In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.

Example Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Protection of Lawful Commerce in 
Arms Act''.

SEC 2. AMENDMENT TO ORGANIC ACT.

    The Act entitled ``An Act to establish the Department of Commerce 
and Labor'', approved February 14, 1903 (15 U.S.C. 1501 et seq.), is 
amended by redesignating section 13 as section 14 and by inserting 
after section 12 the following:

``SEC. 13. RESTRICTION ON COMMERCE.

    ``(a) Secretary of Commerce List.--The Secretary of Commerce shall 
establish and maintain a list consisting of each person that notifies 
the Secretary under subsection (b) that it is a manufacturer or seller 
in interstate or foreign commerce of a firearm or ammunition product or 
is a trade association representing such manufacturers or sellers. The 
list shall contain the name of the person, the chief executive officer 
of the person, and the address and location of the headquarters of the 
person. The Secretary shall maintain and update the list and may 
publish the list in the Federal Register.
    ``(b) Notification.--Each person that--
            ``(1) is a manufacturer in interstate or foreign commerce 
        of a firearm or ammunition product, and is licensed to engage 
        in business as such manufacturer to the extent required under 
        chapter 44 of title 18, United States Code,
            ``(2) is a seller in interstate or foreign commerce of a 
        firearm or ammunition product, and is licensed to engage in 
        business as such seller to the extent required under chapter 44 
        of title 18, United States Code, or
            ``(3) is a trade association representing such 
        manufacturers or sellers,
 may notify the Secretary of its existence and provide to the Secretary 
the information described in subsection (a).
    ``(c) Freedom From Restriction.--Conduct that--
            ``(1)(A) is carried out by a manufacturer in interstate or 
        foreign commerce of a firearm or ammunition product, involves 
        such firearm or ammunition product, and is described in 
        paragraph (4) of subsection (d);
            ``(B) is carried out by a seller in interstate or foreign 
        commerce of a firearm or ammunition product, involves a firearm 
        or ammunition product, and is described in paragraph (6) of 
        subsection (d); or
            ``(C) is carried out by a trade association in the course 
        of organizing, advising, or representing its members who are 
        manufacturers in interstate or foreign commerce of a firearm or 
        ammunition product, or who are sellers in interstate or foreign 
        commerce of a firearm or ammunition product, with respect to 
        conduct of such manufacturers or sellers described in paragraph 
        (4) or (6) of subsection (d), as the case may be; and
            ``(2) is lawful under chapter 44 of title 18, United States 
        Code, or under applicable State law;
shall not be a basis for imposing a restriction on interstate or 
foreign commerce on a person on the list described in subsection (a) as 
a result of harm caused by the criminal or other unlawful misuse of 
such firearm or ammunition product by any other person.
    ``(d) Definitions.--In this section:
            ``(1) Ammunition product.--The term `ammunition product' 
        means `ammunition' as defined in section 921(a)(17) of title 
        18, United States Code, and includes a component part of such 
        ammunition product that has been shipped or transported in 
        interstate or foreign commerce.
            ``(2) Firearm product.--The term `firearm product' means 
        `firearm' as defined in subparagraph (A) or (B) section 
        921(a)(3) of title 18, United States Code, and includes any 
        `antique firearm' as defined in section 921(a)(16) of such 
        title, and includes a component part of such a firearm that has 
        been shipped or transported in interstate or foreign commerce.
            ``(3) Interstate or foreign commerce.--The term `interstate 
        or foreign commerce' has the  meaning given that term in 
section 921(a)(2) of title 18, United States Code.
            ``(4) Manufacturer.--The term `manufacturer in interstate 
        or foreign commerce of a firearm or ammunition product' means--
                    ``(A) a person who, in the course of a business in 
                interstate or foreign commerce to import, make, 
                produce, create, assemble, design, or formulate a 
                firearm or ammunition product, imports, makes, 
                produces, creates, assembles, designs, or formulates a 
                firearm or ammunition product, or engages another 
                person to import, make, produce, create, assemble, 
                design, or formulate a firearm or ammunition product;
                    ``(B) a seller in interstate or foreign commerce of 
                a firearm or ammunition product made by another person, 
                but only with respect to an aspect of the firearm or 
                ammunition product that the seller makes, produces, 
                creates, assembles, designs, or formulates; and
                    ``(C) any seller in interstate or foreign commerce 
                of a firearm or ammunition product on which, or on the 
                packaging of which, the seller is also represented as 
                the manufacturer of the firearm or ammunition product.
            ``(5) Restriction on interstate or foreign commerce.--The 
        term `restriction on interstate or foreign commerce'--
                    ``(A) means--
                            ``(i) civil damages or equitable relief, or
                            ``(ii) any other limitation or condition,
                awarded or ordered by a Federal, State, or local court, 
                that restricts the ability of a person listed under 
                subsection (a) to freely engage in interstate or 
                foreign commerce with respect to firearm or ammunition 
                products, or of a trade association listed under 
                subsection (a) to freely engage in lawful activities on 
                behalf of its membership; and
                    ``(B) does not include any damages, equitable 
                relief, or other limitation or condition arising from--
                            ``(i) breach of contract or warranty in 
                        connection with the purchase of a firearm or 
                        ammunition product; or
                            ``(ii) physical injuries or property damage 
                        resulting directly from the failure to function 
                        or improper functioning of a firearm or 
                        ammunition product, when used as intended, due 
                        to a defect in design or manufacture.
            ``(6) Seller.--The term `seller in interstate or foreign 
        commerce of a firearm or ammunition product' means a person 
        who--
                    ``(A) in the course of a business conducted in 
                interstate or foreign commerce for such purpose, sells, 
                distributes, rents, leases, prepares, blends, packages, 
                labels, or otherwise is involved in placing a firearm 
                or ammunition product in the stream of commerce; or
                    ``(B) in the course of a business conducted in 
                interstate or foreign commerce for such purpose, 
                installs, repairs, refurbishes, reconditions, or 
                maintains an aspect of a firearm or ammunition product.
            ``(7) State.--The term `State' includes the District of 
        Columbia, the Commonwealth of Puerto Rico, and any territory or 
        possession of the United States.
            ``(8) Trade association.--The term `trade association' 
        means any association or business organization (whether or not 
        incorporated under the laws of any State), 2 or more members of 
        which are manufacturers or sellers in interstate or foreign 
        commerce of a firearm or ammunition product.
    ``(e) Limitation on Use of List.--No officer, agency, or 
instrumentality of the United States may use the list established and 
maintained under this section for any purpose other than the 
enforcement of the provisions of this section, nor shall the list be 
used or allowed to be used in any way that would result in the creation 
of any registry of firearms, firearm owners, or firearm purchasers by 
the United States, or by any State or any political subdivision 
thereof.''.
Example Output: Protection of Lawful Commerce in Arms Act - Amends the Organic Act establishing the Department of Commerce to direct the Secretary of Commerce to establish and maintain a list of each person that notifies the Secretary that it is a manufacturer or seller that is: (1) licensed to engage in interstate or foreign commerce of a firearm (including antique firearm) or ammunition product; or (2) is a trade association representing such manufacturers or sellers. Declares that any lawful conduct carried out by a manufacturer or seller in interstate or foreign commerce of a firearm or ammunition product, or lawful conduct carried out by a trade association in the course of representing such manufacturers or sellers, shall not be the basis for imposing a restriction on such commerce (the award of civil damages, equitable relief, or any other specified limitation) as a result of harm caused by the criminal or other unlawful misuse of such firearm or ammunition product by any other person.

Example Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``National Student Dropout Prevention 
and Recovery Act of 2000''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Lowering the student dropout rate is one of the most 
        significant challenges facing educators today. Students must 
        stay in school in order to receive the education they need to 
        succeed in the new economy and contribute fully to American 
        society.
            (2) The ability of local educational agencies to lower the 
        student dropout rate has been inhibited by the lack of focus at 
        the Federal level and the limited availability of appropriate 
        dropout prevention-focused curriculum, instruction, 
        professional development, and administrative support services.
            (3) According to the National Dropout Prevention Network, 
        it is at the local and community level where school 
        improvements and change occur that will eventually have an 
        impact on the graduation rate of students. The focus of these 
        efforts should be concentrated on the most successful 
        strategies that research has identified as having an impact on 
        increasing the graduation rate. These strategies encompass--
                    (A) systemic renewal;
                    (B) community collaboration;
                    (C) professional development;
                    (D) family involvement;
                    (E) early childhood education;
                    (F) reading and writing programs;
                    (G) individualized instruction;
                    (H) instructional technologies;
                    (I) mentoring and tutoring;
                    (J) service learning;
                    (K) learning styles and multiple intelligences;
                    (L) violence prevention and conflict resolution;
                    (M) career education and workforce readiness;
                    (N) out-of-school experiences; and
                    (O) alternative public schooling.
            (4) The National Dropout Prevention Network has found that 
        the strategies described in paragraph (3) have been successful 
        in all school levels from K-12 in rural, suburban, or urban 
        centers. When schools or school districts develop a program 
        improvement plan that encompasses most or all of these 
        strategies, positive outcomes will result.
            (5) It is necessary to develop a number of model dropout 
        prevention programs to fully develop the effective strategies 
        listed above into comprehensive dropout prevention programs. 
        These model programs should be used as examples by schools 
        across the country that wish to implement similar programs. 
        Subsequently, a nationwide dropout prevention program, in order 
        to be effective, should be based on these model programs.
            (6) Dropout prevention and recovery programs which are 
        proven to be successful in lowering dropout rates need to be 
        disseminated to school and community leaders willing to adapt 
        and support these innovative programs in their schools and 
        community.

SEC. 3. SCHOOL DROPOUT PREVENTION GRANT PROGRAMS.

    Part C of title V of the Elementary and Secondary Education Act of 
1965 (20 U.S.C. 7261 et seq.) is amended to read as follows:

           ``PART C--SCHOOL DROPOUT PREVENTION GRANT PROGRAMS

       ``Subpart 1--Model School Dropout Prevention Grant Program

``SEC. 5311. AUTHORIZATION.

    ``(a) In General.--The Director of the Office of Dropout Prevention 
and Program Completion shall award grants to public elementary schools, 
middle schools, and secondary schools that have established and are 
carrying out school dropout prevention programs to provide those 
schools with additional resources to develop such programs further, 
develop methods to assist other schools to implement similar programs, 
and provide for research on the effects of such programs on the student 
populations of the schools involved.
    ``(b) Duration.--A grant under subsection (a) shall be awarded for 
a period of not more than 5 years. A school that desires to continue to 
receive funding for the purposes described in subsection (a) shall 
apply for a grant under the national school dropout prevention grant 
program under subpart 2.

``SEC. 5312. REQUIRED ACTIVITIES.

    ``A school that receives a grant under section 5311 shall use 
amounts under the grant to establish and carry out, or further develop, 
school dropout prevention programs, intervention programs, and recovery 
programs, including as many of the following activities as possible: 
systemic renewal, community and family participation, professional 
development, early childhood education, reading and writing programs, 
alternative public schooling, individualized instruction, use of 
instructional technologies, mentoring and tutoring, service learning, 
instruction that recognizes that students learn in different ways 
(commonly referred to as `learning styles instruction'), violence 
prevention and conflict resolution, career education and workforce 
readiness, out-of-school experiences, and a comprehensive plan for 
dropout prevention.

``SEC. 5313. APPLICATION; SELECTION OF SCHOOLS; FISCAL AGENT.

    ``(a) Application.--
            ``(1) In general.--Each school desiring a grant under 
        section 5311 shall submit an application, after review by the 
        local educational agency of the school, to the Director at such 
        time, in such manner, and accompanied by such information as 
        the Director may require.
            ``(2) Contents.--A school desiring a grant under section 
        5311 shall submit an application, through the local educational 
        agency of the school under paragraph (1), that contains a 
        description of the current dropout prevention program of the 
        school.
    ``(b) Selection of Schools.--
            ``(1) Limitation.--The Director may award grants to not 
        more than 20 schools under section 5311. Such schools shall 
        have demonstrated success in establishing and carrying out 
        activities described in section 5312.
            ``(2) Allocation.--Grants awarded under section 5311 shall 
        be allocated among schools that meet the following 
        requirements:
                    ``(A) 4 elementary schools that have established 
                and are carrying out early childhood education 
                programs.
                    ``(B) 4 secondary schools that have established and 
                are carrying out academic intervention programs and 
                mediation programs.
                    ``(C) 4 secondary schools that have established and 
                are carrying out intervention programs and recovery 
                programs.
                    ``(D) 4 schools (either elementary, middle, or 
                secondary) that are located in rural school districts 
                and that have demonstrated success in establishing and 
                carrying out 12 or more of the activities described in 
                section 5312.
                    ``(E) 4 schools (either elementary, middle, or 
                secondary) that are located in urban school districts 
                and that have demonstrated success in establishing and 
                carrying out all of the activities described in section 
                5312.
            ``(3) Priority.--In awarding grants under section 5311, the 
        Director shall give priority to schools that have demonstrated 
        success in establishing and carrying out the highest number of 
        activities described in section 5312.
    ``(c) Fiscal Agent.--The local educational agency of the school 
shall act as the fiscal agent for the school and shall accept and 
administer the grant awarded to the school under section 5311, except 
that all funds shall be expended at the school level.

     ``Subpart 2--National School Dropout Prevention Grant Program

``SEC. 5321. AUTHORIZATION.

    ``(a) In General.--Beginning in the third year of the Model School 
Dropout Prevention Grant Program under subpart 1, the Director of the 
Office of Dropout Prevention and Program Completion shall award grants 
to public elementary schools, middle schools, and secondary schools to 
enable the schools to implement, or further carry out, effective, 
sustainable, and coordinated school dropout prevention programs.
    ``(b) Duration.--A grant under subsection (a) shall be awarded for 
a period of not less than 2 years but not more than 5 years.

``SEC. 5322. REQUIRED ACTIVITIES.

    ``A school that receives a grant under section 5321 shall use 
amounts under the grant to establish and carry out, or further develop, 
school dropout prevention programs, intervention programs, and recovery 
programs, including as many of the following activities as possible: 
systemic renewal, community and family participation, professional 
development, early childhood education, reading and writing programs, 
alternative public schooling, individualized instruction, use of 
instructional technologies, mentoring and tutoring, service learning, 
instruction that recognizes that students learn in different ways 
(commonly referred to as `learning styles instruction'), violence 
prevention and conflict resolution, career education and workforce 
readiness, out-of-school experiences, and a comprehensive plan for 
dropout prevention.

``SEC. 5323. APPLICATION; SELECTION OF SCHOOLS; FISCAL AGENT.

    ``(a) Application.--Each school desiring a grant under section 5321 
shall submit an application, after review by the local educational 
agency of the school, to the Director at such time, in such manner, and 
accompanied by such information as the Director may require.
    ``(b) Selection of Schools.--The Director shall establish clear and 
specific selection criteria for awarding grants to schools under 
section 5321, including the number of grants to award and the type of 
schools to be awarded grants. Such criteria shall be based on school 
dropout rates and other relevant factors, such as the quality of the 
existing or proposed dropout prevention program, the number of students 
who are dropouts, the number of students who are eligible to receive 
free or reduced price lunches under the Richard B. Russell National 
School Lunch Act, the number of students who are below their grade 
level in basic skills, the number of students who are involved in 
family court or the juvenile justice system, and the number of students 
who are teen mothers.
    ``(c) Fiscal Agent.--The local educational agency of the school 
shall act as the fiscal agent for the school and shall accept and 
administer the grant awarded to the school under section 5321, except 
that all funds shall be expended at the school level.

  ``Subpart 3--Additional Requirements for Model and National Dropout 
                        Prevention Grant Program

``SEC. 5331. DISSEMINATION ACTIVITIES.

    ``Each school that receives a grant under section 5311 or 5321, or 
the local educational agency of the school, shall provide information 
and technical assistance, including presentations, document-sharing, 
and joint staff development, to other schools within their school 
district and to other schools in their State that are desiring to 
receive grants under section 5311 or 5321, as the case may be.

``SEC. 5332. SCHOOL DROPOUT RATE CALCULATION.

    ``For purposes of calculating a school dropout rate under subparts 
1 and 2, a school shall use--
            ``(1) the annual event school dropout rate for students 
        leaving a school in a single year determined in accordance with 
        the National Center for Education Statistics' Common Core of 
        Data, if available;
            ``(2) the standard method used by the State agency; or
            ``(3) in other cases, a standard method for calculating the 
        school dropout rate as determined by the Director.

``SEC. 5333. REPORTING AND ACCOUNTABILITY.

    ``(a) Reporting.--In order to receive funding under subpart 1 or 2 
for a fiscal year after the first fiscal year a school receives funding 
under subpart 1 or 2, as the case may be, the school shall provide, on 
an annual basis, to the Director a report regarding the status of the 
implementation of activities funded under subpart 1 or 2 and 
certification of progress from the eligible entity whose strategies the 
school is implementing.
    ``(b) Accountability.--On the basis of the reports submitted under 
subsection (a), the Director shall evaluate the effect of the 
activities assisted under subpart 1 or 2, as the case may be, on school 
dropout prevention compared to a control group, to the extent 
practicable.

    ``Subpart 4--National Clearinghouse on Effective School Dropout 
                               Prevention

``SEC. 5341. ESTABLISHMENT OF NATIONAL CLEARINGHOUSE.

    ``Not later than 6 months after the date of enactment of this part, 
the Director shall establish a national clearinghouse on effective 
school dropout prevention, intervention programs, and reentry programs. 
The clearinghouse shall be established through a competitive grant or 
contract awarded to an organization with a demonstrated capacity to 
provide technical assistance and disseminate information in the area of 
school dropout prevention, intervention programs, and reentry programs. 
The clearinghouse shall--
            ``(1) collect and disseminate to educators, parents, and 
        policymakers information on research, effective programs, best 
        practices, and available Federal resources with respect to 
        school dropout prevention, intervention programs, and reentry 
        programs, including dissemination by an electronically 
        accessible database, a worldwide Web site, and a national 
        journal;
            ``(2) provide technical assistance regarding securing 
        resources with respect to, and designing and implementing, 
        effective and comprehensive school dropout prevention, 
        intervention programs, and reentry programs; and
            ``(3) provide professional development opportunities 
        through workshops, seminars, and institutes for educators and 
        program providers responsible for planning, implementing, and 
        evaluating comprehensive school dropout prevention, 
        intervention programs, and recovery programs.

       ``Subpart 5--Definitions; Authorization of Appropriations

``SEC. 5351. DEFINITIONS.

    ``In this part:
            ``(1) Director.--The term `Director' means the Director of 
        the Office of Dropout Prevention and Program Completion 
        established under section 218 of the General Education 
        Provisions Act.
            ``(2) Intervention programs.--The term `intervention 
        programs' means programs or strategies that are designed to 
        improve academic or personal problems of students that 
        negatively affect the students' performance or ability to 
        remain in school and graduate from school with a diploma.
            ``(3) Prevention programs.--The term `prevention programs' 
        means programs that anticipate, forestall, or relate to 
        cognitive, social, or personal problems of students before such 
        problems impair a student's ability to perform in school.
            ``(4) Recovery programs.--The term `recovery programs' 
        means programs or strategies designed to offer another 
        schooling option to an individual who has dropped out of 
        school.
            ``(5) School dropout.--The term `school dropout' has the 
        meaning given the term in section 4(17) of the School-to-Work 
        Opportunities Act of 1994.

``SEC. 5352. AUTHORIZATION OF APPROPRIATIONS.

    ``(a) Subpart 1.--There are authorized to be appropriated to carry 
out subpart 1 such sums as may be necessary for fiscal year 2001 and 
for each of the 4 succeeding fiscal years.
    ``(b) Subpart 2.--There are authorized to be appropriated to carry 
out subpart 2 such sums as may be necessary for fiscal year 2003 and 
for each of the 4 succeeding fiscal years.
    ``(c) Subpart 4.--There are authorized to be appropriated to carry 
out subpart 4 such sums as may be necessary for fiscal year 2001 and 
for each of the 4 succeeding fiscal years.''.

SEC. 4. OFFICE OF DROPOUT PREVENTION AND PROGRAM COMPLETION.

    (a) Establishment.--Title II of the Department of Education 
Organization Act (20 U.S.C. 3411 et seq.) is amended by adding at the 
end the following:

         ``office of dropout prevention and program completion

    ``Sec. 218. (a) Establishment.--There shall be in the Department of 
Education an Office of Dropout Prevention and Program Completion 
(hereafter in this section referred to as the `Office'), to be 
administered by the Director of the Office of Dropout Prevention and 
Program Completion. The Director of the Office shall report directly to 
the Under Secretary of Education and shall perform such additional 
functions as the Under Secretary may prescribe.
    ``(b) Duties.--The Director of the Office of Dropout Prevention and 
Program Completion (hereafter in this section referred to as the 
`Director'), through the Office, shall--
            ``(1) help coordinate Federal, State, and local efforts to 
        lower school dropout rates and increase program completion by 
        elementary, middle, and secondary school students;
            ``(2) recommend Federal policies, objectives, and 
        priorities to lower school dropout rates and increase program 
        completion;
            ``(3) oversee the implementation of subparts 1 and 2 of 
        part C of title V of the Elementary and Secondary Education Act 
        of 1965;
            ``(4) annually prepare and submit to Congress and the 
        Secretary a national report describing efforts and recommended 
        actions regarding school dropout prevention and program 
        completion;
            ``(5) recommend action to the Secretary and the President, 
        as appropriate, regarding school dropout prevention and program 
        completion; and
            ``(6) consult with and assist State and local governments 
        regarding school dropout prevention and program completion.
    ``(c) Scope of Duties.--The scope of the Director's duties under 
subsection (b) shall include examination of all Federal and non-Federal 
efforts related to--
            ``(1) promoting program completion for children attending 
        elementary, middle, or secondary school;
            ``(2) programs to obtain a secondary school diploma or its 
        recognized equivalent (including general equivalency diploma 
        (GED) programs); and
            ``(3) reentry programs for individuals aged 12 to 24 who 
        are out of school.
    ``(d) Detailing.--In carrying out the Director's duties under this 
section, the Director may request the head of any Federal department or 
agency to detail personnel who are engaged in school dropout prevention 
activities to another Federal department or agency in order to 
implement the National School Dropout Prevention Strategy.''.
    (b) Conforming Amendment.--The table of contents of the Department 
of Education Organization Act (20 U.S.C. 3401 note) is amended by 
inserting after the item relating to section 217 the following new 
item:

``Sec. 218. Office of Dropout Prevention and Program Completion.''.
Example Output: Requires the Director of the Office of Dropout Prevention and Program Completion (established by this Act in the Department of Education) to carry out provisions for: (1) a model school dropout prevention grant program; (2) a national school dropout prevention grant program; and (3) a national clearinghouse on effective school dropout prevention, intervention programs, and reentry programs.
Authorizes appropriations for such part C programs.
Amends the Department of Education Organization Act to establish an Office of Dropout Prevention and Program Completion, to be administered by a Director who shall report directly to the Under Secretary of Education. Sets forth the Director's duties and their scope.

Example Input: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Home Health Agency 
Efficiency Act of 1998''.

SEC. 2. CHANGES TO INTERIM PAYMENT SYSTEM FOR HOME HEALTH SERVICES.

    (a) Per Visit Cost Limits.--
            (1) Basis for limits.--Section 1861(v)(1)(L)(i) of the 
        Social Security Act (42 U.S.C. 1395x(v)(1)(L)(i)), as amended 
        by section 4602(a) of the Balanced Budget Act of 1997, is 
        amended--
                    (A) by striking ``or'' at the end of subclause 
                (III); and
                    (B) by striking subclause (IV) and inserting the 
                following:
            ``(IV) October 1, 1997, and before October 1, 1998, 110 
        percent of such mean, or
            ``(V) October 1, 1998, 107 percent of such mean.''.
            (2) Elimination of two-year freeze.--Section 1861(v)(1)(L) 
        of such Act (42 U.S.C. 1395x(v)(1)(L)), as amended by section 
        4601 of the Balanced Budget Act of 1997, is amended--
                    (A) by striking clause (iv) and redesignating 
                clause (v) as clause (iv);
                    (B) by redesignating clauses (vi) and (vii) as 
                clauses (viii) and (ix) respectively; and
                    (C) in clause (ix), as so redesignated, by striking 
                ``clause (v)(I)'' and inserting ``clause (iv)(I)''.
    (b) Per Beneficiary Cost Limits.--Section 1861(v)(1)(L) of such Act 
(42 U.S.C. 1395x(v)(1)(L)), as amended by section 4602(c) of the 
Balanced Budget Act of 1997, is amended--
            (1) by amending clause (iv)(I) (as redesignated by 
        subsection (a)(2)(A)) to read as follows:
            ``(I) a per beneficiary annual limitation calculated under 
        clause (v); and'';
            (2) by inserting after clause (iv), as so redesignated, the 
        following new clause:
    ``(v) For purposes of clause (iv)(I), the per beneficiary annual 
limitation calculation under this clause is based--
            ``(I) 25 percent on the average of the reasonable costs 
        (including nonroutine medical supplies) for agencies in the 
        State in which an agency is located for cost reporting periods 
        beginning in fiscal year 1995, such costs updated by the home 
        health market basket index and adjusted for the wage-related 
        portion of such costs by an area wage index that the Secretary 
        determines reflects the relative hospital wage level in the 
        geographic area of the agency (determined without regard to 
        whether the hospitals in such area have been reclassified to a 
        new geographic area pursuant to section 1886(d)(8)(B), a 
        decision of the Medicare Geographic Classification Review 
        Board, or a decision of the Secretary under section 
        1886(d)(10)) compared to the State average hospital wage level; 
        and
            ``(II) 75 percent on the national average of such costs for 
        cost reporting periods beginning in fiscal year 1995, such 
        costs updated by the home health market basket and adjusted for 
        the wage-related portion of such costs by the wage index 
        described in clause (iii).''; and
            (3) by amending subclause (I) of clause (viii), as 
        redesignated by subsection (a)(2)(B), to read as follows:
            ``(I) For new providers and those providers without a cost 
        reporting period beginning in fiscal year 1995, the per 
        beneficiary limitation shall be equal to the per beneficiary 
        limitation determined under clause (v).''.
    (c) Per Beneficiary Efficiency Standard.--Section 1861(v)(1)(L) of 
such Act (42 U.S.C. 1395x (v)(1)(L), as amended by section 4602(c) of 
the Balanced Budget Act of 1997, is amended--
            (1) in clause (iv) (as redesignated by subsection 
        (a)(2)(A)), by striking ``Payment'' and inserting ``Except as 
        provided in clause (vi), payment''; and
            (2) by inserting after clause (v), as added by subsection 
        (b)(2), the following new clauses:
    ``(vi) Notwithstanding the limits imposed by clause (iv), in the 
case of a home health agency that for any cost reporting period 
beginning on or after October 1, 1997, for which the agency's 
reasonable costs (determined without regard to such limits) do not 
exceed the per beneficiary efficiency standard established under clause 
(vii), payment to such home health agency shall equal such reasonable 
costs or, if lower, the limits determined under clause (i).
    ``(vii) For services furnished by home health agencies for cost 
reporting periods beginning on or after October 1, 1997, the Secretary 
shall establish a per beneficiary efficiency standard equal to the 
product of--
            ``(I) the national average per beneficiary reasonable costs 
        (including nonroutine medical supplies) for all home health 
        agencies for cost reporting periods beginning in fiscal year 
        1995, such costs updated by the home health market basket and 
        adjusted for the wage-related portion of such costs by the wage 
        index described in clause (iii); and
            ``(II) the agency's unduplicated census count of patients 
        (entitled to benefits under this title) for the cost reporting 
        period to which the standard relates.''.
    (d) Elimination of Default Reduction of Interim Limits.--Section 
4603(e) of the Balanced Budget Act of 1997 is amended by striking 
``reduction'' and all that follows through ``1999'' and inserting 
``reduction of the cost limits and per beneficiary limits described in 
section 1861(v)(1)(L) of such Act (as those limits would otherwise be 
in effect on September 30, 1999) by such uniform percentage as is 
necessary to achieve the budgetary savings attributed by the 
Congressional Budget Office to this subsection (or to the 15 percent 
reduction under the prospective payment system) for such cost reporting 
periods in its final cost estimate of the conference agreement on this 
Act''.
    (e) Effective Date.--The amendments made by this section shall be 
effective as if included in the enactment of the Balanced Budget Act of 
1997.
Example Output:
Medicare Home Health Agency Efficiency Act of 1998 - Amends title XVIII (Medicare) of the Social Security Act, as amended by the Balanced Budget Act of 1997, with respect to the interim payment system for home health services.  Replaces the current reasonable cost limit under the system (105 percent of the median of per visit costs of freestanding home health agencies) with:  (1) 110 percent of the mean of such costs (during FY 1998); and (2) 107 percent of such mean (for cost reporting periods beginning on or after October 1, 1998). 
Repeals the two-year freeze on payment increases for such services. 
Revises the formula for the per beneficiary annual limitation. 
Requires the Secretary of Health and Human Services to establish, according to a specified formula, a per beneficiary efficiency standard for services furnished by home health agencies for cost reporting periods beginning on or after October 1, 1997. 
Repeals the default reduction of interim limits.