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SECTION 1. SHORT TITLE.

This Act may be cited as the ''Security and Freedom Through
Encryption (SAFE) Act''.

SEC. 2. SALE AND USE OF ENCRYPTION.

(a) In General.--Part I of title 18, United States Code, is amended
by inserting after chapter 121 the following new chapter:

''CHAPTER 122--ENCRYPTED WIRE AND ELECTRONIC INFORMATION

''2801. Definitions.
''2802. Freedom to use encryption.
''2803. Freedom to sell encryption.
''2804. Prohibition on mandatory key escrow.
''2805. Unlawful use of encryption in furtherance of a criminal act.
''Sec. 2801. Definitions
''As used in this chapter--
''(1) the terms 'person', 'State', 'wire communication',
'electronic communication', 'investigative or law enforcement
officer', 'judge of competent jurisdiction', and 'electronic
storage' have the meanings given those terms in section 2510 of
this title;
''(2) the terms 'encrypt' and 'encryption' refer to the
scrambling of wire or electronic information using mathematical
formulas or algorithms in order to preserve the
confidentiality, integrity, or authenticity of, and prevent
unauthorized recipients from accessing or altering, such
information;
''(3) the term 'key' means the variable information used in
a mathematical formula, code, or algorithm, or any component
thereof, used to decrypt wire or electronic information that
has been encrypted; and
''(4) the term 'United States person' means--
''(A) any United States citizen;
''(B) any other person organized under the laws of
any State, the District of Columbia, or any
commonwealth, territory, or possession of the United
States; and
''(C) any person organized under the laws of any
foreign country who is owned or controlled by
individuals or persons described in subparagraphs (A)
and (B).
''Sec. 2802. Freedom to use encryption
''Subject to section 2805, it shall be lawful for any person within
any State, and for any United States person in a foreign country, to
use any encryption, regardless of the encryption algorithm selected,
encryption key length chosen, or implementation technique or medium
used.
''Sec. 2803. Freedom to sell encryption
''Subject to section 2805, it shall be lawful for any person within
any State to sell in interstate commerce any encryption, regardless of
the encryption algorithm selected, encryption key length chosen, or
implementation technique or medium used.
''Sec. 2804. Prohibition on mandatory key escrow
''(a) Prohibition.--No person in lawful possession of a key to
encrypted information may be required by Federal or State law to
relinquish to another person control of that key.
''(b) Exception for Access for Law Enforcement Purposes.--
Subsection (a) shall not affect the authority of any investigative or
law enforcement officer, acting under any law in effect on the
effective date of this chapter, to gain access to encrypted
information.
''Sec. 2805. Unlawful use of encryption in furtherance of a criminal
act
''Any person who willfully uses encryption in furtherance of the
commission of a criminal offense for which the person may be prosecuted
in a court of competent jurisdiction--
''(1) in the case of a first offense under this section,
shall be imprisoned for not more than 5 years, or fined in the
amount set forth in this title, or both; and
''(2) in the case of a second or subsequent offense under
this section, shall be imprisoned for not more than 10 years,
or fined in the amount set forth in this title, or both.''.
(b) Conforming Amendment.--The table of chapters for part I of
title 18, United States Code, is amended by inserting after the item
relating to chapter 33 the following new item:

''122. Encrypted wire and electronic information............ 2801''.

SEC. 3. EXPORTS OF ENCRYPTION.

(a) Amendment to Export Administration Act of 1979.--Section 17 of
the Export Administration Act of 1979 (50 U.S.C. App. 2416) is amended
by adding at the end thereof the following new subsection:
''(g) Computers and Related Equipment.--
''(1) General rule.--Subject to paragraphs (2), (3), and
(4), the Secretary shall have exclusive authority to control
exports of all computer hardware, software, and technology for
information security (including encryption), except that which
is specifically designed or modified for military use,
including command, control, and intelligence applications.
''(2) Items not requiring licenses.--No validated license
may be required, except pursuant to the Trading With The Enemy
Act or the International Emergency Economic Powers Act (but
only to the estent that the authority of such Act is not
exercised to extend controls imposed under this Act), for the
export or reexport of--
''(A) any software, including software with
encryption capabilities--
''(i) that is generally available, as is,
and is designed for installation by the
purchaser; or
''(ii) that is in the public domain for
which copyright or other protection is not
available under title 17, United States Code,
or that is available to the public because it
is generally accessible to the interested
public in any form; or
''(B) any computing device solely because it
incorporates or employs in any form software (including
software with encryption capabilities) exempted from
any requirement for a validated license under
subparagraph (A).
''(3) Software with encryption capabilities.--The Secretary
shall authorize the export or reexport of software with
encryption capabilities for nonmilitary end-uses in any country
to which exports of software of similar capability are
permitted for use by financial institutions not controlled in
fact by United States persons, unless there is substantial
evidence that such software will be--
''(A) diverted to a military end-use or an end-use
supporting international terrorism;
''(B) modified for military or terrorist end-use;
or
''(C) reexported without any authorization by the
United States that may be required under this Act.
''(4) Hardware with encryption capabilities.--The Secretary
shall authorize the export or reexport of computer hardware
with encryption capabilities if the Secretary determines that a
product offering comparable security is commercially available
outside the United States from a foreign supplier, without
effective restrictions.
''(5) Definitions.--As used in this subsection--
''(A) the term 'encryption' means the scrambling of
wire or electronic information using mathematical
formulas or algorithms in order to preserve the
confidentiality, integrity, or authenticity of, and
prevent unauthorized recipients from accessing or
altering, such information;
''(B) the term 'generally available' means, in the
case of software (including software with encryption
capabilities), software that is offered for sale,
license, or transfer to any person without restriction,
whether or not for consideration, including, but not
limited to, over-the-counter retail sales, mail order
transactions, phone order transactions, electronic
distribution, or sale on approval;
''(C) the term 'as is' means, in the case of
software (including software with encryption
capabilities), a software program that is not designed,
developed, or tailored by the software publisher for
specific purchasers, except that such purchasers may
supply certain installation parameters needed by the
software program to function properly with the
purchaser's system and may customize the software
program by choosing among options contained in the
software program;
''(D) the term 'is designed for installation by the
purchaser' means, in the case of software (including
software with encryption capabilities) that--
''(i) the software publisher intends for
the purchaser (including any licensee or
transferee), who may not be the actual program
user, to install the software program on a
computing device and has supplied the necessary
instructions to do so, except that the
publisher may also provide telephone help line
services for software installation, electronic
transmission, or basic operations; and
''(ii) the software program is designed for
installation by the purchaser without further
substantial support by the supplier;
''(E) the term 'computing device' means a device
which incorporates one or more microprocessor-based
central processing units that can accept, store,
process, or provide output of data; and
''(F) the term 'computer hardware', when used in
conjunction with information security, includes, but is
not limited to, computer systems, equipment,
application-specific assemblies, modules, and
integrated circuits.''.
(b) Continuation of Export Administration Act.--For purposes of
carrying out the amendment made by subsection (a), the Export
Administration Act of 1979 shall be deemed to be in effect.
Security and Freedom Through Encryption (SAFE) Act - Amends the Federal criminal code to permit any person within any State, and any U.S. person in a foreign country, to use any encryption regardless of the encryption algorithm selected, encryption key length chosen, or implementation technique or medium used, with an exception for the unlawful use of encryption in furtherance of a criminal act.
Allows any person within any State to sell in interstate commerce any encryption.
Specifies that no person in lawful possession of a key to encrypted information may be required by Federal or State law to relinquish to another person control of that key, with an exception for access for law enforcement purposes.
Sets penalties for the willful use of encryption in furtherance of the commission of a criminal offense.
(Sec. 3) Amends the Export Administration Act of 1979 to grant the Secretary of Commerce exclusive authority to control exports of all hardware, software, and technology for information security (including encryption), except that which is specifically designed or modified for military use.
Prohibits requiring any validated license (with limited exceptions pursuant to the Trading With The Enemy Act or the International Emergency Economic Powers Act) for the export or reexport of any: (1) software, including software with encryption capabilities that is generally available as is and that is designed for installation by the purchaser, or that is in the public domain for which copyright or other protection is not available or is available to the public because it is generally accessible to the public in any form; or (2) computing device solely because it incorporates or employs in any form software (including software with encryption capabilities) exempted from any requirement for a validated license under this section.
Directs the Secretary to authorize the export or reexport of: (1) software with encryption capabilities for nonmilitary end-uses in any country to which exports of software of similar capability are permitted for use by financial institutions not controlled in fact by U.S. persons, unless there is substantial evidence that such software will be diverted to a military end-use or an end-use supporting international terrorism, modified for military or terrorist end-use, or reexported without any U.S. authorization that may be required under the Act; and (2) computer hardware with encryption capabilities if the Secretary determines that a product offering comparable security is commercially available outside the United States from a foreign supplier without effective restrictions.

SECTION 1. SHORT TITLE.

This Act may be cited as the ''Women's Health Research and
Prevention Amendments of 1998''.

TITLE I--PROVISIONS RELATING TO WOMEN'S HEALTH RESEARCH AT NATIONAL
INSTITUTES OF HEALTH

SEC. 101. RESEARCH ON DRUG DES; NATIONAL PROGRAM OF EDUCATION.
(a) Research.--Section 403A(e) of the Public Health Service Act (42
U.S.C. 283a(e)) is amended by striking ''1996'' and inserting ''2003''.
(b) National Program for Education of Health Professionals and
Public.--Title XVII of the Public Health Service Act (42 U.S.C. 300u et
seq.) is amended by adding at the end the following:

''education regarding des

''Sec. 1710. (a) In General.--The Secretary, acting through the
heads of the appropriate agencies of the Public Health Service, shall
carry out a national program for the education of health professionals
and the public with respect to the drug diethylstilbestrol (commonly
known as DES). To the extent appropriate, such national program shall
use methodologies developed through the education demonstration program
carried out under section 403A. In developing and carrying out the
national program, the Secretary shall consult closely with
representatives of nonprofit private entities that represent
individuals who have been exposed to DES and that have expertise in
community-based information campaigns for the public and for health
care providers. The implementation of the national program shall begin
during fiscal year 1999.
''(b) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 1999 through 2003. The
authorization of appropriations established in the preceding sentence
is in addition to any other authorization of appropriation that is
available for such purpose.''.
SEC. 102. RESEARCH ON OSTEOPOROSIS, PAGET'S DISEASE, AND RELATED
BONE DISORDERS.
Section 409A(d) of the Public Health Service Act (42 U.S.C.
284e(d)) is amended by striking ''and 1996'' and inserting ''through
2003''.

SEC. 103. RESEARCH ON CANCER.

(a) Research on Breast Cancer.--Section 417B(b)(1) of the Public
Health Service Act (42 U.S.C. 286a-8(b)(1)) is amended--
(1) in subparagraph (A), by striking ''and 1996'' and inserting
''through 2003''; and
(2) in subparagraph (B), by striking ''and 1996'' and inserting
''through 2003''.
(b) Research on Ovarian and Related Cancer Research.--Section
417B(b)(2) of the Public Health Service Act (42 U.S.C. 286a-8(b)(2)) is
amended by striking ''and 1996'' and inserting ''through 2003''.
SEC. 104. RESEARCH ON HEART ATTACK, STROKE, AND OTHER
CARDIOVASCULAR DISEASES IN WOMEN.
Subpart 2 of part C of title IV of the Public Health Service Act
(42 U.S.C. 285b et seq.) is amended by inserting after section 424 the
following:

''heart attack, stroke, and other cardiovascular diseases in women

''Sec. 424A. (a) In General.--The Director of the Institute shall
expand, intensify, and coordinate research and related activities of
the Institute with respect to heart attack, stroke, and other
cardiovascular diseases in women.
''(b) Coordination With Other Institutes.--The Director of the
Institute shall coordinate activities under subsection (a) with similar
activities conducted by the other national research institutes and
agencies of the National Institutes of Health to the extent that such
Institutes and agencies have responsibilities that are related to heart
attack, stroke, and other cardiovascular diseases in women.
''(c) Certain Programs.--In carrying out subsection (a), the
Director of the Institute shall conduct or support research to expand
the understanding of the causes of, and to develop methods for
preventing, cardiovascular diseases in women. Activities under such
subsection shall include conducting and supporting the following:
''(1) Research to determine the reasons underlying the
prevalence of heart attack, stroke, and other cardiovascular
diseases in women, including African-American women and other women
who are members of racial or ethnic minority groups.
''(2) Basic research concerning the etiology and causes of
cardiovascular diseases in women.
''(3) Epidemiological studies to address the frequency and
natural history of such diseases and the differences among men and
women, and among racial and ethnic groups, with respect to such
diseases.
''(4) The development of safe, efficient, and cost-effective
diagnostic approaches to evaluating women with suspected ischemic
heart disease.
''(5) Clinical research for the development and evaluation of
new treatments for women, including rehabilitation.
''(6) Studies to gain a better understanding of methods of
preventing cardiovascular diseases in women, including applications
of effective methods for the control of blood pressure, lipids, and
obesity.
''(7) Information and education programs for patients and
health care providers on risk factors associated with heart attack,
stroke, and other cardiovascular diseases in women, and on the
importance of the prevention or control of such risk factors and
timely referral with appropriate diagnosis and treatment. Such
programs shall include information and education on health-related
behaviors that can improve such important risk factors as smoking,
obesity, high blood cholesterol, and lack of exercise.
''(d) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 1999 through 2003. The
authorization of appropriations established in the preceding sentence
is in addition to any other authorization of appropriation that is
available for such purpose.''.

SEC. 105. AGING PROCESSES REGARDING WOMEN.

Section 445H of the Public Health Service Act (42 U.S.C. 285e-10)
is amended--
(1) by striking ''The Director'' and inserting ''(a) The
Director''; and
(2) by adding at the end the following subsection:
''(b) For the purpose of carrying out this section, there are
authorized to be appropriated such sums as may be necessary for each of
the fiscal years 1999 through 2003. The authorization of appropriations
established in the preceding sentence is in addition to any other
authorization of appropriation that is available for such purpose.''.

SEC. 106. OFFICE OF RESEARCH ON WOMEN'S HEALTH.

Section 486(d)(2) of the Public Health Service Act (42 U.S.C.
287d(d)(2)) is amended by striking ''Director of the Office'' and
inserting ''Director of NIH''.

TITLE II--PROVISIONS RELATING TO WOMEN'S HEALTH AT CENTERS FOR DISEASE
CONTROL AND PREVENTION

SEC. 201. NATIONAL CENTER FOR HEALTH STATISTICS.

Section 306(n) of the Public Health Service Act (42 U.S.C. 242k(n))
is amended--
(1) in paragraph (1), by striking ''through 1998'' and
inserting ''through 2003''; and
(2) in paragraph (2), by striking ''through 1998'' and
inserting ''through 2003''.

SEC. 202. NATIONAL PROGRAM OF CANCER REGISTRIES.

Section 399L(a) of the Public Health Service Act (42 U.S.C. 280e-
4(a)) is amended by striking ''through 1998'' and inserting ''through
2003''.
SEC. 203. NATIONAL BREAST AND CERVICAL CANCER EARLY DETECTION
PROGRAM.
(a) Services.--Section 1501(a)(2) of the Public Health Service Act
(42 U.S.C. 300k(a)(2)) is amended by inserting before the semicolon the
following: ''and support services such as case management''.
(b) Providers of Services.--Section 1501(b) of the Public Health
Service Act (42 U.S.C. 300k(b)) is amended--
(1) in paragraph (1), by striking ''through grants'' and all
that follows and inserting the following: ''through grants to
public and nonprofit private entities and through contracts with
public and private entities.''; and
(2) by striking paragraph (2) and inserting the following:
''(2) Certain applications.--If a nonprofit private entity and
a private entity that is not a nonprofit entity both submit
applications to a State to receive an award of a grant or contract
pursuant to paragraph (1), the State may give priority to the
application submitted by the nonprofit private entity in any case
in which the State determines that the quality of such application
is equivalent to the quality of the application submitted by the
other private entity.''.
(c) Authorizations of Appropriations.--
(1) Supplemental grants for additional preventive health
services.--Section 1509(d)(1) of the Public Health Service Act (42
U.S.C. 300n-4a(d)(1)) is amended by striking ''through 1998'' and
inserting ''through 2003''.
(2) General program.--Section 1510(a) of the Public Health
Service Act (42 U.S.C. 300n-5(a)) is amended by striking ''through
1998'' and inserting ''through 2003''.
SEC. 204. CENTERS FOR RESEARCH AND DEMONSTRATION OF HEALTH
PROMOTION.
Section 1706(e) of the Public Health Service Act (42 U.S.C. 300u-
5(e)) is amended by striking ''through 1998'' and inserting ''through
2003''.

Speaker of the House of Representatives.

Vice President of the United States and
President of the Senate.
TABLE OF CONTENTS:
Title I: Provisions Relating to Women's Health Research at
National Institutes of Health
Title II: Provisions Relating to Women's Health at Centers
for Disease Control and Prevention
Women's Health Research and Prevention Amendments of 1998 -
Title I: Provisions Relating to Women's Health Research at National Institutes of Health
- Amends the Public Health Service Act to extend the authorization of appropriations for programs regarding diethylstilbestrol (DES).
Mandates a program of education of health professionals and the public concerning DES. Authorizes appropriations.
(Sec. 102) Extends the authorizations of appropriations for: (1) research on osteoporosis, Paget's disease, and related bone disorders; (2) breast cancer programs; and (3) programs on ovarian and other cancers of the reproductive system of women.
(Sec. 104) Mandates expansion, intensification, and coordination of research and related activities of the National Heart, Lung, and Blood Institute regarding heart attack, stroke, and other cardiovascular diseases in women. Authorizes appropriations.
(Sec. 105) Extends the authorization of appropriations for research on the aging processes of women.
(Sec. 106) Requires that the Director of the National Institutes of Health (currently, the Director of the Office of Research on Women's Health) appoint members of the Advisory Committee on Women's Health.
Title II: Provisions Relating to Women's Health at Centers for Disease Control and Prevention
- Extends the authorization of appropriations for the National Center for Health Statistics and the National Program of Cancer Registries.
(Sec. 203) Authorizes grants to States to ensure the provision to women screened for breast or cervical cancer of support services such as case management. Allows certain breast and cervical cancer programs to be carried out through grants to public and nonprofit private entities and contracts with public or private entities (currently, through grants and contracts with public or nonprofit private entities). Allows a State to give priority to a nonprofit entity over an entity that is not a nonprofit if the quality of the entities' applications are equivalent. Extends authorizations of appropriations for: (1) annual evaluations of programs relating to preventive health measures regarding breast and cervical cancers; and (2) various breast and cervical cancer preventive health measures.
(Sec. 204) Extends the authorization of appropriations for centers for research and demonstration regarding health promotion and disease prevention.

SECTION 1. SHORT TITLE AND REFERENCES IN ACT.

(a) Short Title.--This Act may be cited as the ''Medicare
Contractor Reform Amendments of 1996''.
(b) References in Act.--Except as otherwise expressly provided,
whenever in this Act an amendment or repeal is expressed in terms of an
amendment to, or repeal of, a section or other provision, the reference
shall be considered to be made a section or other provision of the
Social Security Act.

SEC. 2. INCREASED FLEXIBILITY IN CONTRACTING FOR MEDICARE CLAIMS
PROCESSING.

(a) Carriers To Include Entities That Are Not Insurance
Companies.--
(1) Section 1842(a) (42 U.S.C. 1395u(a)) is amended in the
matter preceding paragraph (1) by striking ''with carriers''
and inserting ''with agencies and organizations (hereafter in
this section referred to as 'carriers')''.
(2) Section 1842(f) (42 U.S.C. 1395u(f)) is repealed.
(b) Choice of Fiscal Intermediaries by Providers of Services;
Secretarial Flexibility in Assigning Functions to Intermediaries and
Carriers.--
(1) Section 1816(a) (42 U.S.C. 1395h(a)) to read as
follows:
''(a)(1) The Secretary may enter into contracts with agencies or
organizations to perform any or all of the following functions, or
parts of those functions (or, to the extent provided in a contract, to
secure performance thereof by other organizations):
''(A) Determination (subject to the provisions of section
1878 and to such review by the Secretary as may be provided for
by the contracts) the amount of the payments required pursuant
to this part to be made to providers of services.
''(B) Making payments described in subparagraph (A).
''(C) Provision of consultative services to institutions or
agencies to enable them to establish and maintain fiscal
records necessary for purposes of this part and otherwise to
qualify as providers of services.
''(D) Serving as a center for, and communicate to
individuals entitled to benefits under this part and to
providers of services, any information or instructions
furnished to the agency or organization by the Secretary, and
serve as a channel of communication from individuals entitled
to benefits under this part and from providers of services to
the Secretary.
''(E) Making such audits of the records of providers of
services as may be necessary to ensure that proper payments are
made under this part.
''(F) Performance of the functions described under
subsection (d).
''(G) Performance of such other functions as are necessary
to carry out the purposes of this part.
''(2) As used in this title and title XI, the term 'fiscal
intermediary' means an agency or organization with a contract under
this section.''.
(2) Subsections (d) and (e) of section 1816 (42 U.S.C.
1395h) are amended to read as follows:
''(d) Each provider of services shall have a fiscal intermediary
that--
''(1) acts as a single point of contact for the provider of
services under this part,
''(2) makes its services sufficiently available to meet the
needs of the provider of services, and
''(3) is responsible and accountable for arranging the
resolution of issues raised under this part by the provider of
services.
''(e)(1)(A) The Secretary shall, at least every 5 years, permit
each provider of services (other than a home health agency or a hospice
program) to choose an agency or organization (from at least 3 proposed
by the Secretary, of which at least 1 shall have an office in the
geographic area of the provider of services, except as provided by
subparagraph (B)(ii)(II)) as the fiscal intermediary under subsection
(d) for that provider of services. If a contract with that fiscal
intermediary is discontinued, the Secretary shall permit the provider
of services to choose under the same conditions from 3 other agencies
or organizations.
''(B)(i) The Secretary, in carrying out subparagraph (A), shall
permit a group of hospitals (or a group of another class of providers
other than home health agencies or hospice programs) under common
ownership by, or control of, a particular entity to choose one agency
or organization (from at least 3 proposed by the Secretary) as the
fiscal intermediary under subsection (d) for all the providers in that
group if the conditions specified in clause (ii) are met.
''(ii) The conditions specified in this clause are that--
''(I) the group includes all the providers of services of
that class that are under common ownership by, or control of,
that particular entity, and
''(II) all the providers of services in that group agree
that none of the agencies or organizations proposed by the
Secretary is required to have an office in any particular
geographic area.
''(2) The Secretary, in evaluating the performance of a fiscal
intermediary, shall solicit comments from providers of services.''.
(3)(A) Section 1816(b)(1)(A) (42 U.S.C. 1395h(b)(1)(A)) is
amended by striking ''after applying the standards, criteria,
and procedures'' and inserting ''after evaluating the ability
of the agency or organization to fulfill the contract
performance requirements''.
(B) The first sentence of section 1816(f)(1) (42 U.S.C.
1395h(f)(1)) is amended--
(i) by striking ''develop standards, criteria, and
procedures'' and inserting '', after public notice and
opportunity for comment, develop contract performance
requirements'', and
(ii) by striking '', and the Secretary shall
establish standards and criteria with respect to the
efficient and effective administration of this part''.
(C) The second sentence of section 1842(b)(2)(A) (42 U.S.C.
1395u(b)(2)(A)) is amended to read as follows: ''The Secretary
shall, after public notice and opportunity for comment, develop
contract performance requirements for the efficient and
effective performance of contract obligations under this
section.''.
(D) Section 1842(b)(2)(A) (42 U.S.C. 1395u(b)(2)(A)) is
amended by striking the third sentence.
(E) Section 1842(b)(2)(B) (42 U.S.C. 1395u(b)(2)(B)) is
amended in the matter preceding clause (i) by striking
''establish standards'' and inserting ''develop contract
performance requirements''.
(F) Section 1842(b)(2)(D) (42 U.S.C. 1395u(b)(2)(D)) is
amended by striking ''standards and criteria'' each place is
appears and inserting ''contract performance requirements''.
(4)(A) Section 1816(b) (42 U.S.C. 1395h(b)) is amended in
the matter preceding paragraph (1) by striking ''an agreement''
and inserting ''a contract''.
(B) Paragraphs (1)(B) and (2)(A) of section 1816(b) (42
U.S.C. 1395h(b)) are each amended by striking ''agreement'' and
inserting ''contract''.
(C) The first sentence of section 1816(c)(1) (42 U.S.C.
1395h(c)(1)) is amended by striking ''An agreement'' and
inserting ''A contract''.
(D) The last sentence of section 1816(c)(1) (42 U.S.C.
1395h(c)(1)) is amended by striking ''an agreement'' and
inserting ''a contract''.
(E) Section 1816(c)(2)(A) (42 U.S.C. 1395h(c)(2)(A)) is
amended in the matter preceding clause (i) by striking
''agreement'' and inserting ''contract''.
(F) Section 1816(c)(3)(A) (42 U.S.C. 1395h(c)(3)(A)) is
amended by striking ''agreement'' and inserting ''contract''.
(G) The first sentence of section 1816(f)(1) (42 U.S.C.
1395h(f)(1)) is amended by striking ''an agreement'' and
inserting ''a contract''.
(H) Section 1816(h) (42 U.S.C. 1395h(h)) is amended--
(i) by striking ''An agreement'' and inserting ''A
contract'', and
(ii) by striking ''the agreement'' each place it
appears and inserting ''the contract''.
(I) Section 1816(i)(I) (42 U.S.C. 1395h(i)(1)) is amended
by striking ''an agreement'' and inserting ''a contract''.
(J) Section 1816(j) (42 U.S.C. 1395h(j)) is amended by
striking ''An agreement'' and inserting ''A contract''.
(K) Section 1816(k) (42 U.S.C. 1395h(k)) is amended by
striking ''An agreement'' and inserting ''A contract''.
(L) Section 1842(a) (42 U.S.C. 1395u(a)) is amended in the
matter preceding paragraph (1) is amended by striking
''agreements'' and inserting ''contracts''.
(M) Section 1842(h)(3)(A) (42 U.S.C. 1395u(h)(3)(A)) is
amended by striking ''an agreement'' and inserting ''a
contract''.
(5) Section 1816(f)(1) (42 U.S.C. 1395h(f)(1)) is amended
by striking the second sentence.
(6)(A) Section 1816(c)(2)(A) (42 U.S.C. 1395h(c)(2)(A)) is
amended in the matter preceding clause (i) by inserting ''that
provides for making payments under this part'' after ''this
section''.
(B) Section 1816(c)(3)(A) (42 U.S.C. 1395h(c)(3)(A)) is
amended by inserting ''that provides for making payments under
this part'' after ''this section''.
(C) Section 1816(k) (42 U.S.C. 1395h(k)) is amended by
inserting ''(as appropriate)'' after ''submit''.
(D) Section 1842(a) (42 U.S.C. 1395u(a)) is amended in the
matter preceding paragraph (1) by striking ''some or all of the
following functions'' and inserting ''any or all of the
following functions, or parts of those functions''.
(E) The first sentence of section 1842(b)(2)(C) (42 U.S.C.
1395u(b)((2)(C)) is amended by inserting ''(as appropriate)''
after ''carriers''.
(F) Section 1842(b)(3) (42 U.S.C. 1395u(b)(3)) is amended
in the matter preceding subparagraph (A) by inserting ''(as
appropriate)'' after ''contract''.
(G) Section 1842(b)(7)(A) (42 U.S.C. 1395u(b)(7)(A)) is
amended in the matter preceding clause (i) by striking ''the
carrier'' and inserting ''a carrier''.
(H) Section 1842(b)(11)(A) (42 U.S.C. 1395u(b)(11)(A)) is
amended in the matter preceding clause (i) by inserting ''(as
appropriate)'' after ''each carrier''.
(I) Section 1842(h)(2) (42 U.S.C. 1395u(h)(2)) is amended
in the first sentence by inserting ''(as appropriate)'' after
''shall''.
(J) Section 1842(h)(5)(A) (42 U.S.C. 1395u(h)(5)(A)) is
amended by inserting ''(as appropriate)'' after ''carriers''.
(7)(A) Section 1816(c)(2)(C) (42 U.S.C. 1395h(c)(2)(C)) is
amended by striking ''hospital, rural primary care hospital,
skilled nursing facility, home health agency, hospice program,
comprehensive outpatient rehabilitation facility, or
rehabilitation agency'' and inserting ''provider of services''.
(B) Section 1816(j) (42 U.S.C. 1395h)(j)) is amended in the
matter preceding paragraph (1) by striking ''for home health
services, extended care services, or post-hospital extended
care services''.
(8) Section 1842(a)(3) (42 U.S.C. 1395u(a)(3)) is amended
by inserting ''(to and from individuals enrolled under this
part and to and from physicians and other entities that furnish
items and services)'' after ''communication''.
(c) Elimination of Special Provisions for Terminations of
Contracts.--
(1) Section 1816(b) (42 U.S.C. 1395h(b)) is amended in the
matter preceding paragraph (1) is amended by striking ''or
renew''.
(2) The last sentence of section 1816(c)(1) (42 U.S.C.
1395h(c)(1)) is amended by striking ''or renewing''.
(3) Section 1816(f)(1) (42 U.S.C. 1395h(f)(1)) is amended--
(A) by striking '', renew, or terminate'', and
(B) by striking '', whether the Secretary should
assign or reassign a provider of services to an agency
or organization,''.
(4) Section 1816(g) (42 U.S.C. 1395h(g)) is repealed.
(5) The last sentence of section 1842(b)(2)(A) (42 U.S.C.
1395u(b)(2)(A)) is amended by striking ''or renewing''.
(6) Section 1842(b) (42 U.S.C. 1395u(b)) is amended by
striking paragraph (5).
(d) Repeal of Fiscal Intermediary Requirements That Are Not Cost-
Effective.--Section 1816(f)(2) (42 U.S.C. 1395h(f)(2)) is amended to
read as follows:
''(2) The contract performance requirements developed under
paragraph (1) shall include, with respect to claims for
services furnished under this part by any provider of services
other than a hospital, whether such agency or organization is
able to process 75 percent of reconsiderations within 60 days
and 90 percent of reconsiderations within 90 days.''.
(e) Repeal of Cost Reimbursement Requirements.--
(1) The first sentence of section 1816(c)(1) (42 U.S.C.
1395h(c)(1)) is amended--
(A) by striking the comma after ''appropriate'' and
inserting ''and'', and
(B) by striking ''subsection (a)'' and all that
follows through the period and inserting ''subsection
(a).''.
(2) Section 1816(c)(1) (42 U.S.C. 1395h(c)(1)) is further
amended by striking the second and third sentences.
(3) The first sentence of section 1842(c)(1) (42 U.S.C.
1395u(c)(1)) is amended--
(A) by striking ''shall provide'' the first place
it appears and inserting ''may provide'', and
(B) by striking ''this part'' and all that follows
through the period and inserting ''this part.''.
(4) Section 1842(c)(1) (42 U.S.C. 1395u(c)(1)) is further
amended by striking the second and third sentences.
(5) Section 2326(a) of the Deficit Reduction Act of 1984 is
repealed.
(f) Competition Required for New Contracts and in Cases of Poor
Performance.--
(1) Section 1816(c) (42 U.S.C. 1395h(c)) is amended by
adding at the end the following new paragraph:
''(4)(A) A contract with a fiscal intermediary under this
section may be renewed from term to term without regard to any
provision of law requiring competition if the fiscal
intermediary has met or exceeded the performance requirements
established in the current contract.
''(B) Functions may be transferred among fiscal
intermediaries without regard to any provision of law requiring
competition.''.
(2) Section 1842(b)(1) (42 U.S.C. 1395u(b)(1)) is amended
to read as follows:
''(b)(1)(A) A contract with a carrier under subsection (a) may be
renewed from term to term without regard to any provision of law
requiring competition if the carrier has met or exceeded the
performance requirements established in the current contract.
''(B) Functions may be transferred among carriers without regard to
any provision of law requiring competition.''.
(g) Waiver of Competitive Requirements for Initial Contracts.--
(1) Contracts that have periods that begin during the 1-
year period that begins on the first day of the fourth calendar
month that begins after the date of enactment of this Act may
be entered into under section 1816(a) of the Social Security
Act (42 U.S.C. 1395h(a)) without regard to any provision of law
requiring competition.
(2) The amendments made by subsection (f) apply to
contracts that have periods beginning after the end of the 1-
year period specified in paragraph (1).
(h) Effective Dates.--
(1) The amendments made by subsection (c) apply to
contracts that have periods ending on, or after, the end of the
third calendar month that begins after the date of enactment of
this Act.
(2) The amendments made by subsections (a), (b), (d), and
(e) apply to contracts that have periods beginning after the
third calendar month that begins after the date of enactment of
this Act.
Medicare Contractor Reform Amendments of 1996 (sic) - Amends title XVIII (Medicare) of the Social Security Act to make specified changes in the way Medicare administers its contracts for administrative operations. Provides chiefly among such changes for: (1) augmenting the types of entities eligible to serve as carriers under the program; (2) allowing service providers their periodic choice of fiscal intermediaries; (3) repealing certain contract termination, cost reimbursement, and non-cost-effective fiscal intermediary requirements; and (4) requiring competition in cases of certain new contracts and in cases involving poor contract performance.
Waives competition requirements in specified circumstances.