In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
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Question: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Grandparents Raising Grandchildren
Assistance Act of 1993''.

SEC. 2. FINDINGS.

The Congress finds that--
(1) many grandparents throughout the United States are the
primary caregivers to their grandchildren and such grandparents
are essentially starting over as parents;
(2) grandparents are acting as parents for a second time
primarily because of problems relating to the natural parents
of their grandchildren such as drug and alcohol addiction,
abuse, divorce, AIDS and other health problems, and teenage
pregnancy;
(3) grandparents and the grandchildren for whom they
provide care often suffer legal, financial, emotional, and
bureaucratic hardships; and
(4) it is desirable to develop national policies that
assist grandparents who are serving as the primary caregivers
to their grandchildren.

SEC. 3. GRANDCHILD SOCIAL SECURITY BENEFITS BASED ONLY ON DEPENDENCY.

(a) In General.--Subsection (e) of section 216 of the Social
Security Act (42 U.S.C. 416) is amended--
(1) by striking '', but only if'' in the first sentence and
all that follows through ''such individual died''; and
(2) by striking the last sentence.
(b) Additional Requirements if Parents Are Alive.--Section
202(d)(9) of the Social Security Act (42 U.S.C. 402(d)(9)) is amended
by adding at the end the following new subparagraph:
''(C) If--
''(i) a child is treated as a child of an individual under
clause (3) of the first sentence of section 216(e), and
''(ii) a natural or adoptive parent of the child is living
at the time specified in paragraph (1)(C) of this subsection,
such child shall not be treated as dependent on such individual as of
such time unless the period described in subparagraphs (A) and (B) is
two years, and the natural or adoptive parent, if over the age of 18
years, is not a dependent for whom a deduction is allowable under
section 151 of the Internal Revenue Code of 1986 to such individual.''.
(c) Suspension of Benefits if Child Reunites With Parents.--Section
202(d)(1) of the Social Security Act (42 U.S.C. 402(d)(1)) is amended--
(1) by striking ''or'' at the end of subparagraph (F);
(2) by striking the period at the end of subparagraph (G)
and inserting ''; or''; and
(3) by inserting after subparagraph (G) the following new
subparagraph:
''(H) in the case of a child described in paragraph (9)(C),
the first month during which such child lives with such child's
natural or adoptive parent who has attained the age of 18 and
who is not a dependent as described in such paragraph.''.
(d) Effective Date.--The amendments made by this section shall
apply to benefits payable for months after the date of the enactment of
this Act, but only on the basis of applications filed after such date.

SEC. 4. DEVELOPMENT OF OPTIONAL MODEL PROCEDURE FOR NOTIFYING RELATIVES
PRIOR TO PLACEMENT OF A CHILD IN FOSTER CARE.

(a) In General.--Part E of title IV of the Social Security Act (42
U.S.C. 670 et seq.) is amended by inserting after section 477 the
following new section:

''development of model procedure for notifying relatives prior to
placement of a child in foster care

''Sec. 478. Not later than 180 days after the date of the enactment
of this section, the Secretary shall develop a model procedure to be
used by any State with a plan approved under this part which ensures
that reasonable efforts will be made prior to the placement of a child
in foster care to give notice to a relative (including a maternal or
fraternal grandparent, adult sibling, aunt, or uncle) who might be
available to care for the child.''.
(b) State Option to Establish Model Procedure.--Subsection (a) of
section 471 of the Social Security Act (42 U.S.C. 671) is amended--
(1) by striking ''and'' at the end of paragraph (16);
(2) by striking the period at the end of paragraph (17) and
inserting ''; and''; and
(3) by adding at the end the following new paragraph:
''(18) at the option of the State, provides that the State
agency will establish the procedure developed by the Secretary
under section 478 or an alternate procedure for notifying
relatives prior to the placement of a child in foster care.''.
(c) Effective Date.--The amendments made by this section shall be
effective on the date of the enactment of this Act.

SEC. 5. MODEL STANDARDS FOR INSURANCE COVERAGE OF DEPENDENTS.

(a) Development of Model Standards.--If, within 1-year after the
date of the enactment of this section, the National Association of
Insurance Commissioners has not developed model standards for the
coverage of dependents under health insurance policies, the Secretary
of Health and Human Services (hereafter in this section referred to as
the ''Secretary''), shall develop such standards not later than 180
days after the end of such 1-year period.
(b) Distribution of Model Standards.--If the Secretary develops
model standards under subsection (a), the Secretary shall distribute
such standards to the commissioner of insurance, or any similar
official, of each State.

SEC. 6. CENSUS DATA ON GRANDPARENTS AS PRIMARY CAREGIVERS FOR THEIR
GRANDCHILDREN.

(a) In General.--Not later than 90 days after the date of the
enactment of this section, the Secretary of Commerce (hereafter in this
section referred to as the ''Secretary''), in carrying out the
provisions of section 141 of title 13, United States Code, shall expand
the data collection efforts of the Bureau of the Census (hereafter in
this section referred to as the ''Bureau'') to enable the Bureau to
collect statistically significant data, in connection with its
decennial census and its mid-decade census, concerning the growing
trend of grandparents who are the primary caregivers for their
grandchildren.
(b) Expanded Census Question.--In carrying out the provisions of
subsection (a), the Secretary shall expand the Bureau's census question
that details households which include both grandparents and their
grandchildren. The expanded question shall be formulated to distinguish
between the following households:
(1) a household in which a grandparent temporarily provides
a home for a grandchild for a period of weeks or months during
periods of parental distress; and
(2) a household in which a grandparent provides a home for
a grandchild and serves as the primary caregiver for the
grandchild.

SEC. 7. GRANTS FOR THE ESTABLISHMENT AND OPERATION OF A NATIONAL
RESOURCE CENTER FOR GRANDPARENTS.

(a) In General.--Section 202 of the Older Americans Act of 1965 (42
U.S.C. 3012) is amended by adding at the end the following:
''(f)(1) The Commissioner shall make grants to, or enter into
contracts with, one eligible entity to establish and operate the
National Resource Center for Grandparents (referred to in this
subsection as the 'Center') to serve as a central source of information
and assistance to older individuals who--
''(A) raise their grandchildren;
''(B) encounter problems obtaining access to their
grandchildren for purposes of visitation; or
''(C) need financial, legal, emotional, or informational
assistance regarding their relationship with their
grandchildren.
''(2) The Center shall--
''(A) be staffed by employees and volunteers, including
such older individuals;
''(B) provide a toll-free telephone number to increase
access to the information and assistance available from the
Center;
''(C) collect and make available to such older individuals
information regarding programs, projects, and activities of
public and private entities (including governmental entities)
relating to the matters described in subparagraphs (A), (B),
and (C) of paragraph (1), including information on State law
regarding grandparent visitation and Federal assistance
available to such older individuals; and
''(D) refer individual grandparents to public and private
entities that provide information or assistance regarding the
rearing of grandchildren, including information regarding the
prevention of drug abuse and the promotion of good health and
nutrition.
''(3) For purposes of this subsection, the term 'eligible entity'
means a nonprofit private organization with a demonstrated record of
experience in representing the concerns of older individuals with
respect to their relationship to their grandchildren.''.
(b) Effective Date.--The amendment made by subsection (a) shall
take effect on the first day of the first fiscal year beginning after
the date of the enactment of this Act.

Answer: Grandparents Raising Grandchildren Assistance Act of 1993 - Amends title II (Old Age, Survivors and Disability Insurance) (OASDI) of the Social Security Act (SSA) to qualify grandchildren for social security benefits based only on their dependency on social security recipients. Sets special rules if one of a grandchild's natural or adoptive parents is living. Provides for suspension of such benefits in the event the grandchild reunites with a natural or adoptive parent.
Amends part E (Foster Care and Adoption Assistance) of SSA title IV to direct the Secretary of Health and Human Services to develop a model procedure for States to use in notifying relatives before the placement of a child in foster care.
Directs the Secretary, if the National Association of Insurance Commissioners (NAIC) has not done so by a specified deadline, to develop model standards for the coverage of dependents under health insurance policies.
Requires the Secretary of Commerce to expand the data collection efforts of the Bureau of the Census to enable it to collect statistically significant data on the growing trend of grandparents who are the primary caregivers for their grandchildren.
Amends the Older Americans Act of 1965 to direct the Commissioner on Aging to make grants to or enter contracts with one eligible entity to establish and operate the National Resource Center for Grandparents to serve as a central source of information and assistance to older individuals who: (1) raise their grandchildren; (2) encounter problems obtaining visitation access to their grandchildren; or (3) need financial, legal, emotional, or informational assistance regarding their relationship with their grandchildren.

Question: SECTION 1. SHORT TITLE.

This Act may be cited as the ''United States Fire Administration
Reauthorization Act of 2008''.

SEC. 2. FINDINGS.

Congress finds the following:
(1) The loss of life due to fire has dropped significantly
over the last 25 years in the United States. However, the
United States still has one of the highest fire death rates in
the industrialized world. For 2006, the National Fire
Protection Association reported 3,245 civilian fire deaths,
17,925 civilian fire injuries, and $11,307,000,000 in direct
losses due to fire.
(2) Every year, over 100 firefighters die in the line of
duty. The United States Fire Administration should continue its
leadership to help local fire agencies dramatically reduce
these fatalities.
(3) Members of the fire service community should continue
to work together to further the promotion of national voluntary
consensus standards that increase firefighter safety.
(4) The United States Fire Administration provides crucial
support to the Nation's 30,300 fire departments through
training, data collection, fire awareness and education, and
other activities for improving fire prevention, control, and
suppression technologies.
(5) The collection of data on fire and other emergency
incidents is a vital tool both for policy makers and emergency
responders to identify and develop responses to emerging
hazards. Improving the United States Fire Administration's data
collection capabilities is essential for accurately tracking
and responding to the magnitude and nature of the Nation's fire
problem.
(6) The research and development performed by the Federal
Government and non-government organizations on fire
technologies, techniques, and tools advance the capabilities of
the Nation's fire service to prevent and suppress fires.
(7) The United States Fire Administration is one of the
strongest voices representing the Nation's fire service within
the Federal Government, and, as such, it should have a
prominent place within the Federal Government.

SEC. 3. AUTHORIZATION OF APPROPRIATIONS FOR UNITED STATES FIRE
ADMINISTRATION.

Section 17(g)(1) of the Federal Fire Prevention and Control Act of
1974 (15 U.S.C. 2216(g)(1)) is amended--
(1) in subparagraph (C), by striking ''and'' after the
semicolon;
(2) in subparagraph (D), by striking the period at the end
and inserting a semicolon; and
(3) by adding after subparagraph (D) the following new
subparagraphs:
''(E) $70,000,000 for fiscal year 2009;
''(F) $72,100,000 for fiscal year 2010;
''(G) $74,263,000 for fiscal year 2011; and
''(H) $76,490,890 for fiscal year 2012.''.

SEC. 4. NATIONAL FIRE ACADEMY TRAINING PROGRAM MODIFICATIONS AND
REPORTS.

(a) Amendments to Fire Academy Training.--Section 7(d)(1) of the
Federal Fire Prevention and Control Act of 1974 (15 U.S.C. 2206(d)(1))
is amended--
(1) by amending subparagraph (H) to read as follows:
''(H) response, tactics, and strategies for dealing
with national catastrophes, including terrorist-caused
national catastrophes and incidents that involve
weapons of mass destruction;'';
(2) in subparagraph (K), by striking ''forest'' and
inserting ''wildland'';
(3) in subparagraph (M), by striking ''response tactics
and'' and inserting ''response, tactics, and'';
(4) by redesignating subparagraphs (I) through (N) as
subparagraphs (M) through (R), respectively; and
(5) by inserting after subparagraph (H) the following new
subparagraphs:
''(I) response, tactics, and strategies for
fighting large-scale fires or multiple fires in a
general area that cross jurisdictional boundaries;
''(J) response, tactics, and strategies for
fighting fires occurring at the wildland-urban
interface;
''(K) response, tactics, and strategies for
fighting fires involving hazardous materials;
''(L) advanced emergency medical services
training;''.
(b) Triennial Reports.--Section 7 of such Act (15 U.S.C. 2206) is
amended by adding at the end the following new subsection:
''(m) Triennial Report.--In the first annual report filed pursuant
to section 16 for which the deadline for filing is after the expiration
of the 18-month period that begins on the date of the enactment of the
United States Fire Administration Reauthorization Act of 2008, and in
every third annual report thereafter, the Administrator shall include
information about changes made to the Academy curriculum, including--
''(1) the basis for such changes, including a review of the
incorporation of lessons learned by emergency response
personnel after significant emergency events and emergency
preparedness exercises performed under the National Exercise
Program; and
''(2) the desired training outcome of all such changes.''.
(c) Authorizing the Administrator to Enter Into Contracts to
Provide On-Site Training Through Certain Accredited Organizations.--
Section 7(f) of such Act (15 U.S.C. 2206(f)) is amended to read as
follows:
''(f) Assistance.--
''(1) In general.--The Administrator is authorized to
provide assistance to State and local fire service training
programs through grants, contracts, or otherwise.
''(2) Authorization to enter into contracts to provide on-
site training through certain accredited organizations.--
''(A) In general.--The Administrator is authorized
to enter into a contract with one or more nationally
recognized organizations that have established on-site
training programs that prepare fire service personnel
to meet national voluntary consensus standards for fire
service personnel and that facilitate the delivery of
the education and training programs outlined in
subsection (d)(1) directly to fire service personnel.
''(B) Restrictions.--The Administrator shall not
enter into a contract with such organization unless
such organization--
''(i) provides training that leads to
certification by a program accredited by a
nationally recognized accreditation
organization; or
''(ii) at the time the Administrator enters
into the contract, provides training under such
a program under a cooperative agreement with a
Federal agency.
''(3) Restriction on use of funds.--The amounts expended by
the Administrator to carry out this subsection in any fiscal
year shall not exceed 4 percent of the amount authorized to be
appropriated in such fiscal year pursuant to section 17 of this
Act.''.
(d) Incident Command Training Course for Fires at Ports Required.--
Not later than 2 years after the date of the enactment of this Act, the
Administrator of the United States Fire Administration, in consultation
with the Superintendent of the National Academy for Fire Prevention and
Control, shall consolidate and integrate into the current Academy
curriculum a course on incident command training for fire service
personnel for fighting fires at United States ports and in marine
environments, including fires on the water and aboard vessels. Such
course shall not relate to border and port security.

SEC. 5. NATIONAL FIRE INCIDENT REPORTING SYSTEM UPGRADES.

(a) Incident Reporting System Database.--Section 9 of the Federal
Fire Prevention and Control Act of 1974 (15 U.S.C. 2208) is amended by
adding at the end the following new subsection:
''(d) National Fire Incident Reporting System Update.--Of the
amounts made available pursuant to subparagraphs (E), (F), and (G) of
section 17(g)(1), the Administrator shall use no more than an aggregate
amount of $5,000,000 during the 3-year period consisting of fiscal
years 2009, 2010, and 2011 to carry out activities necessary to update
the National Fire Incident Reporting system to an Internet-based, real-
time incident reporting database, including capital investment,
contractor engagement, and user education.''.
(b) Technical Correction.--Section 9(b)(2) of such Act (15 U.S.C.
2208(b)(2)) is amended by striking ''assist State,'' and inserting
''assist Federal, State,''.

SEC. 6. FIRE TECHNOLOGY ASSISTANCE AND DISSEMINATION.

(a) Assistance to Fire Services for Fire Prevention and Control in
Wildland-Urban Interface.--Section 8(d) of the Federal Fire Prevention
and Control Act of 1974 (15 U.S.C. 2207(d)) is amended--
(1) by striking ''Rural Assistance'' in the heading and
inserting ''Rural and Wildland-Urban Interface Assistance'';
(2) by striking ''The Administrator'' and inserting ''(1)
The Administrator''; and
(3) by adding at the end the following new paragraph:
''(2) The Administrator is authorized to assist the Nation's fire
services, directly or through contracts, grants, or other forms of
assistance, for activities and equipment to improve fire prevention and
control in the wildland-urban interface.''.
(b) Dissemination.--Section 8 of such Act (15 U.S.C. 2207) is
amended by adding at the end the following new subsection:
''(h) Dissemination.--Beginning 1 year after the date of the
enactment of the United States Fire Administration Reauthorization Act
of 2008, the Administrator, in collaboration with the relevant
departments and agencies of the Federal Government, shall make
available to the public information regarding United States Fire
Administration funded activities to advance new knowledge and best
practices in firefighting, through a regularly updated Internet
database.''.

SEC. 7. ENCOURAGING ADOPTION OF STANDARDS FOR FIREFIGHTER HEALTH AND
SAFETY.

The Federal Fire Prevention and Control Act of 1974 (15 U.S.C. 2201
et seq.) is amended by adding at the end the following new sections:

''SEC. 37. ENCOURAGING ADOPTION OF STANDARDS FOR FIREFIGHTER HEALTH AND
SAFETY.

''The Administrator shall promote adoption by fire services of
national voluntary consensus standards for firefighter health and
safety, including such standards for firefighter operations, training,
staffing, and fitness, by educating fire services about such standards,
encouraging the adoption at all levels of government of such standards,
and making recommendations on other ways in which the Federal
Government can promote the adoption of such standards by fire services.

''SEC. 38. TRAINING AGENCIES ON IMPORTANCE OF CLEARING BIOMASS IN
WILDLAND AREAS TO PROMOTE FIREFIGHTER SAFETY.

''In collaboration with the relevant departments and agencies of
the Federal Government, the Administrator shall develop and provide
information and training to relevant departments and agencies of the
Federal Government on the importance of clearing biomass in wildland
areas of Federal lands to promote the safety of firefighters.''.

SEC. 8. COORDINATION REGARDING FIRE SERVICE-BASED EMERGENCY MEDICAL
SERVICES.

(a) In General.--Section 21(e) of the Federal Fire Prevention and
Control Act of 1974 (15 U.S.C. 2218(e)) is amended to read as follows:
''(e) Coordination.--
''(1) In general.--To the extent practicable, the
Administrator shall utilize existing programs, data,
information, and facilities already available in other Federal
Government departments and agencies and, where appropriate,
existing research organizations, centers, and universities.
''(2) Coordination of fire prevention and control
programs.--The Administrator shall provide liaison at an
appropriate organizational level to assure coordination of the
Administrator's activities with State and local government
agencies, departments, bureaus, or offices concerned with any
matter related to programs of fire prevention and control with
private and other Federal organizations and offices so
concerned.
''(3) Coordination of fire service-based emergency medical
services programs.--The Administrator shall provide liaison at
an appropriate organizational level to assure coordination of
the Administrator's activities with State and local government
agencies, departments, bureaus, or offices concerned with
programs related to emergency medical services provided by fire
service-based systems with private and other Federal
organizations and offices so concerned.''.
(b) Fire Service-Based Emergency Medical Services Best Practices.--
Section 8(c) of such Act (15 U.S.C. 2207(c)) is amended--
(1) by redesignating paragraphs (2) through (4) as
paragraphs (3) through (5), respectively; and
(2) by inserting after paragraph (1) the following new
paragraph:
''(2) The Administrator is authorized to conduct, directly or
through contracts or grants, studies of the operations and management
aspects of fire service-based emergency medical services and
coordination between emergency medical services and fire services. Such
studies may include the optimum protocols for on-scene care, the
allocation of resources, and the training requirements for fire
service-based emergency medical services.''.

SEC. 9. DEFINITIONS.

Section 4 of the Federal Fire Prevention and Control Act of 1974
(15 U.S.C. 2203) is amended--
(1) in paragraph (3), by striking ''Administration'' and
inserting ''Administration, who is the Assistant Administrator
of the Federal Emergency Management Agency'';
(2) in paragraph (7), by striking ''and'' after the
semicolon;
(3) in paragraph (8), by striking the period at the end and
inserting ''; and'';
(4) by redesignating paragraphs (6), (7), and (8) as
paragraphs (7), (8), and (9), respectively;
(5) by inserting after paragraph (5) the following new
paragraph:
''(6) 'hazardous materials' has the meaning given such term
in section 5102(2) of title 49, United States Code;''; and
(6) by adding at the end the following new paragraph:
''(10) 'wildland-urban interface' has the meaning given
such term in section 101(16) of the Healthy Forests Restoration
Act of 2003 (16 U.S.C. 6511(16)).''.

SEC. 10. SUPPORTING THE ADOPTION OF FIRE SPRINKLERS.

Congress supports the recommendations of the United States Fire
Administration regarding the adoption of fire sprinklers in commercial
buildings and educational programs to raise awareness of the importance
of installing fire sprinklers in residential buildings.

Passed the House of Representatives April 3, 2008.

Attest:

LORRAINE C. MILLER,

Clerk.

Answer: United States Fire Administration Reauthorization Act of 2008 - (Sec. 3) Amends the Federal Fire Prevention and Control Act of 1974 to authorize appropriations for the U.S. Fire Administration (USFA) for FY2009-FY2012.

(Sec. 4) Authorizes the Superintendent of the National Academy for Fire Prevention and Control to include within fire service personnel training: (1) response, tactics, and strategies for dealing with non-terrorist-caused national catastrophes and incidents that involve weapons of mass destruction; (2) applying new technology and developing strategies and tactics for fighting wildfires; (3) response, tactics, and strategies for fighting large-scale or multiple fires in a general area that cross jurisdictional boundaries, fires occurring at the wildland-urban interface, and fires involving hazardous materials; and (4) advanced emergency medical services (EMS) training.

Requires the Administrator of USFA to: (1) include in triennial reports information about changes made to the National Fire Academy curriculum; and (2) consolidate and integrate into that curriculum a course on incident command training for fire service personnel for fighting fires at U.S. ports and in marine environments, including fires on the water and aboard vessels. Provides that such course shall not relate to border and port security.

Authorizes the Administrator to contract with one or more nationally recognized organizations that have established on-site training programs that prepare fire service personnel to meet national voluntary consensus standards for fire service personnel and that facilitate delivery of education and training programs, provided that such an organization: (1) provides training that leads to certification by a program accredited by a nationally recognized accreditation organization; or (2) provides training under such a program pursuant to a cooperative agreement with a federal agency. Limits the amounts that may be expended by the Administrator to carry out this provision to 4% of the amount authorized to be appropriated in that fiscal year to facilitate the delivery of education and training programs directly to fire service personnel.

(Sec. 5) Directs the Administrator to use specified funds during FY2009-FY2011 to update the National Fire Incident Reporting system to an Internet-based, real-time incident reporting database.

(Sec. 6) Authorizes the Administrator to assist the nation's fire services for activities and equipment to improve fire prevention and control in the wildland-urban interface. Directs the Administrator to make available to the public information regarding USFA funded activities, to advance new knowledge and best practices in firefighting through a regularly updated Internet database.

(Sec. 7) Requires the Administrator to: (1) promote adoption by fire services of voluntary national consensus standards for firefighter health and safety; and (2) develop and provide information and training to relevant federal departments on the importance of clearing biomass in wildland areas of federal lands to promote firefighter safety.

(Sec. 8) Directs the Administrator to provide liaison to assure coordination of fire service-based EMS programs. Authorizes the Administrator to conduct studies of the operations and management aspects of fire service-based EMS and coordination between EMS and fire services, including the optimum protocols for on-scene care, the allocation of resources, and the training requirements for fire service-based EMS.

(Sec. 10) Expresses support for USFA recommendations regarding the adoption of fire sprinklers in commercial buildings and educational programs to raise awareness of the importance of installing fire sprinklers in residential buildings.

Question: SECTION 1. SHORT TITLE.

This Act may be cited as the ''Medicare Patient Access to
Preventive and Diagnostic Tests Act of 2003''.

SEC. 2. CODING AND PAYMENT PROCEDURES FOR NEW CLINICAL DIAGNOSTIC
LABORATORY TESTS UNDER MEDICARE.

(a) Determining Payment Basis for New Lab Tests.--Section 1833(h)
of the Social Security Act (42 U.S.C. 1395l(h)) is amended by adding at
the end the following:
''(9)(A) The Secretary shall establish procedures for
determining the basis for, and amount of, payment under this
subsection for any clinical diagnostic laboratory test with
respect to which a new or substantially revised HCPCS code is
assigned on or after January 1, 2004 (hereinafter in this
paragraph and paragraph (10) referred to as 'new tests'). Such
procedures shall provide that--
''(i) the payment amount for such a test will be
established only on--
''(I) the basis described in paragraph
(10)(A); or
''(II) the basis described in paragraph
(10)(B); and
''(ii) the Secretary will determine whether the
payment amount for such a test is established on the
basis described in paragraph (10)(A) or the basis
described in paragraph (10)(B) only after the process
described in subparagraph (B) has been completed with
respect to such test.
''(B) Determinations under subparagraph (A)(ii) shall be
made only after the Secretary--
''(i) makes available to the public (through an
Internet site and other appropriate mechanisms) a list
that includes any such test for which establishment of
a payment amount under paragraph (10) is being
considered for a year;
''(ii) on the same day such list is made available,
causes to have published in the Federal Register notice
of a meeting to receive comments and recommendations
(including the data upon which such recommendations are
based) from the public on the appropriate basis under
paragraph (10) for establishing payment amounts for the
tests on such list;
''(iii) not less than 30 days after publication of
such notice, convenes a meeting to receive such
comments and recommendations, with such meeting--
''(I) including representatives of all
entities within the Centers for Medicare &
Medicaid Services (hereinafter in this
paragraph referred to as 'CMS') that will
be involved in determining the basis on which payment amounts will be
established for such tests under paragraph (10) and implementing such
determinations;
''(II) encouraging the participation of
interested parties, including beneficiaries,
device manufacturers, clinical laboratories,
laboratory professionals, pathologists, and
prescribing physicians, through outreach
activities; and
''(III) affording opportunities for
interactive dialogue between representatives of
CMS and the public; and
''(iv) taking into account the comments and
recommendations received at such meeting, develops and
makes available to the public (through an Internet site
and other appropriate mechanisms) a list of proposed
determinations with respect to the appropriate basis
for establishing a payment amount under paragraph (10)
for each such code, together with an explanation of the
reasons for each such determination, and the data on
which the determination is based.
The Secretary may convene such further public meetings to
receive public comment on payment amounts for new tests under
this subsection as the Secretary determines appropriate.
''(C) Under the procedures established pursuant to
subparagraph (A), the Secretary shall--
''(i) identify the rules and assumptions to be
applied by the Secretary in considering and making
determinations of whether the payment amount for a new
test should be established on the basis described in
paragraph (10)(A) or the basis described in paragraph
(10)(B);
''(ii) make available to the public the data (other
than proprietary data) considered in making such
determinations; and
''(iii) provide for a mechanism under which--
''(I) an interested party may request an
administrative review of an adverse
determination;
''(II) upon the request of an interested
party, an administrative review is conducted
with respect to an adverse determination; and
''(III) such determination is revised, as
necessary, to reflect the results of such
review.
''(D) For purposes of this paragraph and paragraph
(10)--
''(i) the term 'HCPCS' refers to the
Healthcare Common Procedure Coding System; and
''(ii) a code shall be considered to be
'substantially revised' if there is a
substantive change to the definition of the
test or procedure to which the code applies
(such as a new analyte or a new methodology for
measuring an existing analyte-specific test).
''(10)(A) Notwithstanding paragraphs (1), (2), and (4), if
a new test is clinically similar to a test for which a fee
schedule amount has been established under paragraph (5), the Secretary
shall pay the same fee schedule amount for the new test. In determining
whether tests are clinically similar for purposes of this paragraph,
the Secretary may not take into account economic factors.
''(B)(i) Notwithstanding paragraphs (1), (2), (4), and (5),
if a new test is not clinically similar to a test for which a
fee schedule has been established under paragraph (5), payment
under this subsection for such test shall be made on the basis
of the lesser of--
''(I) the actual charge for the test; or
''(II) an amount equal to 60 percent (or in the
case of a test performed by a qualified hospital (as
defined in paragraph (1)(D)) for outpatients of such
hospital, 62 percent) of the prevailing charge level
determined pursuant to the third and fourth sentences
of section 1842(b)(3) for the test for a locality or
area for the year (determined without regard to the
year referred to in paragraph (2)(A)(i), or any
national limitation amount under paragraph (4)(B), and
adjusted annually by the percentage increase or
decrease under paragraph (2)(A)(i));
until the beginning of the third full calendar year that begins
on or after the date on which an HCPCS code is first assigned
with respect to such test, or, if later, the beginning of the
first calendar year that begins on or after the date on which
the Secretary determines that there are sufficient claims data
to establish a fee schedule amount pursuant to clause (ii).
''(ii) Notwithstanding paragraphs (2) and (4), and (5), the
fee schedule amount for a clinical diagnostic laboratory test
described in clause (i) that is performed--
''(I) during the first calendar year after clause
(i) ceases to apply to such test, shall be an amount
equal to the national limitation amount that the
Secretary determines (consistent with clause (iii))
would have applied to such test under paragraph
(4)(B)(viii) during the preceding calendar year,
adjusted by the percentage increase or decrease
determined under paragraph (2)(A)(i) for such first
calendar year; and
''(II) during a subsequent year, is the fee
schedule amount determined under this clause for the
preceding year, adjusted by the percentage increase or
decrease that applies under paragraph (5)(A) for such
year.
''(iii) For purposes of clause (ii)(I), the national
limitation amount for a test shall be set at 100 percent of the
median of the payment amounts determined under clause (ii)(I)
for all payment localities or areas for the last calendar year
for which payment for such test was determined under clause
(i).
''(iv) Nothing in clause (ii) shall be construed as
prohibiting the Secretary from applying (or authorizing the
application of) the comparability provisions of the first
sentence of such section 1842(b)(3) with respect to amounts
determined under such clause.''.
(b) Establishment of National Fee Schedule Amounts.--
(1) In general.--Section 1833(h) of the Social Security
Act, as amended by subsection (a), is further amended--
(A) in paragraph (2), by striking ''paragraph (4)''
and inserting in lieu thereof ''paragraphs (4), (5),
and (10)'';
(B) in paragraph (4)(B)(viii), by inserting ''and
before January 1, 2004,'' after ''December 31, 1997,'';
(C) by redesignating paragraphs (5), (6), and (7),
as paragraphs (6), (7), and (8), respectively; and
(D) by inserting after paragraph (4) the following:
''(5) Notwithstanding paragraphs (2) and (4), the Secretary
shall set the fee schedule amount for a test (other than a test
to which paragraph (10)(B)) applies) at--
''(A) for tests performed during 2004, an amount
equal to the national limitation amount for that test
for 2003, and adjusted by the percentage increase or
decrease determined under paragraph (2)(A)(i) for such
year; and
''(B) for tests performed during a year after 2004,
the amount determined under this subparagraph for the
preceding year, adjusted by the percentage increase or
decrease determined under paragraph (2)(A)(i) for such
year.''.
(2) Conforming changes.--Section 1833(a) of the Social
Security Act (42 U.S.C. 1395l(a)) is amended--
(A) in paragraph (1)(D)(i), by striking ''the
limitation amount for that test determined under
subsection (h)(4)(B),''; and
(B) in paragraph (2)(D)(i), by striking ''the
limitation amount for that test determined under
subsection (h)(4)(B),''.
(c) Mechanism for Review of Adequacy of Payment Amounts.--Section
1833(h) of the Social Security Act, as amended by subsections (a) and
(b), is further amended by adding at the end the following:
''(11) The Secretary shall establish a mechanism under
which--
''(A) an interested party may request a timely
review of the adequacy of the existing payment amount
under this subsection fee for a particular test; and
''(B) upon the receipt of such a request, a timely
review is carried out.''.
(d) Prohibition on Assignment of Certain New Codes.--The Secretary
may not assign a code for a new clinical diagnostic laboratory test
that differs from the code recommended by the American Medical
Association Common Procedure Terminology Editorial Panel and results in
lower payment than would be made if the Secretary accepted such
recommendation solely on the basis that the test is a test that may be
performed by a laboratory with a certificate of waiver under section
353(d)(2) of the Public Health Service Act (42 U.S.C. 263a(d)(2)).
(e) Prohibition on Application of Least Costly Alternative to Fee
Schedule.--Section 1833(h) of the Social Security Act, as amended by
subsections (a), (b), and (c), is further amended by adding at the end
the following:
''(12) Notwithstanding any other provision of this title,
the Secretary may not substitute for the fee schedule amount
otherwise established under this subsection for a test a least
costly alternative fee schedule amount for the test.''.
(f) Effective Dates.--
(1) In general.--The Secretary of Health and Human Services
shall establish the procedures required to implement paragraphs
(9), (10), and (11) of section 1833(h) of the Social Security
Act (42 U.S.C. 1395l(h)), as added by this section, by not
later than October 1, 2003.
(2) Prohibitions.--(A) Subsection (d) shall apply to code
assignment determinations made on or after the date of the
enactment of this Act.
(B) The amendment made by subsection (e) shall apply to
tests furnished on or after the date of the enactment of this
Act without regard to whether a determination to substitute a
least costly alternative fee schedule amount for a test was
made before, on, or after such date.

Answer:
Medicare Patient Access to Preventive and Diagnostic Tests Act of 2003 - Amends title XVIII (Medicare) of the Social Security Act to direct the Secretary of Health and Human Services to: (1) establish procedures for determining the basis for, and amount of, Medicare payment for any clinical diagnostic laboratory test with respect to which a new or substantially revised Health Care Financing Administration Common Procedure Coding System (HCPCS) code is assigned on or after January 1, 2004; (2) set the national fee schedule amounts for tests performed; and (3) establish a mechanism for review of the adequacy of payment amounts for a particular test.Prohibits the Secretary from: (1) assigning a code for a new clinical diagnostic laboratory test that differs from the code recommended by the American Medical Association Common Procedure Terminology Editorial Panel and results in lower payment than would be made if the Secretary accepted such recommendation solely on the basis that the test is a test that may be performed by a laboratory with a certificate of waiver under the Public Health Service Act; or (2) substituting for the fee schedule amount otherwise established under the Act for a test a least costly alternative fee schedule amount.