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Bill· SS. 1779 (103rd)open
United States · United States Congress · 22 November 1993
TABLE OF CONTENTS: Title I: Health Care Security Subtitle A: Universal Coverage and Individual Responsibility Subtitle B: Benefits Subtitle C: State Responsibilities Subtitle D: Health Alliances Subtitle E: Health Plans Subtitle F: Federal Responsibilities Subtitle G: Employer Responsibilities Subtitle J (sic): General Definitions; Miscellaneous Provisions Title II: New Benefits Subtitle B (sic): Long-Term Care Title III: Public Health Initiatives Subtitle A: Workforce Priorities Under Federal Payments Subtitle B: Academic Health Centers Subtitle C: Health Research Initiatives Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health Subtitle E: Health Services for Medically Underserved Populations Subtitle F: Mental Health; Substance Abuse Subtitle G: Comprehensive School Health Education; School-Related Health Services Subtitle H: Public Health Service Initiative Subtitle I: Coordination With COBRA Continuation Coverage Title V (sic): Quality and Consumer Protection Subtitle A: Quality Management and Improvement Subtitle B: Information Systems, Privacy, and Administrative Simplification Subtitle C: Remedies and Enforcement Title VI: Premium Caps; Premium-Based Financing; and Plan Payments Subtitle A: Premium Caps Subtitle B: Premium-Related Financing Subtitle C: Payments to Regional Alliance Health Plans Title VIII (sic): Health and Health-Related Programs of the Federal Government Subtitle E (sic): Amendments to the Employee Retirement Income Security Act of 1974 Title IX: Aggregate Government Payments Subtitle B (sic): Aggregate Federal Alliance Payments Subtitle C: Borrowing Authority to Cover Cash-Flow Shortfalls Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance Subtitle A: Workers Compensation Insurance Subtitle C (sic): Commission on Integration of Health Benefits Subtitle E (sic): Davis-Bacon Act and Service Contract Act Subtitle F: Effective Dates Title XI: Transitional Insurance Reform Health Security Act - Title I: Health Care Security - Subtitle A: Universal Coverage and Individual Responsibility - Entitles each eligible individual to: (1) the benefit provided under subtitle B through the applicable health plan in which the individual is enrolled; and (2) a health security card to be issued by the alliance or other entity that offers the applicable health plan in which the individual is enrolled. Defines an eligible individual as an individual who resides in the United States and is: (1) a citizen or national of the United States; (2) an alien permanently residing in the U.S. under color of law; or (3) a long-term nonimmigrant. Entitles a Medicare-eligible individual to benefits under Medicare instead of the above provisions of this Act. (Sec. 1002) Requires each eligible individual to enroll in an applicable health plan and pay any required premium. Prohibits disenrollment of an eligible individual until the individual is either enrolled in another plan or in Medicare. (Sec. 1003) States that nothing in this Act shall be construed as prohibiting: (1) an individual from purchasing any health services; (2) an individual from purchasing supplemental insurance; (3) an individual who is not an eligible individual from purchasing health insurance; or (4) employers from providing additional coverage. (Sec. 1004) States that a regional alliance health plan is the applicable plan for a family, unless a family member is eligible for a corporate alliance health plan. Allows military personnel, veterans, and Indians to enroll either with an alliance or with a military, veteran, or Indian plan, respectively. (Sec. 1005) Prohibits an undocumented alien from enrolling in a health plan under this Act. (Sec. 1011) Defines a family as an eligible individual's eligible spouse and children. Defines couple as meaning an individual and the individual's spouse. Defines a child as being under age 18, or under age 24 in the case of a full-time student. Subtitle B: Benefits - Includes the following terms and services in the comprehensive benefit package: (1) hospital services; (2) services of health professionals; (3) emergency and ambulatory medical and surgical services; (4) clinical preventive services; (5) mental illness and substance abuse services; (6) family planning services and services for pregnant women; (7) hospice care; (8) home health care; (9) extended care services; (10) ambulance services; (11) outpatient laboratory, radiology, and diagnostic services; (12) outpatient prescription drugs and biologicals; (13) outpatient rehabilitation services; (14) durable medical equipment and prosthetic and orthotic devices; (15) vision care; (16) dental care; (17) health education classes; and (18) investigational treatments. Describes such items and services. (Sec. 1131) Requires each health plan to offer to its enrollees only one of the following cost sharing schedules: (1) lower cost sharing; (2) higher cost sharing; or (3) combination cost sharing. Provides that the annual maximum out-of-pocket expenses for an individual in any of the plans shall be $1500 and for a family the annual maximum shall be $3000. (Sec. 1135) Sets forth a table of copayments and coinsurance. (Sec. 1141) Excludes the following items and services: (1) an item or service that is not medically necessary or appropriate; (2) an item or service that the National Health Board may determine is not medically necessary or appropriate; (3) custodial care, except hospice care; (4) surgery performed solely for cosmetic purposes, unless required to correct a congenital anomaly or performed to correct a part of the body injured by either disease or accident; (5) hearing aids; (6) eyeglasses and contact lenses for individuals at least 18 years of age; (7) in vitro fertilization; (8) sex change surgery and related services; (9) private duty nursing; (10) personal comfort items, except in the case of hospice care; and (11) any dental procedures involving orthodontic care, inlays, gold or platinum fillings, bridges, crowns, pin/post retention, dental implants, surgical periodontal procedures, or the preparation of the mouth for the fitting or continued use of dentures, except as specified. (Sec. 1151) Gives the National Health Board the authority to promulgate such regulations or establish such guidelines as necessary to assure uniformity in the application of the comprehensive benefit package across all health plans. Permits the Board to expand the benefit package. (Sec. 1162) Permits a health professional or facility to refuse to provide a benefit if the professional or facility objects on the basis of a religious belief or moral conviction. Subtitle C: State Responsibilities - Requires a State, in order to be approved as a participating State, to submit a document describing the State's health care system. (Sec. 1201) Requires a participating State to: (1) establish one or more regional alliances; (2) establish and publish the criteria used in the certification of its health plan; (3) meet minimum financial solvency requirements for health plans established by the National Health Board; (4) designate an agency or official to coordinate State responsibilities under this Act; (5) conform State laws to meet the requirements of title X of this Act with respect to workers' compensation and automobile insurance; and (6) carry out all the responsibilities of a participating State specified in this Act. (Sec. 1221) Permits a State, with the Board's approval, to operate a single-payer system if specified requirements are met. Subtitle D: Health Alliances - Provides for regional alliances and corporate alliances. (Sec. 1302) Requires a regional alliance to be governed by a Board of Directors consisting of: (1) employers, including self-employed individuals; and (2) members who represent individuals purchasing coverage. Requires each regional alliance to establish a provider advisory board consisting of health care providers and professionals. (Sec. 1311) Includes in a corporate alliance an eligible sponsor who is either a large employer (more than 5000 full-time employees) or a multiemployer plan (a plan with more than 5000 active participants). Excludes: (1) an employer whose primary business is employee leasing; (2) the Federal Government (other than the U.S. Postal Service); and (3) a State or local government. Excludes from corporate alliance eligibility the following classes of individuals: (1) AFDC recipients; (2) SSI recipients; (3) military personnel and families, veterans, and Indians who elect to enroll in specified plans specifically designed for them; and (4) seasonal or temporary employees. (Sec. 1321) Directs each regional alliance to negotiate with any State-certified health plan for a contract with the alliance for the enrollment under the plan of eligible individuals. (Sec. 1322) Requires each regional alliance to offer a choice of health plans, including at least one fee-for-service plan. (Sec. 1326) Requires each regional alliance to establish and maintain an office of an ombudsman to assist consumers in dealing with problems that arise with health plans and the alliance. (Sec. 1329) Permits a regional alliance to adjust payments to plans or use other financial incentives to encourage health plans to expand into areas that have inadequate health services. (Sec. 1341) Set forth provisions concerning the collection of funds by regional alliances from individuals, employers, and others. (Sec. 1351) Requires each regional alliance to compute a blended plan per capita payment amount for each regional alliance health plan for enrollment in the alliance. (Sec. 1361) Requires each regional alliance to comply with specified standards relating to the management of finances, maintenance of records, accounting practices, auditing procedures, financial reporting, and employer payments. (Sec. 1371) Provides for a reduction in cost sharing for low-income families. (Sec. 1373) Provides for premium discounts and reduction in liabilities for low-income families. (Sec. 1381) Permits each corporate alliance to: (1) offer coverage under either an appropriate self-insured health plan; or (2) negotiate with a State-certified plan to enter into a contract with the plan. (Sec. 1382) Requires each corporate alliance to provide a choice of health plans, including at least one fee-for-service plan and two health plans that are not fee-for-service plans. (Sec. 1385) Requires each corporate alliance to make an additional contribution towards the enrollment in health plans of the alliance by certain low-wage families. (Sec. 1386) Sets forth provisions relating to a corporate alliance concerning: (1) consumer information and marketing; (2) plan and information requirements; (3) management of funds; (4) cost control; (5) payments by corporate alliance employers to corporate alliances; (6) ERISA; and (7) disclosure and reserve requirements. Subtitle E: Health Plans - Requires a health plan to: (1) be either a self-insured plan (meaning a group health plan as defined by a the Employee Retirement Income Security Act of 1974) or a State-certified plan (meaning a plan certified by a State or the National Health Board); and (2) meet the applicable regulatory requirements. (Sec. 1402) Requires each health plan offered by either a regional or corporate alliance to accept for enrollment every alliance eligible individual, unless the plan has reached its enrollment limit. Prohibits the limit from being imposed on the basis of any personal characteristics of enrollees such as health status, need for health care, age, occupation, or affiliation with any person or entity. Prohibits a plan from: (1) restricting or terminating coverage for any reason, including nonpayment of premiums; (2) cancelling coverage for any eligible individual until that individual is enrolled in another plan; (3) excluding an eligible individual because of an existing medical condition; (4) imposing a waiting period before coverage begins; or (5) imposing a rider that excludes the coverage of particular eligible individuals. Prohibits discrimination by a health plan on the basis of race, national origin, sex, language, socioeconomic status, age, disability, health status, or anticipated need for health services. (Sec. 1405) Requires each plan to have a grievance procedure. (Sec. 1421) Permits an entity to offer a supplemental insurance policy if the policy and the entity meet specified requirements. (Sec. 1431) Requires each health plan, with respect to each electing essential community provider located within the plan's service area, to enter into either a written provider participation agreement or a written agreement under which the plan will make payment to the provider as specified. Provides a special rule for providers of school health services. Makes the provisions of the preceding sentence applicable only to health plans offered by a health alliance during the five-year period beginning with the first year in which any health plan is offered by the alliance. Directs the Secretary of Health and Human Services to study essential community providers and to make recommendations concerning such providers to the Congress. Provides that such recommendations shall apply unless a joint resolution of disapproval is enacted by the Congress. (Sec. 1441) Requires each health plan to meet specified requirements of title X of this Act with respect to workers' compensation and automobile medical liability services. Subtitle F: Federal Responsibilities - Establishes the National Health Board in the Executive Branch. Directs the President to appoint the Board's seven members. (Sec. 1503) Directs the Board to: (1) interpret the comprehensive benefit package; (2) adjust the delivery of preventive services; (3) take steps to assure that the comprehensive benefit package is available on a uniform national basis; (4) recommend to the President and the Congress appropriate revisions to the package; (5) oversee cost containment requirements; (6) develop and implement eligibility standards; (7) establish a performance based system of quality management; (8) develop and implement standards for a national health information system; (9) establish State requirements and monitor State compliance; (10) establish premium class factors; (11) develop a methodology for the risk-adjustment of premium payments; (12) establish financial requirements for guaranty funds; (13) establish standards for health plan grievance procedures; and (14) report annually to the President and the Congress. (Sec. 1506) Authorizes appropriations for the Board. (Sec. 1511) Requires the Board to approve a State health care system if the system meets the applicable requirements of this Act. Prohibits approval of a State health care system prior to 1996. (Sec. 1512) Imposes sanctions upon States failing to meet conditions for compliance. (Sec. 1515) Provides for planning grants to States for implementation assistance. (Sec. 1521) Provides for the Federal assumption of responsibilities in the absence of a State system. Provides for increased premiums of 15 percent during Federal operation of a State system to provide reimbursement for the Federal cost of operating the system. (Sec. 1541) Directs the Board to develop a risk adjustment and reinsurance methodology. Sets forth guideline for developing such methodology. (Sec. 1543) Directs the Board to establish an advisory committee to provide technical advice and recommendations regarding the risk adjustment and reinsurance methodology. (Sec. 1551) Directs the Board to establish minimum capital requirements for regional alliance health plans under which at least $500,000 of capital must be maintained for each plan in the area. Permits the Board to require additional capital. (Sec. 1552) Requires the Board to establish standards for guaranty funds established by the States. (Sec. 1571) Sets forth the responsibilities of the Secretary of Health and Human Services. Directs the Secretary to administer and implement all provisions of this Act, except those duties delegated to the Board, any other executive agency, or to any State. (Sec. 1572) Directs the Secretary to appoint an Advisory Council on Breakthrough Drugs that will examine the reasonableness of launch prices of new breakthrough drugs. (Sec. 1581) Provides for the certification of essential community providers. Sets forth the following categories of providers automatically certified (under provisions of the Public Health Service Act): (1) migrant health centers; (2) community health centers; (3) homeless program providers; (4) public housing providers; (5) family planning clinics; and (6) AIDS providers under the Ryan White Act. Includes as automatically certified (under other Acts) the following: (1) Indian health programs under the Indian Health Act; and (2) maternal and child health providers and a Federal qualified health center or rural health clinic under the Social Security Act. Includes as automatically certified (under provisions of this Act) the following: (1) providers of school health services; and (2) a qualified community practice network. Provides for the setting of standards for additional health providers. (Sec. 1591) Sets forth the responsibilities of the Secretary of Labor. Includes among those responsibilities the following: (1) enforcement requirements applicable to employers; (2) elections to become corporate alliances; (3) temporary assumption of insolvent self-insured corporate alliance health plans; (4) establishment and administration of the Corporate Alliance Health Plan Insolvency Fund; and (5) administering title I of ERISA as it relates to group health plans maintained by corporate alliances. Subtitle G: Employer Responsibilities - Requires employers to provide for the payments required under title VI of this Act. Sets forth other employer responsibilities including: (1) information reporting requirements; (2) requirements relating to new employees; (3) recordkeeping requirements; and (4) antidiscrimination requirements. (Sec. 1606) Prohibits self-funding of cost sharing benefits by regional alliance employers. (Sec. 1607) Requires an employer to make equal employer premium payments to all qualifying employees, if a voluntary premium payment is made. Places a limit on such voluntary employer premium payments. (Sec. 1608) Sets forth an employer's obligation to a qualifying retired beneficiary where the employer, as of October 1, 1993, was providing a threshold payment. (Sec. 1609) Authorizes the Secretary of Labor to impose a civil penalty of up to $10,000 for each violation of this subtitle with respect to each individual. Subtitle J (sic): General Definition; Miscellaneous Provisions - Sets forth the definitions and rules used in this Act. (Sec. 1911) Grants the National Health Board, the Secretary of Health and Human Services, and the Secretary of Labor authority to issue regulations as necessary to permit the timely implementation of this Act. Title II: New Benefits - Subtitle B (sic): Long-Term Care - Establishes requirements for State plans for home and community-based services to individuals with disabilities. Includes among those requirements the following: (1) a prohibition of limiting eligibility of individuals with disabilities based on income, age, geography, severity of disability, residential setting, or other grounds specified by the Secretary; (2) a requirement to serve low-income individuals; (3) a requirement to specify how Federal and State funds will be managed; (4) quality assurance requirements; and (5) reporting requirements. Requires a State to consult with individuals and groups of individuals with disabilities when developing the plan in order to have the plan approved. (Sec. 2103) Defines individuals with disabilities to mean any individual within one or more of the following four categories: (1) individuals requiring help with the activities of daily living; (2) individuals with severe cognitive or mental impairment; (3) individuals with severe or profound mental retardation; and (4) severely disabled children. (Sec. 2104) Requires a State plan to specify the services available. Requires each individualized plan to be developed in close consultation with the individual and the individual's family. Prohibits a State plan from covering: (1) room and board; (2) services furnished in a hospital, nursing facility, intermediate care facility for the mentally retarded, or other specified institutional setting; or (3) items or services to the extent coverage is provided for an individual under a health plan or Medicare. (Sec. 2105) Sets forth provisions relating to: (1) cost sharing; (2) quality assurance and safeguards; (3) advisory groups; (4) payments to States; and (5) the total Federal budget for State plans and allotments to States. (Sec. 2301) Directs the Secretary, with the advice and assistance of the National Long-Term Care Insurance Advisory Council to promulgate regulations as necessary to implement provisions concerning private long-term care insurance. Directs the Secretary to make appointments to such Council. Authorizes appropriations for such Council. (Sec. 2321) Directs the Secretary, after considering the Council's recommendations to promulgate regulations designed to: (1) standardize formats and terminology used in long-term care policies; (2) require insurers to provide customers on the range of public and private long-term care coverage available; and (3) establish other requirements promoting consumer understanding of benefits. (Sec. 2322) Directs the Secretary to promulgate regulations establishing requirements with respect to the terms of the benefits under long-term care policies, which shall include the following requirements that the policy may not: (1) limit coverage based on a preexisting condition, subject to an exception for a six-month period; (2) condition eligibility for benefits based on the need or receipt of any other service; (3) condition eligibility for any benefit on any particular diagnosis; (4) condition eligibility for benefits by providers on compliance with requirements not required by State or Federal law; and (5) condition coverage of any service by a provider on the provision of such service at a higher level of care than required by the insured individual. Prohibits discrimination by diagnosis in the treatment of: (1) Alzheimer's disease; (2) any organic or inorganic mental illness; (3) mental retardation or any other cognitive or mental impairment; or (4) HIV infection or AIDS. (Sec. 2323) Sets forth other requirements for such policies, including requirements related to: (1) premium; (2) sales practices; (3) continuation, renewal, replacement, conversion, and cancellation of policies; and (4) payment of benefits. (Sec. 2342) Provides for grants to States to enforce the Federal standards concerning long-term care policies. Sets forth requirements for receiving such grants. Authorizes appropriations. Prohibits the sale of a long-term care policy in a State without a regulatory program. (Sec. 2361) Authorizes the Secretary to make grants for the development and implementation of long-term care information, counseling, and other programs to: (1) States; (2) regional alliances (at the option of States within which such alliances are located; and (3) national organizations representing insurance consumers, long-term care providers, and insurers. Authorizes appropriations for such grants. Title III: Public Health Initiatives - Subtitle A: Workforce Priorities Under Federal Payments - Establishes within the Department of Health and Human Services the National Council on Graduate Medical Education. Directs the National Council to designate for each academic year the number of individuals nationwide who are authorized to be enrolled in each specified approved physician training program for each medical specialty. (Sec. 3061) Directs the Secretary to carry out a program with respect to graduate nurse training programs that is equivalent to the program for approved physician training programs. Establishes a National Council on Graduate Nurse Education. (Sec. 3071) Authorizes appropriations for the following programs: (1) primary care physician and physician assistant training; (2) training of underrepresented minorities and disadvantaged persons; and (3) nurse training. (Sec. 3072) Authorizes appropriations for the following programs: (1) a program of skill upgrading and occupational retraining for health care workers; (2) a demonstration program to assist workers in health care institutions in obtaining advanced career positions; (3) a program to develop and operate health-worker job banks in local employment services agencies, subject to certain conditions; (4) a program to provide joint labor-management decision-making in the health care sector on workplace matters related to the restructuring of the health care delivery system of this Act; and (5) a program to facilitate the comprehensive workforce adjustment initiative. (Sec. 3073) Directs the Secretary of Health and Human Services and the Secretary of Labor to jointly establish the National Institute for Health Care Workforce Development. States that the Director of the Institute shall make recommendations to the Secretaries regarding: (1) the supply of health care workers; (2) the impact of this Act; and (3) the development and implementation of high-performance, high-quality health care delivery systems. Directs the Secretaries to establish an advisory board to assist in the development of such recommendations. Subtitle B: Academic Health Centers - Provides for the access of regional and corporate alliance patients to qualified academic health centers. Subtitle C: Health Research Initiatives - Amends the Public Health Service Act to ensure that the National Institutes of Health conducts and supports biomedical and behavioral research on promoting health and preventing diseases, disorders, and other health conditions. Provides for health services research. Authorizes appropriations for such research. Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health - Authorizes appropriations for the core functions of public health programs and national initiatives regarding health promotion and disease prevention. (Sec. 3312) Authorizes the Secretary to make grants to States to carry out one or more of the following core functions: (1) data collection; (2) activities to protect the environment and to assure the safety of housing, workplaces, and food and water; (3) investigation and control of adverse health conditions; (4) public information and education programs to reduce risks to health such as use of tobacco, alcohol, and drugs, sexual activities that increase the risk of HIV transmission and other sexually transmitted diseases, poor diet, physical inactivity, and low childhood immunization levels; (5) accountability and quality assurance activities; (6) provision of public health laboratory services to complement private clinical laboratory services that screen for diseases and conditions; (7) training and education to assure provision of care by all health professionals; and (8) leadership policy development and administrative activities. (Sec. 3331) Authorizes the Secretary to make grants to agencies of State or local government, private nonprofit organizations, and coalitions that link two or more of these groups for the purpose of carrying out projects to develop and implement innovative community-based strategies to provide for health promotion and disease prevention activities for which there is a significant need. Subtitle E: Health Services for Medically Underserved Populations - Directs the Secretary to make grants to migrant health centers and community health centers, which shall be in addition to other funds available to such centers. Authorizes appropriations. (Sec. 3412) Authorizes appropriations for: (1) grants and contracts for the development of qualified community health plans and practice networks; and (2) loans and guaranteeing the principal and interest to Federal and non-Federal lenders on behalf of public and private entities for the capital costs of developing qualified community health plans and practice networks. (Sec. 3461) Authorizes the Secretary to make grants and enter into contracts with qualified community health groups to provide enabling services such as transportation, community and patient outreach, patient education, and translation services in order to increase the capacity of individuals to utilize the items and services under title I of this Act. Authorizes appropriations. (Sec. 3471) Authorizes appropriations for: (1) the National Health Service Corps; and (2) such amounts as are necessary to ensure that at least 20 percent of participants in the Scholarship Program or the Loan Repayment Program of the Corps are nurses. (Sec. 3481) Entitles a hospital with a low-income utilization rate in a base year of at least 25 percent to a payment as specified. Requires 75 percent of the total available to be allocated to hospitals for low-income assistance. Requires 25 percent of the total available to be allocated to hospitals for assistance in furnishing inpatient hospital services that are not covered services under title I of this Act. Subtitle F: Mental Health; Substance Abuse - Authorizes appropriations to carry out this part. Provides for grants to: (1) increase access to mental health and substance abuse services; (2) improve State and local capacity to coordinate and monitor such services; (3) provide incentives to integrate public and private service systems; and (4) supplement any activity under part B (Alcohol and Drug Abuse and Mental Services Block Grant) of title XIX of the Public Health Service Act. (Sec. 3503) Authorizes the Secretary to make loans for the capital costs incurred in the development of non-acute, residential treatment centers and community-based ambulatory clinics. (Sec. 3521) Requires the establishment of a pilot program demonstrating the integration of the mental illness and substance abuse services of the States with the services included under title I of this Act. Subtitle G: Comprehensive School Health Education; School-Related Health Services - Authorizes appropriations for the programs of this subtitle. States that the purposes of the programs shall be to: (1) support the provision in kindergarten through grade 12 of comprehensive health education programs; (2) establish a national framework within which States can create comprehensive school health education programs that target the health risk behaviors of youth, including tobacco use, alcohol and drug abuse, sexual behaviors resulting in infections, injury prevention, dietary patterns, and sedentary lifestyles; (3) pay the initial costs of planning and establishing such programs; (4) support related Federal demonstrations and training; (5) motivate youth to stay in school, avoid teen pregnancy, and strive for success; (6) improve the knowledge of health education among youth; and (7) further the National Education Goals set forth in title I of the Goals 2000: Educate America Act. Defines comprehensive school health education program. Requires such programs to be sensitive to cultural and ethnic issues, promote involvement by families, and promote personal responsibility. Sets forth requirements for applying for grants and selection of grantees. Subtitle H: Public Health Service Initiative - Establishes a Public Health Service Initiative consisting of specified amounts authorized to be appropriated for the Initiative. States that: (1) the Initiative includes the programs of subtitles C through G of this title and the programs of subtitle D of title VIII; and (2) amounts appropriated to carry out the Initiative, including subtitles A through F of this title, are available to carry out specific programs for which the amounts are appropriated. Subtitle I: Coordination with COBRA Continuation Coverage - Amends title XXII (Requirements for Certain Group Health Plans for Certain State and Local Employees) of the Public Health Service Act to provide for coordination with COBRA continuation coverage. Repeals such title XXII upon implementation of this Act. Title V (sic): Quality and Consumer Protection - Subtitle A: Quality Management and Improvement - Requires the National Health Board to establish and oversee a performance-based program of quality management and improvement designed to enhance the quality, appropriateness, and effectiveness of health care services and access to such services which will be called the National Quality Management Program. (Sec. 5002) Establishes the National Quality Management Council which shall: (1) administer the National Quality Management Program; (2) perform any other duty specified in this subtitle; and (3) advise the National Health Board with respect to its duties under this subtitle. Requires the Council to develop a set of national measures of quality performance to be used in the assessment of and the provision of access to health care services. Requires the Council, in addition, to: (1) recommend to the Board establishing goals for performance by health plans and health care providers on a subset of national measures of quality performance; (2) direct the Administrator for Health Care Policy and Research to develop, review, and disseminate practice guidelines to determine how diseases can most effectively be prevented, diagnosed, treated, and managed; and (3) direct the Administrator for Health Care Policy and Research to support research related to a five-year priority list of performance measures. (Sec. 5008) Directs the National Health Board to: (1) establish and oversee regional professional foundations to perform such duties as develop lifetime learning programs for health professionals and conduct research on health care quality; and (2) establish the National Quality Consortium to perform such duties as establishing continuing education for health professionals and provide advice on research priorities. (Sec. 5012) Requires each regional alliance and each corporate alliance to: (1) disseminate specified information to consumers; and (2) ensure that performance and quality standards are continually approved. Subtitle B: Information System, Privacy, and Administrative Simplification - Directs the National Health Board to develop and implement a health information system, in consultation with Federal agencies, States, employers, health plans, and others, by which the Board shall collect, report, and regulate the collection and dissemination of health care information which shall be used for: (1) health care planning by Federal, State, and local government; (2) establishing and monitoring payments for health services; (3) assessing and improving the quality of health care; (4) managing and containing costs at the alliance and plan levels; and (5) other specified purposes. Requires the establishment of an electronic data network to collect, compile, and transmit information. (Sec. 5120) Sets forth provisions providing for health information privacy standards. (Sec. 5130) Directs the National Health Board to develop the following standard health care benefit forms: (1) an enrollment and disenrollment form; (2) a clinical encounter record; and (3) a claim form. (Sec. 5140) Establishes the National Privacy and Health Data Advisory Council in order to advise the National Health Board with respect to its duties under this subtitle. (Sec. 5141) Sets forth monetary penalties for violating health information system standards. Subtitle C: Remedies and Enforcement - Sets forth provisions with respect to the review of benefit determinations for enrolled individuals, including provisions: (1) regulating the time limits for notice of disposition of a claim; (2) governing a plan's duty to review claim denials; (3) concerning urgent requests for preauthorization; and (4) concerning other time limits with respect to time limits and notice. (Sec. 5202) Requires each State to establish a complaint review office for each regional alliance established by a State. Permits aggrieved individuals to file complaints with the appropriate review office. (Sec. 5205) Provides for a Federal Health Plan Review Board to review the decisions of complaint review office hearing officers. (Sec. 5207) Sets monetary penalties for a plan which unreasonably denies or delays payment or provision of benefits. (Sec. 5211) Directs each State to establish and maintain an Early Resolution Program in each complaint review office. Requires a program to include: (1) forums for mediation of disputes; and (2) other forums of alternative dispute resolution as may be prescribed. Establishes guidelines for the eligibility of cases for submission to the Early Resolution Program. States that conclusions of the mediation proceedings shall be treated as nonbinding and shall not affect any rights to review. (Sec. 5231) Sets forth additional remedies and enforcement provisions. Title VI: Premium Caps; Premium-Based Financing; and Plan Payments - Subtitle A: Premium Caps - Sets forth provisions which provide for the computation of factors that limit the growth of premiums for the comprehensive benefit package in regional alliance health plans, including the computation of a: (1) regional alliance inflation factor; and (2) general health care inflation factor. (Sec. 6002) Directs the Board to determine: (1) a national per capita baseline premium target; (2) the national average per capita current coverage health expenditures; and (3) current health care expenditures. (Sec. 6003) Directs the Board to determine a regional alliance per capita premium. (Sec. 6004) Requires a regional alliance to annually obtain premium bids from each plan seeking to participate as a regional alliance health plan with respect to the alliance. (Sec. 6005) Permits any participating State to assume responsibility for containment of health care expenditures in the State consistent with this Act. (Sec. 6006) Directs the chair of the Board to establish an advisory commission on regional variations in health expenditures. Requires the commission to examine methods of eliminating variation in regional alliance per capital premium targets due to variation in practice patterns, not due to other factors. Requires the Board to submit its recommendations to the Congress. Requires such recommendations to apply unless a joint resolution of disapproval is passed. (Sec. 6011) Subjects each noncomplying regional alliance health plan for a year to a reduction in plan payment as specified, in order to assure that payments to regional alliance health plans by a regional alliance are consistent. Defines a noncomplying plan to include a plan in which the final accepted bid exceeds the maximum complying bid for the per capita target premium. Defines maximum complying bid. (Sec. 6021) Directs the Board to develop a methodology for calculating an annual per capita expenditure equivalent for amounts paid for coverage for the comprehensive benefit package within a corporate alliance. (Sec. 6022) Terminates a corporate alliance with two excess years in a three year period. Provides that employers that were corporate alliance employers with respect to a terminated alliance shall become regional alliance employers. Defines an excess year as one in which the rate of increase for the corporate alliance exceeds the national corporate inflation factor. Defines rate of increase and national corporate inflation factor. (Sec. 6031) Sets forth special rules for a single-payer State. (Sec. 6041) Directs the Secretary to establish a program to monitor prices and expenditures in the U.S. health care system. Subtitle B: Premium-Related Financings - Makes each family enrolled in a regional health alliance plan or in a corporate alliance health plan in a class of family enrollment responsible for payment of the family share of premium payable for enrollment. Provides for income-related discounts and specified credits. (Sec. 6102) Establishes the formula for determining the premiums. (Sec. 6111) Provides for the repayment of alliance credits by certain families. (Sec. 6114) Provides for the special treatment of certain retirees and qualified spouses and children. (Sec. 6121) Requires each regional alliance employer to pay a monthly premium to the regional alliance for a qualifying employee. Sets forth provisions for determining such premium. Varies the premium depending upon such factors as the employer's size and average wages paid. (Sec. 6126) Sets forth provisions applicable to self-employed individuals. (Sec. 6131) Sets forth provisions for determining the corporate employer premium. Subtitle C: Payments to Regional Alliance Health Plans - Sets forth provisions to determine the computation of: (1) the blended plan per capita payment amount; and (2) the plan bid, AFDC, and SSI proportions. Title VIII (sic): Health and Health-Related Programs of the Federal Government - Subtitle E (sic): Amendments to the Employee Retirement Income Security Act of 1974 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to revise and limit the coverage of group health plans ERISA. Makes certain ERISA provisions inapplicable with respect to State-certified health plans. Provides for an exception from ERISA civil action provisions where review is otherwise available under the Health Security Act (this Act, HSA). (Sec. 8402) Establishes ERISA requirements for expeditious reporting and disclosure applicable to group health plans, through special rules consistent with ERISA and HSA purposes. Excludes plans maintained by regional alliances from treatment as multiple employer welfare arrangements. (Sec. 8403) Revises certain ERISA provisions relating to continuation coverage under group health plans. Repeals such provisions upon implementation of HSA. (Sec. 8404) Makes ERISA standards for group health plans regarding: (1) cases of adoption applicable except to the extent otherwise provided in regulations of the National Health Board under HSA; and (2) coverage of pediatric vaccines inapplicable to a group health plan upon its becoming a corporate alliance health plan under HSA. (Sec. 8405) Requires group health plans under ERISA to comply with HSA requirements relating to health plan claims procedure. Title IX: Aggregate Government Payments - Subtitle B (sic): Aggregate Federal Alliance Payments - States that this section constitutes budget authority in advance of appropriation Acts and obligates the Federal Government to provide for the payment to regional alliances of a capped Federal alliance payment amount. Defines capped Federal alliance payment amount. Subtitle C: Borrowing Authority to Cover Cash-flow Shortfalls - Authorizes the Secretary to make available loans to regional alliances to cover any period of temporary cash-flow shortfall attributable to: (1) any estimation discrepancy; (2) a period of temporary cash-flow shortfall attributable to an administrative error; or (3) a period of temporary cash-flow shortfall relating to the relative timing during the year in which amounts are received and payments are required. Sets forth loan terms and conditions. Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance - Subtitle A: Workers Compensation Insurance - Requires each health plan that provides services to enrollees through participating providers to make arrangements to provide workers' compensation to such enrollees. (Sec. 10002) Requires each workers compensation carrier that is liable for payment for workers compensation services furnished by or through a health plan, regardless of whether or not the services are included in the comprehensive benefit package, to make payment for such services. (Sec. 10011) Sets forth requirements for participating States. (Sec. 10031) Authorizes demonstration projects in one or more States with respect to the treatment of work-related injuries and illnesses. Subtitle C (sic): Commission on Integration of Health Benefits - Establishes the Commission on Integration of Health Benefits, which shall study and report on the feasibility and appropriateness of transferring financial responsibility for all medical benefits, including those currently covered by workers' compensation and automobile insurance, to health plans. Authorizes appropriations. Subtitle E (sic): Davis-Bacon Act and Service Contract Act - Amends the Davis-Bacon Act and the Service Contract Act of 1965 to require Health Security Act benefits. Subtitle F: Effective Dates - Sets forth effective date provisions. Title XI: Transitional Insurance Reform - Sets forth transitional provisions concerning: (1) enforcement; (2) preservation of current coverage; (3) restrictions on premium increases during transition; (4) portability requirements; (5) restrictions limiting benefit reductions; and (6) the establishment of the National Transitional Health Insurance Risk Pool.
Law· SS. 1769 (103rd)enacted
United States · United States Congress · 22 November 1993
Authorizes the city of Slidell, Louisiana, to submit, within ten days of enactment of this Act, a final statement of objectives with respect to a FY 1994 community development block grant. Directs the Secretary of Housing and Urban Development to consider and accept such final statement.
Bill· SS. 1775 (103rd)open
United States · United States Congress · 22 November 1993
TABLE OF CONTENTS: Title I: Health Care Security Subtitle A: Universal Coverage and Individual Responsibility Subtitle B: Benefits Subtitle C: State Responsibilities Subtitle D: Health Alliances Subtitle E: Health Plans Subtitle F: Federal Responsibilities Subtitle G: Employer Responsibilities Subtitle J (sic): General Definitions; Miscellaneous Provisions Title II: New Benefits Subtitle A: Medicare Outpatient Prescription Drug Benefit Subtitle B: Long-Term Care Title III: Public Health Initiatives Subtitle A: Workforce Priorities Under Federal Payments Subtitle B: Academic Health Centers Subtitle C: Health Research Initiatives Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health Subtitle E: Health Services for Medically Underserved Populations Subtitle F: Mental Health; Substance Abuse Subtitle G: Comprehensive School Health Education; School-Related Health Services Subtitle H: Public Health Service Initiative Subtitle I: Coordination With COBRA Continuation Coverage Title IV: Medicare and Medicaid Subtitle A: Medicare and the Alliance System Subtitle B: Savings in Medicare Program Subtitle C: Medicaid Subtitle D: Increase in SSI Personal Needs Allowance Title V: Quality and Consumer Protection Subtitle A: Quality Management and Improvement Subtitle B: Information Systems, Privacy, and Administrative Simplification Subtitle C: Remedies and Enforcement Subtitle D: Medical Malpractice Subtitle E: Fraud and Abuse Subtitle F: McCarran-Ferguson Reform Title VI: Premium Caps; Premium-Based Financing; and Plan Payments Subtitle A: Premium Caps Subtitle B: Premium-Related Financing Subtitle C: Payments to Regional Alliance Health Plans Title VII: Revenue Provisions Subtitle A: Financing Provisions Subtitle B: Tax Treatment of Employer-Provided Health Care Subtitle C: Employment Status Provisions Subtitle D: Tax Treatment of Funding of Retiree Health Benefits Subtitle E: Coordination with COBRA Continuing Care Provisions Subtitle F: Tax Treatment of Organizations Providing Health Care Services and Related Organizations Subtitle G: Tax Treatment of Long-term Care Insurance and Services Subtitle H: Tax Incentives for Health Services Providers Subtitle I: Miscellaneous Provisions Title VIII: Health and Health-Related Programs of the Federal Government Subtitle A: Military Health Care Reform Subtitle B: Department of Veterans Affairs Subtitle C: Federal Employees Health Benefits Program Subtitle D: Indian Health Service Subtitle E: Amendments to the Employee Retirement Income Security Act of 1974 Subtitle F: Special Fund for WIC Program Title IX: Aggregate Government Payments to Regional Alliances Subtitle A: Aggregate State Payments Subtitle B: Aggregate Federal Alliance Payments Subtitle C: Borrowing Authority to Cover Cash-Flow Shortfalls Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance Subtitle A: Workers Compensation Insurance Subtitle B: Automobile Insurance Subtitle C: Commission on Integration of Health Benefits Subtitle D: Federal Employees' Compensation Act Subtitle E: Davis-Bacon Act and Service Contract Act Subtitle F: Effective Dates Title XI: Transitional Insurance Reform Health Security Act - Title I: Health Care Security - Subtitle A: Universal Courage and Individual Responsibility - Entitles each eligible individual to: (1) the benefit provided under subtitle B through the applicable health plan in which the individual is enrolled; and (2) a health security card to be issued by the alliance or other entity that offers the applicable health plan in which the individual is enrolled. Defines an eligible individual as an individual who resides in the United States and is: (1) a citizen or national of the United States; (2) an alien permanently residing in the U.S. under color of law; or (3) a long-term nonimmigrant. Entitles a Medicare-eligible individual to benefits under Medicare instead of the above provisions of this Act. (Sec. 1002) Requires each eligible individual to enroll in an applicable health plan and pay any required premium. Prohibits disenrollment of an eligible individual until the individual is either enrolled in another plan or in Medicare. (Sec. 1003) States that nothing in this Act shall be construed as prohibiting: (1) an individual from purchasing any health services; (2) an individual from purchasing supplemental insurance; (3) an individual who is not an eligible individual from purchasing health insurance; or (4) employers from providing additional coverage. (Sec. 1004) States that a regional alliance health plan is the applicable plan for a family, unless a family member is eligible for a corporate alliance health plan. Allows military personnel, veterans, and Indians to enroll either with an alliance or with a military, veteran, or Indian plan respectively. (Sec. 1005) Prohibits an undocumented alien from enrolling in a health plan under this Act. (Sec. 1011) Defines a family as an eligible individual's eligible spouse and children. Defines couple as meaning an individual and the individual's spouse. Defines a child as being under age 18, or under age 24 in the case of a full-time student. Subtitle B: Benefits - Includes the following terms and services in the comprehensive benefit package: (1) hospital services; (2) services of health professionals; (3) emergency and ambulatory medical and surgical services; (4) clinical preventive services; (5) mental illness and substance abuse services; (6) family planning services and services for pregnant women; (7) hospice care; (8) home health care; (9) extended care services; (10) ambulance services; (11) outpatient laboratory, radiology, and diagnostic services; (12) outpatient prescription drugs and biologicals; (13) outpatient rehabilitation services; (14) durable medical equipment and prosthetic and orthotic devices; (15) vision care; (16) dental care; (17) health education classes; and (18) investigational treatments. Describes such items and services. (Sec. 1131) Requires each health plan to offer to its enrollees only one of the following cost sharing schedules: (1) lower cost sharing; (2) higher cost sharing; or (3) combination cost sharing. Provides that the annual maximum out-of-pocket expenses for an individual in any of the plans shall be $1500 and for a family the annual maximum shall be $3000. (Sec. 1135) Sets forth a table of copayments and coinsurance. (Sec. 1141) Excludes the following items and services: (1) an item or service that is not medically necessary or appropriate; (2) an item or service that the National Health Board may determine is not medically necessary or appropriate; (3) custodial care, except hospice care; (4) surgery performed solely for cosmetic purposes, unless required to correct a congenital anomaly or performed to correct a part of the body injured by either disease or accident; (5) hearing aids; (6) eyeglasses and contact lenses for individuals at least 18 years of age; (7) in vitro fertilization; (8) sex change surgery and related services; (9) private duty nursing; (10) personal comfort items, except in the case of hospice care; and (11) any dental procedures involving orthodontic care, inlays, gold or platinum fillings, bridges, crowns, pin/post retention, dental implants, surgical periodontal procedures, or the preparation of the mouth for the fitting or continued use of dentures, except as specified. (Sec. 1151) Gives the National Health Board the authority to promulgate such regulations or establish such guidelines as necessary to assure uniformity in the application of the comprehensive benefit package across all health plans. Permits the Board to expand the benefit package. (Sec. 1162) Permits a health professional or facility to refuse to provide a benefit if the professional or facility objects on the basis of a religious belief or moral conviction. Subtitle C: State Responsibilities - Requires a State, in order to be approved as a participating State, to submit a document describing the State's health care system. (Sec. 1201) Requires a participating State to: (1) establish one or more regional alliances; (2) establish and publish the criteria used in the certification of its health plan; (3) meet minimum financial solvency requirements for health plans established by the National Health Board; (4) designate an agency or official to coordinate State responsibilities under this Act; (5) conform State laws to meet the requirements of title X of this Act with respect to workers' compensation and automobile insurance; and (6) carry out all the responsibilities of a participating State specified in this Act. (Sec. 1221) Permits a State, with the Board's approval, to operate a single-payer system if specified requirements are met. Subtitle D: Health Alliances - Provides for regional alliances and corporate alliances. (Sec. 1302) Requires a regional alliance to be governed by a Board of Directors consisting of: (1) employers, including self-employed individuals; and (2) members who represent individuals purchasing coverage. Requires each regional alliance to establish a provider advisory board consisting of health care providers and professionals. (Sec. 1311) Includes in a corporate alliance an eligible sponsor who is either a large employer (more than 5,000 full-time employees) or a multiemployer plan (a plan with more than 5000 active participants). Excludes: (1) an employer whose primary business is employee leasing; (2) the Federal Government (other than the U.S. Postal Service); and (3) a State or local government. Excludes from corporate alliance eligibility the following classes of individuals: (1) AFDC recipients; (2) SSI recipients; (3) military personnel and families, veterans, and Indians who elect to enroll in specified plans specifically designed for them; and (4) seasonal or temporary employees. (Sec. 1321) Directs each regional alliance to enter into a contract with any State-certified health plan to contract with the alliance for the enrollment under the plan of eligible individuals. (Sec. 1322) Requires each regional alliance to offer a choice of health plans, including at least one fee-for-service plan. (Sec. 1326) Requires each regional alliance to establish and maintain an office of an ombudsman to assist consumers in dealing with problems that arise with health plans and the alliance. (Sec. 1329) Permits a regional alliance to adjust payments to plans or use other financial incentives to encourage health plans to expand into areas that have inadequate health services. (Sec. 1341) Set forth provisions concerning the collection of funds by regional alliances from individuals, employers, and others. (Sec. 1351) Requires each regional alliance to compute a blended plan per capita payment amount for each regional alliance health plan for enrollment in the alliance. (Sec. 1353) Requires each regional alliance to make payments to the Federal Government for academic health centers and graduate medical education. (Sec. 1361) Requires each regional alliance to comply with specified standards relating to the management of finances, maintenance of records, accounting practices, auditing procedures, financial reporting, and employer payments. (Sec. 1371) Provides for a reduction in cost sharing for low-income families. (Sec. 1373) Provides for premium discounts and reduction in liabilities for low-income families. (Sec. 1381) Permits each corporate alliance to: (1) offer coverage under either an appropriate self-insured health plan; or (2) negotiate with a State-certified plan to enter into a contract with the plan. (Sec. 1382) Requires each corporate alliance to provide a choice of health plans, including at least one fee-for-service plan and two health plans that are not fee-for-service plans. (Sec. 1385) Requires each corporate alliance to make an additional contribution towards the enrollment in health plans of the alliance by certain low-wage families. (Sec. 1386) Sets forth provisions relating to corporate alliances concerning: (1) consumer information and marketing; (2) plan and information requirements; (3) management of funds; (4) cost control; (5) payments by corporate alliance employers to corporate alliances; (6) ERISA; (7) disclosure and reserve requirements; (8) trusteeship of insolvent corporate alliance health plans; (9) imposition and collection of periodic assessments on self-insured corporate alliance plans; and (10) payments to the Federal Government by multiemployer corporate alliances for academic health centers and gradual medical education. Subtitle E: Health Plans - Requires a health plan to: (1) be either a self-insured plan (meaning a group health plan as defined by a the Employee Retirement Income Security Act of 1974) or a State-certified plan (meaning a plan certified by a State or the National Health Board); and (2) meet the applicable regulatory requirements. (Sec. 1402) Requires each health plan offered by either a regional or corporate alliance to accept for enrollment every alliance eligible individual, unless the plan has reached its enrollment limit. Prohibits the limit from being imposed on the basis of any personal characteristics of enrollees such as health status, need for health care, age, occupation, or affiliation with any person or entity. Prohibits a plan from: (1) restricting or terminating coverage for any reason, including nonpayment of premiums; (2) cancelling coverage for any eligible individual until that individual is enrolled in another plan; (3) excluding an eligible individual because of an existing medical condition; (4) imposing a waiting period before coverage begins; or (5) imposing a rider that excludes the coverage of particular eligible individuals. Prohibits discrimination by a health plan on the basis of race, national origin, sex, language, socio-economic status, age, disability, health status, or anticipated need for health services. (Sec. 1405) Requires each plan to have a grievance procedure. (Sec. 1421) Permits an entity to offer a supplemental insurance policy if the policy and the entity meet specified requirements. (Sec. 1431) Requires each health plan, with respect to each electing essential community provider located within the plan's service area, to either: (1) enter into a written provider participation agreement; or (2) enter into a written agreement under which the plan will make payment to the provider as specified. Provides a special rule for providers of school health services. Makes the provisions of the proceeding sentence applicable only to health plans offered by a health alliance during the five year period beginning with the first year in which any health plan is offered by the alliance. Directs the Secretary of Health and Human Services to study essential community providers and to make recommendations concerning such providers to the Congress. Provides that such recommendations shall apply unless a joint resolution of disapproval is enacted by the Congress. (Sec. 1441) Requires each health plan to meet specified requirements of title X of this Act with respect to workers' compensation and automobile medical liability services. Subtitle F: Federal Responsibilities - Establishes the National Health Board in the Executive Branch. Directs the President to appoint the Board's seven members. (Sec. 1503) Directs the Board to: (1) interpret the comprehensive benefit package; (2) adjust the delivery of preventive services; (3) take steps to assure that the comprehensive benefit package is available on a uniform national basis; (4) recommend to the President and the Congress appropriate revisions to the package; (5) oversee cost containment requirements; (6) develop and implement eligibility standards; (7) establish a performance based system of quality management; (8) develop and implement standards for a national health information system; (9) establish State requirements and monitor State compliance; (10) establish premium class factors; (11) develop a methodology for the risk-adjustment of premium payments; (12) establish financial requirements for guaranty funds; (13) establish standards for health plan grievance procedures; and (14) report annually to the President and the Congress. (Sec. 1506) Authorizes appropriations for the Board. (Sec. 1511) Requires the Board to approve a State health care system if the system meets the applicable requirements of this Act. Prohibits approval of a State health care system prior to 1996. (Sec. 1512) Provides for sanctions for States failing to meet conditions for compliance. (Sec. 1515) Provides for planning grants to States for implementation assistance. (Sec. 1521) Provides for the Federal assumption of responsibilities in the absence of a State system. Provides for increased premiums of 15 percent during Federal operation of a State system to provide reimbursement for the Federal cost of operating the system. (Sec. 1541) Directs the Board to develop a risk adjustment and reinsurance methodology. Sets forth guidelines for developing such methodology. (Sec. 1543) Directs the Board to establish an advisory committee to provide technical advice and recommendations regarding the risk adjustment and reinsurance methodology. (Sec. 1551) Directs the Board to establish minimum capital requirements for regional alliance health plans under which at least $500,000 of capital must be maintained for each plan in the area. Permits the Board to require additional capital. (Sec. 1552) Requires the Board to establish standards for guaranty funds established by the States. (Sec. 1571) Sets forth the responsibilities of the Secretary of Health and Human Services. Directs the Secretary to administer and implement all provisions of this Act, except those duties delegated to the Board, any other executive agency, or to any State. (Sec. 1572) Directs the Secretary to appoint an Advisory Council on Breakthrough Drugs that will examine the reasonableness of launch prices of new breakthrough drugs. (Sec. 1581) Provides for the certification of essential community providers. Sets forth the following categories of providers automatically certified (under provisions of the Public Health Service Act): (1) migrant health centers; (2) community health centers; (3) homeless program providers; (4) public housing providers; (5) family planning clinics; and (6) AIDS providers under the Ryan White Act. Includes as automatically certified (under other Acts) following: (1) Indian health programs under the Indian Health Act; and (2) maternal and child health providers and a federally qualified health center or rural health clinic under the Social Security Act. Includes as automatically certified (under provisions of this Act) the following: (1) providers of school health services; and (2) a qualified community practice network. Provides for the setting of standards for additional health providers. (Sec. 1591) Sets forth the responsibilities of the Secretary of Labor. Includes among those responsibilities the following: (1) enforcement requirements applicable to employers; (2) elections to become corporate alliances; (3) temporary assumption of insolvent self-insured corporate alliance health plans; (4) establishment and administration of the Corporate Alliance Health Plan Insolvency Fund; and (5) administering title I of ERISA as it relates to group health plans maintained by corporate alliances. Subtitle G: Employer Responsibilities - Requires employers to provide for the payments required under title VI of this Act. Sets forth other employer responsibilities including: (1) information reporting requirements; (2) requirements relating to new employees; (3) recordkeeping requirements; and (4) antidiscrimination requirements. (Sec. 1606) Prohibits self-funding of cost sharing benefits by regional alliance employers. (Sec. 1607) Requires an employer to make equal employer premium payments to all qualifying employees, if a voluntary premium payment is made. Places a limit on such voluntary employer premium payments. (Sec. 1608) Sets forth an employer's obligation to a qualifying retired beneficiary where the employer, as of October 1, 1993, was providing a threshold payment. (Sec. 1609) Authorizes the Secretary of Labor to impose a civil penalty of up to $10,000 for each violation of this subtitle with respect to each individual. Subtitle J (sic): General Definitions; Miscellaneous Provisions - Sets forth the definitions and rules used in this Act. Subtitle B: Miscellaneous Provisions (sic) - (Sec. 1911) Grants the National Health Board, the Secretary of Health and Human Services, and the Secretary of Labor authority to issue regulations as necessary to permit the timely implementation of this Act. Title II: New Benefits - Subtitle A: Medicare Outpatient Prescription Drug Benefit - (Secs. 2001 through 2005) Amends title XVIII of the Social Security Act to provide for: (1) Medicare coverage of covered outpatient prescription drugs and biologicals as well as home infusion drug therapy services; (2) payment rules and related requirements, such as those pertaining to deductibles, for covered outpatient prescription drugs; (3) manufacturer rebates to the Secretary under Medicare part B for covered outpatient prescription drugs; and (4) determination of the Medicare part B premium attributable to covered outpatient prescription drugs. Subtitle B: Long-Term Care - Establishes requirements for State plans for home and community-based services to individuals with disabilities. Includes among those requirements the following: (1) a prohibition of limiting eligibility of individuals with disabilities based on income, age, geography, severity of disability, residential setting, or other grounds specified by the Secretary; (2) a requirement to serve low-income individuals; (3) a requirement to specify how Federal and State funds will be managed; (4) quality assurance requirements; and (5) reporting requirements. Requires a State to consult with individuals and groups of individuals with disabilities when developing the plan in order to have the plan approved. (Sec. 2103) Defines "individuals with disabilities" to mean any individual within one or more of the following four categories: (1) individuals requiring help with the activities of daily living; (2) individuals with severe cognitive or mental impairment; (3) individuals with severe or profound mental retardation; and (4) severely disabled children. (Sec. 2104) Requires a State plan to specify the services available. Requires each individualized plan to be developed in close consultation with the individual and the individual's family. Prohibits a State plan from covering: (1) room and board; (2) services furnished in a hospital, nursing facility, intermediate care facility for the mentally retarded, or other specified institutional setting; or (3) items or services to the extent coverage is provided for an individual under a health plan or Medicare. (Sec. 2105) Sets forth provisions relating to: (1) cost sharing; (2) quality assurance and safeguards; (3) advisory groups; (4) payments to States; and (5) the total Federal budget for State plans and allotments to States. (Sec. 2301) directs the Secretary, with the advice and assistance of the National Long-Term Care Insurance Advisory Council to promulgate regulations as necessary to implement provisions concerning private long-term care insurance. Directs the Secretary to make appointments to such Council. Authorizes appropriations for such Council. (Sec. 2321) Directs the Secretary, after considering the Council's recommendations to promulgate regulations designed to: (1) standardize formats and terminology used in long-term care policies; (2) require insurers to provide information to customers on the range of public and private long-term care coverage available; and (3) establish other requirements promoting consumer understanding of benefits. (Sec. 2322) Directs the Secretary to promulgate regulations establishing requirements with respect to the terms of and benefits under long-term care policies, which shall include the following requirements that the policy may not: (1) limit coverage based on a preexisting condition, subject to an exception for a six month period; (2) condition eligibility for benefits based on the need or receipt of any other service; (3) condition eligibility for any benefit on any particular diagnosis; (4) condition eligibility for benefits by providers on compliance with requirements not required by State or Federal law; and (5) condition coverage of any service by a provider on the provision of such service at a higher level of care than required by the insured individual. Prohibits discrimination by diagnosis in the treatment of: (1) Alzheimer's disease; (2) any organic or inorganic mental illness; (3) mental retardation or any other cognitive or mental impairment; or (4) HIV infection or AIDS. Sets forth other requirements for such policies, including requirements related to: (1) premiums; (2) sales practices; (3) continuation, renewal, replacement, conversion, and cancellation of policies; and (4) payment of benefits. (Sec. 2342) Provides for grants to States to enforce the Federal standards concerning long-term care policies. Sets forth requirements for receiving such grants. Authorizes appropriations. Prohibits the sale of a long-term care policy in a State without a regulatory program. (Sec. 2361) Authorizes the Secretary to make grants for the development and implementation of long-term care information, counseling, and other programs to: (1) States; (2) regional alliances (at the option of States within which such alliances are located; and (3) national organizations representing insurance consumers, long-term care providers, and insurers. Authorizes appropriations for such grants. (Sec. 2601) Authorizes the Secretary to conduct a demonstration program to test the effectiveness of various approaches to financing and providing integrated acute and long-term care services for the chronically ill and disabled. Sets forth the services and benefits to be provided, including: (1) all benefits of the comprehensive benefit package provided under title I of this Act; (2) transitional benefits, including assessment and home care; (3) long-term care benefits, including adult day care, home-delivered meals, and nursing facility services in specialized care units; and (4) habilitation services. Permits any of the following to be eligible for such services under criteria to be established by the Secretary: (1) individuals with disabilities under a State program; (2) individuals entitled to benefits under the Medicare program; and (3) individuals entitled to Medicaid and who are also either entitled to Medicare or Supplemental Security Income benefits. Requires reports to the Congress on the demonstration program. Title III: Public Health Initiatives - Subtitle A: Workforce Priorities Under Federal Payments - Establishes within the Department of Health and Human Services the National Council on Graduate Medical Education. Directs the National Council to designate for each academic year the number of individuals nationwide who are authorized to be enrolled in each specified approval physician training program for each medical specialty. Sets forth provisions specifying: (1) Federal formula payments to approved physician training programs; (2) application for payments; and (3) amount of payments. (Sec. 3061) Directs the Secretary to carry out a program with respect to graduate nurse training programs that is equivalent to the program for approved physician training programs. Establishes a National Council on Graduate Nurse Education. (Sec. 3071) Authorizes appropriations for the following programs: (1) primary care physician and physician assistant training; (2) training of underrepresented minorities and disadvantaged persons; and (3) nurse training. (Sec. 3072) Authorizes appropriations for the following programs: (1) a program of skill upgrading and occupational retraining for health care workers; (2) a demonstration program to assist workers in health care institutions in obtaining advanced career positions; (3) a program to develop and operate health-worker job banks in local employment services agencies, subject to certain conditions; (4) a program to provide joint labor-management decision-making in the health care sector on workplace matters related to the restructuring of the health care delivery system of this Act; and (5) a program to facilitate the comprehensive workforce adjustment initiative. (Sec. 3073) Directs the Secretary of Health and Human Services and the Secretary of Labor to jointly establish the National Institute for Health Care Workforce Development. States that the Director of the Institute shall make recommendations to the Secretaries regarding: (1) the supply of health care workers; (2) the impact of this Act; and (3) the development and implementation of high-performance, high-quality health care delivery systems. Directs the Secretaries to establish an advisory board to assist in the development of such recommendations. Subtitle B: Academic Health Centers - Directs the Secretary to make payments to a qualified academic health center or qualified teaching hospital in order to assist such eligible institutions with costs that are not routinely incurred by other entities in providing health services, but are incurred by such institutions by virtue of the academic nature of such institutions. States that such costs include: (1) costs resulting from reduced staff productivity due to teaching responsibilities; (2) the uncompensated costs of clinical research; and (3) exceptional costs associated with an institutions specialized expertise. Provides that the funding for such payments will come from transfers from the Federal Hospital Insurance Trust Fund, payments made by regional alliances to the Federal government for academic health centers and graduate medical education, and payments from corporate alliances. (Sec. 3131) Provides for the access of regional and corporate alliance patients to academic health centers. Subtitle C: Health Research Initiatives - Amends the Public Health Service Act to ensure that the National Institutes of Health conducts and supports biomedical and behavioral research on promoting health and preventing diseases, disorders, and other health conditions. Provides for health services research. Authorizes appropriations for such research. Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health - Authorizes appropriations for the core functions of public health programs and national initiatives regarding health promotion and disease prevention. (Sec. 3312) Authorizes the Secretary to make grants to States to carry out one or more of the following core functions: (1) data collection; (2) activities to protect the environment and to assure the safety of housing, workplaces, and food and water; (3) investigation and control of adverse health conditions; (4) public information and education programs to reduce risks to health such as use of tobacco, alcohol, and drugs, sexual activities that increase the risk of HIV transmission and other sexually transmitted diseases, poor diet, physical inactivity, and low childhood immunization levels; (5) accountability and quality assurance activities; (6) provision of public health laboratory services to complement private clinical laboratory services that screen for diseases and conditions; (7) training and education to assure provision of care by all health professionals; and (8) leadership policy development and administrative activities. (Sec. 3331) Authorizes the Secretary to make grants to agencies of State or local government, private nonprofit organizations, and coalitions that link two or more of these groups for the purpose of carrying out projects to develop and implement innovative community-based strategies to provide for health promotion and disease prevention activities for which there is a significant need. Subtitle E: Health Services for Medically Underserved Populations - Directs the Secretary to make grants to migrant health centers and community health centers, which shall be in addition to other funds available to such centers. Authorizes appropriations. (Sec. 3412) Authorizes appropriations for: (1) grants and contracts for the development of qualified community health plans and practice networks; and (2) loans and guaranteeing the principal and interest to Federal and non-Federal lenders on behalf of public and private entities for the capital costs of developing qualified community health plans and practice networks. (Sec. 3461) Authorizes the Secretary to make grants and enter into contracts with qualified community health groups to provide enabling services such as transportation, community and patient outreach, patient education, and translation services in order to increase the capacity of individuals to utilize the items and services under title I of this Act. Authorizes appropriations. (Sec. 3471) Authorizes appropriations for: (1) the National Health Service Corps; and (2) such amounts as are necessary to ensure that at least 20 percent of participants in the Scholarship Program or the Loan Repayment Program of the Corps are nurses. (Sec. 3481) Entitles a hospital with a low-income utilization rate in a base year of at least 25 percent to a payment as specified. Requires 75 percent of the total available to be allocated to hospitals for low-income assistance. Requires 25 percent of the total available to be allocated to hospitals for assistance in furnishing inpatient hospital services that are not covered services under title I of this Act. Subtitle F: Mental Health; Substance Abuse - Authorizes appropriations to carry out this part. Provides for grants to: (1) increase access to mental health and substance abuse services; (2) improve State and local capacity to coordinate and monitor such services; (3) provide incentives to integrate public and private service systems; and (4) supplement any activity under part B (Alcohol and Drug Abuse and Mental Services Block Grant) of title XIX of the Public Health Service Act. (Sec. 3503) Authorizes the Secretary to make loans for the capital costs incurred in the development of non-acute, residential treatment centers and community-based ambulatory clinics. (Sec. 3521) Requires the establishment of a pilot program demonstrating the integration of the mental illness and substance abuse services of the States with the services included under title I of this Act. Subtitle G: Comprehensive School Health Education; School-Related Health Services - Authorizes appropriations for the programs of this subtitle. States that the purposes of the programs shall be to: (1) support, in kindergarten through grade 12, the provision of comprehensive health educator programs; (2) establish a national framework within which States can create comprehensive school health education programs that target the health risk behaviors of youth, including tobacco use, alcohol and drug abuse, sexual behaviors resulting in infections, injury prevention, dietary patterns, and sedentary lifestyles; (3) pay the initial costs of planning and establishing such programs; (4) support related Federal demonstrations and training; (5) motivate youth to stay in school, avoid teen pregnancy, and strive for success; (6) improve the knowledge of health education among youth; and (7) further the National Education Goals set forth in title I of the Goals 2000: Educate America Act. Defines "comprehensive school health education program." Requires such programs to be sensitive to cultural and ethnic issues, promote involvement by families, and promote personal responsibility. Sets forth requirements for applying for grants and selection of grantees. Subtitle H: Public Health Service Initiative - Establishes a Public Health Service Initiative consisting of specified amounts authorized to be appropriated for the Initiative. States that: (1) the Initiative includes the programs of subtitles C through G of this title and the programs of subtitle D of title VIII; and (2) amounts appropriated to carry out the Initiative, including subtitles A through F of this title, are available to carry out specific programs for which the amounts are appropriated. Subtitle I: Coordination with COBRA Continuation Coverage - Amends title XXII (Requirements for Certain Group Health Plans for Certain State and Local Employees) of the Public Health Service Act to provide for coordination with COBRA continuation coverage. Repeals such title XXII upon implementation of this Act. Title IV: Medicare and Medicaid - Subtitle A: Medicare and the Alliance System - Amends title XVIII of the Social Security Act to provide for optional State integration of Medicare beneficiaries into regional alliance plans. (Sec. 4002) Allows individuals to elect to remain in certain plans. (Sec. 4003) Provides for payments to regional alliances on behalf of certain Medicare-eligible individuals. (Sec. 4004) Extends protections for working aged and disabled individuals to group health plans of all employers. Repeals the limitation on the period of protection for individuals with end stage renal disease. Prohibits Medicare payment for items and services provided under any health plan under this Act. Simplifies Medicare benefit coordination in cases where the individual is also eligible for benefits under this Act's health plans. (Sec. 4011) Makes various changes concerning eligible organization and Medicare supplemental policy enrollment and comparative informational materials, eligible organization outlier payments, and participating provider point-of-service networks. (Sec. 4022) Provides for expanded Medicare coverage for physician assistant, nurse practitioner, and clinical nurse specialist services. (Sec. 4031) Amends title XI of the Social Security Act to: (1) provide for termination of the separate Medicare peer review program upon adoption of the National Quality Management Program above under subtitle A of title V of this Act; and (2) repeal provisions on surgical procedure review and second opinions. (Sec. 4032) Amends title XVIII of the Social Security Act to provide for mandatory assignment for all Medicare part B services. (Sec. 4033) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate administration of Medicare parts A and B and supersedes certain conflicting requirements to the extent required to achieve such purpose. (Sec. 4035) Prohibits the Secretary from implementing any change in procedures for billing and processing Medicare claims within six months of implementing any previous change. Adds advanced notification to providers as a requirement for carriers and fiscal intermediaries under Medicare. (Sec. 4041) Amends title XI of the Social Security Act to: (1) provide for civil monetary penalties for kickback violations under Medicare and State health care programs (the programs); (2) make other penalty-related changes, including increases in criminal and civil monetary penalties, a new criminal penalty exception for certain providers, additional civil monetary penalty offenses related to alliance systems, and requirements for the deposit of penalties collected into the All-Payer Account established above under title V of this Act; (3) revise exclusion provisions, with changes establishing a minimum period of exclusion for certain individuals and entities subject to permissive exclusion from the programs, and providing for program exclusions based on actions under alliance systems; and (4) modify sanction provisions, with changes removing certain conditions for imposing sanctions and setting specified civil money penalties for use in lieu of authorized sanctions. (Sec. 4042) Amends title XVIII of the Social Security Act to revise the limitations on physician self-referrals. (Sec. 4051) Provides for the termination of payments under Medicare for medical education costs and directs the Secretary to make specified transfers from certain Medicare trust funds to the new accounts established above for funding physician training programs and academic health centers. (Sec. 4061) Amends title XVIII of the Social Security Act to provide for the treatment of: (1) uniformed services and VA health plans as eligible organizations under Medicare; and (2) health care facilities of the Department of Veterans Affairs as providers under Medicare. Subtitle B: Savings in Medicare Program - Amends title XVIII of the Social Security Act to provide for: (1) reductions in the update for inpatient hospital services and the adjustment for indirect medical education costs, in payments for capital-related costs for inpatient hospital services; (2) revisions to payment adjustments for disproportionate share hospitals in States participating under this Act; and (3) an extension of the freeze on updates to routine service costs of skilled nursing facilities. (Sec. 4111) Amends title XVIII of the Social Security Act to provide for: (1) establishment of cumulative expenditure goals for physician services; (2) use of real gross domestic product for volume adjustments; (3) repeal of restrictions on the maximum reduction permitted in default update; (4) reduction in the conversion factor for the physician fee schedule for 1995; (5) place limitations on payment for physicians' services furnished by high-cost hospital medical staffs; (6) requirements for physicians to identify the hospital at which the service was furnished; (7) an increase in practice expense relative value units for certain services while assuring budget neutrality; (8) a study and report to the Congress by the Secretary on a resource-based system for determining practice expense relative value units for each physician's service; (9) an increase in work relative value units for office visits while assuring budget neutrality; (10) a reduction in relative values for office consultations; (11) adjustment of outlier intensity of relative values; (12) changes in underserved area bonus payments; (13) elimination of formula-driven payments for certain outpatient hospital services; (14) copayments for laboratory services; and (15) competitive acquisition procedures for Medicare part B items and services (including clinical diagnostic laboratory tests). (Sec. 4131) Makes changes with respect to: (1) Medicare as secondary payer; (2) payments for health maintenance organizations and competitive medical plans with risk-sharing contracts; and (3) routine cost limits and copayments for, respectively, home health services and visits. (Sec 4135) Directs the Secretary to use a competitive process to contract with centers of excellence for cataract surgery, coronary artery by-pass surgery, and such other services as the Secretary determines to be appropriate. (Sec. 4141) Amends title XVIII of the Social Security Act to revise Medicare part B premium provisions. (Sec. 4151) Requires the Secretary to submit a report to the Congress on the growth in spending under Medicare for FY 2000 through 2003. Subtitle C: Medicaid - Amends title XIX (Medicaid) of the Social Security Act to provide that if a State Medicaid plan provides for payment to regional alliances of the amounts required above it is not required to provide payment for items and services covered under the comprehensive benefit package for alliance eligible individuals and will receive no Federal financial assistance with respect to such items and services. (Sec. 4211) Provides for: (1) spenddown eligibility and increased income and resource disregard for nursing facility residents; and (2) informing such residents about the availability of assistance for home and community-based services. (Sec. 4221) Provides for: (1) treatment of items and services not covered under the comprehensive benefit package; and (2) establishment of a program under Medicare of noncovered items and services for poor children. (Sec. 4231) Discontinues certain payment policies under Medicaid. (Sec. 4241) Limits the frequency of changes in a State's billing and claims processing system, and provides for advance notification to providers of any major billing change. (Sec. 4251) Establishes the Medicaid Commission to study, report, and make recommendations with respect to options involving block grant use, integration of long-term care services, and consolidation of institutional and home- and community-based long-term care in relation to the Medicaid program. Authorizes appropriations. Subtitle D: Increase in SSI Personal Needs Allowance - Amends title XVI (Supplemental Security Income) (SSI) to provide for an increase in the SSI personal needs allowance. Title V: Quality and Consumer Protection - Subtitle A: Quality Management and Improvement - Requires the National Health Board to establish and oversee a performance-based program of quality management and improvement designed to enhance the quality, appropriateness, and effectiveness of heath care services and access to such services which will be called the National Quality Management Program. (Sec. 5002) Establishes the National Quality Management Council which shall: (1) administer the National Quality Management Program; (2) perform any other duty specified in this subtitle; and (3) advise the National Health Board with respect to its duties under this subtitle. Requires the Council to develop a set of national measures of quality performance to be used in the assessment of and the provision of access to health care services. Requires the Council, in addition, to: (1) recommend to the Board establishing goals for performance by health plans and health care providers on a subset of national measures of quality performance; (2) direct the Administrator for Health Care Policy and Research to develop, review, and disseminate practice guidelines to determine how diseases can most effectively be prevented, diagnosed, treated, and managed; and (3) direct the Administrator for Health Care Policy and Research to support research related to a five year priority list of performance measures. (Sec. 5008) Directs the National Health Board to: (1) establish and oversee regional professional foundations to perform such duties as develop lifetime learning programs for health professionals and conduct research on health care quality; and (2) establish the National Quality Consortium to perform such duties as establishing continuing education for health professionals and provide advice on research priorities. (Sec. 5012) Requires each regional alliance and each corporate alliance to: (1) disseminate specified information to consumers; and (2) ensure that performance and quality standards are continually improved. Subtitle B: Information Systems, Privacy, and Administrative Simplification - Directs the National Health Board to develop and implement a health information system, in consultation with Federal agencies, States, employers, health plans, and others, by which the Board shall collect, report, and regulate the collection and dissemination of health care information which shall be used for: (1) health care planning by Federal, State, and local government; (2) establishing and monitoring payments for health services; (3) assessing and improving the quality of health care; (4) managing and containing costs at the alliance and plan levels; and (5) other specified purposes. Requires the establishment of an electronic data network to collect, compile, and transmit information. (Sec. 5120) Sets forth provisions providing for health information privacy standards. (Sec. 5130) Directs the National Health Board to develop the following standard health care benefit forms: (1) an enrollment and disenrollment form; (2) a clinical encounter record; and (3) a claim form. (Sec. 5140) Establishes the National Privacy and Health Data Advisory Council in order to advise the National Health Board with respect to its duties under this subtitle. (Sec. 5141) Sets forth monetary penalties for violating health information system standards. Subtitle C: Remedies and Enforcement - Sets forth provisions with respect to the review of benefit determinations for enrolled individuals, including provisions: (1) regulating the time limits for notice of disposition of a claim; (2) governing a plan's duty to review claim denials; (3) concerning urgent requests for preauthorization; and (4) concerning other time limits with respect to time limits and notice. (Sec. 5202) Requires each State to establish a complaint review office for each regional alliance established by a State. Permits aggrieved individuals to file complaints with the appropriate review office. (Sec. 5205) Provides for a Federal Health Plan Review Board to review the decisions of complaint review office hearing officers. (Sec. 5207) Sets monetary penalties for a plan which unreasonably denies or delays payment or provision of benefits. (Sec. 5211) Directs each State to establish and maintain an Early Resolution Program in each complaint review office. Requires a program to include: (1) forums for mediation disputes; and (2) other forums of alternative dispute resolution as may be prescribed. Establishes guidelines for the eligibility of cases for submission to the Early Resolution Program. States that conclusions of the mediation proceedings shall be treated as nonbinding and shall not affect any rights to review. (Sec. 5231) Sets forth additional remedies and enforcement provisions. Subtitle D: Medical Malpractice - Prohibits any medical malpractice liability action until the final resolution of the claim under alternative dispute resolution. Requires each regional alliance health plan and corporate alliance health plan to adopt at least one specified method of alternative dispute resolution. Prohibits an individual from bringing a medical malpractice liability action unless the individual submits an affidavit that includes a report by a qualified specialist that states that there is a meritorious cause for filing the action. (Sec. 5311) Directs the Secretary to establish: (1) a project to demonstrate whether substituting liability for medical malpractice on the part of the health plan in which a physician participates for the personal liability of the physician will result in improvements in the quality of care, reductions in defense medical practices, and better risk management; (2) a pilot program under which the Secretary provides funds to one or more eligible States to determine the effect of applying practice guidelines in the resolution of medical malpractice liability actions. Subtitle E: Fraud and Abuse - Directs the Secretary and the Attorney General to establish a program: (1) to coordinate the functions of the Attorney General, the Secretary, and other organizations with respect to the prevention, detection, and control of health care fraud and abuse; (2) to conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for health care; and (3) to facilitate the enforcement of this and other statutes applicable to health care fraud. (Sec. 5402) Creates, in the Treasury, the All-Payer Health Care Fraud and Abuse Control Account which shall consist of: (1) gifts and bequests; (2) administrative penalties and assessments and portions of civil monetary penalties imposed under provisions of the Social Security Act; (3) all criminal fines imposed in cases involving a Federal health care offense; (4) penalties imposed under the False Claims Act involving claims related to the provision of health care items and services; and (5) amounts resulting from the forfeiture of property by reason of Federal health care offense. States that amounts in the fund may be used to cover costs incurred in operating the Program. (Sec. 5411) Excludes from participation in any health plan any individual or entity excluded from participation in a public program under provisions of the Social Security Act. (Sec. 5413) Sets forth physician self-referral limitations. (Sec. 5431) Amends the Federal criminal code to set penalties for knowingly executing a scheme or artifice to: (1) defraud any health alliance, health plan, or other person (alliance) in connection with the delivery of, or payment for, health care benefits, items, or services (benefits); and (2) obtain, by false or fraudulent means, money or property owned by, or under the custody of control of, any such alliance in connection with the delivery of, or payment for, health care benefits. (Sec. 5432) Amends: (1) the Federal criminal code to require the court, in imposing sentence on a person convicted of a Federal health care offense that poses a serious threat to the health of any person or has a significant detrimental impact on the health care system, to order such person to forfeit property used in the commission of the offense or that constitutes, or is derived from, proceeds traceable to the commission of the offense which is of a value proportionate to the seriousness of the offense; and (2) the Federal judicial code to require that all proceeds of forfeiture relating to Federal health care offenses be deposited into the Department of Justice Assets Forfeiture Fund. (Sec. 5433) Amends the Federal criminal code to set penalties for: (1) knowingly and willfully falsifying, concealing, or covering up a material fact, making any false, fictitious, or fraudulent statements or representations, or making or using any false writing or document knowing it to contain any false, fictitious, or fraudulent statement or entry, in any matter involving a health alliance or health plan; and (2) bribery of, and graft by, a health care official. (Sec. 5435) Authorizes: (1) the Attorney General to commence a civil action in Federal court to enjoin a Federal health care offense; and (2) a person privy to certain grand jury information concerning a health law violation to disclose that information to an attorney for the Government to use in any civil proceeding related to a Federal health care offense. (Sec. 5437) Sets penalties for: (1) theft or embezzlement in connection with a health alliance, health plan, or fund connected with such alliance or plan; and (2) misuse of a health security card issued, or unique identifier provided, pursuant to this Act. (Sec. 5441) Makes provisions of the Civil False Claims Act applicable to the use of false records or statements made to a health plan. Includes within the definition of "claim" for purposes of such Act any request or demand for money or property which is made or presented to a health plan. Subtitle F: McCarran-Ferguson Reform - Amends the McCarran-Ferguson Act to repeal the exemption under specified antitrust laws for the business of insurance to the extent that such business relates to the provision of health benefits. Title VI: Premium Caps; Premium-Based Financing; and Plan Payments - Subtitle A: Premium Caps - Sets forth provisions which provide for the computation of factors that limit the growth of premiums for the comprehensive benefit package in regional alliance health plans, including the computation of a: (1) regional alliance inflation factor; and (2) general health care inflation factor. (Sec. 6002) Directs the Board to determine: (1) a national per capita baseline premium target; (2) the national average per capita current coverage health expenditures; and (3) current health care expenditures. (Sec. 6003) Directs the Board to determine a regional alliance per capita premium. (Sec. 6004) Requires a regional alliance to annually obtain premium bids from each plan seeking to participate as a regional alliance health plan with respect to the alliance. (Sec. 6005) Permits any participating State to assume responsibility for containment of health care expenditures in the State consistent with this Act. (Sec. 6006) Directs the chair of the Board to establish an advisory commission on regional variations in health expenditures. Requires the commission to examine methods of eliminating variation in regional alliance per capita premium targets due to variation in practice patterns, not due to other factors. Requires the Board to submit its recommendations to the Congress. Requires such recommendations to apply unless a joint resolution of disapproval is passed. (Sec. 6011) Subjects each noncomplying regional alliance health plan for a year to a reduction in plan payment as specified, in order to assure that payments to regional alliance health plans by a regional alliance are consistent. Defines a noncomplying plan to include a plan in which the final accepted bid exceeds the maximum complying bid for the per capita target premium. Defines "maximum complying bid." (Sec. 6021) Directs the Board to develop a methodology for calculating an annual per capita expenditure equivalent for amounts paid for coverage for the comprehensive benefit package within a corporate alliance. (Sec. 6022) Terminates a corporate alliance with two excess years in a three year period. Provides that employers that were corporate alliance employers with respect to a terminated alliance shall become regional alliance employers. Defines an excess year as one in which the rate of increase for the corporate alliance exceeds the national corporate inflation factor. Defines rate of increase and national corporate inflation factor. (Sec. 6031) Sets forth special rules for a single-payer State. (Sec. 6041) Directs the Secretary to establish a program to monitor prices and expenditures in the U.S. health care system. Subtitle B: Premium-Related Financings - Makes each family enrolled in a regional health alliance plan or in a corporate alliance health plan in a class of family enrollment responsible for payment of the family share of premium payable for enrollment. Provides for income related discounts and specified credits. (Sec. 6102) Establishes the formula for determining the premiums. (Sec. 6111) Provides for the repayment of credit by certain families. (Sec. 6114) Provides for the special treatment of certain retirees and qualified spouses and children. (Sec. 6121) Requires each regional alliance employer to pay a monthly premium to the regional alliance for a qualifying employee. Sets forth provisions for determining such premium. Varies the premium depending upon such factors as the employer's size and average wages paid. (Sec. 6126) Sets forth provisions applicable to self-employed individuals. (Sec. 6131) Sets forth provisions for determining the corporate employer premium. Subtitle C: Payments to Regional Alliance Health Plans - Sets forth provisions to determine the computation of: (1) the blended plan per capita payment amount; and (2) the plan bid, AFDC, and SSI proportions. Title VII: Revenue Provisions - Subtitle A: Financing Provisions - Amends the Internal Revenue Code to increase the excise taxes on cigarettes and other tobacco products. (Sec. 7113) Imposes an excise tax on the manufacture or importation of roll-your-own tobacco. (Sec. 7121) Imposes an assessment on each corporate alliance employer and a temporary assessment on employers with retiree health benefit costs. Requires such assessments to be paid in the same manner as employment taxes. (Sec. 7131) Provides for the recapture of certain health care subsidies received by high-income individuals. Transfers such amounts to the Supplemental Medical Insurance Trust Fund. (Sec. 7141) Requires certain shareholders of S corporations and limited partners who materially participate in corporate activities to include their share of income or loss from such corporation when determining net earnings from self-employment. (Sec. 7142) Provides for extending Medicare coverage and applying the hospital insurance tax to all State and local government employees. Subtitle B: Tax Treatment of Employer-Provided Health Care - Provides exceptions to the exclusion of employer-provided contributions to an accident or health plan from the gross income of an employee. (Sec. 7202) Prohibits the provision of health benefit under cafeteria plans. (Sec. 7203) Makes permanent the deduction for health insurance costs of self-employed individuals. Increases such deduction to 100 percent of the basic coverage purchased from a health alliance with limitations. Subtitle C: Employment Status Provisions - Requires the Secretary of the Treasury to prescribe regulations defining an employee for employment tax purposes. (Sec. 7302) Increases the penalty for failure to file correct returns involving payments for services. (Sec. 7303) Sets forth rules to limit retroactive employment tax reclassifications. Subtitle D: Tax Treatment of Funding of Retiree Health Benefits - Requires additional reserves for post-retirement medical and life insurance benefits to cover not less than ten years of the working lives of covered employees and to be maintained as separate accounts. (Sec. 7402) Terminates the authority of pension plans to maintain health benefits accounts. Subtitle E: Coordination with COBRA Continuing Care Provisions - Repeals provisions concerning continuation coverage requirements of group health plans upon implementation of this Act. Subtitle F: Tax Treatment of Organizations Providing Health Care Services and Related Organizations - Provides for the tax treatment of charitable organizations providing health care services, insurance provided by health maintenance organizations, and certain private foundations. (Sec. 7602) Sets forth transitional rules for taxing certain organizations providing health insurance and other prepaid health care services as insurance companies other than life insurance companies. (Sec. 7603) Exempts regional alliances from income tax. Subtitle G: Tax Treatment of Long-term Care Insurance and Services - Treats qualified long-term care services as medical care for purposes of the medical expense deduction. (Sec. 7702) Provides for the treatment of long-term care insurance as accident and health insurance. (Sec. 7703) Allows accelerated death benefits under life insurance contracts to be paid to terminally ill individuals. Subtitle H: Tax Incentives for Health Service Providers - Allows a tax credit for certain qualified individuals who provide primary health services full time in a health professional shortage area. (Sec. 7802) Increases the allowable depreciation deduction for expensing certain medical equipment. Subtitle I: Miscellaneous Provisions - Allows a tax credit for the cost of personal assistance services required by an employed individual who for medical reasons is unable to engage in substantial gainful activity. (Sec. 7902) Denies tax-exempt status for private activity bonds of regional alliances, corporate alliances, or guaranty funds established under this Act. Title VIII: Health and Health-Related Programs of the Federal Government - Subtitle A: Military Health Care Reform - Directs the Secretary of Defense to establish one or more uniformed services health plans in order to provide health care services to members of the armed forces on active duty for 30 or more days as well as their covered beneficiaries. Requires conformity of such plans with health plan requirements set forth in this Act. (Sec. 8001b) Allows any such plan to rely upon the use of military health care facilities, supplemented by civilian health care providers or health plans under agreements entered into by the Secretary. Requires at least the items and services in the comprehensive benefit package under this Act to be included in each such plan. Preempts any conflicting State health plan requirements. Provides for plan enrollment, effect of failure to enroll, and choosing between a uniformed services health plan and other available plans. Prohibits the imposition of plan charges to an active-duty member other than subsistence charges, but allows the Secretary to impose limited charges for covered beneficiaries. Establishes in the Department of Defense a financial account for payments received in connection with a uniformed services health plan, allowing such funds to be used only for purposes directly related to the delivery and financing of health care services under this Subtitle. Subtitle B: Department of Veterans Affairs - Allows each veteran who is an eligible individual under this Act and individuals currently enrolled in a health plan under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to be enrolled with a Department of Veterans Affairs (VA) health plan. Requires conformity of such plans with health plan requirements set forth in this Act, with all the items and services of the comprehensive benefit package under this Act included. Allows such plans to offer supplemental health benefits and cost-sharing policies as consistent with this Act. Provides a limitation with regard to veterans enrolled with health plans outside the VA. Prohibits the imposition of any plan enrollment charges upon service-connected disabled veterans, veterans receiving disability compensation from the VA, former prisoners of war, and veterans unable to defray the costs of such care. Allows the Secretary of Veterans Affairs to establish plan charges for other veterans. Deems a VA facility to be a Medicare provider for purposes of any program administered by the Secretary of Health and Human Services. Allows for the recovery of certain care and services provided under a VA plan in the case of an individual who has coverage under another plan. Establishes in the Treasury the Department of Veterans Affairs Health Plan Fund to be used for VA health plan payments and services. Preserves existing benefits for VA facilities not operating within a health plan certified under this Act. (Sec. 8102) Directs the Secretary of Veterans Affairs to organize health plans and operate VA facilities as, or within, health plans under this Act. Preempts existing State health plan standards or requirements. Authorizes the Secretary to contract for the provision of services by a VA health plan when cost-effective, or to share resources with other health care plans, providers, or organizations. Authorizes appropriations to the VA for FY 1995 through 1997 for VA health plans under this Subtitle, subject to availability of appropriations. Requires a report from the Secretary to the Congress concerning the operation of the VA health care system within the requirements of this Act. Authorizes the Secretary to accept and use grants for health care services provided to special populations if used by the VA while operating under a VA health plan. Subtitle C: Federal Employees Health Benefits Programs - (Secs. 8202 through 8204) Provides for termination of the Federal Employees Health Benefits Program (FEHB) and treatment of Federal employees, annuitants, and other individuals (including those residing abroad) who would otherwise have been eligible for FEHBP under this Act's health plans. Subtitle D: Indian Health Service - Makes qualifying Indians eligible to enroll in a comprehensive benefits health program of the Indian Health Service. (Sec. 8303) Authorizes appropriations for supplemental Indian health care benefits. (Sec. 8305) Exempts tribal governments and organizations from making employer payments. (Sec. 8306) Sets forth provisions regarding health service to non-enrollees and non-Indians. (Sec. 8311) Requires each health program of the Indian Health Service to establish a comprehensive benefit package fund. (Sec. 8313) Authorizes appropriations for the Indian Health Service programs. Subtitle E: Amendments to the Employee Retirement Income Security Act of 1974 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to revise and limit the coverage of group health plans under ERISA. Makes certain ERISA provisions inapplicable with respect to State-certified health plans. Provides for an exception from ERISA civil action provisions where review is otherwise available under the Health Security Act (this Act, HSA). (Sec. 8402) Establishes ERISA requirements for expeditious reporting and disclosure applicable to group health plans, through special rules consistent with ERISA and HSA purposes. Excludes plans maintained by regional alliances from treatment as multiple employer welfare arrangements. (Sec. 8403) Revises certain ERISA provisions relating to continuation coverage under group health plans. Repeals such provisions upon implementation of HSA. (Sec. 8404) Makes ERISA standards for group health plans regarding: (1) cases of adoption applicable except to the extent otherwise provided in regulations of the National Health Board under HSA; and (2) coverage of pediatric vaccines inapplicable to a group health plan upon its becoming a corporate alliance health plan under HSA. (Sec. 8405) Requires group health plans under ERISA to comply with HSA requirements relating to health plan claims procedure. Subtitle F: Special Fund for WIC Program - Authorizes appropriations through FY 2000 for the special supplemental food program for women, infants, and children under the Child Nutrition Act of 1966. Title IX: Aggregate Government Payments - Subtitle A: Aggregate State Payments - Sets forth provisions which have formulas for determining each participating State's payment to regional alliances within the State. Provides two different formulas. Establishes one payment formula for non-cash assistance recipients. Establishes another formula relating to cash assistance recipients. Defines a non-cash assistance adult as an individual who is: (1) over 21 years; (2) a U.S. citizen or lawful alien; and (3) is not an AFDC or SSI recipient or a Medicare-eligible individual. (Sec. 9022) Directs the National Health Board to review appropriateness of such payments. Subtitle B: Aggregate Federal Alliance Payments - Sets forth the formula for determining Federal payments to regional alliances for cash assistance recipients. (Sec. 9102) States that this section constitutes budget authority in advance of appropriation Acts and obligates the Federal Government to provide for the payment to regional alliances of a capped Federal alliance payment amount. Defines "capped Federal alliance payment amount." Subtitle C: Borrowing Authority to Cover Cash-flow Shortfalls - Authorizes the Secretary to make available loans to regional alliances to cover any period of temporary cash-flow shortfall attributable to: (1) any estimation discrepancy; (2) a period of temporary cash-flow shortfall attributable to an administrative error; or (3) a period of temporary cash-flow shortfall relating to the relative timing during the year in which amounts are received and payments are required. Sets forth loan terms and conditions. Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance - Subtitle A: Workers Compensation Insurance - Requires each health plan that provides services to enrollees through participating providers to make arrangements to provide workers compensation to such enrollees. (Sec. 10002) Requires each workers' compensation carrier that is liable for payment for workers' compensation services furnished by or through a health plan, regardless of whether or not the services are included in the comprehensive benefit package, to make payment for such services. (Sec. 10011) Sets forth requirements for participating States. (Sec. 10031) Authorizes demonstration projects in one or more States with respect to the treatment of work-related injuries and illnesses. Subtitle B: Automobile Insurance - Requires an individual entitled to automobile insurance medical benefits and enrolled in a health plan to receive automobile insurance medical services through the provision of such services by the health plan. (Sec. 10102) Requires each automobile insurance carrier that is liable for payment for automobile insurance medical services furnished by or through a health plan, regardless of whether or not the services are included in the comprehensive benefit package, to make payment for such services. (Sec. 10111) Requires each participating State to develop a fee schedule applicable to payment for automobile insurance medical services for which a fee is not included in the applicable fee schedule. Subtitle C: Commission on Integration of Health Benefits - Establishes the Commission on Integration of Health Benefits which shall study and report on the feasibility and appropriateness of transferring financial responsibility for all medical benefits, including those currently covered by workers compensation and automobile insurance, to health plans. Authorizes appropriations. Subtitle D: Federal Employees' Compensation Act - Requires the Federal Employees' Compensation Act to be interpreted and administered consistent with the provisions of subtitle A. Subtitle E: Davis-Bacon Act and Service Contract Act - Amends the Davis-Bacon Act and the Service Contract Act of 1965 to require Health Security Act benefits. Subtitle F: Effective Dates - Sets forth effective date provisions. Title XI: Transitional Insurance Reform - Sets forth transitional provisions concerning: (1) enforcement; (2) preservation of current coverage; (3) restrictions on premium increases during transition; (4) portability requirements; (5) restrictions limiting benefit reductions; and (6) the establishment of the National Transitional Health Insurance Risk Pool.
Bill· SS. 1778 (103rd)referred
United States · United States Congress · 22 November 1993
Amends the Internal Revenue Code to exclude cooperative housing corporations from the limitations on deductions incurred by certain membership organizations in transactions with their members. Prohibits patronage losses of an organization from being used to offset earnings which are not patronage earnings. Specifies earnings to be treated as patronage earnings in the case of cooperative housing corporations.
Bill· HRH.R. 3699 (103rd)referred
United States · United States Congress · 22 November 1993
TABLE OF CONTENTS: Title I: Health Policy Title II: Health Services Title III: Health Professions Title IV: Research and Data Collection Title V: Miscellaneous Minority Health Improvement Act of 1993 - Title I: Health Policy - Amends the Public Health Service Act to establish the Advisory Committee on Minority Health to advise the Secretary of Health and Human Services on the development of the goals of the Office of Minority Health for each racial and ethnic group. Authorizes appropriations for FY 1994 through 1998. (Sec. 102) Provides for the establishment of an Office of Minority Health at the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Substance Abuse and Mental Health Administration, and the Agency for Health Care Policy and Research. Requires such Offices to develop and implement health programs that target racial and ethnic minority populations. (Sec. 103) Authorizes the Secretary to make grants to States for the purpose of improving the health status in minority communities, through the operation of State offices of minority health established to monitor and facilitate the achievement of the Health Objectives for the Year 2000 as they affect minority populations. Authorizes appropriations for FY 1995 through 1997. (Sec. 104) Establishes in the Department of Health and Human Services an Assistant Secretary for Civil Rights, who shall be appointed by the President, by and with the advice and consent of the Senate. Title II: Health Services - Extends authorized appropriations for grants to States for the community scholarship program until FY 1996. Revises the eligibility requirements for such program. (Sec. 202) Extends the authorized appropriations for the grant program for health services for residents of public housing to FY 1996. (Sec. 203) Amends the Disadvantaged Minority Health Improvement Act of 1990 to allow substance abuse services under the grant program for health service for Pacific Islanders. Extends authorized appropriations for such program through FY 1996. Requires a report to the Congress on the effectiveness of projects funded under such program. Title III: Health Professions - Extends authorized appropriations until FY 1996 for: (1) loans for disadvantaged students; (2) the Cesar Chavez Scholarship Program (currently known as the Exceptional Financial Need Program); (3) the Thurgood Marshall Scholarship Program (currently known as the Scholarship for Disadvantaged Students program); (4) loan repayments and fellowships regarding faculty positions at health professions schools; (5) Centers of Excellence; and (6) educational assistance regarding undergraduates. Exempts from certain residency training requirements: (1) students from disadvantaged backgrounds who are underrepresented in the health professions; and (2) historically black colleges. (Sec. 305) Requires Centers of Excellence (health professions schools) to carry out community-based training programs to prepare students in secondary schools and institutions of higher education for attendance at such schools. Requires such schools to provide training to students to enable them to provide health service to minorities at community-based health facilities. Allows such schools to establish consortia. Allows schools of pharmacy and clinical psychology to be Centers of Excellence. Allows Centers of Excellence to collaborate with the National Institutes of Health. Title IV: Research and Data Collection - Requires the Director of the Office of Minority Health to ensure that activities address the most prevalent morbidity and mortality concerns of the various racial and ethnic minority groups. Establishes the Advisory Subcommittee on Research on Minority Health to advise the Advisory Committee to the Director of the National Institutes of Health. (Sec. 402) Extends authorized appropriations through FY 1997 for the National Center for Health Statistics. (Sec. 403) Requires that research, demonstration projects, and evaluations be carried out on the health status of, and the delivery of, health care to racial and ethnic minority groups residing in medically underserved urban and rural areas and low-income groups, including the elderly, women, and children with low incomes. Title V: Miscellaneous - Directs the Secretary to study and report to the Congress on the need to combine the designations of medically underserved area and health professional shortage area. (Sec. 502) Establishes in the Department of Health and Human Services the Office of Urban Health Policy to collect and disseminate information on health care issues, research findings, and innovative approaches to deliver health care to such areas. Authorizes the making of grants to States to improve health care in underserved urban areas. (Sec. 503) Authorizes the making of grants and contracts regarding organ and bone marrow transplantation for minority populations. (Sec. 504) Extends the demonstration project for grants to States for Alzheimer's disease through FY 1998. Requires improved access for individuals with Alzheimer's disease, particularly racial and ethnic minorities and individuals living in isolated rural areas, to services that are home-based or community-based. (Sec. 505) Waives individuals from disadvantaged backgrounds who are underrepresented in the health professions from certain obligations regarding training or practicing in primary health care.
Bill· HRH.R. 3689 (103rd)referred
United States · United States Congress · 22 November 1993
Public Housing for the Elderly Protection Act - Amends the United States Housing Act of 1937 to limit occupancy of nonelderly single persons in public housing projects for the elderly.
Bill· HRH.R. 3649 (103rd)referred
United States · United States Congress · 22 November 1993
Industrial Regulatory Relief Commission Act - Establishes the Industrial Regulatory Relief Commission to develop and submit to the President and the Congress recommendations for reducing the regulatory burden to the manufacturing, housing, and biotechnology industries nationwide so as to promote investment in those industries. Requires: (1) the Commission to report its recommendations to the President within 90 days; (2) the President to report his approval or disapproval of the recommendations to the Congress within ten days; (3) the Congress to introduce approved recommendations as a joint resolution; and (4) the Commission to have an additional ten days to consider changes submitted by the President to disapproved recommendations and to submit a final report to the Congress. Sets forth procedures for congressional consideration of a joint resolution approving the recommendations submitted by the President.
Bill· SS. 1757 (103rd)open
United States · United States Congress · 20 November 1993
TABLE OF CONTENTS: Title I: Health Care Security Subtitle A: Universal Coverage and Individual Responsibility Subtitle B: Benefits Subtitle C: State Responsibilities Subtitle D: Health Alliances Subtitle E: Health Plans Subtitle F: Federal Responsibilities Subtitle G: Employer Responsibilities Subtitle J (sic): General Definitions; Miscellaneous Provisions Title II: New Benefits Subtitle A: Medicare Outpatient Prescription Drug Benefit Subtitle B: Long-Term Care Title III: Public Health Initiatives Subtitle A: Workforce Priorities Under Federal Payments Subtitle B: Academic Health Centers Subtitle C: Health Research Initiatives Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health Subtitle E: Health Services for Medically Underserved Populations Subtitle F: Mental Health; Substance Abuse Subtitle G: Comprehensive School Health Education; School-Related Health Services Subtitle H: Public Health Service Initiative Subtitle I: Coordination With COBRA Continuation Coverage Title IV: Medicare and Medicaid Subtitle A: Medicare and the Alliance System Subtitle B: Savings in Medicare Program Subtitle C: Medicaid Subtitle D: Increase in SSI Personal Needs Allowance Title V: Quality and Consumer Protection Subtitle A: Quality Management and Improvement Subtitle B: Information Systems, Privacy, and Administrative Simplification Subtitle C: Remedies and Enforcement Subtitle D: Medical Malpractice Subtitle E: Fraud and Abuse Subtitle F: McCarran-Ferguson Reform Title VI: Premium Caps; Premium-Based Financing; and Plan Payments Subtitle A: Premium Caps Subtitle B: Premium-Related Financing Subtitle C: Payments to Regional Alliance Health Plans Title VII: Revenue Provisions Subtitle A: Financing Provisions Subtitle B: Tax Treatment of Employer-Provided Health Care Subtitle C: Employment Status Provisions Subtitle D: Tax Treatment of Funding of Retiree Health Benefits Subtitle E: Coordination with COBRA Continuing Care Provisions Subtitle F: Tax Treatment of Organizations Providing Health Care Services and Related Organizations Subtitle G: Tax Treatment of Long-term Care Insurance and Services Subtitle H: Tax Incentives for Health Services Providers Subtitle I: Miscellaneous Provisions Title VIII: Health and Health-Related Programs of the Federal Government Subtitle A: Military Health Care Reform Subtitle B: Department of Veterans Affairs Subtitle C: Federal Employees Health Benefits Program Subtitle D: Indian Health Service Subtitle E: Amendments to the Employee Retirement Income Security Act of 1974 Subtitle F: Special Fund for WIC Program Title IX: Aggregate Government Payments to Regional Alliances Subtitle A: Aggregate State Payments Subtitle B: Aggregate Federal Alliance Payments Subtitle C: Borrowing Authority to Cover Cash-Flow Shortfalls Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance Subtitle A: Workers Compensation Insurance Subtitle B: Automobile Insurance Subtitle C: Commission on Integration of Health Benefits Subtitle D: Federal Employees' Compensation Act Subtitle E: Davis-Bacon Act and Service Contract Act Subtitle F: Effective Dates Title XI: Transitional Insurance Reform Health Security Act - Title I: Health Care Security - Subtitle A: Universal Courage and Individual Responsibility - Entitles each eligible individual to: (1) the benefit provided under subtitle B through the applicable health plan in which the individual is enrolled; and (2) a health security card to be issued by the alliance or other entity that offers the applicable health plan in which the individual is enrolled. Defines an eligible individual as an individual who resides in the United States and is: (1) a citizen or national of the United States; (2) an alien permanently residing in the U.S. under color of law; or (3) a long-term nonimmigrant. Entitles a Medicare-eligible individual to benefits under Medicare instead of the above provisions of this Act. (Sec. 1002) Requires each eligible individual to enroll in an applicable health plan and pay any required premium. Prohibits disenrollment of an eligible individual until the individual is either enrolled in another plan or in Medicare. (Sec. 1003) States that nothing in this Act shall be construed as prohibiting: (1) an individual from purchasing any health services; (2) an individual from purchasing supplemental insurance; (3) an individual who is not an eligible individual from purchasing health insurance; or (4) employers from providing additional coverage. (Sec. 1004) States that a regional alliance health plan is the applicable plan for a family, unless a family member is eligible for a corporate alliance health plan. Allows military personnel, veterans, and Indians to enroll either with an alliance or with a military, veteran, or Indian plan respectively. (Sec. 1005) Prohibits an undocumented alien from enrolling in a health plan under this Act. (Sec. 1011) Defines a family as an eligible individual's eligible spouse and children. Defines couple as meaning an individual and the individual's spouse. Defines a child as being under age 18, or under age 24 in the case of a full-time student. Subtitle B: Benefits - Includes the following terms and services in the comprehensive benefit package: (1) hospital services; (2) services of health professionals; (3) emergency and ambulatory medical and surgical services; (4) clinical preventive services; (5) mental illness and substance abuse services; (6) family planning services and services for pregnant women; (7) hospice care; (8) home health care; (9) extended care services; (10) ambulance services; (11) outpatient laboratory, radiology, and diagnostic services; (12) outpatient prescription drugs and biologicals; (13) outpatient rehabilitation services; (14) durable medical equipment and prosthetic and orthotic devices; (15) vision care; (16) dental care; (17) health education classes; and (18) investigational treatments. Describes such items and services. (Sec. 1131) Requires each health plan to offer to its enrollees only one of the following cost sharing schedules: (1) lower cost sharing; (2) higher cost sharing; or (3) combination cost sharing. Provides that the annual maximum out-of-pocket expenses for an individual in any of the plans shall be $1500 and for a family the annual maximum shall be $3000. (Sec. 1135) Sets forth a table of copayments and coinsurance. (Sec. 1141) Excludes the following items and services: (1) an item or service that is not medically necessary or appropriate; (2) an item or service that the National Health Board may determine is not medically necessary or appropriate; (3) custodial care, except hospice care; (4) surgery performed solely for cosmetic purposes, unless required to correct a congenital anomaly or performed to correct a part of the body injured by either disease or accident; (5) hearing aids; (6) eyeglasses and contact lenses for individuals at least 18 years of age; (7) in vitro fertilization; (8) sex change surgery and related services; (9) private duty nursing; (10) personal comfort items, except in the case of hospice care; and (11) any dental procedures involving orthodontic care, inlays, gold or platinum fillings, bridges, crowns, pin/post retention, dental implants, surgical periodontal procedures, or the preparation of the mouth for the fitting or continued use of dentures, except as specified. (Sec. 1151) Gives the National Health Board the authority to promulgate such regulations or establish such guidelines as necessary to assure uniformity in the application of the comprehensive benefit package across all health plans. Permits the Board to expand the benefit package. (Sec. 1162) Permits a health professional or facility to refuse to provide a benefit if the professional or facility objects on the basis of a religious belief or moral conviction. Subtitle C: State Responsibilities - Requires a State, in order to be approved as a participating State, to submit a document describing the State's health care system. (Sec. 1201) Requires a participating State to: (1) establish one or more regional alliances; (2) establish and publish the criteria used in the certification of its health plan; (3) meet minimum financial solvency requirements for health plans established by the National Health Board; (4) designate an agency or official to coordinate State responsibilities under this Act; (5) conform State laws to meet the requirements of title X of this Act with respect to workers' compensation and automobile insurance; and (6) carry out all the responsibilities of a participating State specified in this Act. (Sec. 1221) Permits a State, with the Board's approval, to operate a single-payer system if specified requirements are met. Subtitle D: Health Alliances - Provides for regional alliances and corporate alliances. (Sec. 1302) Requires a regional alliance to be governed by a Board of Directors consisting of: (1) employers, including self-employed individuals; and (2) members who represent individuals purchasing coverage. Requires each regional alliance to establish a provider advisory board consisting of health care providers and professionals. (Sec. 1311) Includes in a corporate alliance an eligible sponsor who is either a large employer (more than 5,000 full-time employees) or a multiemployer plan (a plan with more than 5000 active participants). Excludes: (1) an employer whose primary business is employee leasing; (2) the Federal Government (other than the U.S. Postal Service); and (3) a State or local government. Excludes from corporate alliance eligibility the following classes of individuals: (1) AFDC recipients; (2) SSI recipients; (3) military personnel and families, veterans, and Indians who elect to enroll in specified plans specifically designed for them; and (4) seasonal or temporary employees. (Sec. 1321) Directs each regional alliance to enter into a contract with any State-certified health plan to contract with the alliance for the enrollment under the plan of eligible individuals. (Sec. 1322) Requires each regional alliance to offer a choice of health plans, including at least one fee-for-service plan. (Sec. 1326) Requires each regional alliance to establish and maintain an office of an ombudsman to assist consumers in dealing with problems that arise with health plans and the alliance. (Sec. 1329) Permits a regional alliance to adjust payments to plans or use other financial incentives to encourage health plans to expand into areas that have inadequate health services. (Sec. 1341) Set forth provisions concerning the collection of funds by regional alliances from individuals, employers, and others. (Sec. 1351) Requires each regional alliance to compute a blended plan per capita payment amount for each regional alliance health plan for enrollment in the alliance. (Sec. 1353) Requires each regional alliance to make payments to the Federal Government for academic health centers and graduate medical education. (Sec. 1361) Requires each regional alliance to comply with specified standards relating to the management of finances, maintenance of records, accounting practices, auditing procedures, financial reporting, and employer payments. (Sec. 1371) Provides for a reduction in cost sharing for low-income families. (Sec. 1373) Provides for premium discounts and reduction in liabilities for low-income families. (Sec. 1381) Permits each corporate alliance to: (1) offer coverage under either an appropriate self-insured health plan; or (2) negotiate with a State-certified plan to enter into a contract with the plan. (Sec. 1382) Requires each corporate alliance to provide a choice of health plans, including at least one fee-for-service plan and two health plans that are not fee-for-service plans. (Sec. 1385) Requires each corporate alliance to make an additional contribution towards the enrollment in health plans of the alliance by certain low-wage families. (Sec. 1386) Sets forth provisions relating to corporate alliances concerning: (1) consumer information and marketing; (2) plan and information requirements; (3) management of funds; (4) cost control; (5) payments by corporate alliance employers to corporate alliances; (6) ERISA; (7) disclosure and reserve requirements; (8) trusteeship of insolvent corporate alliance health plans; (9) imposition and collection of periodic assessments on self-insured corporate alliance plans; and (10) payments to the Federal Government by multiemployer corporate alliances for academic health centers and gradual medical education. Subtitle E: Health Plans - Requires a health plan to: (1) be either a self-insured plan (meaning a group health plan as defined by a the Employee Retirement Income Security Act of 1974) or a State-certified plan (meaning a plan certified by a State or the National Health Board); and (2) meet the applicable regulatory requirements. (Sec. 1402) Requires each health plan offered by either a regional or corporate alliance to accept for enrollment every alliance eligible individual, unless the plan has reached its enrollment limit. Prohibits the limit from being imposed on the basis of any personal characteristics of enrollees such as health status, need for health care, age, occupation, or affiliation with any person or entity. Prohibits a plan from: (1) restricting or terminating coverage for any reason, including nonpayment of premiums; (2) cancelling coverage for any eligible individual until that individual is enrolled in another plan; (3) excluding an eligible individual because of an existing medical condition; (4) imposing a waiting period before coverage begins; or (5) imposing a rider that excludes the coverage of particular eligible individuals. Prohibits discrimination by a health plan on the basis of race, national origin, sex, language, socio-economic status, age, disability, health status, or anticipated need for health services. (Sec. 1405) Requires each plan to have a grievance procedure. (Sec. 1421) Permits an entity to offer a supplemental insurance policy if the policy and the entity meet specified requirements. (Sec. 1431) Requires each health plan, with respect to each electing essential community provider located within the plan's service area, to either: (1) enter into a written provider participation agreement; or (2) enter into a written agreement under which the plan will make payment to the provider as specified. Provides a special rule for providers of school health services. Makes the provisions of the proceeding sentence applicable only to health plans offered by a health alliance during the five year period beginning with the first year in which any health plan is offered by the alliance. Directs the Secretary of Health and Human Services to study essential community providers and to make recommendations concerning such providers to the Congress. Provides that such recommendations shall apply unless a joint resolution of disapproval is enacted by the Congress. (Sec. 1441) Requires each health plan to meet specified requirements of title X of this Act with respect to workers' compensation and automobile medical liability services. Subtitle F: Federal Responsibilities - Establishes the National Health Board in the Executive Branch. Directs the President to appoint the Board's seven members. (Sec. 1503) Directs the Board to: (1) interpret the comprehensive benefit package; (2) adjust the delivery of preventive services; (3) take steps to assure that the comprehensive benefit package is available on a uniform national basis; (4) recommend to the President and the Congress appropriate revisions to the package; (5) oversee cost containment requirements; (6) develop and implement eligibility standards; (7) establish a performance based system of quality management; (8) develop and implement standards for a national health information system; (9) establish State requirements and monitor State compliance; (10) establish premium class factors; (11) develop a methodology for the risk-adjustment of premium payments; (12) establish financial requirements for guaranty funds; (13) establish standards for health plan grievance procedures; and (14) report annually to the President and the Congress. (Sec. 1506) Authorizes appropriations for the Board. (Sec. 1511) Requires the Board to approve a State health care system if the system meets the applicable requirements of this Act. Prohibits approval of a State health care system prior to 1996. (Sec. 1512) Provides for sanctions for States failing to meet conditions for compliance. (Sec. 1515) Provides for planning grants to States for implementation assistance. (Sec. 1521) Provides for the Federal assumption of responsibilities in the absence of a State system. Provides for increased premiums of 15 percent during Federal operation of a State system to provide reimbursement for the Federal cost of operating the system. (Sec. 1541) Directs the Board to develop a risk adjustment and reinsurance methodology. Sets forth guidelines for developing such methodology. (Sec. 1543) Directs the Board to establish an advisory committee to provide technical advice and recommendations regarding the risk adjustment and reinsurance methodology. (Sec. 1551) Directs the Board to establish minimum capital requirements for regional alliance health plans under which at least $500,000 of capital must be maintained for each plan in the area. Permits the Board to require additional capital. (Sec. 1552) Requires the Board to establish standards for guaranty funds established by the States. (Sec. 1571) Sets forth the responsibilities of the Secretary of Health and Human Services. Directs the Secretary to administer and implement all provisions of this Act, except those duties delegated to the Board, any other executive agency, or to any State. (Sec. 1572) Directs the Secretary to appoint an Advisory Council on Breakthrough Drugs that will examine the reasonableness of launch prices of new breakthrough drugs. (Sec. 1581) Provides for the certification of essential community providers. Sets forth the following categories of providers automatically certified (under provisions of the Public Health Service Act): (1) migrant health centers; (2) community health centers; (3) homeless program providers; (4) public housing providers; (5) family planning clinics; and (6) AIDS providers under the Ryan White Act. Includes as automatically certified (under other Acts) following: (1) Indian health programs under the Indian Health Act; and (2) maternal and child health providers and a federally qualified health center or rural health clinic under the Social Security Act. Includes as automatically certified (under provisions of this Act) the following: (1) providers of school health services; and (2) a qualified community practice network. Provides for the setting of standards for additional health providers. (Sec. 1591) Sets forth the responsibilities of the Secretary of Labor. Includes among those responsibilities the following: (1) enforcement requirements applicable to employers; (2) elections to become corporate alliances; (3) temporary assumption of insolvent self-insured corporate alliance health plans; (4) establishment and administration of the Corporate Alliance Health Plan Insolvency Fund; and (5) administering title I of ERISA as it relates to group health plans maintained by corporate alliances. Subtitle G: Employer Responsibilities - Requires employers to provide for the payments required under title VI of this Act. Sets forth other employer responsibilities including: (1) information reporting requirements; (2) requirements relating to new employees; (3) recordkeeping requirements; and (4) antidiscrimination requirements. (Sec. 1606) Prohibits self-funding of cost sharing benefits by regional alliance employers. (Sec. 1607) Requires an employer to make equal employer premium payments to all qualifying employees, if a voluntary premium payment is made. Places a limit on such voluntary employer premium payments. (Sec. 1608) Sets forth an employer's obligation to a qualifying retired beneficiary where the employer, as of October 1, 1993, was providing a threshold payment. (Sec. 1609) Authorizes the Secretary of Labor to impose a civil penalty of up to $10,000 for each violation of this subtitle with respect to each individual. Subtitle J (sic): General Definitions; Miscellaneous Provisions - Sets forth the definitions and rules used in this Act. Subtitle B: Miscellaneous Provisions (sic) - (Sec. 1911) Grants the National Health Board, the Secretary of Health and Human Services, and the Secretary of Labor authority to issue regulations as necessary to permit the timely implementation of this Act. Title II: New Benefits - Subtitle A: Medicare Outpatient Prescription Drug Benefit - (Secs. 2001 through 2005) Amends title XVIII of the Social Security Act to provide for: (1) Medicare coverage of covered outpatient prescription drugs and biologicals as well as home infusion drug therapy services; (2) payment rules and related requirements, such as those pertaining to deductibles, for covered outpatient prescription drugs; (3) manufacturer rebates to the Secretary under Medicare part B for covered outpatient prescription drugs; and (4) determination of the Medicare part B premium attributable to covered outpatient prescription drugs. Subtitle B: Long-Term Care - Establishes requirements for State plans for home and community-based services to individuals with disabilities. Includes among those requirements the following: (1) a prohibition of limiting eligibility of individuals with disabilities based on income, age, geography, severity of disability, residential setting, or other grounds specified by the Secretary; (2) a requirement to serve low-income individuals; (3) a requirement to specify how Federal and State funds will be managed; (4) quality assurance requirements; and (5) reporting requirements. Requires a State to consult with individuals and groups of individuals with disabilities when developing the plan in order to have the plan approved. (Sec. 2103) Defines "individuals with disabilities" to mean any individual within one or more of the following four categories: (1) individuals requiring help with the activities of daily living; (2) individuals with severe cognitive or mental impairment; (3) individuals with severe or profound mental retardation; and (4) severely disabled children. (Sec. 2104) Requires a State plan to specify the services available. Requires each individualized plan to be developed in close consultation with the individual and the individual's family. Prohibits a State plan from covering: (1) room and board; (2) services furnished in a hospital, nursing facility, intermediate care facility for the mentally retarded, or other specified institutional setting; or (3) items or services to the extent coverage is provided for an individual under a health plan or Medicare. (Sec. 2105) Sets forth provisions relating to: (1) cost sharing; (2) quality assurance and safeguards; (3) advisory groups; (4) payments to States; and (5) the total Federal budget for State plans and allotments to States. (Sec. 2301) directs the Secretary, with the advice and assistance of the National Long-Term Care Insurance Advisory Council to promulgate regulations as necessary to implement provisions concerning private long-term care insurance. Directs the Secretary to make appointments to such Council. Authorizes appropriations for such Council. (Sec. 2321) Directs the Secretary, after considering the Council's recommendations to promulgate regulations designed to: (1) standardize formats and terminology used in long-term care policies; (2) require insurers to provide information to customers on the range of public and private long-term care coverage available; and (3) establish other requirements promoting consumer understanding of benefits. (Sec. 2322) Directs the Secretary to promulgate regulations establishing requirements with respect to the terms of and benefits under long-term care policies, which shall include the following requirements that the policy may not: (1) limit coverage based on a preexisting condition, subject to an exception for a six month period; (2) condition eligibility for benefits based on the need or receipt of any other service; (3) condition eligibility for any benefit on any particular diagnosis; (4) condition eligibility for benefits by providers on compliance with requirements not required by State or Federal law; and (5) condition coverage of any service by a provider on the provision of such service at a higher level of care than required by the insured individual. Prohibits discrimination by diagnosis in the treatment of: (1) Alzheimer's disease; (2) any organic or inorganic mental illness; (3) mental retardation or any other cognitive or mental impairment; or (4) HIV infection or AIDS. Sets forth other requirements for such policies, including requirements related to: (1) premiums; (2) sales practices; (3) continuation, renewal, replacement, conversion, and cancellation of policies; and (4) payment of benefits. (Sec. 2342) Provides for grants to States to enforce the Federal standards concerning long-term care policies. Sets forth requirements for receiving such grants. Authorizes appropriations. Prohibits the sale of a long-term care policy in a State without a regulatory program. (Sec. 2361) Authorizes the Secretary to make grants for the development and implementation of long-term care information, counseling, and other programs to: (1) States; (2) regional alliances (at the option of States within which such alliances are located; and (3) national organizations representing insurance consumers, long-term care providers, and insurers. Authorizes appropriations for such grants. (Sec. 2601) Authorizes the Secretary to conduct a demonstration program to test the effectiveness of various approaches to financing and providing integrated acute and long-term care services for the chronically ill and disabled. Sets forth the services and benefits to be provided, including: (1) all benefits of the comprehensive benefit package provided under title I of this Act; (2) transitional benefits, including assessment and home care; (3) long-term care benefits, including adult day care, home-delivered meals, and nursing facility services in specialized care units; and (4) habilitation services. Permits any of the following to be eligible for such services under criteria to be established by the Secretary: (1) individuals with disabilities under a State program; (2) individuals entitled to benefits under the Medicare program; and (3) individuals entitled to Medicaid and who are also either entitled to Medicare or Supplemental Security Income benefits. Requires reports to the Congress on the demonstration program. Title III: Public Health Initiatives - Subtitle A: Workforce Priorities Under Federal Payments - Establishes within the Department of Health and Human Services the National Council on Graduate Medical Education. Directs the National Council to designate for each academic year the number of individuals nationwide who are authorized to be enrolled in each specified approval physician training program for each medical specialty. Sets forth provisions specifying: (1) Federal formula payments to approved physician training programs; (2) application for payments; and (3) amount of payments. (Sec. 3061) Directs the Secretary to carry out a program with respect to graduate nurse training programs that is equivalent to the program for approved physician training programs. Establishes a National Council on Graduate Nurse Education. (Sec. 3071) Authorizes appropriations for the following programs: (1) primary care physician and physician assistant training; (2) training of underrepresented minorities and disadvantaged persons; and (3) nurse training. (Sec. 3072) Authorizes appropriations for the following programs: (1) a program of skill upgrading and occupational retraining for health care workers; (2) a demonstration program to assist workers in health care institutions in obtaining advanced career positions; (3) a program to develop and operate health-worker job banks in local employment services agencies, subject to certain conditions; (4) a program to provide joint labor-management decision-making in the health care sector on workplace matters related to the restructuring of the health care delivery system of this Act; and (5) a program to facilitate the comprehensive workforce adjustment initiative. (Sec. 3073) Directs the Secretary of Health and Human Services and the Secretary of Labor to jointly establish the National Institute for Health Care Workforce Development. States that the Director of the Institute shall make recommendations to the Secretaries regarding: (1) the supply of health care workers; (2) the impact of this Act; and (3) the development and implementation of high-performance, high-quality health care delivery systems. Directs the Secretaries to establish an advisory board to assist in the development of such recommendations. Subtitle B: Academic Health Centers - Directs the Secretary to make payments to a qualified academic health center or qualified teaching hospital in order to assist such eligible institutions with costs that are not routinely incurred by other entities in providing health services, but are incurred by such institutions by virtue of the academic nature of such institutions. States that such costs include: (1) costs resulting from reduced staff productivity due to teaching responsibilities; (2) the uncompensated costs of clinical research; and (3) exceptional costs associated with an institutions specialized expertise. Provides that the funding for such payments will come from transfers from the Federal Hospital Insurance Trust Fund, payments made by regional alliances to the Federal government for academic health centers and graduate medical education, and payments from corporate alliances. (Sec. 3131) Provides for the access of regional and corporate alliance patients to academic health centers. Subtitle C: Health Research Initiatives - Amends the Public Health Service Act to ensure that the National Institutes of Health conducts and supports biomedical and behavioral research on promoting health and preventing diseases, disorders, and other health conditions. Provides for health services research. Authorizes appropriations for such research. Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health - Authorizes appropriations for the core functions of public health programs and national initiatives regarding health promotion and disease prevention. (Sec. 3312) Authorizes the Secretary to make grants to States to carry out one or more of the following core functions: (1) data collection; (2) activities to protect the environment and to assure the safety of housing, workplaces, and food and water; (3) investigation and control of adverse health conditions; (4) public information and education programs to reduce risks to health such as use of tobacco, alcohol, and drugs, sexual activities that increase the risk of HIV transmission and other sexually transmitted diseases, poor diet, physical inactivity, and low childhood immunization levels; (5) accountability and quality assurance activities; (6) provision of public health laboratory services to complement private clinical laboratory services that screen for diseases and conditions; (7) training and education to assure provision of care by all health professionals; and (8) leadership policy development and administrative activities. (Sec. 3331) Authorizes the Secretary to make grants to agencies of State or local government, private nonprofit organizations, and coalitions that link two or more of these groups for the purpose of carrying out projects to develop and implement innovative community-based strategies to provide for health promotion and disease prevention activities for which there is a significant need. Subtitle E: Health Services for Medically Underserved Populations - Directs the Secretary to make grants to migrant health centers and community health centers, which shall be in addition to other funds available to such centers. Authorizes appropriations. (Sec. 3412) Authorizes appropriations for: (1) grants and contracts for the development of qualified community health plans and practice networks; and (2) loans and guaranteeing the principal and interest to Federal and non-Federal lenders on behalf of public and private entities for the capital costs of developing qualified community health plans and practice networks. (Sec. 3461) Authorizes the Secretary to make grants and enter into contracts with qualified community health groups to provide enabling services such as transportation, community and patient outreach, patient education, and translation services in order to increase the capacity of individuals to utilize the items and services under title I of this Act. Authorizes appropriations. (Sec. 3471) Authorizes appropriations for: (1) the National Health Service Corps; and (2) such amounts as are necessary to ensure that at least 20 percent of participants in the Scholarship Program or the Loan Repayment Program of the Corps are nurses. (Sec. 3481) Entitles a hospital with a low-income utilization rate in a base year of at least 25 percent to a payment as specified. Requires 75 percent of the total available to be allocated to hospitals for low-income assistance. Requires 25 percent of the total available to be allocated to hospitals for assistance in furnishing inpatient hospital services that are not covered services under title I of this Act. Subtitle F: Mental Health; Substance Abuse - Authorizes appropriations to carry out this part. Provides for grants to: (1) increase access to mental health and substance abuse services; (2) improve State and local capacity to coordinate and monitor such services; (3) provide incentives to integrate public and private service systems; and (4) supplement any activity under part B (Alcohol and Drug Abuse and Mental Services Block Grant) of title XIX of the Public Health Service Act. (Sec. 3503) Authorizes the Secretary to make loans for the capital costs incurred in the development of non-acute, residential treatment centers and community-based ambulatory clinics. (Sec. 3521) Requires the establishment of a pilot program demonstrating the integration of the mental illness and substance abuse services of the States with the services included under title I of this Act. Subtitle G: Comprehensive School Health Education; School-Related Health Services - Authorizes appropriations for the programs of this subtitle. States that the purposes of the programs shall be to: (1) support, in kindergarten through grade 12, the provision of comprehensive health educator programs; (2) establish a national framework within which States can create comprehensive school health education programs that target the health risk behaviors of youth, including tobacco use, alcohol and drug abuse, sexual behaviors resulting in infections, injury prevention, dietary patterns, and sedentary lifestyles; (3) pay the initial costs of planning and establishing such programs; (4) support related Federal demonstrations and training; (5) motivate youth to stay in school, avoid teen pregnancy, and strive for success; (6) improve the knowledge of health education among youth; and (7) further the National Education Goals set forth in title I of the Goals 2000: Educate America Act. Defines "comprehensive school health education program." Requires such programs to be sensitive to cultural and ethnic issues, promote involvement by families, and promote personal responsibility. Sets forth requirements for applying for grants and selection of grantees. Subtitle H: Public Health Service Initiative - Establishes a Public Health Service Initiative consisting of specified amounts authorized to be appropriated for the Initiative. States that: (1) the Initiative includes the programs of subtitles C through G of this title and the programs of subtitle D of title VIII; and (2) amounts appropriated to carry out the Initiative, including subtitles A through F of this title, are available to carry out specific programs for which the amounts are appropriated. Subtitle I: Coordination with COBRA Continuation Coverage - Amends title XXII (Requirements for Certain Group Health Plans for Certain State and Local Employees) of the Public Health Service Act to provide for coordination with COBRA continuation coverage. Repeals such title XXII upon implementation of this Act. Title IV: Medicare and Medicaid - Subtitle A: Medicare and the Alliance System - Amends title XVIII (Medicare) of the Social Security Act to provide for optional State integration of Medicare beneficiaries into regional alliance plans. (Sec. 4002) Allows individuals to elect to remain in certain plans. (Sec. 4003) Provides for payments to regional alliances on behalf of certain Medicare-eligible individuals. (Sec. 4004) Extends protections for working aged and disabled individuals to group health plans of all employers. Repeals the limitation on the period of protection for individuals with end stage renal disease. Prohibits Medicare payment for items and services provided under any health plan under this Act. Simplifies Medicare benefit coordination in cases where the individual is also eligible for benefits under this Act's health plans. (Sec. 4011) Makes various changes concerning eligible organization and Medicare supplemental policy enrollment and comparative informational materials, eligible organization outlier payments, and participating provider point-of-service networks. (Sec. 4022) Provides for expanded Medicare coverage for physician assistant, nurse practitioner, and clinical nurse specialist services. (Sec. 4031) Amends title XI of the Social Security Act to: (1) provide for termination of the separate Medicare peer review program upon adoption of the National Quality Management Program above under subtitle A of title V of this Act; and (2) repeal provisions on surgical procedure review and second opinions. (Sec. 4032) Amends title XVIII of the Social Security Act to provide for mandatory assignment for all Medicare part B services. (Sec. 4033) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate administration of Medicare parts A and B and supersedes certain conflicting requirements to the extent required to achieve such purpose. (Sec. 4035) Prohibits the Secretary from implementing any change in procedures for billing and processing Medicare claims within six months of implementing any previous change. Adds advanced notification to providers as a requirement for carriers and fiscal intermediaries under Medicare. (Sec. 4041) Amends title XI of the Social Security Act to: (1) provide for civil monetary penalties for kickback violations under Medicare and State health care programs (the programs); (2) make other penalty-related changes, including increases in criminal and civil monetary penalties, a new criminal penalty exception for certain providers, additional civil monetary penalty offenses related to alliance systems, and requirements for the deposit of penalties collected into the All-Payer Account established above under title V of this Act; (3) revise exclusion provisions, with changes establishing a minimum period of exclusion for certain individuals and entities subject to permissive exclusion from the programs, and providing for program exclusions based on actions under alliance systems; and (4) modify sanction provisions, with changes removing certain conditions for imposing sanctions and setting specified civil money penalties for use in lieu of authorized sanctions. (Sec. 4042) Amends title XVIII of the Social Security Act to revise the limitations on physician self-referrals. (Sec. 4051) Provides for the termination of payments under Medicare for medical education costs and directs the Secretary to make specified transfers from certain Medicare trust funds to the new accounts established above for funding physician training programs and academic health centers. (Sec. 4061) Amends title XVIII of the Social Security Act to provide for the treatment of: (1) uniformed services and VA health plans as eligible organizations under Medicare; and (2) health care facilities of the Department of Veterans Affairs as providers under Medicare. Subtitle B: Savings in Medicare Program - Amends title XVIII of the Social Security Act to provide for: (1) reductions in the update for inpatient hospital services and the adjustment for indirect medical education costs, in payments for capital-related costs for inpatient hospital services; (2) revisions to payment adjustments for disproportionate share hospitals in States participating under this Act; and (3) an extension of the freeze on updates to routine service costs of skilled nursing facilities. (Sec. 4111) Amends title XVIII of the Social Security Act to provide for: (1) establishment of cumulative expenditure goals for physician services; (2) use of real gross domestic product for volume adjustments; (3) repeal of restrictions on the maximum reduction permitted in default update; (4) reduction in the conversion factor for the physician fee schedule for 1995; (5) place limitations on payment for physicians' services furnished by high-cost hospital medical staffs; (6) requirements for physicians to identify the hospital at which the service was furnished; (7) an increase in practice expense relative value units for certain services while assuring budget neutrality; (8) a study and report to the Congress by the Secretary on a resource-based system for determining practice expense relative value units for each physician's service; (9) an increase in work relative value units for office visits while assuring budget neutrality; (10) a reduction in relative values for office consultations; (11) adjustment of outlier intensity of relative values; (12) changes in underserved area bonus payments; (13) elimination of formula-driven payments for certain outpatient hospital services; (14) copayments for laboratory services; and (15) competitive acquisition procedures for Medicare part B items and services (including clinical diagnostic laboratory tests). (Sec. 4131) Makes changes with respect to: (1) Medicare as secondary payer; (2) payments for health maintenance organizations and competitive medical plans with risk-sharing contracts; and (3) routine cost limits and copayments for, respectively, home health services and visits. (Sec 4135) Directs the Secretary to use a competitive process to contract with centers of excellence for cataract surgery, coronary artery by-pass surgery, and such other services as the Secretary determines to be appropriate. (Sec. 4141) Amends title XVIII of the Social Security Act to revise Medicare part B premium provisions. (Sec. 4151) Requires the Secretary to submit a report to the Congress on the growth in spending under Medicare for FY 2000 through 2003. Subtitle C: Medicaid - Amends title XIX (Medicaid) of the Social Security Act to provide that if a State Medicaid plan provides for payment to regional alliances of the amounts required above it is not required to provide payment for items and services covered under the comprehensive benefit package for alliance eligible individuals and will receive no Federal financial assistance with respect to such items and services. (Sec. 4211) Provides for: (1) spenddown eligibility and increased income and resource disregard for nursing facility residents; (2) informing such residents about the availability of assistance for home and community-based services; (3) treatment of items and services not covered under the comprehensive benefit package; and (4) establishment of a program under Medicare of noncovered items and services for poor children. (Sec. 4231) Discontinues certain payment policies under Medicaid. (Sec. 4241) Limits the frequency of changes in a State's billing and claims processing system, and provides for advance notification to providers of any major billing change. (Sec. 4251) Establishes the Medicaid Commission to study, report, and make recommendations with respect to options involving block grant use, integration of long-term care services, and consolidation of institutional and home- and community-based long-term care in relation to the Medicaid program. Authorizes appropriations. Subtitle D: Increase in SSI Personal Needs Allowance - Amends title XVI (Supplemental Security Income) (SSI) to provide for an increase in the SSI personal needs allowance. Title V: Quality and Consumer Protection - Subtitle A: Quality Management and Improvement - Requires the National Health Board to establish and oversee a performance-based program of quality management and improvement designed to enhance the quality, appropriateness, and effectiveness of heath care services and access to such services which will be called the National Quality Management Program. (Sec. 5002) Establishes the National Quality Management Council which shall: (1) administer the National Quality Management Program; (2) perform any other duty specified in this subtitle; and (3) advise the National Health Board with respect to its duties under this subtitle. Requires the Council to develop a set of national measures of quality performance to be used in the assessment of and the provision of access to health care services. Requires the Council, in addition, to: (1) recommend to the Board establishing goals for performance by health plans and health care providers on a subset of national measures of quality performance; (2) direct the Administrator for Health Care Policy and Research to develop, review, and disseminate practice guidelines to determine how diseases can most effectively be prevented, diagnosed, treated, and managed; and (3) direct the Administrator for Health Care Policy and Research to support research related to a five year priority list of performance measures. (Sec. 5008) Directs the National Health Board to: (1) establish and oversee regional professional foundations to perform such duties as develop lifetime learning programs for health professionals and conduct research on health care quality; and (2) establish the National Quality Consortium to perform such duties as establishing continuing education for health professionals and provide advice on research priorities. (Sec. 5012) Requires each regional alliance and each corporate alliance to: (1) disseminate specified information to consumers; and (2) ensure that performance and quality standards are continually improved. Subtitle B: Information Systems, Privacy, and Administrative Simplification - Directs the National Health Board to develop and implement a health information system, in consultation with Federal agencies, States, employers, health plans, and others, by which the Board shall collect, report, and regulate the collection and dissemination of health care information which shall be used for: (1) health care planning by Federal, State, and local government; (2) establishing and monitoring payments for health services; (3) assessing and improving the quality of health care; (4) managing and containing costs at the alliance and plan levels; and (5) other specified purposes. Requires the establishment of an electronic data network to collect, compile, and transmit information. (Sec. 5120) Sets forth provisions providing for health information privacy standards. (Sec. 5130) Directs the National Health Board to develop the following standard health care benefit forms: (1) an enrollment and disenrollment form; (2) a clinical encounter record; and (3) a claim form. (Sec. 5140) Establishes the National Privacy and Health Data Advisory Council in order to advise the National Health Board with respect to its duties under this subtitle. (Sec. 5141) Sets forth monetary penalties for violating health information system standards. Subtitle C: Remedies and Enforcement - Sets forth provisions with respect to the review of benefit determinations for enrolled individuals, including provisions: (1) regulating the time limits for notice of disposition of a claim; (2) governing a plan's duty to review claim denials; (3) concerning urgent requests for preauthorization; and (4) concerning other time limits with respect to time limits and notice. (Sec. 5202) Requires each State to establish a complaint review office for each regional alliance established by a State. Permits aggrieved individuals to file complaints with the appropriate review office. (Sec. 5205) Provides for a Federal Health Plan Review Board to review the decisions of complaint review office hearing officers. (Sec. 5207) Sets monetary penalties for a plan which unreasonably denies or delays payment or provision of benefits. (Sec. 5211) Directs each State to establish and maintain an Early Resolution Program in each complaint review office. Requires a program to include: (1) forums for mediation disputes; and (2) other forums of alternative dispute resolution as may be prescribed. Establishes guidelines for the eligibility of cases for submission to the Early Resolution Program. States that conclusions of the mediation proceedings shall be treated as nonbinding and shall not affect any rights to review. (Sec. 5231) Sets forth additional remedies and enforcement provisions. Subtitle D: Medical Malpractice - Prohibits any medical malpractice liability action until the final resolution of the claim under alternative dispute resolution. Requires each regional alliance health plan and corporate alliance health plan to adopt at least one specified method of alternative dispute resolution. Prohibits an individual from bringing a medical malpractice liability action unless the individual submits an affidavit that includes a report by a qualified specialist that states that there is a meritorious cause for filing the action. (Sec. 5311) Directs the Secretary to establish: (1) a project to demonstrate whether substituting liability for medical malpractice on the part of the health plan in which a physician participates for the personal liability of the physician will result in improvements in the quality of care, reductions in defense medical practices, and better risk management; (2) a pilot program under which the Secretary provides funds to one or more eligible States to determine the effect of applying practice guidelines in the resolution of medical malpractice liability actions. Subtitle E: Fraud and Abuse - Directs the Secretary and the Attorney General to establish a program: (1) to coordinate the functions of the Attorney General, the Secretary, and other organizations with respect to the prevention, detection, and control of health care fraud and abuse; (2) to conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for health care; and (3) to facilitate the enforcement of this and other statutes applicable to health care fraud. (Sec. 5402) Creates, in the Treasury, the All-Payer Health Care Fraud and Abuse Control Account which shall consist of: (1) gifts and bequests; (2) administrative penalties and assessments and portions of civil monetary penalties imposed under provisions of the Social Security Act; (3) all criminal fines imposed in cases involving a Federal health care offense; (4) penalties imposed under the False Claims Act involving claims related to the provision of health care items and services; and (5) amounts resulting from the forfeiture of property by reason of Federal health care offense. States that amounts in the fund may be used to cover costs incurred in operating the Program. (Sec. 5411) Excludes from participation in any health plan any individual or entity excluded from participation in a public program under provisions of the Social Security Act. (Sec. 5413) Sets forth physician self-referral limitations. (Sec. 5431) Amends the Federal criminal code to set penalties for knowingly executing a scheme or artifice to: (1) defraud any health alliance, health plan, or other person (alliance) in connection with the delivery of, or payment for, health care benefits, items, or services (benefits); and (2) obtain, by false or fraudulent means, money or property owned by, or under the custody of control of, any such alliance in connection with the delivery of, or payment for, health care benefits. (Sec. 5432) Amends: (1) the Federal criminal code to require the court, in imposing sentence on a person convicted of a Federal health care offense that poses a serious threat to the health of any person or has a significant detrimental impact on the health care system, to order such person to forfeit property used in the commission of the offense or that constitutes, or is derived from, proceeds traceable to the commission of the offense which is of a value proportionate to the seriousness of the offense; and (2) the Federal judicial code to require that all proceeds of forfeiture relating to Federal health care offenses be deposited into the Department of Justice Assets Forfeiture Fund. (Sec. 5433) Amends the Federal criminal code to set penalties for: (1) knowingly and willfully falsifying, concealing, or covering up a material fact, making any false, fictitious, or fraudulent statements or representations, or making or using any false writing or document knowing it to contain any false, fictitious, or fraudulent statement or entry, in any matter involving a health alliance or health plan; and (2) bribery of, and graft by, a health care official. (Sec. 5435) Authorizes: (1) the Attorney General to commence a civil action in Federal court to enjoin a Federal health care offense; and (2) a person privy to certain grand jury information concerning a health law violation to disclose that information to an attorney for the Government to use in any civil proceeding related to a Federal health care offense. (Sec. 5437) Sets penalties for: (1) theft or embezzlement in connection with a health alliance, health plan, or fund connected with such alliance or plan; and (2) misuse of a health security card issued, or unique identifier provided, pursuant to this Act. (Sec. 5441) Makes provisions of the Civil False Claims Act applicable to the use of false records or statements made to a health plan. Includes within the definition of "claim" for purposes of such Act any request or demand for money or property which is made or presented to a health plan. Subtitle F: McCarran-Ferguson Reform - Amends the McCarran-Ferguson Act to repeal the exemption under specified antitrust laws for the business of insurance to the extent that such business relates to the provision of health benefits. Title VI: Premium Caps; Premium-Based Financing; and Plan Payments - Subtitle A: Premium Caps - Sets forth provisions which provide for the computation of factors that limit the growth of premiums for the comprehensive benefit package in regional alliance health plans, including the computation of a: (1) regional alliance inflation factor; and (2) general health care inflation factor. (Sec. 6002) Directs the Board to determine: (1) a national per capita baseline premium target; (2) the national average per capita current coverage health expenditures; and (3) current health care expenditures. (Sec. 6003) Directs the Board to determine a regional alliance per capita premium. (Sec. 6004) Requires a regional alliance to annually obtain premium bids from each plan seeking to participate as a regional alliance health plan with respect to the alliance. (Sec. 6005) Permits any participating State to assume responsibility for containment of health care expenditures in the State consistent with this Act. (Sec. 6006) Directs the chair of the Board to establish an advisory commission on regional variations in health expenditures. Requires the commission to examine methods of eliminating variation in regional alliance per capita premium targets due to variation in practice patterns, not due to other factors. Requires the Board to submit its recommendations to the Congress. Requires such recommendations to apply unless a joint resolution of disapproval is passed. (Sec. 6011) Subjects each noncomplying regional alliance health plan for a year to a reduction in plan payment as specified, in order to assure that payments to regional alliance health plans by a regional alliance are consistent. Defines a noncomplying plan to include a plan in which the final accepted bid exceeds the maximum complying bid for the per capita target premium. Defines "maximum complying bid." (Sec. 6021) Directs the Board to develop a methodology for calculating an annual per capita expenditure equivalent for amounts paid for coverage for the comprehensive benefit package within a corporate alliance. (Sec. 6022) Terminates a corporate alliance with two excess years in a three year period. Provides that employers that were corporate alliance employers with respect to a terminated alliance shall become regional alliance employers. Defines an excess year as one in which the rate of increase for the corporate alliance exceeds the national corporate inflation factor. Defines rate of increase and national corporate inflation factor. (Sec. 6031) Sets forth special rules for a single-payer State. (Sec. 6041) Directs the Secretary to establish a program to monitor prices and expenditures in the U.S. health care system. Subtitle B: Premium-Related Financings - Makes each family enrolled in a regional health alliance plan or in a corporate alliance health plan in a class of family enrollment responsible for payment of the family share of premium payable for enrollment. Provides for income related discounts and specified credits. (Sec. 6102) Establishes the formula for determining the premiums. (Sec. 6111) Provides for the repayment of credit by certain families. (Sec. 6114) Provides for the special treatment of certain retirees and qualified spouses and children. (Sec. 6121) Requires each regional alliance employer to pay a monthly premium to the regional alliance for a qualifying employee. Sets forth provisions for determining such premium. Varies the premium depending upon such factors as the employer's size and average wages paid. (Sec. 6126) Sets forth provisions applicable to self-employed individuals. (Sec. 6131) Sets forth provisions for determining the corporate employer premium. Subtitle C: Payments to Regional Alliance Health Plans - Sets forth provisions to determine the computation of: (1) the blended plan per capita payment amount; and (2) the plan bid, AFDC, and SSI proportions. Title VII: Revenue Provisions - Subtitle A: Financing Provisions - Amends the Internal Revenue Code to increase the excise taxes on cigarettes and other tobacco products. (Sec. 7113) Imposes an excise tax on the manufacture or importation of roll-your-own tobacco. (Sec. 7121) Imposes an assessment on each corporate alliance employer and a temporary assessment on employers with retiree health benefit costs. Requires such assessments to be paid in the same manner as employment taxes. (Sec. 7131) Provides for the recapture of certain health care subsidies received by high-income individuals. Transfers such amounts to the Supplemental Medical Insurance Trust Fund. (Sec. 7141) Requires certain shareholders of S corporations and limited partners who materially participate in corporate activities to include their share of income or loss from such corporation when determining net earnings from self-employment. (Sec. 7142) Provides for extending Medicare coverage and applying the hospital insurance tax to all State and local government employees. Subtitle B: Tax Treatment of Employer-Provided Health Care - Provides exceptions to the exclusion of employer-provided contributions to an accident or health plan from the gross income of an employee. (Sec. 7202) Prohibits the provision of health benefit under cafeteria plans. (Sec. 7203) Makes permanent the deduction for health insurance costs of self-employed individuals. Increases such deduction to 100 percent of the basic coverage purchased from a health alliance with limitations. Subtitle C: Employment Status Provisions - Requires the Secretary of the Treasury to prescribe regulations defining an employee for employment tax purposes. (Sec. 7302) Increases the penalty for failure to file correct returns involving payments for services. (Sec. 7303) Sets forth rules to limit retroactive employment tax reclassifications. Subtitle D: Tax Treatment of Funding of Retiree Health Benefits - Requires additional reserves for post-retirement medical and life insurance benefits to cover not less than ten years of the working lives of covered employees and to be maintained as separate accounts. (Sec. 7402) Terminates the authority of pension plans to maintain health benefits accounts. Subtitle E: Coordination with COBRA Continuing Care Provisions - Repeals provisions concerning continuation coverage requirements of group health plans upon implementation of this Act. Subtitle F: Tax Treatment of Organizations Providing Health Care Services and Related Organizations - Provides for the tax treatment of charitable organizations providing health care services, insurance provided by health maintenance organizations, and certain private foundations. (Sec. 7602) Sets forth transitional rules for taxing certain organizations providing health insurance and other prepaid health care services as insurance companies other than life insurance companies. (Sec. 7603) Exempts regional alliances from income tax. Subtitle G: Tax Treatment of Long-term Care Insurance and Services - Treats qualified long-term care services as medical care for purposes of the medical expense deduction. (Sec. 7702) Provides for the treatment of long-term care insurance as accident and health insurance. (Sec. 7703) Allows accelerated death benefits under life insurance contracts to be paid to terminally ill individuals. Subtitle H: Tax Incentives for Health Service Providers - Allows a tax credit for certain qualified individuals who provide primary health services full time in a health professional shortage area. (Sec. 7802) Increases the allowable depreciation deduction for expensing certain medical equipment. Subtitle I: Miscellaneous Provisions - Allows a tax credit for the cost of personal assistance services required by an employed individual who for medical reasons is unable to engage in substantial gainful activity. (Sec. 7902) Denies tax-exempt status for private activity bonds of regional alliances, corporate alliances, or guaranty funds established under this Act. Title VIII: Health and Health-Related Programs of the Federal Government - Subtitle A: Military Health Care Reform - Directs the Secretary of Defense to establish one or more uniformed services health plans in order to provide health care services to members of the armed forces on active duty for 30 or more days as well as their covered beneficiaries. Requires conformity of such plans with health plan requirements set forth in this Act. (Sec. 8001b) Allows any such plan to rely upon the use of military health care facilities, supplemented by civilian health care providers or health plans under agreements entered into by the Secretary. Requires at least the items and services in the comprehensive benefit package under this Act to be included in each such plan. Preempts any conflicting State health plan requirements. Provides for plan enrollment, effect of failure to enroll, and choosing between a uniformed services health plan and other available plans. Prohibits the imposition of plan charges to an active-duty member other than subsistence charges, but allows the Secretary to impose limited charges for covered beneficiaries. Establishes in the Department of Defense a financial account for payments received in connection with a uniformed services health plan, allowing such funds to be used only for purposes directly related to the delivery and financing of health care services under this Subtitle. Subtitle B: Department of Veterans Affairs - Allows each veteran who is an eligible individual under this Act and individuals currently enrolled in a health plan under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to be enrolled with a Department of Veterans Affairs (VA) health plan. Requires conformity of such plans with health plan requirements set forth in this Act, with all the items and services of the comprehensive benefit package under this Act included. Allows such plans to offer supplemental health benefits and cost-sharing policies as consistent with this Act. Provides a limitation with regard to veterans enrolled with health plans outside the VA. Prohibits the imposition of any plan enrollment charges upon service-connected disabled veterans, veterans receiving disability compensation from the VA, former prisoners of war, and veterans unable to defray the costs of such care. Allows the Secretary of Veterans Affairs to establish plan charges for other veterans. Deems a VA facility to be a Medicare provider for purposes of any program administered by the Secretary of Health and Human Services. Allows for the recovery of certain care and services provided under a VA plan in the case of an individual who has coverage under another plan. Establishes in the Treasury the Department of Veterans Affairs Health Plan Fund to be used for VA health plan payments and services. Preserves existing benefits for VA facilities not operating within a health plan certified under this Act. (Sec. 8102) Directs the Secretary of Veterans Affairs to organize health plans and operate VA facilities as, or within, health plans under this Act. Preempts existing State health plan standards or requirements. Authorizes the Secretary to contract for the provision of services by a VA health plan when cost-effective, or to share resources with other health care plans, providers, or organizations. Authorizes appropriations to the VA for FY 1995 through 1997 for VA health plans under this Subtitle, subject to availability of appropriations. Requires a report from the Secretary to the Congress concerning the operation of the VA health care system within the requirements of this Act. Authorizes the Secretary to accept and use grants for health care services provided to special populations if used by the VA while operating under a VA health plan. Subtitle C: Federal Employees Health Benefits Programs - (Secs. 8202 through 8204) Provides for termination of the Federal Employees Health Benefits Program (FEHB) and treatment of Federal employees, annuitants, and other individuals (including those residing abroad) who would otherwise have been eligible for FEHBP under this Act's health plans. Subtitle D: Indian Health Service - Makes qualifying Indians eligible to enroll in a comprehensive benefits health program of the Indian Health Service. (Sec. 8303) Authorizes appropriations for supplemental Indian health care benefits. (Sec. 8305) Exempts tribal governments and organizations from making employer payments. (Sec. 8306) Sets forth provisions regarding health service to non-enrollees and non-Indians. (Sec. 8311) Requires each health program of the Indian Health Service to establish a comprehensive benefit package fund. (Sec. 8313) Authorizes appropriations for the Indian Health Service programs. Subtitle E: Amendments to the Employee Retirement Income Security Act of 1974 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to revise and limit the coverage of group health plans under ERISA. Makes certain ERISA provisions inapplicable with respect to State-certified health plans. Provides for an exception from ERISA civil action provisions where review is otherwise available under the Health Security Act (this Act, HSA). (Sec. 8402) Establishes ERISA requirements for expeditious reporting and disclosure applicable to group health plans, through special rules consistent with ERISA and HSA purposes. Excludes plans maintained by regional alliances from treatment as multiple employer welfare arrangements. (Sec. 8403) Revises certain ERISA provisions relating to continuation coverage under group health plans. Repeals such provisions upon implementation of HSA. (Sec. 8404) Makes ERISA standards for group health plans regarding: (1) cases of adoption applicable except to the extent otherwise provided in regulations of the National Health Board under HSA; and (2) coverage of pediatric vaccines inapplicable to a group health plan upon its becoming a corporate alliance health plan under HSA. (Sec. 8405) Requires group health plans under ERISA to comply with HSA requirements relating to health plan claims procedure. Subtitle F: Special Fund for WIC Program - Authorizes appropriations through FY 2000 for the special supplemental food program for women, infants, and children under the Child Nutrition Act of 1966. Title IX: Aggregate Government Payments - Subtitle A: Aggregate State Payments - Sets forth provisions which have formulas for determining each participating State's payment to regional alliances within the State. Provides two different formulas. Establishes one payment formula for non-cash assistance recipients. Establishes another formula relating to cash assistance recipients. Defines a non-cash assistance adult as an individual who is: (1) over 21 years; (2) a U.S. citizen or lawful alien; and (3) is not an AFDC or SSI recipient or a Medicare-eligible individual. (Sec. 9022) Directs the National Health Board to review appropriateness of such payments. Subtitle B: Aggregate Federal Alliance Payments - Sets forth the formula for determining Federal payments to regional alliances for cash assistance recipients. (Sec. 9102) States that this section constitutes budget authority in advance of appropriation Acts and obligates the Federal Government to provide for the payment to regional alliances of a capped Federal alliance payment amount. Defines "capped Federal alliance payment amount." Subtitle C: Borrowing Authority to Cover Cash-flow Shortfalls - Authorizes the Secretary to make available loans to regional alliances to cover any period of temporary cash-flow shortfall attributable to: (1) any estimation discrepancy; (2) a period of temporary cash-flow shortfall attributable to an administrative error; or (3) a period of temporary cash-flow shortfall relating to the relative timing during the year in which amounts are received and payments are required. Sets forth loan terms and conditions. Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance - Subtitle A: Workers Compensation Insurance - Requires each health plan that provides services to enrollees through participating providers to make arrangements to provide workers compensation to such enrollees. (Sec. 10002) Requires each workers' compensation carrier that is liable for payment for workers' compensation services furnished by or through a health plan, regardless of whether or not the services are included in the comprehensive benefit package, to make payment for such services. (Sec. 10011) Sets forth requirements for participating States. (Sec. 10031) Authorizes demonstration projects in one or more States with respect to the treatment of work-related injuries and illnesses. Subtitle B: Automobile Insurance - Requires an individual entitled to automobile insurance medical benefits and enrolled in a health plan to receive automobile insurance medical services through the provision of such services by the health plan. (Sec. 10102) Requires each automobile insurance carrier that is liable for payment for automobile insurance medical services furnished by or through a health plan, regardless of whether or not the services are included in the comprehensive benefit package, to make payment for such services. (Sec. 10111) Requires each participating State to develop a fee schedule applicable to payment for automobile insurance medical services for which a fee is not included in the applicable fee schedule. Subtitle C: Commission on Integration of Health Benefits - Establishes the Commission on Integration of Health Benefits which shall study and report on the feasibility and appropriateness of transferring financial responsibility for all medical benefits, including those currently covered by workers compensation and automobile insurance, to health plans. Authorizes appropriations. Subtitle D: Federal Employees' Compensation Act - Requires the Federal Employees' Compensation Act to be interpreted and administered consistent with the provisions of subtitle A. Subtitle E: Davis-Bacon Act and Service Contract Act - Amends the Davis-Bacon Act and the Service Contract Act of 1965 to require Health Security Act benefits. Subtitle F: Effective Dates - Sets forth effective date provisions. Title XI: Transitional Insurance Reform - Sets forth transitional provisions concerning: (1) enforcement; (2) preservation of current coverage; (3) restrictions on premium increases during transition; (4) portability requirements; (5) restrictions limiting benefit reductions; and (6) the establishment of the National Transitional Health Insurance Risk Pool.
Bill· SS. 1760 (103rd)open
United States · United States Congress · 20 November 1993
Public Buildings Reform Act of 1993 - Amends the Public Buildings Act of 1959 (the Act) to require the Administrator of General Services to: (1) submit biennially to the Congress a public buildings plan for the first two fiscal years that begin after the date of submission for such projects relating to the construction, alteration, purchase, or acquisition of public buildings, or the lease of office or storage space that is necessary to carry out the duties of the Administrator under any law; and (2) hold a public hearing and certify in the biennial plan that the hearing was held in the locality of each major project included in the plan. Includes in the biennial plan, with respect to each project: (1) any final report that is required to be prepared pursuant to any applicable Federal law including any environmental assessment or impact statement pursuant to the National Environmental Policy Act of 1969; and (2) a report that indicates the consideration that was given to facts and issues concerning the project and the various alternatives that were raised during the hearing or that were otherwise considered. Authorizes the Administrator to include a project in the next biennial plan if such project is included in a biennial plan and the project is not approved in accordance with the Act or if funds are not made available to carry out the project. Prohibits the Administrator from obligating funds that are made available for any project for which approval is required unless the project was included in the biennial plan for the fiscal year and a prospectus for the project was submitted to the Congress. Reduces the ceiling on appropriations from $1.5 million to $1 million for the General Services Administration (GSA), without congressional approval, to construct, alter, purchase, or acquire any building to be used as a public building, or to lease any space at an average annual rental for public purpose use. Prohibits, without prior approval, the use of funds to: (1) alter a public building if the aggregate cost of such alteration exceeds the ceiling over a five-year period; or (2) lease space within a public building if the aggregate cost of the leased space annually exceeds the ceiling. Authorizes the Administrator to submit to specified congressional committees a written request for authority to carry out an emergency project if the Administrator determines that an overriding economic or safety interest requires such authority and it cannot be obtained in a timely manner through the biennial planning process. Requires a specific Act of the Congress before such emergency project can be carried out. Repeals provisions authorizing the Administrator to increase the estimated maximum cost of any project set forth in any prospectus that has been transmitted to the Congress. Authorizes the Administrator to: (1) include in a biennial public building plan a prospectus for the funding of an authorized uncompleted public building project; and (2) use the results of the continuing investigation and survey required by the Act to establish a central repository for Federal asset management information. Requires the Administrator to designate an official to act as ombudsman within the Public Building Service of the GSA. Requires the Director of the Office of Management and Budget to: (1) report to the Congress on ending GSA monopoly with respect to providing office and storage space for Federal agencies, including whether the ending of the monopoly is necessary and would be cost-effective; and (2) submit a plan for ending the monopoly, along with recommendations to implement the plan, if the report determines that it is feasible and desirable to do so. Requires: (1) each Federal agency to review and report to the Congress on the agency's long-term housing needs and to attempt to reduce such needs; and (2) the Administrator to designate two account managers for each agency to assist the agency in carrying out the review and to assist the Administrator in preparing uniform standards for housing needs for Federal executive agencies and establishments in the judicial branch. Directs each Federal agency, by the end of the third fiscal year that begins after the enactment of this Act, to reduce by at least five percent: (1) the aggregate office and storage space held on the enactment of this Act; or (2) the annual housing costs (including the costs of energy, supplies, furniture, and minor repairs) of the agency as compared to the housing costs of the agency for the fiscal year during which this Act was enacted.
Bill· HRH.R. 3600 (103rd)reported
United States · United States Congress · 20 November 1993
TABLE OF CONTENTS: Title I: Health Care Security Subtitle A: Universal Coverage and Individual Responsibility Subtitle B: Benefits Subtitle C: State Responsibilities Subtitle D: Health Alliances Subtitle E: Health Plans Subtitle F: Federal Responsibilities Subtitle G: Employer Responsibilities Subtitle J (sic): General Definitions; Miscellaneous Provisions Title II: New Benefits Subtitle A: Medicare Outpatient Prescription Drug Benefit Subtitle B: Long-Term Care Title III: Public Health Initiatives Subtitle A: Workforce Priorities Under Federal Payments Subtitle B: Academic Health Centers Subtitle C: Health Research Initiatives Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health Subtitle E: Health Services for Medically Underserved Populations Subtitle F: Mental Health; Substance Abuse Subtitle G: Comprehensive School Health Education; School-Related Health Services Subtitle H: Public Health Service Initiative Subtitle I: Coordination With COBRA Continuation Coverage Title IV: Medicare and Medicaid Subtitle A: Medicare and the Alliance System Subtitle B: Savings in Medicare Program Subtitle C: Medicaid Subtitle D: Increase in SSI Personal Needs Allowance Title V: Quality and Consumer Protection Subtitle A: Quality Management and Improvement Subtitle B: Information Systems, Privacy, and Administrative Simplification Subtitle C: Remedies and Enforcement Subtitle D: Medical Malpractice Subtitle E: Fraud and Abuse Subtitle F: McCarran-Ferguson Reform Title VI: Premium Caps; Premium-Based Financing; and Plan Payments Subtitle A: Premium Caps Subtitle B: Premium-Related Financing Subtitle C: Payments to Regional Alliance Health Plans Title VII: Revenue Provisions Subtitle A: Financing Provisions Subtitle B: Tax Treatment of Employer-Provided Health Care Subtitle C: Employment Status Provisions Subtitle D: Tax Treatment of Funding of Retiree Health Benefits Subtitle E: Coordination with COBRA Continuing Care Provisions Subtitle F: Tax Treatment of Organizations Providing Health Care Services and Related Organizations Subtitle G: Tax Treatment of Long-term Care Insurance and Services Subtitle H: Tax Incentives for Health Services Providers Subtitle I: Miscellaneous Provisions Title VIII: Health and Health-Related Programs of the Federal Government Subtitle A: Military Health Care Reform Subtitle B: Department of Veterans Affairs Subtitle C: Federal Employees Health Benefits Program Subtitle D: Indian Health Service Subtitle E: Amendments to the Employee Retirement Income Security Act of 1974 Subtitle F: Special Fund for WIC Program Title IX: Aggregate Government Payments to Regional Alliances Subtitle A: Aggregate State Payments Subtitle B: Aggregate Federal Alliance Payments Subtitle C: Borrowing Authority to Cover Cash-Flow Shortfalls Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance Subtitle A: Workers Compensation Insurance Subtitle B: Automobile Insurance Subtitle C: Commission on Integration of Health Benefits Subtitle D: Federal Employees' Compensation Act Subtitle E: Davis-Bacon Act and Service Contract Act Subtitle F: Effective Dates Title XI: Transitional Insurance Reform Health Security Act - Title I: Health Care Security - Subtitle A: Universal Courage and Individual Responsibility - Entitles each eligible individual to: (1) the benefit provided under subtitle B through the applicable health plan in which the individual is enrolled; and (2) a health security card to be issued by the alliance or other entity that offers the applicable health plan in which the individual is enrolled. Defines an eligible individual as an individual who resides in the United States and is: (1) a citizen or national of the United States; (2) an alien permanently residing in the U.S. under color of law; or (3) a long-term nonimmigrant. Entitles a Medicare-eligible individual to benefits under Medicare instead of the above provisions of this Act. (Sec. 1002) Requires each eligible individual to enroll in an applicable health plan and pay any required premium. Prohibits disenrollment of an eligible individual until the individual is either enrolled in another plan or in Medicare. (Sec. 1003) States that nothing in this Act shall be construed as prohibiting: (1) an individual from purchasing any health services; (2) an individual from purchasing supplemental insurance; (3) an individual who is not an eligible individual from purchasing health insurance; or (4) employers from providing additional coverage. (Sec. 1004) States that a regional alliance health plan is the applicable plan for a family, unless a family member is eligible for a corporate alliance health plan. Allows military personnel, veterans, and Indians to enroll either with an alliance or with a military, veteran, or Indian plan respectively. (Sec. 1005) Prohibits an undocumented alien from enrolling in a health plan under this Act. (Sec. 1011) Defines a family as an eligible individual's eligible spouse and children. Defines couple as meaning an individual and the individual's spouse. Defines a child as being under age 18, or under age 24 in the case of a full-time student. Subtitle B: Benefits - Includes the following terms and services in the comprehensive benefit package: (1) hospital services; (2) services of health professionals; (3) emergency and ambulatory medical and surgical services; (4) clinical preventive services; (5) mental illness and substance abuse services; (6) family planning services and services for pregnant women; (7) hospice care; (8) home health care; (9) extended care services; (10) ambulance services; (11) outpatient laboratory, radiology, and diagnostic services; (12) outpatient prescription drugs and biologicals; (13) outpatient rehabilitation services; (14) durable medical equipment and prosthetic and orthotic devices; (15) vision care; (16) dental care; (17) health education classes; and (18) investigational treatments. Describes such items and services. (Sec. 1131) Requires each health plan to offer to its enrollees only one of the following cost sharing schedules: (1) lower cost sharing; (2) higher cost sharing; or (3) combination cost sharing. Provides that the annual maximum out-of-pocket expenses for an individual in any of the plans shall be $1500 and for a family the annual maximum shall be $3000. (Sec. 1135) Sets forth a table of copayments and coinsurance. (Sec. 1141) Excludes the following items and services: (1) an item or service that is not medically necessary or appropriate; (2) an item or service that the National Health Board may determine is not medically necessary or appropriate; (3) custodial care, except hospice care; (4) surgery performed solely for cosmetic purposes, unless required to correct a congenital anomaly or performed to correct a part of the body injured by either disease or accident; (5) hearing aids; (6) eyeglasses and contact lenses for individuals at least 18 years of age; (7) in vitro fertilization; (8) sex change surgery and related services; (9) private duty nursing; (10) personal comfort items, except in the case of hospice care; and (11) any dental procedures involving orthodontic care, inlays, gold or platinum fillings, bridges, crowns, pin/post retention, dental implants, surgical periodontal procedures, or the preparation of the mouth for the fitting or continued use of dentures, except as specified. (Sec. 1151) Gives the National Health Board the authority to promulgate such regulations or establish such guidelines as necessary to assure uniformity in the application of the comprehensive benefit package across all health plans. Permits the Board to expand the benefit package. (Sec. 1162) Permits a health professional or facility to refuse to provide a benefit if the professional or facility objects on the basis of a religious belief or moral conviction. Subtitle C: State Responsibilities - Requires a State, in order to be approved as a participating State, to submit a document describing the State's health care system. (Sec. 1201) Requires a participating State to: (1) establish one or more regional alliances; (2) establish and publish the criteria used in the certification of its health plan; (3) meet minimum financial solvency requirements for health plans established by the National Health Board; (4) designate an agency or official to coordinate State responsibilities under this Act; (5) conform State laws to meet the requirements of title X of this Act with respect to workers' compensation and automobile insurance; and (6) carry out all the responsibilities of a participating State specified in this Act. (Sec. 1221) Permits a State, with the Board's approval, to operate a single-payer system if specified requirements are met. Subtitle D: Health Alliances - Provides for regional alliances and corporate alliances. (Sec. 1302) Requires a regional alliance to be governed by a Board of Directors consisting of: (1) employers, including self-employed individuals; and (2) members who represent individuals purchasing coverage. Requires each regional alliance to establish a provider advisory board consisting of health care providers and professionals. (Sec. 1311) Includes in a corporate alliance an eligible sponsor who is either a large employer (more than 5,000 full-time employees) or a multiemployer plan (a plan with more than 5000 active participants). Excludes: (1) an employer whose primary business is employee leasing; (2) the Federal Government (other than the U.S. Postal Service); and (3) a State or local government. Excludes from corporate alliance eligibility the following classes of individuals: (1) AFDC recipients; (2) SSI recipients; (3) military personnel and families, veterans, and Indians who elect to enroll in specified plans specifically designed for them; and (4) seasonal or temporary employees. (Sec. 1321) Directs each regional alliance to enter into a contract with any State-certified health plan to contract with the alliance for the enrollment under the plan of eligible individuals. (Sec. 1322) Requires each regional alliance to offer a choice of health plans, including at least one fee-for-service plan. (Sec. 1326) Requires each regional alliance to establish and maintain an office of an ombudsman to assist consumers in dealing with problems that arise with health plans and the alliance. (Sec. 1329) Permits a regional alliance to adjust payments to plans or use other financial incentives to encourage health plans to expand into areas that have inadequate health services. (Sec. 1341) Set forth provisions concerning the collection of funds by regional alliances from individuals, employers, and others. (Sec. 1351) Requires each regional alliance to compute a blended plan per capita payment amount for each regional alliance health plan for enrollment in the alliance. (Sec. 1353) Requires each regional alliance to make payments to the Federal Government for academic health centers and graduate medical education. (Sec. 1361) Requires each regional alliance to comply with specified standards relating to the management of finances, maintenance of records, accounting practices, auditing procedures, financial reporting, and employer payments. (Sec. 1371) Provides for a reduction in cost sharing for low-income families. (Sec. 1373) Provides for premium discounts and reduction in liabilities for low-income families. (Sec. 1381) Permits each corporate alliance to: (1) offer coverage under either an appropriate self-insured health plan; or (2) negotiate with a State-certified plan to enter into a contract with the plan. (Sec. 1382) Requires each corporate alliance to provide a choice of health plans, including at least one fee-for-service plan and two health plans that are not fee-for-service plans. (Sec. 1385) Requires each corporate alliance to make an additional contribution towards the enrollment in health plans of the alliance by certain low-wage families. (Sec. 1386) Sets forth provisions relating to corporate alliances concerning: (1) consumer information and marketing; (2) plan and information requirements; (3) management of funds; (4) cost control; (5) payments by corporate alliance employers to corporate alliances; (6) ERISA; (7) disclosure and reserve requirements; (8) trusteeship of insolvent corporate alliance health plans; (9) imposition and collection of periodic assessments on self-insured corporate alliance plans; and (10) payments to the Federal Government by multiemployer corporate alliances for academic health centers and gradual medical education. Subtitle E: Health Plans - Requires a health plan to: (1) be either a self-insured plan (meaning a group health plan as defined by a the Employee Retirement Income Security Act of 1974) or a State-certified plan (meaning a plan certified by a State or the National Health Board); and (2) meet the applicable regulatory requirements. (Sec. 1402) Requires each health plan offered by either a regional or corporate alliance to accept for enrollment every alliance eligible individual, unless the plan has reached its enrollment limit. Prohibits the limit from being imposed on the basis of any personal characteristics of enrollees such as health status, need for health care, age, occupation, or affiliation with any person or entity. Prohibits a plan from: (1) restricting or terminating coverage for any reason, including nonpayment of premiums; (2) cancelling coverage for any eligible individual until that individual is enrolled in another plan; (3) excluding an eligible individual because of an existing medical condition; (4) imposing a waiting period before coverage begins; or (5) imposing a rider that excludes the coverage of particular eligible individuals. Prohibits discrimination by a health plan on the basis of race, national origin, sex, language, socio-economic status, age, disability, health status, or anticipated need for health services. (Sec. 1405) Requires each plan to have a grievance procedure. (Sec. 1421) Permits an entity to offer a supplemental insurance policy if the policy and the entity meet specified requirements. (Sec. 1431) Requires each health plan, with respect to each electing essential community provider located within the plan's service area, to either: (1) enter into a written provider participation agreement; or (2) enter into a written agreement under which the plan will make payment to the provider as specified. Provides a special rule for providers of school health services. Makes the provisions of the proceeding sentence applicable only to health plans offered by a health alliance during the five year period beginning with the first year in which any health plan is offered by the alliance. Directs the Secretary of Health and Human Services to study essential community providers and to make recommendations concerning such providers to the Congress. Provides that such recommendations shall apply unless a joint resolution of disapproval is enacted by the Congress. (Sec. 1441) Requires each health plan to meet specified requirements of title X of this Act with respect to workers' compensation and automobile medical liability services. Subtitle F: Federal Responsibilities - Establishes the National Health Board in the Executive Branch. Directs the President to appoint the Board's seven members. (Sec. 1503) Directs the Board to: (1) interpret the comprehensive benefit package; (2) adjust the delivery of preventive services; (3) take steps to assure that the comprehensive benefit package is available on a uniform national basis; (4) recommend to the President and the Congress appropriate revisions to the package; (5) oversee cost containment requirements; (6) develop and implement eligibility standards; (7) establish a performance based system of quality management; (8) develop and implement standards for a national health information system; (9) establish State requirements and monitor State compliance; (10) establish premium class factors; (11) develop a methodology for the risk-adjustment of premium payments; (12) establish financial requirements for guaranty funds; (13) establish standards for health plan grievance procedures; and (14) report annually to the President and the Congress. (Sec. 1506) Authorizes appropriations for the Board. (Sec. 1511) Requires the Board to approve a State health care system if the system meets the applicable requirements of this Act. Prohibits approval of a State health care system prior to 1996. (Sec. 1512) Provides for sanctions for States failing to meet conditions for compliance. (Sec. 1515) Provides for planning grants to States for implementation assistance. (Sec. 1521) Provides for the Federal assumption of responsibilities in the absence of a State system. Provides for increased premiums of 15 percent during Federal operation of a State system to provide reimbursement for the Federal cost of operating the system. (Sec. 1541) Directs the Board to develop a risk adjustment and reinsurance methodology. Sets forth guidelines for developing such methodology. (Sec. 1543) Directs the Board to establish an advisory committee to provide technical advice and recommendations regarding the risk adjustment and reinsurance methodology. (Sec. 1551) Directs the Board to establish minimum capital requirements for regional alliance health plans under which at least $500,000 of capital must be maintained for each plan in the area. Permits the Board to require additional capital. (Sec. 1552) Requires the Board to establish standards for guaranty funds established by the States. (Sec. 1571) Sets forth the responsibilities of the Secretary of Health and Human Services. Directs the Secretary to administer and implement all provisions of this Act, except those duties delegated to the Board, any other executive agency, or to any State. (Sec. 1572) Directs the Secretary to appoint an Advisory Council on Breakthrough Drugs that will examine the reasonableness of launch prices of new breakthrough drugs. (Sec. 1581) Provides for the certification of essential community providers. Sets forth the following categories of providers automatically certified (under provisions of the Public Health Service Act): (1) migrant health centers; (2) community health centers; (3) homeless program providers; (4) public housing providers; (5) family planning clinics; and (6) AIDS providers under the Ryan White Act. Includes as automatically certified (under other Acts) following: (1) Indian health programs under the Indian Health Act; and (2) maternal and child health providers and a federally qualified health center or rural health clinic under the Social Security Act. Includes as automatically certified (under provisions of this Act) the following: (1) providers of school health services; and (2) a qualified community practice network. Provides for the setting of standards for additional health providers. (Sec. 1591) Sets forth the responsibilities of the Secretary of Labor. Includes among those responsibilities the following: (1) enforcement requirements applicable to employers; (2) elections to become corporate alliances; (3) temporary assumption of insolvent self-insured corporate alliance health plans; (4) establishment and administration of the Corporate Alliance Health Plan Insolvency Fund; and (5) administering title I of ERISA as it relates to group health plans maintained by corporate alliances. Subtitle G: Employer Responsibilities - Requires employers to provide for the payments required under title VI of this Act. Sets forth other employer responsibilities including: (1) information reporting requirements; (2) requirements relating to new employees; (3) recordkeeping requirements; and (4) antidiscrimination requirements. (Sec. 1606) Prohibits self-funding of cost sharing benefits by regional alliance employers. (Sec. 1607) Requires an employer to make equal employer premium payments to all qualifying employees, if a voluntary premium payment is made. Places a limit on such voluntary employer premium payments. (Sec. 1608) Sets forth an employer's obligation to a qualifying retired beneficiary where the employer, as of October 1, 1993, was providing a threshold payment. (Sec. 1609) Authorizes the Secretary of Labor to impose a civil penalty of up to $10,000 for each violation of this subtitle with respect to each individual. Subtitle J (sic): General Definitions; Miscellaneous Provisions - Sets forth the definitions and rules used in this Act. Subtitle B: Miscellaneous Provisions (sic) - (Sec. 1911) Grants the National Health Board, the Secretary of Health and Human Services, and the Secretary of Labor authority to issue regulations as necessary to permit the timely implementation of this Act. Title II: New Benefits - Subtitle A: Medicare Outpatient Prescription Drug Benefit - (Secs. 2001 through 2005) Amends title XVIII of the Social Security Act to provide for: (1) Medicare coverage of covered outpatient prescription drugs and biologicals as well as home infusion drug therapy services; (2) payment rules and related requirements, such as those pertaining to deductibles, for covered outpatient prescription drugs; (3) manufacturer rebates to the Secretary under Medicare part B for covered outpatient prescription drugs; and (4) determination of the Medicare part B premium attributable to covered outpatient prescription drugs. Subtitle B: Long-Term Care - Establishes requirements for State plans for home and community-based services to individuals with disabilities. Includes among those requirements the following: (1) a prohibition of limiting eligibility of individuals with disabilities based on income, age, geography, severity of disability, residential setting, or other grounds specified by the Secretary; (2) a requirement to serve low-income individuals; (3) a requirement to specify how Federal and State funds will be managed; (4) quality assurance requirements; and (5) reporting requirements. Requires a State to consult with individuals and groups of individuals with disabilities when developing the plan in order to have the plan approved. (Sec. 2103) Defines "individuals with disabilities" to mean any individual within one or more of the following four categories: (1) individuals requiring help with the activities of daily living; (2) individuals with severe cognitive or mental impairment; (3) individuals with severe or profound mental retardation; and (4) severely disabled children. (Sec. 2104) Requires a State plan to specify the services available. Requires each individualized plan to be developed in close consultation with the individual and the individual's family. Prohibits a State plan from covering: (1) room and board; (2) services furnished in a hospital, nursing facility, intermediate care facility for the mentally retarded, or other specified institutional setting; or (3) items or services to the extent coverage is provided for an individual under a health plan or Medicare. (Sec. 2105) Sets forth provisions relating to: (1) cost sharing; (2) quality assurance and safeguards; (3) advisory groups; (4) payments to States; and (5) the total Federal budget for State plans and allotments to States. (Sec. 2301) directs the Secretary, with the advice and assistance of the National Long-Term Care Insurance Advisory Council to promulgate regulations as necessary to implement provisions concerning private long-term care insurance. Directs the Secretary to make appointments to such Council. Authorizes appropriations for such Council. (Sec. 2321) Directs the Secretary, after considering the Council's recommendations to promulgate regulations designed to: (1) standardize formats and terminology used in long-term care policies; (2) require insurers to provide information to customers on the range of public and private long-term care coverage available; and (3) establish other requirements promoting consumer understanding of benefits. (Sec. 2322) Directs the Secretary to promulgate regulations establishing requirements with respect to the terms of and benefits under long-term care policies, which shall include the following requirements that the policy may not: (1) limit coverage based on a preexisting condition, subject to an exception for a six month period; (2) condition eligibility for benefits based on the need or receipt of any other service; (3) condition eligibility for any benefit on any particular diagnosis; (4) condition eligibility for benefits by providers on compliance with requirements not required by State or Federal law; and (5) condition coverage of any service by a provider on the provision of such service at a higher level of care than required by the insured individual. Prohibits discrimination by diagnosis in the treatment of: (1) Alzheimer's disease; (2) any organic or inorganic mental illness; (3) mental retardation or any other cognitive or mental impairment; or (4) HIV infection or AIDS. Sets forth other requirements for such policies, including requirements related to: (1) premiums; (2) sales practices; (3) continuation, renewal, replacement, conversion, and cancellation of policies; and (4) payment of benefits. (Sec. 2342) Provides for grants to States to enforce the Federal standards concerning long-term care policies. Sets forth requirements for receiving such grants. Authorizes appropriations. Prohibits the sale of a long-term care policy in a State without a regulatory program. (Sec. 2361) Authorizes the Secretary to make grants for the development and implementation of long-term care information, counseling, and other programs to: (1) States; (2) regional alliances (at the option of States within which such alliances are located; and (3) national organizations representing insurance consumers, long-term care providers, and insurers. Authorizes appropriations for such grants. (Sec. 2601) Authorizes the Secretary to conduct a demonstration program to test the effectiveness of various approaches to financing and providing integrated acute and long-term care services for the chronically ill and disabled. Sets forth the services and benefits to be provided, including: (1) all benefits of the comprehensive benefit package provided under title I of this Act; (2) transitional benefits, including assessment and home care; (3) long-term care benefits, including adult day care, home-delivered meals, and nursing facility services in specialized care units; and (4) habilitation services. Permits any of the following to be eligible for such services under criteria to be established by the Secretary: (1) individuals with disabilities under a State program; (2) individuals entitled to benefits under the Medicare program; and (3) individuals entitled to Medicaid and who are also either entitled to Medicare or Supplemental Security Income benefits. Requires reports to the Congress on the demonstration program. Title III: Public Health Initiatives - Subtitle A: Workforce Priorities Under Federal Payments - Establishes within the Department of Health and Human Services the National Council on Graduate Medical Education. Directs the National Council to designate for each academic year the number of individuals nationwide who are authorized to be enrolled in each specified approval physician training program for each medical specialty. Sets forth provisions specifying: (1) Federal formula payments to approved physician training programs; (2) application for payments; and (3) amount of payments. (Sec. 3061) Directs the Secretary to carry out a program with respect to graduate nurse training programs that is equivalent to the program for approved physician training programs. Establishes a National Council on Graduate Nurse Education. (Sec. 3071) Authorizes appropriations for the following programs: (1) primary care physician and physician assistant training; (2) training of underrepresented minorities and disadvantaged persons; and (3) nurse training. (Sec. 3072) Authorizes appropriations for the following programs: (1) a program of skill upgrading and occupational retraining for health care workers; (2) a demonstration program to assist workers in health care institutions in obtaining advanced career positions; (3) a program to develop and operate health-worker job banks in local employment services agencies, subject to certain conditions; (4) a program to provide joint labor-management decision-making in the health care sector on workplace matters related to the restructuring of the health care delivery system of this Act; and (5) a program to facilitate the comprehensive workforce adjustment initiative. (Sec. 3073) Directs the Secretary of Health and Human Services and the Secretary of Labor to jointly establish the National Institute for Health Care Workforce Development. States that the Director of the Institute shall make recommendations to the Secretaries regarding: (1) the supply of health care workers; (2) the impact of this Act; and (3) the development and implementation of high-performance, high-quality health care delivery systems. Directs the Secretaries to establish an advisory board to assist in the development of such recommendations. Subtitle B: Academic Health Centers - Directs the Secretary to make payments to a qualified academic health center or qualified teaching hospital in order to assist such eligible institutions with costs that are not routinely incurred by other entities in providing health services, but are incurred by such institutions by virtue of the academic nature of such institutions. States that such costs include: (1) costs resulting from reduced staff productivity due to teaching responsibilities; (2) the uncompensated costs of clinical research; and (3) exceptional costs associated with an institutions specialized expertise. Provides that the funding for such payments will come from transfers from the Federal Hospital Insurance Trust Fund, payments made by regional alliances to the Federal government for academic health centers and graduate medical education, and payments from corporate alliances. (Sec. 3131) Provides for the access of regional and corporate alliance patients to academic health centers. Subtitle C: Health Research Initiatives - Amends the Public Health Service Act to ensure that the National Institutes of Health conducts and supports biomedical and behavioral research on promoting health and preventing diseases, disorders, and other health conditions. Provides for health services research. Authorizes appropriations for such research. Subtitle D: Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health - Authorizes appropriations for the core functions of public health programs and national initiatives regarding health promotion and disease prevention. (Sec. 3312) Authorizes the Secretary to make grants to States to carry out one or more of the following core functions: (1) data collection; (2) activities to protect the environment and to assure the safety of housing, workplaces, and food and water; (3) investigation and control of adverse health conditions; (4) public information and education programs to reduce risks to health such as use of tobacco, alcohol, and drugs, sexual activities that increase the risk of HIV transmission and other sexually transmitted diseases, poor diet, physical inactivity, and low childhood immunization levels; (5) accountability and quality assurance activities; (6) provision of public health laboratory services to complement private clinical laboratory services that screen for diseases and conditions; (7) training and education to assure provision of care by all health professionals; and (8) leadership policy development and administrative activities. (Sec. 3331) Authorizes the Secretary to make grants to agencies of State or local government, private nonprofit organizations, and coalitions that link two or more of these groups for the purpose of carrying out projects to develop and implement innovative community-based strategies to provide for health promotion and disease prevention activities for which there is a significant need. Subtitle E: Health Services for Medically Underserved Populations - Directs the Secretary to make grants to migrant health centers and community health centers, which shall be in addition to other funds available to such centers. Authorizes appropriations. (Sec. 3412) Authorizes appropriations for: (1) grants and contracts for the development of qualified community health plans and practice networks; and (2) loans and guaranteeing the principal and interest to Federal and non-Federal lenders on behalf of public and private entities for the capital costs of developing qualified community health plans and practice networks. (Sec. 3461) Authorizes the Secretary to make grants and enter into contracts with qualified community health groups to provide enabling services such as transportation, community and patient outreach, patient education, and translation services in order to increase the capacity of individuals to utilize the items and services under title I of this Act. Authorizes appropriations. (Sec. 3471) Authorizes appropriations for: (1) the National Health Service Corps; and (2) such amounts as are necessary to ensure that at least 20 percent of participants in the Scholarship Program or the Loan Repayment Program of the Corps are nurses. (Sec. 3481) Entitles a hospital with a low-income utilization rate in a base year of at least 25 percent to a payment as specified. Requires 75 percent of the total available to be allocated to hospitals for low-income assistance. Requires 25 percent of the total available to be allocated to hospitals for assistance in furnishing inpatient hospital services that are not covered services under title I of this Act. Subtitle F: Mental Health; Substance Abuse - Authorizes appropriations to carry out this part. Provides for grants to: (1) increase access to mental health and substance abuse services; (2) improve State and local capacity to coordinate and monitor such services; (3) provide incentives to integrate public and private service systems; and (4) supplement any activity under part B (Alcohol and Drug Abuse and Mental Services Block Grant) of title XIX of the Public Health Service Act. (Sec. 3503) Authorizes the Secretary to make loans for the capital costs incurred in the development of non-acute, residential treatment centers and community-based ambulatory clinics. (Sec. 3521) Requires the establishment of a pilot program demonstrating the integration of the mental illness and substance abuse services of the States with the services included under title I of this Act. Subtitle G: Comprehensive School Health Education; School-Related Health Services - Authorizes appropriations for the programs of this subtitle. States that the purposes of the programs shall be to: (1) support, in kindergarten through grade 12, the provision of comprehensive health educator programs; (2) establish a national framework within which States can create comprehensive school health education programs that target the health risk behaviors of youth, including tobacco use, alcohol and drug abuse, sexual behaviors resulting in infections, injury prevention, dietary patterns, and sedentary lifestyles; (3) pay the initial costs of planning and establishing such programs; (4) support related Federal demonstrations and training; (5) motivate youth to stay in school, avoid teen pregnancy, and strive for success; (6) improve the knowledge of health education among youth; and (7) further the National Education Goals set forth in title I of the Goals 2000: Educate America Act. Defines "comprehensive school health education program." Requires such programs to be sensitive to cultural and ethnic issues, promote involvement by families, and promote personal responsibility. Sets forth requirements for applying for grants and selection of grantees. Subtitle H: Public Health Service Initiative - Establishes a Public Health Service Initiative consisting of specified amounts authorized to be appropriated for the Initiative. States that: (1) the Initiative includes the programs of subtitles C through G of this title and the programs of subtitle D of title VIII; and (2) amounts appropriated to carry out the Initiative, including subtitles A through F of this title, are available to carry out specific programs for which the amounts are appropriated. Subtitle I: Coordination with COBRA Continuation Coverage - Amends title XXII (Requirements for Certain Group Health Plans for Certain State and Local Employees) of the Public Health Service Act to provide for coordination with COBRA continuation coverage. Repeals such title XXII upon implementation of this Act. Title IV: Medicare and Medicaid - Subtitle A: Medicare and the Alliance System - Amends title XVIII of the Social Security Act to provide for optional State integration of Medicare beneficiaries into regional alliance plans. (Sec. 4002) Allows individuals to elect to remain in certain plans. (Sec. 4003) Provides for payments to regional alliances on behalf of certain Medicare-eligible individuals. (Sec. 4004) Extends protections for working aged and disabled individuals to group health plans of all employers. Repeals the limitation on the period of protection for individuals with end stage renal disease. Prohibits Medicare payment for items and services provided under any health plan under this Act. Simplifies Medicare benefit coordination in cases where the individual is also eligible for benefits under this Act's health plans. (Sec. 4011) Makes various changes concerning eligible organization and Medicare supplemental policy enrollment and comparative informational materials, eligible organization outlier payments, and participating provider point-of-service networks. (Sec. 4022) Provides for expanded Medicare coverage for physician assistant, nurse practitioner, and clinical nurse specialist services. (Sec. 4031) Amends title XI of the Social Security Act to: (1) provide for termination of the separate Medicare peer review program upon adoption of the National Quality Management Program above under subtitle A of title V of this Act; and (2) repeal provisions on surgical procedure review and second opinions. (Sec. 4032) Amends title XVIII of the Social Security Act to provide for mandatory assignment for all Medicare part B services. (Sec. 4033) Directs the Secretary of Health and Human Services to take such steps as may be necessary to consolidate administration of Medicare parts A and B and supersedes certain conflicting requirements to the extent required to achieve such purpose. (Sec. 4035) Prohibits the Secretary from implementing any change in procedures for billing and processing Medicare claims within six months of implementing any previous change. Adds advanced notification to providers as a requirement for carriers and fiscal intermediaries under Medicare. (Sec. 4041) Amends title XI of the Social Security Act to: (1) provide for civil monetary penalties for kickback violations under Medicare and State health care programs (the programs); (2) make other penalty-related changes, including increases in criminal and civil monetary penalties, a new criminal penalty exception for certain providers, additional civil monetary penalty offenses related to alliance systems, and requirements for the deposit of penalties collected into the All-Payer Account established above under title V of this Act; (3) revise exclusion provisions, with changes establishing a minimum period of exclusion for certain individuals and entities subject to permissive exclusion from the programs, and providing for program exclusions based on actions under alliance systems; and (4) modify sanction provisions, with changes removing certain conditions for imposing sanctions and setting specified civil money penalties for use in lieu of authorized sanctions. (Sec. 4042) Amends title XVIII of the Social Security Act to revise the limitations on physician self-referrals. (Sec. 4051) Provides for the termination of payments under Medicare for medical education costs and directs the Secretary to make specified transfers from certain Medicare trust funds to the new accounts established above for funding physician training programs and academic health centers. (Sec. 4061) Amends title XVIII of the Social Security Act to provide for the treatment of: (1) uniformed services and VA health plans as eligible organizations under Medicare; and (2) health care facilities of the Department of Veterans Affairs as providers under Medicare. Subtitle B: Savings in Medicare Program - Amends title XVIII of the Social Security Act to provide for: (1) reductions in the update for inpatient hospital services and the adjustment for indirect medical education costs, in payments for capital-related costs for inpatient hospital services; (2) revisions to payment adjustments for disproportionate share hospitals in States participating under this Act; and (3) an extension of the freeze on updates to routine service costs of skilled nursing facilities. (Sec. 4111) Amends title XVIII of the Social Security Act to provide for: (1) establishment of cumulative expenditure goals for physician services; (2) use of real gross domestic product for volume adjustments; (3) repeal of restrictions on the maximum reduction permitted in default update; (4) reduction in the conversion factor for the physician fee schedule for 1995; (5) place limitations on payment for physicians' services furnished by high-cost hospital medical staffs; (6) requirements for physicians to identify the hospital at which the service was furnished; (7) an increase in practice expense relative value units for certain services while assuring budget neutrality; (8) a study and report to the Congress by the Secretary on a resource-based system for determining practice expense relative value units for each physician's service; (9) an increase in work relative value units for office visits while assuring budget neutrality; (10) a reduction in relative values for office consultations; (11) adjustment of outlier intensity of relative values; (12) changes in underserved area bonus payments; (13) elimination of formula-driven payments for certain outpatient hospital services; (14) copayments for laboratory services; and (15) competitive acquisition procedures for Medicare part B items and services (including clinical diagnostic laboratory tests). (Sec. 4131) Makes changes with respect to: (1) Medicare as secondary payer; (2) payments for health maintenance organizations and competitive medical plans with risk-sharing contracts; and (3) routine cost limits and copayments for, respectively, home health services and visits. (Sec 4135) Directs the Secretary to use a competitive process to contract with centers of excellence for cataract surgery, coronary artery by-pass surgery, and such other services as the Secretary determines to be appropriate. (Sec. 4141) Amends title XVIII of the Social Security Act to revise Medicare part B premium provisions. (Sec. 4151) Requires the Secretary to submit a report to the Congress on the growth in spending under Medicare for FY 2000 through 2003. Subtitle C: Medicaid - Amends title XIX (Medicaid) of the Social Security Act to provide that if a State Medicaid plan provides for payment to regional alliances of the amounts required above it is not required to provide payment for items and services covered under the comprehensive benefit package for alliance eligible individuals and will receive no Federal financial assistance with respect to such items and services. (Sec. 4211) Provides for: (1) spenddown eligibility and increased income and resource disregard for nursing facility residents; and (2) informing such residents about the availability of assistance for home and community-based services. (Sec. 4221) Provides for: (1) treatment of items and services not covered under the comprehensive benefit package; and (2) establishment of a program under Medicare of noncovered items and services for poor children. (Sec. 4231) Discontinues certain payment policies under Medicaid. (Sec. 4241) Limits the frequency of changes in a State's billing and claims processing system, and provides for advance notification to providers of any major billing change. (Sec. 4251) Establishes the Medicaid Commission to study, report, and make recommendations with respect to options involving block grant use, integration of long-term care services, and consolidation of institutional and home- and community-based long-term care in relation to the Medicaid program. Authorizes appropriations. Subtitle D: Increase in SSI Personal Needs Allowance - Amends title XVI (Supplemental Security Income) (SSI) to provide for an increase in the SSI personal needs allowance. Title V: Quality and Consumer Protection - Subtitle A: Quality Management and Improvement - Requires the National Health Board to establish and oversee a performance-based program of quality management and improvement designed to enhance the quality, appropriateness, and effectiveness of heath care services and access to such services which will be called the National Quality Management Program. (Sec. 5002) Establishes the National Quality Management Council which shall: (1) administer the National Quality Management Program; (2) perform any other duty specified in this subtitle; and (3) advise the National Health Board with respect to its duties under this subtitle. Requires the Council to develop a set of national measures of quality performance to be used in the assessment of and the provision of access to health care services. Requires the Council, in addition, to: (1) recommend to the Board establishing goals for performance by health plans and health care providers on a subset of national measures of quality performance; (2) direct the Administrator for Health Care Policy and Research to develop, review, and disseminate practice guidelines to determine how diseases can most effectively be prevented, diagnosed, treated, and managed; and (3) direct the Administrator for Health Care Policy and Research to support research related to a five year priority list of performance measures. (Sec. 5008) Directs the National Health Board to: (1) establish and oversee regional professional foundations to perform such duties as develop lifetime learning programs for health professionals and conduct research on health care quality; and (2) establish the National Quality Consortium to perform such duties as establishing continuing education for health professionals and provide advice on research priorities. (Sec. 5012) Requires each regional alliance and each corporate alliance to: (1) disseminate specified information to consumers; and (2) ensure that performance and quality standards are continually improved. Subtitle B: Information Systems, Privacy, and Administrative Simplification - Directs the National Health Board to develop and implement a health information system, in consultation with Federal agencies, States, employers, health plans, and others, by which the Board shall collect, report, and regulate the collection and dissemination of health care information which shall be used for: (1) health care planning by Federal, State, and local government; (2) establishing and monitoring payments for health services; (3) assessing and improving the quality of health care; (4) managing and containing costs at the alliance and plan levels; and (5) other specified purposes. Requires the establishment of an electronic data network to collect, compile, and transmit information. (Sec. 5120) Sets forth provisions providing for health information privacy standards. (Sec. 5130) Directs the National Health Board to develop the following standard health care benefit forms: (1) an enrollment and disenrollment form; (2) a clinical encounter record; and (3) a claim form. (Sec. 5140) Establishes the National Privacy and Health Data Advisory Council in order to advise the National Health Board with respect to its duties under this subtitle. (Sec. 5141) Sets forth monetary penalties for violating health information system standards. Subtitle C: Remedies and Enforcement - Sets forth provisions with respect to the review of benefit determinations for enrolled individuals, including provisions: (1) regulating the time limits for notice of disposition of a claim; (2) governing a plan's duty to review claim denials; (3) concerning urgent requests for preauthorization; and (4) concerning other time limits with respect to time limits and notice. (Sec. 5202) Requires each State to establish a complaint review office for each regional alliance established by a State. Permits aggrieved individuals to file complaints with the appropriate review office. (Sec. 5205) Provides for a Federal Health Plan Review Board to review the decisions of complaint review office hearing officers. (Sec. 5207) Sets monetary penalties for a plan which unreasonably denies or delays payment or provision of benefits. (Sec. 5211) Directs each State to establish and maintain an Early Resolution Program in each complaint review office. Requires a program to include: (1) forums for mediation disputes; and (2) other forums of alternative dispute resolution as may be prescribed. Establishes guidelines for the eligibility of cases for submission to the Early Resolution Program. States that conclusions of the mediation proceedings shall be treated as nonbinding and shall not affect any rights to review. (Sec. 5231) Sets forth additional remedies and enforcement provisions. Subtitle D: Medical Malpractice - Prohibits any medical malpractice liability action until the final resolution of the claim under alternative dispute resolution. Requires each regional alliance health plan and corporate alliance health plan to adopt at least one specified method of alternative dispute resolution. Prohibits an individual from bringing a medical malpractice liability action unless the individual submits an affidavit that includes a report by a qualified specialist that states that there is a meritorious cause for filing the action. (Sec. 5311) Directs the Secretary to establish: (1) a project to demonstrate whether substituting liability for medical malpractice on the part of the health plan in which a physician participates for the personal liability of the physician will result in improvements in the quality of care, reductions in defense medical practices, and better risk management; (2) a pilot program under which the Secretary provides funds to one or more eligible States to determine the effect of applying practice guidelines in the resolution of medical malpractice liability actions. Subtitle E: Fraud and Abuse - Directs the Secretary and the Attorney General to establish a program: (1) to coordinate the functions of the Attorney General, the Secretary, and other organizations with respect to the prevention, detection, and control of health care fraud and abuse; (2) to conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for health care; and (3) to facilitate the enforcement of this and other statutes applicable to health care fraud. (Sec. 5402) Creates, in the Treasury, the All-Payer Health Care Fraud and Abuse Control Account which shall consist of: (1) gifts and bequests; (2) administrative penalties and assessments and portions of civil monetary penalties imposed under provisions of the Social Security Act; (3) all criminal fines imposed in cases involving a Federal health care offense; (4) penalties imposed under the False Claims Act involving claims related to the provision of health care items and services; and (5) amounts resulting from the forfeiture of property by reason of Federal health care offense. States that amounts in the fund may be used to cover costs incurred in operating the Program. (Sec. 5411) Excludes from participation in any health plan any individual or entity excluded from participation in a public program under provisions of the Social Security Act. (Sec. 5413) Sets forth physician self-referral limitations. (Sec. 5431) Amends the Federal criminal code to set penalties for knowingly executing a scheme or artifice to: (1) defraud any health alliance, health plan, or other person (alliance) in connection with the delivery of, or payment for, health care benefits, items, or services (benefits); and (2) obtain, by false or fraudulent means, money or property owned by, or under the custody of control of, any such alliance in connection with the delivery of, or payment for, health care benefits. (Sec. 5432) Amends: (1) the Federal criminal code to require the court, in imposing sentence on a person convicted of a Federal health care offense that poses a serious threat to the health of any person or has a significant detrimental impact on the health care system, to order such person to forfeit property used in the commission of the offense or that constitutes, or is derived from, proceeds traceable to the commission of the offense which is of a value proportionate to the seriousness of the offense; and (2) the Federal judicial code to require that all proceeds of forfeiture relating to Federal health care offenses be deposited into the Department of Justice Assets Forfeiture Fund. (Sec. 5433) Amends the Federal criminal code to set penalties for: (1) knowingly and willfully falsifying, concealing, or covering up a material fact, making any false, fictitious, or fraudulent statements or representations, or making or using any false writing or document knowing it to contain any false, fictitious, or fraudulent statement or entry, in any matter involving a health alliance or health plan; and (2) bribery of, and graft by, a health care official. (Sec. 5435) Authorizes: (1) the Attorney General to commence a civil action in Federal court to enjoin a Federal health care offense; and (2) a person privy to certain grand jury information concerning a health law violation to disclose that information to an attorney for the Government to use in any civil proceeding related to a Federal health care offense. (Sec. 5437) Sets penalties for: (1) theft or embezzlement in connection with a health alliance, health plan, or fund connected with such alliance or plan; and (2) misuse of a health security card issued, or unique identifier provided, pursuant to this Act. (Sec. 5441) Makes provisions of the Civil False Claims Act applicable to the use of false records or statements made to a health plan. Includes within the definition of "claim" for purposes of such Act any request or demand for money or property which is made or presented to a health plan. Subtitle F: McCarran-Ferguson Reform - Amends the McCarran-Ferguson Act to repeal the exemption under specified antitrust laws for the business of insurance to the extent that such business relates to the provision of health benefits. Title VI: Premium Caps; Premium-Based Financing; and Plan Payments - Subtitle A: Premium Caps - Sets forth provisions which provide for the computation of factors that limit the growth of premiums for the comprehensive benefit package in regional alliance health plans, including the computation of a: (1) regional alliance inflation factor; and (2) general health care inflation factor. (Sec. 6002) Directs the Board to determine: (1) a national per capita baseline premium target; (2) the national average per capita current coverage health expenditures; and (3) current health care expenditures. (Sec. 6003) Directs the Board to determine a regional alliance per capita premium. (Sec. 6004) Requires a regional alliance to annually obtain premium bids from each plan seeking to participate as a regional alliance health plan with respect to the alliance. (Sec. 6005) Permits any participating State to assume responsibility for containment of health care expenditures in the State consistent with this Act. (Sec. 6006) Directs the chair of the Board to establish an advisory commission on regional variations in health expenditures. Requires the commission to examine methods of eliminating variation in regional alliance per capita premium targets due to variation in practice patterns, not due to other factors. Requires the Board to submit its recommendations to the Congress. Requires such recommendations to apply unless a joint resolution of disapproval is passed. (Sec. 6011) Subjects each noncomplying regional alliance health plan for a year to a reduction in plan payment as specified, in order to assure that payments to regional alliance health plans by a regional alliance are consistent. Defines a noncomplying plan to include a plan in which the final accepted bid exceeds the maximum complying bid for the per capita target premium. Defines "maximum complying bid." (Sec. 6021) Directs the Board to develop a methodology for calculating an annual per capita expenditure equivalent for amounts paid for coverage for the comprehensive benefit package within a corporate alliance. (Sec. 6022) Terminates a corporate alliance with two excess years in a three year period. Provides that employers that were corporate alliance employers with respect to a terminated alliance shall become regional alliance employers. Defines an excess year as one in which the rate of increase for the corporate alliance exceeds the national corporate inflation factor. Defines rate of increase and national corporate inflation factor. (Sec. 6031) Sets forth special rules for a single-payer State. (Sec. 6041) Directs the Secretary to establish a program to monitor prices and expenditures in the U.S. health care system. Subtitle B: Premium-Related Financings - Makes each family enrolled in a regional health alliance plan or in a corporate alliance health plan in a class of family enrollment responsible for payment of the family share of premium payable for enrollment. Provides for income related discounts and specified credits. (Sec. 6102) Establishes the formula for determining the premiums. (Sec. 6111) Provides for the repayment of credit by certain families. (Sec. 6114) Provides for the special treatment of certain retirees and qualified spouses and children. (Sec. 6121) Requires each regional alliance employer to pay a monthly premium to the regional alliance for a qualifying employee. Sets forth provisions for determining such premium. Varies the premium depending upon such factors as the employer's size and average wages paid. (Sec. 6126) Sets forth provisions applicable to self-employed individuals. (Sec. 6131) Sets forth provisions for determining the corporate employer premium. Subtitle C: Payments to Regional Alliance Health Plans - Sets forth provisions to determine the computation of: (1) the blended plan per capita payment amount; and (2) the plan bid, AFDC, and SSI proportions. Title VII: Revenue Provisions - Subtitle A: Financing Provisions - Amends the Internal Revenue Code to increase the excise taxes on cigarettes and other tobacco products. (Sec. 7113) Imposes an excise tax on the manufacture or importation of roll-your-own tobacco. (Sec. 7121) Imposes an assessment on each corporate alliance employer and a temporary assessment on employers with retiree health benefit costs. Requires such assessments to be paid in the same manner as employment taxes. (Sec. 7131) Provides for the recapture of certain health care subsidies received by high-income individuals. Transfers such amounts to the Supplemental Medical Insurance Trust Fund. (Sec. 7141) Requires certain shareholders of S corporations and limited partners who materially participate in corporate activities to include their share of income or loss from such corporation when determining net earnings from self-employment. (Sec. 7142) Provides for extending Medicare coverage and applying the hospital insurance tax to all State and local government employees. Subtitle B: Tax Treatment of Employer-Provided Health Care - Provides exceptions to the exclusion of employer-provided contributions to an accident or health plan from the gross income of an employee. (Sec. 7202) Prohibits the provision of health benefit under cafeteria plans. (Sec. 7203) Makes permanent the deduction for health insurance costs of self-employed individuals. Increases such deduction to 100 percent of the basic coverage purchased from a health alliance with limitations. Subtitle C: Employment Status Provisions - Requires the Secretary of the Treasury to prescribe regulations defining an employee for employment tax purposes. (Sec. 7302) Increases the penalty for failure to file correct returns involving payments for services. (Sec. 7303) Sets forth rules to limit retroactive employment tax reclassifications. Subtitle D: Tax Treatment of Funding of Retiree Health Benefits - Requires additional reserves for post-retirement medical and life insurance benefits to cover not less than ten years of the working lives of covered employees and to be maintained as separate accounts. (Sec. 7402) Terminates the authority of pension plans to maintain health benefits accounts. Subtitle E: Coordination with COBRA Continuing Care Provisions - Repeals provisions concerning continuation coverage requirements of group health plans upon implementation of this Act. Subtitle F: Tax Treatment of Organizations Providing Health Care Services and Related Organizations - Provides for the tax treatment of charitable organizations providing health care services, insurance provided by health maintenance organizations, and certain private foundations. (Sec. 7602) Sets forth transitional rules for taxing certain organizations providing health insurance and other prepaid health care services as insurance companies other than life insurance companies. (Sec. 7603) Exempts regional alliances from income tax. Subtitle G: Tax Treatment of Long-term Care Insurance and Services - Treats qualified long-term care services as medical care for purposes of the medical expense deduction. (Sec. 7702) Provides for the treatment of long-term care insurance as accident and health insurance. (Sec. 7703) Allows accelerated death benefits under life insurance contracts to be paid to terminally ill individuals. Subtitle H: Tax Incentives for Health Service Providers - Allows a tax credit for certain qualified individuals who provide primary health services full time in a health professional shortage area. (Sec. 7802) Increases the allowable depreciation deduction for expensing certain medical equipment. Subtitle I: Miscellaneous Provisions - Allows a tax credit for the cost of personal assistance services required by an employed individual who for medical reasons is unable to engage in substantial gainful activity. (Sec. 7902) Denies tax-exempt status for private activity bonds of regional alliances, corporate alliances, or guaranty funds established under this Act. Title VIII: Health and Health-Related Programs of the Federal Government - Subtitle A: Military Health Care Reform - Directs the Secretary of Defense to establish one or more uniformed services health plans in order to provide health care services to members of the armed forces on active duty for 30 or more days as well as their covered beneficiaries. Requires conformity of such plans with health plan requirements set forth in this Act. (Sec. 8001b) Allows any such plan to rely upon the use of military health care facilities, supplemented by civilian health care providers or health plans under agreements entered into by the Secretary. Requires at least the items and services in the comprehensive benefit package under this Act to be included in each such plan. Preempts any conflicting State health plan requirements. Provides for plan enrollment, effect of failure to enroll, and choosing between a uniformed services health plan and other available plans. Prohibits the imposition of plan charges to an active-duty member other than subsistence charges, but allows the Secretary to impose limited charges for covered beneficiaries. Establishes in the Department of Defense a financial account for payments received in connection with a uniformed services health plan, allowing such funds to be used only for purposes directly related to the delivery and financing of health care services under this Subtitle. Subtitle B: Department of Veterans Affairs - Allows each veteran who is an eligible individual under this Act and individuals currently enrolled in a health plan under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) to be enrolled with a Department of Veterans Affairs (VA) health plan. Requires conformity of such plans with health plan requirements set forth in this Act, with all the items and services of the comprehensive benefit package under this Act included. Allows such plans to offer supplemental health benefits and cost-sharing policies as consistent with this Act. Provides a limitation with regard to veterans enrolled with health plans outside the VA. Prohibits the imposition of any plan enrollment charges upon service-connected disabled veterans, veterans receiving disability compensation from the VA, former prisoners of war, and veterans unable to defray the costs of such care. Allows the Secretary of Veterans Affairs to establish plan charges for other veterans. Deems a VA facility to be a Medicare provider for purposes of any program administered by the Secretary of Health and Human Services. Allows for the recovery of certain care and services provided under a VA plan in the case of an individual who has coverage under another plan. Establishes in the Treasury the Department of Veterans Affairs Health Plan Fund to be used for VA health plan payments and services. Preserves existing benefits for VA facilities not operating within a health plan certified under this Act. (Sec. 8102) Directs the Secretary of Veterans Affairs to organize health plans and operate VA facilities as, or within, health plans under this Act. Preempts existing State health plan standards or requirements. Authorizes the Secretary to contract for the provision of services by a VA health plan when cost-effective, or to share resources with other health care plans, providers, or organizations. Authorizes appropriations to the VA for FY 1995 through 1997 for VA health plans under this Subtitle, subject to availability of appropriations. Requires a report from the Secretary to the Congress concerning the operation of the VA health care system within the requirements of this Act. Authorizes the Secretary to accept and use grants for health care services provided to special populations if used by the VA while operating under a VA health plan. Subtitle C: Federal Employees Health Benefits Programs - (Secs. 8202 through 8204) Provides for termination of the Federal Employees Health Benefits Program (FEHB) and treatment of Federal employees, annuitants, and other individuals (including those residing abroad) who would otherwise have been eligible for FEHBP under this Act's health plans. Subtitle D: Indian Health Service - Makes qualifying Indians eligible to enroll in a comprehensive benefits health program of the Indian Health Service. (Sec. 8303) Authorizes appropriations for supplemental Indian health care benefits. (Sec. 8305) Exempts tribal governments and organizations from making employer payments. (Sec. 8306) Sets forth provisions regarding health service to non-enrollees and non-Indians. (Sec. 8311) Requires each health program of the Indian Health Service to establish a comprehensive benefit package fund. (Sec. 8313) Authorizes appropriations for the Indian Health Service programs. Subtitle E: Amendments to the Employee Retirement Income Security Act of 1974 - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to revise and limit the coverage of group health plans under ERISA. Makes certain ERISA provisions inapplicable with respect to State-certified health plans. Provides for an exception from ERISA civil action provisions where review is otherwise available under the Health Security Act (this Act, HSA). (Sec. 8402) Establishes ERISA requirements for expeditious reporting and disclosure applicable to group health plans, through special rules consistent with ERISA and HSA purposes. Excludes plans maintained by regional alliances from treatment as multiple employer welfare arrangements. (Sec. 8403) Revises certain ERISA provisions relating to continuation coverage under group health plans. Repeals such provisions upon implementation of HSA. (Sec. 8404) Makes ERISA standards for group health plans regarding: (1) cases of adoption applicable except to the extent otherwise provided in regulations of the National Health Board under HSA; and (2) coverage of pediatric vaccines inapplicable to a group health plan upon its becoming a corporate alliance health plan under HSA. (Sec. 8405) Requires group health plans under ERISA to comply with HSA requirements relating to health plan claims procedure. Subtitle F: Special Fund for WIC Program - Authorizes appropriations through FY 2000 for the special supplemental food program for women, infants, and children under the Child Nutrition Act of 1966. Title IX: Aggregate Government Payments - Subtitle A: Aggregate State Payments - Sets forth provisions which have formulas for determining each participating State's payment to regional alliances within the State. Provides two different formulas. Establishes one payment formula for non-cash assistance recipients. Establishes another formula relating to cash assistance recipients. Defines a non-cash assistance adult as an individual who is: (1) over 21 years; (2) a U.S. citizen or lawful alien; and (3) is not an AFDC or SSI recipient or a Medicare-eligible individual. (Sec. 9022) Directs the National Health Board to review appropriateness of such payments. Subtitle B: Aggregate Federal Alliance Payments - Sets forth the formula for determining Federal payments to regional alliances for cash assistance recipients. (Sec. 9102) States that this section constitutes budget authority in advance of appropriation Acts and obligates the Federal Government to provide for the payment to regional alliances of a capped Federal alliance payment amount. Defines "capped Federal alliance payment amount." Subtitle C: Borrowing Authority to Cover Cash-flow Shortfalls - Authorizes the Secretary to make available loans to regional alliances to cover any period of temporary cash-flow shortfall attributable to: (1) any estimation discrepancy; (2) a period of temporary cash-flow shortfall attributable to an administrative error; or (3) a period of temporary cash-flow shortfall relating to the relative timing during the year in which amounts are received and payments are required. Sets forth loan terms and conditions. Title X: Coordination of Medical Portion of Workers Compensation and Automobile Insurance - Subtitle A: Workers Compensation Insurance - Requires each health plan that provides services to enrollees through participating providers to make arrangements to provide workers compensation to such enrollees. (Sec. 10002) Requires each workers' compensation carrier that is liable for payment for workers' compensation services furnished by or through a health plan, regardless of whether or not the services are included in the comprehensive benefit package, to make payment for such services. (Sec. 10011) Sets forth requirements for participating States. (Sec. 10031) Authorizes demonstration projects in one or more States with respect to the treatment of work-related injuries and illnesses. Subtitle B: Automobile Insurance - Requires an individual entitled to automobile insurance medical benefits and enrolled in a health plan to receive automobile insurance medical services through the provision of such services by the health plan. (Sec. 10102) Requires each automobile insurance carrier that is liable for payment for automobile insurance medical services furnished by or through a health plan, regardless of whether or not the services are included in the comprehensive benefit package, to make payment for such services. (Sec. 10111) Requires each participating State to develop a fee schedule applicable to payment for automobile insurance medical services for which a fee is not included in the applicable fee schedule. Subtitle C: Commission on Integration of Health Benefits - Establishes the Commission on Integration of Health Benefits which shall study and report on the feasibility and appropriateness of transferring financial responsibility for all medical benefits, including those currently covered by workers compensation and automobile insurance, to health plans. Authorizes appropriations. Subtitle D: Federal Employees' Compensation Act - Requires the Federal Employees' Compensation Act to be interpreted and administered consistent with the provisions of subtitle A. Subtitle E: Davis-Bacon Act and Service Contract Act - Amends the Davis-Bacon Act and the Service Contract Act of 1965 to require Health Security Act benefits. Subtitle F: Effective Dates - Sets forth effective date provisions. Title XI: Transitional Insurance Reform - Sets forth transitional provisions concerning: (1) enforcement; (2) preservation of current coverage; (3) restrictions on premium increases during transition; (4) portability requirements; (5) restrictions limiting benefit reductions; and (6) the establishment of the National Transitional Health Insurance Risk Pool.
Bill· HRH.R. 3582 (103rd)referred
United States · United States Congress · 20 November 1993
Amends the National School Lunch Act (NSLA) to make Head Start participants automatically eligible for free meals under the NSLA school lunch program and the school breakfast program of the Child Nutrition Act of 1966 (CNA). Revises the child and adult care food program under NSLA. Broadens the definition of eligible institution. Provides for additional reimbursement for family or group day care home sponsoring organizations and an enhanced administrative reimbursement rate for such organizations serving rural or low-income area providers. Increases the allowable amount of startup and expansion funds. Allows expansion funds to be used for outreach to unlicensed day care homes. Extends the authorization of appropriations for such program. Adds provisions relating to information about Medicaid and the special nutrition program for women, infants, and children (WIC). Expands eligibility for meal supplements for the afterschool care program to youths up to age 18. Requires the Secretary of Agriculture to report on demonstration projects to improve food service for homeless children. Directs the Secretary to use certain funds for nutrition counseling, assessments, and referrals for participants in such homeless demonstration program, WIC, Medicaid, and similar programs for homeless pregnant women or those at risk of becoming so, homeless mothers with newborn infants, or the guardians of boarder babies or other abandoned infants. Requires periodic reports. Amends the Child Nutrition Act of 1966 (CNA) to require States to use a portion of certain increased grant funds for nutrition education and training assistance for family day care home sponsors and day care center staff.
Bill· SS. 1685 (103rd)open
United States · United States Congress · 19 November 1993
DOE Minority Bank Preservation Act of 1993 - Amends the Federal Deposit Insurance Act to provide separate Federal deposit insurance for each beneficiary of an irrevocable trust or insured depository institution depositing funds pursuant to the Bank Deposit Financial Assistance Program of the Department of Energy. Authorizes appropriations for wastewater treatment projects in minority communities with special needs in order to: (1) improve housing stock infrastructure; and (2) abate health hazards caused by groundwater contamination.
Bill· HRH.R. 3564 (103rd)open
United States · United States Congress · 19 November 1993
Disabled and Blind Homeowners Home Equity Conversion Mortgage Act - Amends the National Housing Act to make homeowners who are at least 50 years old and disabled or blind eligible for insured home equity conversion mortgages.
Bill· SS. 1662 (103rd)referred
United States · United States Congress · 16 November 1993
Community Development Flexibility Act - Amends the Housing and Community Development Act of 1974 to increase the maximum amount of community development block grant assistance that may be used for public service activities.
Bill· HRH.R. 3511 (103rd)open
United States · United States Congress · 16 November 1993
Fiscal Year 1994 Rescission Act - Rescinds certain budget authority made to the following entities: (1) the Department of Agriculture; (2) the Department of Commerce; (3) the Department of State; (4) judicial defender services; (5) the Board for International Broadcasting; (6) the United States Information Agency; (7) the Civil Corps of Engineers; (8) the Department of the Interior; (9) the Department of Energy; (10) certain economic assistance funds and military assistance funds appropriated to the President; (11) the Department of the Treasury; (12) the Department of Labor; (13) the Department of Health and Human Services; (14) the Department of Education; (15) the House of Representatives and certain congressional agencies; (16) Department of Defense military construction; (17) the Department of Transportation; (18) the General Services Administration; (19) the Department of Veterans Affairs; (20) the Department of Housing and Urban Development; (21) the Environmental Protection Agency; (22) the Federal Emergency Management Agency; (23) the National Aeronautics and Space Administration; (24) the National Science Foundation; and (25) the National Service Initiative.
Bill· SS. 1653 (103rd)referred
United States · United States Congress · 10 November 1993
Directs the Secretary of the Treasury to pay a specified sum to a named Utah corporation in full satisfaction of its claims against the United States arising out of a contract for the rehabilitation of military housing.
Bill· HRH.R. 3500 (103rd)referred
United States · United States Congress · 10 November 1993
TABLE OF CONTENTS: Title I: AFDC Transition and Work Program Title II: Paternity Establishment Title III: Expansion of Statutory Flexibility of States Title IV: Expansion of State and Local Flexibility Title V: Child Support Enforcement Title VI: Welfare Restrictions for Aliens Title VII: Controlling Welfare Costs Title VIII: Consolidated Block Grant to States for Food Assistance Title IX: Miscellaneous Responsibility and Empowerment Support Program Providing Employment, Child Care, and Training Act - Title I: AFDC Transition and Work Program - Amends part F (Job Opportunities and Basic Skills Training Program) (JOBS) of title IV of the Social Security Act (SSA) to give the JOBS program the new purpose of assuring that needy families with children obtain not only the education and training needed to prepare them for a life without welfare, but the work experience as well. (Sec. 101) Requires State JOBS programs to include a transition component and a work supplementation component that: (1) are each allowed to include any State work experience program approved by the Secretary; and (2) with respect to the first component, must include the State's job search program, and, with respect to the second component, may include the State's work supplementation or community work experience program. Amends part A (Aid to Families with Dependent Children) (AFDC) of SSA title IV to revise State AFDC plan participation requirements to incorporate participation in the two JOBS program components above under specified guidelines as a requirement for qualified individuals to receive AFDC. Imposes sanctions for a qualified individual's failure to participate in the JOBS program as required under such guidelines, which include a reduction in AFDC benefits and eventual benefit termination for repeated failures. Revises the exemptions from JOBS program participation requirements. Extends to all States the option to limit AFDC-UP. Increases State JOBS program and work program participation rates with regard to, respectively, AFDC-eligible individuals and unemployed parents. Provides for additional payments to States for JOBS programs. (Sec. 102) Amends community work experience and work supplementation program provisions. Title II: Paternity Establishment - Amends SSA title IV part A to: (1) provide for denial or reduction of AFDC for children whose paternity is not established; and (2) require unmarried individuals under 19 who are eligible for AFDC and are pregnant or with dependent children under their care to reside at home in order to receive AFDC. (Sec. 203) Amends SSA title IV part D (Child Support and Establishment of Paternity) to require earlier specified paternity establishment efforts by States. Expresses the encouragement of the Congress for States to develop procedures in public hospitals and clinics to facilitate the acknowledgment of paternity. (Sec. 204) Increases the paternity establishment percentage. Title III: Expansion of Statutory Flexibility of States - Amends SSA title IV part A to give States the option to: (1) convert AFDC into a block grant program; (2) exempt themselves from otherwise mandatory denial of AFDC where either parent is a minor; (3) treat families moving interstate who apply for AFDC in their new State of residence (where they have resided for less than on year) under the AFDC rules of their former State of residence; (4) reduce AFDC for parents under 21 who have dropped out of school and dependent children who, without good cause, do not maintain minimum school attendance; (5) exempt themselves from otherwise mandatory denial of AFDC for additional children; (6) modify certain AFDC income disregard rules; (7) provide for a married couple transitional benefit in cases where an AFDC recipient marries an individual who is not a parent of the recipient's child, and the resulting family would become ineligible for AFDC by reason of the marriage; (8) disregard certain savings and income of a family on AFDC designated for education, training, employability, home purchase, or residence change in determining eligibility for AFDC; and (9) condition the receipt of AFDC on the recipient's attendance at parenting and money management classes and prior approval of any action requiring a change in the educational institution attended by the recipient's dependent child. Title IV: Expansion of State and Local Flexibility -Establishes an Interagency Waiver Request Board in order to provide a focal point within the Federal Government for the development and coordination of waiver requests to improve opportunities for low-income individuals and families. (Sec. 402) Prescribes contents of applications to implement Federal assistance plans, as well as the review, approval, implementation, and evaluation processes. (Sec. 405) Requires any entity applying for plan approval to establish a Public Private Partnership Committee to advise it on plan development and implementation. Title V: Child Support Enforcement - Provides for a national system for employee reporting of any child support owed, the obligee involved, and other specified related information on W-4 forms for employer withholding and distribution of support owed, and reporting of related information to the State involved for availability to other States through the Interstate Locate Network established under this title. (Sec. 502) Makes various changes with regard to State child support order registries, the Parent Locater Service, regulations for sharing child support information, withholding orders, and noncustodial parents with child support arrearages who are receiving certain public welfare assistance. Title VI: Welfare Restrictions for Aliens - Makes aliens (except refugees, permanent residents, and certain current residents) ineligible for various specified types of public welfare assistance, including non-emergency related assistance under Medicaid, food stamps, and job training assistance. (Sec. 602) Amends part A (Aid to Families with Dependent Children) (AFDC) of title IV of the Social Security Act (SSA) to require State AFDC agencies to provide information on illegal aliens to the Immigration and Naturalization Service. Title VII: Controlling Welfare Costs - Amends the Congressional Budget Act of 1974, the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings Act), and other Federal law to establish various specified measures for controlling welfare costs, including Federal spending caps. Title VIII: Consolidated Block Grant to States for Food Assistance - Repeals the Food Stamp Act of 1977, National School Lunch Act, Commodity Distribution Reform Act and WIC Amendments of 1987, and other specified Federal laws and replaces them with a: (1) State food assistance block grant program to provide food assistance to economically disadvantaged individuals and families (eligible populations); and (2) new food coupon program. Authorizes appropriations. (Sec. 803) Grants the Secretary of Agriculture and the Commodity Credit Corporation the authority to sell surplus commodities and foodstuffs to the States to provide food assistance to eligible populations. Title IX: Miscellaneous - Amends SSA title IV part A to require AFDC applicants and recipients to undergo any necessary substance abuse treatment as a condition of receiving AFDC. (Sec. 902) Amends SSA title XVI (Supplemental Security Income) (SSI) to: (1) make ineligible for SSI benefits individuals receiving SSI on the basis of a disability resulting from illegal drug addiction who continue to use illegal drugs or refuse to be tested for them; and (2) make representative payee changes. (Sec. 903) Directs the Secretary of Health and Human Services to: (1) conduct research projects to evaluate the impact of education and training programs on the ability of individuals to end participation in the AFDC program; (2) conduct demonstration projects and report to the Congress on whether providing benefits based on need through the use of electronic cards and automatic teller machines would reduce administrative costs and fraud; and (3) establish a commission to determine the cost and feasibility of creating an interstate system to compare the social security numbers of all AFDC recipients in order to identify those recipients receiving AFDC from multiple States. (Sec. 904) Amends SSA to require State AFDC applicants to participate in job search activities while the application is pending, unless a State by law exempts itself from this requirement. (Sec. 906) Public Housing Rent Reform and Empowerment Act - Amends the United States Housing Act of 1937 with regard to the determination of income and rent charges. Authorizes the Secretary of Housing and Urban Development to allow, upon request, under certain circumstances, a public housing agency or resident management corporation to carry out a demonstration program to determine the feasibility and desirability of providing such entities with the authority to establish policies for agency-administered public housing projects, without regard to the public housing requirements of the United States Housing Act of 1937. (Sec. 907) Amends SSA title IV part A to deny AFDC for certain children who have not received appropriate medical examinations and immunizations. Amends the Child Care and Development Block Grant Act with regard to childhood immunizations. Requires the Surgeon General to issue and periodically revise recommendations for the immunization of children under age six.
Law· HRH.R. 3474 (103rd)enacted
United States · United States Congress · 9 November 1993
TABLE OF CONTENTS: Title I: Regulatory Reform Subtitle A: Amendments Relating to the Federal Deposit Insurance Corporation Improvement Act of 1991 Subtitle B: General Regulatory Reform Subtitle C: Other Regulatory Reform Subtitle D: Reports, Studies, Streamlined Regulatory Requirements Title II: Community Development Financial Institutions Title I: Regulatory Reform - Regulatory Reform Act of 1993 - Subtitle A: Amendments Relating to the Federal Deposit Insurance Corporation Improvement Act of 1991 - Amends the Federal Deposit Insurance Act (FDIA) to: (1) modify holding company audit requirements; (2) increase the asset size of small insured depository institutions eligible for Federal 18-month examination schedules; (3) repeal the mandate that each appropriate Federal banking agency prescribe stock valuation standards for insured depository institutions; (4) exclude depository institution holding companies from the scope of Federal standards for safety and soundness; and (5) direct the Federal Deposit Insurance Corporation to minimize the regulatory burden on insured depository institutions when prescribing reporting requirements. Subtitle B: General Regulatory Reform - Amends the Financial Institutions Reform, Recovery, and Enforcement Act of 1989 to direct the Appraisal Subcommittee to encourage the States to develop reciprocity agreements permitting licensed appraisers in good standing to perform appraisals in sister States. (Sec. 112) Amends the FDIA to: (1) permit certain small changes in agreements for collateralization of public deposits; (2) provide separate insurance for deposits made pursuant to any revocable trust established under the Bank Deposit Financial Assistance Program of the Department of Energy; and (3) mandate that State and Federal regulatory agencies coordinate their examinations and reporting requirements for insured depository institutions. (Sec. 116) Amends the Federal Reserve Act to limit the liability of member banks for deposits made at foreign branches. (Sec. 117) Amends the Bank Holding Company Act of 1956 (BHCA) to provide expedited procedures for forming a bank holding company. Amends specified banking law to: (1) reduce the number of directors of national banking associations which must come from a designated geographical area; and (2) repeal specified obsolete requirements for national banks. Subtitle C: Other Regulatory Reform - Amends the Real Estate Settlement Procedures Act (RESPA) to permit specified disclosures under the Truth in Lending Act to be used in lieu of RESPA disclosure requirements with respect to home equity loans. (Sec. 122) Amends the Housing and Urban Development Act of 1968 to state that creditors shall not be required to provide homeownership debt counseling notification more than once annually. (Sec. 123) Amends RESPA to: (1) modify the disclosure requirements regarding the servicing of federally related mortgage loans; and (2) exempt from its purview extensions of credit for business, commercial, or agricultural purposes and loans to government agencies. (Sec. 125) Amends the Truth in Lending Act, the Truth in Savings Act, and the Truth in Leasing Act to prescribe special disclosure guidelines for radio broadcast advertisements for open end consumer credit plans, specified other credit plans, certain deposits, and consumer leases, including use of a toll-free telephone number. Subtitle D: Reports, Studies, Streamlined Regulatory Requirements - Directs the Secretary of the Treasury to study and report to the Congress on: (1) the impact of the implementation of risk-based capital standards on the domestic economy; and (2) the availability of credit for consumers and small businesses. (Sec. 133) Directs the Board and selected Federal and congressional agencies to study and report to the Congress on the impact (including budgetary impact) of the payment of interest on the sterile reserves of insured depository institutions. (Sec. 134) Directs Federal banking agencies to: (1) review, streamline, and make uniform regulatory requirements, and report jointly to the Congress; (2) work jointly to simplify and make uniform the financial status reports required of the banking industry; (3) consider the burden upon such industry of additional regulatory requirements; (4) eliminate duplicative filings; and (5) jointly review and revise (if necessary) the manner in which recourse loans are treated under capital standards and other accounting principles. (Sec. 139) Amends the FDIA to cite conditions under which banking agencies shall not be required to submit antitrust reports in connection with bank merger transactions. (Sec. 140) Amends selected Federal banking laws and the Home Owners' Loan Act to modify the guidelines under which a national banking association or Federal savings association may purchase for its own account shares of stock owned exclusively by depository institution holding companies functioning as bankers' banks. (Sec. 141) Amends the FDIA to apply Federal due process protections to the prejudgment attachment of assets of a depository institution whose insured status has been terminated, without regard to the requirement that the applicant show irreparable and immediate injury or loss. Title II: Community Development Financial Institutions - Community Development Banking and Financial Institutions Act of 1993 - Establishes the Community Development Banking and Financial Institutions Fund as a wholly-owned government corporation to: (1) provide financial and technical assistance, including training, to community development financial institutions; and (2) establish a national information clearinghouse. Requires the Fund to submit to the President an annual status report and specified studies. (Sec. 212) Authorizes appropriations.
Bill· SS. 1639 (103rd)open
United States · United States Congress · 8 November 1993
Presidio Corporation Establishment Act - Establishes within the Department of the Interior the Presidio Corporation to manage the leasing, maintenance, rehabilitation, repair, and improvement of the following properties within the Presidio in California, leaseholds to which shall be transferred, pursuant to this Act, by the Secretary of the Interior to the Corporation: (1) the Letterman-LAIR complex; (2) Fort Scott; (3) Main Post; (4) Golden Gate; (5) Calvary Stables; (6) Presidio Hill; (7) Wherry Housing; (8) East Housing; (9) the structures at Crissy Field; and (10) such other buildings within the Presidio as the Secretary determines appropriate. Reverts all interests and assets of the Corporation to the United States in the event the Corporation fails or defaults. Requires the Corporation to establish competitive bidding procedures for issuance of leases and contracts under this Act. Authorizes appropriations.
Bill· HRH.R. 3460 (103rd)open
United States · United States Congress · 8 November 1993
Hazardous Materials Transportation Act Reauthorization Amendments of 1993 - Amends the Hazardous Materials Transportation Act to prohibit a person from representing that a component of a container or package for the transportation of hazardous materials is safe, certified, or in compliance with the requirements of this Act unless it meets such requirements. (Sec. 4) Authorizes the Secretary of Transportation (Secretary) to waive mandatory registration statement filing requirements and the payment of certain fees for any person not domiciled in the United States who solely offers from a place outside of the United States the transportation of hazardous materials to the United States if the country in which such person is domiciled does not require U.S. domiciliaries to file such statements or to pay such fees when making such offer. (Sec. 7) Authorizes appropriations for the regulation of the transportation of hazardous materials. (Sec. 8) Directs the Secretary, in order to further the training of public sector employees to respond to hazardous materials accidents, to make grants to national nonprofit employee organizations engaged solely in fighting fires for the purpose of training individuals with statutory responsibility to respond to such accidents. Authorizes appropriations. (Sec. 10) Authorizes the Secretary to make grants to one or more persons, including a State or local government or department, agency or instrumentality, to carry out a pilot project to demonstrate the feasibility of establishing a reporting system and computerized telecommunication data center that is capable of: (1) receiving and retrieving data on shipments of hazardous materials; (2) identifying types of hazardous material being shipped; and (3) providing information to facilitate responses to accidents involving such shipments. Authorizes appropriations. (Sec. 11) Directs the Secretary to study and report to the Congress on the safety considerations of transporting hazardous materials in close proximity to Federal prisons, particularly those housing maximum security prisoners. (Sec. 12) Directs the Secretary to enter into arrangements with the National Academy of Sciences to study and report to the Secretary and the Congress on both commercial motor vehicles carrying hazardous materials and commercial vehicles in general with respect to: (1) the regulation of radar detectors in such vehicles; (2) ways in which radio microwave technologies may be used to enhance the safety of such vehicles; and (3) ways in which such technologies may be used in the the application of intelligent vehicle highway systems consistent with the goals of the Intelligent Vehicle-Highway Systems Act of 1991. (Sec. 14) Requires the Secretary to initiate a rulemaking proceeding to determine whether certain requirements under the Hazardous Materials Transportation Act with respect to openhead fiber drum packaging can be met for the domestic transportation of liquid hazardous materials with standards other than certain performance oriented packaging standards contained in 49 Code of Federal Regulations 178. Requires the Secretary to implement any other performance oriented packaging standard that will provide an equal or greater level of safety for the transportation of liquid hazardous materials.
Bill· HRH.R. 3433 (103rd)open
United States · United States Congress · 3 November 1993
Establishes within the Department of the Interior the Presidio Corporation to manage the leasing, maintenance, rehabilitation, repair, and improvement of the following properties within the Presidio in California leaseholds to which shall be transferred under this Act to the Corporation by the Secretary of the Interior: (1) the Letterman-LAIR complex; (2) Fort Scott; (3) Main Post; (4) Cavalry Stables; (5) Presidio Hill; (6) Wherry Housing; (7) East Housing; (8) the structures at Crissy Field; and (9) such other buildings within the Presidio as the Secretary determines appropriate. Requires the Corporation to establish competitive bidding procedures for issuance of leases and contracts under this Act. Reverts all interests and assets of the Corporation to the United States in the event the Corporation fails or defaults. Authorizes appropriations.
Law· SS. 1614 (103rd)open
United States · United States Congress · 2 November 1993
TABLE OF CONTENTS: Title I: Special Nutrition Program for Women, Infants, and Children Title II: School Breakfast and Related Programs Title III: School Lunch and Related Programs Title IV: Program Integrity Title V: Effective Dates Better Nutrition and Health for Children Act of 1993 - Amends the Child Nutrition Act of 1966 (CNA) and the National School Lunch Act (NSLA) to revise and reauthorize child nutrition programs. Title I: Special Nutrition Program for Women, Infants, and Children - Amends CNA to extend and increase the authorization of appropriations for the special nutrition program for women, infants, and children (WIC) (currently named the special supplemental food program for WIC). (Sec. 102) Increases funding and activities under the WIC breastfeeding promotion program. (Sec. 103) Expands the WIC farmers market program. Directs the Secretary of Agriculture to promote use of farmers markets by recipients of Federal nutrition programs. Title II: School Breakfast and Related Programs - Amends CNA to remove certain limitations on providing milk to low-income children. (Sec. 202) Eliminates the cost basis for the severe need reimbursement rate under CNA, if at least 40 percent of a school's students participating in the school lunch program under the NSLA are eligible to receive meals for free or at reduced prices. (Sec. 203) Directs the Secretary to permit schools to offer low-fat yogurt (which may be required to be enriched) as a meat alternative in the school breakfast program. (Sec. 205) Extends and increases the authorization of appropriations for startup costs for school breakfast programs. (Sec. 206) Provides for: (1) expansion of school breakfast programs through competitive grants to States; and (2) increased payments for State administrative expenses under CNA and NSLA programs. (Sec. 208) Authorizes State agencies and school food authorities to establish more stringent rules and policies than the minimum Federal requirements under CNA and NSLA, including prohibiting or controlling sale of competitive (or junk) food throughout the school campus during the school day. Directs the Secretary to develop model language for banning sale of competitive foods of minimal nutritional value anywhere on school grounds before the end of the last lunch period. (Sec. 209) Adds several authorized uses of funds under nutrition education and training programs. Authorizes appropriations. Title III: School Lunch and Related Programs - Amends NSLA to require that school lunch program lunches offer students fluid milk, removing the requirement that there be a choice of both whole milk and unflavored lowfat milk. (Sec. 302) Directs the Secretary to permit schools to offer low-fat yogurt (which may be required to be fortified) as a meat alternative in the school lunch program. (Sec. 303) Requires various reports by the Secretary to the appropriate congressional committees on increasing consumption of healthy foods in school lunches. (Sec. 304) Directs the Secretary to assist States through grants and other means to provide information to parents on the importance of nutrition, including parent-student education and parent visiting of school breakfast and lunch programs. Authorizes appropriations. (Sec. 305) Revises income guidelines for free lunches to increase the numbers of eligible elementary school students. (Sec. 306) Allows State agencies or local food authorities to use a determination of eligibility of a child for free or reduced price meals to demonstrate the child's eligibility for benefits under other Federal, State, or local means-tested programs. (Sec. 307) Makes Head Start participants automatically eligible for free breakfasts and lunches under CNA and NSLA. (Sec. 308) Revises the formula for special assistance payments to consider the number of free meals served (currently only lunches are considered). (Sec. 309) Directs the Secretary to develop and make available public service advertisements that promote healthy eating habits for children. (Sec. 310) Establishes a program to encourage use of organically produced foods in school breakfast and lunch programs. Allows priority to be given to socially disadvantaged, very rural, or small-scale farmers or ranchers. (Sec. 311) Directs the Secretary to award annual grants to private nonprofit educational organizations in three States to create food and nutrition projects fully integrated with elementary school curricula. Authorizes appropriations. (Sec. 312) Revises the summer food service program for children, expanding or making it more flexible with respect to specified features. Authorizes appropriations. (Sec. 313) Reauthorizes the commodity distribution program. Directs the Secretary to: (1) improve overall nutritional quality of entitlement commodities provided to schools; and (2) require that nutritional content information labels be placed on packages or shipments of such entitlement commodities or otherwise provide such information. (Sec. 314) Revises the child and adult care food program. Allows expansion funds to be used for outreach to unlicensed day care homes. Authorizes appropriations. Provides for dissemination of Medicaid and WIC information in connection with such program. (Sec. 315) Makes a child automatically eligible for a free or reduced price meal supplement in afterschool care if already certified eligible for free or reduced price school breakfasts or lunches. (Sec. 316) Reauthorizes appropriations for demonstration projects to improve food service to homeless children under age six in emergency shelters. Authorizes appropriations. (Sec. 317) Establishes pilot programs, under the school breakfast and lunch programs, to increase: (1) offerings of fruits and vegetables; (2) consumption of low-fat dairy products and lean meats; and (3) use of fortified fluid milk, including an information program. Authorizes appropriations. (Sec. 320) Requires that specified activities be conducted with assistance for food service management institutes and other institutions. Authorizes appropriations. (Sec. 321) Requires the Secretary to report to specified congressional committees on the coordinated review system under NSLA. (Sec. 322) Requires revision of menu planning guides with respect to reduction of fat and saturated fat. Requires the Secretary to report to the Congress on compliance with such fat guidelines as well as those for dietary fiber, sodium, and sugar in school breakfast and lunch programs. (Sec. 323) Directs the Secretary to enter into a contract with a nongovernmental organization for an information clearinghouse for nongovernmental groups that assist low-income individuals or communities with food assistance or self-help or other empowering activities. Authorizes appropriations. Title IV: Program Integrity - Amends NSLA to set forth duties of the Secretary relating to anticompetitive activities under various child nutrition programs under CNA and NSLA, including debarment policy. (Sec. 403) Authorizes the Secretary to provide grants to State educational agencies and other State agencies that administer child nutrition programs for prevention and control of anticompetitive activities. Authorizes appropriations. Title V: Effective Dates - Sets forth effective dates.
Bill· SS. 1608 (103rd)open
United States · United States Congress · 2 November 1993
TABLE OF CONTENTS: Title I: Department of Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Title II: Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Title III: Energy and Water Development Title IV: Foreign Operations, Export Financing, and Related Programs Title V: Department of Defense Title VI: Department of Transportation and Related Agencies Title VII: General Services Title VIII: Department of Veterans Affairs and Housing and Urban Development, and Independent Agencies Title I: Department of Agriculture, Rural Development, Food and Drug Administration, and Related Agencies - Rescinds funds made available to the Department of Agriculture for the Agricultural Research Service, the Cooperative State Research Service, the Agricultural Stabilization and Conservation Service, the Soil Conservation Service, the Farmers Home Administration, the Rural Electrification Administration, and the Food and Nutrition Service. Title II: Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies - Rescinds funds made available to: (1) the State Justice Institute; (2) the Department of Commerce for the National Oceanic and Atmospheric Administration and the International Trade Administration; (3) the Small Business Administration; (4) the Department of State for the Administration of Foreign Affairs; and (5) the United States Information Agency. Title III: Energy and Water Development - Rescinds funds made available to: (1) the Department of the Army for the Civil Corps of Engineers; (2) the Bureau of Reclamation of the Department of the Interior; and (3) the Department of Energy. Title IV: Foreign Operations, Export Financing, and Related Programs - Rescinds certain funds appropriated to the President for the international development assistance and international security assistance. Title V: Department of Defense - Rescinds funds appropriated to the Department of Defense for military construction. Title VI: Department of Transportation and Related Agencies - Rescinds funds made available to the Department of Transportation for the Federal Aviation Administration, the Federal Highway Administration, and the Federal Transit Administration. Title VII: General Services Administration - Rescinds funds made available for the Federal Buildings Fund. Title VIII: Departments of Veterans Affairs and Housing and Urban Development, and Independent Agencies - Rescinds funds made available for certain housing programs.
Bill· SS. 1607 (103rd)open
United States · United States Congress · 1 November 1993
TABLE OF CONTENTS: Title I: Public Safety and Policing Title II: Death Penalty Title III: Habeas Corpus Reform Title IV: Gun Crime Penalties Title V: Obstruction of Justice Title VI: Youth Violence Subtitle A: Increased Penalties for Drug Trafficking and Criminal Street Gangs Subtitle B: Juvenile Drug Trafficking and Gang Prevention Grants Subtitle C: Bindover System for Certain Violent Juveniles Title VII: Terrorism Subtitle A: Maritime Navigation and Fixed Platforms Subtitle B: General Provisions Title VIII: Sexual Violence and Child Abuse Subtitle A: Sexual Abuse Subtitle B: Child Protection Subtitle C: Crimes Against Children Title IX: Crime Victims Subtitle A: Victims' Rights Subtitle B: Crime Victims' Fund Title X: State and Local Law Enforcement Subtitle A: DNA Identification Subtitle B: Department of Justice Community Substance Abuse Prevention Subtitle C: Racial and Ethnic Bias Study Grants Title XI: Provisions Relating to Police Officers Subtitle A: Law Enforcement Family Support Subtitle B: Police Pattern or Practice Subtitle C: Police Corps and Law Enforcement Officers Training and Education Title XII: Drug Court Programs Title XIII: Prisons Subtitle A: Federal Prisons Subtitle B: State Prisons Title XIV: Rural Crime Subtitle A: Fighting Drug Trafficking in Rural Areas Subtitle B: Drug Free Truck Stops and Safety Rest Areas Title XV: Drug Control Subtitle A: Increased Penalties Subtitle B: Precursor Chemicals Act Subtitle C: General Provisions Title XVI: Drunk Driving Provisions Title XVII: Commissions Subtitle A: Commission on Crime and Violence Subtitle B: National Commission to Study the Causes of the Demand for Drugs in the United States Subtitle C: National Commission to Support Law Enforcement Title XVIII: Bail Posting Reporting Title XIX: Motor Vehicle Theft Prevention Title XX: Protection for the Elderly Title XXI: Consumer Protection Title XXII: Financial Institution Fraud Prosecutions THIS Title XXIII: Savings and Loan Prosecution Task Force Title XXIV: Sentencing Provisions Title XXV: Sentencing and Magistrates Amendments Title XXVI: Computer Crime Title XXVII: International Parental Kidnapping Title XXVIII: Safe Schools Title XXIX: Miscellaneous Subtitle A: Increases in Penalties Subtitle B: Extension of Protection of Civil Rights Statutes Subtitle C: Audit and Report Subtitle D: Gambling Subtitle E: White Collar Crime Amendments Subtitle F: Safer Streets and Neighborhoods Subtitle G: Other Provisions Title XXX: Technical Corrections Violent Crime Control and Law Enforcement Act of 1993 - Title I: Public Safety and Policing - Public Safety Partnership and Community Policing Act of 1993 - Amends the Omnibus Crime Control and Safe Streets Act of 1968 (Omnibus Act) to authorize the Attorney General to make grants and provide technical assistance to units of State and local government, and to other public and private entities, to increase police presence (including the rehiring of law enforcement officers laid off as a result of State and local budget reductions, as well as the hiring of new, additional career law enforcement officers, for deployment in community-oriented policing), expand and improve cooperative efforts between law enforcement agencies (LEAs) and members of the community, and otherwise enhance public safety. Sets forth matching fund, application, and related requirements. Authorizes appropriations. Title II: Death Penalty - Federal Death Penalty Act of 1993 - Amends the Federal criminal code to provide for imposition of the death penalty for various offenses, including: (1) murder by a Federal prisoner; (2) civil rights murders; (3) drive-by shootings and carjackings resulting in death; (4) foreign murder of U.S. nationals; (5) rape and child molestation murders; (6) gun murders during Federal crimes of violence and drug trafficking crimes; and (7) murder in the course of alien smuggling. (Sec. 202) Sets forth procedures for the imposition, implementation, and review of such sentence. Limits mitigating factors (such as impaired capacity, duress, minor participation, and victim's consent) and aggravating factors (such as involvement of a firearm or previous conviction of a violent felony involving a firearm, previous conviction of other serious offenses, vulnerability of victim, and continuing criminal enterprise involving drug sales to minors). Requires a special hearing to determine whether a death sentence is justified. Directs the court to instruct the jury not to consider the race, color, religious beliefs, national origin, or sex of the defendant or of any victim. Prohibits the execution of a woman while she is pregnant and of a person who is mentally retarded. Title III: Habeas Corpus Reform - An Act to enforce the fourteenth amendment and to reform habeas corpus - Amends the Federal judicial code to impose a 180-day limitations period for the filing of Federal habeas corpus petitions, applicable in both capital and non-capital cases in which the State has offered the petitioner counsel for State post-conviction review, which begins from the time the petitioner's conviction becomes final on State direct review. Tolls such period while the petitioner pursues State post-conviction remedies, unless the petitioner fails to initiate post-conviction review within 270 days in capital cases or 180 days in non-capital cases. Provides for a one-time 60-day extension of the period upon a showing of good cause. (Sec. 303) Provides an automatic stay of execution in capital cases through the consideration of the first Federal habeas corpus petition. Permits a stay of execution to be granted thereafter only if the petition on its face satisfies the requirements for successive petitions. (Sec. 304) Prohibits a Federal court from announcing or applying a new rule to grant relief to a habeas corpus petitioner, except where the new rule places a class of individual conduct beyond the power of the criminal lawmaking authority to proscribe or prohibits the imposition of a certain type of punishment for a class of persons because of their status or offense, or constitutes a watershed rule of criminal procedure implicating the fundamental fairness and accuracy of the criminal proceeding. Codifies caselaw providing for an independent Federal habeas corpus review of claims under Federal law, except for fourth amendment exclusionary rule claims. Specifies that the State bears the burden of proving harmless error in Federal habeas corpus review of State criminal convictions. (Sec. 305) Sets forth provisions regarding: (1) limits on successive petitions (allows a prisoner to bring a second or subsequent petition only upon a showing of cause for not having brought the claim before and prejudice if the claim is not heard); and (2) new evidence (allows prisoners in capital cases to present claims of actual innocence based on newly discovered evidence that the petitioner did not previously know about). (Sec. 308) Sets standards and procedures for the provision of counsel for indigent defendants at all stages of State capital litigation. Requires each State in which a sentence of death may be imposed to establish a State counsel certification authority, comprised of members of the State's criminal defense bar, to create a roster of qualified lawyers eligible for court appointment and monitor the performance of attorneys so certified. (Sec. 309) Amends the Omnibus Act to require the Director of the Bureau of Justice Assistance (BJA) to make grants to States to help fund the provision of defense counsel. Authorizes: (1) Federal grants of up to 75 percent of the additional costs imposed by the new counsel requirements during the first three years following enactment of this title and 50 percent thereafter; and (2) grants for the prosecution of Federal habeas corpus cases in an amount equal to that allocated to capital resource centers. (Sec. 310) Abrogates State sovereign immunity from suit in Federal court for a violation of specified provisions regarding the establishment of a State certification authority and attorney compensation. Title IV: Gun Crime Penalties - Directs the U.S. Sentencing Commission to amend its sentencing guidelines to enhance the penalty for: (1) use of a semiautomatic firearm during a crime of violence or a drug trafficking crime; (2) a second offense of using an explosive to commit a Federal felony; (3) use of a firearm in the commission of counterfeiting or forgery; and (4) firearms possession by violent felons and serious drug offenders. (Sec. 403) Prohibits and sets penalties for: (1) smuggling firearms in aid of drug trafficking; (2) theft of firearms and explosives; (3) the transfer of firearms to a nonresident of a State, except for lawful sporting purposes; (4) conspiracies to commit firearms and explosives crimes; and (5) the distribution of explosives to a person who is legally disqualified from having the explosives. (Sec. 405) Mandates the revocation of: (1) supervised release and the institution of a prison term for a defendant who possesses a controlled substance or firearm in violation of a condition of such release, or who refuses to cooperate with drug testing; and (2) probation for possession of a controlled substance or firearms in violation of a condition of probation, or who refuses to cooperate with drug testing. (Sec. 407) Increases the penalty for: (1) knowingly making a false, material statement in connection with the acquisition of a firearm from a licensed dealer; and (2) interstate gun trafficking. Title V: Obstruction of Justice - Increases the penalties for threats and intimidation of jurors and court officers, obstruction of justice, and attempted retaliatory killings of witnesses, victims, and informants. (Sec. 501) Provides the death penalty for: (1) the murder of jurors and court officers; (2) retaliatory killings of witnesses, victims, and informants; (3) the murder of State officials working with Federal law enforcement officials in connection with Federal criminal investigations; and (4) the murder of Federal witnesses. (Sec. 503) Creates an exception to current law requiring that persons charged with capital offenses be furnished with a list (with addresses) of veniremen and witnesses, if the court finds by a preponderance of the evidence that providing such list may jeopardize the life or safety of any person. Title VI: Youth Violence - Subtitle A: Increased Penalties for Drug Trafficking and Criminal Street Gangs - Amends: (1) the Controlled Substances Act (CSA) to increase penalties for employing children to distribute drugs or avoid apprehension for a drug offense; and (2) the Federal criminal code to provide for imprisonment of up to ten years for a gang member or person acting on behalf of a criminal street gang who commits a Federal drug or violent crime offense and who has had a prior drug or crime of violence conviction, with the penalty to run consecutively to any other sentence imposed. Subtitle B: Juvenile Drug Trafficking and Gang Prevention Grants - Amends the Juvenile Justice and Delinquency Prevention Act of 1974 to authorize the Administrator of the Office of Juvenile Justice and Delinquency Prevention to make grants for: (1) programs to reduce the formation or continuation of juvenile gangs and the use and sale of illegal drugs by juveniles; (2) public or non-profit private organizations or individuals to identify promising new juvenile drug reduction and enforcement programs; and (3) public or non-profit private organizations or individuals to support promising new programs that specifically address the unique crime, drug, and alcohol related challenges faced by juveniles living at or near international ports of entry and in other international border communities. Authorizes appropriations. Subtitle C: Bindover System for Certain Violent Juveniles - Amends the Omnibus Act to authorize grants for bindover systems for the prosecution of 16- and 17-year-olds as adults for certain violent crimes (first- and second-degree murder, attempted murder, armed robbery with a firearm, aggravated battery or assault with a firearm, criminal sexual penetration when armed with a firearm, and drive-by shooting). Title VII: Terrorism - Subtitle A: Maritime Navigation and Fixed Platforms - Amends the Federal criminal code to prohibit and set penalties for the seizure of a ship or fixed platform by force, an act of violence against a person aboard, damage or destruction, or the injuring or killing of a person in connection with such activities. Provides the death penalty where death results. Subtitle B: General Provisions - Provides the death penalty where death results from the use of a weapon of mass destruction. (Sec. 714) Extends: (1) the application of State, territory, or district law for offenses committed in territorial waters not otherwise committed within a State's territory or district; (2) special maritime and territorial jurisdiction to offenses committed by or against a U.S. national during a voyage on a foreign vessel scheduled to depart from or arrive in the United States; and (3) the statute of limitations to ten years for certain terrorist offenses. (Sec. 716) Provides: (1) the death penalty for the commission of torture outside the United States and for the killing of a U.S. national outside the country; (2) the Federal Bureau of Investigation (FBI) with access to telephone subscriber information if the Director or Deputy Assistant Director certifies that such information is relevant to a foreign counterintelligence investigation and that it pertains to an agent of a foreign power; and (3) criminal penalties for willful violations of airport or airline security regulations. (Sec. 719) Prohibits: (1) acts of terrorism at U.S. international airports (and provides the death penalty where death results), subject to certain limitations; and (2) counterfeiting U.S. currency abroad (and sets penalties). Enhances penalties for any felony that involves or is intended to promote international terrorism. Sets penalties for those who provide material support to terrorists. (Sec. 722) Creates an Economic Terrorism Task Force. (Sec. 725) Amends the Immigration and Nationality Act to authorize the Attorney General to grant a nonimmigrant visa to an alien who possesses critical information about a criminal organization and whose presence in the United States is essential to an investigation or prosecution of such organization. Title VIII: Sexual Violence and Child Abuse - Subtitle A: Sexual Abuse - Amends the Federal criminal code to include within the definition of "sexual act" the intentional touching, not through the clothing, of the genitalia of another person who has not attained age 16 with intent to abuse, humiliate, harass, degrade, or arouse or gratify the sexual desire of any person. Subtitle B: Child Protection - National Child Protection Act of 1993 - Provides for the establishment of a national background check system whereby child care organizations can determine whether prospective employees have histories of child abuse or other serious crimes. Requires States to have at least 80 percent currency of crime cases in their systems within three years. Directs the Administrator of the Office of Juvenile Justice and Delinquency Prevention to begin a study of child abusers' criminal records. (Sec. 816) Amends the Omnibus Act to provide for the use of drug control and system improvement grants for the improvement of State record systems and the sharing of records of child abuse crime information to implement this subtitle. Subtitle C: Crimes Against Children - Jacob Wetterling Crimes Against Children Registration Act - Directs the Attorney General to establish guidelines for State programs requiring any person convicted of a criminal offense against a victim who is a minor to register a current address with a designated State LEA for ten years after release from prison or being placed on parole or supervised release. Subjects to criminal penalties a person required to register under a State program who knowingly fails to register and keep such registration current. (Sec. 823) Specifies that the allocation of BJA grant funds (under the Omnibus Act) received by a State not complying with provisions of this Act three years after its enactment shall be reduced by ten percent, with the unallocated funds to be reallocated to the States in compliance with this Act. Title IX: Crime Victims - Subtitle A: Victims' Rights - Amends Rule 32 of the Federal Rules of Criminal Procedure to give victims of violent crimes and sexual abuse the right to address the court concerning the sentence to be imposed on convicted offenders. Permits such right to be exercised by a parent or guardian if the victim is under 18, or by one or more family members if the victim is deceased or incapacitated. (Sec. 902) Requires courts to order criminal defendants who are convicted to pay restitution to victims. Specifies that a restitution order shall constitute a lien against real or personal property. Subtitle B: Crime Victims' Fund - Amends the Victims of Crime Act of 1984 to provide that if the compensation paid by an eligible crime victim compensation program would cover costs that a Federal, or a federally financed State or local, program would otherwise pay: (1) such victim compensation program shall not pay such compensation; and (2) the other program shall make its payments without regard to the existence of the crime victim compensation program. (Sec. 913) Allows: (1) up to five percent of a victim compensation or assistance program grant to be used for administrative costs; and (2) the Director of the Office for Victims of Crime to use unspent compensation funds for assistance programs in either the year such funds are not spent or in the following year. (Sec. 917) Requires grantees to certify that no grant funds will be used to supplant State and local funds, but rather will supplement those otherwise available funds. Title X: State and Local Law Enforcement - Subtitle A: DNA Identification - DNA Identification Act of 1993 - Amends the Omnibus Act to authorize the use of drug control and system improvement grants to develop or improve in a forensic laboratory a capability to analyze deoxyribonucleic acid (DNA) for specified identification purposes. Sets forth provisions regarding: (1) restrictions on the use of funds; and (2) reporting and recordkeeping (including access to records) requirements. Authorizes appropriations. (Sec. 1003) Requires the Director of: (1) the FBI to appoint a distinct advisory board on DNA quality assurance methods from among nominations proposed by the National Academy of Sciences and professional societies of crime laboratory officials and issue standards for quality assurance; and (2) the National Institute of Justice (NIJ) to make specified certifications to the House and Senate Judiciary Committees regarding the establishment of a proficiency testing program for DNA analyses. (Sec. 1004) Authorizes the Director to establish an index of DNA identification records of persons convicted of crimes, and of analyses of DNA samples recovered from crime scenes and from unidentified human remains. (Sec. 1005) Sets forth proficiency testing and privacy protection requirements, and penalties for violations. (Sec. 1006) Authorizes appropriations. Subtitle B: Department of Justice Community Substance Abuse Prevention - Department of Justice Community Substance Abuse Prevention Act of 1993 - Amends the Omnibus Act to authorize the Attorney General to make grants to eligible coalitions to develop and implement substance abuse prevention programs, with the efforts of such coalitions involving substantial community participation. Grants priority to communities providing evidence of significant abuse. Authorizes appropriations. Subtitle C: Racial and Ethnic Bias Study Grants - Authorizes the Attorney General to make grants to States that have established, by State law or the court of last resort, plans for analyzing the role of race in their criminal justice systems. Requires State plans to include recommendations designed to correct any findings of racial and ethnic bias. Authorizes appropriations. Title XI: Provisions Relating to Police Officers - Subtitle A: Law Enforcement Family Support - Amends the Omnibus Act to: (1) require the Director of the BJA to establish guidelines and oversee the implementation of family-friendly policies in law enforcement divisions of the Department of Justice (DOJ), identify model programs that provide support to law enforcement families, and provide technical assistance for stress reduction and family support efforts by State and local LEAs; and (2) authorize the Director to make grants to States and local LEAs and organizations representing State or local law enforcement personnel to provide family support services to law enforcement personnel. Authorizes appropriations. Subtitle B: Police Pattern or Practice - Prohibits any governmental authority, or any agent or person acting on behalf of such authority, from engaging in a pattern or practice of conduct by law enforcement officers that deprives persons of their constitutional or Federal rights. Authorizes the Attorney General to bring a civil action against such officers to eliminate such practices. (Sec. 1112) Directs the Attorney General to acquire data about the use of excessive force by law enforcement officers. Subtitle C: Police Corps and Law Enforcement Officers Training and Education - Chapter 1: Police Corps - Police Corps Act - Establishes in DOJ an Office of the Police Corps and Law Enforcement Education, headed by a Director. Authorizes the Director to award college and graduate school scholarships (of up to $30,000 per student) in exchange for four years work with a State or local police force upon graduation. Requires participants who do not follow through on their commitment to pay back all the scholarship money plus ten percent interest. (Sec. 1127) Sets forth provisions regarding: (1) selection and training of participants; (2) swearing in, discipline, and layoffs; (3) State plan requirements; and (4) assistance to States and localities employing police corps officers. Authorizes appropriations. Chapter 2: Law Enforcement Scholarship Program - Law Enforcement Scholarships and Recruitment Act - Requires the Director to provide scholarships for in-service law enforcement personnel who seek further education, allotting 80 percent of funds based on the relative number of law enforcement officers per State and 20 percent based on the relative shortage of officers. Provides grants for summer jobs or part-time jobs during the year for high school students interested in law enforcement careers. Authorizes appropriations. Title XII: Drug Court Programs - Amends the Omnibus Act to authorize the BJA to make grants to States: (1) for drug testing upon arrest, during the pretrial period, or during participation in any pre- or post-conviction diversion program; (2) to develop alternative methods of punishment for young nonviolent offenders to traditional forms of incarceration and probation; and (3) for residential substance abuse treatment programs in State prisons. Authorizes appropriations. Title XIII: Prisons - Subtitle A: Federal Prisons - Amends the Federal criminal code to: (1) prohibit the Bureau of Prisons from showing favoritism to prisoners of high social or economic status in designating their place of imprisonment; and (2) require that any submission of legislation by the judicial or executive branch that might affect prison populations be accompanied by an impact statement (and requires the Attorney General to prepare and transmit to the Congress annual prison impact assessments). (Sec. 1303) Federal Prisoner Drug Testing Act of 1993 - Requires the Director of the Administrative Office of the U.S. Courts to establish a program of drug testing of Federal offenders on post-conviction release. (Sec. 1304) Drug Treatment in Federal Prisons Act of 1993 - Establishes a schedule for the Bureau of Prisons to place all eligible prisoners into residential substance abuse treatment programs for between nine and 12 months, in facilities separate from the general prison population. Specifies that prisoners who successfully complete such programs could be released up to a year early. Authorizes appropriations. (Sec. 1305) Directs the court, in imposing sentence, to consider the expected costs to the Government of any imprisonment, supervised release, or probation. Authorizes the Sentencing Commission, in promulgating guidelines, to include as a component of a fine the expected costs to the Government of any imprisonment, supervised release, or probation sentence that is ordered. Subtitle B: State Prisons - Authorizes the Attorney General to make grants to States and to multi-State compact associations for the development and operation of boot camp prisons (for prisoners not convicted of violent felonies, providing a highly regimented schedule of strict discipline, physical training, and work, as well as remedial education and treatment for substance abuse) and regional prisons (for violent offenders with serious substance abuse problems). Specifies that grants may support the activation of boot camp and regional prison facilities already constructed by State or local governments, and shall support aftercare services (to reduce the likelihood of repeat criminality following release). Authorizes appropriations. (Sec. 1323) Requires the Director of NIJ to study: (1) the feasibility of establishing an information clearinghouse to facilitate the interstate transfer of prisoners to facilities near their families; (2) the recidivism rates of persons who were under the influence of alcohol at the time they committed their crimes, comparing recidivism rates of those who participated in a residential treatment program while in custody with those who did not; and (3) the use of alcohol, alone or in combination with other drugs, as a factor in criminal activity. (Sec. 1324) Requires the Bureau of Prisons to notify State and local law enforcement authorities concerning the release or relocation to their areas of Federal offenders under post-release supervision, with respect to prisoners convicted of drug trafficking and violent crimes. Title XIV: Rural Crime - Subtitle A: Fighting Drug Trafficking in Rural Areas - Amends the Omnibus Act to authorize appropriations, and increase the base allocation, for rural drug enforcement assistance. (Sec. 1402) Directs the Attorney General, subject to the availability of appropriations, to establish a Rural Drug Enforcement Task Force in each of the Federal judicial districts which encompass significant rural lands. (Sec. 1403) Authorizes the Attorney General to cross-designate up to 100 Federal officers with jurisdiction to enforce CSA provisions on non-Federal lands to the extent necessary to effect the purposes of this title. (Sec. 1404) Requires the Director of the Federal Law Enforcement Training Center to develop a specialized course of instruction devoted to training law enforcement officers from rural agencies in the investigation of drug trafficking and related crimes. Authorizes appropriations. Subtitle B: Drug Free Truck Stops and Safety Rest Areas - Amends the CSA to enhance penalties for drug distribution at or near truck stops and safety rest areas. Title XV: Drug Control - Subtitle A: Increased Penalties - Amends: (1) the Federal criminal code to enhance penalties for drug trafficking and illegal drug use in prisons; (2) the Tariff Act of 1930 to make the penalty for failure to declare a controlled substance 1,000 percent of the value of the article (as under current law) or $500, whichever is greater; and (3) the CSA to enhance penalties for drug dealing in or near public housing authority facilities, and to set penalties for any physical trainer or adviser who endeavors to persuade or induce an individual to possess or use anabolic steroids in violation of such Act. (Sec. 1505) Directs the Sentencing Commission to amend the sentencing guidelines to increase penalties for drug-dealing in "drug-free" zones. Subtitle B: Precursor Chemicals Act - Chemical Control Amendments Act of 1993 - Amends the CSA to impose registration requirements for precursor chemicals. (Sec. 1514) Requires manufacturers to submit annual reports concerning listed chemicals manufactured during the year. (Sec. 1515) Amends the Controlled Substances Import and Export Act to: (1) subject brokers and traders to the same recordkeeping and reporting requirements for international transactions, and the same criminal penalties, as exporters; and (2) authorize the Attorney General to require that the 15-day advance notice requirement with respect to the importation and exportation of listed chemicals apply to all exports of specific listed chemicals to specified countries, regardless of the status of certain customers in such countries as regular customers, if necessary to support effective diversion control programs or as required by treaty; and (3) establish criminal penalties for attempting to evade reporting requirements and for smuggling listed drugs. (Sec. 1519) Grants the Attorney General the same inspection authority for listed chemicals as presently exists with respect to controlled substances. (Sec. 1521) Makes it a felony to violate the Solid Waste Disposal Act in the handling of chemicals used to illegally manufacture a controlled substance. Requires that violators be assessed costs of the initial cleanup an disposal of the listed chemical and contaminated property and the costs of restoring property damaged by exposure to such chemical. Subtitle C: General Provisions - Prohibits advertising which aims to illegally solicit or sell drugs. (Sec. 1535) Includes among the long-term goals of the National Drug Control Strategy making drug treatment available to all who need it. (Sec. 1536) Amends the Federal Aviation Act of 1958 to require the Administrator of the Federal Aviation Administration to issue regulations requiring employees to report to law enforcement authorities the discovery of illegal drugs or amounts of cash over $10,000 in airport security screenings. Title XVI: Drunk Driving Provisions - Drunk Driving Child Protection Act of 1993 - Amends the Federal criminal code to provide supplementary prison terms and fine authorizations in cases where drunk driving endangers or injures a person under 18 years of age. (Sec. 1603) Expresses the sense of the Congress that in determining child custody and visitation rights the courts should consider the history of drunk driving of anyone involved in the determination. Title XVII: Commissions - Subtitle A: Commission on Crime and Violence - Establishes the National Commission on Crime and Violence in America to develop a comprehensive crime control plan for the 1990's. Subtitle B: National Commission to Study the Causes of the Demand for Drugs in the United States - National Commission to Study the Causes of the Demand for Drugs in the United States - Establishes a National Commission to Study the Causes of the Demand for Drugs in the United States. Subtitle C: National Commission to Support Law Enforcement - National Commission to Support Law Enforcement Act - Establishes a National Commission to Support Law Enforcement. Title XVIII: Bail Posting Reporting - Illegal Drug Profits Act of 1993 - Requires State and Federal criminal court clerks to report to the Internal Revenue Service (IRS) and prosecutors the name and taxpayer identification number of anyone accused of a drug, money laundering, or racketeering crime who posts cash bail exceeding $10,000. Title XIX: Motor Vehicle Theft Prevention - Motor Vehicle Theft Prevention Act - Directs the Attorney General to develop a national voluntary motor vehicle theft prevention program which would involve placing identifiable decals on the vehicles of consenting owners, whereby such vehicles could then be stopped by law enforcement officers upon a reasonable suspicion that the vehicles were not being operated by or with the consent of their owners. (Sec. 1903) Prohibits and sets penalties for tampering with the decals, with exceptions. Title XX: Protections for the Elderly - Directs the Attorney General, subject to the availability of appropriations, to make grants in support of programs to protect and locate missing patients with Alzheimer's disease and related dementias. Authorizes appropriations. (Sec. 2002) Directs the Sentencing Commission to ensure that the sentences for those convicted of crimes of violence against elderly victims be sufficiently stringent to deter such crimes, protect the public from additional crimes of such a defendant, and provide enhanced penalties under specified criteria. Title XXI: Consumer Protection - Amends the Federal criminal code to set penalties for insurance industry crimes, including embezzling from insurance companies, making false entries in insurance company books with intent to deceive, and corruptly influencing or obstructing proceedings before State insurance regulatory agencies or insurance examiners. Prohibits persons convicted of criminal felonies involving dishonesty or breach of trust from engaging in the insurance business without the written consent of an insurance regulatory official authorized to regulate the insurer. (Sec. 2102) Consumer Protection Against Credit Card Fraud Act of 1993 - Prohibits the sale of credit cards without credit card company authorization, fraudulent receipt of payments via credit card for goods never received or inferior to those promised, and laundering to credit card receipts. (Sec. 2103) Extends the mail fraud statute to include mail sent by private interstate carriers. Title XXII: Financial Institution Fraud Prosecutions - Financial Institutions Fraud Prosecution Act of 1991 (sic) - Amends the Federal Deposit Insurance Act and the Federal Credit Union Act to disqualify certain persons with criminal records from participating in the affairs of insured depository institutions and credit unions. (Sec. 2204) Amends the Crime Control Act of 1990 to encourage the Attorney General to report to the Congress on the collapse of private insurance deposit corporations. Title XXIII: Savings and Loan Prosecution Task Force - Directs the Attorney General to establish within DOJ a savings and loan criminal fraud task force to prosecute those criminal cases involving savings and loan institutions. Title XXIV: Sentencing Provisions - Amends the Federal criminal code to allow the court, in determining the sentence to be imposed in the case of a violation of probation or supervised release, to consider guidelines or policy statements issued by the Sentencing Commission. (Sec. 2403) Directs the court to revoke a term of supervised release and require the defendant to serve in prison all or part of the term of release authorized by statute for the offense that resulted in such term, without credit for time previously served on post-release supervision, if the court finds that the defendant violated a condition of supervised release, subject to specified limitations. Authorizes the court to include a requirement that the defendant be placed on supervised release after imprisonment when a term of supervised release is revoked and the defendant is required to serve a term of imprisonment less than the maximum authorized. Specifies that the power of the court to revoke a term of supervised release for violation of a condition of such release extends beyond the expiration of the term of release for a period reasonably necessary for the adjudication of matters arising before its expiration if, prior to such expiration, a warrant or summons ha been issued on the basis of an allegation of such a violation. (Sec. 2404) Provides for the application of the sentencing guidelines (and any pertinent policy statement issued by the U.S. Sentencing Commission) for certain nonviolent drug offenses in which a mandatory minimum term of imprisonment would otherwise be required. Directs the Sentencing Commission to: (1) review the consideration of defendants' criminal histories under the guidelines; and (2) monitor the operation of this Act. Title XXV: Sentencing and Magistrates Amendments - Permits concurrent sentencing of a defendant to imprisonment and probation for petty offenses. (Sec. 2502) Authorizes the trial of petty offenses by magistrate judges. Title XXVI: Computer Crime - Computer Abuse Amendments Act of 1993 - Amends the Computer Fraud and Abuse Act to make it a felony to knowingly transmit an unauthorized program or code that alters the information stored in a computer with the intent to damage the system or information contained within the affected computer or system, or to withhold or deny the use of such system or information, if the transmission: (1) occurred without the authorization of the person responsible for the computer system receiving the program; and (2) causes damage exceeding $1,000 in any one-year period or modifies or impairs the medical care of one or more individuals. Makes it a misdemeanor to recklessly transmit a destructive computer program or code. Creates a civil cause of action for persons suffering damage or loss by virtue of a violation of this Act. Modifies the prohibition against accessing a Government computer where such conduct affects the use of the Government's operation of such computer to cover only actions that "adversely" affect such use. Title XXVII: International Parental Kidnapping - International Parental Kidnapping Crime Act of 1993 - Amends the Federal criminal code to establish penalties for removing a child from, or retaining a child outside, the United States with intent to obstruct the lawful exercise of parental rights. (Sec. 2703) Authorizes appropriations to carry out under the State Justice Institute Act of 1984 national, regional, and in-State training and educational programs dealing with criminal and civil aspects of interstate and international parental child abduction. Title XXVIII: Safe Schools - Safe Schools Act of 1993 - Amends the Omnibus Act to: (1) authorize the Director of the BJA to make grants to local educational agencies for the purpose of providing assistance to such agencies most directly affected by crime and violence; and (2) require the Director to develop a written safe schools model in English and in Spanish and make such model available to any such agency that requests it. Authorizes appropriations. Title XXIX: Miscellaneous - Subtitle A: Increases in Penalties - Increases penalties for assault: (1) of Federal officers, foreign officials, and official guests and internationally protected persons; (2) within a maritime and territorial jurisdiction; and (3) of the President, presidential staff, congressional leaders, cabinet officials, and Supreme Court justices. (Sec. 2902) Increases the maximum penalties for voluntary and involuntary manslaughter. (Sec. 2903) Broadens the scope and increases the penalties for conspiracies to deprive persons of their civil rights. (Sec. 2904) Increases penalties for: (1) trafficking in counterfeit goods and services; (2) conspiracy to commit murder for hire; and (3) Travel Act violations. Subtitle B: Extension of Protection of Civil Rights Statutes - Extends the protections of the criminal civil rights statute to any person in a State. (Currently, the statute only covers State "inhabitants.") Subtitle C: Audit and Report - Directs the Attorney General to: (1) require State and local LEAs to annually audit and detail the uses and expenses to which forfeiture funds were dedicated and the amount used for each use or expense; and (2) report to the Congress on the administrative and contracting expenses paid from the DOJ Assets Forfeiture Fund. Subtitle D: Gambling - Grants a State gaming enforcement office located within a State Attorney General's office access to FBI criminal history record information for licensing purposes. Subtitle E: White Collar Crime Amendments - Establishes penalties for knowingly receiving the proceeds of: (1) extortion; (2) a kidnapping; and (3) a postal robbery. (Sec. 2943) Extends the prohibition against obstructing civil investigative demands to include obstruction in racketeering and false claims investigations. Subtitle F: Safer Streets and Neighborhoods - Safer Streets and Neighborhoods Act of 1993 - Amends the Omnibus Act to authorize the Director of the BJA to make grants to, or enter into contracts with, non-Federal public or private agencies, institutions, or organizations to carry out specified purposes of such Act (current law does not specify "non-Federal"), effective October 1, 1993. Subtitle G: Other Provisions - Authorizes the venue for espionage and related offenses to be in the District of Columbia or in any other district authorized by law. (Sec. 2963) Amends the Anti-Drug Abuse Act to make amendments with respect to certain IRS undercover operations effective from the date of this Act's enactment through December 31, 1994. (Sec. 2964) Directs the Attorney General and the Secretary of Health and Human Services to report to the Congress on the medical and psychological basis of "battered women's syndrome" and the extent to which evidence of the syndrome has been held to be admissible as evidence of guilt or as a defense in a criminal trial. (Sec. 2966) Amends the Federal criminal code to set penalties for: (1) the theft of major art works from museums; (2) misuse of the words "Drug Enforcement Administration" or the initials "DEA"; and (3) attempted robbery, kidnapping, smuggling, and property damage offenses. (Sec. 2971) Extends the statute of limitations of arson. Title XXX: Technical Corrections - Makes technical corrections to various criminal law provisions.
Bill· HRH.R. 3420 (103rd)referred
United States · United States Congress · 1 November 1993
FHA Water Purification Standards Amendments Act - Amends the Housing and Community Development Act of 1987 to direct the Secretary of Housing and Urban Development (the Secretary) to provide for the approval of both point-of-use and point-of-entry water treatment equipment and water purification systems that meet certain statutory standards. Prohibits the Secretary from requiring the use of a water treatment system on any water supply source that will not be used primarily for human consumption.
Bill· HRH.R. 3400 (103rd)open
United States · United States Congress · 28 October 1993
TABLE OF CONTENTS: Title I: Department of Agriculture Title II: Department of Commerce Title III: Department of Defense Title IV: Department of Energy Title V: Department of Health and Human Services Title VI: Department of Housing and Urban Development Title VII: Department of the Interior Title VIII: Miscellaneous Provisions Title IX: Department of Labor Title X: Department of State and United States Information Agency Title XI: Department of Transportation Title XII: Department of Veterans Affairs Title XIII: Human Resource Management Title XIV: Reinventing Support Services Title XV: Streamlining Management Control Title XVI: Financial Management Title XVII: Year-End Spending Government Reform and Savings Act of 1993 - Title I: Department of Agriculture - Subtitle A: Department of Agriculture Reorganization - Directs the Secretary of Agriculture to reduce and reorganize the Department of Agriculture, including specified levels of personnel reduction. Subtitle B: Eliminate Federal Support for Wool and Mohair - Repeals the National Wool Act as of December 31, 1995. Reduces 1994 and 1995 wool and mohair support levels. Subtitle C: Eliminate Federal Support for Honey - Amends the Agricultural Act of 1949 to eliminate the honey price support program as of December 31, 1995. Reduces 1994 and 1995 support levels. (Sec. 1203) Reduces honey loan forfeiture limitations. Title II: Department of Commerce - Directs the Departments of Commerce and of Defense and the National Aeronautics and Space Administration to propose a single operational polar environmental and weather satellite system which meets national needs. Requires the Director of the Office of Science and Technology Policy to submit to the Congress by a certain date an implementation plan designed to result in specified savings in budget authority and outlays between FY 1994 and 1999. Title III: Department of Defense - Subtitle A: Create Incentives for the Department of Defense to Generate Revenues - Allows the commander of a military installation, at his discretion, to credit proceeds from the sale of recyclable materials to the nonappropriated morale and welfare account of such installation for use for morale and welfare activities. Subtitle B: Closure of the Uniformed Services University of the Health Sciences - Repeals Federal provisions establishing the Uniformed Services University of the Health Sciences. Phases out such University beginning in FY 1995, with closure no later than September 30, 1998. Subtitle C: Streamline and Reorganize the U.S. Army Corps of Engineers - Directs the Secretary of the Army to reorganize the U.S. Army Corps of Engineers through the reorganization and reduction of offices and the restructuring of functions in order to increase efficiency and reduce costs, with a goal of achieving $50 million in net annual savings by FY 1998. Title IV: Department of Energy - Subtitle A: Alaska Power Administration Sale Authorization Act - Alaska Power Administration Sale Authorization Act - Authorizes the Secretary of Energy, in accordance with specified purchase agreements, to sell: (1) the Snettisham Hydroelectric Project to the State of Alaska Industrial Development and Export Authority; and (2) the Eklutna Hydroelectric Project to the Anchorage Municipal Light and Power, the Chugach Electric Association, Inc., and the Matanuska Electric Association Inc. Directs the Secretary to: (1) close out the Alaska Power Administration; and (2) assess alternative options for maximizing the return to the Treasury from the sale of the Alaska Power Marketing Administration before taking any of the sales action authorized by this Title. Subtitle B: Federal-Private Cogeneration of Electricity - Amends the National Energy Conservation Policy Act to modify the definition of "energy savings" to include increased efficiency from cogeneration processes for other than federally owned buildings or other federally owned facilities. Subtitle C: Power Marketing Administration Debt Buyout - Part 1: Bonneville Power Administration Debt Buyout - Bonneville Power Administration Repayment Bonds Act - Authorizes the Administrator of the Bonneville Power Administration to sell bonds according to prescribed procedures. (Sec. 4203) Amends the Federal Columbia River Transmission System Act to authorize the Administrator to make expenditures from the Bonneville Power Administration fund to pay the financing and debt service costs of such bonds. (Sec. 4204) Amends the Pacific Northwest Electric Power Planning and Conservation Act to authorize the Administrator to base power and transmission rates upon a single, combined generation and transmission repayment study which demonstrates that all indebtedness is repaid by its due date. Part 2: Other Power Marketing Administrations Debt Buyout - Power Marketing Administrations Financing Act - Sets forth procedural guidelines for the Administrators of the Southeastern, Southwestern and Western Area Power Administrations to repay the discounted present value of existing indebtedness to the United States. (Sec. 4209) Establishes a Power Marketing Administration Sinking Fund. (Sec. 4210) Authorizes each Administrator to issue revenue bonds and other instruments of indebtedness to refinance existing indebtedness. Title V: Department of Health and Human Services - Subtitle A: Increased Flexibility in Contracting for Medicare Claims Processing - Amends title XVIII (Medicare) of the Social Security Act (SSA) to make various changes with respect to the contractor system under Medicare, including eliminating the authority of the Railroad Retirement Board to contract for processing the Medicare claims of railroad retirees. Subtitle B: Workers' Compensation Data Exchange Pilot Projects - Authorizes the Secretary of Health and Human Services to conduct pilot projects with up to three States for studying the ways of obtaining workers' compensation data for the Secretary. Reimburses participating States out of the social security trust funds for the costs of participation. Subtitle C: Federal Clearinghouse on Death Information - Amends SSA title II (Old Age, Survivors and Disability Insurance) to restructure the current program for the exchange of death information to, for example, use a Federal Clearinghouse on Death Information as the vehicle for all such exchanges and, in the case of individuals with respect to whom federally funded benefits are provided by (or through) a Federal or State agency other than under SSA, require such agency to pay a set fee to cover all costs connected with the provision of such information for them. Requires any contract requiring a State to furnish death information to the Secretary of Health and Human Services to authorize the Secretary to use such information and redisclose it to any Federal, State, or local agency in accordance with certain SSA information sharing requirements. Subtitle D: Continuing Disability Reviews - Amends SSA title II to earmark specified levels of administrative funding for continuing disability reviews of disabled beneficiaries for FY 1994 through 1999. Title VI: Department of Housing and Urban Development - Subtitle A: Multifamily Property Disposition - Amends the Housing and Community Development Amendments of 1978 to revise provisions regarding the management and disposition of Department of Housing and Urban Development (HUD) - held multifamily properties and mortgages. Subtitle B: Merger of the Certificate and Voucher Programs - Amends the United States Housing Act of 1937 to merge the public housing certificate and voucher programs. Subtitle C: Streamline HUD - Directs the Secretary of Housing and Urban Development to carry out HUD reorganization and reduction activities. Subtitle D: Refinance Section 235 Mortgages - Amends the National Housing Act to cover mortgage refinancing costs under the lower-income family homeownership assistance program. Subtitle E: Section 8 Rents for New Construction and Rehabilitation Projects - Prohibits temporarily the adjustment of maximum monthly public housing (section 8) rents for new construction and rehabilitation projects. Title VII: Department of the Interior - Subtitle A: Improve the Federal Helium Program - Amends the Helium Act Amendments of 1960 to authorize the Secretary of the Interior (the Secretary) to: (1) reduce costs and increase operational efficiencies; and (2) establish and adjust fees charged private industry for storage, transmission, and withdrawal of privately-owned helium from government storage facilities to compensate fully for all costs incurred. Directs the Secretary to: (1) avoid disruptions of the helium market when making helium sales; (2) sell helium at prices comparable to those of private industry; and (3) develop a long-term, comprehensive plan to cancel the outstanding debt owed to the Treasury by the Department of the Interior related to the Federal helium program, and improve Federal helium program operations. Subtitle B: Improve Minerals Management Service Royalty Collection - Directs the Secretary of the Interior to require the Minerals Management Service, Royalty Management Program, to develop and implement: (1) an automated business information system to provide its auditors with a lease history according to prescribed guidelines; (2) the optimum methods to identify and resolve anomalies and verify that royalties are paid correctly; (3) a more efficient and cost-effective royalty collection process; and (4) any other actions necessary to reduce royalty underpayment and increase revenue by a certain amount. Amends the Federal Oil and Gas Royalty Management Act of 1982 to prescribe penalty assessment guidelines for substantial underreporting of lease royalties. Subtitle C: Phase Out the Mineral Institute Program - Directs the Secretary to phase out the Mining and Mineral Resources Research Institute Act of 1984. Authorizes appropriations. Prohibits appropriations after September 30, 1998. Title VIII: Department of Justice - Amends the Federal criminal code to authorize the Attorney General to: (1) assess a nominal fee against a Federal prison inmate's trust fund account for any health services provided the inmate; and (2) waive or refund all or part of such fees for good cause at any time. Declares that no inmate shall be denied health services treatment because of inability to pay a health services fee. Title IX: Department of Labor - Subtitle A: Deterrence of Fraud and Abuse in the FECA Program - Amends the Federal Employees Compensation Act (FECA) to add provisions to deter fraud and abuse in the FECA program. Subtitle B: Enhancement of Reemployment Programs for Federal Employees Disabled in the Performance of Duty - Amends FECA to authorize the Secretary of Labor, as part of the vocational rehabilitation effort, to assist permanently disabled individuals in seeking and/or obtaining employment. Authorizes the Secretary to reimburse an employer (including a Federal employer), who was not the employer at the time of injury and who agrees to employ a disabled beneficiary, for portions of the salary, through payments from the Employees' Compensation Fund. (Sec. 9101) Authorizes the Secretary to expand the FECA Periodic Roll Management Project to all offices of the Office of Workers' Compensation Program of the Department of Labor. Subtitle C: Wage Determinations: McNamara-O'Hara Service Contract Act and Davis-Bacon Act - Amends the McNamara-O'Hara Service Contract Act and the Davis-Bacon Act to authorize the Secretary of Labor to develop and implement electronic data interchange systems to request and obtain wage determinations required under such Acts. Subtitle D: Elimination of Filing Requirement for Plan Descriptions, Summary Plan Descriptions, and Descriptions of Material Modifications to a Plan - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to eliminate certain filing requirements for routine disclosure to employee benefit plan participants and beneficiaries of plan descriptions, summary plan descriptions, and descriptions of material modifications to a plan. Provides for such disclosures by plan administrators through written requests to the Secretary of Labor. Title X: Department of State/United States Information Agency - Directs the Secretary of State to reduce costs of providing marine guard and other security at diplomatic missions overseas by a specified amount by the end of FY 1999. (Sec. 10002) Requires the Director of the United States Information Agency (USIA) to improve the efficiency of USIA's public diplomacy activities and save a specified amount by the end of FY 1999. Title XI: Department of Transportation - Subtitle A: Authority to Charge Tuition for Attendance at the U.S. Merchant Marine Academy - Amends the Merchant Marine Act, 1936 to require the Secretary of Transportation (Secretary) to impose a system of tuition and fees on individuals attending the Academy equal to an amount that is up to one-half the total operating costs of the Academy during the preceding fiscal year. Authorizes the Secretary to impose reasonable fees on cadets at the Academy for all required uniforms and textbooks. (Currently, the Academy is required to provide for such items.) Subtitle B: Reform of the Essential Air Service Program - Amends the Federal Aviation Act of 1958 to provide that in order for a point to be eligible for basic essential air service it must not require a rate of subsidy per passenger in excess of $200, and may not be located fewer than 70 highway miles from the nearest hub airport or small hub airport. Decreases the amount of funds from the Airway Trust Fund for the essential air service program for FY 1994 through 1998. Authorizes amounts from such Fund for FY 1999. Subtitle C: Repeal of Authorizations for the Airway Science Program, Collegiate Training Initiative, and Air Carrier Maintenance Technician Training Facility Grant Program - Repeals all authority for: (1) the Airway Science Program; (2) the Collegiate Training Initiative; and (3) the Air Carrier Maintenance Technician Training Facility Grant Program. Title XII: Department of Veterans Affairs - Subtitle A: Remove Certain Limitations and Restrictions Contained in Veterans Law - Eliminates: (1) Department of Veterans Affairs (Department) hospital and nursing home bed capacity requirements; (2) a required increase in the number of full-time personnel in the Office of the Inspector General of the Department; (3) required reports to the Congress concerning Department administrative reorganizations; (4) the requirement of certain services and offices within the Veterans Health Administration of the Department; and (5) the requirement of a Deputy, Associate Deputy, and various assistant medical directors within the Office of the Chief Medical Director of the Department. Subtitle B: Closure of Supply Depots and Transfer of Revolving Supply Fund Money - Directs the Secretary of Veterans Affairs to: (1) phase out and close Department supply depots in Somerville, New Jersey, Hines, Illinois, and Bell, California; and (2) transfer to the General Fund of the Treasury in FY 1994 and 1995 specified amounts from the Department Revolving Supply Fund. Subtitle C: Provision of Information from the Medicare and Medicaid Coverage Data Bank to the Department of Veterans Affairs - Provides as an additional purpose of the Medicare and Medicaid Coverage Data Bank the provision of information to the Secretary of Veterans Affairs concerning the collection of payments from third parties for health care items and services furnished to veterans. Subtitle D: Veterans' Appeals Improvement Act of 1993 - Veterans' Appeals Improvement Act of 1993 - Provides for the appointment by the Chairman of the Board of Veterans Appeals of any necessary number of Deputy Vice Chairmen. Removes current limitations on the authorized period of service for acting Board members. Requires the Chairman to include in an annual report information with respect to activities of acting Board members during the previous year. (Sec. 12303) Authorizes the Chairman to decide alone, or to assign to another Board member, any matter or motion before the Board. (Current law requires a minimum three-member Board determination of such matters.) Prohibits judicial review of any such assignments. (Sec. 12304) Authorizes the Board to: (1) dismiss appeals which allege no specific error of fact or law or in which the determination being appealed has become moot; (2) remand cases for which additional developments require appropriate disposition; and (3) render a written final Board decision on issues not dismissed or remanded. Revises provisions concerning situations under which the Chairman shall exclude himself from the reconsideration of an appeal. Provides for the reconsideration of a case based on a difference of opinion as to how the evidence should be evaluated rather than on a specific error in the prior decision. (Sec. 12307) Authorizes Board member to: (1) collect medical opinions from Board employees, Department employees, or employees of other Federal departments and agencies, as long as such employees are licensed to practice medicine in any State; and (2) secure advisory medical opinions from independent medical experts when the case warrants such opinions. Requires opinions to be in writing and to be made part of the record, with an opportunity for the appellant to respond. Revises provisions concerning appellant hearing procedures. Title XIII: Human Resource Management - Subtitle A: Federal Workforce Restructuring Act of 1993 - Federal Workforce Restructuring Act of 1993 - Amends Federal civil service law to eliminate various restrictions on employee training and authorize certain Federal agencies to establish temporary programs to offer a lump sum financial incentive (the lesser of $25,000 or the amount of an employee's severance pay) to selected groups of employees in order to encourage them to voluntarily separate from an agency, whether by retirement or resignation, in order to assist agency heads in restructuring their workforce. Provides for repayment of separation incentives if any employee rejoins the Federal Government within two years. Requires Federal agencies to pay a specified contribution to the Civil Service Retirement and Disability Fund based on the final rate of basic pay of each agency employee who retires early. (Sec. 13003) Expresses the sense of the Congress that: (1) employment in the Executive Branch should be reduced by not less than one full-time equivalent position for each two employees who are paid voluntary separation incentives under this Act; and (2) each agency should adjust its employment levels to achieve this result. Subtitle B: SES Annual Leave Accumulation - Repeals the authorization for unlimited accumulation of annual leave by members of the Senior Executive Service. Title XIV: Reinventing Support Services - Government Information Dissemination and Printing Improvement Act of 1993 - Directs the President to establish policy for the acquisition of printing by executive agencies and promulgate appropriate Government-wide regulations. Requires such policy to ensure that the Government Printing Office (GPO) has the opportunity to compete on an equal basis for executive agency printing acquisitions. (Sec. 14005) Requires GPO to remain the mandatory source for certain executive agency printing for two years after the enactment of this Act, except that during such period executive agencies may obtain printing services costing under $2500 from other sources. (Sec. 14006) Requires the Director of the Office of Management and Budget to develop policies and practices for agency dissemination of public information to ensure, among other things, that agencies: (1) avoid establishing, or permitting others to establish, exclusive, restricted, or other distribution arrangements that interfere with the availability of information dissemination products on a timely and equitable basis; and (2) set user charges for information dissemination products no higher than sufficient to recover the cost of dissemination, except where required by statute or specifically authorized by the Director. (Sec. 14007) Specifies Federal agency responsibilities for information dissemination. (Sec. 14008) Requires the Director of OMB to propose amendments to Federal law to ensure the distribution of government information dissemination products to depository libraries. (Sec. 14009) Requires the Director to: (1) maintain a publicly accessible comprehensive inventory of all approved Federal agency information collection requests in order to assist agencies and the public in reducing the burden of agency information and collection requests by minimizing duplication; (2) cause to be established and maintained an agency-based electronic Government Information Locator Service in order to assist agencies and the public in locating information; (3) require each agency having significant information dissemination products to establish and maintain a comprehensive inventory of such products; and (4) establish an interagency committee to develop technical standards for agency inventory systems. Abolishes the old Federal Information Locator System. Title XV: Streamlining Management Control - Authorizes the Director of OMB to publish annually in the President's Budget any recommendations for the consolidation, elimination, or adjustments in frequency and due dates of statutorily required periodic reports to the Congress or its committees. Title XVI: Financial Management - Federal Financial Management Act of 1993 - Subtitle A: Electronic Payments - Amends Federal law to require direct deposit of Federal wage, salary, and retirement payments by electronic funds transfer for recipients who begin such payments on or after January 1, 1995. Subtitle B: Franchise Funds and Innovation Funds - Authorizes the establishment of a franchise fund in an executive agency for expenses and equipment necessary for the maintenance and operations of administrative services that may be performed more advantageously on a centralized basis. Authorizes the establishment of an innovation fund in an executive agency to provide a self-sustaining source of financing to invest in projects designed to produce measurable improvements in agency efficiency and significant taxpayer savings. Requires such funds to be made available without further appropriation action by the Congress. Subtitle C: Simplifying the Management Reporting Process - Authorizes the Director of the Office of Management and Budget (OMB) to publish annually in the President's budget recommendations for consolidation, elimination, or adjustments in frequency and due dates of statutorily required periodic reports of agencies to the OMB or the President and of agencies or the OMB to the Congress under any laws for which the OMB has general management or financial management responsibility. Subtitle D: Annual Financial Reports - Requires the annual financial statements of executive agencies to be audited prior to submission to OMB. Subtitle E: Strengthening Debt Collection Programs - Authorizes appropriations from debt collection payments to improve debt collection activities. (Sec. 16502) Makes provisions governing contracts for collection services inapplicable to certain claims or debts under the Social Security Act or the Internal Revenue Code. Subtitle F: Improving Department of Justice Debt Collection - Establishes a Debt Collection Fund to reimburse executive agency expenses incurred in conducting or providing support to debt collection litigation, enforcing judgments, and related activities. Subtitle G: Adjusting Civil Monetary Penalties for Inflation - Amends the Federal Civil Penalties Inflation Adjustment Act of 1990 to require adjustment to the civil monetary penalties for inflation every four years (currently, every five years). Title XVII: Year-End Spending - Limits the amount of appropriations for salaries and expenses that can remain available for successive fiscal years. Limits the amount of such carried-over funds for employee cash awards and training programs.
Bill· HRH.R. 3401 (103rd)referred
United States · United States Congress · 28 October 1993
Amends the Housing and Community Development Act of 1974 to increase from 15 percent to 20 percent the limitation on the amount of community development block grant assistance that may be expended for public services activities.
Bill· HRH.R. 3353 (103rd)open
United States · United States Congress · 26 October 1993
Amends the Omnibus Crime Control and Safe Streets Act of 1968 to authorize the Director of the Bureau of Justice Assistance to make grants to assist States and local governments (or combinations thereof) in planning, operating, coordinating, and evaluating projects for the development of more effective programs, including education, prevention, treatment, and enforcement programs, to reduce: (1) the formation or continuation of juvenile gangs; and (2) the use and sale of illegal drugs by juveniles. Specifies uses of such grants, including: (1) reducing juvenile participation in drug-related crimes (particularly in and around elementary and secondary schools) and juvenile involvement in organized crime, drug- and gang-related activity (particularly activities that involve the distribution of drugs by or to juveniles and such activity in public housing projects); (2) developing new and innovative means to address the problems of juveniles convicted of serious, drug- and gang-related offenses; (3) promoting the involvement of all juveniles in lawful activities; (4) providing pre- and post-trial drug abuse treatment to juveniles in the juvenile justice system and education and treatment programs for youth exposed to severe violence in their homes, schools, or neighborhoods; and (5) identifying promising new juvenile drug demand reduction and enforcement programs, replicating and demonstrating such programs to serve as national, regional, or local models, and providing technical assistance and training to public or private organizations to implement similar programs. Sets forth application requirements. Authorizes appropriations.
Bill· SS. 1581 (103rd)referred
United States · United States Congress · 25 October 1993
TABLE OF CONTENTS: Title I: Increase in the Number of Trained Law Enforcement Personnel Subtitle A: Rapid Deployment Strike Force Subtitle B: Federal-State Anti-Drug and Anti-Violence Task Forces Subtitle C: Police Corps Program Subtitle D: Law Enforcement Scholarship and Employment Program Subtitle E: Job Training and Placement for Separated Members of the Armed Forces Title II: Studies Subtitle A: Commission on Crime and Violence Subtitle B: Use of Antiloitering Laws to Fight Crime Title III: Violent and Habitual Offenders Subtitle A: Serious Habitual Offender Comprehensive Action Program Subtitle B: Federal Law Enforcement Assistance Grants Title IV: Prisons Subtitle A: Prison for Violent Drug Offenders Subtitle B: Task Force on Prison Construction Standardization and Techniques Title V: Violent Crime and Drug Emergency Areas Violent Crime Reduction Act of 1993 - Title I: Increase in the Number of Trained Law Enforcement Personnel - Subtitle A: Rapid Deployment Strike Force - Directs the Attorney General to establish in the Federal Bureau of Investigation (FBI) a Rapid Deployment Force (RDF), which shall be made available to assist units of local government in combatting crime. Requires the RDF to be headed by a Deputy Assistant Director of the FBI and comprised of approximately 2,500 Federal law enforcement officers with training and experience in the investigation of violent and drug-related crime, criminal gangs, and juvenile delinquency and in community action to prevent crime. (Sec. 102) Authorizes the Deputy Assistant Director, upon application of the Governor of a State and the chief executive officer of the affected local government and upon finding that criminal activity in a particular jurisdiction is being exacerbated by the interstate flow of drugs, guns, and criminals, to deploy on a temporary basis an RDF unit to assist State and local law enforcement agencies in the investigation of criminal activity. Sets forth provisions regarding application requirements, conditions of deployment, and deputization of RDF members. (Sec. 104) Authorizes appropriations. Subtitle B: Federal-State Anti-Drug and Anti-Violence Task Forces - Authorizes appropriations for the support and expansion of Federal-State anti-drug and anti-violence task forces participated in by the FBI, the Drug Enforcement Administration, the Bureau of Alcohol, Tobacco, and Firearms, and U.S. Attorneys Offices with State and local law enforcement agencies and prosecutors for the purposes of: (1) enhancing interagency coordination of activities in the provision of intelligence information; (2) facilitating multijurisdictional investigations; and (3) aiding in the investigation, arrest, and prosecution of drug traffickers and violent criminals. Subtitle C: Police Corps Program - Requires a State that desires to participate in the Police Corps program (established pursuant to this Act) to designate a lead agency and submit a State plan containing assurances with respect to: (1) lead agency cooperation with other State and local agencies; (2) the State advertising of the assistance available; (3) State screening and selection of law enforcement personnel for participation in the program; and (4) compliance with other specified requirements. (Sec. 124) Establishes within the Department of Justice (DOJ) an Office of the Police Corps to be headed by a Director. (Sec. 125) Authorizes the Director to award scholarships to participants who agree to work for four years in a State or local police force after completion of a baccalaureate program and police corps training. Sets forth provisions regarding: (1) scholarship assistance for dependent children of law enforcement officers; (2) the selection of participants; (3) minority recruitment; and (4) leaves of absence. (Sec. 127) Requires the Director to establish up to three training centers to provide basic law enforcement training to State Police Corps program participants. Requires participants to attend two eight-week training sessions at such centers and to meet certain performance standards in order to remain in the program. Requires the Director to pay participants a weekly stipend during training. (Sec. 129) Requires a State, in order to participate in the Police Corps program, to submit a plan for implementing such program to the Director for approval. Requires such plan to: (1) include assurances that participants will receive additional State or local training after completing Federal training which shall count toward the four-year service obligation; and (2) provide that program participants shall be assigned to community and preventive patrol in geographic areas with the greatest need for additional law enforcement personnel. (Sec. 129A) Sets forth provisions regarding: (1) assistance to States and localities employing Police Corps officers; (2) the swearing in of participants and members of the police force to which they are assigned after completing Federal training and meeting the requirements of that police force; and (3) layoffs. (Sec. 129C) Authorizes appropriations. Subtitle D: Law Enforcement Scholarship and Employment Program - Sets forth requirements regarding designation of a lead agency and submission of a State plan which are analogous to those under the Police Corps program. (Sec. 135) Directs each State to pay from funds under this Act the Federal share (not more than 60 percent) of the costs of: (1) awarding scholarships to in-service law enforcement personnel for further education; and (2) providing full-time employment in the summer or part-time employment for a period not to exceed one year. (Sec. 138) Sets forth State and individual application requirements. Grants priority in awarding scholarships to persons who are members of underrepresented groups, are pursuing an undergraduate degree, and are not receiving financial assistance under the Higher Education Act of 1965. (Sec. 139A) Requires each scholarship recipient to work in a law enforcement position in the State for a period of one month for each credit hour for which funds are received under the scholarship (with a six-month minimum and two-year maximum). (Sec. 139C) Authorizes appropriations. Subtitle E: Job Training and Placement for Separated Members of the Armed Forces - Amends the Job Training Partnership Act (JTPA) to require the Secretary of Veterans Affairs to enter into an interagency agreement with the Directors of the FBI and the National Institute of Justice (NIJ) under which the FBI and NIJ will develop and operate, on a reimbursable basis, a training program to assist eligible separated members of the armed forces in obtaining the training necessary to become law enforcement personnel. Sets forth provisions regarding the selection and number of participants, the content of the training program, and job placement assistance. Authorizes appropriations. (Sec. 142) Amends the JTPA to require the Secretary to offer to enter into a cooperative agreement with the National Center for Housing Management under which the Center will develop and operate a training program to assist eligible separated members of the armed forces in obtaining the training necessary to become managers and employees in public housing agencies and organizations that manage housing projects for such agencies. Sets forth provisions regarding the selection and number of participants, the content of the training program, the use of experts, evaluations, and job placement assistance. Authorizes appropriations. Title II: Studies - Subtitle A: Commission on Crime and Violence - Establishes the National Commission on Crime and Violence in America to: (1) review all segments of the criminal justice system and the effectiveness of traditional criminal justice approaches in preventing and controlling crime and violence; (2) examine the impact that changes to Federal and State law during the past 25 years have had in controlling crime and violence; (3) convene hearings in various parts of the country to receive testimony from a cross-section of criminal justice professionals, victims of crime, and others; (4) bring to public attention successful models and programs in crime prevention, control, and antiviolence; and (5) develop a comprehensive and effective crime control and antiviolence strategy and recommend how to implement such a strategy in a coordinated fashion by Federal, State, and local authorities. Subtitle B: Use of Antiloitering Laws to Fight Crime - Directs the Attorney General to: (1) study ways in which antiloitering laws can be used, without violating the constitutional rights of citizens, to eradicate open-air drug markets and other blatant criminal activity; (2) prepare a model antiloitering statute and guidelines for enforcing it to prevent, deter, and punish illegal drug and other criminal activity; and (3) make the results of the study and the model statute and guidelines available to Federal, State, and local law enforcement authorities. Title III: Violent and Habitual Offenders - Subtitle A: Serious Habitual Offender Comprehensive Action Program - Directs the Attorney General, using specified funds appropriated under the Juvenile Justice and Delinquency Prevention Act of 1974, to continue the funding of new demonstration projects in the Serious Habitual Offenders Comprehensive Action Program during FY 1995 through 1997. Subtitle B: Federal Law Enforcement Assistance Grants - Amends the Omnibus Crime Control and Safe Streets Act of 1968 to: (1) require States to impose a mandatory sentence of 20 years' imprisonment without possibility of probation, parole, or any other form of early release for a firearm offense committed by a career criminal (i.e., a person with three or more convictions under Federal or State law for crimes of violence) in order to avoid a 50 percent reduction of drug control and system improvement grant funds (to be reallocated equally among States in compliance); and (2) permit the use of such grants for programs designed to keep victims informed concerning the status of cases against offenders and to provide victims advance notification of the release of alleged offenders prior to conviction and of convicted offenders at the conclusion of their terms of imprisonment or on probation, parole, or any other form of release. Title IV: Prisons - Subtitle A: Prison for Violent Drug Offenders - Directs the Attorney General to construct and operate ten regional prisons in which eligible prisoners shall participate in a drug treatment program under conditions established by the Director of National Drug Control Policy. Requires the Director to choose former military facilities as locations for such prisons. Sets forth provisions regarding: (1) goals in prisoner selection; (2) postrelease treatment; (3) payment of costs; and (4) prisoner eligibility (including return of prisoners not in compliance with the conditions for participation in a drug treatment program). Authorizes appropriations. Subtitle B: Task Force on Prison Construction Standardization and Techniques - Requires the Director of the Bureau of Prisons to establish a task force composed of experts in prison design and construction to: (1) establish and recommend standardized construction plans and techniques for prison construction and to evaluate and recommend new construction technologies, techniques, and materials to reduce prison construction costs and make such construction more efficient; (2) disseminate such information to State and local officials involved in prison construction; and (3) work to promote the implementation of, evaluate and advise on the results and effectiveness of, and certify the effectiveness of, cost-saving efforts at the Federal, State, and local levels. Title V: Violent Crime and Drug Emergency Areas - Authorizes the President to declare a State or part of a State to be a violent crime or drug emergency area and to provide emergency Federal assistance to protect property, public health, and safety. Specifies that requests for declaration of an emergency must be made in writing by the chief executive officer of a State or local government and that the President must act on the request within 30 days. Authorizes the President to direct any Federal agency to utilize its resources in support of State and local assistance efforts and to provide technical and advisory assistance to meet any such emergency. Limits assistance under this title.
Bill· HRH.R. 3347 (103rd)referred
United States · United States Congress · 22 October 1993
Asset Forfeiture Justice Act - Amends the Tariff Act of 1930 (the Act) and the Federal criminal code to mandate that forfeiture proceedings be conducted only upon the conviction of the property owner for the relevant crime. (Sec. 4) Amends the Act to shift, in all forfeiture or recovery proceedings, to the Federal Government the burden of proof to establish by clear and convincing evidence that certain property (including vessels, aircraft, and vehicles) was subject to forfeiture. (Sec. 5) Amends the Controlled Substances Act, Federal criminal law, and the Act to modify the procedural guidelines and provide for a preliminary hearing for certain property subject to civil forfeiture. (Sec. 6) Amends the Act in connection with claims for seized property to: (1) eliminate the requirement for posting bond; and (2) provide for court-appointed counsel for claimants financially unable to obtain representation; and (3) provide the right to a jury trial. (Sec. 8) Amends Federal criminal law and the Controlled Substances Act to shield from liability to seizure any property which has been paid or pledged as bona fide attorney's fees. (Sec. 9) Amends Federal criminal law to authorize in personam proceedings, only upon conviction of violations, against the owner of certain seized vessels. (Sec. 11) Amends the Controlled Substances Act with respect to civil and criminal forfeitures to prohibit the value of the forfeited property from exceeding the pecuniary gain derived from the offense. (Sec. 12) Amends Federal criminal law and the Controlled Substances Act to repeal the relation-back doctrine with respect to any forfeited property subsequently transferred to other persons. (Sec. 13) Amends the Controlled Substances Act to revise the list of kinds of property subject to seizure. (Sec. 14) Amends the Act, Federal criminal law, and the Controlled Substances Act to specify that any forfeiture proceeds transferred to a State or local law enforcement agency that participated directly in the seizure proceedings be disposed of according to State law. (Sec. 15) Amends the Judicial Code to: (1) make the Department of Justice Assets Forfeiture Fund (the Fund) available to certain community-based crime control and drug programs; and (2) give priority to the communities in which the assets were seized. (Sec. 16) Amends certain Federal laws to revise the limit on amounts paid to informants to allow more than $250,000 in any case, but no more than that in any year. (Sec. 17) Amends the Controlled Substances Act and Federal monetary law to direct the Attorney General to assure that forfeited property transferred to a State or local law enforcement agency is not so transferred to a circumvent any requirement of State law that prohibits forfeiture or limits use or disposal of property forfeited to State or local agencies. (Sec. 18) Amends the Act to direct the Secretary of the Treasury to maintain individual records concerning certain forfeited property. (Sec. 19) Amends the judicial code to: (1) require payment of interest on certain seized property upon entry of judgment for the claimant; and (2) limit the amounts available from the Fund for certain administrative and contracting expenses. (Sec. 22) Amends the Controlled Substances Act to require the Attorney General to offer civilly or criminally forfeited real property of low value located in a metropolitan statistical area for sale, for nominal consideration, to tax-exempt organizations that provide direct services furthering community-based crime control, housing, or educational efforts in such area. (Sec. 23) Amends the judicial code to provide for Federal tort claims proceedings with respect to damage or loss to property while in the possession of a law enforcement officer because of negligence, misfeasance, malfeasance, or nonfeasance.
Law· HRH.R. 3321 (103rd)enacted
United States · United States Congress · 20 October 1993
Amends the Housing and Community Development Reauthorization Act of 1992 to permit a State to consider the amount of the heating or cooling utility allowances received by certain tenants when setting benefit levels under the Low-Income Home Energy Assistance Program.
Bill· HRH.R. 3326 (103rd)referred
United States · United States Congress · 20 October 1993
Delays the effective date of certain regulations governing the admission of single persons into public and assisted housing for the elderly.
Bill· HRH.R. 3322 (103rd)referred
United States · United States Congress · 20 October 1993
Low-Income Housing Preservation Act of 1993 - Amends the Internal Revenue Code to provide a 15-year recovery period for the depreciation deduction for new investments to rehabilitate qualified low-income housing projects. Exempts a specified amount of such rehabilitation costs from the passive loss limitations.
Bill· SS. 1569 (103rd)open
United States · United States Congress · 19 October 1993
TABLE OF CONTENTS: Title I: Health Policy Title II: Health Services Title III: Health Professions Title IV: Research and Data Collection Title V: Miscellaneous Title VI: General Provisions Preventive Health Services and Health Professions Amendments Act of 1993 - Title I: Health Policy - Amends the Public Health Service Act to establish the Advisory Committee on Minority Health to advise the Secretary of Health and Human Services on the development of the goals of the Office of Minority Health for each racial and ethnic group. Authorizes appropriations for FY 1994 through 1998. Requires a specific amount of such funds to be used to improve access to health care services for individuals with limited English proficiency. (Sec. 102) Provides for the establishment of an Office of Minority Health at the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Substance Abuse and Mental Health Administration, and the Agency for Health Care Policy and Research. Requires such Offices to develop and implement health programs that target racial and ethnic minority populations. (Sec. 103) Authorizes the Secretary to make grants to States for the purpose of improving the health status in minority communities, through the operation of State offices of minority health established to monitor and facilitate the achievement of the Health Objectives for the Year 2000 as they affect minority populations. Authorizes appropriations for FY 1995 through 1997. (Sec. 104) Establishes in the Department of Health and Human Services an Assistant Secretary for Civil Rights, who shall be appointed by the President, by and with the advice and consent of the Senate. Title II: Health Services - Extends authorized appropriations for grants to States for the community scholarship program until FY 1996. Revises the eligibility requirements for such program. Modifies the definition of primary health care to include dentistry and mental health provided by physicians and other health professionals (currently, provided by physicians, certified nurse practitioners, certified nurse midwives, or physician assistants). (Sec. 202) Extends the authorized appropriations for the grant program for health services for residents of public housing to FY 1996. (Sec. 203) Requires the Secretary to issue regulations to reduce the extent to which having limited English proficiency constitutes a significant impediment to individuals for eligibility in health programs under the Public Health Service Act. (Sec. 204) Amends the Disadvantaged Minority Health Improvement Act of 1990 to allow substance abuse services under the grant program for health services for Pacific Islanders. Extends authorized appropriations for such program through FY 1996. Requires a report to the Congress on the effectiveness of projects funded under such program. Title III: Health Professions - Extends authorized appropriations until FY 1996 for: (1) loans for disadvantaged students; (2) the Cesar Chavez Scholarship Program (currently known as the Exceptional Financial Need Program); (3) the Thurgood Marshall Scholarship Program (currently known as the Scholarship for Disadvantaged Students program); (4) loan repayments and fellowships regarding faculty positions at health professions schools; (5) Centers of Excellence; and (6) educational assistance regarding undergraduates. (Sec. 305) Requires Centers of Excellence (health professions schools) to carry out community-based training programs to prepare students in secondary schools and institutions of higher education for attendance at such schools. Requires such schools to provide training to students to enable them to provide health service to minorities at community-based health facilities. Allows such schools to establish consortia. Allows schools of pharmacy and clinical psychology to be Centers of Excellence. Title IV: Research and Data Collection - Establishes an Advisory Committee on Research on Minority Health to advise the Director of the Office on Minority Health on appropriate research activities. (Sec. 402) Extends authorized appropriations through FY 1997 for the National Center for Health Statistics. (Sec. 403) Requires that research, demonstration projects, and evaluations be carried out on the health status of, and the delivery of health care to, populations of medically underserved urban and rural areas and low-income, minority groups, and the elderly. Title V: Miscellaneous - Extends authorized appropriations for the program for State offices of rural health through FY 1996 and revises the matching fund requirement. (Sec. 504) Extends the demonstration project for grants to States for Alzheimer's disease through FY 1998. Requires improved access for individuals with Alzheimer's disease, particularly racial and ethnic minorities and individuals living in isolated rural areas, to services that are home-based or community-based. (Sec. 505) Directs the Secretary to study and report to the Congress on the need to combine the designations of medically underserved area and health professional shortage area. (Sec. 506) Requires the Secretary to establish programs regarding birth defects. Title VI: General Provisions - Declares that this Act is effective October 1, 1993, or upon enactment, whichever occurs later.
Bill· SS. 1565 (103rd)referred
United States · United States Congress · 19 October 1993
Older Americans' Housing Preservation Act - Delays the effective date of certain regulations governing the admission of single persons into public and assisted housing for the elderly.
Law· HRH.R. 3313 (103rd)enacted
United States · United States Congress · 19 October 1993
TABLE OF CONTENTS: Title I: Women Veterans Health Improvements Title II: Care for Veterans Exposed to Toxic Substances Title III: Readjustment Services Title IV: Services for Mentally Ill Veterans Veterans Health Improvements Act of 1993 - Title I: Women Veterans Health Improvements - Women Veterans Health Improvements Act of 1993 - Directs the Secretary of Veterans Affairs to ensure that each Department of Veterans Affairs health care facility is able to provide in a timely and appropriate manner all authorized health care services to women veterans. Requires the provision of direct Department care (rather than by contract or other agreement) for women veterans in an area in which the number of such veterans makes it cost effective to do so. Extends the requirement for, and adds to the information required in, an annual report concerning women veterans health care and research. Prohibits mammograms from being performed at a Department facility unless it is accredited by a private nonprofit organization designated by the Secretary. Directs the Secretary to prescribe mammogram quality assurance and control standards and to perform periodic inspections of Department mammogram equipment and facilities. Requires application of such standards to non-Department facilities or providers under contract with the Department. Requires the Secretary, in conducting or supporting clinical research, to ensure that women and minority veterans are included as subjects in such research. Extends through 1998 the authority for the provision of sexual trauma counseling to women veterans. Requires with respect to such counseling: (1) the availability of a toll-free telephone number; (2) appropriate training to Department personnel who provide counseling assistance; and (3) a report to the Congress on the operation of the telephone assistance service. Amends the Veterans Health Care Act of 1992 to require each coordinator of women's services to serve on a full-time basis. Requires such coordinators to be fully able to carry out their responsibilities and to provide women veterans with equal access to Department facilities. Directs the Secretary to: (1) conduct a survey to identify deficiencies relating to women patient privacy in Department medical centers; (2) correct any such deficiencies; and (3) report to the Congress. Title II: Care for Veterans Exposed to Toxic Substances - Extends eligibility for hospital, nursing home, or outpatient medical care through the Department of Veterans Affairs to: (1) a veteran who may have been exposed to a herbicide agent while serving on active duty in Vietnam during the Vietnam era if the National Academy of Sciences has, in a report issued under the Agent Orange Act of 1991, made specified determinations regarding an association between exposure to a herbicide agent and occurrence of the veteran's disease; and (2) a radiation-exposed veteran if the Secretary of Veterans Affairs, based on advice of the Advisory Committee on Environmental Hazards, determines that there is credible evidence of a positive association between exposure to ionizing radiation and the veteran's disease. Terminates eligibility for herbicide-exposed veterans under this Act after September 30, 1996. Title III: Readjustment Services - Authorizes the Secretary to furnish counseling in a vet center to assist any veteran who served in combat during World War II or the Korean conflict in overcoming the effects of such combat experience. Requires a report. Establishes in the Department the Advisory Committee on Veterans Readjustment Counseling to perform advisory services with respect to veterans' readjustment, taking into special account Vietnam era veterans. Requires reports. Directs the Secretary to report to specified congressional committees a plan for the expansion of the Vietnam Veteran Resource Centers program. Title IV: Services for Mentally Ill Veterans - Authorizes the Secretary to establish at any Veterans Health Administration facility a nonprofit corporation to: (1) arrange for therapeutic work for patients of such facility or other Department facilities; and (2) provide a funding mechanism to achieve such purposes. Outlines provisions concerning: (1) the establishment of a board of directors for each such corporation; (2) the deposit of excess corporation funds; (3) annual reports by the corporation and the Secretary; (4) a prohibition against the establishment of such corporations after FY 1999; and (5) required recognition of such corporation within four years as a tax-exempt organization under Internal Revenue Service rules. Extends through FY 1998 (currently 1994) the Department compensated work therapy and therapeutic transitional housing demonstration program. Removes the 50-residence limit under the housing program, increasing such amount for each of FY 1994 through 1998. Directs the Secretary to establish a Special Committee on Care of Severely Chronically Mentally Ill Veterans to carry out a continual assessment of the Department's ability to meet the treatment and rehabilitation needs of severely, chronically mentally ill veterans and to provide appropriate advice and recommendations after such assessment. Requires annual reports.
Bill· HRH.R. 3308 (103rd)referred
United States · United States Congress · 19 October 1993
Authorizes the provision of loans guaranteed by the Department of Veterans Affairs to veterans for the purpose of purchasing residential property in a cooperative housing project if such cooperative is approved by the Secretary of Veterans Affairs.
Bill· SS. 1550 (103rd)referred
United States · United States Congress · 15 October 1993
TABLE OF CONTENTS: Title I: Department of Defense Title II: Department of State Title III: Committee on Agriculture, Nutrition, and Forestry Subtitle A: Commodity Programs Subtitle B: Replacement of Federal Crop Insurance with Emergency Crop Loss Assistance Subtitle C: Other Agricultural Programs Title IV: Committee on Energy and Natural Resources Title V: Committee on Environment and Public Works Title VI: Committee on Commerce, Science, and Transportation Title VII: Civil Service Programs Title VIII: Committee on Finance Title IX: Reinventing Government Federal Spending and Deficit Reduction Act of 1993 - Title I: Department of Defense - Limits to $18 billion the total amount appropriated for FY 1994 through 1998 for programs managed by the Ballistic Missile Defense Organization. Limits the obligation of such funds to research only. (Sec. 102) Limits: (1) as of December 31, 2000, the number of nuclear warheads to be maintained by the United States (with a waiver exercised by the President under certain conditions); and (2) the total amount that may be expended by the Department of Energy for nuclear weapons research, development, and testing activities during FY 1994 through 1998. (Sec. 104) Directs the Secretary of Defense to require the secretaries of the military departments to retire at least 60,000 members of the armed forces before October, 1, 1994, under the military early retirement program. (Sec. 105) Directs the Secretary to carry out a study to determine the most cost effective alternatives for meeting| requirements for military family housing. (Sec. 106) Provides end strength and grade distribution limitations for civilian personnel of the Department of Defense (DOD). (Sec. 107) Directs the Secretary to consolidate and reduce the recruiting activities of the armed forces, with a waiver in the case of war or national emergency. (Sec. 108) Prohibits DOD funds from being used to operate any commissary store on or after October 1, 1996, unless determined necessary for the continued operation of such store due to its remote location or high costs of operation. Requires revenues received from store operations to be used to pay operating costs. Requires the Secretary to ensure that actions to increase a store's effectiveness of operations do not result in reduced benefits for store patrons and do not adversely affect stores that are in remote or high cost locations. Provides a phased reduction during FY 1994 through 1996 in the authorization of appropriations for commissary store operations. (Sec. 109) Authorizes military personnel to be used to perform a base operations function or to carry out a military construction project under certain conditions, with an exception if the cost of such performance is found to exceed its benefits. (Sec. 110) Directs the President to enter into negotiations with each member of the North Atlantic Treaty Organization (NATO) and every nation with which the United States has a bilateral or multilateral defense agreement to conclude an agreement that requires each such nation to pay a significant portion of the costs of stationing U.S. military and civilian personnel and equipment in such nation. Excludes the pay and allowances of such personnel from such costs. Title II: Department of State - Requires the Secretary of State to: (1) determine which foreign affairs programs, agencies, and activities, whether within or without the jurisdiction of the Department of State, are redundant, duplicative, outmoded, or obsolete; (2) undertake actions necessary to streamline, consolidate, or eliminate those programs, agencies, or activities under the Department's jurisdiction such that funding equals a level constant in real terms (inflation-adjusted) with the funding level in 1984; and (3) report to the Congress on those programs, agencies, and activities outside the Department's jurisdiction which are redundant, outmoded, or obsolete. Title III: Committee on Agriculture, Nutrition, and Forestry - Subtitle A: Commodity Programs - Amends the Agricultural Act of 1949 to reduce deficiency payments for wheat, feed grains, cotton, and rice. (Sec. 302) Reduces the base acreage eligible for deficiency payments. (Sec. 303) Increases dairy producer program contributions. (Sec. 304) Amends the Agricultural Adjustment Act to revise milk marketing order provisions, including elimination of minimum regional price adjustments and parity price determinations. (Sec. 305) Repeals the National Wool Act of 1954 (eliminates the wool and mohair price support program). (Sec. 306) Amends the Agricultural Act of 1949 to eliminate the honey price support program. Subtitle B: Replacement of Federal Crop Insurance with Emergency Crop Loss Assistance - Amends the Agricultural Act of 1949 to replace the Federal crop insurance program with an emergency crop loss assistance program for: (1) annual crops (program and nonprogram target crops, peanuts, sugar, and tobacco, soybeans and nonprogram crops, forage crops, and crop quality reduction payments); (2) orchards; and (3) forest crops. Authorizes appropriations. Subtitle C: Other Agricultural Programs - Repeals title I (sales) and title II (grants) of the Agricultural Trade Development and Assistance Act of 1954. (Sec. 332) Amends the Rural Electrification Act of 1936 to eliminate the interest rate subsidy for Rural Electrification Administration direct loans. (Sec. 333) Directs the Secretary of Agriculture to consolidate specified Department of Agriculture field offices. Title IV: Committee on Energy and Natural Resources - Amends the National Forest Management Act of 1976 to prohibit the Secretary of Agriculture from selling any timber on National Forest System lands for which sales revenues are less than the legal minimum bid. (Sec. 402) Amends the Tennessee Valley Authority Act of 1933 to preclude the use of Federal funds to: (1) support or implement a recreational activity or program; or (2) establish or maintain the National Fertilizer and Environmental Research Center. Prohibits the Board of Directors (the Board) of the Tennessee Valley Authority (TVA) from using Federal funds for stewardship activities unrelated to the power system. Authorizes the Board to develop and implement a user fee mechanism for: (1) users of TVA stewardship activities that are unrelated to the power system to cover the costs of such nonpower-related activities; and (2) users of power from the system to cover the costs of all stewardship activities. (Sec. 403) Amends specified Federal law relating to power regulation and development to mandate that all moneys received from Federal power sales be deposited in the Treasury through uniform annual payments that consist of equal amounts of principal and interest and that reflect a commencement of payments for each project with the first year in which project electric power and energy is delivered to the Secretary of Energy. (Sec. 404) Amends the Federal Land Policy and Management Act of 1976 to direct the Secretaries of Agriculture and the Interior to establish, according to prescribed guidelines, an annual domestic livestock grazing fee equal to fair market value in certain National Forest System and public domain lands within their respective jurisdictions. Directs the Secretary of the Interior, acting through the Director of the National Park Service, to establish a fee structure for entrance and user fees at public lands that are part of the National Park System. Title V: Committee on Environment and Public Works - Prohibits: (1) the Secretary of Transportation from carrying out, or entering into any agreement to carry out, a highway demonstration project described in the Intermodal Surface Transportation Efficiency Act of 1991 in FY 1994 through 1998, except in the case of an agreement entered into before March 31, 1994; and (2) the expenditure of funds in such fiscal years for such a project. Rescinds: (1) any amounts set aside or otherwise made available for such projects that are not expended as a result of this title; and (2) the underlying appropriations for such amounts. Title VI: Committee on Commerce, Science, and Transportation - (Sec. 601) Amends the Communications Act of 1934 (the Act) to subject revenues from the use of the electromagnetic spectrum pursuant to any initial license of construction permit issued after the enactment of this Act to a royalty of four percent. Subjects any licensee who knowingly or willfully submits inaccurate information or who fails to submit information required under this title to forfeiture of the license. (Sec. 602) Requires the Secretary of Transportation to develop and implement a system to require the payment of a user fee for the inland waterway transportation system to generate revenues sufficient to fully recover operation, maintenance, and construction costs. Title VII: Civil Service Programs - Amends Federal civil service law to require each Federal agency to prefund the Government share of its annuitants' Federal health insurance coverage. (Sec. 702) Repeals provisions excluding senior executives from the limitation on the accumulation of annual leave. (Sec. 703) Eliminates administratively uncontrollable overtime pay, except for law enforcement officers. Title VIII: Committee on Finance - Amends title XVIII (Medicare) of the Social Security Act to: (1) authorize the Secretary of Health and Human Services to impose a one dollar fee for processing paper part B (Supplementary Medical Insurance) claims; and (2) reduce reimbursements for items and services not billed electronically by the amount of any such fee imposed. (Sec. 802) Directs the Secretary of the Treasury to establish a program for the issuance and sale of import licenses at public auction to administer quantitative restrictions with respect to textiles and textile products and sugar. Title IX: Reinventing Government - Provides that, in any fiscal year, any agency with budget authority appropriated in operation accounts which will be unobligated on the last day of such fiscal year, and will expire at the end of such day, may place up to 50 percent of such budget authority into an agency innovation fund to be established for specified activities for each executive agency of the Federal Government. Requires any funds transferred to one of these funds to remain available for obligation for a qualified purpose for an additional two years beyond the date the funds would otherwise have expired.
Bill· HRH.R. 3298 (103rd)open
United States · United States Congress · 15 October 1993
National Property Reinsurance Act - Amends the National Housing Act to extend program authority for: (1) State plans to assure fair insurance access (FAIR plans); (2) property reinsurance; (3) burglary and theft insurance; and (4) claims. Requires the Director of the Federal Emergency Management Agency to designate underserved areas for FAIR plan purposes. Replaces the existing program of reinsurance of losses from riots or civil disorders with a national property reinsurance program. Limits coverage to underserved areas in States with FAIR plans. Sets forth program provisions. Establishes in the Treasury the National Property Reinsurance Fund. Reestablishes the Advisory Board.
Bill· HRH.R. 3296 (103rd)referred
United States · United States Congress · 15 October 1993
Home Refinancing Assistance Act of 1993 - Amends the National Housing Act to authorize the Secretary of Housing and Urban Development to insure qualifying single family home refinancings.
Bill· HRH.R. 3267 (103rd)referred
United States · United States Congress · 13 October 1993
TABLE OF CONTENTS: Title I: Supplemental Appropriations for Full Employment Economy Title II: Work Hours Title III: Wages Title IV: Tax Incentives for Full Employment Title V: Entitlement Programs Full Employment Act for Fiscal Year 1994 - Title I: Supplemental Appropriations for Full Employment Economy - Makes supplemental appropriations for FY 1994 to: (1) the Department of Agriculture for watershed and flood prevention operations, rural water and waste disposal grants, the special supplemental food program, and the National Forest System; (2) the Small Business Administration for the business loans program account; (3) the Department of the Interior for the National Park System; (4) the Department of Energy for energy conservation activities; (5) the Department of Labor for training and employment services and community service employment for older Americans; (6) the Department of Health and Human Services for health resources and services, the Office of the Assistant Secretary for Health, and children and families services programs; (7) the Department of Education for compensatory education for the disadvantaged and student financial assistance; (8) the Department of Transportation for grants-in-aid for airports, Federal-aid highways, grants to the National Railroad Passenger Corporation, and formula grants; (9) the Department of the Treasury for Internal Revenue Service information systems; (10) the Department of Housing and Urban Development for homeless assistance and community development grants; and (11) the Environmental Protection Agency for construction grants. Title II: Work Hours - Amends the Fair Labor Standards Act of 1938 to require overtime to be paid at two times the regular hourly rate (currently, one- and one-half times). Reduces the regular 40-hour workweek to a 30-hour workweek. Title III: Wages - Establishes the minimum wage at $7 an hour. Title IV: Tax Incentives for Full Employment - Expresses the sense of the Congress that appropriate tax incentives should be provided to businesses that hire new employees, create new jobs, provide ongoing education and training for their employees, provide child care arrangements for their employees, establish health care plans for their employees, and undertake research and development. Title V: Entitlement Programs - Expresses the sense of the Congress that individuals who receive assistance under any Federal entitlement program should seek to obtain employment providing livable wages and, where appropriate, affordable child care arrangements.
Resolution· HRESH.Res. 275 (103rd)passed
United States · United States Congress · 13 October 1993
Waives points of order against the consideration of the conference report on H.R. 2491 (FY 1994 appropriations for the Departments of Veterans Affairs and Housing and Urban Development and certain independent agencies and entities).
Bill· HRH.R. 3264 (103rd)referred
United States · United States Congress · 12 October 1993
TABLE OF CONTENTS: Title I: Access to SSI Work Incentives Title II: Work Incentives Waiver Authority Title III: Amendments to Work Incentives Provisions Title IV: Effective Date Work Incentives Amendments of 1993 - Title I: Access to SSI Work Incentives - Amends title XVI (Supplemental Security Income) (SSI) of the Social Security Act (SSA) with respect to access to work incentives under SSI for SSI disability benefits (SSDI)-only recipients who lose eligibility for SSDI benefits because of working. Title II: Work Incentives Waiver Authority - Amends SSA titles XIX (Medicaid) and XVI with respect to: (1) the eligibility of certain individuals with disabilities for coverage under Medicaid and community-based care waivers; and (2) work incentives waiver authority. Title III: Amendments to Work Incentives Provisions - Amends SSA title XVI: (1) to disregard the deemed income of an ineligible spouse when determining continued Medicaid eligibility for certain individuals; (2) to provide for continuation of Medicaid for the aged who lose SSI due to excessive earnings; (3) to deem approved self-support plans not disapproved within 30 days; (4) to require the Secretary of Health and Human Services to establish a time limit by which activities under a plan for achieving self-support must be completed; (5) to provide for the expansion of self-support plans to include housing goals; and (6) with regard to self-support plans for the aged, additional State supplementation requirements, treatment of unemployment compensation, workers' compensation, and sick pay as earned income for SSI purposes, treatment of certain grant, scholarship, or fellowship income as earned income for SSI purposes, and SSI eligibility for students temporarily abroad. Amends SSA title XIX to provide for the exclusion of income and resources under self-support plans in determining Medicaid eligibility in certain States. Title IV: Effective Date - Sets forth the effective date of this Act.
Resolution· HRESH.Res. 268 (103rd)passed
United States · United States Congress · 5 October 1993
Waives points of order against the consideration of the conference report on H.R. 2491 (Departments of Veterans Affairs and Housing and Urban Development and independent agencies appropriations).
Bill· SS. 1510 (103rd)open
United States · United States Congress · 30 September 1993
Increases from $46,000 to $50,750 the amount of the loan guaranty by the Department of Veterans Affairs for loans to qualifying veterans for the purchase or construction of homes.
Bill· HRH.R. 3191 (103rd)referred
United States · United States Congress · 30 September 1993
TABLE OF CONTENTS: Title I: Definitions Title II: Compliance and Increased Participation Title III: Ratings and Incentives for Community Floodplain Management Programs Title IV: Mitigation of Flood and Erosion Risks Title V: Flood Insurance Task Force Title VI: Miscellaneous Provisions National Flood Insurance Reform Act of 1993 - Title I: Definitions - Defines specified terms under the Flood Disaster Protection Act of 1973 and the National Flood Insurance Act of 1968. Title II: Compliance and Increased Participation - Amends the Flood Disaster Protection Act of 1973 to require the Secretary of Housing and Urban Development (HUD) to: (1) prohibit any lending institution from making, increasing, extending, or renewing any loan for real estate in a special flood hazards area unless such real estate is covered by flood insurance under the National Flood Insurance Act of 1968; and (2) direct the Federal National Mortgage Association and the Federal Home Loan Mortgage Corporation to implement procedures to achieve those results. Prohibits any other Federal agency lender from making such a loan for appropriate real estate not covered by such flood insurance. Requires residential real estate lenders to establish flood insurance premium escrow accounts. Requires Federal lenders and regulated lending institutions (banks, savings and loans, credit unions) to notify borrowers of special flood hazards and of the need to purchase and maintain flood insurance. Requires such entities, after 60 days' notice, to purchase such insurance on behalf of the borrower and charge the borrower for premium costs. Provides for review of special hazards determinations by the Director of the Federal Emergency Management Agency (FEMA). Imposes civil penalties upon lenders who fail to require flood insurance or to provide appropriate borrower notification of the need for such insurance. Requires the transferor of a loan to notify the transferee of a determination that the real estate that is the basis of such loan is in a special flood hazards area. Provides exceptions. Requires similar notification on loans transferred by the Federal Deposit Insurance Corporation (FDIC) and the Resolution Trust Corporation (RTC). Requires the Director to develop a standard flood hazard determination form for use in connection with loans for residential properties located in an area of special flood hazards and in which flood insurance is available. Amends the Federal Deposit Insurance Act and the Federal Credit Union Act to require regulated lending institutions to conduct examinations and report to the Congress with respect to compliance with the National Flood Insurance Program. Amends the Federal Housing Enterprises Financial Safety and Soundness Act of 1992 to require the FEMA Director to annually determine whether enterprises under such Act are in compliance with requirements of the national flood insurance program. Amends the Federal Financial Institutions Examinations Council Act of 1978 to direct the Financial Examinations Council to coordinate with Federal entities for lending regulation and the HUD Secretary to develop uniform lender standards. Title III: Ratings and Incentives for Community Floodplain Management Programs - Amends the National Flood Insurance Act of 1968 to provide for a community rating system and premium rate incentives for community floodplain management. Provides program funding. Title IV: Mitigation of Flood and Erosion Risks - Amends the National Flood Insurance Act of 1968 to terminate: (1) the insured flooded property purchase or loan program; and (2) the schedule for payment of flood insurance for structures on land subject to imminent collapse or subsidence. Amends the Housing and Urban Development Act of 1968 to require the FEMA Director to: (1) coordinate all flood and erosion mitigation activities under the Federal Insurance Administrator; and (2) provide financial assistance to States and communities, from the National Flood Mitigation Fund established under this Act, for planning and carrying out flood and erosion mitigation activities. Establishes in the Treasury the National Flood Mitigation Fund for providing such assistance. Requires the FEMA Director to assess an insurance premium mitigation surcharge to cover the flood and erosion mitigation coverage expenses. Repeals (with a one-year transition period) the current programs for the purchase of certain insured properties and the demolition or relocation of threatened structures. Requires the FEMA Director to: (1) conduct a study (and make a report) to determine the feasibility of providing mitigation insurance for increasing repair and reconstruction costs of repeatedly and severely flood damaged insured buildings; (2) conduct a study of riverine erosion; and (3) coordinate coastal zone management programs under the Secretary of Commerce for Oceans and Atmosphere and with the States. Title V: Flood Insurance Task Force - Establishes a two-year interagency Flood Insurance Task Force to: (1) develop standardized flood insurance enforcement procedures; (2) study Federal agency and secondary mortgage market assistance with respect to such enforcement; and (3) study the possibility of existing Federal and corporate flood insurance programs as models for new programs. Title VI: Miscellaneous Provisions - Amends the National Flood Insurance Act of 1968 to: (1) extend through FY 1999 the national flood insurance program; (2) increase flood insurance coverage amounts for nonresidential, single family, and multifamily structures; (3) permit flood insurance private sector participation; and (4) require an assessment (and revision if necessary) of flood insurance maps (with identification of erosion hazard areas) at least every five years. Provides additional funding for the preparation of such maps.
Bill· SS. 1500 (103rd)referred
United States · United States Congress · 29 September 1993
Amends the Job Training Partnership Act to direct the Secretary of Labor to enter into a cooperative agreement with the National Center for Housing Management to provide for a training program to assist recently discharged members of the Armed Forces to obtain training and employment as managers and employees with public housing authorities and management companies. Authorizes appropriations.
Bill· HRH.R. 3169 (103rd)referred
United States · United States Congress · 29 September 1993
Insurance Disclosure Act - Directs the Secretary of Housing and Urban Development (the Secretary) to establish requirements for insurers to compile and submit information to the Secretary for each annual reporting period concerning the affordability and availability of insurance coverage for: (1) noncommercial insurance; (2) commercial insurance for residential properties and small businesses in urban areas; (3) bid, performance, and payment bonds for small businesses; and (4) insurance in designated rural areas. Authorizes the Secretary to waive such disclosure requirements if the State within which the insurer transacts business has an equivalent disclosure mechanism in place. Directs the Financial Institutions Examination Council to determine the extent to which private mortgage insurers make available to the public and to regulatory agencies the mortgage information required to be reported under the Home Mortgage Disclosure Act of 1975. Provides for contracting out such data collection or submission of such data through statistical agents. Directs the Secretary to set forth specified annual disclosure requirements for loans and investments made by designated insurers in a designated metropolitan statistical area. Prescribes guidelines for: (1) the compilation and public accessibility of the disclosures mandated by this Act; and (2) written notification by an insurer to applicants and policyholders regarding the reasons that coverage was denied. Sets forth civil penalties for insurers in violation of this Act. Directs the Secretary to establish a task force to report to certain congressional committees on insurance agency appointments affecting inner city and minority agents. Requires the Secretary to conduct studies and report to certain congressional committees on: (1) prescreening of insurance applicants; (2) insurer practices affecting the insurance needs of low- and moderate-income neighborhoods, minority neighborhoods, and small businesses located in such neighborhoods; (3) disparate treatment of policyholders by insurers based upon sex, race, or income level; (4) the disparate impact upon policyholders of basing insurance premiums upon the territory in which the insured risk is located; and (5) community reinvestment requirements for insurers that are comparable to those for depository institutions.
Law· HRH.R. 3161 (103rd)enacted
United States · United States Congress · 28 September 1993
Older Americans Act Technical Amendments of 1993 - Makes numerous miscellaneous technical amendments necessitated by the enactment of the Older Americans Act Amendments of 1992 to various provisions of the Older Americans Act of 1965 (OAA), including those extending the deadlines for certain reports to the Congress, and those uner OAA and other specified Federal laws elevating the Commissioner on Aging to Assistant Secretary for Aging within the Department of Health and Human Services. Amends the Older Americans Act Amendments of 1992 to: (1) extend the deadlines for obligating funds for operation of the National Ombudsman Resource Center and National Center on Elder Abuse; and (2) delay the applicability of certain amendments, including those relating to vulnerable elder rights protection activities. Amends the Native American Programs Act of 1974 to: (1) make numerous miscellaneous technical amendments; and (2) authorize appropriations for FY 1994 for demonstration projects for research related to Native American studies and Indian policy development and for a plan for the establishment of a National Center for Native American Studies and Indian Policy Development. Amends the Older Americans Amendments of 1987 to: (1) extend the deadline for the President to convene the White House Conference on Aging; (2) authorize appropriations for FY 1995 and 1996 for the Conference; and (3) make miscellaneous technical amendments regarding Conference administration and availability of funds. Amends the Community Services Block Grant Act to: (1) make miscellaneous technical amendments; and (2) change annual reporting requirements; and (3) split the discretionary grants program for rural housing and community facilities in to two separate items. Amends specified Federal law authorizing appropriations for the continued implementation of the Juvenile Justice and Delinquency Prevention Act of 1974 to replace references to the Development Block Grant Act Amendments of 1992 with references to the Child Care and Development Block Grant Act of 1990. Amends the Child Abuse, Domestic Violence, Adoption and Family Services Act of 1992 to make certain changes to the State grant program for child abuse and neglect prevention and treatment effective only after annual appropriations reach 40 million.
Law· HJRESH.J.Res. 267 (103rd)enacted
United States · United States Congress · 27 September 1993
Makes continuing appropriations for FY 1994 for projects or activities, including the costs of direct loans and loan guarantees, provided for in the following Acts: (1) the Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 1994; (2) the Departments of Commerce, Justice, and State, the Judiciary, and Related Agencies Appropriations Act, 1994; (3) the Department of Defense Appropriations Act, 1994; (4) the District of Columbia Appropriations Act, 1994; (5) the Energy and Water Development Appropriations Act, 1994; (6) the Department of the Interior and Related Agencies Appropriations Act, 1994; (7) the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 1994; (8) the Military Construction Appropriations Act, 1994; (9) the Department of Transportation and Related Agencies Appropriations Act, 1994; (10) the Treasury, Postal Service, and General Government Appropriations Act, 1994; and (11) the Departments of Veterans Affairs and Housing and Urban Development, and Independent Agencies Appropriations Act, 1994. Sets forth limitations on the use of such funds. Requires the following functions to be maintained at the current rate of operations: (1) the Council on Environmental Quality and Office of Environmental Quality activities; and (2) activities funded by the Selective Service System salaries and expenses account.