		I
		112th CONGRESS
		1st Session
		H. R. 2109
		IN THE HOUSE OF REPRESENTATIVES

			June 3, 2011
			Mr. Sessions (for
			 himself, Mrs. Blackburn,
			 Mr. Burton of Indiana,
			 Mr. Terry,
			 Mr. Smith of Texas,
			 Mr. Neugebauer, and
			 Mr. Hensarling) introduced the
			 following bill; which was referred to the Committee on Ways and Means, and in
			 addition to the Committee on Oversight and
			 Government Reform, for a period to be subsequently determined
			 by the Speaker, in each case for consideration of such provisions as fall
			 within the jurisdiction of the committee concerned

		A BILL
		To provide for each American the opportunity to provide
		  for his or her retirement through a S.A.F.E. account, and for other
		  purposes.

		1.Short title and table of
			 contents
			(a)Short
			 titleThis Act may be cited as the Savings Account for Every American Act of
			 2011.
			(b)Table of
			 contentsThe table of contents is as follows:

					Sec. 1. Short title and table of contents.
					TITLE I—Personal retirement program
					Sec. 101. Definitions.
					Sec. 102. S.A.F.E. account payroll deduction
				programs.
					Sec. 103. Designation of S.A.F.E. accounts.
					Sec. 104. Self-employed individuals.
					Sec. 105. Elective participation.
					Sec. 106. Penalties.
					Sec. 107. Federal civilian and military personnel.
					TITLE II—Tax-exempt S.A.F.E. accounts
					Sec. 201. S.A.F.E. accounts.
					Sec. 202. Effective date.
					TITLE III—Conforming amendments to the Social Security Act and
				the Internal Revenue Code of 1986
					Sec. 301. Reductions in and exemptions from FICA taxes and SECA
				taxes with respect to eligible individuals.
					Sec. 302. Exclusion of eligible individuals from old-age,
				survivors, and disability insurance coverage.
					Sec. 303. Information provided in social security account
				statements.

			IPersonal
			 retirement program
			101.DefinitionsFor purposes of this title—
				(1)Account
			 holderThe term account holder means, with respect
			 to any S.A.F.E. account, the individual for whose benefit such account is
			 maintained.
				(2)Business
			 dayThe term business day means any day other than a
			 Saturday, Sunday, or legal holiday in the area involved.
				(3)Covered
			 employerThe term covered employer means, for any
			 calendar year, a person for whom an eligible individual is engaged in
			 employment during the year.
				(4)Eligible
			 individualThe term eligible individual means any
			 individual with respect to whom there is in effect an election under section
			 105(a).
				(5)EmploymentThe
			 term employment has the meaning provided in section 210 of the
			 Social Security Act.
				(6)Prescribed
			 employee contributionThe term prescribed employee
			 contribution means, with respect to any eligible individual who is
			 engaged in employment for a covered employer during any calendar year, an
			 amount equal to 6.2 percent of the wages received by such employee with respect
			 to such employment. The Commissioner of Social Security shall provide by
			 regulation for exclusion of remuneration paid to any employee during any
			 calendar year from the total amount of remuneration treated under this
			 paragraph as wages paid to such employee during such calendar
			 year to the extent that such total amount exceeds the contribution and benefit
			 base for such calendar year under section 230 of the Social Security
			 Act.
				(7)Prescribed
			 self-employment contributionThe term prescribed
			 self-employment contribution means, with respect to the self-employment
			 income of an eligible individual for any calendar year, the excess (if any)
			 of—
					(A)6.2 percent of the
			 amount of such self-employment income for such calendar year, to the extent
			 that such self-employment income does not exceed, for such calendar year, the
			 contribution and benefit base for such calendar year under section 230 of the
			 Social Security Act, over
					(B)the total of all
			 prescribed employee contributions and prescribed employer contributions payable
			 with respect to such eligible individual for such calendar year.
					Effective
			 with the commencement of the 16th calendar year for which the eligible
			 individual’s election under section 105 is in effect, 12.4
			 percent shall be substituted for 6.2 percent in
			 subparagraph (A).(8)Prescribed
			 employer contributionThe term prescribed employer
			 contribution means, with respect to any eligible individual who is
			 engaged in employment for a covered employer during any calendar year, an
			 amount equal to 6.2 percent of the wages received by such employee with respect
			 to such employment, to the extent that such wages do not exceed, for such
			 calendar year, the contribution and benefit base for such calendar year under
			 section 230 of the Social Security
			 Act.
				(9)S.A.F.E.
			 accountThe term S.A.F.E. account has the meaning
			 provided in section 224(c) of the Internal Revenue Code of 1986.
				(10)Self-employment
			 incomeThe term self-employment income has the
			 meaning provided in section 211(b) of the Social
			 Security Act.
				(11)WagesThe
			 term wages has the meaning provided in section 209 of the
			 Social Security Act.
				102.S.A.F.E.
			 account payroll deduction programs
				(a)In
			 generalEach person who is a covered employer for any calendar
			 year shall have in effect throughout such calendar year a S.A.F.E. account
			 payroll deduction program for such person’s employees who are eligible
			 individuals.
				(b)RequirementsFor
			 purposes of this Act, the term S.A.F.E. account payroll deduction
			 program means a written program maintained by a covered employer
			 if—
					(1)under such
			 program, the prescribed employee contribution is deducted from the wages of
			 each employee who is an eligible individual and paid as a contribution on
			 behalf of the employee to a S.A.F.E. account of such employee designated in
			 accordance with section 103,
					(2)under such
			 program, the covered employer—
						(A)makes timely
			 payment of the amount so deducted as a contribution to the designated S.A.F.E.
			 account, and
						(B)effective upon
			 receipt from the eligible individual of certification (in accordance with
			 regulations which shall be prescribed by the Commissioner of Social Security)
			 of the commencement of the 16th calendar year for which the eligible employee’s
			 election under section 105 has been in effect, makes timely payment, together
			 with the amount so deducted, of the prescribed employer contribution with
			 respect to the eligible individual,
						under
			 regulations of the Commissioner of Social Security applying the same principles
			 relating to the timeliness of payment as are applicable under chapter 62 of the
			 Internal Revenue Code of 1986 with respect to taxes under chapter 21 of such
			 Code, and(3)the employer
			 receives no compensation for the cost of administering such program.
					(c)Amounts
			 otherwise payable may be accumulated by employer in certain
			 casesIf, under the terms of the governing instruments creating a
			 S.A.F.E. account designated under section 103, contributions below a specified
			 amount will not be accepted, the requirements of subsection (b)(2) shall be
			 treated as met if amounts deducted from the wages of an employee who is an
			 eligible individual, together with prescribed employer contributions (if any),
			 are accumulated by the covered employer and paid to such account otherwise in
			 accordance with subsection (b)(2) with reference to the first day on which the
			 accumulated amount exceeds such specified amount.
				103.Designation of
			 S.A.F.E. accounts
				(a)In
			 generalExcept as provided in subsection (b), a S.A.F.E. account
			 to which contributions with respect to any employee who is an eligible
			 individual are required to be paid under section 102 shall be such an account
			 designated by such employee to such employer not later than 10 business days
			 after the date on which such employee becomes an employee of such employer. Any
			 such designation shall be made in such form and manner as may be prescribed in
			 regulations of the Commissioner of Social Security.
				(b)Designation in
			 absence of timely designation by employeeIn any case in which no
			 timely designation of a S.A.F.E. account is made, the covered employer shall
			 designate such account in accordance with regulations of the Commissioner of
			 Social Security.
				(c)Subsequent
			 substitution of accountsThe Commissioner of Social Security
			 shall provide by regulation for subsequent designation of a S.A.F.E. account by
			 an account holder in lieu of an account previously designated by such account
			 holder under this section.
				104.Self-employed
			 individuals
				(a)In
			 generalIn the case of an eligible individual who has
			 self-employment income for any calendar year, such individual shall make timely
			 payments to a S.A.F.E. account designated by such individual of the prescribed
			 self-employment contribution with respect to such individual for such calendar
			 year in accordance with regulations of the Commissioner of Social Security,
			 applying the same principles relating to timeliness of payment as are
			 applicable under chapter 62 of the Internal Revenue Code of 1986 with respect
			 to taxes under chapter 2 of such Code.
				(b)Designation of
			 accountThe designation of a S.A.F.E. account for payment of
			 prescribed self-employment contributions shall be made in such form and manner
			 as may be prescribed in regulations of the Commissioner of Social
			 Security.
				(c)Periodic
			 paymentThe Commissioner of Social Security shall provide by
			 regulation for periodic installment payments during the calendar year of
			 prescribed self-employment contributions for each eligible individual, taking
			 into account, as appropriate for each period, prescribed employee contributions
			 for such individual.
				105.Elective
			 participation
				(a)ElectionAny
			 individual who has been assigned a social security account number under section
			 205(c)(2)(B) of the Social Security
			 Act and has been paid wages or has derived self-employment income
			 may, on or after January 1, 2012, elect under this section to be an eligible
			 individual for purposes of this Act. Any such election shall be made by filing
			 with the Commissioner of Social Security, the Secretary of the Treasury, and
			 each person (if any) who is an employer of such individual on the date of the
			 filing, in such form and manner as shall be prescribed in regulations of the
			 Commissioner (in consultation with the Secretary of the Treasury), a written
			 and signed declaration of such individual’s intention to be treated as an
			 eligible individual for purposes of this Act. An election under this section
			 shall be effective with respect to wages paid, and self-employment income
			 derived, on or after January 1 following the date of the filing of the
			 election.
				(b)Election
			 ineffective if entitled to social security benefitsAny election
			 under this section shall not take effect if, as of the effective date of the
			 election, the individual is entitled to an old-age insurance benefit under
			 section 202(a) of the Social Security
			 Act or to a disability insurance benefit under section 223 of such
			 Act.
				(c)Irrevocability
			 subject to grace period
					(1)In
			 generalUnless revoked in accordance with paragraph (2), an
			 election under this section shall be irrevocable.
					(2)Five-year grace
			 period
						(A)In
			 generalAn individual may
			 revoke an election under this section by filing with the Commissioner of Social
			 Security, the Secretary of the Treasury, and each person (if any) who is an
			 employer of such individual on the date of the filing, in such form and manner
			 as shall be prescribed in regulations of the Commissioner (in consultation with
			 the Secretary of the Treasury), a written and signed revocation of the election
			 at any time before the end of the five-year period beginning with the effective
			 date of the election. A revocation under this subsection shall take effect
			 January 1 following the date of the filing of the revocation, except that a
			 revocation filed during the 90-day period beginning with the date of the filing
			 of the election shall take effect as of the effective date of the election.
			 Upon the effective date of a revocation under this subsection, entitlement to
			 benefits under title II of the Social Security
			 Act shall be determined as if the revoked election had not occurred,
			 except that, for purposes of any such entitlement, wages paid, and
			 self-employment income derived, during the period for which the election was in
			 effect shall not be taken into account. No subsequent election under this
			 section may take effect with respect to an individual who has filed a
			 revocation under this subsection (except a revocation filed during the 90-day
			 period beginning with the date of the filing of the election).
						(B)Reduction in
			 benefitsThe primary insurance amount, as determined under
			 section 215 of the Social Security
			 Act, of any individual who has filed a revocation under this
			 subsection before the end of the five-year period described in subparagraph (A)
			 (and after the 90-day period referred to in subparagraph (A)) shall be reduced
			 (except for purposes of determining benefits under section 223 of such Act, and
			 before any application of section 215(i) of such Act) by the applicable
			 percentage specified in the following table:

										If the first calendar year for

										 which the revocation The
					 applicable

										 is effective is: percentage
					 is:

										The first, second, or third calendar year of such five-year
					 period20
					 percent

										The fourth calendar year of such five-year
					 period40
					 percent

										The fifth calendar year of such five-year
					 period60
					 percent

										The calendar year following such five-year
					 period80
					 percent.

						106.Penalties
				(a)Failure To
			 establish S.A.F.E. account payroll deduction programAny covered
			 employer who fails to meet the requirements of section 102 for any calendar
			 year shall be subject to a civil penalty of not to exceed—
					(1)$250,000, in the
			 case of an employer who is an individual, or
					(2)$500,000, in any
			 other case.
					(b)Failure To make
			 deductions required under programAny covered employer who fails
			 to timely deduct in full the amount from the wages of an employee who is an
			 eligible individual as required under an applicable S.A.F.E. account payroll
			 deduction program shall be subject to a civil penalty for each such failure of
			 not to exceed—
					(1)$250,000, in the
			 case of an employer who is an individual, or
					(2)$500,000, in any
			 other case.
					(c)Failure To pay
			 deducted wages to S.A.F.E. accountIf an amount deducted under a
			 S.A.F.E. account payroll deduction program from the wages of an employee who is
			 an eligible individual is not timely paid in full to the designated S.A.F.E.
			 account in accordance with section 102, the covered employer failing to make
			 such payment—
					(1)shall be subject
			 to a civil penalty for each such failure of not to exceed—
						(A)$250,000, in the
			 case of an employer who is an individual, or
						(B)$500,000, in any
			 other case, and
						(2)shall be liable to
			 the employee for interest on the unpaid amount at a rate equal to 10 percentage
			 points in excess of the Federal short-term rate under section 1274(d)(1) of the
			 Internal Revenue Code of 1986, calculated from the last day by which such
			 amount was required to be so paid to the date on which such amount is paid into
			 the designated S.A.F.E. account.
					(d)Failure To pay
			 prescribed self-Employment contributions to S.A.F.E. accountAny
			 eligible individual failing to timely pay in full a prescribed self-employment
			 contribution to a designated S.A.F.E. account as required under section 104
			 shall be subject to a civil penalty for each such failure of not to exceed
			 $250,000, plus interest on the unpaid amount at a rate equal to 10 percentage
			 points in excess of the Federal short-term rate under section 1274(d)(1) of the
			 Internal Revenue Code of 1986, calculated from the last day by which such
			 amount was required to be so paid to the date on which such amount is paid into
			 the designated S.A.F.E. account.
				(e)Rules for
			 application of section
					(1)Penalties
			 assessed by Commissioner of Social SecurityAny civil penalty
			 assessed by this section shall be imposed by the Commissioner of Social
			 Security and collected in a civil action.
					(2)CompromisesThe
			 Commissioner may compromise the amount of any civil penalty imposed by this
			 section.
					(3)Authority to
			 waive penalty in certain casesThe Commissioner may waive the
			 application of this section with respect to any failure if the Commissioner
			 determines that such failure is due to reasonable cause and not to intentional
			 disregard of rules and regulations.
					107.Federal
			 civilian and military personnel
				(a)In
			 generalNot later than December 31, 2011, the Office of Personnel
			 Management, after appropriate study, shall submit to the President and each
			 House of Congress a written report containing recommendations on how to provide
			 for the application of this Act with respect to Federal civilian and military
			 personnel.
				(b)RequirementsThe
			 report—
					(1)shall be prepared
			 in consultation with the Social Security Administration, the Securities and
			 Exchange Commission, and other appropriate agencies; and
					(2)shall be
			 accompanied by draft legislation which, if enacted, would carry out the
			 recommendations contained in such report.
					(c)Provisions
			 relating to the continued operation of existing retirement
			 systemsTo the extent that the report and draft legislation
			 relate to provisions of law in effect before the date of enactment of this Act,
			 each shall address at least the following:
					(1)Federal
			 employees’ retirement system
						(A)Section 8401(11)
			 of title 5, United States Code (relating to the definition of an
			 employee), which includes the requirement that the individual
			 concerned be someone whose civilian service is employment for the purposes of
			 title II of the Social Security Act
			 and chapter 21 of the Internal Revenue Code of 1986.
						(B)Section 8421 of
			 such title (relating to annuity supplement), which includes provisions
			 incorporating the notion of the period of time for which the individual is or
			 would be entitled to old-age insurance benefits under title II of the
			 Social Security Act, and provisions
			 for computing the amount of such supplement based on the amount of certain
			 benefits to which the individual would be entitled under such Act.
						(C)Section 8442 of
			 such title (relating to rights of a widow or widower), which includes
			 provisions under which a supplementary annuity for a widow or widower is not
			 payable to anyone who would not be entitled to certain benefits under the
			 Social Security Act, and provisions
			 for the computation of any such annuity based on the amount of certain benefits
			 which would be payable to that individual under the
			 Social Security Act.
						(D)Section 8443 of
			 such title (relating to rights of a child), which includes provisions under
			 which, as part of the formula for computing the amount of a survivor annuity
			 for a child, there is incorporated the notion of the amount of child’s
			 insurance benefits which are or would be payable under title II of the
			 Social Security Act.
						(2)Civil service
			 retirement system
						(A)Section 8334(k) of
			 such title (relating to special rules for determining deductions and
			 contributions for individuals subject to offset-83 treatment),
			 which incorporates the notion of the OASDI contribution made from Federal wages
			 of the individual concerned.
						(B)Section 8349 of
			 such title (relating to offset based on certain benefits under the
			 Social Security Act), which
			 incorporates notions relating to actual or constructive eligibility for
			 benefits under the Social Security
			 Act, and the amount of those benefits.
						(3)Coordination
			 provisionsProvisions of law involving a reduction or other
			 adjustment in retirement benefits (or eligibility therefor), based on any
			 individual’s eligibility for benefits under title II of the
			 Social Security Act.
					(4)Other retirement
			 systemsSimilar provisions of law under other retirement systems
			 covering Federal civilian or military personnel.
					(d)Provisions
			 relating to the new systemTo the extent that the report and
			 draft legislation relate to the implementation of any other title of this Act,
			 each shall address at least the following:
					(1)What the
			 specifications for the S.A.F.E. account payroll deduction program or programs
			 covering Federal civilian and military personnel shall be or, alternatively,
			 how those specifications shall be developed.
					(2)Which agencies or
			 instrumentalities of the Federal Government shall be responsible for operating
			 or maintaining which aspects of the program or programs referred to in
			 paragraph (1).
					(3)Which penalty
			 provisions are appropriate or inappropriate with respect to the Federal
			 Government in its capacity as a covered employer, subject to
			 what modifications (if any).
					IITax-exempt
			 S.A.F.E. accounts
			201.S.A.F.E.
			 accounts
				(a)In
			 generalPart VII of subchapter B of chapter 1 of the Internal
			 Revenue Code of 1986 (relating to additional itemized deductions for
			 individuals) is amended by redesignating section 224 as section 225 and by
			 inserting after section 223 the following new section:

						224.S.A.F.E.
				accounts
							(a)Deduction
				allowedIn the case of an individual, there shall be allowed as a
				deduction the aggregate amount paid in cash during the taxable year by or on
				behalf of such individual to a S.A.F.E. account of such individual.
							(b)LimitationThe
				amount allowable as a deduction under subsection (a) for any taxable year shall
				not exceed 6.2 percent of the lesser of—
								(1)the contribution
				and benefit base (as determined under section 230 of the
				Social Security Act) for the calendar
				year which ends with or within such taxable year, or
								(2)the sum of—
									(A)the amount of
				wages (as defined in section 3121(a)) received during such calendar year,
				and
									(B)the amount of the
				self-employment income (as defined in section 1402) of such individual for the
				taxable year.
									Effective
				with the commencement of the 16th calendar year for which the individual’s
				election under section 105 of the Savings
				Account for Every American Act of 2011 is effective, the
				limitation under the preceding sentence shall be increased by any prescribed
				employer contribution paid to a personal retirement account of such individual
				pursuant to section 102(b)(2)(B) of such Act and the portion of any prescribed
				self-employment contribution paid to such an account which is attributable to
				the increase in such contribution required by the last sentence of section
				101(7) of such Act.(c)S.A.F.E.
				accountFor purposes of this section, the term S.A.F.E.
				account means a trust created or organized in the United States
				exclusively for the benefit of an individual or his beneficiaries, but only if
				the written governing instrument creating the trust meets the following
				requirements:
								(1)Except in the case
				of rollover contributions from another S.A.F.E. account of such
				individual—
									(A)no contribution
				will be accepted unless it is in cash,
									(B)contributions will
				not be accepted for the taxable year in excess of 6.2 percent of the
				contribution and benefit base (as determined under section 230 of the
				Social Security Act) for the calendar
				year which ends with or within such taxable year, and
									(C)any contributions
				with respect to an account holder which are not accepted pursuant to this
				paragraph are promptly refunded directly to the account holder.
									In the
				case of any such individual, effective for taxable years beginning with or
				after the 16th calendar year for which the individual’s election under section
				105 of the Savings Account for Every American
				Act of 2011 is effective, 12.4 percent shall be
				substituted for 6.2 percent in subparagraph (B).(2)The trustee is a
				bank (as defined in section 408(n)) or such other person who demonstrates to
				the satisfaction of the Secretary that the manner in which such other person
				will administer the trust will be consistent with the requirements of this
				section.
								(3)No part of the
				trust funds will be invested in life insurance contracts.
								(4)The interest of an
				individual in the balance in his account is nonforfeitable.
								(5)The assets of the
				trust will not be commingled with other property except in a common trust fund
				or common investment fund.
								(d)Tax treatment of
				distributions
								(1)In
				generalExcept as otherwise provided in this subsection, any
				amount distributed out of a S.A.F.E. account shall be included in gross income
				of the distributee for the taxable year in which the distribution is received.
				Notwithstanding any other provision of this title (including chapters 11 and
				12), the basis of any person in such an account is zero.
								(2)Exceptions for
				distributions after social security retirement age or
				deathParagraph (1) shall not apply to any distribution out of a
				S.A.F.E. account—
									(A)made on or after
				the date on which the account beneficiary attains retirement age (as defined in
				section 216(l) of the Social Security Act), or
									(B)made to the
				account beneficiary (or to the estate of the beneficiary) on or after the death
				of the account beneficiary.
									(3)Exceptions for
				distributions to purchase certain insuranceParagraph (1) shall
				not apply to any distribution out of a S.A.F.E. account to the account
				beneficiary to the extent such distributions do not exceed the sum of the
				expenses paid or incurred during the taxable year for—
									(A)any qualified
				long-term care insurance contract (but only to the extent of eligible long-term
				care premiums (as defined in section 213(d)(10)),
									(B)disability
				insurance, or
									(C)term life
				insurance.
									(4)Exceptions for
				certain other distributionsRules similar to the rules of
				paragraphs (3), (4), (5), and (6) of section 408(d) shall apply for purposes of
				this section.
								(e)Tax treatment of
				accounts
								(1)Exemption from
				taxA S.A.F.E. account is exempt from taxation under this
				subtitle unless such account has ceased to be a S.A.F.E. account by reason of
				paragraph (2). Notwithstanding the preceding sentence, any such account is
				subject to the taxes imposed by section 511 (relating to imposition of tax on
				unrelated business income of charitable, etc. organizations).
								(2)Account
				terminationsRules similar to the rules of paragraphs (2) and (4)
				of section 408(e) shall apply to S.A.F.E. accounts, and any amount treated as
				distributed under such rules shall be treated as not used to pay expenses
				described in subsection (d)(3).
								(f)Additional tax
				on amounts included in gross incomeIf any distribution from a
				S.A.F.E. account is includible in gross income of the account beneficiary, the
				tax liability of such beneficiary under this chapter for the taxable year in
				which the distribution is received shall be increased by an amount equal to 20
				percent of the amount of the distribution.
							(g)Other definition
				and special rules
								(1)Account
				beneficiaryFor purposes of this section, the term account
				beneficiary means the individual for whose benefit the S.A.F.E. account
				was established.
								(2)Certain rules to
				applyRules similar to the following rules shall apply for
				purposes of this section:
									(A)Section 219(d)(2)
				(relating to no deduction for rollovers).
									(B)Section 219(f)(3)
				(relating to time when contributions deemed made).
									(C)Section 219(f)(5)
				(relating to employer payments).
									(D)Section 408(g)
				(relating to community property laws).
									(E)Section 408(h)
				(relating to custodial accounts).
									(h)ReportsThe
				trustee of a S.A.F.E. account shall make such reports regarding such account to
				the Secretary and to the individual for whose benefit the account is maintained
				with respect to contributions, distributions, and such other matters as the
				Secretary may by regulation prescribe. The reports required by this subsection
				shall be filed at such time and in such manner, and furnished to such
				individuals at such time and in such manner, as may be required by such
				regulations.
							.
				(b)Deduction
			 allowed in arriving at adjusted gross incomeSubsection (a) of
			 section 62 of the Internal Revenue Code of 1986 is amended by inserting after
			 paragraph (21) the following new paragraph:

						(22)S.A.F.E.
				account contributionsThe deduction allowed by section
				224.
						.
				(c)Tax on excess
			 contributions
					(1)Subsection (a) of
			 section 4973 of such Code (relating to tax on excess contributions to
			 individual retirement accounts, etc.) is amended by striking or
			 at the end of paragraph (4), by inserting or at the end of
			 paragraph (5), and by inserting after paragraph (5) the following new
			 paragraph:

							(6)a S.A.F.E. account
				(within the meaning of section
				224(c)),
							.
					(2)Section 4973 of
			 such Code is amended by adding at the end the following new subsection:

							(h)Excess
				contributions to S.A.F.E. accountsFor purposes of this section,
				in the case of S.A.F.E. accounts (within the meaning of section 224(c)), the
				term excess contributions means the sum of—
								(1)the excess (if
				any) of—
									(A)the aggregate
				amount contributed for the taxable year to the accounts (other than rollover
				contributions), over
									(B)the amount
				allowable as a deduction under section 224 for such contributions, and
									(2)the amount
				determined under this subsection for the preceding taxable year, reduced by the
				sum of—
									(A)the distributions
				out of the accounts which were included in gross income under rules similar to
				the rules of section 408(d)(5) which apply to such accounts by reason of
				section 224(d)(4), and
									(B)the excess (if
				any) of—
										(i)the maximum amount
				allowable as a deduction under section 224(b) for the taxable year, over
										(ii)the amount
				contributed to the accounts for the taxable year.
										For
				purposes of this subsection, any contribution which is distributed out of the
				S.A.F.E. account in a distribution to which the rules similar to the rules of
				section 408(d)(4) which apply to such accounts by reason of section 224(d)(4)
				shall be treated as an amount not
				contributed..
					(d)Tax on
			 prohibited transactions
					(1)In
			 generalParagraph (1) of section 4975(e) of such Code (relating
			 to prohibited transactions) is amended by striking or at the end
			 of subparagraph (F), by redesignating subparagraph (G) as subparagraph (H), and
			 by inserting after subparagraph (F) the following new subparagraph:

							(G)a S.A.F.E. account
				described in section 224(c),
				or
							.
					(2)Special
			 ruleSubsection (c) of section 4975 of such Code is amended by
			 adding at the end the following new paragraph:

							(7)Special rule for
				s.a.f.e. accountsAn individual for whose benefit a S.A.F.E.
				account is established shall be exempt from the tax imposed by this section
				with respect to any transaction concerning such account (which would otherwise
				be taxable under this section) if section 224(e)(2) applies with respect to
				such
				transaction.
							.
					(e)Failure To
			 provide reports on S.A.F.E. accountsParagraph (2) of section
			 6693(a) of such Code (relating to failure to provide reports on individual
			 retirement accounts or annuities) is amended by striking and at
			 the end of subparagraph (D), by striking the period at the end of subparagraph
			 (E) and inserting , and, and by adding at the end the following
			 new subparagraph:

						(F)Section 224(h)
				(relating to S.A.F.E.
				accounts).
						.
				(f)Clerical
			 amendmentThe table of sections for part VII of subchapter B of
			 chapter 1 of such Code is amended by striking the item relating to section 224
			 and inserting the following new items:

							Sec. 224. S.A.F.E. accounts.
							Sec. 225. Cross
				references.

						.
				202.Effective
			 dateThe amendments made by
			 this title shall apply to contributions made for taxable years beginning after
			 December 31, 2011.
			IIIConforming
			 amendments to the Social Security Act and the Internal Revenue Code of
			 1986
			301.Reductions in
			 and exemptions from FICA taxes and SECA taxes with respect to eligible
			 individuals
				(a)FICA tax on
			 employeesSection 3101 of the Internal Revenue Code of 1986
			 (relating to OASDI tax on employees) is amended—
					(1)in subsection (a),
			 by striking In addition and inserting Subject to
			 subsection (c), in addition;
					(2)by redesignating
			 subsection (c) as subsection (d); and
					(3)by inserting after
			 subsection (b) the following new subsection:

							(c)Exemption from
				OASDI tax for eligible individualsSubsection (a) shall not apply
				with respect to wages received by an eligible individual (as defined in section
				101(4) of the Savings Account for Every
				American Act of 2011).

					(b)FICA tax on
			 employersSection 3111 of such Code (relating to OASDI tax on
			 employees) is amended—
					(1)in subsection (a),
			 by striking In addition and inserting Subject to
			 subsection (c), in addition;
					(2)by redesignating
			 subsection (c) as subsection (d); and
					(3)by inserting after
			 subsection (b) the following new subsection:

							(c)Exemption from
				OASDI tax with respect to eligible individualsIn the case of an
				eligible individual (as defined in section 101(4) of the
				Savings Account for Every American Act of
				2011), effective with the 16th calendar year for which such
				individual’s election under section 105 of such Act is effective, subsection
				(a) shall not apply with respect to wages received by such
				individual.

					(c)Reduction in and
			 exemption from self-Employment taxSection 1401 of such Code
			 (relating to OASDI tax on self-employment income) is amended—
					(1)in subsection (a),
			 by striking In addition and inserting Subject to
			 subsection (c), in addition;
					(2)by redesignating
			 subsection (c) as subsection (d); and
					(3)by inserting after
			 subsection (b) the following new subsection:

							(c)Adjustment to
				OASDI tax
								(1)ReductionIn
				the case of an eligible individual (as defined in section 101(4) of the
				Savings Account for Every American Act of
				2011), for taxable years beginning with or during the 1st 15
				calendar years for which such individual’s election is in effect under section
				105 of such Act, the rate of tax under subsection (a) shall be 6.20
				percent.
								(2)ExemptionIn
				the case of such an eligible individual, effective for taxable years beginning
				with or during the 16th calendar year for which such individual’s election
				under such section 105 is effective, subsection (a) shall not
				apply.

					(d)Effective
			 dateThe amendments made by this section shall apply with respect
			 to wages received after December 31, 2012, and with respect to self-employment
			 income for taxable years beginning after such date.
				302.Exclusion of
			 eligible individuals from old-age, survivors, and disability insurance
			 coverage
				(a)Monthly
			 insurance benefits under Section 202Section 202 of the
			 Social Security Act (42 U.S.C. 402) is
			 amended by adding at the end the following new subsection:

						(z)Limitation on payment to eligible individuals under Savings
		  Account for Every American Act of 2011(1)Notwithstanding any
				other provision of this title, no monthly benefits shall be paid under this
				section based on the wages and self-employment income of an eligible individual
				(as defined in section 101(4) of the Savings
				Account for Every American Act of 2011).
							(2)Determinations of entitlement to
				hospital insurance benefits under section 226 or 226A shall be made without
				regard to paragraph
				(1).
							.
				(b)Disability
			 insurance benefits under Section 223Section 223 of such Act (42
			 U.S.C. 423) is amended by adding at the end the following new
			 subsection:
					(k)Limitation on payment to
		  eligible individuals under Savings Account for every American Act of
		  2011(1)Notwithstanding any
				other provision of this title, no monthly benefits shall be paid under this
				section based on the wages and self-employment income of an eligible individual
				(as defined in section 101(4) of the Savings
				Account for Every American Act of 2011).
							(2)Determinations of entitlement to
				hospital insurance benefits under section 226 or 226A shall be made without
				regard to paragraph
				(1).
							.
				303.Information
			 provided in social security account statements
				(a)In
			 generalSection 1143 of the Social
			 Security Act (42 U.S.C. 1320b–13) is amended to read as
			 follows:

						1143.Social Security Account Statement(a)Provision of annual statementsThe Commissioner of
				Social Security shall provide an annual social security account statement
				(hereinafter in this section referred to as the statement) to
				each eligible individual who is not receiving benefits under title II and for
				whom a mailing address can be determined through such methods as the
				Commissioner determines to be appropriate.
							(b)Contents of statementEach statement
				shall contain—
								(1)the amount of
				wages paid to and self-employment income derived by the eligible individual as
				shown by the records of the Commissioner;
								(2)an estimate of the
				aggregate of the employer, employee, and self-employment contributions of the
				eligible individual for old-age, survivors, and disability insurance as shown
				by the records of the Commissioner;
								(3)a separate
				estimate of the aggregate of the employer, employee, and self-employment
				contributions of the eligible individual for hospital insurance as shown by the
				records of the Commissioner; and
								(4)an estimate of the
				potential monthly retirement, disability, survivor, and auxiliary benefits
				payable on the eligible individual’s account together with a description of the
				benefits payable under the medicare program of title XVIII.
								(c)Eligible individualFor purposes of
				this section, the term eligible individual means an individual
				who—
								(1)has a social
				security account number, and
								(2)has wages or net
				earnings from
				self-employment.
								.
				(b)Effective
			 dateThe amendment made by subsection (a) shall apply with
			 respect to statements provided on or after October 1, 2012.


		I
		112th CONGRESS
		1st Session
		H. R. 92
		IN THE HOUSE OF REPRESENTATIVES

			January 5, 2011
			Mrs. Biggert
			 introduced the following bill; which was referred to the
			 Committee on Energy and
			 Commerce, and in addition to the Committee on
			 Ways and Means, for a
			 period to be subsequently determined by the Speaker, in each case for
			 consideration of such provisions as fall within the jurisdiction of the
			 committee concerned

		A BILL
		To amend title XVIII of the Social Security Act to
		  provide payments under the Medicare Program to licensed health care
		  practitioners for unscheduled telephone consultation services in the case that
		  such payments are determined to be cost and quality effective.

		1.Short titleThis Act may be cited as the
			 Tele-Care Act of
			 2011.
		2.Medicare payment
			 for unscheduled physician telephone services
			(a)Coverage under
			 part B
				(1)In
			 generalSection 1861(s)(2) of the Social Security Act (42 U.S.C.
			 1395x(s)(2)) is amended—
					(A)in subparagraph
			 (EE), by striking and at the end;
					(B)in subparagraph
			 (FF), by adding at the end and; and
					(C)by adding at the
			 end the following new subparagraph:

							(GG)subject to section 2(c) of the
				Tele-Care Act of 2011,
				unscheduled telephone consultation services (as defined in subsection (iii)(1))
				by a licensed health care practitioner, as defined by the Secretary (such as a
				physician, nurse practitioner, physician assistant, or nurse midwife), with
				respect to the furnishing of primary care services to an individual, if—
								(i)the Medicare number of the individual is
				associated with the national provider identifier of the licensed health care
				practitioner;
								(ii)to ensure the quality and appropriateness
				of such consultation services, the utilization of such services by the
				individual can be reviewed by a utilization and quality control peer review
				organization or eligible entity with which the Secretary has entered into a
				contract under part B of title XI or section 1893, respectively, by the
				organization or entity applying for purposes of the review under this
				subparagraph the processes and standards used by such organization or entity
				under such part or section, respectively, in the same manner that such
				processes and standards apply for purposes of carrying out utilization and
				quality review under such part or section, respectively;
								(iii)such
				consultation services are securely recorded by the Secretary (or an entity
				described in subsection (iii)(1) with which the Secretary enters into a
				contract) for purposes of appropriate review by peers of the licensed health
				care practitioner who practice in the same medical specialty as the licensed
				health care practitioner and Medicare administrative contractor oversight of
				such services; and
								(iv)the licensed
				health care practitioner provides for the submission to the Secretary (or an
				entity described in subsection (iii)(1) with which the Secretary enters into a
				contract) and the Secretary (or such an entity) records and maintains a summary
				of each such consultation service furnished by the licensed health care
				practitioner that includes—
									(I)the date and time
				(including duration) of the consultation service;
									(II)a unique medical
				record number specified by the Secretary (or such entity) to identify the
				consultation service;
									(III)the name of the
				individual;
									(IV)the name of the
				licensed health care practitioner; and
									(V)a summary of the
				content of the consultation
				service;
									.
					(2)Unscheduled
			 telephone consultation services definedSection 1861 of such Act (42 U.S.C. 1395x)
			 is amended by adding at the end the following new subsection:

						(iii)Unscheduled telephone consultation
		  services(1)The term
				unscheduled telephone consultation service means a consultation
				conducted by means of telephone or similar electronic communication device
				between a licensed health care practitioner described in subsection (s)(2)(GG)
				and an individual (or a representative of such individual), with respect to the
				furnishing of primary care services to such individual, that is not included as
				a scheduled physician service (as defined by the Secretary in regulations), and
				which is initiated by the individual (or representative) contacting a
				communication network operated by the Secretary (or an entity with which the
				Secretary enters into a contract) that connects the individual to the licensed
				health care practitioner, securely records the consultation for purposes of
				subsection (s)(2)(GG), and maintains the information described in clause (iv)
				of such subsection with respect to such consultation.
							(2)For purposes of applying the
				regulations promulgated pursuant to section 264(c) of the Health Insurance
				Portability and Accountability Act of 1996 (Public Law 104–191; 110 Stat. 2033)
				with respect to an unscheduled telephone consultation service furnished by a
				licensed health care practitioner—
								(A)an entity with which the Secretary
				contracts under this subsection shall be treated as a health oversight agency;
				and
								(B)activities of such an entity described
				in subparagraph (A) in relation to such licensed health care practitioner and
				such unscheduled telephone consultation service are deemed to be health
				oversight
				activities.
								.
				(b)Payment under
			 physician fee scheduleSection 1848(j)(3) of such Act (42 U.S.C.
			 1395w–4(j)(3)) is amended by inserting (2)(GG), after
			 health risk assessment),.
			(c)Contingent
			 effective date, demonstration program
				(1)Contingent
			 effective dateThe amendments made by this section shall become
			 effective (if at all) in accordance with paragraph (2).
				(2)Demonstration
			 program
					(A)In
			 generalThe Secretary of
			 Health and Human Services (in this paragraph referred to as the
			 Secretary) shall establish a demonstration program to begin not
			 later than 6 months after the date of the enactment of this Act to test the
			 effectiveness of providing coverage under the Medicare program for unscheduled
			 telephone consultation services (as defined in section 1861(iii) of the Social
			 Security Act, as added by subsection (a)(2)), by licensed health care
			 practitioners to the extent provided under the amendments made by this section
			 to a sample group of Medicare beneficiaries. For purposes of such demonstration
			 program, the Secretary shall find that the provision of such coverage is
			 effective if—
						(i)the
			 coverage reduces costs to the Medicare program (such as through a reduction in
			 admissions to the emergency departments of hospitals), whether or not such
			 reduction is demonstrated in a reduction in the facility fees of hospital
			 emergency departments, professional fees of emergency department licensed
			 health care practitioners, laboratory fees, pathologist fees, hospital
			 radiology department fees for technical components of x-rays, radiologist
			 professional fees for interpreting x-rays, hospital respiratory department fees
			 for respiratory treatments, hospital cardiology department fees for
			 electrocardiograms, professional fees for interpreting such electrocardiograms,
			 or any other cost specified by the Secretary; and
						(ii)the
			 coverage results in patient health outcomes that are at least as favorable as
			 would apply in the absence of such coverage (as determined in accordance with
			 criteria established by the Centers for Medicare & Medicaid Services, in
			 consultation with physician organizations).
						(B)Initial period
			 of demonstration programThe demonstration program under
			 subparagraph (A) shall be conducted for an initial period of 24 months.
					(C)Report to
			 Congress
						(i)In
			 generalNot later than 30 days after the last day of the initial
			 period under subparagraph (B), the Secretary shall submit to Congress a report
			 on the results of the demonstration program under this paragraph.
						(ii)Finding that
			 payments are effectiveIf the
			 Secretary finds, on the basis of the data derived from the demonstration
			 program under subparagraph (A) and in accordance with such subparagraph, that
			 providing coverage under the Medicare program for unscheduled telephone
			 consultation services by licensed health care practitioners (to the extent
			 provided under the amendments made by this section) is effective, the
			 amendments made by this section shall become effective on the first day of the
			 first month beginning after the date the report under clause (i) is submitted
			 to Congress.
						(iii)Finding that
			 payments are not effectiveIf
			 the Secretary finds, on the basis of the data derived from the demonstration
			 program under subparagraph (A) and in accordance with such subparagraph, that a
			 finding of effectiveness (as described in clause (ii)) cannot be made, the
			 demonstration program shall continue for a period of an additional 24 months.
			 Not later than 30 days after the last day of such period, the Secretary shall
			 submit to Congress a final report on the results of such program. The
			 amendments made by this section shall become effective on the first day of the
			 first month beginning after the date such report is submitted to Congress
			 unless the report contains a finding by the Secretary, on the basis of such
			 data and in accordance with such subparagraph, that providing coverage under
			 the Medicare program for unscheduled telephone consultation services by
			 licensed health care practitioners (to the extent provided under the amendments
			 made by this section) is not effective, in which case the amendments made by
			 this section shall not become effective.
						(d)ClarificationNothing
			 in the provisions of this section or the amendments made by this section shall
			 be construed as authorizing the creation of a national reporting system on
			 licensed health care practitioner quality.


116 S237 IS: Promoting Access to Diabetic Shoes Act
U.S. Senate
2019-01-28
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

II116th CONGRESS1st SessionS. 237IN THE SENATE OF THE UNITED STATESJanuary 28, 2019Mr. Brown (for himself and Ms. Collins) introduced the following bill; which was read twice and referred to the Committee on FinanceA BILLTo amend title XVIII of the Social Security Act to permit nurse practitioners and physician
			 assistants to satisfy the documentation requirement under the Medicare
			 program for coverage of certain shoes for individuals with diabetes.

 1.Short titleThis Act may be cited as the Promoting Access to Diabetic Shoes Act. 2.Permitting nurse practitioners and physician assistants to satisfy Medicare documentation requirement for coverage of certain shoes for individuals with diabetesSection 1861(s)(12) of the Social Security Act (42 U.S.C. 1395x(s)(12)) is amended—
 (1)in subparagraph (A), by inserting , nurse practitioner, or physician assistant after physician; and (2)in subparagraph (C), by inserting , nurse practitioner, or physician assistant after each occurrence of physician.


		I
		111th CONGRESS
		1st Session
		H. R. 1941
		IN THE HOUSE OF REPRESENTATIVES

			April 2, 2009
			Mr. Mitchell (for
			 himself, Mr. Flake,
			 Mr. Heller, and
			 Ms. Titus) introduced the following
			 bill; which was referred to the Committee
			 on Transportation and Infrastructure

		A BILL
		To allow for additional flights beyond the perimeter
		  restriction applicable to Ronald Reagan Washington National
		  Airport.

		1.Extending the length of
			 flights from Ronald Reagan Washington National AirportSection 41718 of title 49, United States
			 Code, is amended by adding at the end the following:

				(g)Use of airport
				slots for beyond perimeter flightsNotwithstanding section 49109 or any other
				provision of law, any air carrier that holds or operates air carrier slots at
				Ronald Reagan Washington National Airport as of January 1, 2009, pursuant to
				subparts K and S of part 93 of title 14, Code of Federal Regulations, which are
				being used as of that date for scheduled service between that airport and a
				large hub airport (as defined in section 40102(a)) may use such slots for
				service between Ronald Reagan Washington National Airport and any airport
				located outside of the perimeter restriction described in section
				49109.
				.


117 HR 1160 IH: Intelligence on Nefarious Foreign Leaders Using Education Networks for Corrupt Enrichment Act
U.S. House of Representatives
2021-02-18
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I117th CONGRESS1st SessionH. R. 1160IN THE HOUSE OF REPRESENTATIVESFebruary 18, 2021Mr. Murphy of North Carolina (for himself, Mr. Rice of South Carolina, Mr. Tiffany, and Mr. Budd) introduced the following bill; which was referred to the Committee on Education and LaborA BILLTo amend the Higher Education Act of 1965 to improve protections against foreign influence at institutions of higher education, and for other purposes.1.Short titleThis Act may be cited as the Intelligence on Nefarious Foreign Leaders Using Education Networks for Corrupt Enrichment Act or the INFLUENCE Act.2.FindingsCongress finds the following:(1)Schools in the United States, especially institutions of higher education overseeing either sensitive research or critical military technology systems, have provided a level of access to the Chinese government that the Chinese government has refused to provide to the United States. (2)China’s control over the flow of information means the American people have an incomplete picture of Chinese government actions and policies that run counter to the interest of the United States at home and abroad.(3)In the last 15 years, the Chinese government has opened over 100 Confucius Institutes on college and university campuses in the United States to increase their cultural standing in popular culture. While there are currently more than 500 Confucius Institutes worldwide, the United States has more Confucius Institutes than any other country. (4)Federal Government officials have expressed concerns about Confucius Institutes. Christopher Wray, Director of the Federal Bureau of Investigation, testified that the FBI is watching warily Confucius Institutes and in certain instances have developed appropriate investigative steps.(5)The Department of Education has not conducted regular oversight of the compliance of institutions of higher education with foreign gift reporting requirements and, until recently, has failed to adequately enforce the requirements of section 117 of the Higher Education Act of 1965 (relating to disclosures of foreign gifts). The Department of Education maintains a database detailing the reporting of foreign gifts received by institutions, but relies solely on the institutions to self-report gifts.(6)The Department of Education is updating the reporting requirements applicable to institutions of higher education. Previously, the Department of Education had not issued guidance on foreign gift reporting by institutions of higher education since 2004. As a result, institution’s informed Congress that the reporting requirements were unclear and confusing. Institutions also informed Congress that the Department of Education website used to report foreign gifts was dated and difficult to use.(7)Absent full transparency regarding how Confucius Institutes operate and full reciprocity for the cultural outreach efforts of the United States on college campuses in China, Confucius Institutes should not continue in the United States unchecked or unsupervised.3.Enhanced disclosure of certain foreign gifts and contractsSection 117 of the Higher Education Act of 1965 (20 U.S.C. 1011f) is amended—(1)by amending subsection (a) to read as follows:(a)Disclosure reportAn institution shall file a disclosure report with the Secretary on January 31 or July 31, whichever is sooner, whenever one or more of the following occurs:(1)The institution is owned or controlled by a foreign source.(2)The institution receives a gift from or enters into a contract with a foreign source determined by the Secretary to be acting directly or indirectly on behalf of a foreign government that is adversarial to the United States, regardless of the value of the gift or contract.(3)The institution receives a gift from or enters into a contract with a foreign source not described in paragraph (2), the value of which is—(A)$50,000 considered alone; or(B)$100,000 or more in combination with all other gifts from or contracts with that foreign source within a calendar year.;(2)by amending subsection (e) to read as follows:(e)Public availability of information(1)Public inspectionSubject to paragraph (4), all disclosure reports required by this section shall be public records open to inspection and copying during business hours.(2)Publication by Department of EducationNot later than 180 days after the date of enactment of the INFLUENCE Act, and on an annual basis thereafter, the Secretary of Education shall make available, on a publicly accessible website of the Department of Education, a database of the information disclosed to the Secretary under this section during the preceding year.(3)Publication by institutionsNot later than 180 days after the date of enactment of the INFLUENCE Act, and on an annual basis thereafter, each institution that receives a gift or enters into a contract described in subsection (a) shall make available, on a publicly accessible website of the institution—(A)in the case of a gift described in such subsection, a detailed explanation of the gift, including the amount of the gift, identification of the source of the gift, and any conditions or restrictions on the gift; and(B)in the case of a contract described in such subsection, a complete and accurate copy of the contract.(4)Restriction on publication of sensitive information(A)In generalInformation made publicly available under this section shall not include information that is determined by an institution to be confidential, proprietary, or otherwise prohibited from disclosure by law.(B)Enforcement authorityIf the Secretary determines that an institution of higher education willfully or negligently disclosed information that is confidential, proprietary, or otherwise prohibited from disclosure by law in violation of subparagraph (A), the Secretary may declare such institution ineligible to participate in programs authorized under title IV of this Act.; and(3)in subsection (f)(2), by inserting before the period at the end the following: , in addition to any other amounts as determined appropriate by the Secretary of Education. 4.Foreign involvement in sensitive projectsThe Higher Education Act of 1965 (20 U.S.C. 1001 et seq.) is further amended by inserting after section 117 the following:117a.Requirements for certain foreign contracts(a)Foreign involvement in sensitive projects(1)In generalIn a case in which an institution enters into a contract with a foreign individual under which the individual will participate in a sensitive project—(A)the institution shall disclose to the Secretary—(i)the date on which individual is expected to return to their home country; and(ii)and the name of the country to which the individual is expected to return; and(B)such contract shall provide—(i)that the individual may not disclose information derived from such project to a foreign government or any other foreign entity; and(ii)that the penalties for disclosure of such information shall be the cancellation of the contract and a requirement to reimburse the Federal Government as described in paragraph (2).(2)Liability for disclosureA foreign individual who knowingly or willfully discloses information in violation of a contract under paragraph (1) shall be required to reimburse the Federal Government for the full costs of any investigation or administrative action resulting from such violation, in addition to any other amounts as determined appropriate by the Secretary.(b)China-Affiliated cultural or language programIn a case in which an institution enters into a contract with an individual or entity under which a China-affiliated cultural or language program will be allowed to operate at the institution, such contract—(1)shall include a provision protecting academic freedom at the institution; and(2)shall not include any provision that would limit the rights of an individual under the Constitution of the United States.(c)DefinitionsIn this section:(1)The term China-affiliated cultural or language program means any project, program, or other activity that—(A)seeks to familiarize students with Chinese language or culture; and(B)is directly or indirectly funded by the Government of the People’s Republic of China.(2)The term sensitive project means any project, program, or other activity carried out by an institution—(A)that is funded, in whole or in part, by Federal funds; and(B)for which a security clearance is required as a condition of participation..5.Interagency coordination on enforcement of foreign gift and contract requirementsThe Higher Education Act of 1965 (20 U.S.C. 1001 et seq.) is further amended by inserting after section 117a (as added by section 4) the following:117b.Interagency coordination on enforcement of foreign gift and contract requirements(a)Notification of violationsThe Secretary of Education shall establish a process to notify appropriate Federal agencies of any violation of section 117 or section 117a.(b)Consideration of enforcement actionAfter receiving notice of a violation under subsection (a), the head of the Federal agency that received such notice shall determine—(1)whether such violation constitutes a violation of a provision of law over which the agency has enforcement authority; and(2)if such a violation occurred, whether to pursue an enforcement action against the individual or entity responsible for the violation..6.ReportsSection 636 of the Higher Education Act of 1965 (20 U.S.C. 1132–5) is amended to read as follows:636.Report on foreign and national security issues affecting institutions of higher education(a)Report requiredOn an annual basis, the Secretary of Education, in consultation and collaboration with the Secretary of State, the Secretary of Defense, the Director of National Intelligence, the Attorney General, and the heads of other relevant Federal agencies, shall submit to the authorizing committees a report on foreign and national security issues affecting institutions of higher education.(b)ElementsEach report under subsection (a) shall include—(1)identification of areas of national need in foreign language, area, and international studies as such studies relate to government, education, business, and nonprofit needs and a plan to address those needs;(2)a description of any risks associated with allowing foreign students and other foreign individuals at institutions of higher education to access classified information, protected intellectual property, research and development information, and military technology critical to the national security of the United States;(3)best practices that may be implemented by the Department of Education, the Department of Defense, and other Federal agencies with responsibilities relating to national security to strengthen the secrecy of grants, projects, and contracts that involve providing foreign individuals at institutions of higher education with access to classified or sensitive information, including recommended enforcement actions to respond to the misuse of such information;(4)a description of the ongoing efforts of Federal law enforcement organizations, including the Federal Bureau of Investigation, to address the theft of sensitive information by adversarial foreign actors; and(5)a summary of any information from national security-related projects at institutions of higher education that was stolen, misused, or wrongfully disclosed during the period covered by the report and any actions taken to remedy the theft, misuse, or disclosure of such information.(c)Form of reportEach report under subsection (a) shall be submitted in unclassified form, but may include a classified annex.(d)Public availabilityThe Secretary of Education shall make each report under subsection (a) available on a publicly accessible website of the Department of Education, except no report published on such website shall contain classified information..


114 HR 2422 IH: To amend the Federal Food, Drug, and Cosmetic Act with respect to third-party quality system assessment.
U.S. House of Representatives
2015-05-19
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I
114th CONGRESS
1st Session
H. R. 2422
IN THE HOUSE OF REPRESENTATIVES

May 19, 2015
Mr. Shimkus introduced the following bill; which was referred to the Committee on Energy and Commerce

A BILL
To amend the Federal Food, Drug, and Cosmetic Act with respect to third-party quality system assessment.

1.Third-party quality system assessment
(a)Establishment of third-Party quality system assessment programChapter V of the Federal Food, Drug, and Cosmetic Act is amended by inserting after section 524A (21 U.S.C. 360n–1) the following new section:  524B.Third-party quality system assessment (a)Accreditation and assessment (1)In general; certification of device quality systemThe Secretary shall, in accordance with this section, establish a third-party quality system assessment program—
(A)to accredit persons to assess whether a requestor’s quality system, including its design controls, can reasonably assure the safety and effectiveness of in-scope devices subject to device-related changes (as defined in paragraph (2)); (B)under which accredited persons shall, as applicable, certify that a requestor’s quality system meets the criteria issued under paragraph (5) with respect to the in-scope devices at issue; and
(C)under which the Secretary shall rely on such certifications for purposes of determining the safety and effectiveness of in-scope devices subject to the device-related changes involved, in lieu of compliance with the following submission requirements: (i)A thirty-day notice (as defined in paragraph (2)).
(ii)A Special PMA supplement (as defined in paragraph (2)). (2)DefinitionsFor purposes of this section─
(A)the term device-related changes means changes made by a requestor with respect to in-scope devices, which are— (i)manufacturing changes subject to a 30-day notice;
(ii)changes that qualify for a Special PMA supplement; and (iii)such other changes relating to the devices or the device manufacturing process as the Secretary determines appropriate;
(B)the term in-scope device means a device within the scope of devices agreed to by the requestor and the accredited person for purposes of a request for certification under this section; (C)the term quality system means a quality system described in section 520(f);
(D)the term requestor means a device manufacturer that is seeking certification under this section of a quality system used by such manufacturer; (E)the term Special PMA means a Special PMA supplement under section 814.39(d) of title 21, Code of Federal Regulations (or any successor regulations); and
(F)the term thirty-day notice means a notice described in section 515(d)(6). (3)Accreditation process; accreditation renewalExcept as inconsistent with this section, the process and qualifications for accreditation of persons and renewal of such accreditation under section 704(g) shall apply with respect to accreditation of persons and renewal of such accreditation under this section.
(4)Use of accredited parties to conduct assessments
(A)Initiation of assessment services
(i)Date assessments authorizedBeginning after issuance of the final guidance under paragraph (5), an accredited person may conduct an assessment under this section. (ii)Initiation of assessmentsUse of one or more accredited persons to assess a requestor’s quality system under this section with respect to in-scope devices shall be at the initiation of the person who registers and lists the devices at issue under section 510.
(B)CompensationCompensation for such accredited persons shall— (i)be determined by agreement between the accredited person and the person who engages the services of the accredited person; and
(ii)be paid by the person who engages such services. (C)Accredited person selectionEach person who chooses to use an accredited person to assess a requestor’s quality system, as described in this section, shall select the accredited person from a list of such persons published by the Secretary in accordance with section 704(g)(4).
(5)Guidance; criteria for certification
(A)In generalThe criteria for certification of a quality system under this section shall be as specified by the Secretary in guidance issued under this paragraph. (B)Contents; certification criteriaThe guidance under this paragraph shall include specification of—
(i)evaluative criteria to be used by an accredited person to assess and as applicable certify a requestor’s quality system under this section with respect to in-scope devices ; and (ii)criteria for accredited persons to apply a waiver of and exemptions from the certification criteria under clause (i).
(C)Timeframe for issuing guidanceThe Secretary shall issue under this paragraph— (i)draft guidance not later than 12 months after the enactment of the 21st Century Cures Act; and
(ii)final guidance not later than 12 months after issuance of the draft guidance under clause (i). (b)Use of third-Party assessment (1)Assessment summary; certification (A)Submission of assessment to secretaryAn accredited person who assesses a requestor’s quality system under subsection (a) shall submit to the Secretary a summary of the assessment—
(i)within 30 days of the assessment; and (ii)which as applicable shall include—
(I)the accredited person’s certification that the requestor has satisfied the criteria issued under subsection (a)(5) for quality system certification with respect to the in-scope devices at issue; and (II)any waivers or exemptions from such criteria applied by the accredited person.
(B)Treatment of assessmentsSubject to action by the Secretary under subparagraph (C), with respect to assessments which include a certification under this section— (i)the Secretary’s review of the assessment summary shall be deemed complete on the day that is 30 days after the date on which the Secretary receives the summary under subparagraph (A); and
(ii)the assessment summary and certification of the requestor shall be deemed accepted by the Secretary on such 30th day. (C)Actions by Secretary (i)In generalWithin 30 days of receiving an assessment summary and certification under subparagraph (A), the Secretary may, by written notice to the accredited person submitting such assessment certification, deem any such certification to be provisional beyond such 30-day period, suspended pending further review by the Secretary, or otherwise qualified or cancelled, based on the Secretary’s determination that (as applicable)—
(I)additional information is needed to support such certification; (II)such assessment or certification is unwarranted; or
(III)such action with regard to the certification is otherwise justified according to such factors and criteria as the Secretary finds appropriate. (ii)Acceptance of certificationIf following action by the Secretary under clause (i) with respect to a certification, the Secretary determines that such certification is acceptable, the Secretary shall issue written notice to the applicable accredited person indicating such acceptance.
(2)Notifications to Secretary by certified manufacturers for program evaluation purposes
(A)Periodic notification for manufacturing changes otherwise subject to thirty-day noticeA requestor certified under this section that effectuates device-related changes with respect to in-scope devices, without prior submission of a thirty-day notice, shall provide notification to the Secretary of such changes in the requestor’s next periodic report under section 814.84(b) of title 21, Code of Federal Regulations (or any successor regulation). Such notification shall— (i)describe the changes made; and
(ii)indicate the effective dates of such changes. (B)Periodic notification for device-related changes otherwise subject to special pma supplementA requestor certified under this section that effectuates device-related changes with respect to in-scope devices, without prior submission of a Special PMA Supplement, shall provide notification to the Secretary of such changes in the requestor’s next periodic report under section 814.84(b) of title 21, Code of Federal Regulations (or any successor regulation). Such notification shall—
(i)describe the changes made, including a full explanation of the basis for the changes; and (ii)indicate the effective dates of such changes.
(C)Use of notifications for program evaluation purposesInformation submitted to the Secretary under subparagraphs (A) and (B) shall be used by the Secretary for purposes of the program evaluation under subsection (d). (c)Duration and effect of certificationA certification under this section—
(1)shall remain in effect for a period of two years from the date such certification is accepted by the Secretary, subject to paragraph (6); (2)may be renewed through the process described in subsection (a)(3);
(3)shall continue to apply with respect to device-related changes made during such 2-year period, provided the certification remains in effect, irrespective of whether such certification is renewed after such 2-year period; (4)shall have no effect on the need to comply with applicable submission requirements specified in subsection (a)(1)(C) with respect to any change pertaining to in-scope devices which is not a device-related change under subsection (a)(2);
(5)shall have no effect on the authority of the Secretary to conduct an inspection or otherwise determine the requestor’s conformance with the applicable requirements of this Act; and (6)shall be considered to be revoked if the Secretary provides written notification to the certified requestor that its quality system does not satisfy the certification criteria issued under subsection (a)(5) with respect to the in-scope devices at issue, such that the applicable submission requirements specified in subsection (a)(1)(C) must be met for changes made after receipt of such written notification, with respect to such devices.
(d)Program evaluation; sunset
(1)Program evaluation and report
(A)EvaluationThe Secretary shall complete an evaluation of the third-party quality system assessment program under this section no later than January 31, 2021, based on— (i)analysis of information from a representative group of device manufacturers obtained from notifications provided by certified requestors under subsection (b)(2); and
(ii)such other available information and data as the Secretary determines appropriate. (B)ReportNo later than 1 year after completing the evaluation under subparagraph (A), the Secretary shall issue a report of the evaluation’s findings on the website of the Food and Drug Administration, which shall include the Secretary’s recommendations with respect to continuation and as applicable expansion of the program under this section to include additional types of submissions and additional types of changes beyond those identified in subsection (a)(1)(C), including changes to devices cleared under section 510(k). At the discretion of the Secretary, the program may be expanded prior to January 31, 2021.
(2)SunsetThis section shall cease to be effective October 1, 2022. (e)Rule of constructionNothing in this section shall be construed to limit the authority of the Secretary to request and review the complete assessment of a certified requestor under this section on a for-cause basis..
(b)Conforming amendments
(1)Requirements for premarket approval supplementsSection 515(d)(6)(A)(i) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360e(d)(6)(A)(i)) is amended by inserting , subject to section 524B, after that affects safety or effectiveness. (2)Requirements for thirty-day noticeSection 515(d)(6)(A)(ii) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360e(d)(6)(A)(ii)) is amended by inserting , subject to section 524B, after the date on which the Secretary receives the notice.


		IV
		111th CONGRESS
		2d Session
		H. RES. 1140
		IN THE HOUSE OF REPRESENTATIVES

			March 4, 2010
			Mr. Engel (for
			 himself, Mr. Poe of Texas,
			 Mr. Gene Green of Texas,
			 Mr. Payne,
			 Ms. Lee of California,
			 Ms. Baldwin,
			 Mr. Doyle,
			 Ms. Matsui,
			 Mr. Nadler of New York,
			 Mrs. Maloney,
			 Ms. Schakowsky,
			 Mr. Smith of Washington, and
			 Mr. Crowley) submitted the following
			 resolution; which was referred to the Committee on Foreign Affairs, and in
			 addition to the Committee on Energy and
			 Commerce, for a period to be subsequently determined by the
			 Speaker, in each case for consideration of such provisions as fall within the
			 jurisdiction of the committee concerned

		RESOLUTION
		Commending the progress made by
		  anti-tuberculosis programs.

		Whereas tuberculosis (hereafter in this preamble referred
			 to as TB) is the second leading global infectious disease killer
			 behind HIV/AIDS, claiming 1,800,000 million lives each year;
		Whereas the global TB pandemic and the spread of drug
			 resistant TB present a persistent public health threat to the United
			 States;
		Whereas according to 2009 data of the World Health
			 Organization, 5 percent of all new TB cases are drug resistant;
		Whereas TB is the leading killer of people with
			 HIV/AIDS;
		Whereas TB is the third leading killer of adult women, and
			 the stigma associated with TB disproportionately affects women, causing them to
			 delay seeking care and interfering with treatment adherence;
		Whereas the Institute of Medicine (IOM) found that the
			 resurgence of TB between 1980 and 1992 was caused by cuts in TB control funding
			 and the spread of HIV/AIDS;
		Whereas, although the numbers of TB cases in the United
			 States continue to decline, progress towards TB elimination has slowed, and it
			 is a disease that does not recognize borders;
		Whereas New York City had to spend over $1,000,000,000 to
			 control a multi-drug resistant TB outbreak between 1989 and 1993;
		Whereas an extensively drug resistant form of TB, known as
			 XDR–TB (hereafter referred to in this preamble as XDR–TB)), is
			 very difficult and expensive to treat and has high and rapid fatality rates,
			 especially among HIV/AIDS patients;
		Whereas the United States has had more than 83 cases of
			 XDR–TB over the last decade;
		Whereas the Centers for Disease Control and Prevention
			 estimated in 2009 that it costs $483,000 to treat a single case of
			 XDR–TB;
		Whereas African-Americans are 8 times more likely to have
			 TB than Caucasians, and significant disparities exist among other United States
			 minorities, including Native Americans, Asian-Americans, and Hispanic
			 Americans;
		Whereas the United States public health system has the
			 expertise to eliminate TB, but many State TB programs have been left seriously
			 under-resourced due to budget cuts at a time when TB cases are growing more
			 complex to diagnose and treat;
		Whereas, although drugs, diagnostics and vaccines for TB
			 exist, these technologies are antiquated and are increasingly inadequate for
			 controlling the global epidemic;
		Whereas the most commonly used TB diagnostic in the world,
			 sputum microscopy, is more than 100 years old and lacks sensitivity to detect
			 TB in most HIV/AIDS patients and in children;
		Whereas current tests to detect drug resistance take at
			 least 1 month to complete and faster drug susceptibility tests must be
			 developed to stop the spread of drug resistant TB;
		Whereas the TB vaccine, BCG, provides some protection to
			 children, but has little or no efficacy in preventing pulmonary TB in
			 adults;
		Whereas there is also a critical need for new TB drugs
			 that can safely be taken concurrently with antiretroviral therapy for
			 HIV;
		Whereas the Global Health Initiative commits to reducing
			 TB prevalence by 50 percent through 2015;
		Whereas enactment of the Lantos-Hyde Global Leadership
			 Against HIV/AIDS, TB and Malaria Act and the Comprehensive TB Elimination Act
			 provide an historic United States commitment to the global eradication of TB,
			 including to the successful treatment of 4,500,000 new TB patients and 90,000
			 new multi-drug resistant (MDR) TB cases by 2013, while providing additional
			 treatment through coordinated multilateral efforts;
		Whereas the United States Agency for International
			 Development provides financial and technical assistance to nearly 40 highly
			 burdened TB countries and supports the development of new diagnostic and
			 treatment tools, and is authorized to support research to develop new vaccines
			 to combat TB;
		Whereas the Centers for Disease Control and Prevention,
			 working in partnership with States and territories of the United States,
			 directs the national TB elimination program and essential national TB
			 surveillance, technical assistance, prevention activities and supports the
			 development of new diagnostic, treatment and prevention tools to combat
			 TB;
		Whereas the National Institutes of Health, through its
			 many institutes and centers, plays the leading role in basic and clinical
			 research into the identification, treatment and prevention of TB; and
		Whereas the Global Fund to Fight AIDS, Tuberculosis and
			 Malaria provides 63 percent of all international financing for TB programs
			 worldwide and finances proposals worth $3,200,000,000 in 112 countries, and TB
			 treatment for 6,000,000 and HIV/TB services for 1,800,000, and in many
			 countries in which the Global Fund supports programs, TB prevalence is
			 declining, as are TB mortality rates: Now, therefore, be it

		That the House of Representatives—
			(1)commends the
			 progress made by anti-tuberculosis programs, including the U.S. Agency for
			 International Development, the Centers for Disease Control and Prevention and
			 the Global Fund to Fight AIDS, Tuberculosis and Malaria; and
			(2)reaffirms its
			 commitment to global tuberculosis control made through the Lantos-Hyde U.S.
			 Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2008.


116 HR 6539 IH: Coronavirus Medicaid Response Act
U.S. House of Representatives
2020-04-17
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.

I116th CONGRESS2d SessionH. R. 6539IN THE HOUSE OF REPRESENTATIVESApril 17, 2020Mrs. Lee of Nevada introduced the following bill; which was referred to the Committee on Energy and CommerceA BILLTo amend title XIX of the Social Security Act to increase Federal support to State Medicaid programs during economic downturns, and for other purposes.1.Short titleThis Act may be cited as the Coronavirus Medicaid Response Act.2.Increasing Federal support to State Medicaid programs during economic downturns(a)In generalSection 1905 of the Social Security Act (42 U.S.C. 1396d) is amended—(1)in subsection (b), by striking and (ff) and inserting (ff), and (gg); and(2)by adding at the end the following new subsection:(gg)Increased FMAP during economic downturns(1)In generalNotwithstanding subsection (b), (y), or (z)(2), if a fiscal quarter that begins on or after January 1, 2020, is an economic downturn quarter (as defined in paragraph (2)) with respect to a State, then the Federal medical assistance percentage applicable to amounts expended by the State for medical assistance for services furnished during such quarter shall be increased in accordance with paragraphs (3) and (4).(2)Economic downturn quarter(A)In general(i)In generalIn this subsection, the term economic downturn quarter means, with respect to a State, a fiscal quarter during which the State’s unemployment rate for the quarter exceeds the percentage determined for the State and quarter under clause (ii).(ii)Threshold percentageThe percentage determined under this clause for a State and fiscal quarter is the percentage equal to the lower of—(I)the State unemployment rate at the 20th percentile of the distribution of the State’s quarterly unemployment rates for the 60-quarter period preceding the quarter involved, increased by 1 percentage point; and(II)the State’s average quarterly unemployment rate for the 12-quarter period preceding the quarter involved, increased by 1 percentage point.(B)Unemployment data(i)In generalExcept as provided in clause (ii), for purposes of determining unemployment rates for a State and a quarter under this paragraph, the Secretary shall use data from the Local Area Unemployment Statistics from the Bureau of Labor Statistics. (ii)Application to certain territoriesIn the case of the Virgin Islands, Guam, the Northern Mariana Islands, or American Samoa, the Secretary shall use data from the U–6 unemployment measure of the Bureau of Labor Statistics to make any necessary determinations under subparagraph (A).(3)FMAP increase during economic downturn quarter(A)In generalDuring a fiscal quarter that is an economic downturn quarter with respect to a State, the Federal medical assistance percentage otherwise determined for the State and quarter under subsection (b) and, if applicable, the Federal medical assistance percentage applicable under subsection (y), (z)(2), or (ff) with respect to medical assistance furnished by the State during such quarter to individuals described in either such subsection shall be increased by the number of percentage points (rounded to the nearest tenth of a percentage point) equal to the product of—(i)the number of percentage points (rounded to the nearest tenth of a percentage point) by which the unemployment rate for the State and quarter exceeds the percentage determined for the State and quarter under paragraph (2)(A)(ii); and(ii)4.8.(B)Application of COVID–19 FMAP increaseAny increase applicable to the Federal medical assistance percentage of a State for a fiscal quarter under subparagraph (A) shall be in addition to any increase to such percentage for such quarter made pursuant to section 6008(a) of the Families First Coronavirus Response Act.(C)LimitationIn no case shall an increase to the Federal medical assistance percentage of a State under this paragraph result in a Federal medical assistance percentage that exceeds 95 percent.(D)Scope of applicationAny increase to the Federal medical assistance percentage of a State for a fiscal quarter under this paragraph shall only apply with respect to payments for amounts expended by the State for medical assistance for services furnished during such quarter and shall not apply with respect to—(i)disproportionate share hospital payments described in section 1923;(ii)payments under title IV or XXI;(iii)any payments under this title that are based on the enhanced FMAP described in section 2105(b); or(iv)any payments under this title that are based on a Federal medical assistance percentage determined for a State under subsection (aa) (but only to the extent that such Federal medical assistance percentage is higher than the economic recovery FMAP).(4)Advance payment; retrospective adjustment(A)In generalPrior to the beginning of each fiscal quarter that begins on or after July 1, 2020, the Secretary shall, with respect to each State— (i)determine the increase (if any) that is expected to apply to the Federal medical assistance percentage of such State for such quarter under this subsection based on the projections made for the State and quarter under subparagraph (B); and(ii)shall apply such increase to the Federal medical assistance percentage of the State for purposes of making payments to the State for amounts expended during such quarter as medical assistance under the State plan.(B)Projection of State unemployment ratesPrior to the beginning of each fiscal quarter that begins on or after July 1, 2020, the Secretary, acting through the Chief Actuary of the Centers for Medicare & Medicaid Services, shall, using the most recently available data described in paragraph (2)(B), make projections with respect to—(i)the unemployment rates for each State for such quarter;(ii)the threshold percentages described in paragraph (2)(A)(ii) for each State for such quarter; and(iii)the national unemployment rate for such quarter.(C)Retrospective adjustmentAs soon as practicable after final unemployment data becomes available for a fiscal quarter that begins on or after July 1, 2020, the Secretary shall, with respect to each State— (i)make a final determination of the increase (if any) applicable to the Federal medical assistance percentage of the State for the quarter under this subsection; and(ii)in accordance with subsection (d)(2) of section 1903, reduce or increase the amount payable to the State under subsection (a) of such section for a subsequent fiscal quarter to the extent of any overpayment or underpayment which the Secretary determines was made as a result of a miscalculation of the increase applicable to the Federal medical assistance percentage of the State for such prior fiscal quarter under this subsection.(5)Retrospective application of over-the-limit FMAP increases(A)In generalIf a State has excess percentage points with respect to an economic downturn quarter and an applicable FMAP (as determined under subparagraph (B)), the State may elect to apply such excess percentage points to increase such applicable FMAP for one or more quarters during the look-back period for the State and economic downturn quarter in accordance with this paragraph.(B)Excess percentage pointsFor purposes of this paragraph, the number of excess percentage points for a State, economic downturn quarter, and an applicable FMAP shall be equal to the number of percentage points by which— (i)the applicable FMAP for the State and quarter (after application of paragraph (3) but without regard to subparagraph (C) of such paragraph); exceeds(ii)95 percent.(C)Effect of application of excess percentage pointsIf a State elects to apply excess percentage points to an applicable FMAP to a quarter during a look-back period under this paragraph, the Secretary shall determine the additional amount of payment under section 1903(a) to which the State would have been entitled for such quarter if the applicable FMAP (as so increased) had been in effect for such quarter, and shall treat such additional amount as an underpayment for such quarter.(D)Distribution of excess percentage pointsA State that has excess percentage points with respect to an economic downturn quarter and applicable FMAP may elect to divide such points among more than 1 quarter during the look-back period for such State and quarter provided that no excess percentage point (or fraction of an excess percentage point) is applied to the applicable FMAP of more than 1 quarter.(E)Limitations(i)No increases over 100 percentA State may not increase an applicable FMAP for any quarter during a look-back period under this paragraph if such increase would result in the applicable FMAP for such quarter exceeding 100 percent.(ii)Scope of applicationAny increase to an applicable FMAP of a State for a fiscal quarter under this paragraph— (I)shall only apply with respect to payments for amounts expended by the State for medical assistance for services furnished during such quarter to which such applicable FMAP is applicable; and (II)shall not apply with respect to payments described in paragraph (3)(D).(F)DefinitionsIn this paragraph: (i)Applicable FMAPThe term applicable FMAP means, with respect to a State and fiscal quarter—(I)the Federal medical assistance percentage determined for the State and quarter under subsection (b); (II)the Federal medical assistance percentage applicable under subsection (y); (III)the Federal medical assistance percentage applicable under subsection (z)(2); or(IV)the Federal medical assistance percentage determined for the State and quarter under subsection (ff).(ii)Look-back periodThe term look-back period means, with respect to a State and a fiscal quarter that is an economic downturn quarter for the State, the period of 4 fiscal quarters that ends with the fourth quarter which precedes the most recent fiscal quarters that was not an economic downturn quarter for the State.(6)Requirement for all StatesA State may not receive an increase in the Federal medical assistance percentage for such State under this subsection, with respect to a fiscal quarter, if—(A)eligibility standards, methodologies, or procedures under the State plan or a waiver of such plan are more restrictive during such quarter than the eligibility standards, methodologies, or procedures, respectively, under such plan (or waiver) as in effect on the last day of the most recent fiscal quarter that was not an economic downturn quarter for the State;(B)the amount of any premium imposed by the State pursuant to section 1916 or 1916A during such quarter, with respect to an individual enrolled under such plan (or waiver), exceeds the amount of such premium as of the date described in subparagraph (A); or(C)the State fails to provide that an individual who is enrolled for benefits under such plan (or waiver) as of the date described in subparagraph (A) or enrolls for benefits under such plan (or waiver) during the period beginning with such date and ending with the day before the first day of the next quarter that is not an economic downturn quarter for the State shall be treated as eligible for such benefits for not less than 12 months (or, if such period is less than 12 months, throughout such period) unless the individual requests a voluntary termination of eligibility or the individual ceases to be a resident of the State..(b)Exclusion of economic downturn FMAP increases from territorial capsSection 1108 of the Social Security Act (42 U.S.C. 1308) is amended—(1)in subsection (f), in the matter preceding paragraph (1), by striking subsection (g) and section 1935(e)(1)(B) and inserting subsections (g) and (h) and section 1935(e)(1)(B); and(2)by adding at the end the following:(h)Exclusion from caps of amounts attributable to economic downturn FMAPThe portion of any payment made to a territory for a fiscal year that is attributable to an increase in the Federal medical assistance percentage for a fiscal quarter during such year under section 1905(gg) shall not be taken into account for purposes of applying payment limits under subsections (f) and (g)..