276
(2) analyzing the effect of such laws on the pro-
vision of health care and securing payment for such
care.
(b) 
MODIFICATION
OF
DEADLINE.—Section
264(c)(1) of the Health Insurance Portability and Ac-
countability Act of 1996 (Public Law 104–191; 110 Stat.
2033) is amended by striking ‘‘36 months after the date
of the enactment of this Act,’’ and inserting ‘‘6 months
after the date on which the Comptroller General of the
United States submits to the Congress a report under sec-
tion 5003(a) of the Patient Protection Act of 1998,’’.
SEC. 5004. PROTECTION FOR CERTAIN INFORMATION DE-
VELOPED TO REDUCE MORTALITY OR MOR-
BIDITY OR FOR IMPROVING PATIENT CARE
AND SAFETY.
(a) PROTECTION OF CERTAIN INFORMATION.—Not-
withstanding any other provision of Federal or State law,
health care response information shall be exempt from any
disclosure requirement (regardless of whether the require-
ment relates to subpoenas, discovery, introduction of evi-
dence, testimony, or any other form of disclosure), in con-
nection with a civil or administrative proceeding under
Federal or State law, to the same extent as information
developed by a health care provider with respect to any
of the following:
277
(1) Peer review.
(2) Utilization review.
(3) Quality management or improvement.
(4) Quality control.
(5) Risk management.
(6) Internal review for purposes of reducing
mortality, morbidity, or for improving patient care
or safety.
(b) NO WAIVER OF PROTECTION THROUGH INTER-
ACTION WITH ACCREDITING BODY.—Notwithstanding any
other provision of Federal or State law, the protection of
health care response information from disclosure provided
under subsection (a) shall not be deemed to be modified
or in any way waived by—
(1) the development of such information in con-
nection with a request or requirement of an accredit-
ing body; or
(2) the transfer of such information to an ac-
crediting body.
(c) DEFINITIONS.—For purposes of this section:
(1) The term ‘‘accrediting body’’ means a na-
tional, not-for-profit organization that—
(A) accredits health care providers; and
278
(B) is recognized as an accrediting body by
statute or by a Federal or State agency that
regulates health care providers.
(2) The term ‘‘health care provider’’ has the
meaning given such term in section 1188 of the So-
cial Security Act (as added by section 5001 of this
Act).
(3) The term ‘‘health care response informa-
tion’’ means information (including any data, report,
record, memorandum, analysis, statement, or other
communication) developed by, or on behalf of, a
health care provider in response to a serious, ad-
verse, patient-related event—
(A) during the course of analyzing or
studying the event and its causes; and
(B) for purposes of—
(i) reducing mortality or morbidity; or
(ii) improving patient care or safety
(including the provider’s notification to an
accrediting body and the provider’s plans
of action in response to such event).
(5) The term ‘‘State’’ has the meaning given
such term in section 1188 of the Social Security Act
(as added by section 5001 of this Act).
279
TITLE VI—MEDICAL SAVINGS AC-
COUNTS FOR FEDERAL EM-
PLOYEES
SEC. 6001. MEDICAL SAVINGS ACCOUNTS FOR FEDERAL
EMPLOYEES.
(a) MEDICAL SAVINGS ACCOUNTS.—
(1) CONTRIBUTIONS.—Title 5, United States
Code, is amended by redesignating section 8906a as
section 8906c and by inserting after section 8906
the following:
‘‘§ 8906a. Government contributions to medical sav-
ings accounts
‘‘(a) An employee or annuitant enrolled in a high de-
ductible health plan is entitled, in addition to the Govern-
ment contribution under section 8906(b) toward the sub-
scription charge for such plan, to have a Government con-
tribution made, in accordance with succeeding provisions
of this section, to a medical savings account of such em-
ployee or annuitant.
‘‘(b)(1) The biweekly Government contribution under
this section shall, in the case of any such employee or an-
nuitant, be equal to the amount by which—
‘‘(A) the biweekly equivalent of the maximum
Government contribution for the contract year in-
280
volved (as defined by paragraph (2)), exceeds (if at
all)
‘‘(B) the amount of the biweekly Government
contribution payable on such employee’s or annu-
itant’s behalf under section 8906(b) for the period
involved.
‘‘(2) For purposes of this section, the term ‘maximum
Government contribution’ means, with respect to a con-
tract year, the maximum Government contribution that
could be made for health benefits for an employee or annu-
itant for such contract year, as determined under section
8906(b) (disregarding paragraph (2) thereof)).
‘‘(3) Notwithstanding any other provision of this sec-
tion, no contribution under this section shall be payable
to any medical savings account of an employee or annu-
itant for any period—
‘‘(A) if, as of the first day of the month before
the month in which such period commences, such
employee or annuitant (or the spouse of such em-
ployee or annuitant, if coverage is for self and fam-
ily) is entitled to benefits under part A of title
XVIII of the Social Security Act;
‘‘(B) to the extent that such contribution, when
added to previous contributions made under this sec-
tion for that same year with respect to such em-
281
ployee or annuitant, would cause the total to ex-
ceed—
‘‘(i) the highest annual limit deductible
permitted under clause (i) or (ii) of section
220(c)(2)(A) of the Internal Revenue Code of
1986, as appropriate (determined taking into
account any changes in coverage that may
occur), for the calendar year in which such pe-
riod commences; or
‘‘(ii) such lower amount (relative to the
limitation that would otherwise apply under
clause (i)) as the employee or annuitant may
specify in accordance with regulations of the
Office, including an election not to receive con-
tributions under this section for a year or the
remainder of a year; or
‘‘(C) for which any information (or documenta-
tion) under subsection (d) that is needed in order to
make such contribution has not been timely submit-
ted.
‘‘(4) Notwithstanding any other provision of this sec-
tion, no contribution under this section shall be payable
to any medical savings account of an employee for any
period in a contract year unless that employee was en-
282
rolled in a health benefits plan under this chapter as an
employee for not less than—
‘‘(A) the 1 year of service immediately before
the start of such contract year, or
‘‘(B) the full period or periods of service be-
tween the last day of the first period, as prescribed
by regulations of the Office of Personnel Manage-
ment, in which he is eligible to enroll in the plan and
the day before the start of such contract year,
whichever is shorter.
‘‘(5) The Office shall provide for the conversion of
biweekly rates of contributions specified by paragraph (1)
to rates for employees and annuitants whose pay or annu-
ity is provided on other than a biweekly basis, and for
this purpose may provide for the adjustment of the con-
verted rate to the nearest cent.
‘‘(c) A Government contribution under this section—
‘‘(1) shall be made at the same time that, and
the same frequency with which, Government con-
tributions under section 8906(b) are made for the
benefit of the employee or annuitant involved; and
‘‘(2) shall be payable from the same appropria-
tion, fund, account, or other source as would any
Government contributions under section 8906(b)
with respect to the employee or annuitant involved.
284
would not be allowable by reason of subparagraph
(A) or (B)(i) of subsection (b)(3) thereof;
‘‘(2) for which any information (or documenta-
tion) that is needed in order to make such contribu-
tion has not been timely submitted; or
‘‘(3) if the employee or annuitant submits a re-
quest for termination of withholdings, beginning on
or after the effective date of the request and before
the end of the year.
‘‘(c) The Office of Personnel Management shall pre-
scribe any regulations necessary to carry out this section,
including provisions relating to the time, form, and man-
ner in which any request for withholdings under this sec-
tion may be made, changed, or terminated.’’.
(2) RULES
OF
CONSTRUCTION.—Nothing in
this section or in any amendment made by this sec-
tion shall be considered—
(A) to permit or require that any contribu-
tions to a medical savings account (whether by
the Government or through withholdings from
pay or annuity) be paid into the Employees
Health Benefits Fund; or
(B) to affect any authority under section
1005(f) of title 39, United States Code, to vary,
add to, or substitute for any provision of chap-
285
ter 89 of title 5, United States Code, as amend-
ed by this section.
(3) CONFORMING AMENDMENTS.—
(A) The table of sections at the beginning
of chapter 89 of title 5, United States Code, is
amended by striking the item relating to section
8906a and inserting the following:
‘‘8906a.
Government contributions to medical savings accounts.
‘‘8906b.
Individual contributions to medical savings accounts.
‘‘8906c.
Temporary employees.’’.
(B) Section 8913(b)(4) of title 5, United
States 
Code, 
is 
amended 
by 
striking
‘‘8906a(a)’’ and inserting ‘‘8906c(a)’’.
(b) INFORMATIONAL REQUIREMENTS.—Section 8907
of title 5, United States Code, is amended by adding at
the end the following:
‘‘(c) In addition to any information otherwise re-
quired under this section, the Office shall make available
to all employees and annuitants eligible to enroll in a high
deductible health plan, information relating to—
‘‘(1) the conditions under which Government
contributions under section 8906a shall be made to
a medical savings account;
‘‘(2) the amount of any Government contribu-
tions under section 8906a to which an employee or
annuitant may be entitled (or how such amount may
be ascertained);
286
‘‘(3) the conditions under which contributions
to a medical savings account may be made under
section 8906b through withholdings from pay or an-
nuity; and
‘‘(4) any other matter the Office considers ap-
propriate in connection with medical savings ac-
counts.’’.
(c) HIGH DEDUCTIBLE HEALTH PLAN AND MEDI-
CAL SAVINGS ACCOUNT DEFINED.—Section 8901 of title
5, United States Code, is amended—
(1) in paragraph (10) by striking ‘‘and’’ after
the semicolon;
(2) in paragraph (11) by striking the period
and inserting a semicolon; and
(3) by adding at the end the following:
‘‘(12) the term ‘high deductible health plan’
means a plan described by section 8903(5) or sec-
tion 8903a(d); and
‘‘(13) the term ‘medical savings account’ has
the meaning given such term by section 220(d) of
the Internal Revenue Code of 1986.’’.
(d) AUTHORITY TO CONTRACT FOR HIGH DEDUCT-
IBLE HEALTH PLANS.—Section 8902 of title 5, United
States Code, is amended by adding at the end the follow-
ing:
287
‘‘(p)(1) The Office shall contract under this chapter
for a high deductible health plan with any qualified carrier
that offers such a plan and, as of the date of enactment
of the Federal Employees Health Care Freedom of Choice
Act, offers a health benefits plan under this chapter.
‘‘(2) The Office may contract under this chapter for
a high deductible health plan with any qualified carrier
that offers such a plan, but does not, as of the date of
enactment of the Federal Employees Health Care Free-
dom of Choice Act, offer a health benefits plan under this
chapter.’’.
(e) DESCRIPTION OF HIGH DEDUCTIBLE HEALTH
PLANS
AND
BENEFITS
TO
BE
PROVIDED
THERE-
UNDER.—
(1) IN
GENERAL.—Section 8903 of title 5,
United States Code, is amended by adding at the
end the following:
‘‘(5) HIGH DEDUCTIBLE HEALTH PLANS.—(A)
One or more plans described by paragraph (1), (2),
(3), or (4), which—
‘‘(i) are high deductible health plans (as
defined by section 220(c)(2) of the Internal
Revenue Code of 1986); and
‘‘(ii) provide benefits of the types referred
to by section 8904(a)(5).
288
‘‘(B) Nothing in this section shall be consid-
ered—
‘‘(i) to prevent a carrier from simulta-
neously offering a plan described by subpara-
graph (A) and a plan described by paragraph
(1) or (2); or
‘‘(ii) to require that a high deductible
health plan offer two levels of benefits.’’.
(2) TYPES OF BENEFITS.—Section 8904(a) of
title 5, United States Code, is amended by inserting
after paragraph (4) the following:
‘‘(5) HIGH DEDUCTIBLE HEALTH PLANS.—Ben-
efits of the types named under paragraph (1) or (2)
of this subsection or both.’’.
(3) CONFORMING AMENDMENTS.—
(A) Section 8903a of title 5, United States
Code, is amended by redesignating subsection
(d) as subsection (e) and by inserting after sub-
section (c) the following:
‘‘(d) The plans under this section may include one
or more plans, otherwise allowable under this section, that
satisfy the requirements of clauses (i) and (ii) of section
8903(5)(A).’’.
289
(B) Section 8909(d) of title 5, United
States 
Code, 
is 
amended 
by 
striking
‘‘8903a(d)’’ and inserting ‘‘8903a(e)’’.
(4) REFERENCES.—Section 8903 of title 5,
United States Code, is amended by adding after
paragraph (5) (as added by paragraph (1) of this
subsection) as a flush left sentence, the following:
‘‘The Office shall prescribe regulations in accordance with
which the requirements of section 8902(c), 8902(n),
8909(e), and any other provision of this chapter that ap-
plies with respect to a plan described by paragraph (1),
(2), (3), or (4) of this section shall apply with respect to
the corresponding plan under paragraph (5) of this sec-
tion. Similar regulations shall be prescribed with respect
to any plan under section 8903a(d).’’.
SEC. 6002. EFFECTIVE DATE.
The amendments made by this title shall apply with
respect to contract years beginning on or after January
1, 2000. The Office of Personnel Management shall take
appropriate measures to ensure that coverage under a
high deductible health plan under chapter 89 of title 5,
United States Code (as amended by this section) shall be
available as of the beginning of the first contract year de-
scribed in the preceding sentence.
Æ