IB

Union Calendar No. 506

106TH CONGRESS

2D SESSION H. R. 1349

[Report No. 106–851]

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 HOUSE OF REPRESENTATIVES

MARCH 25, 1999

Mr. SALMON (for himself, Mr. SHOWS, Mr. SMITH of New Jersey, Mr. MARTINEZ, Mr. COBURN, Mr. TAYLOR of Mississippi, Mr. SCHAFFER, Mr.

HAYWORTH, Mr. NETHERCUTT, Mr. ENGLISH, Mr. GILMAN, Mr. COOK,

Mr. BARTON of Texas, Mr. FOLEY, and Mr. CASTLE) introduced the following bill; which was referred to the Committee on the Judiciary

SEPTEMBER 14, 2000

Additional sponsors: Mr. SMITH of Washington, Mr. GARY MILLER of California, Mr. WHITFIELD, Mr. EVANS, Mr. CHABOT, Mr. BARRETT of Nebraska, Mr. BILBRAY, Mr. GOODE, Mr. CUNNINGHAM, Mr. NEY, Mr.

FORBES, Mr. PETERSON of Pennsylvania, Mr. PITTS, Mr. KOLBE, Mr.

STUMP, Mr. GREEN of Wisconsin, Mr. CONDIT, Mr. WELDON of Florida,

Mr. CALVERT, Mr. CANNON, Mr. LATHAM, Mr. MILLER of Florida, Mr.

GIBBONS, Mr. SENSENBRENNER, Mr. RILEY, Mr. JONES of North Carolina, Mr. GRAHAM, Mr. DEMINT, Mr. GOODLATTE, Mr. BARR of Georgia,

Mr. LAZIO, Mr. MCKEON, Mr. ROHRABACHER, Mr. GEKAS, Mr. HERGER,

Mr. BARCIA, Mr. SOUDER, Mrs. FOWLER, Mr. DEFAZIO, Mr. PACKARD,

Mr. BARTLETT of Maryland, Mr. SAM JOHNSON of Texas, and Mrs.

MYRICK

SEPTEMBER 14, 2000

Reported with an amendment, committed to the Committee of the Whole

House on the State of the Union, and ordered to be printed
2

•HR 1349 RH

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

[For text of introduced bill, see copy of bill as introduced on March 25, 1999]

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 Health

5 Care Copayment Act of 2000’’.

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

7 INSTITUTIONS.

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

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

10 ‘‘§ 4048. Fees for health care services for prisoners

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

12 ‘‘(1) the term ‘account’ means the trust fund ac13 count (or institutional equivalent) of a prisoner;

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

15 Bureau of Prisons;

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

17 person who is—
3

•HR 1349 RH

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

2 health care services; and

3 ‘‘(B) operating within the scope of such au4 thorization;

5 ‘‘(4) the term ‘health care visit’—

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

7 Director, by a prisoner to an institutional or

8 noninstitutional health care provider; and

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

10 prisoner—

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

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

13 treatment for a chronic condition; and

14 ‘‘(5) the term ‘prisoner’ means—

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

16 an institution under the jurisdiction of the Bu17 reau of Prisons; or

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

19 the Director, who has been charged with or con20 victed of an offense against the United States.

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

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

23 with this section and with such regulations as the Di24 rector shall promulgate to carry out this section, may

25 assess and collect a fee for health care services pro-
4

•HR 1349 RH

1 vided in connection with each health care visit re2 quested by a prisoner.

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

4 or collect a fee under this section for preventative

5 health care services, emergency services, prenatal care,

6 diagnosis or treatment of chronic infectious diseases,

7 mental health care, or substance abuse treatment, as

8 determined by the Director.

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

10 under this section shall be collected by the Director from

11 the account of—

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

13 connection with a health care visit described in sub14 section (b)(1); or

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

16 in connection with a health care visit described in

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

18 on a prisoner by another prisoner, the prisoner who

19 inflicted the injury, as determined by the Director.

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

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

22 $1.

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

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

25 be required for the collection of a fee from the account of
5

•HR 1349 RH

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

2 shall be given a reasonable opportunity to dispute the

3 amount of the fee or whether the prisoner qualifies under

4 an exclusion under this section.

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

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

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

8 that—

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

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

11 assessed under this section.

12 ‘‘(g) USE OF AMOUNTS.—

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

14 Amounts collected by the Director under this section

15 from a prisoner subject to an order of restitution

16 issued pursuant to section 3663 or 3663A shall be

17 paid to victims in accordance with the order of res18 titution.

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

20 amounts collected by the Director under this section

21 from prisoners not subject to an order of restitution

22 issued pursuant to section 3663 or 3663A—

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

24 Crime Victims Fund established under section
6

•HR 1349 RH

1 1402 of the Victims of Crime Act of 1984 (42

2 U.S.C. 10601); and

3 ‘‘(B) 25 percent shall be available to the At4 torney General for administrative expenses in5 curred in carrying out this section.

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

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

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

9 applicability of this section to the prisoner. Notwith10 standing any other provision of this section, a fee under

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

12 such person—

13 ‘‘(1) until the expiration of the 30-day period be14 ginning on the date on which each prisoner in the

15 prison system is provided with such notices; and

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

17 such period.

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

19 regulations promulgated by the Director under subsection

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

21 take effect until the expiration of the 30-day period begin22 ning on the date on which each prisoner in the prison sys23 tem is provided with written and oral notices of the provi24 sions of those regulations (or amendments, as the case may

25 be). A fee under this section may not be assessed against,
7

•HR 1349 RH

1 or collected from, a prisoner pursuant to such regulations

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

3 before the expiration of such period.

4 ‘‘(j) NOTICE BEFORE PUBLIC COMMENT PERIOD.—Be5 fore the beginning of any period a proposed regulation

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

7 shall provide written and oral notice of the provisions of

8 that proposed regulation to groups that advocate on behalf

9 of Federal prisoners and to each prisoner subject to such

10 proposed regulation.

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

12 after the date of the enactment of the Federal Prisoner

13 Health Care Copayment Act of 2000, and annually there14 after, the Director shall transmit to Congress a report,

15 which shall include—

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

17 this section during the preceding 12-month period;

18 ‘‘(2) an analysis of the effects of the implementa19 tion of this section, if any, on the nature and extent

20 of health care visits by prisoners;

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

22 and administering the program;

23 ‘‘(4) a description of current inmate health sta24 tus indicators as compared to the year prior to enact25 ment; and
8

•HR 1349 RH

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

2 services provided to inmates during the preceding 12-

3 month period, as compared with the quality of those

4 services provided during the 12-month period ending

5 on the date of the enactment of such Act.’’.

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

7 303 of title 18, United States Code, is amended by adding

8 at the end the following:

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

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

10 NON-FEDERAL INSTITUTIONS.

11 Section 4013 of title 18, United States Code, is amend12 ed by adding at the end the following:

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

14 IN NON-FEDERAL INSTITUTIONS.—

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

16 paid under subsection (a)(3), a State or local govern17 ment may assess and collect a reasonable fee from the

18 trust fund account (or institutional equivalent) of a

19 Federal prisoner for health care services, if—

20 ‘‘(A) the prisoner is confined in a non-Fed21 eral institution pursuant to an agreement be22 tween the Federal Government and the State or

23 local government;

24 ‘‘(B) the fee—

25 ‘‘(i) is authorized under State law; and
9

•HR 1349 RH

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) of

12 this title; and

13 ‘‘(iii) are not preventative health care

14 services, emergency services, prenatal care,

15 diagnosis or treatment of chronic infectious

16 diseases, 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

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

25 a fee assessed under this subsection.
10

•HR 1349 RH

1 ‘‘(3) NOTICE TO PRISONERS OF LAW.—Each per2 son who is or becomes a prisoner shall be provided

3 with written and oral notices of the provisions of this

4 subsection and the applicability of this subsection to

5 the prisoner. Notwithstanding any other provision of

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

7 assessed against, or collected from, such person—

8 ‘‘(A) until the expiration of the 30-day pe9 riod beginning on the date on which each pris10 oner in the prison system is provided with such

11 notices; and

12 ‘‘(B) for services provided before the expira13 tion of such period.

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

15 IMPLEMENTATION.—The implementation of this sub16 section by the State or local government, and any

17 amendment to that implementation, shall not take ef18 fect until the expiration of the 30-day period begin19 ning on the date on which each prisoner in the prison

20 system is provided with written and oral notices of

21 the provisions of that implementation (or amendment,

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

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

24 pursuant to such implementation (or amendments, as
11

•HR 1349 RH

1 the case may be) for services provided before the expi2 ration of such period.

3 ‘‘(5) NOTICE BEFORE PUBLIC COMMENT PE4 RIOD.—Before the beginning of any period a proposed

5 implementation under this subsection is open to pub6 lic comment, written and oral notice of the provisions

7 of that proposed implementation shall be provided to

8 groups that advocate on behalf of Federal prisoners

9 and to each prisoner subject to such proposed imple10 mentation.’’.

11 SEC. 4. COMPREHENSIVE HIV/AIDS SERVICES REQUIRED TO

12 BE INCLUDED IN HEALTH CARE SERVICES

13 FOR WHICH HEALTH CARE FEES MAY BE AS14 SESSED.

15 Any health care services for which a person may be

16 assessed a fee under section 4048 of title 18, United States

17 Code (as added by section 2) or section 4013(c) of such title

18 (as added by section 3) shall include comprehensive cov19 erage for services relating to human immunodeficiency

20 virus (HIV) and acquired immune deficiency syndrome

21 (AIDS).
Union Calendar No. 506

106TH CONGRESS

2D SESSION H. R. 1349

[Report No. 106–851]

A BILL

To amend title 18, United States Code, to combat

the overutilization of prison health care servicesand control rising prisoner health care costs.

SEPTEMBER 14, 2000

Reported with an amendment, committed to the Committee of the Whole House on the State of the Union,

and ordered to be printed