analysis and Review - Amends Federal law to define "major rule" as a rule or a group of closely related rules that the proposing agency, the President, or an officer with presidentially delegated authority determines is likely to have an annual effect on the economy of $100 million or more in reasonably quantifiable direct and indirect costs, or has a significant impact on a subsector of the economy. (Sec. 101) Authorizes an agency, the President, or an officer with presidentially delegated authority to designate as a major rule also any rule or group of closely related rules which is likely to result in: (1) a substantial increase in costs or prices for wage earners, consumers, individual industries, nonprofit organizations, Federal, State, or local government agencies, or geographic regions; or (2) significant adverse effects on wages, economic growth, investment, productivity, innovation, the environment, public health or safety, or the ability of enterprises whose principal places of business are in the United States to compete in domestic or export markets. Excludes from the meaning of major rule under this Act any rule: (1) involving Federal taxes; (2) authorizing the introduction into commerce or recognizing the marketable status of a product under the Federal Food, Drug, and Cosmetic Act; (3) exempting from notice and public procedure; or (4) relating to specified aspects of depository institutions with federally insured deposits or accounts. Requires each Federal agency, before publishing notice of proposed rulemaking for any rule, to determine whether the rule is or should be designated major. Provides for such determination by the President or by an officer with presidentially delegated authority. Requires the agency to issue at the time of the notice of proposed rulemaking a preliminary regulatory cost-benefit analysis, summarized in such notice, with specified contents. Requires issuance of a final regulatory analysis with the publication of a final major rule. Allows judicial review of an agency determination of major rule status, but not of such a determination by the President or by an officer with presidentially delegated authority. Prescribes executive oversight requirements and authority. Requires the President to require the heads of certain covered agencies to prepare: (1) a risk assessment for each proposed major rule relating to human health, safety, or the environment; and (2) for each such proposed or final rule, an assessment of incremental risk reduction or other benefits associated with each significant regulatory alternative considered by the agency in connection with the rule. Exempts from such requirements emergency situations and certain screening analyses. Limits covered agencies to: (1) the Environmental Protection Agency; (2) the Department of Labor; (3) the Food and Drug Administration; (4) the Consumer Product Safety Commission; (5) the Department of Transportation; (6) the Department of Energy; (7) the Department of Agriculture; (8) the Department of the Interior; and (9) the Nuclear Regulatory Commission. Specifies principles for risk assessment, risk characterization, and risk communication, requiring generally that scientific findings and best estimates of risk be distinguished from other considerations. Requires each covered agency to: (1) issue guidelines to implement risk assessment and risk characterization principles; and (2) publish, within 18 months after enactment of this Act, a plan to review and revise any risk assessment published before the end of such 18-month period if the agency determines that significant new information or methodologies are available that could significantly alter the results of the prior risk assessment. Requires an agency head or the President to determine for each major rule that: (1) the risk assessment and incremental benefit analysis are based on a scientific evaluation supported by the best available scientific data; and (2) there is no regulatory alternative allowed by statute under which the regulation is promulgated that would achieve an equivalent reduction in risk in a more cost-effective and flexible manner. Requires the Director of the Office of Science and Technology Policy to: (1) survey periodically how each covered agency is conducting risk assessment; (2) make recommendations to the President and the Congress based on such surveys; (3) establish interagency mechanisms to promote coordination among agencies conducting risk assessment and promote use of state-of-the-art assessment practices; and (4) establish mechanisms between Federal and State agencies, including periodic meetings, to communicate state-of-the-art risk assessment practices and assess Federal-State cooperation. Requires each agency: (1) to identify in the Federal Register existing rules it determines to be major; and (2) to review each such rule, according to certain procedures, and amend, repeal, or renew the rule, with public participation. (Sec. 102) Authorizes each Federal agency head, in the administration of a Federal statute with respect to any State or locality, to adopt as a Federal rule, recordkeeping or reporting requirement, or implementation procedure a State or local rule, requirement, or procedure that is substantively equivalent to or more stringent than its Federal counterpart. Title II: Risk-Based Priorities - Risk Reduction Priorities Act of 1995 - Urges each covered agency to strive to set priorities and use the resources available under applicable laws to address human health, safety, and environmental risks: (1) which the agency considers most serious; and (2) which can be addressed in a cost- effective manner. (Sec. 204) Sets forth general criteria for determining the most serious risks, with review of agency determinations by the Director of the Office of Management and Budget (OMB). Requires each agency head to incorporate such risk-based priorities into budget and planning activities. (Sec. 205) Requires the OMB Director to enter into arrangements with an accredited scientific body to conduct: (1) a study of the methodologies for using comparative risk to rank dissimilar human health, safety, and environmental risks; and (2) a comparative risk analysis according to specified criteria. Requires reports to the President and the Congress. Exempts agency compliance or noncompliance with this title from judicial review. Prohibits judicial consideration of any analysis prepared under this title apart from the requirement, rule, program, or law to which it relates. Title III: Regulatory Accounting - Regulatory Accounting Act of 1995 - Requires the President to submit to Congress biennial accounting statements estimating the costs of Federal regulatory programs and corresponding benefits over the next five fiscal years. Prescribes the general contents of such statements. (Sec. 303) Requires the President, acting through the OMB Director, to submit to Congress along with the accounting statement an associated report containing impact analyses and recommendations for reform. (Sec. 304) Requires the OMB Director to provide guidance to agencies to standardize cost and benefit measures and the format of the accounting statements. (Sec. 305) Requires the Director of the Congressional Budget Office, after each accounting statement and associated report submitted to Congress, to make recommendations to the President for improving such statements and reports. Title IV: Market Incentives and Economically Efficient Regulation - Market Incentives Act of 1995 - Requires agencies to ensure that major rules, especially those that limit the emission of environmental pollutants or otherwise govern the use of natural resources, operate through the application of market-based mechanisms (or comparable alternatives). (Sec. 403) Requires each agency to include in each proposed rule an assessment of market-based mechanisms, which shall be reviewed by OMB.
Bill· HRH.R. 720 (104th)open
United States · United States Congress · 27 January 1995
Medisave Patient Empowerment Act of 1995 - Amends the Internal Revenue Code to allow individuals a tax deduction for contributions made to a Medisave account established for the benefit of an eligible individual. Limits the amount of allowable contributions. Describes an eligible individual as one who is covered under a catastrophic health plan. Allows the use of a Medisave account to pay for medical care or long-term care expenses of beneficiaries. Makes such accounts exempt from taxation. Allows a tax deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to Medisave accounts.
Bill· SS. 266 (104th)referred
United States · United States Congress · 24 January 1995
Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide that ERISA shall not preempt the Hawaii Prepaid Health Care Act or any amendments made to it, provided that such amendments do not lower the proportion of the population with health care coverage or the level of benefit coverage.
Bill· HRH.R. 641 (104th)referred
United States · United States Congress · 23 January 1995
Women's Right To Know Act of 1995 - Amends title XI of the Civil Rights Act of 1964 to prohibit a governmental authority, in or through any program or activity that provides health care services or information, from limiting the right of any person to provide or to receive nonfraudulent information about the availability of reproductive health care services, including family planning, prenatal care, adoption, and abortion services.
Bill· HRH.R. 625 (104th)referred
United States · United States Congress · 20 January 1995
Fairness in Medicaid Funding Act of 1995 - Amends title XIX (Medicaid) of the Social Security Act to revise the State percentage factor and related factors in the Federal medical assistance percentage used under the Medicaid program. Bases payments to the States for administration costs on the Federal medical assistance percentage.
Bill· HRH.R. 598 (104th)referred
United States · United States Congress · 20 January 1995
Pharmacy Compounding Preservation Act of 1994 - Amends the Federal Food, Drug, and Cosmetic Act to make such Act inapplicable to: (1) licensed retail pharmacies that compound drugs in conformance with applicable local laws regulating the practice of pharmacy and medicine; and (2) bulk drug products intended to be used by pharmacies for compounding, except to the extent that such provisions relate directly to the purity and quality of such bulk drug products.
Bill· HRH.R. 608 (104th)referred
United States · United States Congress · 20 January 1995
Vaccine Injury Compensation Reform Act - Amends the Public Health Service Act to allow petitions for compensation under the National Vaccine Injury Compensation Program to be filed until 36 months after the date on which the injury is diagnosed. Specifies that if the injury is first diagnosed before the date of this Act's enactment, no petition may be filed for compensation under the Program for such injury after the expiration of 36 months after the latest of: (1) the date on which such injury is diagnosed; (2) the date of the occurrence of the first symptom or manifestation of onset or of the significant aggravation of such injury (manifestation date); or (3) the date of this Act's enactment, if such injury is first diagnosed after the expiration of 36 months after the manifestation date.
Bill· SS. 245 (104th)referred
United States · United States Congress · 19 January 1995
TABLE OF CONTENTS: Title I: All-Payer Fraud and Abuse Control Program Title II: Revisions to Current Sanctions for Fraud and Abuse Title III: Administrative and Miscellaneous Provisions Title IV: Civil Monetary Penalties Title V: Amendments to Criminal Law Title VI: Payments For State Health Care Fraud Control Units Health Care Fraud Prevention Act of 1995 - Title I: All-Payer Fraud and Abuse Control Program - Directs the Secretary of Health and Human Services to establish: (1) an all-payer fraud and abuse control program; and (2) standards, including information standards and disclosure standards, to carry out such program. Authorizes appropriations. Establishes, to carry out such program, the Health Care Fraud and Abuse Account (the Account), which shall consist of gifts, bequests, deposits, and transfers under certain health care offenses provisions of specified Acts. (Sec. 102) Provides for the application to any health plan of specified health anti-fraud and abuse provisions of part A (General Provisions) of title XI of the Social Security Act. (Sec. 103) Directs the Secretary to annually solicit proposals for modification of, and modify, existing safe harbor rules. Permits any individual, at any time, to request a notice from the Inspector General (IG) which informs the public of practices which the IG considers to be suspect or of particular concern. (Sec. 104) Directs the Secretary to establish a program through which individuals entitled to Medicare benefits may confidentially report instances of suspected fraud. Title II: Revisions to Current Sanctions for Fraud and Abuse - Amends provisions of titles XI (General Provisions and Peer Review) and XVIII (Medicare) of the Social Security Act to: (1) provide for the mandatory exclusion of individuals with a felony fraud conviction from participation in Medicare and State health care programs; (2) establish a minimum period of exclusion for certain individuals and entities subject to permissive exclusion from Medicare and State health care programs; (3) provide for the permissive exclusion of individuals with ownership or control interest in sanctioned activities; (4) provide for a minimum period of exclusion for practitioners and individuals failing to meet statutory obligations; and (5) intermediate sanctions for Medicare health maintenance organizations. Title III: Administrative and Miscellaneous Provisions - Directs the Secretary to provide for the establishment of a national health care fraud and abuse data collection program for the reporting of final adverse actions against health care providers, suppliers, or practitioners. Title IV: Civil Monetary Penalties - Provides, under part A of title XI of the Social Security Act, for: (1) the payment of the portion of amounts recovered under provisions of this Act into the Account; and (2) an increase in the civil monetary penalty. Subjects an excluded individual retaining an ownership or controlling interest in a Medicare or State health care program to such penalty. Permits the Secretary to impose a penalty on any individual (including any organization, but excluding a beneficiary) who knowingly receives any kickback or bribe in return for making a referral or purchasing equipment in a Medicare or State health care program. Title V: Amendments to Criminal Law - Amends the Federal criminal code provisions: (1) relating to mail fraud, to impose a fine or imprisonment for up to ten years or both in the case of health care fraud; (2) to provide for the forfeiture of property in certain Federal health care offenses; (3) provide for injunctive relief as specified; (4) provides for fines or imprisonment or both in connection with Federal health care offenses; (5) establish a voluntary disclosure program in connection with Federal health care offenses; and (6) provide penalties for obstructions of criminal investigations of Federal health care offenses, theft or embezzlement in connection with health care, and the laundering of monetary instruments in connection with a Federal health care offense. Title VI: Payments for State Health Care Fraud Control Units - Directs the Governor of each State to establish and maintain a State agency to act as a State Health Care Fraud and Abuse Control Unit. Provides for specified Federal payments to the States for such agencies.
Bill· SS. 246 (104th)referred
United States · United States Congress · 19 January 1995
TABLE OF CONTENTS: Title I: Initiatives to Move Welfare Recipients Into the Work Force Title II: Initiatives to Strengthen Families and Break the Cycle of Welfare Dependency Title III: Changes to Federal Laws and State Initiatives to Increase Child Support and Paternal Responsibility Title IV: Initiatives to Diversify and Improve the Performance of Welfare Services Title V: Offsetting Expenditure Reductions Welfare Reforms That Work Act - Establishes general application requirements for States desiring to conduct a five-year demonstration project under this Act. Prohibits disbursement of Federal funds for an approved project until the State submits an evaluation plan developed according to standards prescribed by the Secretary of Health and Human Services. Requires every such plan to provide for evaluation of the project by an independent expert entity, whose conclusions shall be included in the State's annual and final reports to the Secretary on the project. (Sec. 4) Requires the Secretary to evaluate each project, based on the State reports, and if any of the reforms in the projects is determined likely to achieve the purposes of this Act, to submit proposed legislation to the Congress to: (1) implement such reforms nationally if appropriate; or (2) give States the option of adopting a successful reform in a State plan approved under the Social Security Act, where the reform may be effective in some States but not in others. Directs the Secretary to establish a clearinghouse to collect and disseminate to State officials and the public current information on approved demonstration projects. (Sec. 5) Authorizes appropriations. Title I: Initiatives to Move Welfare Recipients Into the Work Force - Directs the Secretary to provide for demonstration projects which condition Aid to Families With Dependent Children (AFDC) benefits for certain individuals on school attendance or job training, limit the time period for receipt of such benefits, and require teenage parents to live at home. (Sec. 101) Limits such a project to families which: (1) include a parent under age 20; (2) include at least one dependent child of such parent; but (3) do not include a child under six months of age. Prohibits AFDC payments to such a family unless the teenage parent is for at least 35 hours a week: (1) attending school or studying for a general equivalency diploma; or (2) participating in a job, job training, or job placement program. Requires such parent, except in specified circumstances, to reside: (1) with his or her parent, legal guardian, or other adult relative in the latter's own home; or (2) in a foster home, maternity home, or other adult-supervised supportive living arrangement. Requires the AFDC payments, where possible, to be provided to the teenage parent's parent, guardian, or other adult relative on behalf of the individual and the individual's child. Entitles such a family to such aid for a State-determined appropriate period of time which shall, at a minimum, permit the individual to complete the required educational or job-related activities. (Sec. 102) Amends the Job Training Partnership Act to authorize the Secretary of Labor to enter into agreements with Federal, State, or local agencies, or private organizations, for the development of pilot projects to provide services at Job Corps centers to eligible youth whose families receive AFDC and who are mothers of children who have not reached the age of compulsory school attendance. Requires the Job Corps center to: (1) provide child care at or near the center for such individuals; and (2) require each such individual to participate in certain activities through a parents as teachers program operating parent education programs providing group meetings and home visits by experienced parent educators and periodic screening by them of the educational, hearing, and visual development of the children of such individuals. (Sec. 103) Directs the Secretary of Health and Human Services to provide for State demonstration projects requiring a parent or other relative of a dependent child, as part of the application process for AFDC, to undergo 30 days of assisted job search or substance abuse treatment (or both) before the family may receive aid. Limits such demonstration project to families: (1) all of whose dependent children are over six months of age; (2) for whom the State has made adequate child care available, as well as all fee payments for the job search or substance abuse treatment activities; and (3) for whom application of the project does not endanger the welfare and safety of a dependent child member of the family. (Sec. 104) Amends part A (Aid to Families With Dependent Children) of title IV of the Social Security Act (SSA) to require disregard as a resource for AFDC eligibility (except for a family's initial eligibility determination) of up to $10,000 in a qualified education and employment account established by the State to hold savings from the earned income of a dependent child or the child's parent in an AFDC family, qualified distributions from which may be used for expenses directly related to secondary or postsecondary school attendance or to improving the employability of family members. Requires disregard as income of any qualified distributions from such an account. (Sec. 105) Amends the SSA and the Internal Revenue Code to require a State plan to: (1) permit certain participants in a State self-employment program a one-time election to purchase capital equipment for a small business in lieu of a depreciation deduction for income tax purposes; and (2) treat repayments by such persons of the principal portion of small business loans as business expenses. Directs the Secretary to provide for State demonstration projects under which one or more partnerships are developed between State agencies and community businesses or educational institutions to provide technical assistance to: (1) eligible self-employed AFDC recipients; and (2) eligible participants in the establishment and operation of child care centers in the home or in the community. Directs the Secretary to provide for State demonstration projects to promote the ownership of family-owned businesses by AFDC recipients. (Sec. 106) Amends part F (Job Opportunities and Basic Skills Training Program) of SSA title IV to declare that it is the purpose of such part to encourage individuals receiving education and training to enter the permanent work force by developing programs through which they enter the work force and then receive post-employment education and training. (Sec. 107) Directs the Secretary to provide for additional State demonstration projects to better move AFDC recipients into the work force. Title II: Initiatives to Strengthen Families and Break the Cycle of Welfare Dependency - Directs the Secretary to provide for State demonstration projects to establish child-centered programs through conversion of certain AFDC and JOBS payments into block grants. (Sec. 201) Requires the Secretary to make payments, according to a specified formula, to a State for such projects in lieu of all AFDC and JOBS payments to which the State would otherwise be entitled. Specifies the kinds of programs for which such block grants may be used, including: (1) residential programs for teenage mothers with dependent children where education, job training, community service, or other employment is found; (2) certain pilot projects (authorized by this Act) at Job Corps centers providing services to eligible teenage AFDC recipients whose children have not reached the age of compulsory school attendance; (3) programs for adoption of neglected or abused children; (4) expanded child care assistance for children of needy working parents; (5) residential schooling for children from needy families; and (6) other services provided directly to children from needy families. Requires the Secretary to ensure that each State uses its grant to the fullest extent possible to support community-based services. (Sec. 202) Directs the Secretary to provide for demonstration projects: (1) providing no additional benefits with respect to children born while a family is receiving AFDC, but allowing increases in the earned income disregard; (2) waiving certain work history and related requirements for a parent of a dependent child who is married to the child's natural parent; (3) increasing the stepparent earned income disregard; (4) reducing AFDC benefits if school attendance is irregular or preventive health care for dependent children is not obtained; (5) developing community-based programs for teenage pregnancy prevention and family planning; and (6) developing additional programs to strengthen families and break the cycle of welfare dependency. Title III: Changes to Federal Laws and State Initiatives to Increase Child Support and Paternal Responsibility - Directs the Secretary to provide for demonstration projects to: (1) develop a program to increase paternity establishment; and (2) increase child support collection efforts. Title IV: Initiatives to Diversify and Improve the Performance of Welfare Services - Directs the Secretary to provide for demonstration projects to: (1) provide placement of AFDC recipients in private sector jobs; and (2) establish performance-based incentives for State public welfare providers. Amends the Electronic Fund Transfer Act to prohibit the Board of Governors of the Federal Reserve System from applying to electronic benefit transfers established under a State or local governmental entitlement program certain disclosures, protections, responsibilities, and remedies (including, in effect, the liability limits currently applicable to private sector ATM and consumer credit cards), unless the payment under such program is made directly into a consumer's account held by the recipient. Exempts from such prohibition employment-related payments established by Federal, State, or local governments. Title V: Offsetting Expenditure Reductions - Amends the Food Security Act of 1985 to eliminate the "three-entity" rule (which allows an individual agricultural producer to form two other business entities with two other individuals to multiply the number of maximum agricultural subsidies of which the producer can take advantage). Requires the Secretary of Agriculture, in the case of corporations and other entities, to attribute all Federal agricultural payments to natural persons in proportion to their ownership interests in an entity and in any other entity, or partnership, that owns or controls the entity, or partnership, receiving the payments.
Bill· HRH.R. 574 (104th)referred
United States · United States Congress · 19 January 1995
Southwest Public Health Laboratory Act - Authorizes the Secretary of Health and Human Services, acting as appropriate through the Director of the Centers for Disease Control and Prevention or through other agencies, to make grants to States for the operation of laboratories to protect the public health through analyzing human, wildlife, air, water, and soil samples if the State involved agrees that the laboratory will be operated by the State and will serve the region along the international border between the United States and Mexico. Directs the Secretary to ensure that such a laboratory: (1) is established in an urban area that is centrally located in such region; (2) is located within 25 miles of such border; and (3) receives the principal amount of assistance under this Act.
Bill· HRH.R. 580 (104th)referred
United States · United States Congress · 19 January 1995
Amends title XVIII (Medicare) of the Social Security Act and other Federal law to make any managed health care plan established by the Secretary of Defense in the Military Health Services System eligible for payments by the Secretary of Health and Human Services on behalf of any plan enrollees entitled to Medicare benefits.
Bill· SS. 237 (104th)referred
United States · United States Congress · 18 January 1995
TABLE OF CONTENTS: Title I: Value Added Tax Title I: Surplus Revenues Deficit and Debt Reduction and Health Care Financing Act of 1995 - Title I: Value Added Tax - Amends the Internal Revenue Code to impose a five percent tax on taxable transactions (such tax to be known as a value added tax). Describes taxable transactions as the sale, import, or export of certain property or services. Sets forth rules for the administration of such tax. Title II: Surplus Revenues - Establishes the Deficit Reduction and Health Care Reform Trust Fund. Appropriates to such Fund 80 percent of the revenues from the value added tax to reduce the public debt and 20 percent to carry out Federal health care reform programs.
Bill· HRH.R. 559 (104th)referred
United States · United States Congress · 18 January 1995
Amends part B (Supplementary Medical Insurance) of title XVIII (Medicare) of the Social Security Act to limit the late enrollment penalty to a ten percent increase in the monthly part B premium due over a period equal to twice the number of years that the part B beneficiary could have been but was not enrolled under part B.
Bill· HRH.R. 548 (104th)referred
United States · United States Congress · 17 January 1995
Menopause Outreach, Research, and Education Act of 1995 - Amends the Public Health Service Act to require the Director of the National Institute on Aging to provide for the expansion of at least five centers for research on: (1) menopause; and (2) conditions arising from the diminishing or cessation of the functioning of the ovaries, whether occurring naturally or otherwise. Outlines research activities to be performed at each center. Requires the Director to establish a program to develop protocols for the prevention and treatment of menopausal health conditions and other conditions regarding women's midlife health. Requires the Director to provide for an equitable geographical distribution of such centers. Requires each center to be supported for at least five years, with possible renewal after review and recommendation by an appropriate technical and scientific peer review group established by the Director.
Resolution· HCONRESH.Con.Res. 14 (104th)referred
United States · United States Congress · 17 January 1995
Declares that the leaderships of the House of Representatives and the Senate should work together in a bipartisan manner to pass any health care reform that has overwhelming bipartisan support.
Bill· HRH.R. 507 (104th)referred
United States · United States Congress · 13 January 1995
Comprehensive Long-Term Care Act of 1995 - Amends title XVIII (Medicare) of the Social Security Act to: (1) extend Medicare part A (Hospital Insurance) coverage of extended care services to chronically dependent individuals; and (2) provide for coverage of home care services and outpatient prescription drugs under Medicare part B (Supplementary Medical Insurance). Provides for application of a deductible in determining the amount of an individual's payment for covered prescription drugs. Requires the Secretary of Health and Human Services to: (1) establish a program for assuring appropriate prescribing and dispensing practices for covered prescription drugs; (2) develop, and update annually, an information guide for physicians on wholesale drug prices; and (3) report to the Congress on the prices of prescription drugs and their use by individuals eligible for Medicare part B benefits. Requires pharmacies to enter into an agreement with the Secretary in order to receive payment for prescription drugs dispensed to such individuals. Requires the Secretary to establish a point-of-sale electronic system for use by carriers and pharmacies in the submission of information on prescription drugs dispensed. Authorizes sanctions against pharmacies that violate their agreement with the Secretary. Limits the length of prescriptions. Requires the Director of the Office of Technology Assessment to provide for a Prescription Drug Payment Review Commission. Requires the Commission to report annually to the Congress on methods of determining payment for covered prescription drugs. Authorizes appropriations. Requires the Secretary to develop a standard prescription drugs claims form for use under Medicare and by other third-party payors.
Bill· SS. 210 (104th)referred
United States · United States Congress · 12 January 1995
Rural Emergency Access Care Hospital Act of 1995 - Amends title XVIII (Medicare) of the Social Security Act to: (1) permit certain rural hospitals to serve as rural emergency access care hospitals; and (2) provide for coverage of rural emergency access care hospital services under Medicare part B.
Bill· SS. 198 (104th)referred
United States · United States Congress · 11 January 1995
Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) make permanent the Medicare select policy program; and (2) allow access to Medicare select policies in all States. Amends title XVIII (Medicare) of the Social Security Act to revise the Medicare select policy program and provide for a civil penalty for misrepresentations made in connection with a Medicare select policy.
Bill· SS. 194 (104th)referred
United States · United States Congress · 11 January 1995
Abolishes the Medicare and Medicaid Coverage Data Bank established under the Omnibus Budget Reconciliation Act of 1993. Directs the Secretary of Health and Human Services to study and report to the Congress on how to achieve the former objectives of such entity in the most cost-effective manner.
Law· HRH.R. 483 (104th)enacted
United States · United States Congress · 11 January 1995
Amends the Omnibus Budget Reconciliation Act of 1990 to: (1) make permanent the Medicare select policy program; and (2) allow access to Medicare select policies in all States. Amends title XVIII (Medicare) of the Social Security Act to revise the Medicare select policy program and provide for a civil penalty for misrepresentations made in connection with a Medicare select policy.
Bill· HRH.R. 485 (104th)referred
United States · United States Congress · 11 January 1995
Requires the Secretary of Health and Human Services, in administering a specified provision of the Federal Food, Drug, and Cosmetic Act, to make a determination, based on either of two specified notices concerning the approval of a medical device for marketing or investigational use in the European Community or by the Ministry of Health and Welfare of Japan, that the exportation of such medical device is not contrary to public health and safety, and has the approval of the importing country.
Bill· SS. 184 (104th)referred
United States · United States Congress · 9 January 1995
Office for Rare Disease Research Act of 1995 - Amends the Public Health Service Act to establish, in the National Institutes of Health, the Office for Rare Disease Research.
Bill· HRH.R. 435 (104th)referred
United States · United States Congress · 9 January 1995
TABLE OF CONTENTS: Title I: Fair Health Information Practices Subtitle A: Duties of Health Information Trustees Subtitle B: Use and Disclosure of Protected Health Information Subtitle C: Access Procedures and Challenge Rights Subtitle D: Miscellaneous Provisions Subtitle E: Enforcement Title II: Amendments to Title 5, United States Code Title III: Regulations, Research, and Education; Effective Dates; Applicability; and Relationship to Other Laws Fair Health Information Practices Act of 1995 - Title I: Fair Health Information Practices - Subtitle A: Duties of Health Information Trustees - Requires, subject to stated exceptions, health care providers, health information service organizations, health oversight agencies, health benefit plan sponsors, and health researchers (health information trustees) to permit an individual (protected individual) to examine his or her own medical records (protected health information). Excepts certain mental health or other records which may endanger the protected individual. Sets forth provisions concerning: (1) notice of information practices; (2) accounting for disclosures; and (3) security. Subtitle B: Use and Disclosure of Protected Information - Sets forth the general rule that a health information trustee may use protected information only for a purpose: (1) that is compatible with and directly related to the purpose for which the information was collected or received by the trustee; or (2) for which the trustee has received authorization to disclose such information. Makes exceptions, if proper procedures are followed, for the following situations: (1) next of kin and directory information; (2) public health; (3) health research; (4) emergencies; (5) judicial and administrative purposes; (6) law enforcement; (7) subpoenas, warrants, and search warrants; and (8) health information service organizations. Subtitle C: Access Procedures and Challenge Rights - Sets forth access and challenge procedures for subpoenas, warrants, and search warrants concerning protected health information. Subtitle D: Miscellaneous Provisions - Permits a health information trustee to disclose only such information as is necessary to process a payment when payment is made by a debit, credit, or other payment card. (Sec. 143) Directs the Secretary of Health and Human Services to establish electronic documents transmission, receipt, and maintenance standards. (Sec. 147) Directs a State to establish a process under which any created or recorded protected health information is delivered to and maintained by the State or its designated entity. Subtitle E: Enforcement - Sets forth civil and criminal penalties for violations of this Act's provisions. Directs the Secretary to develop alternative dispute resolution methods to resolve the civil complaints. Title II: Amendments to Title 5, United Sates Code - Amends provisions of title 5 (Government Organization and Employees) of the United States Code concerning agency records maintained on individuals to direct the head of any agency that is a health information trustee to promulgate rules to exempt a system of records within the agency from stated provisions of title 5, to the extent that the such system contains protected health information. Title III: Regulations, Research, and Education; Effective Dates; Applicability; and Relationship to Other Laws - Directs the Secretary to prescribe regulations to carry out this Act. Authorizes the Secretary to sponsor research concerning protected health information. Directs the Secretary to establish education and awareness programs concerning such information. (Sec. 303) Sets forth provisions concerning: (1) the applicability of the provisions of this Act to protected health information; and (2) the relationship of the provisions of this Act to other laws.
Bill· HRH.R. 439 (104th)referred
United States · United States Congress · 9 January 1995
Health Insurance Equity Act of 1995 - Amends the Social Security Act to add a new title XXI (Standards for Health Coverage). Prohibits an insurer or group health plan providing health coverage from denying, limiting, or conditioning health services coverage or benefits, or varying premiums, based on an individual's health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability. Permits coverage exclusion of a preexisting condition for the first six months only. Prohibits such exclusion for: (1) services to newborns covered at the time of birth; or (2) treatment of conditions relating to pregnancy. Provides for the crediting of previous coverage. Specifies terms under which a health insurer providing coverage to individuals or small employers may cease from enrolling new individuals or small employers because the insurer's financial or provider capacity to serve current beneficiaries will be impaired if required to enroll additional beneficiaries. Defines small employer as one with fewer than 50 employees who normally perform, on a monthly basis, at least 30 hours of service per week. Prohibits: (1) denial of coverage renewal except for specified, non-health-related reasons; and (2) market reentry for five years for any insurer which elects not to renew any health insurance coverage for individuals or small employers. Makes each State responsible for establishing a program to enforce the requirements of this Act. Authorizes appropriations for grants to States for such enforcement programs. Provides for Federal enforcement in the event that an annual review of a State enforcement program shows such program to be inadequate. Requires the Secretary of Health and Human Services to provide for procedures for the imposition of specified civil money penalties on any noncomplying insurer in a State which fails to provide for adequate enforcement of the requirements of this Act. Provides for enforcement of such requirements by the Department of Labor for group health plans under the Employee Retirement Income Security Act of 1974 (ERISA).
Bill· HRH.R. 449 (104th)referred
United States · United States Congress · 9 January 1995
Primary Health Care Education Act of 1995 - Amends title VII (Health Professions Education) of the Public Health Service Act to require giving preference, in making grants and contracts under the title, to: (1) schools of medicine or osteopathic medicine that emphasize primary health care training and encourage selection of primary care as a career choice; and (2) entities that operate medical residency training programs that include instruction from primary care faculty and have rotations providing primary care training.
Bill· HRH.R. 448 (104th)referred
United States · United States Congress · 9 January 1995
Myelogram-Related Arachnoiditis Amendments of 1995 - Amends the Federal Food, Drug, and Cosmetic Act to prohibit a myelogram involving the use of Pantopaque, Amipaque, Omipacque, or Isovue. Amends the Public Health Service Act to require a study and research with respect to individuals who have undergone a myelogram and who have subsequently developed arachnoiditis.
Resolution· SRESS.Res. 31 (104th)open
United States · United States Congress · 6 January 1995
Expresses the sense of the Senate that the Attorney General should fully enforce the law and take any necessary measures to protect from violent attack persons seeking to provide or obtain reproductive health services.
Bill· SS. 169 (104th)open
United States · United States Congress · 5 January 1995
TABLE OF CONTENTS: Title I: Legislative Accountability and Reform Title II: Regulatory Accountability and Reform Title III: Review of Unfunded Federal Mandates Title IV: Judicial Review Unfunded Mandate Reform Act of 1995 - Prohibits the application of this Act to any proposed Federal legislation or proposed or final Federal regulation that: (1) enforces the constitutional rights of individuals; (2) establishes or enforces any statutory rights that prohibit various specified types of discrimination; (3) requires compliance with accounting and auditing procedures with respect to grants or other money or property provided by the Federal Government; (4) provides for emergency assistance or relief at the request of any State, local, or tribal government (small government); or (5) is designed as emergency legislation or is necessary for national security or international treaty purposes. Requires each Federal agency to provide to the Director of the Congressional Budget Office (CBO) such information and assistance as the Director may reasonably request to assist him or her in carrying out this Act. Title I: Legislative Accountability and Reform - Amends the Congressional Budget and Impoundment Control Act of 1974 and the Congressional Budget Act of 1974 with respect to unfunded Federal mandates. (Sec. 101) Includes tribal governments and the private sector within the purview of mandate analysis by CBO and congressional committees. Requires authorization committees to identify to CBO any Federal mandates in legislation ordered to be reported. Requires the report accompanying any reported legislation with a Federal mandate to contain statements on whether the legislation is intended to preempt any State, local, or tribal law (and the reasons for such intention), as well as individual mandate descriptions, cost-benefit analyses, and statements regarding Federal financial assistance to State, local, and tribal governments for meeting mandate costs. Requires the CBO Director, for each piece of legislation, to prepare and submit the authorizing committee certain statements estimating the direct costs of mandate compliance and the amount of new or increased Federal financial assistance needed to meet such costs, if the estimates indicate at least a $50 million per fiscal year direct cost of all intergovernmental mandates in the legislation, or a $200 million per fiscal year direct cost of private sector mandates. Makes it out of order for the Senate to consider: (1) any reported nonappropriations legislation unless it has a CBO Director report; or (2) any reported nonappropriations legislation containing a Federal intergovernmental mandate with direct costs exceeding the thresholds specified by this Act, unless it provides for new or increased budget, entitlement, or direct spending authority or makes other specified arrangements for each fiscal year to ensure that Federal funds equal or exceed the estimated direct costs of the mandate, or that State, local, and tribal programmatic and financial responsibilities are reduced so they do not exceed the amount of Federal funding. Gives the House Committee on Government Reform and Oversight and the Senate Committee on Governmental Affairs final authority to determine questions on the applicability of this Act to pending bills, joint resolutions, amendments, motions, or conference reports. Requires the direct costs of a Federal mandate for a fiscal year to be determined based on estimates by congressional budget committees. Provides that it shall not be in order in the House of Representatives to consider a rule or order waiving application of these provisions to a bill or joint resolution reported by an authorization committee. (Sec. 102) Amends House rules with regard to the Committee of the Whole and Committee on Rules: (1) to make it always in order in the former to strike from the portion of any bill open to amendment any Federal mandate whose direct costs exceed the prescribed threshold; and (2) to require the latter to include in its reports on waived points of order a separate item identifying all waivers of points of order relating to Federal mandates. (Sec. 103) Provides that, at the request of any congressional committee, the CBO Director shall: (1) consult with and assist it in analyzing the budgetary or financial impact of any proposed legislation that may have a significant impact on the State, local, or tribal government involved or on the private sector; and (2) study any legislative proposal containing a Federal mandate. Requires the CBO Director to conduct continuing studies to enhance comparisons of budget outlays, credit authority, and tax expenditures. Requires any congressional committee that anticipates considering any legislative proposal establishing, amending, or reauthorizing any Federal program likely to have a significant impact on any State, local, or tribal government or on the private sector to include its views and estimates on that proposal to the applicable budget committee. (Sec. 104) Authorizes appropriations to CBO to carry out this Act. (Sec. 106) Repeals the State and Local Government Cost Estimate Act of 1981. Title II: Regulatory Accountability and Reform - Requires each Federal agency to: (1) assess the effects of Federal regulations on State, local, and tribal governments (other than to the extent that such regulations incorporate requirements specifically set forth in legislation) and the private sector, including specifically the availability of resources to carry out any Federal mandates in those regulations; and (2) seek to minimize those burdens that uniquely or significantly affect such governmental entities, consistent with achieving statutory and regulatory objectives. (Sec. 201) Directs each agency to permit elected officials and other representatives of State, local, and tribal governments to provide meaningful and timely input in the development of regulatory proposals containing significant Federal mandates. Requires each agency: (1) before establishing regulatory requirements, to develop plans for notifying small governments of such requirements; and (2) before promulgating any final rule that includes any Federal intergovernmental mandate that may result in State, local, or tribal government and private sector expenditures, in the aggregate, of $100 million or more in any one year, to prepare a written statement of specified estimates and analyses for forwarding to the CBO Director. Authorizes appropriations. (Sec. 204) Directs the Director of the Office of Management and Budget to establish pilot programs in at least two agencies to test innovative approaches to reducing reporting and compliance burdens on small governments. Title III: Review of Unfunded Federal Mandates - Establishes the Commission on Unfunded Federal Mandates to investigate and review the role of unfunded Federal mandates in intergovernmental relations and their impact on local, State, and Federal government objectives and responsibilities. Requires the Commission to make recommendations to the President and the Congress with regard to: (1) consolidating or simplifying unfunded Federal mandates in order to facilitate compliance by State, local, and tribal governments, especially with respect to specific mandates for which the terms of compliance are unnecessarily rigid or complex; (2) terminating unfunded mandates which are duplicative, obsolete, or lacking in practical utility; and (3) temporarily suspending those unfunded mandates which are not vital to public health and safety and which compound the fiscal difficulties of State, local, and tribal governments. (Sec. 307) Authorizes appropriations. Title IV: Judicial Review - Disallows judicial review under this Act.
Bill· SS. 171 (104th)referred
United States · United States Congress · 5 January 1995
Medicaid Substance Abuse Treatment Act - Amends title XIX (Medicaid) of the Social Security Act to provide federally reimbursed Medicaid coverage of alcoholism and drug dependency residential treatment services for pregnant women whose family income is below 185 percent of the Federal poverty level and for their Medicaid-eligible children and spouses. Lists the required services included in such coverage. Requires that such coverage continue for at least 12 months, except in certain circumstances, such as where the coverage of pregnant women must continue for one year following the end of pregnancy. Limits the size of a residential treatment facility. Allows a State agency to grant exceptions to such limit. Prohibits the facility from being licensed as a hospital. Caps the number of nationwide beds for which Federal assistance may be provided under such residential treatment programs. Increases such annual bed cap for calendar years 1995 through 1999. Addresses treatment needs of pregnant addicted Indian and Alaska Native women in Indian Health Service areas.
Bill· SS. 168 (104th)referred
United States · United States Congress · 5 January 1995
TABLE OF CONTENTS: Title I: Health Care Security Subtitle A: Universal Coverage and Individual Responsibility Subtitle B: Benefits Subtitle C: State Role in Reform Subtitle D: Expanded Access to Health Plans Subtitle E: Standards for Reform Subtitle F: Federal Responsibilities Subtitle G: Miscellaneous Employer Requirements Subtitle H: General Definitions; Miscellaneous Provisions Title II: New Benefits Subtitle A: Home and Community-Based Services Subtitle B: Life Care Subtitle C: Sense of the Committee with Regard to Prescription Drugs Title III: Public Health Initiatives Subtitle A: Workforce Priorities Under Federal Payments Subtitle B: Health Research Initiatives Subtitle C: Health Services for Medically Underserved Populations Subtitle D: Assistance for State Managed Mental Health and Substance Abuse Programs Subtitle E: Comprehensive School Health Education; School-Related Health Services Subtitle F: Public Health Service Initiative Title IV: Medical Malpractice Subtitle A: Liability Reform Subtitle B: Other Provisions Relating to Medical Malpractice Liability Title V: Fall-Back Premium Limits in Cases of Ineffective Competition; Premium-Based Financing; Assistance to Low Income Individuals and to Businesses Subtitle A: Fall-Back Premium Limits Subtitle B: Premium-Related Financings Subtitle C: Payments to Health Plans and Miscellaneous Provisions Subtitle D: Cost-Sharing Assistance, Application for Assistance and Premium Discounts, and Income Reconciliation Title VI: Aggregate Government Payments Subtitle A: Aggregate Federal Payments to Participating State Subtitle B: Borrowing Authority to Cover Cash-Flow Shortfalls Subtitle C: Miscellaneous Provisions Affordable Health Care for All Americans Act - Title I: Health Care Security - Subtitle A: Universal Coverage and Individual Responsibility - Entitles each U.S. citizen or national, resident alien, and long-term nonimmigrant (except for individuals exempt from paying Social Security taxes and except for individuals eligible under title XVIII (Medicare) of the Social Security Act)) to the benefits required under subtitle B. (Sec. 1004) Declares that: (1) subject to exception, the applicable health plan for a family is a community-rated plan for the community-rating area in which the family resides; and (2) the applicable health plan for a family member eligible to enroll in an experienced-rated (sic) plan is such an experienced-rated (sic) plan. Allows eligible individuals who are permitted to elect coverage under more than one plan to elect which will be the applicable plan. (Sec. 1005) Prohibits aliens who are not eligible individuals from obtaining benefits through enrollment under this Act. Allows benefits to lawful nonimmigrants (who are not long-term nonimmigrants) only in accordance with any reciprocal agreements between the United States and foreign States. (Sec. 1011) Requires, subject to exception, all members of the same family to be enrolled in the same applicable plan. Authorizes national rules regarding who will be treated as children under this Act. (Sec. 1012) Provides for the treatment of certain families that include: (1) Medicare-eligible individuals; (2) recipients under part A (Aid to Families with Dependent Children (AFDC)) of the Social Security Act; and (3) disabled and nondisabled recipients under title XVI (Supplemental Security Income for the Aged, Blind, and Disabled (SSI)) of the Social Security Act. Allows qualifying students to enroll in a community-rate plan for the area in which the school is located. (Sec. 1013) Requires individuals (and their spouses) who are eligible as an employee for more than one plan to elect the applicable plan. Subtitle B: Benefits - Requires a certified health plan to provide benefits actuarially equivalent to the BlueCross-Blue Shield standard option plan provided under the Federal Employees Health Benefits Program (FEHBP) on January 1, 1995. Includes in minimum services: (1) hospital services; (2) health professionals' services; (3) emergency and ambulatory medical and surgical services; (4) clinical preventive services; (5) mental illness and substance abuse services; (6) family planning services and services for pregnant women; (7) hospice care, home health care, extended care services, outpatient rehabilitation services, and ambulance services; (8) outpatient laboratory, radiology and diagnostic services; (9) outpatient prescription drugs and biologicals; (10) durable medical equipment; (11) vision care and dental care for children; and (12) patient care costs of qualified investigational treatments. Prohibits scope or duration limits on certain services. Declares that certain services are not medically necessary or appropriate. Prohibits cost-sharing for preventive and prenatal services. Mandates establishment of three model certified plans having cost-sharing and scope and duration limits appropriate for fee-for-service plans, preferred provider plans, and health maintenance organization (HMO) plans. Requires a study on the provision and enrollment patterns of certified plans. (Sec. 1102) Declares that a health professional or a health facility may not be required to provide an item or service under a certified plan if the professional or facility objects on the basis of a religious belief or moral conviction. (Sec. 1103) Prohibits balance billing. Subtitle C: State Role in Reform - Requires each State to establish a State market reform program (SMRP) meeting the requirements of this title. (Sec. 1202) Mandates certain SMRP actions, including regarding certification of insured health plans, establishment of community rating areas, certification of purchasing cooperatives, establishment of purchasing cooperative coordination rules, development of standardized comparative certified plan information and information on accessing plans and cooperatives, providing for risk adjustment programs for community-rated and association health plans, and enrollment periods. (Sec. 1209) Authorizes a SMRP to certify a network plan to operate in a service area different from the borders of a community rating area if certain requirements are met. (Sec. 1210) Allows a State, on approval by the Secretary of Health and Human Services and notwithstanding specified provisions of this Act, to tighten premium rate bands beyond the variation permitted, establish association plan rules more restrictive than provided for, and establish financial solvency requirements exceeding requirements. (Sec. 1211) Mandates establishment (by grant or contract) and oversight of a National Center of Consumer Advocacy to provide technical assistance, training, and support to States and Offices of Consumer Advocacy in each State. (Sec. 1212) Requires each participating State to establish a procedure for exempt employers to elect to be treated as a community- rated employer. (Sec. 1222) Sets forth requirements for single-payer systems, including: (1) operation by the State or a designated agency of the State; (2) enrollment of all individuals in the State, subject to exception; (3) payments made by the State (directly or through fiscal intermediaries) to providers; (4) coverage of all items and services as required by subtitle B of this title (allowing reduced but not increased cost-sharing); (5) limiting the health care spending increase rate; and (6) meeting the requirements applicable to certified plans. Subtitle D: Expanded Access to Health Plans - Requires that each employer make available to each employee the opportunity to enroll in one of at least three certified plans, including either a fee-for-service plan or a point-of-service option. Allows a small employer (defined as having fewer than 100 employees) to meet this requirement through a purchasing cooperative; requires a large employer (defined as having 100 or more employees) to meet this requirement only through offering experience-rated health plans. Provides for payroll withholding of any required employee premiums. (Sec. 1302) Allows small employer employees who are community- rated individuals to elect to enroll in any certified plan in the community rating area in which the employees work or live. (Sec. 1311) Allows a State to establish or charter purchasing cooperatives. Prohibits any individual or entity engaged in the sale of health insurance from forming or underwriting a purchasing cooperative (PC) or holding or controlling any right to vote regarding a PC. (Sec. 1313) Requires PCs to: (1) accept all small employers and individuals eligible for coverage in the community-rated market and residing in the area served by the cooperative; and (2) enter into agreements with at least three certified plans providing the benefits described in subtitle B, including at least one fee-for-service plan or point-of-service plan. Prohibits PCs from: (1) being involved in approval or enforcement of payment rates for providers; (2) being involved in the compliance of certified plans; or (3) assuming financial risk relating to a plan. (Sec. 1321) Requires certified association plans (APs), except as otherwise provided, to meet all requirements of this Act for certified plans offered by large employers. Requires, for APs meeting those requirements, treating: (1) the AP as a plan established and maintained by a large employer; and (2) individuals enrolled in the AP as experience-rated individuals. Requires an AP to cover at least 500 lives. Declares that the certifying authority for APs is: (1) the Secretary of Labor for a certified AP that is a multistate self- insured plan; (2) the State for a certified AP that is a single State self-insured plan. Applies risk adjustment provisions of this Act to APs. Mandates solvency standards for APs. (Sec. 1324) Repeals specified provisions of the Employee Retirement Income Security Act of 1974 (ERISA) relating to multiple employer welfare arrangements. (Sec. 1325) Requires church plans and multiemployer plans, except as otherwise provided, to meet all requirements of this Act for certified plans offered by large employers. Requires, for plans meeting those requirements, treating: (1) the plan as a plan established and maintained by a large employer; and (2) individuals enrolled in the plan as experience-rated individuals. Declares that the certifying authority for such plans is the Secretary of Labor. Sets forth risk adjustment and solvency requirements. (Sec. 1331) Requires any health plan participating under the Federal Employees Health Benefits Program to offer the plan to community-rated individuals and small employers in community rating areas served by the plan at a premium established in accordance with specified provisions of this Act. Subtitle E: Standards for Reform - Sets forth requirements regarding certified health plans. Requires a plan sponsor offering a community-rated plan to offer the plan to any community-rated individual and a plan sponsor offering an experience-rated plan to offer the plan to any experience-rated individual. Declares that a network plan may be made available only in a service area not identical to a community rating area if specified requirements are met. Mandates renewability, subject to exception. (Sec. 1413) Requires standard premiums within each community rating area to be the same for each plan. Requires the premium charged to be the product of the standard premium, an adjustment for the class of enrollment (individual, couple only, single parent, or dual parent), and an age adjustment factor. (Sec. 1414) Prohibits denial, limitation, or conditioning of coverage on any reason, including health status, except as provided in this Act. (Sec. 1416) Allows a plan to offer: (1) additional coverage only if offered and priced separately, if the purchase of the plan is not conditioned on purchase of additional coverage, and if the additional coverage is also offered to individuals not in the plan; and (2) a reduction in cost-sharing only to enrollees for a price that includes any use increase expected to result from the cost-sharing reduction. (Sec. 1417) Requires each community-rated plan to: (1) participate in a risk adjustment program; (2) meet financial solvency requirements; (3) provide information to the State; and (4) provide for quality improvement and quality assurance. Prohibits: (1) utilization management from creating financial incentives for reviewers to reduce or limit medically necessary or appropriate services; and (2) physician incentive plans unless in accordance with specified provisions of title XVIII (Medicare) of the Social Security Act. (Sec. 1421) Applies to each plan Medicare provisions relating to procedures to notify a patient of the patient's right to accept or refuse treatment and to execute an advance directive. Limits plan gatekeepers in complex or chronic health conditions so as to avoid undue enrollee burdens. Mandates procedures to protect confidentiality. Prohibits: (1) selective marketing; (2) patient lability for unpaid plan obligations; and (3) discrimination in selecting providers for a provider network based on the actual or anticipated health status of the provider's patients. Mandates: (1) physician participation in matters affecting patient care; and (2) patient ability to choose any primary care physician from among participating providers. (Sec. 1422) Requires certification of specified types of providers as essential community providers, including: (1) covered entities under provisions of the Public Health Service Act (PHSA); (2) Medicare-dependent small rural hospitals; (3) children's hospitals; (4) mental health and substance abuse providers receiving funds under specified provisions of the PHSA; (5) runaway homeless youth centers or homeless youth transitional living programs; (6) maternal and child health providers receiving funds under specified provisions of the Social Security Act; (7) rural health clinics; (8) school health services centers; and (9) nonprofit hospitals providing a specified percentage of services to individuals entitled to or eligible for benefits under Medicare or under title XIX (Medicaid) of the Social Security Act. Requires each plan, if such providers so elect, to have a written provider participation agreement with such providers or have an agreement to make payment to the provider. (Sec. 1423) Requires each plan to have in its network (or through other arrangements) a sufficient number, distribution, and variety of specialists to assure service availability to adults, infants, children, and persons with disabilities. Directs the Secretary of Health and Human Services to establish criteria for designating, and to designate, centers of specialized care. (Sec. 1424) Requires each plan to: (1) have the capacity, within its network or through arrangements with providers, to deliver the benefits required in subtitle B throughout the community rating area; and (2) provide emergency out-of-area and out-of-plan coverage for enrollees and urgent out-of-area coverage. (Sec. 1431) Specifies which certified health plan requirements apply to certified self-insured health plans. Applies certain fiduciary requirements of the Employee Retirement Income Security Act of 1974 (ERISA) to self-insured plans and imposes financial management and record keeping requirements. (Sec. 1441) Prohibits States from requiring: (1) the offering, as part of a certified plan, of any services different from the benefit categories of this Act; or (2) a right of conversion from a group certified plan to an individual certified plan. (Sec. 1442) Prohibits State limits, regulations, or prohibitions regarding: (1) incentives for certified plan enrollees to use participating providers; (2) limiting coverage to services provided by a participating provider; (3) rate and payment form negotiations; (4) limitations on the number of participating providers; (5) requiring that services be provided or authorized by a participating provider; (6) the corporate practice of medicine; (7) utilization management and review programs; (8) single-source suppliers; and (9) point-of-service options. (Sec. 1451) Sets forth plan standards for the interim period between January 1, 1996, and when the State becomes a participating State. Subtitle F: Federal Responsibilities - Directs the Secretary of Labor to develop and publish standards for certified self-insured plans and to provide for the certification of the plans. (Sec. 1502) Mandates procedures for corrective actions when a self-insured plan has failed to meet requirements. Provides for termination of self-insured plans. (Sec. 1503) Amends the Employee Retirement Income Security Act of 1974 (ERISA) to authorize special rules for the application of portions of ERISA to group health plans. (Sec. 1521) Requires sanctions and corrective action orders if a participating State fails to meet requirements of this Act. Allows the Secretary of Health and Human Services to carry out activities in the same manner as a participating State would. (Sec. 1522) Requires treating related employers as a single employer if a reason for their separation relates to their employees' health risk characteristics. (Sec. 1523) Mandates development of certification criteria for workplace wellness programs. (Sec. 1532) Repeals these provisions relating to collective bargaining dispute resolution on a specified date. Authorizes a health care entity or a labor organization certified or recognized as representing a health care entity's employees to request that the Director of the Federal Mediation and Conciliation Service appoint an impartial Health Care Board of Inquiry to investigate a collective bargaining dispute between the entity and the labor organization. Subtitle G: Miscellaneous Employer Requirements - Prohibits discrimination against employees on the basis of family status or class of family enrollment selected. (Sec. 1603) Makes it unlawful to take adverse action against an employee if a purpose of the action is to interfere with the employee's attainment of status as a qualifying employee, full time employee, or part-time employee, or if a purpose is to evade or avoid any obligation under this Act. (Sec. 1604) Allows a community-rated employer (and an experience- rated employer with respect to employees who are community-rated eligible individuals) to provide benefits to employees that consist of benefits in a cost-sharing policy only through a contribution toward the purchase of a cost-sharing policy that is funded primarily through insurance. Makes the responsibilities of individuals and employers in single payer States supersede their obligations under this subtitle. (Sec. 1605) Authorizes the Secretary of Labor to impose a civil money penalty for violations of this subtitle. Subtitle H: General Definitions; Miscellaneous Provisions - Sets forth definitions for purposes of this Act. (Sec. 1714) Amends the Davis-Bacon Act to modify the definitions of "wages" and related terms by adding references to this Act. Amends the Service Contract Act of 1965 to add references to this Act in provisions relating to required contract provisions. (Sec. 1715) Declares that it is the sense of the Committee on Labor and Human Resources of the Senate that, when this Act is enacted, it should include these sources of financing not within the jurisdiction of the Committee: (1) the net savings and revenues included in the Health Security Act; (2) a specified increase in the cigarette tax; (3) a phased-in premium assessment; (4) other savings or revenues as necessary to provide budget neutrality; and (5) a payroll assessment on exempt employers with specified numbers of workers. Title II: New Benefits - Subtitle A: Home and Community-Based Services - Sets forth requirements in order to approve a State plan for home and community-based services for individuals with disabilities, including: (1) State maintenance of effort (with a base amount set with regard to expenditures under title XIX (Medicaid) of the Social Security Act); (2) eligibility (including initial screenings, restrictions, and continuation of services during transition from Medicaid to the State plan); (3) types of providers and requirements for participation; (4) provider reimbursement; (5) State matching funds; and (6) health care worker redeployment. Mandates annual compliance monitoring. (Sec. 2103) Requires the State plan to specify the services available and any limitations on those services. Mandates a needs assessment, an individualized plan of care, care management services, coverage of personal assistance services. Sets forth a list of other services the plan may cover. Prohibits coverage of room and board or services in institutional settings. Declares that service recipients shall retain the right to independently select, terminate, and direct the work of a home care provider. (Sec. 2104) Prohibits cost-sharing for individuals with an income under a specified level. Mandates coinsurance and an annual deductible in graduated steps above that level. (Sec. 2105) Requires the plan to ensure and monitor service quality. Mandates State plan adherence to federal standards in: (1) case review; (2) mandatory reporting of abuse, neglect, and exploitation; (3) a registry of providers against whom complaints have been sustained; (4) sanctions on States or providers; (5) surveys of client satisfaction; and (6) State optional training programs for informal care givers. Requires client advocacy services. (Sec. 2106) Mandates a Federal advisory group and an advisory group in each State. (Sec. 2107) Sets forth formulas for payments to States. (Sec. 2108) Authorizes appropriations. Subtitle B: Life Care - Life Care Act - Amends the Public Health Service Act to create a new title establishing a voluntary insurance program for individuals 35 years old and over to cover nursing home stays. Covers the nursing facility services to inpatients of: (1) nursing care; (2) physical, occupational, or speech therapy; (3) medical social work; (4) drug, biological, supply, appliance, and equipment; (5) other services as necessary to the functioning of a patient, including personal care and assistance with activities of daily living; and (6) the portion of the first six months of room and board not covered by copayments. Limits the dollar amount of coverage to three levels electable by the individual. Mandates a report on the feasibility of making payments for services delivered in residential care facilities. Declares an individual eligible if the individual is a legal U.S. resident, needs hands-on or standby assistance, supervision, or cueing over at least 90 days, and has elected coverage. Makes individuals in a hospital or nursing home at the time of enrollment ineligible until their next spell of illness. Gives an individual the option to purchase coverage under this title when the individual is within six months of his or her 35th, 45th, 55th, or 65th birthday, with one premium rate for each of the periods between those birthdays or after the 65th birthday. Requires that covered services be provided by nursing homes certified by the State. Sets the monthly reimbursement at 80 percent of the amount reasonable and appropriate to cover costs. Mandates, to extent feasible, a prospective payment mechanism. Makes the benefit recipient responsible for specified percentages of room and board charges. Requires nursing facility services reimbursement, to the extent available, to be made under title XIX (Medicaid) of the Social Security Act, Department of Veterans Affairs' programs, or private insurance policies before reimbursement under this title. Directs the Secretary to contract with entities to act as Long- Term Care Screening Agencies for each designated area of the State to assess the eligibility of individuals for services under this title. Allows Screening Agencies to require payment from individuals only in accordance with standards set by the Secretary. Prohibits requiring payment from individuals with incomes below a specified level. Requires, notwithstanding any other law, that the assets an individual may retain and be eligible for nursing facility benefits under State Medicaid programs be increased by the amount of coverage elected under this title. Prohibits insurers from offering long-term care policies duplicating coverage provided under this title. Directs the Secretary to develop standard long-term care packages insurers may offer that complement this title. Subtitle C: Sense of the Committee with Regard to Prescription Drugs - Declares that it is the sense of the Committee on Labor and Human Resources of the Senate that, when this Act is enacted, it should include coverage of outpatient prescription drugs as included in the Health Security Act (as introduced in the 103d Congress) and providing for a deductible, coinsurance, and out-of-pocket limits not over specified amounts. Title III: Public Health Initiatives - Subtitle A: Workforce Priorities Under Federal Payments - Establishes in the Department of Health and Human Services the National Council on Graduate Medical Education. Repeals provisions of the Health Professions Education Extension Amendments of 1992 establishing the Council on Graduate Medical Education. (Sec. 3011) Allows payments to physician training programs in a medical specialty only if the program will ensure that the number of individuals enrolled in the program in the subsequent academic year is in accordance with these provisions. (Sec. 3012) Requires the National Council to designate, for each medical specialty for each academic year, starting with academic year 2001-2002, the number of individuals nationwide authorized to be enrolled in eligible programs, with at least 55 percent completing programs in primary care. Mandates interim voluntary targets set by the National Council. (Sec. 3013) Requires the National Council, for each academic year and each medical specialty, to make allocations among eligible programs of the number of positions for the year. (Sec. 3031) Mandates payments to qualified entities for the operational costs of an approved physician training program. Requires, in order to be qualified, that entities providing primary care training rotate enrollees to community programs in underserved areas. Specifies the amounts to be available for payments in certain calendar years under these provisions and under provisions relating to transitional payments to institutions. Declares that these amounts constitute the annual health professions workforce account. (Sec. 3041) Mandates payments to medical schools (to be administered as a grant) for the direct costs of academic programs, including the education of medical students, graduate students in biomedical sciences, and otherwise unfunded faculty research. Specifies the amounts to be available for payments in certain academic years. Declares that these amounts constitute the annual medical school fund account. (Sec. 3051) Mandates payments to academic health centers or teaching hospitals (to be administered as a contract, grant, or cooperative agreement) for costs not routinely incurred by other entities providing health services but are incurred by such institutions by virtue of their academic nature, including productivity decreased by teaching responsibilities, uncompensated costs of clinical research, and exceptional costs associated with treatment using the institution's specialized expertise. Specifies the amounts to be available for payments in certain calendar years. Declares that these amounts constitute the annual academic health center account. (Sec. 3061) Requires transitional payments to eligible entities losing specialty positions to assist operational costs. (Sec. 3071) Mandates a program regarding graduate nurse training programs (nurse program) equivalent to the program in previous provisions of this Act relating to physician training programs (physician program). Applies the physician program provisions of this Act to the nurse program provisions of this Act, including calling the council established the National Council on Graduate Nurse Education. (Sec. 3073) Specifies the amounts to be available for payments in certain calendar years. Declares that these amounts constitute the annual graduate nurse training account. (Sec. 3081) Sets forth transitional provisions, terminating them on a specified date and applying them only to health care entities employing more than 25 individuals. Requires hiring preference for displaced employees of those entities and provides for termination of preference eligibility. Requires successor health care entity employers to provide employees of the previous entity continued employment unless their positions no longer exist. Regulates collective bargaining matters during the transition period. Provides for enforcement of these transitional provisions. Subtitle B: Health Research Initiatives - Makes available specified percentages of the premiums required to be paid under this Act. Amends the Public Health Service Act (PHSA) to make those amounts available to: (1) the Office of the Director of the National Institutes of Health (NIH), to be used to carry out the responsibilities of the Office and for construction and acquisition of equipment or facilities; (2) the National Center for Research Resources to carry out provisions of the National Institutes of Health Revitalization Act of 1993 concerning biomedical and behavioral research facilities; (3) carry out PHSA provisions regarding health information communications; and (4) the NIH institutes. (Sec. 3102) Amends provisions of the PHSA to require the Agency for Health Care Policy and Research to conduct and support U.S. health care reform research. Authorizes appropriations. Subtitle C: Health Services for Medically Underserved Populations - Authorizes appropriations to carry out specified provisions of this subtitle. Declares that these authorizations are in addition to any others for the same purposes. (Sec. 3321) Authorizes grants and contracts for: (1) the development of community groups to provide benefits under subtitle B of title I of this Act in health professional shortage areas or to members of a medically underserved population; and (2) the expansion and development of health delivery sites and services. (Sec. 3322) Specifies permitted fund uses, including: (1) recruitment, compensation, and training of professional and administrative staff; (2) purchase and upgrading of equipment, supplies, and information systems; and (3) establishment of reserves for furnishing services on a prepaid or capitated basis. (Sec. 3341) Mandates grants and loans to eligible entities, essential access community hospitals, and rural primary care hospitals for the capital costs of developing community health groups and expanding or developing health delivery sites. (Sec. 3361) Authorizes grants and contracts with eligible entities to provide services to increase the capacity of individuals to use the benefits under title I (including transportation, outreach, patient and family education, translation services, case management, and home visiting) and to provide access to essential supplemental services that are not fully reimbursable under title I before a specified date. Authorizes appropriations in addition to any other authorizations. (Sec. 3371) Authorizes appropriations to carry out provisions of the Public Health Service Act (PHSA) relating to the National Health Service Corps and to carry out these provisions on nurse participation in PHSA scholarship and loan repayment programs. Requires reservation of sufficient funds to ensure that a specified percentage of the participants in those programs are being educated in specified nursing fields. (Sec. 3373) Requires reservation of sufficient funds to ensure that a specified percentage of the participants in those programs are being educated or are serving as psychiatrists, psychologists, and clinical social workers. (Sec. 3381) Directs the Secretary of Health and Human Services to make payments to eligible hospitals. Declares that this: (1) is an entitlement in the Secretary on behalf of the hospitals but not an entitlement in the State in which any hospital is located or in any individual receiving hospital services; and (2) constitutes budget authority in advance of appropriations and the obligation of the Government to provide funding in specified amounts for certain years. (Sec. 3382) Identifies as eligible those hospitals with low income use rates of at least a specified percentage. (Sec. 3383) Regulates the amount of payments. (Sec. 3391) Declares that it is the sense of the Senate Committee on Labor and Human Resources that this Act and later appropriations Acts should recognize the success of community and migrant health centers. Subtitle D: Assistance for State Managed Mental Health and Substance Abuse Programs - Mandates grants to States for the development and operation of comprehensive managed mental health and substance abuse programs integrated with the health delivery system established under this Act. Authorizes appropriations. Subtitle E: Comprehensive School Health Education; School- Related Health Services - Mandates grants to State educational agencies to integrate comprehensive school health education. Authorizes requirements waivers for the Prevention, Treatment, and Rehabilitation Model Projects for High Risk Youth, the State and Local Comprehensive School Health Programs to Prevent Important Health Problems and Improve Educational Outcomes, and programs carried out under certain provisions of the Drug-Free Schools and Communities Act of 1986. Authorizes appropriations. (Sec. 3503) Establishes the Healthy Students-Healthy Schools Interagency Task Force. (Sec. 3504) Directs the Secretary of Health and Human Services to establish and maintain a national clearinghouse and mechanisms for the dissemination of school health education material. (Sec. 3581) Authorizes appropriations for: (1) planning and development grants to local community partnerships (LCPs), both directly and through State health agencies; and (2) operational grants to LCPs, both directly and through States. Requires that LCPs include at least one local health care provider, one local educational agency on behalf of one or more public schools, and one community-based organization. Authorizes the Secretary to make the grants to develop and operate school-based or school-linked health service sites. Limits the Federal share of operational grants. Subtitle F: Public Health Service Initiative - Directs the Secretary of Health and Human Services to pay, under specified provisions of this Act, certain amounts for: (1) health services research activities; (2) the development of community groups to provide benefits in health professional shortage areas or to members of a medically underserved population and the expansion and development of health delivery sites and services; (3) the capital costs of developing community health groups; (4) increasing the capacity of individuals to use benefits; (5) providing access to essential supplemental services not fully reimbursable before a specified date; (6) the National Health Service Corps; (7) comprehensive managed mental health and substance abuse programs; and (8) school-based or school-linked health service sites. Title IV: Medical Malpractice - Subtitle A: Liability Reform - Applies this subtitle to any medical malpractice liability action in State or Federal court except for actions under title XXI (Vaccines) of the Public Health Service Act. (Sec. 4002) Requires parties, before or after beginning a medical malpractice action, to participate in the alternative dispute resolution system (ADR) administered by the State. Requires each State to adopt at least one ADR satisfying specified requirements. (Sec. 4003) Limits attorneys contingent fees. (Sec. 4004) Reduces damages for collateral source recovery. (Sec. 4005) Allows a party to ask the court to award future damages on a periodic basis. Subtitle B: Other Provisions Relating to Medical Malpractice Liability - Mandates grants to States for malpractice reform demonstration projects assessing the fairness and effectiveness of one or more of no-fault liability, enterprise liability, or practice guidelines. Authorizes appropriations. Title V: Fall-Back Premium Limits in Cases of Ineffective Competition; Premium-Based Financing; Assistance to Low Income Individuals and to Businesses - Subtitle A: Fall-Back Premium Limits - Directs the Secretary of Health and Human Services to: (1) compute and publish annually an area inflation factor for each community rating area; (2) determine baseline premium amounts; and (3) annually determine baseline premiums for each community rating area. (Sec. 5004) Regulates the process for community-rated plan's submitting premium rate bids to States and premium bids to cooperatives. Conditions community and cooperative bids on the plan s agreement to accept any payment reduction that may be imposed under these provisions. (Sec. 5005) Allows any State to assume responsibility for containment of health care expenditures. (Sec. 5011) Directs the Secretary to develop and use a method to reduce payments to each noncomplying plan in a noncomplying community rating area. Defines "noncomplying community rating area" as one in which the weighted average accepted bid exceeds the community rating area baseline premium. Defines "noncomplying plan" as a plan in a noncomplying area if the premium rate exceeds the baseline premiums. (Sec. 5012) Requires community-rated plans to include in their contracts with providers a provision reducing provider payments if the plan is noncomplying. (Sec. 5021) Directs the Secretary to develop a method for calculating an annual per capita expenditure equivalent for amounts paid for benefit package coverage by a large employer. (Sec. 5022) Directs the Secretary of Labor to take corrective action if a large employer has two years in which the rate of increase exceeds the national corporate inflation factor. Requires considering the large employer a small employer and requiring it to make premium payments in accordance with specified provisions of this Act. (Sec. 5031) Directs the Secretary of Health and Human Services, for a statewide single-payer State, to compute a statewide per capita premium target in the same manner as the community rating area per capita premium target. Subtitle B: Premium-Related Financings - Makes each family enrolled in a community- or experience-rated plan responsible for payment of the family share of premium. Allows payment of the premium by an employer or another person. (Sec. 5102) Provides for family credits for community- and experience-rated plans. (Sec. 5103) Provides for a premium discount for families that: (1) are AFDC families or SSI; (2) have a family income below a certain level; or (3) have a family obligation that would otherwise exceed specified percentages of family income. (Sec. 5110) Makes families that are provided a family credit liable for repayment of the base employment monthly premium. Reduces that amount by the amount of: (1) any employer payments made based on the net earnings from self-employment; and (2) employer premiums payable. (Sec. 5112) Limits repayment liability for low income families. (Sec. 5113) Regulates the net liability of families with one or more nonqualifying employees and no full-time qualifying employees. (Sec. 5114) Provides for special treatment for certain individuals eligible for Medicare. (Sec. 5116) Exempts small employers (no more than 10 employees and average annual wages under a specified amount) from these requirements on employer premium payments. (Sec. 5118) Allows an exempt employer to elect to be treated as a community-rated employer. Requires treating an exempt employer as a community-rated employer after an election and makes the employer eligible for discounts. (Sec. 5120) Applies Medicare rules relating to Medicare as a second payer to individuals eligible for premium assistance under this title in relation to any non-electing employer. (Sec. 5121) Requires community-rated employers to pay at least a specified amount of the premium payment for each qualifying employee. (Sec. 5122) Requires each State to provide for the annual computation of a base employment premium for each class of family enrollment. (Sec. 5123) Limits the amount of the employer s required premium payment to a specified percentage of the qualifying employee s wages, with different levels for medium employers (eleven to 75 employees) and small employers. Provides for the treatment of certain self- employed individuals. Requires, for employers that make premium payments in more than one community rating area, application of the reduction in a pro-rated manner to the payments in all areas. (Sec. 5124) Adjusts employee payments of large employers if certain average costs and rate increases exceed limits. (Sec. 5125) Considers a self-employed individual to be an employer of himself or herself and to pay wages to himself or herself equal to the amount of net earnings from self-employment. Limits the payment obligation of certain individuals to a specified amount. (Sec. 5131) Requires each experience-rated large employer to contribute to premiums in specified amounts. Increases the share of large employers for low income employees entitled to a premium discount. Subtitle C: Payments to Health Plans and Miscellaneous Provisions - Makes States responsible for assisting plans and cooperatives in premium collection. (Sec. 5202) Makes the payment amount for a community-rated plan equal to a blended payment amount reflecting the final bid for each plan, the number of enrollees in each class, and the proportion of AFDC and SSI beneficiaries in the area. (Sec. 5203) Requires States to develop and implement adjustments (including risk adjustment, reinsurance, premium discounts, and adjustments to reflect AFDC and SSI beneficiaries) necessary to reconcile the amounts collected by plans with the amounts owed to the plans. (Sec. 5204) Requires each State to compute and publish specified components of the general family share of premiums and the general employer premium payment amount. (Sec. 5205) Declares that the obligations of an employer regarding employees that reside in a single-payer State supersede the obligations of an employer to provide for payments under specified provisions of this Act. (Sec. 5207) Requires, if an employer makes available a voluntary payment on behalf of an employee in a community- or experience-rated plan and except as provided under collective bargaining agreements, that the employer make such a voluntary payment in the same dollar amount available to all qualifying employees of the employer in any community- or experience-rated plan in the same class of enrollment and the same area. Prohibits employers from discriminating in the terms or conditions of employment based on the health plan (or the premium of a plan) in which an employee is enrolled. (Sec. 5208) Requires employers to deduct from the wages of qualifying employees the amount of the family share of the premium. Mandates that States require payment for families that do not include a qualifying employee to be made prospectively. Subtitle D: Cost-Sharing Assistance, Application for Assistance and Premium Discounts, and Income Reconciliation - Entitles AFDC, SSI, and low income families to a reduction in cost-sharing, unless: (1) for community-rated families, there are sufficient at- or below- average cost plans with cost-sharing similar to the model certified preferred provider network plans or model certified health maintenance organization plans established under this Act; or (2) for experience- rated families, the employer offers such a plan. (Sec. 5302) Allows a family to apply for a determination of the family adjusted income or wage adjusted income of the family to establish eligibility for cost-sharing reductions, premium discounts, and reductions in liability. Makes each individual who knowingly understates income or otherwise makes a material misrepresentation liable to the State for triple the excess payments and interest. (Sec. 5303) Requires families with premium discounts or reductions in liability to file an income reconciliation statement for the year. Mandates related payment adjustments. (Sec. 5304) Requires States to make eligibility determinations for premium discounts, liability reductions, and cost-sharing reductions in a way that keeps error rates below a level specified by the Secretary of Health and Human Services or the Secretary of Labor. Title VI: Aggregate Government Payments - Subtitle A: Aggregate Federal Payments to Participating State - Directs the Secretary of Health and Human Services to provide for payments to each participating State of the capped Federal payment amount. Declares that this constitutes budget authority in advance of appropriations Acts and represents the obligation of the Government to provide for the payments. Sets forth a formula for determination of amounts, including determination of caps. Provides for the handling of anticipated shortfalls. Subtitle B: Borrowing Authority to Cover Cash-Flow Shortfalls - Authorizes the Secretary of Health and Human Services to make loans available to States to cover temporary cash-flow shortfalls. (Sec. 6102) Provides for the use of funds resulting from estimation discrepancies. Subtitle C: Miscellaneous Provisions - Declares that it is the sense of the Committee on Labor and Human Resources that, when this Act is enacted, it should include requirements that States: (1) pay premiums for AFDC and SSI recipients at a level established as described in the Health Security Act; and (2) make maintenance of effort payments to be included in the amounts receivable under certain provisions at a level established as described in the Health Security Act.
Bill· SS. 170 (104th)referred
United States · United States Congress · 5 January 1995
Comprehensive Fetal Alcohol Syndrome Prevention Act - Amends the Public Health Service Act to establish a comprehensive Fetal Alcohol Syndrome and Fetal Alcohol Effects prevention program, including an education and public awareness program, an applied epidemiologic research and prevention program, support for and the conducting of basic research, a procedure for disseminating diagnostic criteria, and an Inter-Agency Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effects. Provides for related technical assistance, grants, cooperative agreements, contracts, and professional education. Authorizes appropriations.
Bill· HRH.R. 431 (104th)open
United States · United States Congress · 5 January 1995
Comprehensive One-Call Notification Act of 1995 - Directs the Secretary of Transportation to provide for the establishment of a nationwide toll-free telephone number to be used by State one-call (call before you dig) notification systems. Requires each State to consider whether to adopt a comprehensive statewide one-call notification program containing all elements required under this Act. Outlines required elements of the program, including prior notification of any intended excavations and its application to all excavators and underground facility operators. Provides an exception. Provides penalties for violations of the requirements of the program, as well as enforcement procedures. Directs the Secretary to make grants to States (or to operators of State notification systems) which have elected to establish and maintain a notification system with all required elements. Allows grants for alternative programs if they are at least as protective of the public health and safety and environment as a State program under this Act. Directs the Secretary to: (1) coordinate the implementation of this Act with Federal pipeline safety requirements; (2) review and report to the Congress on the achievement of the purposes of this Act; and (3) develop and make available to States a model State one-call notification program, with suggested elements. Requires each State to provide an initial and annual status reports on progress made in implementing a State program. Directs the Secretary to report annually to the Congress on accidents caused by routine railroad maintenance. Allows States to implement more protective notification systems than that required under this Act. Directs the Secretary to consult with other agencies as to the availability and affordability of technologies which will help relocate pipelines from above-ground and remote locations. Directs the Secretary to carry out a study under the vision waiver study program which would include drivers who failed to qualify under the original study program due to application time limits and the failure to learn of the program in a timely manner. Expresses the sense of the Congress that equipment and products purchased with funds made available under this Act should be American-made. Requires notification of such preference to the recipients of assistance under this Act.
Bill· HRH.R. 425 (104th)referred
United States · United States Congress · 5 January 1995
TABLE OF CONTENTS: Title I: Tax Incentives Regarding Rural Health Care Title II: Public Health Service Programs Regarding Rural Health Care Subtitle A: National Health Service Corps Subtitle B: Other Programs Regarding Rural Health Care Title III: Provisions Relating to the Medicare Program Title IV: Treatment of Student Loans for Health Professionals Rural Health Professional Shortage Act of 1995 - Title I: Tax Incentives Regarding Rural Health Care - Amends the Internal Revenue Code to exclude from gross income any payment made on behalf of a taxpayer by the National Health Service Corps Loan Repayment Program. (Sec. 102) Permits a deduction for medical education loan interest incurred by health professionals serving in medically underserved rural areas. (Sec. 103) Provides a credit for a qualified primary health services provider providing primary health services full time to an individual residing in a rural health professional shortage area and who: (1) is not receiving a National Health Service Corps Scholarship as a loan repayment under the National Health Service Corps Loan Repayment Program; (2) is not fulfilling service obligations under such Programs; and (3) has not defaulted on such obligations. (Sec. 104) Provides for an increase in the amount which may be expensed as depreciable business assets in the case of rural health care property. Title II: Public Health Service Programs Regarding Rural Health Care - Subtitle A: National Health Service Corps - Amends the Public Health Service Act to add criteria for use in determining health professional shortage areas by including in the criteria the number of individuals paying for health services through Medicare or Medicaid and the number of individuals who have no health insurance, as well as the number of physicians who will accept Medicare and Medicaid patients. (Sec. 202) Requires that at least five percent of appropriations for the National Health Service Corps be used for special loans for former Corps members to enter private practice in health professional shortage areas. (Sec. 211) Provides increased funding for the Scholarship Program and the Loan Repayment Program. (Sec. 212) Directs the Secretary of Health and Human Services to give priority in making scholarships to individuals from rural backgrounds who are likely, after their service, to serve in a rural health professional shortage area. (Sec. 221) Establishes the Rural Primary Health Care Fund for the purpose of making loans to assist individuals with the costs of attending professions schools if the individuals agree to provide primary health services in an underserved rural area. Authorizes appropriations. Subtitle B: Other Programs Regarding Rural Health Care - Requires a State, in order for the State to receive a grant for an Office of Rural Health, to undertake activities to recruit and train physicians to serve in rural areas. Authorizes appropriations for such Offices. (Sec. 232) Authorizes appropriations for area health education center programs. Title III: Provisions Relating to the Medicare Program - Amends title XVIII (Medicare) of the Social Security Act to eliminate, after a specified fiscal year, the geographic adjustment factor from the formula used to determine Medicare payment for physician's services. Increases rural geographic index values so that, by that fiscal year, the values will be the same for all fee schedule areas. Decreases index values for other areas so as to avoid a resulting increase in total payments. (Sec. 302) Amends title XI, Part A (General Provisions) of the Social Security Act to exempt rural hospitals from provisions relating to illegal remunerations, allowing repayment of medical education loans or subsidization of medical practice startup costs. (Sec. 303) Amends Medicare provisions to authorize incentive payments to service providers in health professional shortage areas or if a specified percentage of the provider's patients are: (1) entitled to Medicare or Medicaid (title XIX of the Social Security Act) benefits; or (2) patients for whom the provider received no payment. (Current law authorizes the payments to physicians in health professional shortage areas.) Title IV: Treatment of Student Loans for Health Professionals - Amends the Higher Education Act of 1965 to defer certain student loan repayments for a borrower who is serving in an internship or residency program in a health facility located in a rural area.
Bill· HRH.R. 426 (104th)referred
United States · United States Congress · 5 January 1995
National Commission on Telemedicine Act - Establishes the National Commission on Telemedicine to assess the use of existing and emerging wired and wireless telecommunications and information systems technologies in: (1) health care and health research; (2) health professions student training and continuing education; and (3) medical condition monitoring by individuals at home. Requires the Commission to: (1) assess whether the technologies are effective in improving health care quality and accessibility and reducing cost; (2) identify provider use and acceptance obstacles; (3) develop a model definition of "telemedicine"; and (4) establish appropriate telemedicine service reimbursement. Authorizes appropriations from amounts otherwise appropriated for the National Telecommunications and Information Administration of the Department of Commerce.
Bill· HRH.R. 424 (104th)referred
United States · United States Congress · 5 January 1995
TABLE OF CONTENTS: Title I: Programs of Health Care Financing Administration Subtitle A: Medicare Program Subtitle B: Other Programs Title II: Programs of Public Health Service Title III: Antitrust Provisions Title IV: Commission on Reducing the Burden of Regulations and Paperwork on Small Rural Hospitals Rural Hospital Survival Act of 1995 - Title I: Programs of Health Care Financing Administration - Subtitle A: Medicare Program - Amends title XVIII (Medicare) of the Social Security Act regarding guidelines for determining a national adjusted DRG (diagnosis-related group) prospective payment rate to instruct the Secretary of Health and Human Services to compute, for rural hospital discharges, beginning FY 1995, the portion of the average standardized amount attributable to wages and wage-related costs. States that the portion of such amount not attributable to wages and wage-related rural hospital costs shall be equal to such portions of such amount for hospitals in another urban area. Requires the Secretary to adjust the proportion of hospitals' costs taking into account only costs attributable to wages and salaries, employee benefits, and professional fees. (This eliminates payment differentials between urban and rural hospitals.) Expresses the sense of the Congress that payment reductions made to providers under Medicare should be adjusted to reduce their disproportionate impact upon providers in rural areas. Subtitle B: Other Programs - Amends the Omnibus Budget Reconciliation Act of 1987 to increase the authorization of appropriations for rural health transition grants. Title II: Programs of Public Health Service - Amends the Public Health Service Act to authorize the Secretary to make grants to public and private entities for demonstration projects for: (1) telecommunications which make medical advice and technologies available to rural area health professionals; and (2) increased access of rural populations to primary health services. Authorizes appropriations. Title III: Antitrust Provisions - Provides antitrust exemption guidelines for certain rural hospitals. Title IV: Commission on Reducing the Burden of Regulations and Paperwork on Small Rural Hospitals - Establishes the Advisory Commission on Reducing the Burden of Regulations and Paperwork on Small Rural Hospitals to analyze and report to the Secretary and the Congress on the impact on such hospitals of governmental regulations and paperwork. Authorizes appropriations.
Resolution· HRESH.Res. 30 (104th)referred
United States · United States Congress · 5 January 1995
Expresses the sense of the House of Representatives that: (1) obstetrician-gynecologists should be designated as primary care providers for women in Federal laws relating to the provision of health care; and (2) legislative proposals that define primary care should include services performed by obstetrician-gynecologists in such definition.
Law· SS. 1 (104th)enacted
United States · United States Congress · 4 January 1995
TABLE OF CONTENTS: Title I: Legislative Accountability and Reform Title II: Regulatory Accountability and Reform Title III: Review of Unfunded Federal Mandates Title IV: Judicial Review Unfunded Mandate Reform Act of 1995 - Prohibits the application of this Act to any proposed Federal legislation or proposed or final Federal regulation that: (1) enforces the constitutional rights of individuals; (2) establishes or enforces any statutory rights that prohibit various specified types of discrimination; (3) requires compliance with accounting and auditing procedures with respect to grants or other money or property provided by the Federal Government; (4) provides for emergency assistance or relief at the request of any State, local, or tribal government (small government); or (5) is designed as emergency legislation or is necessary for national security or international treaty purposes. Requires each Federal agency to provide to the Director of the Congressional Budget Office (CBO) such information and assistance as the Director may reasonably request to assist him or her in carrying out this Act. Title I: Legislative Accountability and Reform - Amends the Congressional Budget and Impoundment Control Act of 1974 and the Congressional Budget Act of 1974 with respect to unfunded Federal mandates. (Sec. 101) Includes tribal governments and the private sector within the purview of mandate analysis by CBO and congressional committees. Requires authorization committees to identify to CBO any Federal mandates in legislation ordered to be reported. Requires the report accompanying any reported legislation with a Federal mandate to contain statements on whether the legislation is intended to preempt any State, local, or tribal law (and the reasons for such intention), as well as individual mandate descriptions, cost-benefit analyses, and statements regarding Federal financial assistance to State, local, and tribal governments for meeting mandate costs. Requires the CBO Director, for each piece of legislation, to prepare and submit the authorizing committee certain statements estimating the direct costs of mandate compliance and the amount of new or increased Federal financial assistance needed to meet such costs, if the estimates indicate at least a $50 million per fiscal year direct cost of all intergovernmental mandates in the legislation, or a $200 million per fiscal year direct cost of private sector mandates. Makes it out of order for the Senate to consider: (1) any reported nonappropriations legislation unless it has a CBO Director report; or (2) any reported nonappropriations legislation containing a Federal intergovernmental mandate with direct costs exceeding the thresholds specified by this Act, unless it provides for new or increased budget, entitlement, or direct spending authority or makes other specified arrangements for each fiscal year to ensure that Federal funds equal or exceed the estimated direct costs of the mandate, or that State, local, and tribal programmatic and financial responsibilities are reduced so they do not exceed the amount of Federal funding. Gives the House Committee on Government Reform and Oversight and the Senate Committee on Governmental Affairs final authority to determine questions on the applicability of this Act to pending bills, joint resolutions, amendments, motions, or conference reports. Requires the direct costs of a Federal mandate for a fiscal year to be determined based on estimates by congressional budget committees. Provides that it shall not be in order in the House of Representatives to consider a rule or order waiving application of these provisions to a bill or joint resolution reported by an authorization committee. (Sec. 102) Amends House rules with regard to the Committee of the Whole and Committee on Rules: (1) to make it always in order in the former to strike from the portion of any bill open to amendment any Federal mandate whose direct costs exceed the prescribed threshold; and (2) to require the latter to include in its reports on waived points of order a separate item identifying all waivers of points of order relating to Federal mandates. (Sec. 103) Provides that, at the request of any congressional committee, the CBO Director shall: (1) consult with and assist it in analyzing the budgetary or financial impact of any proposed legislation that may have a significant impact on the State, local, or tribal government involved or on the private sector; and (2) study any legislative proposal containing a Federal mandate. Requires the CBO Director to conduct continuing studies to enhance comparisons of budget outlays, credit authority, and tax expenditures. Requires any congressional committee that anticipates considering any legislative proposal establishing, amending, or reauthorizing any Federal program likely to have a significant impact on any State, local, or tribal government or on the private sector to include its views and estimates on that proposal to the applicable budget committee. (Sec. 104) Authorizes appropriations to CBO to carry out this Act. (Sec. 106) Repeals the State and Local Government Cost Estimate Act of 1981. Title II: Regulatory Accountability and Reform - Requires each Federal agency to: (1) assess the effects of Federal regulations on State, local, and tribal governments (other than to the extent that such regulations incorporate requirements specifically set forth in legislation) and the private sector, including specifically the availability of resources to carry out any Federal mandates in those regulations; and (2) seek to minimize those burdens that uniquely or significantly affect such governmental entities, consistent with achieving statutory and regulatory objectives. (Sec. 201) Directs each agency to permit elected officials and other representatives of State, local, and tribal governments to provide meaningful and timely input in the development of regulatory proposals containing significant Federal mandates. Requires each agency: (1) before establishing regulatory requirements, to develop plans for notifying small governments of such requirements; and (2) before promulgating any final rule that includes any Federal intergovernmental mandate that may result in State, local, or tribal government and private sector expenditures, in the aggregate, of $100 million or more in any one year, to prepare a written statement of specified estimates and analyses for forwarding to the CBO Director. Authorizes appropriations. (Sec. 204) Directs the Director of the Office of Management and Budget to establish pilot programs in at least two agencies to test innovative approaches to reducing reporting and compliance burdens on small governments. Title III: Review of Unfunded Federal Mandates - Establishes the Commission on Unfunded Federal Mandates to investigate and review the role of unfunded Federal mandates in intergovernmental relations and their impact on local, State, and Federal government objectives and responsibilities. Requires the Commission to make recommendations to the President and the Congress with regard to: (1) consolidating or simplifying unfunded Federal mandates in order to facilitate compliance by State, local, and tribal governments, especially with respect to specific mandates for which the terms of compliance are unnecessarily rigid or complex; (2) terminating unfunded mandates which are duplicative, obsolete, or lacking in practical utility; and (3) temporarily suspending those unfunded mandates which are not vital to public health and safety and which compound the fiscal difficulties of State, local, and tribal governments. (Sec. 307) Authorizes appropriations. Title IV: Judicial Review - Disallows judicial review under this Act.
Bill· SS. 7 (104th)open
United States · United States Congress · 4 January 1995
TABLE OF CONTENTS: Title I: Health Insurance Market Reform Subtitle A: Insurance Market Standards Subtitle B: Establishment and Application of Standards Subtitle C: Health Care Cost and Access Advisory Commission Subtitle D: Definitions Title II: Improving Access to Health Care Coverage Subtitle A: Coverage Under Qualified Health Plans and Premium Assistance Subtitle B: Self-Employed Health Insurance Deduction Title III: Improving Access in Rural Areas Subtitle A: Offfice of Rural Health Policy Subtitle B: Development of Telemedicine in Rural Underserved Areas Subtitle C: Rural Health Plan Demonstration Projects Subtitle D: Antitrust Safe Harbors for Rural Health Providers Title IV: Quality and Consumer Protection Subtitle A: Administrative Simplification Subtitle B: Privacy of Health Information Subtitle C: Enhanced Penalties for Health Care Fraud Subtitle D: Health Care Malpractice Reform Title V: Budget Neutrality Family Health Insurance Protection Act - Title I: Health Insurance Market Reform - Subtitle A: Insurance Market Standards - Prohibits a health plan, with specified exceptions, from denying, limiting, or conditioning its coverage (or benefits), or varying its premium, for an individual based on the health status, medical condition, claims experience, receipt of health care, medical history, anticipated need for health care services, disability, or lack of evidence of insurability. (Sec. 1002) Requires each health plan that offers coverage in the small group market or large employer market to guarantee enrollment in and renewal of (at the option of the individual or employer) such plan to each individual purchaser and employer. (Sec. 1003) Requires a health plan offering coverage in the small group market to comply with certain rating (premium rates) standards to be developed by the National Association of Insurance Commissioners (NAIC). (Sec. 1004) Requires the Secretary of Health and Human Services to establish minimum guidelines for the issuance by each State of delivery system quality standards. Sets forth such guidelines, including: (1) establishing health plan quality assurance; (2) providing consumer protection for health plan enrollees; and (3) ensuring reasonable access for vulnerable populations in underserved areas. (Sec. 1005) Requires a sponsor of a health plan to offer a benchmark benefits package which covers specified health care items and services and provides for a cost-sharing schedule. Authorizes a sponsor to offer any other health benefits package. (Sec. 1006) Requires each health plan offering coverage in the small group market in a State to participate in a risk adjustment program. Subtitle B: Establishment and Application of Standards - Prohibits any requirement or standard imposed on a health plan under this Act from preempting any State consumer protection laws unless such laws conflict with such requirement or standard. (Sec. 1012) Declares that nothing in this Act shall be construed as prohibiting States from enacting health care reform measures that exceed the measures established under this Act, including reforms that expand access to health care services, control health care costs, and enhance quality of care. (Sec. 1013) Requires the Secretary to make grants to States that submit applications that meet certain requirements for the establishment and operation of small group health insurance purchasing arrangements. Requires the Secretary in awarding such grants to consider the potential impact of the State's proposal on the cost of health insurance for the small group market and on the number of uninsured, and the need for regional variation in the award of such grants. Authorizes the use of grant funds to finance administrative costs associated with developing such arrangements. Authorizes appropriations. (Sec. 1014) Directs States to require that each health plan issued, sold, offered for sale, or operated in such State meets the insurance reform standards established under this title pursuant to an enforcement plan filed by it with, and approved by, the Secretary. Subtitle C: Health Care Cost and Access Advisory Commission - Establishes the Health Care Cost and Advisory Commission to monitor and respond to trends in national health care spending and health insurance coverage. Requires the Commission to report annually to the Congress and the President on the status of health care spending and health insurance coverage in the nation. Sec. 1023) Authorizes appropriations. Subtitle D: Definitions - Sets forth definitions. Title II: Improving Access to Health Care Coverage - Subtitle A: Coverage Under Qualified Health Plans and Premium Assistance - Part 1: Access to Qualified Health Plans - Requires States, in order to qualify for certain Federal payments, to establish a program under which a State: (1) makes available at least one qualifed health plan to each premium subsidy eligible individual residing there; and (2) furnishes premium assistance to such individual. (Sec. 2002) Requires the Secretary to issue regulations specifying requirements for State programs with respect to determining eligibility for premium assistance, including measures to prevent individuals from knowingly making material misrepresentations of information or providing false information in applications for assistance under the program. Requires a premium subsidy eligible individual who receives premium assistance to use such assistance only for payments toward the premium under a qualified State health plan. (Sec. 2011) Sets forth a formula for: (1) the amount of premium assistance for a month that a premium subsidy eligible individual shall receive; and (2) the maximum subsidy amount for a State. (Sec. 2012) Sets forth eligibility requirements for children and temporarily unemployed individuals to receive premium assistance. Part 2: Aggregate Federal Payments - Sets forth a formula for determining the amount of Federal payments to States for the payment of premium assistance under a qualified State health plan. Part 3: Definitions and Determinations of Income - Sets forth definitions. Subtitle B: Self-Employed Health Insurance Deduction - Amends the Internal Revenue Code to increase the deduction for health insurance costs of self-employed individuals from 25 percent through 1996 to 50 percent in 1997 to 75 percent in 1998 and to 100 percent in 1999 and thereafter. Title III: Improving Access in Rural Areas - Subtitle A: Office of Rural Health Policy - Amends the Social Security Act (SSA) to mandate that the Office of Rural Health Policy of the Department of Health and Human Services (HHS) be headed by an Assistant Secretary for Rural Health, who shall report directly to the Secretary. Adds as one of the duties of the Assistant Secretary that he or she advise the Secretary on reforms to the health care system and their implications for rural areas. Transfers the functions, powers, duties, and authority of the Office of Rural Health Policy to the Office of the Assistant Secretary for Rural Health. Subtitle B: Development of Telemedicine in Rural Underserved Areas - Directs the Secretary to award grants to eligible entities to expand access to health care services for individuals in rural areas through the use of telemedicine. (Sec. 3102) Directs the White House Information Infrastructure Task Force to report to the Congress an evaluation of the cost effectiveness of telemedicine, including recommendations for a coordinated Federal strategy to increase access to health care through telemedicine. (Sec. 3103) Directs the Secretary to issue regulations regarding reimbursement for telemedicine services provided under title XVIII (Medicare) of the SSA. (Sec. 3104) Authorizes appropriations. Subtitle C: Rural Health Plan Demonstration Projects - Directs the Secretary to establish not more than three demonstration projects for the designation of rural health plan areas. Subtitle D: Antitrust Safe Harbors for Rural Health Providers - Directs the Attorney General to establish, and publish in the Federal Register, policy guidelines to assist rural health care providers in complying with safe harbor requirements with respect to the provision of health care services in rural areas. Title IV: Quality and Consumer Protection - Subtitle A: Administrative Simplification - Part 1: Purpose and Definitions - Establishes a national framework for health information whose goal, through standardization of data elements, code sets, and electronic transactions, and by assuring a secure environment for the transmission and exchange of health information, is to reduce the burden of administrative complexity, paper work, and cost on the health care system, including Medicare under title XVIII and Medicaid under title XIX the SSA. Part 2: Standards for Data Elements and Information Transactions - Directs the Secretary to adopt standards for health information transactions and data elements. (Sec. 4012) Directs the Secretary to promulgate regulations specifying procedures for the electronic transmission and authentication of signatures on medical records and prescriptions. Part 3: Requirements with Respect to Certain Transactions and Information - Sets forth specified requirements with respect to certain transactions conducted by a health plan or health care provider. Part 4: Accessing Health Information - Requires the Secretary to adopt technical standards for persons to locate and access health information that is available through the health information network. Part 5: Penalties - Sets forth penalties for violations committed under this subtitle. Part 6: Miscellaneous Provisions - Mandates that any provision, requirement, or standard under this subtitle supercede any contrary provision of State law (except State provisions governing the reporting of disease or injury, child abuse, birth, or death, public serveillance, or public health investigation or intervention). (Sec. 4052) Authorizes appropriations. Subtitle B: Privacy of Health Information - Part 1: Defintions - Set forth definitions. Part 2: Authorized Disclosures - Subpart A: General Provisions - Sets forth requirements for the disclosure of protected health information by a health information trustee, or by a health care provider and person receiving such information, including a health information protection organization. Subpart B: Specific Disclosures Relating to Patient - Authorizes a health care provider, health plan, employer, or person who receives protected health information to disclose it to a health care provider for the purpose of providing health care (including emergency situations) to, or providing for the payment of such care for, an individual. Subpart C: Disclosure for Oversight, Public Health, and Research Purposes - Authorizes a health information trustee to disclose protected health information to a health oversight agency or to a health researcher. (Sec. 4117) Authorizes a health care provider, health plan, public health authority, employer, or person who receives protected health information to disclose it to a public health authority or other person authorized by law for use in: (1) disease or injury reporting; (2) public health surveillance; or (3) public health investigation or intervention. Subpart D: Disclosure for Judicial, Administrative, and Law Enforcement Purposes - Authorizes a health care provider, health plan, health oversight agency, employer, or person who receives protected health information to disclose it, (subject to a court's rules of procedure): (1) in connection with litigation where an individual's physical or mental condition is at issue; (2) in response to a court- ordered physical or mental examination; or (3) pursuant to a law requiring the reporting of specific medical information to law enforcement authorities. (Sec. 4122) Authorizes such entities or persons to disclose such information to law enforcement agencies. Subpart E: Disclosure Pursuant to Government Subpoena or Warrant - Authorizes a health care provider, health plan, health oversight agency, employer, or person who receives protected health information to disclose it pursuant to an administrative or judicial subpoena or warrant. Subpart F: Disclosure Pursuant to Party Subpoena - Authorizes a health care provider, health plan, employer, or person who receives protected health information to disclose it pursuant to a party subpoena. Part 3: Procedures for Ensuring Security of Protected Health Information - Subpart A: Establishment of Safeguards - Directs a health information trustee to establish administrative, technical, and physical safeguards to ensure the confidentiality of protected health information created or received by such trustee. Subpart B: Review of Protected Health Information By Subjects of the Information - Requires a health care provider or health plan to allow an individual who is the subject of protected health information to inspect any such information, with specified exceptions, that the provider or plan maintains. (Sec. 4142) Requires a health care provider or health plan, upon the written request of the subject individual, to correct or amend his or her protected health information. (Sec. 4143) Requires a health care provider or health plan to provide written notice of its information practices, including notice of individual rights with respect to protected health information. Part 4: Sanctions - Subpart A: Civil Sanctions - Sets forth civil penalties for violations of this subtitle. (Sec. 4152) Authorizes an individual who is aggrieved by the negligent conduct of a health information trustee to bring a civil action in court. Subpart B: Criminal Sanctions - Subjects to civil and criminal penalties any person who, in violation of this subtitle, knowingly: (1) obtains protected health information relating to an individual; or (2) discloses such information to another person. Part 5: Administrative Provisions - Sets forth provisions regarding: (1) preemption of State law with respect to the disclosure of protected health information; and (2) the rights of incompetents with respect to such information. Subtitle C: Enhanced Penalties for Health Care Fraud - Directs the Secretary to establish a program to: (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to the delivery of and payment for health care in the United States; (2) conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for such health care; (3) facilitate the enforcement of specified sections of the SSA and other applicable statutes with respect to health care fraud and abuse; and (4) provide for the modification and establishment of safe harbors, and to issue interpretative rulings and special fraud alerts. (Sec. 4201) Establishes a Health Care Fraud and Abuse Control Account which shall comprise all criminal and administrative fines imposed in cases involving a Federal health care offense. (Sec. 4202) Amends SSA title XI to provide for the application of sanctions under the Medicare and Medicaid Fraud and abuse programs for all fraud and abuse against any health plan. Subjects any person (including any organization, agency, or other entity, but excluding a beneficiary) who violates a provision of this section to a civil monetary penalty. (Sec. 4203) Directs the Secretary to establish a national health care fraud and abuse data collection program for the reporting of final adverse actions (not including settlements in which no findings of liability have been made) against health care providers, suppliers, or practitioners. (Sec. 4204) Amends Federal criminal law to subject to civil and criminal penalties any person who knowingly executes, or attempts to execute, a scheme to: (1) defraud any health plan or other person, in connection with the delivery of or payment for health care benefits or services; or (2) obtain, by false pretenses, any money or property owned by, or under the control of, any health plan, or person in connection with the delivery of or payment for such health care or services. Subtitle D: Health Care Malpractice Reform - Declares that these provisions apply to any health care liability action (except damages for vaccine-related injury or death) brought in any Federal or State court. (Sec. 4302) Requires each State to adopt an alternative dispute resolution method for the resolution of health care malpractice claims and consumer grievances. (Sec. 4303) Limits attorney contingency fees and award amounts for noneconomic damages. (Sec. 4304) Authorizes a party to a medical malpractice liability action to petition the court to instruct the trier of fact to award any future damages on an appropriate periodic basis. (Sec. 4305) Requires 50 percent of any punitive damages awarded in a medical liability action to be paid to the State in which such action is brought to carry out: (1) licensing or cretifying health care professionals and providers; (2) implementing health care quality assurance and improvement programs; (3) reducing malpractice-related costs for providers volunteering to provide services in medically underserved sreas; and (4) providing resources for additional investigation and disciplinary activites. Title V: Budget Neutrality - Prohibits any provision of this Act from taking effect until legislation is enacted which provides for its Federal budget neutrality.
Bill· SS. 29 (104th)open
United States · United States Congress · 4 January 1995
Federal Adoption Services Act of 1995 - Amends the Public Health Service Act to permit family planning projects to offer adoption services. Requires such services to be nondiscriminatory as to race, color, religion, or national origin.
Bill· SS. 28 (104th)open
United States · United States Congress · 4 January 1995
Unborn Children's Civil Rights Act - Prohibits funds appropriated by the Congress from being used to take the life of an unborn child, except for those medical procedures required to prevent the death of either the pregnant woman or her unborn child so long as every reasonable effort is made to preserve the life of each. Prohibits the use of such funds to promote, encourage, counsel for, refer for, pay for (including travel expenses), or do research on, abortions. Prohibits the Federal Government from entering into any contract for insurance which provides for payment or reimbursement for abortion services. States that no institution receiving Federal financial assistance shall: (1) discriminate against any employee, applicant, or student on the basis of that person's opposition to abortion; or (2) require any employee or student to participate in abortion procedures. States that attorney's fees shall not be allowed in any civil action involving a law prohibiting or restricting abortions. Provides for Supreme Court review of lower court decisions which declare State and local anti-abortion statutes unconstitutional.
Bill· SS. 121 (104th)referred
United States · United States Congress · 4 January 1995
TABLE OF CONTENTS: Title I: Portable and Permanent Private Health Insurance Subtitle A: Portability Subtitle B: Permanence Title II: Affordable Health Insurance Coverage Subtitle A: Equitable Tax Treatment of Individuals Providing Own Health Care Subtitle B: Medical Savings Accounts Title III: Enhanced Efficiency Through Paperwork Reduction Title IV: Meaningful Medical Liability Reform Family Health Care Preservation Act - Title I: Portable and Permanent Private Health Insurance - Subtitle A: Portability - Amends the Internal Revenue Code to modify required continuation coverage of group health plans by allowing the offering of annual deductibles for such coverage. Terminates such continuation coverage after an individual is eligible for employer-based coverage for more than 90 days. (Sec. 102) Allows penalty-free withdrawals from qualified retirement plans to pay for health insurance during a continuation period. Subtitle B: Permanence - Prohibits an insurer from cancelling an individual or group health insurance plan or denying renewal of coverage except for specified reasons, including premium nonpayment or fraud by the insured. Prohibits an employer from cancelling a self-insured group health plan or denying renewal of coverage except for similar reasons. (Sec. 112) Requires individual health insurance plans and group health plans to offer insureds the option to purchase new health insurance plans after enactment of this Act. Title II: Affordable Health Insurance - Subtitle A: Equitable Tax Treatment of Individuals Providing Own Health Care - Makes inapplicable to qualified health insurance costs under this Act the adjusted gross income limitation on deductibility of medical expenses. Subtitle B: Medical Savings Accounts - Allows individuals covered under a catastrophic health insurance plan a tax deduction for contributions made to a medical care savings account established for the benefit of the individual or such individual's spouse and dependents, if they are also covered under the plan. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Imposes an excise tax for excess contributions to medical care savings accounts and for prohibited transactions. Title III: Enhanced Efficiency Through Paperwork Reduction - Directs the Secretary of Health and Human Services to adopt standards to reduce the administrative and paperwork burdens of all Federal health care programs by 50 percent within the two-year period following the date of this Act's enactment (initial reduction), and by an additional 50 percent over a subsequent three-year period (subsequent reduction), for a total reduction of 75 percent over the five-year period following such date. Requires the Secretary, to achieve the initial reduction, to adopt standards for Federal health care programs relating to: (1) data elements for use in paper and electronic claims processing under health insurance plans, as well as for use in utilization review and management of care; (2) uniform claims forms; and (3) uniform electronic transmission of the data elements, including protections to assure the confidentiality of patient-specific information and to protect against the unauthorized use and disclosure of information. Directs the Secretary, in order to achieve the subsequent reduction, to modify by regulation the standards adopted with respect to the initial reduction. (Sec. 302) Requires each State, to be eligible for Federal funds in connection with any State-administered health care program, to standardize the processing of paper and electronic claims to reduce the administrative and paperwork burdens on such programs by 75 percent during the five-year period following enactment of this Act. Sets forth provisions regarding enforcement of this provision and waivers of payment reductions for noncompliance. Title IV: Meaningful Medical Liability Reform - Makes this title applicable with respect to any medical malpractice liability claim or action brought in State or Federal court, except with respect to certain claims or actions for damages arising from a vaccine-related injury or death. Sets forth provisions regarding: (1) preemption; (2) negotiated liability; (3) effect on sovereign immunity and choice of law or venue; and (4) jurisdiction. (Sec. 402) Prohibits such action from being initiated after the expiration of: (1) the two-year period that begins on the latter of the date the alleged injury that is the subject of the claim was discovered or should reasonably have been discovered; and (2) the four-year period that begins on the date on which the alleged injury occurred. Makes an exception for a minor who has not attained age six. (Sec. 403) Provides that: (1) the liability of each defendant in such action, with respect to economic and noneconomic damages, shall be several only and not joint; (2) damages payable by a defendant shall be directly proportional to such defendant's percentage of fault or responsibility for the injury; and (3) the trier of fact shall determine and assign a percentage of responsibility for each such defendant. (Sec. 404) Requires: (1) all requests for discovery pursuant to such action to identify the relevant portion of the complaint, answer, or other pleading to which responses to the discovery requests are expected to relate; and (2) the court, with respect to any motion for discovery, to award the prevailing party reasonable fees and expenses, including reasonable attorney's fees, unless the court finds that the position of the unsuccessful party was substantially justified or that special circumstances make such an award unjust. (Sec. 405) Limits the total amount of noneconomic damages that may be awarded to a claimant and family members to $250,000, regardless of the number of parties against whom the action is brought or the number of actions brought with respect to the injury. (Sec. 406) Specifies that a defendant may not be required to pay damages awarded for any economic losses to be incurred after the date on which the judgment is entered exceeding $100,000, in a single, lump-sum payment, but shall be permitted to make such payments periodically based on projections of the amount of expected damages at intervals, as determined by the court. Permits the court to require that a defendant purchase an annuity or fund a reversionary trust to make periodic payments. Prohibits reopening of a judgment awarding such payments at any time to contest, amend, or modify the schedule or amount of the payments in the absence of fraud or any other basis under which a party may obtain relief from a final judgment. (Sec. 407) Sets forth provisions regarding costs and fees, including limitations on attorneys charging or collecting contingency fees. Establishes recordkeeping requirements as a prerequisite to the receipt of an award of attorney's fees. (Sec. 408) Sets forth provisions regarding: (1) contribution and indemnification; and (2) collateral sources. (Sec. 410) Prohibits the award of noneconomic damages with respect to any medical product liability claim alleged against a medical product producer if: (1) the drug or device that is the subject of such claim was subject to specified approval or premarket approval under the Federal Food, Drug, and Cosmetic Act by the Food and Drug Administration (FDA); or (2) the drug or device is generally recognized as safe and effective pursuant to conditions established by the FDA and applicable regulations, including packaging and labeling regulations. Makes exceptions in cases of withheld information, misrepresentation, or illegal payment of FDA officials to secure approval. (Sec. 411) Provides that, in any medical malpractice liability action that is certified as a class action: (1) the share of damages under any final judgment or settlement that is awarded to any party serving as a representative claimant shall be calculated in the same manner as the shares awarded to all other members of the claimant class (but permits the award of reasonable compensation, costs, and expenses relating to the representation of the class); (2) if a party is represented by an attorney who has a beneficial interest in the subject of the litigation, the court shall make a determination of whether such interest constitutes a conflict of interest sufficient to disqualify the attorney; and (3) an attorney may not represent the class if the attorney has paid, or is obligated to pay, a referral fee with respect to the action (and bars an attorney who knowingly violates this provision from representing the party in any other action to which this title applies).
Bill· SS. 142 (104th)referred
United States · United States Congress · 4 January 1995
TABLE OF CONTENTS: Title I: Formula Grants for State Core Functions of Public Health Title II: Centers for Disease Control and Prevention Activities Title III: Repeals Public Health Enhancement Act of 1995 - Title I: Formula Grants for State Core Functions of Public Health - Amends the Public Health Service Act to consolidate grant programs of the Centers for Disease Control and Prevention (CDC) into formula grants to States for core functions of public health, including: (1) data collection and needs assessment; (2) environmental protection and safety of housing, workplaces, food and water, and the public health of communities; (3) investigation and control of adverse health conditions; (4) public information and education programs; (5) accountability and quality assurance; (6) provision of laboratory services; (7) training and education; and (8) leadership, policy development, and administration. Sets restrictions on the use of grant funds and limitations on administrative expenses. Requires development of a fund distribution formula which incorporates measures of population, the health status of the population, and the financial resources of the various States. Requires, under specified conditions, the reservation of portions of State allotments for Indian tribes and tribal organizations. Authorizes appropriations. Requires development of a uniform application that States shall use to apply for grants. Requires certain State assurances in applications, including State-specific descriptions of deficiencies and successes in the State's public health system. Requires the development of a Uniform Core Public Health Functions Reporting System which uses outcomes consistent with the goals of Healthy People 2000. Title II: Centers for Disease Control and Prevention Activities - Directs the Secretary of Health and Human Services, acting through the CDC Director, to submit to the President and the Congress a report containing certain information, including: (1) a description of CDC activities and recommendations for legislative changes; and (2) a description of steps taken to improve and streamline grants and contracting accountability. Requires the Secretary, through the CDC Director, to address priority public health needs of regional and national significance through the provision of training, technical assistance, applied research, and demonstration projects. Authorizes appropriations. Title III: Repeals - Repeals specified provisions of the Public Health Service Act.
Bill· SS. 85 (104th)referred
United States · United States Congress · 4 January 1995
TABLE OF CONTENTS: Title I: Home and Community-Based Services for Individuals With Disabilities Title II: Provisions Relating to Medicare Long-Term Care Reform and Deficit Reduction Act of 1995 - Title I: Home and Community Based Services for Individuals with Disabilities - Entitles each State with an approved plan for home- and community-based services for individuals with disabilities to specified payments. Prohibits such plans from requiring cost sharing for low-income individuals. Requires such plans to: (1) ensure the quality of services; (2) adhere to Federal quality standards; (3) provide for a client advocacy office; (4) provide safeguards on confidentiality and against abuse; and (5) protect individual rights. (Sec. 107) Establishes an advisory group to advise the Secretary of Health and Human Services and the States on all aspects of such State programs. (Sec. 109) Authorizes appropriations and provides for allotments to States. (Sec.110) Requires the Secretary to report to the Congress on evaluations of services to individuals with low-incomes and disabilities. (Sec. 111) Amends the Public Health Service Act to direct the Secretary to disseminate information and materials to assist specified entities in replicating successful programs aimed at offering care management to hospitalized individuals in need of long-term care so that services to meet individual needs and preferences can be arranged in home- and community-based settings as an alternative to long-term nursing home placement. Authorizes the Secretary to provide technical assistance to such entities. Directs the Secretary to establish a program under which incentive grants may be awarded to assist agencies and organizations in developing and expanding programs and projects that facilitate the discharge of individuals in hospitals or other acute care facilities who are in need of long-term care services and placement of such individuals into home- and community-based settings. Sets forth provisions regarding: (1) eligibility to receive grants; (2) application requirements; (3) criteria for the award of grants; (4) use of, and limitations on, grants; and (5) evaluation and reports. Authorizes appropriations. Title II: Provisions Relating to Medicare - Provides for the recapture of certain health care subsidies received by high-income individuals. Transfers such amounts to the Supplemental Medical Insurance Trust Fund. (Sec. 202) Amends title XVIII (Medicare) of the Social Security Act to impose a ten percent copayment on home health services. Modifies the formula for determining the amount of payments for home health care services (other than osteoporosis drugs). (Sec. 203) Reduces payments for capital-related costs for inpatient hospital services. (Sec. 204) Revises the payment formulae for ambulatory surgical center procedures and radiology services and diagnostic procedures. (Sec. 205) Reduces routine cost limits for home health services.
Bill· SS. 96 (104th)referred
United States · United States Congress · 4 January 1995
Amends the Public Health Service Act to authorize the Secretary of Health and Human Services to carry out projects to reduce the incidence of traumatic brain injury through grants or contracts to public or nonprofit entities. Authorizes the following activities: (1) the conduct of research into identifying effective strategies for the prevention of traumatic brain injury; and (2) the implementation of public information and education programs for the prevention of such injury and for broadening the awareness of the public concerning the public health consequences of such injury. (Sec. 2) Requires the National Institutes of Health research program on trauma to include the authority to award grants or contracts to public or nonprofit entities for the conduct of basic and applied research regarding traumatic brain injury. (Sec. 3) Authorizes the Secretary to make grants to States for the purpose of carrying out demonstration projects to improve access to health and other services regarding traumatic brain injury. Permits the Secretary to make a grant only if the State agrees to establish an advisory board within the appropriate health department or another department of the State. Authorizes appropriations. (Sec. 4) Directs the Secretary to conduct: (1) a study concerning traumatic brain injuries; and (2) a national consensus conference on managing traumatic brain injury and related rehabilitation concerns. Authorizes appropriations.
Bill· SS. 69 (104th)referred
United States · United States Congress · 4 January 1995
Authorizes payment through the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) for items and for services for which payment is also made through Medicare, with a reduction for the amount already covered by Medicare. Continues CHAMPUS eligibility for veterans eligible for care or treatment for a service-connected disability in facilities of the Department of Veterans Affairs. Requires a person receiving medical or dental care for which payment may be made under both Medicare and CHAMPUS to certify the amounts charged and paid for such items and services.
Bill· SS. 65 (104th)referred
United States · United States Congress · 4 January 1995
Amends the Public Health Service Act to provide for grants and contracts with eligible individuals and institutions to encourage the provision of psychological training and services in underserved treatment areas. Requires individuals to already possess a doctoral degree in psychology and agree to provide services in a medically underserved population during the grant and at least one year thereafter. Requires institutions to use amounts provided for fellowships to such individuals. Authorizes appropriations.
Bill· SS. 61 (104th)referred
United States · United States Congress · 4 January 1995
Amends title XIX (Medicaid) of the Social Security Act to provide for coverage of nursing school clinic services.
Bill· SS. 86 (104th)referred
United States · United States Congress · 4 January 1995
Amends title XIX (Medicaid) of the Social Security Act to modify its estate recovery provisions to change from mandatory to discretionary the authority of a State to recover the costs of home and community-based services for individuals over age 55. Prohibits a nursing facility from receiving reimbursement under the Medicare program under title XVIII, the Medicaid program, or any other Federal program for services furnished with respect to any beds first operated by such facility on or after the date of the enactment of this Act, unless a certificate of need is issued by the State with respect to them. Allows a State to issue such a certificate of need with respect to a geographic area only if the ratio of the number of nursing facility beds in such area to the total area population likely to need such beds is below the ratio included in guidelines the State must establish, with the approval of the Secretary of Health and Human Services.
Bill· SS. 78 (104th)referred
United States · United States Congress · 4 January 1995
Compassionate Pain Relief Act - Amends the Public Health Service Act to direct the Secretary of Health and Human Services to establish a 60-month program under which parenteral diacetylmorphine may be dispensed from pharmacies for the relief of pain from terminal cancer (as defined by this Act). States that for purposes of such program the Federal Food, Drug, and Cosmetic Act and titles II and III of the Comprehensive Drug Abuse Prevention and Control Act of 1970 shall not apply with respect to: (1) the importing of opium; and (2) the manufacture, distribution, and dispensing of parenteral diacetylmorphine. Requires the Secretary to report to specified congressional committees concerning: (1) program-related activities; and (2) activities related to the management of pain. Permits the Secretary, at any time six months after implementation of the program, to modify or terminate the program if: (1) the program is no longer needed; or (2) modifications or termination are needed to prevent substantial diversion of the diacetylmorphine.
Bill· SS. 63 (104th)referred
United States · United States Congress · 4 January 1995
Amends title XVIII (Medicare) of the Social Security Act to provide for reimbursement of clinical social worker services covered under Medicare according to a new reimbursement methodology similar to the one currently used for other health care professionals. Provides coverage and reimbursement under the new methodology for supplies furnished incident to such services. Excludes the services of clinical social workers from the definition of "inpatient hospital services" for purposes of Medicare.