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

Input: Consider Input: SECTION 1. FINDINGS.

    Congress finds the following:
            (1) Twice since 1989, the northwestern coast of Maui, 
        Hawaii, has been plagued with massive blooms of the green alga, 
        Cladorphora sericea. Blooms of the red alga, Hypnea 
        musciformis, have also occurred in the area and in the Kihei 
        area.
            (2) The algal blooms have destroyed corals and other reef-
        building organisms, and have washed up on beaches and severely 
        impeded the recreational use of affected coastal areas.
            (3) The algal blooms are particularly detrimental to the 
        natural ecological balance of the near-shore reef environment.
            (4) Although the specific causes of the algal blooms are 
        uncertain, algal growth is stimulated in a proportional manner 
        by concentrations of chemicals such as fertilizers and 
        insecticides, which enter the ocean through freshwater runoff.
            (5) The Department of Health of the State of Hawaii has 
        indicated that the department does not have the resources at 
        this time to determine the cause of the algal blooms.
            (6) Extensive research will be required to determine the 
        factors that contribute to algal growth.
            (7) Potential sources of nutrients that may contribute to 
        algal growth include the near-shore disposal of sewage in 
        injection wells from the Lahaina Wastewater Treatment Plant, 
        surface runoff from agricultural lands and urban resort areas, 
        and subsurface point sources in the areas.
            (8) The long-term environmental impacts of the algal blooms 
        are unknown, but in the short term, reefs exposed to the algae 
        are being destroyed and the deterioration of the coral has 
        detrimental effects on fish and other wildlife that depend on 
        the reefs for survival.
            (9) The algal blooms are generating negative economic 
        impacts as well as negative biological impacts, as additional 
        reports indicate that the algae are decreasing the intake of 
        fish caught by local fishermen in the affected marine waters.
            (10) The Maui Algae Task Force is comprised of community 
        environmental activists and has been assembled to address the 
        problem of algal blooms.
            (11) The Maui Algae Task Force hopes to work in cooperation 
        with the Department of Health of the State of Hawaii and the 
        Environmental Protection Agency to identify and eradicate the 
        causes of the algal blooms.

SEC. 2. STUDY.

    (a) In General.--The Administrator of the Environmental Protection 
Agency (hereafter in this Act referred to as the ``Administrator'') 
shall conduct a study to--
            (1) determine the causes of recent algal blooms off the 
        northwestern coast of Maui, Hawaii; and
            (2) research alternatives for the improved management of 
        chemicals present in wastewater treatment and fresh water 
        runoff.
    (b) Study Requirements.--In carrying out the study under this 
section, the Administrator shall--
            (1) survey and monitor--
                    (A) seaweed populations and animals for which the 
                seaweed is a food source;
                    (B) surface water runoff sediments in the study 
                area; and
                    (C) inputs into the study area from subsurface 
                point sources, including any such inputs from the 
                Lahaina wastewater treatment plant; and
            (2) study the responses of--
                    (A) the seaweed populations referred to in 
                paragraph (1)(A) to different concentrations of 
                nutrients; and
                    (B) the animals referred to in paragraph (1)(A) to 
                pesticides and other biological toxins.
    (c) Equipment; Grants.--
            (1) Acquisition of equipment.--In carrying out the study 
        under this section, the Administrator is authorized to acquire 
        such monitoring and testing equipment as the Administrator 
        determines necessary.
            (2) Grants.--In carrying out the study under this section, 
        the Administrator is authorized to establish a grant program to 
        provide grants to eligible entities that submit approved 
        applications to the Administrator. The following entities may 
        submit an application to conduct study activities under this 
        section:
                    (A) The Department of Health of the State of 
                Hawaii.
                    (B) The Maui Algae Task Force.
                    (C) Appropriate Federal, State, or county 
                departments or agencies.
                    (D) Any other entity that the Administrator 
                determines to be appropriate.
    (d) Demonstration Projects.--In carrying out the study under this 
section, the Administrator is authorized to establish demonstration 
projects to identify and implement best management practices for the 
control of nonpoint source pollution from erosion and agricultural 
runoff.
    (e) Reports.--
            (1) Interim report.--Not later than 1 year after the date 
        of enactment of this Act, the Administrator shall submit to 
        Congress a report that includes interim results of the study 
        conducted under this section, and such recommendations as the 
        Administrator determines to be appropriate.
            (2) Final report.--Not later than January 31, 1996, the 
        Administrator shall submit to Congress a final report that 
        summarizes the results of the study conducted under this 
        section and includes such recommendations as the Administrator 
        determines to be appropriate.
    (f) Authorization of Appropriations.--There are authorized to be 
appropriated to the Environmental Protection Agency to carry out this 
section $500,000 for each of fiscal years 1994 and 1995.

Output: Directs the Administrator of the Environmental Protection Agency to study and report to the Congress on the causes of recent algal blooms off the northwestern coast of Maui, Hawaii, and to research alternatives for the improved management of chemicals present in wastewater treatment and fresh water runoff. 
Authorizes the Administrator to establish:  (1) a grant program to enable eligible entities to conduct study activities; and (2) demonstration projects to implement best management practices for the control of nonpoint source pollution from erosion and agricultural runoff. 
Authorizes appropriations.


Input: Consider Input: SECTION 1. PARTICIPATION OF TAIWAN IN THE WORLD HEALTH ORGANIZATION.

    (a) Findings.--Congress makes the following findings:
            (1) The World Health Organization (WHO) is a specialized 
        agency of the United Nations, charged with coordinating health 
        efforts within the United Nations system. The World Health 
        Assembly (WHA) is the decision-making body of the WHO, which 
        convenes annually in May to set the policies and priorities of 
        the organization. Statehood is not a requirement for attendance 
        at the WHA, and numerous observers, including non-members and 
        non-governmental organizations, attended the most recent WHA in 
        May 2017.
            (2) Taiwan began seeking to participate in the WHO as an 
        observer in 1997. In 2009, with strong support from successive 
        United States Administrations, Congress, and like-minded WHO 
        Member States, and during a period of improved Cross-Strait 
        relations, Taiwan received an invitation to attend the WHA as 
        an observer under the name ``Chinese Taipei''. Taiwan received 
        the same invitation each year until 2016, when following the 
        election of President Tsai-Ing Wen of the Democratic 
        Progressive Party, Taiwan's engagement in the international 
        community began facing increased resistance from the People's 
        Republic of China (PRC). Taiwan's invitation to the 2016 WHA 
        was received late and included new language conditioning 
        Taiwan's participation on the PRC's ``one China principle''. In 
        2017, Taiwan did not receive an invitation to the WHA.
            (3) Taiwan remains a model contributor to world health, 
        having provided financial and technical assistance to respond 
        to numerous global health challenges. Taiwan has invested over 
        $6 billion in international medical and humanitarian aid 
        efforts impacting over 80 countries since 1996. In 2014, Taiwan 
        responded to the Ebola crisis by donating $1 million and 
        providing 100,000 sets of personal protective equipment. 
        Through the Global Cooperation and Training Framework, the 
        United States and Taiwan have jointly conducted training 
        programs for experts to combat MERS, Dengue Fever, and Zika. 
        These diseases know no borders, and Taiwan's needless exclusion 
        from global health cooperation increases the dangers presented 
        by global pandemics.
            (4) Taiwan's international engagement has faced increased 
        resistance from the PRC. Taiwan was not invited to the 2016 
        Assembly of the International Civil Aviation Organization 
        (ICAO), despite participating as a guest at the organization's 
        prior summit in 2013. Taiwan's request to participate in the 
        2016 General Assembly of the International Criminal Police 
        Organization (INTERPOL) was also rejected. In May 2017, PRC 
        delegates disrupted a meeting of the Kimberley Process on 
        conflict diamonds held in Perth, Australia, until delegates 
        from Taiwan were asked to leave. In June 2017, the Republic of 
        Panama granted diplomatic recognition to the PRC, terminating a 
        longstanding diplomatic relationship with Taiwan.
            (5) Congress has established a policy of support for 
        Taiwan's participation in international bodies that address 
        shared transnational challenges, particularly in the WHO. 
        Congress passed H.R. 1794 in the 106th Congress, H.R. 428 in 
        the 107th Congress, and S. 2092 in the 108th Congress to direct 
        the Secretary of State to establish a strategy for, and to 
        report annually to Congress on, efforts to obtain observer 
        status for Taiwan at the WHA. Congress also passed H.R. 1151 in 
        the 113th Congress, directing the Secretary to report on a 
        strategy to gain observer status for Taiwan at the ICAO 
        Assembly, and H.R. 1853 in the 114th Congress, directing the 
        Secretary to report on a strategy to gain observer status for 
        Taiwan at the INTERPOL Assembly. However, in 2016 Taiwan did 
        not receive invitations to attend any of these events as an 
        observer.
    (b) Augmentation of Report Concerning the Participation of Taiwan 
in the World Health Organization.--
            (1) In general.--Subsection (c) of section 1 of Public Law 
        108-235 (118 Stat. 656) is amended by adding at the end the 
        following new paragraph:
            ``(3) An account of the changes and improvements the 
        Secretary of State has made to the United States plan to 
        endorse and obtain observer status for Taiwan at the World 
        Health Assembly, following any annual meetings of the World 
        Health Assembly at which Taiwan did not obtain observer 
        status.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall take effect and apply beginning with the first report 
        required under subsection


              

         (c) of section 1 of Public Law 108-235 that is submitted after 
        the date of the enactment of this Act.

            Passed the House of Representatives January 9, 2018.

            Attest:

                                                 KAREN L. HAAS,

                                                                 Clerk.

Output:  (Sec. 1) This bill requires the annual reports submitted by the Department of State to Congress concerning the U.S. plan to endorse and obtain observer status for Taiwan at the annual summit of the World Health Assembly (WHA) held by the World Health Organization in Geneva, Switzerland, to include an account of the changes and improvements that the State Department has made to such plan following any annual meetings of the WHA at which Taiwan did not obtain such status. 


Input: Consider Input: SECTION 1. SHORT TITLE; FINDINGS.

    (a) Short Title.--This Act may be cited as the ``Osteoporosis Early 
Detection and Prevention Act of 2004''.
    (b) Findings.--Congress makes the following findings:
            (1) Nature of osteoporosis.--
                    (A) Osteoporosis is a disease characterized by low 
                bone mass and structural deterioration of bone tissue 
                leading to bone fragility and increased susceptibility 
                to fractures of the hip, spine, and wrist.
                    (B) Osteoporosis has no symptoms and typically 
                remains undiagnosed until a fracture occurs.
                    (C) Once a fracture occurs, the condition has 
                usually advanced to the stage where the likelihood is 
                high that another fracture will occur.
                    (D) There is no cure for osteoporosis, but drug 
                therapy has been shown to reduce new hip and spine 
                fractures by 50 percent and other treatments, such as 
                nutrition therapy, have also proven effective.
            (2) Incidence of osteoporosis.--Osteoporosis is a common 
        condition:
                    (A) Of the 44 million Americans who have (or are at 
                risk for) osteoporosis, 80 percent are women.
                    (B) Annually there are 1.5 million bone fractures 
                attributable to osteoporosis.
                    (C) Half of all women, and one-fourth of all men, 
                age 50 or older will have a bone fracture due to 
                osteoporosis.
            (3) Impact of osteoporosis.--The cost of treating 
        osteoporosis is significant:
                    (A) The annual cost of osteoporosis in the United 
                States was $17 billion in 2001.
                    (B) The average cost in the United States of 
                repairing a hip fracture due to osteoporosis is 
                $37,000, while the average cost of an osteoporosis 
                screening test ranges from $59 to $300.
                    (C) Fractures due to osteoporosis frequently result 
                in disability and institutionalization of individuals.
                    (D) Because osteoporosis is a progressive condition 
                causing fractures primarily in aging individuals, 
                preventing fractures particularly in post menopausal 
                women before they become eligible for medicare, has a 
                significant potential of reducing osteoporosis-related 
                costs under the medicare program.
            (4) Use of bone mass measurement.--
                    (A) Bone mass measurement is a non-invasive, 
                painless, and reliable way to diagnose osteoporosis 
                before costly fractures occur.
                    (B) Low bone mass is as predictive of future 
                fractures as is high cholesterol or high blood pressure 
                of heart disease or stroke.
                    (C) Bone mass measurement is the only reliable 
                method of detecting osteoporosis at an early stage.
                    (D) Under section 4106 of the Balanced Budget Act 
                of 1997, medicare provides coverage, effective July 1, 
                1998, for bone mass measurement for qualified 
                individuals who are at risk of developing osteoporosis.

SEC. 2. REQUIRING COVERAGE OF BONE MASS MEASUREMENT UNDER HEALTH PLANS.

    (a) Group Health Plans.--
            (1) Public health service act amendments.--(A) Subpart 2 of 
        part A of title XXVII of the Public Health Service Act is 
        amended by adding at the end the following new section:

``SEC. 2707. STANDARDS RELATING TO BENEFITS FOR BONE MASS MEASUREMENT.

    ``(a) Requirements for Coverage of Bone Mass Measurement.--A group 
health plan, and a health insurance issuer offering group health 
insurance coverage, shall include (consistent with this section) 
coverage for bone mass measurement for beneficiaries and participants 
who are qualified individuals.
    ``(b) Definitions Relating to Coverage.--In this section:
            ``(1) Bone mass measurement.--The term `bone mass 
        measurement' means a radiologic or radioisotopic procedure or 
        other procedure approved by the Food and Drug Administration 
        performed on an individual for the purpose of identifying bone 
        mass or detecting bone loss or determining bone quality, and 
        includes a physician's interpretation of the results of the 
        procedure. Nothing in this paragraph shall be construed as 
        requiring a bone mass measurement to be conducted in a 
        particular type of facility or to prevent such a measurement 
        from being conducted through the use of mobile facilities that 
        are otherwise qualified.
            ``(2) Qualified individual.--The term `qualified 
        individual' means an individual who--
                    ``(A) is at clinical risk for osteoporosis, 
                including an estrogen-deficient woman;
                    ``(B) has vertebral abnormalities;
                    ``(C) is receiving chemotherapy or long-term 
                gluococorticoid (steroid) therapy;
                    ``(D) has primary hyperparathyroidism, 
                hyperthyroidism, or excess thyroid replacement; or
                    ``(E) is being monitored to assess the response to 
                or efficacy of approved osteoporosis drug therapy.
    ``(c) Limitation on Frequency Required.--Taking into account the 
standards established under section 1861(rr)(3) of the Social Security 
Act, the Secretary shall establish standards regarding the frequency 
with which a qualified individual shall be eligible to be provided 
benefits for bone mass measurement under this section. The Secretary 
may vary such standards based on the clinical and risk-related 
characteristics of qualified individuals.
    ``(d) Restrictions on Cost-Sharing.--
            ``(1) In general.--Subject to paragraph (2), nothing in 
        this section shall be construed as preventing a group health 
        plan or issuer from imposing deductibles, coinsurance, or other 
        cost-sharing in relation to bone mass measurement under the 
        plan (or health insurance coverage offered in connection with a 
        plan).
            ``(2) Limitation.--Deductibles, coinsurance, and other 
        cost-sharing or other limitations for bone mass measurement may 
        not be imposed under paragraph (1) to the extent they exceed 
        the deductibles, coinsurance, and limitations that are applied 
        to similar services under the group health plan or health 
        insurance coverage.
    ``(e) Prohibitions.--A group health plan, and a health insurance 
issuer offering group health insurance coverage in connection with a 
group health plan, may not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan, solely for the purpose of avoiding the requirements 
        of this section;
            ``(2) provide incentives (monetary or otherwise) to 
        individuals to encourage such individuals not to be provided 
        bone mass measurements to which they are entitled under this 
        section or to providers to induce such providers not to provide 
        such measurements to qualified individuals;
            ``(3) prohibit a provider from discussing with a patient 
        osteoporosis preventive techniques or medical treatment options 
        relating to this section; or
            ``(4) penalize or otherwise reduce or limit the 
        reimbursement of a provider because such provider provided bone 
        mass measurements to a qualified individual in accordance with 
        this section.
    ``(f) Rule of Construction.--Nothing in this section shall be 
construed to require an individual who is a participant or beneficiary 
to undergo bone mass measurement.
    ``(g) Notice.--A group health plan under this part shall comply 
with the notice requirement under section 714(g) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
of this section as if such section applied to such plan.
    ``(h) Level and Type of Reimbursements.--Nothing in this section 
shall be construed to prevent a group health plan or a health insurance 
issuer offering group health insurance coverage from negotiating the 
level and type of reimbursement with a provider for care provided in 
accordance with this section.
    ``(i) Preemption.--
            ``(1) In general.--The provisions of this section do not 
        preempt State law relating to health insurance coverage to the 
        extent such State law provides greater benefits with respect to 
        osteoporosis detection or prevention.
            ``(2) Construction.--Section 2723(a)(1) shall not be 
        construed as superseding a State law described in paragraph 
        (1).''.
            (B) Section 2723(c) of such Act (42 U.S.C. 300gg-23(c)) is 
        amended by striking ``section 2704'' and inserting ``sections 
        2704 and 2707''.
            (2) ERISA amendments.--(A) Subpart B of part 7 of subtitle 
        B of title I of the Employee Retirement Income Security Act of 
        1974 is amended by adding at the end the following new section:

``SEC. 714. STANDARDS RELATING TO BENEFITS FOR BONE MASS MEASUREMENT.

    ``(a) Requirements for Coverage of Bone Mass Measurement.--A group 
health plan, and a health insurance issuer offering group health 
insurance coverage, shall include (consistent with this section) 
coverage for bone mass measurement for beneficiaries and participants 
who are qualified individuals.
    ``(b) Definitions Relating to Coverage.--In this section:
            ``(1) Bone mass measurement.--The term `bone mass 
        measurement' means a radiologic or radioisotopic procedure or 
        other procedure approved by the Food and Drug Administration 
        performed on an individual for the purpose of identifying bone 
        mass or detecting bone loss or determining bone quality, and 
        includes a physician's interpretation of the results of the 
        procedure. Nothing in this paragraph shall be construed as 
        requiring a bone mass measurement to be conducted in a 
        particular type of facility or to prevent such a measurement 
        from being conducted through the use of mobile facilities that 
        are otherwise qualified.
            ``(2) Qualified individual.--The term `qualified 
        individual' means an individual who--
                    ``(A) is at clinical risk for osteoporosis, 
                including an estrogen-deficient woman;
                    ``(B) has vertebral abnormalities;
                    ``(C) is receiving chemotherapy or long-term 
                gluococorticoid (steroid) therapy;
                    ``(D) has primary hyperparathyroidism, 
                hyperthyroidism, or excess thyroid replacement; or
                    ``(E) is being monitored to assess the response to 
                or efficacy of approved osteoporosis drug therapy.
    ``(c) Limitation on Frequency Required.--The standards established 
under section 2707(c) of the Public Health Service Act shall apply to 
benefits provided under this section in the same manner as they apply 
to benefits provided under section 2707 of such Act.
    ``(d) Restrictions on Cost-Sharing.--
            ``(1) In general.--Subject to paragraph (2), nothing in 
        this section shall be construed as preventing a group health 
        plan or issuer from imposing deductibles, coinsurance, or other 
        cost-sharing in relation to bone mass measurement under the 
        plan (or health insurance coverage offered in connection with a 
        plan).
            ``(2) Limitation.--Deductibles, coinsurance, and other 
        cost-sharing or other limitations for bone mass measurement may 
        not be imposed under paragraph (1) to the extent they exceed 
        the deductibles, coinsurance, and limitations that are applied 
        to similar services under the group health plan or health 
        insurance coverage.
    ``(e) Prohibitions.--A group health plan, and a health insurance 
issuer offering group health insurance coverage in connection with a 
group health plan, may not--
            ``(1) deny to an individual eligibility, or continued 
        eligibility, to enroll or to renew coverage under the terms of 
        the plan, solely for the purpose of avoiding the requirements 
        of this section;
            ``(2) provide incentives (monetary or otherwise) to 
        individuals to encourage such individuals not to be provided 
        bone mass measurements to which they are entitled under this 
        section or to providers to induce such providers not to provide 
        such measurements to qualified individuals;
            ``(3) prohibit a provider from discussing with a patient 
        osteoporosis preventive techniques or medical treatment options 
        relating to this section; or
            ``(4) penalize or otherwise reduce or limit the 
        reimbursement of a provider because such provider provided bone 
        mass measurements to a qualified individual in accordance with 
        this section.
    ``(f) Rule of Construction.--Nothing in this section shall be 
construed to require an individual who is a participant or beneficiary 
to undergo bone mass measurement.
    ``(g) Notice Under Group Health Plan.--The imposition of the 
requirements of this section shall be treated as a material 
modification in the terms of the plan described in section 102(a)(1), 
for purposes of assuring notice of such requirements under the plan; 
except that the summary description required to be provided under the 
last sentence of section 104(b)(1) with respect to such modification 
shall be provided by not later than 60 days after the first day of the 
first plan year in which such requirements apply.
    ``(h) Preemption.--
            ``(1) In general.--The provisions of this section do not 
        preempt State law relating to health insurance coverage to the 
        extent such State law provides greater benefits with respect to 
        osteoporosis detection or prevention.
            ``(2) Construction.--Section 731(a)(1) shall not be 
        construed as superseding a State law described in paragraph 
        (1).''.
            (B) Section 731(c) of such Act (29 U.S.C. 1191(c)) is 
        amended by striking ``section 711'' and inserting ``sections 
        711 and 714''.
            (C) Section 732(a) of such Act (29 U.S.C. 1191a(a)) is 
        amended by striking ``section 711'' and inserting ``sections 
        711 and 714''.
            (D) The table of contents in section 1 of such Act is 
        amended by inserting after the item relating to section 712 the 
        following new item:

``714. Standards relating to benefits for bone mass measurement.''.
    (b) Individual Health Insurance.--(1) Part B of title XXVII of the 
Public Health Service Act is amended by inserting after section 2752 
the following new section:

``SEC. 2753. STANDARDS RELATING TO BENEFITS FOR BONE MASS MEASUREMENT.

    ``(a) In General.--The provisions of section 2707 (other than 
subsection (g)) shall apply to health insurance coverage offered by a 
health insurance issuer in the individual market in the same manner as 
it applies to health insurance coverage offered by a health insurance 
issuer in connection with a group health plan in the small or large 
group market.
    ``(b) Notice.--A health insurance issuer under this part shall 
comply with the notice requirement under section 714(g) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
referred to in subsection (a) as if such section applied to such issuer 
and such issuer were a group health plan.
    ``(c) Preemption.--
            ``(1) In general.--The provisions of this section do not 
        preempt State law relating to health insurance coverage to the 
        extent such State law provides greater benefits with respect to 
        osteoporosis detection or prevention.
            ``(2) Construction.--Section 2762(a) shall not be construed 
        as superseding a State law described in paragraph (1).''.
    (2) Section 2762(b)(2) of such Act (42 U.S.C. 300gg-62(b)(2)) is 
amended by striking ``section 2751'' and inserting ``sections 2751 and 
2753''.
    (c) Effective Dates.--(1) The amendments made by subsection (a) 
shall apply with respect to group health plans for plan years beginning 
on or after January 1, 2005.
    (2) The amendments made by subsection (b) shall apply with respect 
to health insurance coverage offered, sold, issued, renewed, in effect, 
or operated in the individual market on or after such date.


Output: Osteoporosis Early Detection and Prevention Act of 2004 - Amends the Public Health Service Act and the Employee Retirement Income Security Act of 1974 to require a group health plan, and an insurer offering group coverage, to include coverage for bone mass measurement for individuals who: (1) are at a clinical risk for osteoporosis, including estrogen-deficient women; (2) have vertebral abnormalities; (3) are receiving chemotherapy or long-term gluococorticoid (steroid) therapy; (4) have primary hyperparathyroidism, hyperthyroidism, or excess thyroid replacement; or (5) are being monitored to assess the response to or efficacy of approved osteoporosis drug therapy. Allows the Secretary of Health and Human Services to regulate the frequency with which individuals will be provided this benefit. Permits cost sharing, including deductibles and coinsurance. Prohibits specified actions discouraging the use of this benefit, including: (1) denying coverage; (2) offering incentives to not obtain or provide bone mass measurements; (3) restricting provider-patient communications; and (4) penalizing or limiting reimbursements to providers. Allows State laws providing greater detection or prevention benefits. Amends the Public Health Service Act to apply these requirements to coverage offered in the individual market.