arrangement or an employee benefit plan (as
defined under the Employee Retirement Income
Security Act of 1974), or any other entity pro-
viding a plan of health insurance subject to
State insurance regulation, but such term does
not include for purposes of section 103 an en-
tity that provides health insurance or health
benefits under a multiple employer welfare ar-
rangement.
(B)(i) Subject to clause (ii), the term ‘‘em-
ployer health benefit plan’’ means a health ben-
efit plan (including an employee welfare benefit
plan, as defined in section 3(1) of the Employee
Retirement Income Security Act of 1974) which
is offered to employees through an employer
and for which the employer provides for any
contribution to such plan or any premium for
such plan are deducted by the employer from
compensation to the employee.
(ii) A State may provide (for a plan in a
State) that the term ‘‘employer health benefit
plan’’ does not include an association plan (as
defined in clause (iii)).
(iii) For purposes of clause (ii), the term
‘‘association plan’’ means a health benefit plan
offered by an organization to its members if the
organization was formed other than for pur-
poses of purchasing insurance.
(C) The term ‘‘full-time employee’’ means,
with respect to an employer, an individual who
normally is employed for at least 30 hours per
week by the employer.
(D) The term ‘‘health benefit plan’’ means
any hospital or medical expense incurred policy
or certificate, hospital or medical service plan
contract, or health maintenance subscriber con-
tract, or a multiple employer welfare arrange-
ment or employee benefit plan (as defined
under the Employee Retirement Income Secu-
rity Act of 1974) which provides benefits with
respect to health care services, but does not in-
clude—
(i) coverage only for accident, dental,
vision, disability income, or long-term care
insurance, or any combination thereof,
(ii) medicare supplemental health in-
surance,
(iii) coverage issued as a supplement
to liability insurance,
(iv) worker’s compensation or similar
insurance, or
(v) automobile medical-payment insur-
ance,
or any combination thereof.
(E) The term ‘‘small employer carrier’’
means a carrier with respect to the issuance of
an employer health benefit plan which provides
coverage to one or more full-time employees of
an entity actively engaged in business which, on
at least 50 percent of its working days during
the preceding year, employed at least 2, but
fewer than 36, full-time employees. For pur-
poses of determining if an employer is a small
employer, rules similar to the rules of sub-
section (b) and (c) of section 414 of the Inter-
nal Revenue Code of 1986 shall apply.
(b) ENFORCEMENT THROUGH EXCISE TAX.—
(1) IN GENERAL.—Chapter 43 of the Internal
Revenue Code of 1986 (relating to qualified pension,
etc., plans) is amended by adding at the end thereof
the following new section:
‘‘SEC. 
4980C. 
FAILURE 
TO 
COMPLY 
WITH 
EMPLOYER
HEALTH 
BENEFIT 
PLAN 
STANDARDS 
RE-
GARDING PREVENTIVE HEALTH CARE.
‘‘(a) IMPOSITION OF TAX.—
‘‘(1) IN GENERAL.—There is hereby imposed a
tax on the failure of a carrier or an employer health
benefit plan to comply with section 3(a)(1) of the
Comprehensive Preventive Health and Promotion
Act of 199 .
‘‘(2) EXCEPTION.—Paragraph (1) shall not
apply to a failure by a small employer carrier or
plan in a State if the Secretary of Health and
Human Services determines that the State has in ef-
fect a regulatory enforcement mechanism that pro-
vides adequate sanctions with respect to such a fail-
ure by such a carrier or of such a plan.
‘‘(b) AMOUNT OF TAX.—
‘‘(1) IN GENERAL.—Subject to paragraph (2),
the tax imposed by subsection (a) shall be an
amount not to exceed 25 percent of the amounts re-
ceived by the carrier or under the plan for coverage
during the period such failure persists.
‘‘(2) LIMITATION IN CASE OF INDIVIDUAL FAIL-
URES.—In the case of a failure that only relates to
specified individuals or employers (and not to the
plan generally), the amount of the tax imposed by
subsection (a) shall not exceed the aggregate of
$100 for each day during which such failure persists
for each individual to which such failure relates. A
rule similar to the rule of section 4980B(b)(3) shall
apply for purposes of this section.
‘‘(c) LIABILITY FOR TAX.—The tax imposed by this
section shall be paid by the carrier.
‘‘(d) EXCEPTIONS.—
‘‘(1) CORRECTIONS WITHIN 30 DAYS.—No tax
shall be imposed by subsection (a) by reason of any
failure if—
‘‘(A) such failure was due to reasonable
cause and not to willful neglect, and
‘‘(B) such failure is corrected within the
30-day period beginning on earliest date the
carrier knew, or exercising reasonable diligence
would have known, that such failure existed.
‘‘(2) WAIVER BY SECRETARY.—In the case of a
failure which is due to reasonable cause and not to
willful neglect, the Secretary may waive part or all
of the tax imposed by subsection (a) to the extent
that payment of such tax would be excessive relative
to the failure involved.
‘‘(e) DEFINITIONS.—For purposes of this section, the
terms ‘carrier’, ‘employer health benefit plan’, and ‘small
employer carrier’ have the respective meanings given such
terms in section 3(a)(2) of the Comprehensive Preventive
Health and Promotion Act of 1995.’’
(2) CLERICAL AMENDMENT.—The table of sec-
tions for chapter 43 of such Code is amended by
adding at the end thereof the following new items:
‘‘Sec. 4980C. Failure to comply with employer health plan stand-
ards regarding preventive health care.’’.
(3) EFFECTIVE DATE.—The amendments made
by this subsection shall apply to plan years begin-
ning after December 31, 1995.
SEC. 4. COVERAGE OF PREVENTIVE HEALTH CARE SERV-
ICES UNDER MEDICARE.
(a) IN GENERAL.—Section 1861(s)(2) of the Social
Security Act (42 U.S.C. 1395x(s)(2)) is amended—
(1) by striking ‘‘and’’ at the end of subpara-
graph (O);
(2) by striking the semicolon at the end of sub-
paragraph (P) and inserting ‘‘; and’’; and
(3) by adding at the end the following new sub-
paragraph:
‘‘(Q) in the case of an individual, services appli-
cable to the individual under the schedule of preven-
tive health care services established under the Com-
prehensive Preventive Health and Promotion Act of
1993 (to the extent such services are not otherwise
covered with respect to the individual under this
title);’’.
(b) CONFORMING AMENDMENTS.—Section 1862(a)
of such Act (42 U.S.C. 1395y(a)) is amended—
(1) in paragraph (1)—
(A) in subparagraph (E), by striking
‘‘and’’ at the end,
(B) in subparagraph (F), by striking the
semicolon at the end and inserting ‘‘, and’’, and
(C) by adding at the end the following new
subparagraph:
‘‘(G) in the case of items or services described
in section 1861(s)(2)(Q), which are not provided in
accordance with the schedule of preventive health
care services established under the Comprehensive
Preventive Health and Promotion Act of 1995;’’;
and
(2) in paragraph (7), by striking ‘‘paragraph
(1)(B) or under paragraph (1)(F)’’ and inserting
‘‘subparagraphs (B), (F), or (G) of paragraph (1)’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to services furnished on or after
January 1, 1995.
SEC. 5. COVERAGE UNDER STATE MEDICAID PLANS.
(a) IN GENERAL.—
(1) INCLUSION IN MEDICAL ASSISTANCE.—Sec-
tion 1905(a) of the Social Security Act (42 U.S.C.
1396d(a)) is amended—
(A) by striking ‘‘and’’ at the end of para-
graph (21);
(B) in paragraph (24), by striking the
comma at the end and inserting a semicolon;
(C) by redesignating paragraphs (22),
(23), and (24) as paragraphs (25), (22), and
(23), respectively, and by transferring and in-
serting paragraph (25) after paragraph (23), as
so redesignated; and
(D) by inserting after paragraph (23) the
following new paragraph:
‘‘(24) services applicable to the individual under
the schedule of preventive health care services estab-
lished under the Comprehensive Preventive Health
and Promotion Act of 1995 (to the extent such serv-
ices are not otherwise covered with respect to the in-
dividual under the State plan under this title); and’’.
(2) COVERAGE
MADE
MANDATORY.—(A) Sec-
tion 1902(a)(10)(A) of such Act (42 U.S.C.
1396a(a)(10)(A)) is amended by striking ‘‘(17) and
(21)’’ and inserting ‘‘(17), (21), and (24)’’.
(B) Section 1902(a)(10)(C)(iv) of such Act (42
U.S.C. 1396a(a)(10)(C)(iv)) is amended—
(i) by striking ‘‘(5) and (17)’’ and insert-
ing ‘‘(5), (17), and (24)’’; and
(ii) by striking ‘‘through (21)’’ and insert-
ing ‘‘through (24)’’.
(C) Section 1902(j) of such Act (42 U.S.C.
1396a(j)) is amended by striking ‘‘through (22)’’
and inserting ‘‘through (24)’’.
(b) EFFECTIVE DATE.—(1) Except as provided in
paragraph (2), the amendments made by subsection (a)
shall apply to calendar quarters beginning on or after Jan-
uary 1, 1994, without regard to whether or not final regu-
lations to carry out such amendments have been promul-
gated by such date.
(2) In the case of a State plan for medical assistance
under title XIX of the Social Security Act which the Sec-
retary of Health and Human Services determines requires
State legislation (other than legislation appropriating
funds) in order for the plan to meet the additional require-
ments imposed by the amendments made by subsections
(a) and (b), the State plan shall not be regarded as failing
to comply with the requirements of such title solely on the
basis of its failure to meet these additional requirements
before the first day of the first calendar quarter beginning
after the close of the first regular session of the State leg-
islature that begins after the date of the enactment of this
Act. For purposes of the previous sentence, in the case
of a State that has a 2-year legislative session, each year
of such session shall be deemed to be a separate regular
session of the State legislature.
SEC. 6. COVERAGE OF PREVENTIVE HEALTH CARE SERV-
ICES FOR VETERANS.
(a) IN GENERAL.—Section 1701(6) of title 38,
United States Code is amended—
(1) by striking ‘‘and’’ at the end of subpara-
graph (A);
(2) by striking the period at the end of sub-
paragraph (B) and inserting ‘‘; and’’; and
(3) by adding at the end the following new sub-
paragraph:
‘‘(C) with respect to any veteran, any preventive
care services applicable under the schedule of pre-
ventive health care services established under the
Comprehensive Preventive Health and Promotion
Act of 1995, to the extent such services are not oth-
erwise treated as medical services under this para-
graph.’’.
(b) PROVIDING SERVICES
IN OUTPATIENT SET-
TING.—Section 1712(a)(5)(A) of such title is amended—
(1) in the first sentence, by striking the period
at the end and inserting the following: ‘‘, or any
other medical services applicable to the veteran
under the schedule of preventive health care services
established under the Comprehensive Preventive
Health and Promotion Act of 1995.’’; and
(2) in the second sentence, by inserting after
‘‘admission’’ the following: ‘‘or any services applica-
ble to the veteran under the schedule of preventive
health care services established under the Com-
prehensive Preventive Health and Promotion Act of
199 (other than services applicable under such
schedule that are reasonably necessary in prepara-
tion for hospital admission)’’.
(c) EFFECTIVE DATE.—The amendments made by
this section shall apply to services furnished on or after
January 1, 1995.
SEC. 7. COVERAGE OF PREVENTIVE HEALTH CARE SERV-
ICES UNDER FEDERAL EMPLOYEES HEALTH
BENEFIT PLANS.
(a) IN GENERAL.—Paragraphs (1) and (2) of section
8904(a) of title 5, United States Code, are each amended
by adding at the end the following new subparagraph:
‘‘(G) With respect to an individual, any
preventive health care services applicable to the