473
(C) by striking ‘‘3 other’’ and inserting
‘‘3’’;
(2) in subsection (d)—
(A) in the matter preceding paragraph (1),
by striking ‘‘program,’’ and inserting ‘‘pro-
gram’’, and
(B) in the second sentence, by striking
‘‘plan’’ each place it appears and inserting
‘‘program’’; and
(3) in subsection (i), by striking ‘‘FUNDS’’ and
inserting ‘‘FUNDS’’.
(b) Section 4712(c) of OBRA–1990 is amended—
(1) in paragraph (1), by inserting ‘‘of section
1930 of the Social Security Act’’ after ‘‘subsection
(h)’’; and
(2) in paragraph (2), by striking ‘‘this section’’
and inserting ‘‘such section’’.
SEC. 5162. CORRECTION RELATING TO SECTION 4713
(COBRA CONTINUATION COVERAGE).
(a) Section 1902(a)(10) is amended in the matter fol-
lowing subparagraph (F)—
(1) by striking ‘‘; and (XI)’’ and inserting ‘‘,
(XI)’’;
(2) by striking ‘‘individuals, and (XI)’’ and in-
serting ‘‘individuals, and (XII)’’; and
474
(3) by striking ‘‘COBRA continuation pre-
miums’’ and inserting ‘‘COBRA premiums’’.
(b) Section 1902(u)(3), as added by section
4713(a)(2) of OBRA–1990, is amended by striking ‘‘title
VI’’ and inserting ‘‘part 6 of subtitle B of title I’’.
SEC. 5163. CORRECTION RELATING TO SECTION 4716 (MED-
ICAID 
TRANSITION 
FOR 
FAMILY 
ASSIST-
ANCE).
Section 4716(a) of OBRA–1990 is amended by strik-
ing ‘‘AMENDMENTS.—Subsection (f) of section’’ and in-
serting ‘‘IN GENERAL.—Section’’.
SEC. 5164. CORRECTIONS RELATING TO SECTION 4723
(MEDICAID SPENDDOWN OPTION).
Section 1903(f)(2), as amended by section 4723(a)
of OBRA–1990, is amended—
(1) by striking ‘‘(A)’’ after ‘‘(2)’’;
(2) by striking ‘‘or, (B)’’ and inserting ‘‘. There
shall also be excluded,’’;
(3) by striking ‘‘to the State, provided that’’
and inserting ‘‘to the State if’’; and
(4) by striking ‘‘pursuant to this subpara-
graph.’’ and inserting ‘‘pursuant to the previous sen-
tence’’.
475
SEC. 5165. CORRECTIONS RELATING TO SECTION 4724 (OP-
TIONAL 
STATE 
DISABILITY 
DETERMINA-
TIONS).
Section 1902(v), as added by section 4724 of OBRA–
1990, is amended—
(1) by striking ‘‘(v)(1)’’ and inserting ‘‘(v)’’;
and
(2) by striking ‘‘of the Social Security Act’’.
SEC. 5166. CORRECTION RELATING TO SECTION 4732 (SPE-
CIAL RULES FOR HEALTH MAINTENANCE OR-
GANIZATIONS).
Section 1903(m)(2)(F)(i), as amended by section
4732(b)(2)(B) of OBRA–1990, is amended by striking
‘‘or’’ before ‘‘with an eligible organization’’.
SEC. 5167. CORRECTIONS RELATING TO SECTION 4741
(HOME AND COMMUNITY-BASED WAIVERS).
The first sentence of section 1915(d)(3) is amended
by striking the period at the end and inserting the follow-
ing: ‘‘, and a waiver of the requirements of section
1902(a)(23) (relating to choice of providers) insofar as
such requirements relate to the provision of case manage-
ment services and the State provides assurances satisfac-
tory to the Secretary that a waiver of such requirements
will not substantially limit access to such services).’’
476
SEC. 5168. CORRECTIONS RELATING TO SECTION 4744
(FRAIL ELDERLY WAIVERS).
(a) Section 1924(a)(5), as added by section
4744(b)(1) of OBRA–1990, is amended by striking
‘‘1986.’’ and inserting ‘‘1986 or a waiver under section
603(c) of the Social Security Amendments of 1983.’’.
(b) Section 603(c) of the Social Security Amend-
ments of 1983 is amended—
(1) by striking ‘‘(c)’’ and inserting ‘‘(c)(1)’’;
(2) by redesignating paragraphs (1) and (2) as
subparagraphs (A) and (B); and
(3) by adding at the end the following new
paragraph:
‘‘(2) Section 1924 of the Social Security Act shall
apply to any individual receiving services from an organi-
zation receiving a waiver under this subsection.’’.
SEC. 5169. CORRECTIONS RELATING TO SECTION 4747 (COV-
ERAGE OF HIV-POSITIVE INDIVIDUALS).
Section 4747 of OBRA–1990 is amended—
(1) in subsection (a), by striking ‘‘subsection
(c)’’ and inserting ‘‘subsection (b)’’;
(2) in subsection (b)(2)—
(A) by striking ‘‘preventative’’ each place it
appears and inserting ‘‘preventive’’, and
(B) by adding a period at the end of sub-
paragraph (J);
477
(3) in subsection (c)(1)—
(A) by striking ‘‘subsection (c)’’ and in-
serting ‘‘subsection (b)’’, and
(B) by striking ‘‘paragraphs (1) and (2)
of’’; and
(4) in subsection (d)—
(A) by striking ‘‘paragraph (3)’’ and in-
serting ‘‘subsection (b)’’, and
(B) by striking ‘‘paragraph (1)’’ and in-
serting ‘‘subsection (a)’’.
SEC. 5170. CORRECTION RELATING TO SECTION 4751 (AD-
VANCE DIRECTIVES).
Section 1903(m)(1)(A), as amended by section
4751(b)(1) of OBRA–1990, is amended—
(1) by striking ‘‘1902(w)’’ and inserting
‘‘1902(w) and’’; and
(2) by striking ‘‘1902(a)’’ and inserting
‘‘1902(w)’’.
SEC. 5171. CORRECTIONS RELATING TO SECTION 4752 (PHY-
SICIANS’ SERVICES).
(a) The paragraph (58) of section 1902(a) added by
section 4752(c)(1)(C) of OBRA–1990 is amended by
striking ‘‘subsection (v)’’ and inserting ‘‘subsection (x)’’.
479
(d) Section 1919(f)(2)(B)(i) is amended by striking
‘‘facilities,’’ and inserting ‘‘facilities (subject to clause
(iii)),’’.
(e) Section 1919(f)(2)(B)(iii)(I)(c) is amended by
striking ‘‘clauses’’ each place it appears and inserting
‘‘clause’’.
(f) Section 1919(g)(5)(B) is amended by striking
‘‘paragraphs’’ and inserting ‘‘paragraph’’.
(g) Section 4801(a)(6)(B) of OBRA–1990 is amend-
ed—
(1) by striking ‘‘The amendments’’ and insert-
ing ‘‘(i) The amendments’’;
(2) by redesignating clauses (i) through (v) as
subclauses (I) through (V); and
(3) by adding at the end the following new
clause:
‘‘(ii) Notwithstanding clause (i) and sub-
ject to section 1919(f)(2)(B)(iii) of the Social
Security Act (as amended by subparagraph
(A)), a State may approve a training and com-
petency evaluation program or a competency
evaluation program offered by or in a nursing
facility described in clause (i) if, during the pre-
vious 2 years, none of the subclauses of clause
(i) applied to the facility.’’.
480
SEC. 5173. OTHER TECHNICAL CORRECTIONS.
(a) Section 1905(o)(1)(A) is amended—
(1) in the first sentence, by striking ‘‘intermedi-
ate care facility services’’ and inserting ‘‘for nursing
facility services or intermediate care facility services
for the mentally retarded’’; and
(2) in the second sentence, by striking ‘‘or in-
termediate care facility’’ and inserting ‘‘(for pur-
poses of title XVIII), a nursing facility, or an inter-
mediate care facility for the mentally retarded’’.
(b) Section 1915(d) is amended—
(1) by striking ‘‘skilled nursing facility or inter-
mediate care facility’’ each place it appears in para-
graphs (1), (2)(B), and (2)(C) and inserting ‘‘nurs-
ing facility’’;
(2) in paragraph (2)(B)(i), by striking ‘‘skilled
nursing or intermediate care facility’’ and inserting
‘‘nursing facility’’;
(3) in paragraph (5)(A), by striking ‘‘under’’
the second place it appears and inserting ‘‘(or, in the
case of waiver years beginning on or after October
1, 1990, with respect to nursing facility services and
home and community-based services) under’’; and
(4) in paragraph (5)(B)—
(A) in clause (i), by striking ‘‘furnished’’
and inserting ‘‘(or, with respect to waiver years
481
beginning on or after October 1, 1990, for
nursing facility services) furnished’’; and
(B) in clause (iii)(I), by striking ‘‘(regard-
less’’ and inserting ‘‘(or, with respect to waiver
years beginning on or after October 1, 1990,
which comprise nursing facility services) (re-
gardless’’.
SEC. 5174. CORRECTIONS TO DESIGNATIONS OF NEW PRO-
VISIONS.
(a) PARAGRAPHS ADDED TO SECTION 1902(a).—
Section 1902(a) is amended—
(1) by striking ‘‘and’’ at the end of paragraph
(54);
(2) in the paragraph (55) inserted by section
4602(a)(3) of OBRA–1990, by striking the period at
the end and inserting a semicolon;
(3) by redesignating the paragraph (55) in-
serted by section 4604(b)(3) of OBRA–1990 as
paragraph (56), by transferring and inserting it
after the paragraph (55) inserted by section
4602(a)(3) of such Act, and by striking the period
at the end and inserting a semicolon;
(4) by placing paragraphs (57) and (58), in-
serted by section 4751(a)(1)(C) of OBRA–1990, im-
482
mediately after paragraph (56), as redesignated by
paragraph (3);
(5) in the paragraph (58) inserted by section
4751(a)(1)(C) of OBRA–1990, by striking the pe-
riod at the end and inserting ‘‘; and’’; and
(6) by redesignating the paragraph (58) in-
serted by section 4752(c)(1)(C) of OBRA–1990 as
paragraph (59) and by transferring and inserting it
after the paragraph (58) inserted by section
4751(a)(1)(C) of such Act.
(b) PARAGRAPHS ADDED TO SECTION 1903(i).—Sec-
tion 1903(i), as amended by section 2(b)(2) of the Medic-
aid Voluntary Contribution and Provider-Specific Tax
Amendments of 1991, is amended—
(1) in the paragraph (10) inserted by section
4401(a)(1)(B) of OBRA–1990, by striking all that
follows ‘‘1927(g)’’ and inserting a semicolon;
(2) by redesignating the paragraph (12) in-
serted by section 4752(a)(2) of OBRA–1990 as
paragraph (11), by transferring and inserting it
after the paragraph (10) inserted by section
4401(a)(1)(B) of OBRA–1990, and by striking the
period at the end and inserting a semicolon;
(3) by redesignating the paragraph (14) in-
serted by section 4752(e) of OBRA–1990 as para-
483
graph (12), by transferring and inserting it after
paragraph (11), as redesignated by paragraph (2),
and by striking the period at the end and inserting
‘‘; or’’; and
(4) by redesignating the paragraph (11) in-
serted by section 4801(e)(16)(A) of OBRA–1990 as
paragraph (13) and by transferring and inserting it
after paragraph (12), as redesignated by paragraph
(3).
(c) PARAGRAPHS ADDED TO SECTION 1905(a).—
(1) IN GENERAL.—Section 1905(a) is amend-
ed—
(A) by striking ‘‘and’’ at the end of para-
graph (21);
(B) in paragraph (24), by striking the pe-
riod at the end and inserting ‘‘; and’’; and
(C) by redesignating paragraphs (22),
(23), and (24) as paragraphs (24), (22), and
(23), respectively, and by transferring and in-
serting paragraph (24) after paragraph (23), as
so redesignated.
(2) CONFORMING AMENDMENTS.—(A) Effective
July 1, 1991, section 1902(a)(10)(C)(iv), as amend-
ed by section 4755(c)(1)(A) of OBRA–1990, is
484
amended by striking ‘‘through (21)’’ and inserting
‘‘through (23)’’.
(B) Effective July 1, 1991, section 1902(j), as
amended by section 4711(d)(1) of OBRA–1990, is
amended by striking ‘‘through (22)’’ and inserting
‘‘through (24)’’.
(d) FINAL SECTIONS.—Section 1928, as redesignated
by section 4401(a)(3) of OBRA–1990, is amended—
(1) by transferring such section to the end of
title XIX of the Social Security Act; and
(2) by redesignating such section as section
1931.
CHAPTER 2—UNIVERSAL ACCESS TO
CHILDHOOD IMMUNIZATIONS
SEC. 5181. ESTABLISHMENT OF ENTITLEMENT AND MON-
ITORING 
PROGRAMS 
WITH 
RESPECT 
TO
CHILDHOOD IMMUNIZATIONS.
(a) IN GENERAL.—Title XXI of the Public Health
Service Act (42 U.S.C. 300aa–1 et seq.) is amended by
adding at the end the following subtitle:
485
‘‘Subtitle 3—Entitlement and Mon-
itoring Programs With Respect
to Childhood Immunizations
‘‘PART A—ENTITLEMENT PROGRAM
‘‘SEC. 2151. DELIVERY TO STATES OF SUFFICIENT QUAN-
TITIES OF PEDIATRIC VACCINES.
‘‘(a) IN GENERAL.—In the case of any State that
submits to the Secretary an application in accordance with
section 2157, the Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall
provide for the purchase and delivery on behalf of the
State of such quantities of pediatric vaccines as may be
necessary for the immunization of each eligible child in
the State. The preceding sentence is subject to sections
2152(d) and 2159(a).
‘‘(b) ELIGIBLE CHILDREN.—For purposes of this
part, the term ‘eligible child’ means an individual 18 years
of age or younger who—
‘‘(1) with respect to the State involved, is enti-
tled to medical assistance under the plan approved
for the State under title XIX of the Social Security
Act (including a State operating under a statewide
waiver under section 1115 of such Act);
‘‘(2)(A) is uninsured with respect to health in-
surance policies or plans (including group health
486
plans or prepaid health plans and including em-
ployee welfare benefit plans under the Employee Re-
tirement Income Security Act of 1974); or
‘‘(B) is covered under such a policy or plan, but
under the policy or plan benefits are not available
with respect to immunizations; or
‘‘(3) is an Indian.
‘‘SEC. 2152. ENTITLEMENTS.
‘‘(a) ENTITLEMENT OF STATES.—Subject to sub-
section (d), in the case of any State that submits to the
Secretary an application in accordance with section 2157,
the State is entitled to have the Secretary provide for the
purchase and delivery on behalf of the State of pediatric
vaccines under section 2151. The preceding sentence con-
stitutes budget authority in advance of appropriations
Acts, and represents the obligation of the Federal Govern-
ment to provide for the purchase and delivery to the State
of the vaccines.
‘‘(b) ENTITLEMENTS OF CHILDREN AND HEALTH
CARE PROVIDERS.—Subject to subsection (d), the Sec-
retary may provide for the purchase and delivery of pedi-
atric vaccines under section 2151 on behalf of a State only
if the State agrees as follows:
‘‘(1) Each eligible child in the State, in receiv-
ing an immunization with a pediatric vaccine from
487
a program-registered provider (as defined in section
2153(a)), is entitled to receive the immunization
without charge for the cost of such vaccine.
‘‘(2) Each program-registered provider in the
State who administers a pediatric vaccine to an eligi-
ble child in the State is entitled to receive such vac-
cine from the State without charge.
‘‘(3) The State will carry out a program to ad-
minister the entitlements established pursuant to
paragraphs (1) and (2).
‘‘(c) ENFORCEMENT OF PROVIDER RIGHTS BY ELI-
GIBLE CHILDREN.—With respect to the obligation of a
State under the entitlement established in subsection
(b)(2), an eligible child (or representative of the child)
may enforce the rights of the provider under such para-
graph if—
‘‘(1) the provider administered a pediatric vac-
cine to the child notwithstanding the failure of the
State to carry out such obligation with respect to the
vaccine; or
‘‘(2) an immunization with the vaccine was
sought for the child by a parent of the child, but the
provider, on the basis of such failure of the State,
did not administer the vaccine to the child.
‘‘(d) CERTAIN CONDITIONS.—
488
‘‘(1) IN GENERAL.—This part does not apply
with respect to any vaccine administered before Oc-
tober 1, 1994.
‘‘(2) RELATIONSHIP TO PURCHASE CONTRACTS
WITH
MANUFACTURERS.—With respect to a pedi-
atric vaccine, the obligation of the Federal Govern-
ment pursuant to subsection (a), and the obligations
of the State pursuant to subsection (b), are effective
only to the extent that there is in effect a contract
under section 2158 for the purchase and delivery of
the vaccine.
‘‘(3) SUBMISSION OF APPLICATION.—
‘‘(A) Subject to subparagraph (C), the en-
titlements established pursuant to subsections
(a) and (b) are established with respect to a
State upon the State submitting to the Sec-
retary an application in accordance with section
2157.
‘‘(B) An application submitted to the Sec-
retary under section 2157 is deemed to have
been submitted in accordance with such section
unless the Secretary, not later than 30 days
after the date on which the application is sub-
mitted, notifies the State that the application is
not in accordance with such section.
489
‘‘(C) In the case of a State whose applica-
tion submitted under section 2157 is not sub-
mitted in accordance with such section, the Sec-
retary may, upon the submission by the State
of an application that is in accordance with
such section, provide that the entitlements es-
tablished pursuant to such submission are
deemed to have been established on the date on
which the State first submitted the application.
‘‘SEC. 2153. VOLUNTARY PARTICIPATION OF HEALTH CARE
PROVIDERS.
‘‘(a) IN GENERAL.—
‘‘(1) REQUEST FOR PARTICIPATION; REQUIRED
APPROVAL.—The Secretary may provide for the pur-
chase and delivery of pediatric vaccines under sec-
tion 2151 on behalf of a State only if the State
agrees that federally-supplied pediatric vaccines will
not be distributed to a health care provider unless—
‘‘(A) the provider submits to the State a
written request to participate in the program
established by the State pursuant to section
2152(b)(3);
‘‘(B) the request is in such form and is
made in such manner as the Secretary may
require; and
490
‘‘(C) the provider makes the agreements
described in this section.
‘‘(2) PROGRAM-REGISTERED
PROVIDERS.—For
purposes of this part, the term ‘program-registered
provider’ means a health care provider that meets
the conditions specified in subparagraphs (A)
through (C) of paragraph (1).
‘‘(b) ELIGIBILITY OF CHILDREN.—
‘‘(1) IN GENERAL.—An agreement for a health
care provider under subsection (a) is that the pro-
vider—
‘‘(A) before administering a pediatric vac-
cine to a child, will ask a parent of the child
such questions as are necessary to determine
whether the child is an eligible child;
‘‘(B) will, for a period of time specified by
the Secretary, maintain records of responses
made to the questions; and
‘‘(C) will, upon request, make such records
available to the State involved and to the Sec-
retary, subject to paragraph (2).
‘‘(2) RESTRICTION ON USE OF INFORMATION.—
Records provided to a State or to the Secretary
under paragraph (1)(C) may be used only for pur-
491
poses of audit of the program carried out under sec-
tion 2152(b)(3) by the State.
‘‘(c) CHARGES FOR VACCINES.—
‘‘(1) VACCINES PER SE.—An agreement for a
health care provider under subsection (a) is that, in
administering a federally-supplied pediatric vaccine
to an eligible child, the provider will not impose a
charge for the cost of the vaccine.
‘‘(2) ADMINISTRATION OF VACCINES.—With re-
spect to compliance with an agreement under para-
graph (1), a program-registered provider may im-
pose a charge for the administration of a federally-
supplied pediatric vaccine, subject to an agreement
by the provider that the provider will not impose
such charge with respect to a child if a parent of the
child certifies to the provider that the parent is un-
able to pay the charge.
‘‘(d) RULES OF CONSTRUCTION.—
‘‘(1) EXTENT OF PARTICIPATION.—This section
may not be construed as requiring that a program-
registered provider administer a federally-supplied
pediatric vaccine to each eligible child for whom an
immunization with the vaccine is sought from the
provider.
492
‘‘(2) VERIFICATION
OF
INFORMATION.—With
respect to compliance with agreements under sub-
sections (b) and (c), such agreements may not be
construed as requiring a program-registered provider
to verify independently the information provided to
the provider by a parent pursuant to such sub-
sections.
‘‘SEC. 2154. INTRASTATE DISTRIBUTION OF PEDIATRIC VAC-
CINES.
‘‘(a) IN GENERAL.—Not later than 180 days after
the date of the enactment of the Omnibus Budget Rec-
onciliation Act of 1993, the Secretary shall, through publi-
cation in the Federal Register, establish criteria for the
delivery on behalf of the States of federally-supplied pedi-
atric vaccines to program-registered providers in the
State.
‘‘(b) INVOLVEMENT OF CERTAIN PROVIDERS.—
‘‘(1) IN
GENERAL.—In establishing criteria
under subsection (a), the Secretary shall establish
criteria with respect to encouraging the entities de-
scribed in paragraph (2) to become program-reg-
istered providers.
‘‘(2) RELEVANT PROVIDERS.—The entities re-
ferred to in paragraph (1) are—
‘‘(A) private health care providers; and
493
‘‘(B)(i) health care providers that receive
funds under title V of the Indian Health Care
Improvement Act;
‘‘(ii) the Indian Health Service; and
‘‘(iii) health programs or facilities operated
by Indian tribes or tribal organizations.
‘‘(c) CULTURAL CONTEXT OF SERVICES.—In estab-
lishing criteria under subsection (a), the Secretary shall
require that, in providing a federally-supplied pediatric
vaccine to any population of eligible children a substantial
portion of whose parents have a limited ability to speak
the English language, a State have in effect a reasonable
plan to administer the vaccines through program-reg-
istered providers who are able to communicate with the
population involved in the language and cultural context
that is most appropriate.
‘‘(d) COMPLIANCE BY STATES.—The Secretary may
provide for the purchase and delivery of pediatric vaccines
under section 2151 on behalf of a State only if the State
agrees to maintain compliance with the criteria established
under subsection (a).
‘‘SEC. 2155. GENERAL PROVISIONS.
‘‘(a) FEDERAL STANDARDS ON ACCOUNTABILITY.—
‘‘(1) ESTABLISHMENT
OF
STANDARDS.—Not
later than 180 days after the date of the enactment
494
of the Omnibus Budget Reconciliation Act of 1993,
the Secretary shall, through publication in the Fed-
eral Register, establish standards with respect to de-
termining the extent to which States and program-
registered providers are in compliance with the
agreements made under this part.
‘‘(2) COMPLIANCE BY STATES.— The Secretary
may provide for the purchase and delivery of pedi-
atric vaccines under section 2151 on behalf of a
State only if the State agrees to maintain compli-
ance with the standards established under subsection
(a).
‘‘(b) STATE
MAINTENANCE
OF
IMMUNIZATION
LAWS.—The Secretary may provide for the purchase and
delivery of vaccines under section 2151 on behalf of a
State only if the State certifies to the Secretary that, if
it had in effect as of May 1, 1993, a law that requires
some or all health insurance policies or plans to provide
some coverage with respect to a pediatric vaccine, the
State has not modified or repealed such law in a manner
that reduces the amount of coverage so required.
‘‘(c) PARTICIPATION IN NATIONAL MONITORING SYS-
TEM.—On and after January 1, 1998, the Secretary may
provide for the purchase and delivery of vaccines under
section 2151 on behalf of a State only if the State certifies
495
to the Secretary that the State is operating a registry in
accordance with part B.
‘‘SEC. 2156. STATE OPTION REGARDING IMMUNIZATION OF
ADDITIONAL CATEGORIES OF CHILDREN.
‘‘(a) STATE PURCHASES.—Subject to subsections (b)
and (c), for the purpose of administering a pediatric vac-
cine to children in addition to eligible children, any partici-
pating State under section 2151 may, pursuant to section
2158(a)(2), purchase the vaccine from a manufacturer of
the vaccine at the price in effect under section 2158.
‘‘(b) REQUIREMENTS.—A State may purchase pedi-
atric vaccines pursuant to subsection (a) only if the follow-
ing conditions are met:
‘‘(1) The State agrees that the vaccines will be
used to provide immunizations for children who are
not eligible children.
‘‘(2) The State designates the particular cat-
egories of children who are to receive the immuniza-
tions, and submits to the Secretary a description of
the categories so designated.
‘‘(3) The State provides to the Secretary such
information as the Secretary determines to be nec-
essary to provide for quantities of pediatric vaccines
for the State to purchase pursuant to section
2158(a)(2).
496
‘‘(4) The State agrees, subject to subsection (c),
that the program established by the State pursuant
to section 2152(b)(3) applies to children designated
under paragraph (2) to the same extent and in the
same manner as the program applies to eligible chil-
dren (except for the State being the purchaser of the
pediatric vaccines involved).
‘‘(c) CERTAIN LIMITATIONS.—A State may purchase
pediatric vaccines pursuant to subsection (a) only if the
State agrees as follows:
‘‘(1) The authorization established in such sub-
section with respect to a pediatric vaccine is subject
to the quantity of the vaccine that, on behalf of the
State, the Secretary provides for under section
2158(a)(2).
‘‘(2) In any case in which multiple contracts are
in effect under section 2158 with respect to such a
vaccine and the State elects to purchase the vaccine
pursuant to subsection (a), the Secretary will deter-
mine which of such contracts will be applicable to
the purchase.
‘‘SEC. 2157. STATE APPLICATION FOR VACCINES.
‘‘(a) IN GENERAL.—An application by a State for pe-
diatric vaccines under section 2151(a) is in accordance
with this section if the application—
497
‘‘(1) is submitted not later than the date speci-
fied by the Secretary;
‘‘(2) contains each agreement required in this
part (including the agreements required in section
2156, if the State is electing to purchase pediatric
vaccines pursuant to such section);
‘‘(3) contains any information required in this
part to be submitted to the Secretary (including the
information required in section 2156, if the State is
electing to purchase pediatric vaccines pursuant to
such section);
‘‘(4) contains the certification required in sub-
section (b) of section 2155 and, as applicable, the
certification required in subsection (c) of such sec-
tion; and
‘‘(5) is in such form, is made in such manner,
and contains such agreements, assurances, and in-
formation as the Secretary determines to be nec-
essary to carry out this part.
‘‘(b) FAILURE TO APPLY.—
‘‘(1) IN GENERAL.—If, as of January 1, 1998,
a State is not receiving pediatric vaccines under sec-
tion 2151 and carrying out a program pursuant to
section 2152(b)(3), the Secretary shall, subject to
498
paragraph (2), terminate payments to the State
under part A of title XIX.
‘‘(2) EXCEPTIONS.—Paragraph (1) does not
apply in the case of a State described in such para-
graph that—
‘‘(A) is, through all willing health care pro-
viders, providing for the immunization of eligi-
ble children with pediatric vaccines, and is not
imposing a charge on such providers or children
for the costs of the vaccines; or
‘‘(B) meets or exceeds the objectives estab-
lished by the Secretary for the year 2000 for
the immunization status of children in the
United States who are 2 years of age.
‘‘SEC. 2158. CONTRACTS WITH MANUFACTURERS OF PEDI-
ATRIC VACCINES.
‘‘(a) IN GENERAL.—Subject to the provisions of this
section, the Secretary shall periodically enter into negotia-
tions with manufacturers of pediatric vaccines for the pur-
pose of maintaining contracts under which—
‘‘(1) the Secretary provides for the purchase of
quantities of pediatric vaccines necessary for carry-
ing out section 2151, and provides for the delivery
of the vaccines to participating States under such
section; and
499
‘‘(2) each participating State, at the option of
the State under section 2156, is permitted to obtain
additional quantities of pediatric vaccines (subject to
limits in such contracts regarding quantities)
through purchasing the vaccines from the manufac-
turers at the price negotiated by the Secretary for
the quantities specified in paragraph (1).
The Secretary shall enter into the initial negotiations
under the preceding sentence not later than 180 days after
the date of the enactment of the Omnibus Budget
Reconciliation Act of 1993.
‘‘(b) NEGOTIATION OF PURCHASE PRICE.—
‘‘(1) IN GENERAL.—In negotiating the prices at
which pediatric vaccines will be purchased from a
manufacturer under subsection (a), the Secretary
shall negotiate a price that provides a reasonable
profit for the manufacturer.
‘‘(2) CERTAIN FACTORS.—
‘‘(A) In determining a reasonable profit for
a manufacturer under paragraph (1), the Sec-
retary shall consider the following factors:
‘‘(i) The costs of the manufacturer in
researching, developing, and producing the
pediatric vaccine involved.
500
‘‘(ii) The costs of the manufacturer in
researching and developing new or im-
proved vaccines (pediatric or otherwise).
‘‘(iii) The costs of shipping and han-
dling pediatric vaccines in compliance with
the agreement under subsection (c).
‘‘(iv) Such other factors as the Sec-
retary determines to be appropriate.
‘‘(B) With respect to factors considered
under subparagraph (A), the Secretary may
enter into a contract under subsection (a) only
if the manufacturer involved provides to the
Secretary such information regarding the fac-
tors as the Secretary determines to be appro-
priate.
‘‘(3) CONFIDENTIALITY.—With respect to infor-
mation provided to the Secretary by a manufacturer
under paragraph (2), the following applies:
‘‘(A) The Secretary shall maintain the con-
fidentiality of the information, with provision
for reasonable disclosures.
‘‘(B) For purposes of section 552(b)(4) of
title 5, United States Code, the information
shall be considered to be trade secrets and com-
501
mercial or financial information obtained from
a person and privileged or confidential.
‘‘(C) Section 1905 of title 18, United
States Code, applies to information maintained
confidentially under subparagraph (A).
‘‘(c) CHARGES FOR SHIPPING AND HANDLING.—The
Secretary may enter into a contract under subsection (a)
only if the manufacturer involved agrees that the manu-
facturer will provide for delivering the vaccines on behalf
of the States in accordance with the programs established
by the States pursuant to section 2152(b)(3), and will not
impose any charges for the costs of such delivery (except
to the extent such costs are provided for in the price nego-
tiated under subsection (b)).
‘‘(d) QUANTITY OF VACCINES.—For the purpose of
ensuring that the Federal Government has the ability to
carry out section 2151, the Secretary, in negotiations
under subsection (a), shall negotiate for maintaining a
supply of pediatric vaccines to meet unanticipated needs
for the vaccines. For purposes of the preceding sentence,
the Secretary shall negotiate for a 6-month supply of vac-
cines in addition to the quantity that the Secretary other-
wise would provide for in such negotiations. In carrying
out this paragraph, the Secretary shall consider the poten-
502
tial for outbreaks of the diseases with respect to which
the vaccines have been developed.
‘‘(e) NEGOTIATING AUTHORITY OF SECRETARY.—In
carrying out subsection (a), the Secretary, to the extent
determined by the Secretary to be appropriate, may enter
into contracts described in such subsection, may decline
to enter into such contracts, and with the consent of the
manufacturers involved, may modify such agreements and
may extend such agreements.
‘‘(f) CERTAIN CONTRACT PROVISIONS.—
‘‘(1) DURATION.—A contract entered into by
the Secretary under subsection (a) is effective for
such period as the Secretary and the manufacturer
involved may agree in the contract.
‘‘(2) ADVANCE FUNDING.—The Secretary may,
pursuant to section 2152(a), enter into contracts
under subsection (a) under which the Federal Gov-
ernment is obligated to make outlays, the budget au-
thority for which is not provided for in advance in
appropriations Acts.
‘‘(g) REPORTS TO SECRETARY.—The Secretary may
enter into a contract under subsection (a) only if the man-
ufacturer involved agrees to submit to the Secretary such
reports as the Secretary determines to be appropriate with
respect to compliance with the contract. For purposes of
503
paragraph (3) of subsection (b), such reports shall be con-
sidered to be information provided by the manufacturer
to the Secretary under paragraph (2) of such subsection.
‘‘(h) MULTIPLE SUPPLIERS.—
‘‘(1) IN GENERAL.—In the case of the pediatric
vaccine involved, the Secretary shall, as appropriate,
enter into a contract under subsection (a) with each
manufacturer of the vaccine that meets the terms
and conditions of the Secretary for an award of such
a contract (including terms and conditions regarding
safety, quality, and price).
‘‘(2) RULE OF CONSTRUCTION.—With respect
to multiple contracts entered into pursuant to para-
graph (1), such paragraph may not be construed as
prohibiting the Secretary from having in effect dif-
ferent prices under each of such contracts.
‘‘SEC. 2159. CERTAIN ADMINISTRATIVE VARIATIONS.
‘‘(a) TRIBES AND TRIBAL ORGANIZATIONS.—
‘‘(1) IN GENERAL.—Subject to paragraph (2),
the Secretary shall provide for the purchase and de-
livery on behalf of each Indian tribe and each tribal
organization of such quantities of pediatric vaccines
as may be necessary for the immunization of each
Indian child in the State in which the tribe or orga-
nization (as the case may be) is located.
504
‘‘(2) ENTITLEMENTS; 
ADMINISTERING
PRO-
GRAM.—The Secretary may provide for the purchase
and delivery of pediatric vaccines under paragraph
(1) on behalf of an Indian tribe or tribal organiza-
tion only if the tribe or organization (as the case
may be) agrees that this part applies to the tribe or
organization (in relation to Indian children) to the
same extent and in the manner as such part applies
to States (in relation to eligible children).
‘‘(b) STATE AS MANUFACTURER.—
‘‘(1) PAYMENTS IN LIEU OF VACCINES.—In the
case of a participating State under section 2151 that
manufactures a pediatric vaccine and is not receiv-
ing the vaccine under such section, if the Secretary
determines that the program of the State under
2152(b)(3) is carried out with respect to the vaccine,
the Secretary shall provide to the State an amount
equal to the value of the quantity of such vaccine
that otherwise would have been delivered to the
State under section 2151, subject to the provisions
of this subsection.
‘‘(2) DETERMINATION
OF
VALUE.—In deter-
mining the amount to pay a State under paragraph
(1) with respect to a pediatric vaccine, the value of
the quantity of vaccine shall be determined on the
505
basis of the price in effect for the vaccine under con-
tracts under section 2158. If more than 1 such con-
tract is in effect, the Secretary shall determine such
value on the basis of the average of the prices under
the contracts, after weighting each such price in re-
lation to the quantity of vaccine under the contract
involved.
‘‘(3) USE OF PAYMENTS.—A State may expend
payments received under paragraph (1) only for pur-
poses relating to pediatric vaccines.
‘‘SEC. 2160. LIST OF PEDIATRIC VACCINES; SCHEDULE FOR
ADMINISTRATION.
‘‘(a) RECOMMENDED PEDIATRIC VACCINES.—
‘‘(1) IN GENERAL.—The Secretary shall estab-
lish a list of the vaccines that the Secretary rec-
ommends for administration to all children for the
purpose of immunizing the children, subject to such
contraindications for particular medical categories of
children as the Secretary may establish under sub-
section (b)(1)(D). The Secretary shall periodically
review the list, and shall revise the list as appro-
priate.
‘‘(2) RULE OF CONSTRUCTION.—
507
‘‘(D) Any contraindications regarding ad-
ministration of the vaccine to particular medical
categories of children.
‘‘(E) Such other guidelines as the Sec-
retary determines to be appropriate with re-
spect to administering the vaccine to children.
‘‘(2) VARIATIONS IN MEDICAL PRACTICE.—In
establishing and revising a schedule under para-
graph (1), the Secretary shall ensure that, in the
case of the pediatric vaccine involved, the schedule
provides for the full range of variations in medical
judgment regarding the administration of the vac-
cine, subject to remaining within medical norms.
‘‘(3) RULE OF CONSTRUCTION.—
‘‘(A) The schedule specified in subpara-
graph (B) is deemed to be the schedule main-
tained under paragraph (1).
‘‘(B) The schedule specified in this sub-
paragraph is the schedule that, for purposes of
paragraph (1), is established (and periodically
reviewed and as appropriate revised) by the ad-
visory 
committee 
specified 
in 
subsection
(a)(2)(B).
‘‘(c) GENERALLY APPLICABLE RULES OF CONSTRUC-
TION.—
508
‘‘(1) IN GENERAL.—The list established under
subsection (a) and the schedules established under
subsection (b) do not constitute guidelines, stand-
ards, performance measures, or review criteria for
purposes of the program carried out by the Adminis-
trator for Health Care Policy and Research under
part B of title IX or under section 1142 of the
Social Security Act.
‘‘(2) STATE LAWS.—This section does not su-
persede any State law on requirements with respect
to receiving immunizations (including any such law
relating to religious exemptions or medical exemp-
tions).
‘‘(d) ISSUANCE OF LIST AND SCHEDULES.—Not later
than 180 days after the date of the enactment of the Om-
nibus Budget Reconciliation Act of 1993, the Secretary
shall establish the initial list required in subsection (a) and
the schedule required in subsection (b).
‘‘SEC. 2161. CHILDHOOD IMMUNIZATION TRUST FUND.
‘‘(a) ESTABLISHMENT OF FUND.—There is estab-
lished in the Treasury of the United States a fund to be
known as the National Childhood Immunization Trust
Fund (in this section referred to as the ‘Fund’). The Fund
shall consist of such amounts as may be appropriated to
the Fund in appropriations Acts, in the Internal Revenue
509
Code of 1986, or in subsection (c)(3). Amounts appro-
priated to the Fund shall remain available until expended.
‘‘(b) EXPENDITURES FROM FUND.—Amounts in the
Fund are available to the Secretary for the purpose of car-
rying out this part. Payments under the program under
this part, and the costs of carrying out such program,
shall be exempt from reduction under any order issued
under part C of the Balanced Budget and Emergency
Deficit Control Act of 1985.
‘‘(c) INVESTMENT.—
‘‘(1) IN
GENERAL.—The Secretary of the
Treasury shall invest such amounts of the Fund as
such Secretary determines are not required to meet
current withdrawals from the Fund. Such invest-
ments may be made only in interest-bearing obliga-
tions of the United States. For such purpose, such
obligations may be acquired on original issue at the
issue price, or by purchase of outstanding obliga-
tions at the market price.
‘‘(2) SALE
OF
OBLIGATIONS.—Any obligation
acquired by the Fund may be sold by the Secretary
of the Treasury at the market price.
‘‘(3) AVAILABILITY OF INCOME.—Any interest
derived from obligations acquired by the Fund, and
510
proceeds from any sale or redemption of such obliga-
tions, are hereby appropriated to the Fund.
‘‘SEC. 2162. DEFINITIONS.
‘‘For purposes of this subtitle:
‘‘(1) The term ‘eligible child’ has the meaning
given such term in section 2151(b).
‘‘(2) The term ‘federally-supplied’, with respect
to a pediatric vaccine, means that such vaccine is
purchased and delivered on behalf of a State under
section 2151(a).
‘‘(3) The term ‘health care provider’, with re-
spect to the administration of vaccines to children,
means an entity that is licensed or otherwise author-
ized for such administration under the law of the
State in which the entity administers the vaccine,
subject to section 333(e).
‘‘(4) The term ‘immunization’ means an immu-
nization against a vaccine-preventable disease.
‘‘(5) Each of the terms ‘Indian’, ‘Indian tribe’,
and ‘tribal organization’ has the meaning given such
term in section 4 of the Indian Health Care
Improvement Act.
‘‘(6) The term ‘Indian child’ means an Indian
who is 18 years of age or younger.
511
‘‘(7) The term ‘manufacturer’ means any cor-
poration, organization, or institution, whether public
or private (including Federal, State, and local de-
partments, agencies, and instrumentalities), which
manufactures, imports, processes, or distributes
under its label any pediatric vaccine. The term
‘manufacture’ means to manufacture, import, proc-
ess, or distribute a vaccine.
‘‘(8) The term ‘parent’, with respect to a child,
means a legal guardian of the child.
‘‘(9) The term ‘participating State under sec-
tion 2151’ means a State that has submitted to the
Secretary an application in accordance with section
2157.
‘‘(10) The term ‘pediatric vaccine’ means a vac-
cine included on the list established under section
2160(a).
‘‘(11) The term ‘program-registered provider’
has the meaning given such term in 2153(a)(2).
‘‘SEC. 2163. TERMINATION OF PROGRAM.
This part shall cease to be in effect beginning on such
date as may be prescribed in Federal law providing for
immunization services for all children as part of a broad-
based reform of the national health care system.
512
‘‘PART B—NATIONAL SYSTEM FOR MONITORING
IMMUNIZATION STATUS OF CHILDREN
‘‘SEC. 2171. FORMULA GRANTS FOR STATE REGISTRIES
WITH RESPECT TO MONITORING.
‘‘(a) IN GENERAL.—For the purpose described in
subsection (b), the Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall
make an allotment each fiscal year for each State in an
amount determined in accordance with section 2175. The
Secretary shall make a grant to the State of the allotment
made for the State for the fiscal year if the State submits
to the Secretary an application in accordance with section
2174.
‘‘(b) AUTHORIZED ACTIVITIES.—The Secretary may
make a grant under subsection (a) only if the State agrees
to expend the grant for the purpose of—
‘‘(1) collecting the data described in section
2172;
‘‘(2) operating registries to maintain the data
(and establishing such registries, in the case of a
State that is not operating such a registry);
‘‘(3) utilizing the data to monitor the extent to
which children have received immunizations in ac-
cordance with the schedule established under section
2160(b);
513
‘‘(4) notifying parents if children have not re-
ceived immunizations in accordance with such sched-
ule; and
‘‘(5) such other activities as the Secretary may
authorize with respect to achieving the objectives es-
tablished by the Secretary for the year 2000 for the
immunization status of children in the United
States.
‘‘(c) REQUIREMENT REGARDING STATE LAWS.—
‘‘(1) IN GENERAL.—The Secretary may make a
grant under subsection (a) only if the State in-
volved—
‘‘(A) provides assurances satisfactory to
the Secretary that, not later than October 1,
1996, the State will be operating a registry in
accordance with this part, including having in
effect such laws and regulations as may be nec-
essary to so operate such a registry; and
‘‘(B) agrees that, prior to such date, the
State will make such efforts to operate a reg-
istry in accordance with this part as may be au-
thorized in the law and regulations of the State.
‘‘(2) RULES OF CONSTRUCTION.—
‘‘(A) With respect to the agreements made
by a State under this part, other than the
514
agreement under paragraph (1)(B), the Sec-
retary may require compliance with the agree-
ments only to the extent consistent with such
paragraph.
‘‘(B) This part does not authorize the Sec-
retary, as a condition of the receipt of a grant
under subsection (a) by a State, to prohibit the
State from providing any parent, upon the re-
quest of the parent, with an exemption from the
requirements established by the State pursuant
to this part for the collection of data regarding
any child of the parent.
‘‘SEC. 2172. REGISTRY DATA.
‘‘(a) 
IN
GENERAL.—For 
purposes 
of 
section
2171(b)(1), the data described in this section are the data
described in subsection (b) and the data described in sub-
section (c). This section applies to data regarding a child
without regard to whether the child is an eligible child as
defined in section 2162.
‘‘(b) DATA REGARDING BIRTH OF CHILD.—With re-
spect to the birth of a child, the data described in this
subsection is as follows:
‘‘(1) The name of each child born in the State
involved on or after October 1, 1993.
‘‘(2) Demographic data on the child.
515
‘‘(3) The name of one or both of the parents of
the child.
‘‘(4) The address, as of the date of the birth of
the child, of each parent whose name is received in
the registry pursuant to paragraph (3).
‘‘(c) DATA
REGARDING
INDIVIDUAL
IMMUNIZA-
TIONS.—With respect to a child to whom a pediatric vac-
cine is administered in the State involved, the data de-
scribed in this subsection is as follows:
‘‘(1) The name, age, and address of the child.
‘‘(2) The date on which the vaccine was admin-
istered to the child.
‘‘(3) The name and business address of the
health care provider that administered the vaccine.
‘‘(4) The address of the facility at which the
vaccine was administered.
‘‘(5) The name and address of one or both par-
ents of the child as of the date on which the vaccine
was administered, if such information is available to
the health care provider.
‘‘(6) The type of vaccine.
‘‘(7) The number or other information identify-
ing the particular manufacturing batch of the vac-
cine, if such information appears on the container or
516
packaging for the vaccine or is otherwise readily ac-
cessible to the health care provider.
‘‘(8) The dosage of vaccine that was adminis-
tered.
‘‘(9) A description of any adverse medical reac-
tions that the child experienced in relation to the
vaccine and of which the health care provider is
aware.
‘‘(10) Any other contraindications noted by the
health care provider with respect to administration
of the vaccine to the child.
‘‘(11) Such other data regarding immunizations
for the child, including identifying data, as the Sec-
retary may require consistent with applicable law
(including social security account numbers furnished
pursuant to section 205(c)(2)(E) of the Social
Security Act).
‘‘(d) DATE CERTAIN
FOR SUBMISSION
TO REG-
ISTRY.—The Secretary may make a grant under section
2171 only if the State involved agrees to ensure that, with
respect to a child—
‘‘(1) the data described in subsection (b) are
submitted to the registry under such section not
later than 6 weeks after the date on which the child
is born; and
517
‘‘(2) the data described in subsection (c) with
respect to a vaccine are submitted to such registry
not later than 6 weeks after the date on which the
vaccine is administered to the child.
‘‘SEC. 2173. GENERAL PROVISIONS.
‘‘(a) FEDERAL STANDARDS ON CONFIDENTIALITY.—
The Secretary shall by regulation establish standards pro-
viding for maintaining the confidentiality of the identity
of individuals with respect to whom data are maintained
in registries under section 2171. Such standards shall,
with respect to a State, provide that the State is to have
in effect laws regarding such confidentiality, including ap-
propriate penalties for violation of the laws. The Secretary
may make a grant under such section only if the State
involved agrees to comply with the standards.
‘‘(b) USE
OF SOCIAL SECURITY ACCOUNT NUM-
BERS.—Any usage or disclosure of data in registries under
section 2171 that consists of social security account num-
bers and related information which is otherwise permitted
under this part may be exercised only to the extent per-
mitted under section 205(c)(2)(E) of the Social Security
Act. For purposes of the preceding sentence, the term ‘re-
lated information’ has the meaning given such term in
clause (iv)(II) of such section.
518
‘‘(c) UNIFORMITY IN METHODOLOGIES.—The Sec-
retary shall establish standards regarding the methodolo-
gies used in establishing and operating registries under
section 2171, and may make a grant under such section
only if the State agrees to comply with the standards. The
Secretary shall provide for a reasonable degree of uniform-
ity among the States in such methodologies for the pur-
pose of ensuring the utility, comparability, and exchange
of the data maintained in such registries.
‘‘(d) COORDINATION AMONG STATES.—The Sec-
retary may make a grant under section 2171 to a State
only if, with respect to the operation of the registry of
the State under such section, the State agrees to cooperate
with the Secretary and with other States in carrying out
activities with respect to achieving the objectives estab-
lished by the Secretary for the year 2000 for the immuni-
zation status of children in the United States.
‘‘(e) REPORTS TO SECRETARY.—The Secretary may
make a grant under section 2171 only if the State involved
agrees to submit to the Secretary such reports as the Sec-
retary determines to be appropriate with respect to the
activities of the State under this part.
‘‘SEC. 2174. APPLICATION FOR GRANT.
‘‘An application by a State for a grant under section
2171 is in accordance with this section if the application—
519
‘‘(1) is submitted not later than the date speci-
fied by the Secretary;
‘‘(2) contains each agreement required in this
part;
‘‘(3) contains any information required in this
part to be submitted to the Secretary; and
‘‘(4) is in such form, is made in such manner,
and contains such agreements, assurances, and in-
formation as the Secretary determines to be nec-
essary to carry out this part.
‘‘SEC. 2175. DETERMINATION OF AMOUNT OF ALLOTMENT.
‘‘The Secretary shall determine the amount of the al-
lotments required in section 2171 for States for a fiscal
year in accordance with a formula established by the Sec-
retary that allots the amounts appropriated under section
2177 for the fiscal year on the basis of the costs of the
States in establishing and operating registries under sec-
tion 2171.
‘‘SEC. 2176. DEFINITIONS.
‘‘For purposes of this part, each of the terms ‘health
care provider, ‘pediatric vaccine’ and ‘parent’ has the
meaning given the term in section 2162.
‘‘SEC. 2177. AUTHORIZATION OF APPROPRIATIONS.
‘‘For the purpose of carrying out this part, there are
authorized to be appropriated $50,000,000, for fiscal year
520
1994, $152,000,000 for fiscal year 1995, $125,000,000
for fiscal year 1996, and $35,000,000 for each of the fis-
cal years 1997 through 1999.
‘‘PART C—FUNDING FOR OTHER PURPOSES REGARDING
CHILDHOOD IMMUNIZATIONS
‘‘SEC. 2181. GRANTS REGARDING YEAR 2000 HEALTH OBJEC-
TIVES.
‘‘(a) IN GENERAL.—The Secretary, acting through
the Director of the Centers for Disease Control and Pre-
vention, may make grants to States for the purpose of car-
rying out activities with respect to achieving the objectives
established by the Secretary for the year 2000 for the im-
munization status of children in the United States, other
than providing for the purchase and delivery on behalf of
the State of any pediatric vaccine (as defined in section
2162).
‘‘(b) CERTAIN ACTIVITIES.—Subject to subsection
(a), the purposes for which a grant under such subsection
may be expended include the following:
‘‘(1) Research into the prevention and control
of diseases that may be prevented through vaccina-
tion.
‘‘(2) Demonstration projects for the prevention
and control of such diseases.
521
‘‘(3) Public information and education pro-
grams for the prevention and control of such dis-
eases.
‘‘(4) Education, training, and clinical skills im-
provement activities in the prevention and control of
such diseases for health professionals (including al-
lied health personnel).
‘‘(5) Such other activities as the Secretary de-
termines to be appropriate.
‘‘(c) APPLICATION FOR GRANT.—The Secretary may
make a grant under subsection (a) only if an application
for the grant is submitted to the Secretary and the appli-
cation is in such form, is made in such manner, and con-
tains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this
section.
‘‘(d) SUPPLIES AND SERVICES IN LIEU OF GRANT
FUNDS.— The Secretary, at the request of a recipient of
a grant under subsection (a), may reduce the amount of
such grant by—
‘‘(1) the fair market value of any supplies or
equipment furnished the grant recipient, and
‘‘(2) the amount of the pay, allowances, and
travel expenses of any officer or employee of the
Federal Government when detailed to the grant re-
522
cipient and the amount of any other costs incurred
in connection with the detail of such officer or
employee.
When the furnishing of such supplies or equipment or the
detail of such an officer or employee is for the convenience
of and at the request of such grant recipient and for the
purpose of carrying out a program with respect to which
the grant under subsection (a) is made. The amount by
which any such grant is so reduced shall be available for
payment by the Secretary of the costs incurred in furnish-
ing the supplies or equipment, or in detailing the person-
nel, on which the reduction of such grant is based, and
such amount shall be deemed as part of the grant and
shall be deemed to have been paid to the grant recipient.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this part, there are authorized to
be appropriated $580,000,000 for fiscal year 1993,
$680,000,000 for fiscal year 1994, and such sums as may
be necessary for each of the fiscal years 1995 through
1999.’’.
(b) AUTHORITY TO USE SOCIAL SECURITY ACCOUNT
NUMBERS.—Section 205(c)(2) of the Social Security Act
(42 U.S.C. 405(c)(2)) is amended—
(1) by redesignating subparagraphs (E) and
(F) as subparagraphs (F) and (G), respectively; and
523
(2) by inserting after subparagraph (D) the fol-
lowing new subparagraph:
‘‘(E)(i) The Secretary and each State receiving
grants under section 2171(a) of the Public Health Service
Act may utilize social security account numbers issued by
the Secretary under this subsection for purposes of—
‘‘(I) operating registries under such section to
maintain information including such numbers (and
establishing such registries, in the case of a State
that is not operating such a registry),
‘‘(II) utilizing such numbers to monitor the ex-
tent to which children have received immunizations
in accordance with the schedule established under
section 2160(b) of the Public Health Service Act,
and
‘‘(III) notifying parents if children have not re-
ceived immunizations in accordance with such sched-
ule.
‘‘(ii) Disclosure by individuals of social security ac-
count numbers may be required by a State for purposes
of identification of children in a registry operated pursu-
ant to a grant referred to in clause (i), except that such
disclosure may be required to be made only to persons spe-
cifically authorized in regulations of the Secretary pre-
scribed under part B of subtitle 3 of title XXI of the Pub-
524
lic Health Service Act. The Secretary shall take such ac-
tions as are necessary to restrict access to information
consisting of such numbers and related information only
to such authorized persons whose duties or responsibilities
require access for the purposes described in clause (i). The
Secretary shall issue regulations governing the use, main-
tenance, and disclosure by any holder of such information,
including appropriate administrative, technical, and phys-
ical safeguards, to ensure that only such authorized per-
sons have access to such information. Any use or disclo-
sure of such information in violation of such regulations
shall be deemed a disclosure in violation of subparagraph
(C)(vii).
‘‘(iii) The Secretary shall submit a report to the Com-
mittee on Ways and Means of the House of Representa-
tives and the Committee on Finance of the Senate not
later than January 1, 1996, and biennially thereafter, on
the operation of this subparagraph.
‘‘(iv) For purposes of this subparagraph—
‘‘(I) the term ‘State’ has the meaning provided
such term under section 2(f) of the Public Health
Service Act, and
‘‘(II) the term ‘related information’ means any
record, list, or compilation which indicates, directly
or indirectly, the identity of any individual with re-
525
spect to whom a social security account number is
maintained pursuant to this subparagraph and part
B of subtitle 3 of title XXI of the Public Health
Service Act.’’.
(c) RELATIONSHIP OF NEW PROGRAM OF IMMUNIZA-
TION GRANTS TO CURRENT PROGRAM.—
(1) STRIKING OF CURRENT PROGRAM.—Section
317 of the Public Health Service Act (42 U.S.C.
247b) is amended—
(A) in subsection (j)—
(i) by striking paragraph (1); and
(ii) by striking the remaining para-
graph designation; and
(B) in subsection (k)—
(i) by striking paragraph (1); and
(ii) by redesignating paragraphs (2)
through (5) as paragraphs (1) through (4),
respectively.
(2) TRANSITIONAL
AUTHORITY
UNDER
NEW
PROGRAM.—With respect to activities that the Sec-
retary of Health and Human Services was author-
ized to carry out pursuant to section 317(j)(1) of
the Public Health Service Act (as in effect on the
day before the date of the enactment of this Act),
the Secretary may, for fiscal year 1994, carry out
526
any such activity under section 2181 of the Public
Health Service Act (as added by subsection (a) of
this section), notwithstanding the provisions of such
section 2181. The authority established in the pre-
ceding sentence includes the authority to purchase
vaccines.
(d) CONTINUED COVERAGE OF COSTS OF A PEDI-
ATRIC VACCINE UNDER GROUP HEALTH PLANS.—
(1) REQUIREMENT.—The requirement of this
paragraph, with respect to a group health plan for
plan years beginning after the date of the enactment
of this Act, is that the group health plan not reduce
its coverage of the costs of pediatric vaccines (as de-
fined under section 2162 of the Public Health Serv-
ice Act) below the coverage it provided as of May 1,
1993.
(2) ENFORCEMENT.—
(A) For purposes of section 2207 of the
Public Health Service Act, the requirement of
paragraph (1) is deemed a requirement of title
XXII of such Act.
(B) For purposes of subsections (a)
through (e) of section 4980B of the Internal
Revenue Code of 1986, paragraph (1) is
527
deemed a requirement of subsection (f) of such
section.
(C) For purposes of section 502 of the
Employee Retirement Income Security Act of
1974, paragraph (1) is deemed a provision of
part 6 of subtitle B of title I of such Act.
SEC. 5182. NATIONAL VACCINE INJURY COMPENSATION
PROGRAM AMENDMENTS.
(a) USE OF VACCINE INJURY COMPENSATION TRUST
FUND.—Section 6601(r) of the Omnibus Budget Rec-
onciliation Act of 1989 is amended by striking
‘‘$2,500,000 for each of fiscal years 1991 and 1992’’ each
place it appears and inserting ‘‘$3,000,000 for fiscal year
1994 and each fiscal year thereafter’’ (in three places).
(b) AMENDMENT OF VACCINE INJURY TABLE.—Sec-
tion 2116(b) of the Public Health Service Act (42 U.S.C.
300aa–16(b)) is amended by striking ‘‘such person may
file’’ and inserting ‘‘or to significantly increase the likeli-
hood of obtaining compensation, such person may, not-
withstanding section 2111(b)(2), file’’.
(c) EXTENSION OF TIME FOR DECISION.—Section
2112(d)(3)(D) 
of 
such 
Act 
(42 
U.S.C. 
300aa–
12(d)(3)(D)) is amended by striking ‘‘540 days’’ and in-
serting ‘‘30 months (but for no more than 6 months at
a time)’’.
528
(d) SIMPLIFICATION OF VACCINE INFORMATION MA-
TERIALS.—
(1) Section 2126(b) of such Act (42 U.S.C.
300aa–26(b)) is amended—
(A) by striking ‘‘by rule’’ in the matter
preceding paragraph (1);
(B) by striking, in paragraph (1), ‘‘, op-
portunity for a public hearing, and 90’’ and in-
serting ‘‘and 30’’; and
(C) by striking, in paragraph (2), ‘‘, appro-
priate health care providers and parent organi-
zations’’.
(2) Section 2126(c) of such Act (42 U.S.C.
300aa–26(c)) is amended—
(A) by inserting ‘‘shall be based on avail-
able data and information,’’ after ‘‘such mate-
rials’’ in the matter preceding paragraph (1),
and
(B) by striking paragraphs (1) through
(10) and inserting the following:
‘‘(1) a concise description of the benefits of the
vaccine,
‘‘(2) a concise description of the risks associ-
ated with the vaccine,
529
‘‘(3) a statement of the availability of the Na-
tional Vaccine Injury Compensation Program, and
‘‘(4) such other relevant information as may be
determined by the Secretary.’’.
(3) Subsections (a) and (d) of section 2126 of
such Act (42 U.S.C. 300aa–26) are each amended
by inserting ‘‘or to any other individual’’ after ‘‘to
the legal representatives of any child’’.
(4) Subsection (d) of section 2126 of such Act
(42 U.S.C. 300aa–26) is amended—
(A) by striking all after ‘‘subsection (a),’’
the second place it appears in the first sentence
and inserting ‘‘supplemented with visual presen-
tations or oral explanations, in appropriate
cases.’’, and
(B) by striking ‘‘or other information’’ in
the last sentence.
SEC. 5183. MEDICAID IMMUNIZATION PROVISIONS.
(a) OUTREACH AND EDUCATION.—
(1) IMMUNIZATION OUTREACH THROUGH EPSDT
PROGRAM.—Section 
1902(a)(43)(A) 
(42 
U.S.C.
1396a(a)(43)(A)) is amended by inserting before the
comma at the end the following: ‘‘and the need for
age-appropriate immunizations against vaccine-pre-
ventable diseases’’.
530
(2) COORDINATION
WITH
MATERNAL
AND
CHILD HEALTH BLOCK GRANT PROGRAMS AND WIC
PROGRAMS.—Section 
1902(a)(11) 
(42 
U.S.C.
1396a(a)(11)) is amended—
(A) in clause (B)—
(i) by striking ‘‘effective July 1,
1969,’’,
(ii) by striking ‘‘and’’ before ‘‘(ii)’’,
and
(iii) by striking ‘‘to him under section
1903’’ and inserting ‘‘to the individual
under section 1903, and (iii) providing for
coordination of information and education
on childhood vaccinations and delivery of
immunization services’’; and
(B) in clause (C), by inserting ‘‘(including
the provision of information and education on
childhood vaccinations and the delivery of im-
munization services)’’ after ‘‘operations under
this title’’.
(3) COVERAGE OF PUBLIC HOUSING HEALTH
CENTERS AS FEDERALLY-QUALIFIED HEALTH CEN-
TERS.—Section 
1905(l)(2)(B) 
(42 
U.S.C.
1396d(l)(2)(B)) is amended by striking ‘‘or 340’’
each place it appears and inserting ‘‘340, or 340A’’.
531
(4) EFFECTIVE DATE.—(A) Except as provided
in subparagraph (B), the amendments made by this
subsection shall apply to calendar quarters beginning
on or after October 1, 1993, without regard to
whether or not final regulations to carry out such
amendments have been promulgated by such date.
(B) In the case of a State plan for medical as-
sistance under title XIX of the Social Security Act
which the Secretary of Health and Human Services
determines requires State legislation (other than leg-
islation appropriating funds) in order for the plan to
meet the additional requirements imposed by the
amendments made by this subsection, 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 legislature that begins after the date of the en-
actment 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.
533
(1) PAYMENT
RATES.—Section 1926(a)(4)(B)
(42 U.S.C. 1396r–7(a)(4)(B)) is amended by insert-
ing ‘‘(including the administration of vaccines)’’
after ‘‘means services’’.
(2) EFFECTIVE DATE.—The amendment made
by paragraph (1) shall apply to the plan amendment
required to be submitted under section 1926(a)(2) of
the Social Security Act by not later than April 1,
1994.
(d) DENIAL OF FEDERAL FINANCIAL PARTICIPATION
FOR INAPPROPRIATE ADMINISTRATION OF SINGLE–ANTI-
GEN VACCINE.—
(1) IN GENERAL.—Section 1903(i) (42 U.S.C.
1396b(i)), as amended by sections 5174(b) and
5131(a), is amended—
(A) in paragraph (13), by striking ‘‘or’’ at
the end,
(B) in paragraph (14), by striking the pe-
riod at the end and inserting ‘‘; or’’, and
(C) by inserting after paragraph (14) the
following new paragraph:
‘‘(15) with respect to any amount expended for
a single-antigen vaccine and its administration in
any case in which the administration of a combined-
534
antigen vaccine was medically appropriate (as deter-
mined by the Secretary).’’.
(2) EFFECTIVE DATE.—The amendments made
by paragraph (1) shall apply to amounts expended
for vaccines administered on or after October 1,
1993.
(e) REQUIRING MEDICAID MANAGED CARE PLANS
TO COMPLY WITH IMMUNIZATION AND OTHER EPSDT
REQUIREMENTS.—
(1) IN GENERAL.—Section 1903(m) (42 U.S.C.
1396b(m)) is amended—
(A) in paragraph (2)(A), as amended by
subsections (a)(1) and (b)(1) of section 5135—
(i) by striking ‘‘and’’ at the end of
clause (xii),
(ii) by striking the period at the end
of clause (xiii) and inserting ‘‘; and’’, and
(iii) by adding at the end the follow-
ing new clause:
‘‘(xiv) the entity complies with the requirements
of paragraph (7) (relating to EPSDT compliance).’’;
and
(B) by adding at the end the following new
paragraph:
535
‘‘(7) The contract between the State and an entity
referred to in paragraph (2)(A)(iii) shall—
‘‘(A) specify which early and periodic screening,
diagnostic, and treatment services are to be provided
under the contract to individuals under age 21 en-
rolled with the entity;
‘‘(B) in the case of such services which are not
to be so provided, specify the steps the entity will
take (through referrals or other arrangements) to
assure that such individuals will receive such serv-
ices; and
‘‘(C) require the entity to submit such periodic
reports as may be necessary to enable the State to
prepare and submit timely reports under section
1902(a)(43)(D) and section 506(a)(2).’’.
(2) APPLICATION
OF
INTERMEDIATE
SANC-
TIONS
FOR
FAILURE
TO
PROVIDE
IMMUNIZA-
TIONS
AND
OTHER
EPSDT
SERVICES.—Section
1903(m)(5)(A) (42 U.S.C. 1396b(m)(5)(A)) is
amended—
(A) by striking ‘‘, or’’ at the end of clause
(iv) and inserting a semicolon,
(B) by striking the comma at the end of
clause (v) and inserting ‘‘; or’’, and
536
(C) by inserting after clause (v) the follow-
ing new clause:
‘‘(vi) fails substantially to provide early and
periodic screening, diagnostic, and treatment serv-
ices to the extent specified in the contract under
paragraph (7)(A);’’.
(3) EFFECTIVE DATE.—The amendments made
by this subsection shall apply to contract years be-
ginning on or after October 1, 1993, without regard
to whether or not final regulations to carry out such
amendments have been promulgated by such date.
(f) TRANSITION RULE.—
(1) MEDICAID USE OF CDC CONTRACT PRICE.—
The Secretary of Health and Human Services shall
not, on or after the date of the enactment of this
Act, enter into a contract for the purchase by the
Centers for Disease Control and Prevention of pedi-
atric vaccines for distribution (as provided for in
section 317 or section 2181 of the Public Health
Service Act) unless such contract provides that the
charge for such vaccines, for which medical assist-
ance is provided under a State plan under title XIX
of the Social Security Act, will not exceed the price
negotiated under the contract. The previous sentence
shall not apply, with respect to a vaccine for which
537
medical assistance is provided by a State, on and
after such date as the State becomes entitled to have
the Secretary provide for the purchase and delivery
on behalf of the State of that vaccine under section
2151 of the Public Health Service Act.
(2) OPTIONAL USE BY STATES OF CDC CON-
TRACT PRICE.—Nothing in paragraph (1) shall be
construed as limiting the Federal financial participa-
tion available to States, under title XIX of the So-
cial Security Act, for the cost of a pediatric vaccine
to the contract price described in such paragraph for
the vaccine.
SEC. 5184. AVAILABILITY OF MEDICAID PAYMENTS FOR
CHILDHOOD VACCINE REPLACEMENT PRO-
GRAMS.
(a) IN GENERAL.—Section 1902(a)(32) (42 U.S.C.
1396a(a)(32)) is amended—
(1) by striking ‘‘and’’ at the end of subpara-
graph (B),
(2) by striking the period at the end of sub-
paragraph (C) and inserting ‘‘; and’’, and
(3) by adding at the end the following new sub-
paragraph:
‘‘(D) in the case of payment for a child-
hood vaccine administered to individuals enti-
538
tled to medical assistance under the State plan,
the State plan may make payment directly to
the manufacturer of the vaccine under a vol-
untary replacement program agreed to by the
State pursuant to which the manufacturer (i)
supplies doses of the vaccine to providers ad-
ministering the vaccine, (ii) periodically replaces
the supply of the vaccine, and (iii) charges the
State the manufacturer’s bid price to the Cen-
ters for Disease Control and Prevention for the
vaccine so administered plus a reasonable pre-
mium to cover shipping and the handling of re-
turns;’’.
(b) EFFECTIVE DATE.—The amendments made by
subsection (a) shall take effect on the date of the enact-
ment of this Act.
SEC. 5185. HEALTHY START FOR INFANTS.
(a) IN GENERAL.—Part D of title III of the Public
Health Service Act (42 U.S.C. 254b et seq.) is amended
by inserting after section 330 the following section:
‘‘HEALTHY START FOR INFANTS
‘‘SEC. 330A. (a) GRANTS
FOR COMPREHENSIVE
SERVICES.—
‘‘(1) IN GENERAL.—The Secretary may make
grants for the operation of not more than 21 dem-
onstration projects to provide the services described
539
in subsection (b) for the purpose of reducing, in the
geographic areas in which the projects are carried
out—
‘‘(A) the incidence of infant mortality and
morbidity;
‘‘(B) the incidence of fetal deaths;
‘‘(C) the incidence of maternal mortality;
‘‘(D) the incidence of fetal alcohol syn-
drome; and
‘‘(E) the incidence of low-birthweight
births.
‘‘(2) ACHIEVEMENT OF YEAR 2000 HEALTH STA-
TUS OBJECTIVES.—With respect to the objectives es-
tablished by the Secretary for the health status of
the population of the United States for the year
2000, the Secretary shall, in providing for a dem-
onstration project under paragraph (1) in a geo-
graphic area, seek to meet the objectives that are
applicable to the purpose described in such para-
graph and the populations served by the project.
‘‘(b) AUTHORIZED SERVICES.—
‘‘(1) IN GENERAL.—Subject to subsection (h),
the services referred to in this subsection are com-
prehensive services (including preventive and pri-
mary health services for pregnant women and in-
540
fants and childhood immunizations in accordance
with the schedule recommended by the Secretary
under section 2160) for carrying out the purpose de-
scribed in subsection (a), including services other
than health services.
‘‘(2) CERTAIN PROVIDERS.—The Secretary may
make a grant under subsection (a) only if the appli-
cant involved agrees that, in making any arrange-
ments under which other entities provide authorized
services in the demonstration project involved, the
applicant will include among the entities with which
the arrangements are made grantees under any of
sections 329, 330, 340, and 340A, if such grantees
are providing services in the service area of such
project and the grantees are willing to make such
arrangements with the applicant.
‘‘(c) ELIGIBLE GEOGRAPHIC AREAS.—The Secretary
may make a grant under subsection (a) only if—
‘‘(1) the applicant for the grant specifies the
geographic area in which the demonstration project
under such subsection is to be carried out and
agrees that the project will not be carried out in
other areas; and
541
‘‘(2) the rate of infant mortality in the geo-
graphic area equals or exceeds 150 percent of the
national average in the United States of such rates.
‘‘(d) MINIMUM QUALIFICATIONS OF GRANTEES.—
‘‘(1) PUBLIC
OR
NONPROFIT
PRIVATE
ENTI-
TIES.—The Secretary may make a grant under sub-
section (a) only if the applicant for the grant is a
State or local department of health, or other public
or nonprofit private entity, or a consortium of public
or nonprofit private entities.
‘‘(2) APPROVAL OF POLITICAL SUBDIVISIONS.—
With respect to a proposed demonstration project
under subsection (a), the Secretary may make a
grant under such subsection only if—
‘‘(A) the chief executive officer of each po-
litical subdivision in the service area of such
project approves the applicant for the grant as
being qualified to carry out the project; and
‘‘(B) the leadership of any Indian tribe or
tribal organization with jurisdiction over any
portion of such area so approves the applicant.
‘‘(3) STATUS AS MEDICAID PROVIDER.—
‘‘(A) In the case of any service described
in subsection (b) that is available pursuant to
the State plan approved under title XIX of the
542
Social Security Act for a State in which a dem-
onstration project under subsection (a) is car-
ried out, the Secretary may make a grant under
such subsection for the project only if, subject
to subparagraph (B)—
‘‘(i) the applicant for the grant will
provide the service directly, and the appli-
cant has entered into a participation agree-
ment under the State plan and is qualified
to receive payments under such plan; or
‘‘(ii) the applicant will enter into an
agreement with a public or private entity
under which the entity will provide the
service, and the entity has entered into
such a participation agreement under the
State plan and is qualified to receive such
payments.
‘‘(B)(i) In the case of an entity making an
agreement pursuant to subparagraph (A)(ii) re-
garding the provision of services, the require-
ment established in such subparagraph regard-
ing a participation agreement shall be waived
by the Secretary if the entity does not, in pro-
viding health care services, impose a charge or
accept reimbursement available from any third-
543
party payor, including reimbursement under
any insurance policy or under any Federal or
State health benefits plan.
‘‘(ii) A determination by the Secretary of
whether an entity referred to in clause (i) meets
the criteria for a waiver under such clause shall
be made without regard to whether the entity
accepts voluntary donations regarding the pro-
vision of services to the public.
‘‘(e) STATE APPROVAL OF PROJECT.—With respect
to a proposed demonstration project under subsection (a),
the Secretary may make a grant under such subsection
to the applicant involved only if—
‘‘(1) the chief executive officer of the State in
which the project is to be carried out approves the
proposal of the applicant for carrying out the
project; and
‘‘(2) the leadership of any Indian tribe or tribal
organization with jurisdiction over any portion of the
service area of the project so approves the proposal.
‘‘(f) ELIGIBILITY FOR SERVICES PROVIDED WITH
GRANT FUNDS.—
‘‘(1) IN GENERAL.—With respect to any au-
thorized service under subsection (b), if the service
is a service that States are required or authorized to
544
provide under title XIX of the Social Security Act,
the Secretary may make a grant under subsection
(a) only if the applicant involved agrees that the
grant will not be expended to provide the service to
any individual to whom States are required or au-
thorized under such title to provide the service. The
Secretary may not make a grant under subsection
(a) unless the State involved agrees that the grant
will not be expended to make payment for any item
or service to the extent that payment has been
made, or can reasonably be expected to be made,
with respect to such item or service—
‘‘(A) under a health insurance policy or
plan (including a group health plan or a pre-
paid health plan),
‘‘(B) under any Federal or State health
benefits program, including any program under
title V, XVIII, or XIX of the Social Security
Act, or
‘‘(C) under subpart 2 of part B of title
XIX of this Act.
‘‘(2) RULES OF CONSTRUCTION.—For purposes
of paragraph (1):
‘‘(A) Individuals to whom States are au-
thorized to provide services under title XIX of
545
the Social Security Act include, pursuant to
section 1902(l) of such title, pregnant women,
infants, and children with an income level not
less than 133 percent, and not more than 185
percent, of the official poverty line.
‘‘(B) Authorized services under subsection
(b) that are authorized to be provided under
title XIX of such Act include, pursuant to sec-
tion 1920 of such title, ambulatory prenatal
services during a period of presumptive eligi-
bility.
‘‘(C) Authorized services under subsection
(b) that are required to be provided under title
XIX of such Act include, pursuant to section
1905(a)(4)(B) of such title, early and periodic
screening, diagnostic, and treatment services for
children under the age of 21.
‘‘(D) Authorized services under subsection
(b) that are authorized to be provided under
title XIX of such Act include, pursuant to sec-
tion 1905(a)(19) of such title, case-manage-
ment services.
‘‘(g) MAINTENANCE OF EFFORT.—
‘‘(1) GRANTEE.—With respect to authorized
services under subsection (b), the Secretary may
546
make a grant under subsection (a) only if the appli-
cant involved agrees to maintain expenditures of
non-Federal amounts for such services at a level
that is not less than the level of such expenditures
maintained by the applicant for fiscal year 1991.
‘‘(2) RELEVANT
POLITICAL
SUBDIVISIONS.—
With respect to authorized services under subsection
(b), the Secretary may make a grant under sub-
section (a) only if each political subdivision in the
service area of the demonstration project involved
agrees to maintain expenditures of non-Federal
amounts for such services at a level that is not less
than the level of such expenditures maintained by
the political subdivision for fiscal year 1991.
‘‘(h) RESTRICTIONS ON EXPENDITURE OF GRANT.—
‘‘(1) IN GENERAL.—Except as provided in para-
graph (3), the Secretary may make a grant under
subsection (a) only if the applicant involved agrees
that the grant will not be expended—
‘‘(A) to provide inpatient services, except
with respect to residential treatment for sub-
stance abuse provided in settings other than
hospitals;
547
‘‘(B) to make cash payments to intended
recipients of health services or mental health
services; or
‘‘(C) to purchase or improve real property
(other than minor remodeling of existing im-
provements to real property) or to purchase
major medical equipment (other than mobile
medical units for providing ambulatory prenatal
services).
‘‘(2) ADMINISTRATIVE
EXPENSES; DATA
COL-
LECTION.—The Secretary may make a grant under
subsection (a) only if the applicant involved agrees
that not more than an aggregate 10 percent of the
grant will be expended for administering the grant
and the collection and analysis of data.
‘‘(3) WAIVER.—If the Secretary finds that the
purpose described in subsection (a) cannot otherwise
be carried out, the Secretary may, with respect to an
otherwise qualified applicant, waive the restriction
established in paragraph (1)(C).
‘‘(i) 
DETERMINATION
OF
CAUSE
OF
INFANT
DEATHS.—The Secretary may make a grant under sub-
section (a) only if the applicant involved—
548
‘‘(1) agrees to provide for a determination of
the cause of each infant death in the service area of
the demonstration project involved; and
‘‘(2) the applicant has made such arrangements
with public entities as may be necessary to carry out
paragraph (1).
‘‘(j) ANNUAL REPORTS TO SECRETARY.—The Sec-
retary may make a grant under subsection (a) only if the
applicant involved agrees that, for each fiscal year for
which the applicant operates a demonstration project
under such subsection the applicant will, not later than
April 1 of the subsequent fiscal year, submit to the Sec-
retary a report providing the following information with
respect to the project:
‘‘(1) The number of individuals that received
authorized services, and the demographic character-
istics of the population of such individuals.
‘‘(2) The types of authorized services provided,
including the types of ambulatory prenatal services
provided and the trimester of the pregnancy in
which the services were provided.
‘‘(3) The sources of payment for the authorized
services provided.
‘‘(4) The extent to which children under age 2
receiving authorized services have received the ap-
549
propriate number and variety of immunizations
against vaccine-preventable diseases.
‘‘(5) An analysis of the causes of death deter-
mined under subsection (i).
‘‘(6) The extent of progress being made toward
meeting the health status objectives specified in sub-
section (a)(2).
‘‘(7) The extent to which, in the service area in-
volved, progress is being made toward meeting the
participation goals established for the State by the
Secretary under section 1905(r) of the Social Secu-
rity Act (relating to early periodic screening, diag-
nostic, and treatment services for children under the
age of 21).
‘‘(k) COMMUNITY PARTICIPATION.—The Secretary
may make a grant under subsection (a) only if the appli-
cant involved agrees that, in preparing the proposal of the
applicant for the demonstration project involved, and in
the operation of the project, the applicant will consult with
the residents of the service area for the project and with
public and nonprofit private entities that provide author-
ized services to such residents.
‘‘(l) APPLICATION FOR GRANT.—The Secretary may
make a grant under subsection (a) only if an application
for the grant is submitted to the Secretary and the appli-
550
cation is in such form, is made in such manner, and con-
tains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this sub-
section.
‘‘(m) REPORT TO CONGRESS.—Not later than Feb-
ruary 1, 1998, the Secretary shall submit to the Commit-
tee on Energy and Commerce of the House of Representa-
tives, and the Committee on Labor and Human Resources
of the Senate, a report—
‘‘(1) summarizing the reports received by the
Secretary under subsection (j);
‘‘(2) describing the extent to which demonstra-
tion projects under subsection (a) have been cost ef-
fective; and
‘‘(3) describing the extent to which the Sec-
retary has, in the service areas of such projects,
been successful in meeting the health status objec-
tives specified in subsection (a)(2).
‘‘(n) LIMITATION ON CERTAIN EXPENSES OF SEC-
RETARY.—Of the amounts appropriated under subsection
(o) for a fiscal year, the Secretary may not obligate more
than an aggregate 5 percent for the administrative costs
of the Secretary in carrying out this section, for the provi-
sion of technical assistance regarding demonstration
551
projects under subsection (a), and for evaluations of such
projects.
‘‘(o) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘authorized services’ means the
services specified in subsection (b).
‘‘(2) The terms ‘Indian tribe’ and ‘tribal organi-
zation’ have the meaning given such terms in section
4(b) and section 4(c) of the Indian Self-Determina-
tion and Education Assistance Act.
‘‘(3) The term ‘service area’, with respect to a
demonstration project under subsection (a), means
the geographic area specified in subsection (c).
‘‘(p) AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of carrying out this section, there are authorized
to be appropriated for each of the fiscal years 1994
through 1997 such sums as may be necessary.
‘‘(q) SUNSET.—Effective October 1, 1997, this sec-
tion is repealed.’’.
(b) REPORT FOR FISCAL YEAR 1993.—With respect
to grants under section 330A of the Public Health Service
Act, as added by subsection (a) of this section, the Sec-
retary of Health and Human Services may make a grant
under such section for fiscal year 1994 only if the appli-
cant for the grant agrees to submit to the Secretary, not
later than April 1 of such year, a report on any federally-
552
supported project of the applicant that is substantially
similar to the demonstration projects authorized in such
section 330A, which report provides, to the extent prac-
ticable, the information described in subsection (j) of such
section.
(c) SAVINGS PROVISION.—With respect to grants
under section 330A of the Public Health Service Act, as
added by subsection (a) of this section and in effect for
the fiscal years 1994 through 1997, such grants remain
available for obligation and expenditure in accordance with
the terms upon which the grants were made, notwith-
standing the repeal of such section 330A pursuant to sub-
section (q) of such section.
(d) USE OF GENERAL AUTHORITY UNDER PUBLIC
HEALTH SERVICE ACT.—With respect to the program es-
tablished in section 330A of the Public Health Service Act,
as added by subsection (a) of this section, section 301 of
the Public Health Service Act may not be construed as
providing to the Secretary of Health and Human Services
any authority to carry out, during any fiscal year in which
such program is in operation, any demonstration project
to provide any of the services specified in subsection (b)
of such section 330A.
553
SEC. 5186. INCREASE IN AUTHORIZATION OF APPROPRIA-
TIONS FOR THE MATERNAL AND CHILD
HEALTH SERVICES BLOCK GRANT PROGRAM.
Section 501(a) (42 U.S.C. 701(a)) is amended by
striking ‘‘$686,000,000 for fiscal year 1990’’ and insert-
ing ‘‘$705,000,000 for fiscal year 1994’’.
SEC. 5187. MISCELLANEOUS TECHNICAL CORRECTIONS TO
PUBLIC HEALTH SERVICE ACT PROVISIONS.
(a) COMPENSATION FOR MEMBERS OF NATIONAL
ADVISORY COUNCIL
ON NATIONAL HEALTH SERVICE
CORPS.—
(1) IN GENERAL.—Section 337(b)(2) of the Public
Health Service Act (42 U.S.C. 254j(b)(2)) is amended—
(A) by inserting after ‘‘so serving’’ the fol-
lowing: ‘‘compensation at a rate fixed by the
Secretary (but not to exceed’’, and
(B) by striking ‘‘Schedule;’’ and inserting
‘‘Schedule);’’.
(2) EFFECTIVE DATE.—The amendments made
by paragraph (1) shall take effect on the date of the
enactment of this Act.
(b) LIABILITY PROTECTIONS FOR INDIVIDUALS PRO-
VIDING SERVICES AT CERTAIN CLINICS.—
(1) CLARIFICATION OF VOLUNTARY PARTICIPA-
TION BY CERTAIN ENTITIES.—(A) Section 224(g) of
the 
Public 
Health 
Service 
Act 
(42 
U.S.C.
554
133(g)(1)), as added by section 2(a) of the Federally
Supported Health Centers Assistance Act of 1992, is
amended—
(i) in paragraph (4), by striking ‘‘An en-
tity’’ and inserting ‘‘Except as provided in
paragraph (6), an entity’’, and
(ii) by adding at the end the following new
paragraph:
‘‘(6) An entity may elect not to be treated as being
described in paragraph (4) if the entity establishes that
on a continuous basis since October 24, 1992, the entity
has been a participant in, and partial owner of, a nonprofit
risk retention group which offers malpractice and other
liability coverage to the entity.’’.
(B) Section 224(k)(2) of such Act (42 U.S.C.
233(k)(2)), as added by section 4 of the Federally
Supported Health Centers Assistance Act of 1992, is
amended by striking ‘‘entities receiving funds’’ and
all that follows through ‘‘subsection (g)’’ and insert-
ing the following: ‘‘entities described in subsection
(g)(4) and receiving funds under each of the grant
programs described in such subsection’’.
(2) CLARIFICATION OF COVERAGE OF OFFICERS
AND EMPLOYEES OF CLINICS.—The first sentence of
section 224(g)(1) of the Public Health Service Act
555
(42 U.S.C. 233(g)(1)) is amended by striking ‘‘offi-
cer, employee, or contractor’’ and inserting the fol-
lowing: ‘‘officer or employee of such an entity, and
any contractor’’.
(3) COVERAGE FOR SERVICES FURNISHED TO
INDIVIDUALS OTHER THAN PATIENTS OF CLINIC.—
Section 224(g) of such Act (42 U.S.C. 233(g)(1)),
as amended by paragraph (1), is amended—
(A) in the first sentence of paragraph (1),
by inserting after ‘‘Service’’ the following: ‘‘with
respect to services provided to patients of the
entity and (subject to paragraph (7)) to certain
other individuals’’; and
(B) by adding at the end the following new
paragraph:
‘‘(7) For purposes of paragraph (1), an officer, em-
ployee, or contractor described in such paragraph may be
deemed to be an employee of the Public Health Service
with respect to services provided to individuals who are
not patients of an entity described in paragraph (4) only
if the Secretary determines—
‘‘(A) that the provision of the services to such
individuals is necessary to assure the treatment of
patients of such an entity; or
556
‘‘(B) that such services are otherwise required
to be provided to such individuals under an employ-
ment contract (or other similar arrangement) be-
tween the individual and the entity.’’.
(4) DETERMINING
COMPLIANCE
OF
ENTITY
WITH
REQUIREMENTS
FOR
COVERAGE.—Section
224(h) of such Act (42 U.S.C. 233(h)), as added by
section 2(b) of the Federally Supported Health Cen-
ters Assistance Act of 1992, is amended by striking
‘‘the entity—’’ and inserting the following: ‘‘the Sec-
retary, after receiving such assurances and conduct-
ing such investigation as the Secretary considers
necessary, finds that the entity—’’.
(5) EFFECTIVE DATE.—The amendments made
by this subsection shall take effect as if included in
the enactment of the Federally Supported Health
Centers Assistance Act of 1992.
(c) ELIMINATION OF DUPLICATE WAIVER AUTHOR-
ITY FOR PARTICIPANTS IN NATIONAL HEALTH SERVICE
CORPS.—Section 338E(c) of the Public Health Service
Act (42 U.S.C. 254o(c)) is amended by striking paragraph
(3) and redesignating paragraph (4) as paragraph (3).
(d) CLARIFICATION OF PROHIBITION AGAINST RE-
SALE OF DRUGS UNDER DRUG REBATE AGREEMENTS.—
Section 340B(a)(5)(B) of the Public Health Service Act
557
(42 U.S.C. 256b(a)(5)(B)), as added by section 602(a) of
the Veterans Health Care of 1992, is amended by striking
‘‘entity.’’ and inserting ‘‘covered entity.’’.
Subtitle C—Communications
Licensing Improvement
SEC. 5200. TABLE OF CONTENTS.
The table of contents is as follows:
Subtitle C—Communications Licensing Improvement
Sec. 5200. Table of contents.
CHAPTER 1—COMPETITIVE BIDDING AUTHORITY
Sec. 5201. Short title.
Sec. 5202. Findings.
Sec. 5203. Authority to use competitive bidding.
Sec. 5204. Conforming amendments.
Sec. 5205. Regulatory parity.
Sec. 5206. Effective dates; deadlines for Commission action.
CHAPTER 2—EMERGING TELECOMMUNICATIONS TECHNOLOGIES
Sec. 5221. Short title.
Sec. 5222. Amendment to the National Telecommunications and Information
Administration Organization Act.
CHAPTER 3—COMMUNICATIONS TECHNICAL AMENDMENTS
Sec. 5241. Clerical corrections.
Sec. 5242. Transfer of provisions of law concerning public telecommunications
facilities, children’s educational television, and telecommuni-
cations demonstration program.
Sec. 5243. Elimination of expired and outdated provisions.
Sec. 5244. Stylistic consistency.
CHAPTER 1—COMPETITIVE BIDDING
AUTHORITY
SEC. 5201. SHORT TITLE.
This chapter may be cited as the ‘‘Licensing Improve-
ment Act of 1993’’.
558
SEC. 5202. FINDINGS.
The Congress finds that—
(1) current licensing procedures often delay de-
livery of services to the public and can result in the
unjust enrichment of applicants on the basis of the
value of the public airwaves;
(2) if licensees are engaged in reselling the use
of the public airwaves to subscribers for a fee, the
licensee should pay reasonable compensation to the
public for those public resources;
(3) a carefully designed system to obtain com-
petitive bids from competing qualified applicants can
speed delivery of services, promote efficient and in-
tensive use of the electromagnetic spectrum, prevent
unjust enrichment, and produce revenues to com-
pensate the public for the use of the public airwaves;
and
(4) therefore, the Federal Communications
Commission should have the authority to differen-
tiate among multiple qualified applicants for a single
license using a system of competitive bids.
SEC. 5203. AUTHORITY TO USE COMPETITIVE BIDDING.
Section 309 of the Communications Act of 1934 (47
U.S.C. 309) is amended by adding at the end the following
new subsection:
‘‘(j) USE OF COMPETITIVE BIDDING.—
559
‘‘(1) GENERAL AUTHORITY.—If mutually exclu-
sive applications are filed for any initial license or
construction permit which will involve a use of the
electromagnetic spectrum described in paragraph
(2), then the Commission shall have the authority to
grant such license or permit to a qualified applicant
through the use of a system of competitive bidding
that meets the requirements of this subsection.
‘‘(2) USES TO WHICH BIDDING MAY APPLY.—A
use of the electromagnetic spectrum is described in
this paragraph if the Commission determines that—
‘‘(A) the principal use of such spectrum
will involve, or is reasonably likely to involve,
the licensee receiving compensation from sub-
scribers in return—
‘‘(i) for the licensee enabling those
subscribers to receive communications sig-
nals that are transmitted utilizing fre-
quencies on which the licensee is licensed
to operate; or
‘‘(ii) for the licensee enabling those
subscribers to transmit directly commu-
nications signals utilizing frequencies on
which the licensee is licensed to operate;
and
560
‘‘(B) a system of competitive bidding will
promote the objectives described in paragraph
(3).
‘‘(3) DESIGN
OF
SYSTEMS
OF
COMPETITIVE
BIDDING.—For each license or permit, or class of
licenses or permits, that the Commission grants
through the use of a competitive bidding system, the
Commission shall, by rule, establish a competitive
bidding methodology. The Commission shall seek to
design and test multiple alternative methodologies
under appropriate circumstances. In identifying li-
censes and permits to be issued by competitive bid-
ding, in specifying eligibility and other characteris-
tics of such licenses and permits, and in designing
the methodologies for use under this subsection, the
Commission shall seek to promote the purposes
specified in section 1 of this Act and the following
objectives:
‘‘(A) the development and rapid deploy-
ment of new technologies, products, and serv-
ices for the benefit of the public, including
those residing in rural areas, without adminis-
trative or judicial delays;
‘‘(B) promoting economic opportunity and
competition and ensuring that new and innova-
561
tive technologies are readily accessible to the
American people by avoiding excessive con-
centration of licenses and by disseminating li-
censes among a wide variety of applicants, in-
cluding small businesses and businesses owned
by members of minority groups and women;
‘‘(C) recovery for the public of a portion of
the value of the public spectrum resource made
available for commercial use and avoidance of
unjust enrichment through the methods em-
ployed to award uses of that resource; and
‘‘(D) efficient and intensive use of the elec-
tromagnetic spectrum.
‘‘(4) CONTENTS
OF
REGULATIONS.—In pre-
scribing rules pursuant to paragraph (3), the Com-
mission shall—
‘‘(A) consider alternative payment sched-
ules and methods of calculation, including ini-
tial lump sums, installment or royalty pay-
ments, guaranteed annual minimum payments,
or other schedules or methods that promote the
objectives described in paragraph (3)(B), and
combinations of such schedules and methods;
‘‘(B) include performance requirements,
such as appropriate deadlines and penalties for
562
performance failures, to ensure prompt delivery
of service to rural areas, to prevent stockpiling
or warehousing of spectrum by licensees or per-
mittees, and to promote investment in and
rapid deployment of new technologies and serv-
ices;
‘‘(C) consistent with the public interest,
convenience, and necessity, the purposes of this
Act, and the characteristics of the proposed
service, prescribe area designations and band-
width assignments that promote (i) an equitable
distribution of licenses and services among geo-
graphic areas, (ii) economic opportunity for a
wide variety of applicants, including small busi-
nesses and businesses owned by members of mi-
nority groups and women, and (iii) investment
in and rapid deployment of new technologies
and services; and
‘‘(D) require such transfer disclosures and
antitrafficking restrictions and payment sched-
ules as may be necessary to prevent unjust en-
richment as a result of the methods employed
to issue licenses and permits.
‘‘(5) BIDDER AND LICENSEE QUALIFICATION.—
No person shall be permitted to participate in a sys-
563
tem of competitive bidding pursuant to this sub-
section unless such bidder submits such information
and assurances as the Commission may require to
demonstrate that such bidder’s application is accept-
able for filing. No license shall be granted to an ap-
plicant selected pursuant to this subsection unless
the Commission determines that the applicant is
qualified pursuant to subsection (a) and sections
308(b) and 310. Consistent with the objectives de-
scribed in paragraph (3), the Commission shall, by
rule, prescribe expedited procedures consistent with
the procedures authorized by subsection (i)(2) for
the resolution of any substantial and material issues
of fact concerning qualifications.
‘‘(6) RULES
OF
CONSTRUCTION.—Nothing in
this subsection, or in the use of competitive bidding,
shall—
‘‘(A) limit or otherwise affect the require-
ments of subsection (h) of this section, section
301, 304, 307, 310, or 706, or any other provi-
sion of this Act (other than subsections (d)(2)
and (e) of this section);
‘‘(B) be construed to convey any rights, in-
cluding any expectation of renewal of a license,
that differ from the rights that apply to other
564
licenses within the same service that were not
issued pursuant to this subsection; or
‘‘(C) be construed to prohibit the Commis-
sion from issuing nationwide licenses or per-
mits.
‘‘(7) LIMITATION OF EFFECT ON ALLOCATION
DECISIONS.—In making a decision pursuant to sec-
tion 303(c) to assign a band of frequencies to a use
for which licenses or permits will be issued pursuant
to this subsection, and in prescribing regulations
pursuant to paragraph (4)(A) and (4)(C) of this
subsection, the Commission may not base a finding
of public interest, convenience, and necessity solely
or predominantly on the expectation of Federal reve-
nues from the use of a system of competitive bidding
under this subsection.
‘‘(8) TREATMENT OF REVENUES.—All proceeds
from the use of a competitive bidding system under
this subsection shall be deposited in the Treasury in
accordance with chapter 33 of title 31, United
States Code. A license or permit issued by the Com-
mission under this section shall not be treated as the
property of the licensee for tax purposes by any
State or local government entity.
565
‘‘(9) TERMINATION; EVALUATION.—The author-
ity of the Commission to grant a license or permit
under this subsection shall expire September 30,
1998. Not later than September 30, 1997, the Com-
mission shall conduct a public inquiry and submit to
the Congress a report—
‘‘(A) describing the methodologies estab-
lished by the Commission pursuant to para-
graphs (3) and (4);
‘‘(B) comparing the relative advantages
and disadvantages of such methodologies in
terms of attaining the objectives described in
such paragraphs;
‘‘(C) evaluating the extent to which such
methodologies have secured prompt delivery of
service to rural areas; and
‘‘(D) containing a statement of the reve-
nues obtained, and a projection of the future
revenues, from the use of competitive bidding
systems under this subsection.’’.
SEC. 5204. CONFORMING AMENDMENTS.
Section 309 of the Communications Act of 1934 is
further amended—
(1) by striking subsection (i)(1) and inserting
the following:
566
‘‘(i) RANDOM SELECTION.—
‘‘(1) GENERAL AUTHORITY.—If—
‘‘(A) there is more than one application for
any initial license or construction permit which
will involve a use of the electromagnetic spec-
trum; and
‘‘(B) the Commission has determined that
the use is not described in subsection (j)(2)(A);
then the Commission shall have the authority to
grant such license or permit to a qualified applicant
through the use of a system of random selection.’’;
(2) in paragraph (2)—
(A) by indenting paragraph (2), including
subparagraphs (A) through (C), by an addi-
tional 2 em spaces; and
(B) by inserting ‘‘DETERMINATIONS
OF
QUALIFICATIONS.—’’ after ‘‘(2)’’;
(3) in paragraph (3)—
(A) by indenting subparagraphs (A) and
(B), and so much of subparagraph (C) as pre-
cedes clause (i), by an additional 2 em spaces;
(B) by indenting clauses (i) and (ii) of sub-
paragraph (C) by an additional 4 em spaces;
and
567
(C) by inserting ‘‘PREFERENCES; DIVER-
SITY.—’’ after ‘‘(3)’’;
(4) in paragraph (4)—
(A) by indenting subparagraphs (A) and
(B) of such paragraph by an additional 2 em
spaces;
(B) by inserting ‘‘RULEMAKING SCHEDULE
AND AUTHORITY.—’’ after ‘‘(4)’’; and
(C) by adding at the end the following new
subparagraph:
‘‘(C) Not later than 180 days after the date of
enactment of this subparagraph, the Commission
shall 
prescribe 
such 
transfer 
disclosures 
and
antitrafficking restrictions and payment schedules as
are necessary to prevent the unjust enrichment of
recipients of licenses or permits as a result of the
methods employed to issue licenses under this sub-
section.’’.
SEC. 5205. REGULATORY PARITY.
(a) AMENDMENT.—Section 332 of the Communica-
tions Act of 1934 (47 U.S.C. 332) is amended—
(1) by striking ‘‘PRIVATE LAND’’ from the head-
ing of the section; and
(2) by amending striking subsection (c) and in-
serting the following:
568
‘‘(c) REGULATORY TREATMENT OF MOBILE SERV-
ICES.—
‘‘(1) COMMON CARRIER TREATMENT OF COM-
MERCIAL MOBILE SERVICES.—(A) A person engaged
in the provision of commercial mobile services shall,
insofar as such person is so engaged, be treated as
a common carrier for purposes of this Act, except
for such provisions of title II as the Commission
may, consistent with the public interest, specify as
inapplicable by rule. In prescribing any such rule,
the Commission may not specify section 201, 202, or
208, or any other provision that the Commission de-
termines to be necessary in order to ensure that the
charges, practices, classifications, or regulations for
or in connection with commercial mobile services are
just and reasonable and are not unjustly or unrea-
sonably discriminatory or is otherwise in the public
interest.
‘‘(B) Upon reasonable request of any person
providing commercial mobile service, the Commission
shall order a common carrier to establish physical
connections with such service pursuant to the provi-
sions of section 201 of this Act. Except to the extent
that the Commission is required to respond to such
a request, this subparagraph shall not be construed
569
as a limitation or expansion of the Commission’s au-
thority to order interconnection pursuant to this
Act.
‘‘(2) NONCOMMON
CARRIER
TREATMENT
OF
PRIVATE
LAND
MOBILE
SERVICES.—A person en-
gaged in private land mobile service shall not, inso-
far as such person is so engaged, be treated as a
common carrier for any purpose under this Act. A
common carrier (other than a person that was treat-
ed as provider of private land mobile services prior
to the enactment of the Licensing Improvement Act
of 1993) shall not provide any dispatch service on
any frequency allocated for common carrier service,
except to the extent such dispatch service is provided
on stations licensed in the domestic public land mo-
bile radio service before January 1, 1982. The Com-
mission may by regulation terminate, in whole or in
part, the prohibition contained in the preceding sen-
tence if the Commission determines that such termi-
nation will serve the public interest.
‘‘(3) STATE
AUTHORITY
TO
REGULATE.—(A)
Notwithstanding sections 2(b) and 221(b), no State
or local government shall have any authority to im-
pose any rate or entry regulation upon any commer-
cial mobile service or any private land mobile service,
570
except that this paragraph shall not prohibit a State
from regulating the other terms and conditions of
commercial mobile services.
‘‘(B) Notwithstanding subparagraph (A), a
State may petition the Commission for authority to
regulate the rates for any commercial mobile service
and the Commission shall grant such petition if such
State demonstrates that (i) such service is a sub-
stitute for land line telephone exchange service for a
substantial portion of the public within such State,
or (ii) market conditions with respect to such serv-
ices fail to protect subscribers adequately from un-
just and unreasonable rates or rates that are un-
justly or unreasonably discriminatory. The Commis-
sion shall provide reasonable opportunity for public
comment in response to such petition, and shall,
within 9 months after the date of its submission,
grant or deny such petition. If the Commission
grants such petition, the Commission shall authorize
the State to exercise under State law such authority
over rates, for such periods of time, as the Commis-
sion deems necessary to ensure that such rates are
just and reasonable and not unjustly or unreason-
ably discriminatory.
571
‘‘(4) REGULATORY
TREATMENT
OF
COMMU-
NICATIONS
SATELLITE
CORPORATION.—Nothing in
this subsection shall be construed to alter or affect
the regulatory treatment required by title IV of the
Communications Satellite of 1962 of the corporation
authorized by title III of such Act.
‘‘(d) DEFINITIONS.—For purposes of this section—
‘‘(1) the term ‘commercial mobile service’
means all mobile services (as defined in section 3(n))
that—
‘‘(A) are provided for profit (i) to the pub-
lic, (ii) on an indiscriminate basis, or (iii) to
such broad classes of eligible users as to be ef-
fectively available to a substantial portion of the
public; and
‘‘(B) are interconnected (or have requested
interconnection pursuant to paragraph (1)(B))
with the public switched network (as such terms
are defined by regulation by the Commission);
and
‘‘(2) the term ‘private mobile service’ means
any mobile service (as defined in section 3(n)) that
is not a commercial mobile service.’’.
(b) CONFORMING AMENDMENTS.—
572
(1) AMENDMENTS TO DEFINITIONS.—Section 3
of the Communications Act of 1934 (47 U.S.C. 153)
is amended—
(A) in subsection (n)—
(i) by inserting ‘‘(1)’’ after ‘‘and in-
cludes’’; and
(ii) by inserting before the period at
the end the following: ‘‘, (2) a mobile serv-
ice which provides a regularly interacting
group of base, mobile, portable, and associ-
ated control and relay stations (whether li-
censed on an individual, cooperative, or
multiple basis) for private one-way or two-
way land mobile radio communications by
eligible users over designated areas of op-
eration, and (3) any service for which a li-
cense is required in a personal communica-
tions service established pursuant to the
proceeding entitled ‘Amendment of the
Commission’s Rules to Establish New Per-
sonal Communications Services’ (GEN
Docket No. 90–314; ET Docket No. 92–
100), or any successor proceeding’’; and
(B) by striking subsection (gg).
573
(2) CONFORMING
AMENDMENTS
TO
SECTION
332.—Section 332 of such Act is further amended—
(A) in subsection (a), by inserting after
‘‘(a)’’ the following: ‘‘MANAGEMENT
OF PRI-
VATE LAND MOBILE FREQUENCIES.—’’;
(B) in subsection (b)—
(i) by indenting the margin of para-
graphs (2) through (4) by 2 em spaces;
(ii) by striking ‘‘(b)(1)’’ and inserting
the following:
‘‘(b) USE OF ADVISORY COMMITTEE.—
‘‘(1) COORDINATION
OF
FREQUENCY
ASSIGN-
MENT.—’’;
(iii) by inserting ‘‘EXEMPTION.—’’
after ‘‘(2)’’;
(iv) by inserting ‘‘NONEMPLOYEE
STATUS.—’’ after ‘‘(3)’’; and
(v) by inserting ‘‘APPLICATION
OF
FEDERAL
ADVISORY
COMMITTEE
ACT.—’’
after ‘‘(4).
SEC. 5206. EFFECTIVE DATES; DEADLINES FOR COMMIS-
SION ACTION.
(a) EFFECTIVE DATES.—
574
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this chapter are
effective on the date of enactment of this Act.
(2) EFFECTIVE
DATE
OF
MOBILE
SERVICE
AMENDMENTS.—The amendments made by section
5205 shall be effective 1 year after such date of en-
actment, except that any person that provides pri-
vate land mobile services before such date of enact-
ment shall continue to be treated as a provider of
private land mobile service until 3 years after such
date of enactment.
(b) DEADLINES FOR COMMISSION ACTION.—
(1) 
GENERAL
RULEMAKING.—The 
Federal
Communications Commission shall prescribe rules to
implement section 309(j) of the Communications Act
of 1934 (as added by this chapter) within 210 days
after the date of enactment of this Act.
(2) PCS ORDERS AND LICENSING.—The Com-
mission shall—
(A) within 180 days after such date of en-
actment, issue a final report and order (i) in
the matter entitled ‘‘Redevelopment of Spec-
trum to Encourage Innovation in the Use of
New Telecommunications Technologies’’ (ET
Docket No. 92–9); and (ii) in the matter enti-
575
tled ‘‘Amendment of the Commission’s Rules to
Establish New Personal Communications Serv-
ices’’ (GEN Docket No. 90–314; ET Docket
No. 92–100); and
(B) within 270 days after such date of en-
actment, commence issuing licenses and permits
in the personal communications service.
(3) 
MOBILE
SERVICE
RULEMAKING
RE-
QUIRED.—Within 1 year after the date of enactment
of this Act, the Federal Communications Commis-
sion shall—
(A) issue such modifications or termi-
nations of its regulations concerning private
land mobile services as are necessary to imple-
ment the amendments made by section 5205;
(B) make such other modifications of such
regulations as may be necessary to equalize the
regulatory treatment of providers of all com-
mercial mobile services that offer services that
are substantially similar; and
(C) include in such modifications and ter-
minations such provisions as are necessary to
provide for an orderly transition to the regu-
latory treatment required by such amendments.
576
(c) SPECIAL RULE.—The Federal Communications
Commission shall not issue any license or permit pursuant
to section 309(i) of the Communications Act of 1934 after
the date of enactment of this Act unless the Commission
has made the determination required by paragraph (1)(B)
of such section (as added by this chapter).
CHAPTER 2—EMERGING
TELECOMMUNICATIONS TECHNOLOGIES
SEC. 5221. SHORT TITLE.
This chapter may be cited as the ‘‘Emerging Tele-
communications Technologies Act of 1993’’.
SEC. 5222. AMENDMENT TO THE NATIONAL TELECOMMUNI-
CATIONS AND INFORMATION ADMINISTRA-
TION ORGANIZATION ACT.
The National Telecommunications and Information
Administration Organization Act is amended—
(1) by striking the heading of part B and in-
serting the following:
‘‘PART D—SPECIAL AND TEMPORARY
PROVISIONS’’;
(2) by redesignating sections 131 through 135
as sections 151 through 155, respectively; and
(3) by inserting after part A the following new
part:
577
‘‘PART B—EMERGING TELECOMMUNICATIONS
TECHNOLOGIES
‘‘SEC. 111. FINDINGS.
‘‘The Congress finds that—
‘‘(1) the Federal Government currently reserves
for its own use, or has priority of access to, approxi-
mately 40 percent of the electromagnetic spectrum
that is assigned for use pursuant to the Communica-
tions Act of 1934;
‘‘(2) many of such frequencies are underutilized
by Federal Government licensees;
‘‘(3) the public interest requires that many of
such frequencies be utilized more efficiently by Fed-
eral Government and non-Federal licensees;
‘‘(4) additional frequencies are assigned for
services that could be obtained more efficiently from
commercial carriers or other vendors;
‘‘(5) scarcity of assignable frequencies for li-
censing by the Commission can and will—
‘‘(A) impede the development and commer-
cialization of new telecommunications products
and services;
‘‘(B) limit the capacity and efficiency of
the United States telecommunications systems;
578
‘‘(C) prevent some State and local police,
fire, and emergency services from obtaining
urgently needed radio channels; and
‘‘(D) adversely affect the productive capac-
ity and international competitiveness of the
United States economy;
‘‘(6) a reassignment of these frequencies can
produce significant economic returns; and
‘‘(7) the Secretary of Commerce, the President,
and the Federal Communications Commission should
be directed to take appropriate steps to correct these
deficiencies.
‘‘SEC. 112. NATIONAL SPECTRUM PLANNING.
‘‘(a) PLANNING ACTIVITIES.—The Assistant Sec-
retary and the Chairman of the Commission shall meet,
at least biannually, to conduct joint spectrum planning
with respect to the following issues—
‘‘(1) the future spectrum requirements for pub-
lic and private uses, including State and local gov-
ernment public safety agencies;
‘‘(2) the spectrum allocation actions necessary
to accommodate those uses; and
‘‘(3) actions necessary to promote the efficient
use of the spectrum, including spectrum manage-
ment techniques to promote increased shared use of
579
the spectrum that does not cause harmful inter-
ference as a means of increasing commercial access.
‘‘(b) REPORTS.—The Assistant Secretary and the
Chairman of the Commission shall submit a joint annual
report to the Committee on Energy and Commerce of the
House of Representatives, the Committee on Commerce,
Science, and Transportation of the Senate, the Secretary,
and the Commission on the joint spectrum planning activi-
ties conducted under subsection (a) and recommendations
for action developed pursuant to such activities.
‘‘(c) REPORTING REQUIREMENTS.—The first annual
report submitted after the date of the report by the advi-
sory committee under section 113(d)(4) shall—
‘‘(1) include an analysis of and response to that
committee report; and
‘‘(2) include an analysis of the effect on spec-
trum efficiency and the cost of equipment to Federal
spectrum users of maintaining separate allocations
for Federal Government and non-Federal Govern-
ment licensees for the same or similar services.
‘‘SEC. 
113. 
IDENTIFICATION 
OF 
REALLOCABLE 
FRE-
QUENCIES.
‘‘(a) IDENTIFICATION REQUIRED.—The Secretary
shall, within 24 months after the date of the enactment
580
of this part, prepare and submit to the President and the
Congress a report identifying bands of frequencies that—
‘‘(1) are allocated on a primary basis for Fed-
eral Government use and eligible for licensing pursu-
ant to section 305(a) of the Act (47 U.S.C. 305(a));
‘‘(2) are not required for the present or identifi-
able future needs of the Federal Government;
‘‘(3) can feasibly be made available, as of the
date of submission of the report or at any time dur-
ing the next 15 years, for use under the Act (other
than for Federal Government stations under such
section 305);
‘‘(4) will not result in costs to the Federal Gov-
ernment, or losses of services or benefits to the pub-
lic, that are excessive in relation to the benefits that
may be obtained by non-Federal licensees; and
‘‘(5) are most likely to have the greatest poten-
tial for productive uses and public benefits under the
Act.
‘‘(b) MINIMUM
AMOUNT
OF
SPECTRUM
REC-
OMMENDED.—
‘‘(1) IN
GENERAL.—Based on the report re-
quired by subsection (a), the Secretary shall rec-
ommend for reallocation, for use other than by Fed-
eral Government stations under section 305 of the
581
Act (47 U.S.C. 305), bands of frequencies that span
a total of not less than 200 megahertz, that are lo-
cated below 6 gigahertz, and that meet the criteria
specified in paragraphs (1) through (4) of subsection
(a). The Secretary may not include, in such 200
megahertz, bands of frequencies that span more
than 20 megahertz and that are located between 5
and 6 gigahertz. If the report identifies (as meeting
such criteria) bands of frequencies spanning more
than 200 megahertz, the report shall identify and
recommend for reallocation those bands (spanning
not less than 200 megahertz) that meet the criteria
specified in paragraph (5) of such subsection.
‘‘(2) MIXED USES PERMITTED TO BE COUNT-
ED.—Bands of frequencies which the Secretary’s re-
port recommends be partially retained for use by
Federal Government stations, but which are also
recommended to be reallocated to be made available
under the Act for use by non-Federal stations, may
be counted toward the minimum spectrum required
by paragraph (1) of this subsection, except that—
‘‘(A) the bands of frequencies counted
under this paragraph may not count toward
more than one-half of the minimum required by
paragraph (1) of this subsection;
582
‘‘(B) a band of frequencies may not be
counted under this paragraph unless the assign-
ments of the band to Federal Government sta-
tions under section 305 of the Act (47 U.S.C.
305) are limited by geographic area, by time, or
by other means so as to guarantee that the po-
tential use to be made by such Federal Govern-
ment stations is substantially less (as measured
by geographic area, time, or otherwise) than the
potential use to be made by non-Federal
stations; and
‘‘(C) the operational sharing permitted
under this paragraph shall be subject to coordi-
nation procedures which the Commission shall
establish and implement to ensure against
harmful interference.
‘‘(c) CRITERIA FOR IDENTIFICATION.—
‘‘(1) NEEDS OF THE FEDERAL GOVERNMENT.—
In determining whether a band of frequencies meets
the criteria specified in subsection (a)(2), the Sec-
retary shall—
‘‘(A) consider whether the band of fre-
quencies is used to provide a communications
service that is or could be available from a com-
mercial carrier or other vendor;
583
‘‘(B) seek to promote—
‘‘(i) the maximum practicable reliance
on commercially available substitutes;
‘‘(ii) the sharing of frequencies (as
permitted under subsection (b)(2));
‘‘(iii) the development and use of new
communications technologies; and
‘‘(iv) the use of nonradiating commu-
nications systems where practicable; and
‘‘(C) seek to avoid—
‘‘(i) serious degradation of Federal
Government services and operations; and
‘‘(ii) excessive costs to the Federal
Government and users of Federal Govern-
ment services.
‘‘(2) FEASIBILITY
OF
USE.—In determining
whether a frequency band meets the criteria speci-
fied in subsection (a)(3), the Secretary shall—
‘‘(A) assume such frequencies will be as-
signed by the Commission under section 303 of
the Act (47 U.S.C. 303) over the course of not
less than 15 years;
‘‘(B) assume reasonable rates of scientific
progress and growth of demand for tele-
communications services;
584
‘‘(C) determine the extent to which the
reallocation or reassignment will relieve actual
or potential scarcity of frequencies available for
licensing by the Commission for non-Federal
use;
‘‘(D) seek to include frequencies which can
be used to stimulate the development of new
technologies; and
‘‘(E) consider the immediate and recurring
costs to reestablish services displaced by the
reallocation of spectrum.
‘‘(3) ANALYSIS OF BENEFITS.—In determining
whether a band of frequencies meets the criteria
specified in subsection (a)(4), the Secretary shall
consider—
‘‘(A) the extent to which equipment is or
will be available that is capable of utilizing the
band;
‘‘(B) the proximity of frequencies that are
already assigned for commercial or other non-
Federal use; and
‘‘(C) the activities of foreign governments
in making frequencies available for experimen-
tation or commercial assignments in order to
585
support their domestic manufacturers of equip-
ment.
‘‘(4) POWER AGENCY FREQUENCIES.—
‘‘(A) ELIGIBLE FOR MIXED USE ONLY.—
The frequencies assigned to any Federal power
agency may only be eligible for mixed use under
subsection (b)(2) in geographically separate
areas and shall not be recommended for the
purposes of withdrawing that assignment. In
any case where a frequency is to be shared by
an affected Federal power agency and a non-
Federal user, such use by the non-Federal user
shall, consistent with the procedures established
under subsection (b)(2)(C), not cause harmful
interference to the affected Federal power agen-
cy or adversely affect the reliability of its power
system.
‘‘(B) DEFINITION.—As used in this para-
graph, the term ‘Federal power agency’ means
the Tennessee Valley Authority, the Bonneville
Power Administration, the Western Area Power
Administration,
or
the
Southwestern
Power
Administration.
‘‘(d) 
PROCEDURE
FOR
IDENTIFICATION
OF
REALLOCABLE BANDS OF FREQUENCIES.—
586
‘‘(1) SUBMISSION OF PRELIMINARY IDENTIFICA-
TION TO CONGRESS.—Within 12 months after the
date of the enactment of this part, the Secretary
shall prepare and submit to the Congress a report
which 
makes 
a 
preliminary 
identification 
of
reallocable bands of frequencies which meet the cri-
teria established by this section.
‘‘(2) CONVENING OF ADVISORY COMMITTEE.—
Not later than the date the Secretary submits the
report required by paragraph (1), the Secretary shall
convene an advisory committee to—
‘‘(A) review the bands of frequencies iden-
tified in such report;
‘‘(B) advise the Secretary with respect to
(i) the bands of frequencies which should be in-
cluded in the final report required by subsection
(a), and (ii) the effective dates which should be
established under subsection (e) with respect to
such frequencies;
‘‘(C) receive public comment on the Sec-
retary’s report and on the final report; and
‘‘(D) prepare and submit the report re-
quired by paragraph (4).
587
The advisory committee shall meet at least monthly
until each of the actions required by section 114(a)
have taken place.
‘‘(3) COMPOSITION
OF
COMMITTEE; CHAIR-
MAN.—The advisory committee shall include—
‘‘(A) the Chairman of the Commission and
the Assistant Secretary, and one other rep-
resentative of the Federal Government as des-
ignated by the Secretary; and
‘‘(B) representatives of—
‘‘(i) United States manufacturers of
spectrum-dependent 
telecommunications
equipment;
‘‘(ii) commercial carriers;
‘‘(iii) other users of the electro-
magnetic spectrum, including radio and
television broadcast licensees, State and
local public safety agencies, and the avia-
tion industry; and
‘‘(iv) other interested members of the
public who are knowledgeable about the
uses of the electromagnetic spectrum.
A majority of the members of the committee shall be
members described in subparagraph (B), and one of
588
such members shall be designated as chairman by
the Secretary.
‘‘(4) RECOMMENDATIONS ON SPECTRUM ALLO-
CATION
PROCEDURES.—The advisory committee
shall, not later than 36 months after the date of the
enactment of this part, submit to the Secretary, the
Commission, the Committee on Energy and Com-
merce of the House of Representatives, and the
Committee on Commerce, Science, and Transpor-
tation of the Senate, a report containing such rec-
ommendations as the advisory committee considers
appropriate for the reform of the process of allocat-
ing the electromagnetic spectrum between Federal
and non-Federal use, and any dissenting views
thereon.
‘‘(e) TIMETABLE FOR REALLOCATION AND LIMITA-
TION.—
‘‘(1) TIMETABLE
REQUIRED.—The Secretary
shall, as part of the report required by subsection
(a), include a timetable that recommends immediate
and delayed effective dates by which the President
shall withdraw or limit assignments on the fre-
quencies specified in the report.
‘‘(2) EXPEDITED REALLOCATION OF INITIAL 30
MHZ PERMITTED.—The Secretary may prepare and
589
submit to the President a report which specifically
identifies an initial 30 megahertz of spectrum that
meets the criteria described in subsection (a) and
that can be made available for reallocation imme-
diately upon issuance of the report required by this
section.
‘‘(3) DELAYED
EFFECTIVE
DATE.—The rec-
ommended delayed effective dates shall—
‘‘(A) 
permit 
the 
earliest 
possible
reallocation of the frequency bands, taking into
account the requirements of section 115(1);
‘‘(B) be based on the useful remaining life
of equipment that has been purchased or con-
tracted for to operate on identified frequencies;
‘‘(C) be based on the need to coordinate
frequency use with other nations; and
‘‘(D) take into account the relationship be-
tween the costs to the Federal Government of
changing to different frequencies and the bene-
fits that may be obtained from commercial and
other non-Federal uses of the reassigned fre-
quencies.
‘‘SEC. 114. WITHDRAWAL OF ASSIGNMENT TO FEDERAL
GOVERNMENT STATIONS.
‘‘(a) IN GENERAL.—The President shall—
590
‘‘(1) within 6 months after receipt of the Sec-
retary’s report under section 113(a), withdraw the
assignment to a Federal Government station of any
frequency which the report recommends for imme-
diate reallocation;
‘‘(2) within such 6-month period, limit the as-
signment to a Federal Government station of any
frequency which the report recommends be made im-
mediately available for mixed use under section
113(b)(2);
‘‘(3) by the delayed effective date recommended
by the Secretary under section 113(e) (except as
provided in subsection (b)(4) of this section), with-
draw or limit the assignment to a Federal Govern-
ment station of any frequency which the report rec-
ommends be reallocated or made available for mixed
use on such delayed effective date;
‘‘(4) assign or reassign other frequencies to
Federal Government stations as necessary to adjust
to such withdrawal or limitation of assignments; and
‘‘(5) transmit a notice and description to the
Commission and each House of Congress of the
actions taken under this subsection.
‘‘(b) EXCEPTIONS.—
591
‘‘(1) AUTHORITY
TO
SUBSTITUTE.—If the
President determines that a circumstance described
in paragraph (2) exists, the President—
‘‘(A) may substitute an alternative fre-
quency or band of frequencies for the frequency
or band that is subject to such determination
and withdraw (or limit) the assignment of that
alternative frequency or band in the manner re-
quired by subsection (a); and
‘‘(B) shall submit a statement of the rea-
sons for taking the action described in subpara-
graph (A) to the Committee on Energy and
Commerce of the House of Representatives and
the Committee on Commerce, Science, and
Transportation of the Senate.
‘‘(2) GROUNDS FOR SUBSTITUTION.—For pur-
poses of paragraph (1), the following circumstances
are described in this paragraph:
‘‘(A) the reassignment would seriously
jeopardize the national defense interests of the
United States;
‘‘(B) the frequency proposed for reassign-
ment is uniquely suited to meeting important
governmental needs;
592
‘‘(C) the reassignment would seriously
jeopardize public health or safety; or
‘‘(D) the reassignment will result in costs
to the Federal Government that are excessive in
relation to the benefits that may be obtained
from commercial or other non-Federal uses of
the reassigned frequency.
‘‘(3) 
CRITERIA
FOR
SUBSTITUTED
FRE-
QUENCIES.—For purposes of paragraph (1), a fre-
quency may not be substituted for a frequency iden-
tified by the report of the Secretary under section
113(a) unless the substituted frequency also meets
each of the criteria specified by section 113(a).
‘‘(4) DELAYS
IN
IMPLEMENTATION.—If the
President determines that any action cannot be com-
pleted by the delayed effective date recommended by
the Secretary pursuant to section 113(e), or that
such an action by such date would result in a fre-
quency being unused as a consequence of the Com-
mission’s plan under section 115, the President
may—
‘‘(A) withdraw or limit the assignment to
Federal Government stations on a later date
that is consistent with such plan, except that
the President shall notify each committee speci-
593
fied in paragraph (1)(B) and the Commission
of the reason that withdrawal or limitation at
a later date is required; or
‘‘(B) substitute alternative frequencies pur-
suant to the provisions of this subsection.
‘‘(c) LIMITATION ON DELEGATION.—Notwithstand-
ing any other provision of law, the authorities and duties
established by this section may not be delegated.
‘‘SEC. 115. DISTRIBUTION OF FREQUENCIES BY THE COM-
MISSION.
‘‘Not later than 1 year after the President notifies
the Commission pursuant to section 114(a)(5), the Com-
mission shall prepare, in consultation with the Assistant
Secretary when necessary, and submit to the President
and the Congress, a plan for the distribution under the
Act of the frequency bands reallocated pursuant to the
requirements of this part. Such plan shall—
‘‘(1) not propose the immediate distribution of
all such frequencies, but, taking into account the
timetable recommended by the Secretary pursuant to
section 113(e), shall propose—
‘‘(A) gradually to distribute the frequencies
remaining, after making the reservation re-
quired by subparagraph (B), over the course of
594
a period of not less than 10 years beginning on
the date of submission of such plan; and
‘‘(B) to reserve a significant portion of
such frequencies for distribution beginning after
the end of such 10-year period;
‘‘(2) contain appropriate provisions to ensure—
‘‘(A) the availability of frequencies for new
technologies and services in accordance with the
policies of section 7 of the Act (47 U.S.C. 157);
and
‘‘(B) the availability of frequencies to stim-
ulate the development of such technologies;
‘‘(3) address (A) the feasibility of reallocating
spectrum from current commercial and other non-
Federal uses to provide for more efficient use of the
spectrum, and (B) innovation and marketplace de-
velopments that may affect the relative efficiencies
of different spectrum allocations; and
‘‘(4) not prevent the Commission from allocat-
ing bands of frequencies for specific uses in future
rulemaking proceedings.
‘‘SEC. 116. AUTHORITY TO RECOVER REASSIGNED FRE-
QUENCIES.
‘‘(a) AUTHORITY OF PRESIDENT.—Subsequent to the
withdrawal of assignment to Federal Government stations
595
pursuant to section 114, the President may reclaim reas-
signed frequencies for reassignment to Federal Govern-
ment stations in accordance with this section.
‘‘(b) 
PROCEDURE
FOR
RECLAIMING
FRE-
QUENCIES.—
‘‘(1) UNALLOCATED FREQUENCIES.—If the fre-
quencies to be reclaimed have not been allocated or
assigned by the Commission pursuant to the Act,
the President shall follow the procedures for substi-
tution of frequencies established by section 114(b) of
this part.
‘‘(2) ALLOCATED
FREQUENCIES.—If the fre-
quencies to be reclaimed have been allocated or as-
signed by the Commission, the President shall follow
the procedures for substitution of frequencies estab-
lished by section 114(b) of this part, except that the
notification required by section 114(b)(1)(A) shall
include—
‘‘(A) a timetable to accommodate an or-
derly transition for licensees to obtain new fre-
quencies and equipment necessary for its utili-
zation; and
‘‘(B) an estimate of the cost of displacing
spectrum users licensed by the Commission.
596
‘‘(c) COSTS OF RECLAIMING FREQUENCIES; APPRO-
PRIATIONS AUTHORIZED.—The Federal Government shall
bear all costs of reclaiming frequencies pursuant to this
section, including the cost of equipment which is rendered
unusable, the cost of relocating operations to a different
frequency band, and any other costs that are directly at-
tributable to the reclaiming of the frequency pursuant to
this section. There are authorized to be appropriated such
sums as may be necessary to carry out the purposes of
this section.
‘‘(d) EFFECTIVE
DATE
OF
RECLAIMED
FRE-
QUENCIES.—The Commission shall not withdraw licenses
for any reclaimed frequencies until the end of the fiscal
year following the fiscal year in which the President’s noti-
fication is received.
‘‘(e) EFFECT ON OTHER LAW.—Nothing in this sec-
tion shall be construed to limit or otherwise affect the au-
thority of the President under sections 305 and 706 of
the Act (47 U.S.C. 305, 606).
‘‘SEC. 117. DEFINITIONS.
‘‘As used in this part:
‘‘(1) The term ‘allocation’ means an entry in
the National Table of Frequency Allocations of a
given frequency band for the purpose of its use by
one or more radiocommunication services.
610
(1) striking ‘‘and 1995,’’ each place it appears
and inserting ‘‘1995, 1996, 1997, 1998,’’;
(2) striking ‘‘place,’’ and inserting ‘‘place;’’;
and
(3) striking ‘‘port, not, however, to include ves-
sels in distress or not engaged in trade’’ and insert-
ing ‘‘port. However, neither duty shall be imposed
on vessels in distress or not engaged in trade’’.
(b) CONFORMING AMENDMENT.—The Act of March
8, 1910 (36 Stat. 234; 46 App. U.S.C. 132), is amended
by striking ‘‘and 1995,’’ and inserting ‘‘1995, 1996, 1997,
and 1998,’’.
(c) TECHNICAL CORRECTION.—
(1) CORRECTION.—Section 10402(a) of the
Omnibus Budget Reconciliation Act of 1990 (104
Stat. 1388–398) is amended by striking ‘‘in the sec-
ond paragraph’’.
(2) EFFECTIVE DATE.—The amendment made
by paragraph (1) shall be effective on and after No-
vember 5, 1990.
SEC. 8002. SENSE OF THE CONGRESS ON THE INLAND WA-
TERWAYS FUEL TAX.
(a) FINDINGS.—The Congress finds the following:
(1) The Administration has proposed to in-
crease the tax on inland barge fuels from $0.19 to