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Bill· HRH.R. 4070 (102nd)referred
United States · United States Congress · 27 November 1991
International Cooperation Act of 1991 - Title I: Economic Assistance - Amends the Foreign Assistance Act of 1961 to revise policy provisions concerning economic assistance. Sets forth the objectives of U.S. economic cooperation policy and development and economic assistance programs as the: (1) alleviation of poverty through the development of human resources; (2) promotion of broad-based economic growth; (3) improved environmental, natural resource, and agricultural management to achieve environmentally and economically sustainable patterns of development; and (4) promotion of democracy, respect for human rights, and political, social, and economic pluralism. Authorizes appropriations for FY 1992 and 1993 for development assistance. Declares that the Administrator of the agency primarily responsible for administering this title (administering agency) should target a specified amount of such funding for agriculture, rural development, and nutrition assistance. Authorizes appropriations for FY 1992 and 1993 for population planning, health, education, and human resources assistance. Declares that the Administrator should target specified amounts of human resource development funding for child survival activities and for the prevention and control of acquired immune deficiency syndrome (AIDS). Repeals provisions concerning contributions to the International Fund for Agricultural Development. Permits funds authorized to be appropriated for human resources development to be used for assistance to meet the needs of individuals with disabilities and displaced children who have been abandoned or orphaned as a result of poverty or disasters. Authorizes the use of agriculture, rural development, and nutrition assistance for strengthening and expanding marine fisheries and aquaculture programs. Provides that funds made available for family planning projects shall be available only for projects which offer a broad range of family planning methods and services. Authorizes the President to furnish assistance for the prevention and control of AIDS. Revises provisions concerning private sector, environment, energy, and other development assistance. States that Appropriate Technology International qualifies for U.S. development assistance. Declares that a specified amount of economic support assistance should be made available for such organization. Authorizes assistance to be provided to developing countries to support private sector activities meeting specified criteria. Permits the President to issue guarantees assuring against losses incurred in connection with loans made for such activities. Sets forth terms and conditions for such guarantees. Authorizes the President to make direct loans for such activities, subject to certain conditions. Establishes ceilings for direct loans and for contingent liability for guarantees. Authorizes appropriations for FY 1992 and 1993. Declares that beneficiary countries should bear a share of the costs of development assistance programs under this Act. Requires the Administrator to ensure that: (1) development assistance activities incorporate the active participation of local women; (2) sex-disaggregated data is included in country development strategy statements for major sectors in which assistance is to be provided and in project papers and program assistance approval documents; (3) programs are designed so that the percentage of women who benefit from such assistance exceeds the approximate transitional level of participation of women in the sector for which assistance is being provided; and (4) program assistance evaluations include an assessment of the extent to which women are participating in the activity and the impact of the activity on the self-reliance of women and improvement of their incomes. Requires a specified amount to be made available each fiscal year as matching funds to support activities of the missions of the agency which demonstrate potential for integrating women into programs. Increases the percentage of funds to be made available or channeled for each fiscal year (currently, FY 1986 through 1989) to private and voluntary organizations for specified development activities. Authorizes the Administrator to support and encourage development education programs. Requires the Administrator to establish a program performance evaluation capacity to: (1) develop a program performance information system to afford the administering agency's managers a means for monitoring achievement of impact and interim performance of the agency's major programs; (2) prepare and disseminate reports on the agency's progress in meeting development objectives for major assistance categories and recipient countries; (3) strengthen the implementation of foreign assistance projects; and (4) coordinate with the Inspector General of such agency to ensure complementarity of efforts. Directs the President to report annually to the Congress on: (1) progress toward achieving the four basic objectives set forth under this title; and (2) a country-by-country analysis of the impact on economic development in each country during the preceding three to five years of U.S. economic assistance programs, with a discussion of U.S. interests that were served by such assistance. Authorizes appropriations for FY 1992 and 1993 for American schools, hospitals, and libraries abroad. Raises the ceiling on the principal amount of housing guaranties authorized to be issued under the worldwide shelter program. Continues the authority of the housing guaranty program through FY 1993. Repeals provisions concerning the issuance of guaranties for projects using solar energy technology and agricultural and protective credit and self-help community development programs. Requires fees to be charged for housing guaranties. Raises the ceiling on the total face value of guaranties authorized to be issued with respect to any country and on the average face value of guaranties in any fiscal year. Provides that the principal amount of guaranties issued shall be comparable to the amount issued for FY 1984, subject to dollar value limitations. Authorizes appropriations for FY 1992 and 1993 to pay the cost of guaranties with a specified face value and for administrative expenses of the housing guaranty program. Authorizes the issuance of guaranties in connection with loans made for housing and infrastructure in Israel for Soviet refugees. Exempts such guaranties from specified limitations on principal amount, amount of guaranties per country, or average face value. Removes restrictions on Overseas Private Investment Corporation (OPIC) loans for mining operations. Repeals provisions that limit OPIC equity investments to countries in Subsaharan Africa and the Caribbean basin. Increases the amount of OPIC's one-time transfer to the fund established to carry out its activities. Raises the ceiling on the maximum contingent liability for outstanding OPIC guarantees. Authorizes OPIC to draw specified amounts from a noncredit account revolving fund to pay estimated subsidy costs of program levels for the loan guarantee and direct loan programs. Revises provisions concerning OPIC's insurance reserves. Authorizes OPIC to transfer a specified amount from the noncredit account revolving fund for administrative expenses of the direct loan and loan guarantee programs. Makes provisions concerning income and revenues applicable to income and revenues from OPIC's noncredit activities (currently, revenue and income from any source). Changes from mandatory to discretionary OPIC's authority to charge fees for its services. Requires investors in projects receiving OPIC financing to certify to OPIC that any contract for the export of goods as part of a project requires that U.S. insurance companies have a fair and open opportunity to provide insurance against risk of loss of the export. Exempts from such requirement investors who do not have a controlling interest in a project. Directs the U.S. Trade Representative to report to the Congress on OPIC actions with respect to such certifications. Authorizes the President, acting through the Administrator, to provide assistance for microenterprises in developing countries. Directs the administering agency to establish specified criteria for determining the financial intermediaries that will receive such assistance. Requires a significant portion of such assistance to be used to support direct credit assistance by, and the institutional development of, financial intermediaries with a primary emphasis on assisting people living in absolute poverty, especially women. Outlines funding sources for such assistance. Permits the President, in order to generate local currencies for providing such assistance, to use development and economic support fund assistance to provide assistance to developing countries on a loan basis repayable in local currencies. Sets forth minimum levels of assistance to be provided under this Act. Requires the Administrator to develop a monitoring system to evaluate the agency's microenterprise development activities. Authorizes the President to use development and economic support assistance or assistance from the Development Fund for Africa to support human rights and activities to improve the performance of democratic institutions. Requires a substantial portion of such assistance to be provided to nongovernmental organizations. Prohibits such assistance from being used to influence the outcome of an election in any country. Permits Development Fund for Africa assistance to be used only for countries in Subsaharan Africa. Requires the President to report to specified congressional committees on activities designed to promote democracy that are funded by the Department of State, the Agency for International Development (AID), or the U.S. Information Agency (USIA), along with recommendations for ways to improve coordination of responsibilities among such agencies. Authorizes appropriations for FY 1992 and 1993 for contributions to international organizations. Earmarks specified amounts of such funds for: (1) the United Nations Development Program; (2) the United Nations Children's Fund; (3) the United Nations Environment Program; (4) the Organization of American States (OAS), with an amount set aside for establishing an electronic network for the exchange of science and technology information among universities in OAS member countries; (5) the Special Program for Africa of the International Fund for Agricultural Development; (6) the United Nations Development Fund for Women; (7) the Intergovernmental Oceanographic Commission; and (8) the United Nations University Endowment Fund. Permits the President to continue U.S. participation in, and make contributions to, the International Fund for Agricultural Development. Applies evaluation and auditing procedures for the International Bank for Reconstruction and Development and the Asian Development Bank to the International Development Association, the International Finance Corporation, the Multilateral Investment Guarantee Agency, the Inter-American Development Bank, the Inter-American Investment Corporation, the African Development Bank, the African Development Fund, the Asian Development Fund, and the European Bank for Reconstruction and Development. Provides that if Israel is denied its right to participate in any United Nations agency, the United States shall suspend its participation in, and contributions to, such agency until the denial of rights is reversed. Permits the President to use development or economic support assistance or assistance from the Development Fund for Africa for grants to, or contracts with, nongovernmental organizations to enable such organizations to: (1) purchase debt obligations owned by developing countries to commercial lending institutions or other private parties; and (2) cancel such obligations subject to the President's approval, to the extent that such countries make available assets or policy commitments to promote the objectives of this title. Authorizes grantees or contractees to retain interest earned on the proceeds of debt-for-development or debt-for-environment purchases or exchanges pending the disbursement of such proceeds and interest for the purposes for which assistance was provided. Authorizes appropriations for FY 1992 and 1993 for international disaster assistance. Raises the ceiling on the amount that may be obligated against appropriations for use in providing such assistance. Limits the amount that may be obligated against appropriations for development assistance and assistance from the Development Fund for Africa. Authorizes appropriations for economic support fund (ESF) assistance for FY 1992 and 1993 for: (1) Israel; (2) Egypt; (3) Turkey; (4) the International Fund for Ireland; (5) Cyprus (for a scholarship program, bicommunal projects, and measures aimed at the reunification of the island and designed to promote peace between the two communities on Cyprus); (6) Nepal; (7) the South Pacific Regional Program (with earmarked funds for scholarships for study at postsecondary institutions of education in the United States); (8) regional cooperative programs in the Middle East; and (9) other recipients or purposes. Redesignates the Trade and Development Program as the Trade and Development Agency. Revises the authorities of the Director of the Agency. Requires the Agency to disseminate information about its activities to the private sector. Sets forth the duties of the Inspector General of the administering agency with respect to the Agency. Authorizes appropriations for FY 1992 and 1993. Authorizes appropriations for FY 1992 and 1993 for operating expenses of the administering agency and its Office of the Inspector General. Directs the President to report annually to the Congress on: (1) progress toward achieving the four basic objectives set forth under this title; and (2) a country-by-country analysis of the impact on economic development in each country during the preceding three to five years of U.S. economic assistance programs, with a discussion of U.S. interests that were served by such assistance. Requires the President to maintain within the administering agency a Center for University Cooperation in Development and a Center for Voluntary Cooperation in Development. Provides that the respective purposes of such centers shall be to strengthen the partnership for development between the U.S. Government and: (1) U.S. and developing country institutions of higher education engaged in education, research, and public service programs relevant to developing countries; and (2) U.S. private voluntary organizations, cooperatives, and credit unions engaged in activities relevant to such countries. Directs the Administrator to establish an Advisory Committee on University Cooperation in Development and an Advisory Committee on Voluntary Cooperation in Development. Repeals provisions concerning the Board for International Food and Agricultural Development. Expresses the sense of the Congress that the President should continue to make efforts to improve the management of U.S. economic assistance programs. Requires the President to report to the appropriate congressional committees on the feasibility and impact on U.S. foreign policy and foreign assistance objectives of: (1) reducing the number of countries receiving economic assistance; and (2) improving coordination within the U.S. Government and with other donors and improving management of U.S. economic assistance programs. Title II: Military Assistance and Sales and Related Programs - Chapter 1: Military Assistance and Related Programs - Revises policies and objectives of U.S. military assistance programs. Revises the President's authorities to furnish foreign military financing assistance, to remove the authority to detail members of the armed forces to foreign countries, or to transfer funds to countries to meet obligations for payments for arms sales. Exempts from appropriations charges, any defense article or service that is made available under special drawdown authority. Permits financing assistance to be provided on a grant, credit, or guaranty basis. Directs the President, in determining how financing will be provided, to take into account: (1) U.S. national security and foreign policy interests in furnishing such assistance to a country; and (2) the national security and self-defense needs and economic conditions of the country. Requires repayment on credits within a 12-year period unless a longer period is authorized by law. Sets a minimum five percent interest rate on credits. Authorizes financing for the procurement by leasing of defense articles from U.S. commercial suppliers to be provided to Israel and Egypt if there are compelling foreign policy or national security reasons for such articles being provided by lease rather than by government-to-government sale. Permits the financing of the procurement of defense articles and services not sold by the U.S. Government only if the country or international organization proposing to make such procurement has signed an agreement with the United States specifying the conditions under which the procurement may be financed. Requires sales under the Arms Export Control Act which are wholly paid from funds made available on a grant basis under this Act or were transferred or made available under former authorities prior to this Act's enactment to be priced to exclude the costs of salaries of members of the U.S. armed forces (other than members of the Coast Guard). Prohibits assistance from being furnished under this chapter in any case involving coproduction or licensed production outside the United States of any defense article of U.S. origin unless the President furnishes full information on the proposed transaction to the appropriate congressional committees. Prohibits the obligation of certain assistance for the procurement of: (1) any vessel of war built pursuant to a prime contract awarded to a foreign shipyard; or (2) any weapons system or other major system for a vessel of war built pursuant to such a contract awarded to a foreign rather than a U.S. shipyard because of unfair foreign competition. Exempts from such prohibition vessels of war built in the foreign country which is the recipient of such assistance or built pursuant to a prime contract signed before the effective date of this Act or procurement for the maintenance, repair, or replacement of such systems. Authorizes appropriations for foreign military financing for FY 1992 and 1993 for: (1) Israel; (2) Egypt; (3) Turkey; (4) Greece; and (5) other recipients or purposes. Revises provisions concerning eligibility for the receipt of defense articles and services. Raises the ceiling on the amount of defense articles and services and military training to be drawn down under certain emergencies. Limits the amount of such articles, services, and training to be drawn down for purposes of international narcotics control and international disaster assistance. Directs the President to establish monitoring and auditing controls to make financed arms sales subject to requirements no less stringent in accountability than requirements of Federal Acquisition Regulations applicable to sales under the Arms Export Control Act relating to improper business practices and personal conflict of interest. Places a ceiling on the value of additions to stockpiles for FY 1992 and 1993. Revises provisions concerning the location of stockpiles. Extends the President's authority to transfer excess defense articles to countries on NATO's southern flank through FY 1996. Requires excess defense articles to be made available to maintain the military balance in the Eastern Mediterranean. Directs the President to ensure, over a three-year period beginning in FY 1993, that the ratio of the value of such articles made available for Turkey to those made available for Greece closely approximates the ratio of the amount of foreign military financing provided for Turkey to the amount provided for Greece. Authorizes the President to transfer excess defense articles to major drug transit countries for counternarcotics purposes. Amends the Arms Export Control Act to raise the ceiling on the aggregate acquisition cost to the United States of excess defense articles ordered by the President. Amends the Foreign Assistance Act of 1961 to remove a reporting requirement with respect to nonlethal defense articles furnished to foreign countries. Repeals provisions of the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1990 concerning transfers of excess defense articles. Authorizes appropriations for FY 1992 and 1993 for: (1) international military education and training; (2) peacekeeping operations; and (3) antiterrorism assistance. Declares that the President, in providing assistance under this Act, should take into account the cooperation provided by countries in matters connected with international terrorism. Amends the Arms Export Control Act to revise requirements of a report by the President on military exports. Chapter 2: Foreign Military Sales Program - Amends the Arms Export Control Act to repeal provisions concerning purposes of military sales or leases. Requires the President to take the following steps to address financial management problems with respect to payments on account of foreign military sales: (1) certify that payments with respect to such sales are properly recorded by case and country; (2) improve the coordination and uniformity of the military services systems used to account for, control, and report upon the operation of the foreign military sales program; and (3) reconcile the discrepancies between reported disbursements and performance for all uncompleted foreign military sales agreements executed prior to March 1989. Directs the President to notify the House Foreign Affairs Committee and the Senate Foreign Relations Committee on the termination of any discrepancy reconciliation. Designates Australia, Egypt, Israel, Japan, New Zealand, and South Korea as major non-NATO allies. Provides that New Zealand shall be eligible for special treatment authorized for such allies only to the extent that the President notifies the appropriate congressional committees that such treatment is in the national security interest. Authorizes the President to make additional designations with advance notification to the appropriate congressional committees. Raises the threshold on the dollar amount of defense equipment or services on which the President is required to submit specified certifications. Revises provisions concerning presidential certifications and congressional procedures for certain arms transfers. Adds to the list of information required in the President's quarterly report on military exports information on all concluded defense coproduction agreements. Imposes sanctions on foreign parties to coproduction agreements that violate restrictions concerning unauthorized third party transfers or unauthorized dispositions of defense articles or services or technical data if the President notifies the Congress or the Congress so determines by joint resolution. Lists such sanctions as: (1) the suspension of authority to produce defense articles abroad pursuant to such agreements; and (2) a prohibition on the issuance and approval of licenses with respect to the foreign party. Disqualifies for financing under the Foreign Assistance Act of 1961 for 12 months any contracts of a person convicted or debarred for a violation of international traffic in arms regulations under the Arms Export Control Act. Increases the amount of defense trade registration fees required to be credited to a Department of State account. Repeals provisions of the State Department Basic Authorities Act of 1956 concerning munitions control registration fees. Amends the Export Control Act to require the President to review biennially and revise, as necessary, international traffic in arms regulations. Prohibits funds authorized by any Act from being made available to facilitate the sale of M-833 antitank shells or comparable shells containing a depleted uranium penetrating component to any country other than a NATO member or major non-NATO ally. Chapter 3: Technical and Conforming Amendments; Repeal of Obsolete and Inconsistent Provisions - Amends the Foreign Assistance Act of 1961 to apply termination of assistance provisions (with respect to violations of agreements providing defense articles or services) to defense articles or services provided under the Arms Export Control Act. Makes technical and conforming amendments to the Arms Export Control Act. Revises a provision regarding the Guaranty Reserve Fund and redesignates the Fund as the Foreign Military Loan Liquidating Account. Repeals provisions concerning: (1) information to the Congress on credit sales and guaranties; (2) the availability of funds for procurement of defense articles and services outside the United States; (3) discrimination; (4) restraint in arms sales to Subsaharan Africa; (5) foreign military sales credit standards; and (6) foreign military sales to less developed countries. Chapter 4: Transfers of Spoils of War - Spoils of War Act of 1991 - Permits spoils of war in the possession or control of the United States to be transferred to any other party only to the extent and in the same manner that property of the same type, if otherwise owned by the United States, may be so transferred. Title III: International Narcotics Control - Authorizes appropriations for FY 1992 and 1993 for international narcotics control. Revises provisions concerning international narcotics control. Exempts maritime law enforcement operations in archipelagic waters from a prohibition on U.S. participation in foreign police actions. Makes a prohibition on the use of narcotics control funds for the procurement of weapons or ammunition inapplicable (subject to congressional notification requirements) to: (1) weapons or ammunition for the defensive arming of aircraft used for narcotics control purposes; or (2) firearms and related ammunition provided to Department of State employees for narcotics control activities. Requires the President (currently, the Secretary of State) to maintain records on aircraft use under this title. Authorizes foreign military financing assistance under the Arms Export Control Act to be made available to finance the leasing of aircraft. Authorizes (currently, requires) the reallocation of funds withheld from countries which fail to take steps to halt illicit drug production or trafficking. Revises congressional reporting and certification requirements with respect to international narcotics control. Requires the President to notify the appropriate congressional committees annually of countries determined to be major drug transit or illicit drug producing countries. Repeals obsolete provisions of specified Acts. Makes prohibitions on the provision of assistance to foreign law enforcement agencies inapplicable, during FY 1992 and 1993, to: (1) transfers of defense articles and services for counternarcotics purposes; and (2) foreign military financing and international military education and training for narcotics-related purposes. Makes provisions of law that restrict assistance to countries inapplicable with respect to narcotics-related assistance, provided that the President notifies the appropriate congressional committees. Title IV: Special Authorities, Restrictions, Reporting Requirements, Administrative and General Provisions, Definitions, and Conforming Amendments and Repeals - Chapter 1: Contingency and Other Special Authorities - Authorizes appropriations to the President for FY 1992 and 1993 for unanticipated contingencies in programs within the International Affairs Budget Function. Authorizes the President to provide assistance (other than foreign military financing or international military education and training) to a country that is: (1) emerging as a democracy; or (2) emerging from civil strife and has a democratically elected government or is making progress toward a democratic form of government. Raises the ceiling on funds available for unanticipated contingencies. Requires congressional notification prior to the transfer of funds between accounts. Prohibits the transfer of funds authorized for the costs of loan or guarantee programs in accordance with requirements of the Federal Credit Reform Act of 1990. Revises provisions concerning the special waiver authority of the President with respect to prohibitions on assistance. Raises the ceiling on the amount of assistance that may be allocated for national security interests for any one country unless such country is a victim of active (currently, Communist) aggression. Repeals provisions concerning U.S. obligations in West Germany and a certification by the President of inadvisability to specify the nature of the use of funds. Chapter 2: Restrictions on Assistance and Exemptions from Restrictions - Applies a prohibition on assistance for police training to the furnishing of excess defense articles for law enforcement purposes. Exempts from such prohibition: (1) international narcotics control assistance; (2) assistance in protecting and maintaining wildlife habitats and in developing wildlife management and plant conservation programs; (3) antiterrorism assistance; (4) specified assistance for law enforcement in Latin America and the Caribbean; and (5) other exempted assistance. Revises prohibitions concerning restrictions on assistance. Adds to the list of restrictions prohibitions on assistance for: (1) a country whose government engages in a consistent pattern of human rights violations; (2) a country whose elected head of government is deposed by military coup; (3) a country which is more than one year in arrears to the U.S. Government on any U.S. Government loan or credit under the Foreign Assistance Act of 1961 or specified provisions of the Arms Export Control Act; (4) projects designed to increase exports of agricultural, textile, or apparel commodities from developing countries if such exports would be in competition with U.S. exports or be expected to cause injury to U.S. exporters of the same or a similar commodity; and (5) a country that provides lethal military equipment to a government that has repeatedly supported acts of international terrorism. Authorizes the Foreign Claims Settlement Commission, at the request of the President, to evaluate the value of any property that is the subject of expropriation by a foreign country. Exempts from restrictions on foreign assistance (except for countries that support terrorism or violate human rights) assistance for: (1) the needs of individuals with disabilities or displaced children; (2) child survival activities; (3) the prevention and control of AIDS; (4) immunization and oral rehydration; (5) environmentally sound, sustainable resource management; and (6) efficient energy systems. Chapter 3: Reports - Revises provisions regarding: (1) U.S. assistance policies and human rights; and (2) congressional notification for program changes. Outlines required elements of annual congressional presentation documents on economic assistance. Chapter 4: Administrative and General Provisions - Revises provisions concerning the use of private enterprise for the procurement of commodities and defense articles. Authorizes the use of Federal facilities for technical assistance purposes when such facilities are not competitive with private enterprise. Revises provisions concerning procurement standards and procedures. Sets forth provisions concerning the generation and use of local currencies. Authorizes the President to adopt as a U.S. contract or obligation any contract with a U.S. or third-country contractor that had been funded with assistance prior to the termination of such assistance. Permits nongovernmental organizations to invest local currencies accrued as a result of economic assistance provided by this Act and other specified Acts and to use interest earned on investments for assistance purposes. Exempts funds for Israel and Egypt from any restriction on the availability of funds. Prohibits appointments to specific positions within the administering agency without the advice and consent of the Senate. Permits assistance funds to be used to reimburse Federal or State agencies, private and voluntary organizations, or institutions of higher education that detail employees for assistance programs that require special technical skills. Excludes such employees from applicable personnel ceilings during the detail period. Removes funding limitations on assistance for the construction of living quarters, offices, schools, and hospitals abroad and for assistance to schools educating dependents and personnel abroad. Requires the Administrator to ensure that for assistance projects there is displayed an acknowledgment that such projects were funded by the people of the United States. Revises provisions concerning discrimination against U.S. personnel. Chapter 5: Definitions - Sets forth specified definitions. Chapter 6: Conforming Amendments and Repeals - Makes technical and conforming amendments to specified Acts. Repeals specified Acts. Title V: Europe - Chapter 1: Support for East European Democracy Act - Amends the Support for East European Democracy (SEED) Act of 1989 to make eligible for SEED benefits any Eastern European country taking steps toward: (1) political pluralism and economic reform; (2) respect for human rights; and (3) a willingness to build a friendly relationship with the United States. (Currently, most SEED programs target Hungary and Poland.) Includes Albania, Lithuania, Latvia, and Estonia in the list of eligible countries. Extends specified structural adjustment, debt reduction, and stabilization assistance to such countries. Requires the President to support adoption of agricultural policies in eligible countries that are based on free-market policies and to discourage policies that distort market signals through protective import barriers or government export subsidies. Authorizes AID to provide assistance to support private sector development in Eastern Europe and U.S. participation in capital projects. Permits the President, acting through the AID Administrator, to use funds for labor market transition assistance to eligible Eastern European countries. Extends technical assistance and training for labor market transition assistance to eligible Eastern European countries. Removes a provision authorizing appropriations for Peace Corps programs in Poland and Hungary. Extends assistance for the development of Peace Corps and credit unions to eligible Eastern European countries. Applies provisions governing the use of Polish currency generated by agricultural assistance to local Eastern European currencies generated by such assistance. Repeals provisions concerning: (1) OPIC support for Poland and Hungary; (2) Trade and Development Program activities in Poland and Hungary; (3) tax treatment of loans with below market interest rates for Poland and Israel; and (4) the trade credit insurance program for Poland. Extends Export-Import Bank programs to Czechoslovakia. Urges the President to seek bilateral investment treaties with eligible Eastern European countries to establish a legal framework for U.S. investment in such countries. Extends educational and cultural exchange programs and the scholarship partnership program to eligible Eastern European countries. Removes funding provisions concerning the scholarship partnership program. Authorizes the AID Administrator to use funds available for the scholarship partnership program for scholarships to enable Eastern European students to study at American institutions of higher education in Europe. Makes a specified amount of nonconvertible Polish currencies held by the United States available for the Research Center on Jewish History and Culture of the Jagiellonian University of Krakow, Poland. Declares that the President should allocate a specified amount annually for NATO's plan for expanded East European participation. Extends assistance for the support of democratic institutions and environmental protection and energy efficiency activities to eligible Eastern European countries. Authorizes the President, acting through the AID Administrator and the Administrator of the Environmental Protection Agency, to provide assistance for environmental and energy activities in eligible Eastern European countries, with emphasis on assistance for policies encouraging and providing incentives for end-use energy efficiency and conservation and reliance on renewable energy resources. Requires the President to work with officials of the Government of Czechoslovakia to establish a regional program to facilitate cooperative activities to address the public health aspects of environmental degradation. Earmarks funds for such program. Revises provisions concerning medical assistance to Poland. Authorizes the President, acting through the AID Administrator, to: (1) provide medical training, health care planning assistance, and other assistance to improve health care to eligible Eastern European countries; and (2) provide assistance to support the infrastructure for a housing sector in such countries. Directs the SEED Program coordinator to establish an Eastern European Business Information Center System to serve as a central clearinghouse and data resource service for U.S. and Eastern European businesses providing information relating to: (1) business conditions in Eastern Europe; (2) legal and regulatory information needed by U.S. companies seeking to do business in Eastern Europe; (3) investment and trade opportunities for U.S. companies; and (4) voluntary assistance efforts to Eastern European countries. Requires the SEED Program coordinator to make information accessible to local enterprises seeking trade with or investment from the United States through the establishment of Eastern European trade information centers. Declares that the President should establish American Business Centers to support American business initiative in Eastern Europe. Repeals a provision concerning economic and commercial officers at U.S. embassies and missions in Hungary and Poland. Authorizes and allocates appropriations for SEED programs for FY 1992 and 1993. Sets forth provisions concerning the reallocation or reduction of such funds. Treats the Regional Environmental Center for Central and Eastern Europe in Budapest, Hungary, as an international organization for purposes of detailing U.S. Government personnel. Chapter 2: Other Provisions Relating to the Region - Authorizes additional appropriations for FY 1992 and 1993 to carry out the Soviet-East European Research and Training Act of 1983. Revises reporting requirements under such Act. Condemns the resurgence of organized anti-Semitism and ethnic animosity in Romania. Urges the Government of Romania to speak out against anti-Semitism and work to promote harmony among ethnic and religious groups. Calls on: (1) the Romanian people to resist extremist organizations and strengthen the forces of tolerance and pluralism; (2) the Romanian Government to take steps toward greater respect for internationally recognized human rights; and (3) the President of the United States to ensure that progress by such Government in combating anti-Semitism and in protecting the rights and safety of its ethnic minorities shall be a significant factor in determining levels of assistance to Romania. Sets forth congressional findings with respect to the situation in Nagorno-Karabakh in Azerbaijan. Amends the Mutual Educational and Cultural Exchange Act of 1961 to establish the Andrei Sakharov Educational Exchange Program to facilitate cooperation in the fields of environmental protection and health sciences through exchanges of graduate students. Includes such exchange program in the list of actions to be taken under the SEED Act. Expresses the sense of the Congress with respect to the crisis in Yugoslavia. Amends the Anglo-Irish Agreement Support Act of 1986 to remove a certification requirement and to revise reporting requirements. Title VI: Middle East - Makes ESF assistance to Israel available on a cash transfer basis. Requires the President to ensure that the level of such transfer does not cause an adverse impact on the total level of nonmilitary exports from the United States to Israel. Makes foreign military financing for Israel available on a grant basis. Makes certain amounts of such financing available for advanced weapon systems research and development and the procurement of defense articles and services. Amends the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1991 to reduce the amount of defense articles and services and military education and training that were authorized to be drawn down for Israel under such Act. Permits ESF assistance for Egypt to include sector grants only if Egypt implements agreed upon reforms in the relevant sector. Permits specified law enforcement assistance to be provided to Egypt only through U.S. institutions of higher education or through the International Criminal Investigative Training Assistance Program of the Department of Justice. Requires foreign military financing for Egypt to be provided on a grant basis. Earmarks assistance allocated by AID for democratic initiatives and human rights for the growth of indigenous nongovernmental organizations that contribute to increased pluralism, democracy, and respect for human rights and the rule of law in the Middle East and North Africa. Earmarks ESF assistance for FY 1992 and 1993 for the West Bank and Gaza Program. Declares that specified amounts of development assistance should be used to finance cooperative development and cooperative development research projects among the United States, Israel, and eligible East European countries. Expresses the sense of the Congress that the United States should support educational, cultural, and humanitarian activities that bring Israelis together with Palestinians living in the West Bank and Gaza. Sets forth U.S. policy with respect to Lebanon. Declares that specified amounts of ESF and development assistance should be made available for Lebanon. Prohibits assistance to Syria until the President reports to the appropriate congressional committees that the Government of Syria: (1) has demonstrated willingness to enter into negotiations with Israel; (2) does not deny its citizens the right to emigrate and does not impose taxes with respect to emigration; (3) is assisting the U.S. Government in obtaining the release of American hostages in Lebanon; (4) no longer supports international terrorist groups; (5) is withdrawing its armed forces from Lebanon; (6) is no longer acquiring chemical, biological, or nuclear weapons and will not use weapons currently in its arsenal to threaten its neighbors; (7) is cooperating with U.S. antinarcotics efforts and taking steps to remove members of the government who are involved in the drug trade; and (8) has made progress in improving human rights. Expresses the sense of the Congress that the United States should encourage all Arab states to: (1) support efforts to achieve peace and stability in the Middle East and to settle the Arab-Israeli conflict; and (2) take specific steps with respect to Israel and terrorism. Directs the President to report to the appropriate congressional committees on: (1) the impact on Israel of U.S. commercial and government-to-government transfers of defense articles and services to the Middle East; and (2) policies being pursued and steps being taken to preserve Israel's qualitative edge. Amends the International Security and Development Cooperation Act of 1985 to revise U.S. policy with respect to the Palestine Liberation Organization (PLO). Restricts negotiations with the PLO until the PLO amends or supersedes its charter to reflect recognition of Israel and ceases the use of terrorism. Requires the President to report to the Speaker of the House and the chairman of the Senate Foreign Relations Committee on specified issues involving the PLO. Expresses the sense of the Congress that the United States should lead an effort to repeal United Nations General Assembly Resolution 3379 (equates Zionism with racism). Requires the President to report to the appropriate congressional committees on whether the Government of Kuwait has taken steps to: (1) end arbitrary arrest, torture, and other extrajudicial actions and bring to justice those responsible for such actions; (2) ensure that those detained have access to legal counsel, the right to an open and speedy trial, and other internationally recognized standards of due process; (3) allow the presence and activities of international human rights and humanitarian organizations; (4) comply with international law relating to deportations; and (5) ensure that the October 1992 elections are free and fair and permit universal suffrage. Expresses the sense of the Congress that: (1) U.S. businesses engaged in rebuilding Kuwait should use U.S. subcontractors and U.S. goods and services; (2) the Department of Commerce should monitor and encourage this policy; and (3) the President should seek appropriate United Nations Security Council action to establish an international tribunal to try all individuals who were involved in the planning or execution of war crimes and crimes against humanity during and after Iraq's invasion of Kuwait. Directs the President to report to the relevant congressional committees on any spoils of war that were obtained subsequent to August 2, 1990, and that were transferred to any party before the date of enactment of this Act. Expresses the sense of the Congress that: (1) the 1981 Israeli preemptive strike against the Iraqi nuclear reactor at Osirak was a legitimate and justifiable exercise of self-defense which also reduced the threat of Iraqi nuclear aggression against countries bordering Iraq; and (2) the United States should seek the repeal of United Nations Security Council Resolution 487 which condemned the strike. Title VII: Latin America and the Caribbean - Chapter 1: Central America and the Caribbean - Subchapter A: Central America - Declares that it shall be U.S. policy to: (1) support Central American countries in efforts to build democracy, restore peace, establish respect for human rights, expand economic opportunities, and improve living conditions; (2) support dialogue as the proper means of resolving armed conflicts in Central America; (3) assist in the implementation of, and secure international cooperation and support for, recommendations of the International Commission on Central American Recovery and Development; (4) support the United Nations Development Program for its Special Plan of Economic Cooperation for Central America; (5) organize a partnership among donor countries and Central American countries to mobilize resources and promote a forum for dialogue on issues of development, democracy, social justice, and human rights. Prohibits military assistance under the Foreign Assistance Act of 1961 to Guatemala during FY 1992 and 1993, except in connection with a peace agreement. Establishes the Lasting Peace Fund for Guatemala. Authorizes the President to transfer amounts available for military assistance to the Fund. Makes funds available only upon notification to the appropriate congressional committees that the Guatemalan Government and the Guatemalan National Revolutionary Unit have signed a peace agreement. Permits funds to be available for: (1) costs of retraining, relocation, and reemployment in civilian pursuits of former combatants and noncombatants affected by the conflict; and (2) costs of monitoring activities associated with the peace agreement. Prohibits the authorities of the Arms Export Control Act from being used to sell to the Guatemalan Government, or issue licenses for the export to Guatemala of: (1) weapons or ammunition; or (2) aircraft, unless the aircraft are unarmed and the Guatemalan Government has agreed that they will not be armed. Permits FY 1992 and 1993 development and ESF assistance and assistance under the Agricultural Trade Development and Assistance Act of 1954 for Guatemala to be used only by civilian government agencies and nongovernmental organizations. Requires such assistance to be targeted for: (1) programs that address poverty, basic human needs, and environmental concerns; (2) the improvement of democratic institutions and the promotion of political pluralism; (3) the National Reconciliation Commission; (4) fiscal reform and administration; or (5) programs that promote trade and investment. Prohibits such assistance from being used for partisan political purposes or as an instrument of counterinsurgency. Waives assistance target requirements if the President notifies the appropriate congressional committees that Guatemala has made progress in eliminating human rights violations and in bringing to trial those responsible for major human rights cases. Declares that the President should: (1) take into account the extent to which the Nicaraguan Government has brought the armed forces under civilian control and undertaken investigations into, and prosecution of those responsible for, human rights violations prior to providing assistance for FY 1992 and 1993; and (2) consider the extent to which foreign military financing for Nicaragua will further the goals of strengthening civilian control over the military, ending human rights abuses, and stemming the export of lethal military equipment prior to providing such financing for such fiscal years. Prohibits assistance under the Foreign Assistance Act of 1961 for FY 1992 and 1993 from being available for: (1) the Sandinista Popular Army unless requested and authorized by the President of Nicaragua; and (2) any member of the Nicaraguan resistance who has not disarmed or is not abiding by the terms of the cease-fire and the addenda to the Toncontin Agreement. Waives provisions of law that prohibit assistance to countries in arrears on assistance payments to the United States with respect to assistance for Nicaragua. Expresses the sense of the Congress that the Nicaraguan Government should expedite the processing of claims by private citizens based on expropriation of property by the Sandinista Government. Authorizes a specified amount of ESF assistance for FY 1992 and 1993 to be made available to carry out the Concerted Plan of Action in Favor of Central American Refugees. Expresses the sense of the Congress with respect to strengthening democratic legislatures in Central America. Declares that a specified amount of development and economic support assistance should be used for the Central American Journalism Program and Regional Administration of Justice Program's Center for the Administration of Justice to support democracy building activities in the region. Expresses the sense of the Congress that the President should: (1) begin negotiations with the Government of Panama to consider whether the two Governments should allow the permanent stationing of U.S. military forces in Panama beyond December 31, 1991; and (2) consult with the Congress throughout those negotiations. Subchapter B: The Caribbean - Amends the Foreign Assistance Act of 1961 to set forth the Caribbean Regional Development Act of 1991. Sets forth U.S. policy with respect to development and economic assistance for the Caribbean. Provides that priority in providing development assistance should be given to supporting indigenous democratic Caribbean institutions that represent and benefit the poor. Requires priority in the allocation of assistance to the Caribbean to be given to: (1) increased food production; (2) rural development; (3) community-based agro-industries; (4) small- and medium-sized farm and manufacturing enterprises; (5) the expansion of tourism; (6) regional integration; (7) the upgrading of technical and managerial skills; (8) support for renewable natural resources; (9) private sector development; (10) democratic development and the administration of justice; and (11) human services and human resources development. Directs the President, in providing assistance to a Caribbean country, to take into account whether the government of such country has failed to protect worker rights and is taking steps to implement laws that demonstrate advancement in providing such rights. Prohibits the administering agency from providing assistance for the use of any substance in a Caribbean country if such use is prohibited under the country's or U.S. public health laws. Declares that the agency should: (1) ensure the active participation of women in the development process; and (2) take into account the perspectives of the poor in the development process. Expresses the sense of the Congress that: (1) all assistance to the Haitian Government should remain suspended until democratic government is restored; (2) the United States, when democratic government is restored, should provide assistance to such government only if it abides by the Haitian Constitution and respects freedom of expression and human rights; (3) the President should consider, during any period when assistance is suspended to Haiti, whether assistance through private and voluntary organizations should be continued for humanitarian purposes; (4) the United States should provide a specified amount of economic assistance to Haiti during FY 1992 and 1993; and (5) if any assistance is suspended, the balance for any fiscal year should remain available as long as there are reasonable prospects of a return to democracy and constitutional government in Haiti. Prohibits foreign military financing assistance for Haiti (except nonlethal assistance) during FY 1992 and 1993. Encourages the Government of the Dominican Republic to improve respect for the human rights of Haitian laborers engaged in the sugar cane harvesting industry in the Dominican Republic. Withholds a specified amount of economic support assistance from the Dominican Republic until the President notifies the appropriate congressional committees of the steps taken by the Government of the Dominican Republic to improve such human rights. Declares that the President should consider increasing the Dominican Republic's allocation of the U.S. sugar quota and providing additional economic and development assistance if the Government of the Dominican Republic makes progress in specified matters concerning such laborers. Permits assistance under the Foreign Assistance Act of 1961 or the Agricultural Trade Development and Assistance Act of 1954 to be provided to the Government of Guyana only if the President reports to the appropriate congressional committees that such government is in power as a result of free and fair elections. Exempts from such restriction international narcotics control assistance or assistance for the holding of free and fair elections. Expresses the sense of the Congress that the President, following the submission of the report regarding Guyana, should provide assistance for Guyana under such Acts. Declares that a specified amount of assistance should be used to meet basic human needs. Condemns the armed forces of Suriname for the December 1990 coup and for disregard for civilian authority. Urges the armed forces to permit a peaceful transfer of power to the elected civilian government. Calls upon the President to withhold assistance from Suriname until a peaceful transfer of power has taken place, and to use assistance to bolster civilian rule. Applauds the actions of the United Nations Human Rights Commission of March 6, 1991 (concerning human rights in Cuba), and calls on the Government of Cuba to cooperate fully with the Commission. Prohibits the issuance of licenses for certain transactions involving U.S.-controlled firms in third countries and Cuba unless a license would be authorized for such transactions if undertaken by a firm organized under any State law. Applies such prohibition to a foreign subsidiary or affiliate of a domestic concern which is controlled in fact by such concern. Subchapter C: Provisions Relating to Both Central America and the Caribbean - Requires advance congressional notification for the transfer or issuance of licenses for the export of helicopters or military aircraft to any country in Central America or the Caribbean. Directs the Secretary of State to notify the appropriate congressional committees whenever any helicopters or other military aircraft are provided to such countries by any foreign country. Chapter 2: South America - Subchapter A: Andean Initiative - Authorizes appropriations for development and economic support assistance for FY 1992 and 1993 for Andean countries. Requires priority in the use of funds for Bolivia and Peru to be given to support programs that focus on providing coca farmers with alternative sources of income. Declares that specified amounts of such assistance should be used for law enforcement assistance, protection against narco-terrorist attacks, and assistance for human rights offices in Bolivia, Colombia, and Peru. Authorizes appropriations for FY 1992 and 1993 for foreign military financing assistance for Andean countries. Requires such assistance to be designed to: (1) enhance the ability of the recipient government to control illicit narcotics production and trafficking; (2) strengthen respect for human rights and the rule of law to control narcotics production and trafficking; and (3) assist the armed forces of the Andean countries in their support roles for such countries' law enforcement agencies. Permits the provision of such assistance only if: (1) such country has a democratic government; and (2) the government of such country does not engage in a consistent pattern of human rights violations. Permits such assistance to be used for certain law enforcement training and equipment for purposes of narcotics control efforts. Limits the amount of military and law enforcement assistance for Bolivia, Colombia, and Peru. Prohibits a Peruvian police organization that engages in a consistent pattern of human rights violations from being considered as a law enforcement unit. Permits assistance or the transfer of excess defense articles under this Act to an Andean country only if the President determines that: (1) such country is implementing programs to reduce the flow of cocaine to the United States; and (2) the armed forces and law enforcement agencies of such country are not engaged in a consistent pattern of human rights violations and the government of such country has made progress in protecting human rights. Exempts from the human rights condition assistance for programs providing coca farmers with alternative sources of income. Waives provisions of law that prohibit assistance to countries in arrears on loan payments to the United States with respect to narcotics-related assistance to Andean countries. Expresses the sense of the Congress with respect to actions taken by the Government of Colombia to combat drug trafficking. Subchapter B: Other Provisions Relating to South America - Congratulates the Governments of Argentina and Brazil for taking certain steps with respect to nuclear nonproliferation. Chapter 3: Other Provisions Pertaining to the Region - Authorizes a specified amount of economic assistance for FY 1992 and 1993 to be made available for efforts to deal with the cholera epidemic in Latin America. Amends the Foreign Assistance Act of 1961 to permit the delivery of military assistance and sales to the armed forces of a Latin American or Caribbean country with a civilian government only with the prior approval of the country's head of government. Makes law enforcement assistance available for countries with democratically-elected governments in Latin America and the Caribbean. Prohibits the use of such funds for: (1) lethal equipment; and (2) the participation of Department of Defense personnel and members of the U.S. armed forces in law enforcement training. Permits law enforcement training in the Caribbean to be provided only under the auspices of the Department of Justice Criminal Investigative Training Assistance Program. Earmarks funds for such assistance. Requires the Secretary to report annually to the Congress on the status and treatment of indigenous peoples in Latin America and the Caribbean. Authorizes the President to direct the AID Administrator to release the Institute Centroamericano de Administration de Empresas from an obligation to make payments on a specified Alliance for Progress loan. Title VIII: Enterprise for the Americas Initiative - Enterprise for the Americas Act of 1991 - Chapter 1: Foreign Assistance Act Debt Reduction - Supports improvement in the lives of the people of Latin America and the Caribbean through market-oriented reforms and economic growth with actions to promote debt reduction, investment reforms, community based conservation and sustainable use of the environment, and child survival and child development. Makes eligible for Enterprise for the Americas Facility benefits (established pursuant to the Agricultural Trade Development and Assistance Act of 1954) Latin American or Caribbean countries that: (1) have democratically-elected governments; (2) have not provided support for international terrorism; (3) cooperate on international narcotics control matters; (4) do not engage in a consistent pattern of human rights violations; (5) have in effect, received approval for, or are making progress toward, specified International Monetary Fund (IMF) arrangements and structural or sectoral adjustment loans from the International Bank for Reconstruction and Development or the International Development Association; (6) have put in place major investment reforms in conjunction with an Inter-American Development Bank loan or are implementing or making progress toward an open investment regime; and (7) have agreed with commercial bank lenders on a financing program for debt or debt service reduction. Authorizes the President to reduce the amount owed to the United States (as a result of concessional loans made pursuant to the Foreign Assistance Act of 1961 or predecessor foreign economic assistance legislation) by any country eligible for Facility benefits. Sets forth requirements with respect to the exchange of obligations, repayment of principal, and interest on new obligations issued by beneficiary countries. Requires beneficiary countries that enter into Americas Framework Agreements to establish Enterprise for the Americas Funds. Authorizes the Secretary to enter into Americas Framework Agreements concerning the operation and use of Americas Funds with countries eligible for Facility benefits. Directs administering bodies in each beneficiary country to administer the Americas Funds and to make grants. Requires grants from the Funds to be used for activities that link the conservation and sustainable use of natural resources with local community development and for child survival and development activities. Subjects grants of more than $100,000 to veto by the U.S. Government or the government of the beneficiary country. Redesignates the Environment for the Americas Board (established pursuant to the Agricultural Trade Development and Assistance Act of 1954) as the Enterprise for the Americas Board. Requires the Board to: (1) advise the Secretary on the negotiations of Americas Framework Agreements; (2) ensure that a suitable administering body is identified for each Americas Fund; and (3) review the programs, operations, and fiscal audits of administering bodies. Amends the Agricultural Trade Development and Assistance Act of 1954 to increase the number of representatives of the Board. Chapter 2: Export-Import Bank Debt Reduction - Amends the Export-Import Bank Act of 1945 to set forth provisions concerning the Enterprise for the Americas Initiative parallel to those set forth in chapter 1 of title VIII of this Act. Makes eligible for Facility benefits Latin American or Caribbean countries that: (1) have in effect, received approval for, or are making progress toward, specified IMF arrangements and structural or sectoral adjustment loans from the International Bank for Reconstruction and Development or the International Development Association; (2) have put in place major investment reforms in conjunction with an Inter-American Development Bank loan or are implementing or making progress toward an open investment regime; and (3) have agreed with commercial bank lenders on a financing program for debt or debt service reduction. Permits the President, for purposes of facilitating debt-for-equity, debt-for-development, or debt-for-nature swaps, to sell to any eligible purchaser any Export-Import Bank loan made to an eligible country before January 1, 1991. Authorizes appropriations. Chapter 3: Participation of the Inter-American Development Bank - Requires the Secretary of the Treasury to work closely with the management of the Inter-American Development Bank (IDB) to ensure the full implementation of the IDB's proposed investment sector reform program and the coordination of U.S. bilateral assistance programs with IDB efforts to enhance liberalization efforts in countries served by the IDB. Amends the Inter-American Development Bank Act to authorize appropriations for a contribution to the Enterprise for the Americas Investment Fund, provided that certain conditions are met. Requires U.S. assistance to the Fund to be disbursed only for the following purposes: (1) technical assistance for purposes of identifying and resolving domestic constraints to investment; (2) assistance to private enterprises; (3) assistance in building human capital, alleviating poverty, and reducing barriers to economic and social progress; and (4) assistance to support host country capacity for insuring the environmental soundness of investment activities. Limits the amount to be used for any of the preceding purposes. Requires the Secretary to instruct the U.S. representative to the Fund to vote against any action which may have an adverse environmental impact unless an environmental assessment is available at least 120 days before the vote. Makes Latin American or Caribbean countries eligible for Enterprise for the Americas Facility benefits eligible for Fund assistance. Chapter 4: International University for the Americas - Requires the Secretary of State to determine the most appropriate location for the International University for the Americas, an institution to be established for promoting economic integration and the strengthening of democratic institutions in the Western Hemisphere and for commemorating the 500th anniversary of the discovery of the Americas by Christopher Columbus. Authorizes a specified amount of development and economic support assistance for Latin America and the Caribbean to be made available for the University. Chapter 5: Reports - Directs the President to report annually to the Speaker of the House and the President pro tempore of the Senate on the implementation of this title. Title IX: Asia and the Pacific - Chapter 1: East Asia and the Pacific - Requires the President, in determining whether to furnish assistance or make sales of defense articles or services to Burma (Myanmar) during FY 1992 and 1993, to make a specified certification with respect to international narcotics control in Burma and to take into account whether the Burmese Government has: (1) ceded legal authority to a civilian government as mandated by the 1990 elections; (2) released persons arrested for the peaceful expression of their political views; and (3) ceased harassment of persons and political parties attempting to exercise freedoms of expression, association, and assembly. Sets forth notification requirements with respect to certain assistance for Burma. Declares that the Congress would welcome decisions by the President to: (1) decline to negotiate a new textile agreement with Burma; (2) impose economic sanctions on Burma under the Customs and Trade Act of 1990; and (3) call upon industrialized countries to impose similar sanctions upon Burma. Authorizes certain development and economic support assistance to be available for: (1) training and education assistance for Burmese outside of Burma who are displaced as a result of civil conflict; and (2) activities which support democratic pluralism in Burma. Reaffirms that genocide is a crime under international law which the United States undertakes to prevent and calls upon the United Nations to take appropriate action for the prevention and suppression of genocide in Cambodia. Makes a specified amount of development and economic support assistance available for Cambodian civilians. Releases additional funds in the event of a settlement of the Cambodian conflict acceptable to the United States. Makes an additional amount of development and economic support assistance available for humanitarian assistance to children and war victims in Cambodia. Authorizes the President to use development and economic support assistance funds to provide for the nonmilitary training of Cambodians in skills that would be used to support an internationally acceptable political settlement in Cambodia. Requires the President to terminate assistance to any Cambodian organization that is cooperating with the Khmer Rouge in military operations. Directs the President to conduct an onsite assessment within Cambodia to determine requirements for the development of infrastructure and the eradication of explosive mines. Requires the President to report to the Speaker of the House and the President pro tempore of the Senate on all instances of military cooperation since January 1, 1991, between the Khmer Rouge and any faction of the noncommunist resistance and all instances of human rights abuses by the Khmer Rouge. Prohibits the sale, and the issuance of licenses for export, to China of any item on the U.S. Munitions List for military end-users if the President determines that: (1) any U.S. defense article or technology was used in certain missiles or aircraft transferred to Algeria, Iran, Iraq, Libya, Pakistan, or Syria by China in contravention of the Arms Export Control Act; and (2) any chemical weapon or nuclear equipment or materials were transferred to such countries by China. Makes such prohibition inapplicable to the sale or export of systems or components designed for inclusion in civil products and controlled as defense articles only for purposes of export to a controlled country, unless the President determines that the intended recipient is the Chinese military or security forces. Prohibits the provision of FY 1992 and 1993 foreign military financing assistance and assistance for international military education and training to Fiji unless the President certifies to the Congress that Fiji has held elections in which there has been broad participation by all communities. Expresses the sense of the Congress that the President should provide specified amounts to support humanitarian projects in Laos for efforts to resolve questions concerning Vietnam prisoners of war or those missing in action. Sets forth provisions concerning Malaysia's policy of denying first asylum to Indochinese asylum-seekers. Expresses the sense of the Congress that additional assistance should be provided for Mongolia in recognition of Mongolia's movement toward democracy and a free market economy. Amends the Foreign Assistance Act of 1961 to set forth the Multilateral Assistance Initiative for the Philippines. Expresses the sense of the Congress that: (1) the United States should participate with multilateral financial institutions and other bilateral donors in an economic reform and development program in the Philippines; and (2) a multiyear commitment of resources by the United States, donors, and such institutions and a reform effort and leadership role by the Government of the Philippines will be necessary to ensure economic growth in the Philippines and enhanced participation of the Filipino people in the democratic process. Authorizes the President to provide assistance to promote the goals of this Act. Links such assistance to progress by the Government of the Philippines in implementing its economic, structural, judicial, and administrative reform program. Authorizes appropriations. Limits the amount of appropriations for FY 1992. Expresses the sense of the Congress that prior to requesting additional amounts to carry out this Act, the President should take into account: (1) the progress being made by the Philippines toward achieving reform objectives; (2) the extent of participation by the bilateral donors and multilateral financial institutions; and (3) the efforts to coordinate the assistance program. Expresses the sense of the Congress that: (1) the coordination of objectives and programs by donors, institutions, and the Government of the Philippines is critical to the success of the multilateral assistance program; (2) all donors should simplify procurement and disbursement procedures to ensure that conditions on the provision or use of assistance are complementary; and (3) the Philippines should establish internal procedures that will ensure the most effective use of such assistance. Authorizes appropriations for FY 1992 and 1993 for the South Pacific Regional Program. Earmarks an amount of such assistance for scholarships for study at U.S. postsecondary institutions of education. Expresses the sense of the Congress that: (1) the future of Taiwan should be settled peacefully, free from coercion, and in a manner acceptable to the Taiwanese people; and (2) good relations between the United States and China depend on the willingness of the Chinese authorities to refrain from the use or the threat of force in resolving Taiwan's future. Expresses the sense of the Congress that the President should encourage the Organization for Economic Cooperation and Development (OECD) to consider for OECD membership the Governments of South Korea, Taiwan, Hong Kong, and Singapore. Chapter 2: South Asia - Amends the International Security and Development Cooperation Act of 1985 to earmark development and economic support assistance for humanitarian assistance to the Afghan people and for the implementation of bilateral and multilateral reconstruction efforts for Afghanistan and the establishment of a broad-based freely-elected Afghan Government. Congratulates Bangladesh on the transition to a democratically-elected government and welcomes the economic adjustment measures being implemented in coordination with the IMF. Expresses appreciation for Bangladesh's support for international law and collective security. Urges the President to provide debt relief under the Agricultural Trade Development and Assistance Act of 1954 to Bangladesh. Calls upon the Government of India to promote adherence to human rights. Condemns abuses by militants in Kashmir and Punjab and urges all militant groups to cease the use of force to achieve political objectives. Urges the Secretary to raise Indian human rights issues with the Government of India. Calls upon Pakistani authorities not to provide arms or training to militants in Punjab or Kashmir. Welcomes the establishment of a democratically-elected government in Nepal and supports the economic development effort of such government. Authorizes economic support assistance for Nepal for FY 1992 and 1993. Amends the Foreign Assistance Act of 1961 to extend a certain waiver of a prohibition on assistance to Pakistan through April 1, 1993. Prohibits the President from waiving such prohibition unless he makes a specified certification regarding nuclear nonproliferation in Pakistan. Sets forth provisions concerning human rights abuses in Sri Lanka. Requires the President, in determining whether to provide assistance or make sales of defense articles or services to Sri Lanka during FY 1992 and 1993, to take into account whether the Government of Sri Lanka has: (1) established a public register of detainees and ensured that detainees have access to lawyers and family members; (2) taken steps to deter disappearances and killings of civilians by persons under control of government forces; (3) taken measures to minimize civilian casualties in combat operations in the north and the east; and (4) made serious efforts to investigate and prosecute those involved in the murder of journalist Richard DeZoysa. Encourages the Government of Sri Lanka to provide human rights education and training. Chapter 3: Economic Cooperation Projects in China and Tibet - Expresses the sense of the Congress that U.S. economic cooperation projects in China and Tibet should adhere to specified principles, including to: (1) ensure that employment decisions are nondiscriminatory; (2) ensure that methods of production do not pose a danger to project employees and the surrounding environment; (3) ensure that no convict or forced labor is used in the projects; (4) protect freedoms of assembly, association, and expression of project employees; (5) promote the training of employees; (6) discourage compulsory political indoctrination on project premises; and (7) urge the Chinese Government to release a list of the names of individuals detained solely for nonviolent expression of their political views. Directs the Secretary of State to forward a copy of such principles to member nations of the OECD and encourage them to promote such principles. Requires U.S. parent companies of such projects to register with the Secretary and indicate whether such projects will implement the principles. Sets forth specified reporting requirements. Directs the Secretary to report annually to the appropriate congressional committees on: (1) enforcement procedures with respect to prohibitions on the importation of convict-made goods; and (2) investigations with respect to goods produced by convict or forced labor in China and Tibet. Title X: Africa - Chapter 1: Development Fund for Africa - Authorizes appropriations for the Development Fund for Africa for FY 1992 and 1993. Chapter 2: Other Assistance for Africa - Amends the African Development Foundation Act to authorize appropriations for the African Development Foundation for FY 1992 and 1993. Requires funds from the Development Fund for Africa to be used to assist sector projects supported by the Southern African Development Coordination Conference (SADCC). Authorizes the use of such funds without regard to prohibitions on assistance to countries in arrears on assistance payments. Encourages the President to provide increased assistance to promote the development of democratic institutions in Subsaharan Africa. Declares that a specified amount of economic support assistance should be earmarked for Subsaharan Africa. Directs the AID Administrator to provide for the establishment of an African Center for Conflict Resolution to analyze, research, and resolve conflicts in Africa. Requires funds from the Development Fund for Africa to be made available for the Center. Chapter 3: Provisions Relating to Specific Countries - Requires the President, beginning with FY 1992, to provide: (1) nonpartisan election and democracy-building assistance to Angola for support in developing democratic institutions; (2) assistance for the voluntary relocation and resettlement of refugees and displaced persons and for the demobilization and retraining of former military members of the National Union for the Total Independence of Angola (UNITA) and the armed forces of the Government of Angola; (3) humanitarian assistance; and (4) assistance to implement the peace accords. Prohibits such assistance if the Angolan Government or UNITA violates the peace accords. Requires the President, in determining whether to provide assistance to Burundi during FY 1992 and 1993, to take into account that the Government of Burundi has: (1) made progress in reforming its military by engaging in a massive Hutu recruitment program; (2) taken steps to reverse discrimination against the Hutu; and (3) embarked on a major repatriation effort to accommodate the return of Hutu. Sets forth U.S. policy with respect to Kenya. Suspends economic and military assistance to Kenya. Waives such suspension if the President reports to the appropriate congressional committees that the Government of Kenya is taking steps to: (1) release political detainees and end the prosecution of individuals for the expression of their political beliefs; (2) cease physical abuse or mistreatment of prisoners; (3) restore judicial independence; and (4) restore freedom of expression to the Kenyan people. Expresses the sense of the Congress that the President should continue to support the peacekeeping efforts in Liberia carried out by the Economic Community of West African States (ECOWAS). Permits funds authorized by this Act for foreign military financing and unexpended foreign military financing and economic support assistance to be made available to support the efforts of ECOWAS to expand its military involvement in peacekeeping efforts in Liberia. Amends the Foreign Assistance Act of 1961 to authorize the President to provide assistance for civil strife relief, rehabilitation, and general recovery in Liberia. Permits assistance to Liberia during FY 1992 and 1993 only if the President reports to the Congress that the Government of Liberia has achieved progress toward reconciliation and free and fair elections monitored by international observers. Provides that such restriction shall not apply to humanitarian assistance or assistance to enhance progress toward reconciliation and free and fair elections. Waives a prohibition on assistance to countries in arrears on assistance payments with respect to assistance for Liberia. Commends the Malawi Government's response to the influx of refugees from Mozambique. Condemns the abuse of human rights of Malawian citizens. Urges President Banda to release prisoners of conscience, end incommunicado detention and torture of prisoners, and permit freedom of speech and association in Malawi. Prohibits foreign military financing for the Malawi Young Pioneers and permits such assistance only for the Malawian military's effort to secure the Nacala Railroad, programs to support conservation and biological diversity, and for activities to assist in the Mozambique peace process. Sets forth U.S. policy with respect to Mozambique. Conditions the provision of economic support assistance and foreign military financing for FY 1992 and 1993 for Mozambique on steps by the Government of Mozambique to increase respect for human rights and promote a political settlement to the conflict in such country. Expresses the sense of the Congress that: (1) the United States should support the elimination of apartheid and the establishment of democratic majority rule in South Africa through a policy to bring about a nonracial democracy; (2) U.S. firms and the Government should provide specified assistance to disadvantaged South Africans; and (3) the President should seek the cooperation of U.S. allies in Western Europe and Japan to join in multilateral initiatives to aid disadvantaged South Africans. Makes economic support and development assistance and assistance from the Development Fund for Africa available for assistance to disadvantaged South Africans. Requires priority in providing such assistance to be given to South African nongovernmental organizations whose staff are selected on a nonracial basis and which have the support of the disadvantaged communities being served. Authorizes excess assistance for disadvantaged South Africans to be used only for assistance for programs in the health, education, and housing sectors. Prohibits the transfer of such funds to any entity controlled by the South African Government, unless specified conditions are met. Declares that the President, before obligating funds for disadvantaged South Africans, should: (1) consult with South African organizations representative of the majority population of South Africa; and (2) seek a commitment from the South African Government that it will provide additional resources to meet the needs of disadvantaged South Africans. Prohibits assistance to the Communist Party of South Africa or affiliated organizations. Requires the President to ensure that recipients of assistance in South Africa are not engaged in human rights violations and have in place democratic processes for internal decisionmaking and the selection of leaders. Prohibits the provision of foreign military financing, military education and training, and economic support and development assistance to Zaire during FY 1992 and 1993 unless the President reports to the appropriate congressional committees that: (1) free and fair national elections have been held in Zaire; and (2) the elected government demonstrates a commitment to protect freedom of expression and bring about a reformed and independent judiciary and reform of, and applications of, the rule of law to Zaire security forces. Chapter 4: Horn of Africa Recovery and Food Security - Expresses the sense of the Congress with respect to Ethiopia, Somalia, and Sudan. Sets forth U.S. policy with respect to equitable distribution of relief and rehabilitation assistance and international relief efforts in the Horn of Africa (Ethiopia, Somalia, Sudan, and Djibouti). Authorizes the President to: (1) provide international disaster assistance for civil strife and famine relief and rehabilitation in the Horn of Africa; and (2) transfer funds from unobligated security assistance (without regard to a specified 20 percent increase limitation) to carry out this chapter. Makes available a percentage of assistance for management support activities. Urges the President to provide supplemental emergency food assistance for civilian victims of civil strife in the Horn of Africa. Encourages the President to consult with other nations, armed and unarmed parties in the Horn of Africa, and the United Nations Secretary General to bring about negotiated settlements of the armed conflicts in the Horn of Africa. Expresses the sense of the Congress that the President should: (1) direct the U.S. representative to the United Nations to take specified steps with respect to peace and the establishment of an arms embargo in the region; (2) play an active role in other fora in pressing for settlements to conflicts; and (3) participate in regional and international peace consultations. Declares that development assistance in the Horn of Africa should be targeted to aid the poor. States that U.S. Government aid institutions should seek to: (1) build upon the capabilities and experiences of organizations active in local grassroots relief, rehabilitation, and development efforts; (2) consult with such organizations and incorporate their views into the policymaking process; and (3) support the expansion of their activities without compromising their private nature. Declares that development assistance should be: (1) targeted to the voluntary relocation and repatriation of displaced persons and refugees; and (2) carried out in coordination with strategies for debt relief of countries in the region and with efforts to establish an international fund for reconstruction of developing nations which settle civil wars. Requires development assistance and assistance from the Development Fund for Africa to be channeled through private and voluntary or specified international organizations unless the President makes the required certification under this chapter. Prohibits economic support assistance and foreign military financing and international military education and training assistance to Ethiopia, Somalia, or Sudan unless the President certifies that the government of the country has: (1) begun to implement peace or national reconciliation agreements; (2) demonstrated a commitment to human rights; (3) manifested a commitment to democracy and has held or established a timetable for free and fair elections; and (4) agreed to distribute development assistance without discrimination. Chapter 5: Other Provisions - Expresses the sense of the Congress that: (1) special efforts should be undertaken to reduce trade barriers and to promote economic interchange between the United States and developing countries in Subsaharan Africa; and (2) the countries of Subsaharan Africa are to be applauded for their stance during the Persian Gulf conflict and commended for their support of the United States. Permits international military education and training to be provided to a Subsaharan African country only if the President considers whether: (1) that country has a government that was democratically-elected as the result of free and fair elections or is committed to respecting human rights and freedom of expression and has achieved progress in a process of democratization; (2) the armed forces of such country are involved in human rights violations or the government of the country fails to respect human rights; and (3) the armed forces of such country or other elements of the government of that country are engaged in destabilization efforts aimed at any other country. Requires the President, when obligating funds for countries that do not meet such conditions, to report to the appropriate congressional committees on the reasons for providing such assistance. Provides that any sanction imposed by any State or governmental subdivision that is directed at South Africa or persons engaging in commercial or financial transactions in or with South Africa and that also applies to Namibia shall be null and void with respect to Namibia unless such sanction is consistent with Federal law. Expresses the sense of the Congress that a study should be undertaken by the Office of Technology Assessment, in a cross-section of Subsaharan African countries, of the formulation and the economic, social, and environmental impact of adjustment programs supported or leveraged by AID through the Development Fund for Africa. Title XI: Aid, Trade, and Competitiveness - Aid, Trade, and Competitiveness Act of 1991 - Requires the AID Administrator to establish a capital projects office to: (1) develop a program that would focus solely on developmentally sound capital projects; and (2) consider opportunities for U.S. high-technology firms in putting together capital projects for developing countries and SEED eligible East European countries. Sets forth the activities of the capital projects office. Directs the President to report annually to the Congress on the extent to which: (1) U.S. Government resources have been expended to support capital projects in such countries and the extent of interagency coordination; and (2) U.S. Government capital projects and tied-aid programs have affected U.S. exports. Requires the Secretary of the Treasury, if a new agreement within OECD that meets the objective of reducing the level of concessional financing by member countries other than the United States has not been reached by February 1, 1992, to report to the Congress, together with the President of the Export-Import Bank, on: (1) the status of the negotiations; (2) the causes for the failure to reach an agreement by that date; and (3) the reasons the U.S. Government believes that continued negotiations will result in achieving such objective. Urges the President to use specified types and amounts of assistance for grants for capital projects. Directs the President to report to the appropriate congressional committees on the feasibility of allowing AID to offer credit guarantees for the financing of capital projects. Authorizes additional appropriations for FY 1993 for the Trade and Development Agency. Title XII: Peace Corps - Amends the Peace Corps Act to: (1) extend the authorization of appropriations for the Peace Corps through FY 1993; and (2) establish the Foreign Currency Fluctuations, Peace Corps, Account to pay expenses for Peace Corps operations which exceed appropriations for such expenses as a result of currency exchange rate fluctuations. Authorizes appropriations for such Account. Requires the Director of the Peace Corps to contract with an eligible organization to conduct three evaluations of the health care needs of Peace Corps volunteers and the adequacy of the Peace Corps health care system. Provides for the submission of such evaluations to the Director and specified congressional committees. Requires the Director and the Secretary of Labor to report to such committees on: (1) the information provided by the Peace Corps to its volunteers and applicants on the benefits and services to which volunteers and trainees may be entitled in the event they sustain injuries or become disabled during their Peace Corps service or training; (2) the efforts by the Peace Corps and the Department of Labor to coordinate the provision of such information to Peace Corps volunteers and applicants and the processing of claims by volunteers and trainees under the Federal Employees Compensation Act (FECA); (3) the number of Peace Corps volunteers and trainees who have filed claims under FECA and the percentage of claims that have been approved; and (4) the timeliness of approvals or denials of such claims. Earmarks funds for FY 1992 and 1993 for establishing Small Business Development Programs in the Soviet Union or any successor entity. Title XIII: International Development and Finance - Chapter 1: International Monetary Fund - Amends the Bretton Woods Agreements Act to authorize the U.S. Governor of the International Monetary Fund to consent to: (1) an increase in the U.S. quota in the Fund; and (2) the amendments to the Articles of Agreement of the Fund approved in resolution 45-3 of the Fund's Board of Governors. Authorizes the Secretary of the Treasury to instruct the U.S. Executive Director of the Fund to approve the Fund's pledge to sell a specified amount of the Fund's gold to restore the resources of the Reserve Account of the Enhanced Structural Adjustment Facility Trust to meet obligations to lenders who have made loans to the Trust for financing programs of members previously in arrears to the Fund. Permits the Secretary to instruct the U.S. Executive Director of the Fund to support Soviet membership in the Fund only after the President certifies to the Congress that the Soviet Union has taken specified actions to indicate: (1) the implementation of free market policies; (2) the reduction in size and scope of government expenditures; and (3) the embrace of democratic processes. Authorizes the Secretary to instruct the Executive Director of the European Bank for Reconstruction and Development to support expansion of access by the Soviet Union to the Bank's resources only after the President makes such certification. Expresses the sense of the Congress that: (1) encouragement should be given to the efforts being made to address the political and economic problems of nations making the transition to more open political and economic systems; and (2) consideration should be given to developing relationships between such nations, the Fund, the International Bank for Reconstruction and Development, and other international financial institutions as part of assisting such nations in making such transitions. Requires the Secretary to instruct the U.S. Executive Director of the Fund to encourage the Fund to adopt procedures for the publication of economic reviews of the major industrialized nations and other commentary, as appropriate. Expresses the sense of the Congress that procedures should be instituted to review the activities of the Fund and the International Bank for Reconstruction and Development for purposes of coordinating the international economic activities of international financial institutions at the Board, management, and staff levels. Directs the Secretary to instruct the U.S. Executive Director of the Fund to: (1) advocate specified actions concerning poverty alleviation and policy framework papers; and (2) urge renewal of debt and debt service reduction programs. Requires the Secretary to report to the Congress on the debt of the Soviet Union held by commercial banks outside the Soviet Union and the prospects for repayment of such debt. Directs the Secretary to instruct the U.S. Executive Director of the Fund to encourage environmental considerations in Fund programs. Requires the Secretary to instruct the U.S. Executive Directors of the Fund and the International Bank for Reconstruction and Development to urge such entities to develop and report to member nations on criteria for determining whether a nation seeking a loan is engaged in arms and weapons expenditures that are: (1) appropriate to its national circumstances; or (2) an impediment to sound management of its economy and achievement of sustained long-term growth. Chapter 2: International Bank for Reconstruction and Development and Affiliates - Subchapter A: International Finance Corporation - Amends the International Finance Corporation Act to authorize the U.S. Governor of the International Finance Corporation to subscribe to additional shares of the Corporation's capital stock. Authorizes appropriations. Subchapter B: International Bank for Reconstruction and Development - Amends the Bretton Woods Agreements Act to require the Secretary of the Treasury to instruct the U.S. Executive Director of the International Bank for Reconstruction and Development to advocate specified measures to alleviate poverty. Expresses the sense of the Congress that the International Bank for Reconstruction and Development and the International Development Association should: (1) give greater programmatic and budgetary priority to the survival and development of children; and (2) make a commitment to devoting at least five percent of the annual lending of such entities to primary health and basic education, respectively. Directs the Secretary to instruct the U.S. Executive Director of the Bank to urge: (1) renewal of debt and debt service reduction programs; (2) the establishment of a program to provide technical assistance to the Baltic States and the Soviet Union in support of democratic reforms, human rights, the rule of law, and market-oriented reforms; and (3) the coordination of such program with the programs of other donors. Subchapter C: Financial Assistance for Global Environmental Protection - Global Environmental Protection Assistance Act of 1991 - Authorizes the Secretary of the Treasury to contribute a specified amount to the Global Environmental Facility of the International Bank for Reconstruction and Development if the Secretary has certified to specified congressional committees that the Facility has made progress toward implementing certain measures set forth in this Act. Authorizes appropriations. Amends the International Financial Institutions Act to direct the Secretary of the Treasury to report to the House Committee on Banking, Finance and Urban Affairs and the Senate Foreign Relations Committee on the progress made by the multilateral development banks in achieving objectives concerning debt-for-nature exchanges and lending for the environment. Chapter 3: Asian Development Bank - Amends the Asian Development Bank Act to authorize the U.S. Governor of the Asian Development Bank to subscribe to additional shares of the Bank's capital stock. Authorizes appropriations. Chapter 4: African Development Fund - Amends the African Development Fund Act to authorizes the U.S. Governor of the African Development Fund to contribute a specified amount to the sixth replenishment of the Fund. Authorizes appropriations. Chapter 5: Export-Import Bank - Amends the Export-Import Bank Act of 1945 to authorize the President to waive limitations on Export-Import Bank financing for exports to the Soviet Union if such waiver is in the national interest. Directs the Bank to: (1) develop a program for providing guarantees and insurance with respect to the export of high technology items to eligible SEED program countries; and (2) inform high technology companies about Bank programs for U.S. companies interested in exporting high technology goods to such countries. Requires the Bank, in the case of any long-term loan or guarantee of at least $10,000,000, to ensure that U.S. insurance companies are accorded a competitive opportunity to provide insurance against risk of loss in connection with such transactions. Sets forth procedures to be taken in cases where such opportunity is denied. Directs the Bank to report to the Congress on the demand for loans, guarantees, and insurance for trade between the United States and the Baltic States and the Soviet Union and to make recommendations for the promotion of trade between the United States and such countries. Expresses the sense of the Congress that the President should determine that Estonia, Latvia, and Lithuania are not Marxist-Leninist countries for purposes of prohibitions on Export-Import Bank assistance for Marxist-Leninist countries. Chapter 6: Multilateral Development Banks - Subchapter A: Energy Efficiency - International Energy Efficiency Financing Act of 1991 - Amends the International Financial Institutions Act to require the Secretary of the Treasury to instruct the U.S. Executive Directors of the multilateral development banks to: (1) demonstrate programs for measuring the application of systems energy efficiency planning and techniques; and (2) advocate procedures that require assessments of the impacts of proposed actions that would have a significant impact on energy efficiency before votes in favor of such actions. Directs the Secretary to seek the adoption of policies which result in access to the public of energy efficiency assessments by the borrowing countries and the lending institutions. Subchapter B: Alleviation of Poverty, Reduction of Barriers to Economic and Social Progress, and Other Provisions - Requires the Secretary to instruct the U.S. Executive Director of the regional multilateral development banks to advocate the establishment of an organizational unit to aid bank management policies for the reduction of poverty and of barriers to economic and social progress and equity. Directs the Secretary to instruct the U.S. Executive Directors of the international financial institutions to: (1) encourage borrowing countries to involve women in development activities; (2) urge such institutions to reflect the diversity of the population in hiring practices and to strengthen and expand recruitment, hiring, and promotion of minorities and women; and (3) urge such institutions to adopt compensation policies to ensure that comparable pay is provided for people in comparable jobs. Requires the Secretary to instruct the U.S. Executive Directors of the multilateral development banks to oppose any loan, except for basic human needs, to Ethiopia, Somalia, or Sudan until the President certifies to the Senate Foreign Relations Committee and the House Committees on Banking, Finance and Urban Affairs and Foreign Affairs, respectively, that the government of the country has: (1) begun to implement peace or national reconciliation agreements; (2) demonstrated a commitment to human rights; (3) manifested a commitment to democracy and has held or established a timetable for free and fair elections; and (4) agreed to distribute development assistance without discrimination. Directs the Secretary to instruct the U.S. Executive Directors of the international financial institutions to encourage borrowing countries to engage in fair labor practices and to report to the Secretary on actions to promote such practices. Subchapter C: Financial Integrity - Requires the Secretary to instruct such directors to ensure the establishment of an office of Inspector General in such institutions. Chapter 7: Consolidation of Reports - Requires annual reports submitted by the Chairman of the National Advisory Council on International Monetary and Financial Policies to include summaries of reports required under the Bretton Woods Agreements Act. Title XIV: Miscellaneous - Expresses the sense of the Congress that a major effort should be made to strengthen the right to food in international law to assure the access of all persons to adequate food supplies. Declares that the Secretary of State, through the U.S. representative to the United Nations, should propose to the United Nations General Assembly that a Declaration and a Convention concerning the right to food be adopted and submitted to countries for ratification. United States Environmental Security and Foreign Policy Act of 1991 - Sets forth U.S. policy with respect to global environmental security. Gives the Secretary of State primary responsibility for overseeing environmental agreements and activities between the United States and foreign countries and international organizations and commissions. Requires the Secretary to report biennially to the Congress on: (1) multilateral environmental initiatives and negotiations concluded or in process; (2) bilateral agreements on the environment; (3) U.S. participation in, and support of, environment programs in international organizations and multilateral development banks; (4) international cooperation activities with respect to research and monitoring of environmental and natural resource conditions; and (5) environmental policies and activities of the United States in providing foreign assistance. Expresses the sense of the Congress that a major effort should be made to reform and restructure the United Nations mechanism for responding to international disasters and other humanitarian emergencies. Requires the Secretary, through the U.S. representative to the United Nations, to develop a proposal for strengthening the United Nations response to such emergencies. Expresses the sense of the Congress with respect to nuclear non-proliferation regimes. Requires the President to report annually to the Congress on the progress made and obstacles encountered in establishing regional nuclear non-proliferation regimes.
Bill· SS. 2114 (102nd)open
United States · United States Congress · 26 November 1991
Comprehensive Health Insurance Plan of 1991 - Title I: Employer-Provided Health Insurance - Amends the Social Security Act to add a new title XXI under which employers are required to offer to their eligible employees a health plan that provides for basic health benefits and meets certain requirements for certification as a qualified employer plan (plan). Provides that the offer of enrollment in a plan shall include enrollment of the family of the eligible employee. Sets forth enrollment rules in cases of multiple employers. Outlines provisions concerning enrollment timing, period of coverage, and employer plan cards. Details certification procedures. Requires a plan to provide for basic health benefits. Provides that such benefits shall generally consist of the same benefits as described in title XVIII (Medicare) to an individual entitled to benefits under part A (Hospital Insurance), and enrolled under part B (Supplementary Medical Insurance) of Medicare, plus additional specified benefits including well-child care, cancer screening, and prescription drugs. Places limits on exclusions and coverage standards for basic benefits. Provides limitations for employee premiums, deductibles, and copayments as well as for out-of-pocket expenses with respect to items and services provided under a plan offering basic benefits. Permits a plan to provide for employee cost-sharing amounts that are lower than those specified if it contains such cost containment arrangements as described by the Secretary. Permits a plan to provide for supplemental health benefits. Provides that if a plan provides for such benefits and the eligible employee may not elect to forego such benefits, the plan: (1) may not impose a premium, for basic and supplemental benefits, that exceeds the premiums that may be imposed for the basic benefits; and (2) shall assure that cost-sharing is not imposed with respect to basic benefits once the cost-sharing limit has been reached in a year with respect to all benefits. Sets forth requirements relating to coordination and portability of health coverage under qualified employer plans. Preempts certain State requirements with respect to plan benefit and coverage rules and utilization review programs. Authorizes the Secretary of Health and Human Services to award grants to qualified small employer purchasing groups to assist such groups in paying the expenditures associated with the formation and initial operations of such groups. Sets forth grant eligibility criteria. Authorizes appropriations. Requires each State to establish rules governing the approval of the operation of an entity as a small employer purchasing group in such State. Sets forth rule requirements. Provides that, in the absence of any State action to establish such rules, the Secretary shall promulgate rules, including application forms, for the approval of entities to operate as small employer purchasing groups in such State. Requires each entity desiring approval to operate as a small employer purchasing group in any State to submit an application to such State. Establishes Federal standards for imposition on insurers which issue or offer qualified employer plans to small employers. Amends the Internal Revenue Code to impose an excise tax on: (1) employers who fail to offer to enroll eligible employees in qualified employer plans; and (2) insurers which do not meet the Federal standards established above by this Act. Sets forth special rules for the application of such taxes. States that the provisions of new title XXI shall not apply with respect to an employee who is not a resident of one of the 50 States or the District of Columbia. Title II: Health Care Coverage For Individuals Not Otherwise Covered Under Qualified Employer Plans or Medicare - Amends title XIX (Medicaid) of the Social Security Act to extend Medicaid health care coveragae (excluding long-term care services) to individuals not otherwise covered by qualified employer plans or Medicare and whose income does not exceed 240 percent of the official poverty line applicable to a family of the size involved. Gives States certain flexibility in providing benefits and coverage to such individuals. Provides an increase in Federal payments to States enrolling such individuals in coordinated care plans. Provides that there may be imposed premiums, deductibles or other cost sharing with respect to such individuals with family income over 100 percent of the official poverty line on a sliding-scale basis as long as such requirements do not exceed the applicable limitations specified in new title XXI of the Social Security Act. Permits buying-in to Medicare for certain uninsured individuals. Title III: Health Care Access - Tax Provisions - Amends the Internal Revenue Code to allow, in the case of an eligible small employer, as a refundable credit against any income tax imposed for the taxable year, an amount equal to 50 percent of the qualified health care costs paid by such employer during the taxable year. Sets forth special rules for the application of such tax credit. Doubles the health insurance credit and increases to 8.57 percent the phaseout percentage with respect to such credit. Repeals certain earned income tax credit interaction provisions. Provides a full deduction for health insurance costs of self-employed individuals. Makes such deduction permanent. Title IV: Administrative Provisions And Report - Amends part A (General Provisions) of title XI of the Social Security Act to: (1) require the Secretary, to the extent practicable, to develop and implement a universal health identification card and uniform claims form and reporting standards for use under Medicare, Medicaid, and new title XXI; (2) authorize additional funding for outcomes research and practice guidelines; (3) make January 1, 1993, the deadline by which the Secretary must assure the development of an initial set of specified guidelines; (4) require such guidelines to include treatments or conditions that account for a significant portion of national health expenditures (including expenditures under Medicare and Medicaid); and (5) reduce from 70 to 50 percent the amounts to be appropriated for FY 1993 and 1994 from specified trust funds. Directs the Secretary to submit a report to specified congressional committees providing information with respect to: (1) access to health care services, including the effects on access of patterns of utilization, supply and distribution of services and providers, and demographic changes; (2) sources of significantly changing health care costs; (3) the effects on costs of: (a) utilization by service, region, provider type and payer; (b) supplies, labor, capital, and new and emerging technology; (c) State and private efforts to contain such costs; and (d) outcomes research and practice guidelines; and (4) such other matters as the Secretary may consider appropriate.
Bill· SS. 2060 (102nd)open
United States · United States Congress · 26 November 1991
Orphan Drug Amendments of 1991 - Amends provisions of the Federal Food, Drug, and Cosmetic Act (FDCA) relating to designation of drugs for rare diseases or conditions to require that the number of people affected be determined three years after the request for designation as well as on the date of the request. Creates additional exceptions from the protection of exclusive approval, certification, or license for drugs for rare diseases for drugs which qualified for protection because the disease or condition for which they are used affected less than a specified number of persons, but which have ceased to so qualify. Provides for the termination of orphan drug status for drugs having cumulative sales over a certain amount, provided the costs of developing the drug in the United States are not over the same amount. Amends the Public Health Service Act to replace provisions establishing the Orphan Products Board with provisions establishing the Office for Orphan Diseases and Conditions. Includes in the functions of the Office dealing with drugs, devices, and medical foods (currently, the Board deals with drugs and devices). Establishes an advisory committee within the Office. Amends the FDCA to authorize appropriations for grants and contracts for development of drugs for rare diseases and conditions.
Bill· SS. 2116 (102nd)open
United States · United States Congress · 26 November 1991
Comprehensive Child Health Immunization Act - Amends the Public Health Service Act (PHSA) to require the Secretary of Health and Human Services to publish in the Federal Register a designation of those Standards for Immunization Practices, developed and published by the Centers for Disease Control (CDC) under the auspices of the National Vaccine Advisory Committee (standards), that the Secretary determines can be implemented without cost. Directs the Secretary to promulgate regulations that require: (1) all individuals or entities receiving assistance from the Secretary for public sector immunization and social service programs, or for private sector immunization services provided through reimbursements made under the Social Security Act (SSA) or with vaccines made available by the CDC, to comply with the standards; and (2) States receiving Federal funds that are used to provide vaccines to ensure that recipients of such vaccines adhere to the standards. Requires the Secretary to utilize and expand existing audit procedures to monitor compliance. Authorizes the Secretary to provide assistance to enable entities that receive Federal immunization grant funds to implement those standards that the Secretary determines will necessitate the commitment of additional financial resources and increase the access of children to immunizations. Authorizes appropriations. Directs the Secretary to: (1) develop, for use by States in enrolling and recertifying individuals with respect to programs under the PHSA, SSA, special food program of the Child Nutrition Act, and other programs designated by the Secretary, model questions concerning immunization status and medical history and model packets of information concerning the risks and benefits associated with vaccines, locations of immunization providers with respect to each State, and other material determined appropriate by the Secretary; and (2) require States to incorporate the model questions into the forms and procedures utilized for such programs and to provide the appropriate information so developed to recipients of benefits provided under such programs. Requires: (1) such model questions and informational packets to be administered and provided to recipients of benefits under other federally administered health programs; and (2) the Secretary to develop and apply, and require States to apply, procedures relating to the referral of individuals for immunization services, including a plan for the provision of transportation assistance for children eligible to receive assistance under the SSA. Amends the SSA to require a State, to be eligible to receive payments for Aid to Families with Dependent Children and family support services and for social services block grants, to provide assurances to the Secretary that child care providers within the State that receive assistance will utilize the questions concerning immunization status with respect to the children served and provide such information as developed pursuant to this Act to their parents or guardians. Amends the National School Lunch Act to bar participation by institutions unless they provide such assurances. Amends the Child Care and Development Block Grant Act of 1990 to require States to provide such assurances to qualify for grants under such Act. Amends the PHSA to direct the Secretary to award demonstration grants to enable eligible State and local entities to fully implement plans for the Infant Immunization Initiative. Sets forth provisions regarding: (1) eligible entities; (2) maintenance of support; (3) grant amounts (based on the size and demonstrated need of the entity); (4) use of grants (such as for the establishment of express vaccination facilities in health clinics, the provision of vaccinations in hospital emergency rooms, through in-home visits and in day or child care centers, Head Start institutions, and in schools, the establishment of mobile vaccination teams, and other activities determined appropriate by the Secretary); (5) grants to local communities for innovative programs designed to increase access to immunizations; and (6) reporting requirements. Authorizes appropriations. Authorizes the Secretary to provide assistance to specified State and local entities to support the additional operational activities of immunization sites necessary to maintain compliance with the standards relating to infrastructure changes and to support innovative approaches designed to increase the access of children to immunization services. Authorizes appropriations. Directs the Secretary to provide for the development and distribution of consumer educational materials concerning childhood immunizations. Authorizes appropriations. Directs the Secretary to modify regulations with respect to the Early and Periodic Screening, Diagnosis and Treatment program under the SSA to require States to undertake aggressive outreach efforts in contacting parents concerning the immunization of their children and in tracking the immunization status of children through information submitted to the State from immunization providers seeking reimbursement under such Act. Authorizes appropriations to the CDC to pay the costs associated with the utilization of the National Health Interview Survey compiled by the National Center for Health Statistics. Amends the PHSA to direct the Secretary to establish a research and demonstration grant program to award to States or other entities determined appropriate by the Secretary grants for the development of computerized immunization registries. Sets forth provisions regarding: (1) application requirements; (2) the use of grant funds (to develop and implement a computerized system for the identification and tracking of children for immunization purposes, to identify appropriate mechanisms for collecting, updating, maintaining, and accessing data concerning the immunization of children, to implement procedures under which vaccine providers will have access to the current immunization records of their patients, and to carry out any other activities determined appropriate by the Secretary); (3) reporting requirements; (4) development of a nationwide, computerized registry containing immunization information concerning children throughout the United States and procedures to collect information, to give health care providers access to information, and to track the immunization status of children; and (5) coordination with other programs. Authorizes appropriations for grants and for the purchase of computer equipment. Amends the PHSA and the SSA to require the Secretary to establish demonstration programs under which grants will be awarded to enable eligible States to purchase vaccines for distribution to, and use by, private health care providers. Sets forth provisions regarding: (1) eligibility of States for grants; (2) maintenance of support; (3) use of grant funds; and (4) reporting requirements. Authorizes appropriations. Amends the PHSA to direct the Secretary to establish and administer a National Fund for Disease Outbreak Control. Authorizes appropriations. Directs the Secretary, upon the determination by the Secretary that an unanticipated disease outbreak requiring additional vaccine purchases occurs, to utilize the Fund to provide the CDC with the resources necessary to control the spread of such disease through the implementation of necessary preventive measures, including the reimmunization of children in disease-affected areas who have not yet received the recommended second-dose immunization against the disease. Requires the Director of the National Vaccine Program to make appropriations available to appropriate Federal agencies to enable such agencies to carry out special research with respect to the development of: (1) vaccines that are safe and effective in younger infants and newborns; (2) vaccine combinations to decrease the number of injections and required vaccine provider visits; and (3) new vaccines, including vaccines for chicken pox and rotovirus strains common throughout the United States. Directs the CDC to develop program guidance for all entities receiving a grant under this Act or any other childhood immunization grant under the PHSA requiring grantees to: (1) describe in detail their objectives, plans, and specific activities to reach out to high-risk populations for immunization purposes; and (2) submit end-of-year reports to the Director of the CDC. Directs the Secretary to report to the appropriate congressional committees concerning the immunization status of pre-school and school-aged children nationwide.
Bill· SS. 2077 (102nd)open
United States · United States Congress · 26 November 1991
Medicaid Managed Care Improvement Act of 1991 - Amends title XIX (Medicaid) of the Social Security Act to provide for State Medicaid coverage of coordinated care. Defines "coordinated care" as programs operated by any qualifying public or private health maintenance organization or primary care case management program (PCCMP). Revises provisions governing State plans for medical assistance under Medicaid to: (1) eliminate the requirement that Medicare (title XVIII of the Social Security Act) and Medicaid beneficiaries constitute less than 75 percent of the membership of any prepaid medical provider; (2) permit States to mandate enrollment of eligible individuals, provided the individuals have of choice of two or more plans, a choice between enrolling in a plan or in a PCCMP, or a choice among physicians to the extent that two-thirds of the physicians in the area particpate in the plan or system; and (3) require that a plan provide for implementation of an internal quality assurance program containing specified elements. Requires a State contracting for coordinated care: (1) with a PCCMP or a plan, to provide for specified quality assurance activities, including a State-operated enrollee grievance procedure and a survey and analysis of enrollee satisfaction; and (2) with a plan, to provide for an independent review of each plan's quality assurance activities by an organization external to the State. Authorizes the Secretary of Health and Human Services to provide for continuation of any operating managed care program without granting additional waivers if the program is successful in assuring quality and containing costs.
Bill· SS. 2104 (102nd)referred
United States · United States Congress · 26 November 1991
Physician Assistant Incentive Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to provide increased Medicare reimbursement for physician assistants at 97 percent of the physician fee schedule amount for services performed without regard to location or practice setting. Provides for bonus payments for services provided by physician assistants in health professional shortage areas.
Bill· SS. 2103 (102nd)referred
United States · United States Congress · 26 November 1991
Primary Care Health Practitioner Incentive Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to provide increased Medicare reimbursement for nurse practitioners, clinical nurse specialists, and certified nurse midwives (practitioners) at 97 percent of the physician fee schedule amount for services performed without regard to location or practice setting. Provides for bonus payments for services provided by such practitioners in health professional shortage areas. Defines "clinical nurse specialist" as an individual who is a registered nurse and is licensed to practice nursing in the State in which the clinical nurse specialist services are performed and holds a master's degree in a defined clinical area of nursing from an accredited educational institution.
Bill· SS. 2084 (102nd)referred
United States · United States Congress · 26 November 1991
Directs the Secretary of Health and Human Services to provide for cost reporting periods beginning on or after October 1, 1991, and before October 1, 2001, for a minimum Medicare (title XVIII of the Social Security Act) payment level of 90 percent for rural referral centers' allowable capital-related costs.
Bill· SS. 2083 (102nd)referred
United States · United States Congress · 26 November 1991
Extends the regional referral center classification of hospitals so classified as of September 30, 1989, under title XVIII (Medicare) of the Social Security Act through FY 1994.
Bill· HRH.R. 4024 (102nd)open
United States · United States Congress · 26 November 1991
Amends the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 to provide that whenever a U.S. department, agency, or instrumentality (agency) enters into a contract for the sale or lease of, any grant of easement on, or any written agreement for other transfer of, real property (currently, for the sale or other transfer of real property) which is owned by the United States and on which a hazardous substance was stored for one year or more, known to have been released, or disposed of, the head of such agency shall include in such contract, lease, grant, or agreement (currently, contract) notice of the type and quantity of such hazardous substance and notice of the time at which such storage, release, or disposal took place. Provides that each deed entered into for a transfer of such property by the United States to any other person or entity shall contain a covenant warranting that remedial (currently, all remedial) action necessary to protect human health and the environment with respect to any hazardous substance remaining on the property has been taken before the date of the transfer. Specifies that, for purposes of such provision, remedial action has been taken if: (1) remedial action has been completed; (2) no remedial action is required; or (3) remedial action has been commenced with respect to any hazardous substance remaining on the property, the deed entered into for the transfer of such property contains clauses assuring access to the property so that any further remedial action required can be taken and limiting the use of such property to uses that would be consistent with the protection of human health and the environment, and the United States agrees to continue diligently carrying out any further required remedial action on the property until all remedial action has been completed. Authorizes the President, acting through the head of any agency, to remove, or arrange for the removal of, any hazardous substance on real property subject to such Act, regardless of whether an imminent and substantial danger to the public health, welfare, or environment exists. Specifies that, in the case of: (1) real property subject to such Act, the head of the agency with jurisdiction over the property may subdivide it for purposes of sale, lease, grant of easement, or other transfer in accordance with such Act, regardless of whether the property is listed as a site on the National Priorities List; and (2) a parcel of property subdivided out of such real property, the head of the agency may sell, lease, grant an easement to, or otherwise transfer the parcel in accordance with such Act and other Federal provisions relating to Federal property sales or transfers. Directs the Secretary of Defense to: (1) submit to the Congress a report on the manner in which the Department of Defense (DOD) plans to carry out environmental restoration activities on military installations to be closed (pursuant to the Defense Authorization Amendments and Base Closure and Realignment Act, the Defense Base Closure and Realignment Act of 1990, or otherwise by DOD) to take into account the amendments made by this Act; and (2) hold harmless, defend, and indemnify in full specified entities (including any State, or political subdivision thereof, that acquires ownership or control of any facility of a military installation, any person or entity that acquires such ownership or control, and any successor, assignee, transferee, lenders, or lessee of such a person or entity) from and against all suits, claims, or liabilities arising out of the release or threatened release of any hazardous substance, pollutant, or contaminant as a result of DOD activities at a military installation that is closed pursuant to a base closure law, except to the extent that such person or entity caused or contributed to such release or threatened release.
Bill· HRH.R. 4022 (102nd)referred
United States · United States Congress · 26 November 1991
Enterprise Communities Incentives Act of 1991 - Declares it to be the purpose of this Act to establish a demonstration program of incentives for the creation of tax enterprise zones in order to: (1) revitalize economically and physically distressed areas; (2) promote meaningful employment for zone residents; and (3) encourage individuals to reside in the zones in which they are employed. Title I: Designation and Tax Incentives - Amends the Internal Revenue Code to provide for the designation of tax enterprise zones by the Secretary of Housing and Urban Development during calendar years 1993 through 1996. Sets forth eligibility criteria for rural areas. Sets forth the eligibility criteria for such designation, including: (1) a population of not less than 4,000; (2) pervasive poverty, unemployment, and general distress; (3) a high unemployment rate; and (4) a required course of action designed to reduce the various burdens borne by employers or employees in the area. Provides that a course of action under private entities may not be federally funded and may include: (1) a reduction of tax rates or fees; (2) an increase in public services; (3) a reduction in government paperwork requirements; (4) business community commitments to provide jobs and job training; (5) special preference to minority contractors; (6) gifts of land for the operation of neighborhood businesses; (7) pooled health insurance; (8) loans by local financial institutions for business start-ups; and (9) special preference to low-income housing projects and private activity bonds. Allows an enterprise zone employment credit to small employers as a general business credit of ten percent of the qualified zone wages paid plus qualified zone employee health insurance costs. Allows such credit for the first five years of the employee's employment. Makes the rehabilitation credit available for buildings in the tax enterprise zone that are at least 30 years old. Provides a shorter recovery period (20 years) for nonresidential real property. Allows a 60-month amortization period (in lieu of depreciation) for child care facilities. Allows the deferral of capital gain for ten years if the gain is reinvested in tax enterprise zone property. Limits the dollar amount of deferred gain. Declares that loss on any qualified zone corporate investment shall be treated as an ordinary loss. Allows a deduction for the purchase of enterprise zone stock on the original issue by a qualified issuer. Limits such amount to $50,000 for any taxable year, or $250,000 during the taxpayer's lifetime. Increases the research credit for research conducted in tax enterprise zones. Increases the low-income housing credit for qualified buildings in a tax enterprise zone where a portion of such building is used as a qualified child care center. Increases such credit for low-income buildings in tax enterprise zones and the State housing credit ceiling for buildings in such zones. Sets forth incentives with respect to tax-exempt bond provisions for projects in tax enterprise zones. Provides a tax exemption for work-based education organizations in tax enterprise zones. Allows businesses a credit for work-based education contributions as part of the general business credit. Title II: Establishment of Foreign-Trade Zones in Tax Enterprise Zones - Requires enterprise zones to receive priority in the designation of foreign trade zones. Title III: Studies - Requires the Secretary of the Treasury and the Comptroller General each to report to the House Committee on Ways and Means and the Senate Committee on Finance on the effectiveness of the incentives provided by this Act in achieving its purposes. Title IV: Community-Based Crime Control and Alternatives for High-Risk Youth in Enterprise Zones - Directs the Attorney General, through the Bureau of Justice Assistance of the Department of Justice after specified consultations, to make grants to units of general local government that establish or expand community-oriented policing programs and complementary, comprehensive prevention efforts to reduce and prevent drug abuse and crime, particularly among youth and adolescents, offenders and other populations at high risk for involvement in drug abuse and crime. Authorizes appropriations. Title V: Housing and Community Development Activities in Enterprise Zones - Amends the Housing and Community Development Amendments of 1978 to direct the board of directors of the Neighborhood Reinvestment Corporation to appoint an Advisory Council for Neighborhood Development Initiatives to advise the board with respect to: (1) assistance to community development corporations for development activities in tax enterprise zones; (2) grants for housing and community development in such zones; and (3) activities for high-risk youth in such zones. Authorizes appropriations. Allows the sale of federally-held properties within tax enterprise zones to nonprofit and for-profit organizations at a price not exceeding 50 percent of the appraised value of such property. Requires such property to be used for housing, commercial enterprises, job training, or drug treatment. Title VI: Drug Exposed Children - Amends the Individuals with Disabilities Education Act to authorize supplemental grants to carry out demonstration programs for certain drug-exposed infants, toddlers, and children. Amends the Public Health Service Act to require that the clearinghouse for alcohol and drug abuse information collect and disseminate information and instructional materials regarding drug-exposed children. Provides for consultation and technical assistance to educational personnel regarding educational needs of such children. Authorizes appropriations. Authorizes the making of grants to institutions of higher education for teacher training for educating such children. Title VII: Substance Abuse Treatment Corps - Amends the Public Health Service Act to establish within the Public Health Service the Substance Abuse Treatment Corps to increase the availability of treatment for alcohol and drug abuse in geographic areas with a significant incidence of abuse and an inadequate availability of services. Allows the Secretary of Health and Human Services to carry out such purpose only through assigning Corps members to provide services for such areas. Allows the Secretary to assign a Corps member to an entity only if the entity, among other requirements, enters into an agreement with the Secretary regarding the allocation, between the Secretary and the entity, of costs relating to the assignment. Directs the Secretary to establish a program of entering into contracts with students in specified fields under which the students agree to serve in the Corps upon obtaining their degrees in consideration of the Federal Government's agreeing to pay tuition, other expenses, and a stipend. Applies, except as inconsistent, provisions relating to the National Health Service Corps Loan Repayment Program to this program. Directs the Secretary to establish a program of entering into contracts with individuals who have been licensed or certified in certain fields, or who are students in such fields, under which the individuals agree to serve in the Corps in consideration of the Federal Government's agreeing to repay up to a specified sum of educational loans of the individuals. Applies, except as inconsistent, provisions relating to the National Health Service Corps Loan Repayment Program to this program. Authorizes appropriations for the scholarship and loan repayment programs established by this Act. Title VIII: Drug-Free Schools Emergency Target Grants - Amends the Drug-Free Schools and Communities Act of 1986 to revise provisions with respect to emergency grants to authorize the Secretary to make drug-free schools emergency target grants to eligible local educational agencies (LEAs) and consortia of LEAs (currently, limited to LEAs) that: (1) demonstrate significant need for additional assistance for purposes of reducing and preventing drug and alcohol use and drug-related crime among students served by such agencies (currently, to combat drug and alcohol use among such students, and excludes the following provisions); (2) support projects that require cooperative linkages between schools and communities to reduce and prevent drug and alcohol use among schoolchildren; (3) demonstrate the most effective approaches to reducing and preventing drug and alcohol use among schoolchildren; and (4) promote the goal that every school in America will be free of drugs and violence and will offer a discipined environment conductive to learning. Specifies: (1) authorized activities by LEAs with grant funds; and (2) eligibility and application requirements for such grants by LEAs and consortia of LEAs. Directs the Secretary, in awarding grants, to give special preference to applications that: (1) hold particular promise for reducing and preventing the incidence of drug and alcohol use and drug-related violence in elementary and secondary schools; (2) are based on a rigorous and comprehensive research design; and (3) have demonstrated that they will integrate the resources of families, community groups, and the media into an effective, community-based assault on drug and alcohol use in schools. Requires the Secretary to conduct an evaluation of this program. Sets forth provisions with respect to: (1) grant amounts and distribution of funds; and (2) set-asides from appropriations to conduct such evaluation, provide training and technical assistance to LEAs, and disseminate the results of the program. Authorizes appropriations. Requires a local or intermediate educational agency or consortium to include in any application to the State educational agency for a drug and alcohol abuse prevention grant a statement of how any emergency target grants funded by the Government under this Act are integrated into the overall prevention plan set forth in the application. Title IX: Medicaid Coverage for Pregnant Women and Family Members - 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 as: (1) individual, group, and family counseling and addiction education and treatment; (2) room and board in a structured environment with on-site supervision 24 hours a day; (3) child day health services; (4) parental assistance in obtaining developmental assistance for their preschool children and public education for themselves and their school-age children; (5) easier access to apppropriate health, social, and child care services; and (6) planning and assistance in reentering society. Requires that such coverage continue for at least 12 months (unless such coverage is found to be no longer therapeutically necessary), except that the coverage of pregnant women must continue for one year following the end of pregnancy. Limits the size of a residential treatment facility to no more than 40 beds, except under prescribed conditions.
Bill· HRH.R. 4054 (102nd)referred
United States · United States Congress · 26 November 1991
Health Care Access and Security Act of 1991 - Title I: Improvements in Health Insurance Affordability for Small Employers - Amends the Internal Revenue code to raise from 25 to 100 percent the deduction allowed to self-employed individuals for health insurance premiums and makes the deduction permanent. Directs the Secretary of Health and Human Services (the Secretary) to make grants to States for the establishment and operation of small employer health insurance purchasing programs. Permits grant funds to be used to finance administrative costs associated with developing and operating a group purchasing program for small employers. Authorizes appropriations. Title II: Improvements in Health Insurance for Small Employers - Amends the Social Security Act to add a new title, Title XXI: Standards for Small Employer Health Insurance and Certification of Managed Care Plans. Directs the Secretary to request the National Association of Insurance Commissioners to develop model standards and regulations concerning requirements for health insurance plans for small employers. Requires such plans to provide for: (1) guaranteed eligibility; (2) guaranteed availability; and (3) guaranteed renewability. Prohibits: (1) an insurer from refusing to renew or terminate a plan, except for nonpayment of premiums, fraud, or failure to maintain minimum participation rates; and (2) for certain services, discrimination based on health status. Sets limits controlling the variation of premium charges permitted among all small employers insured by an insurer. Requires the full disclosure of an insurer's rating practices. Requires a health insurance plan for small employers to offer: (1) both a standard benefit package and basic benefit package; and (2) a managed care option, if the insurer also offers such an option to other employers. Provides, under both the standard and basic package, for coverage of: (1) inpatient and outpatient hospital care; (2) inpatient and outpatient physician services; (3) diagnostic tests; and (4) preventive services. Provides, in addition, under the standard plan: (1) for the coverage of certain mental health care; (2) that, except as specified, there will be no limits on the amount, scope, or duration of benefits, and (3) for specified limits on deductibles, copayment, coinsurance, and out-of-pocket expenses. Provides under the basic plan that: (1) premiums, deductibles, copayments, or other cost-sharing may be imposed; and (2) there shall be an out-of-pocket limit. Amends the Internal Revenue Code to impose an excise tax of 25 percent of gross premiums on the issuer of any health insurance plan to a small employer if the plan does not meet the requirements of title XXI. Sets forth study and reporting requirements. Title III: Improvements in Portability of Private Health Insurance - Imposes an excise tax of $100 per day, with respect to a covered individual, on a group health plan for its failure to provide coverage for a preexisting condition, subject to stated exceptions. Title IV: Health Care Cost Containment - Establishes a Health Care Cost Commission which shall report annually to the President and the Congress on national health care costs. Authorizes appropriations. Requires the Secretary of Health and Human Services, under title XXI of the Social Security Act, to establish a process for the certification of managed care plans and of utilization review programs. Sets forth requirements for certification. Amends the Public Health Service Act to direct the Administrator of the Agency for Health Care Policy and Research to develop outcomes research and practice parameters for mental health services, including at least the diagnosis and treatment of childhood attention deficit syndrome disorders and manic depression. Amends Part A (General Provisions) of title XI of the Social Security Act to authorize appropriations for research outcomes of health care services and procedures. Requires all Medicare carriers and intermediaries to accept electronic submission of claims in a specified uniform format. Title V: Malpractice Reform - Directs the Secretary of Health and Human Services to make grants to States for the implementation and evaluation of alternative dispute resolution systems (ADR). Sets forth eligibility requirements for States seeking such grants. Directs the Secretary to award not less than ten such grants each fiscal year, with exceptions. Requires the Secretary to: (1) designate each State receiving such a grant as a model ADR State (making such State eligible for a two-year extension); and (2) disseminate information on the ADR systems implemented by such States to other States, health care professionals and providers, and other interested parties. Directs the Secretary to: (1) develop and promulgate standards and regulations necessary to carry out the grant program, including qualification standards that States must meet to receive grants and regulations establishing State data gathering requirements; (2) take into account, in developing qualification standards, specified factors such as the effectiveness of such systems in supporting access to health care, encouraging improvements in the quality of care, resolving claims promptly, and providing predictable outcomes; (3) provide States with technical assistance; and (4) report to the Congress, within four years of the first grant, describing and evaluating the ADR systems implemented. Specifies that, with respect to any health care liability action brought in a Federal or State court and any medical malpractice claim or medical product liability claim subject to an ADR system: (1) no person may be required to pay more than $100,000 in a single payment in damages (whether for economic or non-economic losses) for expenses to be incurred in the future, but shall be permitted to make periodic payments (as determined by the court); (2) the total amount of damages that may be awarded to an individual and the family members of such individual for non-economic losses may not exceed $250,000; (3) the total amount of damages received by an individual shall be reduced by any other payment that has been or will be made to the individual to compensate such individual for the injury that was the subject of the action or claim; (4) a claimant's attorney's fees may not exceed 25 percent of the first $150,000 of any award or settlement, or 15 percent of any additional amounts, paid to the claimant; (5) the total amount of punitive damages that may be assessed may not exceed twice the total amount of the damages awarded to compensate the claimant for losses resulting from the injury; and (6) the liability of each defendant for non-economic losses shall be several only and not joint, and each defendant shall be liable only for the amount of non-economic losses allocated to the defendant in direct proportion to the defendant's percentage of responsibility. Establishes a two year statute of limitations for medical malpractice and product liability claims, beginning on the earlier of the date on which the injury that is the subject of the action was discovered or should reasonably have been discovered. Specifies that, in the case of a medical malpractice or product liability claim relating to services provided during labor or the delivery of a baby, if the claimant was not previously treated for the pregnancy by the defendant health care professional or provider a court may not find that the defendant committed malpractice and assess damages against the defendant unless the malpractice is proven by clear and convincing evidence. Bars a defendant from being found to have committed malpractice unless the defendant's conduct at the time of providing the health care services that are the subject of the action was not reasonable, except where the claimant asserts that the defendant is liable under a strict liability theory. Bars the award of punitive damages with respect to any medical product liability claim alleged against a medical product producer if the drug or device that is the subject of the claim: (1) was subject to approval or premarket approval under the Federal Food, Drug, and Cosmetic Act by the Food and Drug Administration (FDA) with respect to the safety or performance of the drug or device, or the adequacy of the packaging or labeling; (2) was approved by FDA; or (3) is generally recognized as safe and effective pursuant to conditions established by FDA and applicable regulations. Makes an exception in the case of withheld information, misrepresentation, or illegal payment to an FDA official for purposes of securing approval of the drug or device. Provides for a separate proceeding to determine punitive damages. Sets forth provisions with respect to: (1) the admissibility of evidence; and (2) criteria for determining the amount of punitive damages. Provides that the U.S. district courts shall not have jurisdiction over health care liability actions based on Federal questions or based on specified provisions concerning commerce and antitrust regulations. Specifies that these provisions preempt State law only to the extent that State law: (1) permits the recovery by a claimant or the assessment against a defendant of a greater amount of damages; (2) permits the awarding of a greater amount of attorneys' fees; (3) establishes a longer period during which medical malpractice or product liability claims may be initiated; or (4) establishes a less strict standard of proof for determining whether a defendant has committed malpractice than these provisions. Amends the Public Health Service Act to direct the Secretary to encourage the establishment of a nationwide risk retention group (RRG) for community and migrant health centers receiving assistance under such Act that meets specified requirements. Defines a RRG for purposes of these provisions as an entity defined in the Liability Risk Retention Act of 1986 that: (1) provides professional liability insurance and other types of profitable insurance approved for issuance by the Secretary to community and migrant health centers; (2) provides insurance that applies to all claims filed against a community or migrant health center after the entity initiates insurance coverage and to claims arising from acts that occurred prior to the initiation of coverage if the claims are not covered by other insurance; and (3) meets such other requirements as the Secretary may establish. Title VI: Incentives for Private Long-Term Care Coverage - Amends the Internal Revenue Code to provide for: (1) long-term care insurance contracts to be treated as accident or health insurance contracts; (2) amounts received under such contracts with respect to qualified long-term care services to be treated as amounts received for personal injuries or sickness; and (3) employer plans providing such services to be treated as an accident or health plan. Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions. Excludes benefits received under such contracts from gross income. Provides for the treatment of prefunded post-retirement long-term care benefits plans in the same manner as prefunded post-retirement medical and life insurance benefit plans. Permits qualified long-term care insurance contracts to be offered in cafeteria plans (plans which offer two or more benefits). Allows the tax-free exchange of life insurance contracts for long-term care insurance contracts. Provides for the treatment of amounts paid to a terminally ill individual or one who is chronically ill and confined to a qualified facility as death benefits. Allows insurance companies to issue such accelerated death benefit riders on life insurance contracts. Declares that gross income does include excessive long-term care benefits.
Bill· HRH.R. 3990 (102nd)referred
United States · United States Congress · 26 November 1991
Postreproductive Health Care Act - Amends the Public Health Service Act to mandate grants for: (1) prevention and outpatient treatment and counseling for health conditions unique to, more serious, or more prevalent for women of menopausal age or older, or for which the medical risk or types of medical intervention are different; and (2) related education and training of health professionals. Authorizes appropriations.
Bill· HRH.R. 3982 (102nd)referred
United States · United States Congress · 26 November 1991
Medicare HMO Sanction Reform and Anti-Fraud and Abuse Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to authorize the Secretary of Health and Human Services to terminate the risk-sharing contract of, or impose intermediate sanctions (including civil money penalties and the suspension of the enrollment of individuals) against, any participating health maintenance organization (HMO) that: (1) is carrying out the contract in a manner inconsistent with efficient and effective administration; (2) is operating in a manner that is not in the best interests of covered individuals; or (3) does not meet other specified contract requirements. Sets forth requirements for investigation and compliance procedures for terminating a contract or imposing such sanctions. Requires written agreements between participating HMOs with risk-sharing contracts and entities providing peer review services with respect to services provided by HMOs. Requires the Secretary to develop a model of such an agreement. Requires the Comptroller General to conduct a study and report to specified congressional committees on compliance costs incurred by such HMOs with respect to entering into such a written agreement. Amends title XI of the Social Security Act to subject to civil monetary penalties any person that: (1) transfers anything for less than fair market value to (or for the benefit of) a beneficiary in order to influence the individual to receive from a particular provider, practitioner, or supplier a covered item or service for which payment may be made under Medicare or Medicaid (title XIX of the Social Security Act); or (2) pays an incentive to induce an employee to encourage individuals to seek or obtain such an item or service where the amount of the incentive is in proportion to the encouraging activities of the employee.
Bill· HRH.R. 3989 (102nd)referred
United States · United States Congress · 26 November 1991
Medicaid Prostate Screening Act of 1991 - Amends title XIX (Medicaid) of the Social Security Act to mandate coverage of prostate cancer screening tests under State Medicaid plans.
Bill· HRH.R. 3974 (102nd)referred
United States · United States Congress · 26 November 1991
Medicaid Federalization Act of 1991 - Amends title XIX (Medicaid) of the Social Security Act to: (1) convert the Medicaid program to a federally administered program of medical assistance that requires contributions by a State in order for individuals in the State to receive current Medicaid core services; (2) provides for the reversion of Medicaid administrative authority to a State upon the State's request; (3) require the Secretary of Health and Human Services to publish an alternative version of Medicare (title XVIII of the Social Security Act) fee schedule amounts for physicians' services and Medicare payment amounts for the operating costs of inpatient hospital services for use in determining payment amounts for such services under Medicaid that takes into account differences in the individuals covered and such services provided under Medicare and Medicaid; (4) provide that if a physician knowingly and willfully and on a repeated basis refuses to furnish services to individuals eligible for Medicaid, the Secretary may exclude such physician from participating in Medicare for a limited period; and (5) direct the Secretary of the Treasury to increase excise taxes on alcohol, tobacco products, and gasoline and other specified fuels in order to finance a federally administered Medicaid program.
Bill· HRH.R. 3992 (102nd)referred
United States · United States Congress · 26 November 1991
Medicare Prostate Screening Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to provide coverage of prostate cancer screening tests under the Medicare program.
Bill· HRH.R. 3980 (102nd)referred
United States · United States Congress · 26 November 1991
Medicare HMO Qualified Medicare Beneficiary Notification Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to require health maintenance organizations that are participating in the Medicare program and that are parties to specified risk-sharing contracts to determine whether individuals enrolled with such organizations are entitled to medical assistance for Medicare cost-sharing under title XIX (Medicaid) and to assist them in obtaining such assistance.
Bill· HRH.R. 3991 (102nd)referred
United States · United States Congress · 26 November 1991
Primary Health Care Investment Act of 1991 - Amends the Public Health Service Act to authorize appropriations to carry out specified provisions relating to community health centers and the National Health Service Corps scholarships and loan repayment programs. Amends provisions of title XVIII (Medicare) of the Social Security Act relating to payment to hospitals for inpatient services to modify requirements regarding the determination of approved FTE (Full-Time Equivalent) resident amounts.
Bill· HRH.R. 4013 (102nd)referred
United States · United States Congress · 26 November 1991
Coal Industry Retiree Health Benefit Act of 1991 - Amends the Internal Revenue Code to establish the Coal Industry Retiree Health Benefit Corporation to administer a program for the provision of retiree health benefits in the coal industry. Establishes the Coal Industry Retiree Benefit Fund for the deposit of all amounts received by the Corporation. Requires the following payments to the Corporation: (1) an hourly premium on each hour worked in coal production by employees by each person that produces coal for use or for sale; (2) a per-ton premium obligation on the importer of coal; and (3) an annual per beneficiary premium by each last signatory operator and each other employer. Sets forth the eligibility requirements for benefits for orphan miners, and spouses and dependents or orphan miners or deceased coal miners. Requires the Corporation to provide medical and death benefits to such persons. Directs the Corporation to develop managed care rules applicable to the payment of benefits. Establishes the United Mine Workers of America 1991 Benefit Fund as an employee welfare benefit plan consisting of the merger of excess assets from certain closed plans. Sets forth eligibility requirements for benefits from such Fund. Requires the last signatory operator of any individual receiving retiree health care benefits as of February 1, 1993, from an individual employer plan maintained pursuant to a coal wage agreement to provide retiree health care benefits to such individual. Provides for the determination and disposition of excess pension assets to the Corporation or the 1991 Benefit Fund.
Bill· HRH.R. 4062 (102nd)referred
United States · United States Congress · 26 November 1991
Sunset Act of 1991 - Title I: Reauthorization of Government Programs - Requires each Government program to be reauthorized at least once during each sunset reauthorization cycle. (Sunset reauthorization cycle means the period of five Congresses beginning with the 103d Congress and with each sixth Congress following the 103d Congress.) Sets forth the procedure in the House of Representatives and the Senate for the consideration of any legislation which authorizes new budget authority. Exempts from the requirements of this Act specified items, such as interest on Federal debts, health care services, general retirement and disability payments, litigation activities which have as their objectives the protection and implementation of civil rights guaranteed by the Constitution, and specified retirement pay and benefits. Title II: Program Inventory - Directs the Comptroller General and the Director of the Congressional Budget Office, in cooperation with the Director of the Congressional Research Service, to prepare an inventory of Federal programs. Declares that the purpose of such program inventory is to advise and assist the Congress in carrying out reauthorization and reexamination requirements and to link such reauthorization and review process with the budget process. Requires the Comptroller General to submit such program inventory to each House of Congress no later than January 1, 1992. Directs the congressional committees, the Congressional Budget Office, and the Congressional Research Service to review the program inventory and to suggest revisions. Requires that the program inventory be revised at the end of each session of the Congress and that such revisions be reported to each House. Title III: Program Reexamination - Requires each committee of the Senate and the House of Representatives to reexamine selected programs or groups of programs over which it has jurisdiction. Sets forth procedures for such review and criteria for selection of program areas for evaluation. Title IV: Tax Expenditures - Requires the Director of the Congressional Budget Office, after consultation with the Joint Committee on Taxation of the Congress, to prepare an inventory of tax expenditure provisions and to submit a report on such inventory to the Committee on Ways and Means of the House and the Senate Finance Committee by July 1, 1992. Directs the House Committee on Ways and Means and the Senate Committee on Finance to prepare a reauthorization schedule for all tax provisions similar to the schedule set out for Federal programs in title I of this Act. Requires the Congress to take final action on the reauthorization schedule for tax provisions before the end of the 101st Congress. Title V: Miscellaneous - Sets forth miscellaneous provisions to carry out the purposes of this Act. Directs the President, with the cooperation of the head of each appropriate agency, to submit to the Congress a Regulatory Duplication and Conflicts Report for all programs scheduled for reauthorization in the next Congress. Requires specified congressional committees to report on a review of the procedures established under this Act by December 31, 1998, and every five years thereafter. Authorizes appropriations through FY 2001.
Bill· HRH.R. 3954 (102nd)referred
United States · United States Congress · 26 November 1991
Amends title XVIII (Medicare) of the Social Security Act with respect to payment to hospitals for inpatient hospital services to provide that when promulgating or enforcing rules or guidelines which implement guidelines for determining whether a county in which a hospital is located should be treated as being part of a particular Metropolitan Statistical Area (MSA) by establishing proximity criteria to represent affinity of a county to a particular MSA, the Secretary of Health and Human Services shall not require contiguous borders between the county and the MSA.
Bill· HRH.R. 3938 (102nd)referred
United States · United States Congress · 26 November 1991
Health Care Protection Act - Amends the Internal Revenue Code to impose an excise tax on: (1) a group health plan that denies, limits, or conditions the coverage of an individual based on health status, claims experience, receipt of health care, medical history, or lack of evidence of insurability; and (2) any person who has provided coverage to an individual and fails to disclose such coverage to a group health plan that requests such information.
Bill· HRH.R. 3940 (102nd)reported
United States · United States Congress · 26 November 1991
Fertility Clinic Success Rate and Certification Act of 1991 - Mandates development of a model program for the certification of embryo laboratories to be carried out by the States. Requires publication, at least every three years, of information showing pregnancy success rates achieved by each in vitro fertilization program, disclosing which States have implemented the certification program and which laboratories have been certified. Requires specified standards to be included in the model program. Allows States to approve accreditation organizations for certifying embryo laboratories.
Bill· HRH.R. 3951 (102nd)referred
United States · United States Congress · 26 November 1991
Comprehensive Health Care Access Improvement and Cost Containment Act of 1991 - Title I: Improving Access to Health Care - Amends the Internal Revenue Code to allow a tax credit for a percentage of qualified health insurance expenses for incomes of less than $40,000. Limits such credit to $2,500. Excludes Medicare payments and subsidized expenses from treatment as qualified expenses. Provides for the advance payment of such credit to eligible individuals. Coordinates such credit with the: (1) health insurance credit allowed in determining the earned income credit; (2) deductions for health insurance expenses of self-employed individuals; and (3) itemized deduction for medical and dental expenses. Directs the Secretary of the Treasury, in consultation with the Secretary of Health and Human Services (Secretary), to establish a public awareness program to inform the public of the availability of the credit for health insurance expenses. Increases the deductible for health insurance costs for self-employed individuals from 25 percent to 100 percent and makes such deduction permanent. (Currently, it expires December 31, 1991.) Amends the Employee Retirement Income Security Act of 1974 to prohibit the preemption of State mandated benefits. Directs the Secretary to request the National Association of Insurance Commissioners (Association) to develop a model set of regulations and laws to provide a uniform, low-cost, minimum insurance benefit package to include hospital, physician, primary care, preventive care and other selected services for purchase by individuals, businesses and governmental entities. Directs the Association to submit a copy of such model regulations and laws to specified congressional committees after the enactment of this Act. Provides that if the Association does not develop such a model set of regulations and laws, the Secretary shall develop such a model and submit a copy as required above. Amends title XIX (Block Grants) of the Public Health Service Act to add a new part D under which the Secretary shall allocate funds to States to pay for the Federal share of the costs of establishing qualified State uninsurable pool programs that provide health insurance for medically uninsurable individuals. Provides criminal penalties for false statements made in connection with the furnishing of items or services for which payment may be made by a State from funds allotted to the State under new part D. Authorizes appropriations to carry out new part D. Title II: Containing Costs of Health Care - Directs the Secretary to request the Association to develop a plan for standardizing public and private insurance forms. Directs the Association to submit a copy of the plan to specified congressional committees after the enactment of this Act. Provides that it shall not be considered a violation of the antitrust laws for hospitals to jointly undertake, in the provision of care, the purchasing, contracting for, or sharing of high technology services. Amends title VI (Assistance for Construction and Modernization of Hospitals and Other Medical Facilities) of the Public Health Service Act to add a new part D under which the Secretary shall establish and carry out demonstration projects to assist hospitals in acquiring and sharing high technology equipment and services. Authorizes appropriations to carry out such new part D. Title III: Medical Malpractice Reform - Directs the Secretary to conduct a study of resolving medical malpractice claims in the same manner provided for resolving worker's compensation claims. Requires a report to the Congress on such study. Directs the Secretary to provide for demonstration projects by States that seek to reduce infant mortality by improving access in urban and rural underserved areas to obstetric services for eligible pregnant women under title XIX (Medicaid) of the Social Security Act. Requires a report to the Congress on the demonstration projects carried out and on how project results may be used to implement programs to lower infant mortality and morbidity through improving the access of pregnant women to obstetric services in urban and rural underserved areas. Amends the Public Health Service Act to provide liability protections for certain health care professionals of community health centers, migrant health centers, and health centers for the homeless. Prohibits the Secretary from making or renewing grants to such centers unless they implement appropriate policies and procedures to assure against malpractice and have no history of having malpractice claims filed against them, or, if such a history exists, they have fully cooperated with the Attorney General in defending against any such claims and either have taken, or will take, such corrective steps to assure against such claims in the future. Directs the Secretary to develop and make available to the public each year a compendium of the various State initiatives undertaken to address the obstetric access crisis in urban and rural areas. Requires the Secretary to provide a grant to a public or private non-profit organization to conduct a study on the rate of medical malpractice actions or claims relating to obstetrical care for patients whose care is paid for by Medicaid as compared to those whose care is paid for by private insurance. Requires a report to the Congress on such study. Title IV: Encouraging Preventive Health Care - Amends title XVIII (Medicare) of the Social Security Act to provide coverage of a comprehensive health assessment and immunizations for prevention or treatment of infectious diseases. Amends the Public Health Service Act to provide additional authorization of appropriations for provision of education and information regarding cancer. Title V: Improving Long-Term Care for the Elderly - Subtitle A: Comprehensive Long-Term Care Services for Individuals With Alzheimer's Disease - Part I: Expanded Medicare Benefits - Amends the Medicare program to add a new part C under which is created a long-term care program for individuals with Alzheimer's Disease. Part II: Expanding Medicaid Buy-In - Amends the Medicaid program to provide for expanding Medicaid buy-in of Medicare cost-sharing to cover long-term care for individuals with Alzheimer's disease and additional indigent Medicare beneficiaries. Subtitle B: Tax Incentives to Promote Access to Long-Term Care - Amends the Internal Revenue Code to allow a deduction for qualified elderly care expenses to the extent such expenses exceed five percent of the taxpayer's adjusted gross income. Defines such expenses as non-compensated payments for in-home custodial care provided to a qualifying elderly individual. Describes such an individual as one who has attained 65 years of age and who is a parent, grandparent, or dependent of the taxpayer. Includes the rendering of medical services or goods by a physician or registered professional nurse as a charitable contribution and provides for valuation of such services or goods. Excludes from gross income distributions from individual retirement accounts or annuities to pay long-term care expenses or to purchase insurance covering such expenses.
Bill· HRH.R. 3959 (102nd)referred
United States · United States Congress · 26 November 1991
Directs the Secretary of Veterans Affairs, during the five-year period beginning on October 1, 1991, to conduct a rural mobile health care clinic program in States in which significant numbers of veterans reside in rural areas. Makes eligible for such mobile health care veterans otherwise eligible for veterans' health care who reside at least 100 miles from the nearest Department of Veterans Affairs health-care facility. Requires the Secretary to begin operation of at least three mobile health care clinics in each fiscal year of the program. Requires the Secretary to report to the Congress an evaluation of the program. Authorizes appropriations.
Bill· SS. 2037 (102nd)open
United States · United States Congress · 25 November 1991
Medicaid Voluntary Contribution and Provider-Specific Tax Amendments of 1991 - Amends title XIX (Medicaid) of the Social Security Act to provide that, for purposes of determining Federal payments for State Medicaid expenses, the total amount expended under a State plan during a fiscal year as: (1) medical assistance shall be reduced by the sum of any revenues received by the State during the fiscal year from provider-related donations, other than bona fide provider-related donations and certain other donations, health care related taxes, other than broad-based health care related taxes, a broad-based health care related tax, if there is in effect a hold harmless provision with respect to the tax, or broad-based health care related taxes to the extent the amount of such taxes collected exceeds the greater of 25 percent or the State base percentage of the non-Federal share of the total amount expended under the State plan during the State fiscal year; and (2) administrative expenditures shall be reduced by the sum of any revenues received by the State during a fiscal quarter from such other donations, to the extent the amount of such donations exceeds ten percent of the amount expended under the State plan during the fiscal year for authorized administrative purposes. Repeals the prohibition against limiting Federal payments under Medicaid to disproportionate share hospitals. Limits aggregate payment adjustments for disproportionate share hospitals to 12 percent of the total Medicaid expenditures for a fiscal year. Prohibits the use of disproportionate share payment adjustments to hold health care providers harmless for taxes. Limits the authority to restrict disproportionate share hospital designations. Sets forth reporting requirements.
Law· SS. 2050 (102nd)enacted
United States · United States Congress · 25 November 1991
Declares that, notwithstanding any other provision of law, Federal loan insurance may be provided under specified provisions of the Public Health Service Act to new and previous borrowers in FY 1992. Sets the ceiling for the total principal amount of new loans made and installments paid in that year.
Bill· HRH.R. 3930 (102nd)referred
United States · United States Congress · 25 November 1991
Amends provisions of the Federal Food, Drug, and Cosmetic Act (FDCA) relating to drugs for rare diseases or conditions (commonly referred to as orphan drugs) to require the approval of an application under FDCA new drug provisions, a certification under FDCA antibiotic drug provisions, or a license under provisions of the Public Health Service Act regulating biologic products when the current holder of such an application, certification, or license has had: (1) cumulative dollar sales of the drug exceeding specified amounts; and (2) cumulative research and development costs for the drug not exceeding certain amounts.
Bill· HRH.R. 3920 (102nd)referred
United States · United States Congress · 25 November 1991
Primary Health Care Investment Act of 1991 - Amends the Public Health Service Act to authorize appropriations to carry out specified provisions relating to migrant and community health centers, the National Health Service Corps scholarship and loan repayment programs, and health services for the homeless. Amends provisions of title XVIII (Medicare) of the Social Security Act relating to payment to hospitals for inpatient services to modify requirements regarding the determination of approved FTE (Full-Time Equivalent) resident amounts.
Bill· HRH.R. 3923 (102nd)referred
United States · United States Congress · 25 November 1991
Small Business Health Care Reform Act of 1991 - Title I: Improvements in Health Insurance Affordability for Small Employers - Amends the Internal Revenue code to raise from 25 to 100 percent the deduction allowed to self-employed individuals for health insurance premiums and makes the deduction permanent. Directs the Secretary of Health and Human Services (the Secretary) to make grants to up to 15 States for the establishment and operation of small employer health insurance purchasing programs. Permits grant funds to be used to finance administrative costs associated with developing and operating a group purchasing program for small employers. Authorizes appropriations. Title II: Improvements in Health Insurance for Small Employers - Amends the Social Security Act to add a new title, Title XXI: Standards for Small Employer Health Insurance and Certification of Managed Care Plans. Directs the Secretary to develop standards concerning requirements for health insurance plans for small employers. Requires such plans to provide for: (1) guaranteed eligibility; (2) guaranteed availability; and (3) guaranteed renewability. Prohibits: (1) an insurer from refusing to renew or terminate a plan, except for nonpayment of premiums, fraud, or failure to maintain minimum participation rates; and (2) for certain services, discrimination based on health status. Sets limits controlling the variation of premium charges permitted among all small employers insured by an insurer. Requires the full disclosure of an insurer's rating practices. Requires a health insurance plan for small employers to offer: (1) both a standard benefit package and basic benefit package; and (2) a managed care option, if the insurer also offers such an option to other employers. Provides, under both the standard and basic package, for coverage of: (1) inpatient and outpatient hospital care; (2) inpatient and outpatient physician services; (3) diagnostic tests; and (4) preventive services. Provides, in addition, under the standard plan: (1) for the coverage of certain mental health care; (2) that, except as specified, there will be no limits on the amount, scope, or duration of benefits, and (3) for specified limits on deductibles, copayment, coinsurance, and out-of-pocket expenses. Provides under the basic plan that: (1) premiums, deductibles, copayments, or other cost-sharing may be imposed; and (2) there shall be an out-of-pocket limit. Amends the Internal Revenue Code to impose an excise tax of 25 percent of gross premiums on the issuer of any health insurance plan to a small employer if the plan does not meet the requirements of title XXI. Sets forth study and reporting requirements. Title III: Improvements in Portability of Private Health Insurance - Imposes an excise tax of $100 per day, with respect to a covered individual, on a group health plan for its failure to provide coverage for a preexisting condition, subject to stated exceptions. Title IV: Health Care Cost Containment - Establishes a Health Care Cost Commission which shall report annually to the President and the Congress on national health care costs. Authorizes appropriations. Requires the Secretary of Health and Human Services, under title XXI of the Social Security Act, to establish a process for the certification of managed care plans and of utilization review programs. Sets forth requirements for certification. Amends the Public Health Service Act to direct the Administrator of the Agency for Health Care Policy and Research to develop outcomes research and practice parameters for mental health services, including at least the diagnosis and treatment of childhood attention deficit syndrome disorders and manic depression. Amends Part A (General Provisions) of title XI of the Social Security Act to authorize appropriations for research outcomes of health care services and procedures. Mandates development of uniform claims forms for use by beneficiaries and health care providers in submitting claims under group health plans and titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act. Amends the Public Health Service Act to include entities receiving Federal funds under provisions relating to migrant health centers, community health centers, or health services for the homeless, and officers, employees, or contractors of such entities who are licensed health care practitioners, in the coverage of provisions regulating civil actions for injury resulting from medical or related functions against commissioned officers or employees of the Public Health Service. Subrogates to the United States any insurance claim such an entity or person has. Prohibits grants under provisions relating to migrant or community health centers or health services for the homeless unless the applicant has: (1) implemented policies and procedures to assure against malpractice; (2) reviewed the professional credentials, claims history, and other information regarding its licensed health care practitioners; and (3) no history of claims against it under such provisions relating to officers and employees of the Public Health Service, or has cooperated with the Attorney General in defending against such claims and has taken corrective action. Empowers the Attorney General, if certain conditions are met, to determine that an individual practitioner shall not be deemed a Public Health Service employee for purposes of these provisions. Prohibits hospitals from denying admitting privileges to an otherwise qualified health care provider who is an officer, employee, or contractor of such an entity. Title V: Medicare Prevention Benefits - Amends part B (Supplementary Medical Insurance Benefits for the Aged and Disabled) of title XVIII (Medicare) of the Social Security Act to establish frequency and payment limits for screening for fecal-occult blood tests and screening flexible sigmoidoscopies. Amends part C (Miscellaneous Provisions) of title XVIII to provide coverage for tetanus-diphtheria booster and its administration. Provides Medicare coverage for well-child services which is to include routine office visits, immunizations, laboratory tests, and preventive dental care. Expands the coverage of a screening mammography to provide for one such screening annually for all covered women over age 49. Directs the Secretary to establish and provide for a series of ongoing demonstration projects which provide coverage for specified preventive services, including: (1) glaucoma screening; (2) cholesterol screening; (3) osteoporosis screening and treatment; (4) screening services for pregnant women; (5) assessments for individuals beginning at age 65 or 75; and (6) other appropriate services. Authorizes appropriations. Directs the Director of the Office of Technology Assessment to study and report concerning the development of a process for the regular review for the consideration of coverage of preventive services under Medicare.
Bill· HRH.R. 3907 (102nd)referred
United States · United States Congress · 25 November 1991
Universal Health Insurance Act of 1991 - Requires each State to: (1) submit to the Secretary of Health and Human Services, by July 1, 1993, a description of a State health insurance and cost control plan as described in this Act; and (2) have such plan in place and operating by January 1, 1994. Directs the Secretary to make grants to States for developing such plans. Authorizes appropriations. Requires the Secretary to make grants to eligible States based on a specified formula (50 percent for payments in amounts determined by the Advisory Commission on Intergovernmental Relations to assist States in the operation of such plans, 25 percent based on each State's relative percentage of payments made to all States under the Social Security Act (SSA) for quarters in 1991, and 25 percent as determined based on each State's relative percentage of individuals 75 years of age or older in all States). Amends the SSA to provide that the amount of Medicaid payments to a State for quarters beginning January 1, 1994, shall be equal to the amount of such payments for the quarter ending December 31, 1993, increased by an amount considered appropriate by the Secretary to take into account increases in the costs of items and services provided under the State plan for medical assistance under Medicaid and the State's approved health insurance plan under this Act. Directs the Secretary to evaluate the State health insurance plans developed and implemented and, by January 1, 1994, to approve those plans that efficiently and effectively provide quality health care to State residents in a cost-effective manner, to periodically review such plans, and to report to the Congress. Requires the Secretary, for years after 1992, to provide a specified additional payment to at least two States that have implemented a single-payer system for all health care services provided to all individuals in the State. Sets forth required provisions of the State plans. Provides that in the case of a State that elects to operate a plan under which employers either provide coverage or pay for others to provide coverage, such plan shall provide for: (1) a requirement that each employer of 50 or more persons enroll its employees and family members in a health benefit plan (HBP) that meets specified requirements or make a contribution to enable its employees to enroll in such a plan; and (2) the creation and implementation of mechanisms (including insurance pools) designed to reduce the costs of providing health insurance coverage for self-employed individuals, unemployed individuals, and individuals employed by businesses with fewer than 50 employees. Requires State plans to provide for: (1) the establishment of a HBP under which low-income individuals, individuals who are unable to obtain health insurance because of preexisting health conditions, and other individuals who are otherwise unable to obtain health insurance are provided health insurance coverage for a premium that is determined by taking into account the individuals' incomes, subject to specified requirements; (2) the creation of specified mechanisms designed to limit an individual's costs of coverage under health insurance plans offered, such as limitations on the amount of premiums, deductibles, copayment, and coinsurance for individuals; (3) a requirement that the State plan for medical assistance under Medicaid meet national minimum standards; (4) the creation of mechanisms designed to assure, monitor, and maintain the provision of high quality health care; (5) the creation of mechanisms designed to control the costs of providing such care; and (6) any requirements or provisions necessary to ensure that the State is in compliance with specified managed care standards. Specifies services that each HBP shall include, such as: (1) inpatient and outpatient hospital care and physician services with exceptions; (2) diagnostic and screening tests; (3) prenatal and well-baby care provided to children one year of age or younger; (4) long-term care services; (5) prescription drugs; (6) early and periodic screening, diagnostic, and testing services; and (7) immunizations. States that such provisions shall not be construed as requiring a HBP to provide coverage for care and services not medically necessary or for experimental services and procedures. Sets forth provisions with respect to: (1) the amount, scope, and duration of certain benefits; (2) mental health care; (3) a prohibition of preexisting condition provisions; (4) permitting proportional contribution by part-time employees; (5) allowing States to establish or participate in a joint or multistate insurance mechanism; and (6) permitting HBPs to impose deductibles, coinsurance, or other forms of cost-sharing, subject to such restrictions as the Secretary may impose. Prohibits any State insurance, health care, or any other law or regulations from imposing specified limitations with respect to managed care, including: (1) prohibiting a managed care plan from freely selecting the health care providers as participating providers for any HBP in the State; or (2) limiting the ability of a managed care entity to negotiate, enter into contracts or establish alternative rates or forms for payment for participating providers for HBPs in the State or to require or provide incentives that promote the use of participating providers. Specifies that if a carrier in the State (other than a health maintenance organization or reinsurance carrier) offers HBPs to employers that are not small employers in a community where a managed care plan exists, the carrier must make available to small employers in the community a HBP that is such a managed care plan. Amends the SSA to change from discretionary to mandatory the authority of the Secretary to provide that payment for operating costs of inpatient hospital service under Medicare in accordance with alternate State plans shall be made, beginning on October 1, 1993. Directs the Secretary to establish a demonstration program under which the Secretary makes grants to ten eligible States to cover the Federal share (50 percent) of the costs of implementing not more than one feature of the State's health insurance plan under this Act during a period determined by the Secretary. Sets forth provisions regarding: (1) eligibility for grants; and (2) preferences to States that will use the grant to finance features of the State health insurance plan designed to provide health care to specified categories of individuals. Amends the SSA to require that, in order to receive Medicaid payments for any quarter beginning on or after January 1, 1994, a State must certify to the Secretary that it has adopted (and assumed responsibility for enforcing) an approved State health insurance plan under this Act, or has otherwise adopted (and assumed responsibility for enforcing) laws, rules, or regulations which ensure the provision of health insurance coverage to all residents of the State as effectively as such plan, with exceptions. Specifies that: (1) a State is not required under its medical assistance plan to provide assistance for items and services for which payment is made under an approved State health insurance plan under this Act; and (2) nothing in this Act shall be construed as changing the eligibility of individuals for medical assistance under Medicaid or changing the amount, duration, or scope of medical assistance required (or permitted) to be provided under such Act, with exceptions. Directs the Secretary to develop and submit to the Congress appropriate recommendations for uniform eligibility and coverage requirements with respect to the SSA, subject to specified minimum requirements for HBPs developed under this Act. Amends the Employee Retirement Income Security Act of 1974 to require self-insurance plans to comply with State health insurance plan requirements. Amends the Internal Revenue Code (relating to special rules for health insurance costs of self-employed individuals) to: (1) allow as a deduction 25 percent for 1992 or 1993, 50 percent for 1994 or 1995, and 100 percent for 1996 or thereafter (currently, 25 percent) of the amount paid during the taxable year for insurance which constitutes medical care for the taxpayer, his spouse, and dependents; and (2) make such deduction permanent.
Bill· SS. 2036 (102nd)referred
United States · United States Congress · 23 November 1991
Access to Health Care for All Americans Act of 1991 - Title I: Access and Affordability of Health Insurance for Small Employers - Amends the Internal Revenue Code to allow a deduction of 100 percent (currently, 25 percent) of the health insurance costs of self-employed individuals and to remove provisions terminating on a specified date the deductibility of such costs. Imposes a tax on insurers who fail to meet certain requirements regarding accident and health contracts for eligible small employers. Includes in those requirements issuance of contracts providing benefits identical to Medplan core benefits and contracts providing benefits identical to Medplan standard benefits. Sets forth pricing and marketing requirements. Requires that the contracts be guaranteed issue. Requires core and standard benefits to include: (1) inpatient and outpatient hospital services; (2) inpatient and outpatient surgical services; (3) inpatient and outpatient physicians' services; (4) diagnostic and screening services; (5) prenatal care; (6) ambulance services; and (7) durable medical equipment. Requires, in addition, that standard benefits include: (1) inpatient or outpatient treatment for a mental disorder; and (2) inpatient and outpatient treatment of a chemical dependency disorder. Limits deductibles, out-of-pocket expenses, and copayments. Requires guaranteed eligibility. Regulates preexisting condition limitations. Requires guaranteed renewability. Sets forth rating, disclosure, and recordkeeping requirements. Allows the Secretary of Health and Human Services to enter into an agreement with any State to apply State standards instead of the requirements of this Act if the Secretary determines that the State standards will carry out the purposes of this Act. Prohibits any such agreement from waiving the requirement of offering contracts with benefits identical to Medplan core benefits and contracts with benefits identical to Medplan standard benefits. Defines "eligible small employer" to mean those with between one and 50 employees. Preempts any provision of State law: (1) requiring any employer member of a qualified small employer purchasing group to offer any services, category of care, or services of any class or type of provider; (2) requiring any provider of insurance to pay a tax on premiums received from members of such a group; or (3) restricting certain aspects of managed care. Title II: Health Care Cost Control - Subtitle A: Encouraging Managed Care Plans - Mandates development of recommended standards regarding the benefits, coverage, and delivery systems provided under managed care plans, as well as the standards by which managed care entities operate. Establishes the Managed Care Advisory Committee. Preempts, with regard to managed care plans, provisions of State law relating to: (1) reimbursement rates or selective contracting; (2) differential financial incentives; (3) utilization review methods; or (4) benefits. Subtitle B: Medical Malpractice Reform - Chapter 1: Definitions and Findings - Sets forth definitions and findings with regard to this subtitle. Chapter 2: Expedited Medical Malpractice Settlements - Allows any claimant to bring a civil action for damages against a person for harm caused during the provision of medical care under State law, except as superseded by this chapter. Provides, in certain circumstances, for recovery of attorney's fees by the prevailing party if the opposing party failed to accept an offer of settlement. Chapter 3: Alternative Dispute Resolution Procedures - Establishes the Alternative Dispute Resolution Board of Advisors to advise the Secretary of Health and Human Services on the establishment of a model voluntary alternative dispute resolution (ADR) program. Mandates a program to encourage States to develop and implement voluntary ADR procedures that meet the requirements of this subtitle. Requires a State which does not adopt its own procedures to adopt the model system. Allows a claimant or defendant to offer to proceed with an ADR procedure. Requires assessment of attorney's fees and costs against a recipient of such an offer who refuses to proceed if the refusal was unreasonable or not in good faith. Creates a rebuttable presumption that the refusal was unreasonable and not in good faith. Chapter 4: Uniform Standards for Medical Malpractice Cases - Applies this chapter to any medical malpractice action in any Federal or State court and any medical malpractice claim resolved through an ADR system. Limits: (1) lump sum payments for future losses; (2) noneconomic damages; and (3) attorney's fees. Makes the liability of each defendant for noneconomic damages several and not joint. Sets forth time limits. Requires proof of malpractice by clear and convincing evidence in cases related to delivery of a baby when the health care professional did not previously provide prenatal care to the claimant (sometimes referred to as "drop in deliveries"). Chapter 5: Uniform Disciplinary Reforms - Requires States to comply with this chapter. Requires each State to: (1) allocate all fees for licensing or certification of each type of health care practitioner to the State agencies responsible for the conduct of licensing and disciplinary actions regarding that type of practitioner; and (2) allow the general public to be represented on State practitioner disciplinary boards. Prohibits monetary liability on the part of any individual serving on a State disciplinary board. Requires each State to: (1) have in effect a statewide risk management program; and (2) establish a health care disciplinary trust fund. Requires all punitive damages from all medical malpractice and medical products civil actions to be transferred to the fund. Mandates use of fund amounts to provide additional resources to the boards and to provide additional resources for State consumer protection activities. Chapter 6: Medical Products - Limits whether punitive damages, otherwise permitted by applicable law, may be awarded against a health care producer (defined as a designer, manufacturer, producer, or seller of a drug or device) in certain circumstances and, if so, specifies that specified evidence may be considered in determining the amount of the damages. Makes approval of a drug or device by the Food and Drug Administration an absolute defense to a claim of strict liability. Chapter 7: Community Health Centers - Amends the Public Health Service Act to mandate a grant to an entity that represents recipients of grants under provisions relating to migrant and community health centers for the establishment of a nationwide risk retention group as provided for in the Liability Risk Retention Act of 1986. Requires that all such centers become members in the group and purchase the professional liability insurance offered by the group. Authorizes appropriations to carry out provisions relating to the group. Requires amounts saved by centers as a result of the group to be used for additional services by the centers and to defend against medical malpractice claims arising from center services. Authorizes appropriations to carry out specified provisions relating to the centers. Chapter 8: Miscellaneous Provisions - Provides for severability and for compliance deadlines. Title III: Rural Health Improvement Initiatives - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services and the Prospective Payment Assessment Commission to each submit to the Congress a report recommending a methodology for the elimination of the system of determining separate average standardized amounts for hospitals in large urban, other urban, or rural areas. Amends the Public Health Service Act to modify priorities for awarding National Health Service Corps scholarship and loan repayment contracts. Amends the Internal Revenue Code to exclude from gross income repayment under the National Health Service Corps Loan Repayment Program. Amends the Public Health Service Act to authorize appropriations to carry out specified provisions relating to area health education centers. Authorizes competitive grants for networks among rural and urban health care providers to preserve and share health care resources and enhance the quality and availability of health care in rural areas. Allows the networks to be statewide or regional. Authorizes appropriations. Amends the Internal Revenue Code to allow a tax credit for certain health professionals providing services in rural health professional shortage areas during periods when they are not receiving scholarships or loan repayments under National Health Service Corps programs. Allows, with regard to elections to expense depreciable business assets, a higher aggregate cost to be taken into account for rural health care property in a rural health professional shortage area. Allows a deduction for a limited amount of the interest paid on medical education loans by an individual performing services under an agreement with an applicable rural community to perform professional services in the community. Authorizes use of the deduction in computing adjusted gross income. Amends the Public Health Service Act to authorize competitive grants for the development and implementation of a plan for mental health outreach programs in rural areas. Authorizes appropriations. Title IV: Improved Access to Long-Term Care - Subtitle A: Long-Term Care Insurance Promotion - Directs the Secretary of Health and Human Services to establish a procedure for the certification of health insurance policies for the elderly as meeting minimum standards and requirements, including: (1) meeting or exceeding the National Association of Insurance Commissioners Model Act Standards; (2) guaranteed renewability; (3) limited exclusion of preexisting conditions; (4) a specified period during which purchasers may rescind their purchase; and (5) simplified language. Mandates a study and report to the Congress on health insurance policies for the elderly. Amends the Internal Revenue Code to allow a credit for a percentage of qualified long-term care premiums paid. Mandates: (1) an agreement between the Secretary of the Treasury and each State for the advance payment to certain individuals of the tax credit in the form of certificates usable for the purchase of long-term care insurance; and (2) a program to inform the public of the availability of the credit and filing procedures. Excludes distributions from qualified retirement plans, when used by certain individuals to pay for long-term care insurance contracts, from provisions imposing an additional tax on early distributions from such plans. Prohibits recognizing a gain or loss from the exchange by certain individuals of a life insurance, endowment, or annuity contract for a long-term care insurance contract. Subtitle B: Other Provisions Relating to Long-Term Care - Amends the Internal Revenue Code to exclude from gross income any distribution from an individual retirement plan used to pay premiums for any qualified long-term health insurance policy. Requires any amount paid under a life insurance contract on the life of an insured who is terminally ill, has a dread disease, or has been permanently confined to a nursing home to be treated as an amount paid by reason of the death of the insured. Requires, for provisions relating to definitions and special rules involving life insurance companies, references to life insurance to be treated as including a reference to a terminal illness or dread disease rider, defined as a provision of a life insurance contract which provides for payments to or for the benefit of an insured upon the insured becoming a terminally ill individual or incurring a dread disease. Amends provisions defining "life insurance contract" to include a terminal illness or dread disease rider or any qualified long-term care rider in the definition of "qualified additional benefits."
Bill· HRH.R. 3904 (102nd)referred
United States · United States Congress · 23 November 1991
Declares that it is the sense of the Congress that the President should submit to the Congress a proposal for reforming the U.S. health care system.
Bill· HRH.R. 3900 (102nd)referred
United States · United States Congress · 23 November 1991
Medicaid Voluntary Contribution and Provider-Specific Tax Amendments of 1991 - Amends title XIX (Medicaid) of the Social Security Act to provide that, for purposes of determining Federal payments for State Medicaid expenses, the total amount expended under a State plan during a fiscal year as: (1) medical assistance shall be reduced by the sum of any revenues received by the State during the fiscal year from provider-related donations, other than bona fide provider-related donations and certain other donations, health care related taxes, other than broad-based health care related taxes, a broad-based health care related tax, if there is in effect a hold harmless provision with respect to the tax, or broad-based health care related taxes to the extent the amount of such taxes collected exceeds the greater of 25 percent or the State base percentage of the non-Federal share of the total amount expended under the State plan during the State fiscal year; and (2) administrative expenditures shall be reduced by the sum of any revenues received by the State during a fiscal quarter from such other donations, to the extent the amount of such donations exceeds ten percent of the amount expended under the State plan during the fiscal year for authorized administrative purposes. Repeals the prohibition against limiting Federal payments under Medicaid to disproportionate share hospitals. Limits aggregate payment adjustments for disproportionate share hospitals to 12 percent of the total Medicaid expenditures for a fiscal year. Prohibits the use of disproportionate share payment adjustments to hold health care providers harmless for taxes. Limits the authority to restrict disproportionate share hospital designations. Sets forth reporting requirements.
Resolution· HCONRESH.Con.Res. 247 (102nd)referred
United States · United States Congress · 23 November 1991
Expresses the sense of the Congress that the United States should not enter into any international agreement, or approve a certain international report to be submitted to the General Agreement on Tariffs and Trade Council and relating to marine mammal protection that would impair its authority with respect to environmental, labor, agricultural, and public health and safety standards.
Bill· SS. 2028 (102nd)open
United States · United States Congress · 22 November 1991
Women Veterans' Health Equity Act of 1991 - Requires the Secretary of Veterans Affairs to furnish well-women care services to women veterans who: (1) have a service-connected disability; or (2) are eligible for veterans' hospital care and whose annual income does not exceed the maximum rate of pension that would be applicable if such a veteran were eligible for pension. Defines "well-women care services" as health care services provided outside the maternity cycle. Authorizes the Secretary to furnish such services, subject to certain conditions, to a woman veteran who is not eligible for services under the criteria of this Act, but who is otherwise eligible for hospital care. Sets forth requirements concerning personnel to provide such services. Directs the Secretary to initiate research and expand ongoing research into the health consequences for women veterans of the following matters: (1) breast cancer and cancer of the reproductive organs; (2) gynecological and hormonal matters; (3) Alzheimer's disease; (4) osteoporosis; and (5) post-traumatic stress disorder. Requires the Secretary to carry out a research study to determine: (1) the frequency of the diagnosis of psychotic illness as the basis for the admittance of female and male veterans to Department facilities; and (2) an explanation for the difference, if any, in such frequencies. Authorizes appropriations. Directs the Secretary to conduct a ten-year study to determine the health-care needs of women veterans and, as part of such study, examine the medical, biopsychosocial, and demographic histories of women veterans and women members of the armed forces serving on active duty. Authorizes appropriations. Directs the Secretary, in carrying out any medical research based on population analyses, to ensure that: (1) the research reflects matters that are significant for the general population of women in the United States; and (2) the population analyzed in such research is representative of the incidence of the condition or illness in the general population of women in the United States.
Bill· SS. 2029 (102nd)referred
United States · United States Congress · 22 November 1991
Provides that up to one-half of the total amount collected or recovered in a fiscal year as reimbursement from third parties for care and services furnished by a Department of Veterans Affairs medical facility shall be available for the following three fiscal years for the provision of direct patient care at such facility.
Bill· SS. 2017 (102nd)referred
United States · United States Congress · 22 November 1991
Long-Term Care Family Protection Act of 1991 - Title I: Home And Community Care And Nursing Facility Care Under The Medicare Program - Amends title XVIII (Medicare) of the Social Security Act to establish an entitlement under a new part C for payment for home and community care and nursing facility care for individuals determined by a long-term care management agency to be eligible for such care. Sets forth eligibility rules requiring individuals to receive an assessment and be certified as a chronically dependent individual in order to receive part C benefits. Creates in the Treasury the Federal Long-Term Care Trust Fund (Fund) and appropriates to it amounts attributable to additional revenue resulting from this Act. Pays amounts from the Fund for the expenses of providing home and community care. Requires such amounts to be determined under a fee schedule or other prospectively determined reimbursement mechanism established and annually adjusted by the Secretary of Health and Human Services. Requires the fee schedule or reimbursement mechanism to provide for uniform national payment rates, adjusted for area differences in wage levels. Establishes monthly payment limitations with respect to long-term home and community care provided to chronically dependent individuals and dependent children and applies such limitations on an average basis with respect to such care furnished over any period of four consecutive months. Requires the Secretary, before the beginning of each calendar year, to estimate, for nursing facilities located in each State, the State average per diem payment rates that would apply for nursing facility care in the State on a full-time basis in the year if there were no reduction for coinsurance under new part C. Pays a specified amount from the Fund for the daily expenses of providing nursing facility care after applicable copayment requirements have been met. Makes available Fund amounts to carry out the functions of the Long-Term Advisory Council. Authorizes the appropriation of additional sums for the Fund for home and community care, nursing facility care, and long-term care advisory council expenditures. Defines "home care agency." Makes various conforming and miscellaneous amendments, including amendments with respect to entitlement to benefits of social security beneficiaries and dependent children under title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act, to include appropriate references to nursing facilities and home care agencies, the long-term care benefits under new part C, and the Fund. Amends the Railroad Retirement Act of 1974 to include home and community care and nursing facility care. Makes available the hearing and judicial review procedures for appeals of Medicare part A (Hospital Insurance) benefits to persons appealing a negative certification or any other determination with respect to a claim for part C benefits. Title II: Assuring Self-Financing of Long-Term Care Benefits And Quality Assurance - Amends the Medicare program to direct the Secretary, in consultation with the Long-Term Care Advisory Council, to estimate the amounts transferable to the Fund and the amounts expected to be expended during the succeeding fiscal year for home and community care. Provides that if the Secretary estimates that a deficit exists, the amount payable for home and community care shall be reduced by a copayment amount (no more than five percent of the national average daily payment rate for home and community care) necessary to reduce the amount of the deficit by one-half. Directs the Secretary to promulgate a long-term home and community care consumers' bill of rights that may be asserted by the consumer or the consumer's representative. Specifies the rights which such bill of rights must recognize as the rights of long-term home and community care consumers. Directs the Secretary to promulgate regulations: (1) making payment for the provision of long-term home and community care services contingent upon the home health agency's compliance with the home and community care consumer's bill of rights and with other specified requirements; (2) making payment for the provision of case management services contingent upon the long-term care management agency's compliance with the home and community care consumer's bill of rights and with other specified requirements; (3) which establish procedures for surveying long-term care management agencies regarding compliance with conditions of participation; and (4) under which certain peer review organizations shall monitor the provision of home health services and long-term home and community care. Directs the Secretary to establish a Consumer Board to monitor the review activities of peer review organizations. Requires peer review organizations to establish and operate statewide toll-free hotlines for receiving questions and complaints from home and community care consumers, home and community care providers, and other interested persons concerning home and community care quality issues. Requires the Secretary to require peer review organizations to assist home and community care consumers in the resolution of problems related to the quality of home and community care services and case management services. Requires each State to establish and appoint members to a community advisory board for each long-term care management agency to monitor the activities of that agency. Directs the Secretary to develop and implement: (1) methods for monitoring the continuity of care provided to long-term home and community care consumers throughout episodes of illness and across care settings; (2) outcome-oriented criteria for use in determining quality assurance in long-term home and community care services; (3) a range of intermediate sanctions and procedures implementing such sanctions to be applied to long-term care management agencies providing case management services for failing to comply with this Act. Directs the Secretary to: (1) encourage States to develop policies and procedures for the licensing of home health agencies; (2) gather information relating to activities of States in implementing licensing policies and procedures; and (3) issue a biannual report which summarizes such information. Establishes the Long-Term Care Advisory Council to: (1) assist the Secretary in assuring the prompt and efficient implementation of the new part C; (2) review regularly the implementation of such part; and (3) recommend to the Secretary and the Congress any needed changes or refinements to such part or regulations promulgated to implement such part. Requires the Secretary to conduct studies on quality assurance measures for long-term home and community care services provided under new part C. Directs the Secretary to prepare and file an annual report with the Congress regarding the nature and performance during the preceding fiscal year of the home and community care quality assurance system established above. Authorizes appropriations. Title III: Financing Of Long-Term Care - Amends the OASDI program to provide that, notwithstanding any provision of the Social Security Act or the Internal Revenue Code of 1986, there is no limit on the amount of an individual's net earnings from self-employment or remuneration for employment that is subject to the hospital insurance tax. Amends the Internal Revenue Code to increase OASDI taxes beginning in 1993. Title IV: Medicare Buy-In For Individuals With Disabilities - Amends the Medicare program to: (1) permit individuals with disabilities to purchase Medicare part A hospital insurance coverage during the 24-month waiting period for Medicare entitlement without being enrolled under Medicare part B (Supplementary Medical Insurance); (2) permit individuals with disabilities not entitled to long-term care benefits to buy into Medicare to obtain such benefits; and (3) set forth provisions for determining the premiums for such individuals.
Resolution· SRESS.Res. 231 (102nd)referred
United States · United States Congress · 22 November 1991
Declares that it is the sense of the Senate that the President should submit to the Congress a proposal for reforming the U.S. health care system.
Bill· HRH.R. 3878 (102nd)open
United States · United States Congress · 22 November 1991
American Jobs Protection Act - Requires employers to provide specified notice and employee benefits (including severance pay, continuation of health care benefits, reimbursement for retraining, and accelerated eligibility for early retirement) to employees who are subject to a plant closing or mass layoff because their work is transferred to another country which has specified levels of lower wages or less effective employment standards for overtime compensation, child labor, and employee safety. Provides for enforcement of this Act by investigative and administrative actions by the Secretary of Labor, civil actions by employees and the Secretary, and actions for injunctions. Provides for application under this Act of definitions under the Worker Adjustment and Retraining Notification Act, with exceptions for the terms employer, plant closing, mass layoff, and employment loss.
Bill· SS. 2008 (102nd)referred
United States · United States Congress · 21 November 1991
Quality Assurance in the Private Sector Drug Testing Act of 1991 - Amends the Public Health Service Act to prohibit a laboratory from performing a drug test in connection with any drug testing program subject to this Act unless the laboratory is certified under this Act. Directs the Secretary of Health and Human Services to: (1) establish a program for certifying laboratories that meet certain standards; and (2) appoint an expert advisory panel. Requires an employer, as a condition of implementing or maintaining a drug testing program, to establish a written anti-drug abuse policy containing specified elements and a drug-free awareness program. Sets forth employee protections. Provides for enforcement, relief, and supersedure of State laws. Allows professional athletes to be treated as other employees under this Act except for certain provisions relating to confidentiality.
Bill· SS. 2000 (102nd)referred
United States · United States Congress · 21 November 1991
Prescription Drug Cost Containment Act of 1991 - Amends the Internal Revenue Code to require, in the case of any manufacturer of single source drugs or innovator multiple source drugs, a reduction in the Puerto Rico and possession tax credit according to a specified formula involving the amount of the manufacturer's wages paid to eligible employees in Puerto Rico, the sales of the drug, and price increases. Directs the Secretary of Health and Human Services to establish at least 15 five-year demonstration projects to determine the impact on: (1) cost, quality of care, and access to prescription drugs of developing, in the area of each project, a Medicare (title XVIII of the Social Security Act) outpatient prescription drug benefit using various forms of benefit design and reimbursement policies; and (2) cost and quality of care of extending coverage of outpatient prescription drugs to Medicare beneficiaries served by community health centers. Sets forth additional purposes for at least some of the projects. Requires a project to provide for coverage of all drugs and biologicals approved by the Federal Food and Drug Administration and all medically accepted indications of the drugs. Requires establishment of a Drug Use Review Board (DUR Board) in each project area, or use of the State Medicaid (title XIX of the Social Security Act) DUR Board, to recommend the design and development of the benefit within the area and establish a program of prospective and retrospective drug use review. Amends the Social Security Act to establish in the Treasury the Medicare Outpatient Prescription Drug Trust Fund. Appropriates to the Fund amounts raised by the credit reduction under this Act. Makes amounts in the Fund available for: (1) carrying out the projects; (2) the expenses of the Prescription Drug Policy Review Commission established by this Act; and (3) improving the accessibility of prescription drugs to the elderly. Establishes the Prescription Drug Policy Review Commission. Mandates a report to specified congressional committees on Federal subsidies and incentives to the pharmaceutical industry. Amends title XIX (Medicaid) of the Social Security Act to modify reporting requirements regarding average prices for covered outpatient drugs in specified countries.
Bill· HRH.R. 3857 (102nd)referred
United States · United States Congress · 21 November 1991
Medical Injury Compensation Fairness Act of 1991 - Deems any person accepting or providing health care which is to be paid for, in whole or in part, directly or indirectly, with funds under the Social Security Act, the Public Health Service Act, or any other Federal Act to have agreed to participate in the dispute resolution program established under this Act. Makes such agreement binding and enforceable in court. Requires any claim against health care providers for personal injury arising from care rendered under such Acts that is not settled voluntarily by the parties to be resolved only through a resolution service certified under this Act. Requires liability to be determined under the standard of care prescribed by State law except that, in certain circumstances: (1) particular services must be rendered in accordance with medical practice guidelines certified under this Act; (2) expert witnesses must possess specified qualifications; or (3) an alternative method of compensation which has been certified under this Act is applicable. Limits noneconomic damages. Reduces awards for collateral source payments. Provides for periodic payment of certain amounts for future damages. Prohibits paying punitive damages to the claimant, requiring in certain circumstances that they be paid to the State. Requires, subject to exception, that charges by the resolution service be paid by the party against whom the claim is substantially resolved. Amends provisions of the Internal Revenue Code relating to trade or business expenses to prohibit deductions for employer health plan expenses unless the covered employees agree to mandatory and final dispute resolution through a service certified under this Act. Directs the Secretary of Health and Human Services to develop: (1) a standard notice to persons regarding their option to enter into agreements with health care providers to resolve claims in a manner consistent with this Act; and (2) a standard contract for such purposes. Requires health care providers, as a condition of eligibility for reimbursement under titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act, to make a good faith effort to enter into agreements with persons not subject to certain provisions of this Act to provide for the resolution of medical injury claims in a manner consistent with provisions of this Act. Deems contracts entered into in accordance with this provision to be binding and valid contracts in all courts. Directs the Secretary to promulgate: (1) regulations that establish the criteria and procedures to determine whether to certify an alternative dispute resolution service, allowing waiver of the criteria and procedures in certifying services sponsored by the States; and (2) regulations that establish the criteria for certifying medical practice guidelines and that establish the criteria for certifying alternative methods of compensating personal injuries and other losses without regard to provider fault. Declares that the procedures required by this Act are exclusive and prohibits any action seeking recovery for any personal injury covered by this Act in any State or Federal court, except as expressly provided in this Act. Provides that specified provisions of this Act apply to health care plans approved as part of collective bargaining agreements.
Bill· HRH.R. 3846 (102nd)referred
United States · United States Congress · 21 November 1991
Authorizes a grant to The Children's Hospital of Philadelphia for construction of a medical research facility. Authorizes appropriations.
Bill· HRH.R. 3851 (102nd)referred
United States · United States Congress · 21 November 1991
Amends title XVIII (Medicare) of the Social Security Act to provide coverage for annual preventive examinations under Medicare part B (Supplementary Medical Insurance).
Law· HRH.R. 3839 (102nd)enacted
United States · United States Congress · 21 November 1991
Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 1992 - Title I: Department of Labor - Department of Labor Appropriations Act, 1992 - Makes appropriations for FY 1992 for the following agencies within the Department of Labor: (1) Employment and Training Administration; (2) Labor-Management Services; (3) Pension Benefit Guaranty Corporation; (4) Employment Standards Administration; (5) Occupational Safety and Health Administration; (6) Mine Safety and Health Administration; (7) Bureau of Labor Statistics; and (8) departmental management. Prohibits the use of funds to grant variances, interim orders, or letters of clarification to employers which will allow exposure of workers to chemicals or other workplace hazards in excess of existing Occupational Safety and Health Administration standards for the purpose of conducting experiments on workers' health and safety. Directs the Secretary of Labor, acting under the Occupational Safety and Health Act of 1970, to promulgate a final occupational health standard concerning occupational exposure to bloodborne pathogens. Requires the final standard to be based on the proposed standard concerning occupational exposures to the hepatitis B virus, the human immunodeficiency virus and other bloodborne pathogens. Title II: Department of Health and Human Services - Department of Health and Human Services Appropriations Act, 1992 - Makes appropriations for FY 1992 for the following agencies within the Department of Health and Human Services: (1) Health Resources and Services Administration; (2) Centers for Disease Control; (3) National Institutes of Health; (4) Alcohol, Drug Abuse, and Mental Health Administration; (5) Assistant Secretary for Health; (6) Agency for Health Care Policy and Research; (7) Health Care Financing Administration; (8) Social Security Administration; (9) Administration for Children and Families; (10) Human Development Services; and (11) Office of the Secretary. Directs the Secretary of Health and Human Services to make available through assignment not more than 60 employees of the Public Health Service to assist in child survival activities and to work in AIDS programs through and with funds provided by the Agency for International Development, the United Nations International Children's Emergency Fund, or the World Health Organization. Prohibits the use of funds to pay for any experiment, or other activity that presents a danger to the physical, mental, or emotional well-being of a human participant or subject without written, informed consent of the participant or subject (or their parents or legal guardian, if they are under 18 years old). Prohibits any of the funds appropriated in this title for the National Institutes of Health and the Alcohol, Drug Abuse, and Mental Health Administration from being used to pay the salary of an individual, through a grant or extramural mechanism, at a rate in excess of $125,000 per year. Prohibits the use of funds by the National Institutes of Health, or any other Federal agency, or recipient of Federal funds on any project that entails the capture or procurement of chimpanzees obtained from the wild. Makes funds available to the Office of the Director, National Institutes of Health (NIH) for extramural facilities construction grants if awarded competitively. Authorizes the Director to make available one percent of all NIH appropriations to high-priority activities. Prohibits such appropriations from being increased or decreased by more than the one percent by such transfers. Requires the Secretary of Health and Human Services to determine quarterly the extent to which contingency funds may be necessary for management of certain social security hospital and medical insurance trust funds. Prohibits the use of funds to perform abortions except where the life of the mother would be endangered if the fetus were carried to term. Reduces travel expenses for the Department and requires reduction for travel costs to be from amounts set forth in budget estimates submitted for appropriations. Permits the Director of NIH to transfer a portion of funds which become available on September 30, 1992, to other Institutes for cancer research if deemed appropriate. Directs the National Cancer Institute to establish a Matsunaga-Conte Prostate Cancer Research Center with funds provided under this Act. Prohibits the use of funds to conduct the SHARP survey of adult sexual behavior and the American Teenage Survey of adolescent sexual behavior. Provides additional funding for the National Institute on Aging. Permits the Director of NIH to transfer a portion of such funds as deemed appropriate to other Institutes for research directly related to Alzhelimer's disease. Makes funds available for information resource management. Reduces funds appropriated for the Office of Inspector General. Extends the moratorium against foster care cuts resulting from Federal compliance rules. Amends the Public Health Service Act to increase the number of board members of the National Foundation for Biomedical Research. Title III: Department of Education - Department of Education Appropriations Act, 1992 - Makes appropriations for FY 1992 for the following purposes and agencies within the Department of Education: (1) compensatory education for the disadvantaged; (2) impact aid; (3) school improvement programs; (4) bilingual and immigrant education; (5) educational excellence; (6) rehabilitation services and handicapped disability research including the Helen Keller National Center); (7) special institutions for persons with disabilities including the American Printing House for the Blind, the National Technical Institute for the Deaf, and Gallaudet University; (8) vocational and adult education; (9) student financial assistance; (10) guaranteed student loans (liquidation of contract authority); (11) higher education; (12) Howard University; (13) higher education facilities loans; (14) college housing and academic facilities loans; (15) education research, statistics, and improvement; (16) libraries; (17) departmental management; and (18) special education. Sets forth general provisions relating to auditing of certain institutions and to prohibitions on use of funds for certain forms of busing, other transportation, or transfers of students for purposes of desegregation. Prohibits the use of funds to prevent the implementation of programs of voluntary prayer and meditation in the public schools. Makes funds available for civic education programs and emergency grants. Provides for the transfer of educational excellence funds to the Community and Migrant Health Centers program, Comprehensive Child Development Centers, and new America 2000 educational excellence activities, if enacted into law. Provides that the deadline for enacting new authorization for the America 2000 initiatives may be delayed until April 1, 1992, if it is determined that sufficient progress is being made towards final approval of such legislation, except that this delay does not apply to programs administered by Department of Health and Human Services. Makes funds available for tribally controlled postsecondary vocational institutions. Makes funds available for the college housing and academic facilities loans program. Makes funds available the National Clearinghouse for Science and Mathematics, regional consortia, star schools, and territorial teacher training. Makes funds available for a biotechnology information education demonstration project under the Higher Education Act. Amends the Higher Education Act of 1965 to authorize the Commission on Responsibility for Financing Post-Secondary Education to accept, use, and dispose of money, gifts or donations of services or property. Title IV: Related Agencies - Makes appropriations for FY 1991 for the following agencies: (1) ACTION; (2) Corporation for Public Broadcasting; (3) Federal Mediation and Conciliation Service; (4) Federal Mine Safety and Health Review Commission; (5) National Commission on Acquired Immune Deficiency Syndrome; (6) National Commission on Libraries and Information Science; (7) National Commission to Prevent Infant Mortality; (8) National Council on Disability; (9) National Labor Relations Board; (10) National Mediation Board; (11) Occupational Safety and Health Review Commission; (12) Physician Payment Review Commission; (13) Prospective Payment Assessment Commission; (14) Railroad Retirement Board; (15) United States Institute of Peace; (16) Soldiers' and Airmen's Home; (17) United States Naval Home; and (18) the National Commission on Children. Title V: General Provisions - Prohbits the use of funds to pay student assistance or any remuneration to an applicant for admission, student, teacher, or other employee of an institution of higher education if such individual has engaged in conduct on or after August 1, 1969, which involves the use of force (or assistance to others in such use) or the threat of force or the seizure of a property under the control of an institution of higher education, to require or prevent the availability of certain curricula, or to prevent such institution's faculty, administrative officials, or students from engaging in their duties or pursuing their studies. Requires that sums necessary for FY 1992 pay raises for programs funded by this Act be absorbed within the levels appropriated in this Act. Reduces funds appropriated under this Act for salaries and expenses, including certain travel costs. Appropriates additional funds for the Occupational Safety and Health Review Commission and the Federal Mines Safety and Health Review Commission for salaries and expenses. Delays the obligations of funds under the Child Care and Development Block Grant Act until September 30, 1992.
Bill· SS. 1996 (102nd)referred
United States · United States Congress · 20 November 1991
Medicare Cancer Coverage Improvement Act of 1991 - Amends title XVIII (Medicare) of the Social Security Act to cover: (1) any use of a drug in an anticancer chemotherapeutic regimen if such use has been approved by the Food and Drug Administration, published in peer-review medical literature, or included in one or more of three specified medical compendia; and (2) an oral form of a drug prescribed for such a use in an anticancer chemotherapeutic regimen if the drug contains the same active ingredients as a drug that would be covered if administered as incident to a physician's service. Requires a study and report to specified congressional committees on Medicare coverage of patient care costs associated with clinical trials of new cancer therapies.
Bill· SS. 1992 (102nd)referred
United States · United States Congress · 20 November 1991
Amends title XIX (Medicaid) of the Social Security Act to direct the Secretary of Health and Human Services to provide for waivers from Medicaid drug rebate program requirements for States with approved plans that manage payment for covered outpatient drugs for which payments are made under Medicaid.
Bill· SS. 1995 (102nd)referred
United States · United States Congress · 20 November 1991
Health Care Access and Affordability Act of 1991 - Title I: Access to Primary and Preventive Care - Amends the Public Health Service Act to reauthorize appropriations through FY 1996 for the following programs: (1) immunization programs; (2) tuberculosis prevention grants; (3) lead poisoning prevention; (4) prevention and control of sexually transmitted diseases; (5) migrant health centers; (6) community health centers; (7) health care services for the homeless; (8) substance abuse prevention program; (9) family planning project grants; (10) breast and cervical cancer prevention; (11) preventive health and health services block grant; and (12) HIV (human immunodeficiency virus) early intervention. Amends the Social Security Act to reauthorize appropriations for maternal and child health services block grants through FY 1997. Title II: Cost Containment - Amends the Public Health Service Act to authorize the Director of the National Institutes of Health (NIH) to establish and implement a program for the conduct of clinical trials with respect to promising new drugs and disease treatments. Requires the Director to give priority to treatments targeted towards diseases determined: (1) to be the most costly to treat; (2) to have the highest mortality; or (3) to affect the greatest number of individuals. Authorizes appropriations for FY 1993 through 1997. Extends through FY 1996 authorized appropriations for: (1) drug abuse demonstration projects of national significance; and (2) the Agency for Health Care Policy and Research. Requires the Secretary of Health and Human Services to use excess appropriations over FY 1992 amounts to expand research to determine the most cost-effective methods of health care and for developing and disseminating new practice guidelines related to such methods. Requires that priority be given to diseases and disorders determined to be the most costly to the United States and that evidence a wide variation in current medical practice. Directs the Secretary, after considering the recommendations of the Health Care Cost Control Advisory Committee, to report to appropriate congressional committees on the establishment of national spending targets for health care and health care services. Establishes the Health Care Cost Control Advisory Committee.