‘‘(A) the State shall carry out the Sec-
retary’s functions under subsections (e) and (f);
‘‘(B) the State may take action under sub-
sections (h), (i), and (j); and
‘‘(C) the State shall conduct oversight
functions under subsections (g)(2) and (g)(3).
‘‘(4) WITHDRAWAL OF APPROVAL.—
‘‘(A) IN
GENERAL.—The Secretary may,
after providing notice and opportunity for cor-
rective action, withdraw the approval of a
State’s authority under paragraph (1) if the
Secretary determines that the State does not
meet the requirements of such paragraph. The
Secretary shall promulgate regulations for the
implementation of this subparagraph.
‘‘(B) EFFECT
OF
WITHDRAWAL.—If the
Secretary withdraws the approval of a State
under subparagraph (A), the certificate of any
facility accredited by the State shall continue in
effect until the expiration of a reasonable pe-
riod, as determined by the Secretary, for such
facility to obtain certification by the Secretary.
‘‘(p) FUNDING.—
‘‘(1) FEES.—
‘‘(A) IN GENERAL.—The Secretary shall,
in accordance with this paragraph assess and
collect fees from persons described in subsection
(d)(1)(A) (other than persons who are govern-
mental entities, as determined by the Secretary)
to cover the costs of inspections conducted
under subsection (g)(1) by the Secretary or a
State acting under a delegation under subpara-
graph (A) of such subsection. Fees may be as-
sessed and collected under this paragraph only
in such manner as would result in an aggregate
amount of fees collected during any fiscal year
which equals the aggregate amount of costs for
such fiscal year for inspections of facilities of
such persons under subsection (g)(1). A per-
son’s liability for fees shall be reasonably based
on the proportion of the inspection costs which
relate to such person.
‘‘(B) DEPOSIT AND APPROPRIATIONS.—
‘‘(i) DEPOSIT
AND
AVAILABILITY.—
Fees collected under subparagraph (A)
shall be deposited as an offsetting collec-
tion to the appropriations for the Depart-
ment of Health and Human Services as
provided in appropriation Acts and shall
remain available without fiscal year limita-
tion.
‘‘(ii) 
APPROPRIATIONS.—Fees 
col-
lected under subparagraph (A) shall be col-
lected and available only to the extent pro-
vided in advance in appropriation Acts.
‘‘(2) AUTHORIZATION
OF
APPROPRIATIONS.—
There are authorized to be appropriated for the Sec-
retary to carry out activities which are not sup-
ported by fees authorized and collected under para-
graph (1), such sums as may be necessary for fiscal
years 1997 through 2001.’’.
SEC. 403. DATA SURVEY.
The Institute of Medicine, by itself or with the Na-
tional Institutes of Health, shall survey the data collected
on the prevalence of the use of fetal ultrasound and the
interaction between physicians and consumers that may
be driving the use of fetal ultrasound. The survey should
begin with data collected after the report in 1984 by the
National Institutes of Health on a consensus development
conference on diagnostic ultrasound imaging in pregnancy.
SEC. 404. OUTREACH.
The Secretary of Health and Human Services shall
establish a program to provide educational outreach to
medical practitioners and the public regarding the appro-
priateness of fetal ultrasound for the health of mothers
and fetuses.
SEC. 405. REPORT.
No later than January 1, 1999, the Secretary shall
report to the Committee on Labor and Human Resources
of the Senate and the Committee on Commerce of the
House of Representatives on whether this program has re-
sulted in improvement of the quality of fetal ultrasound,
and 
a 
reduction 
in 
nonmedically 
indicated 
fetal
ultrasonography, without affecting access to medically
necessary services or unnecessarily burdening health care
providers.
SEC. 406. TECHNICAL AMENDMENT.
Section 354(q)(3) of the Public Health Service Act
(42 U.S.C. 263b(q)(3)) is amended by striking ‘‘Sec-
retary’’ each place it occurs and inserting ‘‘State’’.
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