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

    This Act may be cited as the ``Rural Physicians' Incentives Act of 
1993''.

SEC. 2. DEDUCTION FOR MEDICAL SCHOOL EDUCATION LOAN INTEREST INCURRED 
              BY DOCTORS SERVING IN MEDICALLY UNDERSERVED RURAL AREAS.

    (a) In General.--Paragraph (1) of section 163(h) of the Internal 
Revenue Code of 1986 (relating to disallowance of deduction for 
personal interest) is amended by striking ``and'' at the end of 
subparagraph (D), by redesignating subparagraph (E) as subparagraph 
(F), and by inserting after subparagraph (D) the following new 
subparagraph:
                    ``(E) any qualified medical education loan interest 
                (within the meaning of paragraph (5)), and''.
    (b) Qualified Medical Education Loan Interest Defined.--Subsection 
(h) of section 163 of such Code is amended by redesignating paragraph 
(5) as paragraph (6) and by inserting after paragraph (4) the following 
new paragraph:
            ``(5) Qualified medical education loan interest.--
                    ``(A) In general.--The term `qualified medical 
                education loan interest' means interest--
                            ``(i) which is on a medical education loan 
                        of a physician,
                            ``(ii) which is paid or accrued by such 
                        physician, and
                            ``(iii) which accrues during the period--
                                    ``(I) such physician is providing 
                                primary care (including internal 
                                medicine, pediatrics, obstetrics/
                                gynecology, family medicine, and 
                                osteopathy) to residents of a medically 
                                underserved rural area, and
                                    ``(II) such physician's principal 
                                place of abode is in such area.
                    ``(B) Medical education loan.--The term `medical 
                education loan' means indebtedness incurred to pay the 
                individual's--
                            ``(i) qualified tuition and related 
                        expenses (as defined in section 117(b)) 
                        incurred for the medical education of such 
                        individual, or
                            ``(ii) reasonable living expenses while 
                        away from home in order to attend an 
                        educational institution described in section 
                        170(b)(1)(A)(ii) for the medical education of 
                        such individual.
                    ``(C) Physician.--For purposes of subparagraph (A), 
                the term `physician' has the meaning given such term by 
                section 1861(r)(1) of the Social Security Act.
                    ``(D) Medically underserved rural area.--The term 
                `medically underserved rural area' means any rural area 
                which is a medically underserved area (as defined in 
                section 330(b) or 1302(7) of the Public Health Service 
                Act).''.
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years ending after the date of the enactment of this 
Act.

SEC. 3. ELIMINATION OF MEDICARE PAYMENT REDUCTIONS FOR NEW DOCTORS FOR 
              SERVICES FURNISHED IN ANY RURAL AREA.

    (a) In General.--Section 1848(a)(4) of the Social Security Act (42 
U.S.C. 1395w-4(a)(4)) is amended--
            (1) by striking ``or services'' and inserting ``, 
        services'', and
            (2) by inserting before the period at the end the 
        following: ``, or services furnished in a rural area (as so 
        defined) by (or under the supervision, or incidental to 
        services, of) a physician described in section 1861(r)(1)''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
apply to services furnished after 1993.

SEC. 4. EXTENSION OF DEFERMENTS.

    (a) Stafford Loans.--
            (1) GSL loans.--Section 428(b)(1)(M) of the Higher 
        Education Act of 1965 (20 U.S.C. 1078(b)(1)(M)) is amended--
                    (A) by striking ``or'' at the end of clause (ii);
                    (B) by inserting ``or'' after the semicolon at the 
                end of clause (iii); and
                    (C) by adding at the end thereof the following new 
                clause:
                            ``(iv) during which the borrower is serving 
                        in an internship or residency program in 
                        preparation for practice in an area of primary 
                        care (including internal medicine, pediatrics, 
                        obstetrics/gynecology, family medicine, and 
                        osteopathy);''.
            (2) FISL loans.--Section 427(a)(2)(C) of such Act (20 
        U.S.C. 1077(a)(2)(C)) is amended--
                    (A) by striking ``or'' at the end of clause (ii);
                    (B) by inserting ``or'' after the semicolon at the 
                end of clause (iii); and
                    (C) by adding at the end thereof the following new 
                clause:
                            ``(iv) during which the borrower is serving 
                        in an internship or residency program in 
                        preparation for practice in an area of primary 
                        care (including internal medicine, pediatrics, 
                        obstetrics/gynecology, family medicine, and 
                        osteopathy);''.
    (b) Perkins Loans.--Section 464(c)(2)(A) of such Act (20 U.S.C. 
1087dd(c)(2)(A)) is amended--
            (1) by striking ``or'' at the end of clause (iii);
            (2) by inserting ``or'' after the semicolon at the end of 
        clause (iv); and
            (3) by adding at the end thereof the following new clause:
                            ``(v) during which the borrower is serving 
                        in an internship or residency program in 
                        preparation for practice in an area of primary 
                        care (including internal medicine, pediatrics, 
                        obstetrics/gynecology, family medicine, and 
                        osteopathy);''.
    (c) Effective Date.--The amendments made by this section shall 
apply to on and after the date of the enactment of this Act with 
respect to loans made under the Higher Education Act of 1965 before, 
on, or after that date.

SEC. 5. CLARIFICATION OF PERMISSIBLE SUBSTITUTE BILLING ARRANGEMENTS 
              FOR PHYSICIANS' SERVICES UNDER THE MEDICARE AND MEDICAID 
              PROGRAMS.

    (a) Medicare Program.--
            (1) In general.--Clause (D) of section 1842(b)(6) of the 
        Social Security Act (42 U.S.C. 1395u(b)(6)) is amended to read 
        as follows: ``(D)(i) payment may be made to a physician for 
        physicians' services (and services incident to such services) 
        to be provided by a second physician on a reciprocal basis to 
        individuals who are patients of the first physician if (I) the 
        first physician is unavailable to provide the services, (II) 
        the services are not provided by the second physician over a 
        continuous period of longer than 60 days, and (III) the claim 
        form submitted to the carrier includes the second physician's 
        unique identifier (provided under the system established under 
        subsection (r)) and indicates that the claim meets the 
        requirements of this clause for payment to the first physician; 
        and (ii) payment may be made to a physician for physicians' 
        services (and services incident to such services) which that 
        physician pays a second physician on a per diem or other fee-
        for-time basis to provide to individuals who are patients of 
        the first physician if (I) the first physician is unavailable 
        to provide the services, (II) the services are not provided by 
        the second physician over a continuous period of longer than 90 
        days (or such longer period as the Secretary may provide), and 
        (III) the claim form submitted to the carrier includes the 
        second physician's unique identifier (provided under the system 
        established under subsection (r)) and indicates that the claim 
        meets the requirements of this clause for payment to the first 
        physician''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall apply to services furnished on or after the first day of 
        the first month beginning more than 60 days after the date of 
        the enactment of this Act.
    (b) Medicaid Program.--
            (1) In general.--Section 1902(a)(32)(C) of the Social 
        Security Act (42 U.S.C. 1396a(a)(32)(C)) is amended to read as 
        follows:
                    ``(C) payment may be made to a physician for 
                services furnished by a substitute physician under the 
                circumstances described in subparagraph (D) of section 
                1842(b)(6), except that, for purposes of this 
                subparagraph, any reference in such subparagraph to `a 
                carrier' or `the system established under subsection 
                (r)' is deemed a reference to the State (or other 
                fiscal agent under the State plan) and to the system 
                established under subsection (x) of this section, 
                respectively.''.
            (2) Effective date.--(A) The amendment made by paragraph 
        (1) shall apply to services furnished on or after the date of 
        the enactment of this Act.
            (B) Until the first day of the first calendar quarter 
        beginning more than 60 days after the date the Secretary of 
        Health and Human Services establishes the physician identifier 
        system under section 1902(x) of the Social Security Act, the 
        requirement under section 1902(a)(32)(C) of such Act that a 
        claim form submitted must include the second physician's unique 
        identifier is deemed to be satisfied if the claim form 
        identifies (in a manner specified by the Secretary of Health 
        and Human Services) the second physician.

SOLUTION: Rural Physicians' Incentives Act of 1993 - Amends the Internal Revenue Code to allow a deduction on medical education loan interest of a physician which accrues while the physician is living in and providing primary care to residents of a medically underserved rural area. 
Amends title XVIII (Medicare) of the Social Security Act to exempt services furnished in a rural area from a special fee schedule applicable to new physicians. 
Amends the Higher Education Act of 1965 to extend beyond the normal two-year limit, for borrowers serving an internship or residency program in preparation for practice in an area of primary care, the deferral of payments on:  (1) insured student loans (Stafford Loans), including those eligible for interest subsidies; and (2) low-interest student loans (Perkins Loans). 
Amends titles XVIII (Medicare) and XIX (Medicaid) of the Social Security Act to modify provisions setting forth requirements concerning billing by one physician for services rendered by another physician in specified circumstances.

PROBLEM: SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.-- This Act may be cited as the ``Tribal Government 
Homeland Security Coordination and Integration Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings and purposes.
Sec. 3. Definitions.
Sec. 4. Office of tribal government homeland security.
Sec. 5. Report to congress.
Sec. 6. Authorization of appropriations.

SEC. 2. FINDINGS AND PURPOSES.

    (a) Findings.--Congress finds the following:
            (1) Since the terrorist attacks of September 11, 2001, and 
        the subsequent introduction of weapons grade anthrax into the 
        United States Postal System and Congressional office buildings 
        in Washington, D.C., the President and the Congress have worked 
        closely to respond to the need to rebuild and strengthen the 
        nation's public health, national security, and emergency 
        response systems.
            (2) Based on Article I, section 8 of the United States 
        Constitution, treaties, Federal statutes, and court decisions, 
        the United States has a unique historical and legal 
        relationship with American Indian and Alaska Native people, 
        which serves as the basis for the Federal Government's trust 
        responsibility and obligations. There are currently 558 
        federally-recognized Indian tribes in the United States, with 
        some 40 percent of Indian tribes located in the State of 
        Alaska. Indian tribes have principle responsibility for lands 
        and people within their jurisdiction.
            (3) Despite the government-to-government relationship 
        between Indian tribes and the United States, the United States 
        has failed to include and consult with Indian tribes with 
        regard to homeland security prevention, protection, and 
        response activities planning. Moreover, there are no specific 
        provisions for the Bureau of Indian Affairs or the Indian 
        Health Service to participate in homeland security programs and 
        funding.
            (4) Throughout many areas of the United States, facilities 
        operated, and services, activities and government functions 
        carried out, by Indian tribes, the Bureau of Indian Affairs and 
        the Indian Health Service are the only sources available to 
        provide emergency health services, disaster response, and law 
        enforcement to the tribal and non-tribal community, thus 
        serving the role as ``first responders'' in the event of a 
        terrorist attack.
            (5) To provide for the public health and safety on tribal 
        lands and in the surrounding communities, it is imperative to 
        establish tribal participation in homeland security 
        initiatives. Indian tribes must be included in the national 
        strategy for homeland security and receive an appropriate share 
        of related funding.
            (6) The treatment of Indian tribes as State governments, as 
        appropriate, for developing funding methodologies, planning, 
        consultation, coordination, and for eligibility for grant 
        monies will ensure Indian tribes are adequately prepared to 
        respond to Homeland Security threats.
            (7) Indian tribes shall be treated as State, as 
        appropriate, for purposes of planning, consultation, 
        coordination, eligibility for grant monies and other purposes 
        to improve the United States capacity to prepare, prevent and 
        respond to terrorist activities.
    (b) Purposes.--The purposes of this Act are as follows:
            (1) To establish within the Department of Homeland Security 
        an office known as the Office of Tribal Government Homeland 
        Security.
            (2) To authorize the Secretary of Homeland Security to 
        appoint, in consultation with Indian tribes, a Director of 
        Tribal Government Homeland Security.
            (3) To provide for more effective management of, and 
        accountability for the proper discharge of, the Secretary's 
        trust responsibility to Indian tribes and individual American 
        Indians and Alaska Natives by establishing in the Department of 
        Homeland Security an Office of Tribal Government Homeland 
        Security.
            (4) To integrate and coordinate the efforts of the 
        Department of Homeland Security and Indian tribes to prepare 
        for, prevent, protect against, respond to, and recover from 
        terrorist attacks.
            (5) To provide strategic integration of the Homeland 
        Security activities of Indian tribes that will complement the 
        operational consolidation of the various directorates within 
        the Department.
            (6) To supplement the capacity of the Indian Health Service 
        and the Bureau of Indian Affairs to respond to the homeland 
        security needs of American Indians and Alaska Natives, without 
        jeopardizing the nonsecurity missions of the Indian Health 
        Service and the Bureau of Indian Affairs.
            (7) To serve as an information clearinghouse and to enhance 
        the integration and coordination of Indian tribes and in the 
        activities of the Department of Homeland Security.
            (8) To establish an organizational framework within the 
        Department of Homeland Security through which the Federal 
        Government, Indian tribes, and State and local governments can 
        work effectively and collaboratively on public health and 
        safety, terrorism detection, prevention, response, and 
        protection of critical infrastructure.

SEC. 3. DEFINITIONS.

     In this Act:
            (1) Director.--The term ``Director'' means the Director of 
        the Office of Tribal Government Homeland Security.
            (2) Indian tribe.--The term ``Indian tribe'' has the 
        meaning given that term in section 4(e) of the Indian Self-
        Determination and Education Assistance Act (25 U.S.C. 450b(e)).
            (3) Office.--The term ``Office'' means the Office of Tribal 
        Government Homeland Security established in section 4.
            (4) Secretary.--The term ``Secretary'' means the Secretary 
        of Homeland Security.

SEC. 4. OFFICE OF TRIBAL GOVERNMENT HOMELAND SECURITY.

    (a) In General.--
            (1) Establishment.--There is hereby established within the 
        Department of Homeland Security an office to be known as the 
        ``Office of Tribal Government Homeland Security''.
            (2) Director.--The Office shall be headed by a Director, 
        appointed by the Secretary in consultation with Indian tribes, 
        whose title shall be the Director of Tribal Government Homeland 
        Security. The Director shall be equal in pay and authority of 
        an Assistant Secretary.
    (b) Duties of Secretary; Director.--
            (1) Duties of the secretary.--The Secretary shall--
                    (A) ensure the coordination of Federal programs 
                that provide assistance (including financial and 
                technical assistance) to eligible Indian tribes and 
                provide those governments with treatment as State 
                governments, as appropriate, for planning, 
                consultation, and coordination and for eligibility for 
                Federal grant monies and funds to improve capacity and 
                help prepare, prevent, and respond to terrorist 
                activities, and for other related purposes in and near 
                tribal communities;
                    (B) ensure Indian tribes are included in the 
                coordination activities of the Homeland Security 
                Department's Border and Transportation functions in the 
                same manner as State and local law enforcement 
                entities;
                    (C) ensure Indian tribes with jurisdiction over 
                lands adjacent to the Canadian and Mexican borders are 
                adequately prepared to help protect United States 
                borders, territorial waters, waterways, and other 
                transportation systems;
                    (D) ensure the broad spectrum of infrastructure 
                throughout Indian Country, including nuclear and 
                electrical power plants, water and sanitation 
                facilities, agricultural, food processing, oil, timber, 
                and other natural resources is adequately protected 
                against terrorist threats;
                    (E) ensure that Indian tribes are properly equipped 
                to prepare for, prevent, and respond to terrorist 
                activities in the same manner as State and local 
                governments;
                    (F) provide Indian tribes the necessary equipment 
                for detection, protection, and decontamination in 
                emergencies involving weapons of mass destruction;
                    (G) provide Indian tribes with emergency 
                preparedness training and exercise programs and further 
                assistance for any emergency, including natural 
                disasters or disease;
                    (H) include Indian tribes in all facets of 
                research, development, resource assessment, and risk 
                analysis in the same manner as State and local 
                governments; and
                    (I) include Indian tribes, as appropriate, in the 
                coordination of the Homeland Security Department's 
                Immigration and Nationality functions in the same 
                manner as State and local law enforcement entities.
            (2) Duties of the director.--The Director shall--
                    (A) coordinate homeland security activities among 
                Indian tribes and related Federal agencies, including 
                integration and coordination of the efforts of the 
                Department of Homeland Security and Indian tribes to 
                prepare for, prevent, protect against, respond to, and 
                recover from terrorist attacks;
                    (B) provide strategic integration to complement the 
                operational consolidation of the various directorates 
                within the Department of Homeland Security, with 
                respect to Indian tribes;
                    (C) ensure that Indian tribes are included in the 
                gathering and analysis of terrorist threats and other 
                information in the same manner as Federal, State, and 
                local law enforcement entities;
                    (D) serve as the Secretary's key point of contact 
                for Indian tribes in need of assistance and information 
                homeland security grants for purposes of planning, 
                consultation, coordination, eligibility for grant 
                monies and other purposes to improve the United States 
                capacity to prepare, prevent and respond to terrorist 
                activities and to work with Indian tribes and executive 
                agencies in promoting homeland security;
                    (E) serve as the coordinating center intended to 
                facilitate communication between and integration with 
                Indian tribes and other Federal departments that have 
                homeland security responsibilities, including but not 
                limited to health surveillance, emergency preparation 
                and response, border security, critical infrastructure 
                protection, technology, and communication;
                    (F) establish a network through which the Federal 
                Government, Indian tribes, and State and local 
                governments work collaboratively on public health and 
                safety, terrorism detection, prevention, response, and 
                protection of critical infrastructure targets; and
                    (G) establish a mechanism for the distribution of 
                warnings and information to tribal communities.
    (c) Treatment of Indian Tribes as States.--
            (1) In general.--The Secretary shall--
                    (A) treat Indian tribes as States, as appropriate, 
                for the purpose of homeland security consultation, 
                planning, coordination, bioterrorism preparedness, 
                prevention, and response, emergency preparedness and 
                response, border and transportation security, and for 
                other purposes related to protecting the homeland;
                    (B) include Indian tribes in funding methodologies 
                for purposes of allocating any financial resources; and
                    (C) support and facilitate the capacity necessary 
                for the Indian Health Service and Bureau of Indian 
                Affairs to respond to the homeland security needs of 
                American Indians and Alaska Natives, without 
                jeopardizing their non-security missions.
            (2) Discretionary authority.--The Secretary may delegate to 
        such Indian tribes primary responsibility for homeland security 
        activities within its respective jurisdiction.
    (d) Information Sharing.--The Secretary shall provide assistance to 
enhance information technology capabilities of Indian tribes and 
ensure--
            (1) the active participation of Indian tribes in the 
        coordination with Federal, State, and local governments and the 
        private sector as related to Homeland Security activities; and
            (2) provide Indian tribes access to the same type of 
        information being exchanged between Federal, State, and local 
        authorities for the purpose of providing government personnel, 
        agencies, and authorities, with appropriate intelligence 
        information, including warnings, regarding threats posed by 
        terrorism in a timely and secure manner.
    (e) Federal Grants.--
            (1) General eligibility.--Indian tribes shall be eligible 
        to apply for, receive, direct, and supervise any homeland 
        security-related Federal grant programs.
            (2) Authority to award grants.--The Secretary may award 
        grants to Indian tribes for the following purposes:
                    (A) Planning, consultation, and coordination to 
                improve infrastructure, to prevent terrorist 
                activities.
                    (B) Training and education of employees responsible 
                for public health, safety and emergency response 
                activities.
                    (C) Addressing communication gaps and 
                infrastructure needs related to homeland security.
                    (D) Increasing the capacity of Indian tribes to 
                help prepare, prevent, and respond to terrorist 
                activities and other public health and safety 
                emergencies.
                    (E) Development of a comprehensive plan to help 
                prepare, prevent, and respond to terrorist activities 
                and other public health and safety emergencies.
                    (F) Implementation of plans to help prepare, 
                prevent, and respond to terrorist activities and other 
                public health and safety emergencies.
                    (G) The preparation of reports assessing the 
                emergency preparedness of Indian tribes, including an 
                assessment of Indian tribes' coordination with the 
                Department.
                    (H) Such other purposes related to the purposes of 
                this Act the Secretary considers appropriate.
    (f) Technical Assistance.--The Secretary shall--
            (1) directly or by contract, provide Indian tribes with 
        technical assistance in developing, implementing and managing 
        emergency response plans.
            (2) Ensure that legal, financial, and other expertise of 
        the Department of Homeland Security is made fully available in 
        an advisory capacity to Indian tribes to assist in the 
        development, implementation, and management of emergency 
        response plans.
            (3) Provide Department of Homeland Security programs 
        designed to provide legal, accounting, financial, or technical 
        assistance to eligible Indian tribes.
            (4) Facilitate cooperation with the heads of appropriate 
        Federal agencies working on Homeland Security initiatives.
            (5) Any other activity that the Secretary, in consultation 
        with the Director, considers appropriate to carry out this 
        section.
    (g) Assessment.--Not later than 6 months after the date of the 
enactment of this Act, the Secretary shall submit an assessment report 
detailing the baseline readiness of Indian tribes to the Committee on 
Indian Affairs of the Senate and the Committee on Resources of the 
House of Representatives. In addition to an assessment of baseline 
readiness, the report shall contain any legislative recommendations 
necessary to improve coordination and integration of Indian tribes in 
the National Homeland Security Strategy.
    (h) Reporting.--The Secretary shall determine the effectiveness of 
the Office through the preparation of reports assessing the emergency 
preparedness of Indian tribes, including an assessment of Indian 
tribes' coordination with the Department of Homeland Security.
    (i) Prohibition.--The Secretary may not provide assistance under 
this section for any activity related to the operation of a gaming 
activity on Indian lands pursuant to the Indian Gaming Regulatory Act 
(25 U.S.C. 2701 et seq.).

SEC. 5. REPORT TO CONGRESS.

    (a) In General.--Not later than 1 year after the date of the 
enactment of this Act, and annually thereafter, the Secretary, in 
consultation with the Director, shall prepare and submit to the 
Committee on Indian Affairs of the Senate and the Committee on 
Resources of the House of Representatives a report on the operation of 
the Office.
    (b) Contents of Report.--Each report prepared under subsection (a) 
shall include--
            (1) for the period covered by the report, a summary of the 
        activities conducted by the Secretary, in carrying out 
        subsections (b) through (h) of section 4; and
            (2) any recommendations for legislation that the Secretary, 
        in consultation with the Director, determines to be necessary 
        to carry out such sections.

SEC. 6. AUTHORIZATION OF APPROPRIATIONS.

     There are authorized to be appropriated such sums are necessary to 
carry out this Act, to remain available until expended.

SOLUTION: Tribal Government Homeland Security Coordination and Integration Act - Establishes the Office of Tribal Government Homeland Security (Office) within the Department of Homeland Security. Requires the Secretary of Homeland Security to appoint a Director to head the Office.

Prescribes the Secretary's and the Director's duties of coordination, infrastructure and equipment readiness, training, and inclusion of Indian tribes in homeland security preparedness. 
 
 Requires the Secretary to treat Indian tribes as states, as appropriate for the purpose of homeland security. Authorizes the Secretary to delegate to Indian tribes primary responsibility for homeland security activities within their respective jurisdictions. Requires the Secretary to integrate the roles of the Bureau of Indian Affairs and Indian Health Services with regard to homeland security. 
 
 Requires the Secretary to provide assistance to enhance information technology capabilities of tribes and ensure the participation of Indian tribes in the coordination with federal, state, and local governments and the private sector as related to Homeland Security activities. 
 
 Declares Indian tribes to be eligible to apply for, receive, direct, and supervise any homeland security-related federal grant program. 
 
 Authorizes the Secretary to award grants to Indian tribes for specified homeland security purposes. 
 
 Requires the Secretary to provide Indian tribes with: (1) technical assistance in developing, implementing, and managing emergency response plans; (2) Department of Homeland Security expertise and programs; (3) the cooperation of the heads of appropriate Federal agencies; and (4) any other activity the Secretary considers appropriate to provide homeland security technical assistance to Indian tribes.

PROBLEM: SECTION 1. REQUIREMENT FOR POST-DELIVERY FOLLOW-UP CARE FOR EARLY 
              HOSPITAL DISCHARGES AFTER CHILDBIRTH.

    (a) Public Health Service Act Amendment.--
            (1) Group health coverage.--Section 2704(a) of the Public 
        Health Service Act (42 U.S.C. 300gg-4(a)) is amended--
                    (A) in paragraph (2), by striking ``Paragraph'' and 
                inserting ``Subject to paragraph (3), paragraph'', and
                    (B) by adding at the end the following new 
                paragraph:
            ``(3) Requiring coverage of post-delivery follow-up care.--
                    ``(A) In general.--In the case of a decision 
                described in paragraph (2) (relating to early 
                discharge), the group health plan or health insurance 
                issuer offering the coverage shall provide coverage for 
                timely post-delivery care in any of the following 
                settings (as selected by the mother): the mother's 
                home, a provider's office, a hospital, a federally 
                qualified health center, a federally qualified rural 
health clinic, a State health department maternity clinic, or another 
setting (which may include a birthing center or an intermediate care 
facility) determined appropriate under regulations promulgated by the 
Secretary.
                    ``(B) Timely care.--For purposes of subparagraph 
                (A), the term `timely post-delivery care' means health 
                care that is provided--
                            ``(i) to a mother and her newborn child 
                        following the discharge of a mother and her 
                        newborn child from the hospital;
                            ``(ii) by a registered nurse, physician (as 
                        defined in section 1861(r)(1) of the Social 
                        Security Act), nurse practitioner, nurse 
                        midwife, or physician assistant experienced in 
                        maternal and child health, as selected by the 
                        mother; and
                            ``(iii) in a manner that meets the health 
                        care needs of the mother and her newborn child, 
                        that provides for the appropriate monitoring of 
                        the conditions of the mother and child, and 
                        that occurs within 72 hours following 
                        discharge.
                    ``(C) Consistency with state law.--The Secretary 
                shall, with respect to regulations promulgated under to 
                carry out this paragraph and concerning appropriate 
                post-delivery care settings, ensure that, to the extent 
                practicable, such regulations are consistent with State 
                licensing and practice laws.''.
            (2) Application to individual health insurance coverage.--
        The amendments made by paragraph (1) apply to health insurance 
        coverage in the individual market under section 2751(a) of the 
        Public Health Service Act (42 U.S.C. 300gg-51).
    (b) ERISA Amendments.--Section 711(a) of the Employee Retirement 
Income Security Act of 1974 (29 U.S.C. 1185(a)) is amended--
            (1) in paragraph (2), by striking ``Paragraph'' and 
        inserting ``Subject to paragraph (3), paragraph'', and
            (2) by adding at the end the following new paragraph:
            ``(3) Requiring coverage of post-delivery follow-up care.--
                    ``(A) In general.--In the case of a decision 
                described in paragraph (2) (relating to early 
                discharge), the group health plan or health insurance 
                issuer offering the coverage shall provide coverage for 
                timely post-delivery care in any of the following 
                settings (as selected by the mother): the mother's 
                home, a provider's office, a hospital, a federally 
                qualified health center, a federally qualified rural 
                health clinic, a State health department maternity 
                clinic, or another setting (which may include a 
                birthing center or an intermediate care facility) 
                determined appropriate under regulations promulgated by 
                the Secretary.
                    ``(B) Timely care.--For purposes of subparagraph 
                (A), the term `timely post-delivery care' means health 
                care that is provided--
                            ``(i) to a mother and her newborn child 
                        following the discharge of a mother and her 
                        newborn child from the hospital;
                            ``(ii) by a registered nurse, physician (as 
                        defined in section 1861(r)(1) of the Social 
                        Security Act), nurse practitioner, nurse 
                        midwife, or physician assistant experienced in 
                        maternal and child health, as selected by the 
                        mother; and
                            ``(iii) in a manner that meets the health 
                        care needs of the mother and her newborn child, 
                        that provides for the appropriate monitoring of 
                        the conditions of the mother and child, and 
                        that occurs within 72 hours following 
                        discharge.
                    ``(C) Consistency with state law.--The Secretary 
                shall, with respect to regulations promulgated under to 
                carry out this paragraph and concerning appropriate 
                post-delivery care settings, ensure that, to the extent 
                practicable, such regulations are consistent with State 
                licensing and practice laws.''.
    (c) Internal Revenue Code of 1986 Amendment.--Section 9811 of the 
Internal Revenue Code of 1986, as inserted by section 1531(a)(4) of the 
Taxpayer Relief Act of 1997, is amended--
            (1) in paragraph (2), by striking ``Paragraph'' and 
        inserting ``Subject to paragraph (3), paragraph'', and
            (2) by adding at the end the following new paragraph:
            ``(3) Requiring coverage of post-delivery follow-up care.--
                    ``(A) In general.--In the case of a decision 
                described in paragraph (2) (relating to early 
                discharge), the group health plan or health insurance 
                issuer offering the coverage shall provide coverage for 
                timely post-delivery care in any of the following 
                settings (as selected by the mother): the mother's 
                home, a provider's office, a hospital, a federally 
                qualified health center, a federally qualified rural 
                health clinic, a State health department maternity 
                clinic, or another setting (which may include a 
                birthing center or an intermediate care facility) 
                determined appropriate under regulations promulgated by 
                the Secretary.
                    ``(B) Timely care.--For purposes of subparagraph 
                (A), the term `timely post-delivery care' means health 
                care that is provided--
                            ``(i) to a mother and her newborn child 
                        following the discharge of a mother and her 
                        newborn child from the hospital;
                            ``(ii) by a registered nurse, physician (as 
                        defined in section 1861(r)(1) of the Social 
                        Security Act), nurse practitioner, nurse 
                        midwife, or physician assistant experienced in 
                        maternal and child health, as selected by the 
                        mother; and
                            ``(iii) in a manner that meets the health 
                        care needs of the mother and her newborn child, 
                        that provides for the appropriate monitoring of 
                        the conditions of the mother and child, and 
                        that occurs within 72 hours following 
                        discharge.
                    ``(C) Consistency with state law.--The Secretary 
                shall, with respect to regulations promulgated under to 
                carry out this paragraph and concerning appropriate 
                post-delivery care settings, ensure that, to the extent 
                practicable, such regulations are consistent with State 
                licensing and practice laws.''.
    (d) Effective Dates.--
            (1) In general.--Subject to paragraph (2), the amendments 
        made by this section shall apply with respect to--
                    (A) group health plans, and health insurance 
                coverage offered in connection with group health plans, 
                for plan years beginning after January 1, 1999; and
                    (B) health insurance coverage offered, sold, 
                issued, renewed, in effect, or operated in the 
                individual market after such date.
            (2) Special rule for collective bargaining agreements.--In 
        the case of a group health plan maintained pursuant to one or 
        more collective bargaining agreements between employee 
        representatives and one or more employers ratified before the 
        date of the enactment of this Act, the amendments made by this 
        section shall not apply to plan years beginning before the 
        later of--
                    (A) the date on which the last of the collective 
                bargaining agreements relating to the plan terminates 
                (determined without regard to any extension thereof 
                agreed to after the date of the enactment of this Act), 
                or
                    (B) January 1, 1999.
        For purposes of subparagraph (A), any plan amendment made 
        pursuant to a collective bargaining agreement relating to the 
        plan which amends the plan solely to conform to any requirement 
        imposed under an amendment made by this Act shall not be 
        treated as a termination of such collective bargaining 
        agreement.

SOLUTION:
Amends the Public Health Service Act (PHSA), the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code to require that, when an attending provider and the mother decide to discharge the mother or her newborn prior to specified minimum inpatient periods following delivery, the group health plan or insurer offering coverage provide coverage for timely post-delivery care in any of specified settings, as selected by the mother.  Applies the requirement to coverage in the individual market under specified provisions of the PHSA.