In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
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Question: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Research on Human Fetal Tissue 
Amendments of 1993''.

SEC. 2. ESTABLISHMENT OF AUTHORITIES AND PROTECTIONS REGARDING 
              TRANSPLANTATION OF HUMAN FETAL TISSUE.

    Part G of title IV of the Public Health Service Act (42 U.S.C. 289 
et seq.) is amended by inserting after section 498 the following new 
section:

             ``research on transplantation of fetal tissue

    ``Sec. 498A. (a) Establishment of Program.--
            ``(1) In general.--The Secretary may conduct or support 
        research on the transplantation of human fetal tissue for 
        therapeutic purposes.
            ``(2) Source of tissue.--Human fetal tissue may be used in 
        research carried out under paragraph (1) regardless of whether 
        the tissue is obtained pursuant to a spontaneous or induced 
        abortion or pursuant to a stillbirth.
    ``(b) Informed Consent of Donor.--
            ``(1) In general.--In research carried out under subsection 
        (a), human fetal tissue may be used only if the woman providing 
        the tissue makes a statement, made in writing and signed by the 
        woman, declaring that--
                    ``(A) the woman donates the fetal tissue for use in 
                research described in subsection (a);
                    ``(B) the donation is made without any restriction 
                regarding the identity of individuals who may be the 
                recipients of transplantations of the tissue; and
                    ``(C) the woman has not been informed of the 
                identity of any such individuals.
            ``(2) Additional statement.--In research carried out under 
        subsection (a), human fetal tissue may be used only if the 
        attending physician with respect to obtaining the tissue from 
        the woman involved makes a statement, made in writing and 
        signed by the physician, declaring that--
                    ``(A) in the case of tissue obtained pursuant to an 
                induced abortion--
                            ``(i) the consent of the woman for the 
                        abortion was obtained prior to requesting or 
                        obtaining consent for the tissue to be used in 
                        such research; and
                            ``(ii) no alteration of the timing, method, 
                        or procedures used to terminate the pregnancy 
                        was made solely for the purposes of obtaining 
                        the tissue;
                    ``(B) the tissue has been donated by the woman in 
                accordance with paragraph (1); and
                    ``(C) full disclosure has been provided to the 
                woman with regard to--
                            ``(i) such physician's interest, if any, in 
                        the research to be conducted with the tissue; 
                        and
                            ``(ii) any known medical risks to the woman 
                        or risks to her privacy that might be 
                        associated with the donation of the tissue and 
                        that are in addition to risks of such type that 
                        are associated with the woman's medical care.
    ``(c) Informed Consent of Researcher and Donee.--In research 
carried out under subsection (a), human fetal tissue may be used only 
if the individual with the principal responsibility for conducting the 
research involved makes a statement, made in writing and signed by the 
individual, declaring that the individual--
            ``(1) is aware that--
                    ``(A) the tissue is human fetal tissue;
                    ``(B) the tissue may have been obtained pursuant to 
                a spontaneous or induced abortion or subsequent to a 
                stillbirth; and
                    ``(C) the tissue was donated for research purposes;
            ``(2) has provided such information to other individuals 
        with responsibilities regarding the research;
            ``(3) will require, prior to obtaining the consent of an 
        individual to be a recipient of a transplantation of the 
        tissue, written acknowledgment of receipt of such information 
        by such recipient; and
            ``(4) has had no part in any decisions as to the timing, 
        method, or procedures used to terminate the pregnancy made 
        solely for the purposes of the research.
    ``(d) Availability of Statements for Audit.--
            ``(1) In general.--In research carried out under subsection 
        (a), human fetal tissue may be used only if the head of the 
        agency or other entity conducting the research involved 
        certifies to the Secretary that the statements required under 
        subsections (b)(2) and (c) will be available for audit by the 
        Secretary.
            ``(2) Confidentiality of audit.--Any audit conducted by the 
        Secretary pursuant to paragraph (1) shall be conducted in a 
        confidential manner to protect the privacy rights of the 
        individuals and entities involved in such research, including 
        such individuals and entities involved in the donation, 
        transfer, receipt, or transplantation of human fetal tissue. 
        With respect to any material or information obtained pursuant 
        to such audit, the Secretary shall--
                    ``(A) use such material or information only for the 
                purposes of verifying compliance with the requirements 
                of this section;
                    ``(B) not disclose or publish such material or 
                information, except where required by Federal law, in 
                which case such material or information shall be coded 
                in a manner such that the identities of such 
                individuals and entities are protected; and
                    ``(C) not maintain such material or information 
                after completion of such audit, except where necessary 
                for the purposes of such audit.
    ``(e) Applicability of State and Local Law.--
            ``(1) Research conducted by recipients of assistance.--The 
        Secretary may not provide support for research under subsection 
        (a) unless the applicant for the financial assistance involved 
        agrees to conduct the research in accordance with applicable 
        State and local law.
            ``(2) Research conducted by secretary.--The Secretary may 
        conduct research under subsection (a) only in accordance with 
        applicable State and local law.
    ``(f) Definition.--For purposes of this section, the term `human 
fetal tissue' means tissue or cells obtained from a dead human embryo 
or fetus after a spontaneous or induced abortion, or after a 
stillbirth.''.

SEC. 3. PURCHASE OF HUMAN FETAL TISSUE; SOLICITATION OR ACCEPTANCE OF 
              TISSUE AS DIRECTED DONATION FOR USE IN TRANSPLANTATION.

    Part G of title IV of the Public Health Service Act, as amended by 
section 2 of this Act, is amended by inserting after section 498A the 
following new section:

              ``prohibitions regarding human fetal tissue

    ``Sec. 498B. (a) Purchase of Tissue.--It shall be unlawful for any 
person to knowingly acquire, receive, or otherwise transfer any human 
fetal tissue for valuable consideration if the transfer affects 
interstate commerce.
    ``(b) Solicitation or Acceptance of Tissue as Directed Donation for 
Use in Transplantation.--It shall be unlawful for any person to solicit 
or knowingly acquire, receive, or accept a donation of human fetal 
tissue for the purpose of transplantation of such tissue into another 
person if the donation affects interstate commerce, the tissue will be 
or is obtained pursuant to an induced abortion, and--
            ``(1) the donation will be or is made pursuant to a promise 
        to the donating individual that the donated tissue will be 
        transplanted into a recipient specified by such individual;
            ``(2) the donated tissue will be transplanted into a 
        relative of the donating individual; or
            ``(3) the person who solicits or knowingly acquires, 
        receives, or accepts the donation has provided valuable 
        consideration for the costs associated with such abortion.
    ``(c) Criminal Penalties for Violations.--
            ``(1) In general.--Any person who violates subsection (a) 
        or (b) shall be fined in accordance with title 18, United 
        States Code, subject to paragraph (2), or imprisoned for not 
        more than 10 years, or both.
            ``(2) Penalties applicable to persons receiving 
        consideration.--With respect to the imposition of a fine under 
        paragraph (1), if the person involved violates subsection (a) 
        or (b)(3), a fine shall be imposed in an amount not less than 
        twice the amount of the valuable consideration received.
    ``(d) Definitions.--For purposes of this section:
            ``(1) The term `human fetal tissue' has the meaning given 
        such term in section 498A(f).
            ``(2) The term `interstate commerce' has the meaning given 
        such term in section 201(b) of the Federal Food, Drug, and 
        Cosmetic Act.
            ``(3) The term `valuable consideration' does not include 
        reasonable payments associated with the transportation, 
        implantation, processing, preservation, quality control, or 
        storage of human fetal tissue.''.

SEC. 4. REPORT BY GENERAL ACCOUNTING OFFICE ON ADEQUACY OF PROTECTIONS.

    (a) In General.--With respect to research on the transplantation of 
human fetal tissue for therapeutic purposes, the Comptroller General of 
the United States shall conduct an audit for the purpose of 
determining--
            (1) whether and to what extent such research conducted or 
        supported by the Secretary of Health and Human Services has 
        been conducted in accordance with section 498A of the Public 
        Health Service Act (as added by section 2 of this Act); and
            (2) whether and to what extent there have been violations 
        of section 498B of such Act (as added by section 3 of this 
        Act).
    (b) Report.--Not later than May 19, 1995, the Comptroller General 
of the United States shall complete the audit required in subsection 
(a) and submit to the Congress a report describing the findings made 
pursuant to the audit.

Answer: Research on Human Fetal Tissue Amendments of 1993 - Amends the Public Health Service Act to authorize and regulate research on human fetal tissue transplantation without regard to whether the tissue is obtained after a spontaneous or induced abortion or a stillbirth in accordance with State law. 
Imposes criminal penalties for:  (1) transferring such tissue for valuable consideration affecting interstate commerce; or (2) soliciting or receiving a directed donation.


Question: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Federal Student Loan Refinancing 
Act''.

SEC. 2. STUDENT LOAN CONSOLIDATION.

    Section 459B of the Higher Education Act of 1965 (20 U.S.C. 1087i-
2) is amended--
            (1) in subsection (a)(3), by striking ``section'' and 
        inserting ``subsection'';
            (2) in subsection (b), by striking ``this section'' and 
        inserting ``subsection (a)'' each place the term appears; and
            (3) by inserting at the end the following:
    ``(c) Temporary Loan Consolidation Authority for Certain Loans Made 
After July 1, 2006.--
            ``(1) Loan consolidation authority.--
                    ``(A) In general.--A borrower who has 1 or more 
                loans in a category described in subparagraph (B) may 
                consolidate all of the loans of the borrower that are 
                described in subparagraph (B) into a Federal Direct 
                Consolidation Loan during the period described in 
                subparagraph (C).
                    ``(B) Categories of loans that may be 
                consolidated.--The categories of loans that may be 
                consolidated under subparagraph (A) are loans made on 
                or after July 1, 2006, that are--
                            ``(i) loans made under this part;
                            ``(ii) loans purchased by the Secretary 
                        pursuant to section 459A; and
                            ``(iii) loans made under part B that are 
                        held by an eligible lender, as such term is 
                        defined in section 435(d).
                    ``(C) Time period in which loans may be 
                consolidated.--
                            ``(i) Federal direct loans.--In the case of 
                        a borrower who has 1 or more loans described 
                        under subparagraph (B)(i), the Secretary 
                        shall--
                                    ``(I) consolidate the loans 
                                described under subparagraph (B)(i) not 
                                later than 90 days after the date of 
                                enactment of the Federal Student Loan 
                                Refinancing Act; and
                                    ``(II) notify the borrower, in 
                                writing, prior to such consolidation 
                                that--
                                            ``(aa) the borrower's loans 
                                        under this part have been 
                                        consolidated at a lower 
                                        interest rate; and
                                            ``(bb) the borrower's 
                                        repayment plan and the other 
                                        terms and conditions of the 
                                        borrower's loan remain 
                                        unchanged.
                            ``(ii) Other loans.--In the case of a 
                        borrower who has 1 or more loans described 
                        under clause (ii) or (iii) of subparagraph (B), 
                        the Secretary shall--
                                    ``(I) initiate the loan 
                                consolidation process for the loans 
                                described under clause (ii) or (iii) of 
                                subparagraph (B), not later than 90 
                                days after the date of enactment of the 
                                Federal Student Loan Refinancing Act, 
                                by sending a completed loan 
                                consolidation application to the 
                                borrower;
                                    ``(II) notify the borrower, as part 
                                of such application, that a fee will be 
                                assessed and that the interest rate of 
                                the Federal Direct Consolidation Loan 
                                will be set in accordance with 
                                paragraph (2); and
                                    ``(III) notify the borrower, as 
                                part of such application, that if the 
                                borrower wishes to consolidate in 
                                accordance with the completed 
                                application, the borrower must endorse 
                                the application and submit the 
                                application to the Secretary not more 
                                than 6 months after receipt of the 
                                application.
            ``(2) Terms of loans.--The following terms and conditions 
        shall apply to a Federal Direct Consolidation Loan made under 
        this subsection:
                    ``(A) The applicable rate of interest on a Federal 
                Direct Consolidation Loan made under this subsection 
                shall be--
                            ``(i) 4 percent; or
                            ``(ii) in a case in which the weighted 
                        average of the interest rates on the 
                        outstanding loans of a borrower that will be 
                        consolidated is less than 4 percent, the lesser 
                        of--
                                    ``(I) the weighted average of the 
                                interest rates on the outstanding loans 
                                of a borrower that will be 
                                consolidated; or
                                    ``(II) a rate of interest equal 
                                to--
                                            ``(aa) 4 percent; minus
                                            ``(bb) 0.4 percent of the 
                                        principal balance of the 
                                        consolidation loan, at the time 
                                        of consolidation.
                    ``(B) In the case of a loan consolidated under 
                paragraph (1)(C)(ii), an origination fee equal to 0.4 
                percent of the principal balance of the consolidation 
                loan, at the time of consolidation, will be added to 
                the principal balance of the loan, and the Secretary 
                shall use the fee to cover the cost of making and 
                servicing the loan.
                    ``(C) If 1 or more of the loans being consolidated 
                is a loan described under paragraph (1)(B)(iii), the 
                interest rate on the Federal Direct Consolidation Loan 
                under this subsection shall be reduced by 0.25 percent.
                    ``(D) Any benefit a borrower is receiving or 
                earning at the time a Federal Direct Consolidation Loan 
                is issued under this subsection shall not be affected 
                by consolidation under this section, including benefits 
                such as a deferment or forbearance, accumulation of 
                monthly payments as part of the public service loan 
                forgiveness program under section 455(m), accumulation 
                of monthly payments toward a loan discharge under the 
                income-based repayment plan under section 493C, 
                participation in a particular repayment plan, and other 
                benefits to the borrower.''.

SEC. 3. EXEMPTIONS FROM OTHER LAWS.

    (a) Exemption From the Paperwork Reduction Act.--Chapter 35 of 
title 44, United States Code, shall not apply to this Act.
    (b) Inapplicability of Rulemaking Requirements.--Sections 482(c) 
and 492 of the Higher Education Act of 1965 (20 U.S.C. 1089(c), 1098a) 
and section 553 of title 5, United States Code, shall not apply to the 
amendments made by this Act, or to any regulations promulgated under 
such amendments.

Answer: Federal Student Loan Refinancing Act This bill amends title IV (Student Assistance) of the Higher Education Act of 1965 to allow borrowers that received loans under the William D. Ford Federal Direct Loan (DL) or Federal Family Education Loan (FFEL) program on or after July 1, 2006, to consolidate those loans as Federal Direct Consolidation Loans.  It directs the Department of Education (ED) to consolidate DLs, and send a completed loan consolidation application to FFEL borrowers, within 90 days of this bill's enactment. It gives FFEL borrowers six months after their receipt of such application to endorse it and submit it to ED if they wish to consolidate their loans. The bill sets the interest rate on Federal Direct Consolidation Loans at 4% or, if the weighted average of the interest rates of the loans being consolidated is less than 4%, the lesser of: (1) that weighted average, or (2) an interest rate equal to 0.4% of the principal balance of the consolidation loan at the time of consolidation. It adds an origination fee equal to 0.4% of the principal balance of the consolidation loan at the time of consolidation if an FFEL is being consolidated. It reduces the interest rate on a Federal Direct Consolidation Loan by 0.25% if one or more of the loans being consolidated is an FFEL held by an eligible lender. The bill prohibits any benefit a borrower is receiving or earning when issued a Federal Direct Consolidation Loan from being affected by the consolidation.


Question: SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Rural Health Access and Improvement 
Act of 2009''.

SEC. 2. GRANTS TO PROMOTE HOSPITAL HEALTH INFORMATION TECHNOLOGY.

    Section 3013 of the Public Health Service Act (42 U.S.C. 300jj-33) 
is amended by adding at the end the following:
    ``(j) Priority.--In awarding a grant under this section, the 
Secretary shall give priority to qualified State-designated entities 
that are critical access hospitals, as defined in section 1861(mm) of 
the Social Security Act.''.

SEC. 3. EXPANDED PARTICIPATION IN SECTION 340B PROGRAM.

    Section 340B(a)(4) of the Public Health Service Act (42 U.S.C. 
256b(a)(4)) is amended by adding at the end the following:
                    ``(M) A children's hospital excluded from the 
                Medicare prospective payment system pursuant to section 
                1886(d)(1)(B)(iii) of the Social Security Act, or a 
                free-standing cancer hospital excluded from the 
                Medicare prospective payment system pursuant to section 
                1886(d)(1)(B)(v) of the Social Security Act, that would 
                meet the requirements of subparagraph (L), including 
                the disproportionate share adjustment percentage 
                requirement under clause (ii) of such subparagraph, if 
                the hospital were a subsection (d) hospital as defined 
                by section 1886(d)(1)(B) of the Social Security Act.
                    ``(N) An entity that is a critical access hospital 
                (as determined under section 1820(c)(2) of the Social 
                Security Act), and that meets the requirements of 
                subparagraph (L)(i).
                    ``(O) An entity that is a rural referral center, as 
                defined in section 1886(d)(5)(C)(i) of the Social 
                Security Act, or a sole community hospital, as defined 
                by section 1886(d)(5)(C)(iii) of such Act, and that 
                both meets the requirements of subparagraph (L)(i) and 
                has a disproportionate share adjustment percentage 
                equal to or greater than 8 percent.
                    ``(P) An entity that is a rural health clinic, as 
                defined in section 1861(aa)(2) of the Social Security 
                Act.''.

SEC. 4. GAO STUDY AND REPORT ON DISPENSING FEES.

    (a) Study.--The Comptroller General of the United States shall 
conduct a study of the cost in each State of dispensing prescription 
drugs under the Medicaid program under title XIX of the Social Security 
Act (42 U.S.C. 1396a et seq.), which shall consider--
            (1) any reasonable costs associated with pharmacists--
                    (A) checking for information regarding Medicaid 
                coverage of individuals; and
                    (B) performing necessary clinical review and 
                quality assurance activities, such as--
                            (i) activities to identify and reduce the 
                        frequency of patterns of fraud, abuse, gross 
                        overuse, and inappropriate or medically 
                        unnecessary care among physicians, pharmacists, 
                        and patients;
                            (ii) activities associated with specific 
                        drugs or groups of drugs, including potential 
                        and actual severe adverse reactions to drugs, 
                        including education on therapeutic 
                        appropriateness, over-utilization and under-
                        utilization of drugs, appropriate use of 
                        generic products, therapeutic duplication, 
                        drug-disease contraindications, drug 
                        interactions, incorrect drug dosage or duration 
                        of drug treatment, drug-allergy interactions, 
                        and clinical abuse or misuse; and
                            (iii) any other clinical review and quality 
                        assurance activities required under Federal or 
                        State law;
            (2) the costs incurred by a pharmacy that are associated 
        with--
                    (A) the measurement or mixing of a drug covered by 
                Medicaid;
                    (B) filling the container for such a drug;
                    (C) physically transferring the prescription to the 
                patient, including any costs of delivering the 
                medication to the home of such patient;
                    (D) special packaging of drugs;
                    (E) overhead costs of the pharmacy, or the section 
                of the facility that is devoted to a pharmacy, and 
                maintenance of the pharmacy or section of the facility 
                (including the equipment necessary to operate such 
                pharmacy or such section and the salaries of 
                pharmacists and other pharmacy workers);
                    (F) geographic factors that impact operational 
                costs;
                    (G) compounding such prescription if necessary; and
                    (H) uncollectability of Medicaid prescription 
                copayments;
            (3) the variation in costs described in paragraph (2) based 
        on--
                    (A) whether a product dispensed is a rural or urban 
                pharmacy;
                    (B) whether the product dispensed is a specialty 
                pharmacy product; and
                    (C) whether the pharmacy is located in, or 
                contracts with, a long-term care facility; and
            (4) the increase in dispensing fees, including the costs 
        described in paragraphs (1), (2), and (3), that would be 
        sufficient to create an incentive for a pharmacist to promote 
        the substitution of covered general alternative therapies.
    (b) Report.--Not later than December 1, 2010, the Comptroller 
General of the United States shall submit to the Secretary of Health 
and Human Services and to each State a report describing the study 
conducted under subsection (a). The report shall include--
            (1) the average cost in each State of dispensing a 
        prescription drug under Medicaid;
            (2) the findings of the study conducted under subsection 
        (a) with respect to--
                    (A) the variation in costs studied under 
                subparagraphs (A) and (B) of paragraph (3) of such 
                subsection; and
                    (B) the increase in dispensing fees described in 
                paragraph (4) of such subsection.
    (c) Use of Study.--Each State shall use the report described in 
subsection (b) to assess the adequacy of Medicaid pharmacy dispensing 
fees. The Secretary of Health and Human Services shall use such report 
to approve State plan amendments for States that submit such amendments 
for the purposes of increasing Medicaid pharmacy dispensing fees.

SEC. 5. STATE OFFICES OF RURAL HEALTH.

    Section 338J of the Public Health Service Act (42 U.S.C. 254r) is 
amended by striking subsection (k).

Answer:
Rural Health Access and Improvement Act of 2009 - Amends the Public Health Service Act to require the Secretary of Health and Human Services (HHS) to give priority to critical access hospitals in awarding grants to facilitate and expand the electronic movement and use of health information among organizations according to nationally recognized standards.

Expands the 340B drug discount program to allow participation as a covered entity by certain children's hospitals, critical access hospitals, rural referral centers, sole community hospitals, and rural health clinics.

Directs the Comptroller General to study and report on the cost in each state of dispensing prescription drugs under the Medicaid program. Requires states to use the report to assess the adequacy of Medicaid pharmacy dispensing fees.

Repeals provisions terminating the grant program for the operation of state offices of rural health.