106TH CONGRESS

2D SESSION S. 704

AMENDMENT

In the House of Representatives, U. S.,

September 19, 2000.

Resolved, That the bill from the Senate (S. 704) entitled

‘‘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’’, do pass with the following

AMENDMENT:

Strike out all after the enacting clause and insert:

1 SECTION 1. SHORT TITLE.

2 This Act may be cited as the ‘‘Federal Prisoner Health

3 Care Copayment Act of 2000’’.

4 SEC. 2. HEALTH CARE FEES FOR PRISONERS IN FEDERAL

5 INSTITUTIONS.

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

7 States Code, is amended by adding at the end the following:

8 ‘‘§ 4048. Fees for health care services for prisoners

9 ‘‘(a) DEFINITIONS.—In this section—

10 ‘‘(1) the term ‘account’ means the trust fund ac11 count (or institutional equivalent) of a prisoner;

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

13 Bureau of Prisons;
2

•S 704 EAH

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

2 person who is—

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

4 health care services; and

5 ‘‘(B) operating within the scope of such au6 thorization;

7 ‘‘(4) the term ‘health care visit’—

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

9 Director, by a prisoner to an institutional or

10 noninstitutional health care provider; and

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

12 prisoner—

13 ‘‘(i) pursuant to a staff referral; or

14 ‘‘(ii) to obtain staff-approved follow-up

15 treatment for a chronic condition; and

16 ‘‘(5) the term ‘prisoner’ means—

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

18 an institution under the jurisdiction of the Bu19 reau of Prisons; or

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

21 the Director, who has been charged with or con22 victed of an offense against the United States.

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

24 ‘‘(1) IN GENERAL.—The Director, in accordance

25 with this section and with such regulations as the Di-
3

•S 704 EAH

1 rector shall promulgate to carry out this section, may

2 assess and collect a fee for health care services pro3 vided in connection with each health care visit re4 quested by a prisoner.

5 ‘‘(2) EXCLUSION.—The Director may not assess

6 or collect a fee under this section for preventative

7 health care services, emergency services, prenatal care,

8 diagnosis or treatment of chronic infectious diseases,

9 mental health care, or substance abuse treatment, as

10 determined by the Director.

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

12 under this section shall be collected by the Director from

13 the account of—

14 ‘‘(1) the prisoner receiving health care services in

15 connection with a health care visit described in sub16 section (b)(1); or

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

18 in connection with a health care visit described in

19 subsection (b)(1) that results from an injury inflicted

20 on a prisoner by another prisoner, the prisoner who

21 inflicted the injury, as determined by the Director.

22 ‘‘(d) AMOUNT OF FEE.—Any fee assessed and collected

23 under this section shall be in an amount of not less than

24 $1.
4

•S 704 EAH

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

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

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

4 the prisoner under this section. However, each such prisoner

5 shall be given a reasonable opportunity to dispute the

6 amount of the fee or whether the prisoner qualifies under

7 an exclusion under this section.

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

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

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

11 that—

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

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

14 assessed under this section.

15 ‘‘(g) USE OF AMOUNTS.—

16 ‘‘(1) RESTITUTION OF SPECIFIC VICTIMS.—

17 Amounts collected by the Director under this section

18 from a prisoner subject to an order of restitution

19 issued pursuant to section 3663 or 3663A shall be

20 paid to victims in accordance with the order of res21 titution.

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

23 amounts collected by the Director under this section

24 from prisoners not subject to an order of restitution

25 issued pursuant to section 3663 or 3663A—
5

•S 704 EAH

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

2 Crime Victims Fund established under section

3 1402 of the Victims of Crime Act of 1984 (42

4 U.S.C. 10601); and

5 ‘‘(B) 25 percent shall be available to the At6 torney General for administrative expenses in7 curred in carrying out this section.

8 ‘‘(h) NOTICE TO PRISONERS OF LAW.—Each person

9 who is or becomes a prisoner shall be provided with written

10 and oral notices of the provisions of this section and the

11 applicability of this section to the prisoner. Notwith12 standing any other provision of this section, a fee under

13 this section may not be assessed against, or collected from,

14 such person—

15 ‘‘(1) until the expiration of the 30-day period be16 ginning on the date on which each prisoner in the

17 prison system is provided with such notices; and

18 ‘‘(2) for services provided before the expiration of

19 such period.

20 ‘‘(i) NOTICE TO PRISONERS OF REGULATIONS.—The

21 regulations promulgated by the Director under subsection

22 (b)(1), and any amendments to those regulations, shall not

23 take effect until the expiration of the 30-day period begin24 ning on the date on which each prisoner in the prison sys25 tem is provided with written and oral notices of the provi-
6

•S 704 EAH

1 sions of those regulations (or amendments, as the case may

2 be). A fee under this section may not be assessed against,

3 or collected from, a prisoner pursuant to such regulations

4 (or amendments, as the case may be) for services provided

5 before the expiration of such period.

6 ‘‘(j) NOTICE BEFORE PUBLIC COMMENT PERIOD.—Be7 fore the beginning of any period a proposed regulation

8 under this section is open to public comment, the Director

9 shall provide written and oral notice of the provisions of

10 that proposed regulation to groups that advocate on behalf

11 of Federal prisoners and to each prisoner subject to such

12 proposed regulation.

13 ‘‘(k) REPORTS TO CONGRESS.—Not later than 1 year

14 after the date of the enactment of the Federal Prisoner

15 Health Care Copayment Act of 2000, and annually there16 after, the Director shall transmit to Congress a report,

17 which shall include—

18 ‘‘(1) a description of the amounts collected under

19 this section during the preceding 12-month period;

20 ‘‘(2) an analysis of the effects of the implementa21 tion of this section, if any, on the nature and extent

22 of heath care visits by prisoners;

23 ‘‘(3) an itemization of the cost of implementing

24 and administering the program;
7

•S 704 EAH

1 ‘‘(4) a description of current inmate health sta2 tus indicators as compared to the year prior to enact3 ment; and

4 ‘‘(5) a description of the quality of health care

5 services provided to inmates during the preceding 12-

6 month period, as compared with the quality of those

7 services provided during the 12-month period ending

8 on the date of the enactment of such Act.

9 ‘‘(l) COMPREHENSIVE HIV/AIDS SERVICES RE10 QUIRED.—The Bureau of Prisons shall provide comprehen11 sive coverage for services relating to human immuno12 deficiency virus (HIV) and acquired immune deficiency

13 syndrome (AIDS) to each Federal prisoner in the custody

14 of the Bureau of Prisons when medically appropriate. The

15 Bureau of Prisons may not assess or collect a fee under this

16 section for providing such coverage.’’.

17 (b) CLERICAL AMENDMENT.—The analysis for chapter

18 303 of title 18, United States Code, is amended by adding

19 at the end the following:

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

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

21 NON-FEDERAL INSTITUTIONS.

22 Section 4013 of title 18, United States Code, is amend23 ed by adding at the end the following:

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

25 IN NON-FEDERAL INSTITUTIONS.—
8

•S 704 EAH

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

2 paid under subsection (a)(3), a State or local govern3 ment may assess and collect a reasonable fee from the

4 trust fund account (or institutional equivalent) of a

5 Federal prisoner for health care services, if—

6 ‘‘(A) the prisoner is confined in a non-Fed7 eral institution pursuant to an agreement be8 tween the Federal Government and the State or

9 local government;

10 ‘‘(B) the fee—

11 ‘‘(i) is authorized under State law; and

12 ‘‘(ii) does not exceed the amount col13 lected from State or local prisoners for the

14 same services; and

15 ‘‘(C) the services—

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

17 the institution by a person who is licensed

18 or certified under State law to provide

19 health care services and who is operating

20 within the scope of such license;

21 ‘‘(ii) constitute a health care visit

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

23 this title; and

24 ‘‘(iii) are not preventative health care

25 services, emergency services, prenatal care,
9

•S 704 EAH

1 diagnosis or treatment of chronic infectious

2 diseases, mental health care, or substance

3 abuse treatment.

4 ‘‘(2) NO REFUSAL OF TREATMENT FOR FINAN5 CIAL REASONS.—Nothing in this subsection may be

6 construed to permit any refusal of treatment to a

7 prisoner on the basis that—

8 ‘‘(A) the account of the prisoner is insol9 vent; or

10 ‘‘(B) the prisoner is otherwise unable to pay

11 a fee assessed under this subsection.

12 ‘‘(3) NOTICE TO PRISONERS OF LAW.—Each per13 son who is or becomes a prisoner shall be provided

14 with written and oral notices of the provisions of this

15 subsection and the applicability of this subsection to

16 the prisoner. Notwithstanding any other provision of

17 this subsection, a fee under this section may not be

18 assessed against, or collected from, such person—

19 ‘‘(A) until the expiration of the 30-day pe20 riod beginning on the date on which each pris21 oner in the prison system is provided with such

22 notices; and

23 ‘‘(B) for services provided before the expira24 tion of such period.
10

•S 704 EAH

1 ‘‘(4) NOTICE TO PRISONERS OF STATE OR LOCAL

2 IMPLEMENTATION.—The implementation of this sub3 section by the State or local government, and any

4 amendment to that implementation, shall not take ef5 fect until the expiration of the 30-day period begin6 ning on the date on which each prisoner in the prison

7 system is provided with written and oral notices of

8 the provisions of that implementation (or amendment,

9 as the case may be). A fee under this subsection may

10 not be assessed against, or collected from, a prisoner

11 pursuant to such implementation (or amendments, as

12 the case may be) for services provided before the expi13 ration of such period.

14 ‘‘(5) NOTICE BEFORE PUBLIC COMMENT PE15 RIOD.—Before the beginning of any period a proposed

16 implementation under this subsection is open to pub17 lic comment, written and oral notice of the provisions

18 of that proposed implementation shall be provided to

19 groups that advocate on behalf of Federal prisoners

20 and to each prisoner subject to such proposed imple21 mentation.

22 ‘‘(6) COMPREHENSIVE HIV/AIDS SERVICES RE23 QUIRED.—Any State or local government assessing or

24 collecting a fee under this subsection shall provide

25 comprehensive coverage for services relating to human
11

•S 704 EAH

1 immunodeficiency virus (HIV) and acquired immune

2 deficiency syndrome (AIDS) to each Federal prisoner

3 in the custody of such State or local government when

4 medically appropriate. The State or local government

5 may not assess or collect a fee under this subsection

6 for providing such coverage.’’.

Attest:

Clerk.