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. MAR-
TINEZ, 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 fol-
lowing bill; which was referred to the Committee on the Judiciary
SEPTEMBER 14, 2000
Additional sponsors: Mr. SMITH of Washington, Mr. GARY MILLER of Cali-
fornia, Mr. WHITFIELD, Mr. EVANS, Mr. CHABOT, Mr. BARRETT of Ne-
braska, 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 Caro-
lina, 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
[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 over-
utilization of prison health care services and control ris-
ing prisoner health care costs.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Federal Prisoner Health
Care Copayment Act of 2000’’.
SEC. 2. HEALTH CARE FEES FOR PRISONERS IN FEDERAL
INSTITUTIONS.
(a) IN GENERAL.—Chapter 303 of title 18, United
States Code, is amended by adding at the end the following:
‘‘§ 4048. Fees for health care services for prisoners
‘‘(a) DEFINITIONS.—In this section—
‘‘(1) the term ‘account’ means the trust fund ac-
count (or institutional equivalent) of a prisoner;
‘‘(2) the term ‘Director’ means the Director of the
Bureau of Prisons;
‘‘(3) the term ‘health care provider’ means any
person who is—
‘‘(A) authorized by the Director to provide
health care services; and
‘‘(B) operating within the scope of such au-
thorization;
‘‘(4) the term ‘health care visit’—
‘‘(A) means a visit, as determined by the
Director, by a prisoner to an institutional or
noninstitutional health care provider; and
‘‘(B) does not include a visit initiated by a
prisoner—
‘‘(i) pursuant to a staff referral; or
‘‘(ii) to obtain staff-approved follow-up
treatment for a chronic condition; and
‘‘(5) the term ‘prisoner’ means—
‘‘(A) any individual who is incarcerated in
an institution under the jurisdiction of the Bu-
reau of Prisons; or
‘‘(B) any other individual, as designated by
the Director, who has been charged with or con-
victed of an offense against the United States.
‘‘(b) FEES FOR HEALTH CARE SERVICES.—
‘‘(1) IN GENERAL.—The Director, in accordance
with this section and with such regulations as the Di-
rector shall promulgate to carry out this section, may
assess and collect a fee for health care services pro-
vided in connection with each health care visit re-
quested by a prisoner.
‘‘(2) EXCLUSION.—The Director may not assess
or collect a fee under this section for preventative
health care services, emergency services, prenatal care,
diagnosis or treatment of chronic infectious diseases,
mental health care, or substance abuse treatment, as
determined by the Director.
‘‘(c) PERSONS SUBJECT TO FEE.—Each fee assessed
under this section shall be collected by the Director from
the account of—
‘‘(1) the prisoner receiving health care services in
connection with a health care visit described in sub-
section (b)(1); or
‘‘(2) in the case of health care services provided
in connection with a health care visit described in
subsection (b)(1) that results from an injury inflicted
on a prisoner by another prisoner, the prisoner who
inflicted the injury, as determined by the Director.
‘‘(d) AMOUNT OF FEE.—Any fee assessed and collected
under this section shall be in an amount of not less than
$1.
‘‘(e) NO CONSENT REQUIRED.—Notwithstanding any
other provision of law, the consent of a prisoner shall not
be required for the collection of a fee from the account of
the prisoner under this section. However, each such prisoner
shall be given a reasonable opportunity to dispute the
amount of the fee or whether the prisoner qualifies under
an exclusion under this section.
‘‘(f) NO REFUSAL OF TREATMENT FOR FINANCIAL
REASONS.—Nothing in this section may be construed to
permit any refusal of treatment to a prisoner on the basis
that—
‘‘(1) the account of the prisoner is insolvent; or
‘‘(2) the prisoner is otherwise unable to pay a fee
assessed under this section.
‘‘(g) USE OF AMOUNTS.—
‘‘(1) RESTITUTION
OF
SPECIFIC
VICTIMS.—
Amounts collected by the Director under this section
from a prisoner subject to an order of restitution
issued pursuant to section 3663 or 3663A shall be
paid to victims in accordance with the order of res-
titution.
‘‘(2) ALLOCATION
OF
OTHER
AMOUNTS.—Of
amounts collected by the Director under this section
from prisoners not subject to an order of restitution
issued pursuant to section 3663 or 3663A—
‘‘(A) 75 percent shall be deposited in the
Crime Victims Fund established under section
1402 of the Victims of Crime Act of 1984 (42
U.S.C. 10601); and
‘‘(B) 25 percent shall be available to the At-
torney General for administrative expenses in-
curred in carrying out this section.
‘‘(h) NOTICE TO PRISONERS OF LAW.—Each person
who is or becomes a prisoner shall be provided with written
and oral notices of the provisions of this section and the
applicability of this section to the prisoner. Notwith-
standing any other provision of this section, a fee under
this section may not be assessed against, or collected from,
such person—
‘‘(1) until the expiration of the 30-day period be-
ginning on the date on which each prisoner in the
prison system is provided with such notices; and
‘‘(2) for services provided before the expiration of
such period.
‘‘(i) NOTICE TO PRISONERS OF REGULATIONS.—The
regulations promulgated by the Director under subsection
(b)(1), and any amendments to those regulations, shall not
take effect until the expiration of the 30-day period begin-
ning on the date on which each prisoner in the prison sys-
tem is provided with written and oral notices of the provi-
sions of those regulations (or amendments, as the case may
be). A fee under this section may not be assessed against,
or collected from, a prisoner pursuant to such regulations
(or amendments, as the case may be) for services provided
before the expiration of such period.
‘‘(j) NOTICE BEFORE PUBLIC COMMENT PERIOD.—Be-
fore the beginning of any period a proposed regulation
under this section is open to public comment, the Director
shall provide written and oral notice of the provisions of
that proposed regulation to groups that advocate on behalf
of Federal prisoners and to each prisoner subject to such
proposed regulation.
‘‘(k) REPORTS TO CONGRESS.—Not later than 1 year
after the date of the enactment of the Federal Prisoner
Health Care Copayment Act of 2000, and annually there-
after, the Director shall transmit to Congress a report,
which shall include—
‘‘(1) a description of the amounts collected under
this section during the preceding 12-month period;
‘‘(2) an analysis of the effects of the implementa-
tion of this section, if any, on the nature and extent
of health care visits by prisoners;
‘‘(3) an itemization of the cost of implementing
and administering the program;
‘‘(4) a description of current inmate health sta-
tus indicators as compared to the year prior to enact-
ment; and
‘‘(5) a description of the quality of health care
services provided to inmates during the preceding 12-
month period, as compared with the quality of those
services provided during the 12-month period ending
on the date of the enactment of such Act.’’.
(b) CLERICAL AMENDMENT.—The analysis for chapter
303 of title 18, United States Code, is amended by adding
at the end the following:
‘‘4048. Fees for health care services for prisoners.’’.
SEC. 3. HEALTH CARE FEES FOR FEDERAL PRISONERS IN
NON-FEDERAL INSTITUTIONS.
Section 4013 of title 18, United States Code, is amend-
ed by adding at the end the following:
‘‘(c) HEALTH CARE FEES FOR FEDERAL PRISONERS
IN NON-FEDERAL INSTITUTIONS.—
‘‘(1) IN
GENERAL.—Notwithstanding amounts
paid under subsection (a)(3), a State or local govern-
ment may assess and collect a reasonable fee from the
trust fund account (or institutional equivalent) of a
Federal prisoner for health care services, if—
‘‘(A) the prisoner is confined in a non-Fed-
eral institution pursuant to an agreement be-
tween the Federal Government and the State or
local government;
‘‘(B) the fee—
‘‘(i) is authorized under State law; and
‘‘(ii) does not exceed the amount col-
lected from State or local prisoners for the
same services; and
‘‘(C) the services—
‘‘(i) are provided within or outside of
the institution by a person who is licensed
or certified under State law to provide
health care services and who is operating
within the scope of such license;
‘‘(ii) constitute a health care visit
within the meaning of section 4048(a)(4) of
this title; and
‘‘(iii) are not preventative health care
services, emergency services, prenatal care,
diagnosis or treatment of chronic infectious
diseases, mental health care, or substance
abuse treatment.
‘‘(2) NO REFUSAL OF TREATMENT FOR FINAN-
CIAL REASONS.—Nothing in this subsection may be
construed to permit any refusal of treatment to a
prisoner on the basis that—
‘‘(A) the account of the prisoner is insol-
vent; or
‘‘(B) the prisoner is otherwise unable to pay
a fee assessed under this subsection.