datamatters24/research-document-archive huggingface dataset:
(x) Representatives of State attorneys 
general. 
(xi) Representatives of law enforce-
ment officials, including local law enforce-
ment officials. 
(xii) Representatives of health benefits 
plans and entities that provide pharmacy 
benefits management services on behalf of 
a health benefits plans. 
(2) CO-CHAIRS.—The co-chairs shall be elected 
by the members of the Working Group. The Work-
ing Group shall select for election from the members 
of the Group two individuals, of whom— 
(A) one shall be a representative of the 
Federal Government or a State government; 
and 
(B) one shall be a representative of a non- 
governmental entity. 
(3) TERM; VACANCIES.—Each member shall be 
appointed for the life of the Working Group. Any va-
cancy in the Working Group shall not affect the 
powers of the Working Group and shall be filled in 
the same manner in which the original appointment 
was made. 
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for the first plan year beginning after De-
cember 31, 2010, and 
‘‘(iii) no event had occurred under 
paragraph (6) or (7) of section 303(c) of 
such Act or paragraph (6) or (7) of section 
430(c) of such Code that, as of the first 
day of the first plan year beginning after 
December 31, 2013, would have modified 
the shortfall amortization base or the 
shortfall amortization installments with re-
spect to the first plan year beginning after 
December 31, 2010. 
‘‘(G) For purposes of this paragraph, the 
7-year shortfall amortization base is an amount, 
determined for the first plan year beginning 
after December 31, 2013, equal to— 
‘‘(i) the shortfall amortization base for 
the first plan year beginning after Decem-
ber 31, 2013, without regard to this para-
graph, minus 
‘‘(ii) the sum of the 11-year shortfall 
amortization base and the 12-year shortfall 
amortization base. 
‘‘(4) RETROACTIVE ELECTION.—Not later than 
December 31, 2014, a plan sponsor may make a 
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243
HR 2491 EH
leases, including the right to amend, modify, ex-
tend, revise, or terminate any of such contracts,
agreements, or leases were irrevocably assigned
to the Corporation for its exclusive benefit.
‘‘(B) Notwithstanding the transfer pursu-
ant to paragraph (1), the United States shall
remain obligated to the parties to the contracts,
agreements, and leases transferred pursuant to
paragraph (1) for the performance of the obli-
gations of the United States thereunder during
the term thereof. The Corporation shall reim-
burse the United States for any amount paid by
the United States in respect of such obligations
arising after the privatization date to the extent
such amount is a legal and valid obligation of
the Corporation then due.
‘‘(C) After the privatization date, upon any
material amendment, modification, extension,
revision, replacement, or termination of any
contract, agreement, or lease transferred under
paragraph (1), the United States shall be re-
leased from further obligation under such con-
tract, agreement, or lease, except that such ac-
tion shall not release the United States from
1045
HR 2491 EH
‘‘(A) IN GENERAL.—Notwithstanding para-
graph (1), any amount included in gross income
under section 951(a)(1)(A) shall be included as
an item of gross income derived from an unre-
lated trade or business to the extent the
amount so included is attributable to insurance
income (as defined in section 953) which, if de-
rived directly by the organization, would be
treated as gross income from an unrelated
trade or business. There shall be allowed all de-
ductions directly connected with amounts in-
cluded in gross income under the preceding sen-
tence.
‘‘(B) 
EXCEPTION.—Subparagraph 
(A)
shall not apply to income attributable to a pol-
icy of insurance or reinsurance with respect to
which the person (directly or indirectly) insured
is—
‘‘(i) such organization,
‘‘(ii) an affiliate of such organization
which is exempt from tax under section
501(a), or
‘‘(iii) a director, officer, or employee
of such organization or affiliate but only if
the insurance covers solely risks associated
the measure specified under (g)(1) as soon as 
practicable. 
‘‘(3) PERFORMANCE STANDARDS.— 
‘‘(A) 
ESTABLISHMENT.—The 
Secretary 
shall establish performance standards with re-
spect to the measure applied under paragraph 
(2) for a performance period for a fiscal year. 
‘‘(B) HIGHER OF ACHIEVEMENT AND IM-
PROVEMENT.—The performance standards es-
tablished under subparagraph (A) shall include 
levels of achievement and improvement. In cal-
culating the SNF performance score under 
paragraph (4), the Secretary shall use the high-
er of either improvement or achievement. 
‘‘(C) TIMING.—The Secretary shall estab-
lish and announce the performance standards 
established under subparagraph (A) not later 
than 60 days prior to the beginning of the per-
formance period for the fiscal year involved. 
‘‘(4) SNF PERFORMANCE SCORE.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
develop a methodology for assessing the total 
performance of each skilled nursing facility 
based on performance standards established 
under paragraph (3) with respect to the meas-
HR 2490 IH1S
(8) RESERVATION.—The term ‘‘Reservation’’
means the Salt River Pima-Maricopa Indian Res-
ervation.
(9) 
SADDLEBACK
PROPERTY.—The 
term
‘‘Saddleback Property’’ means a tract of land that—
(A) consists of approximately 701 acres
within the city of Scottsdale, Arizona; and
(B) includes the Dedication Property, the
Development Property, the Mountain Property,
and the Preservation Property.
(10) 
SECRETARY.—The 
term 
‘‘Secretary’’
means the Secretary of the Interior.
(11) SETTLEMENT
AGREEMENT.—The term
‘‘Settlement Agreement’’—
(A) means the Settlement, Release and
Property Conveyance Agreement executed on
September 11, 1995, by the Community, the
City, and the Resolution Trust Corporation (in
its capacity as the Receiver for the Sun State
Savings and Loan Association, F.S.A.); and
(B) includes the Development Agreement,
the Use Agreement, and all other associated an-
cillary agreements and exhibits.
(12) USE AGREEMENT.—The term ‘‘Use Agree-
ment’’ means the agreement between the City and
113TH CONGRESS 
2D SESSION 
H. R. 4067 
AN ACT 
To provide for the extension of the enforcement instruction 
on supervision requirements for outpatient therapeutic 
services in critical access and small rural hospitals 
through 2014. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
719
Subtitle E, Part 1
‘‘(e) APPROVED MEDICAL RESIDENCY TRAIN-
ING PROGRAM.—For purposes of this title, the
term ‘approved medical residency training
program’ has the meaning given such term in
section 1886(h)(5)(A).
‘‘Subpart 2—Amount Relating to Indirect
Costs of Graduate Medical Education
‘‘SEC. 2221. DETERMINATION OF AMOUNT RELATING TO IN-
DIRECT COSTS.
‘‘(a) IN GENERAL.—For purposes of section
2211(a)(1), the amount determined under this
section for a teaching hospital for a fiscal
year is the product of—
‘‘(1) the amount in the Indirect-Costs
Medical Education Account on the appli-
cable date under section 2201(d) (once
the appropriation under such section is
made); and
‘‘(2) the percentage determined for
the hospital under subsection (b).
‘‘(b) HOSPITAL-SPECIFIC PERCENTAGE.—
‘‘(1) IN GENERAL.—For purposes of sub-
section (a)(2), the percentage determined
under this subsection for a teaching hos-
pital is the mean average of the respec-
SECTION 1. EXTENSION OF ENFORCEMENT INSTRUCTION 
ON SUPERVISION REQUIREMENTS FOR OUT-
PATIENT THERAPEUTIC SERVICES IN CRIT-
ICAL ACCESS AND SMALL RURAL HOSPITALS 
THROUGH 2014. 
The Secretary of Health and Human Services shall 
continue to apply through calendar year 2014 the enforce-
ment instruction described in the notice of the Centers for 
Medicare & Medicaid Services entitled ‘‘Enforcement In-
struction on Supervision Requirements for Outpatient 
Therapeutic Services in Critical Access and Small Rural 
Hospitals for CY 2013’’, dated November 1, 2012 (pro-
viding for an exception to the restatement and clarification 
under the final rulemaking changes to the Medicare hos-
pital outpatient prospective payment system and calendar 
year 2009 payment rates (published in the Federal Reg-
ister on November 18, 2008, 73 Fed. Reg. 68702 through 
68704) with respect to requirements for direct supervision 
by physicians for therapeutic hospital outpatient services). 
Passed the House of Representatives September 9, 
2014. 
Attest: 
Clerk.
113TH CONGRESS 
2D SESSION 
H. R. 4067 
AN ACT 
To provide for the extension of the enforcement in-
struction on supervision requirements for out-
patient therapeutic services in critical access and 
small rural hospitals through 2014.
(c) LIMITATION.—Subsection (d) of the first section
of such Act (16 U.S.C. 698(d)), as amended by subsection
(b), is further amended by adding at the end the following:
‘‘The authority to exchange lands under this subsection
shall expire on July 1, 1998.’’.
SEC. 3. REPORTING REQUIREMENT.
Not later than six months after the date of the enact-
ment of this Act and every six months thereafter until the
earlier of the consummation of the exchange or July 1,
1998, the Secretary of the Interior and the Secretary of
Agriculture shall each submit a report to the Committee
on Resources of the House of Representatives and the
Committee on Energy and Natural Resources of the Sen-
ate concerning the progress in consummating the land ex-
change authorized by the amendments made by Big Thick-
et National Preserve Addition Act of 1993 (Public Law
103–46).
SEC. 4. LAND EXCHANGE IN LIBERTY COUNTY, TEXAS.
If, within one year after the date of the enactment
of this Act—
(1) the owners of the private lands described in
subsection (b)(1) offer to transfer all their right,
title, and interest in and to such lands to the Sec-
retary of the Interior, and
(2) Liberty County, Texas, agrees to accept the
transfer of the Federal lands described in subsection
(b)(2),
the Secretary shall accept such offer of private lands and,
in exchange and without additional consideration, transfer
to Liberty County, Texas, all right, title, and interest of
the United States in and to the Federal lands described
in subsection (b)(2).
(b) LANDS DESCRIBED.—
(1) PRIVATE
LANDS.—The private lands de-
scribed in this paragraph are approximately 3.76
acres of lands located in Liberty County, Texas, as
generally depicted on the map entitled ‘‘Big Thicket
Lake Estates Access—Proposed’’.
(2) FEDERAL LANDS.—The Federal lands de-
scribed in this paragraph are approximately 2.38
acres of lands located in Menard Creek Corridor
Unit of the Big Thicket National Preserve, as gen-
erally depicted on the map referred to in paragraph
(1).
(c) ADMINISTRATION OF LANDS ACQUIRED BY THE
UNITED STATES.—The lands acquired by the Secretary
under this section shall be added to and administered as
part of the Menard Creek Corridor Unit of the Big Thick-
et National Preserve.
Passed the House of Representatives December 5,
1995.
Attest:
Clerk.
‘‘(B) the reasons such comments were rejected.
‘‘(3) If the Director has received notice and failed to
comment on an agency rule within 60 days after the notice
of proposed rulemaking, the Director may not disapprove
any collection of information specifically contained in an
agency rule.
‘‘(4) No provision in this section shall be construed
to prevent the Director, in the Director’s discretion—
‘‘(A) from disapproving any collection of infor-
mation which was not specifically required by an
agency rule;
‘‘(B) from disapproving any collection of infor-
mation contained in an agency rule, if the agency
failed to comply with the requirements of paragraph
(1) of this subsection;
‘‘(C) from disapproving any collection of infor-
mation contained in a final agency rule, if the Direc-
tor finds within 60 days after the publication of the
final rule, and after considering the agency’s re-
sponse to the Director’s comments filed under para-
graph (2), that the collection of information cannot
be approved under the standards set forth in section
3508; or
‘‘(D) from disapproving any collection of infor-
mation contained in a final rule, if—
‘‘(i) the Director determines that the agen-
cy has substantially modified in the final rule
the collection of information contained in the
proposed rule; and
‘‘(ii) the agency has not given the Director
the information required under paragraph (1)
with respect to the modified collection of infor-
mation, at least 60 days before the issuance of
the final rule.
‘‘(5) This subsection shall apply only when an agency
publishes a notice of proposed rulemaking and requests
public comments.
‘‘(6) The decision by the Director to approve or not
act upon a collection of information contained in an agen-
cy rule shall not be subject to judicial review.
‘‘(e)(1) Any decision by the Director under subsection
(c), (d), (h), or (j) to disapprove a collection of informa-
tion, or to instruct the agency to make substantive or ma-
terial change to a collection of information, shall be pub-
licly available and include an explanation of the reasons
for such decision.
‘‘(2) Any written communication between the Admin-
istrator of the Office of Information and Regulatory Af-
fairs, or any employee of the Office of Information and
Regulatory Affairs, and an agency or person not employed
301
HR 2491 PP
(f) USE OF FEES.—Section 4(i) of the Land and
Water Conservation Fund Act of 1965 (16 U.S.C. 460l–
6a(i)) is amended:
(1) By amending the subsection heading to read
as follows: ‘‘USE OF FEES.—’’.
(2) By striking ‘‘fee collection costs for that fiscal
year’’ in the first sentence of subparagraph (B) and
inserting: ‘‘fee collection costs for the immediately
preceding fiscal year’’ and by striking ‘‘section in
that fiscal year’’ and inserting in lieu thereof, ‘‘sec-
tion in such immediately preceding fiscal year.’’.
(3) By striking ‘‘in that fiscal year’’ in the sec-
ond sentence of subparagraph (B).
(4) By striking paragraph (4), and subpara-
graphs (A) and (B) in their entirety and inserting:
‘‘Amounts covered into the special account for the Na-
tional Park Service shall be allocated among park
system units in accordance with subsection (j) of this
section for obligation or expenditure by the Director
of the National Park Service for park operations.’’.
(g) TIME OF REIMBURSEMENT.—Section 4(k) of the
Land and Water Conservation Fund Act of 1965 (16 U.S.C.
460l–6a(k)) is amended by striking the last sentence in its
entirety.
program manager shall notify the person exer-
cising acquisition decision authority for the pro-
gram. 
‘‘(B) 
NOTIFICATION
OF
ACTUAL 
BREACH.—If an actual breach occurs in a 
major acquisition program, the program man-
ager for that program shall notify the head of 
the Component concerned, the Component Ac-
quisition Executive for the program, the Execu-
tive Director referred to in section 709(b) of 
this Act, the Under Secretary for Management, 
and the Deputy Secretary. 
‘‘(C) NOTIFICATION TO SECRETARY.—If a 
major acquisition program has an actual breach 
with a cost overrun greater than 20 percent or 
a schedule delay greater than 12 months from 
the costs or schedule set forth in the acquisition 
program baseline for the program, the Sec-
retary and the Inspector General of the Depart-
ment shall be notified not later than five busi-
ness days after the actual breach is identified. 
‘‘(2) REMEDIATION
PLAN
AND
ROOT
CAUSE 
ANALYSIS.— 
‘‘(A) IN GENERAL.—In the case of an ac-
tual breach with a cost overrun greater than 15
‘‘(1) review the plan and the process by which 
the tribe solicited requests for quotations from inves-
tors and selected the investor partner; and 
‘‘(2)(A) approve the plan, unless the Secretary 
determines that— 
‘‘(i) the assessment of the tribe’s housing 
needs by the qualified entity, or as set forth in 
the plan pursuant to section 904(3), is inac-
curate or insufficient; 
‘‘(ii) the process established by the tribe to 
solicit requests for quotations and select an in-
vestor partner was insufficient or negligent; or 
‘‘(iii) the plan is insufficient to meet the 
housing needs of the tribe, as identified in the 
plan pursuant to section 904(3); 
‘‘(B) approve the plan, on the condition that 
the participating tribe and the investor make such 
revisions to the plan as the Secretary may specify as 
appropriate to meet the needs of the tribe for afford-
able housing; or 
‘‘(C) disapprove the plan, only if the Secretary 
determines that the plan fails to meet the minimal 
housing standards and requirements set forth in this 
Act and the Secretary notifies the tribe of the ele-
ments requiring the disapproval.
(B) in subparagraph (A), by striking ‘‘and 
the American Academy of Pediatrics’’ and in-
serting ‘‘the American Academy of Pediatrics, 
and (with respect to the update pursuant to the 
Trauma Systems and Regionalization of Emer-
gency Care Reauthorization Act) the American 
Burn Association’’. 
(c) CONFORMING AMENDMENTS.—Part B of title XII 
of the Public Health Service Act is amended— 
(1) in section 1218(c)(2) (42 U.S.C. 300d– 
18(c)(2)), in the matter preceding subparagraph (A), 
by striking ‘‘1232(b)(3)’’ and inserting ‘‘section 
1232(b)’’; and 
(2) in section 1222 (42 U.S.C. 300d–22), by 
striking ‘‘October 1, 2008’’ and inserting ‘‘October 1, 
2016’’. 
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H. R. 4067 
One Hundred Thirteenth Congress 
of the 
United States of America 
AT THE SECOND SESSION 
Begun and held at the City of Washington on Friday, 
the third day of January, two thousand and fourteen 
An Act 
To provide for the extension of the enforcement instruction on supervision require-
ments for outpatient therapeutic services in critical access and small rural hos-
pitals through 2014. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. EXTENSION OF ENFORCEMENT INSTRUCTION ON SUPER-
VISION REQUIREMENTS FOR OUTPATIENT THERA-
PEUTIC SERVICES IN CRITICAL ACCESS AND SMALL 
RURAL HOSPITALS THROUGH 2014. 
The Secretary of Health and Human Services shall continue 
to apply through calendar year 2014 the enforcement instruction 
described in the notice of the Centers for Medicare & Medicaid 
Services entitled ‘‘Enforcement Instruction on Supervision Require-
ments for Outpatient Therapeutic Services in Critical Access and 
Small Rural Hospitals for CY 2013’’, dated November 1, 2012 (pro-
viding for an exception to the restatement and clarification under 
the final rulemaking changes to the Medicare hospital outpatient 
prospective payment system and calendar year 2009 payment rates 
(published in the Federal Register on November 18, 2008, 73 Fed. 
Reg. 68702 through 68704) with respect to requirements for direct 
supervision by physicians for therapeutic hospital outpatient serv-
ices). 
Speaker of the House of Representatives. 
Vice President of the United States and
President of the Senate.
I 
113TH CONGRESS 
2D SESSION 
H. R. 4067 
To provide for the extension of the enforcement instruction on supervision 
requirements for outpatient therapeutic services in critical access and 
small rural hospitals through 2014. 
IN THE HOUSE OF REPRESENTATIVES 
FEBRUARY 18, 2014 
Ms. JENKINS introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Ways and Means, for a period to be subsequently determined by the 
Speaker, in each case for consideration of such provisions as fall within 
the jurisdiction of the committee concerned 
A BILL 
To provide for the extension of the enforcement instruction 
on supervision requirements for outpatient therapeutic 
services in critical access and small rural hospitals 
through 2014. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
VerDate Mar 15 2010 
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SECTION 1. EXTENSION OF ENFORCEMENT INSTRUCTION 
ON SUPERVISION REQUIREMENTS FOR OUT-
PATIENT THERAPEUTIC SERVICES IN CRIT-
ICAL ACCESS AND SMALL RURAL HOSPITALS 
THROUGH 2014. 
The Secretary of Health and Human Services shall 
continue to apply through calendar year 2014 the enforce-
ment instruction described in the notice of the Centers for 
Medicare & Medicaid Services entitled ‘‘Enforcement In-
struction on Supervision Requirements for Outpatient 
Therapeutic Services in Critical Access and Small Rural 
Hospitals for CY 2013’’, dated November 1, 2012 (pro-
viding for an exception to the restatement and clarification 
under the final rulemaking changes to the Medicare hos-
pital outpatient prospective payment system and calendar 
year 2009 payment rates (published in the Federal Reg-
ister on November 18, 2008, 73 Fed. Reg. 68702 through 
68704) with respect to requirements for direct supervision 
by physicians for therapeutic hospital outpatient services). 
Æ 
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I
104TH CONGRESS
1ST SESSION
H. R. 2426
To amend the Tariff Act of 1930 with respect to the marking of door
hinges.
IN THE HOUSE OF REPRESENTATIVES
SEPTEMBER 29, 1995
Mr. GEPHARDT (for himself and Mr. TALENT) introduced the following bill;
which was referred to the Committee on Ways and Means
A BILL
To amend the Tariff Act of 1930 with respect to the marking
of door hinges.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. MARKING OF DOOR HINGES.
Section 304 of the Tariff Act of 1930 (19 U.S.C.
1304) is amended—
(1) by redesignating subsections (f), (g), (h),
and (i) as subsections (g), (h), (i), and (j), respec-
tively, and
(2) by inserting after subsection (e) the follow-
ing new subsection:
‘‘(f) MARKING OF CERTAIN DOOR HINGES.—
‘‘(1) Except as provided in paragraph (2), no
exception may be made under subsection (a)(3) of
this section with respect to door hinges and parts
thereof (except metal forgings and castings imported
for further processing into finished hinges and door
hinges designed for motor vehicles), each of which
shall be marked on the exposed surface of the hinge
when viewed after fixture with the English name of
the country of origin by means of die stamping,
cast-in-mold lettering, etching, or engraving.
‘‘(2) If, because of the nature of the article, it
is technically or commercially infeasible to mark it
by 1 of the 4 methods specified in paragraph (1),
the article may be marked by an equally permanent
method of marking such as paint stenciling or, in
the case of door hinges of less than 3 inches in
length, by marking on the smallest unit of packaging
utilized.’’.
SEC. 2. EFFECTIVE DATE.
The amendments made by section 1 apply to goods
entered, or withdrawn from warehouse for consumption,
on or after the date of the enactment of this Act.
Æ
A BILL 
To provide for the extension of the enforcement instruction 
on supervision requirements for outpatient therapeutic 
services in critical access and small rural hospitals 
through 2014. 
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