bill_id,congress,bill_type,bill_number,title,policy_area,introduced_date,latest_action_date,latest_action_text,origin_chamber,sponsor_name,sponsor_state,sponsor_party,sponsor_bioguide_id,cosponsor_count,summary_text,update_date,url
103-hr-5300,103,hr,5300,Affordable Health Care Now Act of 1994,Health,1994-11-29,1994-12-15,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Michel, Robert H. [R-IL-18]",IL,R,M000692,0,"TABLE OF CONTENTS:      Title I:  Improved Access to Affordable Health Care           Subtitle A:  Increased Availability and Continuity of                Health Coverage for Individuals and Their Families           Subtitle B:  Reform of Health Insurance           Subtitle C:  Preemption              Subtitle D:  Health Deduction Fairness           Subtitle E:  Improved Access to Community Health                Services           Subtitle F:  Improved Access to Rural Health Services           Subtitle G:  Assistance in Enrolling Uninsured Children                in Health Insurance           Subtitle H:  Medicaid Reform           Subtitle I:  Remedies and Enforcement with Respect to                Group Health Plans           Subtitle J:  Delivery of Health Care Services to Illegal                Immigrants      Title II:  Health Care Cost Containment and Quality           Enhancement           Subtitle A:  Medical Malpractice Liability Reform           Subtitle B:  Administrative Cost Savings and Fair Health                Information Practices           Subtitle C:  Deduction for Cost of Catastrophic Health                Plan; Medical Savings Accounts           Subtitle D:  Anti-Fraud           Subtitle E:  Increased Medicare Beneficiary Choice;                Additional Medicare Reforms           Subtitle F:  Health Care Antitrust Improvements           Subtitle G:  Encouraging Enforcement Activities of                Medical Self-Regulatory Entities           Subtitle H:  Reform of Clinical Laboratory Requirements                for Simple Tests           Subtitle I:  Miscellaneous Provisions      Title II:   Long-Term Care           Subtitle A:  Tax Treatment of Long-Term Care Insurance           Subtitle B:  Establishment of Federal Standards for                Long-Term Care Insurance           Subtitle C:  Protection of Assets Under Medicaid Through                Use of Qualified Long-term Care Insurance           Subtitle D:  Studies           Subtitle E:  Volunteer Service Credit Demonstration                Projects Affordable Health Care Now Act of 1994 - Title I:  Improved Access to Affordable Health Care - Subtitle A:  Increased Availability and Continuity of Health Coverage for Individuals and Their Families - Part 1:  Required Coverage Options for Eligible Employees, Spouses, and Dependents - Requires each employer to make available to each eligible employee a group health plan under which: (1) coverage of each eligible individual with respect to such employee may be elected on an annual basis; (2) coverage is provided for at least the required coverage specified; and (3) employees may elect to have premiums collected through payroll deduction.  Does not require employer contributions to the cost of coverage under such a plan. Provides for the exclusion of:  (1) employers who have been employers for less than two years or who have no more than two eligible employees or no more than two eligible employees not covered under any group health plan; and (2) family members under specified circumstances.  Specifies that a group health plan shall not be treated as failing to meet the requirements of this Act solely because a period of service by an eligible employee of not more than 60 days is required for coverage. Specifies that the required coverage is standard coverage, except that in the case of a small employer that has not contributed during the previous plan year to the cost of coverage for any eligible employee under any group health plan, the required coverage for the plan year is coverage under a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan.  Requires standard coverage to include at least one option, either a fee-for-service option and if available, a point-of-service option and a managed care option. Provides for a five-year transition for existing group health plans. (Sec. 1002) Sets forth provisions regarding:  (1) compliance with applicable requirements through multiple employer health arrangements; and (2) coverage options under a State medical health allowance program. Part 2:  Portability and Nondiscrimination - Prohibits a group health plan from imposing (and an insurer from requiring an employer from imposing through a waiting period for coverage under a plan or similar requirement) a limitation or exclusion of benefits relating to treatment of a preexisting condition if:  (1) the condition relates to a condition that was not diagnosed or treated within three months before the date of coverage under the plan; (2) the limitation or exclusion extends over more than six months after the date of coverage, applies to an individual who, as of the date of birth, was covered under the plan, or relates to pregnancy; or (3) an eligible individual has such coverage at the time the individual first became eligible.  Specifies that, in the case of an individual who is eligible for coverage under a plan but for a waiting period imposed by the employer, the individual shall be treated as having been covered under the plan as of the earliest date of the beginning of the waiting period.  Provides a one-time amnesty period for pre-existing condition exclusions. (Sec. 1012) Requires each group health plan to waive any period applicable to a preexisting condition for similar benefits with respect to an individual to the extent that the individual, prior to enrollment in such plan, was covered for the condition under any other health plan. (Sec. 1013) Prohibits:  (1) a multiemployer plan and an exempted multiple employer health plan from canceling or denying renewal of coverage under such a plan for an employer other than for nonpayment of contributions, fraud or other misrepresentation, noncompliance with plan provisions, or because the plan is ceasing to provide any coverage in a geographic area; (2) an insurer from canceling a health insurance plan or denying renewal of coverage other than as prescribed above; and (3) an insurer who terminates the offering of health insurance plans in an area from offering such a plan to any employer in the area until five years after the date of the termination. Part 3:  Standards for Managed Care Arrangements and Essential Community Providers - Sets forth requirements for group health plans and insurers that provide health care coverage through managed care arrangements.  Requires such arrangements to assure that covered individuals have reasonably prompt access through the entity's provider network to the benefits package and to centers of excellence. (Sec. 1022) Requires the Secretary of Health and Human Services (Secretary) to establish standards for utilization review programs and periodically review and update such standards to reflect changes in the delivery of health care services. Part 4:  Enforcement; Effective Dates; Definitions - Makes provisions of the Employee Retirement Income Security Act of 1974 applicable with respect to enforcement of this Act (by the Department of Labor). Amends the Internal Revenue Code (Code) to impose a tax ($100 per day for each individual involved, subject to specified limitations) on the failure of an insurer to comply with the requirements under part 2, unless the Secretary determines that the State has in effect a regulatory enforcement mechanism that provides adequate sanctions. Subtitle B: Reform of Health Insurance - Part I:  Marketplace for Small Business - Requires each insurer that makes available a health insurance plan to a small employer in a State to make available to each small employer in the State a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan, with exceptions for health maintenance organizations (HMOs) and if a State provides for guaranteed availability (rather than guaranteed issue). Requires each insurer that offers a MedAccess plan to a small employer in a State to accept:  (1) every small employer in the State that applies for coverage; and (2) every eligible individual who applies for enrollment on a timely basis.  Sets forth provisions regarding:  (1) special rules for HMOs; (2) timely enrollment requirements; and (3) enrollment of spouses and dependents.  Makes such requirements inapplicable in a State that has provided (in accordance with specified standards) a mechanism under which each insurer offering a health insurance plan to a small employer in the State must participate in a program for assigning high-risk small employer groups (or individuals within such a group) among some or all such insurers, if the insurers comply. (Sec. 1102) Defines ""MedAccess coverage"" as a health insurance plan that:  (1) is designed to provide standard coverage with substantial cost-sharing, only catastrophic coverage, or medisave coverage; (2) includes only essential and medically necessary services; (3) meets applicable requirements relating to guaranteed issue; and (4) meets specifies consumer protection standards.  Defines ""MedAccess standard coverage,"" ""MedAccess catastrophic coverage,"" and ""MedAccess medisave coverage"" to mean a MedAccess plan that provides for at least standard coverage, for only catastrophic coverage, or medisave coverage, respectively. Requests the National Association of Insurance Commissioners (NAIC) to submit to the Secretary a set of rules which is sufficient for determining the actuarial value of coverage offered by a plan. Directs the Secretary to certify such set of rules for use under this subtitle if they meet such requirements or establish such a set of rules. Specifies that a health insurance plan is considered to provide:  (1) standard coverage if the benefits are determined, in accordance with certified rules of actuarial equivalence, to have a value that is within five percentage points of an established target actuarial value for standard coverage; (2) catastrophic coverage if benefits are available under the plan for a year only to the extent that expenses for covered services in a year exceed a deductible amount that is consistent with a specified requirement for a catastrophic health plan under the Code, and are determined, in accordance with certified actuarial equivalence rules, to have a value that is within five percentage points of an established target actuarial value for catastrophic coverage; and (3) medisave coverage if such plan consists of a catastrophic health plan within the meaning of the Code and a medical savings account.  Requests NAIC to submit to the Secretary target actuarial values for standard and catastrophic coverage. Permits NAIC to submit periodic revisions of, and permits the Secretary to revise, the set of rules of actuarial equivalence and target actuarial values where necessary to take into account changes in the relevant types of health benefits provisions, in deductible levels for catastrophic coverage, or in relevant demographic conditions. (Sec. 1103) Directs the Secretary to request NAIC to develop model regulations that specify standards with respect to requirements:  (1) that insurers make available MedAccess plans; (2) of guaranteed availability of MedAccess plans to small employers; (3) relating to limits on premiums and certain consumer protections; and (4) relating to limitation of annual premium increases.  Requires the Secretary to review such standards and, if NAIC fails to specify standards meeting such requirements, to promulgate standards.  Sets forth provisions regarding:  (1) the application of MedAccess standards and consumer protection standards by the States; and (2) the Federal role. (Sec. 1104) Sets forth provisions:  (1) regarding limits on premium rate variations, including discounts for employer wellness programs; and (2) requiring an insurer, at the time of offering a health insurance plan to a small employer, to fully disclose rating practices for health insurance plans, including rating practices for different populations and benefit designs. (Sec. 1105) Requires the Secretary of Labor to monitor the prevalence and impact of adverse risk selection in the full insured plans made available to small employers resulting from the decision of small employers to self-insure. (Sec. 1106) Directs the Secretary to:  (1) request NAIC to develop models for reinsurance or allocation of risk mechanisms for health insurance plans made available to small employers for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models or specify models.  Sets forth provisions regarding implementation of reinsurance or allocation of risk mechanisms by the States and the Federal role. Part :   Marketplace for Individuals - Makes the provisions of Part 1 applicable to insurers offering health insurance coverage to individuals and their dependents. Part 3:  Voluntary Health Purchasing Arrangements - Provides for the establishment of voluntary health purchasing arrangements. (Sec. 1124) Requires such arrangements to offer enrollment in health insurance coverage only to:  (1) all eligible employees employed by small employers in a service area; and (2) all eligible individuals residing in such area. Part 4:  Definitions and Miscellaneous Provisions - Provides definitions for purposes of this subtitle. (Sec. 1134) Requires the Secretary to make annual reports to the Congress on the implementation of this subtitle and the need for additional reforms to assure and expand coverage. (Sec. 1135) Authorizes the Director to conduct:  (1) research on the impact of this subtitle on the availability of affordable health coverage for employees and dependents in the small employers group health care coverage market and other specified topics; and (2) demonstration projects relating to such topics.  Requires the Director to develop:  (1) methods for measuring the relative health risks of eligible individuals in terms of the expected costs of providing benefits under health insurance plans and, in particular, MedAccess plans; and (2) a model for equitably distributing health risks among insurers in the small employer health care coverage market.  Authorizes appropriations. Subtitle C:  Preemption - Part 1:  Scope of State Regulation - Makes inapplicable to a group health plan any State or local law requiring coverage of specific benefits, services, or categories of health care, or services of any class or type of provider of health care. (Sec. 1202) Makes inapplicable any State or local law prohibiting two or more employers from obtaining coverage under a multiple employer welfare arrangement under which all coverage:  (1) consists of medical care described under specified provisions of the Employee Retirement Income Security Act of 1974 (ERISA); and (2) is fully insured. (Sec. 1203) Preempts, for a five-year period, State law provisions which restrict:  (1) reimbursement rates or selective contracting; (2) differential financing incentives; and (3) utilization review methods.  Directs the Comptroller General to study benefits and cost effectiveness of use of managed care in health services delivery and to report to the Congress, including recommendations as to whether such preemption should be extended. Part 2:  Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide a limited exemption from certain restrictions on ERISA preemption of State law for health plans maintained by multiple employers subject to certain Federal standards. Relieves such exempted multiple employer health plans of certain restrictions on preemption of State law, and treats them as employee welfare benefit plans. Sets forth exemption procedures, application and eligibility requirements, and additional notice, reporting, and actuarial requirements applicable to exempted multiple employer health plans. Requires multiple employer welfare arrangements providing certain medical care benefits to issue specified disclosures to participating employers. Requires each multiple employer welfare arrangement which is or has been an exempted multiple employer health plan, and under which coverage is not fully insured, to establish certain minimum reserves. Authorizes the Secretary of Labor to permit alternative means of compliance. Sets forth corrective actions, including actions to avoid depletion of reserves and actions in connection with termination of arrangements. Provides for expirations, renewals, suspensions, and revocations of exemptions.  Provides for review of actions of the Secretary, including denials of applications and suspensions or revocations of exemptions.  Provides for alternative means of distribution of summary plan descriptions. (Sec. 1212) Revises provisions relating to scope of preemption rules, treatment of single employer arrangements, and treatment of certain collectively bargained arrangements. (Sec. 1215) Sets forth special rules for employee leasing health care arrangements, providing that they be treated as multiple employer welfare arrangements. (Sec. 1216) Sets forth enforcement provisions relating to multiple employer welfare arrangements and employee leasing health care arrangements, including enforcement of filing requirements, actions by States in Federal court, criminal penalties for certain willful misrepresentations, cease activities orders, and responsibility for claims procedures. (Sec. 1217) Sets forth solvency requirements for certain self- insured group health plans. (Sec. 1218) Sets forth filing requirements for multiple employer welfare arrangements providing health benefits. (Sec. 1219) Provides for cooperation between Federal and State authorities, including:  (1) agreements for State enforcement of ERISA provisions applicable to multiple employer welfare arrangements which are or have been exempted multiple employer health plans; and (2) enforcement and technical assistance to States with respect to issues involving multiple employer welfare arrangements. (Sec. 1220) Sets forth transitional rules. Part 3:  Encouragement of Multiple Employer Arrangements Providing Basic Health Benefits - Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax-exempt trust status in the case of determining whether any multiple employer health plan or insured multiple employer health plan is a voluntary employees' beneficiary association meeting certain requirements, if:  (1) such plan provides at least standard coverage consistent with specified provisions of this Act (the Affordable Health Care Now Act of 1994); and (2) in the case of such an insured plan, it meets specified ERISA requirements not preempted by this Act. (Sec. 1222) Amends ERISA to direct the Secretary of Labor to prescribe an alternative method for the filing of a single annual report with respect to all employers participating under a multiple employer welfare arrangement under which all coverage consists of medical care and is fully insured. (Sec. 1223) Sets forth provisions for determining compliance with coverage requirements through multiple employer health arrangements. Subtitle D:  Health Deduction Fairness - Amends the Internal Revenue Code to provide for:  (1) a permanent extension and an increase in the health insurance tax deduction for self-employed individuals; and (2) a deduction of health insurance premiums for certain previously uninsured individuals. Subtitle E:  Improved Access to Community Health Services - Part 1:  Increased Authorization for Community and Migrant Health Centers - Directs the Secretary to provide for grants to migrant and community health centers to promote primary health care services for underserved individuals.  Allows grants to be used to promote the provision of off-site services, to improve birth outcomes in areas with high infant mortality and morbidity, to establish primary care clinics in areas in need, and for recruitment and training costs of necessary providers and operating costs for unreimbursed services. Authorizes appropriations.  Directs the Secretary to conduct a study of the impact of such grants on access to health care, birth outcomes, and the use of emergency room services. Part 2:  Grants for Projects for Coordinating Delivery of Services - Amends the Public Health Service Act to authorize the Secretary to make grants to public and nonprofit private entities: (1) to carry out demonstration projects to increase access to outpatient primary health services in specified geographic areas (i.e., areas that are rational areas for the delivery of health services, have a population of not more than 500,000 individuals, and have been designated by the Secretary as areas with a shortage of personal health services or that have a significant number of individuals with low incomes or insufficient health care insurance) through coordinating the delivery of services under Federal, State, local, and private programs; and (2) for developing plans to carry out such projects.  Authorizes appropriations. Part 3:  Community Health Networks - Sets forth qualifications for community health network arrangements. Subtitle F:  Improved Access to Rural Health Services - Part 1:  Establishment of Rural Emergency Access Care Hospitals Under Medicare - Amends title XVIII (Medicare) of the Social Security Act (SSA) to provide for:  (1) establishment of rural emergency access care hospitals under Medicare; and (2) coverage of and payment for rural emergency access care hospital services under Medicare part B (Supplementary Medical Insurance). Part 2:  Rural Medical Emergencies Air Transport - Amends the Public Health Service Act to direct the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments.  Sets forth provisions regarding:  (1) application and State plan requirements; (2) considerations in awarding grants; (3) State administration and use of grants; (4) the number of grants; and (5) reporting requirements.   Authorizes appropriations. Part 3:  Emergency Medical Services Amendments - Amends the Public Health Service Act to direct the Secretary to:  (1) establish an Office of Emergency Medical Services, headed by a Director; (2) engage in specified emergency medical services activities, including disseminating information obtained in carrying out specified activities to public and private entities, providing technical assistance to State and local agencies, coordinating Department of Health and Human Services (DHHS) activities with those of other Federal agencies; and (3) ensure that such activities are carried out consistent with certain requirements regarding maintaining an adequate number of health professionals with expertise in the provision of services, developing, periodically reviewing, and revising as appropriate guidelines for the provision of such services, appropriately using available technologies, and serving the unique needs of underserved inner-city and rural areas. (Sec. 1522) Authorizes the Secretary to make grants to States for the purpose of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services, subject to specified matching fund, budgetary, and other requirements. (Sec. 1523) Provides for demonstration projects to establish telecommunications between rural medical facilities and medical facilities with expertise or equipment.  Directs the Secretary to ensure that the telecommunications technologies demonstrated include interactive video telecommunications, static video imaging transmitted through the telephone system, and facsimiles transmitted through such system. (Sec. 1524) Authorizes appropriations for:  (1) emergency medical services (including for State offices of Emergency Medical Services and for telecommunications demonstrations); and (2) trauma care and certain other activities. Part :   Additional Rural Health Care Provisions - Authorizes the Secretary to make grants to public and nonprofit private entities to develop health plans to provide services exclusively in rural and frontier areas.  Authorizes appropriations. (Sec. 1532) Authorizes the Secretary to make grants to public and nonprofit private hospitals in medically underserved rural communities, and to public and nonprofit outpatient facilities in such communities, to develop or increase capacity to provide primary health services. (Sec. 1533) Authorizes the Secretary to make grants to such entities to conduct research and carry out demonstration projects to develop innovative approaches to the delivery of health care in rural areas, such as the use of telemedicine and mobile delivery units. (Sec. 1534) Authorizes appropriations for the training of rural health professionals other than physicians. Subtitle G:  Assistance in Enrolling Uninsured Children in Health Insurance - Amends title XIX (Medicaid) of the Social Security Act (SSA) to provide for the establishment of State premium subsidy programs to assist eligible needy children with premiums for standard health coverage. Subtitle H:  Medicaid Reform - Amends SSA title XIX to:  (1) provide for the establishment of State health allowance programs under which the State makes payments to an approved group health plan which provides coverage to eligible individuals as an allowance towards the costs of providing the individual with benefits under the plan; (2) modify Federal requirements to allow States more flexibility in contracting for coordinated care services under Medicaid; (3) make changes regarding the period of certain waivers under Medicaid; and (4) reduce the amount of Federal payment adjustments under Medicaid for disproportionate share hospitals. (Sec. 1713) Eliminates the duplicative pediatric immunization program under Medicare. Subtitle I:  Remedies and Enforcement with Respect to Group Health Plans - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to set forth claims procedure special rules for group health plans. Directs the Secretary of Labor to establish a mediation program for disputes involving group health plan claims.  Requires the Secretary to maintain a list of individuals with expertise to serve as facilitators under such program, and to propose a facilitator for each mediation subject to one objection by each party.  Sets forth provisions for participation of attorneys, initiation of mediation, mediation procedures, time limits, costs, legal effect of participation, and confidentiality and admissibility. Sets forth court remedies for participants and beneficiaries with respect to group health plans. Subtitle J:  Delivery of Health Care Services to Illegal Immigrants - Directs the Secretary of Health and Human Services to conduct a study of health care to illegal immigrants, including the effect of illegal immigration on health costs and the shifting of health costs.  Requires a report to the Congress, with recommendations on appropriate means of:  (1) alleviating health problems peculiar to illegal immigrants; (2) financing health care provided to illegal immigrants; and(3) increasing intergovernmental cooperation and coordination of efforts of the United States and other countries to alleviate such health problems and finance such efforts. Title II:  Health Care Cost Containment and Quality Enhancement - Subtitle A:  Medical Malpractice Liability Reform - Part 1:  General Provisions - Makes this subtitle applicable with respect to any medical malpractice liability claim and to any medical malpractice liability action brought in State or Federal court, except a claim or action for damages arising from a vaccine-related injury or death to the extent that title XXI of the Public Health Service Act applies. Sets forth provisions regarding:  (1) preemption of State law; (2) effect on sovereign immunity and choice of law or venue; (3) jurisdiction; and (4) effective dates. Part 2:  Medical Malpractice and Product Liability Reform - Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified alternative dispute resolution (ADR) system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States under chapter 171 of the Federal judicial code (U.S. Court of Federal Claims).  Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 2012) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action.  Sets limits on punitive damages and on periodic payments for future losses.  Reduces damages by any other payments made to compensate an individual for injuries. (Sec. 2013) Set forth provisions regarding:  (1) limits on attorney fees and other costs; (2) joint and several liability (generally, liability may be found only for those damages directly attributable to the person's proportionate share of fault or responsibility for the injury); (3) a statute of limitations of seven years; and (4) a uniform standard for determining negligence (the defendant's conduct at the time of providing the health care services was not reasonable). (Sec. 2017) Specifies that in the case of a medical malpractice liability claim relating to services provided during labor or the delivery of a baby, if the health care professional did not previously treat the injured individual for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. Part 3:  Requirements for State Alternative Dispute Resolution Systems - Lists requirements for State ADR systems, including that such a system:  (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 2032) Directs the Secretary, by October 1 of each year, to certify State ADR systems that meet such requirements. Directs the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 2033) Directs the Secretary, within five years, to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system, including:  (1) information on the effect of the ADR systems on health care costs, access to health care, and quality of care provided within the State; and (2) to the extent that such report does not provide information on no-fault systems operated by States as ADR systems, an analysis of the feasibility and desirability of establishing a system for resolving medical malpractice liability claims on a no-fault basis. Part 4:  Other Provisions Relating to Medical Malpractice Liability - Authorizes a State agency responsible for disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies to permit their participation in the licensing of such practitioner and to review any health care malpractice action, claims, or allegation, or other information concerning the practice patterns of any such practitioner.  Sets forth agreement requirements. (Sec. 2042) Directs the Secretary to study incentives adopted by State and local governments, insurers, medical societies, and other entities to encourage physicians to volunteer to provide health care services in medically underserved areas. (Sec. 2043) Directs each State to require:  (1) each health care professional and health care provider to participate in a risk management program to prevent, and provide early warning of, practices which may result in injuries to patients or endanger patient safety; and (2) each provider of health care professional and provider liability insurance in the State to establish risk management programs or sanction programs of risk management for health care professionals and providers provided by other entities, and require each such professional or provider, as a condition of maintaining insurance, to participate in one such program at least once in each three-year period. (Sec. 2044) Directs the Secretary to make grants:  (1) for basic research in the prevention of, and compensation for, injuries resulting from health care professional or provider malpractice and for research of the outcomes of health care procedures; (2) to States to assist in improving their ability to license and discipline health care professionals; and (3) to States and local governments, private nonprofit organizations, and health professional schools for educating the general public about the appropriate use of health care, realistic expectations of medical intervention, and the resources and role of health care professional licensing and disciplinary boards in investigating claims of incompetence or health care malpractice, and for developing programs of faculty training and curricula for educating health care professionals in quality assurance, risk management, and medical injury prevention.  Authorizes appropriations. Subtitle B:  Administrative Cost Savings and Fair Health Information Practices - Part 1:  Administrative Cost Savings - Subpart A:  Standards for Data Elements and Transactions - Directs the Secretary to adopt standards and modifications to standards that a:   (1) consistent with the objective of reducing the costs of providing and paying for health care; and (2) in use and generally accepted, developed, or modified by the standard-setting organizations accredited by the American National Standard Institute. (Sec. 2104) Directs the Secretary to adopt standards:  (1) for data elements of health information; and (2) for transmitting information electronically. Subpart B:  Requirements With Respect to Certain Transactions and Information - Specifies standard transactions. Subpart C:  Miscellaneous Provisions - Requires the Secretary to establish standards with respect to the operation of health information network services. (Sec. 2124) Authorizes the Secretary to make grants for demonstration projects to promote the development and use of electronically integrated community-based clinical information systems and computerized patient medical records. Subpart D:  Assistance to the Secretary - Establishes the Health Care Information Advisory Committee to:  (1) assist the Secretary in complying with requirements under this Act; (2) be generally responsible for advising the Secretary and the Congress on the status of the health information network; and (3) make recommendations to correct problems in the network and to refine and improve the network. Part 2:  Fair Health Information Practices - Subpart A:  Duties of Health Information Trustees - Specifies the duties of health information trustees with respect to inspection of protected health information. (Sec. 2142) Provides a procedure to amend protected health information. Subpart B:  Use and Disclosure of Protected Health Information - Sets forth general limitations on the use and disclosure of protected health information by health information trustees. (Sec. 2152) Authorizes a health information trustee to disclose protected health information pursuant to a written authorization by the protected individual. (Sec. 2153) Describes the circumstances under which health information trustees may disclose protected health information to:  (1) health plans, health care providers, and oversight agencies; (2) next of kin; (3) public health authorities; (4) health research entities; (5) authorities under emergencies; (6) courts or administrative agencies; (6) law enforcement agencies; (7) entities under subpoenas, warrants, and search warrants; and (8) health information service organizations. Subpart C:  Access Procedures and Challenge Rights - Prohibits a government authority from obtaining protected health information about a protected individual from a health information trustee through subpoenas, warrants, and search warrants unless there is probable cause that the information is relevant to the law enforcement inquiry. (Sec. 2172) Establishes challenge procedures to such subpoenas. Subpart D:  Miscellaneous Provisions - Restricts the information a health information trustee may disclose when a protected individual pays for health care through a payment card or electronic means. (Sec. 2183) Directs the Secretary to develop standards for electronic documents and communications. (Sec. 2184) Provides for the disclosure of protected health information to affiliated persons and agents and attorneys. (Sec. 2187) Requires States to establish a process for the maintenance of certain protected health information. Subpart :   Enforcement - Provides for civil actions against health information trustees. (Sec. 2192) Authorizes the Secretary to impose a civil money penalty against such trustees for a demonstrated pattern of failure to comply with this subpart. (Sec. 2193) Requires the Secretary to develop an alternative dispute resolution method for resolving claims for civil actions. (Sec. 2194) Amends the Federal criminal code to impose penalties for violations in disclosing and obtaining protected health information. Subpart F:  Amendments to Title 5, United States Code - Requires certain Federal agency heads to promulgate rules protecting health information. Subpart G:  Regulations, Research, and Education; Effective Dates; Applicability; and Relationship to Other Laws - Requires the Secretary to prescribe regulations to carry out this part not later than July 1, 1996. (Sec. 2197) Makes this part effective on January 1, 1997, except for certain provisions that take effect upon enactment. Subtitle C:  Deduction for Cost of Catastrophic Health Plan; Medical Savings Accounts - Amends the Internal Revenue Code to include under the medical expense deduction the portion of such expense attributable to coverage under a catastrophic health plan. (Sec. 2202) Allows individuals a tax deduction for a percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to medical care savings accounts. Subtitle D:  Anti-Fraud - Directs the Attorney General to establish an all-payer health care fraud and abuse control program. (Sec. 2302) Authorizes additional appropriations for such program and AG investigations of possible health care fraud. (Sec. 2303) Establishes in the Treasury the Anti-Fraud and Abuse Trust Fund for use in preventing anti-fraud and abuse law violations and repaying Medicaid and other beneficiaries for cost-sharing. (Sec. 2311) Amends SSA title XI and the Federal criminal code to: (1) revise current sanctions to provide for, among other things, mandatory exclusion from Medicare and State health care program participation of individuals or entities convicted of a fraud-related felony in connection with the delivery of a health care item or service, and criminal penalties of fines and imprisonment for health care fraud; and (2) authorize the Secretary of Health and Human Services (Secretary) to issue advisory opinions with regard to specified matters, including matters concerning prohibited remuneration and service inducements. (Sec. 2315) Modifies:  (1) current limitations under Medicare (SSA title XVIII) on physician self-referral; and (2) effective date exceptions under the Omnibus Budget Reconciliation Act of 1993 for such referrals made for clinical laboratory services. (Sec. 2316) Directs the Comptroller General to study and report to the Congress on the costs of peer review contracts for Medicare HMOs. (Sec. 2332) Amends SSA title XVIII to require the Secretary to issue advisory opinions relating to prohibited referrals under Medicare. Directs the Secretary to issue regulations establishing systems under SSA titles XI and XVIII for the issuance of advisory opinions. Subtitle E:  Increased Medicare Beneficiary Choice; Additional Medicare Reforms - Amends SSA title XVIII and the Omnibus Budget Reconciliation Act of 1990 to make specified changes in HMO and Medicare supplemental policy provisions.  Imposes mandates on the Secretary in order to afford Medicare beneficiaries additional avenues for choosing health care coverage, including enrollment in private health insurance plans. (Sec. 2411) Extends current rules for computing Medicare part B (Supplementary Medical Insurance) premiums. (Sec. 2412) Amends the Internal Revenue Code to provide for the imposition of a Medicare part B premium tax for high-income Medicare part B beneficiaries. (Sec. 2413) Directs the Secretary to take such steps as necessary to consolidate administration of Medicare parts A (Hospital Insurance) and B. (Sec. 2414) Makes specified extensions with regard to Medicare as secondary payer, including those concerning data matches. Subtitle F:  Health Care Antitrust Improvements - Exempts from all antitrust claims an activity relating to the provision of health care services that is:  (1) within a ""safe harbor"" designated by the Attorney General, except for claims for injunctive relief asserted by the Attorney General or the Chair of the Federal Trade Commission in extraordinary circumstances; and (2) specified in and in compliance with the terms of a certificate of review issued by the Attorney General, where the activity occurs while the certificate is in effect, except for claims for injunctive relief.  Sets forth provisions regarding the award of attorney fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt. (Sec. 2502) Directs the Attorney General to develop and designate specified safe harbors relating to the following, as well as to such other categories of activities as the Attorney General may designate (subject to specified requirements):  (1) joint purchasing of health care services; (2) small hospital mergers; (3) startup and operation of collaborations between State-licensed providers through partial or full integration; (4) standard setting and enforcement activities by medical self-regulatory entities; (5) health care providers collectively supplying non-price medical information to buyers and consumers; (6) health care provider participation in surveys; (7) health care joint ventures' purchase or use of equipment or provision of advanced tertiary care services; (8) provision of market power screens at appropriate levels below which combinations of providers are too small to pose a realistic antitrust threat; (9) joint purchasing arrangements; and (10) good faith negotiations relating to legitimate collaborative activities. Directs the Attorney General to publish notice in the Federal Register soliciting proposals for additional safe harbors. Authorizes the Attorney General to modify or remove a safe harbor following notice and comment upon a determination that the safe harbor does not meet specified criteria. Sets forth criteria in establishing safe harbors, including:  (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. (Sec. 2503) Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates.  Sets forth procedures regarding applications for, renovation of, and review of determinations regarding, such certificates.  Limits the disclosure of information. (Sec. 2504) Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. (Sec. 2505) Directs the Attorney General to periodically review the safe harbors, certificates of review, and notifications. (Sec. 2507) Establishes within the Department of Health and Human Services an Office of Health Care Competition Policy. Subtitle G:  Encouraging Enforcement Activities of Medical Self- Regulatory Entities - Part 1:  Application of the Clayton Act to Medical Self-Regulatory Entities - Provides that no damages, cost of suit, or attorney fee may be recovered under section 4, 4A, or 4C of the Clayton Act, or under any similar State law, except by a State or the United States, from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities that are: (1) designed to promote the quality of health care provided to patients; and (2) not conducted for purposes of financial gain. Directs the court to award the cost of such a suit, including a reasonable attorney fee, to a substantially prevailing defendant. Part 2:  Consultation by Federal Agencies - Requires any Federal agency engaged in the establishment of medical professional standards to consult with appropriate medical societies or associations, specialty boards, or recognized accrediting agencies, if available, in carrying out medical professional standard setting and guidelines or standards relating to the practice of medicine.  Subtitle H:  Reform of Clinical Laboratory Requirements for Simple Tests - Amends the Public Health Service Act to exempt clinical laboratories performing only simple examinations and procedures from certificate requirements.  (Sec. 2703) Directs the Secretary to use existing appropriations to conduct the study relating to the reliability and quality control procedures of clinical laboratory testing programs and the effect of errors in the testing procedures and results on the diagnosis and treatment of patients.  (Sec. 2704) Directs the Secretary to revise the membership of the Clinical Laboratory Improvement Advisory Committee to contain a number of practicing physicians proportionate to the number of physician regulated clinical laboratories.  Subtitle I:  Miscellaneous Provisions - Requires certain Government agencies to prefund health benefit contributions for their annuitants.  (Sec. 2802) Makes aliens ineligible for social security and Medicaid benefits.  (Sec. 2803) Limits the eligibility for social security benefits of certain drug and alcohol addicts.  Title III:  Long-Term Care - Subtitle A:  Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation.  (Sec. 3002) Excludes from gross income benefits provided under a long-term care insurance contract.  Includes in gross income employer-provided coverage for long-term care services.  (Sec. 3003) Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions. Includes any parent or grandparent as a dependent for purposes of such expenses.  Subtitle B:  Establishment of Federal Standards for Long-Term Care Insurance - Amends the Public Health Service Act to mandate the establishment of model Federal standards for long-term care insurance.  Prohibits the offering of a long-term care insurance policy in a State unless the State has a regulatory program meeting the requirements of this Act or the policy has been certified by the Secretary of Health and Human Services.  Authorizes grants to States for demonstration programs to improve enforcement of the standards.  Authorizes appropriations.  Imposes on agents selling long-term policies a duty of good faith and fair dealing.  Prohibits twisting, high pressure tactics, and cold lead advertising.  Mandates minimum financial standards, including income and asset criteria, for advising individuals considering the purchase of a long-term policy.  Prohibits sales:  (1) to an individual eligible for assistance under title XIX (Medicaid) of the Social Security Act; (2) of duplicate service policies; and (3) of policies that reduce, limit, or coordinate benefits on the basis of eligibility for other coverage or benefits.  Provides for:  (1) criminal and civil penalties; and (2) agent training and certification.  Sets forth additional carrier responsibilities relating to refunding of premiums, mailing of policies, providing information on denials of claims, reporting of information, and limiting compensation to agents for the sale or renewal of policies.  Prohibits cancellation or nonrenewal of a long-term care policy except for nonpayment of premium or material misrepresentation.  Sets forth continuation and conversion rights for group policies, regulating premiums for converted policies.  Requires guaranteed issuance to an individual if the individual meets the minimum medical requirements of the policy.  Mandates standards regarding upgraded benefits.  Limits cancellation for nonpayment by an incapacitated individual.  Requires:  (1) subject to exceptions, uniform language and definitions, a uniform format, and at least one standard benefit package; and (2) disclosure of certain matters, including an outline of coverage.  Mandates recommendations by the National Association of Insurance Commissioners (NAIC) regarding informing consumers on the long-term economic viability of long-term care insurance carriers. Limits certain conditions on benefits.  Requires, if benefits are provided for home health care or community-based services, that certain minimum benefits be provided.  Prohibits treating cognitive or mental impairments (including Alzheimer's disease and mental illness) differently from other medical conditions.  Limits preexisting condition requirements.  Requires:  (1) each claimant to have a functional assessment by an individual or entity meeting NAIC qualifications and unconnected to the policy issuer; (2) inflation protection, unless rejected in writing by a policyholder; (3) disclosure of certain premium increases; and (4) nonforfeiture benefits.  Prohibits a carrier from contesting a policy or claim based on fraud or misrepresentation unless notice is provided within a time period set by NAIC.  Establishes the right of a purchaser to return a policy within a specified period.  Defines ""long-term care insurance policy,"" excluding:  (1) any basic Medicare supplemental policies; (2) other insurance offered primarily to provide specified types of coverage; and (3) certain life insurance policies.  Authorizes grants for programs to provide information, counseling, and assistance regarding the procurement of long-term insurance. Authorizes appropriations.  Subtitle :   Protection of Assets Under Medicaid Through Use of Qualified Long-term Care Insurance - Amends the title XIX of the Social Security Act to require State Medicaid plans to disregard some or all of the individual's assets attributable to coverage under a qualified long-term care insurance contract in determining the individual's eligibility for long-term care services.  Subtitle D:  Studies - Requires the Comptroller General to study the feasibility of:  (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their home with an income tax credit.  (Sec. 3303) Requires the Secretary of Health and Human Services to study and report to the Congress on the feasibility of encouraging or requiring the use of a single designated public or nonprofit agency to coordinate, through case management, the provision of long-term care benefits under current Federal, State, and local programs in a geographic area.  Subtitle E:  Volunteer Service Credit Demonstration Projects - Amends the Older Americans Act of 1965 to require the Commissioner of the Administration on Aging to establish and operate a volunteer service credit demonstration project in each State.",2025-08-26T13:51:12Z,
103-hr-5302,103,hr,5302,Health Insurance Equity Act of 1994,Health,1994-11-29,1994-12-14,"Referred to the Subcommittee on Commerce, Consumer Protection and Competitiveness.",House,"Rep. Hayes, James A. [D-LA-7]",LA,D,H000390,0,"Health Insurance Equity Act of 1994 - Amends the Social Security Act to add a new title XXI (Standards for Health Coverage) prohibiting discrimination in health insurance coverage, benefits, and premiums based on health status or claims experience, except with regard to certain preexisting conditions.  Limits the conditions under which an insurer may refuse to renew the coverage of individuals or small employers.    Authorizes appropriations for State enforcement programs.",2025-08-26T13:50:35Z,
103-s-2556,103,s,2556,"A bill to provide for the portability of validly executed advance directives, to provide patients with a better understanding of their health care choices, and to promote study of the quality of care for the gravely or terminally ill or injured, and for other purposes.",Health,1994-10-08,1994-10-08,Read twice and referred to the Committee on Finance.,Senate,"Sen. Danforth, John C. [R-MO]",MO,R,D000030,0,"Provides for the portability among States of validly executed advance directives under Medicare and Medicaid provisions of the Social Security Act. Amends title XVIII (Medicare) and title XIX (Medicaid) of the Social Security Act to require written policies and procedures of service providers to provide for effective communication with individuals regarding relevant aspects of health care decisions affecting such individual, including obtaining informed consent, individual prognosis and treatment decisions, and the formulation of advance directives. Requires a report to the Congress on a study of issues relating to care at the end of life, including how to determine the application of medically necessary or appropriate care for gravely or terminally ill or injured persons.  Authorizes appropriations.",2025-01-14T18:59:41Z,
103-hr-5253,103,hr,5253,Medical Malpractice Reform Act of 1994,Health,1994-10-07,1994-10-20,Referred to the Subcommittee on Economic and Commercial Law.,House,"Rep. Ballenger, Cass [R-NC-10]",NC,R,B000104,0,"Medical Malpractice Reform Act of 1994 - Limits to $250,000 the total amount of noneconomic damages that may be awarded to a claimant and members of the claimant's family for losses resulting from the injury which is the subject of a medical malpractice liability claim or action (claim), regardless of the number of parties against whom the claim is brought or the number of actions brought. Provides for a reduction of the total amount of damages received by an individual under such claim by any other payment made to compensate for the injury. Specifies that, in any such claim in which future economic damages exceed $100,000, a defendant shall be permitted to make payments periodically, rather than in a single, lump-sum payment, based on when the damages are found likely to occur.  Permits a court to waive such provision if the court determines that it is not in the plaintiff's best interests to receive payments on a periodic basis. Prohibits an attorney from charging or collecting a contingency fee for services rendered in connection with such a claim in excess of:  (1) 25 percent of the first $150,000 (or portion thereof) recovered, plus; (2) ten percent of any amount in excess of $150,000 recovered. Makes this Act applicable to any such claim brought in State or Federal court, except with respect to a claim for damages arising from a vaccine-related injury or death to the extent that title XXI of the Public Health Service Act applies. Sets forth provisions regarding:  (1) preemption; and (2) effect on sovereign immunity and choice of law or venue.",2025-08-26T13:49:36Z,
103-hr-5256,103,hr,5256,Pharmacy Compounding Preservation Act of 1994,Health,1994-10-07,1994-10-24,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Brewster, Bill K. [D-OK-3]",OK,D,B000817,1,"Pharmacy Compounding Preservation Act of 1994 - Amends the Federal Food, Drug, and Cosmetic Act to make such Act inapplicable to:  (1) licensed retail pharmacies that compound drugs in conformance with applicable local laws regulating the practice of pharmacy and medicine; and (2) bulk drug products intended to be used by pharmacies for compounding, except to the extent that such provisions relate directly to the purity and quality of such bulk drug products.",2025-08-26T13:52:16Z,
103-hr-5257,103,hr,5257,"To authorize a study regarding the incidence of breast and prostate cancer, and for other purposes.",Health,1994-10-07,1994-10-24,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Brown, Sherrod [D-OH-13]",OH,D,B000944,0,"Requires the Director of the National Cancer Institute to study and report to specified congressional committees on the potential risk factors contributing to the incidence of breast and prostate cancer in northeastern Ohio. Amends the Public Health Service Act to require the Director to carry out activities to inform individuals of the availability, in the geographic areas in which they reside, of programs that:  (1) provide screenings for breast and prostate cancers or other services for the prevention or early diagnosis of such cancers; and (2) provide such services without charge or according to a schedule of discounts based on ability to pay.",2024-02-05T14:30:09Z,
103-hr-5258,103,hr,5258,Health Fraud and Abuse Act of 1994,Health,1994-10-07,1994-10-19,Referred to the Subcommittee on Legislation and National Security.,House,"Rep. Conyers, John, Jr. [D-MI-14]",MI,D,C000714,0,"Health Fraud and Abuse Act of 1994 - Directs the Inspector General (IG) of each of the Departments of Health and Human Services, Defense, Labor, and Veterans Affairs and the Office of Personnel Management to conduct audits, civil and criminal investigations, inspections, and evaluations relating to the prevention, detection, and control of health care fraud and abuse in violation of any Federal law, with exceptions. Sets forth provisions regarding the powers of IGs. Directs the IGs to:  (1) jointly establish a program to prevent, detect, and control health care fraud and abuse which considers the activities of Federal, State, and local law enforcement agencies (LEAs), Federal and State agencies responsible for the licensing and certification of health care providers, and State agencies designated under this Act; (2) develop an annual investigative plan; and (3) regularly consult with each other, such LEAs, Federal and State agencies responsible for the licensing and certification of health care providers, and Health Care Fraud and Abuse Control Units. Requires the Governor of each State to designate State agencies which conduct, supervise, and coordinate audits, civil and criminal investigations, inspections, and evaluations relating to such prevention, detection, and control.  Authorizes each Governor to establish and maintain a State agency to act as a Health Care Fraud and Abuse Control Unit. Requires that each Unit be a single identifiable entity of State government which is separate and distinct from any State agency with principal responsibility for the administration of health care programs and which meets specified requirements, such as being a unit of the State Attorney General or other State department that possesses statewide authority to prosecute individuals for criminal violations.  Authorizes each Unit to submit each year to the IG a plan for preventing, detecting, and controlling health care fraud and abuse. Sets forth provisions regarding:  (1) IG approval of annual plans; (2) reporting requirements; (3) payments to States; and (4) data sharing. Establishes: (1) within the Treasury the Health Care Fraud and Abuse Control Account; and (2) the Account Payments Advisory Board, which shall make recommendations to the IGs regarding the equitable allocation of payments from the Account.",2025-08-26T13:52:32Z,
103-hr-5276,103,hr,5276,To provide for the relief of hospitals treating rural populations under the current calculation of the wage index modifier for the prospective payment under Medicare.,Health,1994-10-07,1994-10-20,Referred to the Subcommittee on Health.,House,"Rep. Regula, Ralph [R-OH-16]",OH,R,R000141,0,Amends title XVIII (Medicare) of the Social Security Act with respect to prospective payment to hospitals for inpatient hospital services to require updates to a specified factor in the calculation of the wage index modifier for certain hospitals in rural and urban areas.,2024-02-07T16:32:33Z,
103-s-2536,103,s,2536,Charitable Medical Care Act of 1994,Health,1994-10-07,1994-10-07,Introduced in the Senate. Read the first time. Placed on Senate Legislative Calendar under Read the First Time.,Senate,"Sen. Danforth, John C. [R-MO]",MO,R,D000030,2,"Charitable Medical Care Act of 1994 - Exempts health care professionals from liability for negligence in the provision of health care services without charge, except in cases of gross negligence or willful misconduct. Makes this Act applicable only if such professional, before furnishing the service:  (1) agrees to furnish such service voluntarily and without charge to the recipient or to any health insurance plan or program under which the recipient is covered; and (2) provides the recipient with adequate notice, as determined by the Secretary of Health and Human Services, of the professional's limited liability for that service. Preempts any inconsistent State law.  Specifies that this Act shall not preempt any State law that provides greater incentives or protections to a health care professional rendering such service.",2025-08-26T13:51:14Z,
103-s-2545,103,s,2545,Home and Community-Based Services for Individuals with Disabilities Act of 1994,Health,1994-10-07,1994-10-07,Introduced in the Senate. Read the first time. Placed on Senate Legislative Calendar under Read the First Time.,Senate,"Sen. Feingold, Russell D. [D-WI]",WI,D,F000061,0,"TABLE OF CONTENTS:      Title I:  Home and Community-Based Services for Individuals           With Disabilities      Title II:  Provisions Relating to Medicare Long-Term Care Reform and Deficit Reduction Act of 1995 - Title I: Home and Community Based Services for Individuals with Disabilities - Entitles each State with an approved plan for home and community-based services for individuals with disabilities to specified payments.  Prohibits such plans from requiring cost sharing for low-income individuals.  Requires such plans to:  (1) ensure the quality of services; (2) adhere to Federal quality standards; (3) provide for a client advocacy office; (4) provide safeguards on confidentiality and against abuse; and (5) protect individual rights. (Sec. 108) Establishes an advisory group to advise the Secretary of Health and Human Services and the States on all aspects of such State programs. (Sec. 110) Authorizes appropriations and provides for allotments to States. (Sec. 111) Requires the Secretary to report to the Congress on evaluations of services to individuals with low-incomes and disabilities. (Sec. 112) Amends the Public Health Service Act to direct the Secretary to disseminate information and materials to assist specified entities in replicating successful programs aimed at offering care management to hospitalized individuals in need of long-term care so that services to meet individual needs and preferences can be arranged in home- and community-based settings as an alternative to long-term nursing home placement.  Authorizes the Secretary to provide technical assistance to such entities. Directs the Secretary to establish a program under which incentive grants may be awarded to assist agencies and organizations in developing and expanding programs and projects that facilitate the discharge of individuals in hospitals or other acute care facilities who are in need of long-term care services and placement of such individuals into home- and community-based settings. Sets forth provisions regarding:  (1) eligibility to receive grants; (2) application requirements; (3) criteria for the award of grants; (4) use of, and limitations on, grants; and (5) evaluation and reports. Authorizes appropriations. Title II:  Provisions Relating to Medicare - Provides for the recapture of certain health care subsidies received by high-income individuals.  Transfers such amounts to the Supplemental Medical Insurance Trust Fund. (Sec. 202) Amends title XVIII (Medicare) of the Social Security Act to impose a ten percent copayment on home health services. (Sec. 203) Reduces payments for capital-related costs for inpatient hospital services. (Sec. 204) Revises the payment formulae for ambulatory surgical center procedures and radiology services and diagnostic procedures. (Sec. 205) Reduces routine cost limits for home health services.",2025-08-26T13:49:07Z,
103-s-2555,103,s,2555,Cooperative Units of Research in Infectious Disease (CURID) of 1994,Health,1994-10-07,1994-10-07,Read twice and referred to the Committee on Labor and Human Resources.,Senate,"Sen. DeConcini, Dennis [D-AZ]",AZ,D,D000185,0,"Cooperative Units of Research in Infectious Disease (CURID) Act of 1994 - Requires Infectious Disease Research and Clinical Units of Excellence to be established jointly by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health and the National Center for Infectious Diseases of the National Centers for Disease Control and Prevention.  Provides that the Units will be dedicated to finding the cause, prevention, and cure of chronic inflammatory diseases of suspected infectious etiology and committed to giving priority to diseases like arthritis and chronic lung disease which hold the most promise for beneficial research results. Requires the establishment of the Units to be based upon past research performance of researchers working on specific microorganisms.  Makes the Units responsible for:  (1) evaluation of patient specimens for the presence of infectious agents; (2) characterization of the immune response to these infectious agents; and (3) characterization of the genetic background of patients. Sets forth provisions regarding personnel, laboratory support, networking, and the initial period of grant funding. Makes NIAID the lead agency.  Apportions responsibility for various aspects of the research program and development of a strategic research plan. Authorizes appropriations.",2025-08-26T13:52:29Z,
103-hconres-310,103,hconres,310,Expressing the sense of the Congress that any comprehensive health care reform legislation that is enacted should not take effect until the legislation is approved through a national referendum.,Health,1994-10-06,1994-10-20,Referred to the Subcommittee on Health.,House,"Rep. Browder, Glen [D-AL-3]",AL,D,B000897,0,Declares that it is the sense of the Congress that health care reform legislation that is enacted should not take effect until approved in a national referendum.,2024-02-07T16:32:33Z,
103-hr-5228,103,hr,5228,Bipartisan Health Care Reform Act of 1994,Health,1994-10-06,1994-11-14,Referred to the Subcommittee on Labor-Management Relations.,House,"Rep. Rowland, J. Roy [D-GA-8]",GA,D,R000481,21,"TABLE OF CONTENTS:           Title I:  Assuring Availability and Continuity of Health           Coverage           Subtitle A:  Insurance Reforms           Subtitle B:  Benefits           Subtitle C:  Employer Responsibilities           Subtitle D:  Standards and Certification; Enforcement;                Preemption           Subtitle E:  Multiple Employer Health Benefits                Protection and Related Provisions           Subtitle F:  Definitions; General Provisions      Title II:  Removal of Financial Barriers to Access           Subtitle A:  Tax Deductibility for Individuals and Self-              Employed           Subtitle B:  Premiums and Cost-Sharing Subsidy Program                for Low-Income Individuals      Title III:  Medicaid Reforms           Subtitle A:  Treatment of Acute Care Benefits for AFDC                and Non-cash Beneficiaries           Subtitle B:  Flexibility in Expenditures for                Supplemental Benefits for AFDC and Non-cash                Beneficiaries           Subtitle C:  Increased State Flexibility in Contracting                for Coordinated Care           Subtitle D:  Additional Medicaid Reforms      Title IV:  Access Improvements           Subtitle A:  Expanding Access in Underserved Areas           Subtitle B:  Improved Access in Rural Areas           Subtitle C:  Academic Health Centers           Subtitle D:  United States-Mexico Border Health                Commission      Title V:  Health Care Quality Enhancement           Subtitle A:  Quality Assurance           Subtitle B:  Primary Care Provider Education      Title VI:  Market Incentives to Containing Costs           Subtitle A:  Facilitating Establishment of Health Plan                Purchasing Organization (HPPOs)           Subtitle B:  Preemption of State Benefit Mandates and                Anti-Managed Care Laws           Subtitle C:  Malpractice Reform           Subtitle D:  Administrative Simplification           Subtitle E:  Fair Health Information Practices           Subtitle F:  Antitrust           Subtitle G:  Fraud and Abuse           Subtitle H:  Billing for Laboratory Services      Title VII:  Medicare           Subtitle A:  Increased Beneficiary Choice; Improved                Program Efficiency           Subtitle B:  Savings      Title VIII:  Incentives to Purchase Long-Term Care Insurance           Subtitle A:  Establishment of Federal Standards for                Long-term Care Insurance           Subtitle B:  Tax Treatment of Long-term Care Insurance      Title IX:  Department of Veterans Affairs      Title X:  Miscellaneous Savings Provisions           Subtitle A:  Automobile Insurance Coordination           Subtitle B:  Prefunding Government Health Benefits                Contributions Bipartisan Health Care Reform Act of 1994 - Title I:  Assuring Availability and Continuity of Health Coverage - Subtitle A: Insurance Reform - Part 1:  Guaranteed Access to Health Coverage - Requires carriers that offer health insurance coverage in the individual-small group market in a fair rating area to make available qualified standard coverage and high-deductible coverage to qualifying individuals or small employers. (Sec. 1001) Exempts federally qualified health maintenance organizations (HMOs) and HMOs or managed care organizations recognized by State laws from the requirement to provide high-deductible coverage. Prohibits the offer of high-deductible coverage unless the carrier also makes standard coverage available with identical benefits and the individual or employee demonstrates that they have available assets equal to at least the deductible amount under the high-deductible coverage. Requires carriers to provide for coverage of benefits for items and services furnished throughout the fair rating area. Prohibits carriers from limiting coverage to portions of interstate metropolitan statistical areas (MSAs), requiring them to provide coverage throughout the entire MSA. Requires coverage offers to include a family coverage option. Prohibits carriers from requiring employers under group health plans to impose waiting periods for health coverage or require conditions on health coverage based on an individual's:  (1) health status; (2) claims experience; (3) receipt of health care; (4) medical history; (5) receipt of public subsidies; or (6) lack of evidence of insurability. (Sec. 1002) Requires carriers to accept every small employer and qualifying individual that applies for enrollment during the required enrollment period. Provides that in the case of coverage offered by carriers or under group health plans that provide benefits through a managed care arrangement, the carriers or plans:  (1) need not establish health care facilities throughout the fair rating area if the facilities are located in a manner that does not discriminate on the basis of health status of individuals residing in proximity to such facilities; and (2) may deny coverage under certain conditions.  Permits carriers to deny coverage if they do not have the necessary financial reserves. (Sec. 1003) Prohibits carriers from denying, cancelling, or refusing to renew health coverage except on the basis of nonpayment of premiums or fraud or because they are not providing a particular coverage option in the market.  Sets limitations on market exit and re-entry by carriers.  Establishes similar conditions for cancellation or denial by multiemployer plans and multiple employer health plans. (Sec. 1004) Prohibits carriers or group health plans from excluding coverage with respect to services provided for preexisting conditions, except as provided by this Act.  Provides for exclusion periods of up to six months subject to certain conditions.  Makes exclusions inapplicable to pregnancy, newborns, adopted children, and certain individuals enrolled or enrolling during an open enrollment period. (Sec. 1005) Sets forth provisions regarding enrollment periods. Part 2:  Provision of Benefits - Establishes:  (1) standards for managed care arrangements and requirements and utilization review programs; and (2) requirements for arrangements with essential community providers. (Sec. 1014) Provides for the establishment of medical savings accounts.  Makes the account beneficiary the owner of the account and includes distributions not used for qualified medical expenses in the beneficiary's gross income.  Sets forth uses and limitations for such accounts. Excludes:  (1) employer contributions to any medical savings account of an eligible employee from gross income (to the extent such contributions do not exceed the excess of premiums for standard coverage over the premiums for high-deductible coverage); and (2) health benefit payments made by employers from employment taxes. Part 3:   Fair Rating Practices - Provides that the premium rate established by carriers for health insurance coverage in the individual-small group market may not vary except by the following: (1) age; (2) geographic area; (3) family class; (4) benefit design of coverage and by type of coverage option; and (5) permitted expense category. (Sec. 1022) Directs carriers and group health plans to accept and apply premium certificates issued under State premium assistance programs under title XXI of the Social Security Act (as established by this Act). (Sec. 1023) Requires the Secretary of Health and Human Services to request the National Association of Insurance Commissioners (NAIC) to develop a model risk adjustment system under which premiums applicable to coverage in the individual-small group market and coverage under small employer pooling arrangements and multiple employer welfare arrangements that are fully insured would be adjusted to take into account factors to predict the future need and efficient use of services by covered individuals in the market.  Incorporates such model into a rule that specifies risk adjustment mechanisms.  Requires each State to develop systems that conform with the Federal model. Part 4:  Consumer Protections - Requires carriers and group health plans to provide information relating to their performance in providing coverage to specified individuals, including prospective enrollees. (Sec. 1032) Prohibits carriers from varying the commission or other remuneration to a person based on the claims experience or health status of individuals enrolled by or through such person. Subtitle B:  Benefits - Sets forth provisions regarding standard coverage, preventive benefits to be covered without any deductible or cost-sharing, and high-deductible coverage. (Sec. 1105) Sets forth conditions under which supplemental benefits may be provided. (Sec. 1106) Requires carriers and group health plans to provide for an option under which children under 26 (without regard to whether they are students or disabled) will be treated as family members. Authorizes additional premiums for such option. (Sec. 1107) Includes coverage provided by Christian Science practitioners or in a Christian Science sanitorium within benefits under standard coverage. Subtitle C:  Employer Responsibilities - Requires employers to make available to qualifying employees coverage under a group health plan that meets specified requirements, including:  (1) an annual offering of coverage; (2) a choice of coverage and family coverage options; (3) an annual enrollment period; and (4) payroll withholding of premiums. (Sec. 1201) Provides that an employer is not required, subject to provisions regarding an equal contribution rule, to make any contribution to the cost of health coverage. Makes requirements regarding choice of coverage inapplicable if a group health plan is in effect as of July 1, 1994, and the employer makes contributions on behalf of employees under a collective bargaining agreement or similar contract. Excludes from this subtitle's requirements certain new and small employers. (Sec. 1202) Imposes an excise tax for failures of employers to comply with this subtitle. Subtitle D:  Standards and Certification; Enforcement; Preemption; General Provisions - Directs the Secretary to request the NAIC to develop model regulations that specify standards with respect to this subtitle for carriers and health insurance coverage. (Sec. 1304) Imposes a tax on carriers that fail to comply with Parts 1 through 4 of Subtitle A and Subtitle B of this title unless a State has in effect a regulatory mechanism that provides sanctions. (Sec. 1305) Prohibits a single employer plan from offering health coverage other than through a carrier unless the plan has at least 100 eligible employees. Subtitle E:  Multiple Employer Health Benefits Protections and Related Provisions - Part 1:  Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to establish certification standards under title I (Protection of Employee Benefit Rights) for multiple employer welfare arrangements (MEWAs) providing health benefits. (Sec. 1401) Treats as employee welfare benefits plans, and exempts from certain restrictions on preemption, a MEWA which provides benefits consisting solely of specified medical care, which is not fully insured, and which applies for and receives a specified certification. Requires certain disclosures to participating employers. Requires certified MEWAs which are not fully insured to maintain excess-stop loss coverage and specified types of reserves. Sets forth corrective actions which such MEWAs' operating committees must take:   (1) to avoid depletion of reserves; or (2) in connection with termination of the MEWA. Provides for review of actions by the Secretary of Labor with respect to denials of applications for, or suspensions or revocations of, such certifications. Requires, in cases where coverage is provided under a multiple employer health plan and more than ten percent of the participating employers are small employers, that the arrangement is maintained in the form of a small employer pooling arrangement.  Sets forth requirements for such arrangements. (Sec. 1402) Revises ERISA with respect to:  (1) a specified exemption from preemption; (2) treatment of single employer arrangements; and (3) treatment of certain collectively bargained arrangements. (Sec. 1405) Sets forth ERISA requirements relating to employee leasing health care arrangements (ELHAs).  Provides for treatment of ELHAs as MEWAs, with certain exceptions.  Sets forth special rules under which an ELHA may receive a MEWA certification. (Sec. 1408) Allows delegation to a State of some or all of the Secretary's enforcement authority with respect to MEWAs with certifications.  Directs the Secretary to provide enforcement and technical assistance to the States with respect to MEWAs. Part 2:  Simplifying Filing of Reports for Employers Covered under Multiple Employer Welfare Arrangements Providing Fully Insured Coverage Consisting of Medical Care - Directs the Secretary to prescribe an alternative method for the filing of a single annual report for all participating employers under MEWAs under which all coverage consists of medical care and is fully insured. Subtitle F:  Definitions; General Provisions - Part 1: Definitions - Sets forth specified definitions. (Sec. 1905) Makes this title effective for plan years beginning on or after 1997 with respect to group health plans and as of January 1, 1997, with respect to carriers (for coverage other than under a group health plan). Part 2:  Report and Recommendations on Health Coverage and Access - Provides that it is an objective of this Act to assure by 2002 that: (1) all eligible individuals in the United States have access to health coverage; and (2) at least 95 percent of such individuals have such coverage. (Sec. 1912) Requires the Secretary of Health and Human Services to report to the Congress on the extent to which eligible individuals have, or have access to, health care coverage. Title II:  Removal Of Financial Barriers To Access - Subtitle A: Tax Deductibility for Individuals and Self-Employed - Amends the Internal Revenue Code to:  (1) increase on a graduated basis the tax deduction for health insurance costs of self-employed individuals; (2) make the deduction permanent; (3) allow a tax deduction, regardless of whether the taxpayer itemizes other deductions, for health insurance costs of non-self-employed individuals not eligible to participate in any subsidized employer health plan; and (4) subject to taxation certain health benefits provided through cafeteria plans and flexible spending arrangements. Subtitle B:  Premium and Cost-Sharing Subsidy Program for Low-Income Individuals - States that the amendments made by this subtitle and title III below provide for a transition from the current Medicaid system to a new system of acute care low-income assistance. (Sec. 2101) Amends the Social Security Act (SSA) to add a new title XXI providing for the establishment of new State programs under which, as a requirement for State participation in Medicaid, certain low-income eligible individuals who are not Medicare beneficiaries, SSI recipients, prison inmates, or unlawful aliens will be eligible for premium and cost-sharing assistance for use in obtaining qualifying coverage of the standard and preventive health benefits discussed above under title I of this Act. Sets forth specific requirements for such programs, allowing waivers in the case of any demonstration project which in the judgment of the Secretary of Health and Human Services is likely to assist in promoting the objectives of new SSA title XXI. Creates in the Treasury the Health Care Assurance Trust Fund to contain the savings resulting from this Act and other specified amounts for use in paying States operating subsidy and supplemental acute care benefits programs. Establishes a mechanism for financing such programs that is designed to be deficit neutral. Prohibits the use of funds appropriated to carry out new SSA title XXI to provide premium or cost-sharing assistance or supplemental acute care benefits under part B added below in connection with any abortion, except in cases where an abortion is necessary to save the life of the mother or where the pregnancy results from rape or incest. Title III:  Medicaid Reforms - Subtitle A:  Treatment of Acute Care Benefits for AFDC and Non-Cash Beneficiaries - Amends SSA title XIX (Medicaid) to:  (1)  establish Medicaid rules for benefits for acute medical services for AFDC recipients and non-cash Medicaid beneficiaries; (2) provide for the division of acute medical service benefits into core benefits and supplemental acute care benefits; (3) limit the amount of Federal financial participation for benefits for acute medical services for AFDC recipient and non-cash Medicaid beneficiaries; (4) condition Federal financial participation on State maintenance-of-effort; and (5) provide for the continuation of State Medicaid eligibility categories. Subtitle B:  Flexibility in Expenditures for Supplemental Benefits for AFDC and Non-Cash Beneficiaries - Amends new SSA title XXI to require each State to establish a State supplemental acute care benefits program. Subtitle C:  Increased State Flexibility in Contracting for Coordinated Care - Amends SSA title XIX to modify Federal requirements to allow States more flexibility in contracting for coordinated care services. Subtitle D:  Additional Medicaid Reforms - Amends SSA title XIX to make various specified changes providing for:  (1) a reduction in the amount of payment adjustments for disproportionate share hospitals; (2) elimination of the medically needy program for individuals not in an institution; and (3) elimination of the Medicaid pediatric immunization program, and establishment of alternative delivery programs. Title IV:  Access Improvements - Subtitle A:  Expanding Access in Underserved Areas - Amends SSA title XI to provide for community health authorities demonstration projects for providing access to cost-effective preventive and primary care and related services for various areas and populations, including low-income residents of medically underserved areas or for medically underserved populations. Amends the Public Health Service Act to authorize the Secretary to make grants to migrant and community health centers for the development of health service networks for serving high impact areas, medically underserved areas, or medically underserved populations within the area they serve. Subtitle B:  Improved Access in Rural Areas - Part 1:  Grants to Encourage Community Rural Health Networks - Directs the Secretary of Health and Human Services to make grants to an eligible State for the development of plans to increase access to health care services for residents of areas in the State designated as chronically underserved areas.  Provides for technical assistance for entities establishing or enhancing a community rural health network in an underserved rural area.  Provides financial assistance to entities to provide for the development and implementation of community rural health networks. Authorizes appropriations. Part 2:  Incentives for Health Professionals to Practice in Rural Areas - Subpart A:  National Health Service Corps Program - Amends the Internal Revenue Code to exclude National Health Service Corps Loan Repayments from gross income. (Sec. 4113) Increases the authorization of appropriations for the National Health Service Corps Scholarship and Loan Repayment Programs. Subpart B:  Incentives Under Other Programs - Amends title XVIII (Medicare) of the Social Security Act to provide incentives under such Act to physicians in former shortage areas.  Directs the Secretary to develop and publish a model law for adoption by States to increase the access of individuals residing in underserved rural areas to health care services by expanding the services which non-physician health care professionals may provide in such areas. Part 3:  Assistance for Institutional Providers - Subpart A: Community and Migrant Health Centers - Extends and increases the authorizations of appropriations for migrant health centers and community health centers. Subpart B:  Emergency Medical Systems - Revises title XII (Trauma Care) of the Public Health Service Act.  Renames such title Emergency Medical and Trauma Care Services.  Directs the Secretary to establish the Office of Emergency Medical and Trauma Care Services. Requires the Secretary to:  (1) conduct and support research and demonstration projects; (2) foster development of appropriate modern systems of services; (3) assist States; and (4) coordinate and sponsor related activities.  Requires that activities meet the unique needs of underserved inner-city and rural areas. (Sec. 4141) Authorizes grants to States to improve the availability and quality of emergency medical services through the operation of State offices of emergency medical services.  Authorizes appropriations for emergency medical services. (Sec. 4142) Directs the Secretary to make grants to assist States in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments for injuries resulting from such emergencies. Authorizes appropriations. Subpart C:  Assistance to Rural Providers Under Medicare - Amends title XVIII (Medicare) of the Social Security Act to:  (1) increase by two the number of States eligible to participate in the essential access community hospital program; and (2) make other revisions concerning such program, including permitting the participation of hospitals in urban areas and the participation of hospitals in States adjoining participating States. Extends, by three years, the deadline for the development of prospective payment systems for both inpatient and outpatient rural primary care hospital services. (Sec. 4152) Defines a rural emergency access care hospital and rural emergency access care hospital services for purposes of title XVIII.  Provides for the coverage of such services under part B (Supplementary Medical Insurance) of title XVIII. Subpart D:  Demonstration Projects to Encourage Primary Care and Rural-Based Graduate Medical Education - Directs the Secretary to establish and conduct a demonstration project to increase the number and percentage of medical students entering primary care practice. Authorizes appropriations. Part 4:  Hospital Affiliated Primary Care Center - Requires the Secretary to make grants and provide technical assistance to community hospitals for the development and operation of primary care services in medically underserved areas.  Provides for a plan to allow primary care centers to retain income earned from operation under certain conditions.  Authorizes appropriations. Subtitle C:  Academic Health Centers - Directs the Secretary to study and report to the Congress on:  (1) the feasibility and desirability of making payments to facilities that are not hospitals for the costs of graduate medical education attributable to residents trained at such facilities; and (2) determining the funding needs of health professions schools. Subtitle D:  United States-Mexico Border Health Commission - Authorizes the President to conclude an agreement with Mexico to establish a binational commission to be known as the United States-Mexico Border Health Commission. (Sec. 4302) Declares that it should be the duty of the Commission to:  (1) conduct a needs assessment in the U.S.-Mexican border area to identify and resolve health problems that affect the general population of the area; and (2) formulate recommendations for a fair method by which the government of one country could reimburse a public or private entity in the other country for the cost of a health care service furnished to a citizen of the first country who is unable to pay for the service. States that the Commission should establish at least two regional border offices in selected locations. Title V:  Health Care Quality Enhancement - Subtitle A:  Quality Assurance - Directs the Secretary to establish a Health Quality Advisory Council to develop an initial set of quality measures to be used to assess the quality of carriers, group health plans, and multiple employer welfare arrangements.  Provides for auditing of such entities to determine compliance with certain quality measure and reporting requirements. Subtitle B:  Primary Care Provider Education - Amends the Public Health Service Act to extend through FY 1999 authorized funding for training for certain health service providers. Title VI:  Market Incentives to Containing Costs - Subtitle A: Facilitating Establishment of Health Plan Purchasing Organization (HPPOs) - Part 1:  Health Plan Purchasing Organizations - Authorizes the establishment of health plan purchasing organizations (HPPOs) in accordance with this part. (Sec. 6002) Requires HPPOs to enter into agreements with carriers that desire to make health coverage available through HPPOs. (Sec. 6004) Requires HPPOs to offer enrollment for coverage for carriers.  Authorizes HPPOs to impose administrative fees for enrollment. (Sec. 6006)  Requires States to:  (1) review the access of residents who are not employees of large employers or Medicare beneficiaries to obtain standard health insurance coverage through an HPPO; and (2) take actions to ensure that public or private entities provide access to residents who are unable to obtain such coverage. Part 2:  Encouragement of Multiple Employer Arrangements Providing Basic Health Benefits - Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax exempt trust status for certified multiple employer health plans, fully-insured multiple employer welfare arrangements, and other specified plans described by ERISA. Part 3:  Tax Exemption for High Risk Pools - Provides tax-exempt status to corporations or similar legal entities created by States or political subdivisions to establish risk pools to provide health insurance coverage to persons unable to obtain such insurance because of health conditions. Subtitle B:  Preemption of State Benefit Mandates and Anti-Managed Care Laws - Preempts State laws that:  (1) mandate health insurance benefits; (2) restrict managed care arrangements and utilization review programs; and (3) prohibit two or more employers from obtaining coverage that is fully-insured under multiple employer health plans. (Sec. 6105) Prohibits States from enforcing standards for health insurance coverage that differ from those established under title I of this Act. (Sec. 6106) Directs the Comptroller General to study and report to the Congress on the benefits and cost effectiveness of the use of managed care in the delivery of health care services. Subtitle C:  Malpractice Reform - Part 1:  Uniform Standards for Malpractice Claims - Makes this part applicable to any medical malpractice liability action brought in a Federal or State court and to any medical malpractice claim subject to an alternative dispute resolution (ADR) system that is initiated on or after January 1, 1996. (Sec. 6202) Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified ADR system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States.  Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 6203) Authorizes States to develop specialty clinical practice guidelines to be certified by the Secretary. (Sec. 6204) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action. (Sec. 6206) Sets forth provisions regarding:  (1) limits on attorney fees and other costs; and (2) statutes of limitations. (Sec. 6208) Specifies that in the case of a medical malpractice claim relating to services provided during labor or the delivery of a baby, if the health care professional or provider did not previously treat the claimant for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. (Sec. 6210) Provides that this part preempts State law, except for State law that imposes greater restrictions than those provided in this part. Part 2:  Requirements for State Alternative Dispute Resolution Systems (ADR) - Lists requirements for State ADR systems, including that such a system:  (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 6222) Directs the Secretary to certify State ADR systems that meet such requirements on an annual basis. Requires the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 6223) Directs the Secretary to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system. Part 3:  Definitions - Sets forth definitions for this subtitle. Subtitle D:  Administrative Simplification - Part 1:  Standards for Data Elements and Transactions - Directs the Secretary to adopt standards for:  (1) the electronic transmission of health information data; and (2) information transactions. Part 2:  Requirements with Respect to Certain Transactions and Information - Lists transactions to be considered as standard transactions with respect to plan sponsors and HPPOs. (Sec. 6322) Requires certified health information security organizations to make available to Federal or State agencies, pursuant to a cost-type contract, any non-identifiable health information that is held by the service, consists of data elements that are subject to a standard under part 1, and is requested by such an agency to fulfill a requirement under this Act. (Sec. 6323) Directs the Secretary to establish a procedure under which a plan sponsor or health provider that does not have the ability to transmit standard data elements and does not have access to a certified health information network may comply with this part. Part 3:  Miscellaneous Provisions - Requires the Secretary to establish standards and a certification procedure for health information network services. (Sec. 6333) Provides that this subtitle supersedes State law. Prohibits the enforcement of any State law that requires medical or health plan records to be maintained or transmitted in written rather than electronic form, except as provided by the Secretary. (Sec. 6334) Authorizes the Secretary to make grants for demonstration projects to promote the development and use of electronically integrated community-based clinical information systems and computerized patient medical records. Part 4:  Assistance to the Secretary - Establishes the Health Care Information Advisory Committee to:  (1) provide assistance to the Secretary in complying with the requirements imposed on the Secretary under this subtitle and subtitle E; (2) be responsible for advising the Secretary and the Congress on the status of the health information network; and (3) make recommendations to correct any problems that may occur in the network's implementation and operations and to refine and improve the network. Subtitle E:  Fair Health Information Practices - Part 1:  Duties of Health Information Trustees - Sets forth rights of individuals with respect to inspection of protected health information maintained by a health information trustee (specified entities, including health care providers, health benefit plan sponsors, and public health authorities).  Makes exceptions to inspection rights if:  (1) the information relates to mental health treatment notes or persons other than the protected individual; (2) the inspection could be expected to threaten an individual's life or personal safety; (3) the information could lead to the identification of a confidential source; (4) the information is used solely for administrative purposes or is duplicative; or (5) the information is compiled principally in anticipation of a legal proceeding. (Sec. 6402) Sets forth conditions under which a trustee must correct or amend information at the request of a protected individual. (Sec. 6404) Provides for:  (1) recordkeeping with respect to health information disclosures; and (2) safeguards to ensure confidentiality and protection of information. Part 2:  Use and Disclosure of Protected Health Information - Permits a health information trustee to use protected health information only for a purpose that is compatible with and related to the purpose for which the information was collected or received or for which the trustee is authorized to disclose under this subtitle. (Sec. 6411) Limits the use or disclosure of protected health information by a health information trustee to the minimum amount of information necessary. (Sec. 6412) Authorizes a health information trustee to disclose protected health information pursuant to an authorization executed by the individual who is the subject of the information if specified requirements are met. (Sec. 6413) Authorizes the disclosure of protected health information, subject to specified restrictions:  (1) in connection with treatment and payment; or (2) for use in an action against or investigation of an individual relating to receipt of or payment for health care. (Sec. 6414) Sets forth provisions regarding the disclosure of protected health information to next of kin and others. (Sec. 6415) Establishes requirements with respect to the reporting of protected health information:  (1) to a public health authority; (2) for a health research project; (3) in emergency circumstances; (4) for judicial and administrative purposes; (5) to a law enforcement agency; (6) pursuant to subpoena or warrant; and (7) to a health information service organization. Part 3:  Access Procedures and Challenge Rights - Sets forth access procedures and challenge rights with respect to attempts to obtain protected health information. Part 4:  Miscellaneous Provisions - Provides that if a protected individual pays a health information trustee for health care by presenting a debit, credit, or other payment card or by other electronic means, the trustee may only disclose protected health information as is necessary for the processing of the payment transaction. (Sec. 6442) Sets forth conditions under which protected health information may be released to persons outside the United States. (Sec. 6443) Directs the Secretary to establish standards with respect to the creation, transmission, receipt, and maintenance, in electronic and magnetic form, of documents required or authorized under this subtitle. (Sec. 6444) Sets forth duties of affiliated persons to whom health information trustees are authorized to provide protected health information. (Sec. 6445) Sets forth the rights of persons acting as agents or attorneys of protected individuals or on behalf of minors. Part 5:  Enforcement - Authorizes persons whose rights under this subtitle have been knowingly or negligently violated to maintain civil actions.  Sets forth penalty provisions. (Sec. 6453) Directs the Secretary to develop alternative dispute resolution methods for use by individuals, health information trustees, and others in resolving claims made in civil actions. (Sec. 6454) Amends the Federal criminal code to provide penalties for offenses related to protected health information. Part 6:  Amendments to Title 5, United States Code - Requires Federal agencies that are health information trustees to promulgate rules to exempt systems of records within such agencies, to the extent that such systems contain protected health information, from certain provisions regarding access and other requirements with respect to an individual's records. Part 7:  Regulations, Research, and Education; Effective Dates; Applicability; and Relationship to Other Laws - Directs the Secretary to prescribe regulations to carry out this subtitle. (Sec. 6471) Authorizes the Secretary to sponsor:  (1) research relating to the privacy and security of protected health information; (2) the development of consent forms governing the disclosure of such information; and (3) the development of technology to implement standards regarding such information. Directs the Secretary to establish education and awareness programs to:  (1) foster security practices by health information trustees; (2) train personnel of health information trustees respecting their duties with respect to such information; and (3) inform individuals and employers who purchase health care respecting their rights with respect to such information. (Sec. 6474) Prohibits States from enforcing any law that is inconsistent with certain requirements of this subtitle or imposes additional requirements with respect to health information trustees. Subtitle F:  Antitrust - Directs the Attorney General to:  (1) provide for the development of guidelines on the application of antitrust laws to the activities of health plans; and (2) establish a review process under which a health plan may request the Department of Justice's opinion on the plan's conformity with the Federal antitrust laws. (Sec. 6502) Requires the Attorney General to issue a certificate of public advantage to each eligible health care collaborative activity that complies with this section's requirements.  Provides that such activity shall not be liable under the antitrust laws for conduct described in the certificate if such conduct occurs while the certificate is in effect.  Directs the Attorney General to issue such a certificate if:  (1) the benefits that are likely to result from the activity outweigh the reduction in competition that is likely to result; and (2) such reduction is necessary to obtain such benefits. Sets forth activity eligibility requirements. (Sec. 6503) Directs the Attorney General to report annually to the Congress as part of the annual budget oversight proceedings concerning the Antitrust Division of the Department of Justice.  Requires the report to enable the Congress to determine how enforcement of antitrust laws is affecting the formation of efficient, cost-saving joint ventures and if the certificate of public advantage procedure has resulted in undesirable reduction in competition in the health care marketplace. Subtitle G:  Fraud and Abuse - Directs the Attorney General to establish a program to:  (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to the delivery of and payment for health care in the United States; (2) conduct investigations, audits, evaluations, and inspections relating to the delivery of and payment for health care in the United States; and (3) facilitate the enforcement of certain SSA title XI mandatory exclusion and other provisions applicable to health care fraud and abuse. Requires the Attorney General in carrying out such program to provide for coordination with law enforcement agencies, State Medicaid Fraud Control Units, State licensing agencies, as well as with third party insurers. (Sec. 6602) Authorizes additional appropriations for the Attorney General to investigate allegations of health care fraud and otherwise carry out the program established above. (Sec. 6603) Creates in the Treasury the Anti-Fraud and Abuse Trust Fund consisting of Federal health anti-fraud and abuse penalties for use in:  (1) carrying out the program above; (2) supporting educational activities to prevent the occurrence of violations of anti-fraud and abuse laws; and (3) repaying beneficiaries for cost- sharing. (Sec. 6611) Amends SSA title XI to revise current sanctions for health care fraud and abuse, among other changes, providing for:  (1) mandatory exclusion from participation in Medicare and State health care programs of any individuals convicted of a felony relating to fraud or the unlawful manufacture, distribution, prescription, or dispensing of a controlled substance; and (2) establishment of a minimum period of exclusion for certain individuals and entities subject to permissive exclusion from Medicare and State health care programs. (Sec. 6615) Amends SSA title XVIII to modify the limitations on physician self-referral. (Sec. 6616) Directs the Comptroller General to study and report to the Congress on the costs incurred by eligible organizations with risk-sharing contracts of complying with the requirement of entering into a written agreement with an entity providing peer review services with respect to services provided by the organization. (Sec. 6621) Amends the Federal criminal code to provide for:  (1) penalties for health care fraud, including making it a felony; (2) rewards for information leading to prosecution relating to health care fraud; and (3) broadened application of mail fraud statute provisions. (Sec. 6631) Amends SSA titles XI and XVIII to authorize the issuance of advisory opinions by the Secretary according to specified guidelines. (Sec. 6641) Requires each State to establish and maintain a State agency to act as a Health Care Fraud and Abuse Control Unit for:  (1) investigating and prosecuting violations under any Federally-funded or mandated health care program relating to fraud under State laws; (2) reviewing complaints of abuse or neglect involving patients of facilities receiving Federal payments and, where appropriate, investigate and prosecute such complaints; and (3) providing for the collection, or referral for collection, of overpayments made under any such program and found by the Unit. Subtitle H:  Billing for Laboratory Services - Amends the Public Health Service Act to make it unlawful for any person who furnishes ancillary health services to present a bill or demand for payment to any person other than the patient receiving such services, with specified exceptions.   Exempts ancillary health services for which payment may be made under Medicare. (Sec. 6701) Defines ""ancillary health services"" as clinical laboratory services, diagnostic x-rays and other diagnostic tests, durable medical equipment, and physical therapy services. Sets forth conditions under which a person who furnishes ancillary health services may present a bill or demand for payment to specified entities other than the patient. Imposes civil penalties for repeated and knowing demands for payment in violation of this subtitle.  Provides for other sanctions for such violations, including the suspension of laboratory certifications and exclusion from participation in Medicare programs. Title VII:  Medicare - Subtitle A:  Increased Beneficiary Choice; Improved Program Efficiency - Amends SSA title XVIII to revise provisions for payments to health maintenance organizations (HMOs) to:  (1) provide for the use of metropolitan statistical areas to determine adjusted average per capita cost; (2) require the Secretary to develop additional specified model packages of health benefits providing coverage for catastrophic illness, prescription drugs, and preventive services which an HMO may provide at its option; and (3) make various specified changes in HMO membership requirements, including changes in associated waiver provisions, and enrollment periods. (Sec. 7002) Amends the Omnibus Budget Reconciliation Act of 1990 to permit Medicare supplemental policies in all States. Modifies Medicare supplemental policy provisions. (Sec. 7003) Includes notice of available HMOs and carriers offering Medicare supplemental policies in the annual notice of Medicare benefits mailed to Medicare beneficiaries. (Sec. 7004) Directs the Secretary to:  (1) develop and submit to the Congress a proposal for legislation which provides for the voluntary enrollment of Medicare beneficiaries in private health insurance plans; (2) provide for a monthly payment to a qualified private health insurance plan on behalf of enrolled Medicare beneficiaries who choose to enroll in such a plan (with the enrollee paying any difference between the monthly premium charged under the plan and the amount paid for under Medicare for the enrollee's class, while maintaining budget-neutrality); and (3) take such steps as may be necessary to consolidate the administration of Medicare parts A (Hospital Insurance) and B (Supplementary Medical Insurance). (Sec. 7003) Includes notice of an individual's rights under State law with regard to the formulation of advance directives in the annual notice of Medicare benefits mailed to Medicare beneficiaries. Subtitle B:  Savings - Amends Medicare provisions relating to Medicare part A to provide for reductions in:  (1) the update for payments for inpatient hospital services; and (2) payments for capital-related costs for inpatient hospital services. (Sec. 7111) Amends Medicare part B provisions on payment for physicians' services to provide for:  (1) use of cumulative performance standards; (2) treatment of default update; (3) use of real GDP to adjust for volume and intensity; (4) repeal of restriction on maximum reduction under conversion factor update adjustment provisions; and (5) reduction in the conversion factor for the physician fee schedule for 1995. (Sec. 7112) Provides for the imposition of coinsurance on laboratory services. (Sec. 7113) Amends the Internal Revenue Code to provide for an increase in the Medicare part B premiums for high-income individuals. (Sec. 7114) Amends Medicare to provide for:  (1) the extension of the 25 percent part B premium; (2) a reduction in hospital outpatient services and home health services through the establishment of a prospective payment system; and (3) various specified changes with regard to Medicare as secondary payer. Title VIII:  Incentives to Purchase Long-Term Care Insurance - Subtitle A:  Establishment of Federal Standards for Long-Term Care Insurance - Amends SSA to provide for model standards incorporating specified requirements for sales practices, benefits, and other matters that long-term care insurance policies must meet.  Establishes civil monetary penalties for violations. Requires the National Association of Insurance Commissioners to issue guidelines for endorsements of long-term care insurance policies, or that permit such policies to be offered for sale through the organization or association. Subtitle B:  Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of long-term care insurance contracts as accident or health insurance contracts generally, with qualified long-term services treated as medical care, among other changes with regard to long-term care insurance. Subtitle C: Studies - Requires the Comptroller General to conduct a study on the feasibility of:  (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their homes with a tax credit. (Sec. 8203) Directs the Secretary to conduct a study and report to the Congress on:  (1) case management of current long-term care benefits; and (2) subacute care. Title IX:  Department of Veterans Affairs - Authorizes each veteran residing in the United States, certain surviving spouses and children of such veterans (also living in the United States) who are not otherwise eligible for medical care under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), and family members thereof to be enrolled with a Department of Veterans Affairs (VA) health care plan.  Requires the payment of appropriate premiums, deductibles, copayments, or coinsurance with respect to such family members.  Continues the eligibility of family members after the death of the veteran originally enrolled.  Directs the Secretary of Veterans Affairs (Secretary, for purposes of this title) to establish enrollment ceilings to limit the number of eligible individuals enrolling for such coverage.  Requires conformity of such plans with health plan requirements set forth in this Act and inclusion of all the items and services in the standard coverage under this Act.  Directs the Secretary to continue to provide to veterans authorized VA care and services which are not included in the standard coverage provided under this Act.  Provides for the continuation in the VA of specialized disabled veteran treatment and rehabilitative needs and facilities and requires a report on such continuation from the Secretary to specified congressional committees. Allows such plans to offer supplemental health benefits and cost-sharing policies consistent with this Act.  Provides a limitation with regard to veterans who elect not to enroll to obtain such coverage. Prohibits the imposition of a cost-share charge of any kind upon a veteran for the treatment of a service-connected disability that requires specialized treatment by the VA.  Prohibits funds appropriated to carry out this title from being used to provide abortions except when necessary to save the life of the mother or when the pregnancy is the result of rape or incest. Prohibits the imposition of cost-sharing charges of any kind upon veterans who are disabled to a degree of ten percent or more, veterans released from service due to a service-connected disability, veterans receiving disability compensation from the VA, former prisoners of war, veterans of the Mexican border period or World War I, and veterans unable to defray the costs of such care.  Directs the Secretary to establish rates for premiums and other applicable charges with respect to all other enrollees.  Empowers the Secretary to recover from third parties the cost of providing such care and services if such care and services would have been required to be provided by such third party. Establishes in the Treasury the Department of Veterans Affairs Health Coverage Fund to be used for VA health plan payments and services.  Preserves existing health care benefits for facilities not offering qualified health coverage under this Act. Authorizes the Secretary to organize VA health plans and facilities as plans and facilities offering qualified health coverage under this Act.  Requires any health insurance program provided for Federal employees to include as an option enrollment to obtain VA coverage.  Requires the Secretary to take appropriate steps to ensure the financial solvency and stability of the VA coverage and of the contractors and subcontractors providing services as part of such coverage.  Preempts certain State action with respect to standards and requirements of such coverage. Requires VA health care facilities to serve as providers to individuals residing in a State that operates as a single payer system, with appropriate reimbursement.  Authorizes the head official offering VA health coverage or the director of a VA health care facility to enter into agreements with health care plans, insurers, health care providers, and other entities to furnish or obtain any health-care resource.  Provides certain other administrative and personnel flexibility to the Secretary in providing or obtaining such services. Directs the Secretary of the Treasury to:  (1) credit to a special fund specified amounts for FY 1995 and 1996 to be used for providing VA health coverage under this Act; and (2) report to the Congress on the operation of the VA health care system with respect to national health care reform as set forth under this Act.  Authorizes the Secretary to apply for and accept grants and other forms of assistance to meet the needs of special populations. (Sec. 9003) Makes veterans enrolled with a VA plan under this title eligible for nursing home care, outpatient care, and care provided to obviate the need for hospital admission. (Sec. 9004) Makes any herbicide-exposed veteran eligible for hospital and nursing home care for any disease for which the National Academy of Sciences has determined:  (1) that there is a positive association between disease occurrence and herbicide exposure; (2) that there is evidence suggesting such an association, though the evidence is limited; or (3) that available studies are insufficient to permit a conclusion about the presence or absence of such an association.  Limits the authorized length of such care for eligible veterans. (Sec. 9005) Extends the authority to provide priority outpatient health care to veterans for exposure to environmental hazards until October 1, 1998, for any disability which becomes manifest before October 1, 1996. (Sec. 9006) Directs the Secretary to report to the Congress on the desirability and feasibility of waiving any requirement for cost-sharing under a VA health plan in the case of medical care provided to a family member of a Persian Gulf War veteran for any disease or disability which may be related to such service. (Sec. 9007) Directs the Secretary, during FY 1995 through 1997, to carry out and report to specified congressional committees on a study of the effect of telemedicine on the delivery of VA health care services. (Sec. 9008) Directs the Secretary of Health and Human Services to develop and submit to the Congress a proposal for legislation which provides for obtaining VA health coverage for Medicare beneficiaries who are veterans. (Sec. 9009) Directs the Secretary to carry out a pilot program to reduce waiting times for patients seeking health-care services in VA outpatient clinics and the traveling distance to such clinics by providing for operation of approximately 20 new outpatient clinics around two VA medical centers. Authorizes appropriations for FY 1998 through 2004.  Title X:  Miscellaneous Savings Provisions - Subtitle A: Automobile Insurance Coordination - Requires individuals enrolled in a health plan to receive automobile insurance medical services exclusively through the health plan.  Makes such services subject to all quality, cost containment, and anti-fraud and abuse provisions that apply generally to medical services provided by or through health plans. (Sec. 10002) Permits an individual and an automobile insurance carrier to agree that treatment for bodily injury sustained in an automobile accident shall be provided by other than the health plan through which such individual is enrolled.  Authorizes States to require such carriers to make direct payment to health care providers for automobile insurance medical services that are covered by Medicare or Medicaid and an automobile insurance contract that provides for direct payment of medical services regardless of fault. (Sec. 10003) Requires carriers liable for payment for automobile insurance medical services to make payment to health plans to the extent of obligations under the contract.  Grants federally funded health care plans first priority to receive payment pursuant to any obligation under an automobile insurance policy covering such medical services. (Sec. 10004) Directs States to establish systems for prompt payment for automobile insurance medical services by such carriers to health plans, including mechanisms for resolution of disputes. Requires sanctions to be prescribed for failures to comply with this subtitle's requirements. (Sec. 10005) Requires the Secretary of Health and Human Services to provide for allotments to States for administrative expenses in carrying out this subtitle. Subtitle B:  Prefunding Government Health Benefits Contributions - Directs each Federal agency within the executive branch whose receipts and disbursements are not generally included in the totals of the Government budget submitted by the President, effective FY 1994 (or February 1, 1995, in the case of the agency with the greatest number of employees), to prepay the Government contributions which will be required in connection with providing health-benefits coverage for annuitants of such agency.",2026-03-23T12:41:21Z,
103-s-2513,103,s,2513,"A bill to enhance the research conducted by the Agency for Health Care Policy and Research concerning primary care, and for other purposes.",Health,1994-10-06,1994-10-06,Read twice and referred to the Committee on Labor and Human Resources.,Senate,"Sen. Rockefeller, John D., IV [D-WV]",WV,D,R000361,0,"Amends the Public Health Service Act to direct the Secretary of Health and Human Services to establish within the Agency for Health Care Policy and Research a Center for Primary Care Research. Authorizes appropriations. Transfers to the Center all functions, personnel, assets, liabilities, contracts, property, records, and unexpended balances of appropriations, authorizations, allocations, and other funds of the Division of Primary Care within the Agency in connection with the functions transferred by this Act.",2025-04-21T12:24:17Z,
103-s-2529,103,s,2529,A bill to amend title XI of the Social Security Act with respect to certain criminal penalties for acts involving the medicare program or State health care programs.,Health,1994-10-06,1994-10-06,Read twice and referred to the Committee on Finance.,Senate,"Sen. Graham, Bob [D-FL]",FL,D,G000352,0,"Amends title XI of the Social Security Act to exempt from criminal penalties for illegal remunerations any payments made by:  (1) a State agency to a health insurer or health maintenance organization with respect to participants in a State Medicaid demonstration project; and (2) a health insurer or health maintenance organization (HMO) to a sales representative or licensed insurance agent for servicing, marketing, or enrolling project participants in a health plan offered by such insurer or HMO.",2025-01-14T18:59:41Z,
103-sjres-232,103,sjres,232,"A joint resolution designating October 23, 1994, through October 31, 1994, as ""National Red Ribbon Week for a Drug-Free Anerica.",Health,1994-10-06,1994-10-06,Read twice and referred to the Committee on Judiciary.,Senate,"Sen. Murkowski, Frank H. [R-AK]",AK,R,M001085,30,"Designates the week of October 23 through 31, 1994, as National Red Ribbon Week for a Drug-Free America.",2025-07-21T19:32:26Z,
103-hr-5195,103,hr,5195,Contact Lens Prescription Release Act,Health,1994-10-05,1994-10-17,Referred to the Subcommittee on Transportation and Hazardous Materials.,House,"Rep. Stark, Fortney Pete [D-CA-13]",CA,D,S000810,1,Contact Lens Prescription Release Act - Directs the Federal Trade Commission to amend its trade regulation rule on ophthalmic practice under 16 C.F.R. 456 to require the release of a prescription for contact lenses after their fitting is completed regardless of whether or not the patient requests the prescription.,2025-08-26T13:50:16Z,
103-hr-5173,103,hr,5173,Office for Rare Disease Research Act of 1994,Health,1994-10-04,1994-10-17,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Wyden, Ron [D-OR-3]",OR,D,W000779,0,Office for Rare Disease Research Act of 1994 - Amends the Public Health Service Act to establish within the Office of the Director of the National Institutes of Health an Office for Rare Disease Research in order to promote and coordinate the conduct of research on rare diseases through a strategic research plan and to establish and manage a rare disease research clinical database. Directs the Secretary to establish an advisory council to provide advice to the Director of the Office.,2025-08-26T13:51:17Z,
103-s-2495,103,s,2495,Gift of Life Congressional Medal Act of 1994,Health,1994-10-03,1994-10-03,Read twice and referred to the Committee on Banking.,Senate,"Sen. Murkowski, Frank H. [R-AK]",AK,R,M001085,31,Gift of Life Congressional Medal Act of 1994 - Directs the Secretary of the Treasury to design and strike a bronze medal to commemorate organ and tissue donors and their families. Makes eligible for the medal any organ or tissue donor or donor's family. Requires the Secretary of Health and Human Services to arrange for medal presentation to eligible individuals. Declares the medals to be national medals. Authorizes the Secretary of the Treasury to enter into agreements with the Organ Procurement and Transplantation Network to solicit donations to offset expenditures relating to medal issuance. Requires the Secretary of the Treasury to deposit all solicited donations into the Numismatic Public Enterprise Fund.,2025-08-26T13:52:02Z,
103-hjres-421,103,hjres,421,"Designating the week of November 6, 1994 through November 12, 1994, ""National Health Information Management Week"".",Health,1994-09-30,1994-09-30,Referred to the House Committee on Post Office and Civil Service.,House,"Rep. Murphy, Austin J. [D-PA-20]",PA,D,M001088,0,"Designates the week of November 6 through 12, 1994, as National Health Information Management Week.",2024-02-06T20:04:02Z,
103-hr-5141,103,hr,5141,Ryan White CARE Reauthorization Act of 1994,Health,1994-09-30,1994-10-17,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Waxman, Henry A. [D-CA-29]",CA,D,W000215,131,"Ryan White CARE Reauthorization Act of 1994 - Amends the Ryan White Comprehensive AIDS Resources Emergency Act of 1990 (title XXVI of the Public Health Service Act) to limit the grant program for emergency relief for areas with substantial need for services to eligible areas with a population of at least 500,000 individuals. Requires an HIV health services planning council (which advises on the distribution of such grants) to be reflective of the demographics of the human immunodeficiency virus (HIV) epidemic in an eligible area, with particular consideration given to disproportionately affected and historically underserved groups. Revises the method of distributing such grants and extends authorized appropriations for them until FY 2000. Revises the care grant program that makes funds available for individuals and families with the HIV disease.  Authorizes the award of supplemental grants to eligible entities to enhance community-based care, treatment, and supportive services through the development and operation of consortia and innovative approaches. Extends authorized appropriations for such grant program through FY 2000. Requires the establishment of grievance procedures to address allegations of egregious violations of title XXVI of the Public Health Service Act. Directs the Secretary of Health and Human Services to coordinate the planning and implementation of Federal HIV programs to facilitate the development of a complete continuum of HIV-related services for individuals with HIV disease and those at risk of such disease. Extends authorized appropriations for early intervention services until FY 2000. Extends authorized appropriations until FY 2000 for grants for coordinated services and access to research for children, youth, women, and families (formerly known as demonstration grants for research and services for pediatric patients regarding acquired immune deficiency syndrome). Makes appropriations available for special projects of the national significance program to award direct grants to public and nonprofit private entities to fund special programs for the care and treatment of individuals with HIV disease.",2025-08-26T13:50:32Z,
103-hr-5147,103,hr,5147,Medicaid Equalization Act of 1994,Health,1994-09-30,1994-10-17,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Hinchey, Maurice D. [D-NY-26]",NY,D,H000627,0,Medicaid Equalization Act of 1994 - Amends title XIX (Medicaid) of the Social Security Act to:  (1) reduce the maximum Federal medical assistance percentage for a State from 83 percent to 60 percent; and (2) increase by 1.2 percentage points the medical assistance percentage for all States.,2025-08-26T13:48:55Z,
103-hr-5153,103,hr,5153,To amend title XVIII of the Social Security Act to provide for an open enrollment period under part B of the medicare program for individuals formerly covered as retirees under group health plans of local educational agencies.,Health,1994-09-30,1994-10-24,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Stark, Fortney Pete [D-CA-13]",CA,D,S000810,0,Amends title XVIII (Medicare) of the Social Security Act to provide a special open enrollment period under part B for certain individuals enrolled in a group health plan by reason of the individual's or the individual's spouse's current or former employment with a local educational agency.,2024-02-07T16:32:33Z,
103-s-2489,103,s,2489,Ryan White CARE Reauthorization Act of 1994,Health,1994-09-30,1994-09-30,Read twice and referred to the Committee on Labor and Human Resources.,Senate,"Sen. Kennedy, Edward M. [D-MA]",MA,D,K000105,63,"Ryan White CARE Reauthorization Act of 1994 - Amends the Ryan White Comprehensive AIDS Resources Emergency Act of 1990 (title XXVI of the Public Health Service Act) to limit the grant program for emergency relief for areas with substantial need for services to eligible areas with a population of at least 500,000 individuals. Requires an HIV health services planning council (which advises on the distribution of such grants) to be reflective of the demographics of the human immunodeficiency virus (HIV) epidemic in an eligible area, with particular consideration given to disproportionately affected and historically underserved groups. Revises the method of distributing such grants and extends authorized appropriations for them until FY 2000. Revises the care grant program that makes funds available for individuals and families with the HIV disease.  Authorizes the award of supplemental grants to eligible entities to enhance community-based care, treatment, and supportive services through the development and operation of consortia and innovative approaches. Extends authorized appropriations for such grant program through FY 2000. Requires the establishment of grievance procedures to address allegations of egregious violations of title XXVI of the Public Health Service Act. Directs the Secretary of Health and Human Services to coordinate the planning and implementation of Federal HIV programs to facilitate the development of a complete continuum of HIV-related services for individuals with HIV disease and those at risk of such disease. Extends authorized appropriations for early intervention services until FY 2000. Extends authorized appropriations until FY 2000 for grants for coordinated services and access to research for children, youth, women, and families (formerly known as demonstration grants for research and services for pediatric patients regarding acquired immune deficiency syndrome). Makes appropriations available for special projects of national significance program to award direct grants to public and nonprofit private entities to fund special programs for the care and treatment of individuals with HIV disease.",2025-08-26T13:52:13Z,
103-hr-5132,103,hr,5132,"To establish a period during which individuals under 65 years of age who are entitled to benefits under part A of the medicare program on the basis of a disability or end state renal disease may enroll under part B of the medicare program in order to meet eligibility requirements for health benefits under the Civilian Health and Medical Program of the Uniformed Services under title 10, United States Code.",Health,1994-09-29,1994-10-17,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Hutchinson, Tim [R-AR-3]",AR,R,H001015,0,Instructs the Secretary of Health and Human Services to establish an open enrollment period for the first quarter of 1995 during which certain individuals under 65 years of age may enroll under Medicare part B (supplementary medical insurance) in order to meet eligibility requirements for health benefits under the Civilian Health and Medical Program of the Uniformed Services.,2024-02-07T16:32:33Z,
103-sjres-225,103,sjres,225,"A joint resolution to designate February 5, 1995, through February 11, 1995, and February 4, 1996, through February 10, 1996, as ""National Burn Awareness Week"".",Health,1994-09-29,1994-11-29,Referred to the House Committee on Post Office and Civil Service.,Senate,"Sen. Reid, Harry [D-NV]",NV,D,R000146,14,"Designates the weeks of February 5 through February 11, 1995, and February 4 through February 10, 1996, each as National Burn Awareness Week.",2025-07-21T19:32:26Z,
103-hjres-418,103,hjres,418,"Designating October 19, 1994, as ""National Mammography Day"".",Health,1994-09-28,1994-09-30,Sponsor introductory remarks on measure. (CR E2012),House,"Rep. Lloyd, Marilyn [D-TN-3]",TN,D,L000381,235,"Designates October 19, 1994, as National Mammography Day.",2024-02-06T20:04:02Z,
103-hr-5119,103,hr,5119,Health Innovation Partnership Act of 1994,Health,1994-09-28,1994-10-26,Referred to the Subcommittee on Labor-Management Relations.,House,"Rep. DeFazio, Peter A. [D-OR-4]",OR,D,D000191,1,"TABLE OF CONTENTS:      Title I:  Health Insurance Reform      Title II:  State Innovation           Subtitle A:  State Waiver Authority           Subtitle B:  Existing State Laws      Title III:  Public Health and Rural and Underserved           Access Improvement      Title IV:  Medical Research      Title V:  Revenue Provisions           Subtitle A:  Financing Provisions           Subtitle B:  Health Care Reform Trust Fund Health Innovation Partnership Act of 1994 - Title I:  Health Insurance Reform - Directs the Secretary of Health and Human Services to request the National Association of Insurance Commissioners (NAIC) to develop standards for health insurance plans with respect to:  (1) the renewability and portability of coverage; (2) guaranteed issue with respect to all health insurance coverage products; (3) the establishment of an adjusted community rating system with adjustment factors limited to age; (4) solvency; (5) stop-loss standards for self-funded health insurance plans and multi-employer welfare arrangements and association plans; (6) the identification of minimum employer size for self- funding and the interrelationship between self-funding and the community-rated pool of enrollees; and (7) other appropriate areas. (Sec. 1001) Requires the Secretary to develop such standards if the NAIC fails to do so. (Sec. 1002) Revises provisions regarding Medicare supplemental policies. Title II:  State Innovation - Subtitle A:  State Waiver Authority - Includes within the objectives of the waiver programs approved under this title:  (1) achieving the goals of increased health coverage and access; (2) containing the annual rate of growth in health care expenditures; (3) ensuring that patients receive high-quality, appropriate health care; and (4) testing alternative reforms. (Sec. 2001) Authorizes States to apply to the Secretary for alternative State health program waivers or limited State health care waivers. Directs the Secretary to establish a State Health Reform Advisory Board to monitor the status and progress achieved under waivers and to promote information exchange between States and the Federal Government.  Requires the Board to make recommendations to the Secretary with respect to minimizing the negative effect of State waivers on national employer groups, provider organizations, and insurers because of differing State requirements under waivers. Permits the Secretary to revoke any waiver of Federal law granted under this subtitle and to terminate any alternative State health program for good cause. Authorizes grants to States for carrying out alternative State health programs.  Grants priority to programs that have the greatest opportunity to succeed in providing expanded coverage and in providing children and youth with access to health care.  Earmarks funds for such grants from the Health Care Reform Trust Fund. Subtitle B:  Existing State Laws - Continues certain existing waivers to Federal law for States and grants specified waivers from requirements of the Employee Retirement Income Security Act of 1974 with respect to health care laws of Hawaii and Oregon. Title III:  Public Health and Rural and Underserved Access Improvement - Public Health and Rural and Underserved Access Improvement Act of 1994 - Amends the Public Health Service Act to authorize appropriations for grants to States for core functions of public health programs.  Includes within such core functions:  (1) data collection and analytical activities related to population-based status and outcomes monitoring; (2) activities to reduce environmental risk and to assure the safety of housing, schools, workplaces, day-care centers, and food and water; (3) investigation, control, and public- awareness activities regarding adverse health conditions; (4) public information and education programs to reduce health risks; (5) public health laboratory services that screen for diseases and conditions; (6) training and education in the field of public health; and (7) leadership, policy development, and administration activities. (Sec. 3002) Authorizes appropriations for grants to States for evaluating the extent to which clinical preventive services, health promotion and unintentional injury prevention activities, and interpersonal and community violence prevention activities achieve health care cost reductions and health status improvement. Directs the Secretary to issue practice guidelines that are based on the results of such evaluations. Authorizes appropriations for:  (1) scholarships and loan repayment programs for individuals attending schools of public health; (2) grants to expand the capacity of certain educational institutions with public health programs; (3) grants to expand public health training programs in States lacking adequate programs; (4) area health education centers and health education training centers; (5) activities regarding centers for the prevention and treatment of poisoning and control of poisons; (6) certain school-related health services; (7) scholarships and loan repayment programs for school nurses; (8) grants to migrant and community health centers; (9) the National Health Service Corps; (10) satellite clinics to provide primary health care; and (11) community health advisor programs. Title IV:  Medical Research - Establishes a National Fund for Health Research in the Treasury. (Sec. 4002) Amends the Internal Revenue Code to designate overpayments of tax or cash contributions to be paid over to the National Fund for Health Research. Title V:  Revenue Provisions - Subtitle A:  Financing Provisions - Increases the excise tax on the following tobacco and tobacco-related products:    (1) cigarettes; (2) cigars; (3) cigarette papers and tubes; and (4) smokeless and pipe tobacco. (Sec. 5001) Imposes a tax on tobacco products and cigarette papers and tubes manufactured or imported into Puerto Rico. Provides a floor stocks tax on tobacco products and cigarette papers and tubes manufactured in or imported into the United States or Puerto Rico which are removed before any tax-increase date and held on such date for sale. Bars a tax on cigarettes held for retail sale on any tax-increase date by any vending machine. Provides a tax credit against floor stocks taxes. Establishes conditions under which articles in foreign trade zones shall be subject to such taxes. (Sec. 5003) Imposes a tax on roll-your-own tobacco manufactured in or imported into the United States. Subtitle B:  Health Care Reform Trust Fund - Establishes the Health Care Reform Trust Fund in the Treasury and provides for the deposit into such Fund of amounts received from taxes on tobacco products.",2026-03-23T12:41:21Z,
103-hr-5104,103,hr,5104,To amend title XIX of the Social Security Act to require each State plan for medical assistance under such title to impose nondiscrimination requirements on hospitals and nursing facilities receiving funds under the plan.,Health,1994-09-26,1994-10-24,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Meek, Carrie P. [D-FL-17]",FL,D,M000628,0,"Amends title XIX (Medicaid) of the Social Security Act to require a State plan for medical assistance to prohibit any hospital or nursing facility receiving plan funds from engaging in conduct (either directly or through contractual arrangements) which would have the effect of discriminating against individuals on specified bases, including anticipated need for health services.",2024-02-05T14:30:09Z,
103-hr-5105,103,hr,5105,To amend title XVIII of the Social Security Act to impose nondiscrimination requirements on hospitals and skilled nursing facilities as a condition of participation in the medicare program.,Health,1994-09-26,1994-10-24,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Meek, Carrie P. [D-FL-17]",FL,D,M000628,0,"Amends title XVIII (Medicare) of the Social Security Act to prohibit a hospital, rural primary care hospital, or skilled nursing facility or nursing facility receiving plan funds from engaging in conduct (either directly or through contractual arrangements) which would have the effect of discriminating against individuals on specified bases, including anticipated need for health services.",2024-02-07T16:32:33Z,
103-s-2460,103,s,2460,A bill to extend for an additional two years the period during which medicare select policies may be issued.,Health,1994-09-26,1994-09-26,Read twice and referred to the Committee on Finance.,Senate,"Sen. Chafee, John H. [R-RI]",RI,R,C000269,20,Amends the Omnibus Budget Reconciliation Act of 1990 to extend from three years to five years the period during which Medicare select policies may be issued.,2025-01-14T18:59:41Z,
103-hr-5087,103,hr,5087,To maintain funding and staffing for the Office of National Drug Control Policy for fiscal year 1995.,Health,1994-09-23,1994-09-28,Referred to the Subcommittee on Legislation and National Security.,House,"Rep. Franks, Gary A. [R-CT-5]",CT,R,F000348,0,Prohibits any funding or staffing reduction for FY 1995 for the Office of National Drug Control Policy.,2025-02-04T16:54:13Z,
103-hr-5093,103,hr,5093,"To amend the Public Health Service Act to provide a 1-year extension of the applicability of certain provisions in the programs for block grants regarding mental health and substance abuse, and for other purposes.",Health,1994-09-23,1994-10-24,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Sanders, Bernard [I-VT-At Large]",VT,I,S000033,0,Amends the Public Health Service Act to provide a one year extension of the applicability to mental health and substance abuse block grant programs of specified provisions regarding transfers between allotments and minimum allotments for States.,2024-02-05T14:30:09Z,
103-hr-5094,103,hr,5094,To provide a 1-year extension of the applicability of the authority to transfer funds under the programs for block grants regarding mental health and substance abuse.,Health,1994-09-23,1994-10-24,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Sanders, Bernard [I-VT-At Large]",VT,I,S000033,0,Amends the Public Health Service Act to provide a one-year extension of the applicability to mental health and substance abuse block grant programs of specified provisions regarding transfers between allotments.,2024-02-05T14:30:09Z,
103-s-2459,103,s,2459,A bill to provide a 1-year extension of the applicability of the authority to transfer funds under the programs for block grants regarding mental health and substance abuse.,Health,1994-09-23,1994-09-23,Read twice and referred to the Committee on Labor and Human Resources.,Senate,"Sen. Jeffords, James M. [R-VT]",VT,R,J000072,1,Amends the Public Health Service Act to provide a one-year extension of the applicability to mental health and substance abuse block grant programs of specified provisions regarding transfers between allotments.,2025-04-21T12:24:17Z,
103-hr-5082,103,hr,5082,To extend for an additional two years the period during which medicare select policies may be issued.,Health,1994-09-22,1994-10-03,"Referred to the Subcommittee on Commerce, Consumer Protection and Competitiveness.",House,"Rep. Johnson, Nancy L. [R-CT-6]",CT,R,J000163,229,Amends the Omnibus Budget Reconciliation Act of 1990 to extend from three years to five years the period during which Medicare select policies may be issued.,2024-02-07T16:32:33Z,
103-hr-5083,103,hr,5083,Women's Health Regional Centers Act,Health,1994-09-22,1994-10-24,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Margolies-Mezvinsky, Marjorie [D-PA-13]",PA,D,M000129,8,"Women's Health Regional Centers Act - Amends the Public Health Service Act to require the Director of the National Institutes of Health to make grants to, or enter into contracts with, public or nonprofit private entities for the development and operation of centers to carry out specified activities regarding women's health conditions. Requires the Director to provide for the development of five centers and to ensure that such a center is developed in each of the principal geographic regions of the United States. Directs each center to:  (1) conduct basic, clinical, and applied research and training programs for health professionals and scientists; (2) devleop curricula and model continuing education programs for training health professionals and scientists and model programs for the delivery of health services to women; (3) disseminate information to health professionals, scientists, and the public; and (4) develop, in the case of women who are in the medical profession, model programs for training such women in the skills necessary for achieving positions of leadership in such schools and in academic health centers. Sets forth provisions regarding:  (1) coordination of information; (2) structure of centers; (3) duration of support; and (4) limits on support. Authorizes appropriations.",2025-08-26T13:52:28Z,
103-s-2452,103,s,2452,Health Innovation Partnership Act of 1994,Health,1994-09-22,1994-09-22,Introduced in the Senate. Read the first time. Placed on Senate Legislative Calendar under Read the First Time.,Senate,"Sen. Graham, Bob [D-FL]",FL,D,G000352,2,"TABLE OF CONTENTS:      Title I:  Health Insurance Reform      Title II:  State Innovation           Subtitle A:  State Waiver Authority           Subtitle B:  Existing State Laws      Title III:  Public Health and Rural and Underserved Access Improvement      Title IV:  Medical Research      Title V:  Revenue Provisions           Subtitle A:  Financing Provisions           Subtitle B:  Health Care Reform Trust Fund Health Innovation Partnership Act of 1994 - Title I:  Health Insurance Reform - Directs the Secretary of Health and Human Services to request the National Association of Insurance Commissioners (NAIC) to develop standards for health insurance plans with respect to:  (1) the renewability and portability of coverage; (2) guaranteed issue with respect to all health insurance coverage products; (3) the establishment of an adjusted community rating system with adjustment factors limited to age; (4) solvency; (5) stop-loss standards for self-funded health insurance plans and multi-employer welfare arrangements and association plans; (6) the identification of minimum employer size for self-funding and the interrelationship between self-funding and the community-rated pool of enrollees; and (7) other appropriate areas. (Sec. 1001) Requires the Secretary to develop such standards if the NAIC fails to do so. (Sec. 1002) Revises provisions regarding Medicare supplemental policies. Title II:  State Innovation - Subtitle A:  State Waiver Authority - Includes within the objectives of the waiver programs approved under this title:  (1) achieving the goals of increased health coverage and access; (2) containing the annual rate of growth in health care expenditures; (3) ensuring that patients receive high-quality, appropriate health care; and (4) testing alternative reforms. (Sec. 2001) Authorizes States to apply to the Secretary for alternative State health program waivers or limited State health care waivers. Directs the Secretary to establish a State Health Reform Advisory Board to monitor the status and progress achieved under waivers and to promote information exchange between States and the Federal Government.  Requires the Board to make recommendations to the Secretary with respect to minimizing the negative effect of State waivers on national employer groups, provider organizations, and insurers because of differing State requirements under waivers. Permits the Secretary to revoke any waiver of Federal law granted under this subtitle and to terminate any alternative State health program for good cause. Authorizes grants to States for carrying out alternative State health programs.  Grants priority to programs that have the greatest opportunity to succeed in providing expanded coverage and in providing children and youth with access to health care.  Earmarks funds for such grants from the Health Care Reform Trust Fund. Subtitle B:  Existing State Laws - Continues certain existing waivers to Federal law for States and grants specified waivers from requirements of the Employee Retirement Income Security Act of 1974 with respect to health care laws of Hawaii, Oregon, Minnesota, Washington, and Connecticut. Title III:  Public Health and Rural and Underserved Access Improvement - Public Health and Rural and Underserved Access Improvement Act of 1994 - Amends the Public Health Service Act to authorize appropriations for grants to States for core functions of public health programs.  Includes within such core functions:  (1) data collection and analytical activities related to population-based status and outcomes monitoring; (2) activities to reduce environmental risk and to assure the safety of housing, schools, workplaces, day-care centers, and food and water; (3) investigation, control, and public-awareness activities regarding adverse health conditions; (4) public information and education programs to reduce health risks; (5) public health laboratory services that screen for diseases and conditions; (6) training and education in the field of public health; and (7) leadership, policy development, and administration activities. (Sec. 3002) Authorizes appropriations for grants to States for evaluating the extent to which clinical preventive services, health promotion and unintentional injury prevention activities, and interpersonal and community violence prevention activities achieve health care cost reductions and health status improvement. Directs the Secretary to issue practice guidelines that are based on the results of such evaluations. Authorizes appropriations for:  (1) scholarships and loan repayment programs for individuals attending schools of public health; (2) grants to expand the capacity of certain educational institutions with public health programs; (3) grants to expand public health training programs in States lacking adequate programs; (4) area health education centers and health education training centers; (5) activities regarding centers for the prevention and treatment of poisoning and control of poisons; (6) certain school-related health services; (7) grants to migrant and community health centers; (8) the National Health Service Corps; (9) satellite clinics to provide primary health care; and (10) community health advisor programs. Title IV:  Medical Research - Establishes a National Fund for Health Research in the Treasury. (Sec. 4002) Amends the Internal Revenue Code to designate overpayments of tax or cash contributions to be paid over to the National Fund for Health Research. Title V:  Revenue Provisions - Subtitle A:  Financing Provisions - Increases the excise tax on the following tobacco and tobacco-related products:    (1) cigarettes; (2) cigars; (3) cigarette papers and tubes; and (4) smokeless and pipe tobacco. (Sec. 5001) Imposes a tax on tobacco products and cigarette papers and tubes manufactured or imported into Puerto Rico. Provides a floor stocks tax on tobacco products and cigarette papers and tubes manufactured in or imported into the United States or Puerto Rico which are removed before any tax-increase date and held on such date for sale. Bars a tax on cigarettes held for retail sale on any tax-increase date by any vending machine. Provides a tax credit against floor stocks taxes. Establishes conditions under which articles in foreign trade zones shall be subject to such taxes. (Sec. 5003) Imposes a tax on roll-your-own tobacco manufactured in or imported into the United States. Subtitle B:  Health Care Reform Trust Fund - Establishes the Health Care Reform Trust Fund in the Treasury and provides for the deposit into such Fund of amounts received from taxes on tobacco products.",2025-08-26T13:50:33Z,
103-hres-538,103,hres,538,Expressing the sense of the House of Representatives that communities should establish multidisciplinary team approaches to treat children who suffer from sickle cell disease.,Health,1994-09-21,1994-10-03,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Cramer, Robert E. (Bud), Jr. [D-AL-5]",AL,D,C000868,0,"Expresses the sense of the House of Representatives that:  (1) communities should establish multidisciplinary team approaches to treat effectively children with sickle cell disease; and (2) such approaches should incorporate the early administration of prophylactic penicillin to infants with sickle cell anemia, patient enrichment programs, educational programs, counseling programs for children and their families, and screening programs.",2024-02-05T14:30:09Z,
103-s-2449,103,s,2449,"A bill to modify the estate recovery provisions of the medicaid program to give States the option to recover the costs of home and community-based services for individuals over age 55, and for other purposes.",Health,1994-09-21,1994-09-21,Read twice and referred to the Committee on Finance.,Senate,"Sen. Feingold, Russell D. [D-WI]",WI,D,F000061,0,"Amends title XIX (Medicaid) of the Social Security Act to change from mandatory to discretionary a State's authority to seek recovery or adjustment of the costs of home and community-based services from the estates of individuals over age 55. Requires a State to issue a certificate of need as a prerequisite to reimbursement of a nursing facility by Medicare, Medicaid, or any other Federal program with respect to any beds first operated on or after enactment of this Act.  Specifies restrictions on the geographic areas for which such a certificate may be issued.",2025-01-14T18:59:41Z,
103-sjres-220,103,sjres,220,"A joint resolution to designate October 19, 1994, as ""National Mammography Day"".",Health,1994-09-21,1994-10-18,Became Public Law No: 103-370.,Senate,"Sen. Biden, Joseph R., Jr. [D-DE]",DE,D,B000444,56,"Designates October 19, 1994, as National Mammography Day.",2025-07-21T19:32:26Z,
103-hjres-410,103,hjres,410,"To authorize the President to issue a proclamation designating October 1994 as ""National Spina Bifida Prevention Month"".",Health,1994-09-20,1994-09-20,Referred to the House Committee on Post Office and Civil Service.,House,"Rep. Brewster, Bill K. [D-OK-3]",OK,D,B000817,2,Designates October 1994 as National Spina Bifida Month.,2024-02-06T20:04:02Z,
103-hr-5056,103,hr,5056,Animal Drug Amendments of 1994,Health,1994-09-19,1994-10-07,See S.340.,House,"Rep. Stenholm, Charles W. [D-TX-17]",TX,D,S000851,3,"Animal Drug Amendments of 1994 - Amends the Federal Food, Drug, and Cosmetic Act to permit the extra-label use of drugs in animals if an approval of an application is in effect with respect to a particular use or intended use of a new animal drug and such use is upon the order of a licensed veterinarian within the context of a veterinarian-client-patient relationship and is in compliance with regulations that establish the conditions for such use. Authorizes the Secretary of Health and Human Services, if the Secretary finds that there is a reasonable probability that such use may present a risk to the public health, to establish a safe level for a residue of an animal drug when used for such different use and require the development of a practical, analytical method for the detection of residues of the drug above the safe level established.  Prohibits such use if it results in residues exceeding the safe level.",2025-08-26T13:50:40Z,
103-s-2440,103,s,2440,Prospective Payment System for Nursing Facilities,Health,1994-09-19,1994-09-19,Read twice and referred to the Committee on Finance.,Senate,"Sen. Pryor, David H. [D-AR]",AR,D,P000556,0,"Prospective Payment System for Nursing Facilities - Makes this Act applicable to the payment for services of nursing facilities under federally funded long-term care programs. (Sec. 102)  Sets forth as payment objectives to:  (1) maintain an equitable and fair balance between cost containment and quality of care in nursing facilities; (2) maintain administrative simplicity for such facilities and the Secretary of Health and Human Services; (3) encourage nursing facilities to admit residents without regard to their source of payment; (4) encourage investment in buildings and improvements to nursing facilities as necessary to maintain quality and access; and (5) provide an incentive to nursing facilities to admit and provide care to persons in need of comparatively greater care. (Sec. 103)  Sets forth provisions regarding:  (1) powers and duties of the Secretary; and (2) the relationship of this Act to title XVIII (Medicare) of the Social Security Act. (Sec. 105)  Directs the Secretary to:  (1) establish a system which groups residents into classes according to similarity of their assessed condition and required services; (2) assign relative weights for resident classes based on the relative value of the resources required for each resident class, performed for each geographic region; and (3) designate no fewer than eight geographic regions. (Sec. 106)  Requires the Secretary to determine payment rates for nursing facilities using the following cost-service groupings:  (1) nursing service costs; (2) administrative and general costs; (3) fee-for-service ancillary services; (4) selected ancillary services and other costs; and (5) property costs. Directs that nursing facilities be:  (1) paid a prospective, facility-specific, per diem rate based on the sum of the per diem rates established for the nursing service, administrative and general, and property cost centers and a facility-specific prospective rate for each unit of the fee-for-service ancillary services; and (2) reimbursed for selected ancillary services and other costs on a retrospective basis. (Sec. 107) Requires the nursing facility to perform periodic resident assessments to determine the resident class of each resident in the facility. (Sec. 108)  Sets forth provisions regarding:  (1) determination of the per diem rates for nursing service, administrative and general, and property costs; (2) payment for fee-for-service ancillary services; (3) reimbursement of selected ancillary services and other costs; (4) mid-year rate adjustments; and (5) exceptions to payment methods for new and low volume nursing facilities. (Sec. 114)  Grants any person or legal entity aggrieved by a decision of the Secretary under this Act, which results in an amount in controversy of $10,000 or more, the right to appeal directly to the Provider Reimbursement Review Board.",2025-08-26T13:49:30Z,
103-hjres-409,103,hjres,409,"Designating October 23, 1994, through October 31, 1994, as ""National Red Ribbon Week for a Drug-Free America"".",Health,1994-09-13,1994-09-13,Referred to the House Committee on Post Office and Civil Service.,House,"Rep. Talent, Jim [R-MO-2]",MO,R,T000024,3,"Designates the week of October 23 through 31, 1994, as National Red Ribbon Week for a Drug-Free America.",2024-02-06T20:04:02Z,
103-hr-5037,103,hr,5037,Bipartisan Health Care Reform Commission Act of 1994,Health,1994-09-13,1994-10-05,Referred to the Subcommittee on Labor-Management Relations.,House,"Rep. Gekas, George W. [R-PA-17]",PA,R,G000121,2,"Bipartisan Health Care Reform Commission Act of 1994 - Establishes an independent Bipartisan Health Care Reform Commission to:  (1) conduct an analysis of the health care systems of the States, as well as proposed or enacted reforms of such systems, and of the problems relating to Federal programs and policies relating to health care; (2) analyze private sector health systems; and (3) make recommendations on reforms that the Congress should consider in response to the findings of the analyses. Directs the Commission to:  (1) hold at least five public hearings; and (2) report to the Congress on the state of health care in the United States. Sets forth provisions regarding procedures for congressional consideration of any recommendations of the Commission and review of any bill proposed by the Commission or an appropriate committee by the Director of the Congressional Budget Office.",2026-03-23T12:41:21Z,
103-hres-530,103,hres,530,Providing that the House should not consider health care legislation in violation of section 252 of the Balanced Budget and Emergency Deficit Control Act of 1985 or any health care legislation that amends or supercedes that section.,Health,1994-09-13,1994-09-13,Referred to the House Committee on Rules.,House,"Rep. Miller, Dan [R-FL-13]",FL,R,M000720,33,"Declares that no health care legislation should be considered by the House of Representatives that would cause a sequestration under the Balanced Budget and Emergency Deficit Control Act of 1985 (Gramm-Rudman-Hollings), or that would amend or supercede a sequestration.",2024-02-07T14:47:33Z,
103-s-2433,103,s,2433,Nursing Education Consolidation and Reauthorization Act of 1994,Health,1994-09-13,1994-10-07,Referred to the House Committee on Energy and Commerce.,Senate,"Sen. Kennedy, Edward M. [D-MA]",MA,D,K000105,1,"Nursing Education Consolidation and Reauthorization Act of 1994 - Amends the Public Health Service Act to revise provisions regarding the general student loan program for nursing education. Makes individuals who breach agreements for obligated service by failing to maintain an acceptable level of academic standing, by being dismissed for disciplinary reasons, by voluntarily terminating the program, or by failing to provide health services under the program for the applicable period, liable for the amount of the award, including amounts provided for expenses related to such attendance, and interest at the maximum legal prevailing rate.  Waives or suspends such liability under specified circumstances. Sets forth provisions regarding:  (1) application requirements, including a plan for carrying out a project, performance standards, and linkages with relevant educational and health care entities; (2) use of funds; (3) matching requirements; (4) preferences; (5) grant and contract awards; (6) information requirements; (7) training program requirements; (8) duration of assistance; and (9) peer review. Establishes a National Advisory Council on Nurse Education and Practice. Permits funds appropriated under the Act to be used by the Secretary to provide technical assistance. Provides for the recovery of construction assistance by the Secretary if specified conditions are not met.  Specifies that the right of recovery of the United States shall not, prior to judgment, constitute a lien on any facility. Authorizes the Secretary to award grants to, and enter into contracts with, eligible entities to meet the costs of:  (1) projects that support the enhancement of advanced practice nursing education, including assistance to individuals in combined Registered Nurse- Master's degree programs; and (2) traineeships for individuals in advanced practice nursing programs. Specifies that nurse practitioner and nurse midwifery programs eligible for support are educational programs for registered nurses that meet specified guidelines and that have as their objective the education of nurses who will upon completion of their studies be qualified to effectively provide primary health care. Authorizes appropriations. Authorizes the Secretary to award grants to, and enter into contracts with, eligible entities:  (1) to meet the costs of special projects to increase nursing education opportunities for individuals who are from disadvantaged racial and ethnic backgrounds underrepresented among registered nurses by providing student scholarships or stipends, pre-entry preparation, and retention activities; and (2) for projects to strengthen capacity for basic nurse education and practice.  Authorizes appropriations.",2025-04-21T12:24:17Z,
103-hr-4988,103,hr,4988,To provide for a four year demonstration project under Medicare which shall establish a preventive health care screening examination program.,Health,1994-08-18,1994-08-23,Referred to the Subcommittee on Health.,House,"Rep. Regula, Ralph [R-OH-16]",OH,R,R000141,1,"Amends title XVIII (Medicare) of the Social Security Act to cover preventive health care examinations for colon and prostate cancer and osteoporosis. Directs the Secretary of Health and Human Services to establish a demonstration project to test the cost-effectiveness of furnishing colon, prostate, and uterine cancer preventive screening examinations to a sample group of Medicare beneficiaries.",2024-02-07T16:32:33Z,
103-hr-4970,103,hr,4970,To amend vaccine injury compensation portion of the Public Health Service Act to permit a petition for compensation to be submitted within 48 months of the first symptoms of injury.,Health,1994-08-16,1994-08-30,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Solomon, Gerald B. H. [R-NY-22]",NY,R,S000675,0,"Amends the Public Health Service Act to permit a petition for vaccine injury compensation to be submitted within 48 (currently, 36) months of the first symptom or manifestation of onset, or of the significant aggravation, of injury.",2024-02-05T14:30:09Z,
103-s-2396,103,s,2396,Affordable Health Care Now Act of 1994,Health,1994-08-16,1994-08-18,Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 579.,Senate,"Sen. Lott, Trent [R-MS]",MS,R,L000447,0,"TABLE OF CONTENTS:      Title I:  Improved Access to Affordable Health Care           Subtitle A:  Increased Availability and Continuity of                Health Coverage for Individuals and Their Families           Subtitle B:  Reform of Health Insurance           Subtitle C:  Preemption              Subtitle D:  Health Deduction Fairness           Subtitle E:  Improved Access to Community Health                Services           Subtitle F:  Improved Access to Rural Health Services           Subtitle G:  Assistance in Enrolling Uninsured Children                in Health Insurance           Subtitle H:  Medicaid Reform           Subtitle I:  Remedies and Enforcement with Respect to                Group Health Plans           Subtitle J:  Delivery of Health Care Services to Illegal                Immigrants      Title II:  Health Care Cost Containment and Quality           Enhancement           Subtitle A:  Medical Malpractice Liability Reform           Subtitle B:  Administrative Cost Savings and Fair Health                Information Practices           Subtitle C:  Deduction for Cost of Catastrophic Health                Plan; Medical Savings Accounts           Subtitle D:  Anti-Fraud           Subtitle E:  Increased Medicare Beneficiary Choice;                Additional Medicare Reforms           Subtitle F:  Health Care Antitrust Improvements           Subtitle G:  Encouraging Enforcement Activities of                Medical Self-Regulatory Entities           Subtitle H:  Reform of Clinical Laboratory Requirements                for Simple Tests           Subtitle I:  Miscellaneous Provisions      Title III:  Long-Term Care           Subtitle A:  Tax Treatment of Long-Term Care Insurance           Subtitle B:  Establishment of Federal Standards for                Long-Term Care Insurance           Subtitle C:  Protection of Assets Under Medicaid Through                Use of Qualified Long-term Care Insurance           Subtitle D:  Studies           Subtitle E:  Volunteer Service Credit Demonstration                Projects Affordable Health Care Now Act of 1994 - Title I:  Improved Access to Affordable Health Care - Subtitle A:  Increased Availability and Continuity of Health Coverage for Individuals and Their Families - Part 1:  Required Coverage Options for Eligible Employees, Spouses, and Dependents - Requires each employer to make available to each eligible employee a group health plan under which: (1) coverage of each eligible individual with respect to such employee may be elected on an annual basis; (2) coverage is provided for at least the required coverage specified; and (3) employees may elect to have premiums collected through payroll deduction.  Does not require employer contributions to the cost of coverage under such a plan. Provides for the exclusion of:  (1) employers who have been employers for less than two years or who have no more than two eligible employees or no more than two eligible employees not covered under any group health plan; and (2) family members under specified circumstances.  Specifies that a group health plan shall not be treated as failing to meet the requirements of this Act solely because a period of service by an eligible employee of not more than 60 days is required for coverage. Specifies that the required coverage is standard coverage, except that in the case of a small employer that has not contributed during the previous plan year to the cost of coverage for any eligible employee under any group health plan, the required coverage for the plan year is coverage under a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan.  Requires standard coverage to include at least one option, either a fee-for-service option and if available, a point-of-service option and a managed care option. Provides for a five-year transition for existing group health plans. Part 2:  Portability and Nondiscrimination - Prohibits a group health plan from imposing (and an insurer from requiring an employer from imposing through a waiting period for coverage under a plan or similar requirement) a limitation or exclusion of benefits relating to treatment of a preexisting condition if:  (1) the condition relates to a condition that was not diagnosed or treated within three months before the date of coverage under the plan; (2) the limitation or exclusion extends over more than six months after the date of coverage, applies to an individual who, as of the date of birth, was covered under the plan, or relates to pregnancy; or (3) an eligible individual has such coverage at the time the individual first became eligible.  Specifies that, in the case of an individual who is eligible for coverage under a plan but for a waiting period imposed by the employer, the individual shall be treated as having been covered under the plan as of the earliest date of the beginning of the waiting period.  Provides a one-time amnesty period for pre-existing condition exclusions. (Sec. 1012) Requires each group health plan to waive any period applicable to a preexisting condition for similar benefits with respect to an individual to the extent that the individual, prior to enrollment in such plan, was covered for the condition under any other health plan. (Sec. 1013) Prohibits:  (1) a multiemployer plan and an exempted multiple employer health plan from canceling or denying renewal of coverage under such a plan for an employer other than for nonpayment of contributions, fraud or other misrepresentation, noncompliance with plan provisions, or because the plan is ceasing to provide any coverage in a geographic area; (2) an insurer from canceling a health insurance plan or denying renewal of coverage other than as prescribed above; and (3) an insurer who terminates the offering of health insurance plans in an area from offering such a plan to any employer in the area until five years after the date of the termination. Part 3:  Standards for Managed Care Arrangements and Essential Community Providers - Sets forth requirements for group health plans and insurers that provide health care coverage through managed care arrangements.  Requires such arrangements to assure that covered individuals have reasonably prompt access through the entity's provider network to the benefits package and to centers of excellence. (Sec. 1022) Requires the Secretary of Health and Human Services (Secretary) to establish standards for utilization review programs and periodically review and update such standards to reflect changes in the delivery of health care services. Part 4:  Enforcement; Effective Dates; Definitions - Makes provisions of the Employee Retirement Income Security Act of 1974 applicable with respect to enforcement of this Act (by the Department of Labor). Amends the Internal Revenue Code (Code) to impose a tax ($100 per day for each individual involved, subject to specified limitations) on the failure of an insurer to comply with the requirements under part 2, unless the Secretary determines that the State has in effect a regulatory enforcement mechanism that provides adequate sanctions. Subtitle B:  Reform of Health Insurance - Part I:  Marketplace for Small Business - Requires each insurer that makes available a health insurance plan to a small employer in a State to make available to each small employer in the State a MedAccess standard, MedAccess catastrophic, and MedAccess medisave plan, with exceptions for health maintenance organizations (HMOs) and if a State provides for guaranteed availability (rather than guaranteed issue). Requires each insurer that offers a MedAccess plan to a small employer in a State to accept:  (1) every small employer in the State that applies for coverage; and (2) every eligible individual who applies for enrollment on a timely basis.  Sets forth provisions regarding:  (1) special rules for HMOs; (2) timely enrollment requirements; and (3) enrollment of spouses and dependents.  Makes such requirements inapplicable in a State that has provided (in accordance with specified standards) a mechanism under which each insurer offering a health insurance plan to a small employer in the State must participate in a program for assigning high-risk small employer groups (or individuals within such a group) among some or all such insurers, if the insurers comply. (Sec. 1102) Defines ""MedAccess coverage"" as a health insurance plan that:  (1) is designed to provide standard coverage with substantial cost-sharing, only catastrophic coverage, or medisave coverage; (2) includes only essential and medically necessary services; (3) meets applicable requirements relating to guaranteed issue; and (4) meets specifies consumer protection standards.  Defines ""MedAccess standard coverage,"" ""MedAccess catastrophic coverage,"" and ""MedAccess medisave coverage"" to mean a MedAccess plan that provides for at least standard coverage, for only catastrophic coverage, or medisave coverage, respectively. Requests the National Association of Insurance Commissioners (NAIC) to submit to the Secretary a set of rules which is sufficient for determining the actuarial value of coverage offered by a plan. Directs the Secretary to certify such set of rules for use under this subtitle if they meet such requirements or establish such a set of rules. Specifies that a health insurance plan is considered to provide: (1) standard coverage if the benefits are determined, in accordance with certified rules of actuarial equivalence, to have a value that is within five percentage points of an established target actuarial value for standard coverage; (2) catastrophic coverage if benefits are available under the plan for a year only to the extent that expenses for covered services in a year exceed a deductible amount that is consistent with a specified requirement for a catastrophic health plan under the Code, and are determined, in accordance with certified actuarial equivalence rules, to have a value that is within five percentage points of an established target actuarial value for catastrophic coverage; and (3) medisave coverage if such plan consists of a catastrophic health plan within the meaning of the Code and a medical savings account.  Requests NAIC to submit to the Secretary target actuarial values for standard and catastrophic coverage. Permits NAIC to submit periodic revisions of, and permits the Secretary to revise, the set of rules of actuarial equivalence and target actuarial values where necessary to take into account changes in the relevant types of health benefits provisions, in deductible levels for catastrophic coverage, or in relevant demographic conditions. (Sec. 1103) Directs the Secretary to request NAIC to develop model regulations that specify standards with respect to requirements:  (1) that insurers make available MedAccess plans; (2) of guaranteed availability of MedAccess plans to small employers; (3) relating to limits on premiums and certain consumer protections; and (4) relating to limitation of annual premium increases.  Requires the Secretary to review such standards and, if NAIC fails to specify standards meeting such requirements, to promulgate standards.  Sets forth provisions regarding:  (1) the application of MedAccess standards and consumer protection standards by the States; and (2) the Federal role. (Sec. 1104) Sets forth provisions:  (1) regarding limits on premium rate variations, including discounts for employer wellness programs; and (2) requiring an insurer, at the time of offering a health insurance plan to a small employer, to fully disclose rating practices for health insurance plans, including rating practices for different populations and benefit designs. (Sec. 1105) Requires the Secretary of Labor to monitor the prevalence and impact of adverse risk selection in the full insured plans made available to small employers resulting from the decision of small employers to self-insure. (Sec. 1106) Directs the Secretary to:  (1) request NAIC to develop models for reinsurance or allocation of risk mechanisms for health insurance plans made available to small employers for whom an insurer is at risk of incurring high costs under the plan; and (2) review such models or specify models.  Sets forth provisions regarding implementation of reinsurance or allocation of risk mechanisms by the States and the Federal role. Part 2:  Marketplace for Individuals - Makes the provisions of Part 1 applicable to insurers offering health insurance coverage to individuals and their dependents. Part 3:  Voluntary Health Purchasing Arrangements - Provides for the establishment of voluntary health purchasing arrangements. (Sec. 1124) Requires such arrangements to offer enrollment in health insurance coverage only to:  (1) all eligible employees employed by small employers in a service area; and (2) all eligible individuals residing in such area. Part 4:  Definitions and Miscellaneous Provisions - Provides definitions for purposes of this subtitle. (Sec. 1134) Requires the Secretary to make annual reports to the Congress on the implementation of this subtitle and the need for additional reforms to assure and expand coverage. (Sec. 1135) Authorizes the Director to conduct:  (1) research on the impact of this subtitle on the availability of affordable health coverage for employees and dependents in the small employers group health care coverage market and other specified topics; and (2) demonstration projects relating to such topics.  Requires the Director to develop:  (1) methods for measuring the relative health risks of eligible individuals in terms of the expected costs of providing benefits under health insurance plans and, in particular, MedAccess plans; and (2) a model for equitably distributing health risks among insurers in the small employer health care coverage market.  Authorizes appropriations. Subtitle C:  Preemption - Part 1:  Scope of State Regulation - Makes inapplicable to a group health plan any State or local law requiring coverage of specific benefits, services, or categories of health care, or services of any class or type of provider of health care. (Sec. 1202) Makes inapplicable any State or local law prohibiting two or more employers from obtaining coverage under a multiple employer welfare arrangement under which all coverage:  (1) consists of medical care described under specified provisions of the Employee Retirement Income Security Act of 1974 (ERISA); and (2) is fully insured. (Sec. 1203) Preempts, for a five-year period, State law provisions which restrict:  (1) reimbursement rates or selective contracting; (2) differential financing incentives; and (3) utilization review methods.  Directs the Comptroller General to study benefits and cost effectiveness of use of managed care in health services delivery and to report to the Congress, including recommendations as to whether such preemption should be extended. Part 2:  Multiple Employer Health Benefits Protections - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to provide a limited exemption from certain restrictions on ERISA preemption of State law for health plans maintained by multiple employers subject to certain Federal standards. Relieves such exempted multiple employer health plans of certain restrictions on preemption of State law, and treats them as employee welfare benefit plans. Sets forth exemption procedures, application and eligibility requirements, and additional notice, reporting, and actuarial requirements applicable to exempted multiple employer health plans. Requires multiple employer welfare arrangements providing certain medical care benefits to issue specified disclosures to participating employers. Requires each multiple employer welfare arrangement which is or has been an exempted multiple employer health plan, and under which coverage is not fully insured, to establish certain minimum reserves. Authorizes the Secretary of Labor to permit alternative means of compliance. Sets forth corrective actions, including actions to avoid depletion of reserves and actions in connection with termination of arrangements. Provides for expirations, renewals, suspensions, and revocations of exemptions.  Provides for review of actions of the Secretary, including denials of applications and suspensions or revocations of exemptions.  Provides for alternative means of distribution of summary plan descriptions. (Sec. 1212) Revises provisions relating to scope of preemption rules, treatment of single employer arrangements, and treatment of certain collectively bargained arrangements. (Sec. 1215) Sets forth special rules for employee leasing healthcare arrangements, providing that they be treated as multiple employer welfare arrangements. (Sec. 1216) Sets forth enforcement provisions relating to multiple employer welfare arrangements and employee leasing healthcare arrangements, including enforcement of filing requirements, actions by States in Federal court, criminal penalties for certain willful misrepresentations, cease activities orders, and responsibility for claims procedures. (Sec. 1217) Sets forth solvency requirements for certain self- insured group health plans. (Sec. 1218) Sets forth filing requirements for multiple employer welfare arrangements providing health benefits. (Sec. 1219) Provides for cooperation between Federal and State authorities, including:  (1) agreements for State enforcement of ERISA provisions applicable to multiple employer welfare arrangements which are or have been exempted multiple employer health plans; and (2) enforcement and technical assistance to States with respect to issues involving multiple employer welfare arrangements. (Sec. 1220) Sets forth transitional rules. Part 3:  Encouragement of Multiple Employer Arrangements Providing Basic Health Benefits - Amends the Internal Revenue Code to eliminate the commonality of interest or geographic location requirement for tax-exempt trust status in the case of determining whether any multiple employer health plan or insured multiple employer health plan is a voluntary employees' beneficiary association meeting certain requirements, if:  (1) such plan provides at least standard coverage consistent with specified provisions of this Act (the Affordable Health Care Now Act of 1994); and (2) in the case of such an insured plan, it meets specified ERISA requirements not preempted by this Act. (Sec. 1222) Amends ERISA to direct the Secretary of Labor to prescribe an alternative method for the filing of a single annual report with respect to all employers participating under a multiple employer welfare arrangement under which all coverage consists of medical care and is fully insured. (Sec. 1223) Sets forth provisions for determining compliance with coverage requirements through multiple employer health arrangements. Subtitle D:  Health Deduction Fairness - Amends the Internal Revenue Code to provide for:  (1) a permanent extension and an increase in the health insurance tax deduction for self-employed individuals; and (2) a deduction of health insurance premiums for certain previously uninsured individuals. Subtitle E:  Improved Access to Community Health Services - Part 1:  Increased Authorization for Community and Migrant Health Centers - Directs the Secretary to provide for grants to migrant and community health centers to promote primary health care services for underserved individuals.  Allows grants to be used to promote the provision of off-site services, to improve birth outcomes in areas with high infant mortality and morbidity, to establish primary care clinics in areas in need, and for recruitment and training costs of necessary providers and operating costs for unreimbursed services. Authorizes appropriations.  Directs the Secretary to conduct a study of the impact of such grants on access to health care, birth outcomes, and the use of emergency room services. Part 2:  Grants for Projects for Coordinating Delivery of Services - Amends the Public Health Service Act to authorize the Secretary to make grants to public and nonprofit private entities: (1) to carry out demonstration projects to increase access to outpatient primary health services in specified geographic areas (i.e., areas that are rational areas for the delivery of health services, have a population of not more than 500,000 individuals, and have been designated by the Secretary as areas with a shortage of personal health services or that have a significant number of individuals with low incomes or insufficient health care insurance) through coordinating the delivery of services under Federal, State, local, and private programs; and (2) for developing plans to carry out such projects.  Authorizes appropriations. Part 3:  Community Health Networks - Sets forth qualifications for community health network arrangements. Subtitle F:  Improved Access to Rural Health Services - Part 1:  Establishment of Rural Emergency Access Care Hospitals Under Medicare - Amends title XVIII (Medicare) of the Social Security Act (SSA) to provide for:  (1) establishment of rural emergency access care hospitals under Medicare; and (2) coverage of and payment for rural emergency access care hospital services under Medicare part B (Supplementary Medical Insurance). Part 2:  Rural Medical Emergencies Air Transport - Amends the Public Health Service Act to direct the Secretary to make grants to States to assist in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments.  Sets forth provisions regarding:  (1) application and State plan requirements; (2) considerations in awarding grants; (3) State administration and use of grants; (4) the number of grants; and (5) reporting requirements.   Authorizes appropriations. Part 3:  Emergency Medical Services Amendments - Amends the Public Health Service Act to direct the Secretary to:  (1) establish an Office of Emergency Medical Services, headed by a Director; (2) engage in specified emergency medical services activities, including disseminating information obtained in carrying out specified activities to public and private entities, providing technical assistance to State and local agencies, coordinating Department of Health and Human Services (DHHS) activities with those of other Federal agencies; and (3) ensure that such activities are carried out consistent with certain requirements regarding maintaining an adequate number of health professionals with expertise in the provision of services, developing, periodically reviewing, and revising as appropriate guidelines for the provision of such services, appropriately using available technologies, and serving the unique needs of underserved inner-city and rural areas. (Sec. 1522) Authorizes the Secretary to make grants to States for the purpose of improving the availability and quality of emergency medical services through the operation of State offices of emergency medical services, subject to specified matching fund, budgetary, and other requirements. (Sec. 1523) Provides for demonstration projects to establish telecommunications between rural medical facilities and medical facilities with expertise or equipment.  Directs the Secretary to ensure that the telecommunications technologies demonstrated include interactive video telecommunications, static video imaging transmitted through the telephone system, and facsimiles transmitted through such system. (Sec. 1524) Authorizes appropriations for:  (1) emergency medical services (including for State offices of Emergency Medical Services and for telecommunications demonstrations); and (2) trauma care and certain other activities. Part 4:  Additional Rural Health Care Provisions - Authorizes the Secretary to make grants to public and nonprofit private entities to develop health plans to provide services exclusively in rural and frontier areas.  Authorizes appropriations. (Sec. 1532) Authorizes the Secretary to make grants to public and nonprofit private hospitals in medically underserved rural communities, and to public and nonprofit outpatient facilities in such communities, to develop or increase capacity to provide primary health services. (Sec. 1533) Authorizes the Secretary to make grants to such entities to conduct research and carry out demonstration projects to develop innovative approaches to the delivery of health care in rural areas, such as the use of telemedicine and mobile delivery units. (Sec. 1534) Authorizes appropriations for the training of rural health professionals other than physicians. Subtitle G:  Assistance in Enrolling Uninsured Children in Health Insurance - Amends title XIX (Medicaid) of the Social Security Act (SSA) to provide for the establishment of State premium subsidy programs to assist eligible needy children with premiums for standard health coverage. Subtitle H:  Medicaid Reform - Amends SSA title XIX to:  (1) provide for the establishment of State health allowance programs under which the State makes payments to an approved group health plan which provides coverage to eligible individuals as an allowance towards the costs of providing the individual with benefits under the plan; (2) modify Federal requirements to allow States more flexibility in contracting for coordinated care services under Medicaid; (3) make changes regarding the period of certain waivers under Medicaid; and (4) reduce the amount of Federal payment adjustments under Medicaid for disproportionate share hospitals. (Sec. 1713) Eliminates the duplicative pediatric immunization program under Medicare. Subtitle I:  Remedies and Enforcement with Respect to Group Health Plans - Amends the Employee Retirement Income Security Act of 1974 (ERISA) to set forth claims procedure special rules for group health plans. Directs the Secretary of Labor to establish a mediation program for disputes involving group health plan claims.  Requires the Secretary to maintain a list of individuals with expertise to serve as facilitators under such program, and to propose a facilitator for each mediation subject to one objection by each party.  Sets forth provisions for participation of attorneys, initiation of mediation, mediation procedures, time limits, costs, legal effect of participation, and confidentiality and admissibility. Sets forth court remedies for participants and beneficiaries with respect to group health plans. Subtitle J:  Delivery of Health Care Services to Illegal Immigrants - Directs the Secretary of Health and Human Services to conduct a study of health care to illegal immigrants, including the effect of illegal immigration on health costs and the shifting of health costs.  Requires a report to the Congress, with recommendations on appropriate means of:  (1) alleviating health problems peculiar to illegal immigrants; (2) financing health care provided to illegal immigrants; and(3) increasing intergovernmental cooperation and coordination of efforts of the United States and other countries to alleviate such health problems and finance such efforts. Title II:  Health Care Cost Containment and Quality Enhancement - Subtitle A:  Medical Malpractice Liability Reform - Part 1:  General Provisions - Makes this subtitle applicable with respect to any medical malpractice liability claim and to any medical malpractice liability action brought in State or Federal court, except a claim or action for damages arising from a vaccine-related injury or death to the extent that title XXI of the Public Health Service Act applies. Sets forth provisions regarding:  (1) preemption of State law; (2) effect on sovereign immunity and choice of law or venue; (3) jurisdiction; and (4) effective dates. Part 2:  Medical Malpractice and Product Liability Reform - Prohibits a medical malpractice liability action from being brought in any State court during a calendar year unless the relevant claim has been initially resolved (i.e., a decision has been reached on whether the defendant is liable to the plaintiff for damages and on the amount of damages) under a certified alternative dispute resolution (ADR) system or an alternative Federal system. Prohibits a medical malpractice liability action from being brought in Federal court based on diversity of citizenship during a calendar year unless the relevant claim has been initially resolved under such a system in the State whose law applies. Directs the Attorney General to establish an ADR process for tort claims consisting of medical malpractice liability claims brought against the United States under chapter 171 of the Federal judicial code (U.S. Court of Federal Claims).  Prohibits a medical malpractice liability action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. (Sec. 2012) Limits to $250,000 the amount of noneconomic damages that may be awarded to a claimant and family members in a medical malpractice liability action.  Sets limits on punitive damages and on periodic payments for future losses.  Reduces damages by any other payments made to compensate an individual for injuries. (Sec. 2013) Set forth provisions regarding:  (1) limits on attorney fees and other costs; (2) joint and several liability (generally, liability may be found only for those damages directly attributable to the person's proportionate share of fault or responsibility for the injury); (3) a statute of limitations of seven years; and (4) a uniform standard for determining negligence (the defendant's conduct at the time of providing the health care services was not reasonable). (Sec. 2017) Specifies that in the case of a medical malpractice liability claim relating to services provided during labor or the delivery of a baby, if the health care professional did not previously treat the injured individual for the pregnancy, the trier of fact may not find that the defendant committed malpractice nor assess damages unless the malpractice is proven by clear and convincing evidence. Part 3:  Requirements for State Alternative Dispute Resolution Systems - Lists requirements for State ADR systems, including that such a system:  (1) applies to all medical malpractice liability claims under the jurisdiction of the courts of that State; (2) requires that a written opinion resolving the dispute be issued within six months after each party against whom the claim is filed has received notice of the claim; (3) is approved by the State or local governments; (4) provides for the transmittal to the State agency responsible for monitoring or disciplining health care professionals and providers of any findings of malpractice; and (5) provides for the regular transmittal of information on disputes resolved under the system to the Administrator for Health Care Policy and Research in a manner that protects the identity of the parties involved. (Sec. 2032) Directs the Secretary, by October 1 of each year, to certify State ADR systems that meet such requirements. Directs the Secretary to establish an alternative Federal ADR system for the resolution of medical malpractice liability claims in States that do not have in effect a certified ADR system. (Sec. 2033) Directs the Secretary, within five years, to submit to the Congress a report describing and evaluating State ADR systems and the alternative Federal system, including:  (1) information on the effect of the ADR systems on health care costs, access to health care, and quality of care provided within the State; and (2) to the extent that such report does not provide information on no-fault systems operated by States as ADR systems, an analysis of the feasibility and desirability of establishing a system for resolving medical malpractice liability claims on a no-fault basis. Part 4:  Other Provisions Relating to Medical Malpractice Liability - Authorizes a State agency responsible for disciplinary actions for a type of health care practitioner to enter into agreements with State or county professional societies to permit their participation in the licensing of such practitioner and to review any health care malpractice action, claims, or allegation, or other information concerning the practice patterns of any such practitioner.  Sets forth agreement requirements. (Sec. 2042) Directs the Secretary to study incentives adopted by State and local governments, insurers, medical societies, and other entities to encourage physicians to volunteer to provide health care services in medically underserved areas. (Sec. 2043) Directs each State to require:  (1) each health care professional and health care provider to participate in a risk management program to prevent, and provide early warning of, practices which may result in injuries to patients or endanger patient safety; and (2) each provider of health care professional and provider liability insurance in the State to establish risk management programs or sanction programs of risk management for health care professionals and providers provided by other entities, and require each such professional or provider, as a condition of maintaining insurance, to participate in one such program at least once in each three-year period. (Sec. 2044) Directs the Secretary to make grants:  (1) for basic research in the prevention of, and compensation for, injuries resulting from health care professional or provider malpractice and for research of the outcomes of health care procedures; (2) to States to assist in improving their ability to license and discipline health care professionals; and (3) to States and local governments, private nonprofit organizations, and health professional schools for educating the general public about the appropriate use of health care, realistic expectations of medical intervention, and the resources and role of health care professional licensing and disciplinary boards in investigating claims of incompetence or health care malpractice, and for developing programs of faculty training and curricula for educating health care professionals in quality assurance, risk management, and medical injury prevention.  Authorizes appropriations. Subtitle B:  Administrative Cost Savings and Fair Health Information Practices - Part 1:  Administrative Cost Savings - Subpart A:  Standards for Data Elements and Transactions - Directs the Secretary to adopt standards and modifications to standards that are:  (1) consistent with the objective of reducing the costs of providing and paying for health care; and (2) in use and generally accepted, developed, or modified by the standard-setting organizations accredited by the American National Standard Institute. (Sec. 2104) Directs the Secretary to adopt standards:  (1) for data elements of health information; and (2) for transmitting information electronically. Subpart B:  Requirements With Respect to Certain Transactions and Information - Specifies standard transactions. Subpart C:  Miscellaneous Provisions - Requires the Secretary to establish standards with respect to the operation of health information network services. (Sec. 2124) Authorizes the Secretary to make grants for demonstration projects to promote the development and use of electronically integrated community-based clinical information systems and computerized patient medical records. Subpart D:  Assistance to the Secretary - Establishes the Health Care Information Advisory Committee to:  (1) assist the Secretary in complying with requirements under this Act; (2) be generally responsible for advising the Secretary and the Congress on the status of the health information network; and (3) make recommendations to correct problems in the network and to refine and improve the network. Part 2:  Fair Health Information Practices - Subpart A:  Duties of Health Information Trustees - Specifies the duties of health information trustees with respect to inspection of protected health information. (Sec. 2142) Provides a procedure to amend protected health information. Subpart B:  Use and Disclosure of Protected Health Information - Sets forth general limitations on the use and disclosure of protected health information by health information trustees. (Sec. 2152) Authorizes a health information trustee to disclose protected health information pursuant to a written authorization by the protected individual. (Sec. 2153) Describes the circumstances under which health information trustees may disclose protected health information to:  (1) health plans, health care providers, and oversight agencies; (2) next of kin; (3) public health authorities; (4) health research entities; (5) authorities under emergencies; (6) courts or administrative agencies; (6) law enforcement agencies; (7) entities under subpoenas, warrants, and search warrants; and (8) health information service organizations. Subpart C:  Access Procedures and Challenge Rights - Prohibits a government authority from obtaining protected health information about a protected individual from a health information trustee through subpoenas, warrants, and search warrants unless there is probable cause that the information is relevant to the law enforcement inquiry. (Sec. 2172) Establishes challenge procedures to such subpoenas. Subpart D:  Miscellaneous Provisions - Restricts the information a health information trustee may disclose when a protected individual pays for health care through a payment card or electronic means. (Sec. 2183) Directs the Secretary to develop standards for electronic documents and communications. (Sec. 2184) Provides for the disclosure of protected health information to affiliated persons and agents and attorneys. (Sec. 2187) Requires States to establish a process for the maintenance of certain protected health information. Subpart E:  Enforcement - Provides for civil actions against health information trustees. (Sec. 2192) Authorizes the Secretary to impose a civil money penalty against such trustees for a demonstrated pattern of failure to comply with this subpart. (Sec. 2193) Requires the Secretary to develop an alternative dispute resolution method for resolving claims for civil actions. (Sec. 2194) Amends the Federal criminal code to impose penalties for violations in disclosing and obtaining protected health information. Subpart F:  Amendments to Title 5, United States Code - Requires certain Federal agency heads to promulgate rules protecting health information. Subpart G:  Regulations, Research, and Education; Effective Dates; Applicability; and Relationship to Other Laws - Requires the Secretary to prescribe regulations to carry out this part not later than July 1, 1996. (Sec. 2197) Makes this part effective on January 1, 1997, except for certain provisions that take effect upon enactment. Subtitle C:  Deduction for Cost of Catastrophic Health Plan; Medical Savings Accounts - Amends the Internal Revenue Code to include under the medical expense deduction the portion of such expense attributable to coverage under a catastrophic health plan. (Sec. 2202) Allows individuals a tax deduction for a percentage of contributions made to a medical care savings account established for the benefit of an eligible individual. Allows such deduction whether or not an individual itemizes deductions. Disallows distributions from such accounts as medical expense deductions. Excludes employer contributions to such accounts from employment taxes. Establishes an excise tax for excess contributions to medical care savings accounts. Subtitle D:  Anti-Fraud - Directs the Attorney General to establish an all-payer health care fraud and abuse control program. (Sec. 2302) Authorizes additional appropriations for such program and AG investigations of possible health care fraud. (Sec. 2303) Establishes in the Treasury the Anti-Fraud and Abuse Trust Fund for use in preventing anti-fraud and abuse law violations and repaying Medicaid and other beneficiaries for cost-sharing. (Sec. 2311) Amends SSA title XI and the Federal criminal code to:  (1) revise current sanctions to provide for, among other things, mandatory exclusion from Medicare and State health care program participation of individuals or entities convicted of a fraud-related felony in connection with the delivery of a health care item or service, and criminal penalties of fines and imprisonment for health care fraud; and (2) authorize the Secretary of Health and Human Services (Secretary) to issue advisory opinions with regard to specified matters, including matters concerning prohibited remuneration and service inducements. (Sec. 2315) Modifies:  (1) current limitations under Medicare (SSA title XVIII) on physician self-referral; and (2) effective date exceptions under the Omnibus Budget Reconciliation Act of 1993 for such referrals made for clinical laboratory services. (Sec. 2316) Directs the Comptroller General to study and report to the Congress on the costs of peer review contracts for Medicare HMOs. (Sec. 2332) Amends SSA title XVIII to require the Secretary to issue advisory opinions relating to prohibited referrals under Medicare. Directs the Secretary to issue regulations establishing systems under SSA titles XI and XVIII for the issuance of advisory opinions. Subtitle E:  Increased Medicare Beneficiary Choice; Additional Medicare Reforms - Amends SSA title XVIII and the Omnibus Budget Reconciliation Act of 1990 to make specified changes in HMO and Medicare supplemental policy provisions.  Imposes mandates on the Secretary in order to afford Medicare beneficiaries additional avenues for choosing health care coverage, including enrollment in private health insurance plans. (Sec. 2411) Extends current rules for computing Medicare part B (Supplementary Medical Insurance) premiums. (Sec. 2412) Amends the Internal Revenue Code to provide for the imposition of a Medicare part B premium tax for high-income Medicare part B beneficiaries. (Sec. 2413) Directs the Secretary to take such steps as necessary to consolidate administration of Medicare parts A (Hospital Insurance) and B. (Sec. 2414) Makes specified extensions with regard to Medicare as secondary payer, including those concerning data matches. Subtitle F:  Health Care Antitrust Improvements - Exempts from all antitrust claims an activity relating to the provision of health care services that is:  (1) within a ""safe harbor"" designated by the Attorney General, except for claims for injunctive relief asserted by the Attorney General or the Chair of the Federal Trade Commission in extraordinary circumstances; and (2) specified in and in compliance with the terms of a certificate of review issued by the Attorney General, where the activity occurs while the certificate is in effect, except for claims for injunctive relief.  Sets forth provisions regarding the award of attorney fees and costs of suit to the prevailing party in an action based on a claim involving activity found to be exempt. (Sec. 2502) Directs the Attorney General to develop and designate specified safe harbors relating to the following, as well as to such other categories of activities as the Attorney General may designate (subject to specified requirements):  (1) joint purchasing of health care services; (2) small hospital mergers; (3) startup and operation of collaborations between State-licensed providers through partial or full integration; (4) standard setting and enforcement activities by medical self-regulatory entities; (5) health care providers collectively supplying non-price medical information to buyers and consumers; (6) health care provider participation in surveys; (7) health care joint ventures' purchase or use of equipment or provision of advanced tertiary care services; (8) provision of market power screens at appropriate levels below which combinations of providers are too small to pose a realistic antitrust threat; (9) joint purchasing arrangements; and (10) good faith negotiations relating to legitimate collaborative activities. Directs the Attorney General to publish notice in the Federal Register soliciting proposals for additional safe harbors.  Authorizes the Attorney General to modify or remove a safe harbor following notice and comment upon a determination that the safe harbor does not meet specified criteria. Sets forth criteria in establishing safe harbors, including:  (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. (Sec. 2503) Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates.  Sets forth procedures regarding applications for, renovation of, and review of determinations regarding, such certificates.  Limits the disclosure of information. (Sec. 2504) Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. (Sec. 2505) Directs the Attorney General to periodically review the safe harbors, certificates of review, and notifications. (Sec. 2507) Establishes within the Department of Health and Human Services an Office of Health Care Competition Policy. Subtitle G:  Encouraging Enforcement Activities of Medical Self- Regulatory Entities - Part 1:  Application of the Clayton Act to Medical Self-Regulatory Entities - Provides that no damages, cost of suit, or attorney fee may be recovered under section 4, 4A, or 4C of the Clayton Act, or under any similar State law, except by a State or the United States, from any medical self-regulatory entity as a result of engaging in standard setting or enforcement activities that are: (1) designed to promote the quality of health care provided to patients; and (2) not conducted for purposes of financial gain. Directs the court to award the cost of such a suit, including a reasonable attorney fee, to a substantially prevailing defendant. Part 2:  Consultation by Federal Agencies - Requires any Federal agency engaged in the establishment of medical professional standards to consult with appropriate medical societies or associations, specialty boards, or recognized accrediting agencies, if available, in carrying out medical professional standard setting and guidelines or standards relating to the practice of medicine. Subtitle H:  Reform of Clinical Laboratory Requirements for Simple Tests - Amends the Public Health Service Act to exempt clinical laboratories performing only simple examinations and procedures from certificate requirements. (Sec. 2703) Directs the Secretary to use existing appropriations to conduct the study relating to the reliability and quality control procedures of clinical laboratory testing programs and the effect of errors in the testing procedures and results on the diagnosis and treatment of patients. (Sec. 2704) Directs the Secretary to revise the membership of the Clinical Laboratory Improvement Advisory Committee to contain a number of practicing physicians proportionate to the number of physician regulated clinical laboratories. Subtitle I:  Miscellaneous Provisions - Requires certain Government agencies to refund health benefit contributions for their annuitants. (Sec. 2802) Makes aliens ineligible for social security and Medicaid benefits. (Sec. 2803) Limits the eligibility for social security benefits of certain drug and alcohol addicts. Title III:  Long-Term Care - Subtitle A:  Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance as accident and health insurance for purposes of insurance company taxation. (Sec. 3002) Excludes from gross income benefits provided under a long-term care insurance contract.  Includes in gross income employer-provided coverage for long-term care services. (Sec. 3003) Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions. Includes any parent or grandparent as a dependent for purposes of such expenses. Subtitle B:  Establishment of Federal Standards for Long-Term Care Insurance - Amends the Public Health Service Act to mandate the establishment of model Federal standards for long-term care insurance. Prohibits the offering of a long-term care insurance policy in a State unless the State has a regulatory program meeting the requirements of this Act or the policy has been certified by the Secretary of Health and Human Services. Authorizes grants to States for demonstration programs to improve enforcement of the standards.  Authorizes appropriations. Imposes on agents selling long-term policies a duty of good faith and fair dealing.  Prohibits twisting, high pressure tactics, and cold lead advertising.  Mandates minimum financial standards, including income and asset criteria, for advising individuals considering the purchase of a long-term policy.  Prohibits sales:  (1) to an individual eligible for assistance under title XIX (Medicaid) of the Social Security Act; (2) of duplicate service policies; and (3) of policies that reduce, limit, or coordinate benefits on the basis of eligibility for other coverage or benefits.  Provides for:  (1) criminal and civil penalties; and (2) agent training and certification. Sets forth additional carrier responsibilities relating to refunding of premiums, mailing of policies, providing information on denials of claims, reporting of information, and limiting compensation to agents for the sale or renewal of policies. Prohibits cancellation or nonrenewal of a long-term care policy except for nonpayment of premium or material misrepresentation.  Sets forth continuation and conversion rights for group policies, regulating premiums for converted policies.  Requires guaranteed issuance to an individual if the individual meets the minimum medical requirements of the policy.  Mandates standards regarding upgraded benefits.  Limits cancellation for nonpayment by an incapacitated individual. Requires:  (1) subject to exceptions, uniform language and definitions, a uniform format, and at least one standard benefit package; and (2) disclosure of certain matters, including an outline of coverage.  Mandates recommendations by the National Association of Insurance Commissioners (NAIC) regarding informing consumers on the long-term economic viability of long-term care insurance carriers. Limits certain conditions on benefits.  Requires, if benefits are provided for home health care or community-based services, that certain minimum benefits be provided.  Prohibits treating cognitive or mental impairments (including Alzheimer's disease and mental illness) differently from other medical conditions.  Limits preexisting condition requirements.  Requires:  (1) each claimant to have a functional assessment by an individual or entity meeting NAIC qualifications and unconnected to the policy issuer; (2) inflation protection, unless rejected in writing by a policyholder; (3) disclosure of certain premium increases; and (4) nonforfeiture benefits.  Prohibits a carrier from contesting a policy or claim based on fraud or misrepresentation unless notice is provided within a time period set by NAIC.  Establishes the right of a purchaser to return a policy within a specified period. Defines ""long-term care insurance policy,"" excluding:  (1) any basic Medicare supplemental policies; (2) other insurance offered primarily to provide specified types of coverage; and (3) certain life insurance policies. Authorizes grants for programs to provide information, counseling, and assistance regarding the procurement of long-term insurance. Authorizes appropriations. Subtitle C: Protection of Assets Under Medicaid Through Use of Qualified Long-term Care Insurance - Amends the title XIX of the Social Security Act to require State Medicaid plans to disregard some or all of the individual's assets attributable to coverage under a qualified long-term care insurance contract in determining the individual's eligibility for long-term care services. Subtitle D:  Studies - Requires the Comptroller General to study the feasibility of:  (1) encouraging health care providers to donate their services to homebound patients; and (2) providing heads of households who care for elderly family members in their home with an income tax credit. (Sec. 3303) Requires the Secretary of Health and Human Services to study and report to the Congress on the feasibility of encouraging or requiring the use of a single designated public or nonprofit agency to coordinate, through case management, the provision of long-term care benefits under current Federal, State, and local programs in a geographic area. Subtitle E:  Volunteer Service Credit Demonstration Projects - Amends the Older Americans Act of 1965 to require the Commissioner of the Administration on Aging to establish and operate a volunteer service credit demonstration project in each State.",2025-08-26T13:52:38Z,
103-hr-4960,103,hr,4960,Consumer Health Quality Protection Act of 1994,Health,1994-08-12,1994-08-12,Referred to the House Committee on Energy and Commerce.,House,"Rep. Wyden, Ron [D-OR-3]",OR,D,W000779,0,"TABLE OF CONTENTS:      Title I:  Duties of the Secretary and the States      Title II:  National Health Quality Management Program      Title III:  State Health Quality Management Programs Consumer Health Quality Protection Act of 1994 - Title I:  Duties of the Secretary and the States - Sets forth the responsibilities of the Secretary of Health and Human Services under this Act, including: (1) determination of initial and ongoing compliance of each State health quality management program; and (2) establishment of a national quality management program, health quality improvement foundations, consumer health care advocates in each State, a national consumer representative support center, national measures of quality performance for health plans, and a relative value scale to reimburse pharmacists for certain patient counseling services. Requires a State, as a condition of receipt of Federal medical assistance payments under title XIX (Medicaid) of the Social Security Act, to certify health plan compliance with quality standards and assure State medical licensure board compliance with requirements of this Act. Title II:  National Health Quality Management Program - Directs the Secretary to:  (1) establish and oversee a performance-based program of quality management and improvement designed to enhance the quality, appropriateness, and effectiveness of health care items and services, to be known as the national quality management program; and (2) collect from each health plan certified under this Act a quarterly fee amounting to .25 percent of the premiums received by the plan, to be utilized by the Secretary solely to support the activities described in title I. Requires the Secretary to:  (1) establish a program of grants to eligible organizations to serve as health quality improvement foundations and perform specified duties for the population of each State; and (2) oversee the operation of such foundations. Sets forth provisions regarding:  (1) eligibility requirements; (2) grants to entities; (3) duties; and (4) limited liability. Requires the Secretary to:  (1) make grants to an entity in each State which shall serve as the consumer health care advocate for the population of the State and grants of a total amount not exceeding $5 million per year to establish national consumer representative support centers; (2) develop a set of national measures of quality performance; (3) review and update such measures annually; (4) conduct periodic surveys of health care consumers; (5) develop and publish a relative value scale for evaluation and management services by pharmacists; and (6) report to the Congress. Title III:  State Health Quality Management Programs - Requires that a health plan, to be certified by a State, be determined to be in substantial compliance with prescribed standards.  Permits the Secretary to conduct onsite inspections and inspect documents generated by or in the possession of a plan, accreditation organization, or State to verify compliance with requirements of this Act. Sets forth provisions regarding:  (1) accreditation; (2) compliance; and (3) fees. Requires each health plan to establish a quality improvement program to systematically measure, assess, and improve enrollee health status, patient outcomes, processes of care, and enrollee satisfaction associated with health care provided under the plan. Sets forth requirements pertaining to State boards of medical examiners.",2025-08-26T13:51:42Z,
103-s-2381,103,s,2381,"A bill to require the Secretary of Health and Human Services to provide health care fraud and abuse guidance, and for other purposes.",Health,1994-08-11,1994-08-18,Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 578.,Senate,"Sen. Cohen, William S. [R-ME]",ME,R,C000598,0,"Directs the Secretary of Health and Human Services (HHS) annually to publish in the Federal Register a notice soliciting proposals for: (1) modifications to existing safe harbors issued pursuant to the Medicare and Medicaid Patient and Program Protection Act of 1987; (2) additional safe harbors specifying payment practices that shall not be treated as criminal offenses or serve as the basis for an exclusion; and (3) certain interpretive rulings and special fraud alerts. Prescribes the rulemaking process to follow, including criteria for modifying and establishing safe harbors. Authorizes any person to present, at any time, a request to the Inspector General of HHS for:  (1) a statement (interpretive ruling) of the current interpretation of the meaning of a specific aspect of Social Security Act civil and criminal prohibitions with respect to Medicare and Medicaid; and (2) a notice (special fraud alert) which informs the public of practices considered suspect or of particular concern under specified kickback, bribe, or rebate prohibitions. Specifies criteria for such rulings and alerts.",2021-06-02T20:35:39Z,
103-hr-4929,103,hr,4929,Women and Children's Health Outreach and Education Act of 1994,Health,1994-08-10,1994-08-30,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Brown, Sherrod [D-OH-13]",OH,D,B000944,0,"Women and Children's Health Outreach and Education Act of 1994 - Amends the Public Health Service Act to authorize the Secretary of Health and Human Services to make grants to public and nonprofit private entities to carry out demonstration projects for:  (1) identifying individuals who may be eligible for, but who are not participating in, Federal, State, or local programs that provide health services to residents of eligible communities (whose residents include a significant number of medically underserved individuals, a health professional shortage area, or communities whose infant mortality rate is significantly above the national rate); (2) assisting individuals in establishing eligibility for the benefits of the programs; (3) educating individuals on obtaining and utilizing the benefits; and (4) providing transportation, child care, translation, and other specified services to enable individuals to utilize the benefits. Authorizes the Secretary to make such grants only if:  (1) the applicant agrees that project services involved will be provided in the language and cultural context most appropriate for the individuals served; and (2) an application is submitted in such form and manner, and contains such agreements, assurances, and information, as the Secretary determines to be necessary. Authorizes appropriations.",2025-08-26T13:49:54Z,
103-s-2374,103,s,2374,Veterans Health Care Administrative Flexibility Act of 1994,Health,1994-08-09,1994-08-11,Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 562.,Senate,"Sen. Dole, Robert J. [R-KS]",KS,R,D000401,1,"TABLE OF CONTENTS:      Title I:  Affordable Health Insurance Coverage           Subtitle A:  Tax Incentives           Subtitle B:  Premium Assistance      Title II:  Health Insurance and Delivery Systems Reform           Subtitle A:  Federal Standards for State Certification                Programs           Subtitle B:  Consolidation of Federal Research           Subtitle C:  Self-Employed Individual and Small Employer                Participation in Federal Employees Health Benefits Plans           Subtitle D:  Report on Health Care System      Title III:  Special Assistance for Rural, Frontier and           Underserved Urban Areas           Subtitle A:  Planning, Demonstrations, and Grants           Subtitle B:  Technical Assistance Grants           Subtitle C:  Capital Assistance Loans and Loan                Guarantees           Subtitle D:  Increasing Primary Care Providers           Subtitle E:  Payment Flexibility           Subtitle F:  Emergency Medical Systems           Subtitle G:  Studies and Reports      Title IV:  Long-Term Care Provisions           Subtitle A:  Long-Term Care Services and Contracts           Subtitle B:  Tax Treatment of Accelerated Death Benefits           Subtitle C:  Credit for Personal Assistance      Title V:  Health Care Providers           Subtitle A:  Education and Research           Subtitle B:  Health Care Liability Reform           Subtitle C:  Health Care Antitrust Improvements      Title VI:  Administrative Simplification and Privacy      Title VII:  Enhanced Penalties for Health Care Fraud           Subtitle A:  All-Payer Fraud and Abuse Control Program           Subtitle B:  Revisions to Current Sanctions for Fraud                and Abuse           Subtitle C:  Administrative and Miscellaneous Provisions           Subtitle D:  Amendments to Criminal Law           Subtitle E:  Amendments to Civil False Claims Act      Title VIII:  Medicare and Medicaid           Subtitle A:  Medicare           Subtitle B:  Medicaid Program      Title IX:  Department of Veterans Affairs Title I:  Affordable Health Insurance Coverage - Subtitle A: Tax Incentives - Amends the Internal Revenue Code to allow a deduction for the qualified health insurance costs of individuals (including self-employed individuals) that provide their own health insurance. (Sec. 111) Allows individuals a tax deduction for contributions made to a medical care savings account established for the benefit of one or more eligible individuals.  Limits the amount of such deduction to specified amounts (dependent upon the tax filing category) or the high deductible health plan differential.  Allows such deduction whether or not an individual itemizes deductions. (Sec. 112) Excludes employer contributions to medical savings accounts from the gross income of the employee, with a dollar limitation or the high deductible health plan differential. Excludes employer contributions to such accounts from employment taxes. (Sec. 113) Provides for the establishment of medical savings accounts.  Sets contribution limitations, including that the individual on whose behalf such contributions are made is covered under a high deductible health plan.  Subjects the account beneficiary to taxation as owner of the account.  Imposes a penalty for distributions that are not used for qualified medical expenses. Subtitle B:  Premium Assistance - Amends title XIX (Medicaid) of the Social Security Act (SSA) to require States with approved Medicaid plans to provide for State programs for furnishing certain low-income families with assistance in regard to certified health plan premiums. Establishes annual limitations on premium assistance spending. Requires the President's budget to include estimates of premium assistance expenditures under Medicare and Medicaid. Title II:  Health Insurance and Delivery Systems Reform - Subtitle A:  Federal Standards for State Certification Programs - Amends SSA title XIX to require State Medicaid plans to provide for State programs under a new SSA title XXI for certifying insured health plans in the State that meet certain Federal standards and delivery system guidelines developed by the Secretary of Health and Human Services (HHS) incorporating specified requirements pertaining, among other things, to guarantee issue and renewal, preexisting condition exclusions, minimum benefit packages, quality assurance, and access to health care services, as certified health plans.  Requires State programs also to provide consumers in the State with comparative value information on the performance of all health plans in each community rating area established in the State.  Requires risk adjustment programs.  Authorizes appropriations. Requires the Secretary of Labor to develop similar standards and guidelines for Federal certification of self-insured health plans. Provides for:  (1) the treatment of certain State laws with regard to health plans; and (2) expanded access to health plans through purchasing cooperatives, the Federal Employee Health Benefits Program in the case of small businesses, and certain multiple employer welfare arrangements maintained by qualified associations; (3) special rules for church, multiemployer, and certain rural cooperative plans; and (4) general employer responsibilities with regard to payroll deductions for certified health plan premiums. Subtitle B:  Consolidation of Federal Research - Establishes the Agency for Quality Assurance and Consumer Information within the Department of Health and Human Services.  Creates an Administrator for Quality Assurance and Consumer Information to head the Agency. (Sec. 211) Directs the Secretary of Health and Human Services, acting through the Administrator, to consolidate Federal research activities relating to quality and consumer information in health care to enable States to gain access to the results of such research from a central source.  Lists current Federal responsibilities to be assumed by the Administrator. Authorizes appropriations. Subtitle C:  Self-Employed Individual and Small Employer Participation in Federal Employees Health Benefits Plans - Amends Federal civil service law to require the Office of Personnel Management (OPM) to promulgate regulations applying the Federal Employees Health Benefits Program (FEHBP) to self-employed individuals and businesses employing 50 or fewer employees, allowing required enrollee and Government contributions to be made by the State or small business involved or else be made in full by the self-employed or small business enrollee. (Sec. 221) Extends continued coverage under FEHBP. Requires carriers under FEHBP and the small business health insurance program to submit periodic reports to OPM comparing costs between the programs. (Sec. 222) Prohibits the FEHBP and the program described by this subtitle from being offered exclusively to Members of the Congress and congressional employees. (Sec. 223) Directs the Secretary to study and report to the Congress on nonworker and noncovered employee buy-ins for FEHBP coverage. Subtitle D:  Report on Health Care System - Directs the President to report to the Congress on specified aspects of the health care system. Title III:  Special Assistance for Rural, Frontier and Underserved Urban Areas - Authorizes States to designate certain rural, frontier, or urban areas as underserved areas based on the lack of access to health plans, quality health providers, and health care facilities. (Sec. 302) Requires the Secretary, upon a State's request, to establish a procedure to certify such areas as underserved areas. Directs the Secretary to give priority in awarding assistance to applicants that serve such areas except with respect to assistance provisions that explicitly direct assistance to areas currently designated as underserved. Subtitle A:  Planning, Demonstrations, and Grants - Authorizes the Secretary to conduct a demonstration project and grant program to encourage the development and operation of health networks.  Authorizes appropriations. (Sec. 312) Amends title XX (Block Grants to States for Social Services) of the Social Security Act to provide for grants to private entities for developing health networks or health plans to serve underserved areas certified under section 302 of this Act.  Authorizes appropriations. (Sec. 313) Amends the Public Health Service Act to establish a program of allotments to States for grants for community-based primary health services to low-income or medically underserved populations.  Earmarks funding for such grants. Subtitle B:  Technical Assistance Grants - Directs the Secretary to award technical assistance grants to public and private entities for establishing infrastructure for health networks and plans in underserved areas certified under section 302 of this Act.  Authorizes appropriations. Subtitle C:  Capital Assistance Loans and Loan Guarantees - Directs the Secretary to make loans to health networks, health plans that cover individuals residing in rural, frontier, or urban underserved areas, or health care providers that serve such areas for the capital costs of developing health delivery systems and expanding existing health delivery sites to make health care services available in underserved areas certified under section 302.     Subtitle D:  Increasing Primary Care Providers - Amends the Internal Revenue Code to:  (1) allow a nonrefundable credit for certain primary health services providers for mandatory service periods in health professional shortage areas; and (2) increase the dollar limitation allowed for expensing medical equipment used in such areas. (Sec. 343) Mandates grants to federally qualified health centers (FQHCs) and other entities for providing access to services for medically underserved populations or in high impact areas not currently being served by a FQHC.  Authorizes appropriations. (Sec. 345) Authorizes the Secretary to award grants to States for primary health care and social service programs targeted to pregnant women and infants.  Authorizes appropriations. (Sec. 346) Amends the Elementary and Secondary Education Act of 1965 to revise provisions regarding the improvement of school health education.  Requires the Secretary of Education to award grants to States for local programs of health education and prevention, early health intervention, and health education in pre-schools and elementary schools and to carry out other related activities.  Authorizes appropriations. (Sec. 347) Authorizes frontier States (including Alaska, Wyoming, and Montana) to implement proposals to:  (1) offer preventive services, including mobile preventive health centers; and (2) participate in demonstration projects to improve recruitment, retention, and training of rural providers. (Sec. 348) Authorizes specified amounts of appropriations for the National Health Service Corps Scholarship Program through FY 2000. (Currently, such sums as necessary are authorized to be appropriated.)  Extends the authorization of appropriations for area health education centers through FY 2000. (Sec. 349) Directs the Secretary of Health and Human Services to establish the Interagency Task Force on Rural Telemedicine. (Sec. 350) Requires the Secretary, acting through the Office of Rural Health, to award grants to eligible entities to promote the use of telemedicine to strengthen health care in rural areas.   Authorizes appropriations. Subtitle E:  Payment Flexibility - Amends SSA title XVIII (Medicare) to:  (1) make various specified changes in essential access community hospital (EACH) program provisions, including changes allowing an unlimited number of States to participate in the program, and eliminating grant tie-in requirements for EACH or rural primary care hospital designation.  Extends the deadline for development of a prospective payment system (PPS) for inpatient rural primary care hospital services.  Provides for the implementation of a PPS for outpatient rural primary care hospital services.  Revises the physician staffing requirements for rural primary care hospitals. Authorizes increased appropriations for the EACH program. (Sec. 352)  Amends Medicare part A to provide for medical assistance facility and emergency access care hospital demonstration projects for improving access to health care in rural areas. Authorizes appropriations. (Sec. 353) Makes various specified changes with regard to Medicare-dependent, small rural hospitals. (Sec. 354) Provides for expanded coverage for physician assistants and nurse practitioners. Subtitle F:  Emergency Medical Systems - Amends the Public Health Service Act to prove for grants to States for systems to transport rural victims of medical emergencies by air.  Authorizes appropriations. Subtitle G:  Studies and Reports - Amends SSA title VII (Administration) to:  (1) provide for the appointment of an Assistant Secretary for Rural Health in the Office of Rural Health Policy; and (2) make administrative changes respecting the Office and duties of the new assistant secretary. (Sec. 372) Requires:  (1) the Prospective Parent Assessment Commission to study and report to the Congress on the need for legislation or regulations to ensure that vulnerable populations have adequate access to health plans and health care providers and services; and (2) the Secretary of HHS to study and report to the Congress on expanding the benefits under health plans for individuals residing in rural areas. Title IV:  Long-Term Care Provisions - Subtitle A:  Long-Term Care Services and Contracts - Amends the Internal Revenue Code to treat qualified long-term care services as medical care for purposes of the medical expense deduction. (Sec. 402) Provides for the treatment long-term care insurance as accident or health insurance.  Excludes qualified long-term care insurance contracts from cafeteria plans. (Sec. 406) Sets forth consumer protection provisions to be satisfied by qualified long-term care insurance contracts, including the model regulation and model Act promulgated by the National Association of Insurance Commissioners (NAIC). (Sec. 407) Imposes an excise tax on insurers who fail to meet requirements for long-term care insurance policies. (Sec. 409) Requires NAIC to promulgate standards for the use of uniform language and definitions in such policies, with certain variations permitted. Subtitle B:  Tax Treatment of Accelerated Death Benefits - Provides for the exclusion as a death benefit of any amount received under a life insurance contract because such individual is terminally ill. Allows insurance companies to issue accelerated death benefit riders on life insurance contracts. Subtitle C:  Credit for Personal Assistance - Allows a tax credit for the cost of personal assistance services required by certain individuals.  Describes such individuals as those who, by reason of a medically determinable physical impairment which can be expected to last for a continuous period of not less than 12 months, are unable to engage in any substantial gainful employment activity without personal assistance services appropriate to carry out activities of daily living.  Limits the amount of such credit and provides a cost-of- living adjustment. Title V:  Health Care Providers - Subtitle A:  Education and Research - Amends SSA title XVIII to:  (1) require the Director of the Office of Technology Assessment to provide for the appointment of an Advisory Commission on Workforce to develop recommendations and assessments with regard to national health care workforce policy and payment for a report to the Congress.  Authorizes appropriations. (Sec. 502) Requires the Secretary of HHS to provide for a consortium demonstration program for testing and evaluating mechanisms for increasing the number of medical students entering primary care practice through the use of funds available for direct graduate medical education (GME) costs.  Authorizes appropriations. (Sec. 503) Requires that residency training time spent in nonhospital-owned facilities be counted in determining full-time- equivalent residents for direct and indirect GME payments. (Sec. 504)  Amends the Internal Revenue Code to create in the Treasury the National Fund for Medical Research consisting of designated overpayments and cash contributions for use by the National Institutes for Health (NIH) for medical research and construction and acquisition of equipment and facilities for NIH, and for health information communications under the Public Health Service Act. Subtitle B:  Health Care Liability Reform - Amends SSA title XI part A to provide for various specified changes with regard to civil actions in State or Federal court for damages arising out of alleged injuries caused by health care providers or payors, including among such changes:  (1) limitations on noneconomic damages, attorney contingency fees, and action time frames; (2) requirements for pleading of punitive damages, periodic damage payments, and risk management programs for health care providers; and (3) providing for State health care quality assurance programs funded out of a portion of all punitive damages awarded in the State. Subtitle C:  Health Care Antitrust Improvements - Exempts from all antitrust claims an activity relating to the provision of health care services that is:  (1) within a ""safe harbor"" designated by the Attorney General, except for claims for injunctive relief asserted by the Attorney General or the Chair of the Federal Trade Commission in extraordinary circumstances; and (2) specified in and in compliance with the terms of a certificate of review issued by the Attorney General, where the activity occurs while the certificate is in effect, except for claims for injunctive relief.  Sets forth provisions regarding the award of attorney fees and costs of suit to the prevailing party in an action based on a claim involving an activity found to be exempt. (Sec. 522)  Directs the Attorney General to develop and designate specified safe harbors relating to the following, as well as to such other categories of activities as the Attorney General may designate (subject to specified requirements):  (1) joint purchasing of health care services; (2) small hospital mergers; (3) startup and operation of collaborations between State-licensed providers through partial or full integration; (4) standard-setting and enforcement activities by medical self-regulatory entities; (5) health care providers collectively supplying non-price medical information to buyers and consumers; (6) health care provider participation in surveys; (7) health care joint venture's purchase or use of new or existing high technology or costly equipment or the provision of advanced tertiary care services; (8) provision of market power screens at appropriate levels below which combinations of providers are too small to pose a realistic antitrust threat; (9) joint purchasing arrangements; and (10) good faith negotiations relating to legitimate collaborative activities. Directs the Attorney General to publish a notice in the Federal Register soliciting proposals for additional safe harbors.  Authorizes the Attorney General to modify or remove a safe harbor following notice and comment upon a determination that the safe harbor does not meet specified required criteria. Sets forth criteria to be considered in establishing safe harbors, including:  (1) the extent to which a competitive or collaborative activity will accomplish an increase in health care access and quality, the establishment of cost efficiencies, and increased ability of health care facilities to provide services in medically underserved areas or to underserved populations; and (2) whether designation as a safe harbor will result in specified desirable outcomes. (Sec.  523)  Directs the Attorney General to issue certificates of review for providers of health care services and to assist persons in applying for such certificates.  Sets forth procedures regarding applications for, revocation of, and review of determinations regarding such certificates.  Limits the disclosure of information. (Sec.  524)  Sets forth provisions regarding notifications providing for a reduction in certain penalties under the antitrust laws for health care cooperative ventures. (Sec.  525)  Directs the Attorney General to:  (1) periodically review the safe harbors, certificates of review, and notifications; and (2) publish, and periodically update, specified guidelines intended to promote greater certainty regarding the application of the antitrust laws to activities in the health care market. Title VI:  Administrative Simplification and Privacy - Amends SSA title XI to provide for administrative simplification in the health care system including Medicare and Medicaid, by directing the Secretary of HHS to adopt specified standards for:  (1) data elements and information transactions to electronic transmission of certain health information; (2) locating and accessing for authorized purposes health information available through the health information network developed through requirements under this title for electronic transmission of such information; and (3) certifying such information networks.  Provides penalties for failure to comply with such standards and requirements.  Authorizes appropriations. Establishes a Health Care Information Advisory Committee to advise the Secretary of HHS and the Congress on the status of the network.  Authorizes appropriations. Directs the Secretary to make grants for electronically integrated demonstration projects for community-based clinical information systems and computerized patient medical records. (Sec. 601) Makes amendments with regard to the Medicare and Medicaid Coverage Data Bank and related identification processes. (Sec. 602) Provides for the establishment of a mechanism for protecting the privacy of individuals with respect to individually identifiable health care information that is created or maintained as part of health treatment, enrollment, payment, testing, or research processes.  Establishes civil and criminal penalties for violations of such privacy protections.  Authorizes appropriations. Title VII:  Enhanced Penalties for Health Care Fraud - Subtitle A:  All-Payer Fraud and Abuse Control Program - Directs the Secretary of HHS to establish a program to:  (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse with respect to the delivery of and payment for health care; and (2) perform other specified tasks applicable to controlling health care fraud and abuse. (Sec. 701) Creates in the Treasury the Anti-Fraud and Abuse Trust Fund for use in conjunction with such program. (Sec. 702) Amends SSA title XI to provide for the application of Federal health anti-fraud and abuse sanctions to all fraud and abuse against any health care plan. (Sec. 703) Directs the Secretary of HHS to publish notice in the Federal Register soliciting proposals for certain:  (1) safe harbor activities related to payment for health care services; and (2) interpretive rulings and special alerts concerning health care fraud and abuse. (Sec. 704) Directs the Secretary to establish a program through which individuals entitled to Medicare benefits may report to the Secretary on a confidential basis instances of suspected Medicare fraud by program providers. Subtitle B:  Revisions to Current Sanctions for Fraud and Abuse - Amends SSA title XI to revise current sanctions for fraud and abuse involving Medicare and State health care programs, providing for:  (1) program exclusion for individuals convicted of a felony relating to fraud or the unlawful manufacture or dispensing or a controlled substance; (2) new offenses under civil monetary penalty provisions, such as the offering of inducements to program-eligible individuals and the misuse of health security cards or unique health identifiers; (3) establishment of a minimum period of exclusion for practitioners and persons who fail to meet statutory obligations; (4) intermediate sanctions on eligible HMOs for program violations; and (5) procedures for imposing such sanctions. Subtitle C:  Administrative and Miscellaneous Provisions - Directs the Secretary to establish a national health care fraud and abuse data collection program for the reporting by government health care providers, suppliers, and practitioners.  Requires program information to be made available to Federal and State governments, subject to a possible fee. Subtitle D:  Amendments to Criminal Law - Amends the Federal criminal code to set penalties for knowingly executing a scheme or artifice to:  (1) defraud any health care plan in connection with the delivery of, or payment for, health care benefits, items, or services; or (2) obtain, by means of false or fraudulent pretenses, representations, or promises, money or property owned by, or under the custody or control of, any health care plan or person in connection with delivery of or payment for health care benefits. (Sec. 731) Requires the Secretary of the Treasury to deposit into the Anti-Fraud and Abuse Trust Fund an amount equal to criminal fines imposed. (Sec. 732) Makes other specified criminal law changes with regard to forfeitures and injunctive relief with respect to Federal health care offenses and provides for similar deposits into the Anti-Fraud and Abuse Trust Fund. Subtitle E:  Amendments to Civil False Claims Act - Makes provisions of the Civil False Claims Act applicable to the use of false records or statements made to a health care plan.  Includes within the definition of ""claim"" for purposes of such Act, a request or demand for money or property which is made or presented to a health care plan.  Provides for deposits into the Anti-Fraud and Abuse Trust Fund of amounts equal to penalties and damages imposed under the Civil False Claims Act. Title VIII:  Medicare and Medicaid - Subtitle A:  Medicare - Directs the Secretary to study and report to the Congress on allowing payment under Medicare for certain Medicare beneficiaries enrolled in either private or other Federal health care plans. (Sec. 802) Revises Medicare provisions on payments to HMOs and competitive medical plans. Directs the Secretary of HHS to establish certain demonstration projects in designated areas for paying such organizations on the basis of a special payment methodology. Amends the Omnibus Budget Reconciliation Act of 1987 to provide for an extension of social health maintenance organizations. (Sec. 803) Amends:  (1) the Omnibus Budget Reconciliation Act of 1990 (OMBRA '90) to permit Medicare supplemental policies to be offered in all States; and (2) SSA title XVIII to make technical corrections to provisions on Medicare supplemental policies. (Sec. 811) Makes specified changes with regard to Medicare part A (Hospital Insurance) provisions with regard to:  (1) inpatient hospital services updates for PPS hospitals; (2) payment reductions for capital-related costs for inpatient hospital services; (3) payment adjustments for disproportionate share hospitals in participating States; (4) moratoriums on new long-term hospitals; (5) adjustment reductions for indirect medical education; and (6) routine service cost limit reductions for skilled nursing facilities. (Sec. 821) Makes specified changes with regard to Medicare part B (Supplementary Medical Insurance) provisions with regard to:  (1) physicians' services updates and payments; (2) establishment of hospital outpatient PPS for hospital outpatient departments; and (3) general Medicare part B premiums. (Sec. 831) Makes specified changes with regard to Medicare parts A and B provisions with regard to:  (1) Medicare as secondary payer; and (2) routine cost limit reductions for home health services. Subtitle B:  Medicaid Program - Provides for coordination of the Medicaid program with the new health care system established under this Act through such changes as:  (1) establishing a cap on payments for certain acute medical services furnished under Medicaid; (2) providing for the integration of certain Medicaid eligibles into the new system; (3) providing for State programs for supplemental benefits; and (4) providing for optional coverage under certified health plans of SSI-eligible individuals. (Sec. 861) Amends SSA title XIX to modify Federal requirements to allow State flexibility in contracting for coordinated care services under Medicaid. (Sec. 871) Amends:  (1) Medicaid long-term care provisions, permitting certain demonstration projects and relief from third party liability requirements when cost-effective, among other changes; and (2) the Omnibus Budget Reconciliation Act of 1986 with regard to frail elderly demonstration projects. (Sec. 878) Modifies Medicaid provisions on case management services and home and community-based waivers. (Sec. 881) Makes specified changes in provisions concerning:  (1) disproportionate share hospital (DSH) payment adjustments; (2) the Federal medical assistance percentage for certain States; and (3) criteria for determining the amount of disallowances. (Sec. 882) Directs the Secretary to submit recommendations to the Congress on a phased-in elimination of Medicaid DSH payment adjustments. (Sec. 885) Makes technical corrections relating to OMBRA '90 provisions on physicians' services. Title IX:  Department of Veterans Affairs - Veterans Health Care Administrative Flexibility Act of 1994 - Expresses as the intent of the Congress that Department of Veterans Affairs health care facilities participate as health care providers recognized under health care reform legislation enacted by the States.  Directs the Secretary of Veterans Affairs to provide health care services in a State enacting such reform legislation.  Prohibits any State from denying Department participation as a health care provider under such legislation unless the State's chief executive officer certifies that:  (1) the benefits to be provided by the Department do not meet the State quality benefits standard; or (2) the location of Department facilities does not meet State proximity requirements. Authorizes the Secretary, in order to facilitate the provision of Department health care services in a manner that is responsive to local market and regulatory conditions, to designate Department health care facilities which shall be exempt from specified Federal regulatory provisions.  Allows exempted Department facilities to enter into contracts and agreements for the provision of health care and related services under a State health care reform plan.  Exempts such contracts and agreements for less than $250,000 from prior review by the Department's Central Office.  Provides for review of contracts or agreements of such amount or greater.  Authorizes the Secretary to utilize Department personnel to provide necessary health care services under this title.  Provides funding by establishing in the Treasury a Department of Veterans Affairs Health Care Reform Fund, into which shall be deposited certain funds collected by the Secretary from third party payers to defray the costs of providing health care services to veterans.  Requires a separate account to be maintained in the Fund for each exempted Department health care facility.  Allows exempted Department facilities to expend funds to cover marketing, advertising, legal, acquisition, construction, repair, and renovation costs.",2025-08-26T13:48:57Z,
103-hjres-399,103,hjres,399,"Designating August 29, 1994, as ""National Sarcoidosis Awareness Day"".",Health,1994-08-08,1994-08-08,Referred to the House Committee on Post Office and Civil Service.,House,"Rep. Bishop, Sanford D., Jr. [D-GA-2]",GA,D,B000490,20,"Designates August 29, 1994, as National Sarcoidosis Awareness Day.",2024-02-06T20:04:02Z,
103-hconres-277,103,hconres,277,Expressing the sense of the Congress regarding the prerogatives of each State for health care reform.,Health,1994-08-04,1994-08-30,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Hoekstra, Peter [R-MI-2]",MI,R,H000676,16,"Expresses the sense of the Congress that legislation providing for a national program for health care reform which would restrict the freedom of any individual State in setting its own course toward health care reform that is reflective of the unique experience of such State, should provide for the inclusion of such State only upon approval by a majority of the voters in a State referendum.",2024-02-07T16:32:33Z,
103-s-2357,103,s,2357,Health Security Act,Health,1994-08-03,1994-08-05,Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 542.,Senate,"Sen. Mitchell, George J. [D-ME]",ME,D,M000811,0,"TABLE OF CONTENTS:      Title I:  Improved Access to Standardized and Affordable           Health Plans           Subtitle A:  Rules and Definitions of General                Applicability           Subtitle B:  Health Plan Standards           Subtitle C:  Benefits and Cost-Sharing           Subtitle D:  Access to Health Plans           Subtitle E:  Federal Responsibilities           Subtitle F:  Participating State Responsibilities           Subtitle G:  Miscellaneous Provisions      Title II:  New Benefits           Subtitle A:  Coverage of Outpatient Prescription Drugs in                Medicare           Subtitle B:  Home and Community-Based Services           Subtitle C:  Long-Term Care Insurance Improvement and                Accountability           Subtitle D:  Life Care           Subtitle E:  Study and Report      Title III:  Health Professions Workforce           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:  Additional Provisions Regarding Public                Health           Subtitle J:  Occupational Safety and Health           Subtitle K:  Full Funding for WIC           Subtitle L:  Border Health Improvement      Title IV:  Medicare and Medicaid           Subtitle A:  Medicare           Subtitle B:  Medicaid Program      Title V:  Quality and Consumer Protection           Subtitle A:  Quality Management and Improvement           Subtitle B:  Administrative Simplification           Subtitle C:  Privacy of Health Information           Subtitle D:  Expanded Efforts to Combat Health Care                Fraud and Abuse Affecting Federal Outlay Programs           Subtitle E:  Medical Liability Reform           Subtitle F:  Remedies and Enforcement           Subtitle G:  Repeal of Exemption      Title VI:  Individual and Employer Subsidies           Subtitle A:  Individual Premium and Cost-Sharing                Assistance           Subtitle B:  Employer Subsidies      Title VII:  Revenue Provisions           Subtitle A:  Financing Provisions           Subtitle B:  Tax Treatment of Employer-Provided Health                Care           Subtitle C:  Exempt Health Care Organizations           Subtitle D:  Tax Treatment of Long-Term Care Insurance                and Services           Subtitle E:  Other Revenue Provisions           Subtitle F:  Graduate Medical Education and Academic                Health Centers Trust Fund      Title VIII:  Other Federal Programs           Subtitle A:  Indian Health Services      Title IX:  Workers Compensation Medical Services      Title X:  Premium Financing           Subtitle A:  National Health Care Cost and Coverage                Commission           Subtitle B:  Employer and Individual Premium Requirements                and Assistance      Title XI: Ensuring Health Care Reform Financing Health Security Act - Title I:  Improved Access to Standardized and Affordable Health Plans:  Subtitle A:  Rules and Definitions of General Applicability - Directs each participating State to require that each health plan or long-term care policy issued, sold, offered for sale, or operated in the State shall be certified by the appropriate certifying authority as one of the following:  (1) a certified standard health plan; (2) a certified supplemental health benefits plan; or (3) a certified long-term care policy.  Applies the following principles to all standard health plans:  (1) no standard health plan may discriminate on the basis of medical history, health status, preexisting medical conditions, or genetic predisposition to medical conditions; (2) a standard plan shall offer an annual open enrollment period and accept all eligible individuals for coverage, shall not impose a rider that serves to exclude coverage to an individual, and shall not impose waiting periods before coverage begins; (3) a standard health plan shall ensure that all medically necessary or appropriate services, as defined in the benefits package, are provided; and (4) health benefits coverage shall be portable from one standard health plan to another. (Sec. 1003) States that nothing in this Act shall be construed as prohibiting the following:  (1) an individual from purchasing any health care services; (2) an individual from purchasing supplemental insurance to cover health care services not included within the standard benefits package; (3) an individual who is not an eligible individual from purchasing health insurance; (4) employers from providing coverage for benefits in addition to such standard benefits package; or (5) an individual from obtaining health care from any health care provider of such individual's choice. Subtitle B:  Health Plan Standards - Sets forth the following standards which a standard health plan must meet:  (1) insurance market reform standards; (2) delivery system reform standards; (3) standards for participation in a guaranty fund; (4) standards for the collection and reporting of data; and (5) standards for effective grievance procedures for enrollees. (Sec. 1111) Requires a standard health plan sponsor to:  (1) when offering a community-rated standard health plan, offer such plan to any community-rated individual applying for coverage; and (2) when offering an experience-rated standard health plan, offer such plan to any experience-rated indivudal eligible for coverage under the plan through such individuals' experience-rated employer. Defines:  (1) a standard health plan as one providing the standard benefits package under subtitle C; (2) a community-rated plan as a plan provided to community-rated individuals; (3) a community-rated individual as one who not an experience-rated individual; (4) an experience-rated plan as a health plan which is a self-insured plan of an experience-rated employer or is an insured health plan which is experience-rated, but which covers only experience-rated individuals; (5) an experience-rated employer as an employer employing more than 500 employees or a multiemployer plan that covers 500 or more employees; and (6) an experience-rated individual as one who is an employee of an experience-rated employer. Requires a community-rated standard health plan to be made available to community-rated individuals throughout the entire community-rating area.  Requires a State to be divided into one or more community rating areas in which there must be a minimum of 250,000 individuals residing.  Prohibits a metropolitan statistical area in a State from being incorporated into more than one community rating area. Permits a standard health plan sponsor to refuse to renew an individual's plan only for:  (1) fraud or materials misrepresentation on the individuals' part; or (2) nonpayment of premiums. (Sec. 1112) Sets forth enrollment process requirements, including the requirement of an annual open enrollment period. (Sec. 1113) Includes in the definition of children, for purposes of coverage, a child who is under 25 years of age or disabled and who is unmarried. (Sec. 1114) Prohibits discrimination based on health status including medical condition, lack of evidence of insurability, or anticipated need for health care services.  Prohibits imposing a waiting period before coverage begins.  Permits a standard health plan to impose a limitation or exclusion of benefits relating to treatment of a condition based on a preexisting condition if:  (1) the condition was diagnosed or treated during the three-month period ending on the day before the date of enrollment; (2) the limitation or exclusion extends for not more than six months; (3) the limitation or exclusion does not apply to an individual who, as of the date of birth, was covered under the plan; or (4) the limitation or exclusion does not relate to pregnancy. (Sec.  1116) Requires a plan to have uniform premiums within a community rating area. (Sec. 1117) Requires each standard health plan to participate in a standard health plan risk adjustment program and a reinsurance program. (Sec. 1118) Sets forth financial solvency requirements. (Sec. 1121) Sets forth provisions concerning: (1) antidiscrimination requirements; (2) quality assurance standards; (3) the consumer grievance process; (4) the issuance of a health security card to each individual enrolled in each standard health plan; (5) information and marketing standards; (6) patient's rights to self-determination in health care; and (7) contracts with purchasing cooperatives. (Sec. 1128) Requires each standard health plan to ensure that all health care providers reimbursed by the plan are authorized under State law to provide applicable services.  Requires a plan to ensure that all nonnetwork items and services covered are reasonably available and accessible.  Requires covered services to be available to all enrollees throughout the service plan area with reasonable promptness.  Requires each plan to establish a program under which participating physicians shall agree to accept the plan's payment schedule as payment in full.  States that nothing in this Act shall be construed to:  (1) force an individual to receive health care solely through the individual's standard plan; or (2) prohibit any individual from privately contracting with any health care provider and paying for such treatment as agreed to between the individual and the provider. (Sec. 1141) States that nothing in this Act shall be construed as to prevent a standard health plan sponsor from offering and pricing supplemental health benefits plans pursuant to a State certification plan.  Applies the same standards to supplemental plans as are applicable to the standard plan concerning issue, availability, enrollment, nondiscrimination, and rating limitation.  Sets forth provisions concerning marketing abuses and requirements for cost-sharing plans. Subtitle C:  Benefits and Cost-Sharing - Defines a standard benefits package as a benefit package that: (1) provides all the items and services under the categories of health care items and services described in section 1202; (2) provides for at least one of the three cost-sharing schedules established under section 1213 by the National Health Benefits Board; and (3) has an actuarial value that is equivalent to the actuarial value of the benefits package provided by the Blue Cross/Blue Shield Standard Option under the Federal Employees Health Benefits Program as in effect during 1994. Defines an alternative standard benefits package as a benefits package that:  (1) provides all the items and services under the categories of health care items and services described in section 1202; (2) provides for the very high deductible cost-sharing schedule established under 1213 by the Board; and (3) has an actuarial value that is less than the actuarial value of the benefits package provided by the Blue Cross/Blue Shield Standard Option as in effect during 1994. (Sec. 1202) Lists the following items and services as categories of medical care to be furnished to health plan enrollees when medically necessary or appropriate:  (1) hospital services, including inpatient hospital services, outpatient hospital services, and 24-hour a day hospital emergency services; (2) health professional services, including consultations that are provided in a home, office, or other ambulatory care setting, or an institutional setting and services and supplies furnished as incident to such health professional services; (3) 24-hour a day emergency services and ambulatory medical or surgical services; (4) clinical preventive services, including services for high risk populations, age-appropriate immunizations, tests, and clinician visits furnished consistent with any periodicity schedule specified by the Board; (5) mental illness and substance abuse services, including inpatient, outpatient, residential non-hospital, and intensive non-residential services, for the treatment of mental illness and substance abuse disorders; (6) voluntary comprehensive family planning services, including counseling and education, contraceptive drugs and devices, and services for pregnant women; (7) items and services provided for end of life care (hospice care); (8) home health care and home infusion drug therapy services provided as an alternative to inpatient hospital treatment, treatment in a skilled nursing facility, or treatment in a rehabilitation facility; (9) extended care services described in title XVIII (Medicare) of the Social Security Act, when provided to an inpatient of a skilled nursing facility or a rehabilitation facility and when provided as an alternative to receiving inpatient hospital services; (10) ambulance services; (11) laboratory, radiology, and diagnostic services provided upon prescription to individuals who are not inpatients of a hospital, hospice, skilled nursing facility, or rehabilitation facility; (12) outpatient prescription drugs, blood clotting factors, drugs used for home infusion therapy, biologicals, and accessories and supplies used directly with the above items; (13) outpatient occupational therapy, physical therapy, respiratory therapy, speech-language pathology services, and outpatient audiology services when used to restore or maintain functional capacity or prevent or minimize limitations on physical and cognitive functions as a result of an illness or other health condition, including attaining new functional abilities at an age-appropriate rate; (14) durable medical equipment, prosthetic devices, orthotics and prosthetics, and accessories and supplies used directly with the above equipment or devices; (15) routine eye examinations, diagnosis, and treatment for defects in vision furnished to individuals who are under 22 years of age, including eyeglasses and contact lenses furnished according to a periodicity schedule established by the Board; (16) to individuals under 22 years of age, emergency dental treatment, prevention and diagnosis of dental disease, treatment of dental disease, space maintenance procedures to prevent orthodontic complications, and interceptive orthodontic treatment to prevent severe malocclusion; (17) for individuals who are over 22 years of age, emergency dental treatment, as specified by the Board; (18) routine ear examinations and diagnosis for defects in hearing as part of a physician visit and hearing aids when recommended by a physician or audiologist; and (19) items and services required to provide patient care pursuant to the design of a qualified investigation treatment. (Sec. 1211) Establishes a National Health Benefits Board to:  (1) promulgate regulations or establish guidelines as may be necessary to clarify and refine items and services under the categories of health care items and services described in section 1202; (2) establish and update periodicity schedules for the items and services in the categories of health care items and services described in section 1202; and (3) design mental illness substance and abuse services so as to achieve parity with services for other medical conditions. Authorizes the Board to establish:  (1) criteria for determinations of medical necessity or appropriateness; (2) procedures for determinations of medical necessity or appropriateness; and (3) regulations or guidelines to be used in determining whether an item or service is medically necessary. Requires the Board to establish cost-sharing schedules to be provided by health plans providing a standard benefits package or an alternative standard benefits package. Authorizes the Board to develop legislative proposals for modifications to the actuarial equivalence provisions of section 1201 and the categories of items and services under section 1202. Authorizes appropriations to the Bord. (Sec. 1217) Sets forth procedures for the congressional consideration of Board proposals. Subtitle D:  Access to Health Plans - Requires each employer to make available to each employee the opportunity:  (1) in the case of an experience-rated employer, to enroll through the employer in one of at least three certified experience-rated standard health plans; or (2) in the case of a community-rated employer, to enroll in any community-rated plan offered through a purchasing cooperative operating in the community rating area of the employer and, at the employer's option, to enroll in one of at least three community-rated standard health plans. (Sec. 1321) Directs a State, in accordance with specified provisions, to certify health insurance purchasing cooperatives. Requires that each cooperative be chartered under State law and operated as a not-for-profit corporation.  Permits a State to establish or sponsor a purchasing cooperative to serve a community rating area. Requires each purchasing cooperative to:  (1) negotiate (regarding premiums and marketing fees) with and enter into agreements with standard health plans; (2) enter into agreements with community-rated employers; (3) enroll community-rated employees and community-rated individuals in standard health plans; (4) collect premiums and make payments to standard health plans on behalf of community-rated employers and community-rated individuals; (5) provide for coordination with other purchasing cooperatives; (6) provide comparative information to the public and the participating State on standard health plans offered through the purchasing opperative; (7) have the capability of accepting data from standard health plans; (8) comply with such fiduciary responsibility, financial management, and administrative requirements as the Secretary may establish; and (9) carry out other functions provided for under this title. Prohibits a cooperative from:  (1) performing any activity (including review, approval, or enforcement) relating to payment rates for providers; (2) performing any activity (including certification or enforcement) relating to compliance of standard health plans with the requirements of this Act; (3) assuming insurance risk; or (4) performing other activities identified by the State as being inconsistent with the performance of its duties under this Act. (Sec. 1322) Requires a purchasing cooperative to offer all community-rated individuals and community-rated employees residing within the community rating area served by the cooperative the opportunity to enroll in any standard health plan that has entered into an agreement with the cooperative. (Sec. 1324) Directs a purchasing cooperative to charge members a uniform membership fee to cover costs. (Sec. 1331) Requires a purchasing cooperative for a community rating area to offer to enter into an agreement with each community-rated employer that employs individuals in the community rating area and that desires to join the cooperative. (Sec. 1341) Sets forth requirements applicable to the Federal Employees Health Benefits Program. (Sec. 1351) Sets forth rules relating to multiple employer welfare arrangements. Subtitle E:  Federal Responsibilities - Directs the Secretary of Health and Human Services to implement all provisions of this Act, subject to stated exceptions, and report annually to the President and the Congress concerning the health care system of this Act.  Authorizes appropriations. (Sec. 1411) Requires the Secretary to approve a State health care system for which a plan has been submitted, unless it does not meet applicable requirements. (Sec. 1412) Provides sanctions for participating States not in compliance, including Federal assumption of responsibilities. (Sec. 1422) Provides for Federal assumption of responsibilities in non-participating States. (Sec. 1431) Directs the Secretary to establish premium class and age class factors. (Sec. 1435) Directs the Secretary to develop a risk adjustment and reinsurance methodology. (Sec. 1441) Directs the Secretary to establish minimum capital requirements for workers, as well as additional capital requirements to reflect factors likely to affect the financial stability of a carriers. (Sec. 1461) Directs the Secretary to certify as an essential community provider any health care provider meeting the standards for certification or that is within any of the following categories of providers:  (1) covered entities as defined under the Public Health Service Act, school health centers, public or nonprofit hospitals, public and private nonprofit mental health and substance abuse providers, runaway homeless youth centers or transitional living programs for homeless youth, public or nonprofit maternal and child health providers, rural health clinics, and programs of the Indian Health Service shall all be considered category one entities; and (2) Medicare dependent small rural hospitals and children's hospitals shall both be considered category two entities. (Sec. 1463) Directs the Secretary to publish standards for the certification of additional categories of health care providers and organizations as essential community providers. (Sec. 1466) Provides that for essential community providers electing to apply to a health plan, the plan shall either:  (1) enter into a provider participation agreement; or (2) enter into an agreement under which the plan makes payments to the provider. (Sec. 1467) Requires the Secretary, within five years of enactment, to submit to the Congress specific recommendations, based on studies, concerning whether, and to what extent, sec. 1466 provisions should continue to apply to some or all essential community providers.  Requires the recommendations to be implemented unless a congressional joint resolution disapproving such recommendations is enacted. (Sec. 1481) Sets forth the responsibilities of the Secretary of Labor. (Sec. 1491) Provides that the Office of Rural Health Policy shall be headed by an Assistant Secretary, instead of a Director. Subtitle F:  Participating State Responsibilities - Sets forth provisions concerning approval of State plans and certification of standard health plans and supplemental health benefits plans.  Requires the Secretary to establish a program for the accreditation, certification, and enforcement (the ACE program) of health plan standards by States. (Sec. 1502) Requires each participating State to be divided into one or more community rating areas. (Sec. 1503) Provides for:  (1) open enrollment periods; (2) a risk adjustment program; (3) guaranty funds; and (4) public access sites. (Sec. 1511) Prohibits, as a general rule, any State law from applying to any services provided under a health plan that is not a fee-for-service plan. (Sec. 1512) Provides for the override of restrictive State practice laws. (Sec. 1521) Provides for the continuance of existing Federal law waivers under Medicare, Medicaid, or the Employee Retirement Income Security Act. (Sec. 1522) Sets forth provisions concerning:  (1) the Hawaii Prepaid Health Care Act; (2) alternative State provider payment systems; and (3) alternative State hospital services payment systems. (Sec. 1531) Sets forth requirements for State single-payer systems. (Sec. 1541) Provides for the early implementation of comprehensive State programs. Subtitle G:  Miscallenous Provisions - Permits a health professional or health facility to deny the provision of an item or service if the professional or facility objects on the basis of religious belief or moral conviction. Prohibits discrimination on the basis of race, national origin, sex, religion, language, income, age, sexual orientation, disability, health status, or anticipated need for health services. Title II:  New Benefits - Subtitle A:  Coverage of Outpatient Prescription Drugs in Medicare - Amends title XVIII (Medicare) of the Social Security Act to provide for:  (1) Medicare coverage of certain 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 (Supplementary Medical Insurance) for covered outpatient prescription drugs; (4) a Prescription Drug Payment Review Commission appointed by the Director of the Congressional Office of Technology Assessment for reporting annually to the Congress on Medicare coverage of outpatient prescription drugs; and (5) the provision of covered outpatient drugs through Medicare drug benefit plans under contract with the Secretary to individuals entitled to benefits under Medicare part A (Hospital Insurance) and enrolled under Medicare part B.  Authorizes appropriations. (Sec. 2007) Allows the Secretary, in providing for payments for covered outpatient drugs under Medicare contracts with HMOs and competitive medical plans, to base such payments on classes of enrollees or geographic factors that are different from those otherwise utilized for determining payment. Subtitle B:  Home and Community Based Services - Entitles each State with an approved plan for home and community-based services for individuals with disabilities to specified payments.  Authorizes appropriations. (Sec. 2111) Amends the Public Health Service Act to direct the Secretary to compile, evaluate, and disseminate information to assist in the replication of successful long-term health care services programs that are aimed at offering care management to hospitalized individuals in need of long-term care so that services to meet individual needs and preferences can be arranged in home and community-based settings as an alternative to long-term nursing home placement.  Establishes a related grant program. Authorizes appropriations. Subtitle C:  Long-Term Care Insurance Improvement and Accountability - Long-Term Care Insurance Improvement and Accountability Act - Provides for the promulgation of standards and model benefits with respect to long-term care insurance. (Sec. 2211) Prohibits the sale of a long-term care policy unless it meets specified standards. (Sec. 2212) Regulates sales practices and renewal practices for long-term care policies. (Sec. 2215) Establishes benefit standards for long-term care policies. Subtitle D:  Life Care - Life Care Act - Amends the Public Health Service Act to add a new title, Title XXVII - Life Care:  Public Insurance Program for Nursing Home Care.  Directs the Secretary to: (1) establish a voluntary insurance program for individuals 35 yers of age and over to cover the nursing home stays of such individuals; and the nursing home stays of such individuals; and (2) establish a process for enrollment in the Life Care Program. Prohibits the coverage amount from exceeding $90,000.  Provides coverage under the title for:  (1) nursing care; (2) specified therapy services; (3) medical social work; (4) drugs and appliances; (5) other nursing home facility services; and (6) with respect to the first six months of covered residence in a nursing facility, such room and board costs as are not covered by beneficiary copayment. Subtitle E:  Study and Report - Provides for a study on issues relating to appropriate care at the end of life. Title III:  Health Professions Workforce - 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 Council to ensure that the aggregate number of individuals entering graduate medical education programs does not exceed specified limits.  Directs the Council to designate the number of individuals authorized to be enrolled in each specialty. (Sec. 3031) Sets forth provisions concerning Federal formula payments to:  (1) qualified entities for the costs of operating approved physician training programs; and (2) academic health centers and other eligible institutions. (Sec. 3061) Sets forth provisions concerning Federal payments to: (1) medical schools; (2) graduate nurse training programs; (3) dental schools; and (4) schools of public health. (Sec. 3081) Authorizes appropriations through FY 2000 for workforce development. Subtitle B:  Academic Health Centers - Authorizes grants to:  (1) eligible centers for the establishment and operation of information and referral systems to provide the services of such centers to rural health plans; and (2) community-and provider-based health plans for the purpose of providing the services of eligible centers to residents of rural or urban communities who otherwise would not have adequate access to such services. Subtitle C:  Health Research Initiatives - Requires 0.25 percent of all premium-related payments made by employers, individuals, and families for coverage under this Act to be used for biomedical and behavioral research and health services research as specified. (Sec. 3221) Authorizes appropriations for a medical technology impact study. Subtitle D:  Core Functions of Public Health Programs; National Initiatives Regarding Preventive Health - Authorizes appropriatons for:  (1) core functions of public health programs; and (2) national initiatives regarding health promotion and disease prevention.  Provides for grants to states for core functions of public health programs.  Provides grants for agencies of State or local government and nonprofit organizations for national prevention initiatives. Provides for grants and authorizes appropriations for the development of rural telemedicine. Subtitle E:  Health Services for Medically Underserved Populations - Authorizes appropriations for:  (1) the development of community health groups and health care sites and services; and (2) the capital costs of the development of community health groups. (Sec. 3402) Authorizes approprations for grants and contracts for enabling and supplemental services. (Sec. 3471) Authorizes appropriations for the National Health Service Corps Program. (Sec. 3481) Provides for payments to hospitals with a low-income utilization rate of not less than 25 percent. Subtitle F:  Mental Health; Substance Abuse - Requires each State, as a condition of participation under title I, to integrate the mental illness and substance abuse services of the State and its political subdivisions with the mental illness and substance abuse services offered by health plans pursuant to title I.  Authorizes appropriations to States for grants for the development and operation of comprehensive managed mental health and substance abuse programs that are integrated with the health delivery system established under this Act. Subtitle G:  Comprehensive School Health Education; School-Related Health Services - Provides for grants to State educational agencies in eligible States to integrate comprehensive school health education in schools within the State, with priority given to those communities in greatest need.  Authorizes appropriations. (Sec. 3603) Establishes a Healthy Students-Healthy Schools Interagency Task Force. (Sec. 3681) Authorizes appropriations for grants to State health agencies or local community partnerships for the development and operation of school-related health services. Subtitle H:  Public Health Service Initiative - Authorizes appropriations through FY 2004 for specified programs under title III, as well as programs of the Indian Health Service under title VIII. Subtitle I:  Additional Provisions Regarding Public Health - Authorizes grants for the purpose of implementing and developing for trainees a curriculum that includes training in identification, treatment, and referral of victims of domestic violence and women's health needs. Subtitle J:  Occupational Safety and Health - Directs the Secretary of Health and Human Services and the Secretary of Labor to work together to develop and implement a comprehensive program to expand and coordinate initiatives to prevent occupational injuries and illnesses. Establishes a National Advisory Board for Occupational Injury and Illness Prevention to provide oversight.  Authorizes appropriations. Subtitle K:  Full Funding for WIC - Amends provisions of the Child Nutrition Act of 1966 concerning the special supplemental food program to authorize to be:  (1) appropriated such amounts as are necessary through FY 2000; and (2) made available other specified amounts through FY 2000. Subtitle L:  Border Health Improvement - Authorizes the President to conclude an agreement with Mexico to establish a binational commission to be known as the United States - Mexico Border Health Commission to:  (1) conduct a needs assessment; (2) develop and implement a plan to carry out actions recommended by the needs assessment; and (3) formulate recommendations to United States and Mexico concerning reimbursement for health care costs. Title IV:  Medicare and Medicaid - Subtitle A:  Medicare - Amends SSA title XVIII (Medicare) to allow individuals to elect to remain in certain plans. (Sec. 4002) Makes specified changes with regard to eligible organization and Medicare supplemental policy enrollment. (Sec. 4101) Revises provisions relating to Medicare part A and concerned with:  (1) various specified hospital and skilled nursing facility payment adjustments for, among other things, capital-related costs for inpatient hospital services and services for low-income patients; (2) the Medicare-dependent, small rural hospital program and the rural health transition grant program; (3) payments for certain multi-campus, rehabilitation, and long-term care hospitals; (4) long-term hospital designation; and (5) indirect medical education payment termination. (Sec. 4111) Replaces the essential access community hospital (EACH) program with a limited service hospital program, prohibiting EACH designations after July 1, 1994, while permitting payment to prior designated EACHs.  Authorizes appropriations. Makes part A and B amendments relating to rural primary care hospitals and medical assistance facilities. Repeals provisions for prospective payment systems (PPSs) for rural primary care services. (Sec. 4112) Requires the Secretary to study and report to the Congress with regard to subacute care. (Sec. 4201) Makes specified changes with regard to Medicare part B provisions on:  (1) payment for physicians' services, adding limitations on payments relating to inpatient stays in certain hospitals and making various other changes concerning, among other things, service updates, adjustments for volume and intensity, and the performance standard factor; (2) underserved area bonus payments; (3) payments for certain outpatient hospital services and durable medical equipment; (4) eye or eye and ear hospitals; and (5) the general Medicare part B premium. (Sec. 4206) Requires the Secretary to establish:  (1) demonstration projects for Medicare State-based performance standard rates of increase; and (2) bidding areas for the competitive acquisition of specified items and services. Provides for a reduction in payment amounts if such competitive acquisition fails to achieve certain savings. (Sec. 4209) Imposes across-the-board co-payments for clinical diagnostic laboratory tests. (Sec. 4212) Provides for expanded coverage for physician assistants and nurse practitioners.  Bases payments for physician assistants and certain nurse practitioners on the physician fee schedule. (Sec. 4213) Prohibits nonparticipating physicians and suppliers from receiving payment for items or services provided under Medicare. (Sec. 4214) Requires the Secretary to develop a methodology for implementing a resource-based system for determining practice expense relative value units for each physician's service. (Sec. 4301) Modifies provisions relating to Medicare parts A and B and concerned with:  (1) medicare as secondary payer; (2) payments for home health services; and (3) Medicare supplemental policies. (Sec. 4303) Directs the Secretary to use a competitive process to contract with centers of excellence for certain appropriate services (including cataract surgery). (Sec. 4305) Imposes co-payments for home health services. (Sec. 4306) Terminates payments for direct graduate medical education costs attributable to an approved medical residency training program. (Sec. 4307) Amends the Omnibus Budget Reconciliation Act of 1990 to permit Medicare supplemental policies in all States. Subtitle B:  Medicaid Program - Amends SSA title XIX (Medicaid) to prohibit a State Medicaid plan from paying for items and services in the standard benefit package described above in title I of this Act, with certain exceptions. (Sec. 4605) Limits State Medicaid expenditures to HMOs to HMOs that are certified as a standard health plan.  Revises the 75/25 rule under Medicaid HMO provisions. (Sec. 4611) Modifies national DSH payment limit provisions. Creates a Medicaid part B (Payments to Hospitals Serving Vulnerable Populations). (Sec. 4615) Makes various specified changes with regard to Medicaid long-term care provisions (including provisions on frail elderly demonstration project waivers) as well as with regard to other provisions concerning:  (1) Medicaid coverage of certified nurse practitioners and clinical nurse specialist services; and (2) relief from third party liability requirements. Title V:  Quality and Consumer Protection - Subtitle A:  Quality Management and Improvement - Directs the Secretary of Health and Human Services to establish the National Quality Council to oversee a program of quality management and improvement designed to enhance the quality, appropriateness, and effectiveness of health care services and access to such services.  Authorizes appropriations. Subtitle B:  Administrative Simplification - States that the purpose of this subtitle is to improve the efficiency and effectiveness of the health care system, including Medicare and Medicaid, by encouraging the development of a health information network through the establishment of standards and requirements for the electronic transmission of certain health information.  Provides for standards for data elements and information transactions.  Imposes penalties for violators of the standards. Requires standards relating to the form of health security cards issued by health plans and the information needed to be encoded electronically on such cards. Establishes the Health Care Information Advisory Committee. Provides for grants for demonstration projects to promote the development and use of electronically integrated community-based clinical information systems and computerized patient medical records. Repeals provisions of the Social Security Act that established the Medicare and Medicaid Coverage Data Bank. Subtitle C:  Privacy of Health Information - States that the purpose of this subtitle is to establish effective mechanisms to protect the privacy of individuals with respect to individually identifiable health care information.  Permits the disclosure of health information only in accordance with provisions of this subtitle. Specifies authorized disclosures. Subtitle D:  Expanded Efforts to Combat Health Care Fraud and Abuse Affecting Federal Outlay Programs - Directs the Secretary and the Attorney General to establish a joint program to:  (1) coordinate Federal, State, and local law enforcement programs to control fraud and abuse affecting Federal outlay programs; (2) conduct investigations and audits relating to the delivery of and payment of health care; and (3) facilitate the enforcement of this subtitle and other statutes applicable to health care fraud and abuse. (Sec. 5302) Establishes the Federal Outlay Program Fraud and Abuse Control Account to be available for carrying out such program.  (Sec. 5303) Establishes the HHS Office of Inspector General Asset Forfeiture Proceeds Fund. (Sec. 5304) Authorizes monetary rewards for information relating to a possible prosecution of a Federal health care offfense. (Sec. 5311) Imposes civil penalties for certain violations, including fraud, with respect to certified standard health or long-term care plans or long-term care services. (Sec. 5313) Excludes an individual or entity from participating in any applicable health plan if the individual or entity:  (1) is excluded from participation in a public program due to conviction for health care-related crimes or patient abuse; (2) has been convicted under Federal or State law of specified felonies in connection with the delivery of a health care item or service; or (3) has been convicted of a felony relating to the unlawful manufacture, distribution, prescription, or dispensing of a controlled substance.  Waives mandatory exclusion if it would significantly harm or pose a risk to public health. Bars payments under a certified standard health plan for the delivery of or payment for any item or service furnished by an excluded individual. (Sec. 5321) Amends the Federal criminal code to provide criminal penalties for fraud, theft, embezzlement, false statements, bribery, and graft in connection with health care. (Sec. 5331) Imposes civil penalties for false claims regarding certified standard health plans or long-term care insurance policies. Subtitle E:  Medical Liability Reform - Requires parties to any malpractice action, before the commencement of such action, to participate in a State-based alternative dispute resolution system. Limits attorney's contingency fees.  Provides for demonstration projects concerning medical malpractice liability. Authorizes appropriations for such projects. Subtitle F:  Remedies and Enforcement - Establishes procedures for the review of health claims, including the review of claims, proceedings in complaint review offices, civil money penalties, the establishment of early resolution programs, mediation proceedings, enforcement of settlement agreements, due process for health care providers, judicial review, civil enforcement, private enforcement rights, consumer protections, discrimination claims, and facial constitutional challenges to invalidate this Act or any provision of this Act. Subtitle G:  Repeal of Exemption - Establishes the applicability of the following Acts to the health insurance business:  (1) the Sherman Act; (2) the Clayton Act; (3) the Federal Trade Commission Act; and (4) the Robinson-Patman Antidiscrimination Act. Title VI:  Individual and Employer Subsidies - Subtitle A: Individual Premium and Cost-Sharing Assistance - Requires a participating State to have in effect a program for furnishing premium assistance and cost-sharing assistance in accordance with the provisions of this subtitle.  Sets forth eligibility standards for such assistance.  Provides for payments to States furnishing premium assistance. Subtitle B: Employer Subsidies - States that it is the purpose of this subtitle to provide subsidies to eligible employers in providing, or expanding the provision of, health care coverage for the employer's employees.  Sets forth provisions concerning the eligibility for and amount of such subsidy. Declares ineligible for such a subsidy:  (1) the self-employed; (2) employee leasing firms; and (3) State or local governments. Title VII:  Revenue Provisions - Subtitle A:  Financing Provisions - Amends the Internal Revenue Code to increase the excise taxes on cigarettes and other tobacco products.  Applies such increases to tobacco products manufactured and sold in Puerto Rico. (Sec. 7103) Imposes an excise tax on the manufacture or importation of roll-your-own tobacco. (Sec. 7111) Imposes a tax:  (1) on a percentage of premiums received under taxable health insurance policies; and (2) on a percentage of amounts received for health-related administrative services. Imposes on self-insured plans a monthly tax on a percentage of the accident or health coverage expenditures and direct administrative expenditures. (Sec. 7112) Imposes a 25 percent tax on community-rated high cost health plans to be paid by the issuer.  Requires the Secretary of Health and Human Services to establish a reference premium for each class of enrollment for community-rated plans within a community rating area. Imposes a 25 percent tax on the excess premium equivalents of an experience-related standard health plan. (Sec. 7121) 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. 7131) Increases the excise tax on certain hollow point and large caliber handgun ammunition. (Sec. 7132) 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. 7133) 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 - Declares that on and after January 1, 2004, gross income of an employee includes employer-provided coverage under an accident or health plan which is not permitted coverage. (Sec. 7202) Prohibits health benefits from being provided under cafeteria plans. (Sec. 7203) Increases and makes permanent the deduction for health insurance costs of self-employed individuals. (Sec. 7211) Imposes a tax on employer-provided health benefits that do not meet the requirements for permitted coverage. Subtitle C:  Exempt Health Care Organizations - Sets forth qualification and disclosure requirements for tax-exempt health care organizations. (Sec. 7302) Imposes an excise tax on the beneficiary of a taxable inurement and on the management of the participating tax-exempt health care organization. (Sec. 7303) Provides for the treatment of health maintenance organizations, parent organizations, and health insurance purchasing cooperatives as tax-exempt entities. (Sec. 7304) Provides for the taxation as an insurance company other than a life insurance company of certain organizations that provide health insurance and other prepaid health care services. (Sec. 7305) Repeals the special rules for Blue Cross and Blue Shield and similar organizations. (Sec. 7306) Provides a tax exemption for certain qualified high risk insurance pools. (Sec. 7308) Provides for the tax treatment of bonds of certain nonprofit tax-exempt organizations in a manner similar to governmental bonds. Subtitle D:  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. 7402) Provides for the treatment of long-term care insurance as accident and health insurance. (Sec. 7403) Allows accelerated death benefits under life insurance contracts to be paid to terminally ill individuals. Subtitle E:  Other Revenue Provisions - Requires the Secretary of the Treasury to submit to specified congressional committees a legislative proposal providing statutory standards for the classification of workers as employees or independent contractors. (Sec. 7502) Increases the penalty for failure to file correct information for returns involving payments for services. (Sec. 7505) Allows a tax credit for certain primary health services providers that practice in health professional shortage areas. (Sec. 7506) Increases the amount allowed to be expensed as a depreciable business asset if such asset is medical equipment. (Sec. 7521) 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. 7522) Allows a tax credit for the cost of personal assistance services required by certain employed individuals.  Limits the amount of such credit and provides a cost-of-living adjustment. Subtitle F:  Graduate Medical Education and Academic Health Centers Trust Fund - Establishes the Graduate Medical Education and Academic Health Centers Trust Fund, consisting of the Graduate Medical Education Accountand the Academic Health Centers Account.  Provides funding for such trust fund through tax and assessments on insured and self-insured plans and transfers from certain social security trust funds. Title VIII:  Other Federal Programs - Subtitle A:  Indian Health Service - Makes qualifying Indians eligible for health and supplemental benefits under the Indian Health Service (IHS). (Sec. 8105) Authorizes an IHS program to contract with a health plan to provide health care services to non-Indians. (Sec. 8107) Makes IHS programs eligible for Medicare payments. (Sec. 8109) Directs the Secretary of Health and Human Services to: (1) establish an advisory group to access budget aspects of IHS programs; (2) conduct health service transitional studies and establish a related advisory group; (3) develop a long-term care demonstration program; (4) survey health services available to Indian veterans; and (5) develop new funding methodologies. (Sec. 8118) Authorizes appropriations. Subtitle B:  Department of Veterans Affairs - Veterans Health Care Reform Act of 1994 - Allows veterans, individuals currently enrolled in a health plan under the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), and their family members to be enrolled in a Department of Veterans Affairs health plan (VA plan).  Requires the Secretary of Veterans Affairs to ensure that each VA plan provides to enrolled individuals the items and services in the standard benefit package under this Act. Allows such plans to offer supplemental health benefits and cost-sharing plans 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, veterans of the Mexican border period or World War I, and veterans unable to defray the costs of such care.  Allows the Secretary to establish plan charges for other veterans.  Deems a VA facility to be a Medicare provider, and a VA health plan to be a Medicare HMO, for purposes of any program administered by the Secretary of Health and Human Services under Medicare (title XXVIII of the Social Security Act).  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. Directs the Secretary to organize health plans and operate VA facilities as, or within, health plans under this Act.  Preempts conflicting State health plan standards or requirements. Directs the Secretary to designate a health plan director for each VA health plan organized and operated under this subtitle.  Authorizes such directors to enter into contracts and agreements for the provision of care and services under the VA plan as well as related services (equipment, maintenance, and repair).  Authorizes the Secretary to enter into resource-sharing agreements with other health care plans and providers, health industry organizations, individuals, and other Government departments and agencies.  Provides certain administrative and personnel flexibility, as well as expenditure authority, for care and services under a VA plan. Establishes in the Treasury the Veterans Health Care Investment Fund.  Authorizes appropriations.  Provides specified credits to the Fund for FY 1995 through 1997 for operation of VA health plans. Requires a report from the Secretary to the Congress on the operation of such plans.  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. Title IX:  Workers Compensation Medical Services - Applies the provisions of subtitle B of title V of this Act to the provision of workers compensation medical services in the same manner as such provisions apply with respect to the provision of services included in the standard benefit package.  Requires that, in cases where a workers compensation claim is challenged, a health plan must provide or pay for all medical care in the standard benefit package according to the applicable workers compensation for schedule, until the challenge is adjudicated.  Provides for demonstration projects with respect to treatment of work-related injuries and illness.  Establishes a Commission on Workers Compensation Medical Services. Title X:  Premium Financing - Subtitle A:  National Health Care Cost and Coverage Commission - Establishes the National health Care Cost and Coverage Commission to monitor and respond to:  (1) trends in health care coverage; and (2) changes in per-capita premiums and other indicators of health care inflation. Provides for congressional consideration of Commission recommendations. Subtitle B:  Employer and Indiandual Premium Requirements and Assistance - Requires, with respect to a participating State, each resident U.S. citizen or lawful alien to:  (1) enroll in or be covered under a health plan; (2) pay any premium required, consistent with this Act.  Excludes individuals covered under an equivalent health care program such as Medicare, Medicaid, a military or veterans health care program, CHAMPUS, the Indian Health Care Improvement Act, or an approved State single-payer system. Provides for a religious exemption.  Excludes inmates. Requires employers of 25 or more and employers of less than 25 than make an election, to make health care coverage premium payments on behalf of the employer's qualifying employees. Permits other employers to elect to be treated as community-rated employers.  Sets forth provisions for providing for the determination premium payments. Title XI:  Ensuring Health Care Reform Financing - States that it is the purpose of this title to ensure that this Act does not result in unanticipated increases in the Federal deficit.  States that any entitlement provided by this Act, including premium assistance, shall be subject to the operation of this Act. Requires the President, annually through FY 2004, to issue a health care baseline.  Requires the President's budget to include a current health care baseline.  Provides that if a baseline exceeds the initial (1995) baseline by more than a specified amount there is to be a proposed order that offsets the excess through a combination of:  (1) reductions in premium assistance; (2) reductions in the Medicare deductible for drugs; and (3) reductions in each direct spending program of this Act by a uniform percentage. Requires the eligibility percentage for children and pregnant women to be reduced last.  Sets forth provisions in the event of war or low growth.  Provides for a Government Accounting Office audit and for additonal reporting requirements by the Office of Management and Budget and the National Health Care Commission.",2025-08-26T13:50:52Z,
103-s-2351,103,s,2351,Health Security Act,Health,1994-08-02,1994-08-19,Considered by Senate.,Senate,"Sen. Moynihan, Daniel Patrick [D-NY]",NY,D,M001054,0,"TABLE OF CONTENTS:      Title I:  Health Insurance and Delivery Systems Reform           Subtitle A:  Federal Standards for State Regulatory                Programs           Subtitle B:  Coordination With Other Provisions of                Law      Title II:  Coverage      Title III:  Premium and Cost-Sharing Assistance      Title IV:  Administrative Simplification and Privacy      Title V:  Malpractice and Fraud           Subtitle A:  Federal Tort Reform           Subtitle B:  Expanded                Efforts to Combat Health Care Fraud and                Abuse Affecting Federal Outlay Programs      Title VI:  Medicare, Medical Education, and Medicaid           Subtitle A:  Medicare           Subtitle B:  Medical Education           Subtitle C:  Home and Community-Based Services           Subtitle D:  Medicaid Program      Title VII:  Revenue Provisions           Subtitle A:  Financing Provisions           Subtitle B:  Tax Treatment of Employer-Provided Health                Care           Subtitle C:  Deduction for Individuals Purchasing Own                Health                Insurance           Subtitle D:  Exempt Organizations           Subtitle E:  Tax Treatment of Long-Term Care Insurance                and Services           Subtitle F:  Health Care Trust Funds           Subtitle G:  Other Revenue Provisions           Subtitle H:  Ensuring Health Care Financing Health Security Act - States that it is the purpose of this Act to achieve universal health insurance coverage through:  (1) subsidies for the purchase of health insurance; (2) affordable standardized health insurance; (3) elimination of exclusionary practices by health insurance companies; (4) a permanent National Health Commission for recommending periodically to the Congress how to increase the number of people covered by health insurance; (5) reduction of health costs through more open competitive markets and continued advances in medical education and research; and (6) health care provided under Medicare and Medicaid and health programs of the Departments of Defense and of Veterans Affairs, and the Indian Health Service. Title I:  Health Insurance and Delivery Systems Reform - Subtitle A:  Federal Standards for State Regulatory Programs - Amends the Social Security Act (SSA) to add a new title XXI under which States are required to establish accreditation, certification, enforcement, and information programs for certifying all health plans and long-term care policies (except multistate self-insured health plans which will be certified by the Secretary of Labor) issued, sold, offered for sale, or operated in the State that meet certain standards incorporating specified requirements, such as those pertaining to community rating, preexisting conditions, and a patient's right to self-determination in health care services, as certified standard, nonstandard, or supplemental health plans or certified long-term care policies in order to participate in Medicaid. (Sec. 101) Requires establishment of such programs also for:  (1) enforcing applicable standards for such plans and policies; (2) providing consumers in the State with comparative value information on the performance of all health plans in each community rating area established in the State; (3) designating State health plan service areas for purposes of access to essential community providers, delivery of benefits, and improved access to underserved areas; (4) providing for reinsurance, risk adjustment, and cost-sharing adjustment programs; (5) specifying an annual general enrollment period; (6) providing for a premium approval process for long-term care policies; (7) providing for the certification of workplace wellness programs; (8) enforcing employer responsibilities with regard to employee access to standard plans; (9) oversight of purchasing cooperatives; (10) supporting quality assurances for measuring access to and appropriateness of health care services provided to consumers; (11) supporting development of community health networks and plans; (12) supporting development of community health networks and plans; (13) providing coordination between health plans and automobile medical liability policies; (14) developing remedy and enforcement mechanisms (including early resolution programs) as described for dealing with complaints involving health plans, collecting any civil monetary penalties assessed by the Secretary of Health and Human Services (HHS) under such program, and for handling civil actions brought to invalidate any provision of this Act; and (15) conforming State laws and procedures to the rules regarding fraud and medical malpractice under SSA title XI. Directs the Secretary to initially determine and approve the compliance of such State programs with the Federal guidelines under this new title and periodically review such State programs to determine if they continue to comply with such guidelines. Provides funding for such programs. Sets forth requirements relating to:  (1) possessions of the United States; (2) State single-payer systems; and (3) treatment of certain State laws.  Directs the Secretary to:  (1) develop certification criteria for workplace wellness programs; and (2) certify certain private accreditation entities. Describes the various benefit packages and the categories of items and services included in them (such as mental illness and substance abuse services as well as family planning services and services for pregnant women). Prescribes general cost-sharing under the standard benefits package. Creates in HHS a National Health Benefits Board to:  (1) establish cost-sharing schedules to be provided by standard packages; and (2) define the standards to be used by a health plan in determining whether an item or service under certain categories of health care items and services is medically necessary or appropriate for an enrollee in the plan.  Outlines the process for congressional consideration of any Board recommendations to modify standard benefit packages and cost-sharing assistance.  Authorizes appropriations. Sets forth special provisions relating to abortion and religious beliefs, providing that nothing under this new title shall be construed to require the creation or maintenance of abortion clinics or other abortion providers within a State or any region of a State. Details general employer responsibilities pertaining to payroll deductions and other specified matters in enrolling their employees in certified standard health plans. Lists specific duties of purchasing cooperatives, which include making enrollment information available, enrolling community-rated individuals in certified standard health plans, and collecting and forwarding plan premiums to the plan, as well as specific requirements governing the organization and operation of purchasing cooperatives. Provides for access to standard health benefit plan coverage through qualified association plans. Sets forth special rules for church and multiemployer plans. Requires the Secretary to direct the Agency for Health Care Policy and Research and the Health Care Financing Administration to support and conduct research on the effects of health care reform on health care delivery systems and methods for risk adjustment.  Authorizes appropriations. Requires the Secretary to award grants to States or community-based, independent, not-for-profit organizations that have submitted applications to establish demonstration projects that provide certified standard health plans with the technical assistance to implement the results of quality improvement research into medical practice. Directs the Secretary to submit an annual report to the Congress which:  (1) reviews the results of the quality improvement research grants; (2) evaluates consumer information programs established by participating States; (3) tracks the evolution of national performance measures and other research; and (4) evaluates State, regional, and national trends on quality of health care. Allows the Secretary to make grants to and enter into contracts with:  (1) eligible public or private non-profit consortia for the development of community health groups (i.e. certified community health plans or community health networks); and (2) community health groups for their operation. Authorizes the Secretary to make certain types of financial assistance available to a community health group or isolated rural facility applying for capital assistance. Directs the Secretary to:  (1) award grants to eligible entities to establish demonstration projects to promote telemedicine and other uses of the telecommunications network in rural areas; and (2) establish the Interagency Task Force on Rural Telemedicine to, among other things, identify specific uses for telemedicine that have proven to be effective and review the policy of the Health Care Financing Administration relating to reimbursement for telemedicine services. Subtitle B:  Coordination With Other Provisions of Law - Eliminates immunity from antitrust suits under provisions commonly known as the McCarran-Ferguson Act with respect to health insurance. (Sec. 112) Elevates the position of the Director of the Office of Rural Health to the position of the Assistant Secretary for Rural Health and expands that official's duties. (Sec. 113) Permits the Secretary of Labor to issue special reporting and disclosure rules for employer group health plans and make other conforming amendments to the Employee Retirement Income Security Act of 1974 (ERISA). Repeals ERISA provisions on multiple employer welfare arrangements. Title II:  Coverage - Amends SSA to add a new title XXII under which is established the National Health Care Commission to monitor and respond to:  (1) trends in health insurance coverage; and (2) changes in per-capita premiums and other indicators of health care inflation.  Requires the Commission to report to the Congress biennially on the status of health insurance coverage in the nation and the national goal of universal coverage. Authorizes appropriations. Provides that if 95 percent of the resident population is not covered by 2002, the Commission shall submit to the Congress an implementing bill which such statutory provisions as the Commission determines are necessary or appropriate to implement recommendations developed by it to achieve that target. Title III:  Premium and Cost-Sharing Assistance - Amends SSA title XIX (Medicaid) to require State Medicaid plans to provide for a State program furnishing premium and cost-sharing assistance in accordance with a new Medicaid part B (State Programs for Premium and Cost-Sharing Assistance), which includes a grant program for providing cost-sharing assistance for certain individuals with incomes above 100 percent of the poverty line. Title IV:  Administrative Simplification and Privacy - Amends SSA title XI to:  (1) delay employer reporting requirements under Medicare and Medicaid Coverage Data Bank provisions; (2) terminate the Bank, effective January 1, 1996; (3) provide for administration simplification in the health care system, including Medicaid and Medicare, through an information network developed according to certain specified data element standards and requirements for electronic transmission and accessing of certain health information; (4) direct the Secretary to establish standards for certifying health information network services as qualified services and for establishing the form of health security cards issued by health plans and the information to be encoded electronically on such cards; (5) provide penalties for failure to comply with data element standards and requirements and for misuse of health security cards and personal health identifiers; (6) provide billing rules for clinical laboratory services; (7) establish the Health Care Information Advisory Committee for advising the Secretary and the Congress with respect to the health information network and network operations; (8) provide for demonstration projects to promote development and use of electronically integrated community-based clinical information systems and computerized patient medical records; (9) provide for privacy of health information; and (10) authorize appropriations. Amends SSA title XVIII (Medicare) to repeal provisions requiring the identification of secondary payer situations. Title V:  Malpractice and Fraud - Subtitle A:  Federal Tort Reform - Amends SSA title XI to provide for Federal medical malpractice provisions preempting inconsistent State laws (with specified exceptions) for governing malpractice actions brought in State or Federal courts (except with regard to actions arising from a vaccine-related injury or death covered under the Public Health Service Act) without establishing any new basis for bringing malpractice in Federal courts. Requires:  (1) States participating under new SSA title XXI to establish alternative dispute resolution procedures for settling medical malpractice claims; and (2) any such claims to have gone through and reached final resolution under such procedures in order for any medical malpractice liability action to be brought with respect to such claim in a participating State. Authorizes the Secretary to provide funds to one or more eligible participating States to establish no-fault medical liability system demonstration projects to replace the common law tort liability system for medical injuries.  Authorizes appropriations. Subtitle B:  Expanded Efforts to Control Health Care Fraud and Abuse Affecting Federal Outlay Programs - Amends SSA title XI to provide for additional measures for controlling health care fraud and abuse affecting Federal outlay programs, among other means by:  (1) mandating a joint program by the Secretary and the Attorney General to coordinate Federal, State, and local law enforcement programs to control fraud and abuse affecting Federal outlay programs; (2) providing qualified immunity to individuals providing information to such officials on health care fraud or abuse; (3) establishing the HHS Office of Inspector General Asset Forfeiture Proceeds Fund, consisting of all proceeds from forfeitures that have been transferred to the HHS Inspector General (IG) from the Department of Justice Asset Forfeiture Fund and available to the IG for investigation expenses; (4) allowing rewards for information leading to possible prosecution for a Federal health care offense; and (5) making revisions with regard to civil monetary penalties for health care fraud and abuse, including increasing such penalties, and with regard to private rights of action and mandatory exclusion from health care program participation. (Sec. 531) Amends Federal criminal code and (Civil False Claims Act) provisions, covering health care fraud as well as theft and embezzlement, false statements, and bribery and graft in connection with health care, and false claims for payments by health plans in order to conform to the changes made above under SSA. Title VI:  Medicare, Medical Education, and Medicaid - Subtitle A: Medicare - Amends SSA title XVIII to replace provisions on payments to health maintenance organizations and competitive medical plans with provisions on payments to certain certified standard health plans, modifying provisions with regard to risk-contracting. (Sec. 611) Makes various specified changes in provisions related to Medicare part A (Hospital Insurance) and concerned with:  (1) inpatient hospital services updates for prospective payment system hospitals; (2) payment reductions for capital-related costs for inpatient hospital services; (3) disproportionate share payment reductions; (4) payment methodology for rehabilitation and long-term care hospitals; (5) new designations of new long-term hospitals; (6) extension of the freeze on updates to routine service cost limits for skilled nursing facilities; (7) payments for sole community hospitals with teaching programs and multihospital campuses; (8) Medicare-dependent, small rural hospitals; (9) the rural health transition grant program; (10) a new limited service hospital program replacing the essential access community hospital program; (11) rural primary care hospitals and medical assistance facilities; and (12) termination of indirect medical education payments. (Sec. 622) Directs the Secretary to study and report to the Congress on subacute care. (Sec. 631) Makes various specified changes in provisions related to Medicare part B (Supplementary Medical Insurance) and concerned with: (1) updates for physicians' services; (2) volume performance standard rates of increase; (3) limitations on payment for physicians' services relating to inpatient stays in certain hospitals; (4) underserved area bonus payments; (5) development and implementation of resource-based methodology for practice expenses; (6) demonstration projects for Medicare State-based performance standard rate of increase; (7) elimination of formula-driven overpayments for certain outpatient hospital services; (8) eye or eye and ear hospitals; (9) imposition of coinsurance on laboratory services; (10) competition acquisition for items and services and laboratory services; (11) expanded coverage for physician assistants and nurse practitioners; and (12) general part B premiums. (Sec. 651) Makes various specified changes in provisions related to Medicare parts A and B and concerned with:  (1) Medicare as secondary payer; (2) physician referral exceptions; (3) Medicare supplemental policies; (4) reductions in routine cost limits for home health services; (5) termination of graduate medical education payments; and (6) extension of social health maintenance organization demonstrations. (Sec. 653) Requires the Secretary to use a competitive process to contract with centers of excellence for cataract surgery and coronary artery by-pass surgery with payment under Medicare to be made for services subject to such contracts on the basis of specified negotiated or all-inclusive rates. (Sec. 659) Requires the Prospective Payment Assessment Commission and the Physician Payment Review Commission to each study and report to the Congress on Medicare spending. (Sec. 660) Directs the Secretary to develop a process to ensure that Medicare claims are submitted first by Medicare, Medicare supplemental policies, and other policies that provide supplemental benefits under Medicare before providers can submit claims to Medicare beneficiaries. Subtitle B:  Medical Education - Amends SSA title XVIII to add a new part D (Medical Education) providing Federal payments to:  (1) qualified applicants of approved physician and dental training programs and graduate nurse training programs; (2) medical schools for certain costs; and (3) academic health centers and other eligible institutions. Establishes the Graduate Medical Education and Academic Health Centers and Biomedical and Behavioral Research Trust Fund Advisory Committee to study and report to the Congress on operations of the Graduate Medical Education and Academic Health Centers Trust Fund, and the Biomedical and Behavioral Research Trust Fund.  Authorizes appropriations. Subtitle C:  Home and Community-Based Services - Amends SSA title XIX to add new parts:  (1) C (State Programs for Home and Community-Based Services for Individuals with Disabilities) under which each State with an approved plan for home and community-based services for individuals with disabilities can receive Federal payments to provide such services to such individuals; and (2) D (Payments to Hospitals Serving Vulnerable Populations). Subtitle D:  Medicaid Program - (Sec. 671) Limits:  (1) coverage under Medicaid of items and services covered under the standard benefits package; and (2) State expenditures to certified health plans. Provides that no certified health plan with a Medicaid contract could have more than 50 percent of its enrollment composed of SSI-Medicaid recipients. (Sec. 673) Replaces disproportionate share hospital payment provisions with provisions relating to payments to hospitals serving vulnerable populations. (Sec. 674) Sets forth Medicaid long-term care provisions, including provisions for payments for personal care services and frail elderly services. (Sec. 675) Provides for an increased resource disregard for individuals receiving certain services. (Sec. 676) Increases the number of frail elderly demonstration project waivers. Amends the Omnibus Budget Reconciliation Act of 1986 to provide for the development of waiver protocols and model certification guidelines for an organization operating a demonstration project under such a waiver. (Sec. 677) Eliminates the:  (1) requirement of prior institutionalization with respect to habilitation services furnished under a waiver for home or community-based services; and (2) rule regarding availability of beds in certain institutions. (Sec. 679) Provides for Medicaid coverage of all certified nurse practitioner and clinical nurse specialist services. Title VII:  Revenue Provisions - Subtitle A:  Financing Provisions - Amends the Internal Revenue Code to increase the excise taxes on cigarettes and other tobacco products.  Applies such increase to tobacco products manufactured and sold in Puerto Rico. Increases such taxes for a temporary period for the funding of subsidies for children and pregnant women. (Sec. 703) Imposes an excise tax on the manufacture or importation of roll-your-own tobacco. (Sec. 705) Imposes a tax:  (1) on a percentage of premiums received under taxable health insurance policies; and (2) on a percentage of amounts received for health-related administrative services. Imposes on self-insured plans a monthly tax on a percentage of the accident or health coverage expenditures and direct administrative expenditures. (Sec. 706) Imposes a 25 percent tax on high cost health plans to be paid by the issuer or the plan sponsor.  Makes such tax non-deductible. (Sec. 711) Provides for the recapture of certain health care subsidies received by high-income individuals.  Transfers such amounts to the Supplementary Medical Insurance Trust Fund. (Sec. 715) Increases the excise tax on certain hollow point and large caliber handgun ammunition. (Sec. 716) 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. 717) 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 - Imposes a tax on employer-provided health benefits that do not meet the requirements for permitted coverage. (Sec. 722) Includes in gross income health insurance coverage provided through flexible spending arrangements. (Sec. 723) Extends the deduction for health insurance costs of self-employed individuals until December 31, 1995. Subtitle C:  Deduction for Individuals Purchasing Own Health Insurance - Allows a full deduction for the costs to individuals who purchase their own health insurance.  Allows such deduction against the gross income of the individual. Subtitle D:  Exempt Organizations - Sets forth qualification and disclosure requirements for tax-exempt health care organizations. (Sec. 742) Imposes an excise tax on the beneficiary of a taxable insurement and on the management of the participating tax-exempt health care organization. (Sec. 743) Provides for the treatment of health maintenance organizations, parent organizations, and health insurance purchasing cooperatives as tax-exempt entities. (Sec. 744) Provides for the taxation as an insurance company other than a life insurance company of certain organizations that provide health insurance and other prepaid health care services. (Sec. 746) Provides a tax exemption for certain qualified high risk insurance pools. (Sec. 748) Provides for the tax treatment of bonds of certain nonprofit tax-exempt organizations in a manner similar to governmental bonds. Subtitle E:  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. 752) Provides for the treatment of long-term care insurance as accident and health insurance. (Sec. 753) Allows accelerated death benefits under life insurance contracts to be paid to terminally ill individuals. Subtitle F:  Health Care Trust Funds - Establishes the following trust funds to finance health-related programs:  (1) the Health Security Trust Fund; (2) the Graduate Medical Education and Academic Health Centers Trust fund; and (3) the Biomedical and Behavioral Research Trust fund.  Provides funding for such Trust Funds through tax and assessments made under this Act. Subtitle G:  Other Revenue Provisions - Requires the Secretary of the Treasury to submit to specified congressional committees a legislative proposal providing statutory standards for the classification of workers as employees or independent contractors. (Sec. 772) Increases the penalty for failure to file correct information for returns involving payments for services. (Sec. 775) Allows a tax credit for certain primary health services providers that practice in health professional shortage areas. (Sec. 776) Increases the amount allowed to be expensed as a depreciable business asset if such asset is medical equipment. (Sec. 781) 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. 783) Allows a tax credit for the cost of personal assistance services required by certain employed individuals.  Limits the amount of such credit and provides a cost-of-living adjustment. (Sec. 785) Makes the limit on annual deferrals inapplicable in the case of an individual covered under an excess benefit arrangement maintained by a tax-exempt group medical practice. Subtitle H:  Ensuring Health Care Financing - Sets forth provision to ensure that programs under this Act and unanticipated increases in other Federal health spending do not increase the Federal deficit.",2025-08-26T13:51:45Z,
103-s-2352,103,s,2352,Mental Health and Substance Abuse Programs Reauthorization Act of 1994,Health,1994-08-02,1994-11-29,Referred to the House Committee on Energy and Commerce.,Senate,"Sen. Kennedy, Edward M. [D-MA]",MA,D,K000105,0,Mental Health and Substance Abuse Programs Reauthorization Act of 1994 - Amends the Public Health Service Act to reauthorize appropriations for specified programs relating to the Substance Abuse and Mental Health Services Administration. Repeals the block grant program that provides funds to States with insufficient capacity for treatment facilities.,2025-04-21T12:24:17Z,
103-hr-4864,103,hr,4864,Medical Device User Fee Act of 1994,Health,1994-08-01,1994-09-26,"Placed on the Union Calendar, Calendar No. 413.",House,"Rep. Waxman, Henry A. [D-CA-29]",CA,D,W000215,1,"Medical Device User Fee Act of 1994 - Amends the Federal Food, Drug, and Cosmetic Act to authorize the assessment and collection of fees from applicants for medical device approval.  Provides for the use of such fees to defray cost increases in the resources allocated for the process of device application review and related activities. Authorizes appropriations for FY 1995 through 1999.",2024-02-05T14:30:09Z,
103-hr-4865,103,hr,4865,Orphan Drug Act Amendments of 1994,Health,1994-08-01,1994-09-26,"Placed on the Union Calendar, Calendar No. 410.",House,"Rep. Waxman, Henry A. [D-CA-29]",CA,D,W000215,1,"Orphan Drug Act Amendments of 1994 - Amends the Federal Food, Drug, and Cosmetic Act to change from seven to four years the period of market exclusivity guaranteed to any approved orphan drug.  Specifies that orphan drugs of ""limited commercial potential,"" as defined by regulations to be issued by the Department of Health and Human Services (HHS) (based on total sales revenue for such drug during the four-year exclusivity period or other factors identified by the Secretary of HHS), would qualify for an additional three years of exclusive marketing rights. Permits more than one company to put a particular orphan drug on the market in instances where both companies were working on the drug in roughly the same time frame. Provides for the withdrawal of exclusive marketing rights if the patient population for the approved treatment exceeds 200,000. Extends the authorization of the research grant program.  Replaces the existing Orphan Products Board with an Office for Orphan Diseases and Conditions.",2024-02-05T14:30:09Z,
103-s-2346,103,s,2346,Public Health Improvement Act of 1994,Health,1994-08-01,1994-08-05,Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 541.,Senate,"Sen. Graham, Bob [D-FL]",FL,D,G000352,0,"Public Health Improvement Act of 1994 - Title I:  Programs Under Public Health Improvement Trust Fund - Subtitle A:  Programs of Public Health Service Act - Amends the Public Health Service Act to establish a new title regarding public health programs. Establishes the Public Health Improvement Trust Fund to carry out public health programs. Directs the Secretary of Health and Human Services (Secretary) to establish the National Public Health Advisory Commission for advice on carrying out this title and on other Federal policies regarding public health. Authorizes appropriations from the Fund for FY 1995 through 2002 for the activities of the Commission. Authorizes appropriations from the Fund for FY 1995 through 2002 for formula grants to States for core functions of public health programs.  Declares the purpose of such grants to provide improvements in the health status of the public through attaining the Healthy People 2000 Objectives. Authorizes appropriations from the Fund for FY 1995 through 2000 for grants to eligible entities for comprehensive evaluations of disease prevention and health promotion programs. Authorizes appropriations from the Fund for FY 1995 through 2002 for:  (1) scholarship and loan repayment programs regarding service in approved public health positions; (2) grants to relevant institutions to expand educational capacities; and (3) grants to States lacking public health training programs. Authorizes appropriations from the Fund for FY 1995 through 1997 for grants to public and nonprofit private entities for regional poison control centers. Authorizes appropriations from the Fund for FY 1996 through 2002 for grants to eligible entities for the development and operation of school health service sites.  Authorizes the Secretary to make loans and loan guarantees regarding such projects. Authorizes appropriations from the Fund for FY 1995 through 2002 for a scholarship program and loan repayment program for school nurses. Authorizes appropriations from the Fund for FY 1995 through 2000 for:  (1) grants to migrant health centers and community health centers; and (2) grants to public or private health care providers for the development of qualified community health plans and qualified community practice networks. Authorizes the Secretary to make and guarantee loans for the capital costs of developing qualified community health groups. Authorizes appropriations from the Fund for FY 1996 through 2000 for grants with relevant entities for enabling services, such as transportation, community and patient outreach, patient education, and translation services. Authorizes appropriations from the Fund for FY 1995 through 2000 for:  (1) the National Health Service Corps program and to increase the participation of nurses in scholarship and loan repayment programs; (2) grants to States to assist outpatient health centers (satellite clinics) that are providers of comprehensive health services; and (3) formula grants for the development and operation of community health advisor programs to assist States in attaining the Healthy People 2000 Objectives. Authorizes appropriations from the Fund for FY 1995 through 2000 for formula grants to States for service activities with respect to mental health and substance abuse.  Authorizes the Secretary to make loans to entities for the capital costs incurred in the development of non-acute, residential treatment centers and community-based ambulatory clinics. Subtitle B:  Comprehensive School Health Education - Authorizes appropriations from the Fund for FY 1995 through 2000 for planning and implementation grants for State education agencies and local educational agencies for programs of comprehensive school health education.",2025-08-26T13:49:08Z,
103-hr-4856,103,hr,4856,Patient Safety Act of 1994,Health,1994-07-28,1994-08-17,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Nadler, Jerrold [D-NY-8]",NY,D,N000002,0,"TABLE OF CONTENTS:     Title I:  General Provisions     Title II:  Creation of Independent and Effective State         Medical Boards     Title III:  Requirements for Health Care Professionals and         Providers     Title IV:  Public Access to Practitioner Data Bank Patient Safety Act of 1994 - Title I:  General Provisions - Declares that the purpose of this Act is to create a national program of medical malpractice prevention. Title II: Creation of Independent and Effective State Medical Boards - Requires each State medical board to create a consumer assistance unit to deal directly with complainants.  Requires the board to disclose information received from complaints to the national practitioner data bank. Establishes guidelines for investigations, disciplinary hearings, and disciplinary actions. Provides for the Secretary of Health and Human Services to assume responsibilities of this Act in cases where a State medical board does not meet requirements. Title III: Requirements for Health Care Professionals and Providers - Requires health care professionals and health care providers to renew their medical licenses every two years. Sets forth reporting requirements for health care professionals and providers and medical examiners. Requires licensed health care professionals to be reexamined every six years as a condition of licensure. Requires State medical boards to perform audits of the office-based practices of licensees to assess performance and to improve practices. Requires an audit of pharmacies to detect illegal drug diversion and other misuse of controlled substances. Requires health care professionals and providers to maintain malpractice insurance. Directs the Secretary to conduct a national interdisciplinary study of medical negligence. Title IV:  Public Access to Practitioner Data Bank - Amends the Health Care Quality Improvement Act of 1986 to require the Secretary to make specified information on health practitioners available to the public.",2025-08-26T13:51:12Z,
103-hr-4840,103,hr,4840,Prescription for Health Act of 1994,Health,1994-07-27,1994-09-16,Referred to the Subcommittee on Labor-Management Relations.,House,"Rep. Johnson, Sam [R-TX-3]",TX,R,J000174,4,"TABLE OF CONTENTS:      Title I:  Insurance Reform           Subtitle A:  Reform of Insured Market for Employers and                Individuals           Subtitle B:  ERISA and Internal Revenue Code                Requirements      Title II:  Tax Fairness      Title III:  Medical Savings Accounts      Title IV:  Medical Malpractice      Title V:  Antitrust Reform      Title VI:  Consumer Information The Prescription for Health Act of 1994 - Title I:  Insurance Reforms - Subtitle A:  Reform of Insured Market for Employers and Individuals - Part 1:  General Reforms - Prohibits an insurer from canceling coverage or denying renewal of coverage of health insurance with respect to an employer or an individual other than:  (1) for nonpayment of premiums, fraud or other misrepresentations, or noncompliance with plan provisions; or (2) because the insurer is ceasing to provide any health insurance in the State or, in the case of a health maintenance organization, in a geographic area with respect to employer or individuals, respectively. Prohibits an insurer that terminates the offering of health insurance plans in an area with respect to the market for employers or individuals from offering such a plan to any employer or individual in the area for five years after such termination. (Sec. 102) Bars an insurer from providing for an increase in the premium charged an employer or an individual for health insurance by a percentage that exceeds the percentage change in the premium charged any other employer or individual with the same characteristics, for similar benefits, and for the same area. (Sec. 103) Prohibits an insurer from denying health insurance coverage to any employer or individual, and a sponsor of a group health plan (GHP) from denying coverage to an eligible individual, on the basis of health status or preexisting condition if the employer or individual was covered by health insurance or a GHP for the same condition by another insurer or GHP for a period of not less than 12 months within the 15-month period ending with the month in which the application for coverage is made, with exceptions. Requires an insurer or sponsor of a GHP to waive any period applicable to a preexisting condition under health insurance or a GHP if the employer or individual was covered by such insurance or GHP for the same condition by another insurer or sponsor of a GHP for a period of not less than 12 months within the 15-month period ending with the month in which the application for coverage is made. (Sec. 104) Prohibits the premium charged by an insurer with respect to an employer or an individual covered under health insurance by another insurer for a period of not less than 12 consecutive months from exceeding the greater of the amount charged during the previous rating period or the premium charged to any other employer or individual with the same characteristics, for similar benefits, and for the same area. (Sec. 105) Permits variations in health insurance premiums among employers or individuals based on differences in covered services, age, gender, family composition, geographic area, or group size. (Sec. 106) Requires an insurer, upon request, to fully disclose all actuarial assumptions and methods used in establishing its premiums for health insurance at the time it offers or renews coverage to any employer or individual. (Sec. 107) Subjects any insurer or sponsor of a GHP which fails to comply with the provisions of this part to a civil monetary penalty of $250,000 per individual for each violation. Part 2:  State Preemptions - Specifies that no provision of State or local law shall apply:  (1) that requires the coverage under health insurance of any insurer of any specific benefits, services, or categories of health care or services of any class or type of provider of health care; and (2) that prohibits two or more employers or groups from obtaining coverage under a multiple health insurance plan. Subtitle B:  ERISA and Internal Revenue Code Requirements - Amends the Employee Retirement Income Security Act of 1974 to direct the Secretary of Labor to prescribe:  (1) solvency standards for GHPs that are single-employer plans which will ensure that benefits under such plans will be provided in full when due; and (2) rules for monitoring and enforcing compliance with such standards. Requires:  (1) the Secretary, in prescribing such solvency standards, to take into consideration the extent to which a plan's potential liabilities are covered by excess or stop-loss coverage; and (2) the plan sponsor of each GHP to take such steps as necessary to ensure that plan assets held for the purpose of complying with such standards are held in trust under the plan and are available solely for such purpose. (Sec. 133) Amends the Internal Revenue Code to provide that the account limit for any qualified asset account for a taxable year is the amount reasonably and actuarially necessary to fund compliance with Federal or State solvency requirements, in the case of an account providing medical benefits, as well as specified claims and administrative costs.  Title II:  Tax Fairness - Amends the Internal Revenue Code to allow individuals a deduction from gross income for medical expenses attributable to health plan coverage and contributions to a medical savings account. Revises the medical expense deduction to include amounts paid under a health plan or paid to a medical savings account.  Makes such deduction inapplicable to participants in a health plan maintained by their employer. Excludes employer contributions to medical savings accounts from employment taxes. Allows an individual tax credit for amounts allocable to FICA taxes used to purchase health plan coverage and to make contributions to medical savings accounts.  Makes such credit inapplicable to participants in a health plan maintained by their employer. Title III:  Medical Savings Accounts - Establishes tax-exempt medical savings accounts as trusts created to pay the medical expenses of beneficiaries. Title IV:  Medical Malpractice - Makes this title applicable to any medical malpractice liability claim (claim) and any medical malpractice liability action (action) brought in State or Federal court, except regarding a claim or action for damages arising from a vaccine-related injury or death to the extent that specified provisions of the Public Health Service Act apply. Sets forth provisions regarding:  (1) preemption and negotiated liability; (2) effect on sovereign immunity and choice of law or venue; and (3) Federal court jurisdiction. (Sec. 402) Sets a two-year statute of limitations from the date the alleged injury was, or reasonably should have been, discovered for actions, with an exception for certain minors. (Sec. 403) Makes the liability of each defendant in an action, with respect to economic and noneconomic damages, several only and not joint.  Specifies that such a defendant shall be liable only for the amount of such damages allocated to the defendant in direct proportion to such defendant's percentage of fault or responsibility for the claimant's injury. (Sec. 404) Limits to $250,000 the total amount of noneconomic damages that may be awarded to a claimant and the members of the claimant's family for losses resulting from the injury which is the subject of an action. (Sec. 405) Prohibits requiring a defendant, in an action in which the damages awarded for any economic losses to be incurred after the date on which the judgment is entered exceed $100,000, from paying such damages in a single, lump-sum payment.  Authorizes the court to require that such a defendant purchase an annuity or fund a reversionary trust to make periodic payments under specified circumstances.  Bars a court judgment awarding periodic payments from being reopened at any time to contest, amend, or modify the schedule or amount of payments in the absence of fraud or any other basis under which a party may obtain relief from a final judgment. (Sec. 406) Authorizes a court, as a condition of the initiation of an action, to require an undertaking for the payment of the costs associated with the action, including reasonable attorney fees. Directs the court to require the party against whom the judgment was rendered to pay to the prevailing party costs and fees incurred, with exceptions. (Sec. 407) Specifies that the total amount of damages received by a claimant in an action shall be reduced by any other payment that has been, or will be, made to such claimant to compensate such claimant for an injury that was part of the action. (Sec. 408) Prohibits the award of noneconomic damages regarding any medical product liability claim alleged against a medical product producer if:  (1) the drug or device that is the subject of such claim was subject to approval or premarket approval by the Food and Drug Administration (FDA) with respect to the safety of the formulation or performance of the aspect, or the adequacy of the packaging or labeling, of the drug or device, and was approved by the FDA; or (2) the drug or device is generally recognized as safe and effective pursuant to conditions established by the FDA and applicable regulations.  Makes an exception in the case of withheld information, misrepresentation, or illegal payment to an FDA official for purposes of securing approval. Title V:  Antitrust Reform - Directs the Attorney General to: (1) provide for the development and publication of explicit guidelines on the application of antitrust laws to the activities of health plans; and (2) establish a review process under which the administrator or sponsor of a health plan may submit a request to the Attorney General to obtain a prompt opinion from the Department of Justice on the plan's conformity with the Federal antitrust laws. (Sec. 502) Requires the Attorney General to issue a certificate of public advantage to each eligible health care collaborative activity that complies with specified requirements in effect on or after the expiration of the one-year period that begins on the date of this Act's enactment (thus making such activity and the parties to such activity immune from liability under the antitrust laws for conduct described). Sets forth provisions regarding requirements applicable to the issuance of such certificates.  Directs the Attorney General to issue a certificate to an eligible health care collaborative activity upon finding that the benefits are likely to outweigh any reduction in competition likely to result from the activity and that such reduction in competition is reasonably necessary to obtain such benefits. Sets forth provisions regarding:  (1) the establishment of criteria and procedures; (2) eligible health care collaborative activity; (3) the review of applications for certificates; (4) revocation of certificates; and (5) judicial review. Title VI:  Consumer Information - Requires each hospital, physician, or other health care provider to make available to an individual, before providing any health care item or service in the United States, a list of all applicable fees and charges (and where not readily determinable in advance, the provider may use such estimates as the Secretary of Health and Human Services may permit), with an exception for emergency treatment.  Specifies that no individual shall be liable for payment for a health care item or service for which disclosure has not been substantially made in accordance with this title.",2026-03-23T12:41:21Z,
103-hr-4841,103,hr,4841,Public Health Improvement Act of 1994,Health,1994-07-27,1994-09-16,Referred to the Subcommittee on Select Education and Civil Rights.,House,"Rep. Moran, James P. [D-VA-8]",VA,D,M000933,24,"TABLE OF CONTENTS:      Title I:  Programs Under Public Health Improvement Trust           Fund           Subtitle A:  Programs of Public Health Service Act           Subtitle B:  Comprehensive School Health Education      Title II:  Amendments to Internal Revenue Code of 1986 Public Health Improvement Act of 1994 - Title I:  Programs Under Public Health Improvement Trust Fund - Subtitle A:  Programs of Public Health Service Act - Amends the Public Health Service Act to establish a new title regarding public health programs. Establishes the Public Health Improvement Trust Fund to carry out public health programs.  Appropriates to such Fund revenues received by the disallowed deduction for certain advertising expenses for tobacco products or alcoholic beverages. Directs the Secretary of Health and Human Services (Secretary) to establish the National Public Health Advisory Commission for advice on carrying out this title and on other Federal policies regarding public health. Authorizes appropriations from the Fund for FY 1995 through 2002 for the activities of the Commission. Authorizes appropriations from the Fund for FY 1995 through 2002 for formula grants to States for core functions of public health programs.  Declares the purpose of such grants to provide improvements in the health status of the public through attaining the Healthy People 2000 Objectives. Authorizes appropriations from the Fund for FY 1995 through 2000 for grants to eligible entities for comprehensive evaluations of disease prevention and health promotion programs. Authorizes appropriations from the Fund for FY 1995 through 2002 for:  (1) scholarship loan repayment programs regarding service in approved public health positions; (2) grants to relevant institutions to expand educational capacities; and (3) grants to States lacking public health training programs. Authorizes appropriations from the Fund for FY 1995 through 1997 for grants to public and nonprofit private entities for regional poison control centers. Authorizes appropriations from the Fund for FY 1996 through 2002 for grants to eligible entities for the development and operation of school health service sites.  Authorizes the Secretary to make loans and loan guarantees regarding such projects.  Authorizes appropriations from the Fund for FY 1995 through 2002 for a scholarship program and loan repayment program for school nurses. Authorizes appropriations from the Fund for FY 1995 through 2000 for:  (1) grants to migrant health centers and community health centers; and (2) grants to public or private health care providers for the development of qualified community health plans and qualified community practice networks. Authorizes the Secretary to make and guarantee loans for the capital costs of developing qualified community health groups. Authorizes appropriations from the Fund for FY 1996 through 2000 for grants with relevant entities for enabling services such as transporation, community and patient outreach, patient education, and translation services. Authorizes appropriations from the Fund for FY 1995 through 2000 for:  (1) the National Health Service Corps program and to increase the participation of nurses in scholarship and loan repayment programs; (2) grants to States to assist outpatient health centers (satellite clinics) that are providers of comprehensive health services; and (3) formula grants for the development and operation of community health advisor programs to assist States in attaining the Health People 2000 Objectives. Authorizes appropriations from the Fund for FY 1995 through 2000 for formula grants to States for service activities with respect to mental health and substance abuse. Authorizes the Secretary to make loans to entities for the capital costs incurred in the development of non-acute, residential treatment centers and community-based ambulatory clinics. Subtitle B:  Comprehensive School Health Education - Authorizes appropriations from the Fund for FY 1995 through 2000 for planning and implementation grants for State education agencies and local educational agencies for programs of comprehensive school health education. Title II:  Amendments to Internal Revenue Code of 1986 - Amends the Internal Revenue Code to disallow the deduction for advertising expenses for tobacco products or alcoholic beverages.",2025-08-26T13:50:54Z,
103-hres-493,103,hres,493,Expressing the sense of the House of Representatives with respect to health care reform and essential community providers.,Health,1994-07-27,1994-09-01,Referred to the Subcommittee on Health.,House,"Rep. Menendez, Robert [D-NJ-13]",NJ,D,M000639,28,"Declares that it is the sense of the House of Representatives that:  (1) one of the principal purposes of health care reform should be to ensure that medically underserved populations are provided adequate access to health services; (2) the reform should require that each health plan make provider agreements with specified types of individuals, institutions, and entities; and (3) the reform should require that those individuals, institutions, and entities provide services in the most appropriate language and cultural context.",2024-02-07T16:32:33Z,
103-hconres-273,103,hconres,273,Expressing the sense of the Congress that any comprehensive health care reform measure should ensure that extemporaneous compounding is made available to provide allergen-free medications for persons who suffer from severe food allergies or other medical conditions.,Health,1994-07-26,1994-08-11,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Barca, Peter [D-WI-1]",WI,D,B001226,3,Declares that it is the sense of the Congress that comprehensive health care reform should make contemporaneous compounding available to provide allergen-free medications.,2024-02-05T14:30:09Z,
103-hr-4829,103,hr,4829,Family Health Care Coverage Act,Health,1994-07-26,1994-09-16,Referred to the Subcommittee on Labor-Management Relations.,House,"Rep. Baker, Bill [R-CA-10]",CA,R,B000078,0,"Family Health Care Coverage Act - Requires health plans that provide a family class of enrollment to offer and provide equal coverage to any child of an eligible individual who is less than 27 years of age, has never been married, has no dependents, and has a parent-child relationship with such individual.",2026-03-23T12:41:21Z,
103-hr-4816,103,hr,4816,Quality Care for Life Act of 1994,Health,1994-07-22,1994-08-01,"Referred to the Subcommittee on Commerce, Consumer Protection and Competitiveness.",House,"Rep. Talent, Jim [R-MO-2]",MO,R,T000024,0,"TABLE OF CONTENTS:     Title I:  Prospective Payment System for Nursing Facilities     Title II:  Subacute Care Continuum Amendments of 1994     Title III:  Long-Term Care Tax Clarification     Title IV:  Long-Term Care Insurance Standards     Title V:  Financial Eligibility Standards     Title VI:  Establishment of Program for Home and         Community-Based Services for Certain Individuals with         Disabilities     Title VII:  Asset Transfers Quality Care for Life Act of 1994 - Title I:  Prospective Payment System for Nursing Facilities - Prospective Payment System for Nursing Facilities Amendments of 1994 - Mandates that payment rates under the Prospective Payment System for Nursing Facilities reflect enumerated objectives.  Declares that this Act does not affect the skilled nursing facility benefit under title XVIII (Medicare) of the Social Security Act (SSA). (Sec. 105) Instructs the Secretary of Health and Human Services to:  (1) establish a resident classification system which groups residents into classes according to similarity of their assessed condition and required services; and (2) determine payment rates for nursing facilities according to prescribed guidelines. (Sec. 107) Prescribes guidelines for:  (1) resident assessment; (2) per diem rate for nursing service costs, administrative and general costs; (3) payment for fee-for-service ancillary services; (4) reimbursement of selected ancillary services including drugs and medical supplies; (5) the per diem rate for property costs; (6) mid-year adjustments; and (7) payment methods for new and low-volume nursing facilities. Title II:  Subacute Care Continuum Amendments of 1994 - Subacute Care Continuum Act of 1994 - Provides that SSA shall not be construed as limiting a skilled nursing facility (SNF) from offering subacute care services.  Prohibits the Secretary or the States from imposing conditions for such services which restrict SNFs from qualifying based upon their status. (Sec. 203) Instructs the Secretary, regardless of the issuance of final regulations, to:  (1) grant an interim exception within 90 days of submission of a request by a SNF providing subacute care services; and (2) establish identical fee schedules for physician visits to a subacute care patient in a SNF or in a hospital. (Sec. 205) Provides coverage under the Medicare program for respiratory therapy services in an SNF.  Requires the Secretary to determine and subsequently publish a list of hospital DRGs appropriate for SNFs and the appropriate hospitalizations and copayments and rebase Medicare payments which reflect the lower cost of such care provided in SNFs. (Sec. 207) Expresses the sense of the Congress that:  (1) the States are encouraged to develop payment methodologies for nursing facilities which provide subacute care for Medicaid patients; and (2) Federal funding should be available for nursing facilities which provide subacute care to Medicaid patients. Title III:  Long-Term Care Tax Clarification - Private Long-Term Care Insurance Incentive Amendments of 1994 - Amends the Internal Revenue Code to:  (1) set forth definitions concerning the treatment of long-term care insurance or plans; (2) treat qualified long-term services as medical care; (3) exclude from taxable income policy benefits pertaining to long-term care; (4) permit the offer of certain long-term care insurance contracts in certain employer (cafeteria) plans; (5) include in gross income excessive long-term care benefits; and (6) mandate that qualified long-term care insurance tax reserves be determined by the National Association of Insurance Commissioners. Title IV:  Long-Term Care Insurance Standards - Long-Term Care Insurance Standards Amendments of 1994 - Directs the Congress to appoint the National Long-Term Care Insurance Advisory Council to advise it and monitor development of the long-term care insurance market.  Authorizes appropriations. (Sec. 402) Amends the Internal Revenue Code to set forth consumer protection provisions regarding long-term care insurance policies. Sets forth tax penalties for non-complying issuers of such policies. (Sec. 404) Declares that insurance policies deemed by a State Insurance Commissioner to be in compliance with this Act and the Internal Revenue Code shall be deemed approved for sale in any other State. Title V:  Financial Eligibility Standards - Amends title XIX (Medicaid) of the Social Security Act to delineate the criteria for financial eligibility for nursing facility services.  Directs the Secretary to provide grants for State demonstration projects to investigate the coordination of private long-term care insurance benefits and financial eligibility requirements. Title VI:  Establishment of Program for Home and Community-Based Services for Certain Individuals with Disabilities - Home and Community-Based Services for Individuals with Disabilities Program Amendments of 1994 - Establishes a program which mandates that States having an approved State plan provide for home and community-based services for eligible individuals with disabilities. (Sec. 602) Increases the amount of an individual's resources which shall be disregarded when determining eligibility for inpatient nursing or intermediate care facilities for the mentally retarded. Title VII:  Asset Transfers - Extends from 36 to 60 months the look-back period for asset transfers.  Modifies the guidelines for such transfers with respect to the treatment of certain trusts.",2025-08-26T13:49:10Z,
103-hr-4809,103,hr,4809,Prostate Cancer Diagnosis and Treatment Act of 1994,Health,1994-07-21,1994-08-10,Referred to the Subcommittee on Hospitals and Health Care.,House,"Rep. McDermott, Jim [D-WA-7]",WA,D,M000404,55,"Prostate Cancer Diagnosis and Treatment Act of 1994 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of specified prostate cancer screening services and certain drug treatments for such cancer.  Requires the Secretary of Health and Human Services to establish fee schedules for such services. Amends Federal law to cover such screening and treatment services for veterans as a preventive health service. Amends the Public Health Service Act to authorize appropriations for certain public health programs related to prostate cancer research and education. Directs the Administrator of the Agency for Health Care Policy and Research to:  (1) conduct and support prostate cancer health services and screening and treatment procedures; and (2) provide for the development, periodic review, and updating of clinically relevant guidelines, standards of quality, performance measures, and medical review criteria.",2025-08-26T13:51:37Z,
103-hr-4810,103,hr,4810,Integrated Child Health Care Network Act of 1994,Health,1994-07-21,1994-08-01,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Schenk, Lynn [D-CA-49]",CA,D,S000119,4,"Integrated Child Health Care Network Act of 1994 - Amends title XIX (Medicaid) of the Social Security Act to prohibit the Secretary of Health and Human Services from granting a waiver under the Medicaid program to permit a State to require children enrolled in the program to receive medical assistance through managed care plans, unless such assistance is provided through an integrated child health care network. Directs the Secretary to make grants to eligible entities over a three-year period for the establishment and operation of such networks using different payment models, including grants to demonstrate the operation of networks (including State-initiated networks) applying a separate capitated payment rate with respect to children enrolled with the network.",2025-08-26T13:51:57Z,
103-s-2310,103,s,2310,"A bill to direct the Secretary of Health and Human Services to revise existing regulations concerning the conditions of payment under part B of the Medicare Program relating to anesthesia services furnished by certified registered nurse anesthetists, and for other purposes.",Health,1994-07-21,1994-07-21,Read twice and referred to the Committee on Finance.,Senate,"Sen. Conrad, Kent [D-ND]",ND,D,C000705,4,Instructs the Secretary of Health and Human Services to revise Medicare regulations governing payment for anesthesia services to compensate:  (1) certified registered nurse anesthetists (CRNAs) for their services; and (2) physicians for supervision of CRNAs. Amends title XVIII (Medicare) of the Social Security Act to provide guidelines for proportionally split payments for anesthesia services furnished jointly by a physician and a CRNA.,2025-01-14T18:59:41Z,
103-hres-485,103,hres,485,Expressing the sense of the House of Representatives that any health care reform legislation passed by Congress must ensure access to and the continued advancement of medical technology.,Health,1994-07-20,1994-08-01,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Ramstad, Jim [R-MN-3]",MN,R,R000033,16,Expresses the sense of the Congress that any legislation enacted to reform health care delivery should not include price controls and limits on national health care expenditures that would restrict access to medical technology or hinder its development.,2024-02-07T16:32:33Z,
103-hr-4789,103,hr,4789,"Morris K. Udall Parkinson's Research, Education, and Assistance Act of 1994",Health,1994-07-19,1994-08-01,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Waxman, Henry A. [D-CA-29]",CA,D,W000215,12,"Morris K. Udall Parkinson's Research, Education, and Assistance Act of 1994 - Amends the Public Health Service Act to require the Director of the National Institutes of Health to establish a council to coordinate Parkinson's research activities. Directs:  (1) the council to convene a National Consensus Conference on Parkinson's Disease and Related Neuro-degenerative Disorders to aid in the development of a broad-based strategy for identifying the cause of and treating such disorders; and (2) the Secretary of Health and Human Services to develop and annually submit to specified congressional committees a coordinated research agenda and to provide for the establishment of ten Parkinson's Research Centers. Authorizes the Secretary to:  (1) award feasibility study grants to support the development of preliminary data sufficient to provide the basis for the submission of applications for independent research support grants or establishment of a Center; and (2) award grants to appropriate institutions for the provision of training and continuing education concerning health and long-term care of individuals with Parkinson's. Directs the Secretary to establish:  (1) a grant program to support scientists who have distinguished themselves in the field of Parkinson's research; (2) a registry for screening and collecting patient and family data that may be useful in determining incidence and possible risk factors concerning Parkinson's; and (3) a national education program designed to foster a national focus on Parkinson's and the care of those with Parkinson's. Sets forth application requirements.  Authorizes appropriations.",2025-08-26T13:50:42Z,
103-hr-4791,103,hr,4791,Medical Malpractice Fairness Act of 1994,Health,1994-07-19,1994-08-05,Referred to the Subcommittee on Economic and Commercial Law.,House,"Rep. Grams, Rod [R-MN-6]",MN,R,G000367,37,"TABLE OF CONTENTS:      Title I:  General Provisions      Title II:  Federal Reform of Health Care Malpractice      Title III:  Requirements for ADR Medical Malpractice Fairness Act of 1994 - Title I:  General Provisions - Sets forth provisions regarding definitions and the period of applicability of this Act. Title II:  Federal Reform of Health Care Malpractice - Prohibits a health care malpractice action from being brought in any:  (1) State court unless the claim that is the subject of the action has been initially resolved under an alternative dispute resolution (ADR) system certified by the Secretary of Health and Human Services (or, in the case of a State in which such a system is not in effect, under the alternative Federal system established under this Act); and (2) Federal court based on diversity of citizenship unless the claim has been initially resolved under the system that applied in the State whose law applies. Directs the Attorney General to establish an ADR process for the resolution of tort claims consisting of such claims brought against the United States.  Prohibits an action based on such a claim from being brought in any Federal court unless the claim has been initially resolved under such process. Sets forth procedures for filing actions. Makes each defendant in such an action severally but not jointly liable.  Directs that each defendant's fault be determined on the basis of the defendant's percentage of responsibility. Limits to $250,000 the total of noneconomic damages that may be awarded to a claimant and the claimant's family for losses resulting from the injury, regardless of the number of parties or actions brought with respect to the injury. Prohibits the award of punitive damages except in cases of gross or criminal negligence.  Limits such awards against the manufacturer or seller of a medical product causing injury. Directs that any punitive damages awarded be:  (1) paid to the State in which the action is brought or, in a case brought in Federal court, the State in which the health care services that caused the injury were provided; and (2) used for activities to assure the safety and quality of health care services. Sets forth provisions regarding:  (1) reductions for contributions from collateral sources; (2) periodic payment of damages for future expenses; (3) a uniform statute of limitations; (4) attorney's fees and costs; (5) expert witness qualifications; (6) preemption; and (7) sovereign immunity and choice of law or venue. Title III:  Requirements for ADR - Sets requirements for State ADR systems.  Provides for the certification of State systems and the applicability of the alternative Federal system, as well as the treatment of States with an alternative system already in effect.",2025-08-26T13:50:45Z,
103-s-2294,103,s,2294,"Morris K. Udall Parkinson's Research, Education, and Assistance Act of 1994",Health,1994-07-19,1994-07-19,Read twice and referred to the Committee on Labor and Human Resources.,Senate,"Sen. Hatfield, Mark O. [R-OR]",OR,R,H000343,8,"Morris K. Udall Parkinson's Research, Education, and Assistance Act of 1994 - Amends the Public Health Service Act to require the Director of the National Institutes of Health to establish a council to coordinate Parkinson's research activities. Directs:  (1) the council to convene a National Consensus Conference on Parkinson's Disease and Related Neuro-degenerative Disorders to aid in the development of a broad-based strategy for identifying the cause of and treating such disorders; and (2) the Secretary of Health and Human Services to develop and annually submit to specified congressional committees a coordinated research agenda and to provide for the establishment of ten Parkinson's Research Centers. Authorizes the Secretary to:  (1) award feasibility study grants to support the development of preliminary data sufficient to provide the basis for the submission of applications for independent research support grants or establishment of a Center; and (2) award grants to appropriate institutions for the provision of training and continuing education concerning health and long-term care of individuals with Parkinson's. Directs the Secretary to establish:  (1) a grant program to support scientists who have distinguished themselves in the field of Parkinson's research; (2) a registry for screening and collecting patient and family data that may be useful in determining incidence and possible risk factors concerning Parkinson's; and (3) a national education program designed to foster a national focus on Parkinson's and the care of those with Parkinson's. Sets forth application requirements.  Authorizes appropriations.",2025-08-26T13:48:46Z,
103-s-2296,103,s,2296,Health Security Act,Health,1994-07-19,1994-07-19,Placed on Senate Legislative Calendar under General Orders. Calendar No. 525.,Senate,"Sen. Kennedy, Edward M. [D-MA]",MA,D,K000105,0,"TABLE OF CONTENTS:      Title I:  Health Care Security           Subtitle A:  Universal Coverage and Individual                Responsibility           Subtitle B:  Benefits           Subtitle C:  State Responsibilities           Subtitle D:  Consumer Purchasing Cooperatives           Subtitle E:  Employer Purchasers           Subtitle F:  Health Plans           Subtitle G:  Federal Responsibilities           Subtitle H:  Miscellaneous Employer Responsibilities           Subtitle I:  General Definitions; Miscellaneous                Provisions      Title II:  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:  Additional Provisions Regarding Public                Health           Subtitle J:  Occupational Safety and Health           Subtitle K:  Full Funding for WIC           Subtitle L:  Border Health Improvement      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           Subtitle D:  Medical Malpractice           Subtitle E:  Expanded Efforts to Combat Health Care                Fraud and Abuse           Subtitle F:  Repeal of Exemption      Title VI:  Premium Caps; Premium-Based Financing; and Plan           Payments           Subtitle A:  Premium Caps           Subtitle B:  Premium-Related Financings           Subtitle C:  Payments to Health Plans and Miscellaneous                Provisions      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 Payments to                Participating State           Subtitle C:  Borrowing Authority to Cover Cash-Flow          Shortfalls      Title X:  Workers Compensation Medical Services      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. Entitles a Medicare-eligible individual to benefits under Medicare instead of the 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 becomes Medicare-eligible. (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) Prescribes principles applicable to all health plans, including:  (1) nondiscrimination based on medical history, pre- existing medical conditions, or genetic predisposition to medical conditions; (2) open enrollment periods; and (3) the provision of services as defined in the benefits package. (Sec. 1005) States that a community-rated health plan is the applicable plan for a family, unless a family member is eligible for an experienced-rated health plan. (Sec. 1006) Prohibits an ineligible alien from enrolling in a health plan under this Act. 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) hearing aids for children; (17) dental care; (18) investigational treatments; and (19) optional 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 $2500 and for a family the annual maximum shall be $3000. (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 altered 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. (Sec. 1163) Requires facilities to promptly report incorrect test results to the provider who ordered the test. 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) Sets forth general responsibilities for participating States. (Sec. 1207) Requires the establishment of a National Center of Consumer Advocacy to provide technical assistance, adequate training, and support to States and Offices of Consumer Advocacy in each State. (Sec. 1209) Requires a State to designate an agency to coordinate the delivery of medical and social services to children with special health care needs. (Sec. 1221) Permits a State, with the Board's approval, to operate a single-payer system if specified requirements are met. (Sec. 1281) Provides for reductions in cost sharing for certain low-income families enrolled in community-rated health plans. Subtitle D:  Consumer Purchasing Cooperatives - Requires a State to certify consumer purchasing cooperatives to:  (1) enter into agreements with health plans; (2) enter into agreements with community-rated employers; (3) enroll eligible individuals in health plans; (4) make payments to health plans on behalf of community-rated employers and eligible individuals; (5) provide for coordination with other cooperatives; (6) provide information on health plans; and (7) carry out other functions as provided in this title. (Sec. 1321) Provides for the Federal Employees Health Benefits Program (FEHBP) to serve as a consumer purchasing cooperative in each health care coverage area designated by a State. Subtitle E:  Employer Purchasers - Sets forth the responsibilities of employer purchasers of health plans. (Sec. 1411) Directs the Secretary of Labor to develop and publish standards applicable to employer sponsored plans offered by large group purchasers. Subtitle F:  Health Plans - Sets forth requirements for the certification of health plans by a State. (Sec. 1531) Sets forth requirements relating to essential community providers. Subtitle G:  Federal Responsibilities - Establishes the National Health Board in the Executive Branch. (Sec. 1603) Sets forth the general duties and responsibilities of the Board, including an annual report to the President and the Congress. (Sec. 1611) 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. 1621) Provides for the Federal assumption of responsibilities in the absence of a State system. (Sec. 1641) Directs the Board to develop a risk adjustment and reinsurance methodology.  Sets forth guidelines for developing such methodology. (Sec. 1651) Directs the Board to establish minimum capital requirements for community-rated health plans. (Sec. 1660) Requires the Board to establish a national annual open enrollment period. (Sec. 1671) 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. 1672) Directs the Secretary to undertake an interdisciplinary medical technology impact study to assess the overall effect on patient outcomes of medical technologies used in treating a list of target diseases and conditions. (Sec. 1681) Provides for the certification of essential community providers.  Sets forth the categories of providers automatically certified. (Sec. 1687) Directs the Secretary to perform responsibilities with respect to the development of workplace wellness programs. (Sec. 1691) Sets forth the responsibilities of the Secretary of Labor in administering provisions of this Act and related Acts. (Sec. 1695) Provides for collective bargaining dispute resolution for the transition period to a restructured health care delivery system. Subtitle H:  Miscellaneous Employer Responsibilities - Sets forth employer responsibilities including:  (1) auditing of records; (2) prohibitions on discrimination based on family status; (3) evasion of obligations; (4) prohibitions on self-funding of cost sharing benefits; and (5) obligations to retirees. Subtitle I:  General Definitions; 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. (Sec. 1917) Expresses the sense of the Senate Committee on Labor and Human Resources that when the Health Security Act is enacted it should include specified sources of financing not within the jurisdiction of the Committee.  Expresses the sense of such Committee that when health reform legislation is enacted it should include the permanent extension of the research and development tax credit. (Sec. 1918) Expresses the sense of such Committee that provisions encouraging the establishment of medical savings accounts be included in any health reform bill passed by the Senate, in conjunction with a comprehensive benefit package described in subtitle B of this title. Title II:  Long-Term Care - Establishes requirements for State programs for home and community-based services to individuals with disabilities.  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. 2107) Directs the Secretary to establish an advisory group to advise on all aspects of such State programs. (Sec. 2111) Provides financial assistance to States to assist in developing and implementing, or expanding and enhancing, a family- centered, culturally competent, community-centered, comprehensive statewide system of extended services and benefits for children with special health care needs. (Sec. 2201) Long-Term Care Insurance Improvement and Accountability Act - Amends the Public Health Service Act to mandate the establishment of model Federal standards for long-term care insurance. (Sec. 2301) Life Care Act - Amends the Public Health Service Act to establish a voluntary long-term care insurance program for individuals 35 years of age and over to cover the nursing home stays of such individuals. (Sec. 2303) Expresses the sense of the Senate Committee on Labor and Human Services concerning the success of PACE (Program of All- inclusive Care for the Elderly) in providing integrated service delivery. 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. 3031) Makes funds available for:  (1) qualified entities for the operation of approved physician training programs; (2) eligible medical schools for the direct costs of academic programs; and (3) qualified academic health centers or teaching hospitals. (Sec. 3071) 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. 3081) Authorizes appropriations to the Secretary of Health and Human Services for the following programs:  (1) primary care physician and physician assistant training; (2) training of underrepresented minorities and disadvantaged persons; (3) expanding rural health career opportunities and retention efforts; and (4) nurse training. Directs the Secretary to establish a National Advisory Board on Health Care Workforce Development to make recommendations on health care worker matters. Amends the Public Health Service Act to authorize appropriations for grants to improve the training of health care workers in assisting the needs of mentally retarded individuals and others with developmental disabilities. (Sec. 3082) Authorizes appropriations to the Secretary of Labor for a retraining program, a demonstration program for advanced career positions, and a workforce adjustment program. Subtitle B:  Academic Health Centers - Authorizes appropriations for grants for:  (1) rural information and referral systems; and (2) community- and provider-based health plans to provide services of eligible centers to residents of rural or urban communities. 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. Subtitle E:  Health Services for Medically Underserved Populations - Authorizes appropriations for:  (1) grants and contracts for the development of qualified community health plans and networks; (2) loans and grants for the capital costs of developing qualified community health groups; and (3) grants and contracts for enabling and supplemental services. (Sec. 3471) Authorizes appropriations for:  (1) the National Health Service Corps; and (2) such amounts as are necessary to ensure that a specified percentage 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 to specified payments. (Sec. 3491) Expresses the sense of the Senate Committee on Labor and Human Resources on the appropriate recognition of the success of community and migrant health centers. Subtitle F:  Mental Health; Substance Abuse - Authorizes appropriations for grants to States for the development and operation of comprehensive managed mental health and substance abuse programs that are integrated with the health delivery system established under this Act. Subtitle G:  Comprehensive School Health Education; School- Related Health Services - Authorizes appropriations for:  (1) the development and implementation of comprehensive age appropriate health education programs in public schools for children and youth kindergarten through grade 12; and (2) increase access to preventive and primary health care services for children and youth through school-based or school-linked health service sites. Subtitle H:  Public Health Service Initiative - Specifies the initiatives under this Act to be funded through funds not otherwise appropriated. Subtitle I:  Additional Provisions Regarding Public Health - Requires the Secretary to reserve allocated appropriations for curriculum development and implementation regarding domestic violence and women's health needs. Subtitle J:  Occupational Safety and Health - Directs the Secretary of Health and Human Services and the Secretary of Labor to work together to develop and implement a comprehensive program to expand and coordinate initiatives to prevent occupational injuries and illnesses. Subtitle K:  Full Funding for WIC - Amends the Child Nutrition Act of 1966 to authorize appropriations for the special supplemental food program. Subtitle L:  Border Health Improvement - Authorizes the President to conclude an agreement with Mexico to establish a binational commission to be known as the United States-Mexico Border Health Commission. 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 Council. (Sec. 5002) Specifies the duties of such Council. Subtitle B:  Information Systems, Privacy, and Administrative Simplification - Directs the National Health Board to develop standards under which health care providers and health plans collect information for a national health care data network. (Sec. 5135) Authorizes the Board to make grants for demonstration projects to promote the development and use of electronically integrated community-based clinical information systems and computerized patient medical records. (Sec. 5160) Health Care Privacy Protection Act - Amends Federal criminal law to prescribe penalties for the wrongful disclosure of protected health information and the misuse of health security cards. (Sec. 5163) Provides limitations on the disclosure of protected health information. (Sec. 5195) Requires the Board to publish standard benefit forms. 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 to permit aggrieved individuals to file complaints. (Sec. 5205) Provides for a Federal Health Plan Review Board to review the decisions of complaint review office hearing officers. (Sec. 5206) 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. (Sec. 5231) Sets forth additional remedies and enforcement provisions. Subtitle D:  Medical Malpractice - Requires States to adopt an alternative dispute resolution system mechanism under which the parties must participate prior to the commencement of a medical malpractice action. Subtitle E:  Expanded Efforts to Combat Health Care Fraud and Abuse - Requires the Secretary of Health and Human Services and the Attorney General to establish a joint program for health care fraud and abuse control. (Sec. 5421) Amends Federal criminal law to impose penalties for health care fraud, theft or embezzlement in connection with health care, false statements relating to health care matters, and bribery and graft relating to health care. Subtitle F:  Repeal of Exemption - Amends specified Acts to repeal the exemption for health insurance. 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 community-rated health plans. (Sec. 6002) Directs the Board to determine:  (1) a national per capita baseline premium target; and (2) the health care coverage area per capita premium target. (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 health care coverage area per capita premium targets due to variation in practice patterns. (Sec. 6011) Subjects each noncomplying community-rated health plan for a year to a reduction in plan payment as specified, in order to assure that payments to community-rated health plans are consistent. (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 large group purchaser. (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 community-rated health plan or an experienced-rated health plan in a class of family enrollment responsible for payment of the family share of premium.  Provides for income-related discounts and specified credits. (Sec. 6116) Exempts certain employers from coverage obligations. (Sec. 6121) Specifies premium payments for community-rated employers, including premium discounts. (Sec. 6131) Specifies premium payments for large group purchasers. Subtitle C:  Payments to Health Plans and Miscellaneous Provisions - Makes States responsible for assisting health plans and cooperatives in the collection of premium payments. Sets forth other duties and responsibilities of States and health plans with respect to payments and other administrative matters. 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 define group health plan. (Sec. 8402) Sets limitations on coverage of group health plans under title I (Protection of Employee Benefit Rights) of ERISA. Authorizes the Secretary of Labor to provide special rules for group health plan reporting and disclosure.  Makes provisions relating to interference with protected rights and coercive interference applicable to enrollees in large group purchaser health plans. (Sec. 8403) Revises certain continuation coverage requirements (from COBRA - the Consolidated Omnibus Budget Reconciliation Act) under ERISA with respect to group health plans.  Repeals ERISA provisions for continuation coverage under group health plans upon full implementation of universal coverage under this Act.  Amends the Public Health Service Act with respect to period of coverage under a qualified health plan.  Repeals such coverage provisions upon full implementation of universal coverage under this Act. (Sec. 8404) Ends certain ERISA provisions' applicability with respect to:  (1) cases of adoption, to the extent otherwise provided in regulations of the National Health Board under this Act; and (2) coverage of pediatric vaccines under group health plans, upon the plan's becoming a large group purchaser health plan under this Act. (Sec. 8405) Requires group health plans covered by specified ERISA provisions to comply with the requirements of this Act for health plan claims procedures. (Sec. 8406) Exempts the Hawaii Prepaid Health care Act from certain ERISA preemption provisions, under specified conditions. Title IX:  Aggregate Government Payments - Subtitle B (sic): Aggregate Federal Payments to Participating State - Directs the Secretary of Health and Human Services (HHS) to pay a capped Federal entitlement payment amount to each participating State in each calendar quarter.  Sets forth formulas and rules for capped entitlement payments. Subtitle C:  Borrowing Authority to Cover Cash-Flow Shortfalls - Directs the Secretary of HHS to make available loans to States to cover any period of temporary cash-flow shortfall attributable to an estimation discrepancy, an administrative error, or relative timing during the year in which amounts are received and payments are required to be made. (Sec. 9201) Requires each State to provide that any surplus of funds resulting from an estimation discrepancy, up to a reasonable amount specified by the Secretary of HHS, shall be held in a State contingency fund for any future shortfalls from such a discrepancy. Title X:  Workers Compensation Medical Services - Makes specified provisions under this Act (HSA) relating to use of standard forms and health care information applicable to a health plan or health care provider's provision of workers compensation medical services.  Requires plans and providers that render such services to: (1) provide relevant health care information necessary to assist the worker in the safe and timely return to work; and (2) comply with legal duties and reporting requirements under State workers compensation laws and other Federal and State laws, including those regarding reporting of occupational injuries and diseases.  Directs the Secretary of Labor to promulgate rules to clarify such plan and provider information responsibilities. (Sec. 10001) Requires health plans to provide care in disputed workers compensation cases, until an adjudicated determination is made that the claim is compensable as workers compensation.  Requires the workers compensation carrier (or the self-insured employer) to reimburse the health plan and the worker if such determination is made. (Sec. 10002) Directs the Secretaries of HHS and Labor to conduct demonstration projects in one or more States with respect to treatment of work-related injuries and illnesses.  Requires project development of:  (1) protocols for treatment of work-related conditions; and (2) model methods of workers compensation carriers capitated payment on a per case basis to health plans for treatment of specified work-related injuries and illnesses. (Sec. 10003) Establishes a Commission on Workers Compensation Medical Services.  Directs the Commission to study the relationship of workers compensation medical services to the new health system under this Act in terms of impact on the cost of such services, access to appropriate care for injured workers, and quality of medical care and its impact on functional and vocational outcomes for injured workers, considering specified issues.  Requires the Commission's final report to the President and specified congressional committees to include a recommendation as to whether a transfer of financial responsibility for some or all medical benefits to health plans should be effected, along with a detailed implementation plan if such transfer is recommended. 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.",2025-08-26T13:51:14Z,
103-hr-4755,103,hr,4755,To provide for demonstration projects for worksite health promotion programs.,Health,1994-07-14,1994-08-01,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Brown, Sherrod [D-OH-13]",OH,D,B000944,1,Directs the Secretary of Health and Human Services to conduct a demonstration project to evaluate the effectiveness of health promotion programs in the worksite and appropriate incentives to encourage employers to adopt such programs.  Authorizes appropriations.,2024-02-05T14:30:09Z,
103-hr-4756,103,hr,4756,To amend title XVIII of the Social Security Act to require the Secretary of Health and Human Services to take into account the health of a primary caregiver in determining whether an item of durable medical equipment is considered medically necessary and appropriate under part B of the medicare program.,Health,1994-07-14,1994-08-01,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Brown, Sherrod [D-OH-13]",OH,D,B000944,0,"Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services, when determining whether an item of durable medical equipment (DME) is reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member with respect to an ill or injured individual, to consider the effect of a denial of payment for the DME item on the health of the individual's live-in primary caregiver. Defines the primary caregiver as one who assists the ill or injured individual without monetary compensation in the performance of such activities of daily living as eating, bathing, dressing, toileting, and transferring in and out of a bed or a chair.",2024-02-07T16:32:33Z,
103-hr-4769,103,hr,4769,"To amend the Internal Revenue Code of 1986 to provide for the treatment of long-term care insurance, and for other purposes.",Health,1994-07-14,1994-10-24,"Referred to the Subcommittee on Commerce, Consumer Protection and Competitiveness.",House,"Rep. Snowe, Olympia J. [R-ME-2]",ME,R,S000663,0,"TABLE OF CONTENTS:      Title I:  Tax Treatment of Long-Term Care Insurance      Title II:  Establishment of Federal Standards for Long-Term           Care Insurance      Title III:  Deduction for Certain Expenses for Dependents with           Alzheimer's Disease or Related Organic Brain Disorders      Title IV:  Dependent Care Credit Expanded and Made Refundable Title I:  Tax Treatment of Long-Term Care Insurance - Amends the Internal Revenue Code to provide for the treatment of qualified long-term care insurance or plans as accident and health insurance or plans for purposes of insurance company taxation. (Sec. 102) Excludes from gross income benefits provided under a long-term care insurance contract.  Includes in gross income employer-provided coverage for long-term care services. (Sec. 103) Allows a tax credit for a percentage of eligible long-term care premiums. (Sec. 104) Includes amounts paid for qualified long-term care services as medical expenses for individual itemized deductions.  Includes any parent or grandparent as a dependent for purposes of such expenses. (Sec. 105) Requires long-term care insurance contracts to use a one-year full preliminary term tax reserve method. (Sec. 106) Excludes from gross income certain amounts withdrawn from individual retirement accounts and certain employer cash or deferred arrangements to pay long-term care premiums. (Sec. 107) Provides for the exclusion as a death benefit of any amount paid or advanced to an individual under a life insurance contract because such individual is terminally ill, chronically ill, or has been permanently confined to a qualified facility. (Sec. 108) Allows insurance companies to issue accelerated death benefit riders on life insurance contracts. (Sec. 109) Permits long-term care insurance contracts to be offered in cafeteria plans. Title II:  Establishment of Federal Standards for Long-term Care Insurance - Amends the Public Health Service Act to mandate the establishment of model Federal standards for long-term care insurance. Prohibits the offering of a long-term care insurance policy in a State unless the State has a regulatory program meeting the requirements of this Act or the policy has been certified by the Secretary of Health and Human Services. Authorizes grants to States for demonstration programs to improve enforcement of the standards.  Authorizes appropriations. Imposes on agents selling long-term policies a duty of good faith and fair dealing.  Prohibits twisting, high pressure tactics, and cold lead advertising.  Mandates minimum financial standards, including income and asset criteria, for advising individuals considering the purchase of a long-term policy. Prohibits sales:  (1) to an individual eligible for assistance under title XIX (Medicaid) of the Social Security Act; (2) of duplicate service policies; and (3) of policies that reduce, limit, or coordinate benefits on the basis of eligibility for other coverage or benefits.  Provides for:  (1) criminal and civil penalties; and (2) agent training and certification. Sets forth additional carrier responsibilities relating to refunding of premiums, mailing of policies, providing information on denials of claims, and reporting of information. Prohibits cancellation or nonrenewal of a long-term care policy except for nonpayment of premium or material misrepresentation.  Sets forth continuation and conversion rights for group policies, regulating premiums for converted policies.  Requires guaranteed issuance to an individual if the individual meets the minimum medical requirements of the policy. Mandates standards regarding upgraded benefits.  Limits cancellation for nonpayment by an incapacitated individual. Requires:  (1) subject to exceptions, uniform language and definitions, a uniform format, and at least one standard benefit package; and (2) disclosure of certain matters, including an outline of coverage.   Mandates recommendations by the National Association of Insurance Commissioners (NAIC) regarding informing consumers on the long-term economic viability of long-term care insurance carriers.  Limits certain conditions on benefits.  Requires, if benefits are provided for home health care or community-based services, that certain minimum benefits be provided.  Prohibits treating cognitive or mental impairments (including Alzheimer's disease and mental illness) differently from other medical conditions.  Limits preexisting condition requirements. Requires:  (1) each claimant to have a functional assessment by an individual or entity meeting NAIC qualifications and unconnected to the policy issuer; (2) inflation protection, unless rejected in writing by a policyholder; (3) disclosure of certain premium increases; and (4) nonforfeiture benefits.  Prohibits a carrier from contesting a policy or claim based on fraud or misrepresentation unless notice is provided within a time period set by NAIC.  Establishes the right of a purchaser to return a policy within a specified period. Defines ""long-term care insurance policy,"" excluding:  (1) any basic Medicare supplemental policies; (2) other insurance offered primarily to provide specified types of coverage; and (3) certain life insurance policies. Authorizes grants for programs to provide information, counseling, and assistance regarding the procurement of long-term insurance.  Authorizes appropriations. Title III:  Deduction for Certain Expenses for Dependents with Alzheimer's Disease or Related Organic Brain Disorders - Amends the Internal Revenue Code to allow an individual an income tax deduction for qualified home health care and adult day and respite care expenses with respect to a dependent who:  (1) resides with the taxpayer; (2) suffers from Alzheimer's disease or a related organic brain disorder; and (3) is physically or mentally incapable of self- care. Title IV:  Dependent Care Credit Expanded and Made Refundable - Repeals the Internal Revenue Code's nonrefundable income tax credit for employment- related dependent care expenses, replacing it with a corresponding refundable 50 percent credit, reduced (but not below 20 percent) as the taxpayer's adjusted gross income exceeds $15,000 (adjusted for inflation). Includes within the scope of the new credit up to $1,200 ($2,400 in the case of more than one qualifying individual) of respite care expenses incurred in the care of:  (1) a dependent of the taxpayer who is at least 13 years old; or (2) a spouse or other dependent who is physically or mentally incapable of self-care.",2024-02-07T16:32:33Z,
103-hres-478,103,hres,478,To recognize Mennonite Mutual Aid.,Health,1994-07-14,1994-08-01,"Referred to the Subcommittee on Commerce, Consumer Protection and Competitiveness.",House,"Rep. Brown, Sherrod [D-OH-13]",OH,D,B000944,0,"Resolves that, in any national health insurance reform legislation that provides for universal coverage, there be a provision that permits Mennonites to continue receiving coverage through Mennonite Mutual Aid.",2024-02-07T16:32:33Z,
103-s-2283,103,s,2283,Prostate Cancer Diagnosis and Treatment Act of 1994,Health,1994-07-14,1994-07-14,Read twice and referred to the Committee on Finance.,Senate,"Sen. Shelby, Richard C. [D-AL]",AL,D,S000320,8,"Prostate Cancer Diagnosis and Treatment Act of 1994 - Amends title XVIII (Medicare) of the Social Security Act to provide for coverage of specified prostate cancer screening services and certain drug treatments for such cancer.  Requires the Secretary of Health and Human Services to establish fee schedules for such services. Amends Federal law to cover such screening and treatment services for veterans as a preventive health service. Amends the Public Health Service Act to authorize appropriations for certain public health programs related to prostate cancer research and education. Directs the Administrator of the Agency for Health Care Policy and Research to:  (1) conduct and support prostate cancer health services and screening and treatment procedures; and (2) provide for the development, periodic review, and updating of clinically relevant guidelines, standards of quality, performance measures, and medical review criteria.",2025-08-26T13:52:16Z,
103-hr-4725,103,hr,4725,Presidential Commission on Telemedicine Act,Health,1994-07-12,1994-08-01,Referred to the Subcommittee on Telecommunications and Finance.,House,"Rep. Schroeder, Patricia [D-CO-1]",CO,D,S000142,0,"Presidential Commission on Telemedicine Act - Establishes the Presidential Commission on Telemedicine, which shall review and study the use of telecommunications and information systems technologies in: (1) the provision of health care and the performance of health research; (2) the training of students of health professions and the continuing education of practicing health care providers; and (3) the monitoring of medical conditions by individuals at home. Requires the Commission to:  (1) assess whether such technologies are effective in improving the quality and accessibility of health care and reducing its cost; (2) examine methods by which training in the use of telecommunications and information systems technologies in the delivery of health care might be improved; (3) analyze any obstacles that may impede the wide use and acceptance of such technologies by health care providers; and (4) develop a model definition of the term ""telemedicine."" Requires a final report to the President and the Congress.",2025-08-26T13:51:05Z,
103-hr-4728,103,hr,4728,Medical Device User Fee Act of 1994,Health,1994-07-12,1994-08-01,For Further Action See H.R.4864.,House,"Rep. Waxman, Henry A. [D-CA-29]",CA,D,W000215,1,"Medical Device User Fee Act of 1994 - Amends the Federal Food, Drug, and Cosmetic Act to authorize the assessment and collection of fees from applicants for medical device approval.  Provides for the use of such fees to defray cost increases in the resources allocated for the process of device application review and related activities. Authorizes appropriations for FY 1995 through 1999.",2025-08-26T13:52:30Z,
103-s-2276,103,s,2276,Medical Device User Fee Act of 1994,Health,1994-07-12,1994-07-12,Read twice and referred to the Committee on Labor and Human Resources.,Senate,"Sen. Kennedy, Edward M. [D-MA]",MA,D,K000105,0,"Medical Device User Fee Act of 1994 - Amends the Federal Food, Drug, and Cosmetic Act to authorize the assessment and collection of fees from applicants for medical device approval.  Provides for the use of such fees to defray cost increases in the resources allocated for the process of device application review and related activities. Authorizes appropriations for FY 1995 through 1999.",2025-08-26T13:51:32Z,
103-sjres-208,103,sjres,208,"A joint resolution designating the week of November 6, 1994, through November 12, 1994, ""National Health Information Management Week"".",Health,1994-07-01,1994-10-07,Referred to the House Committee on Post Office and Civil Service.,Senate,"Sen. Wofford, Harris [D-PA]",PA,D,W000665,53,"Designates the week of November 6 through 12, 1994, as National Health Information Management Week.",2025-07-21T19:32:26Z,
103-hr-4687,103,hr,4687,Children's Health Equity Act of 1994,Health,1994-06-30,1994-07-22,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Lambert, Blanche M. [D-AR-1]",AR,D,L000035,0,"Children's Health Equity Act of 1994 - Amends title XIX (Medicaid) of the Social Security Act to prohibit a State from requiring any child with special health care needs to receive services under the State's Medicaid plan through enrollment with a capitated managed care plan, unless the State adopts pediatric risk adjustment methodologies under which the State adjusts the payment rates for such plans to take into account the financial risks of enrolling such children. Directs the Secretary of Health and Human Services to develop and report to the Congress on model pediatric risk adjustment methodologies for such purpose.",2025-08-26T13:50:55Z,
103-hr-4688,103,hr,4688,Rural Health Care Practitioners Revitalization Act of 1994,Health,1994-06-30,1994-07-22,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Lambert, Blanche M. [D-AR-1]",AR,D,L000035,0,"TABLE OF CONTENTS:      Title I:  Tax Incentives Regarding Rural Health Care      Title II:  Public Health Service Programs Regarding Rural           Health Care           Subtitle A:  National Health Service Corps           Subtitle B:  Other Programs Regarding Rural Health Care      Title III:  State Health Service Corps Demonstration           Projects      Title IV:  Treatment of Student Loans for Health           Professionals Rural Health Care Practitioners Revitalization Act of 1994 - Title I:  Tax Incentives Regarding Rural Health Care - Amends the Internal Revenue Code to exclude from gross income any payment made on behalf of a taxpayer by the National Health Service Corps Loan Repayment Program. (Sec. 102) Permits a deduction for medical education loan interest incurred by health professionals serving in medically underserved rural areas. (Sec. 103) Provides a credit for a qualified primary health services provider providing primary health services full time to an individual residing in a rural health professional shortage area and who:  (1) is not receiving a National Health Service Corps Scholarship as a loan repayment under the National Health Service Corps Loan Repayment Program; (2) is not fulfilling service obligations under such Programs; and (3) has not defaulted on such obligations. (Sec. 104) Provides for an increase in the amount which may be expensed as depreciable business assets in the case of rural health care property. Title II:  Public Health Service Programs Regarding Rural Health Care - Subtitle A:  National Health Service Corps - Amends the Public Health Service Act to add additional criteria for use in determining health professional shortage areas by including in the criteria the number of individuals paying for health services through Medicare or Medicaid and the number of individuals who have no health insurance, as well as the number of physicians who will accept Medicare and Medicaid patients. (Sec. 202) Requires that at least five percent of appropriations for the National Health Service Corps be used for special loans for former Corps members to enter private practice in health professional shortage areas. (Sec. 211) Provides increased funding for the Scholarship Program and the Loan Repayment Program. (Sec. 212) Directs the Secretary of Health and Human Services to give priority in making scholarships to individuals from rural backgrounds who are likely, after their service, to serve in a rural health professional shortage area. (Sec. 221) Establishes the Rural Primary Health Care Fund for the purpose of making loans to assist individuals with the costs of attending professions schools if the individuals agree to provide primary health services in an underserved rural area. Authorizes appropriations. Subtitle B:  Other Programs Regarding Rural Health Care - Requires a State, in order for the State to receive a grant for an Office of Rural Health, to undertake activities to recruit and train physicians to serve in rural areas.  Authorizes appropriations for such Offices. (Sec. 232) Authorizes and increases appropriations through FY 1997 for area health education center programs. Title III:  State Health Service Corps Demonstration Projects - Directs the Secretary of Health and Human Services to establish a State Health Service Corps Demonstration Project. Directs the Secretary to make grants under the Project to up to ten States for the Federal share of training and employment of physician and nonphysician providers serving health professional shortage areas. Authorizes appropriations. Requires each State carrying out a Project to establish a State Health Service Corps Scholarship Program involving a period of service in the service area or on the clinical staff of an area health education center or a medical school in return for a scholarship. Title IV:  Treatment of Student Loans for Health Professionals - Amends the Higher Education Act of 1965 to defer certain student loan repayments for a borrower who is serving in an internship or residency program in a health facility located in a rural area.",2025-08-26T13:49:45Z,
103-hr-4689,103,hr,4689,"To amend title XVIII of the Social Security Act to increase the bonus payment provided for physicians' services furnished under part B of the medicare program in a health professional shortage area to 20 percent in the case or primary care services, to establish updates for 1995 in the conversion factors used to determine the amount of payment made for physicians' services under the medicare program, and for other purposes.",Health,1994-06-30,1994-07-22,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Lambert, Blanche M. [D-AR-1]",AR,D,L000035,0,Amends title XVIII (Medicare) of the Social Security Act to increase from ten percent to 20 percent the bonus payment provided for physicians' primary care services furnished under part B of the Medicare program in a health professional shortage area.  Extends such bonus payments to certain nonphysician providers and other Medicare-dependent providers in such areas. Establishes the following updates for 1995 in the conversion factors used to determine the amount of Medicare payments:  (1) 10.7 percent for surgical services; (2) 10.1 percent for primary care services; and (3) 7.4 percent for all other services.,2024-02-07T16:32:33Z,
103-hr-4690,103,hr,4690,Rural Health Care Improvement Act of 1994,Health,1994-06-30,1994-08-19,See H.R.3600.,House,"Rep. Bereuter, Doug [R-NE-1]",NE,R,B000403,0,"TABLE OF CONTENTS:      Title I:  Grants to Encourage Establishment of Community Rural           Health Networks      Title II:  Incentives For Health Professionals to Practice in           Rural Areas           Subtitle A:  National Health Service Corps Program           Subtitle B:  Incentives Under Other Programs      Title III:  Assistance for Institutional Providers           Subtitle A:  Emergency Medical Systems           Subtitle B:  Assistance to Rural Providers Under Medicare           Subtitle D:  Demonstration Projects to Encourage Primary                Care and Rural-Based Graduate Medical Education      Title IV:  Hospital Antitrust Fairness Rural Health Care Improvement Act of 1994 - Title I:  Grant to Encourage Establishment of Community Rural Health Networks - Directs the Secretary of Health and Human Services to make grants to an eligible State for the development of plans to increase access to health care services for residents of areas in the State designated as chronically underserved areas.  Provides for technical assistance for entities establishing or enhancing a community rural health network in an underserved rural area.  Provides financial assistance to entities to provide for the development and implementation of community rural health networks.  Authorizes appropriations. Title II:  Incentives for Health Professionals to Practice in Rural Areas - Subtitle A:  National Health Service Corps Program - Amends the Internal Revenue Code to exclude National Health Service Corps Loan Repayments from gross income. (Sec. 202) Amends the Public Health Service Act to take into consideration, when designating an area as a health professional shortage area, the number of individuals in the area paying through Medicare or Medicaid, the number of individuals who are uninsured, and the number of physicians who will accept additional Medicare and Medicaid patients. (Sec. 203) Increases the authorization of appropriations for the National Health Service Corps Scholarship and Loan Repayment Programs. Subtitle B:  Incentives Under Other Programs - Amends title XVIII (Medicare) of the Social Security Act and the Higher Education Act of 1965 to provide incentives under those Acts to physicians informer shortage areas and to primary care physicians, in addition to those provided in Subtitle A.  Directs the Secretary to develop and publish a model law for adoption by States to increase the access of individuals residing in underserved rural areas to health care services by expanding the services which non-physician health care professionals may provide in such areas. Title III:  Assistance for Institutional Providers - Subtitle A: Community and Migrant Health Centers - Extends and increases the authorizations of appropriations for migrant health centers and community health centers. Subtitle A:  Emergency Medical Systems - Revises title XII (Trauma Care) of the Public Health Service Act.  Renames such title Emergency Health Services.  Directs the Secretary to establish the Office of Emergency Medical Services to:  conduct and support research and demonstration projects; (2) foster development of appropriate modern systems of services; (3) assist States; and (4) coordinate and sponsor related activities.  Requires that activities meet the unique needs of underserved innercity and rural areas.  Authorizes grants to States in order to improve the availability and quality of emergency medical services through the operation of State offices of emergency medical services. Authorizes appropriations for emergency medical services and trauma care. (Sec. 312) Directs the Secretary to make grants to assist States in the creation or enhancement of air medical transport systems that provide victims of medical emergencies in rural areas with access to treatments for injuries resulting from such emergencies.  Authorizes appropriations. Subtitle B:  Assistance to Rural Providers Under Medicare - Amends title XVIII (Medicare) of the Social Security Act to:  (1) increase by two the number of States eligible to participate in the essential access community hospital program; and (2) make other revisions concerning such program, including permitting the participation of hospitals in urban areas and the participation of hospitals in States adjoining participating States. Extends, by three years, the deadline for the development of prospective payment systems for both inpatient and outpatient rural primary care hospital services. (Sec. 331) Defines a rural emergency access care hospital and rural emergency access care hospital services for purposes of title XVIII. Provides for the coverage of such services under part B (Supplementary Medical Insurance) of title XVIII. Subtitle D:  Demonstration Projects to Encourage Primary Care and Rural-Based Graduate Medical Education - Directs the Secretary to establish and conduct a demonstration project to increase the number and percentage of medical students entering nonprimary care practice.  Authorizes appropriations. Title IV:  Hospital Antitrust Fairness - Exempts the merger or attempted merger of hospitals from the application of the antitrust laws; if specified conditions are met, including that:  (1)a hospital be located outside of a city or in a city of less than 150,000; and (2) consumer costs would not increase and access would not be reduced if there was a merger.",2025-08-26T13:50:38Z,
103-hr-4696,103,hr,4696,Access to Medical Treatment Act,Health,1994-06-30,1994-07-22,Referred to the Subcommittee on Health and the Environment.,House,"Rep. DeFazio, Peter A. [D-OR-4]",OR,D,D000191,9,"Access to Medical Treatment Act - Permits any individual to be treated by a health care practitioner with any method of medical treatment that such individual desires or the legal representative of such individual authorizes, if:  (1) the practitioner agrees to treat the individual; and (2) the administration of such treatment falls within the practitioner's scope of practice. Authorizes health care practitioners to provide any method of treatment to such an individual if:  (1) there is no evidence that the treatment is a danger to the individual; (2) in the case of treatment that is the administration of a food, drug, or device that has not been approved by the Food and Drug Administration, the individual has been informed that the treatment has not been approved and the food, drug, or device contains a warning to that effect; (3) the individual has been informed of the nature of the treatment; (4) there have been no claims, including advertising and labeling claims, made with respect to the efficacy of such treatment; and (5) the individual desires such treatment and has been provided and has signed a written statement that such individual has been fully informed with respect to such information. Requires a practitioner, after administering such treatment and discovering it to be a danger to an individual, to submit a report to the Secretary of Health and Human Services. Authorizes the introduction or delivery into interstate commerce of medication or equipment for use in accordance with this Act. Prohibits a licensing board from denying, suspending, or revoking the license of a health care practitioner solely because such practitioner provides treatment described by this Act.",2025-08-26T13:49:34Z,
103-s-2245,103,s,2245,Medicare and Medicaid Third Party Liability Act,Health,1994-06-28,1994-06-28,Read twice and referred to the Committee on Finance.,Senate,"Sen. Lautenberg, Frank R. [D-NJ]",NJ,D,L000123,1,"Medicare and Medicaid Third Party Liability Act - Authorizes the Attorney General to seek a class action recovery from tobacco product manufacturers of any payments made under the Medicare, Medicaid, veterans' health care, or any other similar Federal health care program to or on behalf of more than one recipient with a disease, illness, condition, or complication caused, in whole or in part, by the use of tobacco products.",2025-08-26T13:48:55Z,
103-hr-4654,103,hr,4654,To amend title XVIII of the Social Security Act to provide for coverage under part B of the medicare program of drugs approved by the Food and Drug Administration for the treatment of individuals with multiple sclerosis.,Health,1994-06-27,1994-07-12,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Greenwood, James C. [R-PA-8]",PA,R,G000439,6,"Amends title XVIII (Medicare) of the Social Security Act, as amended by the Omnibus Budget Reconciliation Act of 1993, to provide for coverage of drugs approved by the Food and Drug Administration for the treatment of individuals with multiple sclerosis.",2024-02-07T16:32:33Z,
103-hr-4659,103,hr,4659,Federal Health Care Liability Reform Act of 1994,Health,1994-06-27,1994-08-18,Referred to the Subcommittee on Economic and Commercial Law.,House,"Rep. Stump, Bob [R-AZ-3]",AZ,R,S001044,0,"TABLE OF CONTENTS:      Title I:  General Provisions      Title II:  Health Care Liability Reform           Subtitle A:  Reform Described           Subtitle B:  Requirements for State Alternative Dispute                Resolution Systems (ADR) Federal Health Care Liability Reform Act of 1994 - Title I: General Provisions - Applies this Act to any health care liability claim or action in State or Federal court, except for vaccine or medical product injuries.  Preempts State laws, subject to limitations. Title II:  Health Care Liability Reform - Subtitle A:  Reform Described - Requires initial resolution under an alternative dispute resolution system (ADR) of State or Federal health care liability actions and claims against the United States. Sets a time limit for commencement of actions. Limits contingent attorney's fees to percentages of the amount recovered (including any periodic payments projected to life expectancy).  Requires payment by the contesting party of attorney's fees and costs if the award amount is not adjusted at least a specified percentage in favor of the contesting party. Limits noneconomic damages for an injury to a specified dollar amount regardless of the number of defendants or the number of actions.  Requires, if requested by either party, that future expense payments over a certain amount be paid on a periodic basis.  Mandates collateral source payment offsets.  Regulates punitive damages with regard to the standard of proof, medical products subject to premarket approval, pleadings, separate proceedings, and amount. Permits several but not joint liability. Allows injunctions prohibiting violations of this title. Authorizes State agencies responsible for health care practitioner disciplinary actions to make agreements with professional societies to participate in health care practitioner licensing and to review malpractice actions and allegations. Subtitle B:  Requirements for State Alternative Dispute Resolutions Systems (ADR) - Sets forth requirements for State ADRs, including requiring that State ADRs apply to all health care liability claims in that State's courts.  Provides for annual Federal certification of State ADRs and mandates an alternative Federal ADR for claims in uncertified States.  Requires uncertified States to reimburse the United States for costs and prohibits payments under the Public Health Service Act to those States, their local governments, or any entity in those States.",2025-08-26T13:49:50Z,
103-hr-4646,103,hr,4646,"To amend title XIX of the Social Security Act to make optional the requirement that a State seek adjustment or recovery from an individual's estate of any medical assistance correctly paid on behalf of the individual under the State plan under such title, and to raise the minimum age of the individuals against whose estates the State is permitted to seek such adjustment or recovery.",Health,1994-06-24,1994-06-30,Referred to the Subcommittee on Health and the Environment.,House,"Rep. Deal, Nathan [D-GA-9]",GA,D,D000168,5,"Amends title XIX (Medicaid) of the Social Security Act, as amended by the Omnibus Budget Reconciliation Act of 1993, to:  (1) make optional the requirement that a State seek adjustment or recovery from an individual's estate of any medical assistance correctly paid on that individual's behalf under the State plan; and (2) raise from 55 to 65 the minimum age of the individuals against whose estates the State is permitted to seek such adjustment or recovery.",2024-02-05T14:30:09Z,
103-s-2239,103,s,2239,Pharmaceutical Marketplace Reform Act of 1994,Health,1994-06-24,1994-06-24,Read twice and referred to the Committee on Finance.,Senate,"Sen. Pryor, David H. [D-AR]",AR,D,P000556,1,"TABLE OF CONTENTS:      Title I:  Medicare Program           Subtitle A:  Covered Outpatient Prescription Drugs and                Rebates           Subtitle B:  Drug Use Review           Subtitle C:  Effective Date      Title II:  Medicaid Program      Title III:  Commissions      Title IV:  Additions to the Master Agreement Pharmaceutical Marketplace Reform Act of 1994 - Title I:  Medicare Program - Subtitle A:  Covered Outpatient Prescription Drugs and Rebates - Amends title XVIII (Medicare) of the Social Security Act (SSA) to cover as medical and other services certain outpatient drugs and biologicals, certain prescription drugs used in immunosuppressive therapy furnished to organ transplant patients, erythropoietin for dialysis patients, anticancer chemotherapeutic oral drugs, as well as other outpatient drugs or biologicals for which payment may be specially allowed. (Sec. 102) Conditions payment for a covered outpatient drug on the manufacturer's having entered into a rebate agreement containing certain terms with the Secretary of Health and Human Services (HHS).  Requires a rebate or discount to Medicare of 17 percent off the average manufacturer's retail price (AMRP).  Authorizes negotiation of higher rebates as well as standard or higher rebates for new drugs. Requires the HHS Secretary to establish a generic-only dispensing policy, subject to a Federal upper limit, for any multiple source (generic) covered outpatient drug for which there are three or more therapeutically and pharmaceutically equivalent brands of the drug sold and marketed in the United States.  Requires exclusion from payment of any innovator version of a multiple source (brand name) drug unless the prescription, in the physician's handwriting, contains the phrase ""brand medically necessary"" and, at the Secretary's option, a medical justification is provided. Authorizes the Secretary to establish, as a condition of outpatient drug coverage or payment, a system requiring approval of a drug before its dispensing. Subtitle B:  Drug Use Review - Directs the Secretary to:  (1) provide for a drug use review program; (2) establish a methodology to provide payment to pharmacists for prospective drug review and certain pharmaceutical care activities; (3) establish standards for counseling by pharmacists of individuals receiving covered outpatient drugs; and (4) a Drug Use Review Board (DUR Board) of physicians and pharmacists. (Sec. 111) Requires the DUR program to provide for case management of drug therapy for individuals receiving covered drugs who are at high risk for potential medication-related problems. Subtitle C:  Effective Date - Sets the effective date of this title. Title II:  Medicaid Program - Amends SSA title XIX (Medicaid) to deny Federal payment to a State for any brand name drug unless the prescription, in the physicians' handwriting, contains the phrase ""brand medically necessary"" and, at the Secretary's option, a medical justification is provided. (Sec. 201) Denies Federal payments for any State expenditures for the dispensing of brand name drugs that exceed 15 percent, for 1995, or ten percent, for 1996 and after, of expenditures for the dispensing of all multiple source drugs, brand name and generic. (Sec. 202) Provides for an 11 percent rebate to Medicaid for a generic drug if its price is more than half the price of the corresponding brand name drug.  Specifies decreasing rebates, from nine to seven to five percent, from 1995 through 1997 and after for generic drugs whose price does not exceed half the price of the corresponding brand name drug. (Sec. 203) Denies Medicaid payments for any calendar quarter to any State which fails to have in effect regulations requiring each health care plan offered in the State covering outpatient prescription drugs to establish a pharmacy and therapeutics committee or drug use board of physicians and pharmacists which shall make recommendations to the plan to assure that outpatient prescription drugs used by enrollees are medically appropriate and likely to result in positive medical outcomes. Requires each health care plan to establish a therapeutic formulary of committee- or board-approved outpatient prescription drugs. Requires each health care plan to establish a pharmaceutical care services program ensuring services by licensed pharmacists and including drug use review, drug therapy and case management, preapproved or protocol-approved interchange of pharmaceutical products, management of patient compliance incentive programs, and other pertinent services. Requires each health care plan to establish a system under which any pharmacists providing outpatient prescription drugs to enrollees is provided payment for services required to comply with any requirements imposed on the pharmacists by this Act. Title III:  Commissions - Amends SSA title XI (General Provisions and Peer Review), as amended by the Omnibus Budget Reconciliation Act of 1993, to direct the Secretary to provide for the appointment of a Pharmaceutical Marketplace Information Commission, which shall:  (1) provide general information about pharmaceutical prices in the U.S. market and in international, industrial-based markets; (2) provide information to buyers about whether the prices of new drugs are reasonable, based on specified factors; (3) monitor the use and prices of generic drugs; and (4) make recommendations to the Congress on the desirability of extending patents on certain pharmaceutical products.  Authorizes appropriations. (Sec. 302) Requires the Director of the Congressional Office of Technology Assessment to provide for the appointment of a Prescription Drug Payment Review Commission to monitor Medicare drug program operations, conduct studies, and make recommendations to the Congress on the operation of the program in general. Title IV:  Additions to the Master Agreement - Amends Federal law with respect to limitations on prices procured by the Department of Veterans Affairs and other Federal agencies.  Requires the master agreement between the Secretary of Veterans Affairs and each manufacturer of covered drugs to require each manufacturer of single source and brand name drugs to offer them for sale to every buyer on equal terms and conditions including any rebates, free merchandise, discounts and other similar adjustments.  Permits such manufacturers to offer rebates, free merchandise, discounts and other similar adjustments only if the manufacturer experiences savings as a result of specified efficiencies in purchasing. (Sec. 402) Requires the master agreement also to require each manufacturer of single source and brand name drugs to report certain information to the Pharmaceutical Marketplace Information Commission.",2025-08-26T13:50:10Z,
103-hres-464,103,hres,464,"Designating July 12, 1994, as ""Public Health Awareness Day"".",Health,1994-06-23,1994-06-23,Referred to the House Committee on Post Office and Civil Service.,House,"Rep. Dingell, John D. [D-MI-16]",MI,D,D000355,4,"Designates July 12, 1994, as Public Health Awareness Day.",2024-02-06T20:04:02Z,
103-sjres-203,103,sjres,203,"A joint resolution designating July 12, 1994, as ""Public Health Awareness Day"".",Health,1994-06-23,1994-06-23,Read twice and referred to the Committee on Judiciary.,Senate,"Sen. Kennedy, Edward M. [D-MA]",MA,D,K000105,1,"Designates July 12, 1994, as Public Health Awareness Day.",2025-07-21T19:32:26Z,
103-hjres-382,103,hjres,382,"Designating September 11, 1994, as ""National Neonatal Nurses Day"".",Health,1994-06-22,1994-06-22,Referred to the House Committee on Post Office and Civil Service.,House,"Rep. Johnson, Eddie Bernice [D-TX-30]",TX,D,J000126,40,"Designates September 11, 1994, as National Neonatal Nurses Day.",2024-02-06T20:04:02Z,