I

106TH CONGRESS

1ST SESSION S. 704

IN THE HOUSE OF REPRESENTATIVES

JUNE 7, 1999

Referred to the Committee on the Judiciary

AN ACT

To amend title 18, United States Code, to combat the overutilization of prison health care services and control rising prisoner health care costs.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Federal Prisoner

5 Health Care Copayment Act of 1999’’.
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1 SEC. 2. HEALTH CARE FEES FOR PRISONERS IN FEDERAL

2 INSTITUTIONS.

3 (a) IN GENERAL.—Chapter 303 of title 18, United

4 States Code, is amended by adding at the end the fol5 lowing:

6 ‘‘§ 4048. Fees for health care services for prisoners

7 ‘‘(a) DEFINITIONS.—In this section—

8 ‘‘(1) the term ‘account’ means the trust fund

9 account (or institutional equivalent) of a prisoner;

10 ‘‘(2) the term ‘Director’ means the Director of

11 the Bureau of Prisons;

12 ‘‘(3) the term ‘health care provider’ means any

13 person who is—

14 ‘‘(A) authorized by the Director to provide

15 health care services; and

16 ‘‘(B) operating within the scope of such

17 authorization;

18 ‘‘(4) the term ‘health care visit’—

19 ‘‘(A) means a visit, as determined by the

20 Director, initiated by a prisoner to an institu21 tional or noninstitutional health care provider;

22 and

23 ‘‘(B) does not include a visit initiated by a

24 prisoner—

25 ‘‘(i) pursuant to a staff referral; or
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1 ‘‘(ii) to obtain staff-approved follow2 up treatment for a chronic condition; and

3 ‘‘(5) the term ‘prisoner’ means—

4 ‘‘(A) any individual who is incarcerated in

5 an institution under the jurisdiction of the Bu6 reau of Prisons; or

7 ‘‘(B) any other individual, as designated by

8 the Director, who has been charged with or con9 victed of an offense against the United States.

10 ‘‘(b) FEES FOR HEALTH CARE SERVICES.—

11 ‘‘(1) IN GENERAL.—The Director, in accord12 ance with this section and with such regulations as

13 the Director shall promulgate to carry out this sec14 tion, may assess and collect a fee for health care

15 services provided in connection with each health care

16 visit requested by a prisoner.

17 ‘‘(2) EXCLUSION.—The Director may not as18 sess or collect a fee under this section for preventa19 tive health care services, emergency services, pre20 natal care, diagnosis or treatment of contagious dis21 eases, mental health care, or substance abuse treat22 ment, as determined by the Director.

23 ‘‘(c) PERSONS SUBJECT TO FEE.—Each fee assessed

24 under this section shall be collected by the Director from

25 the account of—
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1 ‘‘(1) the prisoner receiving health care services

2 in connection with a health care visit described in

3 subsection (b)(1); or

4 ‘‘(2) in the case of health care services provided

5 in connection with a health care visit described in

6 subsection (b)(1) that results from an injury in7 flicted on a prisoner by another prisoner, the pris8 oner who inflicted the injury, as determined by the

9 Director.

10 ‘‘(d) AMOUNT OF FEE.—Any fee assessed and col11 lected under this section shall be in an amount of not less

12 than $2.

13 ‘‘(e) NO CONSENT REQUIRED.—Notwithstanding any

14 other provision of law, the consent of a prisoner shall not

15 be required for the collection of a fee from the account

16 of the prisoner under this section.

17 ‘‘(f) NO REFUSAL OF TREATMENT FOR FINANCIAL

18 REASONS.—Nothing in this section may be construed to

19 permit any refusal of treatment to a prisoner on the basis

20 that—

21 ‘‘(1) the account of the prisoner is insolvent; or

22 ‘‘(2) the prisoner is otherwise unable to pay a

23 fee assessed under this section.

24 ‘‘(g) USE OF AMOUNTS.—
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1 ‘‘(1) RESTITUTION TO SPECIFIC VICTIMS.—

2 Amounts collected by the Director under this section

3 from a prisoner subject to an order of restitution

4 issued pursuant to section 3663 or 3663A shall be

5 paid to victims in accordance with the order of res6 titution.

7 ‘‘(2) ALLOCATION OF OTHER AMOUNTS.—Of

8 amounts collected by the Director under this section

9 from prisoners not subject to an order of restitution

10 issued pursuant to section 3663 or 3663A—

11 ‘‘(A) 75 percent shall be deposited in the

12 Crime Victims Fund established under section

13 1402 of the Victims of Crime Act of 1984 (42

14 U.S.C. 10601); and

15 ‘‘(B) 25 percent shall be available to the

16 Attorney General for administrative expenses

17 incurred in carrying out this section.

18 ‘‘(h) REPORTS TO CONGRESS.—Not later than 1 year

19 after the date of enactment of the Federal Prisoner Co20 payment Act of 1999, and annually thereafter, the Direc21 tor shall submit to Congress a report, which shall

22 include—

23 ‘‘(1) a description of the amounts collected

24 under this section during the preceding 12-month

25 period; and
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1 ‘‘(2) an analysis of the effects of the implemen2 tation of this section, if any, on the nature and ex3 tent of heath care visits by prisoners.’’.

4 (b) CLERICAL AMENDMENT.—The analysis for chap5 ter 303 of title 18, United States Code, is amended by

6 adding at the end the following:

‘‘4048. Fees for health care services for prisoners.’’.

7 SEC. 3. HEALTH CARE FEES FOR FEDERAL PRISONERS IN

8 NON-FEDERAL INSTITUTIONS.

9 Section 4013 of title 18, United States Code, is

10 amended by adding at the end the following:

11 ‘‘(c) HEALTH CARE FEES FOR FEDERAL PRISONERS

12 IN NON-FEDERAL INSTITUTIONS.—

13 ‘‘(1) IN GENERAL.—Notwithstanding amounts

14 paid under subsection (a)(3), a State or local gov15 ernment may assess and collect a reasonable fee

16 from the trust fund account (or institutional equiva17 lent) of a Federal prisoner for health care services,

18 if—

19 ‘‘(A) the prisoner is confined in a non-Fed20 eral institution pursuant to an agreement be21 tween the Federal Government and the State or

22 local government;

23 ‘‘(B) the fee—

24 ‘‘(i) is authorized under State law;

25 and
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1 ‘‘(ii) does not exceed the amount col2 lected from State or local prisoners for the

3 same services; and

4 ‘‘(C) the services—

5 ‘‘(i) are provided within or outside of

6 the institution by a person who is licensed

7 or certified under State law to provide

8 health care services and who is operating

9 within the scope of such license;

10 ‘‘(ii) constitute a health care visit

11 within the meaning of section 4048(a)(4)

12 of this title; and

13 ‘‘(iii) are not preventative health care

14 services, emergency services, prenatal care,

15 diagnosis or treatment of contagious dis16 eases, mental health care, or substance

17 abuse treatment.

18 ‘‘(2) NO REFUSAL OF TREATMENT FOR FINAN19 CIAL REASONS.—Nothing in this subsection may be

20 construed to permit any refusal of treatment to a

21 prisoner on the basis that—

22 ‘‘(A) the account of the prisoner is insol23 vent; or
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1 ‘‘(B) the prisoner is otherwise unable to

2 pay a fee assessed under this subsection.’’.

Passed the Senate May 27, 1999.

Attest: GARY SISCO,

Secretary.