Federal Prisoner Health Care Copayment Act of 2000
PL 106-294 (S.704), enacted 10/12/2000

114 STAT. 1038 
PUBLIC LAW 106-294—OCT. 12, 2000 
Public Law 106-294 
106th Congress 
An Act 
Oct. 12, 2000 
To amend title 18, United States Code, to combat the overutilization of prison 
rg Y04] 
health care services and control rising prisoner health care costs. 
Be it enacted by the Senate and House of Representatives 
of 
Federal Prisoner 
the United States of America in Congress assembled, 
Health Care 
Copayment Act of 
SECTION 1. SHORT TITLE. 
18 use 4001 
This Act may be cited as the "Federal Prisoner Health Care 
note. 
Copayment Act of 2000". 
SEC. 2. HEALTH CARE FEES FOR PRISONERS IN FEDERAL INSTITU-
TIONS. 
(a) IN GENERAL.—Chapter 303 of title 18, United States Code, 
is amended by adding at the end the following: 
"§ 4048. Fees for health care services for prisoners 
"(a) DEFINITIONS.—In this section— 
"(1) the term 'account' means the trust fund account (or 
institutional equivalent) of a prisoner; 
"(2) the term 'Director' means the Director of the Bureau 
of Prisons; 
"(3) the term liealth care provider' means any person who 
is— 
"(A) authorized by the Director to provide health care 
services; and 
"(B) operating within the scope of such authorization; 
"(4) the term ^health care visit'— 
"(A) means a visit, as determined by the Director, 
by a prisoner to an institutional or noninstitutional health 
care provider; and 
"(B) does not include a visit initiated by a prisoner— 
"(i) pursuant to a staff referral; or 
"(ii) to obtain staff-approved follow-up treatment 
for a chronic condition; and 
"(5) the term 'prisoner' means— 
"(A) any individual who is incarcerated in an institu-
tion under the jurisdiction of the Bureau of Prisons; or 
"(B) any other individual, as designated by the 
Director, who has been charged with or convicted of an 
offense against the United States. 
"(b) FEES FOR HEALTH CARE SERVICES.— 
Regulations. 
"(1) IN GENERAL.—The Director, in accordance with this 
section and with such regulations as the Director shall promul-
gate to carry out this section, may assess and collect a fee 
PUBLIC LAW 106-294—OCT. 12, 2000 
114 STAT. 1039 
for health care services provided in connection with each health 
care visit requested by a prisoner. 
"(2) EXCLUSION.—The Director may not assess or collect 
a fee under this section for preventative health care services, 
emergency services, prenatal care, diagnosis or treatment of 
chronic infectious diseases, mental health care, or substance 
abuse treatment, as determined by the Director. 
"(c) PERSONS SUBJECT TO FEE.—Each fee assessed under this 
section shall be collected by the Director from the account o
f
— 
"(1) the prisoner receiving health care services in connec-
tion with a health care visit described in subsection (b)(1); 
or 
"(2) in the case of health care services provided in connec-
tion with a health care visit described in subsection (b)(1) 
that results from an injury inflicted on a prisoner by another 
prisoner, the prisoner who inflicted the injury, as determined 
by the Director. 
"(d) AMOUNT OF FEE.—^Any fee assessed and collected under 
this section shall be in an amount of not less than $1. 
"(e) No CONSENT REQUIRED.—Notwithstanding any other provi-
sion of law, the consent of a prisoner shall not be required for 
the collection of a fee from the account of the prisoner under 
this section. However, each such prisoner shall be given a reason-
able opportunity to dispute the amount of the fee or whether the 
prisoner qualifies under an exclusion under this section. 
"(f) NO REFUSAL OF TREATMENT FOR FINANCIAL REASONS.— 
Nothing in this section may be construed to permit any refusal 
of treatment to a prisoner on the basis that— 
"(1) the account of the prisoner is insolvent; or 
"(2) the prisoner is otherwise unable to pay a fee assessed 
under this section. 
"(g) USE OF AMOUNTS.— 
"(1) RESTITUTION OF SPECIFIC VICTIMS.—Amounts collected 
by the Director under this section from a prisoner subject 
to an order of restitution issued pursuant to section 3663 or 
3663A shall be paid to victims in accordance with the order 
of restitution. 
"(2) ALLOCATION OF OTHER AMOUNTS.—Of amounts collected 
by the Director under this section from prisoners not subject 
to an order of restitution issued pursuant to section 3663 or 
3663A— 
"(A) 75 percent shall be deposited in the Crime Victims 
Fund established under section 1402 of the Victims of 
Crime Act of 1984 (42 U.S.C. 10601); and 
"(B) 25 percent shall be available to the Attorney Gen-
eral for administrative expenses incurred in carrying out 
this section. 
"(h) NOTICE TO PRISONERS OF LAW.—Each person who is or 
becomes a prisoner shall be provided with written and oral notices 
of the provisions of this section and the applicability of this section 
to the prisoner. Notwithstanding any other provision of this section, 
a fee under this section may not be assessed against, or collected 
from, such person— 
"(1) until the expiration of the 30-day period beginning Expiration date, 
on the date on which each prisoner in the prison system is 
provided with such notices; and 
114 STAT. 1040 
PUBLIC LAW 106-294—OCT. 12, 2000 
"(2) for services provided before the expiration of such 
period. 
Effective date. 
"(i) NOTICE TO PRISONERS OF REGULATIONS.—The regulations 
promulgated by the Director under subsection (b)(1), and any 
amendments to those regulations, shall not take effect until the 
expiration of the 30-day period beginning on the date on which 
each prisoner in the prison system is provided with written and 
oral notices of the provisions of those regulations (or amendments, 
as the case may be). A fee under this section may not be assessed 
against, or collected from, a prisoner pursuant to such regulations 
(or amendments, as the case may be) for services provided before 
the expiration of such period. 
"(j) NOTICE BEFORE PUBLIC COMMENT PERIOD.—Before the 
beginning of any period a proposed regulation under this section 
is open to public comment, the Director shall provide written and 
oral notice of the provisions of that proposed regulation to groups 
that advocate on behalf of Federal prisoners and to each prisoner 
subject to such proposed regulation. 
Deadline. 
"(k) REPORTS TO CONGRESS.—Not later than 1 year after the 
date of the enactment of the Federal Prisoner Health Care 
Copayment Act of 2000, and annually thereafter, the Director shall 
transmit to Congress a report, which shall include— 
"(1) a description of the amounts collected under this sec-
tion during the preceding 12-month period; 
"(2) an analysis of the effects of the implementation of 
this section, if any, on the nature and extent of heath care 
visits by prisoners; 
"(3) an itemization of the cost of implementing and admin-
istering the program; 
"(4) a description of current inmate health status indicators 
as compared to the year prior to enactment; £ind 
"(5) a description of the quality of health care services 
provided to inmates during the preceding 12-month period, 
as compared with the quality of those services provided during 
the 12-month period ending on the date of the enactment of 
such Act. 
"(1) 
COMPREHENSIVE 
HIV/AIDS 
SERVICES 
REQUIRED.—The 
Bureau of Prisons shall provide comprehensive coverage for services 
relating to human immunodeficiency virus (HIV) and acquired 
immune deficiency syndrome (AIDS) to each Federal prisoner in 
the custody of the Bureau of Prisons when medically appropriate. 
The Bureau of Prisons may not assess or collect a fee under this 
section for providing such coverage.". 
(b) CLERICAL AMENDMENT.—The analysis for chapter 303 of 
title 18, United States Code, is amended by adding at the end 
the following: 
"4048. Fees for health care services for prisoners.". 
SEC. 3. HEALTH CARE FEES FOR FEDERAL PRISONERS IN NON-FED-
ERAL INSTITUTIONS. 
Section 4013 of title 18, United States Code, is amended by 
adding at the end the following: 
"(c) HEALTH CARE FEES FOR FEDERAL PRISONERS IN NON-FED-
ERAL INSTITUTIONS.— 
"(1) IN GENERAL.—Notwithstanding amoionts paid under 
subsection (a)(3), a State or local government may assess and 
PUBLIC LAW 106-294—OCT. 12, 2000 
114 STAT. 1041 
collect a reasonable fee from the trust fund account (or institu-
tional equivalent) of a Federal prisoner for health care services, 
if— 
"(A) the prisoner is confined in a non-Federal institu-
tion pursuant to an agreement between the Federal 
Government and the State or local government; 
"(B) the fee— 
"(i) is authorized under State law; and 
"(ii) does not exceed the amount collected fi'om 
State or local prisoners for the same services; and 
"(C) the services— 
"(i) are provided within or outside of the institution 
by a person who is licensed or certified under State 
law to provide health care services and who is oper-
ating within the scope of such license; 
"(ii) constitute a health care visit within the 
meaning of section 4048(a)(4) of this title; and 
"(iii) are not preventative health care services, 
emergency services, prenatal care, diagnosis or treat-
ment of chronic infectious diseases, mental health care, 
or substance abuse treatment. 
"(2) N o REFUSAL OF TREATMENT FOR FINANCIAL REASONS.— 
Nothing in this subsection may be construed to permit any 
refusal of treatment to a prisoner on the basis that— 
"(A) the account of the prisoner is insolvent; or 
"(B) the prisoner is otherwise unable to pay a fee 
assessed under this subsection. 
"(3) NOTICE TO PRISONERS OF LAW.—Each person who is 
or becomes a prisoner shall be provided with written and oral 
notices of the provisions of this subsection and the applicability 
of this subsection to the prisoner. Notwithstanding any other 
E
rovision of this subsection, a fee under this section may not 
e assessed against, or collected from, such person— 
"(A) until the expiration of the 30-day period beginning 
on the date on which each prisoner in the prison system 
is provided with such notices; and 
"(B) for services provided before the expiration of such 
period. 
"(4) NOTICE TO PRISONERS OF STATE OR LOCAL IMPLEMENTA- 
Effective date. 
TION.—The implementation of this subsection by the State or 
local government, and any amendment to that implementation, 
shall not take effect until the expiration of the 30-day period 
beginning on the date on which each prisoner in the prison 
system is provided with written and oral notices of the provi-
sions of that implementation (or amendment, as the case may 
be). A fee under this subsection may not be assessed against, 
or collected fi*om, a prisoner pursuant to such implementation 
(or amendments, as the case may be) for services provided 
before the expiration of such period. 
"(5) NOTICE BEFORE PUBLIC COMMENT PERIOD.—Before the 
beginning of any period a proposed implementation under this 
subsection is open to public comment, written and oral notice 
of the provisions of that proposed implementation shall be 
provided to groups that advocate on behalf of Federal prisoners 
and to each prisoner subject to such proposed implementation. 
"(6) COMPREHENSIVE HIV/AIDS SERVICES REQUIRED.—Any 
State or local government assessing or collecting a fee under 
X 
114 STAT. 1042 
PUBLIC LAW 106-294—OCT. 12, 2000 
this subsection shall provide comprehensive coverage for serv-
ices relating to human immunodeficiency virus (HIV) and 
acquired immune deficiency syndrome (AIDS) to each Federal 
prisoner in the custody of such State or local government when 
medically appropriate. The State or local government may not 
assess or collect a fee under this subsection for providing such 
coverage.". 
Approved October 12, 2000. 
LEGISLATIVE HISTORY—S. 704 (H.R. 1349): 
HOUSE REPORTS: No. 106-851 accompanying H.R. 1349 (Comm. on the Judici-
ary). 
CONGRESSIONAL RECORD: 
Vol. 145 (1999): May 27, considered and passed Senate. 
Vol. 146 (2000): Sept. 19, considered and passed House, amended, in lieu of 
H.R. 1349. 
Sept. 28, Senate concurred in House amendment.