United States within the jurisdiction of which the inves-
tigation is carried on or of which the subpoenaed person
is an inhabitant, or in which he carries on business or may
be found, to compel compliance with the subpoena. The
court may issue an order requiring the subpoenaed person
to appear before the Attorney General to produce records,
if so ordered, or to give testimony touching the matter
under investigation. Any failure to obey the order of the
court may be punished by the court as a contempt thereof.
All process in any such case may be served in any judicial
district in which such person may be found.
‘‘(d) IMMUNITY FROM CIVIL LIABILITY.—Notwith-
standing any Federal, State, or local law, any person, in-
cluding officers, agents, and employees, receiving a sub-
poena under this section, who complies in good faith with
the subpoena and thus produces the materials sought,
shall not be liable in any court of any State or the United
States to any customer or other person for such produc-
tion or for nondisclosure of that production to the cus-
tomer.
‘‘(e) USE IN ACTION AGAINST INDIVIDUALS.—
‘‘(1) Health information about an individual
that is disclosed under this section may not be used
in, or disclosed to any person for use in, any admin-
istrative, civil, or criminal action or investigation di-
rected against the individual who is the subject of
the information unless the action or investigation
arises out of and is directly related to receipt of
health care or payment for health care or an action
involving a fraudulent claim related to health; or if
authorized by an appropriate order of a court of
competent jurisdiction, granted after application
showing good cause therefor.
‘‘(2) In assessing good cause under paragraph
(1), the court shall weigh the public interest and the
need for disclosure against the injury to the patient,
to the physician-patient relationship, and to the
treatment services.
‘‘(3) Upon granting of such order, the court, in
determining the extent to which any disclosure of all
or any part of any record is necessary, shall impose
appropriate safeguards against unauthorized disclo-
sure.’’.
(b) CLERICAL AMENDMENT.—The table of sections
at the beginning of such chapter is amended by inserting
after the item relating to section 3485 the following new
item:
‘‘3486. Authorized investigative demand procedures.’’.
(c) 
CONFORMING
AMENDMENT.—Section
1510(b)(3)(B) of title 18, United States Code, is amended
by inserting ‘‘or a Department of Justice subpoena issued
under section 3486 of this title’’ after ‘‘subpoena’’.
Subtitle C—Health Care Fraud
Abuse Account
SEC. 121. FRAUD AND ABUSE CONTROL FUND.
(a) IN GENERAL.—Part A of title XI of the Social
Security Act is amended by adding at the end the follow-
ing new section:
‘‘FRAUD AND ABUSE CONTROL FUND
‘‘SEC. 1145. (a) The Secretary shall, directly or
through contractual or other arrangements and with ap-
propriate coordination with the States, take all steps nec-
essary to assure the accuracy of payments from the trust
funds established under title XVIII (referred to herein as
the ‘Medicare Trust Funds’) and the appropriation for
payments to States to carry out title XIX (referred to
herein as the ‘Medicaid appropriation’) and otherwise as-
sure the appropriateness of expenditures from such Funds
and such appropriation. To carry out this responsibility,
the Secretary shall place particular emphasis on the devel-
opment of and experimentation with innovative or rigorous
techniques and approaches to identifying, investigating,
and eliminating fraudulent or abusive practices that bur-
den the Medicare Trust Funds or the Medicaid appropria-
tion.
‘‘(b) To provide a reliable source of funding to sup-
port the Secretary’s activities under subsection (a) and en-
courage cost-effective innovation, there is established in
the Treasury of the United States a fund to be known
as the ‘HHS Fraud and Abuse Control Fund’ (referred
to herein as the ‘Fund’).
‘‘(c) There shall be deposited in the Fund—
‘‘(1) that portion of amounts recovered in rela-
tion to section 1128A arising out of a claim under
title XIX or title XVIII as remains after application
of subsection (f)(1) (pertaining to reimbursement of
a State’s share of recoveries relating to title XIX) or
subsection (f)(2) (relating to repayment of the Medi-
care Trust Funds) of that section, as may be appli-
cable,
‘‘(2) payments made pursuant to a court or ad-
ministrative order or voluntary settlement agreement
to reimburse for all or part of the costs of investiga-
tions, audits, and monitoring of compliance plans,
conducted by the Department of Health and Human
Services that relate to the programs under title
XVIII or XIX, and
‘‘(3) penalties and damages imposed (other
than funds awarded to a relator or for restitution)
under sections 3729 through 3732 of title 31, Unit-
ed States Code (pertaining to false claims) in cases
involving claims relating to programs under title
XVIII or XIX (to the extent the amounts deposited
in the Fund under paragraphs (1) and (2) in a fiscal
year are less than $2,000,000).
‘‘(d) Amounts deposited in the Fund shall be avail-
able to the Secretary (without the necessity for any provi-
sion therefor in appropriations Acts) until expended for
payment of expenses incurred in carrying out subsection
(a).
‘‘(e) No more than $2,000,000 may be deposited in
the Fund in any fiscal year.’’.
(b) INITIAL DEPOSIT IN HHS FRAUD AND ABUSE
CONTROL FUND.—There is authorized to be appropriated
for fiscal year 1996 an amount (to be deposited in the
HHS Fraud and Abuse Control Fund established by sec-
tion 1145(b) of the Social Security Act) for the initial im-
plementation of activities under section 1145(a) of that
Act (subject to section 1145(e) of that Act).
(c) CONFORMING AMENDMENT.—Section 1128A(f)
of the Social Security Act (42 U.S.C. 1320a–7a(f)) is
amended—
(1) by renumbering paragraph (3) as paragraph
(4), and
(2) by inserting after paragraph (2) the follow-
ing:
‘‘(3) Additional amounts (subject to section 1145(e))
shall be deposited in the HHS Fraud and Abuse Control
Fund established by section 1145(b).’’.
(d) 
EFFECTIVE
DATE.—Sections 
1145(c) 
and
1128A(f)(3) of the Social Security Act (as enacted and
amended by subsections (a) and (c) of this section) apply
to amounts recovered, payments made, and penalties and
damages imposed, after fiscal year 1995.
TITLE II—MEDICARE PLUS
PILOT PROGRAM
SEC. 201. ESTABLISHMENT OF PILOT PROGRAM.
(a) IN GENERAL.—The Secretary of Health and
Human Services shall establish a pilot program (in this
section referred to as the ‘‘pilot program’’) under which
additional health plans (including health plans of the type
described in subsection (b)) may qualify to be offered
under section 1876 of the Social Security Act.
(b) TYPES
OF ORGANIZATIONS DESCRIBED.—The
types of organizations described in this subsection are the
following:
(1) 
PROVIDER-SPONSORED
NETWORKS.—A
health plan offered by a group of affiliated providers
that provides a substantial proportion of medicare
covered items and services directly through the affili-
ated group of providers.
(2) TAFT-HARTLEY
PLANS.—A group health
plan that is established or maintained by two or
more employers or jointly by one or more employers
and one or more employee organizations.
(3) ASSOCIATION
PLANS.—A health plan of-
fered through an association, religious fraternal or-
ganization, or other organization (which may be a
trade, industry, or professional association, a cham-
ber of commerce, or a public entity association)
that—
(A) has been formed for purposes other
than the sale of any health insurance and does
not restrict membership based on the health
status, claims experience, receipt of health care,
medical history, or lack of evidence of insurabil-
ity, of an individual,
(B) does not exist solely or principally for
the purpose of selling insurance, and
(C) has at least 1,000 individual members
or 200 employer members.
(4) HIGH DEDUCTIBLE HEALTH PLANS WITH
CONTRIBUTION TO MEDICAL SAVINGS ACCOUNTS.—
(A) IN GENERAL.—A benefit package con-
sisting of—
(i) a high deductible health plan de-
scribed in subparagraph (B), and
(ii) a contribution to a medical sav-
ings account (of the excess of the medicare
payment amount over the premium for
such high deductible health plan).
(B) HIGH DEDUCTIBLE HEALTH PLAN DE-
SCRIBED.—A high deductible health plan de-
scribed in this subparagraph is a health plan
that—
(i) provides reimbursement for at
least items and services covered under the
medicare program in a year but only after
the enrollee incurs countable expenses (as
specified under the plan) equal to the
amount of a deductible (in an amount that
does not exceed $10,000);
(ii) counts as such expenses (for pur-
poses of such deductible) at least all
amounts that would have been payable
under parts A and B of the medicare pro-
gram or by the enrollee if the enrollee had
elected to receive benefits through the pro-
visions of such parts (rather than through
the plan); and
(iii) provides, after such deductible is
met for a year and for all subsequent ex-
penses for benefits referred to in clause (i)
in the year, for a level of reimbursement
that is not less than—
(I) 100 percent of such expenses,
or
(II) 100 percent of the amounts
that would have been paid (without
regard to any deductibles or coinsur-
ance) under parts A and B of the
medicare program with respect to
such expenses,
whichever is less.
(c) PROGRAM DATES.—
(1) APPLICATIONS.—Under the pilot program
the Secretary shall provide for receipt of applications
by October 1, 1996.
(2) INITIAL OPERATION.—Operation of the pilot
program under approved application shall commence
on January 1, 1997.
(3) TERMINATION DATE.—
(A) IN
GENERAL.—The pilot program
under this section shall terminate on December
31, 2001, unless extended by the Congress.
(B) EARLY TERMINATION.—The Secretary
may terminate any project under the pilot pro-
gram on an earlier date if the Secretary deter-
mines that the continued operation of the
project will endanger the medicare trust funds.
(d) STUDY OF APPLICATION.—In the case of the high
deductible health plans with contribution to medical sav-
ings accounts described in subsection (b)(4), the Secretary
shall conduct a study of the extent to which enrollees rep-
resent a cross-section by age and income of medicare bene-
ficiaries.
(e) STUDY AND REPORT.—The Secretary shall con-
duct a study of the operation of the pilot program and
shall submit to Congress, not later than March 1, 2001,
on such operation and whether the program should be con-
tinued beyond the termination date specified in subsection
(c)(3)(A).
TITLE III—COMMISSION ON THE
EFFECT OF THE BABY BOOM
GENERATION ON THE MEDI-
CARE PROGRAM
SEC. 301. COMMISSION ON THE EFFECT OF THE BABY
BOOM GENERATION ON THE MEDICARE PRO-
GRAM.
(a) ESTABLISHMENT.—There is established a com-
mission to be known as the Commission on the Effect of
the Baby Boom Generation on the Medicare Program (in
this section referred to as the ‘‘Commission’’).
(b) DUTIES.—
(1) IN GENERAL.—The Commission shall—
(A) examine the financial impact on the
medicare program of the significant increase in
the number of medicare eligible individuals
which will occur beginning approximately dur-
ing 2010 and lasting for approximately 25
years, and
(B) make specific recommendations to the
Congress respecting a comprehensive approach
to preserve the medicare program for the period
during which such individuals are eligible for
medicare.
(2) 
CONSIDERATIONS
IN
MAKING
REC-
OMMENDATIONS.—In making its recommendations,
the Commission shall consider the following:
(A) The amount and sources of Federal
funds to finance the medicare program, includ-
ing the potential use of innovative financing
methods.
(B) The most efficient and effective man-
ner of administering the program.
(C) Methods used by other nations to re-
spond to comparable demographic patterns in
eligibility for health care benefits for elderly
and disabled individuals.
(D) Trends in employment-related health
care for retirees, including the use of medical
savings accounts and similar financing devices.
(E) The needs of medicare beneficiaries
and providers located in diverse geographic lo-
cations, including urban and rural areas.
(3) CONSULTATION
WITH
MEDICARE
TRUST-
EES.—The Commission shall conduct its activities in
consultation with the trustees of the Federal Supple-
mentary Medical Insurance Trust Fund.
(c) MEMBERSHIP.—
(1) APPOINTMENT.—The Commission shall be
composed of 15 members appointed as follows:
(A) The President shall appoint 3 mem-
bers.
(B) The Majority Leader of the Senate
shall appoint, after consultation with the minor-
ity leader of the Senate, 6 members, of whom
not more than 4 may be of the same political
party.
(C) The Speaker of the House of Rep-
resentatives shall appoint, after consultation
with the minority leader of the House of Rep-
resentatives, 6 members, of whom not more
than 4 may be of the same political party.
(2) CHAIRMAN
AND
VICE
CHAIRMAN.—The
Commission shall elect a Chairman and Vice Chair-
man from among its members.
(3) VACANCIES.—Any vacancy in the member-
ship of the Commission shall be filled in the manner
in which the original appointment was made and
shall not affect the power of the remaining members
to execute the duties of the Commission.
(4) QUORUM.—A quorum shall consist of 8
members of the Commission, except that 4 members
may conduct a hearing under subsection (e).
(5) MEETINGS.—The Commission shall meet at
the call of its Chairman or a majority of its mem-
bers. The Commission shall hold hearings in dif-
ferent areas throughout the country in order to ob-
tain information and suggestions from a diverse
group of individuals.
(6) COMPENSATION AND REIMBURSEMENT OF
EXPENSES.—Members of the Commission are not
entitled to receive compensation for service on the
Commission. Members may be reimbursed for travel,
subsistence, and other necessary expenses incurred
in carrying out the duties of the Commission.
(d) STAFF AND CONSULTANTS.—
(1) STAFF.—The Commission may appoint and
determine the compensation of such staff as may be
necessary to carry out the duties of the Commission.
Such appointments and compensation may be made
without regard to the provisions of title 5, United
States Code, that govern appointments in the com-
petitive services, and the provisions of chapter 51
and subchapter III of chapter 53 of such title that
relate to classifications and the General Schedule
pay rates.
(2) CONSULTANTS.—The Commission may pro-
cure such temporary and intermittent services of
consultants under section 3109(b) of title 5, United
States Code, as the Commission determines to be
necessary to carry out the duties of the Commission.
(e) POWERS.—
(1) HEARINGS
AND
OTHER
ACTIVITIES.—For
the purpose of carrying out its duties, the Commis-
sion may hold such hearings and undertake such
other activities as the Commission determines to be
necessary to carry out its duties.
(2) STUDIES BY GAO.—Upon the request of the
Commission, the Comptroller General shall conduct
such studies or investigations as the Commission de-
termines to be necessary to carry out its duties.
(3) COST
ESTIMATES
BY
CONGRESSIONAL
BUDGET OFFICE.—
(A) Upon the request of the Commission,
the Director of the Congressional Budget Office
shall provide to the Commission such cost esti-
mates as the Commission determines to be nec-
essary to carry out its duties.
(B) The Commission shall reimburse the
Director of the Congressional Budget Office for
expenses relating to the employment in the of-
fice of the Director of such additional staff as
may be necessary for the Director to comply
with requests by the Commission under sub-
paragraph (A).
(4) DETAIL OF FEDERAL EMPLOYEES.—Upon
the request of the Commission, the head of any Fed-
eral agency is authorized to detail, without reim-
bursement, any of the personnel of such agency to
the Commission to assist the Commission in carry-
ing out its duties. Any such detail shall not interrupt
or otherwise affect the civil service status or privi-
leges of the Federal employee.
(5) TECHNICAL
ASSISTANCE.—Upon the re-
quest of the Commission, the head of a Federal
agency shall provide such technical assistance to the
Commission as the Commission determines to be
necessary to carry out its duties.
(6) USE OF MAILS.—The Commission may use
the United States mails in the same manner and
under the same conditions as Federal agencies and
shall, for purposes of the frank, be considered a
commission of Congress as described in section 3215
of title 39, United States Code.
(7) OBTAINING
INFORMATION.—The Commis-
sion may secure directly from any Federal agency
information necessary to enable it to carry out its
duties, if the information may be disclosed under
section 552 of title 5, United States Code. Upon re-
quest of the Chairman of the Commission, the head
of such agency shall furnish such information to the
Commission.
(8) ADMINISTRATIVE
SUPPORT
SERVICES.—
Upon the request of the Commission, the Adminis-
trator of General Services shall provide to the Com-
mission on a reimbursable basis such administrative
support services as the Commission may request.
(9) ACCEPTANCE OF DONATIONS.—The Com-
mission may accept, use, and dispose of gifts or do-
nations of services or property.
(10) PRINTING.—For purposes of costs relating
to printing and binding, including the cost of per-
sonnel detailed from the Government Printing Of-
fice, the Commission shall be deemed to be a com-
mittee of the Congress.
(f) REPORT.—Not later than January 1, 2001, the
Commission shall submit to Congress a report containing
its findings and recommendations regarding how to pro-
tect and preserve the medicare program in a financially
solvent manner until 2030 (or, if later, throughout the pe-
riod of projected solvency of the Federal Old-Age and Sur-
vivors Insurance Trust Fund). The report shall include de-
tailed recommendations for appropriate legislative initia-
tives respecting how to accomplish this objective.
(g) TERMINATION.—The Commission shall terminate
60 days after the date of submission of the report required
in subsection (f).
(h) AUTHORIZATION
OF APPROPRIATIONS.—There
are authorized to be appropriated $1,500,000 to carry out
this section. Amounts appropriated to carry out this sec-
tion shall remain available until expended.
TITLE 
IV—DEVELOPMENT 
OF
SINGLE MEDICARE ADMINIS-
TRATIVE SYSTEM
SEC. 401. IMPROVED ADMINISTRATIVE EFFICIENCIES.
(a) IN GENERAL.—The Secretary of Health and
Human Services shall take such steps as may be required
to provide for improved efficiency in the medicare program
through—
(1) establishment of a common payment form
(as part of a medicare transaction system) for all
medicare payments, and
(2) consolidation of the administrative system
for parts A and B of the medicare program.
(b) REPORT.—The Secretary shall submit to Con-
gress a report on steps taken under subsection (a) and
in such legislation as may be required to further carry out
subsection (a) and to provide for further administrative
efficiencies under the medicare program.
TITLE V—LOCK-BOX PROVISION
SEC. 501. LIMITATION ON USE OF SAVINGS.
Notwithstanding any other provision of law, all sav-
ings resulting from the enactment of this Act shall be
transferred to the credit of the Federal Hospital Insurance
Trust Fund and may not be used to offset revenue losses
from a tax cut.
Æ
HR 2476 IH——2