H. R. 1747
One Hundred Fourth Congress
of the
United States of America
AT THE FIRST SESSION
Begun and held at the City of Washington on Wednesday,
the fourth day of January, one thousand nine hundred and ninety-five
An Act
To amend the Public Health Service Act to permanently extend and clarify mal-
practice coverage for health centers, and for other purposes.
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; REFERENCES.
(a) SHORT TITLE.—This Act may be cited as the ‘‘Federally
Supported Health Centers Assistance Act of 1995’’.
(b) REFERENCES.—Except as otherwise expressly provided,
whenever in this Act an amendment or repeal is expressed in
terms of an amendment to, or repeal of, a section or other provision,
the reference shall be considered to be made to a section or other
provision of the Public Health Service Act.
SEC. 2. PERMANENT EXTENSION OF PROGRAM.
(a) IN GENERAL.—Section 224(g)(3) (42 U.S.C. 233(g)(3)) is
amended by striking the last sentence.
(b) CONFORMING
AMENDMENTS.—Section 224(k) (42 U.S.C.
233(k)) is amended—
(1) in paragraph (1)(A)—
(A) by striking ‘‘For each of the fiscal years 1993,
1994, and 1995’’ and inserting ‘‘For each fiscal year’’; and
(B) by striking ‘‘(except’’ and all that follows through
‘‘thereafter)’’; and
(2) in paragraph (2), by striking ‘‘for each of the fiscal
years 1993, 1994, and 1995’’ and inserting ‘‘for each fiscal
year’’.
SEC. 3. CLARIFICATION OF COVERAGE.
Section 224 (42 U.S.C. 233) is amended—
(1) in subsection (g)(1), by striking ‘‘an entity described
in paragraph (4)’’ in the first sentence and all that follows
through ‘‘contractor’’ in the second sentence and inserting the
following: ‘‘an entity described in paragraph (4), and any officer,
governing board member, or employee of such an entity, and
any contractor of such an entity who is a physician or other
licensed or certified health care practitioner (subject to para-
graph (5)), shall be deemed to be an employee of the Public
Health Service for a calendar year that begins during a fiscal
year for which a transfer was made under subsection (k)(3)
(subject to paragraph (3)). The remedy against the United
States for an entity described in paragraph (4) and any officer,
governing board member, employee, or contractor’’; and
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(2) in subsection (k)(3), by inserting ‘‘governing board mem-
ber,’’ after ‘‘officer,’’.
SEC. 4. COVERAGE FOR SERVICES FURNISHED TO INDIVIDUALS OTHER
THAN CENTER PATIENTS.
Section 224(g)(1) (42 U.S.C. 233(g)) is amended—
(1) by redesignating paragraph (1) as paragraph (1)(A);
and
(2) by adding at the end thereof the following:
‘‘(B) The deeming of any entity or officer, governing board
member, employee, or contractor of the entity to be an employee
of the Public Health Service for purposes of this section shall
apply with respect to services provided—
‘‘(i) to all patients of the entity, and
‘‘(ii) subject to subparagraph (C), to individuals who are
not patients of the entity.
‘‘(C) Subparagraph (B)(ii) applies to services provided to individ-
uals who are not patients of an entity if the Secretary determines,
after reviewing an application submitted under subparagraph (D),
that the provision of the services to such individuals—
‘‘(i) benefits patients of the entity and general populations
that could be served by the entity through community-wide
intervention efforts within the communities served by such
entity;
‘‘(ii) facilitates the provision of services to patients of the
entity; or
‘‘(iii) are otherwise required under an employment contract
(or similar arrangement) between the entity and an officer,
governing board member, employee, or contractor of the entity.’’.
SEC. 5. APPLICATION PROCESS.
(a) APPLICATION REQUIREMENT.—Section 224(g)(1) (42 U.S.C.
233(g)(1)) (as amended by section 4) is further amended—
(1) in subparagraph (A), by inserting after ‘‘For purposes
of this section’’ the following: ‘‘and subject to the approval
by the Secretary of an application under subparagraph (D)’’;
and
(2) by adding at the end thereof the following:
‘‘(D) The Secretary may not under subparagraph (A) deem
an entity or an officer, governing board member, employee, or
contractor of the entity to be an employee of the Public Health
Service for purposes of this section, and may not apply such deeming
to services described in subparagraph (B)(ii), unless the entity has
submitted an application for such deeming to the Secretary in
such form and such manner as the Secretary shall prescribe. The
application shall contain detailed information, along with support-
ing documentation, to verify that the entity, and the officer, govern-
ing board member, employee, or contractor of the entity, as the
case may be, meets the requirements of subparagraphs (B) and
(C) of this paragraph and that the entity meets the requirements
of paragraphs (1) through (4) of subsection (h).
‘‘(E) The Secretary shall make a determination of whether
an entity or an officer, governing board member, employee, or
contractor of the entity is deemed to be an employee of the Public
Health Service for purposes of this section within 30 days after
the receipt of an application under subparagraph (D). The deter-
mination of the Secretary that an entity or an officer, governing
board member, employee, or contractor of the entity is deemed
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to be an employee of the Public Health Service for purposes of
this section shall apply for the period specified by the Secretary
under subparagraph (A).
‘‘(F) Once the Secretary makes a determination that an entity
or an officer, governing board member, employee, or contractor
of an entity is deemed to be an employee of the Public Health
Service for purposes of this section, the determination shall be
final and binding upon the Secretary and the Attorney General
and other parties to any civil action or proceeding. Except as pro-
vided in subsection (i), the Secretary and the Attorney General
may not determine that the provision of services which are the
subject of such a determination are not covered under this section.
‘‘(G) In the case of an entity described in paragraph (4) that
has not submitted an application under subparagraph (D):
‘‘(i) The Secretary may not consider the entity in making
estimates under subsection (k)(1).
‘‘(ii) This section does not affect any authority of the entity
to purchase medical malpractice liability insurance coverage
with Federal funds provided to the entity under section 329,
330, 340, or 340A.
‘‘(H) In the case of an entity described in paragraph (4) for
which an application under subparagraph (D) is in effect, the entity
may, through notifying the Secretary in writing, elect to terminate
the applicability of this subsection to the entity. With respect to
such election by the entity:
‘‘(i) The election is effective upon the expiration of the
30-day period beginning on the date on which the entity submits
such notification.
‘‘(ii) Upon taking effect, the election terminates the
applicability of this subsection to the entity and each officer,
governing board member, employee, and contractor of the
entity.
‘‘(iii) Upon the effective date for the election, clauses (i)
and (ii) of subparagraph (G) apply to the entity to the same
extent and in the same manner as such clauses apply to an
entity that has not submitted an application under subpara-
graph (D).
‘‘(iv) If after making the election the entity submits an
application under subparagraph (D), the election does not pre-
clude the Secretary from approving the application (and thereby
restoring the applicability of this subsection to the entity and
each officer, governing board member, employee, and contractor
of the entity, subject to the provisions of this subsection and
the subsequent provisions of this section.’’.
(b) APPROVAL PROCESS.—Section 224(h) (42 U.S.C. 233(h)) is
amended—
(1) in the matter preceding paragraph (1), by striking ‘‘Not-
withstanding’’ and all that follows through ‘‘entity—’’ and
inserting the following: ‘‘The Secretary may not approve an
application under subsection (g)(1)(D) unless the Secretary
determines that the entity—’’; and
(2) by striking ‘‘has fully cooperated’’ in paragraph (4) and
inserting ‘‘will fully cooperate’’.
(c) DELAYED APPLICABILITY FOR CURRENT PARTICIPANTS.—If,
on the day before the date of the enactment of this Act, an entity
was deemed to be an employee of the Public Health Service for
purposes of section 224(g) of the Public Health Service Act, the