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condition under paragraph (1)(D) of such section (as added by
subsection (a) of this section) that an application be approved with
respect to the entity does not apply until the expiration of the
180-day period beginning on such date.
SEC. 6. TIMELY RESPONSE TO FILING OF ACTION OR PROCEEDING.
Section 224 (42 U.S.C. 233) is amended by adding at the end
thereof the following subsection:
‘‘(l)(1) If a civil action or proceeding is filed in a State court
against any entity described in subsection (g)(4) or any officer,
governing board member, employee, or any contractor of such an
entity for damages described in subsection (a), the Attorney General,
within 15 days after being notified of such filing, shall make an
appearance in such court and advise such court as to whether
the Secretary has determined under subsections (g) and (h), that
such entity, officer, governing board member, employee, or contrac-
tor of the entity is deemed to be an employee of the Public Health
Service for purposes of this section with respect to the actions
or omissions that are the subject of such civil action or proceeding.
Such advice shall be deemed to satisfy the provisions of subsection
(c) that the Attorney General certify that an entity, officer, govern-
ing board member, employee, or contractor of the entity was acting
within the scope of their employment or responsibility.
‘‘(2) If the Attorney General fails to appear in State court
within the time period prescribed under paragraph (1), upon petition
of any entity or officer, governing board member, employee, or
contractor of the entity named, the civil action or proceeding shall
be removed to the appropriate United States district court. The
civil action or proceeding shall be stayed in such court until such
court conducts a hearing, and makes a determination, as to the
appropriate forum or procedure for the assertion of the claim for
damages described in subsection (a) and issues an order consistent
with such determination.’’.
SEC. 7. APPLICATION OF COVERAGE TO MANAGED CARE PLANS.
Section 224 (42 U.S.C. 223) (as amended by section 6) is amend-
ed by adding at the end thereof the following subsection:
‘‘(m)(1) An entity or officer, governing board member, employee,
or contractor of an entity described in subsection (g)(1) shall, for
purposes of this section, be deemed to be an employee of the
Public Health Service with respect to services provided to individ-
uals who are enrollees of a managed care plan if the entity contracts
with such managed care plan for the provision of services.
‘‘(2) Each managed care plan which enters into a contract
with an entity described in subsection (g)(4) shall deem the entity
and any officer, governing board member, employee, or contractor
of the entity as meeting whatever malpractice coverage require-
ments such plan may require of contracting providers for a calendar
year if such entity or officer, governing board member, employee,
or contractor of the entity has been deemed to be an employee
of the Public Health Service for purposes of this section for such
calendar year. Any plan which is found by the Secretary on the
record, after notice and an opportunity for a full and fair hearing,
to have violated this subsection shall upon such finding cease,
for a period to be determined by the Secretary, to receive and
to be eligible to receive any Federal funds under titles XVIII or
XIX of the Social Security Act.
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‘‘(3) For purposes of this subsection, the term ‘managed care
plan’ shall mean health maintenance organizations and similar
entities that contract at-risk with payors for the provision of health
services or plan enrollees and which contract with providers (such
as entities described in subsection (g)(4)) for the delivery of such
services to plan enrollees.’’.
SEC. 8. COVERAGE FOR PART-TIME PROVIDERS UNDER CONTRACTS.
Section 224(g)(5)(B) (42 U.S.C. 223(g)(5)(B)) is amended to read
as follows:
‘‘(B) in the case of an individual who normally performs
an average of less than 321⁄2 hours of services per week for
the entity for the period of the contract, the individual is
a licensed or certified provider of services in the fields of family
practice, general internal medicine, general pediatrics, or
obstetrics and gynecology.’’.
SEC. 9. DUE PROCESS FOR LOSS OF COVERAGE.
Section 224(i)(1) (42 U.S.C. 233(i)(1)) is amended by striking
‘‘may determine, after notice and opportunity for a hearing’’ and
inserting ‘‘may on the record determine, after notice and opportunity
for a full and fair hearing’’.
SEC. 10. AMOUNT OF RESERVE FUND.
Section 224(k)(2) (42 U.S.C. 223(k)(2)) is amended by striking
‘‘$30,000,000’’ and inserting ‘‘$10,000,000’’.
SEC. 11. REPORT ON RISK EXPOSURE OF COVERED ENTITIES.
Section 224 (as amended by section 7) is amended by adding
at the end thereof the following subsection:
‘‘(n)(1) Not later than one year after the date of the enactment
of the Federally Supported Health Centers Assistance Act of 1995,
the Comptroller General of the United States shall submit to the
Congress a report on the following:
‘‘(A) The medical malpractice liability claims experience
of entities that have been deemed to be employees for purposes
of this section.
‘‘(B) The risk exposure of such entities.
‘‘(C) The value of private sector risk-management services,
and the value of risk-management services and procedures
required as a condition of receiving a grant under section
329, 330, 340, or 340A.
‘‘(D) A comparison of the costs and the benefits to taxpayers
of maintaining medical malpractice liability coverage for such
entities pursuant to this section, taking into account—
‘‘(i) a comparison of the costs of premiums paid by
such entities for private medical malpractice liability insur-
ance with the cost of coverage pursuant to this section;
and
‘‘(ii) an analysis of whether the cost of premiums for
private medical malpractice liability insurance coverage
is consistent with the liability claims experience of such
entities.
‘‘(2) The report under paragraph (1) shall include the following:
‘‘(A) A comparison of—
‘‘(i) an estimate of the aggregate amounts that such
entities (together with the officers, governing board mem-
bers, employees, and contractors of such entities who have
H. R. 1747—6
been deemed to be employees for purposes of this section)
would have directly or indirectly paid in premiums to obtain
medical malpractice liability insurance coverage if this sec-
tion were not in effect; with
‘‘(ii) the aggregate amounts by which the grants
received by such entities under this Act were reduced
pursuant to subsection (k)(2).
‘‘(B) A comparison of—
‘‘(i) an estimate of the amount of privately offered
such insurance that such entities (together with the offi-
cers, governing board members, employees, and contractors
of such entities who have been deemed to be employees
for purposes of this section) purchased during the three-
year period beginning on January 1, 1993; with
‘‘(ii) an estimate of the amount of such insurance that
such entities (together with the officers, governing board
members, employees, and contractors of such entities who
have been deemed to be employees for purposes of this
section) will purchase after the date of the enactment of
the Federally Supported Health Centers Assistance Act
of 1995.
‘‘(C) An estimate of the medical malpractice liability loss
history of such entities for the 10-year period preceding October
1, 1996, including but not limited to the following:
‘‘(i) Claims that have been paid and that are estimated
to be paid, and legal expenses to handle such claims that
have been paid and that are estimated to be paid, by
the Federal Government pursuant to deeming entities as
employees for purposes of this section.
‘‘(ii) Claims that have been paid and that are estimated
to be paid, and legal expenses to handle such claims that
have been paid and that are estimated to be paid, by
private medical malpractice liability insurance.
‘‘(D) An analysis of whether the cost of premiums for private
medical malpractice liability insurance coverage is consistent
with the liability claims experience of entities that have been
deemed as employees for purposes of this section.
‘‘(3) In preparing the report under paragraph (1), the Comptrol-
ler General of the United States shall consult with public and
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private entities with expertise on the matters with which the report
is concerned.’’.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.