Home > 106th Congressional Bills > S. 1619 (is) To amend the Trade Act of 1974 to provide for periodic revision of retaliation lists or other remedial action implemented under section 306 of such Act. [Introduced in Senate] ...

S. 1619 (is) To amend the Trade Act of 1974 to provide for periodic revision of retaliation lists or other remedial action implemented under section 306 of such Act. [Introduced in Senate] ...


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106th CONGRESS
  1st Session
                                S. 1618

     To promote primary and secondary health promotion and disease 
 prevention services and activities among the elderly, to amend title 
 XVIII of the Social Security Act to add preventive benefits, and for 
                            other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                           September 22, 1999

   Mr. Graham (for himself, Mr. Jeffords, Mr. Chafee, Mr. Bryan, Mr. 
 Rockefeller, and Mr. Kerry) introduced the following bill; which was 
          read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
     To promote primary and secondary health promotion and disease 
 prevention services and activities among the elderly, to amend title 
 XVIII of the Social Security Act to add preventive benefits, and for 
                            other purposes.

    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 ``Medicare Wellness 
Act of 1999''.
    (b) Table of Contents.--The table of contents is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Finding.
Sec. 3. Definitions.
               TITLE I--HEALTHY SENIORS PROMOTION PROGRAM

Sec. 101. Healthy Seniors Promotion Program.
Sec. 102. Sense of Congress regarding the response of HCFA to 
                            preventive health issues.
Sec. 103. Sense of Congress regarding the efforts of HCFA to study 
                            health promotion and disease prevention for 
                            medicare beneficiaries.
Sec. 104. Sense of Congress regarding the establishment of a medicare 
                            health promotion and disease prevention 
                            clearinghouse.
           TITLE II--MEDICARE COVERAGE OF PREVENTIVE SERVICES

Sec. 201. Counseling for cessation of tobacco use.
Sec. 202. Screening for hypertension.
Sec. 203. Counseling for hormone replacement therapy.
Sec. 204. Screening for glaucoma.
Sec. 205. Screening for diminished visual acuity.
Sec. 206. Screening for hearing impairment.
Sec. 207. Screening and counseling for osteoporosis.
Sec. 208. Screening for cholesterol.
Sec. 209. Elimination of cost sharing for current preventive benefits.
Sec. 210. National falls prevention education and awareness campaign.
Sec. 211. Program integrity.
    TITLE III--MEDICARE HEALTH EDUCATION AND RISK APPRAISAL PROGRAM

Sec. 301. Medicare Health Education and Risk Appraisal Program.
        TITLE IV--DISEASE SELF-MANAGEMENT DEMONSTRATION PROJECTS

Sec. 401. Disease self-management demonstration projects.
 TITLE V--STUDIES AND REPORTS ADVANCING ORIGINAL RESEARCH IN THE FIELD 
                 OF DISEASE PREVENTION AND THE ELDERLY

Sec. 501. MedPAC biannual report.
Sec. 502. National Institute on Aging study and report.
Sec. 503. Institute of Medicine 5-year medicare prevention benefit 
                            study and report.
Sec. 504. Fast-track consideration of prevention benefit legislation.

SEC. 2. FINDING.

    Congress finds that despite significant advancements in general 
research for health promotion and disease prevention among the elderly, 
there has been a failure in translating that research into practical 
intervention.

SEC. 3. DEFINITIONS.

    As used in this Act:
            (1) Cost-effective benefit.--The term ``cost-effective 
        benefit'' means a benefit or technique that has--
                    (A) been subject to peer review;
                    (B) been described in scientific journals; and
                    (C) demonstrated value as measured by unit costs 
                relative to health outcomes achieved.
            (2) Cost-saving benefit.--The term ``cost-saving benefit'' 
        means a benefit or technique that has--
                    (A) been subject to peer review;
                    (B) been described in scientific journals; and
                    (C) caused a net reduction in health care costs for 
                medicare beneficiaries.
            (3) Medically effective.--The term ``medically effective'' 
        means, with respect to a benefit or technique, that the benefit 
        or technique has been--
                    (A) subject to peer review;
                    (B) described in scientific journals; and
                    (C) determined to achieve an intended goal under 
                normal, programmatic conditions.
            (4) Medical efficacy; medically efficacious.--The terms 
        ``medical efficacy'' and ``medically efficacious'' mean, with 
        respect to a benefit or technique, that the benefit or 
        technique has been--
                    (A) subject to peer review;
                    (B) described in scientific journals; and
                    (C) determined to achieve an intended goal under 
                controlled conditions.
            (5) Medicare beneficiary.--The term ``medicare 
        beneficiary'' means any individual who is entitled to benefits 
        under part A or enrolled under part B of the medicare program, 
        including any individual enrolled in a Medicare+Choice plan 
        offered by a Medicare+Choice organization under part C of such 
        program.
            (6) Medicare program.--The term ``medicare program'' means 
        the health care program under title XVIII of the Social 
        Security Act (42 U.S.C. 1395 et seq.).
            (7) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.

               TITLE I--HEALTHY SENIORS PROMOTION PROGRAM

SEC. 101. HEALTHY SENIORS PROMOTION PROGRAM.

    (a) Definitions.--As used in this section:
            (1) Eligible entity.--The term ``eligible entity'' means an 
        entity that the Working Group determines has demonstrated 
        expertise in research regarding health promotion and disease 
        prevention among the elderly.
            (2) Working group.--The term ``Working Group'' means the 
        Healthy Seniors Working Group established under subsection (d).
    (b) Program Authorized.--The Secretary, subject to the general 
policies and criteria established by the Working Group and in 
accordance with the provisions of this Act, is authorized to make 
grants to eligible entities to pay for the costs of the activities 
described in subsection (c).
    (c) Use of Funds.--An eligible entity may use payments received 
under this section in any fiscal year to study--
            (1) whether using different types of providers of care who 
        are not physicians and alternative settings (including 
        community-based senior centers) for the implementation of a 
        successful health promotion and disease prevention strategy, 
        including the implications regarding the payment of such 
        providers, is medically efficacious or medically effective;
            (2) the most medically effective means of educating 
        medicare beneficiaries and providers of services regarding the 
        importance of health promotion and disease prevention among the 
        elderly and identification of incentives that would increase 
        the use of new and existing preventive services and healthy 
        behaviors by medicare beneficiaries; and
            (3) other topics designated by the Secretary.
    (d) Healthy Seniors Working Group.--
            (1) Establishment.--There is established within the 
        Department of Health and Human Services a Healthy Seniors 
        Working Group.
            (2) Composition.--Subject to paragraph (3), the Working 
        Group established pursuant to subsection (b) shall be composed 
        of 5 members as follows:
                    (A) The Administrator of the Health Care Financing 
                Administration.
                    (B) The Director of the Centers for Disease Control 
                and Prevention.
                    (C) The Administrator of the Agency for Health Care 
                Policy and Research.
                    (D) The Assistant Secretary for Aging.
                    (E) The Director of the National Institute on 
                Aging.
            (3) Alternative membership.--
                    (A) Appointment.--Any member of the Working Group 
                described in a subparagraph of paragraph (2) may 
                appoint an individual who is an officer or employee of 
                the Federal Government to serve as a member of the 
                Working Group instead of the member described in such 
                subparagraph.
                    (B) Deadline.--If a member described in 
                subparagraph (A) elects to appoint an individual under 
                such subparagraph, such individual shall be appointed 
                not later than December 31, 2000.
            (4) General policies and criteria.--The Working Group shall 
        establish general policies and criteria with respect to the 
        functions of the Secretary under this section including--
                    (A) priorities for the approval of applications;
                    (B) procedures for developing, monitoring, and 
                evaluating research efforts conducted under this 
                section; and
                    (C) such other matters as are recommended by the 
                Working Group and approved by the Secretary.
            (5) Chairperson.--The Chairperson of the Working Group 
        shall be the Administrator of the Agency for Health Care Policy 
        and Research.
            (6) Quorum.--A majority of the members of the Working Group 
        shall constitute a quorum, but a lesser number of members may 
        hold hearings.
            (7) Meetings.--The Working Group shall meet at the call of 
        the Chairperson, except that--
                    (A) it shall meet not less than 4 times each year; 
                and
                    (B) it shall meet whenever a majority of the 
                appointed members request a meeting in writing.
            (8) Compensation of members.--Each member of the Working 
        Group shall be an officer or employee of the Federal Government 
        and shall serve without compensation in addition to that 
        received for their service as an officer or employee of the 
        Federal Government.
    (e) Application.--
            (1) In general.--Each eligible entity which desires to 
        receive a grant under this section shall submit an application 
        to the Secretary, at such time, in such manner, and accompanied 
        by such additional information as the Secretary may reasonably 
        require.
            (2) Contents.--Each application submitted pursuant to 
        paragraph (1) shall--
                    (A) describe the activities for which assistance 
                under this section is sought;
                    (B) describe how the research effort proposed to be 
                conducted will reflect the medical, behavioral, and 
                social aspects of care for the elderly, lead to the 
                development of cost-effective benefits and cost-saving 
                benefits, and impact the quality of life of medicare 
                beneficiaries;
                    (C) provide evidence that the eligible entity meets 
                the general policies established by the Working Group 
                pursuant to subsection (d)(4);
                    (D) provide assurances that the eligible entity 
                will take such steps as may be available to it to 
                continue the activities for which the eligible entity 
                is making application after the period for which 
                assistance is sought; and
                    (E) provide such additional assurances as the 
                Secretary determines to be essential to ensure 
                compliance with the requirements of this Act.
            (3) Joint application.--A consortium of eligible entities 
        may file a joint application under the provisions of paragraph 
        (1) of this subsection.
    (f) Approval of Application.--The Secretary shall approve 
applications in accordance with the general policies established by the 
Working Group under subsection (d).
    (g) Payments.--The Secretary shall pay to each eligible entity 
having an application approved under subsection (f) the cost of the 
activities described in the application.
    (h) Evaluation and Report.--
            (1) Evaluation.--The Secretary shall conduct an annual 
        evaluation of grants made under this section to determine--
                    (A) the results of the overall applied research 
                conducted under this Act;
                    (B) the extent to which research assisted under 
                this section has improved or expanded the general 
                research for health promotion and disease prevention 
                among the elderly and identified practical 
                interventions based upon such research;
                    (C) a list of specific recommendations based upon 
                research conducted under this section which show 
                promise as practical interventions for health promotion 
                and disease prevention among the elderly;
                    (D) whether or not as a result of the applied 
                research effort certain health promotion and disease 
                prevention benefits or education efforts should be 
                added to the medicare program, including discussions of 
                quality of life, translating the applied research 
                results into a benefit under the medicare program, and 
                whether each additional benefit would be a cost-
                effective benefit or cost-saving benefit for each 
                proposed addition;
                    (E) the utility of, potential for, and issues 
                surrounding health risk appraisals sponsored under the 
                medicare program and targeted followup; and
                    (F) how best to increase utilization of existing 
                and recommended health promotion and disease prevention 
                services, including an education and public awareness 
                component discussion of financial incentives for 
                providers of services and medicare beneficiaries to 
                improve utilization and other administrative means of 
                increasing utilization.
            (2) Annual report.--Not later than December 31, 2002, and 
        each year thereafter through 2005, the Secretary shall submit a 
        report to Congress based on the annual studies made under 
        paragraph (1), which shall contain a detailed statement of the 
        findings and conclusions of the Working Group together with its 
        recommendations for such legislation and administrative actions 
        as it considers appropriate.
    (i) Authorization of Appropriations.--There are authorized to be 

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