Consolidated Omnibus Budget Reconciliation Act of 1985

Summary

Deficit Reduction Amendments of 1985 - Title I: Medicare Program - Medicare Budget Reconciliation Amendments of 1985 - Part A: Changes Relating Primarily to Part A of the Medicare Program - Amends part A (Hospital Insurance) of title XVIII (Medicare) of the Social Security Act to provide that the applicable percentage increase for cost reporting periods beginning during FY 1986 with respect to payments for inpatient hospital services, shall be one percent. Provides for a one-year extension of the DRG transitional period by maintaining the current blend of rates for an additional year. Directs the Secretary of Health and Human Services to adjust payment amounts for hospitals for discharges occurring during FY 1986 to reflect changes the Secretary has proposed in specified regulations respecting the hospital wage index. Provides for a study and report to the Congress from the Secretary concerning hospital wages in central cities. Revises the formula which provides for additional payments to hospitals for indirect costs of medical education. Provides for an additional payment to an urban hospital of 100 or more beds that serves a disproportionate share of low-income patients. Treats as a rural referral center a rural osteopathic hospital having 3,000 or fewer discharges annually. Prohibits the Secretary from limiting, for a period of one year, the costs that may be recognized as reasonable with respect to the net costs of approved educational activities for a cost reporting period based upon the net costs of those activities for any previous cost reporting period. Prohibits including in the reasonable costs of inpatient hospital services the return on equity capital for hospitals. Permits, in other cases, payment for a return on equity capital, provided that such rate of return equals the average of the rates of interest on obligations issued for purchase by the Federal Hospital Insurance Trust Fund. Provides for the continuation of State hospital reimbursement control demonstration systems, provided certain conditions are met. Permits States with such a system an extra year within which to fulfill certain assurances. Provides for a special rule for the treatment of depreciation and interest on capital indebtedness, in the case of the transfer of ownership of a hospital or skilled nursing facility without monetary consideration from a State to a nonprofit corporation, which would not take into account the acquisition costs to the new owner. Requires a report from the Secretary to the Congress with respect to the impact of policies respecting outliers and patient transfers on payments to rural hospitals. Directs the Secretary to make available to the Prospective Payment Assessment Commission, the Congressional Budget Office, the Committee on Ways and Means of the House, and the Committee on Finance of the Senate the most current information on payments being made under the prospective payment system. Amends the Tax Equity and Fiscal Responsibility Act of 1982, with respect to payment for hospice care, to eliminate the sunset provision. Increases the payment rate for daily hospice care. Limits the time period within which the ten percent penalty for late enrollment under part A can be assessed. Amends the Internal Revenue Code to provide for the application of the hospital insurance tax to State and local employment. Requires any hospital with an emergency department to provide for the examination and stabilizing treatment of emergency conditions (including treatment for active labor) for any individual (whether or not eligible for Medicare) coming to such department. Provides for the termination of a hospital's Medicare agreement and civil penalties, if the hospital does not comply. Provides criminal penalties for noncomplying physicians. Part B: Changes Relating to Parts A and B of the Medicare Program - Requires, in the case of all covered employed individuals, that payment for health care items or services, to the extent possible, be made by the individual's group health plan before any Medicare payments will be made. Amends part B (Supplementary Medical Insurance) of title XVIII to define the "special enrollment period" as the period beginning with the first day of the first month in which an individual is no longer enrolled in a group health plan by reason of current employment and ending seven months later. Amends the Age Discrimination in Employment Act of 1967 to prohibit an employer from discriminating against an employee over age 65 under the employer's group health plan. Requires that in the case of an individual who is receiving inpatient hospital services as of the effective date of the individual's enrollment under Medicare with a health maintenance organization (HMO) or competitive medical plan (CMP): (1) payment for such services until the date of the individual's discharge shall be made under Medicare as if the individual were not enrolled with the HMO or CMP; (2) the HMO or CMP shall not be financially responsible for payment of such services until the date after the date of an individual's discharge; and (3) the HMO or CMP shall nonetheless be paid the full amount otherwise payable to the HMO or CMP. Requires that in the case of an individual who is receiving inpatient hospital services as of the effective date of the individual's termination of enrollment with an HMO or CMP: (1) the HMO or CMP shall be financially responsible for payment of such services after such date and until the date of the individual's discharge; (2) payment for such services shall not be made under the prospective payment system; and (3) the HMO or CMP shall not receive any payment with respect to the individual during the period the individual is not enrolled. Requires all marketing material of an HMO or CMP to be reviewed by the Secretary prior to its distribution. Directs the Secretary to evaluate: (1) the relative effectiveness of peer review organizations that require preadmission certification of 100 percent of elective inpatient surgical procedures as compared with other peer review organizations that require such certification of a lesser percentage of such procedures; and (2) the feasibility of extending the pre-procedure certification activities of peer review organizations to cover elective surgical procedures conducted in outpatient and ambulatory care settings. Requires a report to the Congress. Prohibits the Secretary from providing for the merger of any renal disease network into a utilization and quality control peer review organization or another entity without express statutory authority. Directs the Secretary to extend, for three additional years, approval of three specified municipal health services demonstration projects. Part C: Changes Relating Primarily to Part B of the Medicare Program - Extends, for one year, the current freeze on physician charge levels for nonparticipating physicians under part B, while providing incentives for participating physicians. Increases from 15 to 23 the number of members of the Prospective Payment Assessment Commission. Directs the Chairman of the Commission to provide for two subcommittees of the Commission, one with functions and responsibilities relating primarily to hospital payment issues and the other with functions and responsibilities relating primarily to physician payment issues. Directs the Commission to: (1) annually make recommendations to the Congress regarding adjustments to the reasonable charge levels for physicians' services under part B and changes in the methodology for determining the rates of payment, and for making payment for physicians' services; and (2) advise and make recommendations to the Secretary respecting the development of the relative value scale. Directs the Secretary to: (1) develop a relative value scale that establishes a numerical relationship among the various physicians' services for which payment may be made under part B; and (2) report to the Congress concerning such scale. Extends for an additional year provisions under which part B premiums shall equal 25 percent of program costs. Directs the Secretary by regulation to: (1) describe the factors to be used in determining if a reasonable charge is inherently reasonable; and (2) provide, in those cases where the reasonable charge is not inherently reasonable, for factors that will be considered in establishing a reasonable charge that is realistic and equitable. Revises the computation of customary charges with respect to certain former hospital-compensated physicians. Provides coverage for outpatient occupational therapy services. Revises payment provisions with respect to durable medical equipment. Provides, among other things, that, with respect to durable medical equipment furnished on or after October 1, 1986, the prevailing charge level may not exceed the percentage increase in the Consumer Price Index. Prohibits coverage for an assistant in a cataract operation unless, before surgery, the appropriate utilization and quality control peer review organization has approved the use of an assistant because of a complicating medical condition. Directs the Secretary: (1) after consultation with the Prospective Payment Assessment Commission, to develop recommendations and guidelines respecting other surgical procedures for which an assistant at surgery is generally not medically necessary and the circumstances under which an assistant is appropriate; and (2) to report to the Congress with recommendations and guidelines. Provides that, with respect to the payment for replacement cataract eyeglasses and cataract contact lenses: (1) payment may be made for the replacement of lost or damaged cataract eyeglasses only once every year; and (2) payment may be made, in the first year after surgery, for one original cataract contact lens for each eye and for the replacement only twice of a lost or damaged cataract contact lens for each eye, and in each subsequent year, for the replacement only twice of a lost or damaged cataract contact lens for each eye. Directs the Secretary to establish a demonstration program designed to reduce disability and dependency through the provision of preventive health services to Medicare beneficiaries. Sets forth provisions relating to: (1) preventive health services to be made available under the demonstration program; (2) the conduct of the program; (3) evaluation of the program; (4) reports to the Congress; (5) funding; and (6) waiver of Medicare requirements. Part D: Private Health Insurance Continuation - Amends the Internal Revenue Code to prohibit the expenses paid or incurred by an employer for a group health plan from being allowed as a deduction unless each qualified beneficiary who would lose coverage because of a qualifying event is given the option of electing continued coverage under the plan. Sets forth specifics concerning such continuation, including: (1) five-year maximum length of coverage; and (2) allowing the plan to provide for payment of the total premium by the beneficiary. Title II: Trade and Customs Laws Amendments - Part A: Trade Adjustment Assistance - Amends the Trade Act of 1974 to require trade adjustment assistance for workers if increases in imports like or directly competitive with articles produced by such workers' firm contributed importantly to the total or partial separation of such workers or to the threat of total or partial separation of such workers or to a decline in sales and production of the firm. Provides that workers shall be eligible for trade adjustment assistance if a significant number or proportion of the workers in a workers' firm or subdivision have become totally or partially separated or are threatened with becoming totally or partially separated because of the relocation of the production functions of that firm or subdivision to a foreign country or instrumentality. Limits to seven the number of weeks during which the employee was on employer-authorized leave or was serving as a labor organization representative which may be treated as qualifying weeks of employment. Extends the duration of trade adjustment allowances from 52 to 104 weeks. Defines "reasonable expectation of employment" for purposes of determining if job training should be approved. Requires each State agency that is providing adversely affected workers with testing, counseling, training, and placement services to: (1) advise each adversely affected worker to apply for training under the trade adjustment assistance program at the time the worker applies for trade readjustment allowances; and (2) interview the adversely affected worker within 60 days on suitable training opportunities available under the trade adjustment assistance program. Directs the Secretary of Commerce to certify a firm as eligible for adjustment assistance if sales or production or both of an article that accounted for at least 25 percent of the total production or sales of the firm have decreased during a specified time period. Authorizes making financial assistance available to firms either through a single loan or a combination of loans. Deletes the provision that prohibits granting adjustment assistance or financial assistance to a firm unless the owners, partners, or officers of the firm bind themselves to avoid certain conflicts of interest. Extends adjustment assistance programs for workers and firms until September 30, 1989. Sets forth the effective dates for the provisions of this part. Part B: Authorization of Appropriations for Trade and Customs Agencies - Amends the Tariff Act of 1930 to authorize appropriations for FY 1986 for the International Trade Commission. Amends the Customs Procedural Reform and Simplification Act of 1978 to authorize appropriations for FY 1986 for the U.S. Customs Service. Earmarks specified amounts for: (1) additional inspectors, import specialists, customs patrol officers, and special agents; (2) the operation and maintenance of the air interdiction program of the Service; and (3) programs to enforce or monitor export controls under the Export Administration Act of 1979. Prohibits using any Customs Service funds to close any port of entry at which, during FY 1985: (1) not less than 2,500 merchandise entries were made; and (2) not less than $1,500,000 in customs revenues were assessed. Prohibits using any funds authorized for FY 1985 for the Customs Service for further research and development or acquisition of F-15 avionics for the P-3 aircraft and related equipment until 60 days after specified congressional committees have received a comparative assessment of the suitability of certain aircraft for use by the Customs Service in its air drug interdiction program. Prohibits using any such funds to consolidate the drawback liquidation centers within the Customs Service to less than four centers. Authorizes appropriations to the Department of the Treasury for FY 1986 for: (1) making payments out of the Customs Forfeiture Fund, including an amount for modifying aircraft for drug interdiction; and (2) providing customs services at airports. Requires the General Accounting Office to report to specified congressional committees within 12 months of enactment of this Act on a study that evaluates the air detection and interdiction capability of the Customs Service. Directs the Commissioner of Customs to use any savings resulting from administrative consolidations to strengthen the commercial operations of the Customs Service by increasing the number of inspector, import specialist, patrol officer, and other line operational positions. Prohibits the Commissioner from publishing or taking any other action to give force and effect to a final rule that would revise the current rule relating to the requirement for sureties on customs bonds: (1) unless the Commissioner submits a report to the Congress containing specified information; and (2) until 90 days of continuous session of the Congress after such report is submitted. Amends the Trade Act of 1974 to limit the number of officers and employees that the U.S. Trade Representative may appoint without regard to civil service regulations. Authorizes appropriations for the Office of the United States Trade Representative for FY 1986. Decreases the amount earmarked for entertainment and representation expenses. Part C: User Fees for Customs Services - Amends the Customs Procedural Reform and Simplification Act of 1978 to direct the Secretary of the Treasury to charge and collect specified fees for a period of three years to cover the expenses incurred by the Customs Service in processing arrivals at U.S. ports of entry of commercial vessels of 100 or more tons, commercial trucks, railroad cars, private aircraft or private vessels, each passenger aboard a commercial vessel or aircraft from a place outside the United States, and each passenger aboard a commercial vessel, aircraft, or train from Canada, Mexico, a U.S. territory or possession, or certain islands. Directs the Secretary of the Treasury to establish an advisory committee to advise the Secretary on issues related to the performance of the customs services. Title III: Provisions Relating to Aid to Families with Dependent Children - Amends part A (Aid to Families with Dependent Children) of title IV of the Social Security Act to require each State, in order to establish and maintain improved quality control standards and procedures in the operation and administration of its plan, to: (1) annually collect a statistically reliable sample of the cases under its approved State plan for purposes of quality control review; (2) review the sample and make findings; and (3) submit the findings to the Secretary. Requires the Secretary to review the records submitted and determine the State's error rate. Requires the State to develop a corrective action plan, submit such plan to the Secretary, and, after receiving the Secretary's approval, implement such plan. Specifies AFDC error rates. Provides for disallowances of payments to a State which has an error rate above the tolerance level. Permits a State to request a waiver of any disallowance, upon showing: (1) a good faith effort to reduce erroneous payments; or (2) that the Secretary's determination of the State's error rate was incorrect. Authorizes appropriations for FY 1986 and 1987 to be used by the Secretary for grants to assist States and localities in establishing and carrying out programs: (1) to reduce the rate of teenage pregnancies in AFDC families; and (2) to help pregnant individuals and teenage parents of young children in such families, who might otherwise become long-term recipients of AFDC, in achieving self-sufficiency. Requires a State to use such grants only in areas of high teenage pregnancy or high infant mortality. Requires a State to apply for such grants. Sets forth the objectives of a State's program, including requiring voluntary program participants to seek a high school diploma or equivalent training and providing program participants with job counseling and placement services. Limits participation in the high school and job placement and counseling programs to those individuals who are under the age of 25 or who are teenage parents of dependent children under the age of six. Sets forth: (1) program requirements; and (2) reporting requirements. Requires that the current AFDC program for unemployed parents be implemented in all States. Permits a State to substitute education for work in the definition of "quarters of work." Title IV: Provisions Relating to Railroad Unemployment Repayment Tax and Unemployment Compensation - Amends the Internal Revenue Code to revise provisions relating to the railroad unemployment repayment tax. Revises the formulas for determining the rate of such tax by combining a basic rate and a surtax rate. Provides that "rail wages" for purposes of such tax shall be determined by: (1) reference to the same compensation used in determining the railroad retirement tax; (2) taking into account only employment covered by the Railroad Unemployment Insurance Act; and (3) using a specified wage base during certain periods. Amends the Railroad Retirement Revenue Act of 1983 to revise provisions relating to the use of such tax to repay loans made to the railroad unemployment insurance account. Provides that such taxes attributable to the basic rate be used to reduce the outstanding balance of such loans made before October 1, 1985, and that such taxes attributable to the surtax rate be used to reduce the outstanding balance of such loans made on or after such date. Amends the Railroad Unemployment Insurance Act to extend the borrowing authority under such Act by deleting a prohibition against specified transfers after a certain date from the Railroad Retirement Account to the Railroad Unemployment Insurance Account. Provides that National Guard members who perform temporary disaster services related to a specified major disaster shall not lose their eligibility for Federal supplemental unemployment compensation, under the phase-out of such program benefits, because of certain consecutive-weeks-of-unemployment requirements under the Federal Supplemental Compensation Act of 1972. Title V: Revenue Provisions - Expresses the sense of the Congress that proposed reductions in the budget for the Internal Revenue Service for FY 1986 should be restored and increases in such budget should be approved for revenue enforcement and related purposes. Amends the Internal Revenue Code to make permanent the increase in the excise tax on cigarettes. (Present law terminates such increase as of October 1, 1985.) Establishes in the Treasury the Tobacco Equalization Trust Fund. Appropriates to such trust fund a specified portion of the excise tax on cigarettes. Allows expenditures from such trust fund for the reimbursement of the Commodity Credit Corporation for any net losses sustained with respect to the tobacco price support program. Increases the excise tax on coal. Sets specified per ton rates of such tax for coal from underground mines from 1986 through 1995. Allows for a reduction in such tax after 1995 if loans made to the Black Lung Disability Trust Fund are repaid. Provides that only the amount of railroad retirement benefits which are equivalent to social security benefits shall be treated as tier 1 benefits. Provides for a temporary increase in Pension Benefit Guaranty Corporation premiums for single employer plans for plan years beginning after December 31, 1985, and before January 1, 1989.

This text is taken from the official record. PoliticalRepo does not editorialize.

Timeline

No timeline events have been ingested for this record yet.

Votes

No vote records are attached yet.

Versions

No version snapshots stored. Document URLs remain at the source.

Documents

5 official files

• Public Law (PDF)

  Public Law · EN · 8 April 1986

  ViewDownloadOpen at official source

• House disagreed to Senate amendment

  summary · EN · 19 December 1985

  Open at official source

• Reported to House amended, Part III

  summary · EN · 11 September 1985

  Open at official source

• Reported to House amended, Part II

  summary · EN · 11 September 1985

  Open at official source

• Introduced in House

  summary · EN · 31 July 1985

  Open at official source

Sponsors

No sponsors or actors listed by the source.

Related records

No cross-record relationships stored yet.