Practices of the House of Representatives) a report
which—
(1) shall describe any progress made in imple-
menting the recommendations described in sub-
section (c)(1)(B);
(2) shall include information relating to levels
of pay for male and female employees, respectively,
within the same occupation in the executive branch;
and
(3) may include any other information or rec-
ommendations which the Office considers appro-
priate.
SEC. 105. RULE OF CONSTRUCTION.
Nothing in this title shall be considered to limit any
of the rights or remedies provided under the Civil Rights
Act of 1964, section 6(d) of the Fair Labor Standards
Act of 1938, or any other provision of law relating to dis-
crimination on the basis of race, color, religion, sex, na-
tional origin, handicap, or age.
SEC. 106. FUNDING.
Sums appropriated to the Office of Personnel Man-
agement for general operating expenses shall be available
to carry out this title.
SEC. 107. DEFINITIONS.
For the purpose of this title—
(1) the term ‘‘occupation’’ means any grouping
of positions within an agency, as determined under
chapter 51 of title 5, United States Code, or sub-
chapter IV of chapter 53 of such title;
(2) the term ‘‘agency’’ means an executive
agency, as defined by section 105 of title 5, United
States Code (other than the General Accounting Of-
fice);
(3) the term ‘‘consultant’’ includes an organiza-
tion which provides consultant services;
(4) the term ‘‘appropriate officials’’ means the
Director of the Office of Personnel Management, the
Director of the Office of Management and Budget,
and the Secretary of Labor;
(5) the term ‘‘labor organization’’ has the
meaning given that term by section 7103(a)(4) of
title 5, United States Codes; and
(6) the term ‘‘Government’’ means the Govern-
ment of the United States.
SEC. 108. EFFECTIVE DATE.
This title shall take effect 30 days after the date of
the enactment of this Act.
TITLE 
II—PROVISIONS 
RELAT-
ING TO PAY AND PERSONNEL
PRACTICES IN THE LEGISLA-
TIVE BRANCH
SEC. 201. RESPONSIBILITIES OF THE GENERAL ACCOUNT-
ING OFFICE.
The General Accounting Office shall—
(1) with respect to positions in the legislative
branch to which title VII of the Civil Rights Act of
1964 and section 6(d) of the Fair Labor Standards
Act of 1938 apply, perform studies similar to those
required under title I; and
(2) develop a comprehensive plan under which
the general principles set forth in section 101(a)
may be made applicable to positions in the legislative
branch other than those described in paragraph (1).
SEC. 202. REPORTING REQUIREMENT.
The General Accounting Office shall submit a written
report to the President and each House of Congress not
later than 12 months after the date of the enactment of
this Act. Included in such report shall be—
(1) the findings and conclusions of its studies
under section 201(1), together with any rec-
ommendations which the General Accounting Office
considers appropriate; and
(2) the details of its comprehensive plan, as re-
quired under section 201(2).
TITLE 
III—DISCRIMINATORY
WAGE-SETTING 
PRACTICES
AND DISCRIMINATORY WAGE
DISPARITIES
Subtitle A—Technical Assistance
SEC. 301. STATEMENT OF PURPOSE.
Recognizing that the identification and elimination of
discriminatory wage-setting practices and discriminatory
wage disparities are in the public interest, the purpose of
this subtitle is to help eliminate such practices and dis-
parities by—
(1) providing for the development and utiliza-
tion of techniques that will promote the establish-
ment of wage rates based on the work performed
and other appropriate factors, rather than the sex,
race, or national origin of the employee; and
(2) providing for the public dissemination of in-
formation relating to the techniques described in
paragraph (1), thereby encouraging and stimulating
public and private employers, through the use of
such techniques, to correct wage-setting practices
and eliminate wage disparities, to the extent that
they are based on the sex, race, or national origin
of the employee, rather than the work performed
and other appropriate factors.
SEC. 302. PROGRAM SPECIFICATIONS.
In order to carry out the purpose of this subtitle, the
Secretary of Labor shall develop and carry out a continu-
ing program under which, among other things, the Sec-
retary shall—
(1) develop and implement a program for the
dissemination of information on efforts being made
in the private and public sectors to reduce or elimi-
nate wage disparities, to the extent that they are
based on the sex, race, or national origin of the em-
ployee, rather than the work performed and other
appropriate factors;
(2) undertake and promote research into the
development of techniques to reduce or eliminate
wage disparities, to the extent that they are based
on the sex, race, or national origin of the employee,
rather than the work performed and other appro-
priate factors; and
(3) develop and implement a program for pro-
viding appropriate technical assistance to any public
or private entity requesting such assistance to cor-
rect wage-setting practices or to eliminate wage dis-
parities, to the extent that they are based on the
sex, race, or national origin of the employee, rather
than the work performed and other appropriate fac-
tors.
SEC. 303. DEFINITION.
For the purpose of this subtitle, the term ‘‘other ap-
propriate factors’’ includes factors such as—
(1) the skill, effort, responsibilities, and quali-
fication requirements for the work involved, taken in
their totality;
(2) geographic location and working conditions;
and
(3) seniority, merit, productivity, education, and
work experience.
Subtitle B—Wage Discrimination
Based on Sex, Race, or National
Origin
SEC. 351. AUTHORIZATION OF APPROPRIATIONS.
There is authorized to be appropriated to the Equal
Employment Opportunity Commission $100,000,000 for
each of the fiscal years 1995, 1996, 1997, 1998, and
1999, to be expended—
(1) to enforce the provisions of those laws ad-
ministered by the Commission that relate to wage
discrimination based on sex, race, or national origin;
and
(2) to carry out activities to increase public
awareness of the right to be free from such wage
discrimination that violates such laws.
Subtitle C—Compliance With
Executive Order 11246
The Secretary of Labor shall develop and implement
standard procedures to review compliance with Executive
Order 11246 in every contract audited through the con-
tract compliance program of the Department of Labor.
Subtitle D—Amendments To
Achieve Budget Neutrality
SEC. 381. ESTABLISHMENT OF STANDARD PAYMENT RATES
FOR HOME HEALTH SERVICES.
(a) IN GENERAL.—
(1) STANDARD PAYMENT RATES DESCRIBED.—
Title XVIII of the Social Security Act is amended by
inserting after section 1889 the following new sec-
tion:
‘‘STANDARD PAYMENT RATES FOR HOME HEALTH
SERVICES
‘‘SEC. 1890. (a) IN GENERAL.—Notwithstanding sec-
tion 1814(b)(1), section 1833(a)(2)(A), or any other pro-
vision of this title, the amount of payment made under
this title for home health services furnished by a home
health agency on or after January 1, 1994, shall equal
the adjusted standard per visit payment rate determined
under subsection (b) for the category of home health serv-
ices involved (as defined in subsection (d)(1)) for the fiscal
year during which the services are furnished.
‘‘(b) DETERMINATION OF ADJUSTED STANDARD PER
VISIT PAYMENT RATES.—
‘‘(1) IN GENERAL.—The adjusted standard per
visit payment rate for home health services fur-
nished in a fiscal year is equal to—
‘‘(A) the base per visit rate for the cat-
egory of home health services involved for the
fiscal year determined under paragraph (2), ad-
justed for area wage differences under para-
graph (3); and
‘‘(B) in the case of home health services in
the category of services described in subsection
(d)(1)(A) that involve the furnishing of non-
routine medical supplies directly identifiable as
services for an individual patient (but not in-
cluding durable medical equipment, prosthetic
devices, or orthotics and prosthetics), the
amount described in subparagraph (A) in-
creased by the medical supply add-on described
in paragraph (4).
‘‘(2) BASE PER VISIT RATE.—
‘‘(A) INITIAL
RATE.—The base per visit
rate for a category of home health services fur-
nished by a home health agency in fiscal year
1994 shall be an amount equal to 93 percent of
the mean of the labor-related and nonlabor
costs for that category of services utilized for
purposes of computing limits under section
1861(v)(1)(L) for cost reporting periods begin-
ning on or after July 1, 1993, and before July
1, 1994, increased by the cost reporting period
adjustment factor for January 1994 (as speci-
fied in the regulation setting forth such limits).
‘‘(B) SUBSEQUENT YEARS.—The base per
visit rate for a category of home health services
furnished by a home health agency in a fiscal
year beginning on or after October 1, 1994 is
the base per visit rate for that category of serv-
ices for the preceding fiscal year increased by
the home health market basket percentage in-
crease (as defined in subsection (d)(2)) for such
fiscal year.
‘‘(3) ADJUSTING FOR AREA WAGE LEVELS.—
The Secretary shall adjust the base per visit rate de-
termined under paragraph (2) for home health serv-
ices furnished by a home health agency for a fiscal
year by utilizing the area wage index applicable dur-
ing the fiscal year under section 1886(d)(3)(E) to
hospitals located in the geographic area in which the
agency is located (determined without regard to
whether such hospitals have been reclassified to a
new 
geographic 
area 
pursuant 
to 
section
1886(d)(8)(B), a decision of the Medicare Geo-
graphic Classification Review Board or the Secretary
under section 1886(d)(10)).
‘‘(4) MEDICAL SUPPLY ADD-ON DESCRIBED.—
The medical supply add-on described in this para-
graph is equal to—
‘‘(A) for fiscal year 1994, the estimated
national average cost of non-routine medical
supplies directly identifiable as services for an
individual patient (but not including durable
medical 
equipment, 
prosthetic 
devices, 
or
orthotics and prosthetics) associated with a
home health visit, as estimated by the Secretary
based upon the best data available and updated
through fiscal year 1994 by the Secretary’s es-
timate of the increase in the medical equipment
and supplies component of the supplies and
rental consumer price index for all urban con-
sumers (U.S. city average), from the end of the
period from which the data was drawn through
fiscal year 1994; and
‘‘(B) for a subsequent fiscal year, the add-
on for the preceding fiscal year increased by the
Secretary’s estimate of the percentage increase
in the index referred to in subparagraph (A) for
the fiscal year involved.
‘‘(c) COST REPORTING REQUIREMENTS.—
‘‘(1) IN GENERAL.— Not later than January 1,
1994, the Secretary shall implement a system under
which a random sample of home health agencies
shall submit cost reports. Cost reports submitted
under such system shall be used solely for purposes
of comparing the costs of home health agencies with
the adjusted standard payment rates established
under subsection (b).
‘‘(2) SYSTEM DESCRIBED.—The system devel-
oped under paragraph (1) shall—
‘‘(A) utilize a different random sample of
agencies for each 12-month period,
‘‘(B) include in such random sample 5 per-
cent of all home health agencies, and
‘‘(C) to the greatest extent practicable and
consistent with the preceding provisions of this
paragraph, avoid requiring a home health agen-
cy to submit a cost report pursuant to para-
graph (1) more than once in any 5-year period.
‘‘(3) REPORTS
OF
ADDITIONAL
AGENCIES.—
Any home health agency that is not required to sub-
mit a cost report pursuant to paragraph (1) for a
cost reporting period may be required by the Sec-
retary to submit a simplified cost report for such pe-
riod, in accordance with regulations issued by the
Secretary. The Secretary may use such reports sole-
ly for the purposes described in such paragraph.
‘‘(d) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘category of home health serv-
ices’ means any one of the following home health
services:
‘‘(A) Skilled nursing services.
‘‘(B) Physical therapy services.
‘‘(C) Occupational therapy services.
‘‘(D) Speech therapy services.
‘‘(E) Medical social services.
‘‘(F) Home health aide services.
‘‘(2) The term ‘home health market basket per-
centage increase’ means, with respect to a fiscal
year, the percentage by which the cost of the mix of
goods and services comprising home health services
will exceed the cost of such mix of goods and serv-
ices for the preceding fiscal year, as estimated by
the Secretary before the fiscal year begins.’’.
(2) EXCEPTIONS
AND
ADJUSTMENTS
FOR
COSTS SIGNIFICANTLY IN EXCESS OF PAYMENTS.—
The Secretary of Health and Human Services shall
provide by regulation for such exceptions and adjust-
ments to the payment amounts established for home
health services under section 1890(a) of the Social
Security Act (as added by paragraph (1)) as the
Secretary deems appropriate for services for which a
home health agency incurs costs that significantly
exceed such payment amounts for reasons beyond
the agency’s control, subject to any limits the Sec-
retary may establish to ensure that such an excep-
tion or adjustment does not result in the reimburse-
ment of any costs that the Secretary does not find
to be reasonable.
(b) CONFORMING AMENDMENTS.—
(1) AMENDMENTS RELATING TO PART A.—(A)
Section 1814(b) of such Act (42 U.S.C. 1395f(b)) is
amended in the matter preceding paragraph (1) by
striking ‘‘1813 and 1886’’ and inserting ‘‘1813,
1886, and 1890’’.
(B) Section 1813(a)(5) of such Act, as added
by section 604(a)(1), is amended by striking ‘‘the
average of all the per visit costs’’ and all that follows
and inserting ‘‘the payment amount determined for
such services under section 1890(a).’’.
(2) AMENDMENTS RELATING TO PART B.—(A)
Section 1832(a)(2)(F) of such Act, as added by sec-
tion 604(a)(2), is amended—
(i) by amending clause (i) to read as fol-
lows:
‘‘(i) the payment amount determined
for such service under section 1890(a), less
the amount a provider may charge as de-
scribed 
in 
clause 
(ii) 
of 
section
1866(a)(2)(A);’’; and
(ii) in the matter following clause (iii), by
striking ‘‘the average of all the per visit costs’’
and all that follows and inserting ‘‘the payment
amount determined for such services under sec-
tion 1890(a).’’.
(B) Section 1861(v)(1)(L) of such Act (42
U.S.C. 1395x(v)(1)(L)) is amended by adding at the
end the following new clause:
‘‘(iv) Clauses (i), (ii), and (iii) shall not apply to any
services furnished on or after January 1, 1994.’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to services furnished during cost
reporting periods beginning on or after January 1, 1994.
Æ
HR 3738 IH——2