II

Calendar No. 97

106TH CONGRESS

1ST SESSION S. 704

To amend title 18, United States Code, to combat the overutilization of

prison health care services and control rising prisoner health care costs.

IN THE SENATE OF THE UNITED STATES

MARCH 24, 1999

Mr. KYL (for himself, Mr. JOHNSON, Mr. HATCH, Mr. THURMOND, Mr.

INOUYE, Mr. GRASSLEY, Mr. DORGAN, Mr. SESSIONS, Mr. CLELAND, Mr.

ASHCROFT, Mrs. LINCOLN, Mr. ABRAHAM, Mr. HELMS, Mr. DASCHLE,

Mr. FITZGERALD, and Mr. DEWINE) introduced the following bill; which

was read twice and referred to the Committee on the Judiciary

APRIL 29, 1999

Reported by Mr. HATCH, with an amendment

[Strike out all after the enacting clause and insert the part printed in italic]

A BILL

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’’.
2

S 704 RS

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’ means a visit,

19 as determined by the Director, by a prisoner to an

20 institutional or noninstitutional health care provider;

21 and

22 ‘‘(5) the term ‘prisoner’ means—

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

24 an institution under the jurisdiction of the Bu25 reau of Prisons; or
3

S 704 RS

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

2 the Director, who has been charged with or con3 victed of an offense against the United States.

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

5 ‘‘(1) IN GENERAL.—The Director, in accord6 ance with this section and with such regulations as

7 the Director shall promulgate to carry out this sec8 tion, may assess and collect a fee for health care

9 services provided in connection with each health care

10 visit requested by a prisoner.

11 ‘‘(2) EXCLUSION.—The Director may not as12 sess or collect a fee under this section for preventa13 tive health care services, as determined by the Direc14 tor.

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

16 under this section shall be collected by the Director from

17 the account of—

18 ‘‘(1) the prisoner receiving health care services

19 in connection with a health care visit described in

20 subsection (b)(1); or

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

22 in connection with a health care visit described in

23 subsection (b)(1) that results from an injury in24 flicted on a prisoner by another prisoner, the pris-
4

S 704 RS

1 oner who inflicted the injury, as determined by the

2 Director.

3 ‘‘(d) AMOUNT OF FEE.—Any fee assessed and col4 lected under this section shall be in an amount of not less

5 than $2.

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

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

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

9 of the prisoner under this section.

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

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

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

13 that—

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

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

16 fee assessed under this section.

17 ‘‘(g) USE OF AMOUNTS.—

18 ‘‘(1) RESTITUTION TO SPECIFIC VICTIMS.—

19 Amounts collected by the Director under this section

20 from a prisoner subject to an order of restitution

21 issued pursuant to section 3663 or 3663A shall be

22 paid to victims in accordance with the order of res23 titution.

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

25 amounts collected by the Director under this section
5

S 704 RS

1 from prisoners not subject to an order of restitution

2 issued pursuant to section 3663 or 3663A—

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

4 Crime Victims Fund established under section

5 1402 of the Victims of Crime Act of 1984 (42

6 U.S.C. 10601); and

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

8 Attorney General for administrative expenses

9 incurred in carrying out this section.

10 ‘‘(h) REPORTS TO CONGRESS.—Not later than 2

11 years after the date of enactment of the Federal Prisoner

12 Copayment Act of 1999, and annually thereafter, the Di13 rector shall submit to Congress a report, which shall

14 include—

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

16 under this section during the preceding 24-month

17 period; and

18 ‘‘(2) an analysis of the effects of the implemen19 tation of this section, if any, on the nature and ex20 tent of heath care visits by prisoners.’’.

21 (b) CLERICAL AMENDMENT.—The analysis for chap22 ter 303 of title 18, United States Code, is amended by

23 adding at the end the following:

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

S 704 RS

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

2 NON-FEDERAL INSTITUTIONS.

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

4 amended by adding at the end the following:

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

6 IN NON-FEDERAL INSTITUTIONS.—Notwithstanding

7 amounts paid under subsection (a)(3), a State or local

8 government may assess and collect a reasonable fee from

9 the trust fund account (or institutional equivalent) of a

10 Federal prisoner for health care services, if—

11 ‘‘(1) the prisoner—

12 ‘‘(A) is confined in a non-Federal institu13 tion pursuant to an agreement between the

14 Federal Government and the State or local gov15 ernment; and

16 ‘‘(B) is not indigent;

17 ‘‘(2) the fee—

18 ‘‘(A) is authorized under State law; and

19 ‘‘(B) does not exceed the amount collected

20 from State or local prisoners for the same serv21 ices; and

22 ‘‘(3) the services—

23 ‘‘(A) are provided within or outside of the

24 institution by a person who is licensed or cer25 tified under State law to provide health care
7

S 704 RS

1 services and who is operating within the scope

2 of such license;

3 ‘‘(B) are provided at the request of the

4 prisoner; and

5 ‘‘(C) are not preventative health care serv6 ices.’’.

7 SECTION 1. SHORT TITLE.

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

9 Care Copayment Act of 1999’’.

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

11 INSTITUTIONS.

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

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

14 ‘‘§ 4048. Fees for health care services for prisoners

15 ‘‘(a) DEFINITIONS.—In this section—

16 ‘‘(1) the term ‘account’ means the trust fund ac17 count (or institutional equivalent) of a prisoner;

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

19 Bureau of Prisons;

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

21 person who is—

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

23 health care services; and

24 ‘‘(B) operating within the scope of such au25 thorization;
8

S 704 RS

1 ‘‘(4) the term ‘health care visit’ means a visit, as

2 determined by the Director, by a prisoner to an insti3 tutional or noninstitutional health care provider; and

4 ‘‘(5) the term ‘prisoner’ means—

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

6 an institution under the jurisdiction of the Bu7 reau of Prisons; or

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

9 the Director, who has been charged with or con10 victed of an offense against the United States.

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

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

13 with this section and with such regulations as the Di14 rector shall promulgate to carry out this section, may

15 assess and collect a fee for health care services pro16 vided in connection with each health care visit re17 quested by a prisoner.

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

19 or collect a fee under this section for preventative

20 health care services, as determined by the Director.

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

22 under this section shall be collected by the Director from

23 the account of—
9

S 704 RS

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

2 connection with a health care visit described in sub3 section (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 inflicted

7 on a prisoner by another prisoner, the prisoner who

8 inflicted the injury, as determined by the Director.

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

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

11 $2.

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

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

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

15 the prisoner under this section.

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

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

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

19 that—

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

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

22 assessed under this section.

23 ‘‘(g) USE OF AMOUNTS.—

24 ‘‘(1) RESTITUTION TO SPECIFIC VICTIMS.—

25 Amounts collected by the Director under this section
10

S 704 RS

1 from a prisoner subject to an order of restitution

2 issued pursuant to section 3663 or 3663A shall be

3 paid to victims in accordance with the order of res4 titution.

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

6 amounts collected by the Director under this section

7 from prisoners not subject to an order of restitution

8 issued pursuant to section 3663 or 3663A—

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

10 Crime Victims Fund established under section

11 1402 of the Victims of Crime Act of 1984 (42

12 U.S.C. 10601); and

13 ‘‘(B) 25 percent shall be available to the At14 torney General for administrative expenses in15 curred in carrying out this section.

16 ‘‘(h) REPORTS TO CONGRESS.—Not later than 2 years

17 after the date of enactment of the Federal Prisoner Copay18 ment Act of 1999, and annually thereafter, the Director

19 shall submit to Congress a report, which shall include—

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

21 this section during the preceding 24-month period;

22 and

23 ‘‘(2) an analysis of the effects of the implementa24 tion of this section, if any, on the nature and extent

25 of heath care visits by prisoners.’’.
11

S 704 RS

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

2 303 of title 18, United States Code, is amended by adding

3 at the end the following:

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

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

5 NON-FEDERAL INSTITUTIONS.

6 Section 4013 of title 18, United States Code, is amend7 ed by adding at the end the following:

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

9 IN NON-FEDERAL INSTITUTIONS.—

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

11 paid under subsection (a)(3), a State or local govern12 ment may assess and collect a reasonable fee from the

13 trust fund account (or institutional equivalent) of a

14 Federal prisoner for health care services, if—

15 ‘‘(A) the prisoner is confined in a non-Fed16 eral institution pursuant to an agreement be17 tween the Federal Government and the State or

18 local government;

19 ‘‘(B) the fee—

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

21 ‘‘(ii) does not exceed the amount col22 lected from State or local prisoners for the

23 same services; and

24 ‘‘(C) the services—
12

S 704 RS

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

2 the institution by a person who is licensed

3 or certified under State law to provide

4 health care services and who is operating

5 within the scope of such license;

6 ‘‘(ii) are provided at the request of the

7 prisoner; and

8 ‘‘(iii) are not preventative health care

9 services.

10 ‘‘(2) NO REFUSAL OF TREATMENT FOR FINAN11 CIAL REASONS.—Nothing in this subsection may be

12 construed to permit any refusal of treatment to a

13 prisoner on the basis that—

14 ‘‘(A) the account of the prisoner is insol15 vent; or

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

17 a fee assessed under this subsection.’’.

Calendar No. 97

106TH CONGRESS

1ST SESSION S. 704

A BILL

To amend title 18, United States Code, to combat

and control rising prisoner health care costs.the overutilization of prison health care services

APRIL 29, 1999

Reported with an amendment