I
One Hundred Eleventh Congress of the United States of America At the First SessionBegun and held at the City of Washington on Tuesday, the sixth day of January, two thousand and nine
H. R. 838

AN ACT
To provide for the conveyance of a parcel of land held by the Bureau of Prisons of the Department of Justice in Miami Dade County, Florida, to facilitate the construction of a new educational facility that includes a secure parking area for the Bureau of Prisons, and for other purposes.

1.Short titleThis Act may be cited as the Miami Dade College Land Conveyance Act.
2.Conveyance of Bureau of Prisons land to Miami Dade County, Florida
(a)Conveyance requiredThe Attorney General shall convey to Miami Dade College of Miami Dade County, Florida (in this section referred to as the College), all right, title, and interest of the United States in and to a parcel of land held by the Bureau of Prisons of the Department of Justice in Miami Dade County, Florida, consisting of a parking lot approximately 47,500 square feet and located at 35 NE 2 Street, for the purpose of permitting the College to use the parcel as a site for a new educational building that includes a parking area, of which not less than 118 secure parking spaces shall be designated for use by the Bureau of Prisons of the Department of Justice.
(b)Reversionary interestIf the Attorney General determines at any time that the real property conveyed under subsection (a) is not being used in accordance with the purpose of the conveyance specified in such subsection, all right, title, and interest in and to the property shall revert, at the option of the Attorney General, to the United States, and the United States shall have the right of immediate entry onto the property. Any determination of the Attorney General under this subsection shall be made on the record after an opportunity for a hearing.
(c)SurveyIf the Attorney General considers it necessary, the Attorney General may have the exact acreage or square footage and legal description of the land to be conveyed under subsection (a) determined by a survey satisfactory to the Attorney General. The College shall bear the cost of the survey.
(d)ExemptionSection 102(2)(C) of the National Environmental Policy Act of 1969 (42 U.S.C. 4332(2)(C)) shall not apply to the conveyance of land under subsection (a).
 Speaker of the House of Representatives.Vice President of the United States and President of the Senate.


99 S642 IS: Air Carrier Access Amendments Act of 2021
U.S. Senate
2021-03-09
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.

II117th CONGRESS1st SessionS. 642IN THE SENATE OF THE UNITED STATESMarch 9, 2021Ms. Baldwin (for herself, Mr. Casey, Mr. Blumenthal, Mr. Markey, Mr. Merkley, Ms. Duckworth, and Ms. Hassan) introduced the following bill; which was read twice and referred to the Committee on Commerce, Science, and TransportationA BILLTo protect the rights of passengers with disabilities in air transportation, and for other purposes.1.Short titleThis Act may be cited as the Air Carrier Access Amendments Act of 2021.2.Findings; sense of Congress(a)FindingsCongress makes the following findings:(1)In 1986, President Ronald Reagan signed the Air Carrier Access Act of 1986 (Public Law 99–435; 100 Stat. 1080), adding a provision now codified in section 41705 of title 49, United States Code (in this section referred to as the ACAA), prohibiting disability-based discrimination in air transportation.(2)Despite the effort, individuals, including veterans, with disabilities continue to experience significant barriers to and with traveling in air transportation, such as—(A)damaged assistive devices;(B)inaccessible aircraft, lavatories, and communication media;(C)delayed assistance;(D)treatment of service animals;(E)inadequate disability cultural competency; and(F)a lack of suitable seating accommodations.(b)Sense of CongressThe following is the sense of Congress:(1)Access for individuals with disabilities in air transportation must move into the 21st century. Otherwise, individuals with disabilities will be left behind and unable to compete in today’s job market or enjoy the opportunities available to other citizens of the United States.(2)Aircraft must be designed to accommodate individuals with disabilities and air carriers must acquire aircraft that meet broad accessibility standards.(3)The ACAA must be updated to improve access to air transportation for individuals with disabilities. Legislation is necessary for the modernization of standards and requirements that will strengthen accessibility in air transportation, including the accessibility of aircraft.(4)The Department of Transportation and the Architectural and Transportation Barriers Compliance Board (in this section referred to as the Access Board) must promulgate regulations to ensure that all passengers with disabilities receive—(A)prompt and effective boarding, deplaning, and connections between flights;(B)accommodations, including nonstandard accommodations, that safely facilitate air travel; and(C)better access to airport facilities, including the provision of visually and tactilely accessible announcements and full and equal access to aural communications. (5)Legislation is necessary to ensure that individuals with disabilities have adequate remedies available when air carriers violate the ACAA (including regulations prescribed under the ACAA).(6)Unlike other civil rights statutes, the ACAA does not contain a private right of action, which is critical to the enforcement of civil rights statutes. Legislation is necessary to correct this anomaly.3.DefinitionsIn this Act:(1)Access BoardThe term Access Board means the Architectural and Transportation Barriers Compliance Board.(2)Air carrierThe term air carrier means an air carrier or foreign air carrier (as those terms are defined in section 40102 of title 49, United States Code).(3)DisabilityThe term disability has the meaning given that term in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102), including the meaning under that section as amended by the ADA Amendments Act of 2008 (Public Law 110–325; 122 Stat. 3553).(4)SecretaryThe term Secretary means the Secretary of Transportation.4.Improving access to air transportation for individuals with disabilities(a)In generalSection 41705 of title 49, United States Code, is amended to read as follows:41705.Accessibility of air transportation for individuals with disabilities(a)In generalIn providing air transportation, an air carrier may not discriminate against an individual on the basis of a disability, including by taking any of the actions prohibited under subsection (b) or not taking any of the actions required by subsection (c).(b)Prohibited actions(1)In generalAn air carrier may not—(A)directly or through a contractual, licensing, or other arrangement, discriminate in the full and equal enjoyment (within the meaning of that term under section 302(a) of the Americans with Disabilities Act of 1990 (42 U.S.C. 12182(a))) of air transportation;(B)deny the opportunity of an individual or a class of individuals, on the basis of a disability or disabilities of the individual or class, to participate in or benefit from the goods, services, facilities, advantages, accommodations, or other opportunities provided by the air carrier;(C)afford an individual or a class of individuals, on the basis of a disability or disabilities of the individual or class, with the opportunity to participate in or benefit from a good, service, facility, advantage, accommodation, or other opportunity that is not equal to a good, service, facility, advantage, accommodation, or other opportunity afforded to other individuals;(D)subject to paragraph (2), provide an individual or a class of individuals, on the basis of a disability or disabilities of the individual or class, with a good, service, facility, privilege, advantage, accommodation, or other opportunity that is different or separate from a good, service, facility, privilege, advantage, accommodation, or other opportunity provided to other individuals;(E)deny any goods, services, facilities, privileges, advantages, accommodations, or other opportunities to an individual because of the known disability of another individual with whom the individual is known to have a relationship or association;(F)impose or apply eligibility criteria that screen out or have the effect of screening out individuals with disabilities or a class of individuals with disabilities from fully enjoying any good, service, facility, privilege, advantage, accommodation, or other opportunity provided by the air carrier, unless the air carrier can demonstrate that such criteria are necessary for the provision of the good, service, facility, privilege, advantage, accommodation, or other opportunity;(G)directly or through a contractual, licensing, or other arrangement, use standards or criteria or methods of administration—(i)that have the effect of discriminating on the basis of disability; or(ii)that perpetuate the discrimination of others who are subject to common administrative control;(H)purchase or lease an aircraft that does not comply with this section and regulations prescribed under this section; or(I)refurbish an aircraft cabin in an aircraft manufactured before the date of the enactment of the Air Carrier Access Amendments Act of 2021, or purchase or lease such an aircraft, unless the aircraft, to the maximum extent feasible, is made readily accessible to and usable by individuals with disabilities, including individuals who use wheelchairs, in accordance with this section and upon issuance of regulations prescribed under this section.(2)Exception(A)In generalSubject to subparagraph (B), an air carrier may provide an individual or a class of individuals, on the basis of a disability or disabilities of the individual or class, with a good, service, facility, privilege, advantage, accommodation, or other opportunity that is different or separate from the good, service, facility, privilege, advantage, accommodation, or other opportunity provided to other individuals if doing so is necessary to provide the individual or class of individuals with a good, service, facility, privilege, advantage, accommodation, or other opportunity that is as effective as the good, service, facility, privilege, advantage, accommodation, or other opportunity provided to other individuals.(B)AcceptanceAn individual or a class of individuals shall retain the authority to decide whether to accept or refuse a good, service, facility, privilege, advantage, accommodation, or other opportunity referred to in subparagraph (A).(C)Selection of goods, etc., provided to othersIf, in accordance with subparagraph (A), an air carrier provides to an individual or a class of individuals a good, service, facility, privilege, advantage, accommodation, or other opportunity that is different or separate from the good, service, facility, privilege, advantage, accommodation, or other opportunity provided to other individuals, the air carrier may not deny to an individual with a disability the opportunity to participate in the good, service, facility, privilege, advantage, accommodation, or other opportunity provided to such other individuals.(c)Required actionsAn air carrier shall—(1)afford goods, services, facilities, privileges, advantages, accommodations, and other opportunities to an individual with a disability in the most integrated setting appropriate to the needs of the individual;(2)make reasonable modifications in policies, practices, or procedures, when such modifications are necessary to afford goods, services, facilities, privileges, advantages, accommodations, or other opportunities to individuals with disabilities, unless the air carrier can demonstrate that making such modifications would fundamentally alter the nature of the goods, services, facilities, privileges, advantages, accommodations, or other opportunities;(3)take such measures as may be necessary to ensure that no individual with a disability is excluded, denied services, segregated, or otherwise treated differently from other individuals because of the absence of auxiliary aids or services, unless the air carrier can demonstrate that taking such measures would—(A)fundamentally alter the nature of a good, service, facility, privilege, advantage, accommodation, or other opportunity being offered; or(B)result in an undue burden to the air carrier; and(4)(A)remove architectural barriers to equal access by individuals with disabilities to goods, services, facilities, privileges, advantages, accommodations, or other opportunities provided by the air carrier, and communication barriers to such access that are structural in nature, in facilities of the air carrier (whether owned or leased by the air carrier) that were constructed before or altered after the date of the enactment of the Air Carrier Access Amendments Act of 2021, and remove physical and communication barriers to such access in aircraft manufactured before such date of enactment and used by an air carrier for transporting individuals, if the removal of such barriers is readily achievable; or(B)if the air carrier can demonstrate that the removal of a barrier described in subparagraph (A) is not readily achievable, make such goods, services, facilities, privileges, advantages, accommodations, or other opportunities available through alternative methods that are readily achievable.(d)Complaints(1)In generalThe Secretary of Transportation shall ensure that individuals with disabilities traveling in air transportation are able—(A)to file complaints with the Department of Transportation in response to disability-related discrimination prohibited under this section or regulations prescribed under this section; and(B)to receive assistance from the Department through a toll-free hotline telephone number or comparable electronic means of communication.(2)Notice to passengers with disabilitiesEach air carrier shall include on its publicly available Internet website, any related mobile device application, and online service—(A)the hotline telephone number established under section 42302 or the telephone number for the Aviation Consumer Protection Division of the Department of Transportation and the Department’s disability assistance hotline telephone number or a comparable electronic means of communication;(B)notice that a consumer can file a disability-related complaint with the Aviation Consumer Protection Division;(C)an active link to the Internet website of the Aviation Consumer Protection Division for a consumer to file a disability-related complaint; and(D)notice that the consumer can file a disability-related complaint with the air carrier and the process and any timelines for filing such a complaint.(3)Investigation of complaints(A)In generalThe Secretary shall—(i)investigate each complaint of a violation of this section or a regulation prescribed under this section;(ii)provide, in writing, to the individual that filed the complaint and the air carrier alleged to have violated this section or a regulation prescribed under this section, the determination of the Secretary with respect to—(I)whether the air carrier violated this section or a regulation prescribed under this section;(II)the facts underlying the complaint; and(III)any action the Secretary is taking in response to the complaint; and(iii)assess civil penalties under section 46301 for each violation of this section (with each individual act of discrimination prohibited under subsection (a), (b), or (c) considered a separate violation of this section).(B)ReferralIf the Secretary has reasonable cause to believe that any air carrier or group of air carriers is engaged in a pattern or practice of discrimination under this section, or any person or group of persons has been discriminated against under this section and such discrimination raises an issue of general public importance, the Secretary shall, after the assessment of civil penalties, refer the matter to the Attorney General for further action.(C)Publication of dataThe Secretary shall publish disability-related complaint data in a manner comparable to other aviation consumer complaint data.(D)Review and reportThe Secretary shall regularly review all complaints received by air carriers alleging discrimination on the basis of disability and shall report annually to Congress on the disposition of such complaints.(e)Civil action(1)Aggrieved persons(A)In generalAny person aggrieved by the violation by an air carrier of this section or a regulation prescribed under this section may, during the 2-year period beginning on the date of the violation, bring a civil action in an appropriate district court of the United States.(B)Available reliefIf a court finds in favor of the plaintiff in a civil action brought under subparagraph (A), the court may award to the plaintiff equitable and legal relief, including compensatory and punitive damages, and shall, in addition to any such relief, award reasonable attorney’s fees, reasonable expert fees, and cost of the action to the plaintiff.(C)Exhaustion of administrative remediesAny person aggrieved by the violation by an air carrier of this section or a regulation prescribed under this section shall not be required to exhaust administrative remedies before bringing a civil action under subparagraph (A).(D)Rule of constructionNothing in this paragraph shall be construed to invalidate or limit other Federal or State laws affording to people with disabilities greater legal rights or protections than those granted by this section.(2)Enforcement by Attorney General(A)In generalThe Attorney General may bring a civil action on behalf of persons aggrieved by the violation by an air carrier of this section or a regulation prescribed under this section in any appropriate district court of the United States.(B)Authority of courtIn a civil action under subparagraph (A), the court may—(i)grant any equitable relief that the court considers to be appropriate;(ii)award such other relief as the court considers to be appropriate, including monetary damages to persons aggrieved by the violation by an air carrier of this section or a regulation prescribed under this section, when requested by the Attorney General; and(iii)assess a civil penalty against the air carrier.(f)Rule of constructionNothing in this subchapter shall require an air carrier to permit an individual to participate in or benefit from goods, services, facilities, privileges, advantages, accommodations, or other opportunities if the individual poses a significant risk to the health or safety of others that cannot be eliminated by a modification of policies, practices, or procedures or by the provision of auxiliary aids or services.(g)DefinitionsIn this section:(1)Access BoardThe term Access Board means the Architectural and Transportation Barriers Compliance Board.(2)Air carrierThe term air carrier means an air carrier or, subject to section 40105(b), a foreign air carrier.(3)DisabilityThe term disability has the meaning given that term in section 3 of the Americans with Disabilities Act of 1990 (42 U.S.C. 12102), including the meaning under that section as amended by the ADA Amendments of 2008 (Public Law 110–325; 122 Stat. 3553).(4)Readily achievableThe term readily achievable means easily accomplishable and able to be carried out without much difficulty or expense. In determining whether an action is readily achievable, factors to be considered include—(A)the nature and cost of the action needed; and(B)the overall financial resources of the air carrier..(b)Technical assistanceNot later than 180 days after the date of the enactment of this Act, the Secretary shall ensure the availability and provision of appropriate technical assistance manuals to individuals and entities with rights or responsibilities under section 41705 of title 49, United States Code, as amended by subsection (c).(c)Clerical amendmentThe chapter analysis for chapter 417 of title 49, United States Code, is amended by striking the item relating to section 41705 and inserting the following:41705. Accessibility of air transportation for individuals with disabilities..5.Standards(a)Aircraft with new or amended type certificates(1)In generalNot later than 18 months after the date of the enactment of this Act, the Access Board shall, in consultation with the Secretary, prescribe regulations setting forth the minimum standards to ensure that aircraft with type certificates under part 21 of title 14, Code of Federal Regulations, issued or amended after the date the regulations are issued, and related boarding and deplaning equipment, are accessible, in terms of design for, transportation of, and communication to, individuals with disabilities, including individuals who use wheelchairs.(2)Covered aircraft, equipment, and featuresThe standards issued under paragraph (1) shall address, at a minimum—(A)boarding and deplaning equipment, including ensuring that there is a route accessible for individuals with disabilities;(B)seating accommodations;(C)lavatories;(D)captioning and audio description of in-flight entertainment and captioning of any other aural communication;(E)individual video displays;(F)visually and tactilely accessible announcements;(G)adequate in-cabin stowage for assistive devices; and(H)proper stowage of assistive devices in the cargo hold to prevent damage.(b)Aircraft with an existing type certificate(1)In generalNot later than 1 year after the date of the enactment of this Act, the Access Board shall, in consultation with the Secretary, prescribe regulations setting forth minimum standards to ensure that barriers to the access of individuals with disabilities, including individuals who use wheelchairs, on aircraft with type certificates issued under part 21 of title 14, Code of Federal Regulations, before such date of enactment, are removed to meet basic accessibility needs of individuals with disabilities to the extent readily achievable.(2)Removal of barriersThe standards issued under paragraph (1) shall apply at a minimum to stowage of wheelchairs in the cargo hold, captioning and audio description of in-flight entertainment and captioning of any other aural communication, visually and tactilely accessible announcements, individual video displays, and improved access to seating and lavatories in all aircraft.(c)Airport facilitiesNot later than 1 year after the date of the enactment of this Act, the Access Board shall, in consultation with the Secretary, issue standards under section 41705 of title 49, United States Code (commonly known as the Air Carrier Access Act), that ensure all gates (including counters), ticketing areas, and customer service desks covered under such section at airports are accessible to and usable by all individuals with disabilities, including through the provision of visually and tactilely accessible announcements and full and equal access to aural communications.(d)Websites and kiosksNot later than 1 year after the date of the enactment of this Act, the Access Board shall, in consultation with the Secretary, prescribe regulations setting forth minimum standards to ensure that individuals with disabilities are able to access kiosks and websites in a manner that is equally as effective as individuals without disabilities, with a substantially equivalent ease of use. Such standards shall be consistent with the standards set forth in the Web Content Accessibility Guidelines 2.0 Level AA of the Web Accessibility Initiative of the World Wide Web Consortium or any subsequent version.(e)RegulationsNot later than 180 days after the Access Board issues standards under this section, the Secretary shall prescribe such regulations as are necessary to implement those standards, including the requirement to maintain accessible features of aircraft, equipment, and facilities.


		I
		112th CONGRESS
		1st Session
		H. R. 1097
		IN THE HOUSE OF REPRESENTATIVES

			March 15, 2011
			Mr. Paul introduced
			 the following bill; which was referred to the
			 Committee on Ways and
			 Means

		A BILL
		To amend the Internal Revenue Code of 1986 to expand and
		  make permanent the standard deduction for real property taxes.

		1.Short titleThis Act may be cited as the
			 Complete and Permanent Property Tax
			 Deduction Act of 2011.
		2.Standard
			 deduction for real property taxes expanded and made permanent
			(a)Standard
			 deduction for real property taxes made permanentSubparagraph (C) of section 63(c)(1) of the
			 Internal Revenue Code of 1986 is amended by striking in the case of any
			 taxable year beginning in 2008 or 2009,.
			(b)Repeal of dollar
			 limitation and exclusion of foreign taxesParagraph (7) of
			 section 63(c) of such Code is amended to read as follows:

					(7)Real property
				tax deductionFor purposes of
				paragraph (1), the real property tax deduction is the amount allowable as a
				deduction under section 164(a)(1) (determined without regard to any taxes taken
				into account under section
				62(a)).
					.
			(c)Effective
			 dateThe amendments made by this section shall apply to taxable
			 years beginning after December 31, 2010.


117 S903 IS: End Child Trafficking Now Act
U.S. Senate
2021-03-23
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.

II117th CONGRESS1st SessionS. 903IN THE SENATE OF THE UNITED STATESMarch 23, 2021Mrs. Blackburn (for herself, Mr. Tillis, and Ms. Ernst) introduced the following bill; which was read twice and referred to the Committee on the JudiciaryA BILLTo amend the Immigration and Nationality Act to require a DNA test to determine the familial relationship between an alien and an accompanying minor, and for other purposes.1.Short titleThis Act may be cited as the End Child Trafficking Now Act.2.DNA TestingThe Immigration and Nationality Act (8 U.S.C. 1101 et seq.) is amended by inserting after section 211 the following:211A.Familial relationship documentary requirements(a)In generalExcept as provided in subsection (b), an alien who has attained 18 years of age may not be admitted into the United States with a minor.(b)ExceptionsAn alien described in subsection (a) may be admitted into the United States with a minor if—(1)the alien presents to the Secretary of Homeland Security—(A)one or more documents that prove that the alien is a relative or guardian of the minor; and(B)a witness that testifies that the alien is a relative or guardian of the minor; or(2)a DNA test administered by the Secretary of Health and Human Services proves that the alien is a relative of the minor.(c)Administration of DNA testThe Secretary of Homeland Security shall request, and the Secretary of Health and Human Services shall administer, a DNA test only in a case in which the Secretary of Homeland Security is unable to determine, based on the evidence presented under subsection (b)(1), that the alien is a relative or guardian of the minor accompanying the alien.(d)Denial of consent(1)AlienAn alien described in subsection (a) is inadmissible if—(A)the Secretary of Homeland Security determines that the alien has presented insufficient evidence under subsection (b)(1) to prove that the alien is a relative of the minor; and(B)the alien refuses to consent to a DNA test.(2)MinorA minor accompanying an alien who is inadmissible under paragraph (1) shall be treated as an unaccompanied alien child (as defined in section 462(g) of the Homeland Security Act of 2002 (6 U.S.C. 279(g))).(e)DNA test resultsIn a case in which the results of the DNA test fail to prove that the alien described in subsection (a) is a relative of a minor accompanying the alien, an immigration officer shall conduct interviews as necessary to determine whether the alien is a relative or guardian of the minor.(f)ArrestAn immigration officer may arrest, pursuant to section 287, an alien described in subsection (a) if the immigration officer—(1)determines, after conducting interviews pursuant to subsection (e), that the alien is not related to the minor accompanying the alien; and(2)has reason to believe that the alien is guilty of a felony offense, including the offenses of human trafficking, recycling of a minor, and alien smuggling.(g)DefinitionsIn this section—(1)MinorThe term minor means an alien who has not attained 18 years of age.(2)RecyclingThe term recycling means, with respect to a minor, that the minor is being used to enter the United States on more than 1 occasion, by an alien who has attained 18 years of age and is not the relative or the guardian of the minor;(3)RelativeThe term relative means an individual related by consanguinity within the second degree, as determined by common law..3.Criminalizing recycling of minors(a)In generalChapter 69 of title 18, United States Code, is amended by adding at the end the following:1430.Recycling of minors(a)In generalWhoever, being 18 years of age or over, knowingly uses, for the purpose of entering the United States, a minor to whom the individual is not a relative or guardian, shall be fined under this title, imprisoned not more than 10 years, or both.(b)RelativeIn this section, the term relative means an individual related by consanguinity within the second degree as determined by common law..(b)Clerical amendmentThe table of sections for chapter 69 of title 18, United States Code, is amended by adding at the end the following new item:1430. Recycling of minors..


		II
		112th CONGRESS
		1st Session
		S. 1345
		IN THE SENATE OF THE UNITED STATES

			July 11, 2011
			Ms. Cantwell (for
			 herself and Mrs. Murray) introduced the
			 following bill; which was read twice and referred to the
			 Committee on Indian
			 Affairs

		A BILL
		To provide for equitable compensation to the Spokane
		  Tribe of Indians of the Spokane Reservation for the use of tribal land for the
		  production of hydropower by the Grand Coulee Dam, and for other purposes.

		1.Short
			 titleThis Act may be cited as
			 the Spokane Tribe of Indians of the
			 Spokane Reservation Grand Coulee Dam Equitable Compensation Settlement
			 Act.
		2.FindingsCongress finds that—
			(1)from 1927 to
			 1931, at the direction of Congress, the Corps of Engineers investigated the
			 Columbia River and its tributaries to determine sites at which power could be
			 produced at low cost;
			(2)under section
			 10(e) of the Federal Power Act (16 U.S.C. 803(e)), when licenses are issued
			 involving tribal land within an Indian reservation, a reasonable annual charge
			 shall be fixed for the use of the land, subject to the approval of the Indian
			 tribe having jurisdiction over the land;
			(3)in August 1933,
			 the Columbia Basin Commission, an agency of the State of Washington, received a
			 preliminary permit from the Federal Power Commission for water power
			 development at the Grand Coulee site;
			(4)had the Columbia
			 Basin Commission or a private entity developed the site, the Spokane Tribe
			 would have been entitled to a reasonable annual charge for the use of the land
			 of the Spokane Tribe;
			(5)in the mid-1930s,
			 the Federal Government, which is not subject to licensing under the Federal
			 Power Act (16 U.S.C. 792 et seq.)—
				(A)federalized the
			 Grand Coulee Dam project; and
				(B)began
			 construction of the Grand Coulee Dam;
				(6)when the Grand
			 Coulee Dam project was federalized, the Federal Government recognized
			 that—
				(A)development of
			 the project affected the interests of the Spokane Tribe and the Confederated
			 Tribes of the Colville Reservation; and
				(B)it would be
			 appropriate for the Spokane and Colville Tribes to receive a share of revenue
			 from the disposition of power produced at Grand Coulee Dam;
				(7)in the Act of
			 June 29, 1940 (16 U.S.C. 835d et seq.), Congress—
				(A)granted to the
			 United States—
					(i)in
			 aid of the construction, operation, and maintenance of the Columbia Basin
			 Project, all the right, title, and interest of the Spokane Tribe and Colville
			 Tribes in and to the tribal and allotted land within the Spokane and Colville
			 Reservations, as designated by the Secretary of the Interior from time to time;
			 and
					(ii)other interests
			 in that land as required and as designated by the Secretary for certain
			 construction activities undertaken in connection with the project; and
					(B)provided that
			 compensation for the land and other interests was to be determined by the
			 Secretary in such amounts as the Secretary determined to be just and
			 equitable;
				(8)pursuant to that
			 Act, the Secretary paid—
				(A)to the Spokane
			 Tribe, $4,700; and
				(B)to the
			 Confederated Tribes of the Colville Reservation, $63,000;
				(9)in 1994,
			 following litigation under the Act of August 13, 1946 (commonly known as the
			 Indian Claims Commission Act (60 Stat. 1049, chapter 959; former
			 25 U.S.C. 70 et seq.)), Congress ratified the Colville Settlement Agreement,
			 which required—
				(A)for past use of
			 the land of the Colville Tribes, a payment of $53,000,000; and
				(B)for continued use
			 of the land of the Colville Tribes, annual payments of $15,250,000, adjusted
			 annually based on revenues from the sale of electric power from the Grand
			 Coulee Dam project and transmission of that power by the Bonneville Power
			 Administration;
				(10)the Spokane
			 Tribe, having suffered harm similar to that suffered by the Colville Tribes,
			 did not file a claim within the 5-year statute of limitations under the Indian
			 Claims Commission Act;
			(11)neither the
			 Colville Tribes nor the Spokane Tribe filed claims for compensation for use of
			 the land of the respective Tribes with the Commission prior to August 13, 1951,
			 but both Tribes filed unrelated land claims prior to August 13, 1951;
			(12)in 1976, over
			 objections by the United States, the Colville Tribes were successful in
			 amending the 1951 Claims Commission land claims to add the Grand Coulee claim
			 of the Colville Tribes;
			(13)the Spokane
			 Tribe had no such claim to amend, having settled the Claims Commission land
			 claims of the Spokane Tribe with the United States in 1967;
			(14)the Spokane
			 Tribe has suffered significant harm from the construction and operation of
			 Grand Coulee Dam;
			(15)Spokane tribal
			 acreage taken by the United States for the construction of Grand Coulee Dam
			 equaled approximately 39 percent of Colville tribal acreage taken for
			 construction of the dam;
			(16)the payments and
			 delegation made pursuant to this Act constitute fair and equitable compensation
			 for the past and continued use of Spokane tribal land for the production of
			 hydropower at Grand Coulee Dam; and
			(17)by vote of the
			 Spokane tribal membership, the Spokane Tribe has resolved that the payments and
			 delegation made pursuant to this Act constitute fair and equitable compensation
			 for the past and continued use of Spokane tribal land for the production of
			 hydropower at Grand Coulee Dam.
			3.PurposeThe purpose of this Act is to provide fair
			 and equitable compensation to the Spokane Tribe for the use of the land of the
			 Spokane Tribe for the generation of hydropower by the Grand Coulee Dam.
		4.DefinitionsIn this Act:
			(1)AdministratorThe
			 term Administrator means the Administrator of the Bonneville Power
			 Administration or the head of any successor agency, corporation, or entity that
			 markets power produced at Grand Coulee Dam.
			(2)Colville
			 Settlement AgreementThe term Colville Settlement
			 Agreement means the Settlement Agreement entered into between the United
			 States and the Colville Tribes, signed by the United States on April 21, 1994,
			 and by the Colville Tribes on April 16, 1994, to settle the claims of the
			 Colville Tribes in Docket 181–D of the Indian Claims Commission, which docket
			 was transferred to the United States Court of Federal Claims.
			(3)Colville
			 TribesThe term Colville Tribes means the
			 Confederated Tribes of the Colville Reservation.
			(4)Computed Annual
			 PaymentThe term Computed Annual Payment means the
			 payment calculated under paragraph 2.b. of the Colville Settlement Agreement,
			 without regard to any increase or decrease in the payment under section 2.d. of
			 the agreement.
			(5)Confederated
			 Tribes ActThe term Confederated Tribes Act means
			 the Confederated Tribes of the Colville Reservation Grand Coulee Dam Settlement
			 Act (Public Law 103–436; 108 Stat. 4577).
			(6)FundThe
			 term Fund means the Spokane Tribe of Indians Settlement Fund
			 established by section 5.
			(7)SecretaryThe
			 term Secretary means the Secretary of the Interior.
			(8)Spokane
			 Business CouncilThe term Spokane Business Council
			 means the governing body of the Spokane Tribe under the constitution of the
			 Spokane Tribe.
			(9)Spokane
			 TribeThe term Spokane Tribe means the Spokane Tribe
			 of Indians of the Spokane Reservation, Washington.
			5.Settlement
			 fund
			(a)Establishment
			 of fundThere is established in the Treasury of the United States
			 an interest-bearing trust fund to be known as the Spokane Tribe of
			 Indians Settlement Fund, consisting of—
				(1)amounts deposited
			 in the Fund under subsection (b); and
				(2)any interest
			 earned on investment of amounts in the Fund.
				(b)DepositsFrom
			 amounts made available under section 11—
				(1)for fiscal year
			 2012, the Secretary shall deposit in the Fund $23,900,000; and
				(2)for each of the 4
			 fiscal years thereafter, the Secretary shall deposit in the Fund
			 $18,900,000.
				(c)Maintenance and
			 Investment of FundThe Fund shall be maintained and invested by
			 the Secretary in accordance with the Act of June 24, 1938 (25 U.S.C.
			 162a).
			(d)Payment of
			 Funds to Spokane Business Council
				(1)RequestAt
			 any time after amounts are deposited in the Fund, the Spokane Business Council
			 may submit to the Secretary written notice of the adoption by the Spokane
			 Business Council of a resolution requesting that the Secretary pay all or a
			 portion of the amounts in the Fund to the Spokane Business Council.
				(2)PaymentNot
			 later than 60 days after receipt of a notice under paragraph (1), the Secretary
			 shall pay the amount requested to the Spokane Business Council.
				(e)Use of
			 funds
				(1)Cultural
			 resource repository and interpretive center
					(A)In
			 generalOf the initial deposit under subsection (b)(1),
			 $5,000,000 shall be used by the Spokane Business Council for the planning,
			 design, construction, equipping, and continuing operation and maintenance of a
			 Cultural Resource Repository and Interpretive Center to—
						(i)house, preserve,
			 and protect the burial remains and funerary and cultural resources affected by
			 the operation of the Grand Coulee Dam; and
						(ii)provide an
			 interpretive and educational facility regarding the culture and history of the
			 Spokane Tribe.
						(B)EffectThe
			 funding under subparagraph (A) does not alter or affect any authority,
			 obligation, or responsibility of the United States under—
						(i)the
			 Native American Graves Protection and Repatriation Act (25 U.S.C. 3001 et
			 seq.);
						(ii)the
			 Archaeological Resources Protection Act (16 U.S.C. 470aa et seq.);
						(iii)the National
			 Historic Preservation Act (16 U.S.C. 470 et seq.); or
						(iv)the National
			 Environmental Policy Act of 1969 (42 U.S.C. 4321 et seq.).
						(2)Other
			 usesOf all other amounts deposited in the Fund (including
			 interest generated on those amounts)—
					(A)25 percent shall
			 be—
						(i)reserved by the
			 Spokane Business Council; and
						(ii)used for
			 discretionary purposes of general benefit to all members of the Spokane Tribe;
			 and
						(B)75 percent shall
			 be used by the Spokane Business Council to carry out—
						(i)resource
			 development programs;
						(ii)credit
			 programs;
						(iii)scholarship
			 programs; or
						(iv)reserve,
			 investment, and economic development programs.
						6.Payments by
			 Administrator
			(a)Initial
			 paymentOn March 1, 2012, the Administrator shall pay to the
			 Spokane Tribe an amount equal to 25 percent of the Computed Annual Payment for
			 fiscal year 2011.
			(b)Subsequent
			 payments
				(1)In
			 generalNot later than March 1, 2013, and March 1 of each year
			 thereafter through March 1, 2021, the Administrator shall pay the Spokane Tribe
			 an amount equal to 25 percent of the Computed Annual Payment for the preceding
			 fiscal year.
				(2)March 1, 2022,
			 and subsequent yearsNot later than March 1, 2022, and March 1 of
			 each year thereafter, the Administrator shall pay the Spokane Tribe an amount
			 equal to 32 percent of the Computed Annual Payment for the preceding fiscal
			 year.
				7.Treatment after
			 amounts are paid
			(a)Use of
			 paymentsPayments made to the Spokane Business Council or Spokane
			 Tribe under section 5 or 6 may be used or invested by the Business Council in
			 the same manner and for the same purposes as other Spokane Tribe governmental
			 amounts.
			(b)No trust
			 responsibility of the SecretaryNeither the Secretary nor the
			 Administrator shall have any trust responsibility for the investment,
			 supervision, administration, or expenditure of any amounts after the date on
			 which the funds are paid to the Spokane Business Council or Spokane Tribe under
			 section 5 or 6.
			(c)Treatment of
			 funds for certain purposesThe payments of all amounts to the
			 Spokane Business Council and Spokane Tribe under sections 5 and 6, and the
			 interest and income generated by those amounts, shall be treated in the same
			 manner as payments under section 6 of the Saginaw Chippewa Indian Tribe of
			 Michigan Distribution of Judgment Funds Act (100 Stat. 677).
			(d)Tribal
			 auditAfter the date on which amounts are paid to the Spokane
			 Business Council or Spokane Tribe under section 5 or 6, the amounts
			 shall—
				(1)constitute
			 Spokane Tribe governmental amounts; and
				(2)be subject to an
			 annual tribal government audit.
				8.Repayment
			 credit
			(a)In
			 generalThe Administrator shall deduct from the interest payable
			 to the Secretary of the Treasury from net proceeds (as defined in section 13 of
			 the Federal Columbia River Transmission System Act (16 U.S.C. 838k))—
				(1)in fiscal year
			 2022, $2,700,000; and
				(2)in each
			 subsequent fiscal year in which the Administrator makes a payment under section
			 6, $2,700,000.
				(b)Crediting
				(1)In
			 generalExcept as provided in paragraphs (2) and (3), each
			 deduction made under this section for the fiscal year shall be—
					(A)a credit to the
			 interest payments otherwise payable by the Administrator to the Secretary of
			 the Treasury during the fiscal year in which the deduction is made; and
					(B)allocated pro
			 rata to all interest payments on debt associated with the generation function
			 of the Federal Columbia River Power System that are due during the fiscal
			 year.
					(2)Deduction
			 greater than amount of interestIf, in an applicable fiscal year
			 under paragraph (1), the deduction is greater than the amount of interest due
			 on debt associated with the generation function for the fiscal year, the amount
			 of the deduction that exceeds the interest due on debt associated with the
			 generation function shall be allocated pro rata to all other interest payments
			 due during the fiscal year.
				(3)CreditTo
			 the extent that a deduction exceeds the total amount of interest described in
			 paragraphs (1) and (2), the deduction shall be applied as a credit against any
			 other payments that the Administrator makes to the Secretary of the
			 Treasury.
				9.Delegation of
			 authority; reservation boundary; retention of authority
			(a)Delegation of
			 authorityThe delegation by the Secretary to the Spokane Tribe
			 under the authority of the following, with respect to land that is located
			 within the exterior boundaries of the Spokane Indian Reservation, is
			 confirmed:
				(1)The Act of June
			 17, 1902 (43 U.S.C. 373).
				(2)The Act of June
			 29, 1940 (16 U.S.C. 835d).
				(3)Section 15 of the
			 Act of August 4, 1939 (43 U.S.C. 485i).
				(4)The Lake
			 Roosevelt Cooperative Management Agreement concluded in April 1990 among the
			 Department of the Interior, the Spokane Tribe, and the Confederated Tribes of
			 the Colville Reservation, over all land acquired by the United States pursuant
			 to the Act of June 29, 1940 (16 U.S.C. 835d), also known as the Reservation or
			 Indian Zone.
				(b)Colville-Spokane
			 reservation boundaryNothing in this section—
				(1)establishes or
			 affects—
					(A)the precise
			 location of the boundary between the Spokane Indian Reservation and the
			 Colville Reservation along the Columbia River; or
					(B)the agreement
			 between the Colville Tribes and the Spokane Tribe that the common boundary of
			 the Spokane Tribe and Colville Tribes Indian zones established under the Act of
			 June 29, 1940 (16 U.S.C. 835d), shall follow the center line of Lake Roosevelt,
			 without reference to the course of the submerged Columbia River; or
					(2)affects the
			 rights of the Colville Tribes or the Spokane Tribe to the use of the respective
			 portion of each tribe of the Indian zone, as provided in the Act of June 29,
			 1940 (16 U.S.C. 835d).
				(c)Retention of
			 authority by the United StatesNothing in this Act alters or
			 affects the authority or responsibility of—
				(1)the United States
			 to carry out the Columbia Basin Project under the Columbia Basin Project Act
			 (16 U.S.C. 835 et seq.); or
				(2)the National Park
			 Service to administer the Lake Roosevelt National Recreation Area under the Act
			 of August 25, 1916 (39 Stat. 535, chapter 408; 16 U.S.C. 1 et seq.).
				10.Satisfaction of
			 claimsPayment by the
			 Secretary under section 5 and the Administrator under section 6 and delegation
			 under section 9 constitute full satisfaction of the claim of the Spokane Tribe
			 to a fair share of the annual hydropower revenues generated by the Grand Coulee
			 Dam project for the past and continued use of land of the Spokane Tribe for the
			 production of hydropower at Grand Coulee Dam.
		11.AdministrationNothing in this Act establishes any
			 precedent or is binding on the Southwestern Power Administration, Western Area
			 Power Administration, or Southeastern Power Administration.
		12.Authorization
			 of appropriationsThere are
			 authorized to be appropriated such sums as are necessary to carry out this
			 Act.


110 HRES 584 EH: Supporting the goals and ideals of

U.S. House of Representatives
2007-09-25
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.

		IV
		110th CONGRESS
		1st Session
		H. RES. 584
		In the House of Representatives, U.
		  S.,

			September 25, 2007

		RESOLUTION
		Supporting the goals and ideals of
		  National Life Insurance Awareness Month.

		Whereas life insurance is an essential part of a sound
			 financial plan;
		Whereas life insurance provides financial security for
			 families by helping surviving members meet immediate and long-term financial
			 obligations and objectives in the event of a premature death in their
			 family;
		Whereas approximately 68,000,000 United States citizens
			 lack the adequate level of life insurance coverage needed to ensure a secure
			 financial future for their loved ones;
		Whereas life insurance products protect against the
			 uncertainties of life by enabling individuals and families to manage the
			 financial risks of premature death, disability, and long-term care;
		Whereas individuals, families, and businesses can benefit
			 from professional insurance and financial planning advice, including an
			 assessment of their life insurance needs; and
		Whereas numerous groups supporting life insurance have
			 designated September 2007 as National Life Insurance Awareness
			 Month as a means to encourage consumers to—
			(1)become more aware of their life
			 insurance needs;
			(2)seek professional advice regarding
			 life insurance; and
			(3)take the actions necessary to achieve
			 financial security for their loved ones: Now, therefore, be it

		That the House of
			 Representatives—
			(1)supports the goals
			 and ideals of National Life Insurance Awareness Month;
			 and
			(2)calls on the
			 Federal Government, States, localities, schools, nonprofit organizations,
			 businesses, and the citizens of the United States to observe the month with
			 appropriate programs and activities.

			Lorraine C. Miller,
			Clerk.


113 HR 3796 IH: Comprehensive Care Payment Innovation Act
U.S. House of Representatives
2013-12-19
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.

I113th CONGRESS1st SessionH. R. 3796IN THE HOUSE OF REPRESENTATIVESDecember 19, 2013Mrs. Black (for herself and Mr. Neal) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concernedA BILLTo amend title XVIII of the Social Security Act to provide for bundled payments for certain episodes of care surrounding a hospitalization, and for other purposes.1.Short titleThis Act may be cited as the Comprehensive Care Payment Innovation Act.2.Permanent, national voluntary payment bundlingTitle XVIII of the Social Security Act is amended by inserting after section 1866E (42 U.S.C. 1395cc–5) the following new section:1866F.National voluntary payment bundling(a)Establishment and implementation(1)In generalThe Secretary shall provide for bundled payments under this section for integrated care furnished by a qualified entity during an episode of care to an applicable beneficiary for applicable conditions involving a hospitalization.(2)DeadlineThe Secretary shall implement this section not later than January 1, 2015.(3)Applicable beneficiary definedIn this section, the term applicable beneficiary means an individual who is entitled to, or enrolled for, benefits under part A and enrolled for benefits under part B, but not enrolled under part C or in a PACE program under section 1894, and who is admitted to a hospital for an applicable condition.(b)Qualified entity and application process(1)DefinitionsIn this section:(A)In generalThe term qualified entity means a qualified applicant that has an application approved by the Secretary to receive bundled payments for furnishing applicable services to applicable individuals under this section.(B)Qualified applicantThe term qualified applicant means a corporation, partnership, or limited liability company, that is authorized in writing by a group of providers of services and suppliers, including at least a hospital, that are otherwise participating under this title to act as their agent for the purpose of receiving and distributing bundled payments on their behalf under this section. A qualified applicant may (but is not required to) be a provider of services or supplier that is otherwise participating under this title.(2)Application(A)In generalA qualified applicant may submit to the Secretary an application to become a qualified entity to receive bundled payments under this section.(B)ContentsAn application under subparagraph (A) with respect to a group of providers of services and suppliers—(i)shall contain such information and assurances as the Secretary may specify, including with respect to the requirements under subsection (c)(1); and(ii)shall indicate the applicable conditions with respect to which the group seeks to furnish applicable services during the episode of care involved and the bundled payment methodology under subsection (g) or (h) under which the group would be paid for such services.(3)Choice among applicable conditionsA qualified entity may select one or more applicable conditions for bundled payments under this section. Nothing in this section shall be construed as requiring, or authorizing the Secretary to require, a qualified entity to select any particular applicable condition under this section.(4)Expedited application process for qualified applicants successfully participating in the CMI bundled payment demonstrationIn the case of any qualified applicant that the Secretary determines has successfully participated in any of the payment and service delivery models tested by the Center for Medicare and Medicaid Innovation under section 1115A through the Bundled Payments for Care Improvement (BPCI) Initiative, the Secretary shall provide for an expedited application process under this subsection.(c)Requirements for qualified entities(1)Requirements(A)In generalThe Secretary shall develop requirements for qualified entities to receive bundled payments for furnishing applicable services for applicable conditions during an episode of care under this section.(B)Agreement periodUnder such requirements, a qualified entity shall agree to receive bundled payments for the furnishing of such services for a 5-year period (each such year in such period referred to in this section as an agreement year).(C)Beneficiary transparencySuch requirements shall ensure transparency between a qualified entity and applicable beneficiaries such that notice is provided to an applicable beneficiary sufficiently in advance, to the extent practicable, of the beneficiary’s inpatient admission for the applicable condition and episode of care involved. Such a notice shall include—(i)appropriate notice of bundled payments for the applicable condition for the episode of care involved; and(ii)a statement informing the beneficiary of the beneficiary’s right to select the providers of services and suppliers furnishing items and services related to the episode of care.(D)Methodology and measures for quality and efficiency arrangementsInsofar as a qualified entity uses or seeks to implement a quality and efficiency arrangement under subsection (i), the qualified entity shall specify in the application to the Secretary in detail the methodology for allocating savings under the arrangement and the specific measures to be used to assess the quality of care under the arrangement.(2)Provision of data by Secretary(A)Claims dataThe Secretary shall furnish to a group of providers of services and suppliers interested in submitting an application under subsection (b)(2) claims data under parts A and B, including complete claims files, for applicable conditions relating to the providers and suppliers in the group that are sufficiently specific to permit such group to determine whether to submit such application. Such claims data shall also be furnished to a qualified entity monthly during the agreement period described in paragraph (1)(B) of any approved application with respect to an applicable condition.(B)Quality dataThe Secretary shall furnish to a qualified entity data on quality measures with respect to any applicable condition under an approved application during the agreement period for the entity for each episode of care and across the continuum of care.(d)Applicable conditions(1)Initial conditionsIn this section, the term applicable condition means any of the following procedures furnished as part of inpatient hospital services:(A)Hip/Knee joint replacement.(B)Lumbar spine fusion.(C)Coronary artery bypass graft.(D)Heart valve replacement.(E)Percutaneous coronary intervention with stent.(F)Colon resection.(2)Discretion to add conditionsSuch term also includes such additional procedures or conditions as the Secretary may select. In selecting such procedures or conditions, the Secretary may take into consideration the factors described in section 1866D(a)(2)(B).(e)Applicable services; episode of careIn this section:(1)Applicable servicesThe term applicable services means the following items and services:(A)Acute care inpatient services.(B)Physicians’ services delivered in and outside of an acute care hospital setting.(C)Outpatient hospital services.(D)Post-acute care services, including home health services, skilled nursing services, inpatient rehabilitation services, and inpatient hospital services furnished by a long-term care hospital.(E)Other services the Secretary determines appropriate.(2)Episode of care(A)In generalSubject to subparagraph (B), the term episode of care means, with respect to an applicable condition and an applicable beneficiary, the period consisting of—(i)the 3 days prior to the admission of the applicable beneficiary to a hospital with respect to the applicable condition;(ii)the duration of the applicable beneficiary’s initial inpatient stay in such hospital for the applicable condition; and(iii)the 90 days following the discharge of the applicable beneficiary from such hospital.(B)Establishment of period by the secretaryThe Secretary, as appropriate, may establish a period (other than the period described in subparagraph (A)) for an episode of care under this section based on data analyses.(3)Discharging hospitalThe term discharging hospital means, with respect to applicable services in an episode of care, the hospital referred to in paragraph (2)(A).(f)Bundled payment development(1)In generalSubject to the succeeding provisions of this subsection, the Secretary shall develop bundled payments for qualified entities. A bundled payment shall provide for comprehensive payment for the costs of applicable services furnished to an applicable beneficiary during an episode of care for an applicable condition, including readmissions related to the applicable condition but excluding unrelated readmissions, under either a fee-for-service model with shared savings and losses (under subsection (g)) or under a prospective payment model for advanced qualified entities (under subsection (h)). Bundled payments shall be based on the spending targets computed under paragraph (2).(2)Computation of spending targets(A)In generalThe Secretary shall compute under this paragraph, for each qualified entity for each applicable condition for an episode of care beginning in an agreement year (beginning with 2015) that is attributable to a discharging hospital, a spending target equal to the updated amount computed under subparagraph (C) for that entity, episode, and year.(B)Initial weighted average calculation for discharging hospitals(i)In generalUsing fee-for-service claims data from the base period (as defined in subparagraph (D)), subject to clause (ii), the Secretary shall first calculate a base average spending target for each applicable condition for each discharging hospital equal to a weighted average of spending under parts A and B for all applicable services for such applicable condition associated with initial admissions to such hospital computed as the sum of the following (with respect to such hospital):(I)60 percent of the standardized spending per episode in the most recent year in the base period.(II)30 percent of the standardized spending per episode in the previous year.(III)10 percent of the standardized spending per episode in the second previous year.(ii)Exclusion of outliers and standardizationIn calculating the amount of the base average spending target for an applicable condition under clause (i) for a discharging hospital, the Secretary shall—(I)exclude from the calculation payments for episodes of care for the applicable condition that exceed the 95th percentile of all such spending for such episodes of care and applicable condition, as estimated by the Secretary, based on the most recent data available; and(II)standardize the spending made in each year in the base period to each provider of service or supplier to remove the spending adjustments in effect in such year relating to provider or supplier location (such as area wage indices) and provider type (such as indirect medical education adjustments and disproportionate share hospital adjustments).(C)Trending the spending targets based on national growth rates to agreement year; periodic rebasing for new agreement periods(i)In generalThe Secretary shall update the base average spending targets for all discharging hospitals under subparagraph (B) for each applicable condition and agreement year based on trends in the national fee-for-service claims data for applicable services furnished during an episode of care for an applicable condition from the base period to the agreement year involved. Such update shall not vary by discharging hospital.(ii)Periodic rebasing for new agreement periodsAt the start of each new agreement period, the Secretary shall update the base period and calculate new spending targets under the previous provisions of this paragraph for a discharging hospital and applicable conditions, including providing for adjustments by provider location and provider type of the type described in subparagraph (B)(ii)(II).(D)Base period definedIn this paragraph, except as provided in subparagraph (C)(ii), the term base period means the most recent 3-year period for which complete data are available to carry out this subsection.(g)Fee-for-Service bundled payment model with shared savings and shared losses(1)Fee-for-service-based paymentIf the payment model under this subsection is selected by a qualified entity, the Secretary shall pay providers of services and suppliers of the entity for applicable services for an applicable condition during an episode of care amounts payable under parts A and B for such services in the same manner as such providers and suppliers would otherwise be paid under such parts (referred to in this subsection as fee-for-service payments).(2)Shared savings and losses(A)Computation of each qualified entity’s actual standardized average spending per episode of careIn applying this subsection, in calculating the actual standardized average fee-for-service spending per episode of care for a discharging hospital for each applicable condition in each agreement year, the Secretary shall exclude outlier episodes of care described in subsection (f)(2)(B)(ii)(I), as estimated by the Secretary, based on data applicable to payments in the agreement year and shall standardize such spending per episode of care in the manner provided in subsection (f)(2)(B)(ii)(II). For the purpose of identifying outlier episodes of care for each applicable condition, the percentile ranking of each episode of care and applicable condition and the 95th percentile shall be based on payments standardized by adjustments for provider location and provider type of the type described in subsection (f)(2)(B)(ii)(II).(B)Computation of gross shared savings and shared losses for each applicable condition for each discharging hospitalFor purposes of applying subparagraph (C), if actual standardized average fee-for-service payments to a qualified entity for all episodes of care for an applicable condition in an agreement year for a discharging hospital, as calculated under subparagraph (A), are—(i)less than the applicable spending target under subsection (f)(2)(C) for such condition, year, and hospital, there shall be a gross shared savings for such applicable condition, year, and hospital equal to 60 percent of the difference between such actual average payments and the spending target for such condition, year, and hospital; or(ii)greater than such applicable spending target, there shall be a gross shared loss for such applicable condition, year, and hospital equal to 60 percent of such difference.(C)Retrospective reconciliation(i)Totaling gross shared savings and losses for all conditions and all discharging hospitals for a qualified entityAt the end of each agreement year for each qualified entity, for purposes of applying clauses (ii) and (iii), the Secretary shall aggregate the gross shared savings and the gross shared losses under subparagraph (B) of such entity for the year for all applicable conditions and for all discharging hospitals.(ii)Payment to entity of net savingsSubject to clause (iv) and subsection (j)(3) (relating to quality performance thresholds), if such aggregate gross shared savings exceeds such aggregate gross shared losses for a qualified entity for an agreement year, the Secretary shall pay to the qualified entity a lump sum amount equal to such excess for such year.(iii)Collection from entity of net lossesSubject to clause (iv), if such aggregate gross shared losses exceeds such aggregate gross shared savings for a qualified entity for an agreement year, the qualified entity shall pay to the Secretary (and the Secretary shall collect from the entity) a lump sum amount equal to such excess for such year.(iv)Cap on paymentsIn no case shall the payment under clause (ii) or (iii) with respect to a qualified entity for an agreement year exceed 10 percent of the aggregate spending target for that qualified entity for all applicable conditions and all discharging hospitals for that year.(h)Prospective bundled payment model for advanced qualified entities(1)In generalSubject to approval by the Secretary, if the payment model under this subsection is selected, a qualified entity may elect to receive a prospective bundled payment for each episode of care for each applicable condition and discharging hospital in the agreement year equal to the spending target for such episode, year, and hospital under subsection (f)(2) and the provisions of subsection (g) do not apply. Such spending target shall be adjusted, in the same manner described in subsection (g)(2)(B), in order to take into account outlier episodes of care and standardized adjustments for provider location and provider type of the type described in subsection (f)(2)(B)(ii)(II).(2)Rule of constructionNothing in this section shall be construed as prohibiting a qualified entity that receives bundled payments under this subsection from participating in an accountable care organization under section 1899.(3)Relationship to BPCIThe Secretary may not terminate the Bundled Payments for Care Improvement initiative conducted pursuant to section 1115A until the prospective bundled payment model is implemented under this subsection.(i)Quality and efficiency arrangements(1)In generalSubject to subsection (c)(1)(D) (relating to application requirements for notice of quality and efficiency arrangements and their structure) and subsection (j)(3) (relating to minimum quality performance thresholds), qualified entities participating in either the fee-for-service bundled payment model under subsection (g) or the prospective bundled payment model under subsection (h) may enter into quality and efficiency arrangements under which physicians and other health care practitioners work to improve the quality and efficiency of care under this title.(2)Types of arrangementsThe arrangements under paragraph (1) shall take into account the utilization of the resources of providers of services and suppliers and may provide for a distribution of a portion of any shared savings (or internal saving, as the case may be) realized under this section to qualifying providers and suppliers.(j)Quality measures(1)Selection; development(A)SelectionFor each applicable condition, the Secretary shall select quality measures related to care provided by providers of services and suppliers through qualified entities to which bundled payments are made under this section. In selecting quality measures, to the extent appropriate and practicable, the Secretary shall choose measures that—(i)are endorsed and validated by the entity with a contract under section 1890;(ii)pertain to the National Quality Strategy’s six priorities;(iii)are used by the Secretary under other provisions of this title; and(iv)minimize the incremental data extraction and reporting burden on providers and suppliers.(B)Development of electronically specified episodic measuresThe Secretary shall develop longitudinal quality and efficiency measures to assess performance of qualified entities with respect to patient outcomes and the care provided for each applicable condition across the associated episodes of care. Such measures shall be electronically specified for submittal through the use of qualified electronic health records (as defined in section 3000(13) of the Public Health Service Act (42 U.S.C. 300jj(13))).(2)Reporting on quality measures(A)In generalA qualified entity shall submit data to the Secretary on quality measures selected under paragraph (1) for each agreement year in a form and manner specified by the Secretary consistent with the succeeding provisions of this paragraph.(B)Submission of data through electronic health recordTo the extent practicable, such data shall be submitted through the use of a qualified electronic health record (as defined in section 3000(13) of the Public Health Service Act (42 U.S.C. 300jj(13))).(C)Submission of data used in other programsInsofar as quality measures established under paragraph (1) are the same as those measures used by the Secretary under other provisions of this title, such as those selected under section 1886(b)(3)(B)(viii), the Secretary shall use existing processes for the submission of data for such measures under this paragraph.(3)Quality performance thresholds(A)EstablishmentFor each applicable condition, the Secretary shall establish minimum quality performance thresholds for the measures established under paragraph (1). In the case of a quality and efficiency arrangement, such performance thresholds shall be developed using the quality measures identified by the qualified entity in its application under subsection (c)(1)(D) if approved by the Secretary.(B)Loss of shared savings payment and quality and efficiency arrangements for failure to meet minimum quality performance thresholdsIf a qualified entity fails to meet the minimum quality performance thresholds established under subparagraph (A) for an agreement year—(i)no payment may be made to the entity under subsection (g)(2)(C)(ii) with respect to that year; and(ii)the entity may not implement any quality and efficiency arrangement under subsection (i) for that year.(k)Waivers(1)In generalThe Secretary shall waive such provisions of this title and title XI as may be necessary to carry out the program, including the following:(A)With respect to authorizing quality and efficiency arrangements between qualified entities and providers of services and suppliers, section 1877(a) (relating to physician self-referral), paragraphs (1) and (2) of sections 1128A(b) (relating to the gainsharing civil money penalties), and paragraphs (1) and (2) of section 1128B(b) (relating to the anti-kickback statute).(B)Section 1128A(a)(5) of the Act (relating to the inducement civil money penalties).(C)Section 1861(i) (relating to the 3-day acute hospitalization prerequisite before eligibility for post-hospital extended care services).(D)With respect to home health services—(i)sections 1814(a)(2)(C) and 1835(a)(2)(A) (relating to the requirement that an individual be confined to home in order to be eligible for benefits for home health services);(ii)limitations on the amount, frequency, and duration on home health services; and(iii)prohibitions of free preoperative home safety assessments by home health agencies for patients scheduled to undergo surgery (such as under Advisory Opinion No. 06–01 of the Inspector General of the Department of Health and Human Services).(2)Authority to modify waivers under certain circumstances(A)In generalIn the case of a qualified entity with respect to which one or more waivers under paragraph (1) is in effect, if upon a review of the performance or an audit of the entity the Secretary finds a pattern of deficiencies or harm to applicable beneficiaries, the Secretary may modify or revoke any such waiver at any time as applied to that qualified entity.(B)Termination of certain waivers in the case of excess shared losses(i)In generalSubject to the process described in clause (ii), in the case of a qualified entity that has selected the payment model under subsection (g) and has gross shared losses exceeding the cap under subsection (g)(2)(C)(iv) with respect to an applicable condition, the Secretary shall terminate waivers described in paragraphs (1)(C) and (1)(D) with respect to such qualified entity and applicable condition.(ii)Pre-termination noticeThe Secretary shall establish a process whereby a qualified entity is furnished notice of any deficiency that may give rise to a termination of waivers under clause (i) not later than 6 months before the proposed effective date of the termination.(l)Independent evaluation and reports on program(1)Independent evaluationThe Secretary shall conduct an independent evaluation of the impact of providing bundled payments to qualified entities under this section. Such evaluation shall include an examination of the extent to which the bundling of payments this section have resulted in—(A)improved health outcomes;(B)improved access to care for applicable beneficiaries;(C)reduced spending under this title; and(D)improvement in performance on quality measures selected under subsection (j)(1)(A).(2)Reports(A)Interim reportNot later than March 1, 2018, the Secretary shall submit to Congress a report on the initial results of the independent evaluation conducted under paragraph (1).(B)Final reportNot later than March 1, 2020, the Secretary shall submit to Congress a report on the final results of the independent evaluation conducted under paragraph (1) and may include recommendations for the expansion of bundled payment methodologies and applicable conditions under this section as the Secretary determines to be appropriate..