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[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4124 Introduced in House (IH)]

103d CONGRESS
  2d Session
                                H. R. 4124

To amend title 38, United States Code, to reform health care policy in 
                  the Department of Veterans Affairs.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             March 24, 1994

 Mr. Montgomery (for himself and Mr. Rowland) introduced the following 
     bill; which was referred to the Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL

 
To amend title 38, United States Code, to reform health care policy in 
                  the Department of Veterans Affairs.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. BENEFITS AND ELIGIBILITY THROUGH DEPARTMENT OF VETERANS 
              AFFAIRS MEDICAL SYSTEM.

    (a) DVA As a Participant in Health Care Reform.--
            (1) In general.--Title 38, United States Code, is amended 
        by inserting after chapter 17 the following new chapter:

    ``CHAPTER 18--ELIGIBILITY AND BENEFITS UNDER HEALTH SECURITY ACT

                        ``SUBCHAPTER I--GENERAL

``1801. Definitions.
                      ``SUBCHAPTER II--ENROLLMENT

``1811. Enrollment: veterans.
``1812. Enrollment: CHAMPVA eligibles.
``1813. Enrollment: family members.

                       ``SUBCHAPTER III--BENEFITS

``1821. Benefits for VA enrollees.
``1822. Chapter 17 benefits.
``1823. Supplemental benefits packages and policies.
``1824. Limitation regarding veterans enrolled with health plans 
                            outside Department.

                   ``SUBCHAPTER IV--FINANCIAL MATTERS

``1831. Premiums, copayments, etc.
``1832. Medicare coverage and reimbursement.
``1833. Recovery of cost of certain care and services.
``1834. Health Plan Fund.
``1835. Guaranteed funding of Government costs.

                        ``SUBCHAPTER I--GENERAL

``Sec. 1801. Definitions
    ``For purposes of this chapter:
            ``(1) The term `health plan' means an entity that has been 
        certified under the Health Security Act as a health plan.
            ``(2) The term `VA health plan' means a health plan that is 
        operated by the Secretary under section 7341 of this title.
            ``(3) The term `VA enrollee' means an individual enrolled 
        under the Health Security Act and subchapter II of this chapter 
        in a VA health plan.
            ``(4) The term `comprehensive benefit package' means the 
        package of benefits required to be provided by a health plan 
        under the Health Security Act.
            ``(5) The term `Health Security Act' means the bill H.R. 
        3600 of the 103d Congress, as introduced in the House of 
        Representatives on November 20, 1993.

                      ``SUBCHAPTER II--ENROLLMENT

``Sec. 1811. Enrollment: veterans
    ``Each veteran who is an eligible individual within the meaning of 
section 1001 of the Health Security Act (including a veteran who is a 
medicare-eligible individual as defined in section 1902 of that Act) 
may enroll with a VA health plan. A veteran who wants to receive the 
comprehensive benefit package through the Department shall enroll with 
a VA health plan.
``Sec. 1812. Enrollment: CHAMPVA eligibles
    ``(a) An individual described in subsection (b) who is eligible to 
enroll in a health plan pursuant to section 1001 of the Health Security 
Act may enroll under that Act with a VA health plan.
    ``(b) This section applies to--
            ``(1) the surviving spouse or child of a veteran who (A) 
        died as a result of a service-connected disability, or (B) at 
        the time of death had a total disability permanent in nature, 
        resulting from a service-connected disability, and
            ``(2) the surviving spouse or child of a person who died in 
        the active military, naval, or air service in the line of duty 
        and not due to such person's own misconduct,
who are not otherwise eligible for medical care under chapter 55 of 
title 10 (CHAMPUS).
    ``(c) For purposes of this section, the term `child' has the 
meaning given that term in section 1011 of the Health Security Act.
``Sec. 1813. Enrollment: family members
    ``(a) The Secretary shall authorize a VA health plan to enroll 
members of the family of an enrollee under section 1811 or 1812 of this 
title, subject to payment of premiums, deductibles, copayments, and 
coinsurance as required under the Health Security Act. The enrollee 
shall have the option of enrolling in the VA health plan as an 
individual or with family members. If the enrollee chooses to enroll in 
the VA health plan with family members, all such family members must be 
so enrolled.
    ``(b) An individual who is enrolled with a VA health plan pursuant 
to subsection (a) as a member of the family of a veteran enrolled under 
section 1811 of this title shall not lose eligibility to be enrolled 
with VA health plans by reason of the death of that veteran.
    ``(c) For purposes of subsection (a), the members of the family of 
an enrollee are those individuals (other than the enrollee) included 
within the term `family' as defined in section 1011(b) of the Health 
Security Act.

                       ``SUBCHAPTER III--BENEFITS

``Sec. 1821. Benefits for VA enrollees
    ``The Secretary shall ensure that each VA health plan provides to 
each individual enrolled with it the items and services in the 
comprehensive benefit package under the Health Security Act.
``Sec. 1822. Chapter 17 benefits
    ``(a)(1) In the case of care and services that may be provided 
under chapter 17 of this title that are not included in the 
comprehensive benefit package, the Secretary shall provide to any 
veteran (whether not enrolled with a health plan) the care and services 
authorized under that chapter in accordance with the terms and 
conditions applicable to that veteran and that care under that chapter, 
notwithstanding that such care and services are not included in the 
comprehensive benefit package.
    ``(2) In the case of a veteran who is not an eligible individual 
within the meaning of section 1001 of the Health Security Act, the 
Secretary shall provide to the veteran the care and services that may 
be provided under chapter 17 of this title through any facility of the 
department, whether or not the facility is operating as or within a VA 
health plan.
    ``(b) In carrying out subsection (a), the Secretary shall ensure 
that the Department maintains, within facilities of the Department, the 
capacity to provide for the specialized treatment and rehabilitative 
needs of disabled veterans described in section 1710(a) of this title, 
including veterans with spinal cord dysfunction, blindness, and mental 
illness, in a manner that affords those veterans reasonable access to 
such services.
``Sec. 1823. Supplemental benefits packages and policies
    ``A VA health plan may offer supplemental health benefits policies 
for health care services not provided under chapter 17 of this title 
and cost sharing policies consistent with the requirements of part 2 of 
subtitle E of title I of the Health Security Act.
``Sec. 1824. Limitation regarding veterans enrolled with health plans 
              outside Department
    ``(a) A veteran who is residing in a regional alliance area in 
which the Department operates a health plan and who is enrolled in a 
health plan that is not operated by the Department may be provided the 
items and services in the comprehensive benefit package by a VA health 
plan operating in that regional alliance area only if (except as 
provided in subsection (b)) the plan is reimbursed for the cost of the 
care provided in accordance with the Health Security Act.
    ``(b) The Secretary may not impose on or collect from a veteran 
described in subsection (a) a cost-share charge of any kind in the case 
of treatment for a service-connected disability requiring a specialized 
treatment capacity that is not widely available in the community and 
for which the Department has particular expertise.

                   ``SUBCHAPTER IV--FINANCIAL MATTERS

``Sec. 1831. Premiums, copayments, etc.
    ``(a) In the case of a veteran described in subsection (b) who is a 
VA enrollee, the Secretary may not impose or collect from the veteran a 
cost-share charge of any kind (whether a premium, copayment, 
deductible, coinsurance charge, or other charge). The Secretary shall 
make such arrangements as necessary with health alliances in order to 
carry out this subsection.
    ``(b) The veterans referred to in subsection (a) are the following:
            ``(1) Any veteran with a service-connected disability.
            ``(2) Any veteran whose discharge or release from the 
        active military, naval or air service was for a disability 
        incurred or aggravated in the line of duty.
            ``(3) Any veteran who is in receipt of, or who, but for a 
        suspension pursuant to section 1151 of this title (or both such 
        a suspension and the receipt of retired pay), would be entitled 
        to disability compensation, but only to the extent that such a 
        veteran's continuing eligibility for such care is provided for 
        in the judgment or settlement provided for in such section.
            ``(4) Any veteran who is a former prisoner of war.
            ``(5) Any veteran of the Mexican border period or World War 
        I.
            ``(6) Any veteran who is unable to defray the expenses of 
        necessary care as determined under section 1722(a) of this 
        title.
    ``(c) In the case of a VA enrollee who is not described in 
subsection (b), the Secretary shall charge premiums and establish 
copayments, deductibles, and coinsurance amounts. The premium rate, and 
the rates for deductibles and copayments, for each VA health plan shall 
be established by that health plan based on rules established by the 
health alliance under which it is operating.
    ``(d) In the case of a veteran with a service-connected disability 
who is enrolled in a VA health plan and who has net earnings from self-
employment, the Secretary shall, under regulations prescribed by the 
Secretary, provide for a reduction in any premium payment (or alliance 
credit repayment) owed by the veteran under section 6126 or 6111 of the 
Health Security Act by virtue of the veteran's net earnings from self-
employment.
``Sec. 1832. Medicare coverage and reimbursement
    ``(a) For purposes of any program administered by the Secretary of 
Health and Human Services under title XVIII of the Social Security Act, 
a Department facility shall be deemed to be a Medicare provider.
    ``(b)(1) A VA health plan shall be considered to be a Medicare HMO.
    ``(2) For purposes of this section, the term `Medicare HMO' means 
an eligible organization under section 1876 of the Social Security Act.
    ``(c) In the case of care provided to a veteran other than a 
veteran described in section 1831(b) of this title who is eligible for 
benefits under the Medicare program under title XVIII of the Social 
Security Act, the Secretary of Health and Human Services shall 
reimburse a VA health plan or Department health-care facility providing 
services as a Medicare provider or Medicare HMO in the same amounts and 
under the same terms and conditions as that Secretary reimburses other 
Medicare providers or Medicare HMOs, respectively. The Secretary of 
Health and Human Services shall include with each such reimbursement a 
Medicare explanation of benefits.
    ``(d) When the Secretary provides care to a veteran for which the 
Secretary receives reimbursement under this section, the Secretary 
shall require the veteran to pay to the Department any applicable 
deductible or copayment that is not covered by Medicare.
``Sec. 1833. Recovery of cost of certain care and services
    ``(a) In the case of an individual provided care or services 
through a VA health plan who has coverage under a supplemental health 
insurance policy pursuant to part 2 of subtitle E of title I of the 
Health Security Act or under any other provision of law, or who has 
coverage under a Medicare supplemental health insurance plan (as 
defined in the Health Security Act) or under any other provision of 
law, the Secretary has the right to recover or collect charges for care 
or services (as determined by the Secretary, but not including care or 
services for a service-connected disability) from the party providing 
that coverage to the extent that the individual (or the provider of the 
care or services) would be eligible to receive payment for such care or 
services from such party if the care or services had not been furnished 
by a department or agency of the United States.
    ``(b) The provisions of subsections (b) through (f) of section 1729 
of this title shall apply with respect to claims by the United States 
under subsection (a) in the same manner as they apply to claims under 
subsection (a) of that section.
``Sec. 1834. Health Plan Fund
    ``(a) There is hereby established in the Treasury a revolving fund 
to be known as the `Department of Veterans Affairs Health Plan Fund'.
    ``(b) Any amount received by the Department by reason of the 
furnishing of health care by a VA health plan to an individual other 
than a veteran described in section 1831(b) of this title or the 
enrollment of an individual other than such a veteran with a VA health 
plan (including amounts received as premiums, premium discount 
payments, copayments or coinsurance, and deductibles, amounts received 
as third-party reimbursements, and amounts received as reimbursements 
from another health plan for care furnished to one of its enrollees) 
shall be credited to the revolving fund.
    ``(c) Amounts in the revolving fund are hereby made available for 
the expenses of the delivery by a VA health plan of the items and 
services in the comprehensive benefit package and any supplemental 
benefits package or policy offered by that health plan.
``Sec. 1835. Guaranteed funding of Government costs
    ``(a) The Secretary of the Treasury shall deposit into the 
Department of Veterans Affairs Health Plan Fund on the first day of 
each fiscal year quarter, from amounts not otherwise appropriated, the 
amount certified to the Secretary under subsection (b) with respect to 
the fiscal year quarter beginning on that date. The first such deposit 
shall be made with respect to the first fiscal year quarter during 
which the Secretary operates a VA health plan under the Health Security 
Act.
    ``(b) Not later than 30 days before the beginning of each fiscal 
year quarter, the Secretary of Veterans Affairs shall certify to the 
Secretary of the Treasury the amount determined for that quarter under 
subsection (c).
    ``(c)(1) The amount to be certified to the Secretary of the 
Treasury under subsection (b) for any fiscal year quarter is the 
product of--
            ``(A) the projected number of VA enrollees described in 
        section 1831(b) of this title as of the beginning of that 
        fiscal year quarter, and
            ``(B) the capitated enrollment amount for that fiscal year 
        determined under subsection (d).
    ``(2) The Secretary shall adjust future certifications under this 
subsection to take account of differences between the actual number of 
veterans described in section 1831(b) of this title enrolled for a 
fiscal year quarter and the projected number used in the certification 
for that quarter pursuant to paragraph (1).
    ``(d)(1) The Secretary shall determine the capitated enrollment 
amount for purposes of subsection (c). The initial capitated enrollment 
amount shall be determined as the amount equal to--
            ``(A) the annual full cost (as defined in OMB Circular A-
        25, issued on July 8, 1993) that has been incurred by the 
        Department in providing those services that are specified to be 
        included in the comprehensive benefit package, based upon the 
        most recent cost data available as of the time of the 
        determination, adjusted for inflation to the date of the 
        determination based upon the medical care consumer price index 
        calculated by the Bureau of Labor Statistics, divided by
            ``(B) the total number of veterans described in section 
        1831(b) of this title who received those services.
    ``(2) The Secretary shall include in the total annual cost for 
purposes of paragraph (1)(A) the amount appropriated for fiscal year 
1994 for the medical and prosthetic research functions of the Veterans 
Health Administration.
    ``(3) The Secretary shall develop the methodology for determining 
the initial capitated enrollment amount under paragraph (1) in 
consultation with the Comptroller General of the United States. If the 
Comptroller General disagrees with the methodology proposed to be used 
by the Secretary, the Comptroller General shall promptly notify the 
Committees on Veterans' Affairs of the Senate and House of 
Representatives. The determination of that amount shall be made not 
later than June 1, 1995.
    ``(4) The initial capitated enrollment amount, as adjusted annually 
for inflation based upon the medical care consumer price index 
calculated by the Bureau of Labor Statistics, shall apply for the first 
five fiscal years during which the Secretary operates a VA health plan.
    ``(5)(A) Not later than the end of the third fiscal year during 
which the Secretary operates a VA health plan, the Secretary shall 
submit to the Committees on Veterans' Affairs of the Senate and House 
of Representatives a report on what actions, if any, would be necessary 
in order for the Department to change the annual capitated enrollment 
amount by the end of the fifth such year from the initial amount 
determined under paragraph (1) to an amount determined using the method 
described in subparagraph (B), or to amounts determined using some 
other methodology, without a reduction in quality of care.
    ``(B) The method for determining the annual capitated enrollment 
amount for purposes of the study under this paragraph is to determine 
the average premium that would be payable under the Health Security Act 
for individuals enrolled in health plans other than VA health plans 
which have enrollment populations with disproportionate numbers of 
persons with similar demographic and patient-risk characteristics to 
the population of VA enrollees.''.
            (2) The table of chapters at the beginning of part II of 
        title 38, United States Code, is amended by inserting after the 
        item relating to chapter 17 the following new item:

``18. Benefits and Eligibility Under Health Security Act....   1801.''.
    (b) Preservation of Existing Benefits for Facilities Not Operating 
as Health Plans.--(1) Chapter 17 of title 38, United States Code, is 
amended by inserting after section 1704 the following new section:
``Sec. 1705. Facilities not operating within health plans; veterans not 
              eligible to enroll in health plans
    ``The provisions of this chapter shall apply with respect to the 
furnishing of care and services--
            ``(1) by any facility of the Department that is not 
        operating as or within a health plan certified as a health plan 
        under the Health Security Act; and
            ``(2) by any facility of the Department (whether or not 
        operating as or within a health plan certified as a health plan 
        under the Health Security Act) in the case of a veteran who is 
        not an eligible individual within the meaning of section 1001 
        of the Health Security Act.''.
    (2) The table of sections at the beginning of such chapter is 
amended by inserting after the item relating to section 1704 the 
following new item:

``1705. Facilities not operating within health plans; veterans not 
                            eligible to enroll in health plans.''.

SEC. 2. ORGANIZATION OF DEPARTMENT OF VETERANS AFFAIRS FACILITIES AS 
              HEALTH PLANS.

    (a) In General.--Chapter 73 of title 38, United States Code, is 
amended--
            (1) by redesignating subchapter IV as subchapter V; and
            (2) by inserting after subchapter III the following new 
        subchapter:

 ``SUBCHAPTER IV--PARTICIPATION AS PART OF NATIONAL HEALTH CARE REFORM

``Sec. 7341. Organization of health care facilities as health plans
    ``(a) The Secretary shall organize health plans and operate 
Department facilities as or within health plans under the Health 
Security Act. The Secretary shall prescribe regulations establishing 
standards for the operation of Department health care facilities as or 
within health plans under that Act. In prescribing those standards, the 
Secretary shall assure that they conform, to the maximum extent 
practicable, to the requirements for health plans generally set forth 
in part 1 of subtitle E of title I of the Health Security Act.
    ``(b) Within a geographic area or region, health care facilities of 
the Department located within that area or region may be organized to 
operate as a single health plan encompassing all Department facilities 
within that area or region or may be organized to operate as several 
health plans.
    ``(c) In carrying out responsibilities under the Health Security 
Act, a State (or a State-established entity)--
            ``(1) may not impose any standard or requirement on a VA 
        health plan that is inconsistent with this section or any 
        regulation prescribed under this section or other Federal laws 
        regarding the operation of this section; and
            ``(2) may not deny certification of a VA health plan under 
        the Health Security Act on the basis of a conflict between a 
        rule of a State or health alliance and this section or 
        regulations prescribed under this section or other Federal laws 
        regarding the operation of this section.
``Sec. 7342. Health care resource agreements
    ``(a) A VA health plan or the director of a Department of Veterans 
Affairs' health care facility that is operating as or within a VA 
health plan may, without regard to section 1703 of this title or any 
other law or regulation pertaining to competitive procedures, 
acquisition procedures or policies (other than contract dispute 
settlement procedures), or bid protests, enter into agreements with 
health care plans, insurers, and health care providers, and with any 
other entity or individual, to furnish or obtain any health-care 
resource, as that term is defined in section 8152 of this title.
    ``(b) Any proceeds to the Government received from an agreement 
under subsection (a) shall be credited to the Department of Veterans 
Affairs Health Plan Fund established under section 1834 of this title 
and to funds that have been allotted to the facility that furnished the 
resource involved.
``Sec. 7343. Administrative and personnel flexibility
    ``(a) In order to carry out this subchapter, the Secretary may--
            ``(1) subject to section 1822(b) of this title, carry out 
        administrative reorganizations of the Department without regard 
        to those provisions of section 510 of this title following 
        subsection (a) of that section; and
            ``(2) when the Secretary finds it is cost-effective or 
        necessary in order to provide health care services in a timely 
        manner--
                    ``(A) enter into contracts for procurement of any 
                commercially available item at a cost of under $100,000 
                without regard to any provision of law or regulation 
                (i) requiring competitive procedures; (ii) mandating or 
                giving priority to any source of supply; or (iii) 
                pertaining to protests; and
                    ``(B) enter into contracts without regard to 
                section 8110(c) of this title for the performance of 
                services previously performed by employees of the 
                Department.
    ``(b) The Secretary may establish alternative personnel systems or 
procedures for personnel at facilities operating as or with health 
plans under the Health Security Act whenever the Secretary considers 
such action necessary in order to carry out the terms of that Act, 
except that the Secretary shall provide for preference eligibles (as 
defined in section 2108 of title 5, United States Code) in a manner 
comparable to the preference for such eligibles under subchapter I of 
chapter 33, and subchapter I of chapter 35, of such title.
    ``(c) Subject to the provisions of section 1404 of the Health 
Security Act, the Secretary may carry out appropriate promotional, 
advertising, and marketing activities to inform individuals of the 
availability of facilities of the Department operating as or within 
health plans.
``Sec. 7344. Veterans Health Care Transition Fund
    ``(a) For each of fiscal years 1995, 1996, and 1997, the Secretary 
of the Treasury shall, subject to subsection (a), credit to a special 
fund (in this section referred to as the `Fund') of the Treasury an 
amount equal to--
            ``(1) $1,250,000,000 for fiscal year 1995;
            ``(2) $850,000,000 for fiscal year 1996; and
            ``(3) $1,950,000,000 for fiscal year 1997.
    ``(b) Amounts in the Fund shall be available to the Secretary only 
for the VA health plans authorized under this chapter. Such amounts are 
available without fiscal year limitation for costs of commencing 
operation of VA health plans, including consulting services, 
procurement of equipment, marketing, and other costs, minor 
construction, and (subject to section 8104 of this title) major 
construction.
    ``(c) The Secretary shall submit to Congress, no later than March 
1, 1997, a report concerning the operation of the Department of 
Veterans Affairs health care system in preparing for, and operating 
under, national health care reform under the Health Security Act during 
fiscal years 1995 and 1996. The report shall include a discussion of--
            ``(1) the adequacy of amounts in the Fund for the operation 
        of VA health plans;
            ``(2) the quality of care provided by such plans;
            ``(3) the ability of such plans to attract patients; and
            ``(4) the need (if any) for additional funds for the Fund 
        in fiscal years after fiscal year 1997.
``Sec. 7345. Funding provisions: grants and other sources of assistance
    ``The Secretary may apply for and accept, if awarded, any grant or 
other source of funding that is intended to meet the needs of special 
populations and that but for this section is unavailable to facilities 
of the Department or to health plans operated by the Government if 
funds obtained through the grant or other source of funding will be 
used through a facility of the Department operating as or within a 
health plan.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 is amended by striking out the item relating to the heading 
for subchapter IV and inserting in lieu thereof the following:

 ``Subchapter IV--Participation as Part of National Health Care Reform

``7341. Organization of health care facilities as health plans.
``7342. Health care resource agreements.
``7343. Administrative and personnel flexibility.
``7344. Veterans Health Care Transition Fund.
``7345. Funding provisions: grants and other sources of assistance.
                ``Subchapter V--Research Corporations''.

SEC. 3. ELIGIBILITY FOR CHAPTER 17 CARE.

    (a) Nursing Home Care.--Section 1710(a)(1) of title 38, United 
States Code, is amended by inserting ``(or, in the case of a veteran 
described in subparagraph (A) or (D) below, shall furnish nursing home 
care)'' after ``may furnish nursing home care''.
    (b) Outpatient Care for Enrolled Veterans.--Paragraph (1) of 
section 1712(a) of such title is amended--
            (1) by striking out ``and'' at the end of subparagraph (B);
            (2) by striking out the period at the end of subparagraph 
        (C) and inserting in lieu thereof ``; and''; and
            (3) by adding at the end the following:
            ``(D) to any veteran described in section 1831(b) of this 
        title who is enrolled under section 1811 of this title and the 
        Health Security Act with a VA health plan (as defined in 
        section 1801 of this title), for any disability for which care 
        and treatment is not included within the comprehensive benefit 
        package (as defined in section 1801 of this title).''.
    (c) Obviate-the-Need Outpatient Care.--(1) Paragraph (2) of such 
section is amended by striking out ``The Secretary'' and all the 
follows through ``this subsection--'' and inserting in lieu thereof 
``Except as provided in subsection (b) of this section, the Secretary 
shall furnish on an ambulatory or outpatient basis such medical 
services as the Secretary determines are needed--''.
    (2) Paragraph (4) of such section is amended by striking out 
``medical services for a purpose described in paragraph (5) of this 
subsection'' and inserting in lieu thereof ``, to the extent that 
facilities are available, such medical services as the Secretary 
determines are needed''.
    (3) Such section is further amended by striking out paragraph (5) 
and redesignating paragraph (6) as paragraph (5).

SEC. 4. EFFECTIVE DATE OF COVERAGE FOR HIGH-PRIORITY VETERANS.

    Notwithstanding any other provision of this Act, the provisions of 
the amendments made by sections 1, 2, and 3 shall take effect with 
respect to veterans described in section 1831(b) of title 38, United 
States Code, as added by section 1, on October 1, 1995. The Secretary 
of Veterans Affairs shall take such steps as necessary to implement 
those provisions with respect to those veterans by that date.

                                 <all>

HR 4124 IH----2
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