116 S1260 IS: Reducing Administrative Costs and Burdens in Health Care Act of 2019
U.S. Senate
2019-05-01
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.

II
116th CONGRESS1st Session
S. 1260
IN THE SENATE OF THE UNITED STATES

May 1, 2019
Ms. Smith (for herself and Mr. Cassidy) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions

A BILL
To amend the Public Health Service Act to provide for grants to enable States to carry out activities to reduce administrative costs and burdens in health care.

1.Short titleThis Act may be cited as the Reducing Administrative Costs and Burdens in Health Care Act of 2019. 2.Reducing administrative costs and burdens in health careTitle II of the Public Health Service Act (42 U.S.C. 202 et seq.) is amended by adding at the end the following:

EReducing administrative costs and burdens in health care
281.Eliminating unnecessary administrative burdens and costs
(a)Reducing administrative burdens and costsThe Secretary, in consultation with providers of health services, health care suppliers of services, health care payers, health professional societies, health vendors and developers, health care standard development organizations and operating rule entities, health care quality organizations, health care accreditation organizations, public health entities, States, patients, and other appropriate entities, shall, in accordance with subsection (b)— (1)establish a goal of reducing unnecessary costs and administrative burdens across the health care system, including the Medicare program under title XVIII of the Social Security Act, the Medicaid program under title XIX of such Act, and the private health insurance market, by at least half over a period of 10 years from the date of enactment of this section;
(2)develop strategies and benchmarks for meeting the goal established under paragraph (1); (3)develop recommendations for meeting the goal established under paragraph (1); and
(4)take action to reduce unnecessary costs and administrative burdens based on recommendations identified in this subsection. (b)Strategies, recommendations, and actions (1)In generalTo achieve the goal established under subsection (a)(1), the Secretary, in consultation with the entities described in such subsection, shall not later than 1 year after the date of enactment of this section, develop strategies and recommendations and take actions to meet such goal in accordance with this subsection. No strategies, recommendation, or action shall undermine the quality of patient care or patient health outcomes.
(2)StrategiesThe strategies developed under paragraph (1) shall address unnecessary costs and administrative burdens. Such strategies shall include broad public comment and shall prioritize— (A)recommendations identified as a result of efforts undertaken to implement section 3001;
(B)recommendations and best practices identified as a result of efforts undertaken under this part; (C)a review of regulations, rules, and requirements of the Department of Health and Human Services that could be modified or eliminated to reduce unnecessary costs and administrative burden imposed on patients, providers, payers, and other stakeholders across the health care system; and
(D)feedback from stakeholders in rural or frontier areas on how to reduce unnecessary costs and administrative burdens on the health care system in those areas. (3)RecommendationsThe recommendations developed under paragraph (1) shall include—
(A)actions that improve the standardization and automation of administrative transactions; (B)actions that integrate clinical and administrative functions;
(C)actions that improve patient care and reduce unnecessary costs and administrative burdens borne by patients, their families, and other caretakers; (D)actions that advance the development and adoption of open application programming interfaces and other emerging technologies to increase transparency and interoperability, empower patients, and facilitate better integration of clinical and administrative functions;
(E)actions to be taken by the Secretary and actions that need to be taken by other entities; and (F)other areas, as the Secretary determines appropriate, to reduce unnecessary costs and administrative burdens required of health care providers.
(4)ConsistencyAny improvements in electronic processes proposed by the Secretary under this section should leverage existing information technology definitions under Federal Law. Specifically, any electronic processes should not be construed to include a facsimile, a proprietary payer portal that does not meet standards specified by the Secretary, or an electronic form image. (5)ActionsThe Secretary shall take action to achieve the goal established under subsection (a)(1), and, not later than 1 year after the date of enactment of this section, and biennially thereafter, submit to Congress and make publically available, a report describing the actions taken by the Secretary pursuant to goals, strategies, and recommendations described in this subsection.
(6)FACAThe Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to the development of the goal, strategies, recommendations, or actions described in this section. (7)Rule of constructionNothing in this subsection shall be construed to authorize, or be used by, the Federal Government to inhibit or otherwise restrain efforts made to reduce waste, fraud, and abuse across the health care system.
282.Grants to States to develop and implement recommendations to accelerate State innovation to reduce health care administrative costs
(a)Grants
(1)In generalNot later than 6 months after the date of enactment of this section, the Secretary shall award grants to at least 15 States, and one coordinating entity designated as provided for under subsection (e), to enable such States to establish and administer private-public multi-stakeholder commissions for the purpose of reducing health care administrative costs and burden within and across States. Not less than 3 of such grants shall be awarded to States that are primarily rural, frontier, or a combination thereof, in nature. (2)EntitiesFor purposes of this section, the term State means a State, a State designated entity, or a multi-State collaborative (as defined by the Secretary).
(3)PriorityIn awarding grants under this section, the Secretary shall give priority to applications submitted by States that propose to carry out a pilot program or support the adoption of electronic health care transactions and operating rules. (b)Application (1)In generalTo be eligible to receive a grant under subsection (a) a State shall submit to the Secretary an application in such a manner and containing such information as the Secretary may reasonably require, including the information described in paragraph (2).
(2)Required informationIn addition to any additional information required by the Secretary under this subsection, an application shall include a description of— (A)the size and composition of the commission to be established under the grant, including the stakeholders represented and the degree to which the commission reflects important geographic and population characteristics of the State;
(B)the relationship of the commission to the State official responsible for coordinating and implementing the recommendations resulting from the commission, and the role and responsibilities of the State with respect to the commission, including any participation, review, oversight, implementation or other related functions; (C)the history and experience of the State in addressing health care administrative costs, and any experience similar to the purpose of the commission to improve health care administrative processes and the exchange of health care administrative data;
(D)the resources and expertise that will be made available to the commission by commission members or other possible sources, and how Federal funds will be used to leverage and complement these resources; (E)the governance structure and procedures that the commission will follow to make, implement, and pilot recommendations;
(F)the proposed objectives relating to the simplification of administrative transactions and operating rules, increased standardization, and the efficiency and effectiveness of the transmission of health information; (G)potential cost savings and other improvements in meeting the objectives described in subparagraph (F); and
(H)the method or methods by which the recommendations described in subsection (c) will be reviewed, tested, adopted, implemented, and updated as needed. (c)Multi-Stakeholder commission (1)In generalNot later than 90 days after the date on which a grant is awarded to a State under this section, the State official described in subsection (b)(2)(B), the State insurance commissioner, or other appropriate State official shall convene a multi-stakeholder commission, in accordance with this subsection.
(2)MembershipThe commission convened under paragraph (1) shall include representatives from health plans, health care providers, health vendors, relevant State agencies, health care standard development organizations, and operating rule entities, relevant professional and trade associations, patients, and other entities determined appropriate by the State. (3)RecommendationsNot later than one year after the date on which a grant is awarded to a State under this section, the commission shall make recommendations and plans, consistent with the application submitted by the State under subsection (b), and intended to meet the objectives defined in the application. Such recommendations shall comply with, and build upon, all relevant Federal requirements and regulations, and may include—
(A)common, uniform specifications, best practices, and conventions, for the efficient, effective exchange of administrative transactions adopted pursuant to the Health Insurance Portability and Accountability Act of 1996 (Public Law 104–191); (B)the development of streamlined business processes for the exchange and use of health care administrative data; and
(C)specifications, incentives, requirements, tools, mechanisms, and resources to improve— (i)the access, exchange, and use of health care administrative information through electronic means;
(ii)the implementation of utilization management protocols; and (iii)compliance with Federal and State laws.
(d)Use of funds for implementationA State may use amounts received under a grant under this section for one or more of the following: (1)The development, implementation, and best use of shared data infrastructure that supports the electronic transmission of administrative data.
(2)The development and provision of training and educational materials, forums, and activities as well as technical assistance to effectively implement, use, and benefit from electronic health care transactions and operating rules. (3)To accelerate the early adoption and implementation of administrative transactions and operating rules designated by the Secretary and that have been adopted pursuant to the Health Insurance Portability and Accountability Act of 1996 (Public Law 104–191), including transactions and operating rules described in section 1173(a)(2) of the Social Security Act.
(4)To accelerate the early adoption and implementation of additional or updated administrative transactions, operating rules, and related data exchange standards that are being considered for adoption under the Health Insurance Portability and Accountability Act of 1996 or are adopted pursuant to such Act, or as designated by the Secretary, including the electronic claim attachment. (5)To conduct pilot projects to test approaches to implement and use the electronic health care transactions and operating rules in practice under a variety of different settings. With respect to the electronic attachment transaction, priority shall be given to pilot projects that test and evaluate methods and mechanisms to most effectively incorporate patient health data from electronic health records and other electronic sources with the electronic attachment transaction.
(6)To assess barriers to the adoption, implementation, and effective use of electronic health care transactions and operating rules, as well as to explore, identify, and plan options, approaches, and resources to address barriers and make improvements. (7)The facilitation of public and private initiatives to reduce administrative costs and accelerate the adoption, implementation, and effective use of electronic health care transactions and operating rules for State programs.
(8)Developing, testing, implementing, and assessing additional data exchange specifications, operating rules, incentives, requirements, tools, mechanisms, and resources to accelerate the adoption and effective use of the transactions and operating rules. (9)Ongoing needs assessments and planning related to the development and implementation of administrative simplification initiatives.
(e)Coordinating entity
(1)FunctionsNot later than 6 months after the date of enactment of this section, the Secretary shall designate a coordinating entity under this subsection for the purpose of— (A)providing technical assistance to States relating to the simplification of administrative transactions and operating rules, increased standardization, and the efficiency and effectiveness of the transmission of health care information;
(B)evaluating pilot projects and other efforts conducted under this section for impact and best practices to inform broader national use; (C)using consistent evaluation methodologies to compare return on investment across efforts conducted under this section;
(D)compiling, synthesizing, disseminating, and adopting lessons learned to promote the adoption of electronic health care transactions and operating rules across the health care system; and (E)making recommendations to the Secretary and the National Committee on Vital and Health Statistics regarding the national adoption of efforts conducted under this section.
(2)EligibilityThe entity designated under paragraph (1) shall be a qualified nonprofit entity that— (A)focuses its mission on administrative simplification;
(B)has demonstrated experience using a multi-stakeholder and consensus-based process for the development of common, uniform specifications, operating rules, best practices, and conventions, for the efficient, effective exchange of administrative transactions that includes representation by or participation from health plans, health care providers, vendors, States, relevant Federal agencies, and other health care standard development organizations; (C)has demonstrated experience providing technical assistance to health plans, health care providers, vendors, and States relating to the simplification of administrative transactions and operating rules, increased standardization, and the efficiency and effectiveness of the transmission of health care information;
(D)has demonstrated experience evaluating and measuring the adoption and return on investment of administrative transactions and operating rules; (E)has demonstrated experience gathering, synthesizing, and adopting common, uniform specifications, operating rules, best practices, and conventions for national use based on lessons learned to promote the adoption of electronic health care transactions and operating rules across the health care system;
(F)has a public set of guiding principles that ensure processes are open and transparent, and supports nondiscrimination and conflict of interest policies that demonstrate a commitment to open, fair, and nondiscriminatory practices; (G)builds on the transaction standards issued under Health Insurance Portability and Accountability Act of 1996; and
(H)allows for public review and updates of common, uniform specifications, operating rules, best practices, and conventions to support administrative simplification. (f)Period and amountA grant awarded to a State under this section shall be for a period of 5 years and shall not exceed $50,000,000 for such 5-year period. A grant awarded to the coordinating entity designated by the Secretary under subsection (e) shall be for a period of 5 years and shall not exceed $15,000,000 for such 5-year period.
(g)Reports
(1)StatesNot later than 1 year after receiving a grant under this section, and biennially thereafter, a State shall submit to the Secretary a report on the outcomes experienced by the State under the grant. (2)Coordinating entityNot later than 1 year after receiving a grant under this section, and at least biennially thereafter, the coordinating entity shall submit to the Secretary and the National Committee on Vital and Health Statistics a report of evaluations conducted under the grant under this section and recommendations regarding the national adoption of efforts conducted under this section.
(3)SecretaryNot later than 6 months after the date on which the States and coordinating entity submit the report required under paragraphs (1) and (2), the Secretary, in consultation with National Committee on Vital and Health Statistics, shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives, a report on the outcomes achieved under the grants under this section. (4)GAONot later than 6 months after the date on which the Secretary submits the final report under paragraph (3), the Comptroller General of the United States shall conduct a study, and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives, a report on the outcomes of the activities carried out under this section which shall contain a list of best practices and recommendations to States concerning administrative simplification.
(h)Authorization of appropriationsThere is authorized to be appropriated to carry out this section, $250,000,000 for the 5-fiscal-year period beginning with fiscal year 2020..


		II
		110th CONGRESS
		2d Session
		S. 3266
		IN THE SENATE OF THE UNITED STATES

			July 15, 2008
			Mr. Warner introduced
			 the following bill; which was read twice and referred to the
			 Committee on Homeland Security and
			 Governmental Affairs

		A BILL
		To require Congress and Federal departments and agencies
		  to reduce the annual consumption of gasoline of the Federal
		  Government.

		1.Short
			 titleThis Act may be cited as
			 the Immediate Steps to Conserve
			 Gasoline Act.
		2.Federal
			 conservation of gasoline
			(a)FindingsCongress
			 finds that—
				(1)each day, as
			 Americans contend with rising gasoline prices, personal stories reflect the
			 ways in which Americans are altering their family budgets, including food
			 budgets, to cope with record high gasoline costs;
				(2)as a consequence
			 of economic pressures, Americans are taking initiatives to reduce consumption
			 of gasoline, such as—
					(A)driving less
			 frequently;
					(B)altering daily
			 routines; and
					(C)changing, or even
			 cancelling, family vacation plans;
					(3)the conservation
			 efforts being taken by Americans, on their own initiative, bring hardships but
			 save funds that can be redirected—
					(A)to meet essential
			 family needs; and
					(B)to relieve, to
			 some extent, the demand for gasoline;
					(4)just as
			 individuals are taking initiatives to reduce gasoline consumption, the Federal
			 Government, including Congress, should take initiatives to conserve
			 gasoline;
				(5)such
			 Government-wide initiatives to conserve gasoline would send a signal to
			 Americans that the Federal Government—
					(A)recognizes the
			 burdens imposed by unprecedented gasoline costs; and
					(B)will participate
			 in activities to reduce gasoline consumption;
					(6)an overall
			 reduction of gasoline consumption by the Federal Government by even 3
			 percentage points would send a strong signal that, as a nation, the United
			 States is working to conserve energy;
				(7)in 2005, policies
			 directed at reducing the usage of energy in Federal agency and department
			 buildings by 20 percent by 2015, at a rate of a 2-percent reduction per
			 calendar year, were enacted by the President and Congress;
				(8)in 2007, policies
			 increasing the energy reduction goal to 30 percent by 2015, at a rate of a
			 3-percent reduction per calendar year, were enacted by the President and
			 Congress; and
				(9)Congress and the
			 President should extend the precedent of those mandatory conservation
			 initiatives taken in 2005 and 2007 to usage by the Federal Government of
			 gasoline.
				(b)Reduction of
			 gasoline usage by Federal departments and agenciesFor fiscal
			 year 2009, each Federal department and agency shall develop and carry out
			 initiatives to reduce by not less than 3 percent the annual consumption of
			 gasoline by the department or agency.
			(c)Congressional
			 conservation of gasolineFor fiscal year 2009, Congress shall
			 develop and carry out initiatives to reduce by not less than 3 percent the
			 annual consumption of gasoline by Congress.
			3.Studies and
			 reports on national speed limit and future gasoline conservation
			(a)National speed
			 limit
				(1)In
			 generalNot later than 60 days after the date of enactment of
			 this Act, the Administrator of the Energy Information Administration shall
			 conduct, and submit to Congress a report describing the results of, a study of
			 the potential transportation fuel savings of imposing a national speed limit on
			 highways on the Interstate System of 60 miles per hour.
				(2)InclusionsThe
			 study under paragraph (1) shall include—
					(A)an examination of
			 the fuel efficiency of automobiles in use as of the date on which the study is
			 conducted;
					(B)a description of
			 the range at which those automobiles are most fuel-efficient on highways on the
			 Interstate System;
					(C)an analysis of
			 actions carried out by the Federal Government, with the full support of
			 Congress, during the 1973–1974 energy crisis, resulting in a national speed
			 limit on highways on the Interstate System of 55 miles per hour, which remained
			 in effect until 1995;
					(D)a recognition
			 that in 1974, when fewer than 137,000,000 cars traveled in the United States
			 (as compared to 250,000,000 cars in 2006) and only 30 percent of United States
			 oil was imported from foreign sources (as compared to 60 percent of oil so
			 imported on the date of enactment of this Act), 167,000 barrels of oil per day
			 were saved by the imposition of a national speed limit, such that greater
			 savings are possible on the date of enactment of this Act than the savings
			 realized in 1974; and
					(E)a determination
			 of whether a limitation on the national speed limit on highways on the
			 Interstate System similar to the limitation described in subparagraph (C) could
			 serve as a model to generate gasoline savings, through a national speed limit
			 on highways on the Interstate System of 60 miles per hour, given the improved
			 fuel efficiency of automobile engines in use on the date of enactment of this
			 Act.
					(b)Future gasoline
			 conservation
				(1)In
			 generalNot later than 60 days after the date of enactment of
			 this Act, the Comptroller General of the United States shall conduct, and
			 submit to the Committees on Homeland Security and Governmental Affairs,
			 Environment and Public Works, and Energy and Natural Resources of the Senate
			 and the Committees on House Administration, Transportation and Infrastructure,
			 and Energy and Commerce of the House of Representatives a report describing the
			 results of, a study to determine whether additional gasoline reduction measures
			 by Federal departments and agencies and Congress are technically
			 feasible.
				(2)InclusionThe
			 report under paragraph (1) shall include a proposed schedule of future gasoline
			 reduction measures, if the measures are determined to be technically
			 feasible.


113 S859 IS: Animal and Public Health Protection Act
U.S. Senate
2013-05-06
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.

		II
		113th CONGRESS
		1st Session
		S. 859
		IN THE SENATE OF THE UNITED STATES

			May 6, 2013
			Mr. Bennet introduced
			 the following bill; which was read twice and referred to the
			 Committee on Agriculture, Nutrition, and
			 Forestry

		A BILL
		To amend the Farm Security and Rural Investment Act of
		  2002 to provide for the conducts of activities to detect, and respond in a
		  timely manner to, threats to animal health.

		1.Short
			 titleThis Act may be cited as
			 the Animal and Public Health
			 Protection Act.
		2.National animal health
			 laboratory networkSubtitle E
			 of title X of the Farm Security and Rural Investment Act of 2002 (7 U.S.C. 8301
			 et seq.) is amended by inserting after section 10409 the following:

				10409A.National
				animal health laboratory network
					(a)Definition of
				eligible laboratoryIn this
				section, the term eligible laboratory means a diagnostic
				laboratory that meets specific criteria developed by the Secretary, in
				consultation with State animal health officials, State veterinary diagnostic
				laboratories, and veterinary diagnostic laboratories at institutions of higher
				education.
					(b)ContractsThe Secretary shall offer to enter into
				contracts, grants, cooperative agreements, or other legal instruments with
				eligible laboratories—
						(1)to enhance the capability of the
				Secretary—
							(A)to detect, and respond in a timely manner
				to, emerging or existing threats to animal health; and
							(B)to support the protection of public health,
				the environment, and the agricultural economy of the United States;
							(2)to provide the capacity and capability for
				standardized—
							(A)test procedures, reference materials, and
				equipment;
							(B)laboratory biosafety and biosecurity
				levels;
							(C)quality management system
				requirements;
							(D)interconnected electronic reporting and
				transmission of data; and
							(E)evaluation for emergency preparedness;
				and
							(3)to coordinate the development,
				implementation, and enhancement of national veterinary diagnostic laboratory
				capabilities, with special emphasis on surveillance planning and vulnerability
				analysis, technology development and validation, training, and outreach.
						(c)PriorityTo the extent practicable and to the extent
				capacity and specialized expertise may be necessary, the Secretary shall give
				priority to eligible laboratories at existing Federal facilities, State
				facilities, and facilities at institutions of higher education.
					(d)Authorization of
				appropriationsThere is
				authorized to be appropriated to carry out this section $15,000,000 for each of
				fiscal years 2014 through
				2018.
					.


113 HR 5708 IH: Veterans Care Financial Protection Act of 2014
U.S. House of Representatives
2014-11-14
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
		113th CONGRESS
		2d Session
		H. R. 5708
		IN THE HOUSE OF REPRESENTATIVES

			November 14, 2014
			Mr. Cartwright (for himself, Mr. Cook, Mr. Connolly, Mr. Hastings of Florida, Ms. Jackson Lee, Mr. Conyers, and Mr. Farenthold) introduced the following bill; which was referred to the Committee on Veterans’ Affairs

		A BILL
		To protect individuals who are eligible for increased pension under laws administered by the
			 Secretary of Veterans Affairs on the basis of need of regular aid and
			 attendance from dishonest, predatory, or otherwise unlawful practices, and
			 for other purposes.

		1.Short titleThis Act may be cited as the Veterans Care Financial Protection Act of 2014.
		2.Protection of individuals eligible for increased pension under laws administered by the Secretary
			 of
			 Veterans Affairs on basis of need for regular aid and attendance
			(a)Development and implementation of standards
				(1)In generalThe Secretary of Veterans Affairs shall work with the heads of Federal agencies, States, and such
			 experts as the Secretary considers appropriate to develop and implement
			 Federal and State standards that protect individuals from dishonest,
			 predatory, or otherwise unlawful practices relating to increased pension
			 available to such individuals under chapter 15 of title 38, United States
			 Code, on the basis of need for regular aid and attendance.
				(2)Submittal to CongressNot later than 180 days after the date of the enactment of this Act, the Secretary shall submit to
			 the Committee on Veterans' Affairs of the Senate and the Committee on
			 Veterans' Affairs of the House of Representatives the standards developed
			 under paragraph (1).
				(b)Conditional recommendation by Comptroller GeneralIf the Secretary does not, on or before the date that is 180 days after the date of the enactment
			 of this Act, submit to the Committee on Veterans' Affairs of the Senate
			 and the Committee on Veterans' Affairs of the House of Representatives
			 standards that are developed under subsection (a)(1), the Comptroller
			 General of the United States shall, not later than the date that is one
			 year after the date of the enactment of this Act, submit to such
			 committees a report containing standards that the Comptroller General
			 determines are standards that would be effective in protecting individuals
			 as described in such subsection.
			(c)Study by Comptroller GeneralNot later than 540 days after the date of the enactment of this Act, the Comptroller General of the
			 United States shall complete a study on standards implemented under this
			 section to protect individuals as described in subsection (a)(1) and
			 submit to the Committee on Veterans' Affairs of the Senate and the
			 Committee on Veterans' Affairs of the House of Representatives a report
			 containing the findings of the Comptroller General with respect to such
			 study.


		II
		110th CONGRESS
		1st Session
		S. 956
		IN THE SENATE OF THE UNITED
		  STATES

			March 21, 2007
			Mr. Durbin (for himself
			 and Mr. Obama) introduced the following
			 bill; which was read twice and referred to the
			 Committee on Energy and Natural
			 Resources

		A BILL
		To establish the Land Between the Rivers
		  National Heritage Area in the State of Illinois, and for other
		  purposes.

		1.Short titleThis Act may be cited as the
			 Land Between the Rivers Southern
			 Illinois National Heritage Area Act of 2007.
		2.FindingsCongress finds that—
			(1)southern Illinois has a cohesive,
			 distinctive, and important landscape that distinguishes the area as worthy of
			 designation as a National Heritage Area;
			(2)the historic features of southern Illinois
			 reflect a period during which the area was the strategic convergence point
			 during the westward expansion of the United States;
			(3)the geographic centrality of southern
			 Illinois ensured that the area played a pivotal military, social, and political
			 role during the Civil War, which resulted in the area being known as the
			 Confluence of Freedom;
			(4)southern Illinois is at the junction of the
			 ending glaciers and 6 ecological divisions;
			(5)after the expeditions of Lewis and Clark,
			 the land between the rivers became known as Egypt because of the
			 rivers in, and the beauty and agricultural abundance of, the area;
			(6)Native Americans described the area in
			 southern Illinois between the Mississippi and Ohio Rivers as the Land
			 Between the Rivers;
			(7)a feasibility study led by the Office of
			 Economic and Regional Development at Southern Illinois University Carbondale
			 that was revised in April 2006 documents a sufficient assemblage of nationally
			 distinctive historic resources to demonstrate the feasibility of, and the need
			 for, establishing the Land Between the Rivers National Heritage Area;
			 and
			(8)stakeholders participating in the
			 feasibility study process for the Heritage Area have developed a proposed
			 management entity and financial plan to preserve the natural, cultural,
			 historic, and scenic features of the area while furthering recreational and
			 educational opportunities in the area.
			3.DefinitionsIn this Act:
			(1)Heritage areaThe term Heritage Area means
			 the Land Between the Rivers National Heritage Area established by section
			 4(a).
			(2)Management entityThe term management entity
			 means the management entity for the Heritage Area designated by section
			 4(c).
			(3)SecretaryThe term Secretary means the
			 Secretary of the Interior.
			(4)StateThe term State means the
			 State of Illinois.
			4.Land between the Rivers National Heritage
			 Area
			(a)EstablishmentThere is established in the State the Land
			 Between the Rivers National Heritage Area.
			(b)BoundariesThe Heritage Area shall include—
				(1)Kincaid Mound, Fort de Chartres, Kaskaskia,
			 Fort Massac, Wilkinsonville Contonment, the Lewis and Clark Sculpture, Flat
			 Boat, Cave-in-Rock, the Shawneetown Bank Building, the Iron Furnace, the
			 Crenshaw Slave House, Roots House, the site of the
			 Lincoln-Douglas debate, certain sites associated with John A. Logan, the Fort
			 Defiance Planning Map, Mound City National Cemetary, and Riverlore Mansion;
			 and
				(2)any other sites in Randolph, Perry,
			 Jefferson, Franklin, Hamilton, White, Jackson, Williamson, Saline, Gallatin,
			 Union, Johnson, Pope, Hardin, Alexander, Pulaski, and Massac Counties in the
			 State that the Secretary, in consultation with the management entity,
			 determines to be appropriate for inclusion in the Heritage Area.
				(c)Management entityThe management entity for the Heritage Area
			 shall be the Southern Illinois University Carbondale.


 HR 6655 ENR: To designate the facility of the United States Postal Service located at 44160 State Highway 299 East Suite 1 in McArthur, California, as the “Janet Lucille Oilar Post Office”.
U.S. House of Representatives

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
One Hundred Fifteenth Congress of the United States of AmericaAt the Second SessionBegun and held at the City of Washington on Wednesday, the third day of January, two thousand and eighteen
H. R. 6655

AN ACT
To designate the facility of the United States Postal Service located at 44160 State Highway 299 East Suite 1 in McArthur, California, as the Janet Lucille Oilar Post Office.

1.Janet Lucille Oilar Post Office
(a)DesignationThe facility of the United States Postal Service located at 44160 State Highway 299 East Suite 1 in McArthur, California, shall be known and designated as the Janet Lucille Oilar Post Office.  (b)ReferencesAny reference in law, map, regulation, document, paper, or other record of the United States to the facility referred to in subsection (a) shall be deemed to be a reference to the Janet Lucille Oilar Post Office.
 Speaker of the House of Representatives.Vice President of the United States and President of the Senate.


		II
		112th CONGRESS
		2d Session
		S. 2655
		IN THE SENATE OF THE UNITED STATES

			May 7, 2012
			Mr. Casey introduced the
			 following bill; which was read twice and referred to the
			 Committee on
			 Finance

		A BILL
		To extend the temporary suspension of duty on Styrene,
		  ar-ethyl-,polymer with divinylbenzene and styrene beads having low ash
		  content.

		1.Styrene, ar-ethyl-,polymer
			 with divinylbenzene and styrene beads having low ash content
			(a)In
			 generalHeading 9902.25.40 of the Harmonized Tariff Schedule of
			 the United States (relating to Styrene, ar-ethyl-,polymer with divinylbenzene
			 and styrene beads having low ash content) is amended by striking the date in
			 the effective period column and inserting 12/31/2015.
			(b)Effective
			 dateThe amendment made by subsection (a) applies with respect to
			 goods entered, or withdrawn from warehouse for consumption, on or after the
			 15th day after the date of the enactment of this Act.


		II
		111th CONGRESS
		1st Session
		S. 1459
		IN THE SENATE OF THE UNITED STATES

			July 16, 2009
			Mr. DeMint (for himself
			 and Mr. Vitter) introduced the following
			 bill; which was read twice and referred to the
			 Committee on Health, Education, Labor,
			 and Pensions

		A BILL
		To amend the Public Health Service Act to provide for
		  cooperative governing of individual health insurance coverage offered in
		  interstate commerce.

		1.Short titleThis Act may be cited as the
			 Health Care Choice Act of
			 2009.
		2.Specification of
			 constitutional authority for enactment of lawThis Act is enacted pursuant to the power
			 granted Congress under article I, section 8, clause 3, of the United States
			 Constitution.
		3.FindingsCongress finds the following:
			(1)The application
			 of numerous and significant variations in State law impacts the ability of
			 insurers to offer, and individuals to obtain, affordable individual health
			 insurance coverage, thereby impeding commerce in individual health insurance
			 coverage.
			(2)Individual health
			 insurance coverage is increasingly offered through the Internet, other
			 electronic means, and by mail, all of which are inherently part of interstate
			 commerce.
			(3)In response to
			 these issues, it is appropriate to encourage increased efficiency in the
			 offering of individual health insurance coverage through a collaborative
			 approach by the States in regulating this coverage.
			(4)The establishment
			 of risk-retention groups has provided a successful model for the sale of
			 insurance across State lines, as the acts establishing those groups allow
			 insurance to be sold in multiple States but regulated by a single State.
			4.Cooperative
			 governing of individual health insurance coverage
			(a)In
			 generalTitle XXVII of the Public
			 Health Service Act (42 U.S.C. 300gg et seq.) is amended by adding at
			 the end the following:

					DCooperative
				governing of individual health insurance coverage
						2795.DefinitionsIn this part:
							(1)Primary
				stateThe term primary State means, with respect to
				individual health insurance coverage offered by a health insurance issuer, the
				State designated by the issuer as the State whose covered laws shall govern the
				health insurance issuer in the sale of such coverage under this part. An
				issuer, with respect to a particular policy, may only designate one such State
				as its primary State with respect to all such coverage it offers. Such an
				issuer may not change the designated primary State with respect to individual
				health insurance coverage once the policy is issued, except that such a change
				may be made upon renewal of the policy. With respect to such designated State,
				the issuer is deemed to be doing business in that State.
							(2)Secondary
				stateThe term secondary State means, with respect
				to individual health insurance coverage offered by a health insurance issuer,
				any State that is not the primary State. In the case of a health insurance
				issuer that is selling a policy in, or to a resident of, a secondary State, the
				issuer is deemed to be doing business in that secondary State.
							(3)Health
				insurance issuerThe term health insurance issuer
				has the meaning given such term in section 2791(b)(2), except that such an
				issuer must be licensed in the primary State and be qualified to sell
				individual health insurance coverage in that State.
							(4)Individual
				health insurance coverageThe term individual health
				insurance coverage means health insurance coverage offered in the
				individual market, as defined in section 2791(e)(1).
							(5)Applicable
				state authorityThe term applicable State authority
				means, with respect to a health insurance issuer in a State, the State
				insurance commissioner or official or officials designated by the State to
				enforce the requirements of this title for the State with respect to the
				issuer.
							(6)Hazardous
				financial conditionThe term hazardous financial
				condition means that, based on its present or reasonably anticipated
				financial condition, a health insurance issuer is unlikely to be able—
								(A)to meet
				obligations to policyholders with respect to known claims and reasonably
				anticipated claims; or
								(B)to pay other
				obligations in the normal course of business.
								(7)Covered
				laws
								(A)In
				generalThe term covered laws means the laws, rules,
				regulations, agreements, and orders governing the insurance business pertaining
				to—
									(i)individual health
				insurance coverage issued by a health insurance issuer;
									(ii)the offer, sale,
				rating (including medical underwriting), renewal, and issuance of individual
				health insurance coverage to an individual;
									(iii)the provision
				to an individual in relation to individual health insurance coverage of health
				care and insurance related services;
									(iv)the provision to
				an individual in relation to individual health insurance coverage of
				management, operations, and investment activities of a health insurance issuer;
				and
									(v)the provision to
				an individual in relation to individual health insurance coverage of loss
				control and claims administration for a health insurance issuer with respect to
				liability for which the issuer provides insurance.
									(B)ExceptionSuch
				term does not include any law, rule, regulation, agreement, or order governing
				the use of care or cost management techniques, including any requirement
				related to provider contracting, network access or adequacy, health care data
				collection, or quality assurance.
								(8)StateThe
				term State means the 50 States and includes the District of
				Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American
				Samoa, and the Commonwealth of the Northern Mariana Islands.
							(9)Unfair claims
				settlement practicesThe term unfair claims settlement
				practices means only the following practices:
								(A)Knowingly
				misrepresenting to claimants and insured individuals relevant facts or policy
				provisions relating to coverage at issue.
								(B)Failing to
				acknowledge with reasonable promptness pertinent communications with respect to
				claims arising under policies.
								(C)Failing to adopt
				and implement reasonable standards for the prompt investigation and settlement
				of claims arising under policies.
								(D)Failing to
				effectuate prompt, fair, and equitable settlement of claims submitted in which
				liability has become reasonably clear.
								(E)Refusing to pay
				claims without conducting a reasonable investigation.
								(F)Failing to affirm
				or deny coverage of claims within a reasonable period of time after having
				completed an investigation related to those claims.
								(G)A pattern or
				practice of compelling insured individuals or their beneficiaries to institute
				suits to recover amounts due under its policies by offering substantially less
				than the amounts ultimately recovered in suits brought by them.
								(H)A pattern or
				practice of attempting to settle or settling claims for less than the amount
				that a reasonable person would believe the insured individual or the
				individual's beneficiary was entitled by reference to written or printed
				advertising material accompanying or made part of an application.
								(I)Attempting to
				settle or settling claims on the basis of an application that was materially
				altered without notice to, or knowledge or consent of, the insured.
								(J)Failing to
				provide forms necessary to present claims within 15 calendar days of a requests
				with reasonable explanations regarding their use.
								(K)Attempting to
				cancel a policy in less time than that prescribed in the policy or by the law
				of the primary State.
								(10)Fraud and
				abuseThe term fraud and abuse means an act or
				omission committed by a person who, knowingly and with intent to defraud,
				commits, or conceals any material information concerning, one or more of the
				following:
								(A)Presenting,
				causing to be presented, or preparing with knowledge or belief that it will be
				presented to or by an insurer, a reinsurer, broker, or its agent, false
				information as part of, in support of, or concerning a fact material to one or
				more of the following:
									(i)An application
				for the issuance or renewal of an insurance policy or reinsurance
				contract.
									(ii)The rating of an
				insurance policy or reinsurance contract.
									(iii)A claim for
				payment or benefit pursuant to an insurance policy or reinsurance
				contract.
									(iv)Premiums paid on
				an insurance policy or reinsurance contract.
									(v)Payments made in
				accordance with the terms of an insurance policy or reinsurance
				contract.
									(vi)A document filed
				with the commissioner or the chief insurance regulatory official of another
				jurisdiction.
									(vii)The financial
				condition of an insurer or reinsurer.
									(viii)The formation,
				acquisition, merger, reconsolidation, dissolution, or withdrawal from one or
				more lines of insurance or reinsurance in all or part of a State by an insurer
				or reinsurer.
									(ix)The issuance of
				written evidence of insurance.
									(x)The reinstatement
				of an insurance policy.
									(B)Solicitation or
				acceptance of new or renewal insurance risks on behalf of an insurer,
				reinsurer, or other person engaged in the business of insurance by a person who
				knows or should know that the insurer or other person responsible for the risk
				is insolvent at the time of the transaction.
								(C)Transaction of
				the business of insurance in violation of laws requiring a license, certificate
				of authority, or other legal authority for the transaction of the business of
				insurance.
								(D)Attempt to
				commit, aiding or abetting in the commission of, or conspiracy to commit the
				acts or omissions specified in this paragraph.
								2796.Application
				of law
							(a)In
				generalThe covered laws of the primary State shall apply to
				individual health insurance coverage offered by a health insurance issuer in
				the primary State and in any secondary State, but only if the coverage and
				issuer comply with the conditions of this section with respect to the offering
				of coverage in any secondary State.
							(b)Exemptions from
				covered laws in a secondary stateExcept as provided in this
				section, a health insurance issuer with respect to its offer, sale, rating
				(including medical underwriting), renewal, and issuance of individual health
				insurance coverage in any secondary State is exempt from any covered laws of
				the secondary State (and any rules, regulations, agreements, or orders sought
				or issued by such State under or related to such covered laws) to the extent
				that such laws would—
								(1)make unlawful, or
				regulate, directly or indirectly, the operation of the health insurance issuer
				operating in the secondary State, except that any secondary State may require
				such an issuer—
									(A)to pay, on a
				nondiscriminatory basis, applicable premium and other taxes (including high
				risk pool assessments) which are levied on insurers and surplus lines insurers,
				brokers, or policyholders under the laws of the State;
									(B)to register with
				and designate the State insurance commissioner as its agent solely for the
				purpose of receiving service of legal documents or process;
									(C)to submit to an
				examination of its financial condition by the State insurance commissioner in
				any State in which the issuer is doing business to determine the issuer's
				financial condition, if—
										(i)the State
				insurance commissioner of the primary State has not done an examination within
				the period recommended by the National Association of Insurance Commissioners;
				and
										(ii)any such
				examination is conducted in accordance with the examiners' handbook of the
				National Association of Insurance Commissioners and is coordinated to avoid
				unjustified duplication and unjustified repetition;
										(D)to comply with a
				lawful order issued—
										(i)in a delinquency
				proceeding commenced by the State insurance commissioner if there has been a
				finding of financial impairment under subparagraph (C); or
										(ii)in a voluntary
				dissolution proceeding;
										(E)to comply with an
				injunction issued by a court of competent jurisdiction, upon a petition by the
				State insurance commissioner alleging that the issuer is in hazardous financial
				condition;
									(F)to participate,
				on a nondiscriminatory basis, in any insurance insolvency guaranty association
				or similar association to which a health insurance issuer in the State is
				required to belong;
									(G)to comply with
				any State law regarding fraud and abuse (as defined in section 2795(10)),
				except that if the State seeks an injunction regarding the conduct described in
				this subparagraph, such injunction must be obtained from a court of competent
				jurisdiction;
									(H)to comply with
				any State law regarding unfair claims settlement practices (as defined in
				section 2795(9)); or
									(I)to comply with
				the applicable requirements for independent review under section 2798 with
				respect to coverage offered in the State;
									(2)require any
				individual health insurance coverage issued by the issuer to be countersigned
				by an insurance agent or broker residing in that secondary State; or
								(3)otherwise
				discriminate against the issuer issuing insurance in both the primary State and
				in any secondary State.
								(c)Clear and
				conspicuous disclosureA health insurance issuer shall provide
				the following notice, in 12-point bold type, in any insurance coverage offered
				in a secondary State under this part by such a health insurance issuer and at
				renewal of the policy, with the 5 blank spaces therein being appropriately
				filled with the name of the health insurance issuer, the name of primary State,
				the name of the secondary State, the name of the secondary State, and the name
				of the secondary State, respectively, for the coverage concerned:
							This policy
				is issued by _____ , and is governed by the laws and regulations of the State
				of _____, and it has met all the laws of that State as determined by that
				State's Department of Insurance. This policy may be less expensive than others
				because it is not subject to all of the insurance laws and regulations of the
				State of _____, including coverage of some services or benefits mandated by the
				law of the State of _____. Additionally, this policy is not subject to all of
				the consumer protection laws or restrictions on rate changes of the State of
				_____. As with all insurance products, before purchasing this policy, you
				should carefully review the policy and determine what health care services the
				policy covers and what benefits it provides, including any exclusions,
				limitations, or conditions for such services or
				benefits..

					(d)Prohibition on
				certain reclassifications and premium increases
						(1)In
				generalFor purposes of this section, a health insurance issuer
				that provides individual health insurance coverage to an individual under this
				part in a primary or secondary State may not upon renewal—
							(A)move or
				reclassify the individual insured under the health insurance coverage from the
				class such individual is in at the time of issue of the contract based on the
				health-status related factors of the individual; or
							(B)increase the
				premiums assessed the individual for such coverage based on a health
				status-related factor or change of a health status-related factor or the past
				or prospective claim experience of the insured individual.
							(2)ConstructionNothing
				in paragraph (1) shall be construed to prohibit a health insurance
				issuer—
							(A)from terminating
				or discontinuing coverage or a class of coverage in accordance with subsections
				(b) and (c) of section 2742;
							(B)from raising
				premium rates for all policy holders within a class based on claims
				experience;
							(C)from changing
				premiums or offering discounted premiums to individuals who engage in wellness
				activities at intervals prescribed by the issuer, if such premium changes or
				incentives—
								(i)are disclosed to
				the consumer in the insurance contract;
								(ii)are based on
				specific wellness activities that are not applicable to all individuals;
				and
								(iii)are not
				obtainable by all individuals to whom coverage is offered;
								(D)from reinstating
				lapsed coverage; or
							(E)from
				retroactively adjusting the rates charged an insured individual if the initial
				rates were set based on material misrepresentation by the individual at the
				time of issue.
							(e)Prior offering
				of policy in primary stateA health insurance issuer may not
				offer for sale individual health insurance coverage in a secondary State unless
				that coverage is currently offered for sale in the primary State.
					(f)Licensing of
				agents or brokers for health insurance issuersAny State may
				require that a person acting, or offering to act, as an agent or broker for a
				health insurance issuer with respect to the offering of individual health
				insurance coverage obtain a license from that State, with commissions or other
				compensation subject to the provisions of the laws of that State, except that a
				State may not impose any qualification or requirement which discriminates
				against a nonresident agent or broker.
					(g)Documents for
				submission to state insurance commissionerEach health insurance
				issuer issuing individual health insurance coverage in both primary and
				secondary States shall submit—
						(1)to the insurance
				commissioner of each State in which it intends to offer such coverage, before
				it may offer individual health insurance coverage in such State—
							(A)a copy of the
				plan of operation, feasibility study, or any similar statement of the policy
				being offered and its coverage (which shall include the name of its primary
				State and its principal place of business);
							(B)written notice of
				any change in its designation of its primary State; and
							(C)written notice
				from the issuer of the issuer's compliance with all the laws of the primary
				State; and
							(2)to the insurance
				commissioner of each secondary State in which it offers individual health
				insurance coverage, a copy of the issuer's quarterly financial statement
				submitted to the primary State, which statement shall be certified by an
				independent public accountant and contain a statement of opinion on loss and
				loss adjustment expense reserves made by—
							(A)a member of the
				American Academy of Actuaries; or
							(B)a qualified loss
				reserve specialist.
							(h)Power of courts
				To enjoin conductNothing in this section shall be construed to
				affect the authority of any Federal or State court to enjoin—
						(1)the solicitation
				or sale of individual health insurance coverage by a health insurance issuer to
				any person or group who is not eligible for such insurance; or
						(2)the solicitation
				or sale of individual health insurance coverage that violates the requirements
				of the law of a secondary State which are described in subparagraphs (A)
				through (H) of subsection (b)(1).
						(i)Power of
				secondary states To take administrative actionNothing in this
				section shall be construed to affect the authority of any State to enjoin
				conduct in violation of that State's laws described in subsection
				(b)(1).
					(j)State powers To
				enforce state laws
						(1)In
				generalSubject to the provisions of subsection (b)(1)(G)
				(relating to injunctions) and paragraph (2), nothing in this section shall be
				construed to affect the authority of any State to make use of any of its powers
				to enforce the laws of such State with respect to which a health insurance
				issuer is not exempt under subsection (b).
						(2)Courts of
				competent jurisdictionIf a State seeks an injunction regarding
				the conduct described in paragraphs (1) and (2) of subsection (h), such
				injunction must be obtained from a Federal or State court of competent
				jurisdiction.
						(k)States'
				authority To sueNothing in this section shall affect the
				authority of any State to bring action in any Federal or State court.
					(l)Generally
				applicable lawsNothing in this section shall be construed to
				affect the applicability of State laws generally applicable to persons or
				corporations.
					(m)Guaranteed
				availability of coverage to HIPPA eligible individualsTo the
				extent that a health insurance issuer is offering coverage in a primary State
				that does not accommodate residents of secondary States or does not provide a
				working mechanism for residents of a secondary State, and the issuer is
				offering coverage under this part in such secondary State which has not adopted
				a qualified high risk pool as its acceptable alternative mechanism (as defined
				in section 2744(c)(2)), the issuer shall, with respect to any individual health
				insurance coverage offered in a secondary State under this part, comply with
				the guaranteed availability requirements for eligible individuals in section
				2741.
					2797.Primary state
				must meet federal floor before issuer may sell into secondary
				statesA health insurance
				issuer may not offer, sell, or issue individual health insurance coverage in a
				secondary State if the State insurance commissioner does not use a risk-based
				capital formula for the determination of capital and surplus requirements for
				all health insurance issuers.
					2798.Independent
				external appeals procedures
						(a)Right to
				external appealA health insurance issuer may not offer, sell, or
				issue individual health insurance coverage in a secondary State under the
				provisions of this title unless—
							(1)both the
				secondary State and the primary State have legislation or regulations in place
				establishing an independent review process for individuals who are covered by
				individual health insurance coverage, or
							(2)in any case in
				which the requirements of paragraph (1) are not met with respect to either of
				such States, the issuer provides an independent review mechanism substantially
				identical (as determined by the applicable State authority of such State) to
				that prescribed in the Health Carrier External Review Model Act
				of the National Association of Insurance Commissioners for all individuals who
				purchase insurance coverage under the terms of this part, except that, under
				such mechanism, the review is conducted by an independent medical reviewer, or
				a panel of such reviewers, with respect to whom the requirements of subsection
				(b) are met.
							(b)Qualifications
				of independent medical reviewersIn the case of any independent
				review mechanism referred to in subsection (a)(2), the following provisions
				shall apply:
							(1)In
				generalIn referring a denial of a claim to an independent
				medical reviewer, or to any panel of such reviewers, to conduct independent
				medical review, the issuer shall ensure that—
								(A)each independent
				medical reviewer meets the qualifications described in paragraphs (2) and
				(3);
								(B)with respect to
				each review, each reviewer meets the requirements of paragraph (4) and the
				reviewer, or at least 1 reviewer on the panel, meets the requirements described
				in paragraph (5); and
								(C)compensation
				provided by the issuer to each reviewer is consistent with paragraph
				(6).
								(2)Licensure and
				expertiseEach independent medical reviewer shall be a physician
				(allopathic or osteopathic) or health care professional who—
								(A)is appropriately
				credentialed or licensed in 1 or more States to deliver health care services;
				and
								(B)typically treats
				the condition, makes the diagnosis, or provides the type of treatment under
				review.
								(3)Independence
								(A)In
				generalSubject to subparagraph (B), each independent medical
				reviewer in a case shall—
									(i)not be a related
				party (as defined in paragraph (7));
									(ii)not have a
				material familial, financial, or professional relationship with such a party;
				and
									(iii)not otherwise
				have a conflict of interest with such a party (as determined under
				regulations).
									(B)ExceptionNothing
				in subparagraph (A) shall be construed to—
									(i)prohibit an
				individual, solely on the basis of affiliation with the issuer, from serving as
				an independent medical reviewer if—
										(I)a non-affiliated
				individual is not reasonably available;
										(II)the affiliated
				individual is not involved in the provision of items or services in the case
				under review;
										(III)the fact of
				such an affiliation is disclosed to the issuer and the enrollee (or authorized
				representative) and neither party objects; and
										(IV)the affiliated
				individual is not an employee of the issuer and does not provide services
				exclusively or primarily to or on behalf of the issuer;
										(ii)prohibit an
				individual who has staff privileges at the institution where the treatment
				involved takes place from serving as an independent medical reviewer merely on
				the basis of such affiliation if the affiliation is disclosed to the issuer and
				the enrollee (or authorized representative) and neither party objects;
				or
									(iii)prohibit
				receipt of compensation by an independent medical reviewer from an entity if
				the compensation is provided consistent with paragraph (6).
									(4)Practicing
				health care professional in same field
								(A)In
				generalIn a case involving treatment, or the provision of items
				or services—
									(i)by a physician, a
				reviewer shall be a practicing physician (allopathic or osteopathic) of the
				same or similar specialty, as a physician who, acting within the appropriate
				scope of practice within the State in which the service is provided or
				rendered, typically treats the condition, makes the diagnosis, or provides the
				type of treatment under review; or
									(ii)by a
				non-physician health care professional, the reviewer, or at least 1 member of
				the review panel, shall be a practicing non-physician health care professional
				of the same or similar specialty as the non-physician health care professional
				who, acting within the appropriate scope of practice within the State in which
				the service is provided or rendered, typically treats the condition, makes the
				diagnosis, or provides the type of treatment under review.
									(B)Practicing
				definedFor purposes of this paragraph, the term
				practicing means, with respect to an individual who is a physician
				or other health care professional, that the individual provides health care
				services to individual patients on average at least 2 days per week.
								(5)Pediatric
				expertiseIn the case of an external review relating to a child,
				a reviewer shall have expertise under paragraph (2) in pediatrics.
							(6)Limitations on
				reviewer compensationCompensation provided by the issuer to an
				independent medical reviewer in connection with a review under this section
				shall—
								(A)not exceed a
				reasonable level; and
								(B)not be contingent
				on the decision rendered by the reviewer.
								(7)Related party
				definedFor purposes of this section, the term related
				party means, with respect to a denial of a claim under a coverage
				relating to an enrollee, any of the following:
								(A)The issuer
				involved, or any fiduciary, officer, director, or employee of the
				issuer.
								(B)The enrollee (or
				authorized representative).
								(C)The health care
				professional that provides the items or services involved in the denial.
								(D)The institution
				at which the items or services (or treatment) involved in the denial are
				provided.
								(E)The manufacturer
				of any drug or other item that is included in the items or services involved in
				the denial.
								(F)Any other party
				determined under any regulations to have a substantial interest in the denial
				involved.
								(8)DefinitionsFor
				purposes of this subsection:
								(A)EnrolleeThe
				term enrollee means, with respect to health insurance coverage
				offered by a health insurance issuer, an individual enrolled with the issuer to
				receive such coverage.
								(B)Health care
				professionalThe term health care professional means
				an individual who is licensed, accredited, or certified under State law to
				provide specified health care services and who is operating within the scope of
				such licensure, accreditation, or certification.
								2799.Enforcement
						(a)In
				generalSubject to subsection (b), with respect to specific
				individual health insurance coverage, the primary State for such coverage has
				sole jurisdiction to enforce the primary State's covered laws in the primary
				State and any secondary State.
						(b)Secondary
				state's authorityNothing in subsection (a) shall be construed to
				affect the authority of a secondary State to enforce its laws as set forth in
				the exception specified in section 2796(b)(1).
						(c)Court
				interpretationIn reviewing action initiated by the applicable
				secondary State authority, the court of competent jurisdiction shall apply the
				covered laws of the primary State.
						(d)Notice of
				compliance failureIn the case of individual health insurance
				coverage offered in a secondary State that fails to comply with the covered
				laws of the primary State, the applicable State authority of the secondary
				State may notify the applicable State authority of the primary
				State.
						.
			(b)Effective
			 dateThe amendment made by subsection (a) shall apply to
			 individual health insurance coverage offered, issued, or sold after the date
			 that is one year after the date of the enactment of this Act.
			(c)GAO ongoing
			 study and reports
				(1)StudyThe
			 Comptroller General of the United States shall conduct an ongoing study
			 concerning the effect of the amendment made by subsection (a) on—
					(A)the number of
			 uninsured and under-insured;
					(B)the availability
			 and cost of health insurance policies for individuals with pre-existing medical
			 conditions;
					(C)the availability
			 and cost of health insurance policies generally;
					(D)the elimination
			 or reduction of different types of benefits under health insurance policies
			 offered in different States; and
					(E)cases of fraud or
			 abuse relating to health insurance coverage offered under such amendment and
			 the resolution of such cases.
					(2)Annual
			 reportsThe Comptroller General shall submit to Congress an
			 annual report, after the end of each of the 5 years following the effective
			 date of the amendment made by subsection (a), on the ongoing study conducted
			 under paragraph (1).
				5.SeverabilityIf any provision of the Act or the
			 application of such provision to any person or circumstance is held to be
			 unconstitutional, the remainder of this Act and the application of the
			 provisions of such to any other person or circumstance shall not be
			 affected.


110 HR 630 IH: For the relief of Flavia Maboloc Cahoon.
U.S. House of Representatives
2007-01-22
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.

V
110th CONGRESS
1st Session
H. R. 630
IN THE HOUSE OF REPRESENTATIVES

January 22, 2007
Mr. Filner introduced the following bill; which was referred to the Committee on the Judiciary

A BILL
For the relief of Flavia Maboloc Cahoon.

1.Permanent resident status for Flavia Maboloc Cahoon
(a)In generalNotwithstanding subsections (a) and (b) of section 201, and section 245(d), of the Immigration and Nationality Act, Flavia Maboloc Cahoon shall be eligible for issuance of an immigrant visa or for adjustment of status to that of an alien lawfully admitted for permanent residence upon filing an application for issuance of an immigrant visa under section 204 of such Act or for adjustment of status to lawful permanent resident.
(b)Adjustment of statusNotwithstanding subsection (d) of section 245 of the Immigration and Nationality Act, if Flavia Maboloc Cahoon enters the United States before the filing deadline specified in subsection (c) of this Act, she shall be considered to have entered and remained lawfully and shall, if otherwise eligible, be eligible for adjustment of status under such section 245 as of the date of the enactment of this Act.
(c)Deadline for application and payment of feesSubsections (a) and (b) shall apply only if the application for issuance of an immigrant visa or the application for adjustment of status is filed with appropriate fees within 2 years after the date of the enactment of this Act.
(d)Reduction of immigrant visa numberUpon the granting of an immigrant visa or permanent residence to Flavia Maboloc Cahoon, the Secretary of State shall instruct the proper officer to reduce by 1, during the current or next following fiscal year, the total number of immigrant visas that are made available to natives of the country of the alien’s birth under section 203(a) of the Immigration and Nationality Act or, if applicable, the total number of immigrant visas that are made available to natives of the country of the alien’s birth under section 202(e) of such Act.
(e)Denial of preferential immigration treatment for certain relativesThe natural parents, brothers, and sisters of Flavia Maboloc Cahoon shall not, by virtue of such relationship, be accorded any right, privilege, or status under the Immigration and Nationality Act.


113 HR 4671 IH: Public Interest Declassification Board Reauthorization Act of 2014
U.S. House of Representatives
2014-05-19
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
113th CONGRESS
2d Session
H. R. 4671
IN THE HOUSE OF REPRESENTATIVES

May 19, 2014
Mr. Issa introduced the following bill; which was referred to the Committee on Oversight and Government Reform

A BILL
To extend the Public Interest Declassification Act of 2000.

1.Short titleThis Act may be cited as the Public Interest Declassification Board Reauthorization Act of 2014.
2.ExtensionSection 710(b) of the Public Interest Declassification Act of 2000 (Public Law 106–567; 50 U.S.C. 3161 note) is amended by striking 2014. and inserting 2015..


116 HR 4854 IH: Making DI Work For All Americans Act of 2019
U.S. House of Representatives
2019-10-23
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 CONGRESS1st SessionH. R. 4854IN THE HOUSE OF REPRESENTATIVESOctober 23, 2019Mr. Yoho introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Oversight and 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 concernedA BILLTo amend title II of the Social Security Act to update and improve eligibility criteria for the
			 Social Security Disability Program, and for other purposes.

 1.Short titleThis Act may be cited as the Making DI Work For All Americans Act of 2019. 2.Table of contentsThe table of contents for this Act is as follows:

				Sec. 1. Short title.
				Sec. 2. Table of contents.
				Title I—Administrative Changes
				Sec. 101. Strengthening the administrative law judge quality review process.
				Sec. 102. Applying judicial code of conduct to administrative law judges.
				Sec. 103. Compensation for claimant representatives.
				Sec. 104. Minimum monthly withholding to recover overpayments.
				Sec. 105. Disqualification on receipt of disability insurance benefits in a month for which
			 unemployment compensation is received.
				Sec. 106. Elimination of reconsideration review application stages.
				Sec. 107. Report on hiring new administrative law judges and staff.
				Title II—Eligibility
				Sec. 201. Updating of medical-vocational guidelines.
				Sec. 202. Review of social media activity.
				Sec. 203. Updating data on work which exists in national economy.
				Title III—Continuing Disability Reviews
				Sec. 301. Study on impact of medical review standard.
				Sec. 302. Additional training relating to MIRS exceptions.
				Sec. 303. Increased frequency of continuing disability reviews.
				Sec. 304. Communication relating to termination of benefits.
				Sec. 305. Communication relating to reporting requirements.
				Title IV—Benefits
				Sec. 401. Establishment of annual poverty guideline based disability insurance benefits.
				Sec. 402. Retroactive payment of benefits.
				Sec. 403. Inclusion of unearned income in determination of substantial gainful activity.

		IAdministrative Changes
			101.Strengthening the administrative law judge quality review process
 (a)ReviewNot later than 1 year after the date of enactment of this Act and annually thereafter, the Division of Quality of the Office of Appellate Operations of the Social Security Administration shall conduct a review of a sample of determinations that individuals are entitled to disability insurance benefits by outlier administrative law judges and identify any determinations that are not supported by the evidence.
 (b)ReportNot later than December 1 of each year in which a review described in subsection (a) is conducted, the Division of Quality Review of the Office of Appellate Operations of the Social Security Administration shall submit a report containing the results of such review, including all determinations that were found to be unsupported by the evidence, together with any recommendations for administrative action or proposed legislation that the Division determines appropriate, to—
 (1)the Inspector General of the Social Security Administration; (2)the Commissioner of the Social Security Administration;
 (3)the Committees on Ways and Means and Oversight and Reform of the House of Representatives; and
 (4)the Committees on Finance and Homeland Security and Governmental Affairs of the Senate. (c)Definition of outlier administrative law judgeFor purposes of this section, the term outlier administrative law judge means an administrative law judge within the Office of Disability Adjudication and Review of the Social Security Administration who, in a given year—
 (1)determines that the applicant is entitled to disability insurance benefits more often than 90 percent, or less often than 10 percent, of administrative law judges making determinations under this title; or
 (2)issues more decisions than 90 percent, or less decisions than 10 percent, of administrative law judges making determinations under this title.
					102.Applying judicial code of conduct to administrative law judges
 (a)In generalSection 3105 of title 5, United States Code, is amended— (1)by striking Each agency and inserting

 (a)Each agency; and (2)by adding at the end the following:

 (b)The Code of Conduct for United States Judges adopted by the Judicial Conference of the United States shall apply to administrative law judges appointed under this section.
 (c)If, in applying a standard of conduct to an administrative law judge appointed under this section, there is a conflict between the Code of Conduct for United States Judges and any other law or regulation, the stricter standard of conduct shall apply.
 (d)Pursuant to section 7301, the President may issue such regulations as may be necessary to carry out subsections (b) and (c)..
 (b)Limitation on regulatory authoritySection 1305 of title 5, United States Code, is amended by striking 3105 and inserting 3105(a). 103.Compensation for claimant representatives (a)In generalSection 206 of the Social Security Act (42 U.S.C. 406) is amended to read as follows:

						206.Representation of Claimants(a)
 (1)The Commissioner of Social Security may prescribe rules and regulations governing the recognition of agents or other persons, other than attorneys as hereinafter provided, representing claimants before the Commissioner of Social Security, and may require of such agents or other persons, before being recognized as representatives of claimants that they shall show that they are of good character and in good repute, possessed of the necessary qualifications to enable them to render such claimants valuable service, and otherwise competent to advise and assist such claimants in the presentation of their cases. An attorney in good standing who is admitted to practice before the highest court of the State, Territory, District, or insular possession of his residence or before the Supreme Court of the United States or the inferior Federal courts, shall be entitled to represent claimants before the Commissioner of Social Security.
 (2)Notwithstanding paragraph (1), the Commissioner, after due notice and opportunity for hearing— (A)may refuse to recognize as a representative, and may disqualify a representative already recognized, any attorney who has been disbarred or suspended from any court or bar to which he or she was previously admitted to practice or who has been disqualified from participating in or appearing before any Federal program or agency, and
 (B)may refuse to recognize, and may disqualify, as a non-attorney representative any attorney who has been disbarred or suspended from any court or bar to which he or she was previously admitted to practice.
 (3)The Commissioner of Social Security may, after due notice and opportunity for hearing, suspend or prohibit from further practice before the Commissioner any such person, agent, or attorney who refuses to comply with the Commissioner's rules and regulations.
 (b)In prescribing the rules and regulations described in subsection (a), the Commissioner of Social Security may not prescribe any rules or regulations regarding the permissible fees which may be charged for services performed in connection with any claim before the Commissioner of Social Security under this title or title XVI. In no case shall the Commissioner certify any amount for payment to any representative out of any benefits payable to a claimant under this title or title XVI..
 (b)Conforming amendments to title XVISection 1631(d)(2) of the Social Security Act (42 U.S.C. 1383(d)(2)) is amended— (1)by amending subparagraph (A) to read as follows:

 (A)The provisions of section 206 shall apply to this part to the same extent as they apply in the case of title II.; and
 (2)by redesignating subparagraph (D) as subparagraph (B). (c)Effective dateThe amendments made by this section shall apply with respect to applications for benefits filed on or after January 1, 2020.
				104.Minimum monthly withholding to recover overpayments
 (a)In generalSection 204(a)(1) of the Social Security Act (42 U.S.C. 404(a)(1)) is amended— (1)by redesignating subparagraph (A) as clause (i) of subparagraph (A);
 (2)in subparagraph (A)(i) (as so redesignated), by striking With and inserting Subject to clause (ii), with; and (3)by adding at the end the following:

 (ii)If the Commissioner determines that withholding the full amount of a monthly disability insurance benefit payment to which an individual is otherwise entitled under this title to recover an overpayment pursuant to this section would defeat the purpose of this title, the Commissioner may withhold from such payment an amount that is less than such full amount but not less than 10 percent of such full amount..
 (b)RegulationsThe Commissioner of Social Security shall prescribe such regulations and make any conforming changes to regulations as the Commissioner determines appropriate to carry out the amendments made by this subsection.
 (c)Effective dateThe amendments made by this subsection shall apply with respect to overpayments made on or after January 1, 2020.
				105.Disqualification on receipt of disability insurance benefits in a month for which unemployment
			 compensation is received
 (a)In generalSection 223(d)(4) of the Social Security Act (42 U.S.C. 423(d)(4)) is amended by adding at the end the following:

						(D)
 (i)If for any week ending within a month an individual is paid unemployment compensation, such individual shall be deemed to have engaged in substantial gainful activity for such month.
 (ii)For purposes of clause (i), the term unemployment compensation means— (I)regular compensation, extended compensation, and additional compensation (as such terms are defined by section 205 of the Federal-State Extended Unemployment Compensation Act (26 U.S.C. 3304 note)); and
 (II)trade readjustment allowance under title II of the Trade Act of 1974 (19 U.S.C. 2251 et seq.).. (b)Trial work periodSection 222(c) of the Social Security Act (42 U.S.C. 422(c)) is amended by adding at the end the following:

						(6)
 (A)For purposes of this subsection, an individual shall be deemed to have rendered services in a month if the individual is paid unemployment compensation for any week ending within such month.
 (B)For purposes of subparagraph (A), the term unemployment compensation means— (i)regular compensation, extended compensation, and additional compensation (as such terms are defined by section 205 of the Federal-State Extended Unemployment Compensation Act (26 U.S.C. 3304 note)); and
 (ii)trade readjustment allowance under title II of the Trade Act of 1974 (19 U.S.C. 2251 et seq.).. (c)Data matchingThe Commissioner of Social Security shall implement the amendments made by this section using appropriate electronic data.
 (d)Effective dateThe amendments made by this section shall apply with respect to individuals who initially apply for disability insurance benefits on or after January 1, 2020, and are paid unemployment compensation for any week ending on or after January 1, 2020.
				106.Elimination of reconsideration review application stages
 (a)In generalSection 205(b) of the Social Security Act (42 U.S.C. 405(b)) is amended— (1)in paragraph (1), by adding at the end the following new sentence: Opportunity for a hearing under this title in accordance with this subsection with respect to any initial decision or determination under this title shall be available without any requirement for intervening reconsideration.;
 (2)by striking paragraph (2); (3)by redesignating paragraph (3) as paragraph (2); and
 (4)in paragraph (2) (as so redesignated), by striking or an adverse determination on reconsideration of such an initial determination. (b)Conforming amendmentsTitle II of such Act (42 U.S.C. 401 et seq.), as amended by subsection (a), is further amended—
 (1)in section 201(j), by striking reconsideration interviews and; and (2)in section 221(i)(3)—
 (A)by striking reconsideration of such initial termination or; and (B)by striking reconsideration or before hearing.
 (c)Effective dateThe amendments made by this section shall apply with respect to any initial determination of entitlement to a benefit under title II of the Social Security Act made on or after the date that is one year after the date of the enactment of this Act.
 107.Report on hiring new administrative law judges and staffNot later than 180 days after the date of the enactment of this Act, the Commissioner of Social Security shall submit to Congress a report that includes an estimate of the number of new administrative law judges and support staff that the Commissioner determines would be necessary to make a final decision on the entitlement of each individual for a disability insurance benefit under title II of the Social Security Act not later than 6 months after the date on which such individual applies for such benefits.
			IIEligibility
 201.Updating of medical-vocational guidelinesAs soon as possible after the date of the enactment of this Act, the Commissioner of Social Security shall prescribe rules and regulations that update the medical-vocational guidelines, as set forth in appendix 2 to subpart P of part 404 of title 20, Code of Federal Regulations, used in disability determinations, including full consideration of removing non-medical factors no longer relevant due to new employment opportunities made possible by advances in treatment, rehabilitation, and technology and full consideration of the effect of prevalent languages on education.
			202.Review of social media activity
 (a)In generalSection 205(b)(1) of the Social Security Act (42 U.S.C. 405(b)(1)), as amended by section 110(a), is further amended by inserting after the second sentence the following: In making any initial determination of disability under this title, the Commissioner of Social Security shall consider any relevant evidence from social media of which the Commissioner is made aware prior to issuing a decision involving such determination..
 (b)Effective dateThe amendment made by subsection (a) shall apply with respect to applications for disability insurance benefits filed on or after January 1, 2020.
 203.Updating data on work which exists in national economyNot later than 5 years after the date of the enactment of this Act, and every year thereafter, the Commissioner of Social Security shall—
 (1)update the data used by the Commissioner to determine the jobs which exist in the national economy (within the meaning of section 223(d)(2)(A) of the Social Security Act (42 U.S.C. 423(d)(2)(A))), to ensure that such data reflects the full range of work which exists in the national economy, including newly-created jobs in emerging industries; and
 (2)submit to Congress a report describing each such update. IIIContinuing Disability Reviews 301.Study on impact of medical review standard (a)In generalThe Commissioner of Social Security shall conduct a study with respect to a large number of beneficiaries—
 (1)to determine whether the Social Security Administration would consider such beneficiaries to be disabled using the Initial Disability Standard rather than the Medical Improvement Review Standard (MIRS) during continuing disability reviews; and
 (2)to analyze the cause of any difference of result between the two standards. (b)ReportNot later than 180 days after the date of the enactment of this Act, the Commissioner of Social Security shall submit a report to Congress on the study described in subsection (a).
 302.Additional training relating to MIRS exceptionsThe Commissioner of Social Security shall— (1)provide training, as the Commissioner determines to be appropriate, to employees of State disability determination services and to Federal personnel involved in making disability determinations on the application of exceptions to the Medical Improvement Review Standard (MIRS) during continuing disability reviews; and
 (2)establish a procedure by which such employees and Federal personnel may request assistance from the Social Security Administration in the application of such exceptions.
				303.Increased frequency of continuing disability reviews
 (a)In generalSection 221(i) of the Social Security Act (42 U.S.C. 421(i)) is amended— (1)in paragraph (1)—
 (A)by striking every 3 years and inserting every year; and (B)by striking at such times as the Commissioner of Social Security determines to be appropriate and inserting at least every 5 years; and
 (2)in paragraph (2), by striking every 3 years and inserting once every year. (b)Effective dateThe amendment made by subsection (a) shall apply with respect to applications for disability insurance benefits filed on or after January 1, 2020.
				304.Communication relating to termination of benefits
 (a)In generalThe Commissioner of Social Security shall ensure that each award letter informing an individual of the individual’s initial entitlement to disability insurance benefits under title II of the Social Security Act includes—
 (1)a description of all of the conditions under which such benefits may be terminated; and (2)except in any case in which a finding has been made that the individual’s disability is permanent, an explanation that disability insurance benefits are temporary and that the individual is expected to return to work after medical improvement has occurred.
 (b)Effective dateThe amendment made by subsection (a) shall apply with respect to individuals who become entitled to disability insurance benefits on or after January 1, 2020.
 305.Communication relating to reporting requirementsThe Commissioner of Social Security shall ensure that each communication from the Social Security Administration made to an individual entitled to disability insurance benefits includes a description of the individual’s responsibility to report to the Commissioner of Social Security any change of circumstance that may affect the individual’s entitlement to such benefits.
			IVBenefits
			401.Establishment of annual poverty guideline based disability insurance benefits
 (a)In generalSection 223(a) of the Social Security Act (42 U.S.C. 423(a)(2)) is amended by inserting after paragraph (2) the following new paragraph:

 (3)In the case of an individual who initially becomes entitled to disability benefits in the calendar year 2020 or any subsequent calendar year, and except as provided in section 202(q) of this title, such individual’s disability insurance benefit for any month shall be one-twelfth of the most recently published annual poverty guideline for an individual (as updated annually in the Fed. Reg. by the Department of Health and Human Services under the authority of section 673(2) of the Omnibus Budget Reconciliation Act of 1981)..
 (b)Early retirement benefit reductionSection 202(q)(2) of the Social Security Act (42 U.S.C. 423(a)(2)) is amended by striking subsection (q)(2) and replacing it with the following:

 (2)If an individual is entitled to a disability insurance benefit for a month after a month for which such individual was entitled to an old-age insurance benefit, such disability insurance benefit for each month shall be—
 (A)if such individual initially became entitled to disability benefits in any calendar year before 2020, reduced by the amount such old-age insurance benefit would be reduced under paragraphs (1) and (4) for such month had such individual attained retirement age (as defined in section 416(l) of this title) in the first month for which he most recently became entitled to a disability insurance benefit; or
 (B)if such individual initially became entitled to disability benefits in the calendar year 2020 or any subsequent calendar year, equal to the higher of the individual’s reduced old-age insurance benefit under paragraph (1) and the individual’s disability insurance benefit under section 423(a)(3)..
 (c)Conforming amendmentSection 223(a)(2) of the Social Security Act (42 U.S.C. 423(a)(2)) is amended by striking Except and inserting In the case of an individual who initially becomes entitled for disability benefits in any calendar year before 2020, and except.
				402.Retroactive payment of benefits
 (a)In generalSection 223(b) of the Social Security Act (42 U.S.C. 423(b)) is amended by striking 12th month and inserting 6th month. (b)Effective dateThe amendment made by subsection (a) shall apply with respect to applications for disability insurance benefits filed on or after January 1, 2020.
				403.Inclusion of unearned income in determination of substantial gainful activity
 (a)In generalSection 223(d)(4) of the Social Security Act (42 U.S.C. 423(d)(4)), as amended by section 3(b), is further amended by adding at the end the following:

						(D)
 (i)If the amount of unearned income (as defined in section 1612) of an individual for a month is equal to or greater than the monthly income limit for such month, the individual shall be deemed to have engaged in substantial gainful activity for such month.
 (ii)For purposes of this subparagraph, the monthly income limit is the amount of earnings derived from services, prescribed by the Commissioner under regulations issued pursuant to subparagraph (A), sufficient to demonstrate an individual’s ability to engage in substantial gainful activity for a month..
 (b)Effective dateThe amendment made by subsection (a) shall apply with respect to monthly insurance benefits paid for months beginning after the date that is 1 year after the date of the enactment of this Act.