| Home > 106th Congressional Bills > S. 1345 (is) To amend title 18, United States Code, to prohibit certain interstate conduct relating to exotic animals. [Introduced in Senate] ...
S. 1345 (is) To amend title 18, United States Code, to prohibit certain interstate conduct relating to exotic animals. [Introduced in Senate] ...
July 30, 1999 Ordered to be printed as passed 106th CONGRESS 1st Session S. 1344 _______________________________________________________________________ AN ACT To amend the Public Health Service Act, the Employee Retirement Income Security Act of 1974, and the Internal Revenue Code of 1986 to protect consumers in managed care plans and other health coverage. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE; TABLE OF CONTENTS. (a) Short Title.--This Act may be cited as the ``Patients' Bill of Rights Plus Act''. (b) Table Of Contents.--The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. TITLE I--PATIENTS' BILL OF RIGHTS Subtitle A--Right to Advice and Care Sec. 101.``subpart c--patient right to medical advice and care ``Sec. 721. Patient access to emergency medical care. ``Sec. 722. Offering of choice of coverage options. ``Sec. 723. Patient access to obstetric and gynecological care. ``Sec. 724. Patient access to pediatric care. ``Sec. 725. Timely access to specialists. ``Sec. 726. Continuity of care. ``Sec. 727. Protection of patient-provider communications. ``Sec. 728. Patient's right to prescription drugs. ``Sec. 729. Self-payment for behavioral health care services. ``Sec. 730. Coverage for individuals participating in approved cancer clinical trials. ``Sec. 730A. Prohibiting discrimination against providers. ``Sec. 730B. Generally applicable provision.''. Sec. 102``subchapter c--patient right to medical advice and care986. ``Sec. 9821. Patient access to emergency medical care. ``Sec. 9822. Offering of choice of coverage options. ``Sec. 9823. Patient access to obstetric and gynecological care. ``Sec. 9824. Patient access to pediatric care. ``Sec. 9825. Timely access to specialists. ``Sec. 9826. Continuity of care. ``Sec. 9827. Protection of patient-provider communications. ``Sec. 9828. Patient's right to prescription drugs. ``Sec. 9829. Self-payment for behavioral health care services. ``Sec. 9830. Coverage for individuals participating in approved cancer clinical trials. ``Sec. 9830A. Prohibiting discrimination against providers. ``Sec. 9830B. Generally applicable provision.''. Sec. 103. Effective date and related rules. Subtitle B--Right to Information About Plans and Providers Sec. 111. Information about plans. Sec. 112. Information about providers. Subtitle C--Right to Hold Health Plans Accountable Sec. 121. Amendment to Employee Retirement Income Security Act of 1974. TITLE II--WOMEN'S HEALTH AND CANCER RIGHTS Sec. 201. Women's health and cancer rights. TITLE III--GENETIC INFORMATION AND SERVICES Sec. 301. Short title. Sec. 302. Amendments to Employee Retirement Income Security Act of 1974. Sec. 303. Amendments to the Public Health Service Act. Sec. 304. Amendments to the Internal Revenue Code of 1986. TITLE IV--HEALTHCARE RESEARCH AND QUALITY Sec. 401. Short title. Sec. 402. Amendment to the Public Health Service Act. ``TITLE IX--AGENCY FOR HEALTHCARE RESEARCH AND QUALITY ``Part A--Establishment and General Duties ``Sec. 901. Mission and duties. ``Sec. 902. General authorities. ``Part B--Healthcare Improvement Research ``Sec. 911. Healthcare outcome improvement research. ``Sec. 912. Private-public partnerships to improve organization and delivery. ``Sec. 913. Information on quality and cost of care. ``Sec. 914. Information systems for healthcare improvement. ``Sec. 915. Research supporting primary care and access in underserved areas. ``Sec. 916. Clinical practice and technology innovation. ``Sec. 917. Coordination of Federal government quality improvement efforts. ``Part C--General Provisions ``Sec. 921. Advisory Council for Healthcare Research and Quality. ``Sec. 922. Peer review with respect to grants and contracts. ``Sec. 923. Certain provisions with respect to development, collection, and dissemination of data. ``Sec. 924. Dissemination of information. ``Sec. 925. Additional provisions with respect to grants and contracts. ``Sec. 926. Certain administrative authorities. ``Sec. 927. Funding. ``Sec. 928. Definitions.''. Sec. 403. References. TITLE V--ENHANCED ACCESS TO HEALTH INSURANCE COVERAGE Sec. 501. Full deduction of health insurance costs for self-employed individuals. Sec. 502. Full availability of medical savings accounts. Sec. 503. Permitting contribution towards medical savings account through Federal employees health benefits program (FEHBP). Sec. 504. Carryover of unused benefits from cafeteria plans, flexible spending arrangements, and health flexible spending accounts. TITLE VI--PROVISIONS RELATING TO LONG-TERM CARE INSURANCE Sec. 601. Inclusion of qualified long-term care insurance contracts in cafeteria plans, flexible spending arrangements, and health flexible spending accounts. Sec. 602. Deduction for premiums for long-term care insurance. Sec. 603. Study of long-term care needs in the 21st century. TITLE VII--INDIVIDUAL RETIREMENT PLANS Sec. 701. Modification of income limits on contributions and rollovers to Roth IRAs. TITLE VIII--REVENUE PROVISIONS Sec. 801. Modification to foreign tax credit carryback and carryover periods. Sec. 802. Limitation on use of non-accrual experience method of accounting. Sec. 803. Returns relating to cancellations of indebtedness by organizations lending money. Sec. 804. Extension of Internal Revenue Service user fees. Sec. 805. Property subject to a liability treated in same manner as assumption of liability. Sec. 806. Charitable split-dollar life insurance, annuity, and endowment contracts. Sec. 807. Transfer of excess defined benefit plan assets for retiree health benefits. Sec. 808. Limitations on welfare benefit funds of 10 or more employer plans. Sec. 809. Modification of installment method and repeal of installment method for accrual method taxpayers. Sec. 810. Inclusion of certain vaccines against streptococcus pneumoniae to list of taxable vaccines. TITLE IX--MISCELLANEOUS PROVISIONS Sec. 901. Medicare competitive pricing demonstration project. TITLE I--PATIENTS' BILL OF RIGHTS Subtitle A--Right to Advice and Care SEC. 101. PATIENT RIGHT TO MEDICAL ADVICE AND CARE. (a) In General.--Part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1181 et seq.) is amended-- (1) by redesignating subpart C as subpart D; and (2) by inserting after subpart B the following: ``Subpart C--Patient Right to Medical Advice and Care ``SEC. 721. PATIENT ACCESS TO EMERGENCY MEDICAL CARE. ``(a) Coverage of Emergency Care.-- ``(1) In general.--To the extent that the group health plan (other than a fully insured group health plan) provides coverage for benefits consisting of emergency medical care (as defined in subsection (c)) or emergency ambulance services, except for items or services specifically excluded-- ``(A) the plan shall provide coverage for benefits, without requiring preauthorization, for emergency medical screening examinations or emergency ambulance services, to the extent that a prudent layperson, who possesses an average knowledge of health and medicine, would determine such examinations or emergency ambulance services to be necessary to determine whether emergency medical care (as so defined) is necessary; and ``(B) the plan shall provide coverage for benefits, without requiring preauthorization, for additional emergency medical care to stabilize an emergency medical condition following an emergency medical screening examination (if determined necessary under subparagraph (A)), pursuant to the definition of stabilize under section 1867(e)(3) of the Social Security Act (42 U.S.C. 1395dd(e)(3)). ``(2) Reimbursement for care to maintain medical stability.-- ``(A) In general.--In the case of services provided to a participant or beneficiary by a nonparticipating provider in order to maintain the medical stability of the participant or beneficiary, the group health plan involved shall provide for reimbursement with respect to such services if-- ``(i) coverage for services of the type furnished is available under the group health plan; ``(ii) the services were provided for care related to an emergency medical condition and in an emergency department in order to maintain the medical stability of the participant or beneficiary; and ``(iii) the nonparticipating provider contacted the plan regarding approval for such services. ``(B) Failure to respond.--If a group health plan fails to respond within 1 hours of being contacted in accordance with subparagraph (A)(iii), then the plan shall be liable for the cost of services provided by the nonparticipating provider in order to maintain the stability of the participant or beneficiary. ``(C) Limitation.--The liability of a group health plan to provide reimbursement under subparagraph (A) shall terminate when the plan has contacted the nonparticipating provider to arrange for discharge or transfer. ``(D) Liability of participant.--A participant or beneficiary shall not be liable for the costs of services to which subparagraph (A) in an amount that exceeds the amount of liability that would be incurred if the services were provided by a participating health care provider with prior authorization by the plan. ``(b) In-Network Uniform Costs-Sharing and Out-of-Network Care.-- ``(1) In-network uniform cost-sharing.--Nothing in this section shall be construed as preventing a group health plan (other than a fully insured group health plan) from imposing any form of cost-sharing applicable to any participant or beneficiary (including coinsurance, copayments, deductibles, and any other charges) in relation to coverage for benefits described in subsection (a), if such form of cost-sharing is uniformly applied under such plan, with respect to similarly situated participants and beneficiaries, to all benefits consisting of emergency medical care (as defined in subsection (c)) provided to such similarly situated participants and beneficiaries under the plan, and such cost-sharing is disclosed in accordance with section 714. ``(2) Out-of-network care.--If a group health plan (other than a fully insured group health plan) provides any benefits with respect to emergency medical care (as defined in subsection (c)), the plan shall cover emergency medical care under the plan in a manner so that, if such care is provided to a participant or beneficiary by a nonparticipating health care provider, the participant or beneficiary is not liable for amounts that exceed any form of cost-sharing (including co- insurance, co-payments, deductibles, and any other charges) that would be incurred if the services were provided by a participating provider. ``(c) Definition of Emergency Medical Care.--In this section: ``(1) In general.--The term `emergency medical care' means, with respect to a participant or beneficiary under a group health plan (other than a fully insured group health plan), covered inpatient and outpatient services that-- ``(A) are furnished by any provider, including a nonparticipating provider, that is qualified to furnish such services; and ``(B) are needed to evaluate or stabilize (as such term is defined in section 1867(e)(3) of the Social Security Act (42 U.S.C. 1395dd)(e)(3)) an emergency medical condition (as defined in paragraph (2)). ``(2) Emergency medical condition.--The term `emergency medical condition' means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the
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